bluuebunny/crossref_metadata_2025 huggingface dataset:
Wpływ rehabilitacji na poprawę wydolności fizycznej ocenianej za pomocą sześciominutowego wysiłkowego testu marszowego
Authors: Olbrych Anna
Published: February 2021

Introduction. Chronic obstructive pulmonary disease – COPD (bronchitis and emphysema) is the most common chronic respiratory disease. It is the fourth leading cause of death, and its mortality rate has a rising tendency. Substances contained in tobacco smoke are the main cause of COPD. Reported symptoms include cough, increased sputum cough-up, dyspnea, and subsequent fear of physical activity. Even though it cannot be cured, physical exercise can increase the patient’s physical capacity; it delays the onset of disability, helping the patient to stay fit. Aim. The purpose of the essay was to find out what impact has rehabilitation on patients carrying COPD. Material and methods. The 6-minute walk test was used on the patients carrying COPD at the beginning and at the end of the rehabilitation. The results were identified by using statistical analysis. Results. Obtained results proved that the patients participated the rehabilitation improved their physical exercise capacity. Slightly better results were noticed in male patients. Discussion. COPD is an incurable disease, physical exercise can increase the patient's physical capacity; it delays the onset of disability, helping the patient to stay fit. Patients often avoid physical exercise due to "shortness of breath", but it is exercising that facilitates their proper functioning. The most effective diagnostic test is spirometry which measures lung function, specifically volume and flow of air that can be inhaled and exhaled. COPD is a multi-organ disease, apart from lungs it also attacks muscles, bones or heart. Therefore the treatment and rehabilitation should involve the whole body rather than focus on the respiratory muscles only. Conclusions. Pulmonology rehabilitation has significant influence on patients carrying COPD; improves efficiency and life quality.
Problem hypogonadyzmu ze szczególnym uwzględnieniem problemu u dziewcząt
Authors: Jarząbek-Bielecka Grażyna , Czepczyński Rafał , Pisarska-Krawczyk Magdalena , Kędzia Witold , Wojtyła-Buciora Paulina
Published: February 2021

Hypogonadism is understood as a gonadal defect; it can occur in all periods of life – in embryos, pre-adolescent and post-adolescent children, as well as after menopause. The initial cause of hypogonadism may lie in a pathology of gonads (primary, gonadal, hypergonadotropic hypogonadism) or of the hypothalamic-pituitary system (secondary hypogonadism, hypogonadotrophic hypogonadism). Hypogonadism should be discussed together with the problem of delayed puberty. In all children with delayed puberty, genetic testing with karyotype evaluation is advisable. It is also necessary to exclude pituitary hormone deficiency, especially in children having undergone radiotherapy and/or chemotherapy; it is also necessary to exclude chronic and autoimmune diseases, with special attention brought to the presence of dysmorphic features or anosmia. Molecular studies are also of importance. Guidelines for management of hypogonadism in girls have been presented.
Bursztynowe źródło zdrowia – zastosowanie miodu we współczesnej medycynie
Authors: Jagiełło Jacek , Kołeczek Elżbieta , Horochowska Michalina , Zdrojewicz Zygmunt , Głowaczewska Amelia
Published: February 2021

Honey is a natural food product with sweet taste and precious nutrients, produced by Apis mellifera, Vespa sp. or Meliponini sp. from nectar of various types of flowers. It’s taste, color and smell depends on the flower, from which nectar was collected. From ancient times it was used as food product and it’s considered to be the oldest sweetening substance in human’s cuisine. In recent times scientists got interested in medical properties of honey and it’s influence on people’s health. It was proved that honey has antioxidant, anti-inflammatory, anti-proliferative and antineoplastic properties. Honey has an influence on our immune system and helps to kill bacteria. It is confirmed that honey have an influence on diabetes, cardiovascular system, oral cavity, respiratory tract or eye diseases. What more, honey can improve fertility, because of it’s antioxidant properties. The most famous honey is Manuka honey, which is known all over the world due to containment of methyloglyoxal (substance that is capable of killing bacteria). Unfortunately, in some cases honey can contain endospores and botuline toxin, that can cause infant botulism.
Risk behaviours of NPS users in Hungary and the possibility of harm reduction
Authors: Csák Róbert , Rácz József
Published: February 2021

Introduction. In recent years, the use of injectable new psychoactive substances (NPS) has become a widespread phenomenon. Aim. The aim of this paper was to investigate NPS-related risk behaviours in the context of infectious diseases. Material and methods. Our survey was conducted as a part of a low threshold HCV, HIV, syphilis screening intervention which allowed to reach the people who inject drugs (PWID) population otherwise invisible for the healthcare system, and investigate their injecting and sexual risk behaviours. The survey was based on a risk assessment questionnaire which was a part of a quick screening and counselling intervention provided on site in four cities in Hungary. Results. Injecting NPS is a risk factor – NPSs are injected more frequently than amphetamines or heroin. The limited access to needle exchange programmes with the recent rise in HCV prevalence in the Hungarian PWID population combined with equipment sharing, could lead to a serious public health problem. Conclusions. Scaling up harm reduction interventions is essential to prevent further risks to the population.
Rola psychologicznych aspektów odchudzania się na przykładzie klientek rzeszowskiego fitness clubu
Authors: Grzywacz Renata , Krupa Jan , Cichocka Izabela
Published: February 2021

