bluuebunny/crossref_metadata_2025 huggingface dataset:
Vascular endotelial dysfunction is a pathogenetic factor in the development of neurodegenerative diseases and cognitive impairment
Authors: Goncharov N. V. , Popova P. I. , Golovkin A. S. , Zalutskaya N. M. , Palchikova E. I. , Zanin K. V. , Avdonin Р. V.
Published: October 2020

The amount of publications devoted to the endothelial cells, on the one hand, and neurological diseases, on the other hand, has been growing rapidly in recent years. Nevertheless, the relationship between the endothelial monolayer and the cells of the nervous system remains poorly studied. This review presents the available information about endothelial markers, molecular and cellular mechanisms for maintaining the integrity of the endothelial monolayer and the violations in some acute and chronic neuropsychiatric diseases. At the molecular level, the most important pathogenetic link in endothelial dysfunction is an imbalance of Ca2+ ions, which is associated with redox imbalance in the cells and increased generation of reactive oxygen species. Genetic and epigenetic factors that cause these disorders and their cause-and-effect relationships are considered. Of the genetic diseases, the most studied are monogenic diseases associated with impaired blood-brain barrier integrity: this is a deficiency of protein molecules that ensure glucose transport, structural and functional integrity of tight junctions and the basement membrane of endothelial cells themselves, as well as mutations in pericytes and smooth muscle cells. Mutations that increase the risk of developing known neurodegenerative diseases, but are also the cause of cerebrovascular pathology, are less studied. The small vessel diseases constitute a whole group of primarily epigenetically caused diseases, the clinical consequence of which is often vascular dementia. Special attention is paid to one of the least studied problems—the pathogenesis of toxicological diseases that occur at different times after acute and chronic organophosphate poisoning. Microangiopathies caused by damage to the endothelium in the central and peripheral nervous systems can be the main cause for the development of delayed effects in organophosphate poisoning. In the absence of effective therapies for neurodegenerative diseases, more and more evidence is emerging about the positive impact of the nutritional structure and healthy lifestyle on the state of blood vessels and the risk of developing these diseases.
Modern approaches to the treatment of psychogenic vertigo (persistent postural-perceptual dizziness), review
Authors: Kunelskaya N. L. , Baybakova E. V. , Chugunova M. A. , Zaоeva Z. O.
Published: October 2020

The review of the native and foreign literature was conducted on modern diagnostic and therapeutic algorithms for persistent postural-perceptual dizziness, a new diagnostic syndrome that combines the key features of all previously identified types of chronic subjective vertigo and related disorders. In this article details there is a detailed description of the use of antidepressants and cognitive behavioral therapy.
Reporting randomized trials of psychological and psychosocial interventions: consort-spi 2018
Authors: Trusova A. V. , Klimanova S. G.
Published: October 2020

Randomized controlled trial (RCT) is a “gold standard” evidence-based approach to the assessment of psychological and psychosocial interventions; the results of RCT provide an opportunity to give a scientifically grounded decision about the effectiveness and the applicability of intervention. The current biopsychosocial approach requires the necessity of having precise, comprehensive, and transparent reports about conducting RCT in medicine, as well as psychological and psychosocial interventions, including psychotherapy. The unified standards for reporting RCT’s results were developed by the CONSORT group (CONsolidated Standards Of Reporting Trials, the latest edition in 2010). They are currently considered a guide for presenting results in leading medical journals in the world. The expansion of CONSORT, which described the standards for presenting the results of psychological and psychosocial intervention CONSORTSPI was developed in 2018. The article presents the history of developing the standards, their scientific and methodological principles, the brief content, and the main instruments used (check-list and block-scheme). It is important to consider the guidelines of CONSORT-SPI 2018 and follow them in order for the scientific community to assess the quality, the applicability of different contexts, as well as replicability of psychological and psychosocial interventions studies.
Simulation of Brushless DC Motor Speed Control with Fuzzy Logic Method
Authors: Ginola  , Pulungan Ali Basrah , Purwanto Wawan , Yelfianhar Ichwan
Published: October 2020

Brushless DC Motor is used frequently in industrial applications, because this type of motor has high efficiency and does not cause sparks. However, the speed control of this motor generally has a slow response to the set point and the speed is not constant when given different loads. Therefore, it is essential to design sophisticated speed control system for this motor to improve the constant speed and speed response. In this paper, fuzzy logic method for speed control system is used to give the decision of how much voltage will be added to the motor to get to the desired speed set point value, and how much voltage will be reduced if the speed of the motor passes through the speed set point. brushless dc motor speed is set with input voltage to the motor taking into account speed error and delta speed error using Fuzzy Logic, so that when the speed of the motor almost reaches the set point the input voltage to the motor is reduced so as not to overshoot until the speed of the motor reaches the set point. The results of this study gave a better response than not using fuzzy logic methods. Where at set point 270 gets response time to set point (Tr) faster 0.0002 seconds from 0.0046 seconds to 0.0044, the time to steady state (Ts) is faster 0.025 seconds from 0.04 seconds to 0.015 seconds, the maximum pass percentage (Mp) is reduced from 75% to 20%, and error speed from 1.5% to 0%. And for a trial load at t=0.025 seconds in set point 270 with a load of 4Nm responds to the set point back for 0.014 seconds.
Le microbiote lors du syndrome du grêle court
Authors: Daoud D.C. , Thomas M. , Joly F.
Published: October 2020

