bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dental Considerations in Patients with Loeys-Dietz Syndrome: A Review of the Literature and Case Report
Authors: Kratunova Evelina , Zhang Ivan L. , da Fonseca Marcio A 
Published: September 2021

Loeys-Dietz Syndrome (LDS) is a rare connective tissue disorder with an autosomal dominant pattern of inheritance, linked to heterozygous mutations in six genes from the transforming growth factor beta receptor complex. The classical syndrome characteristics include aortic aneurisms with generalized arterial tortuosity, hypertelorism and cleft palate or bifid/broad uvula. LDS is also associated with a wide range of skeletal, craniofacial, cutaneous and ocular abnormalities, as well as allergic, atopic and inflammatory diseases. Common oral findings include high arched and/or narrow palate, enamel defects and class II skeletal malocclusion. Dental management of patients with LDS is complex and includes approaches to prevent medical complications, as well as considerations for safe delivery of dental care. The purpose of this report, reviews the literature related to LDS oral manifestations as well as to describe the comprehensive dental management of an adolescent patient with LDS and discuss the challenges that dental practitioners may face when providing treatment for these patients.
LDS is a newly described syndrome and the literature reviewing its oral manifestations is limited.
Patients are reported to have lower oral health-related quality of life as a result of tooth sensitivity and malocclusions.
Dental management is compounded by the complexity of medical factors that should be taken into consideration for the safe delivery of care.
The presented case is an example of the challenges that dental practitioners may face when providing treatment for LDS patients.
The study of systemic hemodynamics by the method of volumetric compression oscillometry in young people
Authors: Gorenkov R. V. , Alexandrova O. Yu. , Yakushin M. A. , Vasilyeva T. P. , Mirzokhonov T. O. , Chernus N. P. 
Published: September 2021

Aim. To investigate the state of systemic hemodynamics (SHD) in young people to assess the potential impact of its disorders in the formation of arterial hypertension (AH) and to carry out preventive measures.Methods. A random sample of 91 young people from 17 to 25 years old was examined; 27 of them were men (average age 23.7±1.6 years) and 64 women (average age 20.4±1.1 years). The study involved clinical residents and students who, according to preliminary and periodic medical examinations, excluded the presence of cardiovascular diseases. The indicators of SHD were investigated by the method of volumetric compression oscillometry using a portable automated software and hardware complex for non-invasive research of central hemodynamics (Device “CAP TsG osm-“Globus”).Results. AH was detected in 4.4%; “white coat” AH in 8.79%; arterial hypotension – in 5.49%. In individuals with normal blood pressure (BP) (75 people), an increase in specific peripheral vascular resistance was most often revealed in 30.6%. An unchanged hemodynamic profile in the group with a normal BP level was recorded only in 28.0% of the examinees.Conclusion. The obtained results indicate that even among “healthy” young people aged 18- 25 years with a normal BP level, the proportion of people with impaired SHD values is 72%. People with hypertension and with altered SHD indicators should be included in the regular medical check-up observation group.
Association of cardiovascular biomarkers with myocardial and coronary imaging characteristics in patients having acute myocardial infarction and type 2 diabetes mellitus
Authors: Vorobev A. S. , Kashtalap V. V. , Urvantseva I. A. , Nikolaev K. Yu. , Kovalenko L. V. , Astrakhantseva I. D. 
Published: September 2021

Aim. To assess the dynamic changes and clinical significance of biomarkers of inflammatory processes in patients with acute myocardial infarction (MI) with/ or without type 2 diabetes mellitus (T2DM) and primary percutaneous coronary intervention (pPCI) at various stages of treatment.Methods. 96 patients with acute MI after pPCI were examined. The level of inflammation markers was measured 4 times: before pPCI (first day from admission to the hospital), on the third day, 7–10 days (before discharge from the hospital) and 40–45 days after pPCI.Results. All groups of patients with MI showed an increase in the plasma activity of biomarkers of inflammatory processes. After pPCI for 40–45 days, there is a significant difference in the concentration of biomarkers, depending on the comorbid T2DM presence. Strong associations were found between cardiovascular biomarkers and post-MI cardiac remodeling and coronary atherosclerosis progression.Conclusion. The assessment of the levels of biomarkers of inflammatory processes may have additional clinical value in estimating the course of MI, including patients with T2DM at the postinfarction stages.
The impact of medical activity bureaucratization on professional values of personnel: analysis of international research results and data from sociological surveys of Kuzbass Medical Organizations (NII KPSSZ AND GBUZ “KKKD”)
Authors: Danilchenko Ya. V. , Popsuyko A. N. , Batsina E. A. , Kilizhekova D. V. , Karas D. V. 
Published: September 2021

