bluuebunny/crossref_metadata_2025 huggingface dataset:
Electromyographic Comparison of Lips and Jaw Muscles between Children With Competent and Incompetent Lips: A Cross Sectional Study
Authors: Lipari María Alejandra , Pimentel Gisela , Gamboa Natalia Andrea , Bayas Isidora , Guerrero Nicole , Miralles Rodolfo
Published: November 2020

Objective: This cross-sectional study evaluates the electromyographic (EMG) activity of lips and anterior temporalis muscles of children with competent or incompetent lips. Study design: Forty children were classified clinically according to their lip competence into two groups of 20 each: 1) competent lips group (CLG), and 2) incompetent lips group (ILG). Surface EMG activity of the superior orbicularis oris (SOO), inferior orbicularis oris (IOO), and anterior temporalis (AT) muscles was recorded with the children seated in the upright position during the following tasks: 1) at rest; 2) speaking; 3) swallowing; 4) puffing out the cheeks. Results: ILG showed lower EMG activity than CLG in the SOO and IOO muscles at rest, similar activity in both muscles during speaking, similar activity in the SOO muscle and lower in the IOO during swallowing. ILG showed significantly higher activity than CLG in both muscles while puffing out the cheeks. In the AT muscle, ILG showed lower activity than CLG at rest, during speaking and swallowing, whereas activity was similar while puffing out the cheeks. Conclusion: The difference in EMG activity recorded in children with incompetent lips and with competent lips suggests that the status of their musculature could affect the position and stability of their upper/lower anterior teeth.
Artificial Intelligence and IoT in Dairy Farm
Authors: Amin Ruhul , Rahman Mostafijur
Published: November 2020

Internet of things (IoT) and data-driven techniques are producing greater prospects for smart dairying. The demand for milk is unceasingly increasing because of the rising population of the globe. The employment of dairy products is more in developed countries as compared to developing countries. To fulfill this increased demand for milk products, better technological techniques for improving milk yield are required. It’s foreseeable that the use of IoT and different AI techniques can lend a hand to a farmer to beat different conventional farming challenges and increase milk production. During this research, the authors give a talk about different challenges that a dairy farmer has to countenance in their way of life. A brief introduction of smart dairying (SDF) is presented with relevancy to the modernization in production and therefore the processes of smart dairy farming. This review concentrates on different facets of smart dairying, and at last, a state-of-the-art framework that can aid the farmers to extend the milk yield by using different up-to-the-minute technologies has been proposed. These high-tech methods can reduce the factors negatively upsetting milk production and increase that positively heartrending production with trifling resources.
Composição química, físico-química e atividade antifúngica dos óleos essenciais da flor e do fruto de Myrcia guianensis (Aubl.) DC.
Authors: Menezes Filho Antonio Carlos Pereira de , Sousa Wendel Cruvinel de , Castro Carlos Frederico de Souza
Published: November 2020

Myrcia guianensis is a plant species found in the Cerrado domain, being called “guamirim”. This work aimed to characterize the chemical profile, physicochemical and antifungal activity of the essential oils from M. guianensis flower and fruit. Flowers and fruits were collected in the morning. Essential oil extraction was carried out by Clevenger, the yield was determined in percentage, the observation of color, aroma and touch was performed by proximal analysis, the relative density was measured by a pycnometer, the solubility was determined in a 70% hidroethanolic solution, and the chemical profile was analyzed by gas chromatography with coupled mass spectrometry. The antifungal activity was performed in different concentrations of essential oil, and the percentage of growth inhibition was determined from Sclerotinia sclerotiorum, Colletotrichum gloeosporioides and Aspergillus flavus. The yield of essential oils varied from 0.08% to 1.01%, colorless and light yellow, density of 0.906 g mL1 and 0.908 g mL1, for flower and fruit, respectively. The antifungal activity varied between 70.71% and 100% for S. sclerotiorum, 10.55% and 89.91% for C. gloeosporioides, and 53.32% and 100% for A. flavus by the flower oil, and between 70.71% and 100% for S. sclerotiorum, 12.45% and 100% for C. gloeosporioides and from 8.37% to 25.12% for A. flavus, by the essential oil from fruit. The essential oils of flowers and fruits showed important chemical and antifungal results for isolated tested fungal.
Vanishing point detection with direct and transposed fast Hough transform inside the neural network
Authors:   Institute for Systems Analysis, Federal Research Center ", Sheshkus A. ,   Computer Science and Control",   of Russian Academy of Sciences,   Smart Engines Service LLC, Chirvonaya A. ,   National University of Science and Technology "MISIS",   Smart Engines Service LLC, Matveev D. ,   Lomonosov Moscow State University,   Smart Engines Service LLC, Nikolaev D. ,   Institute for Information Transmission Problems (Kharkevich Institute) RAS,   Smart Engines Service LLC, Arlazarov V.L. ,   Moscow Institute for Physics and Technology,   Institute for Systems Analysis, Federal Research Center "Computer Science and Control" of Russian Academy of Sciences
Published: November 2020

