bluuebunny/crossref_metadata_2025 huggingface dataset:
“All We Had Were the Streets”: Lessons Learned From a Recreation-Based Community Health Space for Young Black MSM and Trans Women Across the HIV Prevention and Care Continuum
Authors: Adams Brian , Krier Sarah , Netto Jess , Feliz Nayck , Friedman M. Reuel
Published: August 2018

Young Black men who have sex with men (MSM) and transgender people experience disparities in HIV incidence and HIV outcomes. To effectively engage these communities in HIV-related programming, we developed a recreation-based community health space. We sought to examine the challenges and successes in implementing this program. Qualitative data were collected from federal progress reports and by a process evaluator who recorded interviews with staff, stakeholders, and participants. These data were coded for themes related to barriers and successes. We consolidated themes into four key domains: community engagement, service provision, stigma, and violence. Each of these domains was determined to significantly affect programmatic success during the implementation period. Young Black MSM and transgender people experience stigmas that pose challenges to effective engagement in HIV-related programming. These lessons learned offer strategies for community engagement and for addressing violence and stigma to maximize programmatic effectiveness.
Imagens de gênero e envelhecimento feminino na série televisiva brasileira Os Experientes
Authors: Mungioli Maria Cristina Palma , Dantas Silvia , Mauro Rosana
Published: August 2018

O artigo analisa dois episódios da série brasileira Os Experientes (O2 Filmes; Globo, 2015) com o objetivo de observar a produção de sentido dos discursos sobre a mulher idosa e a velhice feminina. O artigo embasa-se sobre dois eixos complementares: (1) as discussões sobre o envelhecimento da população e a “feminização” da velhice, considerando os dois fenômenos como parte integrante do profundo e complexo processo de transformação das identidades e da intimidade (Giddens, 1993, 2002) na contemporaneidade;(2) os estudos de linguagem de Bakhtin (2002, 2003), principalmente os conceitos de enunciado concreto e dialogia. A análise evidenciou a pluralidade das imagens do envelhecer feminino na contemporaneidade, destacando a presença de mulheres fortes e conscientes de suas potencialidades para além das visões tradicionais relativas ao tema.
Imagens de natureza nos jornais Folha de S. Paulo e O Estado de S. Paulo
Authors: Silva Gislene
Published: August 2018

RESUMO: Inserido no campo da produção e circulação de sentidos pela mídia e na abordagem do fenômeno jornalístico a partir de estudos do imaginário, o artigo toma como objeto de análise as imagens de natureza em textos jornalísticos impressos. Como metodologias, adotou-se, pela perspectiva epistemológica, a combinação adaptada de dois métodos de Gilbert Durand, a mitocrítica e a mitanálise. Pela perspectiva operacional, tomou-se como objeto empírico as edições impressas de dois jornais diários de circulação nacional, Folha de S. Paulo (1995 -2012) e O Estado de S. Paulo (1995-2012). Não foi feita distinção entre editorias e nem entre gêneros jornalísticos, observando imagens de natureza presentes nas mais diversas situações noticiosas, fossem em matéria de economia ou turismo, notícia curta, artigo assinado ou editorial. No total, 915 unidades noticiosas foram trabalhadas qualitativa e quantitativamente. A investigação pretendeu visualizar conjuntos de imagens na imprensa brasileira que estão orientando ou expressando, nas últimas três décadas, o pensamento da sociedade brasileira a respeito da natureza, do mundo natural.
Comunicação e educação: os movimentos do pêndulo
Authors: Citelli Adilson Odair
Published: August 2018

Este artigo resulta de pesquisa em escolas localizadas na cidade de São Paulo e entorno e se vincula a preocupações concernentes às interfaces educomunicativas. Um dos objetivos do trabalho foi o de verificar como os meios de comunicação e suas linguagens entram em circulação no cotidiano das aulas. Daí decorreram perguntas afeitas aos eventuais usos da comunicação nos processos de ensino e aprendizagem, assim como o reconhecimento dos hábitos midiáticos de discentes e docentes. Entre as técnicas investigativas acionaram-se entrevistas, questionários, observação direta, abrangendo cento e noventa e sete docentes e seiscentos e noventa e nove discentes, distribuídos em trinta e duas escolas. Os resultados indicam existir desencontros entre os ritmos dos discursos escolares e as temporalidades que matizam o cotidiano de alunos e professores, marcadas fortemente pelos media. Propomos promover a inter-relação comunicativo-educativa enquanto possiblidade de circundar aquelas distonias
DYNAMICS OF LEFT VENTRICULAR PARAMETERS IN THE LONG-TERM TREATMENT OF RENAL PARENCHYMATOUS ARTERIAL HYPERTENSION
Authors: Borovkova N. Yu. , Borovkov N. N. , Khor’kina Yu. A. , Obukhova E. O. , Arshinova A. I.
Published: August 2018

Aim. To investigate the dynamics of left ventricular (LV) parameters during the long-term treatment of renal parenchymatous arterial hypertension (RPAH) in patients with primary chronic glomerulonephritis and preserved renal function.

Material and methods. The long-term follow-up included 136 RPAH patients with preserved renal function. Clinical assessment of blood pressure (BP) levels, 24-hour BP monitoring, and Doppler echocardiography (EchoCG) were performed at baseline and during the complex antihypertensive therapy (AHT) and pathogenetic therapy of RPAH patients. The treatment-related dynamics of LV structure and function was evaluated.

Results. The long-term complex treatment of RPAH patients resulted in significantly reduced clinical BP levels, improved 24-hour BPM parameters, LV hypertrophy (LVH) regression, and improved diastolic and systolic LV function.

