bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial performance of alternative citrus scion and rootstock combinations on the northern coast of the state of Bahia, Brazil
Authors: Amorim Maurício da Silva , Girardi Eduardo Augusto , França Natiana de Oliveira , Gesteira Abelmon da Silva , Soares Filho Walter dos Santos , Passos Orlando Sampaio
Published: August 2018

Abstract The diversification of scion and rootstock varieties is tremendously necessary for the citrus industry in Northeastern Brazil. The initial performance of 13 sweet orange varieties grafted onto ‘San Diego’ citrandarin, and of ‘Cara-Cara’ navel orange and ‘CNPMF-02 Persian’ lime grafted onto several rootstocks was evaluated in the municipality of Inhambupe, northern coast of the state of Bahia. Three trials were carried out separately, and tree size, fruit production and quality were assessed in the first three crops, with planting in 2008 at 6.0 m x 3.0 m spacing with supplemental irrigation. ‘Aquiri’, ‘Biondo’, ‘Agridoce’, ‘Kona’, ‘Pineapple’, ‘Russas CNPMF-03’ and ‘Salustiana’ sweet oranges showed the largest cumulative production in the first three crops. ‘Pera CNPMF D-6’, ‘Westin CNPMF’ and ‘Salustiana’ sweet oranges had fewer seeds per fruit, being more appropriate for fresh fruit market, in addition to greater production efficiency for the first one. Although ‘Westin CNPMF’ has shown good fruit quality, its initial production was low. ‘Florida’ rough lemon and ‘Volkamer’ lemon induced higher cumulative production compared to ‘Cara Cara’ navel orange, but tree size and fruit quality were not influenced by any evaluated rootstock. ‘Cleopatra’ mandarin and ‘Riverside’ citrandarin led to higher tree size and cumulative production and heavier fruits of ‘CNPMF-02 Persian’ lime. All scion and rootstock combinations have potential for cultivation on the northern coast of the state of Bahia and appear as an alternative to the prevalent ‘Pera’ sweet orange on ‘Rangpur’ lime combination.
TRANSFERÊNCIA DE POLÍTICA: PERSPECTIVA DO TRATAMENTO DIRETAMENTE OBSERVADO DA TUBERCULOSE
Authors: Peruhype Rarianne Carvalho , Sicsú Amélia Nunes , Lima Mônica Cristina Ribeiro Alexandre d´Auria de , Hoffmann Juliana Feliciati , Palha Pedro Fredemir
Published: August 2018

RESUMO Objetivo: investigar como se desenvolveu a transferência da política do Tratamento Diretamente Observado da Tuberculose na ótica/para dos/os profissionais de saúde comunitária do Grupo Hospitalar Conceição. Método: trata-se de uma pesquisa de abordagem quantitativa do tipo inquérito epidemiológico, que se baseou na aplicação de um instrumento validado e autodirigido para os profissionais de saúde pertencentes às 12 Unidades de Atenção Primária à Saúde do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição. Para a análise,foram utilizados a beta regressão, a descrição das frequências das variáveis, a distribuição da média, mediana e o desvio-padrão. Além disso, foram criados a média padronizada e os escores padronizados. Resultados: participaram do estudo 109 profissionais de saúde, a maioria do sexo feminino (77,06%), com idade entre 30 e 59 anos (87,16%) e pertencentes à categoria médica (37,61%). Em relação às três dimensões analisadas do processo de transferência da política, observou-se que a dimensão Conhecimento foi a que obteve maior escore (77,8%), sendo seguida pelas dimensões Informação (72,7%) e Inovação (67,7%). A necessidade de envolvimento e participação da população nas discussões do Tratamento Diretamente Observado, de melhoria da infraestrutura dos serviços de saúde e a complexificação do processo de realização dessa prática foram alguns, dentre outros, aspectos importantes apontados. Conclusão: urgem medidas de reformulações e melhorias nas ações vinculadas à operacionalização e transferência do Tratamento Diretamente Observadoda Tuberculose.
Planning pathways in the transfer of Directly Observed Treatment of Tuberculosis
Authors: Peruhype Rarianne Carvalho , Mitano Fernando , Hoffmann Juliana Feliciati , Surniche Catiucia de Andrade , Palha Pedro Fredemir
Published: August 2018

ABSTRACT Objective: to investigate the planning pathways in the transfer of Directly Observed Treatment of tuberculosis. Method: a qualitative study conducted using interviews and a semi-structured guide, administered to five subjects who were among the coordinators and managers of the tuberculosis control programs, and the secretary of health of a municipality in the south of Brazil. Situational Strategic Planning and Discourse Analysis of the French matrix were the theoretical and analytical references used, respectively. Results: three reflexive axes were identified: weaknesses in the process of planning the Directly Observed Treatment transfer, antagonism between planning and daily requirements and formulation of planning and execution. Lack of systematization regarding the planning and execution for transfer the Directly Observed Treatment policy, demonstrates the fragility and incipience of this activity, and the possibility of its non-existence. Conclusion: the urgent need for managers and coordinators to better appropriate the theoretical framework for changing public policies, and the related planning mechanisms, includes a proposal for reorganization and qualification of the diffusion process, both practical-operative and political-organization.
Instruments for the care of pressure injury in pediatrics and hebiatrics: an integrative review of the literature
Authors: Ferreira Mayara Kelly Moura , Gurgel Sabrina de Souza , Lima Francisca Elisângela Teixeira , Cardoso Maria Vera Lúcia Moreira Leitão , Silva Viviane Martins da
Published: August 2018