In this paper, we suggest a new neural network architecture for vanishing point detection in images. The key element is the use of the direct and transposed fast Hough transforms separated by convolutional layer blocks with standard activation functions. It allows us to get the answer in the coordinates of the input image at the output of the network and thus to calculate the coordinates of the vanishing point by simply selecting the maximum. Besides, it was proved that calculation of the transposed fast Hough transform can be performed using the direct one. The use of integral operators enables the neural network to rely on global rectilinear features in the image, and so it is ideal for detecting vanishing points. To demonstrate the effectiveness of the proposed architecture, we use a set of images from a DVR and show its superiority over existing methods. Note, in addition, that the proposed neural network architecture essentially repeats the process of direct and back projection used, for example, in computed tomography.
Nonlinear filtering of image contours defined in a complex-valued code
Authors:   Volga State University of Technology, Khafizov R.G. , Okhotnikov S.A. ,   Volga State University of Technology
Published: November 2020

The article describes special aspects of the organization of nonlinear filtering of image contours defined as a sequence of complex numbers. An effect of scale and rotation of the contour on the filtering result is studied. Changes in the contour spectra caused by different nonlinear filters are studied.
Optimization method for designing optical elements with an extended light source
Authors:   IPSI RAS – Branch of the FSRC “Crystallography and Photonics” RAS, Byzov E.V. , Kravchenko S.V. ,   IPSI RAS – Branch of the FSRC "Crystallography and Photonics" RAS; Samara National Research University, Moiseev M.A. ,   IPSI RAS – Branch of the FSRC “Crystallography and Photonics” RAS, Doskolovich L.L. ,   IPSI RAS – Branch of the FSRC “Crystallography and Photonics” RAS,   Samara National Research University
Published: November 2020

A method for designing an optical element with two free-form surfaces generating a prescribed illuminance distribution in the case of an extended light source is considered. The method is based on the representation of the optical element surfaces by bicubic splines and on the subsequent optimization of their parameters using a quasi-Newton method implemented in the Matlab software. To calculate the merit function, a version of the ray tracing method is proposed. Using the proposed method, an optical element with record characteristics was designed: the ratio of the element height to the source size is 1.6; luminous efficiency is 89.1 %; uniformity of the generated distribution (the ratio of the minimum and average illuminance) in a given square region is 0.92.
The Effect of Problem-based Learning Model Modified by Cognitive Load Theory on Mathematical Problem Solving Skills
Authors: Zahara Maulida Nur , Hendrayana Aan , Pamungkas Aan Subhan
Published: November 2020

The background of the research is based on the fact that problem solving skills and its process is still low so that those create overload information. Another way to overcome this problem is to use a problem-based learning model which concerns on cognitive load theory. This study is aimed to determine on how students' problem solving skills when using a problem-based learning model modified by cognitive load theory. This research method uses a combination of research methods, namely quantitative as primary data and qualitative as secondary data. The population in this study are all students of grade VII Junior High School accredited A in Tangerang Regency. The sampling technique used is cluster random sampling and the selected sample is 60 students of Grade VII SMP Negeri 3 Cikupa which divided into experimental class and control class. The instruments in this research are 5 short essay tests and non-tests, questionnaire and interview. Based on data analysis’ result, it can be concluded that the achievement and improvement of students' mathematical problem solving abilities which use problem-based learning model modified by cognitive load theory is better than for those using problem-based learning generally.
The Analysis of Mathematical Communication's Ability in Derivative Materials Observed from Introvert and Extrovert Personality Types
Authors: Rohmah Salisa Rojiatur , Rona Hanif Uli
Published: November 2020

The purpose of this study is to determine mathematical communication skills that assessed from introvert and extrovert personality types, to determine the strengths and weaknesses of each personality type. This research is a qualitative descriptive study. The class subjects are students of SMA Kartika III-1 Banyubiru, grade XI MIPA 2 (Mathematics and Natural Science). The subjects of the research are 2 introvert and 2 extrovert personality types' students. The procedures of collecting data are written tests, interviews, questionnaires and documentation. The results of this study show that mathematical communication skills in terms of introvert personality type are able to meet 1 indicator. That is the ability to explain ideas, situations and mathematical relations in writing. In contrast, the extrovert personality type meets 2 indicators of mathematical communication skills. There is the ability to express daily events in language or mathematical symbols and the ability to read mathematical symbols. The strengths of introvert personality type are able to explain ideas verbally and in writing. Then the weaknesses are difficult to understand the problem of mathematical images and symbols. In contrast to the introvert, extrovert personality's strengths are able to understand mathematical symbols, and then its weaknesses are hard to understand mathematics questions.
The Effect of Job Satisfaction on Employee Performance Through Loyalty at Credit Union (CU) Corporation of East Kutai District, East Kalimantan
Authors: Egenius Samuel , Triatmanto Boge , Natsir Mohamad
Published: November 2020

This research aims to 1) describe the description of Job Satisfaction, Employee Loyalty, and Performance. 2) analyze the effect of Job Satisfaction on Employee Performance. 3) to analyze the influence of Job Satisfaction on Loyalty. 4) to analyze the effect of the influence of loyalty on employee performance. 5) to analyze the influence of Job Satisfaction on Employee Performance through Loyalty as an Intervening Variable in the Credit Union Cooperative, East Kutai Regency, East Kalimantan. The sample in this study was 68 employees. The analysis technique uses path analysis. The results of the analysis show that job satisfaction has a significant effect on employee performance. Job satisfaction has a significant effect on loyalty. Besides, loyalty has a significant effect on employee performance. And job satisfaction has a significant effect on employee performance through loyalty. loyalty moderates job satisfaction on employee performance. Loyalty is the most important part to be noticed and considered by upper management because through loyalty employee work results can be achieved and employee performance increases.
The Dynamics of Communication on the Identity Crisis of Malangan Mask Art in the Cultural Adaptation of Malang People
Authors: Tayibnapis Radita Gora , Tarsani Tarsani , Dwijayanti Risqi Inayah
Published: November 2020