Le syndrome du grêle court (SGC) est une pathologie rare résultant de résections intestinales étendues. Il est caractérisé par un syndrome de malabsorption, qui, lorsque sévère, entraîne une insuffisance intestinale chronique de telle façon qu’une supplémentation intraveineuse est nécessaire. Ainsi, afin de compenser à cette malabsorption, un processus d’adaptation intestinale spontané postchirurgical prend place, que ce soit sous forme d’hyperphagie compensatrice, d’un remodelage muqueux ou d’une modification du microbiote. Le microbiote intestinal des patients atteints d’un SGC avec un côlon en continuité est profondément modifié avec une diminution de sa diversité. De plus, il se distingue par une prédominance en Lactobacillus et une réduction des Clostridiums et Bacteroidetes. Ce « lactobiote » est probablement responsable d’une importante récupération énergétique grâce à la fermentation des glucides complexes en acides gras à chaînes courtes. Il pourrait aussi être un des maillons expliquant des modifications de sécrétion d’entérohormones dans les mécanismes de l’adaptation intestinale. Par ailleurs, des travaux plaident en faveur d’une association entre cette dysbiose et certaines complications métaboliques du SGC telles que l’encéphalopathie D-lactique et l’atteinte hépatique métabolique. Une meilleure connaissance du microbiote intestinal au cours du SGC est un prérequis pour optimiser notre prise en charge thérapeutique, et cela afin d’atteindre une autonomie entérale et prévenir les complications associées.
Peningkatan Pengetahuan Ibu Mengenai Gizi Seimbang Dalam Pemenuhan Gizi Keluarga
Authors: Rifatul Masrikhiyah
Published: October 2020

The prevelency of children's nutritional problems is still high, not only the lack of nutritional problems resulting in children stunting and uderweight; And more nutrients that cause obesity and diabetes. One of the causes of nutritional problems is ignorance about healthy menu and lack of awareness of Kadarzi. This activity aims to improve the knowledge of mothers on balanced nutrition in the fulfillment of family nutrition. PkM is held in Sengon village RT/RW 001/003 kedependants District Brebes in July 2019. The subjects that followed the activities amounted to 25 mothers – housewives. This activity consists of 3 stages including: preparation stage, implementation stage and interview stage. Data is obtained from pre test results and post tests and discussions. Results of this activity is an increase in the knowledge of the mother about balanced nutrition in the fulfillment of family nutrition, there is an increase from 12% to 76%
ECOLOGICAL-PHYTOGEOGRAPHIC CHARACTERISTICS OF THE MAIN EDIFICATORY SPECIES IN THE FORESTS OF LOZENSKA MOUNTAIN
Authors: Glogov Plamen , Georgieva Mira
Published: October 2020

The study covers Phase 2 of the ecological-phytogeographic analysis of the dendroflora of Lozenska Mountain. Its purpose is to characterize 15 species-edificators of tree and shrub communities in the mountain and to point out the indicators that most determine the assessment of their ability to long-term adaptability to mountain conditions (convertibility). The performed characterization of the edificators with respect to the reference species shows some heterogeneity in the influence of the factors and the distribution of the groups of species. Indicators, which determinate the most convertibility assessments of edificators are cryoclimatic factor, edaphic regimes and soil pH.
PRECISION AGRICULTURE THROUGH AGROECOLOGICAL APPROACH AND MATHEMATICAL MODELING
Authors: Sadovski Alexander
Published: October 2020

Precision agriculture is a modern farming management concept using digital techniques to monitor and optimize agricultural production processes. The agroecological approach focuses on the interactions between plants, animals, soil organisms, people, and the environment. It aims to optimize the use of natural resources, enhance biological processes in the soil, and improve biomass, nutrient, carbon, and water cycles. The paper deals with the basic dependencies between some of the factors determining nutrient processes in the soil and the need for fertilizing crops with the main nutrients as components of precision agriculture. An approach to modeling is proposed that meets several requirements and criteria. Mathematical models for calculating fertilizer recommendations give the amounts of the following nutrients: nitrogen, phosphorus, and potassium, required for the target yield on each particular field. Guidelines for improving and refining models for determining the need for fertilizers are given, taking into account all factors governing nutrient flows in the soil.
PENGARUH CORPORATE GOVERNANCE TERHADAP TAX AVOIDANCE DENGAN MEDIASI LIKUIDITAS PADA PERUSAHAAN BUMN YANG TERDAPAT DI BEI TAHUN 2017-2019
Authors: Manurung Vio Lolyta , Hutabarat Francis
Published: October 2020

The aims of this study is to test the effect of corporate governance on tax avoidance by using liquidity as a mediation in state-owned companies (BUMN) that have been listed on the Indonesia Stock Exchange (BEI) for the 2017-2019 period. This study uses descriptive analysis theory and processing is carried out in SPSS software. There are 20 state-owned companies (BUMN) listed on the Indonesia Stock Exchange (BEI) for the 2017-2019 period which were used as samples in this study. This study uses tax avoidance which functions as the dependent variable and uses corporate governance which functions as an independent variable and is assisted by using liquidity as a mediating variable. In addition, descriptive statistics, F test, and t test were also used in this study as statistical analysis. The results of the analysis in this study show that corporate governance has a significant effect on tax avoidance, while liquidity does not have a significant effect on tax avoidance with liquidity as the mediating variable.
Influence of solar radiation on the energy consumption of large buildings on a university campus
Authors: Conceição Eusébio , Sousa António , Gomes João
Published: October 2020