Aim. To assess the correspondence between the results of the European Social Survey (ESS) “The Impact of Medical Activity Bureaucratization on Professional Values of Personnel” and the results of sociological surveys of personnel of medical organizations such as Federal State Budgetary Institution Research Institute for Complex Issues of Cardiovascular Diseases (NII KPSSZ) and Federal State Budgetary Institution “Kuzbass Clinical Cardiology Dispensary named after academician L.S. Barbarash” (GBUZ “KKKD”).Methods. Comparative analysis of the results of ESS (3271 medical workers from 29 countries were questioned) and the results of sociological surveys of the medical personnel at NII KPSSZ (204 respondents in 2017) and at GBUZ “KKKD” (385 respondents in 2021) was carried out.Results. According to the survey data of employees of NII KPSSZ the dominant values are: professionalism and conscientious attitude to work, respectful attitude to colleagues and patients, strict compliance with law and regulatory requirements. Among the main values of GBUZ “KKKD” staff the following were named: discipline and order in fulfilling responsibilities, professionalism and conscientious attitude to work, and respectful attitude to patients.Conclusion. On the basis of the comparative analysis, the authors proved the validity of the conclusions and results of an international study devoted to the problem of the influence of bureaucratization of a medical organization on the structure of personnel values in medical organizations focused only on the treatment and diagnostic process. If an institution functions as a scientific and medical organization, then its employees tend to strive for professional self-development, innovative and creative thinking, which is not consistent with the conclusions of international researchers.
Cardiopulmonary bypass strategy without donor blood components as a method for preventing brain damage in children
Authors: Ivkin A. A. , Borisenko D. V. , Grigoriev E. V. 
Published: September 2021

Aim. To establish the role of donor blood components which are used in the intraoperative period in children with septal congenital heart disease (CHD) who need surgical interventions with cardiopulmonary bypass (CPB) for the prevention of cerebral injury in the postoperative period.Methods. 40 children of 14 months old on average and 8.8 kg of weight were under the study. All patients underwent radical correction of the septal CHD with the use of CPB. The patients were divided into 2 groups according to the donated blood components used. Cerebral damage was assessed with the help of three specific markers: protein S-100-ß, neuron-specific enolase (NSE) and glial fibrillar acidic protein (GFAP). The severity of the systemic inflammatory response was defined by the level of the following markers: interleukin 1, 6 and 10 in serum before operations, after the completion of IC and 16 hours after surgery. The clinical analysis of cerebral injury was performed via the Cornell Assessment for Pediatric Delirium.Results. Statistically the concentration of all three markers of cerebral injury was significantly higher in the transfusion group after the end of CPB. Similar dynamics was observed in the concentrations of interleukins. In addition, the values for GFAP were higher in the transfusion group and 16 hours after surgery.Conclusion. The safety and effectiveness of the strategy on refusal of intraoperative transfusion in order to prevent cerebral injury in children during the correction of septal CHD has been demonstrated.
Organ protection and prevention of polyorgan insufficiency during high-risk percutaneous coronary intervention by using extracorporal membrane oxygenation
Authors: Kornelyuk R. A. 
Published: September 2021