The bias of Malangan mask art is starting to fade. This mask art originating from Malang has lost its authenticity so that it is difficult to distinguish it from the same mask art from other regions. The social changes of the people of Kedungmonggo, as the center of the Malangan mask art, have an impact on the neglect of the authenticity of the local traditional culture. This condition ultimately invalidates the interpretation of the symbols of Malangan mask art and even threatens the sustainability of the Malangan mask art itself. This study aims to rediscover the true meaning of the characteristics of Malangan masks using semiotic and ethnographic approaches to trace the social life of the people of Kedungmonggo and to adapt Malangan mask art as a symbol of Malang traditional culture. The results show that the identity crisis of Malangan mask art occurs because of the lack of cultural literature, especially historical literature. Many stories are hidden from their true meaning as a form of story camouflage so that people believe in myths more than in histories. The life of the Kedungmonggo community is based on cultural symbols that have experienced a cultural crisis due to the flow of modern culture.
Changes of carotid and vertebral arteries in patents with arterial hypertension and hepatobiliary pathology
Authors: Polyakov Vladimir Ya. , Nikolaev Yu. A. , Pegova S. V. , Matsievskaya T. R. , Obukhov I. V.
Published: November 2020

The study included 1172patients (410 men and 762 women) at the mean age of 60.3±10.4years with grade I-II (stage I-II) arterial hypertension (AH) admitted to the clinic of Institute of Experimental Medicine. The patients were divided into 2 groups based on the results of clinical and laboratory diagnostics. Group 1 (n=525) included patients with AH and hepatobiliary system (HBS) diseases, group 2 (n=647) patients with AH without HBS diseases. The patients group 1 had a thicker intima-media complex of carotid arteries, higher peak systolic bloodflow rate in the internal and vertebral carotid arteries, more pronounced coiling of internal carotid arteries than patients of group 2. Patients with AH and HBS diseases exhibited correlation between blood flow rate in external carotid arteries and atherogenicity coefficient. Duplex scanning of neck vessels of in patients with AH without HBS diseases revealed peculiar changes of the intima-media thickness and hemodynamically significant changes of the blood flow in the internal carotid arteries that may be of prognostic value in this nosological syntropy and require the personified approach to diagnostics, treatment, and prevention of these conditions.
Pneumococcal vaccine in adults reduces the risk of infections caused by Streptococcus pneumoniae
Authors: Belocerkovskaja Yulia G. , Romanovskih A. G. , Styrt E. A.
Published: November 2020

Streptococcus pneumoniae is a major cause of severe disease worldwide, particularly in the risk population. Two pneumococcal vaccines are currently available for specific prevention of pneumococcal infections among adults in Russia: a 23-valent pneumococcal polysaccharide vaccine (PPSV23) and a 13-valent pneumococcal conjugate vaccine (PCV13). The article describes modern views on the effectiveness and safety of two pneumococcal vaccines in adults with underlying medical conditions and adults aged ≥65 years and provides current recommendations for routine use of PPSV23 and PCV13 among persons included in the risk group.
Wilson-Konovalov’s disease in two sisters: differences in the clinical picture and successful therapy
Authors: Ignatova T. M. , Solov'eva Olga V. , Arion E. A. , Balashova M. S. , Rozina T. P.
Published: November 2020

Wilson-Konovalov’s disease is a rare genetic pathology of copper metabolism that in the first place affects liver and CNS. Due to autosomal-recessive inheritance of this condition, it most frequently occurs in sibs. We report a case of Wilson-Konovalov’s disease in two sisters differing in its clinical course: severe abdominal variant in the younger sister and largely neurologic form in the elder one. This observation demonstrates clinical variability of Wilson-Konovalov’s disease, the possibility of its late clinical manifestation (at the age 45 years), the necessity of examination of all sibs of a proband regardless of age, and the possibility of radical improvement of prognosis even when the disease is diagnosed at the stage of decompensated liver cirrhosis.
Emotional and personality features of patients with irritable bowel syndrome and bowel inflammatory diseases
Authors: Mnatsakanyan Marina G. , Dyukova G. M. , Pogromov A. P. , Tashchyan O. V.
Published: November 2020

