bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of age and associated pathology in patients with hip artoprosthesics
Authors: Svirgun M.V. , Semenenko A.I. 
Published: October 2020

Objective. To analyze the presence of concomitant pathology in patients of different age categories who underwent hip arthroplasty by different methods.
Materials and methods. The study retrospectively analyzed 555 case histories of patients (282 men and 273 women) for the presence of concomitant pathology in different age groups (from 20 to 95 years). The age category was determined according to the 2015 World Health Organization age classification. Statistical processing was performed according to StatPlus programs, the differences were considered significant at p<0,05.
Results and discussion. By age, patients were distributed as follows: juvenile (up to 25 years) – 2 patients (percentage of the total was 0,36 %); young (from 25 to 44 years) – 36 patients (6,49 %); middle-aged (from 45 to 59 years) – 132 patients (23,78 %); elderly (from 60 to 74 years) – 236 patients (42,52 %); senile (from 75 to 90 years) – 145 patients (26,13 %) and long-lived (over 90 years) – 4 patients (0,72 %). The average age of patients was 65.18±0.55 (M±m). Concomitant pathology was diagnosed in 484 patients (87,22 %). Depending on the existing concomitant pathology, patients were distributed as follows: no concomitant pathology – 71 patients (percentage of the total was 12,79 %); with hypertension – 38 patients (6.85 %); with diabetes – 11 patients (1.98 %); with coronary heart disease (CHD) – 104 patients (18,74 %); CHD + hypertension – 316 patients (56,94 %); with myocardial infarction – 3 patients (0,54 %); with a stroke – 2 patients (0,36 %); patients with encephalopathy of various genesis – 2 patients (0,36 %); with respiratory pathology – 3 patients (0,54 %); patients with systemic connective tissue diseases – 5 patients (0,90 %). Studies to date have shown a significant increase in comorbidities associated with the age of patients. One of the important predictors and unmodified risk factors for postoperative complications is the age of patients. The influence of age on the result of hip arthroplasty can be explained by a number of factors: the formation of endothelial dysfunction with impaired blood flow, changes in the blood coagulation system and more.
Conclusions. With the development of medical practice, the average life expectancy of the population increases, the methods of arthroplasty and the anesthesiological support of operations are improved, the duration of surgical interventions is reduced. These factors contribute to the steady increase in the number of total joint arthroplasty, in the average age of patients undergoing arthroplasty and, accordingly, in the total comorbid load. That is why stratification of the degree of operative risk continues to be one of the most pressing problems in orthopedic patients.
Transfusion therapy optimization at an acute obstetric blood loss
Authors: Sedinkin V.A. 
Published: October 2020

Objective. To define the role of the cryoprecipitate (CP) and prothrombin complex concentrate (PCC) in the acute obstetric blood loss treatment via the assessment of the water sectors’ state, hemostasis, and frequency and severity of clinical manifestations of the multiple organ dysfunction syndrome (MODS).
Materials and methods. 140 women had been examined (over the years 2006-2018), whose child delivery or early postnatal period (fourth stage of labor) had got complicated by an acute severe blood loss with a circulating blood volume deficit of 40 to 60 %. Based on the intensive treatment (IT) characteristics, the patients had been divided into three groups. In the group 1 (post-hoc analysis, n=50), a normal acute blood loss intensive treatment as per the relevant clinical protocols of the Health Ministry of Ukraine had been being provided. In the group 2 (n=44), an acute blood loss intensive treatment as per the abovementioned clinical protocols of the Health Ministry of Ukraine with use of the CP as the first-line drug had been being provided. In the group 3 (n=46), the PCC (Octaplex 20 IU/kg) had been added within the treatment. Thereat, there had been assessed such criteria as follows: RBC count, Hb, Ht, prothrombin index (PI), activated partial thromboplastin time, fibrinogen; the water sectors of the human body had been assessed noninvasively, via the integral impedance method; as well as the clinical signs of the MODS.
Results and discussion. The use of the CP as the first-line drug at a dose of 8 to 10 units had enabled to get decreased the total volume of the infusion and transfusion media by 13.7 % (p<0.05), and the total volume of the administered fresh frozen plazma (FFP) – by 12 % (p<0.05) respectively. The adding of the PCC to the relevant IT guidelines had been resulting in a reduction of the total volume of the infusion and transfusion media by 24.5 % (p<0.01), of the administered plasma volume – by 22 % (p<0.01), and of the corpuscular volume – by 9.1 % (p<0.05) respectively. Furthermore, a decrease in the vasopressor support rate (by 5.1 times, p<0.01) and in the vasopressor support duration (by 1.5 natural days, p<0.01), as well as in the adaptive lung ventilation rate and duration (by 5.7 times, p<0.01), had been being observed; thereat, the number of the patients needing the use of the diuretics had been being reduced (by 2.9 times, p<0.01), as well as the duration of their administration (by 1.7 natural days, p<0.01 respectively). The PI and fibrinogen rate had been corresponding to the norms by the end of the 1st natural day of treatment.
Conclusions. The use of the CP as the first-line drug in the IT of an acute obstetric blood loss ensures a verifiable lessening of need for the infusion and transfusion media. The PCC as the first-line drug prevents the development and progress of the coagulopathy at the treatment of an acute obstetric blood loss, what decreases the frequency and severity of clinical manifestations of the MODS credibly.
Personification of infusion therapy in patients with ischemic stroke depending on the severity of the violation of energy-structural status
Authors: Serikov K.V. , Shifrin G.A. , Smyrnova L.M. 
Published: October 2020

