bluuebunny/crossref_metadata_2025_split huggingface dataset:
Клініко-інструментальна характеристика пацієнтів із хронічною серцевою недостатністю та зниженою фракцією викиду лівого шлуночка залежно від наявності цукрового діабету 2-го типу
Authors: Tkach N. A. , Filatova O. L. , Gavrilenko T. I. , Dudnik G. Ye. , Lipkan N .G. , Voronkov L. G. 
Published: October 2020

The aim – to compare clinical and instrumental parameters in patients with chronic heart failure (CHF) and reduced left ventricular ejection fraction (LVEF) depending on the presence of type II diabetes mellitus.Materials and methods. 490 case histories of patients in the period from 2011 to 2018 with CHF, 40–80 years of age (median – 64 years), II–IV NYHA functional class, LVEF ≤ 40 % were analyzed. The study group included mainly patients with coronary heart disease (CHD) in combination with hypertension – 403 (82.2 %) patients, with isolated CHD – 55 (11.2 %) and with hypertension – 32 (6.6 %) patients. Most patients (278 (56.7 %)) had a permanent form of atrial fibrillation. Among the subjects were 373 (76.1 %) men and 117 (23.9 %) women. Patients were included in the study in the phase of clinical compensation, i.e. in the euvolemic state. All patients were divided into two groups: group I included 338 (69 %) patients with CHF and reduced LVEF without diabetes; group II consisted of 152 (31 %) patients with CHF and reduced LVEF with type II diabetes.Results and discussion. The analysis revealed no significant differences among patients in the study groups by age, general hemodynamic parameters, mean daily heart rate, NYHA functional class, concomitant chronic obstructive pulmonary disease and the duration of CHF. A lower percentage of patients with atrial fibrillation in group II, a higher BMI in patients in group I, Е/е´ and left ventricular myocardial mass index were higher in patients without concomitant diabetes. In the study, we obtained a significantly higher uric acid level in patients with concomitant diabetes mellitus 2 and did not receive statistical differences in oxidative stress and proinflammatory markers, NT-proBNP and insulin. There was also no significant difference in the values ​​of flow-dependent endothelial dysfunction. The combination of coronary heart disease and diabetes mellitus 2 has been shown to be a major factor of high mortality in patients with CHF. However, we did not find a difference in the life expectancy of patients with CHF and reduced LVEF with and without diabetes. We also had a significantly worse survival of patients with HbA1с above 7.4 %.Conclusions. The 5-year survival of patients with CHF with reduced LVEF with and without diabetes mellitus 2 does not differ significantly, while among the general group of patients the worst 5-year survival was demonstrated by those with HbA1с higher than 7.4 %.
Лікування артеріальної гіпертензії в осіб похилого віку
Authors: Kovalyova O. M. 
Published: October 2020

The article is dedicated to the strategy of management of arterial hypertension in older patients based on the Guidelines of the International Society of Hypertension, the European Society of Cardiology, the European and the American Society of Hypertension, the American College of Physicians and the American Academy of Family Physicians. According to the results of epidemiological and clinical investigations is shown the influence of high blood pressure on cardiovascular outcomes and mortality in the population of older persons. Due to the analyses of randomised controlled trials is pointed out the convicing data the need for differtntiated control of blood pressure according to the level of arterial hypertension and factors of cardiovascular risk. The methodology of initial antihypertensive therapy in persons of different age groups is taken in comparative aspects. The main discussed questions related to the blood pressure targets in the dynamics of antihypertensive treatment in patients 65–79 years and age ≥ 80 years are emphasized. The requirements for individual medical tactics of older hypertensive patients taken into account anamnesis, fit and mental state, clinical features, comorbidity, complications and hypertension-mediated organ damages are recommended.
Фітомаса та депонований вуглець у робінієвих насадженнях Північного Степу України
Authors: Sytnyk S. A. , Lakyda P. I. 
Published: October 2020