Introduction. A conscious process of slimming down involves not only an appropriate diet and physical activity but a change of lifestyle in general. It requires actions on two levels, physical as well as mental. A sense of self-discipline plays an important role, too, since it affects whether the diet is followed consistently. Aim. The aim of the research was to establish the knowledge and awareness of psychological aspects of slimming down among women who declared willingness to reduce body weight as well as comparison of motivations and methods practiced in this process. Method and methods. A survey was carried out from April to May 2016 on a sample of ninety women, clients of a Rzeszów fitness club. The results of the survey were processed using both chi-square test of independence and correspondence analysis. Results. It turned out that age was the factor determining reasons for obesity and the desire to slim down. Dwelling place influenced willpower, which is crucial in making decision to slim down and essential for its success. Marital status is related to the absence of weight loss, the eagerness to take up physical activity, but also the pride and joy resulting from effects in the process of slimming down. Conclusions. Lack of awareness leads to wrong choices of methods and motivation. Individuals with low levels of such awareness tend to use other people’s opinion and think that e.g. slimming down will make them more attractive to their partners. The research has not indicated how the awareness of psychological aspects affecting the process of slimming down is related to the method used to achieve the aim. Nonetheless, it is worth noticing that a lot of respondents notice the fact that it is not only the diet and physical activity that determines the effects of slimming down but the change in the way one thinks, too.
Metody leczenia endodontycznego zębów stałych z niezakończonym rozwojem wierzchołków korzenia – rewaskularyzacja, 12-miesięczna obserwacja. Część II
Authors: Pazera Renata , Piechota-Urbańska Magdalena , Proc Patrycja , Szczepańska Joanna
Published: February 2021

Introduction. Apexogenesis is the process of shaping the root for 3 years after the appearance of the crown in the oral cavity. The condition for continuing this process is to preserve the vitality of the tooth. Injury, caries or disorders of the anatomical structure may cause necrosis or irreversible pulpitis. The assumption of endodontic treatment of immature permanent teeth is to create a mineralized barrier closing the lumen of the canal (apexification) or continuing the development of the root (revascularization). Regeneration of the pulpo-dentinal complex allows for the increase of root length, thickening of its walls and narrowing of the apical hole. This can be achieved by a new treatment method – revascularization. The advantage of this therapeutic method is to avoid all the defects arising after endodontic treatment with the use of apexification, i.e. tooth brittleness, susceptibility to root fracture, discoloration of the tooth tissue. Aim. The aim of the study was to evaluate the modern method of treatment of necrosis or irreversible pulpitis in immature permanent teeth by revascularization in the aspect of tissue healing, regeneration of the pulp-dentinal complex, thickness growth and the length of the root walls. Material and methods. The study was conducted among 7 children aged 7-12, including 3 girls and 2 boys. Revascularization was performed in 7 teeth. The study involved 6 central incisors and 1 premolars. During the treatment, polyurethane paste and MTA were used. The control group consisted of patients who were tested using MTA due to the inability to perform revascularization. 23 patients aged 7-13 were qualified to the control group. Control tests were carried out after 3, 6, 12 months after treatment. The clinical condition of the tooth and the radiological image were evaluated. Results. Radiological examination was crucial in assessing the effectiveness of the revascularization procedure. It confirmed the decrease of periapical lesions, increase in root length, root wall thickness and closing of the apical hole. During the clinical examination, the subjective feelings of the patient, discoloration of the tooth's tissues, reaction to tapping, tooth mobility, depth of the gingival pocket, tenderness of the appendage and tightness of the final filling were controlled. The obtained results were compared with the control group. Conclusions. Revascularization is a promising treatment for immature permanent teeth due to the increase in the length of the root and the thickness of its walls. As a result, the teeth after treatment are more durable and are better for long-term maintenance in the mouth. The procedure of revascularization has some limitations at the stage of patient’s qualification for the procedure. If it is not possible to perform this procedure, the alternative is to apexify using MTA.
Postawa dziecka w wieku przedszkolnym i wczesnoszkolnym
Authors: Miszewska Agnieszka , Miszewski Waldemar Józef , Głowacka-Mrotek Iwona , Simińska Joanna , Hagner Wojciech
Published: February 2021

Developmental processes in ontogenesis are divided into consecutive processes. The thesis presents man’s ontogenesis according to A. Malinowski. Man’s posture changes with age and is characterized by certain features in every period. External factors have a great influence on the correct development of the posture: nutrition and physical factors, particularly, the type of strain. The following laws influence the growing organism: Kölker’s and Pomner’s law, Delpech-Wolff’s law and the principles of bone structure development according to P. Lesgartt. To facilitate the proper development of the child it is important to provide them with satisfactory exercise on a daily basis. The thesis does not discuss hereditary factors influencing child’s development. It discusses the development of healthy children who are not burdened with genetic factors. The knowledge of the correct posture of the child is constantly growing due to the work of scientist and therapists working with children. The evaluation of the correct posture depends on the child’s age, and requires the knowledge of human ontogenesis. The ontogenesis is the basis for every kind of therapy of faulty posture. Zukunft-Hubert’s therapy constitutes a good example; in a non-invasive way, it cures faulty feet even in the first year of life, which was treated only surgically before.
Wybrane zagadnienia położnicze: stosowanie leczenia tokolitycznego po przedwczesnym przerwaniu błon płodowych oraz znaczenie oceny długości szyjki macicy w przezpochwowym badaniu ultrasonograficznym
Authors: Jarząbek-Bielecka Grażyna , Wojtyła-Buciora Paulina , Pisarska-Krawczyk Magdalena , Kędzia Witold , Luwański Dawid , Wojtyła Andrzej
Published: February 2021

