bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing Essay Questions on Prism and Pyramid for the Ability to Understand Mathematical Concept
Authors: Jameela Ingkha , Destania Yuriska
Published: November 2020

The purpose of this study was making valid and practical essay questions on prism and pyramid for students' ability to understand mathematical concepts. The method used was Research and Development with the Tessmer development model consisting of preliminary stages, self-evaluation, expert review and one-to-one stages. The results of this study were in the form valid and practical (legible) essay questions on prism and pyramid for the ability to understand mathematical concepts. the validity of the questions was seen from the validators' comments on the questions and the practicality (legibility) of the questions is seen from the readability of the questions when given to students. There were 10 valid and practical (legible) questions obtained in the end of this research.
Analysis of the Mathematical Communication Ability of Pre-Service Mathematics Teachers through Online Learning during the Covid-19 Pandemic
Authors: Sumargiyani Sumargiyani , Nafi'ah Bidayatun
Published: November 2020

During the current Covid-19 pandemic, the learning system in all educational institution is shifted from face to face to online learning, including universities. This study aims to describe the results of the mathematical communication skills of class B students of Mathematics Education from Ahmad Dahlan University for the 2019/2020 academic year during online learning during the Covid-19 pandemic and to examine students' mistakes in solving differential calculus problems regarding the minimum, maximum material. This study employed descriptive qualitative research. The research instrument used is a test and interview guide. The data are collected using tests and interviews. The research subjects were selected by stratified random sampling technique so that 6 students are classified into high, medium and low categories. The questions are in the form of a description of one question with six questions. The results showed that students' mathematical communication skills on indicators (1) restating information was done appropriately, (2) writing down ideas or problem-solving steps clearly and precisely, some were not thorough, (3) presenting information using graphic images again. There are still things that they couldn't understand and (4) Writing down the answers according to what is known and are asked using mathematical formulas, some are still wrong because they are not accurate.
Measuring the Level of Discipline of Bureaucrats in Palu City
Authors: Pasinringi Andi , Alamsyah Muhammad Nur , Samad Muhammad Ahsan
Published: November 2020

This research was conducted to find out why the implementation of the disciplinary policies of the State Civil Apparatus in Palu City has not been running optimally. The scope of this research is the Palu City government using qualitative methods as a reference to produce descriptive data collected through in-depth interviews, observation and document analysis related to the implementation of employee work discipline. With the determination of informants using a purposive method. Purposive sampling is a non-random sampling strategy where the selection is determined by the researcher by determining certain characteristics that are in line with the research objectives so that research questions can be resolved. The results showed that the implementation of the discipline of the Palu City State Civil Apparatus, which was seen from the dimensions of communication, resources, disposition, and bureaucratic structure, had not gone as expected. Thus it is necessary to evaluate and provide motivation given by the leadership to employees in order to increase the quality of performance. Employee discipline is very influential on services for the community.
The Differences in Work Discipline between Permanent Employees and Contract Employees (Outsourcing) Based on Rewards, Punishment, and Leadership Style in Service and Manufacturing Companies in Tangerang Regency, Banten – Indonesia
Authors: Arsadi Arsadi
Published: November 2020

This study aims to determine the differences in work discipline between permanent employees and contract employees based on rewards, punishment and leadership style in service and manufacturing companies in Tangerang, Banten-Indonesia. Data in this study are quantitative data. Samples were taken randomly using a questionnaire as an instrument. In this study, the researcher used a non-probability sampling technique. The researcher also involved 100 permanent employees and 100 contract employees as research sample to make sure that a balanced comparison could be made. Data analysis technique used included reliability and validity testing as a test instrument, classical assumption test, and ANOVA which was used as a hypothesis testing tool. The results of this study include: 1) there is no difference in work discipline between permanent employees and contract employees based on reward, 2) there is no difference in work discipline between permanent employees and contract employees based on punishment, and 3) there is no difference in work discipline between permanent employees and contract employees based on leadership style.
Grammatical and Lexical Cohesion as Students’ Language Ability in Composing Sentences of Observation Report Texts
Authors: Puspitasari Mega , Andayani Andayani , Suwandi Sarwiji
Published: November 2020

This study aims to 1) describe the grammatical and lexical cohesion used by the students to compose sentences of the observation report text and 2) explain the role of grammatical and lexical cohesion in the students' observation report texts. The data source of this research was students as many as 70 people with 70 written text data of student observation reports. The analysis results showed that the use of grammatical cohesion which includes pronoun and conjunction. Lexical cohesion includes repetition, antonym, synonym, and hyponym. The roles of the two cohesions can help students to develop sentences to be cohesive.
Implementation of Green Accounting in Business Sustainability at Public Hospitals in Malang Raya
Authors: Ashari Muhammad Hasyim , Anggoro Yudhi
Published: November 2020