Наведено результати оцінювання обсягів загальної фітомаси та акумульованого в ній вуглецю в робінієвих насадженнях степової зони України, підпорядкованих Дніпропетровському обласному управлінню лісового та мисливського господарства, в період 1973–2011 рр. За ревізійний період площа робінієвих насаджень досягла 17,6 тис. га із загальною фітомасою до 1,96 млн т. Оцінено розподіл загальної фітомаси за структурними компонентами насадження – фітомасою деревини та кори стовбурів, фітомасою деревини та кори гілок крони, листям, коренями й піднаметовою рослинністю. У робінієвих насадженнях регіону дослідження акумульовано до 0,98 млн т вуглецю. Середня щільність вуглецю в робінієвих насадженнях варіювала від 3,21 до 5,56 кг·(м2)-1.
Ентомокомплекс і санітарний стан полезахисних лісових смуг ДП «ДГ “Елітне” ІР ім. В. Я. Юр’єва НААН України»
Authors: Sydorenko S. V. , Zinchenko O. V. , Skrylnyk Yu. Ye. , Kukina O. M , Sydorenko S. H. 
Published: October 2020

Полезахисні лісові смуги (ПЛС) забезпечують формування біологічної повноцінності сільгоспугідь і баланс біогеоценозів, підвищують фауністичне біорізноманіття. Таксаційні дані, породний склад і санітарний стан полезахисних насаджень визначають специфічне середовище існування певних видів комах і формування відповідних ентомокомплексів. Метою роботи було визначення санітарного стану дерев у полезахисних лісових смугах та уточнення складу ентомокомплексу на найпоширеніших деревних породах. Польові дослідження проводили впродовж вегетаційного періоду з використанням загальноприйнятих ентомологічних і лісівничих методів. Досліджувані лісові смуги за санітарним станом були ослабленими та сильно ослабленими (індекс санітарного стану насаджень становив від ІІ,1 до ІІІ,0). У результаті ентомологічного аналізу визначено 45 видів комах із 32 родів і 13 родин. Із них комахи-ксилофаги представлені 23 видами, комахи-філофаги – 21 видом. Загалом, зрідка траплялися 43,2 % видів, масовими та звичайними були 25 і 22,7 % видів відповідно, поодиноко траплялися 9,1 % видів. Ясен звичайний мав індекс санітарного стану IV,1, ясен зелений – III,6, клен гостролистий – III, 9. Виявлено, що недогляд та нехтування проведенням лісівничих та агротехнічних заходів у ПЛС спричинили часткове всихання дерев у насадженні, внаслідок чого поширилися збудники захворювань і шкідливі комахи, які заселяли окремі дерева у насадженні.
Висотно-поясні особливості всихання ялинників на північно- східному мегасхилі Українських Карпат
Authors: Oliinyk V. S. , Zeinalian A. M. 
Published: October 2020

Проаналізовано особливості поширення всихання ялинових насаджень у висотному діапазоні гір 350–1 400 м над рівнем моря на прикладі басейну річки Бистриця Солотвинська північно-східного мегасхилу Українських Карпат. Охарактеризовано кількість і площі осередків часткового та суцільного вс ихання для висотних поясів – передгірних ялицево-букових і гірських буково-ялицевих, буково-ялицево-ялинових і ялинових лісів. Наведено верхню межу поширення всихання. Розраховано емпіричні залежності площ осередків різних видів цього явища від гіпсометричних рівнів гірської системи. З’ясовано, що найбільш уразливою до всихання є ялина на висотах 400–900 м н. р. м. Оцінено вплив експозиції та крутизни гірських схилів на поширення процесів усихання. Виявлено, що в передгірних умовах важлива роль у стійкості похідних ялинників належить ландшафтно-лісівничим особливостям. У цих умовах процеси всихання насаджень найменш активно відбуваються в глибині лісових масивів, дещо активніше – на ділянках, що межують із галявинами, зрубами й молодняками, і сягають максимуму в смугах узлісся.
Clinical Predictors of Poorly-Controlled Childhood Epilepsy: A Case-Control Study
Authors: Asaduzzaman Mohammad , Rahman Md Mizanur , Hasan Mohammad Nadim 
Published: October 2020