In our health care system, family doctor is the first physician that patients have contact with. Family medicine provides basic health care. In his daily work, family doctor independently consults both children and adults regardless of the reason of visit, if necessary, cooperating with consulting physicians working in outpatient specialist centers or referring patients for diagnosis and treatment in specialist centers (hospitals). This also applies to pregnant women. Two specific issues requiring consultation with gynecology clinics are discussed: tocolytic treatment after premature rupture of membranes and the importance of assessing cervical length in transvaginal ultrasound. When discussing obstetric problems from the family doctor’s perspective, the importance of education should be emphasized. The basis of prenatal education for pregnant women, including high-risk pregnant women, consists of an education plan developed by a midwife working in the Primary Health Care Center. The plan is an integral part of the patient’s medical record and includes both practical and theoretical preparation for childbirth, puerperium, breastfeeding and parenting (also in case of group services).
Deep Learning Fault Diagnosis for Spacecraft Attitude Determination and Control
Authors: Mansell Justin R. , Spencer David A.
Published: February 2021

The growing numbers, complexity, and data return of space missions are driving a need for automated fault detection and diagnosis. Traditional fault monitoring techniques possess limited ability to diagnose anomalies, requiring operators to investigate extensive amounts of telemetry to isolate root causes. An important hurdle to automating fault diagnosis for complex subsystems such as attitude determination and control is that interpreting anomalies to determine a root cause is highly contextual and inherently uncertain. This paper presents a method of using one-class support vector machines to train a long short-term memory neural network to diagnose time-varying faults in a simulated CubeSat attitude determination and control subsystem. Using elements of transfer learning, the one-class support vector machines are retrained on nominal flight telemetry, allowing the neural network to diagnose faults on the flight unit. The diagnoses are robust to missing data, false positives, modeling errors, contradicting information, and multiple faults. An application is demonstrated for the LightSail 2 solar sail satellite, where the system succeeds in diagnosing both known and previously unknown attitude determination and control faults.
O olhar dos gestores municipais sobre a planificação da rede temática de atenção à saúde
Authors: Júnior Severino Azevedo de Oliveira , Chaves Elem Cristina Rodrigues , Lima Sergio Beltrão de Andrade , Leite Daniela Silva , Cardoso Keise Bastos , Costa Ilka Lorena de Oliveira Farias , Reis Ana Paula Oliva , Sampaio Ana Tânia Lopes , De Mendonça Maria Helena Rodrigues , De Oliveira Gustavo Nunes
Published: February 2021

Objetivo: Analisar a ótica dos gestores municipais diante das Oficinas de Planificação da Atenção Primária, realizadas na 6ª Região de Saúde no Rio Grande do Norte. Métodos: Trata-se de um estudo exploratório, analítico e qualitativa realizado no período de 2011 a 2013. O percurso teórico-metodológico pautou-se na pesquisa avaliativa de quarta geração. Resultados: De forma geral, a visão da Atenção Primária é ampla, sendo reconhecida como nível de atenção essencial para desenvolver ações de promoção, proteção e recuperação, no entanto, predomina como problemática o subfinanciamento, falta de prioridade política e a desvalorização dos servidos e, referente a influência das Oficinas de Planificação e sua metodologia como instrumento organizacional da APS, foi consensual sua contribuição. Todavia, apesar dos consensos, foram apontadas contrariedades ao período político durante as oficinas, frustração dos grupos envolvidos, rotatividade dos técnicos das Oficinas e falta de apoio da gestão. Conclusão: Apesar do cenário de subfinanciamento, instabilidades política, desvalorização dos servidores e falta de apoio da gestão, foi consenso a positividade da Planificação da APS, utilizadas frente ao planejamento estratégico de ações e serviço de forma integral e regionalizada, além de ampliar conhecimentos no contexto da saúde.
Principais dificuldades vivenciadas por primíparas no cuidado ao recém-nascido
Authors: Silva Deyce Danyelle Lopes , Pacheco Edildete Sene , Da Silva Vanessa Rodrigues , Lima Camila Sabrina de Oliveira , Lima Érica Fernanda Sousa , Carvalho Vanessa Santos , Ribeiro Myslânia de Lima , Lima Sayane Daniela Santos , Valadares Carolina Bezerra , De Sousa Agna Roberta Rodrigues
Published: February 2021

Objetivo: Identificar as principais dúvidas e dificuldades vividas pelas puérperas primíparas em relação ao recém-nascido. Métodos: Trata-se de uma pesquisa de campo, descritiva e exploratória de abordagem quanti-qualitativa, realizada no domicílio de 22 primíparas atendidas pelas Estratégia de Saúde da Família (ESF) de um município do interior do estado do Piauí, sendo executada durante o mês de julho de 2016. Resultados: Durante as entrevistas, as participantes foram questionadas quanto às suas dúvidas ou dificuldades enfrentadas para a realização do cuidado ao recém-nascido. A análise das falas obtidas demonstrou que a dificuldade prevalente foi a amamentação, seguida de engasgo e regurgitação; banho e higiene; choro; vacinas e suas reações adversas. Conclusão: As puérperas, embora tenham sido informadas e orientadas quanto aos cuidados com o recém-nascido, apresentaram dúvidas e dificuldades para realizarem tal prática por diversos motivos, sendo a primiparidade o principal deles e revelando aos profissionais de saúde as necessidades no enfrentamento da maternidade.
Educação sexual no ensino básico: o estudante de medicina como educador
Authors: Custódio Clarissa Garcia , Leonardo Felipe , Niero Helena Boldrini , Tagnin Luisa Hercowitz , Bertonha Luiza Lista , Sousa Rebeca da Silva , Damito Eunice Maria de Toledo , Pavan Maria Valéria
Published: February 2021