Hospitals as health organizations whose business operations have an impact on the environment and society are expected to be responsible for preventing or reducing adverse impacts that may cause damage to the environment and the surrounding communities that are affected. This study aims to determine the effect of the implementation of green accounting at public hospitals in Malang Raya on business sustainability. This research is a survey research with descriptive quantitative and correlational approaches. Collecting data with a questionnaire to 38 research samples from a population of 40 public hospitals scattered in Malang District, Malang City and Batu City. The sample selection uses a probability sample with a snowball sampling technique. The results showed that the implementation of green accounting at public hospitals in Malang Raya had an effect of 15.0% (or 12.7% moderate) on business sustainability, and 85.0% (or 87,3% moderate) the rest is influenced by other factors besides the implementation of green accounting. The novelty of the research is the implementation of green accounting which involves financial, social and environmental activities to measure business sustainability.
Strategies for Dealing with Problems from the Perspective of Islam
Authors: Al-Husseini Khadijeh Abolmaalii , Mirghafoorian Fazaleh , Razian Sara
Published: November 2020

Strategies for dealing with problems from the perspective of Islam include a set of cognitive and behavioral efforts that make human beings overcome the difficulties of life and solve their problems in the best possible way by relying on the source of divine safety. From the Islamic point of view, problem-solving is the process of effectively confronting challenges without haste or avoidance, which is accompanied by rational optimism. Research findings showed that trust in God, emotion control, recognizing the problem, identifying goals and obstacles, thinking, and consulting is an important part of the process of dealing with problems that affect how people evaluate the problem and its severity and moderates the effects of crises and severe life problems and creates a level of acceptance and trust when faced with a problem.
Legal Protection on Workers’ Unilateral Wages Deductions Due to the Covid-19 Pandemic
Authors: Suherman Suherman , Putri Alda Damayanti
Published: November 2020

In 2020, the presence of the Covid-19 Virus has had an impact on many sectors in human life. The impact of this virus is not only on the health sector but also spreads to the economic sector, especially business. The difficulty of business activities in Indonesia amid the Covid-19 pandemic has caused many companies to decide to cut the wages of their workers. However, problems arise when several companies violate the rights of their workers by unilaterally cutting workers’ wages which are not in accordance with the existing regulations in Law no. 13 of 2003 concerning Manpower, Government Regulation no. 78 of 2015 concerning Wages, and more specific regulations in the midst of a pandemic through the Minister of Manpower Regulation No. M/3/HK.04/III/2020 concerning Protection of Workers/Laborers and Business Continuity in the Context of Prevention and Overcoming Covid-19. This research uses empirical normative method. In normative research, the type of data used was secondary data, which consisted of primary, secondary and tertiary legal materials. While empirical research, using primary data in the form of answers that could be obtained in the field. The specific objective that will be achieved in this research is how to protect the law against workers who cut wages to their workers.
The program of physical rehabilitation for patients with coronary heart disease and hypertensive disease
Authors: Makarova Irina N. , Starikov S. M. , Bolotov D. D.
Published: November 2020

The authors demonstrate the importance of individual criteria for the choice of dosed physical load for the patients with cardiological problems during hospitalization. The analysis of the functional state and hemodynamic parameters included 68 patients with various cardiovascular diseases before and after performance of the special program ofphysical rehabilitation. The results suggest high efficiency of the proposed treatment and good prospects for further studies in this field.
Extranodal involvement of the heart in lymphomas
Authors: Gadaev Igor Y. , Ershov V. I. , Bochkarnikova O. V. , Sokolova I. Ya. , Budanova D. A. , Kotova E. S. , Lishuta A. S.
Published: November 2020

The authors report a case of rare cardiac involvement in lymphoma, one of the manifestations of which was rhythm and conduction disorders with their resolution after chemotherapy. Also presented are clinical manifestations of heart lesions in lymphoma and modern methods of their diagnostics and treatment.
Efficient treatment of chronic respiratory failure associated with morbid obesity
Authors: Pal’man Aleksandr D. , Polatvskaya M. G. , Plaksina N. A.
Published: November 2020

Severe obesity sometimes leads to chronic respiratory failure. This condition is termed obesity-hypoventilation or Pickwickian syndrome. This article reports clinical observation illustrating effectiveness of noninvasive pressure support ventilation for the treatment of hypercapnic respiratory failure in a patient with morbid obesity. The treatment strategies for such patients are discussed.
Medical scores in clinical practice. Part II. Thromboembolism
Authors: Belyalov Farid I.
Published: November 2020

Scores for diagnostics, prediction and treatment of cardiovascular diseases are considered in the article. Advantages and limitations ofpopular scores for atrial fibrillation and pulmonary embolism in clinical practice are discussed. The experience with the development of the «Kardio-Ekspert» program for mobile devices governed by the Android operational system is reported.
Hypereosinophilic syndrome associated with sepsis due to Paecilomyces fungi disseminated into the liver
Authors: Akhunov Vasily M. , Akhunova A. M. , Lavrent’eva T. P.
Published: November 2020

