bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contemporary placentography: harm or benefit?
Authors: Bezhenar Vitaly F. , Ivanova Lidiya A. , Grigoriev Stepan G. , Titkova Elena V. 
Published: April 2019

Currently, pediatricians, neonatologists of maternity hospitals often take part in perinatal consultations. One of the indications for early delivery may be chronic placental insufficiency diagnosed during an ultrasound examination.
Objective: to evaluate the effectiveness of the main method of diagnosis of placental insufficiency at the present time – ultrasound evaluation of the placenta.
Materials and methods. An analysis was made of 357 birth histories, exchange cards, protocols for screening ultrasound in the third trimester of pregnancy and conclusions of pathoanatomical investigation.
Results. To substantiate the need for prenatal diagnosis of chronic kidney disease, a comparison was made of the evaluation of newborn babies on the Apgar scale and the state of the placenta according to histological data. With compensated chronic placental insufficiency, there was no difference in Apgar scores at the first and fifth minutes, whereas in the subcompensated stage, Apgar score on the Apgar scale was significantly lower in the first and fifth minutes than in the control group. To identify possible in practical use of the objective parameters of diagnosis of chronic kidney disease, the thickness of the placenta was measured during the screening ultrasound in the third trimester of pregnancy, as well as the thickness of the placenta after its separation. Significant differences in the thickness of the placenta or in the screening ultrasound, or when measuring the placenta after separation in patients with and without chronic placental insufficiency was not detected. When assessing a violation of the rate of maturation of the placenta in the third trimester of pregnancy, no significant differences were found in the presence and absence of placental insufficiency. An analysis of the amniotic index was carried out to determine the amount of amniotic fluid in patients of the main and control groups, which revealed no significant differences between the groups.
Conclusions. The authors believe that the main indicators currently used for diagnosis of chronic placental insufficiency (thickness of the placenta, degree of maturity of the placenta, appearance of structural changes in the placenta, change in the amount of amniotic fluid) are uninformative and modern placenography does more harm than benefit. The only parameter determined during the screening study in the third trimester of pregnancy and having significant differences in the main and control groups is fetal hypotrophy.
Selection of Patients with Resistant Arterial Hypertension for the Catheter-Based Renal Sympathetic Denervation
Authors: Frolova E. V. , Vachev A. N. , Morkovskikh N. V. , Koryttsev V. K. 
Published: April 2019

Purpose: elaboration of algorithm for selection of patients with resistant arterial hypertension (AH) for Catheter-Based Renal Sympathetic Denervation (CBRSD). Materials and methods. We examined 284 patients with resistant AH. On stage 1 we excluded most frequent causes of secondary AH. In 247 patients (86.9 %) we established secondary character of AH, in 37 patients (13.1 %) AH was found to be essential. On stage 2 patients with essential AH were given 3–5 component hypotensive therapy. At the background of this therapy we conducted 24‑hour ambulatory blood pressure monitoring (ABPM). CBRSD procedure was considered indicated if according to ABPM average 24‑hour blood pressure (BP) was above 150 and 100 mm Hg, and 24‑hour elevated BP load exceeded 60 %. In 13 of 37 patients (35 %) BP level satisfied these conditions. For CBRSD we used high frequency generator. Ablation was performed using the Symplicity Catheter. Results were assessed in 1, 2, 9, 12, and 28 months. Results.Target BP level at the background of minimal doses of hypotensive drugs was achieved in 11 patients (85 %), what was confirmed by ABPM data. Levels of mean 24–4 hour systolic and diastolic BP significantly decreased from 173.9±14.9 to 143±21.3, р<0.05, and from 108.2±8.7 to 91.4±13.8 mm Hg., р<0.05, respectively. Index of elevated systolic BP time decreased from 78.2±14.6 to 49.8±29.6 %, р<0.05. Best effect was achieved in patients with AH duration before the procedure less than 7 years. None of the patients had episodes of cerebral vascular insufficiency or heart failure progression. Conclusion. While determining indications to bilateral CBRSD one should be governed by such criteria as exclusion of symptomatic AH and objective proofs of AH resistance (according to ABPM at the background of hypotensive therapy).
Decreased Heart Rate Variability in Sickle Cell Anemia as Effect of Pulmonary Arterial Hypertension
Authors: Akgul F. , Batyraliev T. A. , Fettser D. V. , Seyfeli E. , Arystan A. G. , Seydaliyeva T. , Gali E. , Yalcin F. , Sidorenko B. A. 
Published: April 2019