Objetivo: Descrever a experiência com um projeto que discute desenvolvimento sexual com alunos do Ensino Básico da rede pública, conduzido por estudantes de medicina. Relato de Experiência: Em prática desde 2016, o projeto vem sendo organizado em oficinas desenvolvidas com alunos e seus pais ou responsáveis, capacitação de professores e fornecimento de material para que possa ser replicado pelas escolas. Em 2020, passou por adaptações para ser mediado por plataformas digitais. Em conjunto com os professores, foi produzido um vídeo sobre o desenvolvimento do corpo humano, com foco nas alterações físicas da puberdade; uma aula sobre o comportamento durante o desenvolvimento, mostrando como as crianças respondem às diferentes fases do crescimento e uma história em quadrinhos, online, sobre uma adolescente com suspeita de gravidez que decide ir pela primeira vez a uma consulta na Unidade Básica de Saúde. Considerações Finais: Diferentemente da abordagem preventiva, heteronormativa, graduada de acordo com a idade dos alunos e usualmente inserida como um tema das aulas de ciências, esse projeto procura dar aos professores, família e sistema de saúde local a oportunidade de se apropriarem da tarefa da discussão sobre educação sexual, com reconhecimento dos obstáculos, dos preconceitos e ganho de autonomia.
Perfil metabólico e antropométrico dos pacientes obesos e não obesos portadores de esteatose hepática não alcoólica
Authors: Santana Jéssica Teles , Mota Allan Victor Hora , Gonzaga Yasmin Hora Góis , Gomes Raphaella Maria Oliveira Pereira , Melo Lívia Carvalho , Noronha Victor Fernando Costa Macedo , Santos Anny Carolyne Oliveira Lima , De Jesus Joseane Barbosa , Lima Sonia Oliveira , Cruz Josilda Ferreira
Published: February 2021

Objetivo: Avaliar o perfil metabólico e antropométrico dos pacientes obesos e não obesos portadores de esteatose hepática não alcoólica diagnosticados pela ultrassonografia abdominal. Métodos: Estudo clínico e prospectivo realizado no período entre abril de 2019 a fevereiro de 2020 em um centro de referência em ultrassonografia em Aracaju - SE. Foram avaliados índice de massa corporal, circunferência abdominal e dosados glicemia de jejum, colesterol total, lipoproteínas de alta densidade, lipoproteínas de baixa densidade, lipoproteínas de muito baixa densidade e triglicerídeos de todos os pacientes. Resultados: Foram estudados 85 pacientes portadores de esteatose hepática (45 não obesos e 40 obesos). Deles, 43 pacientes corresponderam ao grau leve e 42 ao grau moderado/severo. Com relação as condições clinicas, 78 pacientes apresentaram dislipidemia, 13 tinham diabetes mellitus tipo 2, 27 tinham hipertensão arterial sistêmica, 40 apresentaram síndrome metabólica e 65 pacientes foram portadores de obesidade central. Houve associação estatisticamente significativa no grupo dos pacientes obesos para triglicerídeos e circunferência abdominal em relação a gravidade da infiltração gordurosa. Entretanto, não houve esta associação no grupo dos pacientes não obesos. Conclusão: A obesidade e as suas condições metabólicas são fatores de risco para a gravidade da esteatose hepática não alcóolica.
Percepção dos enfermeiros do atendimento pré-hospitalar móvel relacionado ao suporte intermediário de vida (SIV)
Authors: Saraiva Gabriel Bezerra do Nascimento , Marques Luana Rodrigues , Almeida Luciene Carvalho Piedade , Barros Marcela Milrea Araújo
Published: February 2021

Objetivo: Compreender a percepção dos enfermeiros relacionado ao Suporte Intermediário de Vida no atendimento pré-hospitalar móvel no município de Porto Velho - RO. Métodos: Trata-se de uma pesquisa descritiva, abordagem qualitativa, constituída por 9 enfermeiros, atuantes no Serviço de Atendimento Móvel de Urgência, a partir da técnica entrevista gravada com roteiro semiestruturado. Resultados: A partir da análise das falas, foram elencadas três categorias temáticas relacionadas ao conhecimento dos enfermeiros acerca do suporte intermediário, importância e contribuições do suporte intermediário para o atendimento de emergência pré-hospitalar e o protagonismo do profissional enfermeiro. Neste cenário, existem fragilidades nas discussões referente ao suporte intermediário. No entanto, essa assistência demanda um nível maior de conhecimento técnico científico, valorização do enfermeiro e não sobrecarga profissional, além de respaldo legal. De acordo com os enfermeiros, o suporte intermediário, contribuirá para garantir a efetividade da “hora de ouro”, melhorando a assistência e minimizando danos irreversíveis. Conclusão: Será necessário a implantação de estratégias de sensibilização quanto a temática com a participação ativa dos gestores, trabalhadores e usuários, através de educação continuada e permanente no serviço de saúde e disseminação da proposta, valorizando a autonomia do profissional enfermeiro para uma assistência oportuna e qualificada.
EFFECTIVENESS OF SINGLE AND DOUBLED DOSES PLATELETS TRANSFUSIONS
Authors: Аюпова Р. , Султанбаев У. , Жибурт Е.
Published: February 2021

Введение. Концентрат тромбоцитов — второй наиболее часто назначаемый компонент крови после эритроцитов. Тромбоциты способствуют свёртыванию крови, а также поддержанию целостности сосудов.
Цель исследования. Сопоставить эффективность переливания единичных и множественных доз патоген-редуцированных тромбоцитов.
Материалы и методы. В 15 клиниках Республики Башкортостан с 14 января по 30 сентября 2016 года выполнено 915 переливаний тромбоцитов: 831 единичных и 84 сдвоенных доз патоген-редуцированных тромбоцитов.
Результаты. Установлена разная частота применения сдвоенных доз в разных клиниках, а также их преимущественное применение по пятницам. У реципиентов единичных и сдвоенных переливаний не выявлено различий следующих показателей: площадь поверхности тела, среднее количество трансфузий в анамнезе, доля первых переливаний тромбоцитов, частота профилактических и лечебных трансфузий, эффективность остановки кровотечения, скорректированный прирост тромбоцитов (СПТ).
Заключение. Не получено доказательств различий в эффективности трансфузий сдвоенных и единичных концентратов донорских тромбоцитов. Прямая корреляция СПТ и исходной концентрации тромбоцитов свидетельствует об ограниченной диагностической значимости СПТ в качестве показателя эффективности переливания тромбоцитов.