A 49 year old woman with signs of chronic sepsis, hepatomegaly, and high eosinophil count was under long-term examination including consultations with an oncologist, parasitologist, and hematologist, diagnostic laparotomy, and studies of liver biopsies. Seeding blood samples onto Saburo’s medium resulted in the growth of Paecilomyces variotii Bainier colonies. Counting mature spherules of the fungus revealed 59000 spherules per 1 mcl compared with the normal value of 1000-6000 which suggested paecilomycotic etiology of sepsis. The histological study of liver biopsies demonstrated hemorrhagic foci and eosinophilic infiltrates around fungal spherules. The clinical recovery of the patient was achieved after 3 courses of pulsed terbinafine therapy (500 mg/d every other day for 14 days during a month) in combination with vitamins and i/v infusion of 100 ml of a fluconazole solution (2 mg/ml) every third day (10 procedures during a course of therapy).
Advantages of remote monitoring the activity of patients with axial spondylitis (progress study)
Authors: Gaidukova Inna Z. , Akulova A. I. , Aparkina A. V. , Rebrov A. P.
Published: November 2020

Aim. To improve the quality of treatment ofpatients with spondyloarthrities based on analysis of adherence to therapy and its timely correction by regular remote monitoring the activity of the disease. Materials and methods. 46 patents with axial spondylitis (ankylosing spondylitis, non-radiographic spondylitis) were interviewed by phone once in 4 weeks for 18 months with a 3 month interval after 12 months. 96 patients underwent routine outpatient examination for the evaluation of the main parameters of the disease. Results and discussion. Arbitrarily examined patients with spondyloarthritis reported poor compliance with therapy and its low efficiency. During 18 months, 79% of the patients were recommended treatment with TNF-a inhibitors. Only 18.5% of them in the remote monitoring group failed to reach the BASDAI index < 4 whereas 73.9% of the patients examined remotely for 1 year had low activity of the disease or its partial remission. An increased period between two phone interviews from 1 to 3 months in 58.6% patients with low activity of the disease was associated with impaired adherence to therapy (decreased intake of the anti-inflammatory drug or its withdrawal) that did not lead to enhancement of activity during 3 months after the change in the treatment. Conclusion. Remote monitoring of activity of the disease (one phone interview every 4 weeks) allows to decrease it or reach remission in 73.9% of the patients with axial spondyloarthritis. The decrease in the frequency of telephone calls to one every 3 months results in the impairment of compliance with therapy but does not lead to increase of disease activity in the short run.
Delayed reperfusion for saving vital myocardium in the acute period of myocardial infarction with elevation of ST segment
Authors: Gazaryan Georgi G.
Published: November 2020

Reperfusion therapy in case of acute myocardial infarction is especially desirable within 12 hr afterfirst clinical manifestations as shown in studies with the use of thrombolytic therapy (TLT). Its efficiency for saving ischemic myocardium decreases as the time from the onset of pain syndrome increases. Nevertheless, patients admitted to the clinic in the period deemed unfavourable for TLT still preserve large part of vital myocardium even if in the risk zone. Delayed saving myocardium impossible by TLT can be ensured by transdermal coronary interventions. The dependence of myocardial necrosis on the duration of occlusion of the coronary artery is as well recognized as the necessity of early interventions. Transdermal coronary interventions can be performed within days 2 or 3 after onset of acute myocardial infarction if it was impracticable in an earlier period.
Diurnal rhythm of arterial pressure in patients with acromegaly
Authors: Zav’yalova Yu. V. , Borovkov N. N. , Dulin Pyotr A. , Borovkova N. Yu. , Zanozina O. V. , Simonenko A. V.
Published: November 2020

24 hr monitoring of arterial pressure (AP) in 46 patients with acromegaly in active phase revealed systolic-diastolic arterial hypertension. Analysis of diurnal profile showed the absence of the normal nocturnal fall in AP (non-dipper profile) and the significant rise in the number of patients with elevated nocturnal AP (night-peakers).
HLA-DR expression on monocytes as a prognostic criterion for the development of pyoinflammatory processes at various stages of surgical treatment
Authors: Chepeleva Mariya V.
Published: November 2020

We studied relative content of CD14+HLA-DR in 214 patients including those with aseptic instability and stable implants of the knee and the hip, periprosthetic infection of the hip, chronic posttraumatic osteomyelitis of long tubular bones, and osteomyelitis generalization (sepsis). We determined HLA-DR expression on monocytes by laser flow cytofluorometry using Beckman Coulter Epics XL (USA) cytometer and monoclonal antibodies (Immunotech Company, France). It has been demonstrated, that the decrease in HLA-DR expression on monocytes can be one of the mechanisms of increasing immune disorders in patients with orthopedic pathology and monitoring HLA-DR monocytic expression can be used as a prognostic criterion of developing pyoinflammatory processes at the stages of surgical treatment.
Iron deficiency syndromes associated with diseases of the gastrointestinal tract: state-of-the-art and new prospects for treatment
Authors: Stuklov Nikolai I.
Published: November 2020

Organs of the gastrointestinal tract (GIT) are essential for iron metabolism and hematopoiesis regulation. Iron deficiency is accompanied by a large number of diseases of GIT. The article discusses the problem of diagnosis and treatment of anemia, It describes mechanisms of development of anemia associated with bleeding, malabsorption, and chronic inflammation. It provides current data on the use of oral and intravenous iron-containing drugs, discusses advantages of the new oral form of sucrosomial iron for the treatment of anemia associated with GIT diseases.
Clinico-functional phenotypes of chronic obstructive pulmonary disease, their influence on the severity of the disease, and prognostic value for risk evaluation
Authors: Karnaushkina Mariya Aleksandrovna , Fedosenko S. V. , Sazonov A. E. , Petrov V. A. , Arutyunova A. B. , Shukhnin S. E. , Ogorodova L. M.
Published: November 2020

