bluuebunny/crossref_metadata_2025 huggingface dataset:
Variabilty of arterial pressure and renal function
Authors: Kravchenko A. Ya. , Chernykh Anna A. , Budnevsky A. V.
Published: November 2020

This review deals with variability of arterial pressure (VAP) as an adverse factor contributing to the development and progression of cardiovascular diseases and renal pathology. VAP has recently attracted much attention in connection with results of ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) showing that VAP is a risk factor of stroke and other complications of arterial hypertension (AH).The relationship between VAP and renal function remains unexplored and is considered to be a vicious circle in which kidneys are both a cause of AH and its target organs. Evidently, elucidation of the relationship between enhanced VAP and renal function is of primary importance.
Chronic hepatitis with double B/C infection: virological, clinical, morphological characteristics
Authors: Dudanova Olga P. , Shubina M. E. , Belavina I. A. , Elpaeva E. A. , Pisareva M. M. , Grudinin M. P. , Kiselev O. I.
Published: November 2020

Aim. To estimate the frequency, virological and clinical characteristics of chronic viral hepatitis (CVH) with double B/C infection. Materials and methods. We examined 282 patients with CVH. Genomes of hepatitis B virus (HBV) and hepatitis C virus (HCV) were studied by PCR in blood and liver (AmpliSens HBV and Amplisens HCV, Russia), nuclear proteins (HBcorAg HBV and NS3 HCV) were determined by immunohistochemical method (Novocastra, UK), HBV genome was sequenced by the Sanger method using ABI prism BigDye Terminator v3.1 kits and ABIPRISM 3100 analyzer (AppliedBiosystems, USA). Indices of histological activity (HAI), fibrosis, and portal vein (PV) congestion index (CI) were calculated by formula CI=SBB/LBV, where S is PV cross section area in cm2 and LBV - linear blood flow velocity in cm/s (Vivid Pro-7 apparatus, USA). Results. CVH with double B/C infection was diagnosed in 85 (30.1%) patients including 44.7% with viral genomes and proteins in the liver, 42.4% with HCV viremia, and 12.9% with HBV/HCV viremia. Maximum CVH activity was documented in patients with latent HBV/HCV viremia (ALT 157.2±59.2 U/l, HAI 11.6±1.3, fibrosis 2.8±0.7, CI 0.059±0.005); it was minimal in patients without viremia (Alt 76.25±63.0 U/l, HAI 6.7+-0.6, fibrosis 1.7±0.5, CI 0.042±0.001; p <0.05). Patients with latent HBV infection had precore/ore and pres/s mutations in HBV genome and cytoplasmic localization of HBcorAg. Conclusion. Double B/C infection was diagnosed in 30.1% of the patients with CVH dominated by HCV. Patients with latent HBV had precore/ore and pres/s mutations. The highest intensity of hepatic cellular inflammation, fibrosis, and PV congestion was associated with HBV/HCV viremia and the lowest with intrahepatic localization of both viruses.
Conflict of interests as a problem of evidence-based medicine
Authors: Arpent’eva Mariyam R.
Published: November 2020

The role of ideology (principles) of evidence-based medicine in prophylaxis and correction of conflict of interests in various spheres of medicine and socio-medical assistance is considered. Professional ethics formed in the course of education and undergoing modification under conditions of real practical work is a main sphere of medical and related edological practices associated with conflicts of interests. Of special importance are principles of bioethics based on the requirements of evidence-based medicine. The role of evidence-based medicine in prophylaxis and resolution of conflicts of interests is related to the training and re-training of specialists, prevention and correction of their professional degradation and deformation in the course of practical clinical work. Analysis of primary and secondary motives underlying occupational out. activities and their role in the formation of the conflict of interests was carried
Arterial hypertension as a risk factor of intra-atrial thrombosis in patients with atrial fibrillation of non-valvular etiology
Authors: Grontkovskaya Alevtina V. , Borovkov N. N. , Amineva N. V.
Published: November 2020

The article considers the influence of arterial hypertension on the frequency of intra-atrial thrombosis in patients with atrial fibrillation (AF) of non-valvular etiology. Materials and methods. 38 patients were examined (26 men and 12 women) aged 35 to 75 years with documented AF. Paroxysmal AF was diagnosed in 10 patients (26.32%). The persistent and permanent forms of arrhythmia were revealed in 14 cases (36.84%). Stage II-III hypertensive disease (HD) was diagnosed in 27 patients (71.1%). The transthoracic and transesophageal echocardiography was performed with the use of ultrasonic devices such as Aloka-SSD-4000 ProSound (Japan) and PhilipsIE 33 (USA). Results. The analysis of results of echocardiography (both transthoracic and transesophageal) made it possible to detect intra-atrial clots in 54,8% of the patients with AF of non-valvular etiology. Atrial cavity thrombosis was registered in 15 of the 22 cases (68,2%) among the patients with hypertension as a direct cause of AF or another concomitant pathology. Lower blood flow velocity from the left atrial appendage was registered in hypertensive patients compared to those without hypertension - 29.0 (4.2) and 35.4 respectively (8.1) mm/s (p = 0.038; Student's t-test). The reduction of the peak bloodflow velocity in the left atrial appendage was proportional to the increase of hypertension (R = -0,861; p <0,001; R - Spearman's coefficient). The frequency of intra-atrial thrombosis did not depend on the form of atrialfibrillation and duration of the arrhythmic anamnesis. Conclusion. Hypertension is an independent predictor of thromboembolic complications in atrial fibrillation of non-valvular etiology.
The problem of classification and organization of medical care for diabetic patients with different forms of ulcerative-necrotic lesions of lower extremities
Authors: Udovichenko Oleg V.
Published: November 2020

