bluuebunny/crossref_metadata_2025_split huggingface dataset:
ANGIOGRAPHIC EVALUATION OF GRAFT PATENCY AFTER MINIMALLY INVASIVE MULTIVESSEL CORONARY BYPASS SURGERY
Authors: Snegirev M. A. , Paivin A. A. , Denisiuk D. O. , Drozdova O. A. , Mitusova G. M. , Sichinava L. B. , Khvan N. E. 
Published: December 2019

The OBJECTIVE was to demonstrate perioperative outcomes and angiographic graft patency rates in the mediumterm period in patients after multivessel minimally invasive coronary artery bypass grafting (MICS CABG) procedures.MATERIAL AND METHODS. In the period from 2014 to 2019, 270 patients with stable forms of coronary artery disease were operated on. All patients received left internal thoracic artery (LITA) and venous or arterial (radial artery) grafts. Off-pump surgery was performed in 264 cases (97.8 %). 127 patients underwent CT-bypass angiography (CT-BA) on a 128-slice computed tomography at least after 1 year after the operation. Mean follow-up duration was (30.3±7.9) months.RESULTS. All patients received full myocardial revascularization. Mean number of grafts was (2.6±0.5). Perioperative mortality rate was 0.4 % (1 patient). Perioperative myocardial infarctions or cerebrovascular accident occurred in 3 (1.1 %) and 1 (0.4 %) patients. Overall graft patency rate in examined patients was 89.8 % (290 of 323). At the time of LITA, the patency of mammary grafts was 98.4 % (124 of 126), venous graft –84.0 % (163 of 194) and radial artery grafts – 100 % (3 of 3).CONCLUSION. MICS CABG was safe and effective and was characterized by minimal rate of perioperative complications. This procedure allowed to achieve complete revascularization of the myocardium without sternotomy and could be performed off-pump (in most cases). MICS CABG provide excellent long-term graft patency rates.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.
SURGICAL TREATMENT OF RECURRENT HIATAL HERNIAS
Authors: Vasilevsky D. I. , Bechvaya G. T. , Ahmatov A. M. 
Published: December 2019

OBJECTIVE. Hiatal hernias are the most common type of visceral anatomy disorder. The unresolved problem of surgical treatment of this pathology remains the high frequency of its relapse. Currently, it is believed that repeated surgical interventions for hiatal hernia are technically difficult, carry a high risk of complications and have unsatisfactory long-term results.MATERIAL AND METHODS. In the period from 2015 to 2019, 55 patients with this pathology were operated. In 52 (94.5 %) cases, the revision operation was performed laparoscopically, in 3 (5.5 %) – through left-side thoracotomy. The technique of the operation implied the removal of hiatal hernia and the implementation of antireflux reconstruction. In five (9.9 %) patients with a shortened esophagus, the fundoplication wrap was originally created in the chest; in 50 (90.1 %), normal anatomy was restored.RESULTS. Long-term results ranging from 12 to 48 months were evaluated in 53 (96.4 %) cases. The natural position of the esophagus and stomach in relation to the diaphragm was detected in 43 (81.1 %) patients, relapse of hiatal hernia – in 5 (9.4 %). In 5 patients, the fundoplication wrap formed in the chest was functional. The absence of gastroesophageal reflux was observed in 41 (91.8 % of patients who had GERD before surgery). In 4 (8.8 %) cases, including one patient with antireflux reconstruction in the chest, a relapse of the disease occurred.CONCLUSION. The presented results allowed the surgical treatment of recurrent hiatal hernias reasonable and effective.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.
TOTAL MESORECTUMECTOMY IN THE SURGICAL TREATMENT OF RECTAL CANCER: OPEN OR LAPAROSCOPIC?
Authors: Azimov E. G. , Aliyev S. A. 
Published: December 2019