ABSTRACT Objective: to identify existing instruments in the scientific literature about the care of pressure injuries in pediatric and hebiatric patients. Method: an integrative review that selected 32 articles from the PubMed/Medline, LILACS, Scopus and CINAHL databases using the descriptors pressure ulcer, decubitus ulcer, pediatrics, adolescent and protocols and their equivalent terms in Portuguese and Spanish. Inclusion criteria: research articles in full, in Portuguese, English or Spanish without any temporal cut-off. The descriptive analysis was adopted to categorize the instruments found into the three domains of care: evaluative, preventive and curative. Results: 25 instruments for the care of pressure injuries in pediatric and hebiatric patients were found, with an emphasis on the Braden Q Scale being the most commonly used to assess pressure injury risk, and the protocols containing pressure injury staging guidelines developed by the National Pressure Ulcer Advisory Panel (NPUAP) and the European Pressure Ulcer Advisory Panel (EPUAP). Conclusion: the scientific literature has valid and reliable instruments that can be used in nursing care practice aimed at the evaluative, preventive and curative care of pressure injuries in pediatric and hebiatric patients.
Critical path of women in situations of intimate partner violence
Authors: Baragatti Daniella Yamada , Carlos Diene Monique , Leitão Maria Neto da Cruz , Ferriani Maria das Graças Carvalho , Silva Eliete Maria
Published: August 2018

ABSTRACT Objective: To know and analyze the critical path followed by women subjected to intimate partner violence until reaching a Reference Center of a Brazilian city, from the perspective of these women. Method: Qualitative research, based on the concept of critical path. Participant observations of the support group of the Reference Center and interviews with ten women in situations of violence who were followed up in this service. Results: the motivating factors for women to seek help were the increase in the severity of the aggressions, the impact of the violence on their children and support from their family. They go to several sectors and services before reaching the Reference Center, such as the police and legal counsel, health and social services. They find little effective responses from the services, and care is indicated as the most relevant response factor to face the situation. Conclusion: the assistance is fragmented and dependent on the posture of the professional. The Reference Center is recognized as an important place of support for women. In addition to governmental efforts to maintain the network structured, the permanent education of the working professionals is also fundamental.
Association between inflammatory mediators, grip strength and mobility in community-dwelling elderly
Authors: Macedo Barbara Gazolla de , Oliveira Hanna Sette Câmara de , Paula Marielle Viotti de , Gomes Gisele de Cássia , Antunes Carlos Maurício de Figueiredo
Published: August 2018

Abstract Introduction: Aging is associated with loss of muscle mass, immunosenescence and increased production of inflammatory mediators, high levels being predictors of a decline in functional capacity in the elderly. Objective: To assess the association between inflammatory mediators, interleukin 6 (IL-6) and C-reactive protein (CRP) and functional capacity in the elderly. Methods: Cross-sectional study with 308 community-dwelling elderly. The study was approved by the Research Ethics Committee, under protocol number 067/2010. Grip strength (GS) was measured using a JAMAR® dynamometer and functional capacity by the Timed Up and Go (TUG) test. Blood tests were performed and serum levels of C-reactive protein and interleukin 6 assessed. Spearman’s coefficient was applied to analyze the correlation between variables and the Mann-Whitney for intergroup comparison. Significance was set at 0.05. Results: There was no significant correlation between GS, the TUG and inflammatory mediators (CRP and IL-6). However, by adjusting for variables such as age, sex and muscle mass, a significant and inverse correlation (p = 0.023) was observed between GS and CPR. Conclusion: Elderly subjects with low C-reactive protein levels performed better in the grip strength test. It is important to investigate the adverse effects on functional capacity that can be influenced by inflammatory cytokines in the elderly during aging.
Changes to the feet of institutionalized elderly persons
Authors: Ferreira Eidimara , Portella Marilene Rodrigues , Doring Marlene
Published: August 2018

Abstract Objective: The present study aimed to identify the most frequent changes to the feet of institutionalized elderly persons. Method: A descriptive study was conducted with elderly persons living in long-term care facilities in the city of Passo Fundo, Rio Grande do Sul, Brazil. A total of 174 people aged 60 years and over of both genders were surveyed regardless of health conditions. Those with amputations, burns or who were undergoing surgery of the lower limbs were excluded. Data were collected through the application of a structured questionnaire containing sociodemographic variables (age, gender, ethnicity, marital status, schooling, main occupation) and variables related to alterations of the feet (nail, dermatological and bone deformities). The Manchester Scale was subsequently applied to evaluate the degree of hallux deformity. Results: The most frequent nail deformities were onychomycosis, onychogryphosis, onycholysis, onychosclerosis; the dermatological findings were callosities, especially interdigital and bromhidrosis; the most prevalent bone deformities were pes cavus and transverse arches. In the assessment of hallux valgus, according to the Manchester Scale, painful feet (38.5%), mild deformities (35.6%) and no deformities (25.3%) were identified. Conclusion: The results suggest signs of neglect of the health of the feet of institutionalized elderly persons. There should be more investment in the training of teams responsible for care.
Sarcopenia, nutritional status and functionality in elderly women living in the community
Authors: Oliveira Neta Rosa Sá de , Souza Isabelle Ferreira da Silva , Câmara Saionara Maria Aires da , Souza Marcelo Cardoso de
Published: August 2018