Introduction:The aim of the present study was to determine clinical factors associated with poorly controlled epilepsy.
Materials and Methods: This retrospective study was performed from January 2007 to December 2008 at Paediatric Neurology outpatient department in Bangabandhu Sheikh Mujib Medical University, Dhaka, among the children with epilepsy of 7 months to 15 years age who had history of at least 6 months treatment with rational antiepileptic drugs daily with adequate compliance. There were two groups of patients; group 1, consisted of 50 poorly controlled epilepsy patients and group 2, comprised 50 well-controlled epilepsy patients. We retrospectively reviewed EEGs and medical records from these children. Features of clinical findings were compared between the two groups.
Results: In this study, age of onset of initial seizure before 1 year, mixed type of seizure, infantile spasm, high initial seizure frequency (daily seizure), symptomatic etiology, mental retardation, neonatal seizure and more than 20 seizures before starting treatment were also found to be significant clinical predictors of poorly controlled epilepsy. Multivariate analysis detected 2 independent clinical predictors of poorly controlled epilepsy: mixed seizures and more than 20 seizures before starting treatment.
Conclusions: The study showed several clinical factors that can be identified early in the course of childhood epilepsy which can predict development of poor seizure control. Knowledge of these factors will help us to discriminate our patients and pay more attention to those at risk of developing poorly controlled epilepsy.
Medicine Today 2020 Vol.32(2): 85-90
Epidemiological & Clinical Manifestation of Cirrhosis of Liver in a Tertiary Hospital
Authors: Hossain SK Moazzem , Kabir Farjana , Kamal SM , Chanda Utpal Chandra , Tarafder Pritish 
Published: October 2020

Introduction:Cirrhosis of liver is common Medical problem in our country and causing for significant morbility & mortality. This study was aimed to findout actiology and clinical presentation of cirrhosis in this southern part of Bangladesh.
Materials & Methods: An observantional study was conducted in Khulna Medical College Hospital from January 2016 to June 2016. That included adult (>15yrs) cirrhosis patient in medicine ward on the basis of history & clinical examination.
Results: Common age is (37-48)yrs, 80% were male patient. Male Female ratio 4:1. Anorexia & dyspepsia were the most common symptom. 78% presented with ascites 34% presented with variceal bledding. Aetiology are Hepatitis B (52%), Hepatitis C (24%) & idiopathic 16%.
Conclusion: Screening for chronic liver disease should include history and physical examination, serum transaminase measurement, upper abdominal ultrasonography, and in some case, fibroscan. Management of patient with cirrhosis should be prevention & early intervention to stabilize disease progression and to avoid or delay clinical decompensation and the need for liver transplantation.
Medicine Today 2020 Vol.32(2): 100-103
Intranasal Splint in Nasal Septal Surgery: Is It Necessary?
Authors: Mazumder Jahangir Alam , Mustafa Md Golam , Delwar AHM , Rashid Shazibur , Rahaman Md Mostafizur , Ahmed Shamsuddin 
Published: October 2020

