bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and paraclinical characteristics of Chlamydia trachomatis pneumonia in infants less than 6 months of age at National Children’s Hospital
Authors: Pham Thu Hien
Published: June 2020

SUMMARY

Objectives: The study aim was to describe clinical and paraclinical characteristics of Chlamydia trachomatis pneumonia in children under 6 months of age at National Children’s Hospital.

Methods: This cross-sectional study included 71 cases of C. trachomatis pneumonia in Respiratory Department, National Children’s Hospital between 1 September 2017 and 31 August 2018.

Results: Important features of C. trachomatis pneumonia in children under 6 months of age include persistent cough, nasopharyngitis, conjunctivitis, history of vaginal birth, mother’s history of vaginosis during pregnancy. Absolute eosinophil counts greater than 300/mm3 may suggest C. trachomatis pneumonia.

Conclusion: Clinical manifestations of pneumonia due to C. trachomatis pneumonia are persistent cough, nasopharyngitis, conjunctivitis, mother’s history of vaginosis during pregnancy. A higher than 300 eosinophils/mm3 is strongly associated with C. trachomatis pneumonia.
THE CHARACTERISTICS OF CLINICLA AND PARACLINICAL IN ACUTE DIARRHEA CHILDREN PATIENT AT VIETNAM NATIONAL CHILDREN'S HOSPITAL
Authors: Ngọc Anh Hoàng
Published: June 2020

Objectives: To descriptive of clinical and subclinical characteristics of pediatric patients with acute diarrhea at Vietnam national children's hospital in 2019. Subjects: Children diagnosed with acute diarrhea at Vietnam national children's hospital from January 2019 to December 2019. Method: Cross-sectional description. Results and conclussion: 63.7% of children had vomiting, of which 59.2% vomited 5-10 times / day. 55.7% had a mild fever. 20.7% had dehydration. 76.7% of yellow feces and 77.3% of feces had no fishy odor. The majority of children had leukocytes, increased hematocrit. 55.1% of children had Escherichia coli in their stool.
Juridical Analysis of the Legal Relationship Between Doctors and Patients in Health Services
Authors: Agustina Enny
Published: June 2020

The doctor and patient relationship is a pattern that is born among the doctor and the patient before continuing to the act of health care. And health services, is a concept used in providing health services to the community. Health services is a sub-system of health services whose main purpose is health services in terms of Preventive (preventive), Promotive (improving health,) Curative (healing health) and Rehabilitative (recovery) are all efforts mobilized by the government in improving the quality of health services prime and in accordance with standard operating procedures and health service standards. This study uses a method of approach to the community so that the public knows in more detail about the juridical analysis of the legal relationship among doctors and patients in health services. The results of this study are in terms of the legal aspects of health, the relationship among doctors and patients cannot decide what is called health services by doctors who have a direct role in improving tasks for the community in order to realize a good and quality society.�Analisis Yuridis Hubungan Hukum Antara Dokter Dan Pasien Dalam Layanan Kesehatan�Hubungan dokter dan pasien merupakan pola yang lahir antara dokter dan pasien sebelum berlanjut pada tindakan pelayanan kesehatan. Dan pelayanan kesehatan,merupakan sebuah konsep yang digunakan dalam memberikan layanan kesehatan kepada masyarakat. Pelayanan kesehatan adalah sebuah sub sistem pelayanan kesehatan yang ditujuan utamanya adalah pelayanan kesehatan dalam hal Preventif (pencegahan), Promotif (peningkatan kesehatan,) Kuratif (penyembuhan kesehatan) dan Rehabilitatif (pemulihan) merupakan segala upaya yang dikerahkan oleh pemerintah dalam peningkatan mutu pelayanan kesehatan yang prima dan sesuai dengan standar prosedur dan standar operasional prosedur pelayanan kesehatan. Penelitian ini menggunakan metode pendekatan kepada masyarakat sehingga masyarakat tahu lebih detail tentang analisis yuridis hubungan hukum antara dokter dan pasien dalam peyanan kesehatan. Hasil penelitian ini yaitu Dalam hal aspek hukum kesehatan, hubungan antara dokter dan pasien tidak dapat memutuskan apa yang disebut layanan kesehatan oleh dokter yang memiliki peran langsung dalam tugas-tugas perbaikan untuk masyarakat dalam rangka mewujudkan masyarakat yang baik dan berkualitas.
The Burning of a Sector Police Office by the Community from a Criminological Perspective
Authors: Radhali Radhali , Ramadhani Wahyu
Published: June 2020