Attempts at optimizing classification of chronic obstructive pulmonary disease (COPD) reflect clinical heterogeneity of this pathology and provide a basis for the search of new phenotypic markers (especially at the early stages of the disease) that could be useful for prognostication of its severity in individual patients. One of the potential makers is phenotyping of COPD with distinguishing bronchitic, emphysemic, and mixed phenotypes. This paper presents results of analysis of functional characteristics of the patients with these phenotypes. They are shown to reflect clinical and functional features of the disease that may be of value for diagnostic purposes, the choice of the treatment strategy and prognosis of the outcome in individual patients.
Dynamics of cognitive disorders in patients with type 2 diabetes mellitus under effect of metabolic therapy
Authors: Gatckikh Irina V. , Petrova M. M. , Shalda T. P. , Varygina E. L. , Kuznetsov M. N. , Narkevich A. N.
Published: November 2020

The aim of thisstudy was to investigatethe efficiency ofmetabolic therapyincorrectionof cognitive impairmentin patientswith type 2 diabetes. We undertook the analysis of results of the treatment of cognitive dysfunction in 80 patients with a diagnosis of type 2 diabetes. All patients received basic hypoglycemic therapy. 32 patients (study group) received in addition to the basal glucose lowering therapy daily intravenous infusion of 10 mlcytoflavindiluted in 200 ml of a 0.9% sodium chloride solution for 10 days, followed by 2 tablets b.i.d. for 25 days.The group of comparison consisted of 29 patients given in addition to the basal glucose-lowering therapy daily intravenous infusion of 24 ml (600 mg) thioctacid diluted in 200 mL of a 0.9% sodium chloride solution for 10 days. Thereafter, they received 1 tablet ofthioctacid BV once dailyfor 30 days. The control group consisted of 19 patients who received basic hypoglycemic therapy without additional metabolic therapy.Inclusion of cytoflavin in the combined treatment ofpatients with type 2 diabetes ensured a more effective correction of cognitive impairment. There was a statistically significant improvement in optical-spatial activities (p = 0.001), attention (p = 0.001), abstract thinking (p = 0.046), and memory (p<0.001) compared to those in other groups, according to the MOS test. Positive dynamics was expressed as the improvement of the optical-spatial activities by 9,8 ± 10,3%, attention by 13,5 ± 11,8%, abstract thinking by 7,0 ± 8,9%, and memory by 23.0 ± 14 6%. The study of variations of the serum level of brain neurotrophic factor (BDNF) over time during the treatment with metabolic preparations revealedits statistically significant increase (p = 0.002) in the patients treated with cytoflavincompared with comparison (p = 0.139) and control (p = 0.078) groups. These results suggest the influence of cytoflavinon the processes of neuroplasticity under conditions of hyperglycemia, improvement of cerebral microcirculation and cerebroprotective action of this medication.
Scientific legacy of I.V. Davydovsky - philosophical foundations of general pathology
Authors: Tsimmernam Ya. S. , Dimov Anatoly S.
Published: November 2020

The vast empirical material on pathogenesis of diseases has thus far been accumulated. However, its systematization and philosophical interpretation have not been given due attention since the time of I.V. Davydovsky. The value and topicality of I.V. Davydovsky’ ideas need a fresh view andfurther development in the context of knowledges of the XXI century. The analysis of the selected provisions of I.V. Davydovsky offered in the article will hopefully contribute to their introduction into applied medicine.
Topical problems of chronic gastritis
Authors: Tsimmerman Yakov S. , Zakharova Yu. A.
Published: November 2020

The authors propose the definition of chronic gastritis with a brief overview of the history of investigation of this diseases and its prevalence with special reference to (1) the bacterial profile and its role in the development of infectious and inflammatory process in gastric mucosa, (2) the modern state of and new trends in the classification of chronic gastritis including their advantages and disadvantages, (3) the relationship between chronic gastritis and functional gastroduodenal dyspepsia syndrome. It is concluded that mucous microflora plays an important factor in the development ofpathology but H.pylori is not its predominant component. Modern classifications of chronic gastritis provide a basis for a deeper insight into evolution of chronic gastritis and its transformation into cancer. The diagnosis of ‘chronic gastritis with functional gastroduodenal dyspepsia syndrome‘ is invalid.
A critical incident during marathon competition as a result of metabolic decompensation
Authors: Orlov Yuri R. , Govorova N. V. , Glushchenko A. V. , Efremov E. N. , Vasilenko Yu. B.
Published: November 2020

