bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of ofatumumab and other disease-modifying therapies for relapsing multiple sclerosis: a network meta-analysis
Authors: Samjoo Imtiaz A , Worthington Evelyn , Drudge Christopher , Zhao Melody , Cameron Chris , Häring Dieter A , Stoneman Dee , Klotz Luisa , Adlard Nicholas 
Published: October 2020

Aim:
To compare the efficacy of ofatumumab to other disease-modifying therapies (DMTs) for relapsing multiple sclerosis (RMS).
Materials & methods:
A network meta-analysis was conducted to determine the relative effect of ofatumumab on annualized relapse rate and confirmed disability progression at 3 months and 6 months.
Results:
For each outcome, ofatumumab was as effective as other highly efficacious monoclonal antibody DMTs (i.e., alemtuzumab, natalizumab and ocrelizumab).
Conclusion:
Ofatumumab offers beneficial outcomes for RMS by reducing relapse and disability progression risk.
O CAMINHO DO VIEJO REALES
Authors: Adoue Silvia Beatriz 
Published: October 2020

Este artigo trata da representação cinematográfica da vida e lutas dos trabalhadores da cana-de-açúcar em Tucumán, Argentina, durante as décadas de 1960 e 1970. O objeto deste trabalho é o filme El camino hacia la muerte del Viejo Reales (1974), do cineasta tucumano Gerardo Vallejo, membro do grupo Cine Liberación. O encontro entre as lutas e o cinema como instância de reflexão e intervenção dos militantes sindicais e políticos dos canaviais naquele período histórico nos remete às possibilidades do cinema, mas também dos trabalhadores pensando a própria ação. O filme em questão é, na sua primeira parte, um trabalho de testemunho da família Reales sobre sua vida, com participação da família na encenação de situações que a simples entrevista não permitiria. A família aceita, inclusive, incluir elementos de ficção, cuja condição não é escamoteada do receptor. Isso facilita a passagem da história singular à história dos trabalhadores canavieiros tucumanos. Na segunda parte, traça um panorama histórico de Tucumán e a indústria açucareira, assim como da construção da Federación Obrera Tucumana de la Industria del Azúcar (FOTIA) através das suas lutas, pela voz dos seus próprios militantes. Ao organizar desta maneira o material fílmico, a montagem constrói um sentido e o coloca a serviço da organização dos trabalhadores, seja para a autorreflexão, seja como material da formação dos seus.

Palavras-chave: Trabalhadores canavieiros. Tucumán-Argentina. Cinema político. Documentário.
La enseñanza y el aprendizaje desde el enfoque de proyectos integradores para la educación turística
Authors: Juan Vázquez Norma Patricia 
Published: October 2020

El objetivo de este artículo es describir una estrategia didáctica que utiliza a los proyectos integradores como articuladores de los conocimientos cognitivos y metacognitivos para asegurar el aprendizaje del estudiante. Por lo anterior, será importante determinar si las estrategias didácticas empleadas se desarrollaron en las condiciones adecuadas para la vinculación de los aprendizajes. Los proyectos integradores son una herramienta didáctica cuyo objetivo es vincular los contenidos temáticos con la práctica. En esta investigación, se tomó como objeto de estudio a la Facultad de Ciencias de la Administración C-IV de la Universidad Autónoma de Chiapas, y en específico a algunos estudiantes de la licenciatura en Gestión Turística. La mayoría de las unidades de competencias que estructuran el séptimo, sexto y tercer semestre estuvieron involucradas. A partir de un total de 136 estudiantes, de ellos 69 % mujeres y 31 % hombres, se formaron 26 equipos y se les dio seguimiento desde agosto del 2016 al 2018.
The Use of Selective Hemosorption of Lipopolysaccharides in the Complex Treatment of Sepsis
Authors: Bulava G. V. , Rey S. I. , Berdnikov G. A. , Nikitina O. V. , Shabanov A. K. , Borovkova N. V. , Salina N. N. , Godkov M. A. 
Published: October 2020