This study aims to identify the legal analysis of the burning of a Sector Police Office by the community from a criminological perspective as well as to analyze the level of community trust in police after the burning of the Sector Police Office based on criminological theories. This descriptive-analytical study applied a normative juridical approach. The results of the legal analysis of the burning of a Sector Police Office by the community from a criminological perspective showed that, according to the anomic theory, the burning is due to the influence of social structure as a correlative factor in the burning of the Sector Police Office of Bendahara. This influence can be seen from the disparity between the goals to be achieved and the means used in achieving these goals. Hence, the community took steps to burn down the Sector Police Office to achieve its goals. Further, the level of community trust in police after the burning of the Sector Police Office was demonstrated through association theory, social control theory, and neutralization theory. Based on the description of the criminological theories and its relation to the phenomenon of the burning of the Sector Police Office of Bendahara, there needs to be an evaluation of the application of the law as the harmonization of the law in the context of criminal provisions is needed.�Pembakaran Kepolisian Sektor oleh Masyarakat dalam Perspektif Kriminologi�Tujuan penelitian ini yaitu untuk mengetahui analisis hukum terhadap pembakaran Kepolisian Sektor oleh masyarakat dalam perspektif kriminologi, untuk mengetahui kepercayaan masyarakat terhadap kepolisian pasca pembakaran Kepolisian Sektor menurut teori-teori kriminologi. Spesifikasi penelitian yang digunakan adalah penelitian bersifat deskriptif-analitis dengan pendekatan yuridis normatif. Hasil penelitian dari analisis hukum terhadap pembakaran Kepolisian Sektor oleh masyarakat dalam kriminologi bahwa menurut teori anomi menekankan pengaruh struktur sosial sebagai faktor korelatif terjadinya pembakaran Kepolisian Sektor Bendahara. Pengaruh ini terlihat dari adanya disparitas antara tujuan yang hendak dicapai dengan sarana yang digunakan dalam mencapai tujuan tersebut. Hal ini akhirnya mengambil langkah-langkah pembakaran Kepolisian Sektor Bendahara untuk mencapai tujuannya. Selanjutnya tingkat kepercayaan masyarakat terhadap kepolisian pasca pembakaran Kepolisian Sektor menunjukkan melalui teori asosiasi; teori kontrol social dan teori netralisasi. Berdasarkan uraian teori-teori kriminologi tersebut dihubungkan fenomena pembakaran Kepolisian Sektor Bendahara saat ini sangatlah dibutuhkan sebagai evaluasi terhadap penerapan hukum sehingga diperlukan harmonisasi hukum dalam konteks ketentuan pidana
Theoretical aspects of impact of the phenomenon of “post-truth” upon cognitive sphere of personality
Authors: Sultanova Irina Viktorovna , Orlova Tat'yana Evgen'evna
Published: June 2020

The subject of this research is the impact of information environment upon people’s psyche. Currently, the volume of information accessible to human vastly exceeds the ability to digest it. The emerging information overload leads to nervous exhaustion, worsening of memory, lapse of attention concentration, and stress. Thus, there are created favorable conditions for negative influences of the policy of “post-truth” upon personality, mentality, perception of the world, and system of relationship. Using the instruments of rationality, the policy of “post-truth” turns them against rational thinking of a person. Affecting emotions and referring to personal beliefs, “post-truth” enhances stigmatization not even denying the facts. The research methodology combines the methods of fundamental psychological mechanisms and patterns of the origin and functioning of human psyche; methods general psychological research; methods of studying mental processes, mentality and personality; methods of cognitive psychology; technologies of examination of cognitive processes and communication in computer networks. The main conclusion consists in the statements that in the conditions of information overload and time deficit for analysis, a person makes hasty decisions based on his previous experience; while “post-truth” can be countered only through the development of the ability of critical thinking, giving assessment, learning to analyze and form own opinion regarding events ongoing in the world.
Patient’s anxiety at the different stages of genesis of myocardial infarction
Authors: Kadyrov Ruslan Vasitovich , Elzesser Anastasiya Sergeevna , Bartkovskaya Natal'ya Sergeevna
Published: June 2020

The subject of this research is the anxiety of patients at different stages of genesis of myocardial infarction (MI). It is a proven fact that the high level of anxiety leads to reoccurrence and unfavorable course of disease both, in combination with other factors or regardless of them. However, the influence of separate aspects of anxiety into reoccurrence of MI remains insufficiently studied, which actualizes determination of the components of anxiety at different staged of emergence of this disease. The article presents a comparative analysis and description of the level of manifestation of various components of anxiety among the following empirical groups: 33 persons without myocardial infarction in past medical history, but in the group of risk by its genesis; 29 patients undergoing 2 to 5 days of hospital treatment for recovering after MI; 27 patients that have already received post-hospital therapy after MI. The observational group included 30 technically healthy persons. The following conclusions are formulated: 1) Anxiety components, such as asthenic, phobic, emotional discomfort are vivid among the patients who have survived MI, as well as persons in the risk group. However, an additional longitude research is required for proving the influence of anxiety into the genesis of myocardial infarction. 2) The currently conducted rehabilitation of MI patients reduces the overall level of situational anxiety, practically avoiding such its components that in the future can prompt recurrence of MI. 3) High level of anxiety is characteristic to all IM patients. The recommended programs for prevention and rehabilitation should be focused on long-term reduction of the level of personal anxiety, such as cognitive-behavioral psychotherapy.
Metacognitive model of coping behavior of a subject during the COVID-19 pandemic
Authors: Chistiakova Natalia Viktorovna , Aisuvakova Tatiana Petrovna
Published: June 2020

