bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental Modeling of General Purulent Peritonitis
Authors: Chepurnykh E. E. , Shurygina I. A. , Fadeeva T. V. , Grigoryev E. G. 
Published: July 2019

General purulent peritonitis takes one of the first places in the structure of purulent complications. Despite the im provement of methods of diagnosis and treatment, mortality in postoperative purulent peritonitis remains quite high.Aim of the study: develop a reproducible model of postoperative general peritonitis to study the pathophysiological mechanisms of its development and the development of pathogenetically substantiated therapy.Materials and methods. The study was performed on 18 Wistar male rats aged 6 months, weighing 250–300 grams. Animals underwent laparotomy and modeling of postoperative general peritonitis according to the proposed method. Hospital strains of Escherichia coli BRLS 109 and Bacteroides fragilis 109 (strain ISCST1982, registered in Genbank), which we isolated from patients with acute appendicitis, with a total volume of 1.0 ml per animal, were used as infectious agents. Animals were taken out of the experiment under anesthesia with compliance with the rules of euthanasia at 1st, 3rd, 7th days after surgery. For morphological studies, samples of a fragment of the abdominal wall and cecum were taken. Bacteriological studies were performed on the 3rd, 7th day from the beginning of the experiment.Results. It was established that all animals developed peritonitis with the progression of purulent-destructive changes in the abdominal cavity and the development of adhesions, which was confirmed by the data of the morphological method of research. According to the results of bacteriological studies on the 3rd day, exudate infection was detected in all rats (in 100 % of observations). E. coli BLS were isolated in all cases at concentrations of 103–104 CFU/ml. The strain B. fragilis is inoculated in 3 animals at a concentration of 103 CFU/ml, which made 50 %. By the 7th day, only an aerobic E. coli strain of BLS was detected in peritoneal exudate at concentrations of 103 CFU/ml in the complete absence of growth of B. fragilis.Conclusion. We have developed a model of postoperative general peritonitis, which allows us to study the dynamics of the development of the inflammatory process in the abdominal cavity and, in terms of its clinical manifestations, is close to a real human disease. The reproducibility of the model is 100 %, which is confirmed by microbiological and morphological data.
Analysis of Long-Term Dynamics of Incidence of Healthcare-Associated Infections in the Irkutsk Region
Authors: Noskova O. A. , Potalitsyna N. E. , Savilov E. D. 
Published: July 2019

Introduction.Healthcare-associated infections incidence is one of the most pressing issues in modern healthcare due to their high abundance as well as economic loss they cause.The aimis to study regional features of the incidence of healthcare-associated infections.Methods.We conducted a retrospective epidemiological analysis of nosocomial morbidity in hospitals of the Irkutsk region within 2006-2017 years. We used data, presented in the following state reports: “On the state of sanitary and epidemiological welfare of the population in the Russian Federation”, “On the state of sanitary and epidemiological welfare of the population in the Irkutsk region”.Results and discussion.According to the results of the conducted analysis, it was shown that the average long-term prevalence of healthcare-associated infections in the Irkutsk region was 41.94 ± 2.040/00000 (Russian Federation – 17.49) with a tendency to stabilization in recent years. The therapeutic and prophylactic organizations of the surgical profile have the highest epidemiological significance (over 51 %). At the same time, the share of postoperative complications during the study period decreased by 1.5 times. We have noted a rising trend line with a positive rate of increase in the incidence of nosocomial pneumonia, which in the last two years has taken a leading position in the structure of healthcare-associated infections. The incidence of infections in newborns in the Irkutsk region ranks the third, with a specific weight of 11.54 %. Moreover, if before 2013 purulent-septic diseases of the newborns were the predominant nosological form, in recent years pneumonia has firmly taken over the leadership. During the study period we revealed an increase in the incidence of postpartum endometritis in puerperas. It has been shown that the registration of sepsis, urinary tract infections in the region is low.
Genetic Aspects of Pathogenesis of Congenital Spastic Cerebral Paralysis
Authors: Prityko A. G. , Chebanenko N. V. , Sokolov P. L. , Zykov V. P. , Klimchuk O. V. , Kanivets I. V. 
Published: July 2019