Objective. To conduct a comparative analysis of the emotional and personality characteristics ofpatients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) in remission with IBS-like symptoms. Patients and methods. This study carried out based at a specialized gastroenterology clinic in the period from 2010 to 2015 included 125 patients with IBS (IBS-D - 46, IBS-C - 20, IBS-M - 59) and 37 patients with IBD in remission: Crohn's disease (CD) - 11 and ulcerative colitis (UC) -26 patients. The levels of depression (Beck questionnaire), urgent and personal anxiety (Spielberger questionnaire), the degree of alexithymia (Toronto scale) as well as the severity of psychopathology and behavioral symptoms (PBS) were estimated. Results. Patients with IBS were not significantly different from those with IBD in remission with IBS-like symptoms in terms of depression, actual anxiety, alexithymia and PBS. Only the index of personal anxiety was significantly higher in the group of patients with IBS compared with IBD in remission with IBS-like symptoms (p = 0.0376). Men with IBS exhibited significantly higher actual anxiety than men with IBD (p = 0.04). Maximum severity of depression, anxiety and alexithymia was documented in the locking version of IBS (IBS-C) in comparison with other variants of IBS (p <0.05). Patients with CD in remission are characterized by higher rates of depression and alexithymia compared to UC (p <0.05). Behavioural disorders are most pronounced in the diarrheal variant of IBS and CD. Conclusion. A higher personal anxiety was observed in patients with IBS compared to those in remission of IBD with IBS-like symptoms although other parameters were not significantly different. Patients with IBS-C were characterized by more pronounced manifestations of emotional and personality disorders. More severe emotional and behavioral disorders distinguish CD from UC.
New approaches to prediction and treatment of advanced gastric cancer based on molecular-biological parameters
Authors: Fedoseeva Evgeniya S. , Savostikova M. V. , Narimanov M. N. , Pashaev A. A. , Kirichenko S. S. , Muzaffarova T. A. , Kipkeeva F. M. , Karpukhin A. V.
Published: November 2020

This review is designed to discuss possibilities for the treatment of advanced gastric cancer with reference to the prognostic and predictive value of molecular-biological parameters and the influence of hereditary predisposition to the development of neoplastic process. The data on modern pharmacotherapy of this disease based on the knowledge of molecular-biological parameters are presented including the following markers: HER2/neu, VGFR, c-met, TUBB3, CDH-1, BRCA-1, EGFR, TGF-ß, p53, Ki67 and PCNA. It is emphasized that the role of molecular-biological parameters associated with advanced gastric cancer is ambiguous. The prognostic and predictive significance of some of the markers is confirmed while that of others remains to be elucidated and requires further research.
Pathogenetic aspects of venous trophic ulcers and approaches to correction of immunological disorders
Authors: Vasil’ev Ivan M. , Muranova A. V. , Smirnova E. S. , Bogdanets L. I. , Sinopal’nikov V. I.
Published: November 2020

The review deals with the problem of venous trophic ulcers. Current data on epidemiology and social significance of this condition are presented with special reference to pathogenetic aspects of its development, such as systemic immunity disorders associated with chronic venous insufficiency. The necessity and possibility of correction of some of them are discussed.
Polymorphism of the C-509 gene of TGFB1 and the risk of obliterative atherosclerosis of lower limb arteries
Authors: Orlova A. Yu. , Artyushkova E. B. , Sukovatykh B. S. , Bushueva Olga Y. , Polonnikov A. V.
Published: November 2020

Genetic factors play an important role in the development of obliterative atherosclerosis of arteries in the lower extremities. There are numerous data in the literature on polymorphic variants of the TGFB1 gene associated with the risk of development of cardiovascular diseases, but some of them are contradictory. The present study aimed at elucidating the role ofpolymorphism of509C/T genes of TGFB1 in the development of obliterative atherosclerosis in arteries of the lower extremities. The material included 328 samples of DNA from 203 unrelated subjects of Russian ethnicity residing in Central Russia (177 men and 23 women) with obliterative atherosclerosis of arteries in the lower extremities hospitalized to the Dpt. of Vascular Surgery and 125 age-matched controls. Genotyping of polymorphism of the C-509T (rs1800469) gene of TGFB1 was performed by the PCR-PDRF method with the use of oligonucleotide primers (Sintol Co., Moscow). The patients with obliterative atherosclerosis showed an increased frequency of the occurrence of alternative allele of the C-509T gene of TGFB1 in comparison with control subjects (r=0,0001). Simultaneously, the frequency of homozygous genotypes of wild-type alleles of -509CC decreased (OR=0,58, 95%CI=0,37-0,92, P=0,02) while the frequency of homozygotes with an alternative allele -509TT increased (OR=4,93, 95%CI=5,20-11,03, P=0,00004). The difference in the frequency of heterozygotes 509CT was absent (OR=0,81, 95%CI=0,52-1,27, P=0,35). Thus, polymorphism of the C-509T gene of TGFB1 is a significant predictor ofpredisposition to the development of obliterative atherosclerosis in arteries of the lower extremities.
Lesions of the nervous system associated with relapsing polychondritis
Authors: Chernyak Vera I. , Savel’ev A. I. , Men’shikova I. V. , Pogromov A. P.
Published: November 2020

Three clinical cases are described including two of relapsing polychondritis with lesions in the central and peripheral nervous system (one of long-standing aseptic lymphocytic meningitis and one of cranial neuropathy of 2, 5, 7, and 8 pairs) and the third case of the optic nerve lesion with amblyopia. The two former cases were successfully treated with high doses of corticosteroids, the third one with moderate doses of the same medications. The data from the current literature concerning variants of clinical manifestations, methods for diagnostics and treatment of neurologic manifestations of relapsing polychondritis are discussed.
Meta-analysis of clinical studies on the use of statins for prevention of atrial fibrillation soon after coronary bypass surgery
Authors: Bokeriya O. L. , Akhobekov A. A. , Shvarts Vladimir A. , Glushko L. A. , Le T. G.
Published: November 2020