Patients with diabetes mellitus (DM) are at risk of development of both diabetic foot syndrome and ulcers on the lower legs due to chronic venous insufficiency and other factors. The main group in this study was comprised of diabetic patients with ulcers of different etiology (venous, post-traumatic, mixed) treated at the Diabetic Foot Cabinet during 5 years (n=101). The group of comparison included simultaneously treated patients with diabetic foot syndrome (n=721). Patients of the main group was dominated by women (71%) and patients with type 2 DM. Ulcer healingdue to the treatment, persistent non-healing ulcers, and high-level amputations occurred equally often in the two groups: 60 and 58%, 18 and 15%, 4 and 5% respectively (р>0,05). Lower leg ulcers in DM are very persistent and constitute a serious medico-social problem to be addresses based at Diabetic Foot cabinets. The frequency of such ulcers and related amputations must be taken into consideration in epidemiological surveys.
Selflessness of besieged Leningrad: problems of motherhood and childhood (on the occasion of the 72nd anniversary of lifting the siege)
Authors: Simonenko V. B. , Abashin Victor G. , Aleksandrov A. S.
Published: November 2020

A yeview of documents on the peculiayities of obstetyic and gynecological caye in besieged Leningyad is pyesented with special yefeyence to the data about the numbey of childyen boyn duying blockade and theiy health status in the fiyst months of life, the woyk of maternity hospitals, theiy numbey and peysonnel. The teym «militayy time amenoyyhea» coined duying blockade is discussed.
C-reactive protein as an indicator of risk of cardiovascular complications in patients with type 2 diabetes mellitus and its correction
Authors: Stryuk Raisa I. , Sviridova M. I. , Mkrtumyan A. M. , Golikova A. A.
Published: November 2020

The study included 74patients (22 men and 52 women) aged 48-75yr with type 2 diabetes mellitus (DM2). 62 (88,6%) of them had grade II hypertensive disease (grade II-III by the WHO/ISH-2010 classification), 46 (67%) presented with II- III class functional stable angina of effort, 7 patients survived myocardial infarction, two ones underwent coronary artery stenting. Patients of the main group (n=50) received oral hypoglycemic agents in combination with 1-exenatide (mimetic of glucagon-like peptide) in the form of two daily subcutaneous injections of 5 mcg for 1 month and 10 mcg during the next 5 months. Control patients (n=20) were given standard hypoglycemic therapy. Analysis of highly sensitive CRP demonstrated its increase to 3 mg/l and more in 72.8% of the patients that was responsible for the high risk of cardiovascular disorders. 22,8% of the patients had a CRP level 1,0-2,9 mg/l (moderate risk) and only in 4,2% it was lower than 1 mg/l (low risk). Six months of exenatide therapy resulted in normalization of glycemia, glycated hemoglobin and significant decrease of CRP level which suggested the improvement of the functional state of vascular endothelium due to reduction of chronic inflammation objectively reflected in the highly sensitive CRP level.
Early diagnosis of stress-induced hypertension in young employees of state law enforcement agencies
Authors: Evsevyeva Mariya E. , Ivanova L. V. , Sergeeva O. V. , Orechova N. V.
Published: November 2020

Psychoemotional stress is one of the leading cardiovascular risk factors. The aim of this study was to explore manifestations of arterial hypertension (AH) in young men employed in the stress associatedfield works. Material and methods. A total of 68 young men, exposed to job stress (JS) of different severity during 1 to 5 years were surveyed. The control group was formed of persons whose daily work was unrelated to operational activities. The study included ambulatory monitoring (AM) blood pressure (BP) on different days of the week, comparing the results of the office and DMBP determination and assessment of resistance to a variety of diagnostic loads. Results. The study revealed an increase of AMBP indicators during the working day and their normalization at weekend. The comparison of the results of office and ambulatory determination of BP demonstrated that different forms of stressful AH (stable, isolated office and latent) occurred significantly more often than in the control group. These changes almost completely disappeared at weekends. The tolerance ofpsychoemotional testing was much worse than that of traditional exercises. It is proposed to more extensively use AMBP during regular medical examinations of young men exposed to JS in order to establish a timely differential diagnosis of various forms of stressful hypertension.
Algorithm of management of patients treated with amiodarone depending on thyroid functional state
Authors: Kryukov E. V. , Potekhin N. P. , Fursov A. N. , Chernavsky Sergei V. , Lyapkova N. B. , Zakharova E. G. , Makeeva T. G.
Published: November 2020

Cardiac arrhythmias are common symptoms of various cardiovascular diseases. Currently, amiodarone is considered to be one of the most efficient and safe antiarrhythmic drugs. Long-term use of amiodarone having the chemical structure similar to that of thyroxine can cause disturbances in the functional state of the thyroid gland. 32 (6.9 percent) of the 462 patients who used the drug for more than six months developed amiodarone-associated thyrotoxicosis and 11 (2,5%) one amiodarone-associated hypothyroidism. Most patients with hyperthyroidism, 22 (68,8%), did not have any structural pathology of the thyroid gland, 8 (25%) presented with CKD euthyroid goiter and 2 (6.2%) with chronic autoimmune thyroiditis. The authors propose a modified algorithm of preventive measures for patients with rhythm disorders receiving long-term amiodarone. Assessment of basal metabolism and the structure of the thyroid gland before and during therapy will allow to adequately monitor adverse events and carry out the necessary corrective treatment.
The use of cytokeratin-18 fragments in diagnostics of non-alcohol fatty liver disease
Authors: Shipovskaya A. A. , Kurbatova I. V. , Dudanova Olga P.
Published: November 2020