This paper reports the numerical study on the influence of solar radiation on the energy consumption of large buildings on a university campus. The actual campus is located in the south of Portugal, in a Mediterranean type environment, and consists of 6 educational buildings. These six buildings have a total area of 27,599 m2 and 595 compartments, where 6,529 opaque surfaces (doors, walls, etc.) and 983 transparent ones (windows) were identified. This study aims to assess numerically how solar radiation transmitted on windows affects the energy consumption of the Heating, Ventilation, and Air-Conditioning (HVAC) systems, controlled by the PMV (Predicted Mean Vote) index, of each of these buildings, and the thermal comfort level of the occupants. Software developed by the authors is used to simulate the thermal behavior of buildings with complex topology. This software evaluates indoor air quality inside the spaces, thermal comfort of the occupants, thermal energy consumption of the HVAC system, and solar radiation distribution outside the buildings and inside the compartments, among others. The HVAC control system based on the PMV index applied in this work was designed to maintain the PMV comfort index within category C of ISO 7730, with a maximum of 15% of people dissatisfied. In order to evaluate the indoor comfort level of the occupants, the totals of cold and warm uncomfortable hours were calculated. Two different weather conditions, typical of the region, were set as inputs for the simulation performed in this study: a typical winter day, and a typical summer day. The outputs obtained were the daily evolution of total solar radiation transmitted on windows, total uncomfortable hours for the occupants, and total HVAC system energy consumption for each building. The results obtained show that, for typical winter conditions, an increase in the transmitted solar radiation on windows causes a decrease in HVAC system energy consumption, and also in the number of uncomfortable hours, which is a favorable situation. On the other hand, for typical summer conditions, it is observed that when transmitted solar radiation on windows increases, HVAC system energy consumption, and the total number of uncomfortable hours increase as well, configuring an unfavorable situation. It is also found that the values of solar radiation transmitted on windows are higher in winter than in summer conditions. In summer, the lowest values of solar radiation transmitted on windows occur at noon. The last two observations lead to the conclusion that, overall, these buildings have correctly positioned passive shading elements, a technique that contributes to an adequate solar passive architectural design.
Pemeriksaan Keuangan Negara pada Masa Pandemi COVID-19
Authors: Sianipar Glory Augusta Elisabeth Mangaranap , Ardini Lilis
Published: October 2020

Penelitian ini bertujuan untuk mengetahui bagaimana strategi dan kebijakan pemeriksaan yang akan dilakukan BPK RI menghadapi banyaknya relaksasi kebijakan dalam keuangan akibat Pandemi COVID-19. Berbagai macam regulasi telah diterbitkan pemerintah akibatnya timbul risiko-risiko rendahnya pengawasan, buruknya akuntabilitas dan penyalahgunaan wewenang yang mengarah ke tindak korupsi. Penelitian ini berdasarkan studi literatur. Metode pengumpulan data dengan dokumentasi. Dari pembahasan menunjukkan sejumlah strategi dan kebijakan yang telah dipersiapkan BPK RI secara comprehensive dengan penilaian berbasis risiko.
FROM THE HISTORY OF THE BINARY NUMBER SYSTEM. THOMAS HARRIOT
Authors: Zlatopolski D. M. , Shilov V. V.
Published: October 2020

For the first time in the Russian-language literature, the article analyzes the works of the English mathematician, geographer and astronomer Thomas Harriot (1560–1621) related to the binary number system. The various variants of the binary notation of numbers presented in the works, examples of converting a decimal number to a binary number and vice versa, examples of four arithmetic operations in the binary number system, the execution methods of which coincide with modern ones, as well as an example of multiplication by an original method, the name of which can be translated in Latin as "another method is sequential addition" are given. All this allows us to conclude that Thomas Harriot described the binary number system earlier than the great German scientist Gottfried Wilhelm Leibniz, who did so in his work "Explication de l'Arithmétique Binaire" in 1703.
HOW CORRECTLY WE TELL PUPILS ABOUT THE NUMBER OF NUMERALS IN DIFFERENT NOTATIONS?
Authors: Eremin E. A. , Polyakov K. Yu.
Published: October 2020

The article proposes to take a fresh look at the traditional for any informatics course material, which describes the fundamental principles of number representation. It considers in details the ideas how different number notations are formed; special attention is paid to the problem related to the amount of numerals used for presenting values in every digit. It is shown that frequent in school informatics definition of radix as an amount of numerals that employed in a system becomes incorrect under careful review. For those who want to discuss this problem at a lesson, two ways are possible: one (stricter) is founded on mathematical formulas, and another is based on a generalization of various notation examples; both methods are presented in the article. Besides for demonstrative narrating of the material to pupils the authors designed their own analogy, which facilitates understanding of the topic. Practical application of notations to computer technique is also discussed.
Консервативна реабілітація опікових реконвалесцентів при реконструкції рубцевих деформацій
Authors: Жернов О. , Осадча О. , Трач Р. , Гузь О.
Published: October 2020

