bluuebunny/crossref_metadata_2025 huggingface dataset:
Complex application of high-intensity phototechnologies in the treatment of melasma
Authors:   Lancet clinic, Gelendzhik, Semizidis A.T. , Manturova N.E. ,   Federal State Budgetary Educational Institution of Higher Education Russian National Research Medical University named after N. I. Pirogov, Kruglova L.S. ,   Academic Affairs of the Federal State Budgetary Institution of Higher Professional Education «Central State Medical Academy» of the Presidential Administration of the Russian Federation
Published: November 2024

Purpose of the study. In clinical practice, combined methods, as a rule, show better efficiency in the treatment of melasma than monotherapy. Also relevant are the issues of studying the efficiency and safety of various combinations of hardware and drug methods. The aim of the study was to optimize the treatment of patients with melasma using the complex use of high-intensity phototechnologies (IPL therapy,
Nd: YAG laser) and thiamidol, taking into account the indicators of oxidative stress. Materials and methods. All patients were divided into 4 groups, depending on the methods of therapy. Lipid peroxidation and total
antioxidant activity indices were studied by spectrophotometry using the Spectrophotometer analyzer.
The results. The overall dynamics of the LPO index in group A was statistically significant, in group B it was 29.8 %, in group B — 28.2 %, in group D — 36.2 %. The overall dynamics of the TAA index in group A was statistically significant, in group B the index increased by 16.5 %, in group B — by 22.3 %, in group D — by 30.2 %.
Conclusion. Thus, it was possible to establish that the use of phototechnologies in melasma statistically significantly increases the level of antioxidant activity, leading to its normalization.
The Effect of BPJS Online Tiered Referral System Health on Patient Satisfaction at Royal Prima Hospital
Authors: Ginting Johannes Bastira
Published: November 2024

The National Health Insurance System (JKN), managed by BPJS, is a strategic initiative of the Indonesian government to ensure access to affordable and quality healthcare. This study aims to evaluate the effect of implementing an online tiered referral system on patient satisfaction at Royal Prima Hospital. The method used was non-experimental quantitative research with a descriptive approach and associative analysis conducted at Royal Prima Hospital Medan from February to March 2019. Data was collected through an online-based questionnaire survey involving 100 respondents and analyzed using the Chi-Square test and multiple logistic regression. The results of the analysis showed a significant relationship between several variables and patient satisfaction, such as ease of requirements (p = 0.010), service procedures (p = 0.017), service time (p = 0.006), cost efficiency (p = 0.001), and facilities/ infrastructure (p = 0.020). In contrast, variables that did not show a significant relationship included product specifications (p = 0.268), executor competence (p = 0.200), executor behavior (p = 0.103), and complaint handling (p = 0.074). From the multivariate analysis, the cost variable showed the highest Odds Ratio (OR) of 7.516, indicating that patients who felt cost-efficient had a 7.516 times greater chance of being satisfied. This study confirms that cost efficiency, service speed, and procedure quality significantly affect patient satisfaction, providing insight for BPJS Kesehatan in improving the quality of health services in Indonesia.
Resistance tofluoroquinolones among Klebsiella pneumoniae isolates collected from patients referred to the teaching hospitals of Ardabil university of medical sciences in 2020
Authors: Javanbakhat Parisa , MohammadShahi Jafar , Teimourpour Amir , Babazadeh Furugh , Johary Peyman , Teimourpour Roghayeh
Published: November 2024

Background. Klebsiella pneumoniae (KP) is one of the most important causes of hospital-acquired infection and one of the most important causes of ventilator-associated pneumonia. During the present study, we investigated the resistance to fluoroquinolones among KP isolates collected from patients referred to hospitals affiliated with Ardabil University of Medical Sciences in 2020. Methods. In this descriptive, cross-sectional study, the minimum inhibitory concentration (MIC) of ciprofloxacin (CLX) was determined by the agar dilution method, and mutations in the gyrA and parC genes and the presence of resistance genes, such as accA, qnr, and qepA, were evaluated using the polymerase chain reaction method. Results. Out of 100 isolates, 43% (n = 43) were resistant to CLX. The MIC range of CLX was 0.5 µg/mL to 1024 µg/mL. Isolates with a high MIC of CLX were investigated for mutations in the gyrA and parC genes. In the investigation of mutations in gyrA, a substitution from serine to isoleucine was observed at position 83, while no mutation was found in parC. In 10 isolates (10%), the presence of the aac (6')-Ib-cr gene was detected, while qepA and qnr resistance genes were not observed in any of the isolates. Conclusion. Based on the findings, a high frequency of the aac (6')-Ib-cr gene was reported in this study. Since this gene is located on a plasmid, it can be easily transferred between KP strains in a hospital setting and leads to the spread of resistance to fluoroquinolones. Practical Implications. The emergence of bacterial resistant strains is on the rise and has become a serious public health problem worldwide. Infection with these strains leads to complicated diseases with worse outcomes, prolonged hospitalization, increased healthcare costs, an increased need to use second-line drugs with costs, and treatment failures.
Salivary level of Interleukins 6 and 8 in people with geographic tongue referred to the department of oral medicine, faculty of dentistry, Tabriz university of medical sciences, Tabriz, Iran, in 2023
Authors: Fakhrzadeh Vahid , Eslami Hosein , Katebi Katayoun , Kahyaie Aghdam Mina , Hekmat Elmira
Published: November 2024