Congenital spastic cerebral palsy (СР) is a large group of non-progressive disorders of the nervous system. The basis of the pathogenesis of these conditions is considered the impact of many factors. The clinical diversity of the disease and the syndromic principle of classification determine the existing uncertainties in the diagnosis of these diseases. The multifactorial nature of the underlying brain lesions is obvious and beyond doubt. The volume of information accumulated to date does not allow one to exclude the role and significance of the direct effect of acute asphyxiation in childbirth on a fetus normally formed during pregnancy, the role of infectious brain lesions, and disorders of neuronal migration. It is impossible to ignore the dependence of the clinical picture of the disease on what stage of ontogenesis the impact of the damaging agent occurs. As one of the pathogenetic factors, the genetic determinism of the phenotype of the clinical picture of a disease is fairly considered. This review focuses on the genetic aspects of the pathogenesis of this pathology. The information on monogenic mechanisms of inheritance is analyzed in detail. Such genetically determined mechanisms of pathogenesis as the inheritance of prerequisites for brain trauma in the perinatal period are considered separately. The new clinically significant variants of chromosomal mutations found in patients with CР are reviewed in detail, the evidence of the influence of genetic factors on the development of cerebral palsy in the absence of a pronounced monogenic cause of the disease, obtained through twin studies, is reviewed. Lit search of polymorphisms markers of predisposition to the development of cerebral palsy genes of the folate cycle, genes of glutamate receptors, the gene of apolipoprotein and of the gene for the transcription factor of oligodendrocytes (OLIG2) in Detail the role of epigenetic effects on the activity of genes coding for mitochondrial proteins.
Pharmacogenetic Warfarin Dosing Algorithm in the Russian Population
Authors: Bairova T. A. , Sambyalova A. Yu. , Rychkova L. V. , Novikova E. A. , Belyalov F. I. , Sargaeva D. S. , Shchedreeva E. A. , Ignatyeva T. G. , Ershova O. A. , Pustozerov V. G. , Kovaleva O. A. , Rasputina I. V. , Noskova I. A. , Batogova T. V. , Kuznetsova O. V. , Bogoslova O. Yu. , Kolesnikov S. I. 
Published: July 2019

Background. To date, there are many pharmacogenetic algorithms for selecting the dose of warfarin. However, there is very little information about the predictive accuracy of the algorithms. We decided to evaluate the predictive accuracy of the Gage algorithm, using a calculator, located on the web site (http://www.warfarindosing.org) in two ethnic groups (Caucasians and Asians), living in Russia.Aim. To compare the actual warfarin dose (AWD) to the calculated warfarin dose (CWD), using the algorithm in two ethnic groups taking warfarin.Materials and methods. We included 114 patients (66 Caucasians and 48 Asians): the mean age was60.91 ± 12.34 years; 61 (53.51 %) men, and 53 (46.49 %) women. The comparative characteristics of the algorithm were tested using the mean absolute error (MAE) between AWD and CWD, and percentage of patients, whose CWD fell within 20 % of AWD (percentage within 20 %). Genotyping for CYP2C9*2, CYP2C9*3, CYP4F*2 and VKORC1 was performed by real-time polymerase chain reaction (RT-PCR) method using Pharmacogenetics Warfarin reagent kits (DNA technology, Russia).Results. The Gage algorithm produced the predictive accuracy with MAE = 1.02 ± 0.16 mg/day and percentage within 20 % for Asian patients was 39.6 %. We obtained MAE = 1.33 ± 0.16 mg/day and percentage within 20 % for Caucasian patients was 40.9 %. In two ethnic groups (Caucasians and Asians) of the Russian population, overall performance of warfarin pharmacogenetic dosing by the Gage algorithm was similar.Conclusions. Despite the performance limitation of the current warfarin pharmacogenetic dosing Gage algorithm, constant international normalized ratio monitoring is important.
Relative Risk Assessment of Intrauterine Infection of the Fetus During Cytomegalovirus Infection in Early Pregnancy
Authors: Petrova K. K. 
Published: July 2019