Introduction: After SMR/septoplasty with or without turbinate surgery, it needs to keep apart the septum and turbinates upto their complete healing otherwise there is a chance of adhesion (synechia) formation. To prevent this there are variousprocedures. To place an intranasal splint in one or both sides of the septum is one of them. Nowadays there raised thequestion of whether the splinting is necessary or not. There is no significant difference in result with or without anintranasal splint. Weighing against the co-morbidities the routine use of an intranasal splint can no longer be justified.
Materials and Methods: This is a randomized control study of 200 patients of SMR/septoplasty, done for nasal septaldeviation causing symptoms in Cumilla Medical College Hospital in the period of January 2016 to December 2019. Theywere equally divided into two groups, group-A were operated placing an intranasal splint and group-B with no intranasalsplint. They were followed up for 6 weeks to detect any synechia and co-morbidities.
Result: The age of our patients wasranged from 13-49 years with a mean age of 22.45 years. The male to female ratio is 1.78:1. Synechia was found in 4% ofthe splinted group and 6 of the nonsplinted groups. Co-morbidities were detected more in the splinted group than that ofnon-splinted. In INS group these were found as follows: pain in the nose, face and head (26%), faint during removal ofnasal splint (6%), nasal obstruction (38%), the anxiety of splint removal in the postoperative period (35%) and vestibulitisdue to persistent irritation by a splint (17%).
Conclusion: There is little significant advantage of using intranasal splintroutinely in septal surgery to prevent synechia formation.
Medicine Today 2020 Vol.32(2): 126-129
Changing Pattern of Post-infectious Glomerulonephritis: A Study in South-Western Region of Bangladesh
Authors: Azim Muhammed Arshad Ul , Rahaman Md Motiur , Md Zahir Kamruzzaman , Hauque Md Obaidul , Wadud Md Abdul , Senior Mafia Akter 
Published: October 2020

Introduction: In developing countries like Bangladesh, post-infectious glomerulonephritis (PIGN) is the common form ofacute glomerulonephritis having its changing pattern over recent decades. The aim of the study was to analyze the clinicalprofile of PIGN in local scenario.
Materials and Methods: This cross-sectional study was conducted at Shaheed Sheikh AbuNaser Specialized Hospital, Khulna during period from 2017 to 2019. A total of 67 cases of PIGN were identified on thebasis of clinical features, laboratory parameters with recent history of infection. The patients’ records were reviewed withrespect to clinical data. Patients with reduced complement level were included.
Result: The age range of the patients wasbetween 2 and 55 years with male predominance. The study revealed that 32.8% of patients had a recent history of sorethroat, 31.3 % of patients had a history of skin infection and rest 35% had a history of fever. Moreover, during presentation68% of patients had hypertension and 37 % of patient had renal impairment. In this study, majority of patients (53%)presented with one plus to two plus proteinuria and the rest of the patients (37%) presented with three plus proteinuria ondipstick. After 2 weeks of follow up, the presence of hematuria found in 58 patients out of 67, proteinuria found in 14patients out of 61 and renal impairment found in 5 patients out of 25.
Conclusion: PIGN has been changing with respect toage, proteinuria and renal function. To follow-up periodically and reduction in overcrowding of the patients, would be oneof the superior suggestions to reduce the spread of infectious diseases in our country.
Medicine Today 2020 Vol.32(2): 130-133
A construção da identidade histórico-cultural no espaço escolar e o ensino de Educação Física
Authors: Serafim Lielle , Salim Maria Alayde Alcantara , Quinquim Marli 
Published: October 2020

A presente artigo apresenta um trabalho com a dança afro-brasileira associada aos processos de construção da identidade histórico cultural, destacando como podemos abordar esse tema no ensino de Educação Física, integrando-o a proposta curricular e a outras disciplinas, desenvolvendo assim atividades de dança que possam oferecer ao aluno a possibilidade de expressão. Adotamos a Pesquisa Participante com o propósito de nos aproximar da realidade das pessoas em articulação com a investigação sobre nossa própria prática como professora de Educação Física. Ao longo do processo, com base na análise das informações registradas no diário de campo observamos como resultado desse trabalho as mudanças de concepções dos alunos a respeito do racismo e da cultura africana. Acreditamos que ao introduzir as práticas culturais de origem africanas no ambiente escolar estamos permitindo aos sujeitos um contato com parte de sua história, bem como possibilitando sentimentos de representatividade e identificação. Destacamos como resultado a possibilidade da utilização das aulas de Educação Física para valorização da cultura afro brasileira, com práticas educativas que contemplam as questões raciais e colaboram para a eliminação do racismo, do preconceito, da discriminação e fortalecem a construção da identidade histórico cultural.
A trajetória de uma vida marcada pelo preconceito e exclusão social em decorrência do estigma da Psoríase: Relato de caso
Authors: Guedes Daniele Ramos , Ferreira Solange da Cunha 
Published: October 2020