The OBJECTIVE of the work was to evaluate the long-term results of surgical treatment of patients underwent open and laparoscopic TME for rectal cancer.MATERIAL AND METHODS. The analysis of the results of surgical treatment of 103 patients aged from 20 to 70 years with rectal cancer was presented. Depending on the methods of total mesorectumectomy (ТМЕ), patients were divided into 2 groups. The 1st group included 47 (45.6 %) patients who had underwent laparoscopic total mesorectumectomy (LTME). The 2nd group included 56 patients who had underwent open total mesorectumectomy (OTME). In all patients, the histological structure of the tumor was represented by adenocarcinoma of varying degrees of differentiation. Long-term results of surgical treatment with actual and relapse-free 3-and 5-years survival were observed in 97 (94.2 %) patients.RESULTS. The frequency of local relapses of RC after OTME and LTME was 11.5 % (6 patients) and 11.1 % (5 patients). Distant metastases were detected in 7.7 (4 patients) and 6.7 % (3 patients) of cases, respectively. The actual 3-year survival rate of patients after LTME was 80 %/, 5-year-57.8 %. In patients underwent OTME, these indicators were 81.8 and 54.5 %, respectively.CONCLUSION. A significant correlation was found between the recurrence rate and distant metastases of the RC and the histological structure and degree of tumor differentiation. The differences between the three-year survival rates of patients in both groups are not statistically significant (p>0.05).The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.
RESULTS OF EMERGENCY SURGICAL INTERVENTIONS FOR COLORECTAL CANCER COMPLICATED BY BLEEDING
Authors: Schaeva S. N. 
Published: December 2019

The OBJECTIVE was to evaluate oncological results of five-year survival of patients with colorectal cancer (CRC) complicated by bleeding who underwent emergency resections.MATERIAL AND METHODS. The study included the data of 240 patients with CRC complicated by bleeding treated in General and specialized surgical hospitals in Smolensk between 2001 and 2013 (13 years).RESULTS. Of 240 patients with CRC complicated by bleeding, 233 underwent emergency resections. Statistically significant differences were revealed in R1 and the number of investigated lymph nodes between the coloproctological and General surgical hospitals (p=0.01, p<0.001) and oncological and General surgical hospitals (p=0.016, p<0.0001). The indicators of 5-year overall and relapse-free survival were more in patients who had underwent emergency surgical interventions in specialized hospitals (p=0.00217, p=0.0143).CONCLUSION. When bleeding from the tumor, the mortality rate after surgery was 17.9%, the frequency of severe postoperative complications (IIIb-IVb complications according to Clavien-Dindo) – 44.7%.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.
MEDIUM-TERM AND LONG-TERM PLANNING OF MEDICAL SUPPORT FOR TROOPS (FORCES) AND AFFECTED POPULATION AT ELIMINATION OF MEDICAL AND SANITARY CONSEQUENCES OF EMERGENCY SITUATIONS
Authors: Dmitriev G. V. , Lemeshkin R. N. , Savchenko I. F. , Stepanov A. V. 
Published: December 2019

Relevance. Currently, the solution to the problem of medical support for troops (forces) and the population during the liquidation of the health consequences of emergencies by forces and means of the medical service of the Armed Forces of the Russian Federation does not lose its relevance.Intention. The system-morphological method to create a multidimensional morphological matrix with the corresponding morphological features and develop solutions to the problem of medical support in responding to the health consequences of emergencies.Methodology. The methodology of system-morphological analysis is presented, which allows creating alternative solutions. Variants of medical support for troops (forces) and the population were developed during the liquidation of the health consequences of emergency situations of a natural, technogenic and social nature: “Departmental”, “Interdepartmental”, “International”. In relation to each option, 9 indicators (criteria) are proposed: normative legal regulation; system controllability; complexity of organizing the system; resource (material) cost; staffing; the adequacy of medical care; efficiency; experience and innovation; autonomy of action. To achieve the goal of the study, the original MPRIORITY 1.0 dialog system (MY PRIORITY) was used which implements a method for analyzing hierarchies through repetitions (iterations).Results and Discussion. The results characterize each of the considered alternative options with an appropriate weight priority, and their preference is determined. During the first iteration, priorities were identified for a system of indicators and criteria that are characteristic for achieving a result with an emphasis on normative legal regulation of activities with its organizational structure and management system. In the second one, the priorities for the system of indicators and criteria were changed with a focus on the organization of medical care with the existing system of material and technical support, medical supply, as well as the proper level of training of medical personnel.Conclusion Proposals have been developed for the medical service of the Armed Forces of the Russian Federation, in particular for the Service for Disaster Medicine of the Ministry of Defense of Russia, on the organization of a medical support system for troops (forces) and the population during mitigation of the health consequences of emergencies.
CASES OF MORBIDITY WITH WORK DAYS LOST AMONG EMPLOYEES OF THE EMERCOM OF RUSSIA AND THE WORKING POPULATION IN RUSSIA
Authors: Evdokimov V. I. , Bobrinev E. V. 
Published: December 2019