Introduction. Platelet concentrates are the second most commonly prescribed blood component after erythrocytes. Platelets promote coagulation and maintain the integrity of blood vessels.
The aim of study: to compare transfusion effectiveness of single and multiple doses of pathogen-reduced platelets.
Materials and methods. In 15 clinics of the Republic of Bashkortostan (from January 14 to September 30, 2016) 915 platelets transfusions were performed: 831 single and 84 double doses of pathogen-reduced platelets.
Results. Frequency of doubled doses platelets transfusions varied in different hospitals, predominantly they used on Fridays. In recipients of single and doubled transfusions we revealed no differences in following parameters: body surface area, average number of transfusions in anamnesis, proportion of first platelets transfusions, frequency of preventive and therapeutic transfusions, effectiveness of bleeding stops, corrected count increment of platelets (CCIP).
Conclusion. No evidences of difference in transfusion effectiveness of doubled and single donor platelets concentrates were received. Direct correlation between CCIP and initial platelets concentration shows the limited diagnostic significance of CCIP as an indicator of platelets transfusion effectiveness.
MECHANISMS OF HEMOSTASIS DISTURBANCES AT VARIOUS PATHOGENETIC TYPES OF ANEMIAS
Authors: Желобов В. , Туев А. , Агафонов А.
Published: February 2021

Введение. Нарушения со стороны системы гемостаза при заболеваниях кроветворных органов чрезвычайно разнообразны как по механизмам развития, так и по клиническим проявлениям.
Цель исследования. Изучение причин гемостазиологических расстройств при различных патогенетических вариантах анемических состояний.
Материалы и методы. Показатели коагуляционного гемостаза, липидной пероксидации и эндотелий-зависимая вазодилатация исследованы у 30 больных железодефицитной анемией, 22 больных витамин В12-дефицитной анемией и 18 больных апластической анемией.
Результаты. Гемическая гипоксия, присущая анемии, сопровождается активацией свободно-радикального окисления липидов — увеличением концентрации малонового диальдегида плазмы и уменьшением антиокислительного потенциала крови. Оксидативный стресс приводит к системному поражению эндотелия, проявляющегося снижением релаксирующих свойств эндотелия сосудов и активацией системы гемостаза, представленной гипокоагуляцией по внутреннему механизму, угнетением плазминовой системы и увеличением концентрации растворимых фибрин-мономерных комплексов.
Заключение. Развитие анемии, независимо от ее патогенетического механизма, сопровождается развитием метаболического дисбаланса, дисфункцией эндотелия, что в конечном итоге приводит к нарушениям со стороны коагуляционного гемостаза.

Introduction. Hemostasis disturbances in diseases of hematopoietic organs are considerably varied both in mechanisms of development, and in clinical manifestations.
The aim: to study the causes of hemostatic disorders at various pathogenetic types of anemias.
Materials and methods. In 30 patients with iron defi ciency anemia, in 22 patients with vitamin B12-deficiency anemia and in 18 patients with aplastic anemia parameters of coagulative hemostasis, lipid peroxidation, and endothelium-dependent vasodilation were studied.
Results. Attributable to anemia hemic hypoxia is accompanied by activation of free-radical lipids oxidation — increasing concentration of plasma malone dialdehyde and decreasing of blood antioxidant potential. Oxidative stress leads to systemic damage of endothelium that manifested by decreasing of vascular endothelial relaxing properties and hemostasis activation: internal mechanism of hypocoagulation, inhibition of plasmin system and increasing concentration of soluble fibrin monomer complexes.
Conclusion. Anemia progression regardless of its pathogenic mechanism is associated with the development of metabolic disbalance, endothelial dysfunction that fi nally leads to disturbances of coagulative hemostasis.
DISTURBANCES OF ANTITHROMBOTIC VASCULAR ENDOTHELIAL FUNCTION AND SOME PLASMA HEMOSTATIC PARAMETERS AT FOCAL CEREBRAL ISCHEMIA AND THEIR CORRECTION BY 4-HYDROXY-3,5-DITRETBUTYL CINNAMIC ACID
Authors: Воронков А. , Поздняков Д.
Published: February 2021

Введение. Рост числа случаев ишемического инсульта (ИИ) в РФ диктует необходимость поиска путей снижения заболеваемости, а также уменьшения числа случаев летального исхода. Одним из таких направлений можно считать рациональное фармакологическое воздействие на основные звенья патогенеза повреждения головного мозга при ИИ.
Цель исследования. Оценить степень изменения антитромботической функции сосудистого эндотелия на фоне фокальной ишемии головного мозга, а также способность 4-гидрокси-3,5-дитретбутил коричной кислоты препятствовать развитию данных изменений.
Материалы и методы. В эксперименте на 60 крысах-самцах линии Wistar), разделенных на 6 равных экспериментальных групп (nH=H10), исследовали влияние 4-гидрокси-3,5-дитретбутил коричной кислоты на антитромботическую функцию эндотелия и некоторые показатели плазменного гемостаза на фоне фокальной ишемии головного мозга. Результаты. Установлено, что введение 4-гидрокси-3,5-дитретбутил коричной кислоты в дозе 100 мг/кг на фоне фокальной ишемии головного мозга способствовало снижению агрегационной активности тромбоцитов: отмечено уменьшение степени (на 37,7%) и скорости (150,3%) агрегации тромбоцитов по сравнению с животными, не получавшими фармакологическую поддержку, а также восстановление активности свертывающей и противосвертывающей систем крови.
Заключение. По величине фармакологического эффекта изучаемое соединение превосходило мексидол и тиоктовую кислоту и не уступало сулодексиду.