Background. Cytokines play an important role in regulating the host response to infection and tissue damage. The aim of this research was to compare the salivary levels of interleukin 6 and 8 in people with geographic tongue and healthy people. Methods. In this case-control study, 34 people with geographic tongue and 34 healthy people participated. Non-stimulated saliva samples were collected from both groups. Subjects spit their saliva into Falcon tubes every 60 seconds for 6 minutes. After completing the sampling, the amount of interleukin 6 and 8 was measured using the ELISA technique. Data analysis was done using independent t-test in SPSS version 24. A P-value of less than 0.05 was considered statistically significant. Results. The mean level of interleukin 8 was significantly higher in patients with geographic tongue (87.53±7.38 pg/mL) than in healthy subjects (53.53±6.04 pg/mL) (P<0.05). The mean level of interleukin 6 was significantly higher in patients with geographic tongue (519.11±49.92 pg/mL) than in healthy subjects (459.65±46.11 pg/mL) (P<0.05). In both control and patient groups, the level of interleukin 6 and 8 in women was significantly higher than in men (P<0.05). Conclusion. The mean levels of interleukin 8 and interleukin 6 in patients with geographic tongue were significantly higher compared to healthy subjects. Practical Implications. By determining the level of interleukins 8 and 6 in geographic tongue patients, their selective antagonists may induce therapeutic effects.
Corneal endothelial iayer changes in various stages of keratoconus and their correlation with topographic findings: a cross-sectional study
Authors: Sorkhabi Rana , Asghari Saba , Arasteh Amin , Jafari Ahad , Ahoor Mohammad Hosein
Published: November 2024

Background. Keratoconus (KCN) is a multifactorial progressive corneal disease that leads to significant disturbances in visual function. Various layers of the cornea, such as the endothelium, are affected by this condition. This study aimed to evaluate the corneal endothelial layer in different stages of the KCN and its correlation to topographic findings. Methods. It is a cross-sectional study of 110 eyes of 70 patients (28 females and 42 males) with KCN. The KCN severity staging in this study was based on the Amsler-Krumeich criteria and topographic findings. Specular microscopy was used to evaluate and compare the condition of the endothelial layer in different stages of KCN. Results. The prevalence of the various stages of KCN was 10%, 33.6%, 13.6%, and 42.8%, respectively, for stages I to IV. There was no significant difference between various stages of OCN regarding endothelial cell density and polymegethism (P=0.759 and P=0.052, respectively). However, the mean frequency of the hexagonal endothelial cells (6A) in stage IV was 7.8% lower than in stage II eyes (P=0.025). In addition, the Kmax had a positive correlation with polymegethism (P<0.001, r2=0.110) and a negative correlation with 6A (P=0.007, r2 =0.066). Conclusion. According to our findings, the progression of KCN could be associated with increased endothelial cell pleomorphism, and higher Kmax could be associated with polymegethism. However, there was no significant difference in endothelial cell density or polymegethism between the various stages of KCN. Practical Implications. Regarding the possible changes in the corneal endothelial layer with KCN progression, the pre-operative endothelial evaluations could improve the surgical plans in these patients.
Relation of telomere length and apoptosis in the hippocampus of Alzheimer’s male rats after twelve weeks of combined exercise
Authors: Vesali-akbarpour Leila , Heidarian-pour Ali
Published: November 2024

Background. Apoptosis of the nerve tissue, especially the hippocampus, has been introduced as one of the potential causes of neurological diseases such as Alzheimer’s disease, and it may be related to telomere length. In addition, exercise affects various aspects of nerve cell activity and may prevent their death. Based on this, the aim of this study was to investigate the relationship between telomere length and apoptosis of hippocampal neurons after 12 weeks of combined exercise in Alzheimer's rats. Methods. Overall, 35 male Wistar rats (weight 174±22g) were divided into control, Alzheimer’s, aerobic, resistance, and combined groups, each including 7 animals. Alzheimer’s was induced, and 8 mg/kg of trimethyltin was injected intraperitoneally. The groups of training were implemented for 12 weeks/5 days a week. After anesthetizing and perfusing the rats, the hippocampal tissue was isolated, and a real-time polymerase chain reaction was used to measure gene expression using the Master-mix Ampliqon and Synaclon DNA synthesis kit. Differences were determined by a one-way analysis of variance, and groups were compared by using Tukey’s post hoc test (P≤0.05). Results. Overall, 35 male Wistar rats (weight 174±22g) were divided into control, Alzheimer’s, aerobic, resistance, and combined groups, each including 7 animals. Alzheimer’s was induced, and 8 mg/kg of trimethyltin was injected intraperitoneally. The groups of training were implemented for 12 weeks/5 days a week. After anesthetizing and perfusing the rats, the hippocampal tissue was isolated, and a real-time polymerase chain reaction was used to measure gene expression using the Master-mix Ampliqon and Synaclon DNA synthesis kit. Differences were determined by a one-way analysis of variance, and groups were compared by using Tukey’s post hoc test (P<0.05). Conclusion. It seems that performing combined exercise (swimming and resistance) is effective in improving the telomere length and decreasing the apoptosis of Alzheimer’s rats’ hippocampus. Practical Implications. Performing combined sports activities (aerobic and strength) effectively improves telomeres while reducing neuron apoptosis.
Molecular resistance of Ethambutol in clinical samples obtained from patients admitted to the health center in Ardabil province using MAS-PCR
Authors: Babazadeh Furugh , Mohammadshahi Jafar , Mirzanejad-Asl Hafez , Rahimzadeh Reyhaneh , Neyestani Zohreh , Teimourpour Roghayeh
Published: November 2024