Objective. To determine the tactics of infusion therapy in patients with ischemic stroke (IS) depending on the severity of the violation of energy-structural status (ESST).
Materials and methods. A study of 32 patients with severe IS on the National Institutes of Health Stroke Scale (16,7±1,5), who were in the department of anesthesiology with intensive therapy units of the Municipal Non-Profit Enterprise «City Hospital № 9» Zaporizhzhia City Council. Of these, 11 were men (34,4 %; the average age – 68,2±2,5 years), 21 were women (65,6 %; average age – 72,1±1,6).
Results and discussion. In patients with IS, disorders ESST were defined as hyperergic damage at values of cardiac index (CI) of 4,45-5,09 L×min-1×m-2 and oxygen consumption index (IVO2) 186-210 ml×min-1×m-2, and at values of CI ≥5,10 L×min-1×m-2 and IVO2 ≥211 ml×min-1×m-2 – as hyperergic insufficiency. While hypoergic damage ESST occurred at values of CI 2,33-1,82 L×min-1×m-2 and IVO2 104-85 ml×min-1×m-2, and at CI ≤1,81 L×min-1×m-2 and IVO2 ≤84 ml×min-1×m-2 hypoergic insufficiency of ESST was observed. The daily fluid requirement of a patient with IS was calculated according to the formula 4+2+1: for the first 10 kg of weight – 4 ml×kg-1×h-1; from 11 to 20 kg – 2 ml×kg-1×h-1; from 21 kg – on 1 ml×kg-1×h-1 (Park G.R., Roe P.G., 2005; Netyazhenko V.Z., Halushko O.A., 2012).
Infusion therapy in patients with IS and hyperergic damage ESST was performed with 0,9 % sodium chloride solution according to the formula 4+2+1 on the background of the use of esmolol intravenously bolus 250 mg and subsequent administration of 50 mсg×kg-1×min-1, and in hyperergic insufficiency 500 mg of esmolol intravenously bolus and subsequent administration of 100 mсg×kg-1×min-1. While in hypoergic damage ESST on the background of infusion therapy used dopamine or dobutamine 1-5 mсg×kg-1×min-1, and in hypoergic insufficiency, the dose of dopamine or dobutamine was increased to achieve the desired effect.
Conclusions. The personification of infusion therapy depending on the severity of the violation of ESST can improve the results of treatment of patients with IS in the most acute period.
Treatment of bleeding in a patient with immune coagulopathy (acquired haemophilia A)
Authors: Stasyshyn O.V. , Krasivska V.V. 
Published: October 2020