Aim. To compare the possibilities of venoarterial extracorporeal membrane oxygenation (VA ECMO) and intra-aortic balloon pump (IABP) to prevent organ damage and the development of multiple organ failure.Methods. According to the inclusion and exclusion criteria, 51 patients underwent the study. The patients were divided into 2 groups depending on the method of mechanical circulatory support used: VA ECMO (n = 29) and IABP (n = 22). To assess organ functions in the intra- and postoperative period, the results of instrumental and laboratory research methods, as well as data from complex scales of organ dysfunction, were analased.Results. Myocardial depression was observed in the IABP group in the intraoperative period of high-risk percutaneous coronary intervention and worse hemodynamic stability compared to the VA ECMO group was traced. Organ dysfunction and multiorgan failure developed more often in the IABP group, which was confirmed by laboratory specific markers.Conclusion. High-risk percutaneous coronary intervention with VA ECMO is accompanied by a lower incidence and severity of organ damage and multiple organ failure. Thus, the VA ECMO has better organ protective effects.
Results of long-term patency of small-diameter biodegradable vascular prostheses with atrombogenic drug coating of sheep model
Authors: Krivkina E. O. , Antonova L. V. 
Published: September 2021

Background. Preclinical tests of biodegradable small diameter vascular prostheses on a sheep model have been carried out.Aim. To assess the results of long-term patency and remodeling of biodegradable vascular prostheses based on polyhydroxybutyrate / valerate and polycaprolactone with an atrombogenic drug coating in a large laboratory animal model.Methods. We researched vascular prostheses made of polyhydroxybutyrate / valerate and polycaprolactone (PHBV/PCL) 4 mm in diameter with layer-by-layer vascular endothelial growth factor incorporated into the polymer framework, the main fibroblast growth factor, chemoattractant molecule containing SDF-1a (GFmix) surface, and additional modifying drug surface heparin and iloprost (PHBV/PCL/ GFmix/Heparin/Iloprost). Animals with implanted synthetic Gore-Tex vascular grafts with a diameter of 4 mm were included into a comparison group.Results. After one day of implantation it was revealed that the patency of biodegradable PHBV/PCL/GFmix/Heparin/Iloprost prostheses was 62.5%, while synthetic Gore-Tex prostheses were thrombosed in 100% of cases. At the same time, after 18 months of implantation, the patency of biodegradable vascular PHBV/PCL/ GFmix/Heparin/Iloprost prostheses decreased to 50%. Passable drug-eluting polymer grafts were completely resorbed after 18 months of implantation, and aneurysmically expanded newly formed vascular tissue was formed in their place.Conclusion. Vascular prostheses made of polyhydroxybutyrate/valerate and polycaprolactone showed better long-term patency results than synthetic prostheses used in the clinical practice. However, the strengthening of the external framework of the prostheses is required in order to prevent the formation of aneurysms.
Factors for the development of atrial fibrillation after open heart surgery
Authors: Lebedev D. I. , Evtushenko A. V. , Khorlampenko A. A. 
Published: September 2021

Aim. To identify the factors influencing the development of postoperative atrial fibrillation (POAF).Methods. The study included 100 patients with indications for cardiac surgery, aged 53 to 82 years (mean age 67.2±17 years). The group included patients who had no history of AF before surgery. Cardiac surgery in the group was presented in 63 patients by coronary artery bypass grafting, and in 37 – by intervention on the heart valves. All respondents were divided into 2 groups: the first included 39 people (39%) who had AF paroxysms lasting more than 30 seconds in the early postoperative period, with a peak at 1–2 days, in 13 (33.3%) cases of AF relapsed. The second group of patients was represented by 61 patients (61%) without cardiac arrhythmias after surgery.Results. The dependence of the development of POAF on age, the concentration of C-reactive protein in the peripheral blood taken on the day of cardiac surgery, the longitudinal size of the left atrium before surgery was revealed.Conclusion. It was found out that a number of factors such as age, preoperative left atrium size, C-reactive protein level in the first days after surgery suggest the development of POAF. The use of the predictors obtained can make it possible to develop an effective strategy for the prevention of POAF.
Results of infrainguinal reconstructions with distal anastomosis below the knee joint fissure in patients with critical ischemia when using various prosthetic materials
Authors: Lutsenko V. A. , Sultanov R. V. , Evtushenko A. V. , Barbarash L. S. 
Published: September 2021