Background. Global stop TB is a critical strategy which aims at reducing the incidence of tuberculosis to less than one case per one million people by 2050. To achieve this goal, it is necessary to establish a timely diagnosis of the disease, provide an effective treatment, and identify the drug-resistant strains. Therefore, this study aimed to identify the resistance to ethambutol in patients referred to Ardabil Health Center. Methods. In this descriptive cross-sectional study, 71 clinical samples were collected from the patients referred to Ardabil Health Center between 2017-2020. The samples were first examined adopting microscopic method, and then DNA was extracted using the boiling method. Specific primers and MAS-PCR technique were employed for identification of ethambutol resistance strains. Results. Out of 71 collected specimens, six samples were NTM (8.45%). Out of all the examined samples, 36 samples (50.7%) had embB306 gene mutation, of which three samples were NTM (total NTM resistance was 50%). Out of the samples identified as resistant to ethambutol, six samples had a low bacterial load as +1 (16.67%), eight samples had a moderate bacterial load as +2 (22.22%), and the rest had a high bacterial load as +3 (61.11%). Conclusion. In sum, the frequency of resistance to ethambutol was 50.7%, which was higher than that reported by previous similar studies. Furthermore, it was determined that the MAS-PCR method was a fast, cheap, and reliable method for identifying resistance to the first-line tuberculosis drugs such as ethambutol. Therefore, this method may have facilitated evaluating the resistance to other first-line drugs at the same time and preventing the spread of resistant strains in the community through early detection of the antibiotic resistance. Practical Implications. Our study results may have been useful in increasing the awareness among the physician and health care workers of the ethambutol resistance level in indigenous strains in Ardabil province.
MMP9 gene expression alterations in gastric cancer and their role in cell migration
Authors: Farhadi Arezoo , Shohre Zare Karizi , Mehdi Ebrahimi , javad behroozi
Published: November 2024

Background. Gastric cancer (GC) is a significant global health concern, ranking as the fifth most common malignant tumor and the fourth leading cause of cancer-related deaths worldwide. The primary treatment approach for metastatic GC is systemic chemotherapy. Matrix metalloproteinases (MMPs) are a group of zinc-dependent proteolytic enzymes that play crucial roles in various physiological processes. Among them, MMP9 is known for its complexity and its ability to degrade the components of the extracellular matrix. This study aimed to compare the expression of the MMP9 gene in cancerous and adjacent tissue of GC and evaluate its knockdown effects on GC cell line migration. Methods. In the present study, 50 tumor tissues and adjacent non-tumor control tissues were collected from patients with GC. Using a real-time polymerase chain reaction, the expression levels of the MMP9 gene were assessed in these samples. Additionally, bioinformatics methods were employed to analyze MMP9 expression in a larger cohort of GC patients. Furthermore, a data mining study was conducted to investigate the potential impact of MMP9 expression on the overall survival of GC patients. In addition, appropriate small interfering RNA (siRNA) was synthesized to suppress the MMP9 oncogene and transfected into the GC cell line, and migration was investigated eventually. Results. The results demonstrated significant upregulation of the MMP9 gene in tumor samples compared to tumor-adjacent samples, with a notable fold change of 4.6. This consistent finding was further supported by our bioinformatics analysis. Additionally, our pan-cancer analysis of TCGA data revealed that MMP9 is upregulated in various malignant tumors, indicating its potential relevance beyond GC. After MMP9 siRNA transfection, the migration rate of the cancer cells was evaluated by a wound-healing assay. The GC cell migration and invasion significantly decreased after the knockdown of MMP9 by specific siRNA. Conclusion. In general, our study showed MMP9 upregulation in GC and suggested that the transfection of MMP9 gene siRNA could reduce invasion and migration. Practical Implications. siRNAs are promising medical breakthroughs for the treatment of MMP9-related cancer invasion and migration. However, there is still a need to deepen our understanding of MMP9 gene function in tumorigenesis.
Effective Intrusion Detection through Hybrid CNN-LSTM and Grey Wolf Optimization for Feature Selection in Complex Network Environments
Authors: Aljanabi Mohammad , Kumaran N.
Published: November 2024

Security and threat identification have always been critical in the interconnected world we live in today, and with emerging and cutting-edge threats, they still remain vital. Consequently, this paper proposes an intrusion detection solution whereby GWO for feature selection to optimize the detection model and a CNN–LSTM for attack detection. This paper describes the potential threat attributed to high dimensionality and non-linearity of network traffic data and aims to improve the overall detection rate and accuracy of different types of cyber-attacks. The GWO algorithm efficiently addresses the selection of relevant features from the data, hence demystifying the data while enhancing the model’s impact. CNN-LSTM architecture adapted from convolution neural networks and long short-term memory nets which performed the best in feature recognizing on networks traffic, allows the detection model to get understanding about complicated patterns in traffic. The described approach is compared with common methods, including Logistic Regression, Gaussian Naive Bayes, Decision Tree, and Random Forest and outperforms each of those regarding precision, recall and F1-score. Evaluation of the results obtained indicates that the proposed system correctly identifies various types of attacks with high precision, and very sensitive to false positive, and scenes the DoS/DDoS, PortScan, BruteForce, Web Attacks, and Botnet attacks correctly and distinctly. This paper shows the efficiency of integrating the state-of-art optimization methods with DL-based models for the development of the sound and highly scalable intrusion detection framework. The proposed method provides a much higher level of security enhancement in the proposed network against the emerging threat of cyber-attacks on existing and new complex networks.
Гипофизарный нанизм: эпидемиологические показатели по Республике Дагестан
Authors: Э.М. Солтаханов , И.Б. Кострова , Н.А. Гончарова , Г.А. Каинбекова
Published: November 2024

Цель: изучить эпидемиологические показатели гипофизарного нанизма (ГН) в Республике Дагестан (РД). Материалы и методы. Анализ данных государственного регистра ГН в РД с 2008 по 2018 год. Результаты. Анализ и использование эпидемиологических показателей заболеваемости ГН позволяет прогнозировать и эффективно применять средства, выделяемые для реабилитации пациентов с ГН. Использование стандартных методов оценки физического развития и федеральных рекомендаций для диагностики и ведения пациентов с ГН позволяет сократить число ложноположительных и ложноотрицательных диагнозов. Изучено распределение заболеваемости и болезненности в целом по РД, по сельской местности и городам. Заключение. Эпидемиологические показатели гипопитуитаризма у детей продолжают оставаться на высоком уровне.