Objective. We are representing the case of acquired haemophilia A and analyze the timeliness and adequacy of treatment.
Materials and methods. The subject of the study was immune coagulopathy with a factor VIII (FVIII) inhibitor – acquired haemophilia A.
Results and discussion. Female, 33 years old, pregnancy II, urgent delivery. There was excessive bleeding in the early postpartum period, hemostatic therapy was provided. She hospitalized three times with recurrences of uterine bleeding. Vacuum aspiration of the walls of the uterine cavity was performed twice. After the third recurrence, blood loss of 1200 ml and ineffectiveness of conservative treatment, laparotomy and extirpation of the uterus was performed. Despite intensive care, the bleeding continued, the patient was transferred to the regional clinical hospital, where she was diagnosed with DIC syndrome, stage III, severe anemia. Three relaparotomies were performed, the source of bleeding was not found, there was excessive bleeding from the operating field. The total blood loss was 24,447 ml. Intensive infusion-transfusion therapy was continued, which gave unstable hemostasis. The patient received 12,060 ml of fresh-frozen plasma (FFP), 15,130 ml of erythrocytes, 600 ml of albumin 10 %, 20 doses of cryoprecipitate (CP), 16,000 U of activated prothrombin complex (APCC), 8 mg of recombinant activated factor VII (rVIIa), 8,000 U of prothrombin complex (PC). 16.1 BU/ml of inhibitor FVIII, FVIII <1.0 %, activated partial thromboplastin time (APTT) – 146.1 s was detected on day 37. Within 30 days, blood loss was 10,608 ml; patient received 23,420 ml of FFP, 2,080 ml of erythrocytes, 17 mg of rVIIa, 19,000 U of APCC, 6000 U of PC, 61 dose of CP, 50,000 IU of FVIII. Immunosuppressive therapy (prednisolone 1-1.5 mg/kg/day) was started on day 67 and lasted for 12 months. Bleeding stopped completely 10 months after delivery, and after 14 months the inhibitor was not detected, factor levels and APTT returned to normal. Scheduled reconstructive surgery on the urinary tract was performed without the use of transfusion replacement therapy.
Conclusions. Recurrent postpartum hemorrhage requires early diagnosis of coagulation factors inhibitors, which will ensure specific transfusion and immunosuppressive therapy, avoidance of serious consequences, including extirpation of the uterus and reduce the economic costs of treatment.
The effectiveness of combined pulse therapy in patients with rheumatoid arthritis
Authors: Shukurova S.M. 
Published: October 2020

Objective. To study the efficacy of the tolerance of combined regimens of the therapy with high doses of methylprednisolone and methotrexate of the patients with rheumatoid arthritis (RA).
Materials and methods. The study included 85 patients with RA who underwent inpatient treatment in the Rheumatologic Department of the Clinical Hospital of Dushanbe city for the period 2018-2019. From them, women – 83.2 %, men – 26.8 %; the average duration of the disease is 7.4 years. Extra-articular manifestations of RA were determined in 74.3 % of patients. Against the background of the standard therapy, a regimen of bolus pulse therapy (methylprednisolone 500-1000 mg and methotrexate) was taken for 3 days, which has been followed for observation for a year. The effectiveness of the treatment was assessed according to the American College of Rheumatology (ACR) 20/50/70 criteria. The number of the swollen joints and painful joints (NPV), ESR, C-reactive protein level, and the overall disease activity were determined.
Results and discussion. After 1 month of therapy, significant positive dynamics were recorded in the all estimated parameters of the RA activity. There was a significant decrease in NPV, as well as the intensity of pain according to the visual analogue scale. During 3 months of observation, 78 % of the observed patients showed improvement and only 11 % of patients had side effects and have not been required of the discontinuation of the treatment.
Conclusions. The combined pulse therapy of methylprednisolone and methotrexate was an effective and well-tolerated for systemic manifestations of RA and contributed to a significant decrease in RA activity in the shortest time.
Efficiency of nitrate oxide donor Tivortin in women with post-infarction cardiosclerosis in the perimenopausal period with heart failure
Authors: Rofieva H.Sh. 
Published: October 2020

Objective. To study the effectiveness of the effect of L-arginine in women in the perimenopausal period with post-infarction cardiosclerosis with manifestations of heart failure.
Materials and methods. The study included 135 women who were hospitalized at the age from 45 to 60 years. All patients were divided into two groups: group I consisted of 80 women (mean age ‒ 45.1±6.6 years) in the perimenopausal period; group II included 55 women (mean age ‒ 60.6±4.6 years) in the postmenopausal period. The functional state of the heart was investigated by the echo-Doppler method. Treatment and observation continued for 3 months. To identify the effectiveness of the therapy was assessed by monthly echo-Doppler sonography. The first group, against the background of basic therapy (nitrates, β-blockers, antiplatelet agents, statins), additionally received the drug L-arginine 4.2 % (Tivortin) solution of 100 ml intravenously drip for 7-8 days, followed by 5 ml (1 g) 3 times per day inside within 3 months. The second group received only the main therapy without the use of L-arginine.
Results. When conducting a comparative assessment of the structural and functional indicators of the heart in women of the first group, it showed that against the background of the main therapy when receiving the drug L-arginine 4.2 % solution 100 ml intravenously before and after treatment were as follows: left atrium size ‒ 5.13±0.18 up to, 4.61±0.14 after; the size of the right ventricle ‒ 3.11±0.01 up to, 2.90±0.08 after; thickness of the interventricular septum ‒ 1.42±0.05 up to, 1.34±0.04 after; posterior wall thickness of left ventricle ‒ 1.38±0.04 up to, 1.34±0.04 after; index of left ventricle myocardial mass ‒ 127.0±5.4 up to, 112.0±4.7 after; end diastolic volume ‒ 144±0.80 up to, 122.0±6.4 after; minute volume ‒ 4.36±0.20 up to, 5.30±0.20 after; ejection fraction ‒ 48 % up to, 52 % after; stroke volume ‒ 54 ml up to, 62 ml after. Clinically noted an increase in exercise tolerance, a decrease in the frequency of nitrate intake and an improvement in the quality of life.
Conclusions. In women of group 1, against the background of basic therapy with the addition of L-arginine 4.2 %, the functional class of heart failure decreases from II to I, the indicators of diastolic filling of the left ventricle are normalized, and the incidence of repeated myocardial infarction decreases.
Effects of Intervention on Maternal Skill in Positioning and Attachment for Successful Breastfeeding
Authors: Ferdousi Asma , Ahmad Mainuddin , Samad Rasheda 
Published: October 2020