Background. Intrauterine fetal infection (IUI), the common cause of which is the cytomegalovirus (CMV), occupies one of the first places in the structure of perinatal morbidity and mortality. There are no data on the relative risk assessment of IUI at the exacerbation of CMV infection and its delitescent course in first trimester of pregnancy in the literature.Aim: to calculate the relative risks of fetal IUI in pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Methods. A retrospective review of the labor and delivery medical records and prenatal records of 104 CMV-seropositive women was carried out. Fifty of these women had an exacerbation of CMV infection in the first trimester of pregnancy – main group and 54 of them were with delitescent course of the disease (comparison group).Results. A comparative analysis of ultrasound and morphological markers of IUI with risk assessment depending on the course of CMV infection in the first trimester of pregnancy has been carried out. A high risk of placental structure abnormalities, as well as amniotic fluid and fetal membranes, fetal and placental blood flow pathology, onset of choroid plexus cyst and fetal growth restriction was found, with a statistically significant difference in the group of pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.Conclusion. The findings suggest that the exacerbation of CMV infection in early pregnancy is a risk factor for IUI.
Strategi Literasi dalam Pembelajaran Matematika pada Era Industri 4.0
Authors: Baiduri Baiduri 
Published: July 2019

Setiap siswa atau manusia ingin sukses, baik secara akademik maupun dalam kehidupan kesehariannya. Kehadiran industri 4.0 membawah perubahan yang sangat cepat, tidak hanya dalam dunia manufaktur dan produksi tetapi juga dalam skill yang dibutuhkan di dunia kerja. Kecapakan yang sangat penting dan mendasar untuk ini adalah kecakapan bahasa dan kecakapan matematika. Kecakapan matematika meliputi kosakata dan notasi, ruang dan bentuk, numerasi, dan kuantitatif. Makna yang tersirat dalam kecakapan (literasi) matematika adalah kemampuan untuk mengajukan, merumuskan, dan memecahkan masalah intra dan ekstra matematika dengan bahasa yang dapat dimengerti oleh orang lain umumnya dan matematikawan pada khususnya. Berbagai strategi literasi dibahas secara teoritis dan implementasinya dalam pembelajaran matematika supaya dapat mahir secara matematis agar dapat mengambil keuntungan hadirnya era industri 4.0 atau era setelahnya.
Long-term results of complex therapy in patients with nonreconstructible chronic lower limb ischemia
Authors: N. Yu. Litvinova  , D. E. Dubenko  , O. I. Kefeli-Yanovska  
Published: July 2019

The aim — to improve the results of surgical treatment of patients with chronic critical lower limb ischemia by developing methods of autologous transplantation of multipotent stem mesenchymal stromal cells, administration of endothelial cells growth factors and therapeutic and diagnostic measures to preserve the lower limb or reduce the level of its amputation, reduce ischemia and the frequency of disability of such patients, improve their quality of life.Materials and methods. The study included 110 patients with a clinical picture of pain at rest, ischemic edema, and trophic changes (IIIA, IIIB, and IV stage of lower limb ischemia according to the classification of the European Association of Angiologists and Vascular Surgeons) caused by nonreconstructible occlusive and obliterating diseases of lower limb arteries. The patients were divided into three groups according to the method of treatment: in the 1st group (n = 48), revascularization osteotrepanation was performed as an operation of indirect revascularization, in the 2nd group (n = 21) a drug of endothelial cells growth factor was administered to stimulate their own angiogenesis, in the 3rd group (n = 41) subcutaneous fat was collected, autologous mesenchymal cells were cultivated and transplanted according to the developed technique. The control group of patients (n = 50) was selected retrospectively according to the case histories in accordance with the criteria of involvement and the results of treatment which could be followed up in a 3‑year observation period.Results and discussion. The safety of the lower limb in the 3rd group was statistically more significant than in the 1st and 2nd groups and remained at the level of 82 % after three years of observation. The smallest number of large amputations was in the 3rd group (2.3 % — above knee‑joint and 7.3 % — below, knee‑joint whereas in the control group the number was 18 % and 24 %, respectively).Conclusions. The level of high amputations directly affects the life expectancy of patients. Only treatment in the 3rd group reduced the risk of large amputation compared with the control group (odds ratio 2.752 (95 % confidence interval — 1.12 — 6.733)). Only treatment in the 3rd group reduced the risk of amputation compared with other types of treatment (odds ratio 0.358 (95 % confidence interval 1.111 — 1.158).
Determination of indications for and long-term results of femoral-popliteal (distal) alloshunting using polytetrafluoroethylene implants in patients with obliterating atherosclerosis on the background of critical ischemia
Authors: A. M. Bytsai  
Published: July 2019