Objective. To study the epidemiological indicators of pituitary nanism (PN) in the Dagestan Republic (DR). Materials and methods. The data of the state register of pituitary dwarfism in the DR from 2008 to 2018 are analyzed. Results. Analysis and use of the epidemiological indicators of the incidence of PN allows us to predict and effectively apply the funds allocated for the rehabilitation of patients with PN. The use of standard methods for assessing physical development and federal recommendations for the diagnosis and management of patients with PN can reduce the number of false positive and false negative diagnoses. The distribution of morbidity and morbidity in the whole of the DR, in rural areas and cities was studied. Cunclusion. The epidemiological indicators of hypopituitarism in children remain at a fairly high level.
Гаплогруппа R1a-M198 в тюркоязычных популяциях Северного Кавказа
Authors: М.А. Джаубермезов , Н.В. Екомасова , С.С. Литвинов , Л.Р. Габидуллина , Э.К. Хуснутдинова
Published: November 2024

Цель: изучение генетической структуры и разнообразия генофондов популяций Северного Кавказа по результатам изменчивости гаплогруппы R1aM198 Yхромосомы. Материал и методы. Проведён анализ генетического разнообразия популяций Кавказа по результатам изменчивости гаплогруппы R1aM198 Yхромосомы. Результаты. По результатам генотипирования выявлено, что мажорной гаплогруппой в тюркоязычных популяциях Центрального и Западного регионов Северного Кавказа является гаплогруппа R1aZ2123, в то время как для тюркоязычных популяций Дагестана и Кубанских ногайцев она оказалась нехарактерной. Нами был проведен анализ распределения частот ветвей гаплогруппы R1aM198 Yхромосомы в популяции балкарцев с учетом их принадлежности к разным субэтническим группам (баксанцы, чегемцы, холамцы, безенгиевцы, малкарцы). Заключение. Субэтнические группы безенгиевцев и холамцев характеризуются наименьшей частотой линий гаплогруппы R1aM198, а в субпопуляции холамцев и вовсе обнаружени лишь гаплогруппа R1aZ2123.

Objective: to study the genetic structure and diversity of gene pools of populations of the North Caucasus based on the variability of the haplogroup R1aM198 of the Y chromosome. Material and methods. The analysis of the genetic diversity of the Caucasian populations was carried out according to the results of the variability of the haplogroup R1aM198 of the Y chromosome. Results. Based on the results of genotyping, it was revealed that the haplogroup R1aZ2123 is the major haplo group in the Turkicspeaking populations of the Central and Western regions of the North Caucasus, while it turned out to be uncharacteristic for the Turkicspeaking populations of Dagestan and the Kuban Nogai. We conducted an analysis of the frequency distribution of the branches of the haplogroup R1aM198 of the Y chromosome in the Balkarian population, taking into account their belonging to different subethnic groups (Baksans, Chegemians, Kholamets, Bezengi, Malkars). Conclusion. The subethnic groups of Bezengis and Kholamets are characterized by the lowest frequency of lines of the haplogroup R1aM198, and in the subpopulation of cholama, only haplogroup R1aZ2123 is detected.
Гипотиреоз и его роль в развитии нарушений углеводного и жирового обмена (обзор литературы)
Authors: И.М. Магомедова , К.Г. Камалов , М.Г. Атаев , А.Ч. Арсланбекова
Published: November 2024

Цель: привести результаты некоторых работ, демонстрирующих механизмы воздействия тиреотропного гормона на процессы регуляции углеводного обмена, а также его взаимосвязь с увеличением массы тела. Результаты. Снижение уровня гормонов щитовидной железы оказывает влияние на печень, вызывая изменения в углеводном обмене, например, в качестве антагонистов инсулина посредством увеличения экспрессию глюкозного транспортера тип 2. Повышение концентрации тиреотропного гормона связано с риском нарушений липидного и углеводного обмена и, следовательно, повышенными риском развития метаболического синдрома, сахарного диабета и других нарушений углеводного обмена. Заключение. Все это показывает важность проблемы сочетания сахарного диабета и заболеваний щитовидной железы в частности гипотиреоза.

Objective. To present the results of some works demonstrating the mechanisms of the action of thyroidstimulating hormone on the processes of regulation of carbohydrate metabolism, as well as its correlation with weight gain. Results. A decrease in the level of thyroid hormones has an effect on the liver, thus causing changes in carbohydrate metabolism, for example, as insulin antagonists by increasing the expression of the glucose transporter type 2. An increase in the concentration of thyroidstimulating hormone is associated with a risk of lipid and carbohydrate metabolism disorders and therefore, increased chances of developing metabolic syndrome, diabetes mellitus and other disorders of carbohydrate metabolism. Conclusion. All this shows the importance of the problem of combined diabetes mellitus and thyroid diseases, in particular hypothyroidism.
ОСОБЕННОСТИ ТРЕВОГИ И ДЕПРЕССИИ У ПАЦИЕНТОВ С НОВОЙКОРОНАВИРУСНОЙ ИНФЕКЦИЕЙ
Authors: А.Ф. Иволгин , М.Д. Аминова , М.А. Самушия , А.А. Рагимова
Published: November 2024