Background. Atrial fibrillation (AF) develops in the early postoperative period in each third patient undergoing coronary bypass surgery (CBPS). Multifactorial pathogenesis ofpostoperative AF is unclear. The concept ofpostoperative inflammation as a potential basic mechanism of this condition has been implied in many studies. Pre- and postoperative treatment with antiinflammatory statins proved beneficial as a means for reducing the frequency of AF. Materials and methods. The meta-analysis is based on the results of 15 clinical studies carried out in the last 15 years. They included 9369 patients of whom 5598 (59.75%) used statins and 3771 (49.25%) did not receive them. The following endpoints were evaluated in the early postoperative periods: frequency of AF, overall lethality, frequency of cerebral circulation disorders and myocardial infarction. Odds ratio (OR) and 95% CI were calculated, levels of inflammation markers before and after surgery and duration of hospitalization were determined. Results. Statins decreased the frequency of AF soon after CBPS (OR 0,481 at 95% CI 0,345-0,672; р = 0,000), they did not influence overall lethality (OR 0,837 at 95% CI 0,501-1,399; p = 0,497) and frequency of myocardial infarction (OR 1,001 at 95% CI 0,702-1,426; p = 0,997), but decreased frequency of cerebral circulation disorders (OR 0,067 at 95% CI 0,037- 0,121; p = 0,000). Also, they reduced duration of hospitalization and serum levels of inflammation markers Conclusion. Results of clinical studies available to date leave no doubt that statins produce anti-inflammatory and anti-arrhythmic effects. Meta-analysis of relevant studies confirmed on the whole the positive role of statin therapy prior to CBPS.
Insulin resistance associated with metabolic syndrome as an indicator of cardiovascular risk
Authors: Dontsov Aleksandr V. , Vasil’eva L. V.
Published: November 2020

Aim. To study blood insulin level in patients with coronary heart disease (CHD) with and without metabolic syndrome (MS) and its relation to cardiovascular risk factors. Materials and methods. We examined 127 patients with stable coronary heart disease (mean age 59.4±5.7 yr) including 63 with MS and 64 without it. The control group consisted of 80 practically healthy subjects. Bloods insulin was determined by immunochemoluminescence, glycated hemoglobin (HbA) by immunoturbidimetry, total cholesterol, HDLP cholesterol, and triglycerides by enzymatic colorimetric method, oxidized LDLP, IL-1β, IL-6, and tumour necrosis factor-a by enzyme immunoassay. The degree of depression was estimated using the Zung scale. Results. Blood insulin level in healthy subjects, CHD patients with and without MS was 6.3 (6.20;6.62), 15.5 (13.96, 16.3) and 9.5 (9.2, 10.1) mcIE/ml respectively (p<0.001). HOMA-IR directly correlated with MBI, waist circumference, HbA total cholesterol, triglyceride, oxidized LDLP, IL-1β, IL-6, and tumour necrosis factor-a levels and negatively with the HDLP cholesterol level. Conclusion. In patients with CHD, metabolic syndrome is associated with a set of additional cardiovascular risk factors, viz. hyperinsulinemia, insulin resistance, increased HbA level, dyslipidemia, oxidative modification of LDLP, activation of proinflammatory cytokines, and depressive disorders. Close correlation of HOMA-IR with certain pathogenetic factors of CHD allow to use it as an indicator of cardiovascular risk in patients with CHD and MS.
Evaluation of arterial stiffness and possibility to predict carotid atherosclerosis in patients with essential hypertension based on an outpatient facility
Authors: Polupanov Andrey G. , Mamasaidov Zh. A. , Geleskhanova Yu. N. , Cheskidova N. B. , Romanova T. A. , Dzhumagulova A. S.
Published: November 2020

Aim. To estimate the possibility of predicting the presence and severity of coronary atherosclerosis from arterial stiffness characteristics and augmentation index (AIx) in patients with essential hypertension (EH) obtained under outpatient conditions. Materials and methods. The general clinical examination of 15 patients aged 30-70 yr with EH was supplemented by measuring blood glucose and creatinine levels, the lipid status (LWLP, HDLP, TG), duplex scanning of carotid arteries, and evaluation of arterial stiffness by pulsed wave contour analysis. Results. AIx and age were independent risk factors of coronary atherosclerosis in patients with EH and severity of its manifestations. AIx values over 25% were with high specificity (over 85%) associated with atherosclerotic lesions.
Relationship between blood aldosterone and somatometric parameters in patients with chronic heart failure and preserved ejection fraction of left ventricle
Authors: Vatutin N. T. , Shevelyok Anna Nikolaevna
Published: November 2020

Blood aldosterone level is an independent predictor of aggravated prognosis in patients with cardiovascular disorders. Synthesis of this hormone and its activity can determine the amount of adipose tissue in the body, but this dependence is poorly known in patients with chronic heart failure (CHF). Aim. To analyse the relationship between blood aldosterone level and somatometric parameters in patients with CHF and preserved ejection fraction of left ventricle (LV). Materials and methods. This prospective cohort study included 56 patients (38 men and 18 women, mean age 59.4±3.4 yr) with CHF and preserved (>45%) ejection fraction of left ventricle. We determined BMI, waist (WC) and hip (HC) circumference, WC/HC ratio, and serum aldosterone level, its reference value being 40-160 pg/ml. Results. The patients were divided into 2 groups based on results of laboratory studies. Group 1 included 34 patients with practically normal blood aldosterone level, group 2 comprised 22 patients with hyperaldosteronemia. Those in group 1 had significantly higher BMI, WC and WC/HC ratio. They more frequently presented with abdominal obesity. Aldosterone level positively correlated with WC (r=0.642), WC/HC ratio (r=0.785) and the length of the history of arterial hypertension (Ro=0.848). It negatively correlated with the age (r=-0.346, in all cases p <0.05. No significant correlation with BMI was documented (r=0.012, p=0.902). Conclusion. In patients with chronic heart failure and preserved ejection fraction of left ventricle, blood aldosterone level is closely related to somatometric parameters being directly proportional to WC and WC/HC but unrelated to BMI. Abdominal obesity is associated with increased risk of hyperaldosteronemia (relative risk 3.4, 95% CI 1.7-6.6).
Obesity: the modern view of a problem
Authors: Achkasov Evgenii E. , Rapoport S. I. , Runenko S. D. , Razina A. O.
Published: November 2020