Conclusion. The long-term complex AHT, in combination with pathogenetic therapy, resulted not only in reduced BP levels and improved circadian BP profile, but also in improved diastolic and systolic LV function and LVH regression among RPAH patients with preserved renal function.
POTENTIAL OF THE MODERN ACE INHIBITOR ZOFENOPRIL IN CLINICAL PRACTICE: CARDIOPROTECTIVE, ANTI-ISCHEMIC, AND ANTIATHEROGENIC EFFECTS
Authors: Bubnova M. G.
Published: August 2018

The review discusses various aspects of angiotensin-converting enzyme (ACE) inhibitor therapy in patients with cardiovascular disease (CVD), including acute myocardial infarction (AMI). The focus is on the modern ACE inhibitor zofenopril, its specific pharmacological characteristics, and additional cardioprotective, anti-ischemic, and antiatherogenic effects. The existing evidence of clinical effectiveness of zofenopril and its potential for a wider use in clinical practice are also addressed.
CURRENT RECOMMENDATIONS ON RISK STRATIFICATION AND SUDDEN CARDIAC DEATH PREVENTION IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY (BASED ON THE 2011 RECOMMENDATIONS BY THE AMERICAN COLLEGE OF CARDIOLOGY / AMERICAN HEART ASSOCIATION)
Authors: Privalova E. V. , Kaplunova V. Yu. , Khabarova N. V. , Shakaryants G. A. , Belenkov Yu. N.
Published: August 2018

One of the clinical scenarios of hypertrophic cardiomyopathy (HCMP) is sudden cardiac death (SCD). The stratification of SCD risk is the key component of defining the therapeutic strategy in HCMP patients. Timely preventive treatment is the only life-saving intervention in patients with high SCD risk. The available clinical evidence suggests that SCD risk stratification is an effective algorithm for determining the need for preventive treatment. The latter should be individualised, based on the risk levels in each patient.
BENEFITS OF VOLUMETRIC COMPRESSION OSCILLOMETRY FOR THE ASSESSMENT OF HEMODYNAMIC PARAMETERS IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Shpak L. V. , Galoshina E. S.
Published: August 2018

Aim.To compare the parameters of central and peripheral hemodynamics in healthy people and patients with Stage 1–3 arterial hypertension (AH).

Material and methods.In total, 105 individuals were examined. The control group (CG) included 50 healthy people (25 women and 25 men; mean age 27,8±0,8 years) with optimal and normal levels of blood pressure (BP) (mean levels 118,5±1,6/71,82±1,2 mm Hg). The main group (MG) included 55 patients (41 women and 14 men; mean age 62,9±1,6 years) with systolo-diastolic AH: Stage 1 in 25 (mean BP levels 146,1±0,9/84,9±1,6 mm Hg), Stage 2 in 20 (164,4±1,8/95±2,1 mm Hg), and Stage 3 in 10 (189,6±10,6/92,6±6,3 mm Hg). The method of volumetric compression oscillometry (VCO) was used to assess a wide range of myocardial and hemodynamic parameters.

Results.In AH patients, all AH phenotypes, vascular and cardiac parameters were increasing, with a simultaneous reduction in vascular wall distensibility, in parallel with the AH progression from Stage 1 to Stage 3. This indicated an increase in myocardial contractility, tone strain of arterial wall, and peripheral vascular resistance. From Stage 1 to Stage 3, the prevalence of hyper- and eukinetic cardiac hemodynamic types was decreasing, while the prevalence of mixed and hypokinetic types was increasing. The mixed hemodynamic type (a combination of hyper-, eu-, and particularly hypokinetic type characteristics) was considered as an incompletely developed disadaptive hypokinetic type.

Conclusion.The VCO method is an effective, non-invasive way to simultaneously assess the status of multiple hemodynamic parameters in both healthy people and AH patients. A specific benefit of this method is the registration of lateral BP levels and identification of mixed (additional) hemodynamic type.
ECG DISPERSION MAPPING PARAMETERS DURING THE TREADMILL TEST IN PATIENTS WITH CORONARY HEART DISEASE
Authors: Ivanov G. G. , Agafoshina E. V. , Pecherskikh A. A. , Khalabi G.
Published: August 2018

Aim.The aim of the study was the complex analysis of the ECG-12 and ECG dispersion mapping (DM) parameters during the physical stress test in patients with coronary heart disease (CHD).

Material and methods.The main group included 143 CHD patients with Functional Class I–III angina (99 men and 44 women; mean age 50,6±4,6 years). The control group included 37 healthy individuals (mean age 44,3±4,8 years). Patients with heart failure signs and symptoms were excluded. All participants underwent the graduated physical stress test.

Results.Two variants of the ECG changes were observed, with normal and abnormal reaction of ECG DM parameters. The latter group was characterised by the following: ratio of heart rate and myocardial micro-alternation index (HRmax/MMImax) 30% at the peak HR.

Conclusion.Using the ECG DM method during the treadmill test is a feasible and useful approach to gain additional diagnostic information on the myocardial electro-physiological status and, therefore, to select the patients who need further examination and treatment.
DEATH CAUSES AND THEIR PREDICTION IN PATIENTS WITH THE ST SEGMENT ELEVATION ACUTE CORONARY SYNDROME AND PRE-HOSPITAL THROMBOLYSIS
Authors: Morozov S. N. , Fedorov A. I. , Loskutova K. S. , Vertkin A. L.
Published: August 2018

Aim.To assess effectiveness and safety of pre-hospital medical treatment in patients with acute coronary syndrome and ST segment elevation (ST-ACS) who are undergoing thrombolytic therapy (TLT); to identify TLT complications and the methods for their prediction.

Material and methods.In total, the pre-hospital TLT effectiveness was assessed in 237 patients. The comparison group included 274 patients who did not undergo TLT, due to various reasons. The causes of death by Day 7–10 were analysed.

Results.The leading cause of death was cardiogenic shock. In addition, in the main group, indirect myocardial rupture was a cause of death more often than in the comparison group (28% vs. 5,3%). Indirect myocardial rupture was associated with haemorrhagic complications of pre-hospital TLT. The proposed method for predicting TLT complications is based on the TIMI scale: 1–4 points suggest TLT safety; 4–5 points correspond to a higher risk of external myocardial rupture (11,6%), which implies the need to perform TLT under control of blood coagulation parameters; and ≥6 points denote the need to avoid pre-hospital TLT and use a mechanic reperfusion strategy.