Aim. To cоmpare the results оf infra-spinal reconstructions of the lower extremities with the formatiоn of a distal anastomоsis below the knee joint fissure with the use of a bioprosthesis and autovein in critical limb ischemia (CLI).Methods. The hospital results of revascularization were retrospectively analyzed in 53 patients with CLI who underwent primary prosthetics of the femoral-popliteal segment with the fоrmation of a distal anastomоsis belоw the knee joint gap. All patients, depending on the prоsthetic material used, were divided into two groups: 1) autovein was used as a prosthesis (39.6%, n = 21)) and 2) a bioprosthesis was used (“KemAngioprosthesis” closed joint-stock company “NeoCor” Kemerovo, Russia) (60.4%, n = 32).Results. In the early postoperative period, thrombosis developed in group 1 in 7 cases (33.3%): in 5 patients – on the first day after the surgery; 2 out of 5 patients were with chronic arterial insufficiency (CAI) of the fourth degree, 1 was with acute arterial insufficiency of the first degree, and 2 patients with the third degree of CAI. In group 2, there were 6 prosthetic thrombosis (18.7%), 4 cases of which developed thrombosis on the first day, 3 patients with CAI of the fourth degree and 1 case with acute arterial insufficiency of the second degree.Conclusion. The application of infra-lingual reconstructions using bioprostheses is quite effective and safe in patients with CLI, in particular with purulent-necrotic trophic processes when a suitable autovein to be used as a prosthetic material is absent.
The features of step-by-step surgical approach for correction of tetralogy fallot using modern palliative methods
Authors: Lyapin A. A. , Halivopulo I. K. , Tarasov R. S. 
Published: September 2021

Aim. To evaluate the hospital results of one-stage radical correction (RC) of Fallot's tetrad (TF) and stage-by-stage correction of the defect using stenting of the right ventricular outflow tract (RVOT).Methods. The group of step-by-step correction included 24 patients with the classic cyanotic form of TF: 1st stage – stenting of the RVOT (Me age 73.5 days, weight 3.8 kg), 2nd stage – RC of TF Me age 187 days. The group of one-stage RC TF included 30 newborns with Me aged 121.5 days and weight 5.5 kg.Results. After performing stenting of RVOT, there was a significant increase in SpO2 from 80 to 94%, end diastolic volume of left ventricle index from 24 to 33.3 ml/m2 , a decrease in the severity of hypoplasia of the pulmonary artery trunk (PA) compared with the stage before stenting of RVOT (p˂ 0.05). Patients of the two groups had equal values of weight, SpO2, the severity of PA hypoplasia, and a gradient in the RVOT at the time of RC. After the RC in stenting group there was an increase in SpO2 up to 98%, a decrease in the RVOT gradient from 75 to 16.5 mm Hg, an increase in the end diastolic volume left ventricle index to 56.5 ml/m2 (p˂ 0.05). The dynamics of the status of patients in Group 1 with the use of palliative intervention did not significantly differ from the dynamics in Group 2 (one-stage RC TF).Conclusion. Application of the approach of step-by-step correction of TF with stenting of RVOT in low weight infants with severe hypoxemia demonstrated an equal effect on the dynamics of SpO2, reverse cardiac remodeling compared with patients who underwent simultaneous RC of classical TF.
Assessment of calcium antagonist therapy protective effect on the thickness of the intima-media complex in patients with arterial hypertension
Authors: Morozova N. I. , Mulerova T. A. 
Published: September 2021

Aim. To evaluate the connection of calcium antagonist (amlodipine) therapy with the dynamics of the intima-media complex thickness in patients with arterial hypertension (AH), depending on genetic polymorphism.Methods. The study included representatives of the indigenous nationality (the Shors) – 901 people, of which a group of 367 people with hypertension was identified. The prospective stage of observation included 234 people who did not receive antihypertensive therapy. Based on the prescription of calcium antagonists, patients with hypertension were divided into two groups. Gene polymorphism was tested by polymerase chain reaction.Results. In the Shor cohort, the regression of the intima-media complex thickness of the carotid arteries was observed more often in hypertensive patients who received calcium antagonists if to compare them with those who did not take the drug [OR = 2.30]. In addition, the decrease in the atherosclerotic process is associated with the genotype carriage: I/I of the ACE gene [OR = 9.42], T/C of the AGT gene [OR = 3.52], 4b/4b and 4b/4a of the eNOS gene [OR = 2.26 and OR = 3.75], C/C of the MTHFR gene [OR = 2.62].Conclusion. Pharmacogenetic aspects are valuable from the point of view of an individual approach and obtaining the most pronounced pharmacological response in order to slow down the processes of vascular wall remodeling in patients with hypertension.
Choice of revascularization method in acute coronary syndrome with non-ST-segment elevation
Authors: Nishonov A. B. , Tarasov R. S. 
Published: September 2021