A case of polyorganic insufficiency syndrome associated with coma, convulsive disorder, acute hepato-renal and respiratory dysfunction, hypovolemic shock, and hyperthermal syndrome in a 46 year-old participant ofa marathon competition is reported. The clinical picture was dominated by acute hepatic insufficiency treated with remaxol to activate substrate phosphorylation under effect of exogenous succinate for slowing down the development of energy deficit in mitochondria under condition of oxygen deficit. This case can be regarded as a variant of correction of mitochondrial dysfunction with the use of a mitochondria-targeted medication such as succinate-containing remaxol. This medication reduced AST and ALT activities and utilization of endogenous enzymes for succinate synthesis from alanine and aspartate under hypoxic conditions. Prescription of remaxol as a form of direct substitution therapy was dictated by pathogenetic considerations.
Right ventricular systolic dysfunction in patients with coronary artery disease:
gender-related differences
Authors: Sumin Alexey N. , Korok E. V. , Arhipov O. G.
Published: November 2020

Right ventricular (RV) dysfunction is one of the most significant independent predictors of prognosis in patients with coronary artery disease (CAD) presenting with and without myocardial infarction (MI). However, gender-related differences in RV function of CAD patients are still poorly understood. Aim. To elucidate gender-related differences in echocardiographic parameters of the right chambers of the heart in CAD patients. Material and Methods. 719 patients with coronary artery disease undergoing medical examination in the Federal Budgetary Institution Rehabilitation Center «Topaz» of the RF Social Insurance Fund were included in the study. All patients were assigned to two groups according to the gender: Group 1 - men (n = 432, 61 [55; 67] years), Group 2 - women (n = 287, 62 [56; 67] years). Results. The analysis of the structure and systolic function of the RV showed that RV and right atrium (RA) end-diastolic dimension, diastolic RV wall thickness, and RA area were significantly higher in men than in women (p <0.001). Thus, the prevalence of RV systolic dysfunction (SD) was similar in both groups of patients: 17.6% in men and 15% in women (p = 0.356). The independent predictors of LV SD in both groups were as follows: prior coronary artery bypass grafting (CABG), decreased early mitral flow propagation velocity (p > 0.05). However, reduced left ventricular ejection fraction (LVEF; p <0.001) was found only in men. Conclusion. The prevalence of right ventricular systolic dysfunction in patients with coronary artery disease was similar in both men and women. Men demonstrated lower values of systolic and diastolic LV function. The factors associated with RV systolic dysfunction in both groups were as follows: prior CABG and diastolic LV dysfunction. Reduced LVEF was found only in men. The results of this study can be used to assess gender-related differences in RV dysfunction in CAD patients.
True acantholytic pemphigus provoked by psychogenic stress.
Authors: Teplyuk N. P. , Dorozhenok I. Yu. , Katranova Daria G.
Published: November 2020

The paper describes the relationship of psychogenic stress with the manifestation/exacerbation of pemphigus. Reviewed psychosomatic mechanisms of manifestation of pemphigus. The authors identified the relationship of clinical manifestations of pemphigus to psychogenic disorders.
Evaluation of body mass indices and arterial pressure as cardiovascular risk factors in the adult population of the city of Voronezh
Authors: Kryuchkova A. V. , Seminina Natal’ya Mikhailovna , Kondusova Yu. V. , Poletaeva I. A. , Knyazeva A. M.
Published: November 2020

Aim. To determine body mass index (BMI) and blood pressure (BP) of the Voronezh city adult population. Materials and methods. 1108 residents of Voronezh city at the age from 20 to 75 years were examined in 2015 including measurement of their height, body mass, arterial pressure, and BMI calculation. Medical histories were analyzed to reveal arterial hypertension in the preceding period in the following age groups: 20-29, 30-39, 40-49, 50-59, 60-75 yr and the entire study group (20-75 yr). Results. The mean BMI of the residents of Voronezh was 28.5 (23.8; 33.1) kg/m. The highest values were found between 40 and 59 years. BMI in women under 40 was lower than in men of the same age. The education level affected the prevalence of obesity in that people with secondary vocational education were more likely to be obese than those given higher education. At the age of 40, the incidence of hypertension among women was lower than among men of the same age, it more frequently occurred at the age of 60-75 years. Both age and BMI were related to the level of blood pressure: higher BMI and blood pressure were recorded at an older age. The prevalence of hypertension also increased with age. Conclusion. Obesity was detected in 29.7% of the Voronezh population recruited to the study. The prevalence of obesity among young adults (20-29 years) iproved lower than in the middle and old age groups. 30.9% of the residents suffered from AH.
Research on the level, components and the type of cooperativity in the patients with asthma
Authors: Bogovin L. V.
Published: November 2020

The patient’s cooperativity is the major factor which determines the patient’s adherence to doctor’s prescriptions and, consequently, the achievement of disease control. We proposed the “Evaluation of the cooperativity in asthma” questionnaire to evaluate the level, components and types of cooperativity in 141 patients with the mixed or atopic form of asthma (94.3 and 5.7%, respectively) at admission to hospital who were aware about their disease. The analysis of investigated parameters depending on the level of patients’ awareness of their condition (according to the “Awareness of patients about asthma” test), severity and duration of the disease, presence of alexithymia and social and economic index was done. It was found out that patients with asthma exaggerate the degree of their compliance. The general indices of cooperativity (GIC=58.1±7.3%) and understanding of danger (35.8±3.3%) in the patients who were aware about their disease were low. Qualitative characteristics of individual cooperativity components in examined patients are presented. Nearly 76% of the patients showed negative cooperativity inversely correlating with the severity of asthma and the duration of the disease. Positive cooperativity appeared to be directly related with the higher educational level, occupation and higher income level of the patients. Generally speaking, low average GIC ratings and low patients’ adherence to asthma treatment suggest their low cooperativity.
Evaluation of cardiovascular risks with the use of morphogenetic Klotho protein in patients with chronic renal disease
Authors: Mukhin N. A. , Milovanova L. Yu. , Fomin V. V. , Kozlovskaya L. V. , Taranova M. V. , Androsova T. V. , Borisov A. A.
Published: November 2020