Abstract Objective: to evaluate the relationship between sarcopenia, functional capacity and nutritional status among elderly women living in the community. Method: an observational, cross-sectional study was performed with 100 elderly women aged over 60 years. A questionnaire containing identification and socioeconomic data and information relating to the practice of physical activity was applied, while anthropometric and body composition data were measured through bioimpedance and functionality data was assessed using the six-minute walk test (6MWT). Independent t-tests were performed for the quantitative variables and analysis of variance (ANOVA) was used to compare the means of the variables. Multiple linear regression analyzes were performed to estimate the mean 6MWTfor each of the variables studied. Results: The average age of the elderly women was 67 (± 8.0) years, 41% practiced physical activity, 38% had at least an elementary school education, 48% received up to two minimum wages and 91% were obese according to waist circumference (WC). The prevalence rates for the presence of sarcopenia were: 5% for sarcopenic obesity (SO), 63% for obesity, 14% for sarcopenia and 18% had adequate weight. Elderly women who practiced physical activity, had at least an elementary education and who were non-obese according to WC, performed better in the 6MWT. There were no significant differences in the 6MWTbased on income or Body Mass Index (p>0.05). Non-obese and non-sarcopenic women walked further in the functional test than the other women (p = 0.021). Conclusion: SO was present in 5% of the elderly women and is related to poor physical performance, which was also present in elderly women with sarcopenia and obesity.
Factors determining the negative perception of the health of Brazilian elderly people
Authors: Zanesco Camila , Bordin Danielle , Santos Celso Bilynkievycz dos , Müller Erildo Vicente , Fadel Cristina Berger
Published: August 2018

Abstract Objective: To identify factors that determine the negative perception of the health of the Brazilian elderly, considering sociodemographic conditions, functional limitations and illness, patterns of utilization of health services and oral health condition. Method: A cross-sectional study with data from the National Health Survey (2013), involving 23,815 elderly persons was carried out. Once the database was treated, dimensionality reduction was performed using the Waikato Environment for Knowledge Analysis. The variables related to health perception were evaluated through logistic regression to measure the magnitude of the associations. Health perception and 36 independent variables were considered as outcome variables. Results: The variables most strongly related to the negative perception of the health of the elderly were illiteracy (OR=1.48), low educational level, total difficulty in performing instrumental activities of daily living (OR=2.04), impossibility of performing any activity (OR=3.20), presence of a diagnosis of physical or mental illness (OR=2.44), negative self-perception of oral health (OR=1.92), an increased need for health services in recent weeks (OR=1.16), medical visits and hospitalization in the last 12 months (OR=1.40). Conclusion: The use of multidimensional methodologies can identify the influence of determinants of a negative perception of health among Brazilian elderly persons, and can support the formulation of public health policies aimed at the elderly population.
Palliative care: A proposal for undergraduate education in Medicine
Authors: Caldas Gustavo Henrique de Oliveira , Moreira Simone de Nóbrega Tomaz , Vilar Maria José
Published: August 2018

Abstract Objective: to propose essential competencies for the teaching of palliative care on undergraduate Medicine courses. Method: a documentary analysis of the literature on general competencies in palliative care was initially carried out, to construct a framework with suggestions of essential competencies for undergraduate education in Brazil. The elaborated material was then presented individually to eight professionals from a range of areas for analysis. All the professionals had specialized training in palliative care, and the material was accompanied by an interview with three open questions. The categorical thematic content analysis proposed by Bardin was used in the documentary analysis and the interviews with the professionals. Results: the initial documentary analysis resulted in five categories, eight subcategories and 96 units of analysis, based on which the researcher was able to construct the suggestions for competences, which were distributed with their respective contents in a framework with five modules. Six categories, 12 subcategories and 168 analysis units emerged from the interviews with the professionals following a reading of the material. From the discourse contained in the subcategories and units of analysis, suggestions emerged for a better distribution of the modules, resulting in the renaming of the same (Basic principles of palliative care, Symptom management, Teamwork, Ethical and legal issues, Care in the last moments of life). Conclusion: the discussion and improvement of the palliative care competencies suggested in this study will be essential at medical education forums, providing clarity about what is really required in general practitioner training.
The experience of spirituality among institutionalized elderly people
Authors: Scortegagna Helenice de Moura , Pichler Nadir Antonio , Fáccio Lúcia Fernanda
Published: August 2018

Abstract Objective: To identify the meanings attributed to the experience of spirituality when faced with life situations among elderly persons living in a long-term care facility. Method: A qualitative, exploratory and descriptive survey was carried out, based on interviews with eight elderly people living in a long-term care facility for the elderly in the state of Rio Grande do Sul, Brazil. Results: The content that emerged from the interviews underwent qualitative analysis for the extraction of units of significance and the elaboration of two thematic categories: Spirituality/religiosity as a direction of life and spirituality/religiosity as a meaning for life and a source of renewal, fulfilment and happiness. Conclusion: When describing the experience of spirituality as an important strategy for finding meaning in life, the elderly persons in this study revealed it to be a psychic and emotional support for coping with existential challenges. This knowledge allows professionals working in these institutions to invest in practices that incorporate spirituality as an element of the comprehensive care of the elderly.
ANCA associated vasculitis: experience of a tertiary care referral center
Authors: Chaudhry Rafia , Bilal Anum , Austin Adam , Mehta Swati , Salman Loay , Foulke Llewellyn , Feustel Paul , Zuckerman Roman , Asif Arif
Published: August 2018