Background: Correct positioning and attachment play a crucial role in the successful establishment and maintenance of breast feeding. Objective of this study was to determine the effectiveness of immediate postnatal training of the mothers on their practice of proper positioning and attachment during breast feeding.
Material and Methods: This one group pretest-posttest quasi-experimental study was conducted at the Department of Pediatrics and Department of Obstetrics and Gynecology of Chittagong Medical College Hospital from January 2006 to June 2006. Three hundred mothers were evaluated for breast feeding position and attachment within 6 hours following normal delivery with a questionnaire and observational checklist. Then they received training on correct positioning and attachment for successful breastfeeding. Post training effect was evaluated by assessing mothers’ practice on 7th postnatal day among 256 mothers. Pre training and post training data were analyzed with SPSS-16 and McNemar test was done to see the difference.
Results: Out of 256 mothers only 22.3% were first time mother and about 40% of them had 1-2 children. Majority (84.4%) of them knew about the benefits of breast feeding though one third (36.3%) of them favored pre-lacteal feeding. Statistically significant improvement in all components of position and attachment for breast feeding was found after intervention.
Conclusion: The study results showed that immediate postnatal intervention towards correct positioning and attachment were highly effective for successful breast feeding.
Bangladesh J Child Health 2020; VOL 44 (1) :13-17
Turkish Sword can Track the Way of Pulmonary Vein: A Concealed Finding
Authors: Sultana Sharmin , Chowdhury Naharuma Aive Hyder , Momen Abdul , Sharifuzzaman Mohammad 
Published: October 2020

Scimitar syndrome is an unusual developmental anomaly causing partial anomalous pulmonary venous return (right sided pulmonary veins) with left-to-right shunt at inter atrial septal level. It occurs more commonly in females, with occasional familial occurrence. The clinical presentation is variable. Patient may remain asymptomatic or may present with heart failure. The objective of this clinical case report is to highlight this unusual anomaly to avoid incorrect diagnosis. A girl of 13 years presented with unusual symptom of nausea following taking meal and a systolic murmur. At first she was diagnosed as “ASD Secundum”. But her typical “Turkish sword” feature of chest x-ray helped to identify anomalous drainage of right pulmonary veins into inferior vena cava and make the diagnosis as “Scimitar syndrome”. It is a total corrective anomaly. She was operated through open heart surgery, recovered early and discharged with a stable condition without any complication. This case illustrates the importance of thorough medical history, careful evaluation of investigation for proper diagnosis, treatment procedure and complications of a rare anomaly.
Bangladesh J Child Health 2020; VOL 44 (1) :64-67
Effect of Intravenous Dexamethasone in Combination with Caudal Analgesia on Post Operative Pain Control after Herniotomy in Children
Authors: Islam Md Jahirul , Jahan Ismat , Islam Aminul 
Published: October 2020