The article is a review of recent epidemiological observations concerning the prevalence of overweight and obesity in different countries among people of different gender, age. social and ethnic groups. It also presents and analyses health risks and comorbidities leading to disability and death as reported by domestic and foreign researchers. It was found that obesity has multifactorial pathogenesis directly related to energy balance, consumed and expended calories. The need of a multidisciplinary approach to the treatment and prevention of the disease is emphasized taking into consideration the influence of the environment and increasing urbanization on the development of the pathology as well as the role of government efforts to stimulate physical activity of the population in the framework of integral interdisciplinary programs and control over the quality of food. The priority areas for the correction of overweight include optimization of motor activity and diet correction.
Respiratory sleep disorders in vehicle drivers
Authors: Elgarov Anatoliy A. , Kalmykova M. A. , Elgarov M. A.
Published: November 2020

Aim: to determine the frequency of respiratory sleep disorders (RSD) in vehicle drivers, peculiarities of their clinical status and workability. Material and methods. The study included the main group of 106 vehicle drivers (VD) and control group of 104 of subjects of other professions. The following methods were used: fibrooptic endoscopy, standard questionnaire, pulsoxymetry, 24 hour blood pressure and ECG monitoring, psychophysiological testing of 86 VD with RSD, arterial hypertension with and without complications. Results. The clinical and instrumental signs of RSD were found in 65.1% VD of the main group and 47,1% of controls. Transitory ischemic attacks, cardiac arrhythmias and their combination occurred more frequently in VD (82.6, 59.2, and 52.2% respectively) than in controls (51.0, 44.8, and 32.6%). In most observations of VD, the smoking rate (98.1%), alcohol intake (95.3%), increased body mass (74.5%), obese (21,7%) dyslypoproteidemia (73.6%), left ventricular hypertrophy (54.7%) and arterial hypertension (57.5%) were significantly higher than in controls : S (76.9%), AI (75.0%), IBM (56.7%), O (18.3%), DLP (59.6%), LVH (41.3%), AH (39.4%). Chronic obstructive pulmonary diseases was diagnosed in 55.6% of VD and 51.9% of controls, diabetes mellitus in 34.9% and 20.2%, epidemiological forms of ischemic heart disease in 22.6% VD and 20.2% controls. Psychophysilogical testing of VD group revealed deterioration of professional qualities and functions of the drivers with respiratory sleep disorders. Conclusion. Significant frequency of RSD among VD (65.1%) in comparison with subjects of other professions (47.1%) was documented. RSD cause deterioration ofprofessional abilities of VD which increases the risk of traffic accidents.
Gastroesophageal reflux disease: current views and prospects
Authors: Tsimmerman Yakov S. , Vologzhanina L. G.
Published: November 2020

This review presents a detailed definition of gastroesophageal reflux disease (GERD) and data on its prevalence, etiological and pathogenetic factors. The clinical picture of the disease, its clinical “masks” and complications including Barrett’s oesophagus and oesophageal carcinoma are discussed. Various diagnostic methods, such as oesophagofibroscopy, targeted biopsy, morphological studies, multichannel 24 hr pH-metry, etc. are considered. Classifications of GERD is presented with special reference to the original clinico-pathogenetic classification developed by one of the authors. The effectiveness of modern methods of GERD pharmacotherapy and surgical treatment is discussed.
The role of cytokine gene polymorphism in the formation of arterial hypertension associated with metabolic syndrome
Authors: Rapoport S. I. , Krivoshey I. V. , Milanova S. N. , Alferov P. K. , Zhernakova N. I. , Proshchaev Kirill I. , Churnosov M. I.
Published: November 2020

We investigated the association ofpolymorphisms of genes tumor necrosis factors and their receptors (-308G/A TNFa, +250A/G Lta, +36 A/G TNFR1, +1663 A/G TNFR2) with the predisposition to the development of essential hypertension (EH) and the features of its clinical course in patients with metabolic syndrome. It has been demonstrated that the molecular genetic marker +36G TNFR1 (OR=1,25) is involved in the formation EH in individuals with metabolic syndrome. The risk of stage III EH in patients with metabolic syndrome is enhanced by genetic variants -308GA TNFa (OR=2,72), -308A TNFa (OR=2,72), +250G Lta (OR=1,80), and combinations thereof -308A TNFa with +1663G TNFR2 (OR=3,85), +250G Lta with +36G TNFR1 (OR=3,85), +250G Lta with +1663G TNFR2 (OR=3,85) while protective properties are inherent in -308GG TNFa (OR=0,32), +250AA Lta (OR=0,45), -308G TNFa (OR=0,37), +250A Lta (OR=0,56) and a combination of genetic markers -308GG TNFa with +250A Lta (OR=0,31), -308G TNFa with +250AA Lta (OR=0,39), -308G TNFa with +250A Lta (OR=0,31).
Cooperation with patients - guarantee of successful treatment
Authors: Saperov Vladimir N.
Published: November 2020