The aim of the study was to explore the Klotho protein significance in patients with different stages of chronic kidney disease (CKD) and to assess the influence of antihypertensive therapy on Klotho protein serum levels. Materials and methods. 130 patients with stage 5 CKD1 were included in the study. Serum PTH, calcium and phosphorus were measured. ELISA was used to determine serum soluble alpha Klotho. Blood pressure including brachial and central (aortic) pressure was measured in all patients together with pulse wave velocity (using a «Sfigmokor» device); in addition, echocardiography (EchoCG), and X-ray examination of the abdominal aorta by Kauppila method were performed. Results. The dynamic study of serum Klotho level showed that it changes with decreasing glomerular filtration rate faster than a rise in phosphate and PTH levels starting from stage 3A of CKD. The two later variables increased at stages 4-5.According to the ROC analysis, the values of serum Klotho below 387 pg /ml suggested enhanced risk of myocardial calcification with 80% sensitivity and 76% specificity. In addition, the highest Klotho serum levels were observed in patients whose target BP values were achieved with angiotensin receptor blockers (ARB) compared to those who used other drugs [р<0,01] or failed to reached target BP levels [p=0,008]. Сonclusion. The study showed the possibility of practical use of Klotho protein as an early diagnostic marker of cardiovascular risk. Reduced serum Klotho was less pronounced in patients who used ARB for correction of high blood pressure. Normal Klotho protein levels in serum have been associated with a lower frequency of heart and vessels calcification in CKD patients.
Characteristic of adhesive properties of endothelium and subendothelial structures of aortic vlve in
patients with calcific aortic stenosis
Authors: Gulyaev N. I. , Zhukov M. V. , Golubok A. O. , Kuranov G. L. , Borisov Yu. A. , Suglobova E. D. , Kuznetsov V. V. , Peremyshlenko A. S. , Gordienko A. V. , Kostina O. V.
Published: November 2020

The article presents results of research on adhesive properties of aortic crescents (endothelial and subendothelial surface) obtained with the use of atomic force microscopy and specially created hydroxyapatite-based probes along with results of identification of the chemical composition of deposited calcium salts in patients with calcified aortic stenosis. The results of the study are supposed to be of pathogenetic significance for understanding the development of calcified aortic stenosis. The proposed method for creating specialized probes for atomic force microscopy can be used in the modeling of processes of ectopic calcification of other organs and system.
Idiopathic pulmonary fibrosis as a possible exrtraesophageal manifestation of
gastroesophageal reflux disease
Authors: Akhmedov V. A. , Gaus O. V. , Petrov D. V.
Published: November 2020

Idiopathic pulmonary fibrosis (IPF) is a most widespread clinic-morphological variant of Idiopathic interstitial pneumonias. Its pathophysiology includes recurrent damages to epithelial cells and anomalous reparative reaction in response to aseptic inflammation in the form of excess fibroblast proliferation. The cause of epithelium damage remains unknown; the involvement of smoking, viral infections, inhaled pollutants, and toxic drug n the initiation of the pathological process is conjectured. Numerous studies of recent years suggest the potential role of gastroesophageal reflux and microaspiration as etiological factors of IPF progression. A brief review of modern views of the relationship between IPF and gastroesophageal reflux is presented.
Endocrine glands and their hormones with
anabolic properties: influence on the course and outcomes of chronic obstructive pulmonary disease
Authors: Kozhevnikova S. A. , Budnevskiy A. V. , Malysh E. Ju. , Ovsyannikov Evgeny S.
Published: November 2020

Chronic obstructive pulmonary disease (COPD) affects not only the lungs and respiratory tract but also other organs and systems. Systemic manifestations of COPD include endocrine disorders involving pituitary, gonads, and adrenals. However, diagnostics and characteristic of combined endocrine dysfunction in COPD are often disregarded. Several studies have demonstrated the influence of hormonal profile on the clinical course and outcome of COPD. In this review article, we consider the relationship between hormones with anabolic properties produced in endocrine glands (pituitary, gonads, adrenals) and COPD with special reference to the effect of COPD on endocrine dysfunction by hypoxemia, hypercapnia, systemic inflammation, and intake of glucocorticosteroids. Also discussed is the strong influence of endocrine disorders on COPD via decreased protein anabolism, increased protein catabolism, non-enzymatic glycosylation, abnormal control of breathing, decreases in respiratory and limb-muscle mass, worsening of respiratory mechanics, impairment of cardiac function and fluid balance disorders. Numerous clinical studies demonstrated high frequency of COPD combined with dysfunctions of endocrine glands (pituitary, gonads, adrenals) producing anabolic effect. Common risk factors and pathogenetic mechanisms as well as direct hormonal effects increase COPD morbidity; adversely affect the clinical course, outcome and prognosis of the disease. Most patients with COPD and endocrine diseases are in need of replacement, stimulation, inhibitory or blocking hormonal therapy in addition to standard medical treatment of the underlying disease. It is concluded that management of patients with COPD and endocrine dysfunction requires an individually-based approach based on better understanding mechanisms of the above associations, the development of modern medication and drug-free therapeutic modalities.
The influence of thrombophilia and obesity on the risk of venous thrombosis
Authors: Belenkov Y. , Golub Anna V. , Popova L. , Shelest E. , Patrushev L. , Kondratieva T. , Aksenova M. , Hlevchuk T.
Published: November 2020