Aim. To evaluate the value of cytokeratin-18 fragments (CKF-18) for diagnostics of non-alcohol fatty liver disease (NAFLD): liver steatosis (LS) and steatohepatitis (SH). Material and methods. We examined 148 patients with NAFLD (94 men, 49 women) including 28 (19.6%) with LS and 115 (80.4%) with SH (mean age 48.85±10.36 and 48.6±12.0 years respectively). The diagnosis was verified based on clinical, ultrasonic, and liver biopsy (in 17 (12.0%) patients) data. CKF-18 were measured by the immunoenzyme assay (TPS ELISA,Biotech, Sweden) and TNF-alpha with the use of a Human TNFα Platinum ELISA kit (Bioscience, Austria). Control group consisted of 27 healthy donors. Results. CKF-18 level in SG patients (420.5±426.9 U/l) was significantly higher than in LS patients and healthy subjects (126.13±48.0 and 129.27±59.78 U/l respectively). TNF-alpha levels were 6.28±0.5, 5.15±0.6, and 4.81±0.7 pg/ml respectively (p<0,05). Correlation of CKF-18 levels with the following parameters was documented : ALT (r=+0,45, p<0,05); AST (r=+0,43, p<0,05), triglycerides (r=+0,25, p<0,05), HDLP (r=-0,21, p<0,05), histological activity index (r=+0,46, p<0,05). No correlation was found between CKF-18 and TNF-alpha levels or between CKF-18 and severity of fibrosis. Conclusion. CKF-18 levels in SH patients are significantly higher than in LF patients and correlate with histological signs of SH activity. Measurement of TNF-alpha can be used for differential diagnostics of SH and LF. Significant elevation of aminotransferase activities and CKF-18 levels in SH compared with LF and their close correlation confirms the important role of necrosis and hepatocyte apoptosis in pathogenesis of NAFLD.
Pituitary adenoma apoplexy
Authors: Tereshchenko Irina V.
Published: November 2020

We present 3 cases of pituitary adenoma apoplexy in young women (one microadenoma and two macroadenomas). The possible risk factors, clinical presentation and outcome of pituitary apoplexy are discussed. Diagnostic errors as regards pituitary adenoma apoplexy are analyzed.
Kyoto consensus - the new etiological classification of chronic gastritis and its discussion
Authors: Tsimmerman Yakov S. , Zakharova Yu. A.
Published: November 2020

The main provisions and headings of the new etiological classification of chronic gastritis are discussed in the context of recent data on the true role of Helicobacter pylori infection in the development of this pathology. The methods and results of the authors ’ investigations into gastric microflora are presented along with information about the frequency of detection of its different forms, concentration of microbial forms in gastric mucosa, their pathogenic properties including urease activity, and possible contribution to chronic gastritis etiology. The possibility of alcoholic and chemical chronic gastritis is discussed along with the role of these conditions in the development of stomach cancer. Special emphasis is laid on the disagreement between the adopted consensuses and principles of evidence-based medicine.
Anemia of chronic
diseases as a systemic manifestation of chronic pulmonary obstructive disease
Authors: Budnevsky A. V. , Voronina E. V. , Ovsyannikov E. S. , Tsvetikova L. N. , Zhusina Yu. G. , Labzhaniya N. B.
Published: November 2020

Anemia of chronic disease (ACD) is one of the most frequent forms of anemia is often observed in patients with infections, cancer and chronic inflammatory or autoimmune diseases. The underlying mechanisms are complex and include dysregulation of iron homeostasis and erythropoietin production, impaired proliferation of erythroid progenitor cells and reduced life span of red blood cells. Moreover, ACD is often superimposed by malnutrition, bleeding and renal failure. ACD is mediated through inflammatory cytokines and characterized by low serum iron (hypoferremia) and often increased reticuloendothelial stores of iron. ACD is usually normocytic, normochromic anemia, but it can become microcytic and hypochromic as the disease progresses. Hepcidin, the main regulator of iron homeostasis and its synthesis, is inhibited by iron deficiency and stimulated by inflammation. In many patients the disease is associated with several extrapulmonary manifestations regarded as the expression of the systemic inflammatory state of chronic obstructive pulmonary disease (COPD). Recent studies showed that anemia in patients with COPD is more frequent than expected, with its prevalence ranging from 8 to 33%. Systemic inflammation may be an important pathogenic factor, but anemia in COPD can also be the result of a number of factors, such as the treatment with certain drugs (angiotensin-converting enzyme inhibitors or theophylline), endocrine disorders, acute exacerbations and oxygen therapy. Anemia in COPD patients is strongly associated with increased functional dyspnea, decreased exercise capacity and is an independent predictor of mortality. Treatment options to correct anemia used in other chronic diseases, such as congestive heart failure, cancer or chronic kidney disease have not been explored in COPD (i.e. erythropoietic agents, iron supplements or combined therapy). It is not known whether treating the underlying inflammation could improve hematological characteristics. It is important to develop basic diagnostic modalities for this group of patients and formulate methods of anemia correction.
Co-morbid pathology: coronary heart disease and gastroesophageal reflux disease
Authors: Yusupova A. O. , Kozhevnikova M. V. , Belenkov Yu. N. , Privalova E. V.
Published: November 2020