Conclusion.Among ST-ACS patients, mortality levels were 20,9%, which was 2,4 times higher than in the comparison group. In the main group, the morphological data obtained at autopsy demonstrated hemorrhagic myocardial transformation, which was associated with the high risk of indirect myocardial rupture (28,1%). In patients with pre-existing arterial hypertension and with the time from the ST-ACS onset of 2–3 hours, the risk of indirect myocardial rupture should be predicted, based on the TIMI scale. This will facilitate more effective assessment of the systemic TLT complication risk and selection of the optimal reperfusion strategy.
COGNITIVE DYSFUNCTION IN PATIENTS WITH ATRIAL FIBRILLATION: ASSESSING THE ROLE OF VASCULAR FACTORS
Authors: Derevnina E. S. , Akimova N. S. , Persashvili D. G. , Schwartz Yu. G.
Published: August 2018

Aim. To study the association between the presence and type of atrial fibrillation (AF), cognitive dysfunction, and brachiocephalic artery pathology.

Material and methods. In total, 54 patients with AF and 20 AF-free patients who had Functional Class I–III chronic heart failure (CHF) underwent cognitive assessment tests, echocardiography, cerebral nuclear magnetic resonance imaging, and duplex brachiocephalic ultrasound.

Results. In AF patients, deteriorated parameters of memory and attention were registered. Patients with persistent AF demonstrated worse cognitive function parameters. The characteristics of short-term memory and attention, attainment of visual and motoric skills, and attention shift and span were not associated with the intima-media thickness of common carotid artery and its bifurcation.

Conclusion. There is an association between the presence of AF, its type, and the severity of cognitive dysfunction, which is independent of the degree of brachiocephalic artery abnormalities.
CARDIOVASCULAR RISK FACTORS AND SELECTED PARAMETERS OF ECG DISPERSION MAPPING IN MEDICAL STUDENTS
Authors: Esina E. Yu. , Zuykova A. A. , Krasnorutskaya O. N.
Published: August 2018

Aim.To investigate the association between the risk factors (RFs) of cardiovascular disease (CVD) and selected parameters of ECG dispersion mapping in medical students, in order to facilitate preclinical diagnostics and timely risk management.

Material and methods.The study included 72 students of the Internal Disease and Paediatrics Faculties of the N. N. Burdenko Voronezh State Medical Academy, aged 21–26 years (mean age 21,9±0,1 years; 18 men and 54 women). The examination included a questionnaire survey on CVD RFs, a clinical assessment, and the measurement of hemodynamic parameters. ECG parameters, including such integral characteristics as “Myocardium”, “Rhythm”, and “Detail Code”, were assessed both at rest and during the physical stress test, using the Cardiovisor 6C device.

Results.All participants were divided into two groups. In the group with multiple CVD RFs, the distribution of these factors was as follows: 40% smoked (n=6), 53% consumed 2–3 drinks of alcohol per occasion (n=8), 40% had high normal blood pressure (BP) or Stage 1 elevation of BP, based on the office measurement data (n=6). Three (20%) and 4 (27%) students were overweight (OW) and obese (O; Stage I), respectively. Low physical activity (PA) was reported by 14 students (93%), and moderate to high levels of stress by 67% (n=10) and 33% (n=5), respectively. Immediately after the physical stress test and 2 minutes later, the “Myocardium” parameter was ≥17%, being significantly different from the values observed in students without multiple RFs. Abnormal values of the integral parameters of ventricular depolarisation and left ventricular repolarisation suggest the myocardial electrical heterogeneity among students with multiple CVD RFs.

Conclusion.Students with multiple CVD RFs, such as smoking, alcohol, elevated BP, OW, Stage I O, moderate to high stress levels, and low PA, also demonstrated the myocardial electrical heterogeneity during the physical stress test.
EARLY DISTURBANCES OF CARBOHYDRATE METABOLISM — A TARGET FOR PRIMARY CARDIOVASCULAR PREVENTION
Authors: Kovrigina M. N. , Mamedov M. N.
Published: August 2018

The paper discusses the social and economic costs associated with diabetes mellitus (DM) and its complications. Cardiovascular disease (CVD) is the leading cause of disability and complications in DM patients. The diagnostics and correction of the early disturbances of carbohydrate metabolism are important components of the primary prevention of Type 2 DM (DM-2). The DM-2 development is preceded by the abnormalities typically overlooked by the busy practitioners, such as impaired fasting glucose and impaired glucose tolerance. The authors present the evidence from international clinical trials confirming that the early disturbances of carbohydrate metabolism are an independent risk factor of CVD. Therefore, recently, the importance of the combined primary prevention of DM-2 and diabetes-associated CVD has been extensively discussed.
MELDONIUM: EFFECTIVE ACTION POINTS
Authors: Vertkin A. L. , Khovasova N. O. , Pshenichnikova V. V. , Alekseev M. A. , Abdullaeva A. U.
Published: August 2018

The paper is focused on hypoxia and cell ischemia as universal pathogenetic mechanisms of disease development, which can be addressed by both etiotropic and pathogenetic therapy. The latter is represented by the so-called metabolic correctors. At present, one of the most widely used metabolic correctors is mildronate. The authors discuss the effectiveness of mildronate in various clinical situations and also present the relevant original findings.
ECHOCARDIOGRAPHY IN RIGHT VENTRICULAR MYOCARDIAL INFARCTION
Authors: Hayrapetyan H. G. , Adamyan K. G.
Published: August 2018