Система заходів консервативної реабілітації хворих з рубцевими ураженнями у перед- та післяопераційні періоди реконструкції деформацій включає місцеві, медикаментозні,фізіотерапевтичні, бальнеологічні засоби та методи еферентної терапії. Позитивний вплив заходів досягається за рахунок зниження рівня вмісту аутоагресивних факторів, що відображується у сприятливому клінічному перебігу процесу. Застосування системи заходів дозволяє своєчасно забезпечити сприятливі умови для компенсації загального стану реконвалесцентів та відновлення чи покращення порушених функцій уражених сегментів за об'єктивними оцінками у 1,75 раза і за оцінками пацієнтів – у 1,44 раза.
Засоби фізичної терапії в корекції немоторних проявів хвороби Паркінсона
Authors: Лабінський А. , Лабінська Г.
Published: October 2020

Мета. Вивчити ефективність розробленого комплексу фізичної терапії у хворихз немоторними проявами хвороби Паркінсона. Методи. Дослідження стану хворих з немоторними проявами хвороби Паркінсона за допомогою уніфікованої рейтингової шкали (UPDRS) та біохімічного дослідження ліпідного гомеостазу волосяних фолікул та волосся хворих з хроматографічним визначенням ліпідних фракцій до і після застосування розробленого авторами комплексу фізичної терапії. Результати. Проаналізовано результати обстеження та фізичного реабілітаційного лікування 32 пацієнтів з немоторними проявами хвороби Паркінсона. Доведено ефективність фізичної терапії в комплексі з гірудо-, апітерапією, мануальною та нутриціологічною корекцією у хворих з немоторними проявами хвороби Паркінсона за уніфікованою рейтинговою шкалою оцінки проявівпаркінсонізму та дослідженням ліпідного гомеостазу. Висновки. Фізична терапія в комплексі з гірудо-, апітерапією, мануальною та нутриціологічною корекцією покращує стан хворих з немоторними проявами хвороби Паркінсона за уніфікованою рейтинговою шкалою оцінки проявів паркінсонізму та сприяє відновленню ліпідного гомеостазу, що дозволяє рекомендувати для ширшого впровадження вказану комплексну фізичну терапію немоторних виявів хвороби Паркінсона.
Заходи фізичної терапії та ерготерапії, спрямовані на відновлення якості життя в осіб з ушкодженнями периферичних нервів верхньої кінцівки після реконструктивно-відновлювальних операцій
Authors: Лазарєва О. , Бісмак О.
Published: October 2020

Мета. Охарактеризувати основні заходи фізичної терапії та ерготерапії, спрямованіна відновлення якості життя в осіб з ушкодженнями периферичних нервів верхньої кінцівкипісля реконструктивно-відновлювальних операцій. Матеріал і методи. У дослідженні брали участь 252 пацієнти, які були рандомізовані на дві групи: основну (127) та групу порівняння (n = 125). Використано методи аналізу, синтезу та узагальнення даних науково-методичної літератури та Інтернет-джерел, контент-аналіз медичних карт хворих, реабілітаційне обстеження. Результати. На основі контент-аналізу медичних карток та реабілітаційного обстеження ми розробили для пацієнтів основної групи комплекс реабілітаційних заходів відповідно до МКФ. На рівні структури і функції із засобів фізичної терапії ми застосовували: кінезитерапію (пасивні, пасивно-активні, активні вправи), нейродинамічні техніки, ПНФ, ортезування, масаж, апаратну фізіотерапію. Із засобів ерготерапії ми використовували розвивальну стратегію, яка включала дзеркальну терапію, терапію дії та спостереження, заняття на тренажері ARAT. На рівні активності кінезитерапевтичні заняття доповнювалися пасивно-активними, активними вправами, застосовували спеціальні вправи для дрібної моторики, силове тренування, ПНФ, масаж, гідрореабілітація, тренажерні технології, тейпування. Ерготерапія була компенсаторного характеру, направлена на більш активне включення пацієнтів у виконання побутових дій – CIMT-терапія, дзеркальна терапія, бімануальна терапія. На рівні участі ми доповнювали комплекс реабілітаційних заходів віртуальними тренажерами (інтерактивні відео-ігри для верхньої кінцівки) та завдання-орієнтованим тренуванням. Висновки. Розроблений комплекс реабілітаційних заходів в основній групі пацієнтів з наслідками травматичних та компресійних невропатій верхньої кінцівки був спрямований на прискорення регенерації уражених нервових волокон, профілактику контрактур, атрофії м’язів, відновлення маніпулятивної та статодинамічної функції руки, самообслуговування у повсякденному житті та покращення якості життя.
Автоматизація розрахунку нормативу використання води для фізкультурно-спортивних комплексів
Authors: Дмитрієва Є. , Шматова О.
Published: October 2020

На сучасному етапі в умовах зростаючого дефіциту якісної питної водипершочерговим заходом повинно бути її раціональне використання та всебічне збереження.Водні ресурси забезпечують не лише задоволення простих фізіологічних і санітарно-гігієнічних потреб, а й є ключовим фактором в розвитку спортивних та оздоровчих комплексів.Законодавством України передбачено лімітоване використання води різноманітнимиустановами. Однак процес розрахунку тривалий і вимагає значних зусиль та часу.Тому виникла необхідність розробки автоматизованої системи розрахунку нормативуводоспоживання, адаптованої до чинного українського законодавства, що забезпечить їїправомірне застосування на території держави.
Внезапная сердечная смерть у спортсменов
Authors: Ландырь Анатолий
Published: October 2020