The article presents data of domestic and foreign authors illustrating current views of mechanisms underlying development, pathogenesis, and difficulties of differential diagnostics of coronary heart disease (CHD) concurrent with gastroesophageal reflux disease (GERD). High prevalence of both conditions and their common risk factors are responsible for frequent occurrence of co-morbidity. The available data suggest positive effect of treatment with proton pump inhibitors (decreased frequency of myocardial ischemia and heart arrhythmia). Co-morbidity of CHD and GERD requires long-term treatment and the use of safe medications having no adverse effects on the course of CHD.
The pathogenetic role of cerebral hyperthermia in brain lesion
Authors: Shevelev O. A. , Butrov A. V. , Cheboksarov D. V. , Khodorovich N. A. , Lapaev N. N. , Pokatilova N. S.
Published: November 2020

Cerebral hyperthermia is a factor of pathogenesis of secondary brain injury. Microwave recording of temperature allows to identify thermal anomalies in the brain while craniocerebral hypothermia arrests their development. Craniocerebral hypothermia has marked neuroprotective effects in patients with brain lesions.
The system of provision of emergency medical aid to patients with acute myocardial infarction; the 30 year experience
Authors: Garganeeva A. A. , Okrugin S. A. , Borel K. N. , Kuzheleva E. A.
Published: November 2020

Aim. The aim of the study was to compare characteristics of the prehospital stage of acute myocardial infarction (AMI) in the residents of Tomsk in 1984 and, 30 years later, in 2013. Materials and methods. The study was based on the materials of research and information database of the WHO epidemiology program “Acute Myocardial Infarction Register” that has been operating in Tomsk since 1984. A total of 713 and 832 AMI cases, registered in 1984 and 2013 respectively were analyzed. The analysis did not include episodes of patient’s death at the prehospital stage. Results: The study revealed a significant increase in the number of AMI patients seeking medical help during the first hours and the first days after onset of the disease, improvement in the quality of AMI diagnosis by primary care physicians, and a significant increase in the number of patient hospitalized within the first six hours and the first days from initial medical examination. All these factors were responsible for a significant increase in the number of AMI patients admitted to the specialized cardiology department within the first six hours and the first days after the onset of AMI. Conclusion. Despite positive dynamics of certain parameters characterizing the system of emergency medical care for AMI patients at the prehospital stage in Tomsk, its activities during the period of interest cannot be considered satisfactory due to untimely provision of medical aid to many AMI patients and the unacceptably low hospital admission rate especially during the first hours after the onset of AMI. Further optimization of preventive health education at the population level is required to improve medical awareness first of all in regard to early clinical manifestations of AMI.
Evaluation of the quality of life in patients with chronic obstructive pulmonary disease in combination with cardiovascular disease.
Authors: Nizov A. A. , Abrosimov V. N. , Vyunova Anna N. , Ponomareva I. B.
Published: November 2020

This article reports the results of evaluation of the quality of life in patients with chronic obstructive pulmonary disease (COPD) and its combination with coronary heart disease (CHD) or essential hypertension (HD) based on the SF-36 questionnaire designed for the non-specific assessment of the patient's quality of life and widely used in clinical studies to characterize theirgeneral well-being and the degree of satisfaction with those aspects of human activity that affect health. SF-36 consists of 36 questions, grouped into eight scales: physical functioning, role-playing activity, bodily pain, general health, vitality, social functioning, emotional well-being and mental health. The scales are combined in such a way that the higher the value (from 0 to 100) the better results of evaluation based on a given scale. They were used to derive two parameters characterizing psychological and physical components of health.
The influence of ARVI and influenza treatment start time on the dynamics of clinical symptoms and outcomes of the diseases (the results
of the international cohort observational study FLU-EE)
Authors: Sitnikov I. G. , Fazylov V. H. , Silina Ekaterina V. , Shevchenko S. B. , Malyshev N. A. , Yeganyan G. A. , Groppa L. G. , Korsantia B. M.
Published: November 2020

Objective - assessment of the influence of the start time of antiviral therapy of acute respiratory viral infection (ARVI) and influenza on dynamics of clinical symptoms and outcome of the disease. Material and methods.The data on 18,946 patients aged 18 to 93 years with previously established clinical diagnosis of ARVI or influenza were obtained and analyzed in the framework of an international multicenter open prospective observational study. The patients were divided into 2 groups: those in the control group received symptomatic treatment without the use of antiviral drugs and patients of group 1 (main group) were given the antiviral drug Kagocel a component of combined therapy. The clinical symptoms, bacterial aggravations, efficacy and safety of prescribed therapy (including antibiotics) were assessed. Results. About a quarter of patients (23.2%) with ARVI and influenza did not seek professional medical help with in the first 24-48 hours after onset of the disease and started treatment on the 3rd day or later. The most common symptom of ARVI or influenza in the first 24-48 hours was hyperthermia that was followed during the next 72 hours or more (in the absence of adequate treatment) by other symptoms, such as coughing the severity of which correlated with the development of bacterial aggravations most often diagnosed on day 5. Administration of interferon inducer Kagocel resulted infaster normalization of body temperature than in the control group regardless of the time of onset of drug administration (both at early and late treatment start time). Therapy with Kagocel led to significant regression of the clinical symptoms of the disease as early as days 2 and 3 with the reduction of the frequency of bacterial aggravations from 13% to 7.9%. The frequency of complete recovery by the 3rd visit was 70.8% in the control group and 77.9% in the main group. The study demonstrated the inexpediency of prophylactic antibiotic treatment for ARVI and influenza (complete recovery rate decreased by 6%) as well as the ambiguity of positive antibiotic effectsonthe outcomeof complications (complete recovery only in 57.7% cases vs 77.4% in the absence of antibiotics). Conclusion. The absence of antiviral treatment for ARVI and influenza is a wrong tactic leading to prolongation of the disease and increased frequency of aggravations. The earlier the antiviral treatment starts, the milder the symptoms are, the lower the aggravation rate is and the earler complete recovery comes. It was shown on a large cohort of patients that administration of antiviral drug Kagocel is effective in case of both the early (24-72 hours after the onset of the disease) and late (72 hours and later) beginning of the treatment.
The influence of
omega-3 polyunsaturated fatty acids on atrial fibrillation development after surgical myocardial revascularisation
Authors: Rubanenko Olesya A. , Fatenkov O. V. , Khokhlunov S. M. , Semagin A. P. , Kuznetsov D. V. , Limareva L. V.
Published: November 2020