Risk factors of venous thromboembolism are acquired factors such as obesity, hormonal contraceptives, immobilization, and thrombophilia. Their combination leads to an increased risk of venous thrombosis. Objective: The aim of the study was to investigate effect of high BMI on the risk of venous thrombosis in patients with thrombophilia. Material and methods. We examined 96 patients with thrombophilia (mean age 51.61 years, 42 women and 54 men) and 73 patients without mutations (mean age 41.12 years, 17 men and 56 women) with different BMI. The first group involved 31 patients with venous thromboembolism, the second group included 15 patients. Results. The combination of BMI > 25 kg/m2 and thrombophilia influences the risk of venous thromboembolism.
Pathological deformations of the internal carotid artery: modern aspects of etiopathogenesis, diagnostics and surgical treatment (review)
Authors: Duvanov Dmitry A. , Kulikova A. N. , Chekhonatskaya M. L. , Ilyasova E. B.
Published: November 2020

Deformation of the internal carotid artery is a variant of pathology of brachiocephalic arteries. The importance of the study of this pathology for health professionals of various specialitiesarises from the lack of data concerning its etiology, mechanisms of development, approaches to diagnostics and treatment. The review considers opinions of domestic and foreign experts on key issues of pathological deformations of the internal carotid artery. The main risk factors for congenital and acquired pathological deformations of the internal carotid artery are systematized. The comprehensive observation of patients is necessary by means of ultrasonic duplex scanning aortic arch branches, magnetic resonance angiography and computed tomography. Approaches to the surgical correction of pathological deformations of the internal carotid artery described in the scientific literaturedemonstrate possibilities for the treatment of these patients.
Open oval window and associated clinical conditions
Authors: Rudoy Andrei S. , Bova A. A. , Nekhaichik T. A.
Published: November 2020

This review deals with pathogenetic mechanisms underlying formation of the open oval window (OOW) with special reference to the prevalence of this condition in the general population, its relationship with the associated clinical manifestations and complications, stratification of OOW risks, and modern diagnostic modalities. Approaches to the treatment of OOW are described in details.
A new early diagnostic criterion for endothelial dysfunction in men
Authors: Khripun Irina A. , Morgunov M. N. , Vorobyev S. V. , Belousov I. I. , Kogan M. I.
Published: November 2020

Endothelial dysfunction (ED) triggers vascular complications in many diseases, including diabetes mellitus. Currently existing methods for detection of ED do not ensure early diagnostics of the pathological process. We examined 168 men with type 2 diabetes mellitus. ED was studied by ultrasound assessment of arterial vasoreactivity of the brachial artery and determination of biochemical ED markers. Based on manifestations of reactive hyperemia, the patients were divided into groups according to the presence or absence of ED. It was shown that 23.2%of the patients exhibiting normal endothelium-dependent vasodilation in response to the reactive hyperemia test had s.582 + 353_379del polymorphism of the endothelial nitric oxide synthase gene. We also demonstrated that the time till maximum vasodilatation in these patients was 33.3% longer, on the average, than in men who did not have such polymorphism. The slowdown of the maximum response of endothelium-dependent vasodilation was associated with increased levels of ED proteomic markers VCAM-1 and ICAM-1 in 27% and 22.9% of the cases respectively. Thus, we showed for the first time that the time till maximum vasodilation is a more reliable marker of ED than the difference between the diameters of the brachial artery during reactive hyperemia test expressed in percentage.
Irritable bowel syndrome in women of
reproductive and menopausal age
Authors: Mnatsakanyan M. G. , Pogromov A. P. , Zuev V. M. , Dyukova G. M. , Tashchyan O. V.
Published: November 2020