Раптова серцева смерть (РСС) спортсмена є серйозною медичною і соціальною проблемою, оскільки зустрічається в молодому віці і стає трагедією для спортсмена, його сім'ї і тренера. Мета. Надання спортивним лікарям сучасної інформації про частоту розвитку і причини ВСС, про фактори, що сприяють їх розвитку, про методи діагностики захворювань і станів, які призводять до розвитку РСС, а також про заходи їх профілактики.Результати. Наведено діагностичні ЕКГ-ознаки гіпертрофічної кардіоміопатії, міокардиту,аритмогенної дисплазії правого шлуночка, аномалій або атеросклерозу коронарних артерій,дилатаційної кардіоміопатії, які призводять до розвитку РСС, що дозволяє вжити заходів насамих ранніх етапах розвитку процесу. У процесі тренувань і змагань необхідно також врахо-вувати вплив на спортсменів зіткнень із суперниками і ударів снарядів (шайба, м'яч тощо), щопризводить до струсу серця. Висновок. Необхідно звернути увагу на використання нечеснимиспортсменами допінгу різної спрямованості (анаболічних стероїдів, стимуляторів, гормонівросту, наркотичних засобів і т.д.), які в стресових умовах змагань, у важких кліматичних умовах, при передозуванні можуть привести до РСС. Завданням спортивного лікаря є виявлення у спортсменів початкових ознак патології, збір поглибленого анамнезу, проведення діагностичних заходів, постановка діагнозу, вжиття заходів з лікування та запобігання розвитку процесу.
Влияние двигательной активности на состояние здоровья лиц пожилого возраста
Authors: Котко Дина , Гончарук Наталия , Путро Людмила
Published: October 2020

Загальмувати старіння можна за допомогою адекватної рухової активності. Рухова активність є фактором профілактики різних хронічних захворювань, збільшення тривалості життя. Мета. Аналіз літератури і результатів власних досліджень щодо особливостей впливу багаторічних фізичних тренувань на фізичну працездатність і стан систем організму у людейпохилого віку. Результати. Показано, що у осіб похилого віку, як і в попередні вікові періоди життя, адекватні фізичні навантаження позитивно впливають на системи організму, що дозволяє зберегти фізичну працездатність і збільшити тривалість життя.
Chronic pain in children with oncopathology: ways of solving the problem
Authors: Adamchuk N.M. , Sorokina O.Yu.
Published: October 2020

Objective. Pain is one of the complications in children with acute leukemia, which requires timely and effective analgesic therapy. We decided to determine the effectiveness and tolerability of analgesia in children with acute leukemia depending on the method of analgesia.

Materials and methods. There was a survey of 60 children (3 groups of 20 children each). In group 1 conducted morphine analgesia, in group 2 – morphine in combination with gabapentin, in group 3 – paracetamol with gabapentin. Investigated performance of the cardiovascular system, gastrointestinal tract. The questionnaire “Feeling. Activity. Mood” was used to determine psycho-emotional disorders, visual-analogue scale and face scale was used to determine the intensity of pain.

Results and discussion. In group 1, all children had dysfunction of the gastrointestinal tract and lability of blood pressure. In group 2, only 11 children had disorders of the digestive system, there were no cardiovascular complications. In group 3, only 5 children had lability of blood pressure. Averages activity in all three groups are almost identical and reflect favorable condition. The average health indicators are the lowest in the 1st group – 3.78±0.11 (p<0.05), in the 2nd group – 3.84±0.06 (p<0.05), and in the 3rd group – 4.01±0.09 (p<0.05). Mood indicators in groups 2 and 3 are almost the same – 4.04±0.12 (p<0.05) and 4.42±0.04 (p<0.05), respectively, and the worst in 1st group – 3.94±0.07 (p<0.05). The pain intensity according to visual-analogue scale on day 30 was in the 1st group ≤5 points, in the 2nd group ≤4 points and in the 3rd group ≤3 points. On day 78, the intensity of pain in group 1 was ≤5 points, in 2nd and 3rd groups – ≤3 points. Severe asthenia was observed only in 6 children (10 %) of the group 1, moderate asthenia – in 45 children (75 %) and the fatigue reaction – in 9 children (25 %).

Conclusions. The best tolerability of analgesia in children, receiving paracetamol with gabapentin, the worst – in children receiving only opiates. Children who combined opiates with gabapentin had better health and significantly fewer complications than children who received opiates alone.
Clinical efficacy of L-arginin aspartate in complex treatment of patients with essential arterial hypertension with concomitant type 2 diabetes mellitus
Authors: Bentsa T.M. , Pastukhova O.A.
Published: October 2020

Objective. Investigate directly the clinical efficacy of L-arginine aspartate in the treatment of patients with essential arterial hypertension (EAG) and type 2 diabetes mellitus (DM).

Materials and methods. The study included 43 patients with EAG II in combination with type 2 DM. The mean age of patients was 55,7±0,6 years, of which 20 (46,5 %) were men and 23 (53,5 %) were women. The duration of the disease on the EAG averaged 8,4±0,4 years, on type 2 DM – 6,5±0,5 years. A comprehensive clinical, laboratory and instrumental examination was carried out. All patients were divided into two groups. Patients in both groups received ramipril 5-10 mg a day in combination with amlodipine 5-10 mg a day and antidiabetic drugs (metformin, gliclazide or a combination thereof) as basic therapy. Patients in group 2 (n=22) were additionally prescribed the drug L-arginine aspartate orally 3 g 3 times a day for 4 weeks. The course of treatment was repeated after 2 months.