Background Sepsis and septic shock are formidable and complications in surgery with mortality 20–50%. In the pathogenesis of sepsis, a significant role belongs to bacterial endotoxin (LPS - liposaccharide).Aim of study Assessment of the efficacy of selective lipopolysaccharides hemosorption (SLH) in treatment of sepsis.Material and methods We examined 65 patients with developed sepsis or suspected presence of gram-negative infection. Patients were retrospectively divided into two groups. In Group 1, 27 patients received Polymyxin B hemoperfusion using Toraymyxin cartridges. In Group 2 (38 patients), adsorber Alteco (LPSA) was used.Results It was established that 28-day mortality was 11.1% in Polymyxin group and 28.9% in LPS group A, p = 0.091, 60-day mortality was 33.3 and 55.3%, respectively (p=0.065). The use of SLH contributed to a decrease in the activity of endotoxin (EAA) from 0.52 (0.39; 0.65) to 0.40 (0.36; 0.57) EU (p=0.330) in Polymyxin group and from 0.59 ( 0.42; 0.72) to 0.54 (0.40; 0.81) EU ( p = 0.981) in the LPS-A group. At the same time, the level of procalcitonin (PCT) in the blood statistically significantly decreased from 8.4 (3.6; 29.0) to 4.8 (1.9; 36.3) ng/ml (p=0.0117) only in the LPS-A group. The level of C-reactive protein (CRB) in the blood statistically significantly decreased only in the Polymyxin group, from 205 (154; 264) to 162 (106; 202) mg/L (p<0.001). After SPH procedures, there was a tendency to a decrease in the level of blood cytokines in both groups. Conclusion 1. The trend of better survival among patients was noted during hemoperfusion when using Polymyxin B in comparison with the results of adsorption of lipopolysaccharide with Alteco cartridges: so, 28-day mortality was 11.1 and 28.9%, respectively (statistically not significant).2. As a result, the procedure of selective lipopolysaccharides hemosorbtion on hemosorbents with Polymyxin B in blood significantly decreased level of C-reactive protein (21%), there was statistically insignificant decrease in the level of endotoxin activity (23.1%), lipopolysaccharide binding protein (21.6%), procalcitonin (2.4 times), presepsin (20%), as well as the level of interleukin-6 (3.4 times) and interleukin-10 (1.6 times) . Adsorption of lipopolysaccharide with Alteco cartridges leads to a statistically significant reduction of procalcitonin in blood (1.8 times), and statistically insignificant decrease of: endotoxin activity (9.3%), lipopolysaccharide binding protein (28.6%), interleukin-6 (3.8 times), interleukin-10 (7.1 times) and soluble receptor to interleukin-2 (2.2 times).
Comparative Analysis of the Results of Various Methods for Pancreatic Head Resection in Chronic Pancreatitis
Authors: Propp A. R. , Degovtsov E. N. 
Published: October 2020

Background In more than half of cases of chronic pancreatitis (CP), enlargement of the pancreatic head is diagnosed with the presence of complications that serve as an indication for organ resection. The development of an optimal method for the surgical treatment of CP with damage to the pancreatic head (PH) is one of the tasks of surgical pancreatology.Aim of study To perform comparative evaluation of immediate and late results of different types of PH resection in CP.Material and methods A prospective controlled study was conducted with a comparative analysis of the results of surgical treatment of 131 patients with CP with pancreatic head enlargement. In 29% (n=38) cases inflammatory complications were revealed, in 86.3% (n=113), they have been associated with compression of adjacent organs, jaundice also developed (n=60), as well as duodenal obstruction at the level of duodenum (n=43), regional portal hypertension (n=10). A total of 47 pancreatoduodenal, 58 subtotal, and 26 partial resections of the pancreas were performed.Results Duodenum preserving pancreatic head resections had significantly better short-term results compared to pancreatoduodenal resections. Subtotal PH resection in the Bern’s version was superior to all other resections in terms of average duration of surgery, postoperative inpatient treatment, and intraoperative blood loss. The frequency of relaparotomy for intraperitoneal complications of hemorrhagic etiology was 8.2% (n=4). The frequency of the adverse effect according to pain preservation 5 years after duodenum preserving resection tract was 0.125; after pancreatoduodenal resection - 0.357 with a statistically significant relative risk (RR) of 0.350 (CI95% = 0.13–0.98). According to other indicators of clinical long-term surgical treatment depending on the various methods of PH resection, there were no statistically significant differences (p>0.05). The quality of life of patients 5 years after the operation according to the EORTC QLQ-C30 questionnaire was statistically significant (p=0.0228) by only two indicators: dyspnea (DY:8.3) and insomnia (SL:16.67; 27.4) with higher values after operations of Beger and the Bern’s version of the subtotal PH resection, respectively.
Prophylaxis of Ischemic Damage to the Ovaries, Taking Into Account Peculiarities of Blood Supply to the Uterus During Endovascular Treatment of Le Yo Fibroids
Authors: Kokov L. S. , Damirov M. M. , Oleinikova O. N. , Medvedev A. A. , Belozyorov G. Y. 
Published: October 2020