Background: Dexamethasone has a powerful anti-inflammatory action and has demonstrated reduced morbidity after surgery.
Objectives: The aim of this study was to examine the effects of a single i.v. dose of dexamethasone in combination with caudalblock on postoperative analgesia in children.
Methods: This study was a randomized, double blind clinical trial, in which 77 children of ASA I and II, aged 3-10 years, undergoing elective unilateral herniotomy operation, was allocated in a double blind manner. Control Group I consist of 39 patients and Dexamethasone Group II consists of 38 patients. Group II received i.v. Dexamethasone 0.5 mg/Kg (Maximum 20 mg) and Group I received the same volume of i.v. saline after induction of anaesthesia. After inhalation induction of general anaesthesia, children received either dexamethasone 0.5-1 mg/Kg (maximum 20 mg) (n=39) or the same volume of saline (n=38) i.v. A caudal anaesthetic block was then performed using 1.5 ml/kg of Bupivacaine 0.25% in all patients. After surgery, rescue analgesic consumption, pain scores, and adverse effects were evaluated for 24 h.
Results: Significantly, fewer patients in the dexamethasone group required fentanyl for rescue analgesia (7.9% vs38.5%, p<0.05) in the post-anaesthetic care unit or acetaminophen (23.7% vs 64.1%) after discharge compared with the control group. The time to first administration of oral acetaminophen was significantly longer in the dexamethasone group (646 vs 430 min). Postoperative pain scores were lower in the dexamethasone group and the incidence of adverse effects was similar in both groups.
Conclusion: Intravenous dexamethasone 0.5-1 mg/Kg in combination with a caudal block augmented the intensity and duration of postoperative analgesia with out adverse effects in children undergoing herniotomy.
DS (Child) H J 2019; 35(2) : 145-149
Analysis of treatment methods for children with bilateral complete cleft of the lip and palate in mixed bite
Authors: Mamedov A. A. , Dudnik O. V. , Chertikhina A. S. , Bille D. S. , Beznosik A. R. 
Published: October 2020

Relevance. According to the World Health Organization, it was found that cleft lip and palate cases ranges from 0.6 to 1.6 cases per 1000 newborns. According to the severity of the lesion, bilateral cleft lip and palate takes the first place, however, it occurs much less common – 15-25%.Purpose – to analyze methods of treatment in children with bilateral cleft lip and palate during the period of the mixed dentition.Materials and methods. An analysis of 51 sources Russian and foreign articles for the period from 1951 to 2019 was carried out. The features of the development of occlusion in children with bilateral cleft lip and palate during the period of a changeable occlusion, as well as methods of treating this pathology, are considered.Results. It was found that the main anatomical features of the maxillofacial region in children with bilateral cleft lip and palate during the period of a changeable bite are -narrowing of the upper and lower jaws, the presence of soft tissue scars. The main methods of treatment for such children are reconstructive surgery, including the closure of a hard palate defect using a mucoperiosteal flap cut out in the lateral part of the hard palate, as well as orthodontic treatment methods, the main purpose of which is to expand and extend the dentition using single jaw removable plate apparatuses, fixed plate apparatuses.Conclusions. Taking everything into account, surgical reconstructive operations, as well as complex orthodontic treatment, the main purpose of which is to expand and extend the upper and lower jaws, are the integral methods of treating such children. Orthodontic treatment should be aimed at eliminating myofunctional disorders with the helpof orthodontic trainers and elastopositioners. Conducting a comprehensive surgical and orthodontic treatment can reduce the rehabilitation time of children with bilateral cleft lip and palate.
Hypersensitivity of teeth after orthodontic treatment in adolescence
Authors: Brusnitsyna E. V. , Zakirov T. V. , Saipeeva M. M. , Ioshchenko E. S. , Sheshenina S. A. 
Published: October 2020

Relevance.In adolescence, focal demineralization after orthodontic treatment is highly prevalent. This, in turn, leads to symptomatic hypersensitivity in the absence of other predisposing factors (recessions, exposure of cervical dentin, increased abrasion, etc.). Reviewed the mechanism for reducing hypersensitivity and remineralizing of calcium-sodium phosphosilicate, also the effectiveness of using a prophylactic toothpaste with this component in adolescents.Materials and methods.A single-center, non-comparative open study was conducted to evaluate the effectiveness of the Sensodyne Restoration and Protection toothpaste at the Department of Pediatric Dentistry and Orthodontics, USMU for 4 weeks. 22 adolescents aged 14-16 years with focal demineralization of enamel in the stain stage after completion of orthodontic treatment participated in the study.Results.The use of toothpaste with calcium-sodium phosphosilicate after a month of use leads to a decrease in the hygiene index by 23.38%, a decrease in hypersensitivity according to the results of the Schiff air index by 56.94% (p ≤ 0.05), and a tendency to an increase in the level of mineralization and a decrease in areas of white spot lesions.Conclusions. Toothpaste with calcium-sodium phosphosilicate has a cleansing effect and reduces sensitivity and can be recommended for adolescents with focal demineralization against the background of orthodontic treatment.