Aim. To estimate the influence of short-term omega-3 polyunsaturated fatty acids (PUFA) treatment on the development of new cases of atrial fibrillation (AF) in patients with coronary artery disease after coronary artery bypass grafting (CABG) with the detection of indicators of inflammation, oxidative stress, myocardial injury or dysfunction. Material and methods. The patients did not receive statins at the stage of out-patient treatment. Interleukin (IL)-6, IL-8, IL-10, C-reactive protein (CRP), fibrinogen, troponin, NT-proBNP, superoxide dismutase (SOD), myeloperoxidase (MPO) levels were measured on admission and 3.6±1.3 days after CABG. All the patients were divided into two groups: group 1 comprised patients who did not receive omega-3 PUFA (51 patients, 86.3% males, mean age 62.8+4.0), 2 group included patients who received PUFA (51 patients, 90.2% males, mean age 62.1±4.0 years) 5 days (mean) before CABG at an average dose 2 g per day and for 3 weeks after CABG at an average dose 1 g per day. Results. Postoperative AF more often occurred in group 1 (41.2% vs 23.5%; p=0.04 ( mean 4.8±3.0 days). The patients of group 1 more often had FC-III angina pectoris (60.8% vs 51.0%, p=0.04), whereas patients of group 2 more often had the history of myocardial infarction (78.4% vs 58.8%, p=0.03) and respiratory pathology (23.5% vs 2.0%, p=0.0009). According to univariate regression analysis, omega-3 PUFA intake was associated with a decrease of new episodes of AF at the early postoperative period (odds ratio (OR) 0.66; 95% confidence interval (CI) 0.43-0.9; p=0.04). IL-6 levels were significantly higher in pre- and postoperative periods in patients of group 1 (34.8±25.5 pg/ml vs 2.9±2.5 pg/ml, p<0.0001; 54.6±44.9 pg/ml vs 39.5±29.7 pg/ml, p=0.04, respectively). Before CABG, SOD levels in both groups were higher than normal (group 1 - 3478.6±2365.7 units/g vs group 2 - 2893.4±2365.7 units/g, p>0.05). After CABG, SOD levels became lower in both groups but remained significantly higher in group 1 (2311.8±1371.6 units/g vs 662.5±572.4 units/g, р<0.0001). MPO after CABG was insignificantly raised in group 1 (before CABG - 176.8±83.8 mg/l, after CABG - 212.5±131.8 mg/l) and lowered in patients with omega-3 PUFA intake (280.4±202.1 before and 235.3±147.6 after CABG). Conclusions. The study showed that omega-3 PUFA intake in perioperative period of CABG leads to a significant decrease in occurrence of new AF cases. The patients who received omega-3 had lower IL-6 levels as a proinflammatory factor and SOD level as a marker of oxidative stress.
Markers right ventricular diastolic dysfunction in patients with pulmonary hypertension.
Authors: Sumin Alexey N. , Arhipov O. G.
Published: November 2020

Objective. To study the indices of the right ventricle filling (RV) in patients with pulmonary chronic pathology with and without pulmonary hypertension (PH). Material and methods. 244 people were examined (181 male; age 63.5 [61,0-71,0] years) The study included patients with pathology of respiratory organs without PH (n = 139), patients with echocardiographic signs of PH (n = 45) and healthy people as a control group (n = 60). At an echocardiography evaluated tricuspid blood flow parameters: peak early diastolic flow velocity (Et), the flow of atrial systole (At), indicators of spectral tissue Doppler of the tricuspid valve ring (e't, a't, e't/a't). We assessed the frequency of detection of RV diastolic dysfunction using the ratio Et/t, ratio Et/e't and the propagation velocity of the tricuspid flow (Vpt). Results. The incidence of the main markers of RV diastolic dysfunction was 18.7% in the control group, 27.8% in the group of patients with pulmonary pathology without symptoms of PH and 35% in patients with PH. Vpt reduction <35 cm/sec, was found in 12.2%, 49.5% and 64.6% of patients, respectively. When used together, the markers incidence of diastolic dysfunction of RV in the control group was 27% in patients without lung pathology PH - 57.6%, and patients with the presence of PH - 75.9%. Conclusion. RV diastolic dysfunction in patients with pulmonary pathology manifests itself not only the deterioration of its main markers, but to a greater degree to reduce the spread of its filling flow rate. With the development of PH noted a further decline of this indicator. The combined use of key indicators and the propagation velocity of the tricuspid flow can improve the detection of RV diastolic dysfunction in diseases of the lungs before the development of PH.
The objective assessment of operational risk in elective surgery.
Authors: Kuznetsov Nikolay A.
Published: November 2020