Aim. To analyze the results of various revascularization techniques in high-risk non – STsegment elevation in acute coronary syndromes performed during the first 24 hours.Methods. As a part of a single-center retrospective study, 45 cases of coronary artery bypass grafting (CABG) were examined in high-risk non – ST-segment elevation in acute coronary syndromes patients during the first 24 hours since their hospitalization for the period from 2017 to 2020. 45 cases of percutaneous coronary intervention (PCI) were selected from a similar group of patients with the help of the copy-pair method.Results. The groups were comparable according to such significant factors as age, gender, postinfarction cardiosclerosis, diabetes mellitus, and multifocal atherosclerosis. However, the severity of coronary atherosclerosis according to the Syntax score was significantly higher in the CABG group (p = 0.0004). The groups were comparable in achieving complete revascularization (p = 0.2). In 8.9% (n = 4) of patients in the PCI group, unscheduled repeated revascularization was required, and in 15.6% (n = 7) of cases stent restenosis/thrombosis was detected during the hospital period and between PCI stages, while in the CABG group, congenital malformations and dysfunction were not found. Mortality in the groups did not differ significantly (4 (8.8%) versus 2 (4.4%), p = 0.4).Conclusion. CABG provides freedom from repeated revascularizations, despite the initially more severe coronary lesion.
The concept of automated functional design of heart valve prostheses
Authors: Onishchenko P. S. , Klyshnikov K. Yu. , Rezvova M. A. , Ovcharenko E. A. 
Published: September 2021

Aim. To develop an algorithm for the automated functional design of the heart valve leaflet apparatus.Methods. The geometry of the aortic valve leaflet was designed in the Matlab programming environment (MathWorks, Massachusetts, USA). Numerical modeling of the opening process was performed using Abaqus/CAE (Dassault Systemes, France).Results. We developed an algorithm, with the help of which a set of models of the leaflet apparatus was designed. 8 models were subjected to numerical modeling of the stress-strain state. The locking pressure simulation has shown that the smallest von Mises stress value was recorded for a sample with a larger surface area of the leaflet belly and it equals 0.422 MPa. The results obtained show that the value of the radius of curvature significantly affects the behavior of the entire valve, which leads to the conclusion that it is necessary to carefully select the design of the valve apparatus for its correct functioning.Conclusion. The study provides the primary confirmation that the concept of the algorithm is efficient for the automated functional design of the aortic heart valve leaflet apparatus.
An innovative approach to managing patient engagement
Authors: Popsuyko A. N. , Danilchenko Ya. V. , Batsina E. A. , Artamonova G. V. 
Published: September 2021

Aim.To analyze and study the possibility of using an innovative approach to managing patient interaction such as design-thinking technology in the activities of a medical organization to improve medical care for cardiovascular disease.Methods.To achieve the goal the analysis of the domestic and foreign literature, and the normative-legal documentation for the period from 2015 to 2020 was carried out. The base of the research was Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo), where medical, scientific, educational and publishing activities are successfully implemented.Results.Based on the studied theoretical ideas about the essence of the considered technology, the authors formulated the definition of design-thinking in health care, which is understood as a set of activities aimed at improving the process of providing medical aid by studying and maximizing satisfaction of the patient’s needs. The stages of the technology are outlined and described: empathy, generation of ideas, solution development, prototyping on the example of a research base.Conclusion.The technology of design-thinking can organizationally and functionally supplement the process of interaction management with patients, and regular evaluation of the level of satisfaction is an initial stage of implementing an innovative approach.