Mental experience is a necessary construct of self-regulation of behavior in a stressful situation. During the pandemics of a new coronavirus infection, metacognitive approach towards analysis of adaptation mechanism of regulation of behavior allows determining the resource potential of personality for the purpose of achieving social re-adaptation. Adequacy of cognitive assessment of a potential COVID-19 threat as a stressogenic factor characterizes the metacognitive model of coping behavior of a subject. Mental representations as coping resources of the system of self-regulation of personality define the nature of mental activity for overcoming a difficult life situation. In the conditions of COVID-19 pandemic increases the risk of mental disturbance due to cognitive dissonance in assessing the situation of potential threat as stressogenic factor. A destructive model of metacognitive activity as a method of regulation of stress resistance leads to maladaptive behavior of a subject based on cognitive distortions. As a factor of social disintegration, cognitive deteriorations negatively affect the subjective level of stress resilience, increasing the risk of chronification psychoemotional tension. The pilot research on the basis of Google platform involved 48 students. The assessment of acquired results is conducted with the use of correlation-regression analysis. It is determined that the adequate cognitive assessment of potential risk of coronavirus infection explains the internal constructive ensemble of the strategies of coping behavior with stressogenic situation of behavior. Therefore, the effective strategies of metacognitive regulation of behavior of a subject pertaining to COVID-19 contribute to social re-adaptation, associated with the need for inner transformation. Metacognitive model of dysfunctional fear regarding the threat of COVID-19 characterizes the external vector of destructive repertoire of coping strategies for regulation of behavior of a subject, and reflects negatively on the personal level.  Therefore, semantic field of metacognitive model of social re-adaptation by means of subjective control of behavior substantiates individual differences in the level of personal anxiety as a factor of stress resilience.
A árvore da vida no Apocalipse: manutenção de uma nova vida
Authors: Rios Cesar Motta
Published: June 2020

A imagem da árvore da vida desperta curiosidade pelo poder atrelado a ela na tradição bíblica. No Apocalipse canônico, a imagem é mobilizada propositadamente em um texto repleto de simbolismos e referências mais ou menos discretas a textos do Primeiro Testamento. Primeiramente, o presente estudo considera o imaginário da árvore da vida (disponível no século I d.C.) em ambiente judaico, o qual é inaugurado pela presença do espécime no Gênesis e, posteriormente, reforçado e tornado mais complexo por suas aparições em diferentes textos do arquivo judaico. Em seguida, tendo em mente o discutido anteriormente, são abordados organizadamente os quatro trechos do Apocalipse em que figura a árvore da vida. Conclui-se, por meio dessa pesquisa bibliográfica em fontes antigas primárias e em fontes secundárias, que a árvore da vida aparece no Apocalipse com o objetivo de assegurar ao ouvinte a doação e manutenção da vida mediante Cristo. Isso se destaca pela concepção comum da interdição do acesso a essa mesma árvore a partir do relato de Gênesis, a qual é evocada em outros textos considerados ao longo do estudo.A imagem da árvore da vida desperta curiosidade pelo poder atrelado a ela na tradição bíblica. No Apocalipse canônico, a imagem é mobilizada propositadamente em um texto repleto de simbolismos e referências mais ou menos discretas a textos do Primeiro Testamento. Primeiramente, o presente estudo considera o imaginário da árvore da vida (disponível no século I d.C.) em ambiente judaico, o qual é inaugurado pela presença do espécime no Gênesis e, posteriormente, reforçado e tornado mais complexo por suas aparições em diferentes textos do arquivo judaico. Em seguida, tendo em mente o discutido anteriormente, são abordados organizadamente os quatro trechos do Apocalipse em que figura a árvore da vida. Conclui-se, por meio dessa pesquisa bibliográfica em fontes antigas primárias e em fontes secundárias, que a árvore da vida aparece no Apocalipse com o objetivo de assegurar ao ouvinte a doação e manutenção da vida mediante Cristo. Isso se destaca pela concepção comum da interdição do acesso a essa mesma árvore a partir do relato de Gênesis, a qual é evocada em outros textos considerados ao longo do estudo.
Movimentos sociais e processos de democratização das cidades no Brasil contemporâneo
Authors: Reis Souza Robson Sávio
Published: June 2020

A história está repleta de exemplos a confirmarem que os movimentos sociais são fundamentais para a conquista de direitos e a efetividade da cidadania. No Brasil, um país historicamente marcado pela violência e injustiça estruturais, a ação da sociedade civil através dos movimentos sociais nas lutas em prol da igualdade, da justiça e da ampliação de políticas públicas e sociais foi responsável por importantes mudanças sociopolíticas, como os avanços conquistados na Constituição Federal de 1988. Notadamente nas cidades, onde se concentra mais de 80% da população brasileira, os movimentos sociais urbanos têm pautas e demandas muito diversas, corroborando a vocalização de múltiplos atores e segmentos sociais e, mais recentemente, articulando esforços na esfera pública das demandas pela efetividade do chamado “direito à cidade”.
A Prelude to Biogermylene Chemistry
Authors: Mahawar, Pritam , Wasson Mishi Kaushal , Sharma Mahendra Kumar , Jha Chandan Kumar , Mukherjee Goutam , Vivekanandan Perumal , Nagendran Selvarajan
Published: June 2020

Abstract: The biological applications of germylenes remain an unconceivable domain owing to their unstable nature. We report the isolation of air, water, and culture-medium stable germylene DPMGeOH (3) and its potential biological application (DPM = dipyrromethene ligand). Compound 3 exhibits antiproliferative effects comparable to that of cisplatin in human cancer cells. The cytotoxicity of compound 3 on normal epithelial cells is minimal and is similar to that of the currently used anti-cancer drugs. These findings provide a framework for a plethora of biological studies using germylenes and have important implications for low-valent main group chemistry.
Sea Urchin Pigments as Potential Therapeutic Agents Against the Spike Protein of SARS-CoV-2 Based on in Silico Analysis
Authors: Barbieri Elena Susana , Rubilar Tamara , Gázquez Ayelén , Avaro Marisa , Seiler Erina Noé , Vera-Piombo Mercedes , Gittardi Agustín , Chaar Florencia , Fernandez Jimena Pía , Sepulveda Lucas
Published: June 2020