This paper presents the views on two-dimensional (2D) echocardiography (EchoCG) in the assessment of right ventricular (RV) structure and function. In order to quantitatively assess the RV global function, the following parameters can be used: RV outflow tract shortening fraction, RV fractional area change, tricuspid annular plane systolic excursion, and Tei index. For these parameters, their assessment methods, as well as their strengths and limitations, are discussed.
A NEW COMBINATION INHIBITS INTESTINAL CHOLESTEROL ABSORPTION, SUPPRESSES ENDOGENOUS CHOLESTEROL SYNTHESIS, AND DEMONSTRATES ANTI-INFLAMMATORY AND HEPATOPROTECTIVE EFFECTS
Authors: Oganov R. G. , Chernova S. I. , Gorbacheva V. Yu.
Published: August 2018

Hypercholesterolemia (HCH) and vascular inflammation are the main therapeutic targets in atherosclerosis. The paper discusses the results of the studies which have focussed on the effects of a new class of physiologically active substances (polyprenols and β-sitosterols) on lipid profile and pro-inflammatory cytokines in HCH patients with low to moderate cardiovascular risk. Polyprenol phosphates and phytosterols could help to achieve significant changes in lipid profile and normalisation of immunologic parameters.
AORTIC STIFFNESS ASSESSMENT IN PATIENTS WITH ARTERIAL HYPERTENSION AND OBESITY
Authors: Shupenina E. Yu. , Yushchuk E. N. , Khadzegova A. B. , Ivanova S. V. , Sadulaeva I. A. , Nadina E. V. , Khuchinaeva A. M. , Vasyuk Yu. A.
Published: August 2018

Cardiovascular disease (CVD) remains the leading cause of death in most developed countries. Morphological and functional status of large arteries plays an important role in the pathogenesis of CVD. At the moment, there are two main methods of aortic stiffness assessment: pulse wave velocity (PWV) measurement and central PW analysis. In advanced age, aortic stiffness increases, which manifests in increased PWV, elevated central blood pressure, and increased parameters of reflected PW. Similar changes can be observed in young patients with arterial hypertension. The existing evidence concerning obesity effects on aortic stiffness is contradictory and warrants further clarification.
ANGIOTENSIN II RECEPTOR ANTAGONISTS AND NEPHROPROTECTION: PLACE OF OLMESARTAN
Authors: Fomin V. V.
Published: August 2018

The paper presents the results of experimental studies and clinical trials which demonstrate nephroprotective effects of olmesartan.
HEART AND AGE (PART II): CLINICAL MANIFESTATIONS OF AGEING
Authors: Akasheva D. U. , Plokhova E. V. , Strazhesko I. D. , Dudinskaya E. N. , Tkacheva O. N.
Published: August 2018

Ageing is an inevitable process which affects quality of life and reduces life expectancy. Age-related cardiac changes reduce compensatory reserves of the heart and accelerate the disease development. Such changes in cardiac structure and function, observed in the absence of cardiovascular disease (CVD), are considered age-related. However, taking into account the high prevalence of CVD in the elderly, it is problematic to define the genuine cardiac ageing. This review discusses a range of subclinical cardiac conditions which are common in older people.
IMPROVING THE METHODOLOGY OF CONTINUOUS MEDICAL EDUCATION IN THE CONTEXT OF ARTERIAL HYPERTENSION TREATMENT
Authors: Vertkin A. L. , Skotnikov A. S. , Mychka V. B. , Prokhorova Yu. V. , Khamurzova M. A. , Uzueva E. I.
Published: August 2018

Aim. To assess the role of the algorithm-based selection of antihypertensive therapy (AHT) and the continuous medical education in the treatment of arterial hypertension (AH).

Material and methods. Based on the autopsy data, we analysed the prevalence of AH and the structure of its complications and comorbidities among 3239 patients of a multidisciplinary Moscow City hospital. We also analysed the practices of preceding ambulatory AHT and conducted the survey on the quality of continuous medical education lectures delivered to internal medicine specialists working at polyclinics.

Results. Among patients who died from cardiovascular disease, a high prevalence of AH (96,1%) was combined with prevalent target organ damage (TOD), a strong association between blood pressure (BP) levels and the risk of major cardiovascular events, and a wide range of comorbidities and AH complications. There was a lack of universal AHT schemes and regimens for patients of similar age, gender, and nature and severity of comorbidities.

Conclusion. Achievement of target BP levels failed to prevent major cardiovascular events which resulted in fatal outcomes. AHT was administered without adequate consideration of organo-protective and pleiotropic effects of antihypertensive medications. The development of an algorithm which considered age, gender, TOD presence, and previous major cardiovascular events in the selection of AHT had improved the doctors’ understanding of the lecture information.
VALUE OF SPECIFIC PARAMETERS AND INTEGRATIVE INDICES OF TREADMILL TEST FOR THE ASSESSMENT OF CORONARY STENOSIS SEVERITY
Authors: Martsevich S. Yu. , Tolpygina S. N. , Malysheva A. M. , Polyanskaya Yu. N. , Gofman E. A. , Lerman O. V. , Mazaev V. P. , Deev A. D.
Published: August 2018

Aim.To assess the value of specific parameters and integrated indices (II; such as Duke Index (DI), Centre for Preventive Medicine Index (CPMI), and modified CPMI) of the treadmill test in the diagnostics of coronary stenosis severity among patients with stable coronary heart disease (CHD).

Material and methods.The study included all patients (260 permanent residents of Moscow City or Moscow Region) who were admitted to the State Research Centre for Preventive Medicine with the CHD diagnosis and who underwent coronary angiography (CAG) and treadmill test in the period between January 1st 2004 and December 31st 2007.

Results.There were statistically significant associations between the main treadmill test parameters and the severity of coronary artery (CA) atherosclerosis. The larger number of stenosis-affected CA was associated with a higher prevalence of chest pain and treadmill tests with positive results and ST segment depression >1 mm, as well as with a decreased total duration of treadmill test. Similarly, the increased risk, as assessed by treadmill test indices (DI, CPMI, and modified CPMI), was linked to an increased number of stenosis-affected CA. Modified CPMI demonstrated the highest diagnostic value for the assessment of coronary atherosclerosis severity.