Relevance. Activities in extreme conditions likely involve stress on functional reserves and impaired health. Intention. Calculate the medical and statistical indicators of cases of morbidity with work days lost among employees of the EMERCOM of Russia and compare the above indicators with the working population in Russia in 2010–2015.Methodology. We analyzed cases of morbidity with temporary disability in employees of the EMERCOM of Russia units according to the automated database of the All-Russian Order of the Badge of Honor Research Institute for Fire Protection, EMERCOM of Russia, over 2010–2015 in about 80% of all employees who had special military ranks: senior commanding officers (officers, warrant officers), junior commanding officers (sergeants) and rank and file. The indicators are calculated per 1000 employees or in ‰. Cases of morbidity correlated with the International Classification of Diseases and Behavioral Disorders of the 10th Revision (ICD-10). Cases of temporary disability of workers in Russia was obtained from the database of the Unified Interdepartmental Information and Statistical System of Russia.Results and analysis. The average annual level of morbidity cases with work days lost among the personnel of the EMERCOM of Russia was (374.2 ± 9.6) ‰, including (345.2 ± 9.1) among the employees of the Federal Fire Service, (361.4 ± 28.3) ‰ in the Main Inspectorate for Small Boats, (339.3 ± 20.5) ‰ in the Search and Rescue Units, and (867.6 ± 97.6) ‰ in the Rescue Military Units. In the structure of cases of work days lost in the EMERCOM of Russia, the shares of employees of the divisions were distributed as follows: 81.5, 2.8, 2.1 and 13.6 %, respectively. The leading classes of diseases among the personnel of the EMERCOM of Russia were: respiratory diseases (Chapter X) with morbidity rate (167.7 ± 8.2) ‰ and 44.7% in the structure; injuries, poisoning and some other consequences of external causes (Chapter XIX) (41.8 ± 1.4) ‰ and 11.2 %; diseases of the musculoskeletal system and connective tissue (Chapter XIII) – (34.7 ± 1.2) ‰ and 9.3%; circulatory system diseases (Chapter IX) – (25.2 ± 1.6) ‰ and 6.7%; and some infectious and parasitic diseases (Chapter I) – (21.9 ± 2.9) ‰ and 5.9 %. For workers in Russia, the average annual level of morbidity cases with work days lost 1.4 times as high: (522.5 ± 28.1) ‰ (p < 0.01). The consistency of the indicators is high, negative, and approaches statistical significance (r = –0.75; p < 0.1), which may indicate the influence of multidirectional factors in the formation of cases of work days lost among the EMERCOM of Russia employees and working population in Russia. Trends over time, structure and morbidity rates for cases with work days lost among employees of the EMERCOM of Russia divisions are presented.Conclusion. Accounting for morbidity indicators with work days lost can contribute to a more rational allocation of resources during the operational activities of the EMERCOM of Russia.
RISKY SEXUAL BEHAVIOR IN PEOPLE LIVING WITH HIV
Authors: Antonova D. V. , Bocharov V. V. , Chrustaleva N. S. 
Published: December 2019