ABSTRACT Background and objectives: Anti-neutrophil cytoplasmic autoantibodies (ANCA) associated vasculitis is a small vessel vasculitis with insufficient epidemiologic estimates in the United States. We aimed to determine demographic and clinical features of ANCA associated vasculitis patients presenting to a large tertiary care referral center in Upstate New York. Design, setting, participants, and measurements: A retrospective analysis of cases with pauci-immune GN on renal biopsy and clinical diagnosis of ANCA vasculitis presenting over 11 years was conducted. Outcomes of interest were: demographics, ANCA antibody positivity, patient and renal survival, and regional trends. Results: 986 biopsies were reviewed, 41 cases met the criteria for inclusion: 18 GPA, 19 MPA, and 4 double positive (anti-GBM disease plus ANCA vasculitis). Mean age at presentation was 52.4 years (SD 23.7), 23 (56%) were male and median creatinine was 2.6 mg/dL. The median patient follow up was 77 weeks (IQR 10 - 263 weeks), with a 3-month mortality rate of 5.7% and a 1-year estimated mortality rate of 12%. Thirteen patients required hemodialysis at the time of diagnosis; 7 patients came off dialysis, with median time to renal recovery of 4.86 weeks (IQR 1.57 - 23.85 weeks). C-ANCA positivity (p < 0.001) and C-ANCA plus PR3 antibody pairing (p = 0.005) was statistically significant in GPA versus MPA. P-ANCA positivity was observed in MPA versus GPA (p = 0.02) and double positive versus GPA (p = 0.002), with P-ANCA and MPO antibody pairing in MPA versus GPA (p = 0.044). Thirty-seven of the 41 cases were referred locally, 16 cases were from within a 15-mile radius of Albany, Schenectady, and Saratoga counties. Conclusions: ANCA vasculitis is associated with end stage renal disease and increased mortality. Our study suggests the possibility of higher regional incidence of pauci-immune GN in Upstate New York. Further studies should investigate the causes of clustering of cases to specific regions.
Nursing education: a conceptual analysis of the evolutionary method of Rodgers
Authors: Bezerril Manacés dos Santos , Chiavone Flávia Barreto Tavares , Lima Jéssica Valeska Herculano de , Vitor Allyne Fortes , Ferreira Júnior Marcos Antônio , Santos Viviane Euzébia Pereira
Published: August 2018

Abstract Objective: To analyze "nursing education" using Rodgers' evolutionary conceptual analysis. Method: An analysis was performed based on Rodgers' evolutionary conceptual analysis. Data collection was performed in June 2017 using the following databases: Lilacs, SciELO, Scopus, Cinahl, Web of Science, PubMed and Cochrane with the descriptors "teaching" and "nursing". The year of publication, country of origin, concept, attributes, antecedents, consequences, surrogate terms and related concepts were evaluated in the analysis of the studies. Results: The antecedents and consequences were punctuated in determinant aspects for the construction of the concept of nursing education and characteristics inherent to the training process; surrogate terms address factors of educational follow-up; the attributes of the concept may be related to the fundamentals of the teaching-learning process and resources related to teaching strategies. Conclusion: The concept of nursing education is dynamic and seeks to train professionals so that they can offer adequate care to the patient according to the transformations and needs of different populations.
Circumcision: postoperative complications that required reoperation
Authors: Talini Carolina , Antunes Letícia Alves , Carvalho Bruna Cecília Neves de , Schultz Karin Lucilda , Del Valle Maria Helena Camargo Peralta , Aranha Junior Ayrton Alves , Cosenza Wilmington Roque Torres , Amarante Antonio Carlos Moreira , Silveira Antonio Ernesto da
Published: August 2018

ABSTRACT Objective To evaluate post-operative complications of circumcision requiring surgical reintervention. Methods Retrospective analysis of medical records of patients submitted to circumcision from May 1st, 2015 to May 31st, 2016. Results A total of 2,441 circumcisions were performed; in that, 1,940 using Plastibell and 501 by the classic technique. Complications requiring surgical reintervention were found in 3.27% of patients. When separated by surgical technique, 3.4% of circumcisions using Plastibell device required reoperation, as compared to 3% of conventional technique (p=0.79). Preputial stenosis was most frequently found in classic circumcision, with statistical significance (p<0.001). Bleeding was more frequent when using Plastibell device, but the difference was not statistically different (p=0.37). Patients’ age was also evaluated to investigate if this variable influenced on the postoperative outcome, but no significant difference was found. Conclusion There was no statistically significant difference when comparing complications between the different techniques performed at this hospital. Preputial stenosis was most frequently found in the classic circumcision, while bleeding was more prevalent when using Plastibell device. Patients’ age did not influence in complications.
Inventario de Evaluación de la Personalidad para adolescentes: consistencia interna y dimensionalidad en adolescentes de Buenos Aires
Authors: Stover Juliana Beatriz , De la Iglesia Guadalupe , Castro Solano Alejandro , Fernández Liporace Mercedes
Published: August 2018