Conclusion.The treadmill test parameters which demonstrated their diagnostic value for the assessment of CHD severity included the following: positive test results, retrosternal chest pain as the reason for test discontinuation, ST segment depression >1mm, and short total duration of the test. Overall, all II demonstrated their high value in CHD diagnostics. Modified CPMI was the most effective II in the assessment of CA atherosclerosis severity.
ASSOCIATION BETWEEN BLOOD LIPID PROFILE AND BLOOD GLUCOSE LEVELS IN MEN WITH CORONARY HEART DISEASE, METABOLIC SYNDROME, AND TYPE 2 DIABETES MELLITUS
Authors: Matveeva S. A.
Published: August 2018

Aim.To study the associations between blood lipid profile and blood glucose levels in men with coronary heart disease (CHD), stable effort angina (SEA), metabolic syndrome (MS), and Type 2 diabetes mellitus (DM-2).

Material and methods.The study included 82 men (mean age 50,5±0,9 years) with CHD, Functional Class I–III SEA, MS, and DM-2. The following lipid profile parameters were assessed: total cholesterol (TCH), triglycerides (TG), low-density lipoprotein cholesterol (LDL–CH), very low-density lipoprotein cholesterol (VLDL–CH), high-density lipoprotein cholesterol (HDL–CH), atherogenic index (AI), and triglyceride index (TGI), together with fasting blood glucose.

Results.There were positive (direct) associations between higher levels (>90th percentile) of lipid profile parameters (TCH, TG, LDL–CH, VLDL– CH, HDL–CH, AI, TGI) and blood glucose, as well as between lower levels (≤10th percentile) of lipid profile parameters (TCH, TG, LDL–CH, VLDL– CH, AI, TGI) and blood glucose. At the same time, there were negative (inverse) associations between lower lipid levels (≤10th percentile of TCH, TG, LDL–CH, VLDL–CH, HDL–CH, AI, TGI) and higher glucose levels (>90th percentile), as well as between higher lipid levels (>90th percentile of TCH, TG, LDL–CH, VLDL–CH, HDL–CH, AI, TGI) and lower glucose levels (≤10th percentile).

Conclusion.Dyslipidemia and hyperglycemia demonstrate synergetic proatherogenic effects in patients with CHD, SEA, MS, and DM-2, as suggested by significant heterogeneous (direct and inverse) associations between lipid profile parameters and fasting blood glucose. The results obtained provide an opportunity for the assessment of risk levels, prognosis, and need for pharmacological prevention and treatment in patients with combined cardiovascular pathology.
CALCIUM CHANNEL BLOCKADE AND FUNCTIONAL MICROCIRCULATION CHANGES IN HYPERTENSIVE PATIENTS WITH DIFFERENT INDIVIDUAL AND TYPOLOGICAL CHARACTERISTICS
Authors: Vasiliev A. P. , Streltsova N. N. , Shumeiko E. A.
Published: August 2018

Aim. To identify individual and typological functional features of peripheral blood flow and assess microcirculation (MC) dynamics after a single-dose administration of nifedipine in patients with arterial hypertension (AH).

Material and methods. Laser Doppler flowmetry (LDF) was used for the MC assessment in 39 patients with Stage II–III AH.

Results. Marked variability in peripheral blood flow parameters was demonstrated for AH patients. Three main LDF types were identified: aperiodic (ApT), hyperemic, and hypoemic. Single-dose administration of nifedipine (20 mg) resulted in a similar antihypertensive effect across all patient groups. Positive MC dynamics was observed, which manifested in a marked increase in the number of patients with ApT (the most balanced type of peripheral blood flow regulation) and increased input of pulse blood filling into hemoperfusion.

Conclusion. In AH patients, nifedipine-induced changes in peripheral blood flow were associated with an increased number of participants with ApT, as the most balanced type of MC regulation.
THERAPY COMPLIANCE IN AMBULATORY PATIENTS: PROFILE REGISTRY DATA
Authors: Lukina Yu. V. , Martsevich S. Yu. , Zagrebelnyi A. V. , Tripkosh S. G. , Aidu F. A. , Deev A. D.
Published: August 2018

Aim.Using the data from the PROFILE Registry and the patients’ questionnaire survey, to analyse the patients’ compliance with medical recommendations on lipid-lowering therapy (LLT).

Material and methods.Over the period from May 1st 2011 to December 31st 2011, 274 patients were included in the PROFILE Registry: 82 were referred to a specialised medical centre for the first time (control group, CG); 167 were regularly attending the medical centre (main group A, MGA); and 25 last visited the centre >2 years ago (main group B, MGB). 262 patients completed a questionnaire on the therapy compliance, while 12 refused to participate in the questionnaire survey.

Results.According to the results of the questionnaire survey, MGA patients were better informed about the LLT goals (65%) than their CG and MGB peers (35% and 48%, respectively; p<0,0001). The percentage of patients who took statins every day was 87% in MGA vs. 41,5% in CG and 64% in MGB (p=0,002). Statin therapy effectiveness was controlled regularly in MGA: cholesterol (CH) levels were measured every 6 months in 37,5% and every 12 months in 28%. For CG, these figures were 17% and 16%, while for MGB, they were 15% and 40%, respectively (p<0,0001). One-third of CG patients, every fourth MGB patient, and only 13% of MGA patients did not control their CH levels (p<0,0001).

Conclusion.The MGA patients who were regularly attending the State Research Centre for Preventive Medicine were the most LLT-compliant: they were well-informed about their disease and therapy goals, were regularly taking prescribed medications (statins), and had better treatment control and the highest LLT effectiveness.
TRIMETAZIDINE MR EFFECTS ON THE PARAMETERS OF 24-HOUR ELECTROCARDIOGRAM MONITORING AND HEART RATE VARIABILITY
Authors: Novikova M. V. , Glezer M. G.
Published: August 2018

Aim. To assess the effects of the four-month trimetazidine MR therapy on the parameters of 24-hour electrocardiogram (ECG) monitoring and heart rate variability (HRV) in patients with stable coronary heart disease (CHD).