Decreased heart rate variability (HRV) is associated with increased mortality risk in various diseases. Theobjective of this investigation:to study HRV in patients with sickle cell anemia (SCA) and to assess the effect of pulmonary arterial hypertension (PAH) on HRV in these patients.Materials and methods. HRV registration and Doppler echocardiographic assessment of systolic pulmonary arterial pressure (PAP) was carried out in 61 stable patients with SCA and 24 healthy subjects.Results. Low frequency power (LFP) and high frequency power (HFP) were decreased in SCA patients compared to healthy subjects. Among SCA patients, PAH patients had lower LFP and HFP than patients without PAH. In SCA patients, systolic PAP showed significant negative correlation with LFP and HFP. Conclusion.HRV is significantly decreased in SCA patients, especially in those with PAH. HRV may be particularly useful in early detection of PAH patients who may have worse prognosis and higher mortality risk.
Non-Central Influences of α2-Adrenergic and Imidazoline Agonist Interactions in Isolated ardiomyocytes Cardiac Cells
Authors: Maltsev A. V. , Kokoz Y. M. 
Published: April 2019

Aim: to investigate the functional interaction of α2-adrenergic and imidazoline receptors recently identified on the sarcolemma of isolated cardiomyocytes for regulation of the intracellular calcium and the production of the signal molecule of nitric oxide (NO).Materials and methods:experiments were performed on isolated left ventricular cardiomyocytes of Wistar rats. Potential-dependent Ca2+-currents were measured from the whole-cell by the patch-clamp method in “perforated-patch” configuration. The intracellular calcium and the production of nitric oxide were estimated from the changes in fluorescence intensity of the Ca2+-specific and NO-sensitive dyes at fluorescent or confocal microscope.Results:It has been shown that α2‑adrenergic and imidazoline receptor agonists inhibit L-type Ca2+-currents by themselves, but their effects do not develop against each other’s background. The blockade of key effector molecules: protein kinase B (Akt kinase) for α2‑adrenergic receptors, and protein kinase C for imidazoline receptors causes the action of agonists to become additive. Both the selective α2‑agonist, guanabenz, and the specific agonist of the first type imidazoline receptors, rilmenidine, show an additional inhibition of Ca2+-currents against the basal background already reduced by the activation of one of the two receptor systems. Wherein rilmenidine increases the level of free Ca2+in the cytosol, and guanabenz, on the contrary, decreases it. The action of guanabenz does not develop against the background of rilmenidine, although it, in turn, effectively increases the intracellular level of calcium in guanabenz-pretreated cardiac cells. Activation of α2‑adrenergic receptors leads to significant stimulation of the endothelial isoform of NO-synthase, and as a result to an increase in the NO level. Activation of imidazoline receptors itself does not affect NO synthesis but it prevents the production of NO induced by α2‑agonists.Conclusion:obtained data make it possible to formulate a number of useful recommendations for clinical practice, and also to clarify the non-central peripheral effects arising from the activation of α2‑adrenergic or imidazoline systems under conditions of endogenous hyperactivation on of the two systems.
Progression of Chronic Heart Failure: Prognostic Criteria and Non-Drug Prevention
Authors: Kurlyanskaya E. R. , Denisevich T. L. , Mrochek A. G. 
Published: April 2019