Introducción: el Inventario de Evaluación de la Personalidad para ado­lescentes (PAI-A, por sus siglas en inglés) examina la sintomatología psicopatológica y las variables vinculadas al diseño de intervenciones psicoterapéuticas. Consta de 264 ítems para su uso en la evaluación clínica de adolescentes entre 12 y 18 años. Incluye escalas de validez clínicas, relacionadas con el tratamiento y de relación interpersonal.Objetivo: en este trabajo se presentan análisis psicométricos del In­ventario de Evaluación de la Personalidad para adolescentes.Méto­do: Participaron 1.002 adolescentes (50,3% mujeres, 49,7% varones; Medad = 14,99; DE = 1,88), residentes en la ciudad de Buenos Aires y alrededores, en Argentina. Se calcularon alfas de Cronbach para es­timar la consistencia interna, y se advirtieron valores excelentes para las escalas clínicas, relacionadas con el tratamiento y de relación in­terpersonal, y aceptables para las escalas de validez y subescalas.Re­sultados: se examinó la dimensionalidad mediante análisis de compo­nentes principales con rotación Varimax. Se aisló una estructura de cuatro factores al incluir las 22 escalas, mientras que al analizar las 11 clínicas, se obtuvieron dos factores.Conclusiones: como conclusión, se aportan evidencias de la calidad psicométrica del PAI-A para su uso con adolescentes de Buenos Aires, cubriendo un área de vacancia en la evaluación psicológica local. Futuras investigaciones deberán ampliar esos análisis de calidad psicométrica, así como replicar los procedimientos en muestras clínicas.
Drogas y rendimiento académico en estudiantes del área de salud de dos universidades latinoamericanas
Authors: De San Jorge-Cárdenas Xóchitl , Beverido-Sustaeta Paulina , Salas-García Betzaida , Cruz-Juárez Alma , Roa-Cubaque Marcela América , Rubiano-Díaz Guiomar Haydee
Published: August 2018

Introducción: el consumo de drogas en la población juvenil de los paí­ses en desarrollo se ha incrementado durante las últimas décadas; las instituciones educativas y de salud están preocupadas por esta ten­dencia, ya que puede alterar el aprendizaje y la memoria, por lo que afecta particularmente a los estudiantes universitarios.Objetivo: des­cribir y comparar la relación entre consumo de drogas y rendimiento académico en estudiantes del área de Ciencias de la Salud de dos uni­versidades latinoamericanas.Metodología: se utilizó un muestreo no probabilístico por conveniencia y se aplicó en línea el cuestionario Consumo de Drogas en Estudiantes Universitarios (CODEU). El aná­lisis de la información se realizó con base en estadísticas descriptivas y se aplicó el coeficiente de correlación biserial puntual y la prueba no paramétrica de Kruskal-Wallis, tomando en cuenta el promedio de calificaciones obtenido durante el último periodo cursado.Resul­tados: en la Universidad Veracruzana se encontró que el consumo de alcohol, marihuana, cocaína e inhalables disminuye el rendimiento académico, mientras que en la Universidad de Boyacá solo el consu­mo de tranquilizantes afectó el rendimiento académico.Conclusiones: es importante continuar realizando estudios similares, a fin de obte­ner resultados más precisos y esclarecer la relación entre consumo de drogas y rendimiento académico, por lo que se recomienda incor­porar variables relacionadas con las consecuencias del consumo en indicadores como asistencia, entrega de tareas y calificaciones.
Neuroendocrine tumors of the pancreas: etio-pathogenesis, diagnosis, current treatment
Authors: Kokhanenko N. Yu. , Morgoshiya T. Sh.
Published: August 2018

Review is devoted to current problems of classification, diagnosis and treatment of pancreatic neuroendocrine tumors. According to modern views, all pancreatic neuroendocrine tumors over 5 mm or those followed by clinical manifestations are biologically malignant. It is shown that certain proportion of pancreatic neuroendocrine tumors are non-functioning. Diagnosis of neuroendocrine tumors is highly difficult issue. Currently, surgery is only radical and adequate approach for functioning pancreatic tumors. Need to optimize diagnostic and surgical algorithm for improvement of outcomes in these patients is emphasized.
Epidemiological and biomolecular aspects of portal cholangiocarcinoma (literature review)
Authors: Makarov E. S. , Nechushkin M. I. , Gladilina I. A. , Vishnevskiy V. A.
Published: August 2018

World literature data and our own findings of the influence of biomolecular markers expression on the prognosis of cholangiocarcinoma are analyzed. The most significant adverse predictors are tumorspread grade, positive regional lymph nodes, cell differentiation grade, perineural and microvascular invasion. Epithelial-mesenchymal transition grade is important for tumor progression in patients with portal cholangiocarcinoma and accordingly may be used as a predictor of long-term survival.
Combined minimally invasive treatment of liver and bile ducts malignancies
Authors: Melekhina O. V. , Kulezneva Yu. V. , Efanov M. G. , Musatov A. B.
Published: August 2018

Aim. To analyze radiofrequency ablation per se and in combination with other X-ray surgical procedures in patients with liver and bile ducts malignancies. Material and methods. Radiofrequency ablation was used in three groups: percutaneous intervention or in combination with liver resection – group 1 (n = 111); ablation combined with intra-arterial chemoembolization (n = 3) – group 2; RFA followed by right portal vein embolization (RALPPES) in order to induce liver hypertrophy to enable liver resection – group 3 (n = 20). Results. There were no recurrences after radiofrequency ablation. Two-year survival was 55% in patients with hepatocellular carcinoma and liver cirrhosis.Colorectal cancer metastases were followed by 4-year survival near 55%. RFA combined with intra-arterial chemoembolization were associated with complete tumor destruction in patients with hepatocellular carcinoma over 4–5 cm and stabilization in patients with progressive intrahepatic cholangiocarcinoma. Liver hypertrophy was over 50% in two weeks after RALPPES that enables liver resection in 95% of patients. Symptoms of liver failure after hemihepatectomy were not observed in any patients. Conclusion. Combination of interventional methods is able to improve outcomes in patients with liver and bile ducts malignancies.
Severe acute pancreatitis: risk factors of adverse outcomes and their correction
Authors: Darvin V. V. , Onishchenko S. V. , Loginov E. V. , Kabanov A. A.
Published: August 2018