Objetivo. Relatar a trajetória de uma vida marcada pelo preconceito e exclusão social em decorrência do estigma da Psoríase, com especial destaque o relato de caso e experiência de uma doença autoimune. Psoríase, uma doença que se manifesta por lesões na pele, em formato de placas avermelhadas e esbranquiçadas. A psoríase não tem cura, apesar da causa não ser conhecida, como em muitas doenças autoimunes, psoríase não é uma doença contagiosa, não se pega psoríase pelo contato. Também não causa nenhum tipo de dor ou incômodos mais sérios para o portador, pelo menos no que diz respeito à parte física (estou me referindo à psoríase vulgar, que é do tipo citado). As lesões costumam assustar muito as pessoas, que acabam evitando contato com o portador e criando um isolamento, que costuma piorar com o passar dos anos e a piora da doença. Método. As informações foram obtidas por meio de um relato de caso, do tipo descritivo, de caráter subjetivo, obtido durante no período de 2015 a 2020. Discussão. O presente relato foi fundamentado em pesquisa de artigos científicos, que abordam assuntos pertinentes à psoríase (estigma, exclusão social, Interação Social). Considerações finais. As dificuldades em interagir socialmente não são exclusividade das pessoas com doença de pele, mas tais indivíduos mostram-se especialmente vulneráveis a elas, visto que a pele é o órgão do corpo mais exposto e extremamente importante para a construção da identidade pessoal e da subjetividade.
Penerapan Teknologi Informasi Sebagai Implementasi Standar Nasional Akreditasi Rumah Sakit (SNARS) Edisi 1 dalam Meningkatkan Program Mutu di Rumah Sakit (RS) Prima Husada
Authors: Endari Lovi Krissadi , Probowati Galuh Ajeng , Adipurna Resa Putra 
Published: October 2020

Latar Belakang: Dewasa ini perkembangan dan kemajuan teknologi informasi berkembang pesat. Sistem aplikasi di berbagai bidang merupakan suatu keharusan bagi suatu instansi/perusahaan untuk memanfaatkan informasi sebagai basis administrasi dan pengolahan data. Sistem informasi rumah sakit memiliki peranan penting dalam pelayanan klinis dan administratif. Hal tersebut memicu adanya inovasi yang mendukung sistem manajemen data pengukuran mutu terintegrasi dengan cara mengintegrasikan Sistem Informasi Manajemen Rumah Sakit (SIMRS) dengan program mutu yang disebut SI PRIMA. SI PRIMA merupakan teknologi informasi yang telah diterapkan di Rumah Sakit Prima Husada. Teknologi ini merupakan sebuah inovasi baru dari Rumah Sakit Prima Husada dalam meningkatkan program mutu rumah sakit. Dengan diterapkannya sistem ini diharapkan mampu memberikan pengaruh positif dalam menjalankan proses pengumpulan data, analisis, serta validasi data mutu sehingga proses tersebut mampu berjalan secara efektif dan efisien.
Tujuan: Mengetahui penerapan SI PRIMA dalam meningkatkan program mutu di Rumah Sakit Prima Husada.
Metode: Observasional deskriptif dengan pendekatan kuantitatif yaitu membandingkan proses pengumpulan data, pelaporan data, dan validasi data mutu empat bulan sebelum menggunakan teknologi informasi dan empat bulan sesudah diterapkannya sistem teknologi informasi, dalam hal ini penulis dibantu oleh tim IT dan PMKP rumah sakit. Pengukuran proses yang dibandingkan adalah kecepatan waktu dan ketepatan input data. Pengukuran dini dilaksanakan pada bulan Oktober 2017 – Mei 2018.
Hasil: Pada periode empat bulan setelah diterapkan sistem teknologi informasi didapatkan peningkatan keakuratan dan efisiensi waktu untuk proses pengumpulan data dan pelaporan serta hasil validasi data 73.1%. Jumlah angka tersebut menunjukan peningkatan > 2x lipat apabila dibandingkan dengan periode empat bulan sebelum diberlakukan sistem teknologi informasi. Kenaikan validitas dikarenakan beberapa faktor salah satunya adalah tersedianya sistem informasi yang memungkinkan hasil data program mutu tidak perlu diproses secara manual namun secara terintegrasi.
Kesimpulan dan Saran: Pada penelitian ini didapatkan angka validitas indikator mutu meningkat signifikan setelah diterapkannya teknologi informasi daripada periode sebelumnya. Diperlukan penelitian lebih lanjut untuk menentukan apakah penerapan sistem teknologi informasi memiliki hubungan dalam peningkatan program mutu rumah sakit.
Meningkatkan Kesadaran Atas Resistensi Antimikroba di Rumah Sakit, Melalui Standar Akreditasi
Authors: Darmadjaja Djoni 
Published: October 2020