This article presents a review of literature and original data concerning specific characteristics of irritable bowel syndrome (IBS) in women. Aim. To compare extraintestinal associated symptoms (EAS) in women and men with IBS, evaluate their frequency and characteristics in relation to age, type of IBS and changes in the psychovegetative status. Materials and methods.245 patients with IBS were enrolled in the study: 183 women and 62 men, aged from 19 to 81 years (mean 45,3 ± 6,9) including 88 with diarrhea-type IBS (IBS-D), 48 with constipation-type IBS (IBS-C) and 109 with mixed-type IBS (IBS-M). All women with IBS were divided into two groups (45 years (n=90) and older (n=93)). We used Rome III criteria (2006) to diagnose IBS. The analysis of EAS was carried out with the use of SOMS-2 questionnaire (Screening for Somatoform Disorders 2; Rief W. and Hiller W., 2008). We evaluated the degree of depression in IBS patients using the BDI scle (Beck Depression Inventory; Beck A.T., 1996) and anxiety using the STAI (State-Trate Anxiety Inventory; SpilbergerCh.D.). Results. IBS was more common in women of both reproductive and menopausalagesthan in men of the same age groups (women/men ratio 3:1). The EAS occurred significantly more frequently in women than in men; its incidence especially increased in elder groups (p < 0,05). High prevalence of pain syndromes was observed in both women groups: back pain up to 60-70%, pain in arms, legs and joints up to 40-60%; its frequency further increased in elder groups (p < 0,05). On the contrary, the prevalence of such symptoms as «dispareunia», «indifference to sex», «irregular periods» decreased in the elder groups. The prevalence of depression, the level of actual and personal anxiety increased in the group of women older than 45 years compared to thoseunder 45 years (p < 0.05). IBS-C was diagnosed only in the women independent of agein association with the age-related increase in the EASrate(p < 0.05). Conclusion. EAS are the integral part of IBS. We revealed their higher prevalence in women comparedwith men. The frequency of EASfurther increases significantly in elder women in comparison with men. A similar tendency was observed in the change of psychovegetative status especially with respect to depression and anxiety.
The role of risk factors of chronic
non-communicable diseases in the development of transnosological polymorbidity in a modern therapeutic clinic
Authors: Sevostyanova Evgeniya V. , Nikolaev Yu. A. , Mitrofanov I. M. , Polyakov V. Ya. , Dolgova N. A.
Published: November 2020

Purpose. To study the dependence of the frequency of occurrence and the values of indicators of basic risk factors for chronic non-communicable diseases on the degree of transnosological polymorbidity in patients of a clinic of general therapeutic profile for the period from 2003 to 2013. Material and methods. The analysis of 5019 medical records (2501 men, 2518 women) treated in the clinic of RIECM, Novosibirsk, was carried out. Transnosological polymorbidity was evaluated from the average number of nosologies in accordance with the International Classification of Diseases, 10th revision (ICD-10). The following risk factors were assessed based on clinical and laboratory tests: high blood pressure, increased concentration of total cholesterol, low density lipoprotein cholesterol, triglycerides, glucose, uric acid, decreased concentration of high density lipoprotein cholesterol, obesity. Results. The dependence of the values of indicators and frequency of occurrence of chronic non-communicable diseases risk factors on the degree of polymorbidity, taking into account gender differences, was studied. In both men and women, increased transnosological polymorbidity index was associated with the growth of indicators of main non-communicable risk factors: systolic blood pressure, diastolic blood pressure, glucose, low density lipoprotein cholesterol, uric acid in the blood. In men, a more pronounced increase with growing polymorbidity index was especially noticeable in the body mass index and blood glucose; in women in blood glucose and triglyceride levels. Conclusion. The study demonstrated the important role of risk factors of chronic non-communicable diseases that collectively represent clinical manifestations of metabolic syndrome in the development of polymorbidity in patients of therapeutic profile. These findings indicate the need of differential prevention and treatment of patients with polymorbidity together with mandatory identification and correction of modifiable risk factors of chronic non-communicable diseases.
Anemia after biliopancreatic diversion
Authors: Dvoretski L. I. , Yashkov Y. I. , Ivleva Olga V.
Published: November 2020

At present, biliopancreatic diversion (BPD) is one of the most effective surgery for the treatment of morbid obesity. However, long-term complications, including different types of anemia are known to occur after such intervention. Objective of the study. To investigate pathogenetic mechanisms of anemia and clinical condition of the patients undergone BPD taking into account risk factors of anemia development, its therapy and prevention. Material and methods. Eighty patients who had undergone BPD surgery were included in the study. Postoperative oral administration of iron medications (IMs) was recommended to all patients. 49 of them regularly received IMs, 31 patients were not given IMs or took them for no more than 2 months after surgery. The follow-up was 3-7 years. Results. A reliable decrease of hemoglobin levels was observed in all patients after BPD. This reduction began as early as month 3 after surgery and progressed during the 7 year follow-up. Iron deficiency anemia (IDA) was diagnosed in 30% of the patients after BPD. Mean levels of hemoglobin, ferritin and serum iron after BPD were significantly lower in patients having risk factors of IDA as well as in patients not receiving iron therapy. Iron deficiency anemia was revealed in 33.3% of the patients regularly receiving IMs in doses containing 100 mg elemental iron per day. There was no significant decrease of vitamin B12 and folic acid levels during 7 years of follow-up. Only one case (1.25%) of B12 deficiency anemia was registered. Normochromic normocytic anemia characterized by normal serum iron and increased ferritin and C-reactive protein levels, was diagnosed after BPD in 7.85% of the patients. Conclusion. BPD surgery is the important risk factor of anemia (especially IDA) development. In compliant patients. Continuous intake of IMs makes up for iron deficiency but in some others IDA occurred despite regular IMs administration. Normochromic normocytic anemia after BPD may be due to chronic inflammation.