The problem of the objectification and quantification of risk can be solved only on an interdisciplinary level. The philosophical definition of the concept «risk» fundamentally changed the perception of this complex and ambiguous phenomenon, interdisciplinary approach contributed to the formation of a simple and effective classification of perioperative criteria. With the help of mathematical and statistical analysis it became possible individual operational prognosis in planned surgery.
-455A allele of FGB gene in differential diagnostics of acute infective endocarditide and sepsis.
Authors: Mal’tseva Nina V. , Laputenko T. A. , Smirnova A. Sh. , Gorbatovskii Y. A. , Nikiforov V. V. , Dadyka I. V.
Published: November 2020

Formation of infective endocarditis (IE), i.e. septic thrombosis of the endocardium may depend on the genetically determined thrombophilia. The aim of this work was the search for the genetic markers of IE in the hemostatic system. 67 patients (20 women and 47 men) with IE, including 35 men and 12 women with acute and 12 men and 8 women with subacute forms of the disease, and 61 patients (28 women и 33 men) with sepsis were genotyped on polymorphic loci -455G-A in the beta-fibrinogen gene (FGB), Leu33Pro in the integrin beta-3 gene (ITGB3), Ala222Val (C677T) in the methylenetetrahydrofolate reductase gene (MTHFR) by allele-specific polymerase chain reaction. The association of single nucleotide polymorphisms, -455G-A of FGB gene and Ala222Val of MTHFR gene, with the risk of development of acute IE was revealed in comparison with sepsis. The greatest (11-fold) risk was found in male patients of different ages bearing the genotype -455A-A of the β-fibrinogen FGB gene. Thus, a susceptibility to thrombus formation, dependent on hemostasis genes, can promote the development of acute infective endocarditis.
Pirogov in the caucasus (To the 170th anniversary of the use of ethereal anesthesia in military field conditions).
Authors: Manyshev S. B. , Manysheva Xenia В.
Published: November 2020

The article is devoted to the jubilee of Nikolai Ivanovich Pirogov’s stay in the Caucasus. Based on a wide range of literature and the first time archival sources introduced into scientific circulation, the authors gave a brief outline of the development of anesthesia in world medical practice. The variants and cases of etheric anesthesia in the Caucasus in the field are described in detail. The article also reflects the difficulties that Nikolai Pirogov encountered when introducing etheric anesthesia into medical practice. The authors point to the criticism that sounded towards Nikolai Pirogov and his methods both from the lips of medical colleagues and ordinary military men. Particular attention is paid to innovative proposals in the field of medical care in military field conditions. One of Nikolay Pirogov’s earlier notes on the organization of medical aid on the battlefield is analyzed, in which the surgeon describes a fundamentally important and new method for sorting the wounded. It was thanks to the tireless work of the great surgeon in the Caucasus that ethereal anesthesia began to be introduced throughout the Russian Empire, which greatly facilitated both the work of doctors and the fate of patients. At the same time, he points out those restrictions, which, according to N.I. Pirogov had to be observed during the application of anesthesia in the military field: this is a closer monitoring of patients, as well as the uninterrupted supply of medical services to medicines. The result of N.I. Pirogov in the Caucasus was the lifting of restrictions on the use of inhalation anesthesia in Russia.
Current approaches to diagnosis and prevention of ishemic stroke.
Authors: Kutlubaev M. A. , Khasanova E. N.
Published: November 2020

Etiology ofembolic stroke is very heterogeneous. It could be related to large vessel disease, small vessel disease, thromboembolism of cardiac origin. Clarification of etiology of stroke is important prerequisite for adequate selection of its secondary prevention measures. Standard work-up allows identification of its etiology in 60-90% of cases. 1n the rest 10-40% of cases stroke is considered cryptogenic. The majority of cryptogenic strokes are embolic. In keeping with this, a concept of embolic stroke of undetermined source (ESUS) was suggested. 1n the paper authors review most sigificant causes of ESUS. Occult atrial fibrillation is one of the common cause of ESUS. 1t could be detected only by means of long term ECG monitoring. Standard 24-hour ECG monitoring after stroke detects around 5% of cases ofpreviously unknown paroxysmal atrial fibrillation, while long-term monitoring of ECG allows detection ofparoxysmal atrial fibrillation in 15% of cases. Patent foramen ovale could lead to stroke in patients with deep vein thrombosis in the legs and pelvis due to paradoxical embolism. Atherosclerosis of aortic arch is observed in the half ofpeople older than 45 years. Large, ulcerated, non-calcified or floating atheromas could cause a stroke. Malignant tumors could lead to cerebral embolism through non-bacterial thrombotic endocarditis. Tumor embolism into cerebral arteries could also be seen in rare cases. The rate of cerebral embolism is high in mixomas. Approaches to diagnosis and secondary prevention of ESUS are discussed in the paper.
Severe alcoholic hepatitis: why do we know a lot, but can do so little?
Authors: Buyeverov A. O. , Syutkin V. E. , Bogomolov P. O.
Published: November 2020

Severe alcoholic hepatitis (SAH) is characterized by high both immediate and long - term mortality, caused by these patients ’ a special form of liver failure development which is acute on the background of chronic one (acute-on-chronic liver failure). Steatosis, oxidative stress, increased permeability of the intestinal wall, the formation of toxic metabolites and the cytokine cascade are considered to be the main pathogenetic elements of the SAH. The course of SAH is accompanied by the so-called liver-associated immunodeficiency, which is associated with a high risk of fatal infectious complications, causing up to А of all deaths. This variant of immunodeficiency is characterized by hyperactivation of some elements of the immune system along with suppression of the activity of others. Despite advances in the study of pathogenesis, today the only therapeutic agent affecting the survival of patients with SAH are corticosteroids. A significant improvement in prognosis in the absence of response to corticosteroid therapy can only be achieved by performing an urgent liver transplant. Currently, several new treatment options for patients with SAH are being developed. We believe that selective influence on key immunopathological processes deserves special attention.
Risk factors of arterial hypertension in patients with nonalcoholic fatty liver disease.
Authors: Sevostyanova E. V. , Polyakov V. Ya. , Nikolaev Yu. A. , Mitrofanov I. M.
Published: November 2020