Material and methods. This prospective, non-randomised study, with the inclusion of 66 consecutive patients who had stable CHD and stable stress test results, investigated the effects of trimetazidine MR therapy on the parameters of 24-hour ECG monitoring and HRV.

Results. Trimetazidine MR did not markedly affect the 24-hour, daytime, or nighttime levels of heart rate. Trimetazidine MR therapy was not associated with any substantial changes in frequency and time-domain HRV parameters or in the incidence of cardiac arrhythmias. However, there was a significant reduction in the number of patients with ST segment depression (from 66,7% to 43,8%; p<0,001) and in the duration of ischemic episodes (from 10 (6,2;21) minutes to 7,42 (5;12,3) minutes (p=0,025)).

Conclusion. Adding trimetazidine MR to the treatment of patients with stable CHD provides an additional beneficial antiischemic effect.
ROLE OF MEDICATIONS WITH NEGATIVE CHRONOTROPIC EFFECT IN THE TREATMENT OF PATIENTS WITH CORONARY HEART DISEASE AND HEART FAILURE
Authors: Glezer M. G. , Astashkin E. I. , Sokolova I. N.
Published: August 2018

The study aim was to assess the importance of adequate administration of medications with negative chronotropic effect in the improvement of clinical course and prognosis among patients with coronary heart disease (CHD) and heart failure. The possibility and appropriateness of combination therapy with β-adrenoblockers (β-AB) and an If channel blocker ivabradine is justified. The authors analyse current real-world trends in the administration and dose titration of these medications among ambulatory Russian patients. Russian doctors need to be more active in the treatment of patients with CHD and heart failure and better understand the need for and benefits of dose titration of medications with negative chronotropic effect, as well as the importance of combination therapy for the improvement of clinical course, prognosis, and quality of life.
SUCCESSES AND FAILURES OF CARDIOVASCULAR PREVENTION
Authors: Oganov R. G. , Maslennikova G. Ya.
Published: August 2018

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HEMODYNAMIC AND BIOELECTRICAL PROPERTIES OF THE BRAIN IN YOUNGER ADULTS WITH NONSTABLE BLOOD PRESSURE
Authors: Efremushkin G. G. , Filippova T. V. , Kharlova A. G. , Dekhar V. V.
Published: August 2018

Aim.To study macro- and microhemodynamics and bioelectrical properties of the brain in younger adults with nonstable blood pressure (BP).

Material and methods.A population of 79 adults at the age of 19–24 (average 19,9±0,9 years) was examined. According to the BP level they were divided into two groups: 1–46 (58,5%) with stable normal BP (SNBP), and 2–33 (41,5%) with high normal BP inside the range for 1stlevel arterial hypertension, whose BP was not stable (UsBP), but changing from normal values to 1st level hypertension. All patients undergone investigation of brachiocephal and intracerebral vessels with blood flow velocity measurement along the vessel direction, the blood sectional volumetric flow and specific kinetic energy. Microcirculation in the brain was measured by rheoencephalography including parameters of the velocity, time and volumetric parameters. Bioelectricity studied by electroencephalography.

Results.In patients with UsBP we found the increase of blood flow velocity, blood volume and specific kinetic flow energy in vertebral and general carotid arteries as in basilar and middle cerebral arteries to. In the area of microcirculation in patients with UsBP the blood filling of frontal lobes was decreased comparing to SNBP patients in whom blood filling showed “mosaic” pattern. In UsBP patients we found changes of bioelectrical activity which are related to the functioning of cortical and subcortical portions of the brain.

Conclusion.In younger patients with UsBP there is developed discirculatory encephalopathy with damage of cortex and subcortical portions of the brain due to impaired hemodynamic and microcirculation.
SEVERAL ASPECTS OF DILTIAZEM AND ORGANIC NITRATES USAGE IN VARIOUS SEVERITY STABLE ANGINA PATIENTS
Authors: Butina E. K. , Bochkareva E. V. , Pozdnyakova N. A.
Published: August 2018

Aim. To estimate the effectiveness of Diltiazem (Dlt) and its combination with nitrates in patients with ischemic heart disease (CHD) and arterial hypertension (AH) according to exercise tolerance by functional class (FC) of stable angina (StA).

Material and methods. 30 CHD male patients at the age of 58,8±7,5 with StA II FC (n=11), III FC (n=19) and 1–2 stage AH were included into open randomized placebo-controlled study. Drug therapy: Dlt 90–180 mg bid, isosorbide 5-mononitrate 50 mg qd, trinitrolong 2 mg bid or tid. Effectiveness of the regular drug intake was controlled by repeated exercise tolerance tests (ETT) by treadmill with the value of threshold effort time (ThT). Total duration of treatment was 4 weeks.

Results. At the beginning the ThT was 249,8±23,4 s for III FC and 368,6±14,4 s for II FC patients (p=0,0001). One dose of Dlt increased ThT in 5 hours to 387,3±37,5 s and 533,7±20,3 s in both groups, respectively (p=0,001), with the difference between groups being held. During regular Dlt intake the ThT in III FC angina patients reached 441,1±26,8 s, but in II FC patients in has not changed: 526,1±22,0 s. Additional nitrate intake to III FC group led to even more increase of ThT; in II FC patients there was no improvement. Combination therapy by Dlt and nitrates has not led to differences between III and II FC groups by achieved exercise tolerance. Hemodynamic parameters in both groups has not differ.

Conclusion. For patients with III FC stable angina it is recommended to prescribe Dlt with nitrates because of additional effectiveness of combination that might be linked to the influence on cardiac hemodynamics and to improvement of myocardium metabolism. In II FC stable angina Dlt alone reaches its maximum antiischemic effect so the addition of nitrates is not helpful.
STUDYING ATRIAL FIBRILLATION ON THE BASIS OF THE “PROFILE” REGISTRY
Authors: Martsevich S. Yu. , Navasardian A. R. , Kutishenko N. P. , Drozdova L. Yu. , Zakharova A. V. , Kiseleva N. V.
Published: August 2018

Aim.To research the prevalence of atrial fibrillation (AF) and to compare the clinical characteristics of the patients to those without AF.