Aim. To analyze management of severe acute destructive pancreatitis and to determine the main tactical, anatomical and pathophysiological factors determining risks of adverse outcomes. Material and methods. 3581 patients with acute pancreatitis were enrolled. Retrospectively, 239 patients were assigned to severe pancreatic necrosis; invasive surgical techniques were applied in 210 cases. Twenty-nine patients with pancreatic necrosis underwent endoscopic papillosphincterotomy with main pancreatic duct stenting. Results. Overall mortality in patients with severe pancreatic necrosis was 32.3%, in case of minimally invasive techniques – 29.6%, conventional approach – 34.1%. There were similar outcomes regardless surgical technique in patients with pancreatic necrosis (p > 0.05), although introduction of main statements of national recommendations for treatment of pancreatic necrosis (regardless severity) reduced mortality from 25.4% to 9.5% (p < 0.001). Advanced parapancreatitis was accompanied by mortality near 36.5%. Stenting of main pancreatic duct was followed by death of 3 out of 29 patients with pancreatic necrosis (10.3%). Conclusion. Indications and choice of surgical approach according to national recommendations are not accompanied by improved postoperative mortality in patients with severe pancreatic necrosis and multiple organ failure. However, according to analysis on the whole, there is reduced postoperative mortality regardless severity of disease if these recommendations are sustained. Widespread involvement of retroperitoneal structures is adverse prognostic factor. Early endoscopic intraduodenal drainage in effective to prevent parapancreatic tissues.
Features of laparoscopic cholecystectomy in patients with chronic calculous cholecystitis and signs of ”non-functioning” gallbladder
Authors: Greyasov V. I. , Chuguyevsky V. M. , Sivokon N. I. , Agapov M. A.
Published: August 2018

Aim. To improve outcomes of laparoscopic cholecystectomy in patients with chronic cholecystitis and signs of “nonfunctioning” gallbladder via development of preventive, curative and diagnostic measures. Material and methods. Laparoscopic cholecystectomу was performed in 14 764 patients with chronic cholecystitis. Incidence and causes of intraoperative injury of extrahepatic bile ducts were retrospectively analyzed. Three basic forms of “non-functioning” gallbladder (hydropsy, sclerosis and atrophy, total filling by stones) were. Results. Biliary injury followed by bile leakage occurred in 38 (0.25%) cases. Intraoperative and early postoperative diagnosis was in 11 (28.9%) and 27 (71.1%) patients, respectively. Tangential trauma of common bile duct was found in 3 (7.8%) cases, complete intersection – in 8 (21%) patients. Herewith, 6 of them had sclerosis, 2 – total filling of gallbladder by stones. New diagnostic and curative approach was followed by only 2 (0.04%) cases of early postoperative bile leakage in 2010–2015. Injury of common bile duct was absent within the same period. Sclerosis and atrophy of gallbladder were diagnosed prior to surgery. Conclusion. There are 3 types of “non-functioning” gallbladder with risk of biliary trauma during laparoscopic cholecystectomy. Sclerosis and atrophy of gallbladder are predominantly followed by certain difficulties during laparoscopic cholecystectomy. New diagnostic and curative approach is useful to prevent iatrogenic biliary trauma.
Trade Openness, FDI, and Economic Growth: Evidence from India and China
Authors: Thaku Ishfaq Ahmad
Published: August 2018

In the era of globalisation, economic growth is considered as the most viable approach to achieve socio-economic development goals in developing economies. Consequently, the proponents of globalisation are vigorously advocating the enhancement of FDI and trade openness. In this context, the recent literature on economic growth in developing economies has mainly focused on relationship nexus of economic growth, trade openness and foreign direct investment (FDI). However, the numerous research studies carried out throughout the world have found mixed results, about the nexus between the stated constructs. Against this backdrop the present study has been undertaken to further analyse the nexus of economic growth, trade openness and FD in India and China. It has been found that in long-run, the results reveal support for both export-led and FDI-led economic growth hypothesis in India, whereas in China support was found only for FDI-led growth hypothesis. However, in short-run support for export-led growth was found only in case of China. However, in short-run support for export-led growth was found only in case of China.
Effect of systemic enzyme therapy on clinical manifestations of inflammation in gonarthrosis
Authors: Mazurov V I , Dorovskikh A G , Trofimov E A
Published: August 2018