Purpose of the study. To study frequency of occurrence and values ofparameters of the main risk factors for cardiovascular diseases in patients with hypertension in combination with non-alcoholic fatty liver disease. Material and methods. The analysis of 17,202 medical cards of patients (6,730 men, 10,472 women), which were examined and treated in the clinic of the Scientific Research Institute of Experimental and Clinical Medicine, Novosibirsk, was carried out. Of them - 3,087patients with arterial hypertension (AH), combined with non-alcoholic fatty liver disease (NAFLD) (main group); 13,384 patients with isolated arterial hypertension; 731 patients with NAFLD (comparison groups). According to the clinical and laboratory examination, the following risk factors were assessed: high blood pressure, obesity, elevated blood levels of total cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, uric acid, a low content of high-density lipoprotein cholesterol in the blood. Results. In patients with hypertension combined with NAFLD, in comparison with patients with isolated diseases, an increase in the values of the indices determining the main modifiable risk factors for cardiovascular diseases (hypertension, obesity, hyperglycemia, hypercholesterolemia, hyperuricemia) was revealed. Similar changes were detected in both men and women. Conclusion. An important role of risk factors for cardiovascular diseases, which together represent the clinical manifestations of the metabolic syndrome, has been identified in the development of comorbid pathology - AH and NAFLD. The data obtained indicate the need for differentiated, personified prevention and treatment of patients with this comorbid pathology with mandatory identification and correction of modifiable risk factors for cardiovascular diseases.
A critical analysis of antithrombotic strategy in the acute period of ischemic stroke
Authors: Shirokov Evgeniy A. , Lomakin N. V. , Buryachkovskaya L. I.
Published: November 2020

The article is a critical review of the current literature on the issue of antithrombotic therapy in the acute phase of ischemic stroke. Despite the overall pathogenesis today, there are significant differences in the antithrombotic strategy used in acute coronary syndrome and ischemic stroke. Although reperfusion therapy is the most effective method of treatment of patients with thrombotic occlusion of the arteries of the heart or brain, only about 5% of neurological patients receive intravenous thrombolysis tissue plasminogen activator. In emergency neurology unused opportunities of platelet antiplatelet agents last generations, not appointed anticoagulants. The article examines issues of interdisciplinary collaboration and perspectives of modern antithrombotic strategies in neurology from the point of view of the neurologist, cardiologist and expert on antithrombotic therapy.
Educación en y para el ejercicio y protección de los DDHH de los niños y las niñas proyecto “tu crecer con dignidad” Samacá
Authors: Naranjo Guio Dahiana Saray
Published: November 2020

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INTERNET FINANCIAL REPORTING: STUDI KOMPARASI ANTARA ASURANSI JIWA SYARIAH DAN ASURANSI UMUM SYARIAH DI INDONESIA
Authors: Salfia Salfia , Suprayogi Noven
Published: November 2020

ABSTRAKTujuan penelitian ini adalah untuk mengetahui perbedaan Kualitas Pelaporan Keuangan Internet antara asuransi jiwa syariah dan asuransi umum syariah di Indonesia. Indeks IFR terdiri dari empat komponen yaitu, konten, ketepatan waktu, teknologi dan dukungan pengguna. Penelitian ini menggunakan pendekatan kuantitatif dengan uji independent sample t-test. Hasil penelitian ini menunjukkan bahwa tidak ada perbedaan yang signifikan dalam Kualitas Pelaporan Keuangan Internet antara asuransi jiwa syariah dan asuransi umum syariah. Tidak adanya perbedaan tersebut disebabkan tidak adanya perbedaan yang signifikan antara kualitas konten, ketepatan waktu, teknologi dan dukungan pengguna IFR antara Asuransi Jiwa Syariah dan Asuransi Umum Syariah di Indonesia. Namun hasil yang diperoleh bahwa asuransi jiwa syariah dan asuransi umum syariah masih belum memberikan kualitas pelaporan keuangan internet yang maksimal atau masih di bawah skor rata-rata 50%.Kata kunci: Pelaporan Keuangan Internet, konten, ketepatan waktu, teknologi, dan dukungan pengguna ABSTRACTThe purpose of this study was to determine the differences in Internet Financial Reporting Quality between sharia life insurance and sharia general insurance in Indonesia. IFR index consists of four components namely, content, timeliness, technology and user support. This research uses a quantitative approach with an independent sample t-test. The results of this study indicate that there is no significant difference in Internet Financial Reporting Quality between sharia life insurance and sharia general insurance. The absence of these differences is due to the absence of a significant difference between the quality of content, timeliness, technology and user support IFR between Sharia Life Insurance and Sharia General Insurance in Indonesia. However, the results obtained that sharia life insurance and sharia general insurance still do not provide maximum on internet financial reporting quality yet or still below the average score of 50%.Keywords: Internet Financial Reporting, content, timeliness, technology, dan user support
PENGARUH FINANCIAL INCLUSION INDICATOR, GDPPC, ICT, DAN UNEMPLOYMENT TERHADAP NEGARA OIC TAHUN 2004-2018
Authors: Firdauzi Anastasya , Sukmana Raditya
Published: November 2020