Purpose: to study frequency of progression of chronic heart failure (CHF), to develop multifactorial models for evaluation of risk of progression, and measures of non-drug secondary prevention of CHF. Materials and methods. We included in this study 531 patients with functional class (FC) I–III CHF (FC I – n=254, FC II – n=255, FC III – n=22). Examination included clinical-instrumental, clinical-functional, and laboratory (with determination of NT-proBNP concentration) investigations, use of the AUDIT and Morisky Green questionnaires. Results. Rate of CHF progression for 24 months was 11.7 % (FC I – 16.1, FC II – 7.8, FC III – 4.5 %). Irrespective of FC significant factors of CHF progression were history of myocardial infarction, and low adherence to treatment. Additional prognostic criteria of increase of CHF FC I to FC II were age >74 years, excessive body mass, disturbance of carbohydrate metabolism, arterial hypertension, and frequent intake of alcohol. FC II CHF progression was associated with such factors as type 2 diabetes, 3‑degree arterial hypertension, permanent atrial fibrillation, and smoking. Using these prognostic criteria, we developed multifactor models, based on which scales for assessing the risk of FC I and II CHF progression were created. These models demonstrated high accuracy of prognosis and good reproducibility (on independent test samples of patients with CHF FC I and FC II prognostic accuracy was 86.3 и 85.5 %, respectively). We also developed a program of secondary non-drug prevention of CHF progression, with inclusion of structured dynamic education of patients with organization of control and self-control of knowledge quality. After this therapeutic education progression CHF in high risk patients was 2.2 %. Conclusion. Complex application of scores for evaluation of risk of FC I–II CHF progression and the program of secondary non-drug prevention determined lowering of frequency of increases of class of CHF severity from 11.7 to 2.2 %.
The Role of Endothelial Dysfunction in the Development of Cardiotoxic Action of Cytostatics in Patients with Lymphoproliferative Diseases
Authors: Budanova D. A. , Belenkov Yu. N. , Sokolova I. Ya. , Antyufeeva O. N. , Ershov V. I. , Ilgisonis I. S. , Gadaev I. Yu. 
Published: April 2019

Understanding mechanisms of chemotherapy cardiotoxicity is an important problem due to the lack of clear understanding of its occurrence. Development of endothelial dysfunction is considered to be one of possible ways in implementation of these side effects. The analysis of endothelin-1 and e-selectin levels in 26 patients with lymphoproliferative diseases before and after the completion of the treatment program was been performed. The results of the study showed normal values of E-selectin level and increased level of endothelin-1 in the whole group of patients before treatment. After completion of chemotherapy program, in the whole group, there was a decrease of these two markers. However, values of level of endothelin-1 with vasoconstrictor effect remained high even after the end of therapy. It is imp ortant that at detailed analysis the dynamics of investigated markers in patients of older age group (median age 64 years) was associated with worsening of endothelial dysfunction.
Myocardial Contractile Function in Patients with Liver Cirrhosis and Syndrome of Bacterial Overgrowth Syndrome
Authors: Ivashkin K. V. , Shirokova E. N. , Ivashkin V. T. , Plyusnin S. V. , Zharkova M. S. , Maslennikov R. V. , Skhirtladze M. R. , Maevskaya M. V. 
Published: April 2019

Objective: to study myocardial contractile function in patients with liver cirrhosis and ascites in the presence of bacterial overgrowth syndrome (BOS) and pathological bacterial translocation. Materials and methods. We included in this study 59 patients with Child-Pugh class B and C liver cirrhosis (LC) of various etiology and ascites. Control group comprised 12 patients with ischemic heart disease complicated by chronic heart failure (CHF). Examination included history taking and laboratory and instrumental investigation. LC was diagnosed basing on clinical symptoms and instrumental studies. Child-Pugh and MELD scores were used for assessment of LC severity and prognosis. International ascites club grading system was used for evaluation of severity of ascites. Hydrogen breath test was applied for diagnosing BOS. Syndrome of pathological bacterial translocation was established based on blood levels of lipopolysaccharide-binding protein and detection of bacterial DNA in ascitic fluid. Structural-functional parameters of the myocardium and hemodynamics were assessed by echocardiography. Brain natriuretic peptide (BNP) concentration was measured in blood serum and ascitic fluid. Results. In 13 of 59 patients with LC the hydrogen breath test was negative, in 33 positive and in 13 patients the positive hydrogen test was combined with the presence of BOS and pathological bacterial translocation. Blood serum and ascitic fluid BNP concentrations in LC patients were low and within normal limits (62.5±4.1 and 53.3±4.9 rg / ml, respectively), what contrasted with high BNP concentrations in patients with CHF (1820±95.5 and 497.1±39.6 rg / ml, respectively). Total protein level in ascitic fluid also was significantly lower in patients with LC than in patients with CHF (1.77±0.1 and 4.43±0.35 mg / dL, respectively). The serum-ascitic albumin gradient (SAAG) in both groups of patients exceeded 1.1 (1.58±0.13 in patients with CHF and 1.88±0.19 in patients with LC). Conclusions. In patients with liver cirrhosis the presence of BOS and bacterial translocation did not produce a distinct negative impact on contractile function.
Can a Multi-modal Communication Program Enhance Empathy and Doctor-Patient Social Interactions?; Results of a Pilot Training Study of Russian Medical Students
Authors: EA Zakharova , J Inklebarger , ES Bogomolova , A Roberts 
Published: April 2019