Several studies have been published regarding the interaction between the spike protein of the novel coronavirus SARS-CoV-2 and ACE2 receptor in the host cells. In the presente work, we evaluated the in silico properties of two sea urchin pigments, Echinochrome A (EchA) and Spinochromes (SpinA) against the Spike protein (S) towards finding a potential therapeutic drug against the disease caused by the novel coronavirus (COVID-19). The best ensemble docking pose of EchaA and SpinA showed a binding affinity of -5.9 and -6.7 kcal mol-1, respectively. The linked aminoacids (T505, G496 and Y449 for EchA and Y449, Q493 and G496 for SpinA) are in positions involved in ACE2 binding in both RBDs frim SARS-CoV and SARS-CoV-2 suggesting that EchA and SpinA may interact with Spike proteins drom both viruses. The results suggest that these pigments could act as inhibitors of S protein, pointing them as antiviral drugs for SARS-CoV-2.
Expanding the Scope of Pyclen-Picolinate Lanthanide Chelates to Po-Tential Theranostic Applications
Authors: Nizou Gwladys , Favaretto Chiara , Borgna Francesca , Grundler Pascal V. , Saffon-Merceron Nathalie , Platas-Iglesias Carlos , Fougère Olivier , Rousseaux Olivier , van der Meulen Nicholas , Müller Cristina , Beyler Maryline , Tripier Raphael
Published: June 2020

A family of three picolinate pyclen based ligands, previously investigated for the complexation of Y3+ and some lanthanide ions (Gd3+, Eu3+), was studied with 161Tb and 177Lu in view of potential radiotherapeutic applications. The set of six Tb3+ and Lu3+ complexes was synthesized and fully characterized. The coordination properties in the solid state and in solution were thoroughly studied. Potentiometric titrations, corroborated by DFT calculations, showed the very high stability constants of the Tb3+ and Lu3+ complexes, which are associated to remarkable kinetic inertness. A complete radiolabeling study performed with both 161Tb and 177Lu radionuclides, including experiments with regard to the stability with and without scavengers and kinetic inertness using challenging agents, proved that the ligands could reasonably compete with the DOTA analogue. To conclude, the potential of using the same ligand for both radiotherapy and optical imaging was highlighted for the first time.
Treatment of chronic viral hepatitis C with direct acting antiviral agent: review
Authors: Malov V A , Ubeeva E A , Ubeeva I P , Nikolaev S M , Umbetova K T
Published: June 2020

HCV infection treatment regimens are viewed from positions of HCV life cycle and replication, effects of NS3/4A protease inhibitors and NS5A/NS5B inhibitors on HCV strain replication. Evolution of HCV treatment regimens from its discovery to modern DAA agents had led to substantial progress although drug resistance poses a new issue to be addressed.
Chronic hepatitis B and C as stigma: Is the problem relevant for Russian society?
Authors: Baramzina S V
Published: June 2020

Chronic hepatitis B and C (CHB and CHC) are a serious medical and social problem of the world community. Aim: to study the problem of stigmatization and attitudes to patients with CHB and CHC among adolescents and adults. Materials and methods. An anonymous survey was conducted in 120 residents of the Kirov region. Of these, 94 adults (aged 18 to 76 years; average age 39.3±11.5 years) of different specialties except medical (group 1) and 26 adolescents aged 16-17 years (average age 16.5±0.5 years), high school students (group 2). The original questionnaire included 16 questions divided into 3 blocks. Block 1 contained questions about the socio - demographic status of the Respondent, block 2 and block 3 included questions on the epidemiology of HCV and HBV infection and on the treatment of patients with CHC and CHB respectively. Results. In the course of work the majority of respondents (50-65.4%) from both groups revealed a negative attitude towards patients with CHB and CHC (to a lesser extent pronounced against close relatives and friends of CHC patients), manifested by a desire to exclude casual contact and refusal to live in the same room with the patient CHB/CHC, no desire of sharing your child/brother in the same kindergarten group patients with CHB/CHC child. Fear of Contracting HBV/HCV infection has been linked to poor knowledge of the factors and pathways of transmission of these diseases. In a few cases, adolescents and adults showed an extreme degree of destructive attitude, which was expressed in the adoption of discriminatory measures against this category of patients - dismissal from work and expulsion from school/University. Conclusion. The results indicate that there is a problem of stigmatization of patients with CHB and CHC in society, both in children and adults, which requires systematic work on health education.
Psychosocial risk factors for cardiovascular disease: gender differences and 22-year dynamics among the population of Siberia (WHO MONICA-Psychosocial Program, HAPIEE)
Authors: Gafarov V V , Gagulin I V , Gafarova A V , Panov D O , Krymov E A , Gromova E A
Published: June 2020