Despite a significant number of studies on various schemes of OA therapy, there are only some studies with the use of systemic enzyme therapy (ETS) in combination with NSAIDs and / or SYSADOA. The aim was to study the effect of different groups of drugs (NSAIDs, ETS, SYSADOA) on the clinical course of gonarthrosis, as well as to develop an algorithm for the choice of treatment tactics depending on the clinical and sonographic manifestations of this disease. Methods. The data of 46 patients with stage I and stage II OA of Kellgren-Lawrence were analyzed. Patients of the first group received combined oral therapy with chondroitin sulfate (HS) 500 mg 2 times a day and glucosamine sulfate (GS) 750 mg 2 times a day in combination with selective NSAIDs. The second group of patients received combined therapy of HS 500 mg 2 times a day with the GS 750 mg 2 times daily together with Phlogenzym (PL), 2 tablets 3 times a day. All patients included in the study were examined initially, after 8 and 12 weeks. Procedures included clinical (VAS, WOMAC) and instrumental methods with the use of ultrasound of joints to evaluate the pathology of soft tissues and detect synovitis.. Results. Comparing groups 1 (HS, GS and NSAIDs) and 2 (HS and GS together with PL) on the effect on the structural state of cartilage and the dynamics of the main ultrasonic manifestations of OA knee joint, it should be noted that the effectiveness of drugs HS and GS in combination with enzyme therapy was higher, because in this group of treatment of synovitis decreased, whereas in the group of HS and GS, together with NSAIDs, these parameters either increased or remained unchanged. Conclusions. The use of polyenzyme drugs significantly increases the effectiveness of complex therapy in patients with osteoarthritis of the knee joints. In patients with gonarthrosis treated with a combination of chondroitin sulfate, glucosamine sulfate and phlogenzym was observed a significant reduction in the severity of synovitis, as well as more frequent lower daily dose of the selective NSAID or their full cancellation, compared with a control group of patients treated with symptomatic drugs retardation in combination with NSAIDs. (For citation: Mazurov VI, Dorovskikh AG, Trofimov EA. Effect of systemic enzyme therapy on clinical manifestations of inflammation in gonarthrosis. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):107-112).
Hemophagocytic syndrome and ankylosing spondylitis
Authors: Belogurov A R , Mazurov V I , Tcigan E N , Tyrenko V V , Toporkov M M , Buryak I S , Voronin S V , Sobolev A V
Published: August 2018

Hemophagocytic syndrome is a consequence of excessive activation of the immune system that develops as a rule in response to infection, neoplasm or as a result of an autoimmune disease leading to uncontrolled hyperinflammatory syndrome, internal injuries, cytopenia and death. The diagnosis of the syndrome is complex and is based on the criteria accepted by the society for the study of hemophagocytosis syndrome in 2004. Therapy involves the use of a combination of cytostatics and glucocorticoids and is carried out for a long time. The article describes the clinical case of hemophagocytic syndrome in a patient with ankylosing spondylitis. (For citation: Belogurov AR, Mazurov VI, Tcigan EN, et al. Hemophagocytic syndrome and ankylosing spondylitis. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):113-120. doi: 10.17816/mechnikov2018102113-120).
Endothelial dysfunction and circulating endothelial cells in patients with chronic ischemic heart disease
Authors: Sayganov S A , Kuzmina-Krutetskaya A M
Published: August 2018

Aim. To evaluate endothelial function in patients with chronic ischemic heart disease by determining the number of circulating endothelial cells in peripheral blood. Material and methods. 71 patient with typical angina class I-III and presence of obstructive coronary artery disease according to coronary angiography were assessed, coronary anatomy was assessed on the SYNTAX Score scale and the number of CEC was determined by flow cytofluorimetry. Depending on the chosen treatment strategy patients were divided into the following groups: a group of medical therapy (group 1) - 22 patients; a group of patients requiring percutaneous coronary intervention (group 2) - 25 patients; a group of patients requiring surgical revascularization by coronary artery bypass surgery (group 3) - 24 patients. The control group consisted of 20 patients without atherosclerotic lesions of the coronary arteries. Results. Study groups do not differ by sex, age, history of smoking, the presence of hypertension, MI history (р > 0.05). In the group of patients who are scheduled to perform CABG significantly more patients with diabetes mellitus (р < 0.05) (group 1 - 3 patients (13.6%), group 2 - 4 patients (16.0%), group 3 - 7 patients (29.1%), control group - 2 patients (11.8%)). Study groups reliably differ in the anatomy of coronary lesions (SYNTAX Score in group 1 - 9.4 ± 2.7, in group 2 - 19.7 ± 5.7, in group 3 - 23.5 ± 6.0), р < 0.05. The number of CECs in the study groups is significantly higher than the generally accepted norm (р < 0.05), (group 1 - 12 (10÷16), group 2 - 14 (10÷17), group 3 - 14 (11÷17), control group - 12 (10÷16)). There are no significant differences between the groups with coronary artery disease (р > 0.05). Conclusion. Study of endothelial function by flow cytometry using monoclonal fluorescently labeled antibodies to CD146 and CD45 can be considered as a criterion for noninvasive assessment of the severity of atherosclerotic lesion of the coronary bed. (For citation: Sayganov SA, Kuzmina-Krutetskaya AM. Endothelial dysfunction and circulating endothelial cells in patients with chronic ischemic heart disease. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):27-32. doi: 10.17816/mechnikov201810227-32).
Diagnostic algorithm for detecting chronic obstructive pulmonary disease in primary care
Authors: Ovakimyan K V , Pokhaznikova M A , Andreeva E A , Kutznetsova O Yu , Plavinskij S L
Published: August 2018