Introduction. Increasing number of ischemic stroke (IS) cases in Russian Federation requires the necessity to find ways for reducing morbidity and death incidence. Balanced pharmacological infl uence on the main pathogenesis links of brain damage at IS can be one of opportunities.
The aim: to assess changes in antithrombotic function of vascular endothelium at focal cerebral ischemia and also the ability of 4-hydroxy-3,5-di-tert-butyl cinnamic acid to prevent the development of these changes.
Materials and methods. The effect of 4-hydroxy-3,5-ditretbutyl cinnamic acid on endothelial antithrombotic function and some plasma hemostatic parameters at focal cerebral ischemia was studied in experiment on 60 male rats (Wistar line) divided into 6 equal experimental groups (nH=H10).
Results. We found that the administration of 4-hydroxy-3,5-ditretbutyl cinnamic acid (100 mg/kg) at focal cerebral ischemia decreased platelet aggregation activity: we registered the reduction in degree (by 37,7%) and speed (150,3%) of platelet aggregation compared to animals who did not receive pharmacological support, and also the restoration of blood coagulation and anticoagulation activities.
Conclusion. Pharmacological effect of studied compound exceeded mexidol and thioctic acid actions and was similar to sulodexide influence.
Prophylaxis of thromboembolic complications in patients with hemorrhagic stroke
Authors: Чуприна С. , Шуленина Е.
Published: February 2021

Введение. Одним из основных клинических факторов риска венозных тромбоэмболических осложнений (ВТЭО), не связанных с травмой и операцией, является инсульт и/или парез нижних конечностей. Однако для пациентов с геморрагическим инсультом до сих пор нет общепринятой эффективной и безопасной схемы профилактики ВТЭО.
Цель исследования: оценка эффективности и безопасности профилактики тромбоза глубоких вен нижних конечностей и тромбоэмболии легочной артерии с помощью препарата Флюксум®.
Материалы и методы. Обследовано 60 пациентов с геморрагическим инсультом: группа 1 (n = 30) – пациенты получали препарат парнапарин в дозе 0,3 мл подкожно 1 раз в сутки ежедневно, начиная со вторых суток от момента начала заболевания; группа 2 (n = 30) – пациенты получали другие низкомолекулярные гепарины в профилактических дозах также со вторых суток от момента начала геморрагического инсульта (эноксапарин в дозе 0,4 мл 1 раз в сутки, надропарин в дозе 0,3 мл 1 раз в сутки).
Результаты. Показано, что у пациентов с геморрагическим инсультом использование нового низкомолекулярного гепарина – парнапарина (Флюксум®, Альфа Вассерманн, Италия) в дозе 0,3 мл подкожно 1 раз в сутки столь же эффективно для профилактики тромбоза глубоких вен, как и терапия другими низкомолекулярными гепаринами, при этом риск развития геморрагических осложнений не увеличивается.
Заключение. Применение препарата Флюксум® может быть приемлемой альтернативой использованию других низкомолекулярных гепаринов для профилактики венозных тромбоэмболических осложнений у пациентов с геморрагическим инсультом.

Introduction. Stroke and/or paresis of lower extremities are one of the main risks of vvenous thromboembolic complications (VTEC) not associated with trauma and surgery. At the same time, there is still no generally accepted effective and safe scheme of VTEC prophylaxis for patients with hemorrhagic stroke.
The aim of study was to evaluate the efficacy and safety of prophylaxis of deep vein thrombosis of lower extremities and pulmonary embolism with drug Fluxum®.
Materials and methods. We examined 60 patients with hemorrhagic stroke: group 1 (n = 30) – patients received Parnaparin at dose 0,3 ml subcutaneously once a day, starting from the second day after the disease onset; group 2 (n = 30) – patients received other low molecular weight heparins in prophylactic doses also from the second day after the onset of hemorrhagic stroke (Enoxaparin at dose 0,4 ml once a day, Nadroparin at dose 0,3 ml once a day).
Results. It was shown that in patients with hemorrhagic stroke the usage of a new low molecular weight heparin – Parnaparin (Fluxum®, Alfa Wassermann, Italy) at dose of 0,3 ml subcutaneously once a day was equally effective for prophylaxis of deep vein thrombosis as therapy with other low-molecular heparins, and risk of hemorrhagic complications not increased.
Conclusion. Fluxum® usage may be an acceptable alternative of other low molecular weight heparins usage for prevention of deep vein thrombosis in patients with hemorrhagic stroke.
POLYTRAUMA AND RETROPERITONEAL HEMATOMA
Authors: Колесников В. , Рахимов Б. , Проценко О.
Published: February 2021

Введение. Лечебная тактика при тяжелой сочетанной травме живота остается наиболее сложным и нерешенным вопросом современной хирургии. При этом от принятия решения о возможности выполнения того или иного вмешательства зависят результаты лечения и исход травмы.
Материалы и методы. Обследовано 811 пострадавших с тяжелой сочетанной травмой живота, наиболее частыми причинами которой были ДТП — 583 (71,9%) и кататравма — 228 (28,1%). Объективную оценку тяжести травмы производили по индексу тяжести повреждения и индексу тяжести состояния. Проведены физикальные, лабораторные и инструментальные методы диагностики забрюшинных гематом.
Результаты. У 129 (16%) пострадавших интраоперационно была выявлена и ревизирована забрюшинная гематома. При ревизии ее у 47 (36,4%) пострадавших были обнаружены повреждения поджелудочной железы, у 6 (4,6%) — разрывы забрюшинных отделов двенадцатиперстной кишки, у 31 (24%) — разрывы почек. В 5 (3,9%) случаях причинами забрюшинных гематом были разрывы полой вены, а в 4 (3,1%) — брюшной аорты. Причинами клинически значимых забрюшинных и внутритазовых гематом, сопровождавшихся геморрагическим шоком III–IV класса, у 34 (15%) пострадавших явились переломы костей таза.
Заключение. Приведены тактические подходы хирургического лечения в зависимости от причин и локализаций гематом.
Ключевые слова: ревизия забрюшинной гематомы, тяжелая сочетанная травма живота, переломы костей таза.