Aim. To determine the gender differentiation and dynamics for 22 years of psychosocial factors (PSF) of the risk of cardiovascular disease among the population aged 25-64 years in Russia / Siberia (Novosibirsk). Materials and methods. Representative samples of the population of the city of Novosibirsk under the program of the World Health Organization “MONICA-MOPSY” in 1994-1995 were examined. III screening (men - 657, women - 870, 25-64 years old); IV screening project HAPIEE in 2003-2005 (men - 576, women - 1074, 45-64 years old) and V screening in 2013-2016. (men - 427, women - 548, 25-44 years old). We used Spielberger tests, MONICA-MOPSY tests, the Breckman - Sim test, the “Knowledge and attitude to your health” questionnaire. Results. In an open population of 25-64 years old, high levels of anxiety (T), depression (D), life exhaustion (LM), and hostility (B) were higher in women than in men. In the group of 55-64 years over 10 years, women have increased personality T, decreased D and LM. Over 22 years, in the group of 25-34 years, men and women decreased T and MI, but D and B increased, while women decreased T, LM and B and D. grew. Low and high close contact indices were higher among men. A low index of social ties prevailed in men, and a high index in women. High levels of stress in the family were more common in women, and at work - in men. For 10 years, the level of stress in the family and at work in men has decreased. Sleep disorders in the population in all age groups were more often in women. Conclusion. It was found that women have significantly higher PSF than men, with the exception of stress at work. The decrease in PSF in women and men in the dynamics
Hypertension and insomnia
Authors: Ostroumova T M , Parfenov V A , Ostroumova O D , Kochetkov A I
Published: June 2020

Insomnia is frequently detected in patients with arterial hypertension (AH): from 19% to 47.9% of all cases according to epidemiological studies. On the other hand, the frequency of hypertension in patients with insomnia ranges from 21.4% to 50.2%, whereas in patients without insomnia, from 11.0% to 41.8%. In single studies in which patients with insomnia underwent ambulatory blood pressure monitoring (ABPM), these patients showed higher nocturnal blood pressure levels. Recent data suggests that insomnia is also a risk factor for hypertension. Among the pathogenetic mechanisms explaining the relationship between hypertension and insomnia, an increase in the activity of the main neuroendocrine stress systems, sympatho - adrenal and hypothalamic - pituitary - adrenal, and the frequent presence of concomitant anxiety disorders are discussed. To determine the sleep quality in patients with insomnia, the Pittsburgh Sleep Quality Index (PSQI) is most often used, patients with hypertension in a number of studies had higher total PSQI score compared to individuals with normal blood pressure. PSQI score correlates with systolic and diastolic blood pressure level, as well as with the presence of non - dipper blood pressure profile. Both hypertension and insomnia are associated with impaired cognitive functions. However, the relationship between cognitive impairment and insomnia is rather contradictory, which is most associated with the methodology for assessing cognitive functions and differences in the initial clinical and demographic characteristics of the examined patient population.
The use of nonsteroidal anti - inflammatory drugs in polymorbid pathology
Authors: Asfandiyarova N S , Philippov E V
Published: June 2020

The literature review presents the possibilities of using non - steroidal anti - inflammatory drugs (NSAIDs) for polymorbid pathology. The mechanism of NSAIDs action, risk factors for the development of undesirable effects on the cardiovascular, digestive, urinary and other systems are considered; prevention measures and drug selection options are discussed, NSAIDs prescribing algorithm is considered.
Assessment of external risk factors of hepatocellular cancer development and markers of genetic predisposition to its development in the ethnic group of yakut - men
Authors: Yushchuk N D , Sleptsova S S , Malov S I , Bilukina I F , Semenov S I , Stepanenko L A , Ogarkov O B , Savilov E D , Malov I V
Published: June 2020

Aim. To establish the main external and genetically determined risk factors for the development of hepatocellular cancer in the ethnic group of male Yakuts living in the Republic of Sakha (Yakutia) [RS (Y)] in the epidemiologically unfavorable conditions of the incidence of viral hepatitis. Materials and methods. A total of 97 male Yakuts were examined, including 44 people diagnosed with hepatocellular cancer and 53 people diagnosed with chronic viral hepatitis. HCC risk factors were identified by analyzing medical records and questioning patients. In the experimental and control groups, genetic studies of single nucleotide polymorphisms of genes mapped on the X-chromosome and involved in the activation of antiviral immunity along the TLR7 signaling pathway were performed. Results and discussion. In 100% of patients with hepatocellular cancer, infection with hepatitis B, C, D viruses or co - infection with these agents was detected. Every fourth patient with HCC in the RS (Y) was infected with hepatitis D. The course of hepatocellular cancer associated with HDV was characterized by rapid progression of liver cirrhosis, development of portal hypertension, bleeding from varicose veins of the stomach and esophagus (36.4%) and edematous ascitic syndrome (63.6%). In addition to viral agents, additional risk factors for liver cancer were identified, such as alcohol abuse, overweight, diabetes mellitus, and smoking. Among the studied variation sites of genes localized on the X-chromosome and encoding the reaction of innate antiviral immunity, no genetic marker was found with a sufficient degree of confidence determining the likelihood of hepatocellular cancer developing. Conclusions. The high incidence of hepatocellular carcinoma of the male population in the RS (Y) is due to the widespread prevalence of parenteral viral hepatitis, especially viral hepatitis D. Due to the introduction of mass vaccination of the population against hepatitis B in the Russian Federation in the foreseeable future in the RS (Y) we should see a decrease in the proportion of hepatocellular cancer associated with hepatitis B and D viruses, and therefore the focus should be on the treatment and prevention of hepatitis C virus and non - infectious risk factors.
Functional diseases of the gastrointestinal tract in the context with overlapping functional disorders: current status of the problem
Authors: Osadchuk M. A. , Svistunov A. A. , Kireeva N. V. , Osadchuk M. M.
Published: June 2020

Functional diseases of the gastrointestinal tract cause significant damage to the health care system. Their frequent combination in the same patient with the migration of clinical symptoms throughout the digestive tube is accompanied by continuous exacerbations, refractory to the therapy and severe psychosocial disorders. This review provides data on the main etiopathogenetic factors, clinical manifestations, course features and management tactics for patients with overlapping for the most common functional diseases of the gastrointestinal tract.
Esophageal disorders in patients with irritable bowel syndrome
Authors: Morozova Yu. N. , Pogromov A. P. , Mnatsakanyan M. G. , Tashchyan O. V. , Kolosova K. Yu.
Published: June 2020

Aim.To study the whole range of esophageal disorders in patients with irritable bowel syndrome (IBS) using high-tech methods.