The aim — improvement of the results of reconstructive operations in patients with obliterating atherosclerosis of the vessels of lower extremities with multiple occlusal‑stenotic lesions on the background of critical ischemia.Materials and methods. The distant results were analyzed of femoropopliteal (distal) alloshunting with the use of polytetrafluoroethylene (PTFE) implants in 121 patients with two‑level occlusive‑stenotic lesions of the lower extremities. The group of patients with «satisfactory» state of distal blood flow, according to Rutherford, was divided into 2 subgroups, depending on the level of distal retrograde blood flow (according to the indications of intraoperative debitometry).Results and discussion. A comparative retrospective analysis of the results of the reconstructions showed a direct dependence of early and distant results of operations on the level of lesion of shank and foot distal blood flow. A differentiated approach in patients with «satisfactory» distal blood flow, according to Rutherford, allowed optimizing the surgical tactics and determining the indications for surgical intervention due to the use of intraoperative debitometry.Conclusions. Determination of quantitative indices of retrograde blood circulation with intraoperative debitometry allows objectivizing the status of the distal bed of the lower extremities, improving the results of the femoro‑popliteal (distal) alloshunting in the remote observation period (up to 4 years). When diagnosing the retrograde blood flow to the popliteal artery less than 60 ml/min, the patient has a high risk of thrombosis of the femoro‑popliteal (distal) alloshunt in the first year of observation. The use of the «Gincor Forte» drug can effectively reduce the manifestations of secondary lympho‑venous insufficiency on the background of reperfusion syndrome in 85 % of patients after the femoro‑popliteal (distal) alloshunt.
Changes of indices of diurnal blood pressure monitoring under the influence of treatment in patients with essential hypertension complicated with hemorrhagic stroke after early recovery period
Authors: O. V. Tkachyshyn  
Published: July 2019

The aim — to compare the indices of diurnal blood pressure monitoring (DBPM) in patients with essential hypertension (EH) іn ≥ 6 months after hemorrhagic stroke (HS) before and after treatment with combination of amlodipine, valsartan, hydroclorothiazide (if necessary) and magnesium oxide monohydrate.Materials and methods. The main group included 33 patients, the comparison group comprised 13 persons. In the first group the office blood pressure (BP) was і 140/90 mm Hg, in the second one it was lower. The groups were matched by main indicators. DBPM was performed twice (before and after treatment) for the main group of patients, and once for the comparison group patients.Results and discussion. In the main group, before and after treatment the mean systolic blood pressure (SBP) was 110.1 ± 16.0 mm Hg and 102.3 ± 12.6 mm Hg, respectively, at daytime, 102.6 ± 17.3 and 83.9 ± 8.1 mm Hg at night, 109.7 ± 15.7 and 96.3 ± 11.9 mm Hg (p < 0.05) per day. The maximum SBP at daytime in the main group was higher before the treatment (169.3 ± 18.4 mm Hg, p < 0.05). The value of the standard deviation of SBP and pulse BP decreased after treatment (p < 0.05). The value of the mean real variability of SBP in the main group was 11.27 ± 2.73 mm Hg before treatment and 9.74 ± 1.84 mm Hg (p < 0.05) after it. Diurnal index of SBD in the main group was 4.95 ± 9.67 % before treatment and 11.44 ± 5.43 % after it.Conclusions. The treatment of patients with EH, who had suffered HS ≥ 6 months before and had office BP ≥ 140/90  mm Hg, with combination of amlodipine (daily dose 5 — 10 mg), valsartan (daily dose 80 — 160 mg), hydroclorothiazide (12.5 mg if necessary) on the basis of chronotherapy approach and magnesium oxide monohydrate (456 mg daily during 1 month period) permits achieving the control of BP according to DBPM data in 73 % of patients. This treatment also permits statistically significant decreasing of short‑term BP variability, in particular, the standard deviation in all time intervals and the average real variability of SBD.
Risk factors for death at long-term follow-up after acute coronary syndrome in patients with atrial fibrillation
Authors: V. Y. Tseluyko  , F. Ben Salem  , O. E. Matuzok  
Published: July 2019