The aim of the study was to substantiate the necessity of efficient therapeutic cooperation between the doctor and the patient. The main factors determining such cooperation are considered including odontologicalbehaviour of the physician, the choice of the adequate treatment model, compliance with the principles and rules of medical ethics, deontological requirements regulating the patient/physician relationship. Special attention is given to such issues as the doctor’s authority, patient’s confidence, and professional preparation of the first patient’s visit. The authority of the physician depends on his professional skills and moral qualities, such as sense of duty, humanism, and love for his occupation. The causes behindfailed relationships between the doctor and the patient are considered with special reference to deontological flaws on the part of the physician.
Clinical significance of heart rhythm variability in patients with gastroesophageal reflux disease
Authors: Maev I. V. , Yurenev Georgiy L. , Yureneva-Tkhorzhevskaya T. V.
Published: November 2020

Cardiac manifestations of gastroesophageal reflux disease (GERD) including retrosternal pain and cardiac rhythm disorders were often mentioned in early publications. However, classification of GERD adopted at the 2005 Montreal congress does not include such conditions. Non-coronarogenic pain in the thoracic cage is recognized to be a typical esophageal syndrome while the reflex spasm of coronary arteries and cardiac rhythm disorders associated with GERD should be regarded as manifestations of comorbidity of GERD and cardiovascular diseases. Arrhythmias occur in 30% of patients with GERD, but relevant therapeutic and preventive modalities are poorly developed. Nor are there reliable predictors of arrhythmias. An important role in their pathogenesis in patients with GERD is played bydisbalance of sympathetic and parasympathetic components of vegetative nervous system (VNS). One of the approaches to studying this issue is the analysis of heart rhythm variability (HRV). We consider basic principles of clinical interpretation of the results of HRV research that allow to evaluate the state of VNS and interaction of its components. Analysis of recent publications gives evidence that many HRV parameters depend not only on the balance between components of VNS as was believed by earlier authors (for the lack of their reciprocal relationship) but also on the activity of these components. Other modulating factors include the heart rate, respiratory pattern, intrathoracic pressure, and diastolic atrial extension. We report the results of HRV assessment in patients with GERD that illustrate heart rhythm rigidity and predominant disorders of activity of the parasympathetic component of VNS especially well apparent in patients with erosive reflux esophagitis. However, other authors demonstrate oppositely directed changes and the involvement of the sympathetic component. A possible cause of this discrepancy is factors other than VNS influencing HRV. It is concluded that analysis of HRV can be used to develop a method for the prevention of GERD-associated arrhythmia. The diagnostic value of such method is limited and requires new algorithms for data interpretation taking account of their multifactorial origin.
The clinical course of atrial fibrillation in patients with coronary heart disease
Authors: Podzolkov V. I. , Tarzimanova Aida I. , Gataulin R. G.
Published: November 2020

The modern medical literature practically does not contain clinical publications reporting studies of factors responsible for progression of atrial fibrillation (AF) in patients with coronary heart disease (CHD). It accounts for the importance of investigations into evolution of the clinical course of AF in such patients.Aim. To elucidate evolution of the clinical course of AF in patients with CHD in a long-term prospective study.Materials and methods. The study included. 112 patient aged 57-74 (mean 67.44±3.3) years with CHD and paroxysmal form of AF carried outfrom 2011 to 2015. Evolution of the clinical course of AF was evaluated based on the number of arrhythmic attacks during the last 3 months. The appearance ofprolonged persistent AF episodes or permanent AF was regarded as progression of arrhythmia.Results. During the 4 year study, 64 (57,2%) patients (group 1) did not experiencea rise in the frequency and duration of AF attacks. Progression of arrhythmia was documented in 48 (42,8%) of the 112 (100%) patients (group 2). These patients more frequently had the history of myocardial infarction and chronic heart failure than patients of group 1. The latter had the mean values of left ventricular (LV) ejection fraction 61,23±6,24%, i.e. significantly higher than 48,47±8,4% in group 2.47 and 28 % of the patients in group 2and 1 respectively suffered mitral regurgitation (p<0,05). Patients of group 2 had significantly more akineticzones. Intake of nitroglycerin in group 1 resulted in positive dynamics of local LV contractility that did not change in patients of group 2. Conclusion. 42,8% of the patients with CHD and paroxysmal form of AF experienced progression of arrhythmia into a persistent or permanent form. Predictors of AF progression in patients with CHD are the history of myocardial infarction, chronic heart failure, mitral regurgitation, and irreversible changes in local myocardial LV contraction.
Antibacterial therapy at different stages of treatment of infectious endocarditis. Do we act correctly?
Authors: Ponomareva Elena Y.
Published: November 2020