SUMMARYUterine arteries embolization (UAE) is one of the modern trends in the treatment of uterine bleeding caused by uterine leiomyomas (UL). However, unfavourable results of this method of treatment are observed in 10–15% of cases. This is primarily concerned with the emerging ischemia of ovarian tissue after embolization.Material and methodsComplex examination and treatment was performed in 48 patients admitted with UL complicated by the development of uterine bleeding. Patients with UL were divided into two groups. In the Group I of patients (n=29) standard embolization was performed, while the patients of the Group II (n=19) with diagnosed interarterial utero-ovarian anastomosis underwent separating technique of UA occlusion using different types of emboli.Results and discussionThe features of the uterine blood supply in patients with UL were analyzed from the perspective of the effecacy and safety of endovascular intervention. A methodology of staged EUA was developed, which involved the staged aortography of the infrarenal aorta (for visualization of the ovarian arteries); pelvic arteriography (for evaluating the vascular anatomy of the pelvis and identifying utero-ovarian intearterial anastomoses); selective arteriography followed by UAE first with cylindrical emboli, and then with standard emboli in the form of microspheres. The application of the developed technique did not show dysfunction of the ovaries in both the short and long-term follow-up period up to 18 months in the Group II.ConclusionThe separating UA occlusion is a safe and effective way of preventing ischemic damage in the presence of signoficant utero-ovarian inter-arterial nastomoses.
Organizational and Informational Support for the Treatment of Patients With COVID-19 in a Multidisciplinary Emergency Hospital
Authors: Petrikov S. S. , Tyrov I. A. , Perminov A. Y. , Fomenko N. S. 
Published: October 2020

In modern conditions of global epidemiological challenges, a systematic approach to engineering (design) and reengineering (redesign) of treatment and diagnostic processes in hospitals acquires a special role for the state healthcare system.In this case, the focus of special attention to the management of hospitals is solving a task of organizing the treatment of patients with COVID-19 in the absence of proven clinical practice and dynamically modify the corresponding information flow, as well as the need for optimization of resource support and enhance its efficiency in the face of strong growth in the number of new cases and lack of standard solutions for the reorganization of hospitals, especially of non-infectious profile.In the paradigm of the systemic approach, effective management of the treatment and diagnostic process is not possible without a deep analysis of all its elements: from the moment the patient is admitted to the hospital until the completion of the treatment process. The recency of COVID-19 and the lack of clinical practice for the treatment of these patients have predetermined the need to develop comprehensive standards of clinical processes and their automation. It is the way of organizing the process to achieve the target state of the patient that forms the requirements for infrastructure and resource provision.The article presents the experience of the N.V. Sklifosovsky Research Institute for Emergency Medicine in organizational and informational support of the process of diagnosis and treatment of patients with COVID-19.
Out-of-hospital Cardiac Arrest in the Republic of Crimea: Analysis of Epidemiology and Practice of Care
Authors: Birkun A. A. , Frolova L. P. , Buglak G. N. , Olefirenko S. S. 
Published: October 2020