Introduction. Treatment policy for severe combined abdominal trauma remains the most complex and unresolved question of modern surgery. At the same time, the results of treatment and outcome of trauma depend on feasibility of one or another intervention.
Materials and methods. The treatment experience of 811 victims with severe combined abdominal trauma is presented, the most common causes of which were road traffi c accidents — 583 (71,9%) and catatrauma — 228 (28,1%). The severity of injury was assessed by indexes of damage severity and severity of state. Physical, laboratory and instrumental methods for diagnostics of retroperitoneal hematomas are presented.
Results. Intraoperatively retroperitoneal hematoma was identifi ed and checked in 129 (16%) of patients. During the revision of retroperitoneal hematoma we found pancreatic damage in 47 (36,4%) of patients, ruptures of retroperitoneal segments of duodenum — in 6 (4,6%) persons and kidney ruptures — in 31 (24%). The causes of retroperitoneal hematomas were vena cava ruptures — in 5 (3,9%) cases and abdominal aorta ruptures — in 4 (3,1%) cases. In 34 (15%) patients clinically signifi cant retroperitoneal and intrapelvic hematomas were caused by fractures of pelvic bones, accompanied by hemorrhagic shock III–IV class.
Conclusion. Tactical approaches of surgical treatment are presented depending on hematomas causes and localization.
ANALYSIS OF ELEMENTAL CONTENT OF ERYTHROCYTES AT ACUTE AND CHRONIC DISORDERS OF CEREBRAL CIRCULATION
Authors: Степанова Ю. , Скоробогатова А. , Слобожанина Е. , Лукьяненко Л. , Гончар И. , Алехнович Л.
Published: February 2021

Введение. Макро- и микроэлементный состав крови опосредует регуляцию нейрональной проводимости, сосудистого тонуса и эндотелиальной функции, системы гемостаза и кислородтранспортной функции эритроцитов; ионы металлов оказывают дозозависимый эффект на про- и антиоксидантные процессы, протекающие в тканях головного мозга.
Цель исследования: анализ элементного состава эритроцитов у пациентов с острым инфарктом головного мозга (ИГМ) и хронической дисциркуляторной энцефалопатией (ДЭП).
Материалы и методы. Обследовано 29 пациентов с острым ИГМ (19 женщин и 10 мужчин) и 18 пациентов с ДЭП (10 женщин и 8 мужчин). В 1-е сутки госпитализации в эритроцитах пациентов оценивали содержание элементов (K, Ca, Na, P, Cu, Fe, Zn, Mg, Mn, S, Be, Si) методом атомно-эмиссионной спектроскопии.
Результаты. При остром ИГМ выявлено повышение внутриэритроцитарного содержания кальция, что обусловливает активацию агрегации эритроцитов. У пациентов с ДЭП обнаружен дефицит меди, цинка и железа, что ведет к снижению активности антиоксидантной системы эритроцитов.
Заключение. Установленные изменения элементного состава эритроцитов у пациентов с ИГМ и ДЭП свидетельствуют о нарушении металло-лигандного гомеостаза при остром и хроническом нарушении мозгового кровообращения,
что вносит несомненный вклад в патогенез ишемической цереброваскулярной патологии.

Introduction. Macro- and microelemental blood composition mediates regulation of neuronal conduction, vascular tone and endothelial function, hemostasis and oxygen transport function of erythrocytes; metal ions have a dose-dependent effect on pro- and antioxidative processes in brain tissues. Aim: to analyze the elemental content of erythrocytes in patients with acute brain infarction (BI) and in patients with chronic dyscirculatory encephalopathy (DEP).
Materials and methods. We examined 29 patients with acute BI (19 women and 10 men) and 18 patients with DEP (10 women and 8 men). On the 1st day of hospitalization we determined the content of elements (K, Ca, Na, P, Cu, Fe, Zn, Mg, Mn, S, Be, Si) in erythrocytes by atomic-emission spectroscopy.
Results. At acute BI we found the increasing of intra-erythrocyte calcium content that caused the activation of erythrocyte aggregation. Patients with DEP had copper, zinc and iron defi ciency that led to decreasing in the activity of erythrocytes antioxidant
system.
Conclusion. Revealed changes in elemental composition of erythrocytes in patients with BI and DEP indicate about disturbance of metal-ligand homeostasis at acute and chronic cerebral circulation that doubtlessly contribute to pathogenesis of
ischemic cerebrovascular pathology.
VISCOELASTIC PROPERTIES OF MEMBRANES AND PARAMETERS OF ERYTHROCYTES AGGREGATION IN PATIENTS WITH ISCHEMIC HEART DISEASE AT VARIOUS PERIODS AFTER URGENT ROENTGEN-ENDOVASCULAR MYOCARDIAL REVASCULIZATION
Authors: Константинова Е. , Мельникова Г. , Цапаева Н. , Чижик С. , Толстая Т. , Миронова Е.
Published: February 2021

Цель исследования: изучить изменения структурно-функционального состояния клеток крови у пациентов с ишемической болезнью сердца (ИБС) в различные сроки после экстренной рентгенэндоваскулярной реваскуляризации миокарда (РЭРМ) на фоне антиагрегантной и антикоагулянтной терапии
Материалы и методы. Проведено исследование локальных механических и вязкостных свойств мембран эритроцитов методом атомно-силовой микроскопии и оценка степени агрегации эритроцитов у 32 пациентов с ИБС в период обострения заболевания, через 10 суток и 1, 3, 6, 8 и 12 месяцев после экстренной РЭРМ.
Результаты. Показано, что при обострении течения ИБС модуль упругости эритроцитов был ниже, сила адгезии их мембран и степень агрегации красных клеток крови были выше, чем у практически здоровых лиц.
Заключение. Стабилизация состояния пациентов сопровождается увеличением локального модуля упругости, уменьшением силы адгезии мембран и снижением степени агрегации эритроцитов. При стабильной стенокардии увеличение модуля упругости сопровождается повышением вязкости мембраны и снижением агрегационной способности эритроцитов.