Типичная клиническая картина заболевания COVID-19 представлена проявлениями на респираторном уровне, с двусторонней атипичной пневмонией со значительным нарушением дыхательной функции из-за диффузного альвеолярного повреждения, но SARS-CoV-2 может также инфицировать другие органы и типы клеток, включая нервную систему. Неврологические нарушения возникают примерно у трети пациентов с COVID-19 и связаны как с нарушением периферической, так и центральной нервной системы (ЦНС). Поражение ЦНС описано в виде тяжелого вирусного геморрагического энцефалита, токсической энцефалопатии, острого демиелинизирующего поражения, острого нарушения мозгового кровообращения. В острой стадии заболевания возможно развитие разнообразных психотических реакций от повышенной тревожности до делирия, а в отдаленном периоде заболевание COVID-19 может стать причиной развития депрессии, тревоги, хронической усталости, бессонницы и посттравматического стрессового расстройства.

The typical clinical picture of COVID-19 disease is represented by manifestations at the respiratory level, with bilateral atypical pneumonia with significant respiratory impairment due to diffuse alveolar damage, but SARS-CoV-2 can also infect other organs and cell types, including the nervous system. Neurological disorders occur in about a third of COVID-19 patients and are associated with both peripheral and central nervous system (CNS) disorders. Damage to the central nervous system is described in the form of severe viral hemorrhagic encephalitis, toxic encephalopathy, acute demyelinating lesion, acute cerebrovascular accident. In the acute stage of the disease, the development of a variety of psychotic reactions from increased anxiety to delirium is possible, and in the long term, COVID-19 disease can cause the development of depression, anxiety, chronic fatigue, insomnia, and post-traumatic stress disorder.
ПРИМЕНЕНИЕ БЛОКАТОРОВ ПОЗДНИХ НАТРИЕВЫХ КАНАЛОВ В ЛЕЧЕНИИ ТОКСИЧЕСКОЙ КАРДИОМИОПАТИИ
Authors: А.А. Цыгвинцев , А.Н. Лищук , П.Г. Шахнович
Published: November 2024

В настоящее время все большую клиническую проблему приобретает ведение онкологических пациентов с развившимися кардиотоксическими реакциями на фоне проводимой химиотерапии. В данной работе представлен клинический случай обратимой доцетаксел-индуцированной кардиомиопатии у пациента с раком предстательной железы. Анализируется тактика ведения подобных пациентов с позиции доказательной медицины.

Currently, an increasing clinical problem is the management of cancer patients with developed cardiotoxic reactions against the background of chemotherapy. This paper presents a clinical case of reversible docetaxel-induced cardiomyopathy in a patient with prostate cancer. The tactics of managing such cases are analyzed from the standpoint of evidence-based medicine.
ПРИМЕНЕНИЕ СОВРЕМЕННЫХ КЛЕТОЧНЫХ ТЕХНОЛОГИЙВ ЛЕЧЕНИИ ЭНТЕЗОПАТИЙ
Authors: В.В. Кокорин , П.Е. Крайнюков , С.А. Епифанов , А.Н. Чеснаков
Published: November 2024

Хронические болезни опорно-двигательного аппарата остаются важнейшей причиной инвалидизации жителей нашей страны и являются одним из социально значимых факторов, определяющих здоровье населения. Распространенность хронических болевых синдромов (ноцицептивного, нейропатического, психогенного) в России варьируется от 13,8 до 56,7%. Энтезопатия является одной из малоизученных на сегодняшний день форм поражения параартикулярных тканей и проявляется в течение жизни у 60-85% взрослого населения. Несмотря на разнообразие медицинских средств, и физиотерапевтических процедур, результаты лечения остаются неудовлетворительными, наблюдается высокая доля рецидивов и хронизации процесса. Вопросы этиопатогенеза данного заболевания остаются открытыми и требуют дальнейшего изучения. Перспективным методом лечения данной патологии в настоящее время считается применение клеточных технологий, в т. ч. развивающееся направление применение стволовых клеток.

Chronic diseases of the musculoskeletal system remain the most important cause of disability in our country and are one of the socially significant factors that determine the health of the population. The prevalence of chronic pain syndromes (nociceptive, neuropathic, psychogenic) in Russia varies from 13.8 to 56,7%. Entesopathy is one of the little- studied forms of damage to paraar-ticular tissues and is manifested during life in 60-85% of adult naseniya. Despite the variety of medical remedies, and physical therapy procedures, treatment results remain unsatisfactory, there is a high proportion of relapses and a chronization of the process. Questions of the etio-pathogenesis of this disease remain open and require further study. A promising method of treating this pathology is currently considered the use of cellular technologies, including the ever-increasing direction of the use of stem cells.
ВЫСОКОПРОИЗВОДИТЕЛЬНОЕ СЕКВЕНИРОВАНИЕ КАК ИНСТРУМЕНТ В КЛИНИЧЕСКОЙ ПРАКТИКЕ
Authors: Ву Глэдис
Published: November 2024

Понимание генетических причин заболевания необходимо не только для постановки точного диагноза, но и может привести к значительному улучшению терапевтических прогнозов и стратегий лечения. Кроме того, в практике часто встречаются редкие заболевания, своевременная диагностика которых является сложной задачей. Внедрение новых методов, основанных на технологии секвенирования (расшифровки аминокислотной последовательности, например ДНК) нового поколения (next-generation sequencing, NGS) позволяет не только успешно диагностировать генетически гетерогенные заболевания даже в случае неочевидной клинической диагностической гипотезы, но и оценить редкие мутации в геноме пациента как с точки зрения склонности к заболеваниям, так и для оценки перспективных возможностей организма. В данной работе мы постарались обсудить влияние внедрения NGS в клиническую практику и преимущества этого метода в классическом диагностическом подходе.