Results and discussion. In group 2 there was a more pronounced tendency to decrease the average daily and night blood pressure levels, in particular diastolic (3,2 and 2,9 mm Hg; p>0,05) and heart rate (by 17,3 %; p<0,05). The use of L-arginine aspartate significantly improved systolic (ejection fraction increased by 7,1 % vs 4,4 % in group 1; p<0,05) and left ventricular (LV) diastolic function (Em/Am increased by 48,8 % vs 34,7 % in group 1; p<0,05), a decrease in the size of the left atrium (10,2 % vs 8,3 % in group 1; p<0,05) and the reversal of LV hypertrophy (index LV myocardial mass decreased by 20,1 % against 15,9 % in group 1; p<0,05). Additional administration of L-arginine aspartate also led to a decrease in fasting and postprandial plasma glucose (4,9 % and 7,0 %; p<0,05, respectively) than the use of basic therapy alone. At the same time in group 2 there was a decrease in microalbuminuria by 27,6 % (p<0,05) and an increase in glomerular filtration rate by 11,4 % (p>0,05).

Conclusions. L-arginine aspartate should be used in patients with EAG in combination with type 2 DM and microalbuminuria to increase the cardio- and nephroprotective efficacy of basic therapy.
The role of rating scales in the diagnosis of postoperative insomnia
Authors: Boduliev O.Yu.
Published: October 2020

Background. Sleep disorders can be considered as an integral expression of the perioperative stress response. Postoperative insomnia is one of the most common postoperative complications: the incidence is exceed 70 %. The gold standard for the diagnosis of insomnia is polysomnography, which is rarely available in postoperative patients. Instead, rating scales are an easy-to-use, inexpensive and affordable tool.

Objective. To compare scales for assessment of sleep in postoperative patients.

Materials and methods. The study included 38 patients after general surgery. The age was 26-68 years (54.6±9.4). The gender distribution: 16 men and 22 women. All patients undergo an overnight 10-hour video-EEG. EEG patterns of insomnia were considered sleep latency of more than 30 min, wakefulness during sleep more than 30 min, total sleep time less than 6.5 h, sleep efficiency index <84 %. The Athens Insomnia Scale (AIS), Richards – Campbell Sleep Questionnaire (RCSQ) and Insomnia Severity Index (ISI) was applied to patients the day after surgery. For reliability analysis was used Cronbach’s alpha. Were calculated sensitivity and specificity of the scales.

Results. Video-EEG patterns of insomnia was present in 15 subjects. The rest 23 subjects did not have signs of insomnia in video-EEG. The Cronbach’s alpha for AIS was 0.90, for RCSQ – 0.89 and for ISI – 0.86. The sensitivity of AIS for postoperative insomnia was 84.6 %, RCSQ – 76.9 % and ISI – 69.2 %. The specificity level was 85.7 % for AIS, 81.0 % for RCSQ, and 69.2 % for ISI.

Conclusions. The rating scales used in the study showed sufficient reliability, sensitivity and specificity and can be used as a valid method of assessing sleep in postoperative patients.
Chronic obstructive pulmonary disease in patients with coronary heart disease of elderly age groups
Authors: Voinarovska G.P. , Asanov E.O.
Published: October 2020

Background. Among the combinations of comorbid conditions, a special role belongs to the combination of coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD). Because COPD is often associated with CHD, most authors believe that there is a direct link between COPD, progression of bronchial obstruction, and pathological conditions of the cardiovascular system, including mortality from myocardial infarction. In elderly patients, according to some researchers, the link between COPD and CHD is most pronounced.

Objective. To establish the frequency of COPD in patients with CHD in older age groups.

Materials and methods. The studies are based on the results of a comprehensive survey of 635 patients with CHD aged 60-89 years, who were observed for a long time of the State Institution “Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine”.

Results and discussion. The share of patients with CHD in whom COPD was detected in the group of elderly people is 19.4 %. This is much more than the average population. The frequency of COPD in patients with CHD decreases significantly with further aging. The prevalence of COPD among elderly patients is much lower than among elderly patients. This can most likely be explained by the fact that a significant proportion of patients with CHD with COPD do not live to old age. The analysis revealed that in elderly patients there is bronchial obstruction of more severe stages. This is due to the fact that CHD patients with COPD who live to old age have worsening bronchial patency due to the longer duration of the disease. It has been established that the majority of patients with CHD with COPD, both elderly and senile, are male. This can be explained by the negative effects of smoking.

Conclusions. The incidence of COPD in patients with CHD in the elderly is much higher than in the population. At the same time, the incidence of COPD among patients with CHD in the elderly is much lower than among the elderly. In patients of advanced age bronchial obstruction is more expressed.
Tactics of infusion therapy in patients with acute cerebral circulatory disorders in the prehospital stage
Authors: Goldovsky B.M. , Serikov K.V. , Potalov S.A. , Serikov V.I. , Filimonova I.V. , Leluk D.V.
Published: October 2020

Objective. To streamline the tactics of infusion therapy in patients with acute cerebrovascular accident (ACVA) in the prehospital stage.

Materials and methods. A retrospective, non-randomized study of 49 patients with ACVA who received emergency medical care in the prehospital phase.