Background. This article aims to implement an adaptation of the international standardized questionnaires, to assess the diagnostic value of their Russian-language version for diagnostics of chronic obstructive pulmonary disease (COPD), to develop the diagnostic algorithm based on questionnaires and spirometry results in order to form COPD high risk group in primary care. Materials and methods. The main results were based on the RESPECT study (RESearch on the PrEvalence and the diagnosis of COPD and its Tobacco-related etiology) population of St. Petersburg. Results. The repeatability of Russian-language version of investigated questionnaires was significantly high. Conclusion. A new diagnostic algorithm was developed to identify individuals at high risk of COPD and could be recommended for primary health care. (For citation: Ovakimyan KV, Pokhaznikova MA, Andreeva EA, et al. Diagnostic algorithm for detecting chronic obstructive pulmonary disease in primary care. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):44-51. doi: 10.17816/mechnikov201810244-51).
Prevention of embolism in patients with atrial fibrillation after resection of left atrium appendage during open heart surgery (pilot study)
Authors: Sotnikov A V , Melnikov M V , Marinin V A , Kisil Yu V , Samko K V
Published: August 2018

Aim. To assess the potential of prevention cardiogenic embolism by resection of left atrium appendage (LAA) during open heart surgery in patients with atrial fibrillation (AFib). Materials and methods. Study design - cohort prospective. Study group consisted of 19 patients with AFib whom during open heart surgery for coronary and/or valvular disease additional radical resection of LAA was made. After removal of the appendage two-layer linear suture to left atrium was performed without leaving a stump. Control group consisted of 20 patients with AFib, in whom during open heart surgery LAA remained intact. Long-term results were studied using CROQ telephone questionnaire. Results. There was no hospital mortality in both groups. Long-term results in control group were followed up to 6 years, in study group up to 2 years. Radical resection of LAA in patients with AFib reduced the risk of thromboembolic events in long-term period. In control group there were 4 strokes (2 of them were fatal), but no strokes in study group (p < 0,05). Conclusion. Radical resection of LAA in patients with AFib during open heart surgery for coronary and/or valvular disease prevents cardiogenic arterial embolism. (For citation: Sotnikov AV, Melnikov MV, Marinin VA, et al. Prevention of embolism in patients with atrial fibrillation after resection of left atrium appendage during open heart surgery (pilot study). Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):52-57. doi: 10.17816/mechnikov201810252-57).
Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients
Authors: Glushkov N I , Gorshenin T L , Dulaeva S K
Published: August 2018

The results of diagnostics and surgical treatment of the combined complications of colon cancer in elderly and senile patients are presented. It is established that modern ray methods of research, along with traditional methods, allow to improve the quality of diagnostics of combined complications. The introduction of endovideosurgical technologies helps to reduce the number of postoperative complications and lethality. (For citation: Glushkov NI, Gorshenin TL, Dulaeva SK. Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):79-86. doi: 10.17816/mechnikov201810279-86).
Behavioural Problems Associated with Child Sexual Abuse in Adolescents: A Retrospective Study
Authors: USTA Miraç Barış , AKBAŞ Seher , AYDIN Berna
Published: August 2018

Backgroud/aim: Child Sexual Abuse (CSA) is a public health problem with negative effects
on the mental health and development of children and adolescents. The aim of this study was
to identify the psychiatric outcomes of child sexual abuse and the trauma-related behavioural
and emotional problems in adolescents.
Method: 136 CSA victims and 136 age and gender-matched control group participated in the
study between 1 December 2010 and 31 December 2013. Diagnostic evaluation of the CSA
victims was applied with the criteria of the DSM-IV-TR by child and adolescent psychiatrists
and behavioral and emotional problems were assessed by the Youth Self Report.
Results: CSA victims are 86.0% were female and %30.1 expereinced multiple sexual abuse
events. %72.1 of CSA victims has psychiatric diagnosis on Axis 1. Compared to age-matched
controls Internalizing problems (p<0.001), Anxiety/depression (p<0.001), Withdrawn
(p<0.001), and Rule breaking behaviour (p=0.002) scores are higher in the CSA group.
Conclusion: Specific problems following a traumatic event may be important in respect of
treatment and a formulation to understand the psychopathology. There is a need for
longitudinal childhood studies to investigate the mediators of the psychopathology and to
understand the emotional and behavioural problems of CSA victims.
CONFERÊNCIA LOCAL DE SAÚDE A PARTIR DO ITINERÁRIO DE PESQUISA DE FREIRE: RELATO DE EXPERIÊNCIA
Authors: Busana Juliano De Amorim , Heideman Ivonete Teresinha Schulter Buss , Wendhausen Águeda Lenita Pereira , Lazzari Daniele Delacanal
Published: August 2018

Objetivo: relatar a experiência resultante das discussões oriunda de uma pesquisa de mestrado sobre Participação Popular em um Conselho Local de Saúde. Método: Descreve o processo de planejamento, desenvolvimento e avaliação de cinco encontros educativos e participativos alicerçados nos Círculos de Cultura de Freire, realizados com onze conselheiros que culminou em uma Conferência Local de Saúde. São apresentados as expectativas e a avaliação dos participantes, suas reflexões sobre os resultados da pesquisa e a proposta de modificação de parte das ações de fortalecimento da Participação Popular e fomento de práticas participativas. Resultados: identificou-se novas possibilidades de atuação na área para o fortalecimento da cidadania e seu exercício consciente. Conclusão: Aponta-se as, ações de responsabilidade dos representantes envolvidos com a temática e evidencia a existência de um espaço em permanente construção de fortalecimento de estratégias de Promoção da Saúde e empoderamento.Descritores: Participação comunitária; Estratégias; Conselhos de saúde; Promoção da Saúde.