Communication is a vital element of basic professional competency within medicine. However, some medical schools may not typically offer structured developmental skills training to medical students. A multi-modal doctor communications enhancement-training program was therefore organized at a medical university in Russia. A total of 83 students ages 18-19 participated. Pre-course communication ability levels were measured at 21.7% low, 69.8% medium, and 7% high level. Post course outcome measurements demonstrated 1.2% low, 51.8% medium, and 47% high communication levels.
Outcome: It was concluded in this pilot study that a formalized multi-modal communications development program in conjunction with performance feedback, could significantly enhance essential patient communication skills in Russian medical students.
Magnitude and associated factors of Perioperative hypothermia in patients who underwent Elective surgery at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
Authors: Fekede Mulualem S. , Sahile Wosenyeleh A. 
Published: April 2019

Background : Body temperature is a vital sign and 37°C is the mean core body temperature of a healthy human. Core body temperature is normally tightly regulated and maintained within narrow range. Perioperative hypothermia is one of the major problems during surgery and anesthesia that can affect operated patients. Methods: Institutional based cross-sectional study was conducted. Patient interview, chart review and temperature measurement were employed for data collection. Temperature was measured using tympanic membrane thermometer. SPSS version 20 software was used for analysis. binary logistic regression was used to look at associations anda p-value of <0.05 was considered statistically significant.
Result :The overall magnitude of preoperative, intra and post-operative hypothermia in this study was 16.2%, 53.2% and 31.3%, respectively. Age (AOR=7.15, 95% CI, 1.16, 43.99), coexisting illness (AOR, 3.32, 95% CI, 1.06; 10.36), preoperative hypothermia (AOR; 57; 95% CI; 7.1, 455.4), operation room temperature (AOR=1.91; 95 % CI, 1.04; 3.5) and crystalloid fluids administered (AOR; 2.3; 95% CI, 1.07, 4.9) were found to be factors associated with intraoperative hypothermia.
Conclusion and recommendation: The magnitude of perioperative hypothermia remains high. Measures should focus on improving room temperature and warming up fluids. Susceptible patients like the aged and those with coexisting disease should be given extra attention.
Current Concepts in the Treatment of adhesive capsulitis of the Shoulder
Authors: Andrés Rossi Luciano , Ranalletta Maximiliano 
Published: April 2019

Adhesive capsulitis is characterized by chronic inflammation of the capsular subsynovial layer, which produces capsular fibrosis, contracture, and adherence of the capsule to itself and to the anatomic neck of the humerus. Physical therapy is the mainstay of treatment, regardless of stage. Based on the natural history of the disease, early corticosteroid injection has a role in shortening the overall duration of symptoms allowing patients to move faster in the stages of rehabilitation and thus return to their daily life activities more rapidly. Most patients will see complete resolution of symptoms with nonsurgical management.
In cases with refractory stiffness, manipulation under anesthesia or arthroscopic capsular release may be indicated. Because of various potential risks of complications with manipulations, arthroscopic capsular release is preferred. There is a lack of high level studies comparing different techniques for capsular release. Both circumferential and limited release have proven to be effective. Regarding postoperative rehabilitation, arthroscopic release should be followed by early, diligent, and directed therapy to prevent recurrent stiffness.
Prevalence aetiology and clinical spectrum of abnormal adrenal functions in human immunodeficiency virus infection
Authors: Nathan Ajay , Brar KS , Valsan Arun K , Mohan Nimitha K , Singh Gautam 
Published: April 2019