Results and discussion. Ensuring adequate brain perfusion in the area of ischemia is the main task of emergency medical care ACVA in the prehospital stage (Zozulya I.S., Volosovets A.O.,  Zozulya A.I.  et al., 2019). Among the drugs that effectively improve blood circulation to the brain in the area of ischemia, an important place is occupied by infusion solutions (Semenenko A.I., Kobeliatskyi Yu.Yu., Kondratskyi B.O. et al., 2016). The choice of the optimal qualitative and quantitative composition of infusion solutions in patients with ACVA is one of the most difficult issues of treatment (Halushko O.A., 2017). Infusion therapy for patients with ACVA in the prehospital stage was used according to the Unified Clinical Protocol of Medical Care “Ischemic stroke (emergency, primary, secondary (specialized) medical care, medical rehabilitation)” (Order of the Ministry of Health of Ukraine from 03.08.2012 № 602) according to the following algorithm: 1) providing venous access by standard venous catheterization procedure with asepsis/antiseptics by intravenous catheter № 18; 2) carrying out infusion therapy by introducing 0,9 % sodium chloride solution at a rate of 100 ml×h-1; 3) the introduction of colloidal solutions in patients with ACVA in the prehospital stage was not carried out.

Conclusions. The choice of the optimal qualitative and quantitative composition of infusion solutions in patients with ACVA in the prehospital stage is one of the most difficult issues of emergency care. After providing venous access by catheterization of the peripheral vein with a catheter № 18 infusion therapy is carried out by administering 0,9 % sodium chloride solution at a rate of 100 ml×h-1. The introduction of colloidal solutions in patients with acute cerebral circulatory disorders in the prehospital stage is contraindicated.
Antibiotics using in Georgia: clinical and epidemiological features
Authors: Korinteli I. , Javakhadze M. , Pagava K.
Published: October 2020

Background. High incidence and lethality of infectious disease is an actual problem of the 21st century medicine. Infectious diseases are one of the most common causes of morbidity worldwide. Untreatable bacterial infections with the current available antibiotics lead to increased morbidity and mortality. Antimicrobials are the most commonly prescribed drugs in the community and hospital setting. However, inappropriate use of antibiotics in recent years has particularly increased the number of antibiotic-resistant strains. Antimicrobial resistance is a significant global health threat. Without effective antimicrobials, much of the progress made in fighting infectious disease would be lost. The recent rise in resistance to these critical medicines is therefore extremely worrisome.

Objective. To study epidemiological and clinical aspects of antibiotics using in Georgia.

Materials and methods. The study was retrospective-prospective. We used ATC/DDD methodology for epidemiological research of antibiotic using in the country and it held 2011-2019. According to this methodology, we calculate defined daily doses of antibiotics per 1000 inhibitors (DID). The point prevalence survey was performed in 2017-2019 in Georgian hospitals for clinical research.

Results and discussion. In last year increased antibiotic using in Georgian population. The lowest rate was in 2014 (19 DID) and the highest in 2019 (37 DID). The most commonly used antibiotics in Georgia are ceftriaxone, amoxicillin / clavulanic acid, azithromycin and ciprofloxacin. Frequency of antibiotic treatment in Georgian hospitals ranges between 77.6 % (2017) and 86.1 % (2019). The use of third generation cephalosporin ranges between 61.9 % (2017) and 59.6 % (2019). From the clinical aspects of antibiotic therapy, it is noteworthy that prevalence of antibiotic using in Georgian clinics is high and ranged from 77.6 % (2017) to 86.1 % (2019). Antibacterial prophylactic decreased and ranged from 38.3 % (2017) to 20.3 % (2019). Antibiotic selection according to guidelines on the most frequent nosology ranges between 73.8 % (2017) and 69.2 % (2019). Empirical antibiotic therapy decreased in last years and ranges between 92.2 % (2017) and 69.2 % (2019).

Conclusions. Increasing rate of antibiotic using in Georgian population and high use of broad-spectrum antibiotics in remarkable. In hospitals, antibiotics are prescribing according to the national or intra hospital guidelines, but there prevalence rate is high. Patient histories included information about general criteria of starting antibiotic therapy. Stop or review date of antibiotic treatment after 72 h in poorly presented. We think that it is very important to continue epidemiological and clinical research for future. Also update or developed new guidelines will be perfect way for optimization.
Optimization of infusion-transfusion therapy in patients with traumatic brain injury
Authors: Nasirova R.I. , Fatullaeva А.А.
Published: October 2020

Objective. Intensive therapy of severe traumatic brain injury belongs to the most difficult section of resuscitation. Therefore, the main purpose of intensive care during the implementation is to eliminate disorders of Rheosorbilact homeostasis.

Materials and methods. We analyzed 30 patients with traumatic brain injury in the intensive care unit of the Republican Clinical Hospital between 2018 and 2019. All patients were divided into two groups: 1st – control group (16 patients) – received complex intensive therapy without Rheosorbilact, while 2nd group (14 patients), received Rheosorbilact in a comprehensive intensive therapy. The main pharmacologically active substances of the drug are sorbitol, basic cations (Na, K, Ca, Mg), and sodium lactate. Thanks to these components, the drug has a hyperosmolar effect, causing fluid from the intercellular space to enter the vascular channel and thus improves microcirculation and perfusion of brain tissue. In order to monitor the effectiveness of the therapy in the dynamics evaluated indicators of hemodynamics (level of consciousness and diuresis), laboratory data (hemotocrit, electrolyte composition of blood, acid-alkaline blood condition, coagulogram), and MRI data. Rheosorbilact was used as part of a complex therapy in an infusion-transfusion program in the amount of 200-400 ml daily intravenous drip.