Material and methods.At the moment of cross-section the Profile Study included 671 patients with various cardiovascular diseases, those who consulted at the Preventive pharmacotherapy department of the Centre.

Results.AF was diagnosed in 99 patients (14,7%). There was no difference by gender with those without AF, but they were significantly older. There was no difference in prevalence of the common risk factors, ischemic heart disease and peripheral atherosclerotic disease. Anamnesis of cerebral stroke was more common for the AF group: 9,1% vs 2,8%. Anamnesis of stomach ulcer disease was also more prevalent in AF group: 9,1% vs 4,4%.

Conclusion.The section-study of patients included into Profile Registry showed typical clinical properties for AF and made it to compare with those found in other registries.
KIDNEY DYSFUNCTION EVALUATION IN CHRONIC HEART FAILURE PATIENTS
Authors: Kamilova U. K. , Alikulov I. T.
Published: August 2018

Aim. To study the signs of kidney dysfunction in chronic heart failure (CHF).

Material and methods. We included 96 patients with postinfarction cardiosclerosis and CHF with the age of 40–60 years. Patients were divided into two groups by functional class (FC) of CHF according to NYHA. In all patients the levels of serum creatinine and MDRD glomerular filtration rate (GFR), urine alanine transferase, aspartat transferase, alkaline phosphatase and cholinaestherase by spectrophotometric method were measured.

Results. In 33,3% of patients with II FC NYHA and in 66,67% with III FC NYHA we found GFR less than 60 ml/min/1,73 sq.m. Investigation of fermenturia levels in those according to renal functioning showed more prevalent increase of urine enzymes in lower GFR, in whom the patients with III FC NYHA consisted 66,67%. The level of ALT was 39% (p<0,01) higher and AP 35% (p<0,001) higher comparing to subjects without renal dysfunction.

Conclusion. In patients with chronic heart failure as the diseases progresses there is kidney dysfunction developing with the decrease of GFR, increase of resdual nitrogen and enzimes in urine. Enzyme levels testing in urine of CHF patients can be a part of diagnostic approach to kidney dysfunction diagnostic at earlier stages.
ТHE ROLE OF GENETIC TESTING FOR OPTIMAL ANTIPLATELET THERAPY SELECTION IN THE TREATMENT OF CORONARY ARTERY DISEASE PATIENTS
Authors: Matskeplishvili S. T. , Arutyunova Y. E.
Published: August 2018

The studies of coronary heart disease as a cause of reduced life quality and disability in population led to improved methods of diagnosis and treatment of this disease. To date, accumulated large evidence base supports the use of DAT (dual antiplatelet therapy) in patients with coronary artery disease after PCI. According to the same data some patients still develop severe complications, i. e. stent thrombosis. In this regard, recent years there is increasing importance of the genetic testing for selection of the optimal antiplatelet therapy in patients with coronary artery disease.
A trajetória do educador Paulo Freire no Ministério da Educação e Cultura no período de 1958 a 1963
Authors: Gouvêa Fernando César Ferreira
Published: August 2018

Resumo O trabalho analisa a pouco conhecida trajetória do intelectual Paulo Freire no Centro Regional de Pesquisas Educacionais do Recife (CRPE-RE) no período de 1958 a 1963 na gestão do sociólogo Gilberto Freyre. Cabe lembrar que o CRPE-RE estava ligado ao Centro Brasileiro de Pesquisas Educacionais (CBPE) sob a direção de Anísio Teixeira. O artigo busca mapear essa atuação, entender os motivos do seu esquecimento por parte dos estudiosos da obra freiriana e a ausência desta trajetória nos livros do próprio Paulo Freire. O que instiga a pensar num jogo de espelhos entre a memória e o esquecimento que nos conduzem aos seguintes questionamentos sobre a referida trajetória: qual a efetiva participação de Paulo Freire no cotidiano do CRPE-RE? Houve um autoapagamento desta experiência? Ou seguiu os passos da tentativa de esquecimento que recaiu sobre o CBPE, após 1964? A fim de compreender tais questões, a metodologia utilizada repousa na pesquisa de caráter documental e histórico. A fonte primária é o Boletim Mensal do Centro Brasileiro de Pesquisas Educacionais, uma publicação do Instituto Nacional de Estudos Pedagógicos no âmbito do Ministério da Educação. A rigor, busca-se o cotejamento entre o dito nos diversos livros do autor e o escrito no referido Boletim.
A dança e a educação da feminilidade: Belo Horizonte – MG (1930-1960)
Authors: Chaves Elisângela , Moreno Andrea
Published: August 2018

Resumo Em 1934, atendendo somente a meninas, foi criado o primeiro espaço privado e especializado no ensino da dança em Belo Horizonte – MG, o “Curso Natália Lessa”. O contexto histórico e cultural no qual viveram as alunas, a professora e a sociedade que acompanhou esse trabalho compõe cenas na cidade que, apesar das porosidades, suscita um rico conjunto de significados para a formação feminina no período em Belo Horizonte. A hipótese central do estudo é de que suas práticas no ensino da dança para meninas teriam proporcionado uma dada direção para educação da feminilidade em Belo Horizonte e se tornaram referência representativa nessa ambiência. A partir das análises de fontes diversificadas, foi possível identificar a intencionalidade pedagógica do Curso de educar, através da dança, a feminilidade, seguindo ideários em circulação. Desde o início de sua carreira, as declarações e as divulgações sobre o Curso o apresentavam como uma atividade educacional e feminina, com os objetivos de desenvolver qualidades e habilidades vinculadas a três eixos: a graça, a saúde e a beleza, que envolviam questões relativas à disciplina, ao ritmo e à eugenia. Percebe-se que a proposta de Natália Lessa gerava poucos estranhamentos e representava seguramente formas de educar, já legitimadas pela escola, reconhecidas e apreciadas pela sociedade local.
Detectar e promover uma perspectiva de 0-6 nos provedores de serviços educacionais para crianças: o desenvolvimento de um instrumento
Authors: Gobbetto Barbara
Published: August 2018