ABSTRAKPenelitian ini bertujuan untuk mengidentifikasi pengaruh dari financial inclusion indicator, GDPPC, ICT, dan unemployment terhadai HDI pada 55 negara OIC. Penelitian ini menggunakan data statistik dari World Bank, IMF, dan UNDP dengan pendekatan kuantitaif dan dianalisis menggunakan panel data. Berdasarkan hasil regresi, semua variabel menunjukkan hasil yang positif signifikan berpengaruh secara simultan pada HDI pada 55 negara OIC. Financial inclusion indicator jumlah atm dan cabang bank berpengaruh secara positif signifikan, sedangkani jumlah akun deposan pada berpengaruh negatif namun tidak signifikan. GDPPC, ICT dan unemployment berpengaruh secara positif signifikan dalam kenaikan HDI pada 55 negara OIC pada tahun 2004-2018Kata Kunci: HDI, Financial Inclusion Indicator, GDPPC, ICT, Unemployment ABSTRACTThis study aims to identify the effects of financial inclusion indicators, GDPPC, ICT, and unemployment for HDI in 55 OIC countries. This study uses statistical data from the World Bank, IMF, and UNDP with a quantitative approach and is analyzed using panel data. Based on the regression results, all variables show a positive and significant effect simultaneously on HDI in 55 OIC countries. The financial inclusion indicator of the number of ATMs and bank branches has a significant positive effect, while the number of depositors' accounts has a negative but insignificant effect. GDPPC, ICT and unemployment had a significant positive effect on the increase in HDI in 55 OIC countries in 2004-2018.Keywords: HDI, Financial Inclusion Indicator, GDPPC, ICT, Unemployment
HUBUNGAN PREMI, PENDAPATAN INVESTASI DAN SURPLUS UNDERWRITTING PADA KEUNTUNGAN PT. ASURANSI JASINDO TAKAFUL
Authors: Satata Elsha Dwi Angganis , Septiarini Dina Fitrisia
Published: November 2020

ABSTRAKAsuransi syariah merupakan salah satu upaya untuk saling melindungi dan saling membantu antar beberapa pihak melalui investasi pada aset dan atau tabarru yang memberikan pola pengembalian untuk menghadapi risiko tertentu melalui suatu kontrak yang sesuai dengan prinsip syariah. Salah satu kegiatan utama perusahaan baik asuransi konvensional maupun syariah adalah penjaminan emisi. Penelitian ini bertujuan untuk mengetahui pengaruh variabel premi, pengembalian investasi dan dana penjaminan surplus tabarru terhadap laba PT Asuransi Takaful Jasindo baik secara parsial maupun simultan. Penelitian ini menggunakan pendekatan kuantitatif dengan menggunakan data sekunder berupa laporan keuangan PT Asuransi Takaful Jasindo periode 2011-2014. Penelitian ini menggunakan taraf signifikansi 5%. Hasil regresi dalam penelitian ini menunjukkan bahwa variabel premi berpengaruh signifikan terhadap laba asuransi, sedangkan variabel hasil investasi dan surplus dana penjaminan tabarru tidak berpengaruh signifikan terhadap laba asuransi syariah.Kata Kunci: Jasindo Takaful, Premi, Pendaptan Investasi, Surplus Underwriting Tabarru', Laba Asuransi ABSTRACTIslamic insurance is one of the efforts to protect each other and mutual help among several parties through investment in assets and or tabarru which provide pattern returns to face certain risks through a contract in accordance with Islamic principles. One of the main activities of the company both conventional and Islamic insurance is underwriting.  This study aims to determine the effect of variable premium, return on investment and underwriting surplus funds tabarru to profits Jasindo PT Asuransi Takaful insurance either partially or simultaneously. This study uses a quantitative approach using secondary data such as financial statements of PT Asuransi Takaful Jasindo period 2011-2014. This study used a significance level of 5%. The regression results in this study indicate that the variable premium significantly affects insurance profit, while the variable investment returns and underwriting surplus funds tabarru not significantly affect on earnings Islamic insurance.Keyword: Jasindo Takaful, Premiums, Return on Investment, Underwriting Surplus Tabarru', Profit Insurance
Does Poverty deter Foreign Direct Investment flows to Developing Countries?
Authors: Gnangnon Sena Kimm
Published: November 2020

The present paper investigates the effect of poverty on foreign direct investment (FDI) inflows in developing countries. It complements the important extant literature on the effect of FDI inflows on poverty by examining the issue the other way around. The analysis is conducted using a sample of 117 countries over the period 1980-2017, and the two-step system Generalized Methods of Moments (GMM) technique. It has relied on two indicators of poverty, namely poverty headcount ratio and poverty gap. Findings indicate that over the full sample, poverty influences negatively FDI inflows, including through its adverse effect on human capital (that is, both education and health). Unsurprisingly, low-income countries (considered as poorest countries in the full sample) experience a higher negative effect of poverty on FDI inflows than other countries. On another note, participation in international trade matters for the effect of poverty on FDI inflows. In fact, an increase in poverty levels results in lower FDI inflows in countries that experience low workers' productivity, a less developed financial sector, and a low level of infrastructure development. Furthermore, the effect of poverty on FDI inflows does not depend on the prevailing economic growth rate. Finally, the analysis has revealed the existence of a non-linear effect of poverty on FDI inflows for the poverty headcount indicator, but not for the poverty gap indicator. The non-linear effect of poverty headcount on FDI inflows is such that a rise in poverty headcount ratio results in lower FDI inflows, but an additional increase in poverty more than further discourages FDI inflows. The conclusion discusses the implications of these findings.