Objective. To study characteristics of antibacterial therapy (ABT) at different stages of treatment of patients with infective endocarditis (IE) in clinical practice. Materials and methods. In retrospective (2001 to 2008) and prospective (2008 to 2014) studies lasting 14-years, 302 hospitalized patients with confirmed native valve IE were given antibiotic therapy at outpatient and inpatient stages of treatment. The choice of antibacterial drugs, duration and side effects ofprolonged use of antibiotics (AB) were analyzed in comparison with the results of hospital treatment of patients with IE. Results. It was shown that outpatients with IE due to fever without a specific diagnosis, were frequently prescribed short courses of antibiotics with the prevalence of ceftriaxone monotherapy and its combination with aminoglycosides as the starting treatment under hospital conditions. The cases of incompliance with the recommended duration of antimicrobial therapy were documented. The most common side effects of AB included diarrheal disorders, but the most serious problem was nephrotoxicity resulting in total or partial withdrawal of ABT. Conclusions. The potential of antibiotic treatment of IE is employed but incompletely, the main obstacles to the implementation of adequate antibiotic therapy of IE being the low rate of early diagnosis of the disease including etiological one and the unacceptable level of long-term safety of ABT for the patients.
Risk factors of death in diabetes mellitus
Authors: Asfandiyarova Nailya S.
Published: November 2020

Objective. To study risk factors of death in diabetes mellitus (DM). Materials and methods. This prospective cohort study included 337 patients with compromised carbohydrate metabolism (36 with impaired fasting glycemia or impaired glucose tolerance, 80 with type 1 diabetes, 194 with type 2 diabetes, 27 with diabetes due to chronic pancreatitis). Mean follow-up was 11.2±4.8 years (from 1 January 1995 through 31 December 2014). We investigated causes and risk factors of death in patients with impaired carbohydrate metabolism. Results. 115 patients died during the study period. The most common causes of death of patients with type 1 and 2 diabetes are cardiovascular diseases and cancer. Risk factors of death in type 1 DM include cardiovascular disease, diabetic nephropathy and retinopathy. Patients die at a younger age due to early onset of the disease. In type 2 diabetes risk factors of death are cardiovascular and oncologic diseases, nephropathy, the use of insulin. Patients die in elderly and senile age due to the late onset of diabetes. Gender differences in mortality associated with type 1 and 2 diabetes mellitus were not observed. Conclusion. Main causes of death in patients with type 1 and 2 DM are cardiovascular diseases and cancer. Risk factors of death include macro - and microvascular complications.
The onset of infectious endocarditis with neurological symptoms
Authors: Burduli Nikolay M. , Ranyuk L. G. , Tadeeva T. A.
Published: November 2020

Despite the well known clinical and laboratory signs of infectious endocarditis, it remains one of the most difficult conditions in terms of diagnostics. A cause of its late diagnostics is polymorphism of the clinical picture accompanied, especially at early stages, by clinical “masks” (cardiac, pulmonary, renal, cerebral, etc.). We report a case of atypical onset of the disease with multiple thromboembolism of cerebral arteries, minimal clinical manifestations, and rapid destruction of the mitral valve that required surgical intervention.
Medical scores in clinical practice. Part III. Heart Failure
Authors: Belyalov Farid I.
Published: November 2020

Scores for heartfailure prognosis are discussed in the review. The prognostic scores may help in patients’ selection for advanced device-based treatment.
The role of protein in the development of
chronic disease anemia in patients with chronic cardiac failure
Authors: Ershov V. I. , Gadaev Igor Yu. , Solomakhina N. I. , Nakhodnova E. S. , Kotova E. S.
Published: November 2020

The review of the current literature presents data on chronic disease anemia (CDA), a topical problem of internal medicine belonging to the group of iron-deficient anemia and taking its name from the inflammatory process behind its pathogenesis. It is also called inflammation anemia or cytokine-mediated anemia. This condition is of primary importance in connection with associated, according to recent epidemiological studies , with high prevalence of CDA that impairs quality of life, aggravates prognosis, and increases mortality. Mechanisms of CDA development are discussed with special reference to three trigger factors, viz. cytokines, erythropoietin, and the recently discovered protein hepcidin. The latter has attracted especially much attention in the past years. Iron-containing medications being inefficient in the patients with CDA, other modern approaches to their treatment designed to directly influence the pathophysiological processes behind the disease are considered with special emphasis laid on the enhancement of ferroportin activity and reduction of hepcidin synthesis.
Cardiorespiratory continuum: general pathogenetic aspects
Authors: Poteshkina N. G. , Troshina Anastasiya A. , Adhzigaytkanova S. K. , Suvorov A. Yu.
Published: November 2020

The XXI century brought new challenges to clinical medicine. According to several epidemiological studies, the combination of cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) is the most common comorbid condition, worsening the quality of life and prognosis. Such dualism of these nosologies is called "cardiorespiratory continuum. The recent worldwide trend is to ascribe common risk factors and pathogenetic mechanisms to cardiovascular disease and COPD bearing in mind the wide spread of smoking habits, obesity, hypertension, and metabolic syndrome. The major common pathogenetic mechanisms include activation of RAAS, persistent systemic inflammation, and endothelial dysfunction. This article provides an overview of common risk factors and pathogenetic mechanisms in the patients presenting with a combination of CVD and COPD in the framework of a broader approach to diagnosis, risk stratification and therapy strategies needed to manage the comorbidity in question.
Precancerous lesions and early gastric cancer: modern clinical-morphological data
Authors: Mikhaleva Lyudmila M. , Birukov A. E. , Polyanko N. I.
Published: November 2020

Modern data on precancerous lesions and early gastric cancer (EGC) give a deeper insight into clinical and morphological features of this disease and its their treatment; also, they provides new information on etiology, epidemiology, classification, carcinogenesis and prognostic factors of this condition.