Introduction. Efficient organization of measures aimed at decreasing mortality from out-of-hospital cardiac arrest (OHCA) warrants a clear understanding of OHCA epidemiology and performance of the prehospital care system in such cases. The study was aimed at performing respective analysis and identifying the ways for improving prehospital management of OHCA in the Republic of Crimea.Material and methods. Annual data from the Crimean OHCA and Resuscitation Registry for 2018 were utilized. All OHCA cases attended by emergency medical services (EMS) with attempted cardiopulmonary resuscitation (CPR) were included, regardless of cardiac arrest etiology or patients’ age (n=419). For ensuring conformity and comparability of the study results, data collection and analysis were executed in correspondence with the statements of the Utstein recommendations.Results. The overall incidence of EMS-attended OHCA in the Republic of Crimea was 673.3 per 100,000 population per year, the incidence of OHCA with attempted CPR – 21.9 per 100,000 population per year, the proportion of CPR attempts out of all OHCA cases – 3.3%. Mean patient age was 66.9 years, and 52.7% were male. The etiology was cardiac in 42.5% cases. In 71.8% cases OHCA was witnessed by EMS, in 25.5% – by a bystander before EMS arrival. Bystanders initiated CPR in 5.7% cases. The initial rhythm was asystole in 80.4% of all cases. When excluding EMS-witnessed cases, the mean EMS response time was 13 min. 5.0% patients had a sustained return of spontaneous circulation at hospital admission. Survival was associated with lower EMS response time (p=0.027), administration of shock (p<0.001) and advanced airway management with endotracheal tube or laryngeal mask (p=0.047).Conclusion. High incidence of OHCA, low rates of CPR commencement and low rates of survival from OHCA in the Republic of Crimea determine the necessity of implementing a comprehensive program to improve prehospital care in the region. Considering the critical relevance of early intervention in OHCA and the revealed low bystander CPR rate, the measures for involving community into the process of prehospital care should form the basis of this program.
Association of SP-A and SP-D Surfactant Proteins with the Severity of CommunityAcquired Pneumonia
Authors: Kharlamova O. S. , Nikolayev K. Y. , Ragino Y. I. , Voyevoda M. I. 
Published: October 2020

Relevance. In current clinical practice, there is a need for research to find new diagnostic tests for the purpose of determining the patients with the highest risk of death from pneumonia. Surfactant proteins SP-A and SP-D play a key role in the pathogenesis of the response to microbial invasion of lung tissue, which participate in a cascade of reactions of both innate and adaptive immunity, and therefore proteins SP-A and SP-D may be considered as markers of the severity of community-acquired pneumonia (CAP).Aim of study. To evaluate the associations of surfactant proteins SP-A and SP-D in blood plasma with the severity of CAP.Material and methods. The study included 247 patients admitted to the therapeutic department. The group of patients with CAP (n=188) was divided into groups of severe (n=103) and non-severe (n=85) pneumonia. The comparison group (n=59) consisted of patients without acute and chronic diseases of the bronchi and lungs. The mean age (years, Me, 25th; 75th percentile) of patients was 55 (47; 68), 55 (47; 70), and 61 (37; 63) years, respectively. All patients underwent clinical, functional, diagnostic and laboratory studies (including determination of the content of SP-A and SP-D proteins by enzyme immunoassay).Results. In the group of patients with severe pneumonia unlike mild pneumonia, and group of comparison higher levels of proteins SP-A and SP-D were observed. Correlation analysis described below revealed statistically significant connection: protein SP-D — direct relation with leukocyte levels (r=0.320, p<0.0001), erythrocyte sedimentation rate (r=0.331, p<0.0001), inverse relation with blood oxygen saturation (r=-0.407, p<0.0001), for SP-A protein — direct relation with body temperature (r=0.355, p<0.0001), erythrocyte sedimentation rate (r=0.369, p<0.0001) in the blood C-reactive protein (r=0.446, p<0.0001), SP-D (r=0.357, p<0.0001), and also relation with the duration of clinical symptoms (r=0.528, p<0.0001) and blood oxygen saturation (r=-0.401, p<0.0001). When conducting ROCanalysis for the surfactant protein SP-A, the area under the ROC- curve was 0.70, the optimal sensitivity for severe pneumonia was 68%, the specificity was 69% at the SP-A level in blood plasma equal to 42.9 ng/ml. When performing ROC analysis for the surfactant protein SP-D, the area under the ROC curve was 0.64 for severe pneumonia, the optimal sensitivity was 62%, and the specificity was 62% at the SP-D content in blood plasma equal to 319.2 ng/ml.Conclusion. According to the results of this study, the SP-A and SP-D proteins are associated with clinical and laboratory signs that reflect the severity of CAP. Thus, SP-A and SP-D are new laboratory markers of CAP severity.
Treatment Tactics and Complications After Surgical Treatment of HIV-Infected Patients With Extra-Articular Fractures of the Long Bones of Extremities
Authors: Doronin N. G. , Khoroshkov S. N. , Naumenko M. V. 
Published: October 2020