KARS telah memasukkan edisi penyelenggaraan PPRA di rumah sakit sebagai standar akreditasi dalam Standar Nasional Akreditasi Rumah Sakit (SNARS) edisi 1 yang diberlakukan sejak 1 Januari 2018. Seluruh rumah sakit yang akan menjalani proses akreditasi, dipersyaratkan melakukan 5 kegiatan pokok dalam standar PPRA
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Modifikasi Manajemen Risiko Jatuh Pada Pasien Rawat Inap Psikogeriatri RSJ Dr. Radjiman Wediodiningrat Lawang
Authors: Sunarko Yuniar , Zamroni Muhammad , Kusumawardani Diah Ayu , Ayu Jennyla Puspitaning , Indahri Mariani , Amalia Etha Riska 
Published: October 2020

Masalah Mutu: Jatuh adalah insiden keselamatan pasien yang sangat menonjol pada populasi pasien berusia lanjut dengan masalah psikogeriatrik di rumah sakit, sehingga manajemen risikonya tidak dapat disamakan dengan populasi umum. Berbagai karakteristik yang melekat pada populasi ini menyebabkan para Profesi Pemberi Asuhan (PPA) harus melakukan pengamatan yang seksama, merencanakan, implementasi, hingga mengevaluasi secara terus menerus. Pedoman Manajemen Risiko Jatuh yang ada di RSJ Dr. Radjiman Wediodiningrat Lawang (RSJRW) belum dapat mengakomodasi seluruh kebutuhan di atas.
Pilihan Solusi: Implementasi peningkatan mutu berkelanjutan dan konsep patient-centered care dalam manajemen risiko jatuh sehingga sesuai bagi populasi pasien psikogeriatrik di RSJRW.
Implementasi: Tim Pengembang Layanan Psikogeriatri bekerjasama dengan Komite Mutu dan Keselamatan Pasien melakukan modifikasi sebagai translasi hasil pengamatan dalam implementasi asesmen, reasesmen, penggunaan penanda risiko, integrasi proses asuhan, pendokumentasian, dan tindak lanjut pelaporan insiden yang berkaitan dengan risiko jatuh pada pasien rawat inap psikogeriatri di RSJRW.
Evaluasi dan Pembelajaran: Proses yang melibatkan PPA multidisipliner ini berhasil menurunkan angka kejadian pasien jatuh dari 1,5% (2016) menjadi 0,8% (2017), dan 0% (2018). Komunikasi efektif dan komitmen semua pihak mendasari semua proses pembelajaran berkelanjutan ini, sementara pendokumentasian menggunakan sistem informasi teknologi menjadi katalisator perubahan-perubahan yang terjadi.