Relevance. There is a continuing growth of infection with the human immunodeficiency virus (HIV) and the need for effective design of preventive measures.Intention. To explore features of risky sexual behavior in people living with HIV with and without substance abuse and in healthy respondents.Methodology. The study involved 136 individuals in the groups as follows: 1st (n = 50) – drug users with blood-borne HIV infection, 2nd (n = 50) – heterosexual HIV infection, 3rd (n = 36) – without HIV infection. A specially developed clinical map was used, as well as an original questionnaire recording the characteristics of risky behavior and the main characteristics of the life situation of the disease (“Infection risk and the disease situation”). Statistical data processing included the Fisher criterion (ϕ-criterion).Results and Discussion. The characteristics of respondents’ sexual behavior related to gender, the presence/absence of HIV and the transmission route were revealed in the study. It has been established that HIV-infected and healthy respondents do not differ in the frequency of barrier protection methods (condoms) use. Various variants of risky sexual behavior were noted in all groups, in particular, unjustified rejection of condoms. The results are partially confirmed in the published data. In the Russian sample, non-use of condoms and the prevalence of “trust in a partner” were studied for the first time.Conclusion. Important components of prevention programs include increasing sexual literacy and working with people who use psychostimulants and other drugs.
Engelli Çocuklara Yönelik Yerel Kamu Politikalarının Yönetişim Anlayışı Çerçevesinde Planlanması
Authors: ZENGİN Eyüp 
Published: December 2019

Bu çalışmada, yerel yönetimler ve
engelli çocuklar hakkında bilgi verildikten sonra, yerel yönetişim ve yerel
kamu politikalarının özellikleri üzerinde durulacak ardından, engelli çocuklara
yönelik yerel kamu politikalarının yönetişim anlayışı çerçevesinde planlanması
ve yürütülen/yürütülmesi gereken çalışmalar değerlendirilecektir.

Engelli çocuklar için
geliştirilmesi gereken yerel po­litikaların eşit vatandaşlık çerçevesinde, farklılıkların
göz önünde bulundurulması ve tahammül edilmesi temelinde planlanması ve
uygulanması gerekmektedir. Engelli bireylerin günlük yaşamda karşılaştıkları
sorunların önemli bir bölümünü yerel düzeydeki politika ve uygulamalardan
kaynaklanmaktadır. Bu çerçevede, ilgili mevzuatta yer alan düzenlemeler
değerlendirilmeli bu düzenlemelerin etkin bir biçimde nasıl ve ne şekilde
uygulanması gerektiği üzerinde durulması gerekmektedir.

Hayatta kalma ve gelişip büyüme
engelli çocuklar için özellikle güç olabilir. Yoksul kalma riskleri, engeli
olmayan yaşıtlarına göre daha büyüktür. Çocukların aynı dezavantajlarla –
örneğin yoksulluk ya da belirli bir azınlık gruba mensup olma gibi-
karşılaştıkları durumlarda bile, kendi özellikleri ve toplumun önlerine diktiği
birçok engel nedeniyle engelli çocuklar ek güçlüklerle karşılaşmaktadır.

Yönetişim, hesap verebilirlik,
katılımcılık, şeffaflık gibi belirli ilkelerin uygulanmasını gerektiren bir
anlayışa sahiptir. Yerel yönetişim, yerel seviyedeki görev ve sorumlulukların
yerine getirilmesi amacıyla, farklı düzeylerde, farklı yetkilere sahip yerel
kuruluşlar ile vatandaşlar arasında güçbirliği, işbirliği ve etkileşim oluşturma
sürecidir.
Hubungan Pemberian Syringe Pump Norepinephrine dengan Kadar Gula Darah Acak pada Pasien di Ruang ICU RSUD Mardi Waluyo Kota Blitar
Authors: Prasetya Yuda Dwi , Arsa Sandi Alfa Wiga 
Published: December 2019