Materials and methods.102 IBS patients (47 males, mean age 40.8, diagnosis of IBS was established according to Rome III criteria) with esophageal symptoms (heartburn, belching, globus sensation and noncardiac chest pain) were examined in gastroenterology department. All patients underwent endoscopy, with biopsies if required, X-ray examination of upper gastrointestinal tract; 24-hour pH-impedance monitoring;13C-urea breath test. Evaluation of esophageal symptoms was carried out on the basis of Rome IV criteria.

Results.21 (20.6%) individuals had esophagitis (ERD). According to 24-hour pH-monitoring data, 7 of them had overlap between GERD and functional esophageal disorders (FED). 27 (26.5%) individuals had nonerosive reflux disease (NERD). In 54 (52.9%) individuals endoscopy and pH-impedance monitoring data did not differ from normal, suggesting this group as group of patients with FED. There was no significant difference for age, sex and IBS subtypes in GERD, NERD and FED groups.

Conclusion.Comorbid esophageal disorders in patients with IBS are different and represented by organic diseases, FED and overlap between them. Methods such as 24-h pH-impedance measurement and esophageal manometry should be used to assess comorbid esophageal disorders in IBS patients.
Clinical implications of chronic mesenteric ischemia in elderly and senile patients
Authors: Dolgushina A. I. , Kuznecova A. S. , Seljanina A. A. , Genkel V. V. , Vasilenko A. G.
Published: June 2020

Aim.To evaluate the sensitivity and specificity of the clinical criteria for the diagnosis of chronic mesenteric ischemia in elderly and senile patients with mesenteric atherosclerosis.
Materials and methods.The study included 142 patients (82 men and 60 women). The median age of patients is 66.0 [62.0; 72.0] years.
Results.According to MDCT atherosclerotic lesions of the abdominal aorta and its unpaired visceral branches were diagnosed in 105 (73.9%) patients. A combination of atherosclerosis of the celiac trunk and the superior mesenteric artery with the presence of hemodynamically insignificant stenosis was revealed. Hemodynamically significant atherosclerotic narrowing of at least one mesenteric artery was present in 15% of cases. Among them, a single vascular lesion was found in 6 patients (4.2%), a combination of hemodynamically significant lesions of two arteries in 15 (11%) patients. Depending on the clinical manifestations, all patients are divided into two groups: the first group 30 (21.1%) patients with the presence of symptoms characteristic of chronic mesenteric ischemia (CMI). The second group consisted of 112 (78.8%) patients without a characteristic triad of symptoms. The clinical symptom complex of СMI, including postprandial abdominal pain, intestinal dysfunction and progressive weight loss, as a diagnostic criterion showed low sensitivity 13.3% and specificity 77.9%. At the same time, the sensitivity of such a clinical combination as a combination of atherosclerosis of the arteries of the lower extremities, weight loss and abdominal pain syndrome with a severity of more than 5.5 points, with respect to the detection of hemodynamically significant stenoses of two or more mesenteric arteries was sensitivity 86.7%, specificity 74.0%.
Vedolizumab in patients with inflammatory bowel diseases of in real clinical practice
Authors: Shapina M. V. , Nanaeva B. A.
Published: June 2020

Vedolizumab is currently the only selective biological drug for the treatment of inflammatory bowel diseases (IBD). Its effectiveness and safety has been shown in clinical trials. This article presents the experience of using vedolizumab in real clinical practice in patients with various forms of ulcerative colitis (UC) and Crohns disease (CD).
Materials and methods.96 patients with IBD (62 with CD and 34 with UC) were prescribed therapy with vedolizumab at a dose of 300 mg intravenously at 0, 2, and 6 weeks, and further maintenance therapy was continued every 8 weeks. Most patients had prolonged inflammation (27 (79.4%) with total UC, 35 patients with CD (56.5%) had ileocolitis), resistance to therapy, including biological drugs (19 (55.9%) in patients with UC and 49 (79.0%) in patients with CD). The effectiveness of therapy was evaluated after 3 months (based on clinical response and clinical remission), 6 and 12 months (endoscopic response and endoscopic remission were additionally evaluated).
Results.After 3 months, clinical remission was observed in 62.5% and 36.6%, respectively. After 6 months, these indicators were 66.7% and 61.0%, and after 12 months, 70.8% and 61.0%, respectively. After 6 months, endoscopic remission was observed in 50.0% of UC patients and 26.8% of CD patients. After 12 months, it reached 58.3% and 31.7%, respectively. The analysis showed greater efficacy in bio-naive patients with CD (steroid-free remission after 12 months 62.5%, endoscopic remission 37.5%), as well as patients with non-stricturizing non-penetrating CD (58%). In patients with UC, vedolizumab showed the same effectiveness both in bio-naive patients (70.0%) and as a second-line therapy (71.2%). It turned out to be more effective in patients with moderate UC (76.2%) and steroid-dependent UC (77.8%).
Conclusions.Vedolizumab is effective in achieving clinical response and clinical remission, as well as endoscopic response and endoscopic remission in patients with UC and CD. Given the selective mechanism of action of the drug, it can be recommended as a first-line therapy.
Features of the course of gallstone disease in patients with non-alcoholic fatty liver disease
Authors: Cherkashchenko N. A. , Livzan M. A. , Krolevets T. S.
Published: June 2020