Understanding the genetic causes of a disease is essential not only for an accurate diagnosis, but can lead to significant improvements in therapeutic prognosis and treatment strategies. Rare diseases are often encountered, the timely diagnosis of which is a difficult task. The introduction of new methods based on the sequencing technology (decoding of the amino acid sequence, for example, DNA) of a new generation (next-generation sequencing, NGS) not only makes it possible to successfully diagnose genetically heterogeneous diseases even in the case of an unobvious clinical diagnostic hypothesis, but also makes it possible to assess rare mutations in the patient’s genome, both from the point of view of the propensity to diseases, and to assess the promising capabilities of the organism. In this paper, we tried to discuss the impact of the introduction of NGS into clinical practice and the advantages of this method in the classical diagnostic approach.
РОЛЬ АОРТО-МЕЗЕНТЕРИАЛЬНОГО «ПИНЦЕТА» В РАЗВИТИИ НАРУШЕНИЙ МАГИСТРАЛЬНОГО ВЕНОЗНОГО КРОВОТОКА ЛЕВОЙ ПОЧКИ
Authors: А.Г. Тонян , В.В. Хан
Published: November 2024

Определены особенности работы левой почечной вены в системе аорто-мезентериального «пинцета» на основе изучения гемодинамических изменений и их клинических проявлений. Проводилось полипозиционное (6 положений - стоя, сидя, на спине, на животе, на правом и левом боку) УЗИ почек, почечных артерий и вен. В положении с минимальными и максимальными колебаниями венозного кровотока в левой почечной вене проводился забор венозной крови утром (натощак) для оценки уровня дегидроэпиандростерона и тестостерона. В левой почечной вене скорость кровотока, давление и диаметр не постоянны и зависят от «лабильности» размеров аотро-мезентериального «пинцета», влияют на функциональное состояние левого надпочечника, что определяет многообразие взаимоотношений данных гормонов. Колебания давления в вене являются фактором, влияющим на общую гемодинамику, работу надпочечниково-тестикулярной системы, что является основополагающим в диагностике и лечении осложнений нарушения магистрального венозного кровотока в левой почечной вене.

The features of the left renal vein in the system of aorto-mesenteric «tweezers» were determined based on the study of hemodynamic changes and their clinical manifestations. Polypositional testing was performed (6 positions- standing, sitting, on the back, on the stomach, on the right and left sides) Ultrasound of the kidneys, renal arteries and veins. In a position with minimal and maximum fluctuations in venous blood flow in the left renal vein, venous blood was collected in the morning (on an empty stomach) to assess the level of dehydroepiandrosterone and testosterone. In the left renal vein, the blood flow rate, pressure and diameter are not constant and depend on the «lability» of the size of the aotro-mesenteric «tweezers», affect the functional state of the left adrenal gland, which determines the diversity of the relationships of these hormones. Fluctuations in the pressure in the vein are a factor affecting the overall hemodynamics, the work of the adrenal-testicular system, which is fundamental in the diagnosis and treatment of complications of a violation of the main venous blood flow in the left renal vein.
ВЗАИМОДЕЙСТВИЕ МЕЖДУ СИСТЕМНОЙ ВОСПАЛИТЕЛЬНОЙ РЕАКЦИЕЙ И НАРУШЕНИЯМИ В СИСТЕМЕ ГЕМОСТАЗА У БОЛЬНЫХ С ОСТРЫМ ТЯЖЕЛЫМ ПАНКРЕАТИТОМ
Authors: В.В. Киселев , М.С. Жигалова , Е.В. Клычникова
Published: November 2024

Острый панкреатит представляет собой наиболее частую причину госпитализаций среди всех заболеваний желудочно-кишечного тракта и связан с высоким риском летального исхода. За последние 25 лет отмечается глобальный рост заболеваемости острым панкреатитом, наряду со многими достижениями в диагностике и лечении. У пациентов с острым панкреатитом наблюдается системная активация как воспаления, так и коагуляции. Все больше доказательств указывают на перекрестную связь между этими двумя системами, в результате которой воспаление приводит к активации коагуляции, а коагуляция значительно влияет на воспалительную активность.

Acute pancreatitis is the most common cause of hospitalization among all diseases of the gastrointestinal tract and is associated with a high risk of death. Over the past 25 years, there has been a global increase in the incidence of acute pancreatitis, along with many advances in diagnosis and treatment. In patients with acute pancreatitis, systemic activation of both inflammation and coagulation is observed. A growing body of evidence points to a cross-link between the two systems, as a result of which inflammation leads to the activation of coagulation, and coagulation significantly influences inflammatory activity.
ПРИМЕНЕНИЕ ПЕРСОНИФИЦИРОВАННОЙ ПРОГРАММЫ МЕДИЦИНСКОЙ РЕАБИЛИТАЦИИ БОЛЬНЫХ, ПЕРЕНЕСШИХ ЭНДОПРОТЕЗИРОВАНИЕПОСЛЕ ПЕРЕЛОМА ШЕЙКИ БЕДРЕННОЙ КОСТИ
Authors: А.В. Есипов , Д.Е. Ищук , А.М. Щегольков , А.И. Павлов
Published: November 2024

Значимость персонифицированных программ в реабилитации больных, перенесших эндопротезирование после перелома шейки бедренной кости, возрастает. Изложены непосредственные и отдалённые результаты применения персонифицированной программы медицинской реабилитации (включающей кинезиотерапию с реализацией принципов 4Р-медицины), разработанной с учётом особенностей функционального состояния 107 больных, перенесших эндопротезирование после перелома шейки бедренной кости и поступивших через 2 мес на реабилитацию в поликлиническое отделение госпиталя. Применение программы значительно повышает эффективность реабилитации и сокращает её сроки.