The aim — to evaluate the predictive significance of clinical, instrumental and laboratory parameters regarding the mortality of patients with acute coronary syndrome (ACS) and atrial fibrillation (AF) at long‑term follow‑up (over 2 years).Materials and methods. We examined 125 patients with ACS. In 26 (18; 40) months, the information regarding the vital status was collected. The data was available for 67 patients. 22 (32.8 %) of them developed new‑onset AF during the acute disease phase; 11 (16.4 %) had AF before ACS; 34 (50.8 %) had no signs of AF in their medical history and during hospitalization. Blood samples for determination of N‑terminal fragment of brain natriuretic peptide (NT‑proBNP) were taken during the first 24 hours of the disease by enzyme immunoassay.Results and discussion. 14 patients died during the follow‑up period, the mortality rate was 20.9 %. Mortality in patients who developed new‑onset AF on the background of ACS was higher than mortality in patients without AF (36.4 % vs 11.8 %, respectively; р = 0.033); odds ratio was 4.29 (95 % confidence interval — 1.08 — 14.62). Mortality in men was 12.5 %, in women — 33.3 % (р = 0.040). Percentage of smokers was statistically significantly higher in patients who survived (р = 0.007). Prevalence of anemia was 11.3 % in patients who survived and 57.1 % in patients who died (р = 0.0001). Patients who died had higher levels of NT‑proBNP (р = 0.016), glycemia (р = 0.008) and C‑reactive protein (р = 0.005) at admission. ROC‑analysis showed that the risk of death was associated with red blood cell count ≤ 4.09 · 1012/l (р = 0.0004), hemoglobin level ≤ 117 g/l (р = 0.0008), glycemia > 6.6 mmol/l (р = 0.002), C‑reactive protein > 24 mg/l (р = 0.0008), NT‑proBNP > 1788 pg/ml (р < 0.0001).Conclusions. Mortality of patients after ACS at 26 (18; 40) month follow‑up was 20.9 %. Mortality in patients who developed new‑onset AF on the background of ACS was 36.4 %, which was statistically significantly higher than mortality in patients without AF. Female patients, patients with anemia and non‑smokers were more likely to die. ROC‑analysis established laboratory test indices associated with the death risk.
Role of single nucleotide Т786C polymorphism of endothelial NO-synthase gene after myocardial infarction with ST-segment elevation
Authors: O. V. Petyunina  , M. P. Kopytsya  , A. E. Berezin  , D. P. Babichev  
Published: July 2019

The aim — of research was to investigate possible associations between single nucleotide T786C polymorphism of endothelial NO‑synthase (eNOS) gene and clinical events in acute period of myocardial infarction with ST segment elevation (STEMI) and after 6 months of follow‑up.Materials and methods. 177 patients with acute STEMI (139 (78.5 %) males and 38 (21.5 %) females) at average age 61.73 ± 9.44 years that were included to the study between January 2016 and July 2018 were examined. Primary percutaneous coronary intervention using bare‑metal stent (BMS) was performed in 133 patients. In 44 patients system thrombolyses were previously performed. All patients were able to achieve recovery of blood flow at TIMI III level. To determine the T786C polymorphism of the eNOS gene, polymerase chain reaction was used with an electrophoretic scheme for detecting the result in real time. The combined endpoint (repeated hospitalization, de novo heart failure, angina pectoris, cardiovascular death, which occurred 6 months after discharge from the hospital) was analyzed.Results and discussion. The combined endpoint was observed in 24 carriers of 786TT genotype of eNOS gene, in 23 individuals with the 786TC genotype and in 25 patients with 786CC genotype. Kaplan‑Meier curves showed that patients with STEMI carriers of 786CC genotype had a higher incidence of a combined endpoint than individuals with the 786TC and 786TT genotypes after 6 months of follow‑up. Multivariate logistic regression analysis revealed that the 786CC polymorphism of eNOS gene is an independent predictor of adverse clinical events 6 months after STEMI.Conclusions. Along with traditional risk factors (SYNTAX score, TIMI score, abdominal obesity) 786СС polymorphism of eNOS gene was found as an independent predictor for adverse cardiovascular events in 6‑month observation period after successful primary percutaneous coronary intervention in STEMI patients.