Aim.To update information about comorbidity of non-alcoholic fatty liver disease (NAFLD) and gallstones disease (GD), evaluation of clinical and laboratory data, including insulin, leptin and adiponectin in individuals with NAFLD in combination with GD.
Materials and methods.According to the design, we conducted an open comparative study of 169 patients with NAFLD. The following comparison groups were formed: group 1 (n=95) patients with NAFLD without GD, group 2 (n=35) patients with NAFLD and GD and group 3 (n=39) patients with NAFLD, GD and previous cholecystectomy.
Results.A high prevalence of coronary heart disease was found in the group of patients with GD and cholecystectomy (2=6.198,p0.05); positive, statistically significant correlation relationships of cholelithiasis, cholecystectomy with ischemic heart disease (rs=0.172,p0.05 andrs=0.241,p0.05, respectively). There was a statistically significant decrease in total bilirubin and total protein in patients of group 3 (H=7.376,p0.03 and H=6.345,p0.04). The level of leptin is statistically significantly higher and positively interrelated with cholecystectomy (H=5.812,p0.05,rs=0.313,p0.05).
Conclusion.Patients with NAFLD, GD and previous cholecystectomy have a high prevalence of coronary heart disease; the phenomenon of insulin and leptin resistance, high level of adiponectin were revealed in patients with NAFLD and gallstones; hyperleptinemia was observed among patients with NAFLD, GD after cholecystectomy.
Hyperammonaemia in patients with chronic obstructive pulmonary disease and obesity: association mechanisms, detection rate and correction
Authors: Kozhevnikova S. A. , Tribuntseva L. V. , Budnevsky A. V.
Published: June 2020

Chronic obstructive pulmonary disease (COPD) is a world-wide problem. It is characterized by comorbidity. Among the numerous comorbidity obesity is considered. The common pathogenetic factors cause the more severe course of COPD. Obesity is a complex metabolic condition affecting many physiological systems, in particular, the metabolic liver affection is developing in the type of non-alcoholic liver disease. In patients with different stages of non-alcoholic liver disease detoxification function is reduced. Toxic ammonia does not convert in urea. Ammonia begins to affect the whole organism.
Aim.To identify the frequency of hyperammonemia in patients with COPD and obesity, to analyze the degree of its influence on the COPD course and the quality of patients life, to assess the possibility of hyperammonemia correction with L-ornithine L-aspartate (LOLA).
Materials and methods.The study included 50 patients with non-acute COPD (GOLD 2), Group D, phenotype with frequent exacerbations, central-type obesity. At the 1st stage of the investigation, COPD course was evaluated, specific evaluation tests (mMRC, CCQ, CAT, SGRQ, SF-36) were used, the biochemical blood test was performed, hyperammoniemia was detected on a Pocket Chem BA PA-4140, and Number Connecting Test was performed. In the 2ndstage of the investigation, all patients were prescribed a course of treatment with LOLA and after 4 weeks the estimated parameters were compared in dynamics.
Results.After 4 weeks, comparative analysis showed reliable positive dynamics of subjective assessment of weakness, 2 scales of SGRQ questionnaire, all scales of SF-36 questionnaire, as well as reliable reduction of ammonia level by 18.26 mol/l, normal value of Number Connecting Test.
Conclusion.Detection of hyperammoniemia in patients with COPD and obesity and its correction with LOLA seems rational in order to reduce toxic effects of ammonia on organs and systems in this category of patients.
Assessment of the respiratory muscles strength at patients with chronic obstructive pulmonary disease with various forms of comorbidity
Authors: Kurpatov I. G. , Geltser B. I. , Kinyaikin M. F.
Published: June 2020

The respiratory muscles (RM) strength is the main indicator of their functional state. However, RM strength is not used as criteria for chronic obstructive pulmonary disease (COPD) stratification.
Aim. To evaluate the RM power of COPD patients with various variants of comorbidity and to determine the role of comorbidity in the development of respiratory muscle dysfunction.
Materials and methods. RM strength of 64 men with exacerbation of COPD was studied. The severity of comorbidity was assessed by the Charlson index. Depending on the prevalence of comorbidity, patients were divided into 3 groups: cardiovascular, cerebrovascular and metabolic. Maximum inspiratory (MIP) and expiratory (MEP) pressures in the oral cavity, maximum rate of pressure development (MRPD), sniff nasal inspiratory pressure (SNIP), MEP/MIP and SNIP/MIP indexes were determined with MicroRPM device (UK). Measured values of MIP, MEP and SNIP were compared with the proper ones. The most noticeable decrease of RM strength was defined in the group of patients with severe comorbidity.
Results.In case of a mild comorbidity MEP and SNIP values were 68 and 78% of the predicted values and MIP value corresponded to the personified standard. RM strength of patients with COPD depended on the clinical variant of comorbidity. Thus, in the group of patients with cardiovascular variant of comorbidity auxiliary inspiratory muscles strength decreased. In the group of patients with cerebrovascular variant of comorbidity the expiratory muscles dysfunction predominated. In the group of patients with metabolic variant of comorbidity diaphragm dysfunction predominated.
Conclusion. The pathogenetic significance of various factors of COPD comorbidity in the development of RM dysfunction was confirmed by the results of the correlation analysis.
Endothelium-related and neuro-mediated mechanisms of emphysema development in chronic obstructive pulmonary disease
Authors: Brodskaya T. A. , Nevzorova V. A. , Vasileva M. S. , Lavrenyuk V. V.
Published: June 2020