The importance of personalized programs in the rehabilitation of patients who have undergone endoprosthetics after a femoral neck fracture is increasing. The article describes the immediate and longterm results of the application of a personalized medical rehabilitation program (including kinesiotherapy with the implementation of the principles of4P-medicine), developed taking into account the features of the functional state of 107 patients who underwent endoprosthetics after a femoral neck fracture and were admitted to the polyclinic department of the hospital after 2 months for rehabilitation. The application of the program significantly increases the effectiveness of rehabilitation and reduces its time.
УРОВЕНЬ ПОТРЕБЛЕНИЯ АЛКОГОЛЯ И СМЕРТНОСТЬ ОТ ЦИРРОЗА ПЕЧЕНИ - ДВА ВЗАИМОСВЯЗАННЫХ ФАКТОРА. ПРОБЛЕМЫ МЕДИЦИНСКОЙ РЕАБИЛИТАЦИИ И ВОССТАНОВИТЕЛЬНОГО ЛЕЧЕНИЯ
Authors: С.А. Белякин , А.И. Павлов , А.Б. Шамес , М.Н. Фролкин
Published: November 2024

В основу статьи положен анализ взаимосвязи характера и частоты возникновения алкогольной болезни печени и потребления пациентом алкоголя. Представлены данные о зависимости уровня смертности, обусловленной циррозом печени, от уровня потребления алкоголя в Европе и России. Указывается, что алкогольная болезнь печени относится к распространенным заболеваниям, выявляющимся у 10-25% мужского населения большинства развитых стран. Связь между смертностью от цирроза печени и уровнем среднедушевого потребления алкоголя была строго доказана и наблюдалась в различные периоды времени и в различных регионах мира.

The article is based on the analysis of the relationship between the nature and frequency of alcoholic liver disease and the patient’s alcohol consumption. Data on the dependence of the death rate due to cirrhosis of the liver on the level of alcohol consumption in Europe and Russia are presented. It is indicated that alcoholic liver disease is a common disease that is detected in 10-25% of the male population of most developed countries. The link between mortality from cirrhosis and the level of per capita alcohol consumption has been strongly proven and observed in different time periods and in different regions of the world.
eleições para reitor na Universidade Federal de Pernambuco
Authors: Soares Thiago Nunes
Published: November 2024

Neste trabalho foram analisadas as eleições para reitor na Universidade Federal de Pernambuco em 1983, com reflexões acerca dos impactos da ditadura civil-militar de 1964 nas liberdades democráticas. A pesquisa foi desenvolvida por meio da coleta, seleção e análise de um amplo e variado conjunto documental oriundo do Arquivo Nacional e da Hemeroteca Digital da Biblioteca Nacional. Como resultados da investigação, constatou-se que, em face de uma maior articulação e organização da comunidade acadêmica e do incremento das lutas por democratização naquela universidade, em 1983 foram estabelecidas eleições para reitor. O modelo de seleção para o cargo permaneceu indireto, mas conseguiu-se que houvesse uma consulta aos universitários durante o pleito. O fato de ter havido eleição para essa função e consulta à comunidade acadêmica no sufrágio não garantiu a ocupação da vaga pelo candidato mais votado, tendo em vista que a definição era executada pelo presidente da República, por meio de uma lista que a universidade enviava ao Ministério da Educação e Cultura, situação comum a outras instituições de ensino no período. Apesar desse contexto, a eleições para reitor em 1983 resultaram em avanços democráticos, pois diante da crise do governo ditatorial, ampliaram-se as discussões sobre a democracia dentro e fora dos muros da universidade, mobilizando a comunidade acadêmica e outros segmentos sociais com debates e outras formas de resistências cotidianas.
Entrevista com Maria Isabel da Cunha
Authors: Cunha Maria Isabel da , Azevedo Maria Antonia Ramos de
Published: November 2024

Nesta entrevista com Maria Isabel da Cunha, realizada em maio de 2024, mediante troca de e-mails e ligações telefônicas, busca-se compartilhar aspectos da trajetória pessoal e profissional da educadora no contexto da ditadura militar, que assolou o Brasil das décadas de 1960 a 1980.  Nascer em uma família com muitas mulheres professoras a levou ao Curso Normal e ao exercício do magistério como profissão. Maria Isabel cursou primeiro a graduação em Ciências Sociais e depois em Pedagogia, atuou na educação básica e no ensino superior. Viveu, dentro das escolas, as mudanças trazidas pelas marcantes legislações educacionais de 1968 e 1971. Todo esse processo formativo e inserção no campo de trabalho se deram em plena ditadura, possibilitando à entrevistada desenvolver uma perspectiva crítica sobre o papel da educação e ressignificar a sala de aula. Maria Isabel nos chama a atenção para a não neutralidade do conhecimento, o papel emancipatório da escola, o comprometimento docente com as causas da democracia e as responsabilidades do Estado. E conclui refletindo sobre a importância do esperançar, conforme ensinado por Paulo Freire, e do educar como ato de repartir conhecimentos, afetos e experiências.
Vulneración a los derechos humanos de los intervinientes en las prácticas de la gestación subrogada
Authors: Guzmán Quintana Luisa María , Guzmán Quintero Aldemar , Guzmán Quintana Nataly
Published: November 2024