The aim of the study is the comparative analysis of the long-term results of treatment of extra-articular fractures of the long bones in HIV-infected and non-HIV-infected patients.Material and methods. In the presented study, a comparative analysis of the results of surgical treatment of 90 HIV-infected and 112 HIV-uninfected patients with extra-articular fractures of the long bones of the extremities aged from 23 to 54 years was performed.Results. HIV-infected patients are mainly characterized by non-infectious complications from the postoperative wound (formation of seromas, hematomas, dehiscence of the edges of wounds, delayed healing), aseptic loosening and migration of fixators, and delayed consolidation of fractures. The presence of statistically significant relationships between the factors characterizing the course of HIV infection (stage of the disease, the number of CD4 + lymphocytes, the ratio of CD4/CD8 + lymphocytes, viral load) and the risk of postoperative complications was revealed.Conclusion. Thus, the use of standard algorithms for determining the tactics and method of treatment of extra-articular fractures of the long bones of the extremities in HIV-infected patients leads to a significant number of unsatisfactory treatment results (up to 31.1%). For HIV-infected patients, the most typical complications are postoperative wounds, impaired fracture consolidation processes and aseptic loosening of metal fixators, which can lead to the development of infectious complications without proper attention. Expansion of research in this area with an increase in the number of observed contingents will make it possible to develop a scientifically based scale for predicting the development of possible postoperative complications in this category of patients.
Early Results After Coronary Artery Bypass Grafting in Patients With Severe Ischemic Left Ventricular Dysfunction
Authors: Mazanov M. K. , Chernyavsky P. V. , Sagirov M. A. , Bikbova N. M. , Kharitonova N. I. , Chernyshev D. V. , Timerbayev A. V. , Kambarov S. Y. 
Published: October 2020

Introduction. The number of patients with severe ischemic left ventricular dysfunction (ILVD), who undergo coronary artery bypass, increasing each year. ILVD is an established risk factor for mortality in patients after myocardial revascularization during the early and late postoperative periods.Aim of study. To evaluate the early results of surgical myocardial revascularization in patients with coronary artery disease (CAD) and severe ILVD.Material and methods. The study included 149 patients with coronary artery disease with severe left ventricular dysfunction (ejection fraction (EF) ≤39%), operated from January 2002 to December 2018. different variables were assessed (pre- and postoperative), including LV ejection fraction and end systolic volume index (ESVI).Results.The average age of the patients was 59.36±8.97 years (from 30 to 78 years), 93% of the patients were men. In 28 patients (19%), ILVD developed against the background of myocardial infarction (MI) and in 121 (81%) due to ischemic cardiomyopathy (ICMP) with a history of myocardial infarction. The mean EF before surgery was 36.64±3.17 (from 21 to 39%). In the postoperative period, there was an increase in EF, which averaged 44.92±4.92 (from 36 to 59%) (p value <0.001). The mean LV ESVI before surgery was 60.23±11.52 ml/m2. In the immediate postoperative period ESVI decreased to 46.26±12.40 ml/m2(the value of p<0.001). The average number of bypass coronary arteries in one patient was 3.9±0.87. There was also a decrease in the degree of mitral regurgitation in most patients after coronary artery bypass grafting (CABG) (p value <0.001). Hospital mortality was 2% (3 patients).Conclusion. Coronary artery bypass grafting in patients with severe ischemic left ventricular dysfunction can be performed with low mortality. Surgical myocardial revascularization can be considered a safe and effective operation for patients with coronary artery disease with a satisfactory condition of the distal coronary arteries, low ejection fraction, and with a predominance of viable myocardium.