Emphysema is one of the main manifestations of chronic obstructive pulmonary disease (COPD), and smoking is one of the most significant risk factors. The results of studies in humans and animals show the vascular endothelium initiates and modulates the main pathological processes in COPD and smoking is an important factor initiating, developing and persisting inflammation and remodeling of blood vessels and tissues, including the destruction of small respiratory tracts with the development of lung tissue destruction and emphysema. The latest studies describe mechanisms not just associated with the endothelium, but specific neuro-mediated mechanisms. There is reason to believe that neuro-mediated and neuro-similar mechanisms associated and not related to endothelial dysfunction may play the significant role in the pathogenesis of COPD and emphysema formation. Information about components and mechanisms of neurogenic inflammation in emphysema development is fragmentary and not systematized in the literature. It is described that long-term tobacco smoking can initiate processes not only of cells and tissues damage, but also become a trigger for excessive release of neurotransmitters, which entails whole cascades of adverse reactions that have an effect on emphysema formation. With prolonged and/or intensive stimulation of sensor fibers, excessive release of neuropeptides is accompanied by a number of plastic and destructive processes due to a cascade of pathological reactions of neurogenic inflammation, the main participants of which are classical neuropeptides and their receptors. The most important consequences can be the maintenance and stagnation of chronic inflammation, activation of the mechanisms of destruction and remodeling, inadequate repair processes in response to damage, resulting in irreversible loss of lung tissue. For future research, there is interest to evaluate the possibilities of therapeutic and prophylactic effects on neuro-mediated mechanisms of endothelial dysfunction and damage emphysema in COPD and smoking development.
Exacerbation of idiopathic pulmonary fibrosis
Authors: Avdeev S. N. , Gaynitdinova V. V. , Merzhoeva Z. M. , Neklyudova G. V. , Tsareva N. A. , Nuralieva G. S.
Published: June 2020

Idiopathic pulmonary fibrosis (IPF) is usually characterized by a chronic and slowly progressive course. According to several studies, a small number of patients with IPF (about 515%) develops an acute deterioration of deasese exacerbation of IPF. Exacerbations of IPF can occur at any time of the disease and sometimes becomes the first manifestation of IPF. Pulmonary hypertension in IPF is a fairly frequent complication, which leads to severe violations of gas exchange and reduced tolerance to physical stress. Currently, proven effective treatments for exacerbations of IPF do not exist, the management of this condition is based on supportive therapy (oxygen, respiratory support) and interventions with inadequate evidences (corticosteroids, immunosuppressant). During exacerbation of IPF a careful search of all the possible triggers is justified. In the presented clinical case of exacerbation of IPF there was demonstrated the efficacy of complex therapy including antifibrotic therapy, PAH-specific medicines and enhanced oxygen therapy.
Platypnea: оne more type position shortness of breath
Authors: Dvoretskiy L. I. , Rezvan V. V.
Published: June 2020

The article presents modern data on the causes of platypnea, methods of its diagnosis and treatment. The data on the development of platypnea syndrome are given not only in cardiac pathology, but also in severe liver diseases with the development of hepatopulmonary syndrome and chronic obstructive pulmonary disease of a severe course.
UNESCO: bioethical initiatives in 2019
Authors: Chuchalin A. G.
Published: June 2020

The Universal Declaration on Bioethics and Human Rights was adopted at the UNESCO General Conference on October 19, 2005. From today's perspective, it must be recognized that it was adopted at a historically important period in the development of civilization; It has always been seen as a document that significantly expanded the declaration on human rights, as it gave a new interpretation of human activity in modern society. Next year marks 25 years of active implementation of the main provisions of the declaration in the field of education, research and cultural heritage. Scientific ideas about the world were changing dynamically, new pedagogical technologies developed, society more than ever began to perceive cultural heritage more acutely. Under the influence of these processes, our ideas about moral values ​​and ethical principles changed. An idea of ​​bioethics has formed; The term implies versatile human activities, including not only the doctor-patient relationship, but also the active participation of a person in the field of industry, climate change, as well as new areas such as editing the human genome, transplantology and much more.
Delayed coronary obstruction of the left main artery after transcatheter aortic valve replacement
Authors: Komlev A. E. , Lepilin P. M. , Kurilina E. V. , Romakina V. V. , Imaev T. E.
Published: June 2020

Coronary arteries obstruction associated with transcatheter aortic valve implantation (TAVI) may occur either during the procedure or after it. In the latter coronary obstruction can be further divided into early (7 days after procedure) or delayed one (7 days). Delayed coronary obstruction (DCO) is referred as a rare but devastating complication after TAVI and is associated with the extremely high mortality. This case demonstrates the objective difficulties of timely diagnostics of DCO. Since the results of non-invasive methods are indetermined in most cases, the authors conclude that even low-specific clinical symptoms must be interpreted as the definite rationale for the implementation of invasive diagnostic and treatment strategy.