La gestación subrogada es un proceso de naturaleza compleja, pues se encuentra transversalizado por diversos factores, que convierten este método de reproducción asistida en objeto de estudio de diversas disciplinas. De esta manera representa una serie de desafíos que involucran a distintos actores: los contratantes, la gestante y el nasciturus. Se realizó un abordaje teórico desde una perspectiva sociojurídica, describiendo las diferentes perspectivas y concesiones en el contexto del populismo punitivo, en una revisión documental de los actos legislativos. A partir de allí, se reflexiona sobre las percepciones bioéticas y bioestéticas que hacen parte del periodo gestacional y que consideran pertinentes ser tenidas en cuenta en esta práctica. Así, surgen conceptos que sitúan en posición de vulnerabilidad la posibilidad, la motivación y el derecho a la formación familiar.
La dignidad humana, las relaciones laborales y el ejercicio de la prostitución en Colombia
Authors: Jiménez García Pablo Emilio
Published: November 2024

A nivel global, los sistemas jurídicos y sociales han evolucionado para brindar de manera efectiva herramientas que permitan la protección de la dignidad humana, aun en contextos que suponen gran controversia, como lo es el ejercicio de la prostitución. De esta manera, desde un enfoque cualitativo, se propone el estudio de las consecuencias, alcances y adaptación de los derechos laborales de los trabajadores sexuales en Colombia. Lo anterior, a partir del análisis teórico detallado de sentencias de la Corte Constitucional y disposiciones legales sobre esta materia.
Comentarios a la Sentencia STC9311-2024: la sustentación anticipada del recurso de apelación contra sentencias
Authors: Paez Quiñones Jorge Andrés
Published: November 2024

En el marco de los recursos ordinarios, la apelación es posiblemente el más importante de los medios de impugnación, ya que asegura la posibilidad de una revisión por parte del superior sobre los posibles errores cometidos por el juez de primera instancia. A partir de la entrada en vigencia de la Constitución de 1991, la garantía de la doble instancia se ha vuelto un tema de trascendencia constitucional y hasta convencional.
El presente es un análisis de la Sentencia STC9311-2024, emitida por la Corte Suprema de Justicia, en su Sala de Casación Civil, en la cual se decide una acción de tutela; la Corte cambia la postura respecto a la oportunidad procesal para sustentar el recurso de apelación, negando la posibilidad de la llamada sustentación previa. Se pretende hacer un análisis de la poca pertinencia de esta providencia judicial y una crítica de ella, dado que se considera que esta sentencia no es armónica con principios como la tutela judicial efectiva o economía procesal, para lo cual se hará una crítica constructiva respecto de esta providencia judicial.
Presentación del libro: Derecho procesal civil general, escrito por el profesor Henry Sanabria Santos
Authors: Rodríguez Guáqueta Juan Jóse
Published: November 2024

Es un honor para mí escribir unas palabras sobre la obra Derecho procesal civil general, escrita por el profesor Henry Sanabria Santos y publicada por la editorial de la Universidad Externado en 2021. En este libro, el autor aborda temas fundamentales de la parte general del Código General del Proceso y del extinto Decreto 806 de 2020, ahora transformado en la Ley 2213 de 2022. A lo largo de once capítulos, Sanabria Santos examina diversas temáticas, tales como: el concepto y las fuentes del derecho procesal civil; la competencia; las partes, otras partes y terceros en el proceso civil; las reglas de la actuación judicial; la demanda y su contestación; las excepciones previas; las providencias judiciales; los recursos; las nulidades procesales; los modos extraordinarios de terminación del proceso; y las costas. Finalmente, el libro incluye un anexo relacionado con el Decreto Legislativo 806 de 2020.
The impact of changes in spatial development on microclimate conditions and thermal comfort: the example of Manufaktura in Łódź
Authors: Bochenek Anna Dominika , Klemm Katarzyna , Szulc Amanda
Published: November 2024

The paper presents the impact of changes in spatial development on microclimate parameters and thermal comfort. The research area covers the site of the current shopping and service centre Manufaktura in Łódź, located in the former factory complex of Izrael Poznański. Analyses were carried out for the area before and after the revitalisation process. The transformations of the building structure, reductions in green areas, and modifications of the surface were highlighted. Three-dimensional terrain models were prepared, and simulations were conducted using the ENVI-met program. The influence of development transformations on thermal comfort and microclimate was assessed. Due to the negative impact of the changes, adaptive solutions were proposed. The data obtained showed a positive influence of the implemented blue-green strategies on thermal conditions and the microclimate.
A study on turn-off, and on-resistance and short-circuit capability trade-off characteristics in 1.2 kV SiC MOSFETs
Authors: Suzuki Kazuhiro , Yano Hiroshi , Iwamuro Noriyuki
Published: November 2024

This paper presents experimental evaluations of the trade-off characteristics of the turn-off loss (E
OFF)—slew rate of the drain current density (d
J
D/d
t) using the latest 1.2 kV SiC trench and planar metal-oxide-semiconductor field-effect-transistors (MOSFETs). It found that smaller reverse transfer capacitances (C
rss) improved E
OFF − d
J
D/d
t. This was because of the moderately low doping density of the n-drift layer and the optimally designed gate structures. Experimental and numerical explorations were also conducted to identify structures that improve on-resistance (R
on,sp)—short-circuit capabilities (SCWT). The trench MOSFETs achieved suppressed peak drain current densities in the short-circuit state while keeping low R
on,sp, indicating superior R
on,sp—short-circuit withstanding time (SCWT) to planar MOSFETs. Furthermore, the trench MOSFETs with narrower and higher doping J-FET regions can improve the trade-off. In conclusion, trench MOSFETs with optimized J-FET regions exhibited superior R
on,sp—SCWT trade-off characteristics while showing comparable E
OFF − d
J
D/d
t to planar MOSFETs.