Ketidakwaspadaan terhadap kontrol gula pasien yang mendapatkan norepinephrine berakibat perpanjangan masa rawat inap dan perburukan kondisi.Tujuan penelitian adalah menganalisis hubungan pemberian syringe pump norepinephrine dengan kadar gula darah acak pada pasien di ruang ICU RSUD Mardi Waluyo Kota Blitar. Rancangan penelitian menggunakan korelasi dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah semua pasien ICU RSUD Mardi waluyo Kota Blitar yang diberikan syringe pump norepinephrine pada 29 Oktober â€“ 22 November 2018. Jumlah sampel penelitian sebanyak 30 orang dengan menggunakan tehnik pengambilan sampel accidental sampling. Analisa data menggunakan Spearmanâ€™s rho. Hasil penelitian menunjukan ada hubungan yang lemah antara pemberian syringe pump norepinephrine dengan kadar gula darah acak pada pasien di ruang ICU RSUD Mardi Waluyo Kota Blitar dengan p value = 0,034 dan rs = 0,389. Norepinephrine dapat meningkatkan tekanan darah pada pasien kritis yang mengalami hipotensi, akan tetapi berakibat meningkatkan kadar gula darah acak, sehingga diharapkan adanya pemantauan kadar gula darah acak pada pasien kritis serta adanya monitoring penggunaan cairan diluent normal saline 0,9% dan Â dextrose 5% yang harus disesuaikan dengan kondisi dari pasien yang mendapatkan norepinephrine.Â Unawareness of blood sugar control in patients receiving norepinephrine resulted in an extended period of hospitalization and worsening conditions. The aim of the study was to analyze the correlation of giving norepinephrine syringe pump and random blood sugar levels of patients in ICU Mardi Waluyo Hospital, Blitar City. The study used correlation design with cross sectional approach. The population in this study was all ICU patients of Mardi Waluyo Hospital Blitar City who were given the norepinephrine syringe pump on 29 October - 22 November 2018. The sample was 30 people taken by using accidental sampling technique. The data analysis used Spearman's. The results showed there was a weak correlation between the administration of norepinephrine syringe pump and random blood sugar levels of patients in the ICU room at Mardi Waluyo Hospital, Blitar City with p value = 0.034 and rs = 0.389. Norepinephrine could increase blood pressure in critical patients who had hypotension, but it resulted in the increase of random blood sugar levels. It is expected to monitor random blood sugar level of critical patients as well as monitoring the use of diluent normal saline 0.9% and dextrose 5% which should be adapted to the conditions of patients who get norepinephrine.
Peran Petugas Kesehatan Dalam Upaya Pencegahan Kanker Serviks Melalui Peningkatan Cakupan Pemeriksaan Inspeksi Visual Asam Asetat (IVA) di Kelurahan Campurejo Kecamatan Kota Kediri
Authors: Fadhillah Is , Indita Wiwen 
Published: December 2019

Pada saat ini tenaga kesehatan mempunyai tugas besar dalam peranannya terhadap penanggulangan kanker cerviks. Salah satu masalah utama kesehatan reproduksi perempuan di Indonesia adalah kanker serviks. Angka kejadian di seluruh dunia mencapai 490.000 kasus kanker cerviks dan mengakibatkan 240.000 kematian tiap tahunnya, dan 80% dari angka itu yaitu sekitar 392.000 terjadi di wilayah Asia (Soebachman, 2011) Menurut data dari Indonesia (Kemenkes RI) pada tahun 2013, kejadian kanker serviks di Indonesia sebesar 0,8%. Provinsi yang memiliki estimasiÂ jumlahÂ penderitaÂ kankerÂ serviks terbesar adalah Provinsi Jawa Timur denganÂ estimasiÂ 21.313Â kasus (Kemenkes RI, 2015). ProgramÂ IVA akan mengurangi risiko terkena kanker serviks, dimana ibu-ibu dapat melakukanÂ Â pemeriksaan IVA sebagai upaya pencegahan sejak dini. Penelitian ini bertujuan untuk mendiskripsikan pemahaman tenaga kesehatan di wilayah Kota Kediri terhadap masalah kanker serviks, serta mengidentifikasi upaya-upaya apa saja yang dilakukan tenaga kesehatan dalam melakukan pencegahan terhadap kanker serviks melaluiÂ peningkatan cakupan pemeriksaan IVA di Kelurahan Campurejo Kecamatan Mojoroto Kota Kediri. Penelitian ini menggunakan metode kualitatif. Analisis data dalam penelitian ini menggunakan analisis kualitatif interaktif (Milles dan Haberman). Dari hasil penelitian dapat dirangkumkan beberapa faktor yang menyebabkan keberadaan kanker serviks melalui pemahaman petugas kesehatan diantaranya yaitu: kebersihan organ intim, gonta-ganti pasangan, faktor genetik,hubungan seks di luar nikah,pernikahan dini. Peran dan strategi tenaga kesehatan dalan pencegahan kanker serviksÂ yaitu melaui Promosi penyuluhan, membentuk tim, sosialisasi, lintas sektor, model kampung IVA, pemeriksaan gratis.