Results. In patients, whom after the beginning of complex intensive therapy was included Rheosorbilact, was observed earlier (the first 6 h) compared to the control group, which did not use Rheosorbilact, stabilization of hemodynamics.

Conclusions. Infusion therapy with Rheosorbilact in patients with traumatic brain injury contributed primarily to stabilization of hemodynamics and faster normalization of vital functions of the body.
Massive obstetric bleeding: optimization of total hysterectomy surgery technique and conservative treatment
Authors: Niyazmetov R.E. , Matyakubov B.B. , Nazarov B.B. , Usinova Z.B.
Published: October 2020

Objective. Reducing maternal mortality during massive obstetric bleeding (MOB) through optimizing total hysterectomy technique and improving the quality of infusion therapy.

Materials and methods. The analysis and evaluation of the results of MOB treatment in a comparative aspect were carried out in retrospective and prospective groups from 2014 to 2019 in Urgench perinatal center and three maternity complexes of Khorezm region, Uzbekistan. The retrospective group included 72 pregnant women with an average blood loss of 2450.0±80.0 ml, while the prospective group included 78 pregnant women with an average blood loss of 2530.0±70.0 ml.

Results and discussion. 1,419 (6.2 %) cases out of 22,896 deliveries in the retrospective group were accompanied by abnormal blood loss, and the MOB frequency of more than 1500.0 ml was determined in 0.3 % of all deliveries. 5 (62.5 %) of 8 cases of maternal mortality were directly related to MOB. In the retrospective group, a total hysterectomy was performed using traditional method for MOB, with an interoperable blood loss of 860.0±110.0 (p<0.05). Qualitative and quantitative composition of infusion therapy in this group averaged: saline sodium chloride solution 4350,0±350.0; Heloplasm (INN) -500,0±100,0; hydroxyethylated starch 1800.0±150.0; Rheosorbilact 400.0±50.0 and fresh frozen plasma (FFP) 1650.0±110.0. Optimized version of total hysterectomy in a prospective group differs from the traditional with one “hemostatic suture” imposed on all three formations (fallopian tube, own and round ligament). Imposed first in the distal, then proximal, and on descending and ascending departments a. uterinae during the operation. The optimized version of total hysterectomy resulted in reduction of interoperative blood loss by an average of 340.0±60.0 ml in MOB and reduction of operation time by 22.0±4.0 min, thereby improving the outcome of the operation. Amount of saline sodium chloride solution was injected in average by 1900.0; Refortan by 600.0; FFP by 230.0 less, and INN, Gelofuzin by 500.0 and Rheosorbilact by 400.0 more in the prospective group than in the retrospective group.

Conclusions. Optimized version of total hysterectomy with improved qualitative and quantitative composition of infusion therapy for MOB contributed to reduction of maternal mortality by 19.7 % in the prospective group compared to the retrospective group.
The experience of L-arginine using in placental insufficiency
Authors: Safarova S.S. , Aliyeva E.M. , Abbasova F.Yu. , Mirzoyeva Kh.M.
Published: October 2020

Objective. To evaluate the effectiveness of the use of L-arginine in the treatment of placental insufficiency (PI) in pregnant women.

Materials and methods. We examined 49 pregnant women with PI at 22-34 weeks of gestation. The women were divided into two groups. The 1st group included 27 patients who, as part of the standard complex treatment, were injected intravenously with L-arginine (Tivortin®, “Yuria-Pharm”, Ukraine) 4.2 % solution for infusion at a dose of 100 ml a day for 5 days. The 2nd group included 22 women in which standard basic therapy was used for PI treatment. To study the state of the fetoplacental complex in the blood serum of pregnant women, the level of human placental lactogen (hPL) and free estriol (E3) was determined by direct competitive enzyme immunoassay (ELISA).

Results and discussion. All patients included in the study were comparable in somatic and obstetric status. The age of pregnant women in both groups ranged from 22 to 39 years, averaging 26±3.2 years in the 1st and 31±2.4 years in the 2nd group. The level of hPL before therapy was reduced in 10 (37.03 %) patients in the 1st group and in 8 (29.62 %) patients in the 2nd group. The concentration of free E3 was reduced in 12 (44.44 %) patients of the 1st group and in 9 (40.9 %) patients of the 2nd group. In the main group, the average concentration of free E3 was 18.8±13.3 ng/ml, and the hPL was 7.1±2.6 mg/L. In the comparison group, the level of free E3 averaged 19.1±10.2 ng/ml and hPL was 6.9±3.9 mg/L. After adjustment of PI in all patients of the 1st group, and in 19 (86.36 %) of the 2nd group, the concentration of hPL and free E3 corresponded to the norm. Thus, in the main group, the average concentration of free E3 was 22.7±14.1 ng/ml, and the hPL was 8.1±2.9 mg/L. In the comparison group, the level of free E3 averaged 22.1±14.6 ng/ml and hPL – 8.3±3.9 mg/L. Only in 3 (13.63 %) patients of the comparison group, the level of hormones was still reduced.

Conclusions. The inclusion of L-arginine (Tivortin) in therapeutic regimens in order to correct placental dysfunction leads to a regression of fetoplacental circulatory disorders and reduces the risk of unfavorable perinatal outcomes.