Resumo A pesquisa apresentada neste artigo faz parte dos inquéritos de pesquisasobre a avaliação formativa de contexto e representa um dos estudos realizados pelo grupo de pesquisa pedagógica da Universidade de Pavia, Itália. O objetivo principal do trabalho foi desenvolver uma série de indicadores capazes de apoiar formas de autoavaliação reflexiva em grupos de educadores de creches e professores de escola infantil, a fim de construir uma perspectiva educacional 0-6 e, então, promover uma proposta pedagógica “contínua” entre estes dois contextos. O instrumento elaborado foi concebido com o objetivo de proporcionar caminhos de formação em pesquisa, mesmo que os efeitos reais em termos de mudança ainda não tenham sido verificados. Em sequência, as referências teóricas, a metodologia e as etapas que levaram ao processamento da ferramenta serão apresentadas. Por fim, os primeiros resultados da pesquisa in progress são propostos.
“Promover a partir de dentro”: uma abordagem reflexiva e participativa da avaliação de contextos educativos1
Authors: Savio Donatella
Published: August 2018

Resumo Avaliação de contextos educativos como “promoção a partir de dentro” foi desenvolvida por inúmeras pesquisas de campo (Bondioli, 2015a; Savio, 2013). A abordagem se baseia nos princípios da reflexividade e da participação (Guba & Lincoln,1989, 2001); inclui o envolvimento de um grupo de trabalho (os operadores de determinado contexto educacional) e de um facilitador de processos participativo-reflexivos. O referencial teórico, os objetivos, os processos e as estratégias que definem a abordagem serão discutidos, examinando-se especialmente o papel do facilitador e as fases do percurso de avaliação à luz de pesquisas recentes (Bondioli, 2015a, 2015b; Bondioli & Savio, 2009; Bondioli & Savio, 2014a; Savio, 2011; Savio, 2013).
Avaliação e cultura de qualidade nos serviços italianos para a infância: orientações e experiências dos anos 1990 aos dias de hoje
Authors: Bondioli Anna Maria
Published: August 2018

Resumo O artigo apresenta o debate sobre a qualidade dos serviços para a infância na Itália a partir dos anos 90 do século passado, no contexto das reflexões e das propostas que surgiram na Europa. Passando a limpo as experiências mais significativas de avaliação de tais contextos no decorrer de 30 anos, serão expostas as orientações prevalentes, seja no nível das políticas educativas, sobretudo regionais, seja no nível do debate pedagógico. A apresentação se concluirá, mostrando quais seriam, atualmente, os desafios surgidos pela necessidade de difundir uma cultura de avaliação que se coloque em prol de promover processos efetivos de melhoria.
O silenciamento de professores da Educação Básica pela estratégia de fazê-los falar
Authors: Carvalho Janete Magalhães , Lourenço Suzany Goulart
Published: August 2018

Resumo Este artigo objetiva questionar a proposição de uma Base Nacional Comum Curricular (BNCC), como um antiacontecimento, por sufocar a possibilidade de problematização dos professores da Educação Básica, assim como afirmar o currículo como espaço complexo, espaço de acontecimentos éticos, poéticos e políticos, que potencializam a aprendizagem inventiva. Utiliza a associação entre pesquisa bibliográfico-documental e pesquisa de campo em conversações com professores de duas escolas municipais, buscando verificar como eles problematizam os documentos oficiais em sua relação com os currículos dessas escolas como acontecimento ou antiacontecimento. Conclui que os experts silenciam as vozes dos professores, num jogo no qual ocorre um estímulo à participação dos professores com a finalidade de, ao fazê-los falar, legitimar o discurso dos experts e, sob uma aparente participação, mantê-los em consulta, sem efetivo poder de decisão. Conclui, porém, também, pela existência de uma problematização silenciada acerca do processo de sujeição social a modelos verticalmente impostos.
Influência das variáveis antropométricas sobre a força muscular do assoalho pélvico na Incontinência Urinária
Authors: Mansour Kamila Mohammad Kamal , Goulart Cássia da Luz , Dos Santos Lucas Sidnei , Carvalho Luana , Schuh Claudia Maria , Sudbrack Ana Cristina
Published: August 2018

INTRODUÇÃO: A Incontinência Urinária (IU) é definida como qualquer perda involuntária de urina. O aumento do peso e as medidas de circunferências elevadas são fatores de risco para o desenvolvimento destes sintomas. OBJETIVO: Avaliar a influência das variáveis antropométricas (VAs) na força muscular do assoalho pélvico de mulheres com IU. MATERIAIS E MÉTODOS: Estudo transversal com amostragem de conveniência. Iniciada  a avaliação com a anamnese, após aferição das VAs seguiu-se para avaliação funcional do assoalho pélvico (AFA). Aplicada correlação de Spearman, e para avaliar a influência das VAs na AFA realizou-se regressão linear múltipla. RESULTADOS: Avaliadas 12 voluntárias com IU, média de idade 56,9±13,2 anos e maior frequência 10 (83,3%) de incontinência urinária de esforço. Encontradas correlações moderadas e negativas entre VAs e a AFA [Índice de massa corporal (IMC) vs AFA (r= -0,582 p=0,020); Circunferência da Cintura (CC) vs AFA (r= -0,567 p=0,033); Circunferência do Quadril (CQ) vs AFA (r= -0,593 p=0,050); Circunferência Abdominal (CA) vs AFA (r= -0,657 p=0.001)]. Estes achados foram ratificados através da análise de regressão linear múltipla, onde há influência direta de 37% do IMC e CA na AFA das voluntárias com IU. CONCLUSÃO: Valores elevados das VAs estão relacionadas diretamente com um pior desempenho na AFA, em mulheres com incontinência urinária.