Aim: to study structural and functional changes of blood cells in patients with ischemic heart disease (IHD) at various periods after urgent roentgen-endovascular myocardial revascularization (REMR) under antiplatelet and anticoagulant therapy.
Materials and methods. The study of local mechanical and viscous properties of erythrocytes’ membranes by atomic-force microscopy and estimation of erythrocytes’ aggregation degree in 32 patients with IHD at the acute period and in 10 days, 1, 3, 6, 8, and 12 months after urgent REMR was performed.
Results. It was shown that at the period of IHD recurrence erythrocytes’ elasticity modulus was lower, adhesion strength of their membranes and degree of red blood cells’ aggregation were higher than in practically healthy persons.
Conclusion. Stabilization of patients’ state is accompanied by increasing of the local elasticity modulus, reduction of membranes’ adhesion strength and degree of erythrocytes’ aggregation. At the stable angina increase of the elasticity modulus is accompanied by decreasing in both membrane’s viscosity and erythrocytes’ aggregability.
REGULATION OF HEMOSTASIS FUNCTIONS BY GLYPROLIN PEPTIDES AT METABOLIC SYNDROME IN RATS
Authors: Ляпина Л. , Шубина Т. , Григорьева М. , Оберган Т.
Published: February 2021

Цель исследования: изучение влияния регуляторных пептидов глипролинового ряда на состояние системы гемостаза в условиях in vivo на модели крыс с экспериментальным метаболическим синдромом (МС).
Материалы и методы. Эксперимент проводили на 60 беспородных белых крысах-самцах с массой тела 200±10 г в возрасте 2 месяца к началу опыта (к началу кормления высококалорийным рационом — ВКР). Развитие экспериментального МС у животных вызывали содержанием их на ВКР с избыточным содержанием углеводов и насыщенных жиров. Исследовали влияние интраназального многократного (7 раз) введения в малых дозах (50 мкг/кг) регуляторных пептидов Pro-Leu-Pro, Pro-Leu-Pro-Ala, Pro-Gly-Pro-Ala и Phe-Pro-Leu-Pro-Ala животным с МС на систему свертывания крови и фибринолиз.
Результаты. Через 20 часов после последнего введения пептидов наблюдалось усиление антикоагулянтной и суммарной фибринолитической активности плазмы, обусловленной как повышением неферментативного, так и ферментативного фибринолиза плазмы, а также снижение агрегации тромбоцитов. Все исследованные пептиды обладали пролонгированным действием и способностью активировать функцию противосвертывающей системы.
Заключение. Максимальный противосвертывающий эффект проявляли два пептида — Pro-Leu-Pro-Ala и Phe-Pro-Leu-Pro-Ala, причем в период после отмены их применения достоверность и значимость их эффектов возрастали.

Aim: to study the eff ect of glyproline regulatory peptides on hemostasis in vivo in the model of experimental metabolic syndrome (MS) in rats.
Materials and methods. The experiment was carried at 60 outbred white male rats with a body weight of 200±10 g and 2 months age at the beginning of the experiment (at the beginning of feeding with a high caloric diet — HCD). The development of experimental MC in animals was caused by HCD with an excess of carbohydrates and saturated fats. We examined the effects of intranasal repeated (7 times) administration of regulatory peptides Pro-Leu-Pro, Pro-Leu-Pro-Ala, Pro-Gly-Pro-Ala
and Phe-Pro-Leu-Pro-Ala in low doses (50 μg/kg) on blood coagulation and fibrinolysis in animals with MC.
Results. We revealed the enhancement of anticoagulant blood activity and total fibrinolytic activity caused by increasing of non-enzymatic and enzymatic fibrinolysis, and decreasing of platelet aggregation 20 hours after the last peptides administration.
All studied peptides had prolonged action and the ability to activate anticoagulant system.
Conclusion. Peptides Pro-Leu-Pro-Ala and Phe-Pro-Leu-Pro-Ala showed the maximum anticoagulant effect, and after stopping of their application the reliability and signifi cance of their effects increased.
OPTICAL AGGREGOMETRY IN THE EVALUATING OF ANTIPLATELET THERAPY EFFECTIVENESS
Authors: Мансурова Д. , Каражанова Л.
Published: February 2021

В настоящей статье изложены клинические случаи с определением функции тромбоцитов методом оптической агрегометрии на фоне лечения антиагрегантами. Приведены клинические примеры с результатами агрегатограмм: со стандартными агрегационными кривыми на фоне лечения одним и двумя антиагрегантами. Выявлены случаи резистентности к одному из препаратов, случай с высоким риском кровотечения. Тестирование функции тромбоцитов позволило выявить пациентов высокого риска, провести оценку эффективности и коррекцию антитромбоцитарной терапии.

Platelet function in patients taking antiplatelet agents was assayed by optical aggregometry. The clinical cases demonstrated some aggregatograms: standard, under administration of one or two antiplatelet agents as well as the resistance to antiplatelet agents together with high risk of bleeding. Testing of platelet function provided an opportunity to identify patients with high risk as well to evaluate the effectiveness and correction of antiplatelet therapy.