Aim: To find Prevalence, Aetiology and Clinical Spectrum of abnormal adrenal functions in Human Immunodeficiency Virus infection. To diagnose and treat adrenal dysfunction in various stages of HIV infection and see the response to treatment if required.
Material & Methods: 100 patients with HIV infection being admitted to our hospital was evaluated for abnormal adreno cortical functions. Immune dysfunction was assessed with CD4 count. Statistical tests (chi squared test) were applied to the collected data to find out any significant correlations.
Results: The overall prevalence of adrenocortical abnormalities in HIV positive patients was 14% which included hypocortisolemia in 3% and hypercortisolemia in 11% of patients. Frequency of hypocortisolemia was significantly associated with presence of HIV infection with opportunistic infections and low CD4 counts (less than 50cells). In patients having hypercortisolemia, ONDST (Over night dexamethasone suppression test) was done and it showed reduction of serum cortisol to expected level (suppressed to <1.8 mcg/dl). Adjustment disorders and drugs mainly efavirnz more than nevirapine was incriminated in the same.
Conclusion: HPA axis dysfunction is frequently encountered in HIV infected patients. The commonest dysfunction was hypercortisolemia probably due to elevated cytokines. Hypercortisolemia is a feature of early stage HIV infection. The likelihood of adrenal insufficiency increases as the disease advances and patient enters a more immunocompromised state. Hypocortisolemia should be treated regardless of the existence of associated symptoms. Hypercortisolemia in the absence of features of Cushing’s syndrome is common and should not promote treatment or specific studies.
CD30 expression and Detection of Epstein-Barr Virus-Encoded Small RNA by Real-Time RT-PCR of Classic Hodgkin Lymphoma and Their Correlation with Risk Stratification
Authors: Nurusshofa Zahra , Suryanti Sri , . Afiati , Hernowo Bethy Surjawathy 
Published: April 2019

More than 40% patient of Hodgkin lymphoma (HL) are chemoresistance and show early disease relapse that leads to poor prognostic. Epstein-Barr Virus (EBV) appears to have poor prognostic in HL. The CD30 expression at Hodgkin and Reed-Stenberg cells suggested has associated with advanced disease stage. The International Prognostic Score-7 (IPS) is a seven-parameter of risk stratification index for prognostic and as a consideration for treatment plan. The aim of this journal is to see correlation between EBV infection and CD30 expression with IPS-7 in Classic HL (CHL) patient.
Case-control research design was done to 40 Fixed Formalin Paraffin-Embedded (FFPE) of CHL at the Dr Hasan Sadikin Hospital, Bandung. Cases were 20 patients CHL of high-risk score IPS-7 and controls were 20 patients with low-risk score. Detection of EBV-encoded small RNA-1 (EBER1) by Real-Time RT-PCR and Immunohistochemical staining of CD30 was performed to all samples. All data were analyzed using Chi-Square test with p-value <0.05 of significant level.
EBV was present in 10 cases of CHL (25%). The result of this study shows a different statistically significant of EBV infection (p=0.028) and CD30 expression (p=0.004) between low risk and high-risk IPS-7 HL. CD30 expression (OR= 7.429) may provide stronger factor for risk assessment for the patient with HL, compare to EBER1 detection (OR=6.000).
This study concluded that CD30 expression and EBV Infection correlate with risk assessment IPS-7 in CHL.
The Tradition of Tahlilan on Ternate Society
Authors: . Burhan , . Asmiraty 
Published: April 2019

This study aims to analyze the implementation of tahlilan, society perspective towards this tradition, and the factors of the tahlilan existence on Ternate community. The study was designed in the form of qualitative descriptive research by applying field research, teological normative, and socio-cultural approaches. The data were collected through interview and documentation. The result showed that tahlilan for Ternatenese is nothing but the momentum where family, relatives, friends, and surrounding communities gather to recite some hayyibah sentences (hamfdalah, takbir, shalawat, tasbih), Qur’an verses, dhikr, and other prayers. Ternate society believes that tahlilan is crucial as a medium of da’wah. There are many positive benefits felt by the people of Ternate such as psychological, social, economic, and importantly religious awareness. In religion side, tahlilan is a minfestation of love for Islam and the cultivation of the monotheism concept. The development of understanding and awareness in Muslim religion also lead to a process of evaluation and change in the implementation of tahlilan. In this case, Islamic da'wah succeeds in influencing the socio-cultural life of Ternate community. The tahlilan tradition can exist til now because it is considered to still have coherence with Islamic values, customs and culture. Ternate society still hope that the tradition of tahlilan will last forever. However, there has been no inheritance or regeneration model for tahlilan implementers since the process of regenerating the rituals of tahlilan has proceeded naturally so far.