A global research priority agenda to advance public health responses to fatty liver disease

Background & aims An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community. Methods Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy. Results The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of ‘agree’ responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement (‘agree’ + ‘somewhat agree’); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% ‘agree’), 13 priorities had 90% combined agreement. Conclusions Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community’s efforts to advance and accelerate responses to this widespread and fast-growing public health threat. Impact and implications An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat

Features of the Frequency of Distribution of Alleles and Genotypes of Polymorphisms of the Gene Tnf-A (G-308a) in Patients with Rhinosinusitis and the Assessment of Their Role in the Development of This Pathology

In this work, we present the results of studying the characteristics of the distribution of allelic and genotypic frequencies of polymorphic variants of the cytokine gene TNF-? (G-308A) among patients with rhinosinusitis with and without chronic myeloid leukemia (CML), as well as among conditionally healthy individuals. At the same time, we assessed the role of this gene in the development of rhinosinusitis. Analysis of the frequency of occurrence of alleles and genotypes for gene TNF-? (G-308A) polymorphism revealed insignificant differences in the 1st main group of CML patients with rhinosinusitis compared with the control group. Thus, the established absence of significant differences in the frequency of occurrence of the A allele (7.7% versus 8.1%; ?2 <3.85; p> 0.05; OR = 0.95; 95% CI: 0.43-2.6) and genotype G/A (15.4% against 16.2%; ?2<3.85; p> 0.05; OR = 0.94; 95% CI: 0.37-2.4), indicates the absence of their significance in the increased risk of rhinosinusitis in the main group of CML patients. A similar picture was also observed in subgroups 1A and 1B of patients in the main group.&nbsp

Active orthostatic responses in healthy persons and AH and COPD patients in the Surgut-sity

Активная ортостатическая проба была использована у 510 мужчин и 528 женщин жителей региона нефтяных и газовых месторождений. Гемодинамические эффекты активной ортостатической пробы были отмечены у здоровых и больных изолированной артериальной гипертензией и ее сочетанием с хронической обструктивной болезнью легких. Были сформированы 4 возрастные группы мужчин и женщин в возрасте 1721, 2235, 3660 и старше лет. Молодые родились на Севере, старшие прожили на Севере более 20 лет. Здоровые мужчины и женщины демонстрировали классическую форму активной ортостатической пробы, парасимпатическое превалирование вегетативной регуляции, усиление сократительной функции миокарда. У больных артериальной гипертензией происходило снижение гемодинамических ответов, приближение индекса вегетативной регуляции к балансу, повышение инотропной функции сердца. Общая картина изменений параметров сохранялась у пациентов с сочетанной патологией, но была менее выражена.The article reports on a research on active orthostatic response of 510 men and 528 women residing in oil and gas production regions. The hemodynamic effects of the active orthostatic response are defined for the healthy persons as well as patients with isolated arterial hypertension (AH) and its association with chronic obstructive pulmonary disease (COPD). There are 4 age groups including men and women aged 17-21; 22-35; 36-60 and over 60 years of age. The young generation was born in the Far North; the older generation has been living in the Far North for over 20 years. The healthy men and women demonstrate a classic form of the active orthostatic response, parasympathetic prevalence in vegetative regulation, increase of the myocardial contractile function. The AH patients demonstrate decreased hemodynamic parameters, approach of the vegetative regulation index to balance, and increased inotropy. Generally, patients having associated pathologies have identical changes of the studied parameters; though with less distinct values

Environmental risk factors of human adaptation to the natural conditions of the middle Ob river basin

Показано, что развитие адаптационного процесса у новопоселенцев сопровождается смещением негативных реакций в более пожилой возраст. Включается цепь факторов роста климатического характера. Метеочувствительность имеет место у мужчин и женщин. Дисбаланс и рассогласование гомеостаза организма при развитии северного стресса вызываются параметрами погоды колебаниями атмосферного давления, температуры воздуха, силой ветра, низкой влажностью. Субъективные симптомы образуют три степени метеочувствительности. Показана зависимость напряжения функций организма от пола, возраста новопоселенцев северного города. Представлены неспецифические резистентные механизмы, обеспечиваемые кровью, в виде реакций повышенной чувствительности и стресса. Сопротивляемость психоэмоциональному стрессу снижается под влиянием экологических природных факторов. Ремиграция новопоселенцев на Север негативно влияет на метеочувствительность и стрессоустойчивость, ухудшая приспособительные реакции к экологическим условиям среды.The article shows that the development of the adaptation process of the new settlers is accompanied by a shift of the negative reactions to the older age. A chain of growth factors of climatic character is started. Meteosensitivity shows among men and women. Imbalance and misalignment of the homeostasis of the organism in the development of the «North stress» are induced by weather parameters – variations in atmospheric pressure, temperature, force of wind, low humidity. Subjective symptoms form three degrees of meteosensitivity. We demonstrate dependence of the functions of the body from the sex and age of the new settlers in the Northern city. Nonspecific resistant mechanisms are provided, caused by the blood in the form of hypersensitivity reactions and stress. Resistance to the psycho-emotional stress is reduced under the influence of natural environmental factors. Remigration of the settlers to the North has a negative effect on the meteosensitivity and resistance to stress, thus, decreasing the adaptive response to environmental conditions