High sleep reactivity: clinical, psychological and polysomnographic features

Background. The model of sleep reactivity to stress considers sleep reactivity to stress as a link in the pathogenesis of insomnia disorder – the degree to which stress disturbs sleep, which manifests as difficulty in initiating and maintaining sleep.The aim. To study clinical and psychological features as well as subjective and objective sleep indexes of subjects with high level of sleep reactivity to stress.Materials and methods. The psychological status, subjective indexes of sleep and sleep reactivity to stress according to Ford Insomnia Response to Stress Test were studied among 18–75 year-old subjects without significant sleep disturbances and patients with chronic insomnia. Polysomnography was performed for objective evaluation of sleep parameters.Results. It was found that individuals with high levels of sleep reactivity to stress were characterized by high levels of anxiety, restlessness, and neuroticism. According to results of Pittsburg questionnaire, a lower quality of sleep was revealed. These findings were correlated with objective indexes of sleep according to polysomnographic studies: less deep sleep and its lower efficiency due to sleep disturbances.Conclusions. Individuals with high sleep reactivity to stress are characterized by greater anxiety combined with subjective and objective sleep disturbance like insomnia type

Local representative democracy and protest politics:the case of the Five-star Movement

In recent years, protest politics has become a relevant phenomenon in various European countries. Italy has witnessed the rise of the Five-star Movement (M5S), an anti-establishment party, which, at the 2013 general election, obtained one-fourth of the total votes. However, the story of this ‘party-movement’ started at the local level, as a civic network aimed at changing administrative practices in municipal government. By using an original dataset on representation in 671 Italian municipalities from 2010 to 2014, this article aims to explain not only the subnational political success of the M5S but also the challenges and contradictions that a newly formed movement faces in multi-level electoral arenas

ВАЗОНЕВРАЛЬНАЯ КОМПРЕССИЯ: СООТНОШЕНИЯ СОСУДА И REZ У ПАЦИЕНТОВ С ТРИГЕМИНАЛЬНОЙ НЕВРАЛГИЕЙ

Trigeminal neuralgia in most cases caused by compression of trigeminal nerve or its branches with vessels. Compression may locate in root entry zone (REZ) or in a distance from it. The aim of the study is to compare distances from REZ of trigeminal nerve to offending vessel on the symptomatic side to distance to the same vessel on asymptomatic side. Comparing this distances showed significantly shorter distance on symptomatic side. Thus, it could be concluded that this factor has its part in development of trigeminal neuralgia.Тригеминальная невралгия чаще всего вызывается компрессией тройничного нерва или его ветвей сосудистыми структурами. Компрессия может происходить как в зоне выхода корешка из ствола, так называемой root entry zone (REZ), так и на его протяжении. Целью данного исследования является сравнение расстояния от выходной зоны нервного корешка 5-го нерва до «виновного» сосуда в сравнении с аналогичным параметром асимптомной стороны. При сравнении этих показателей расстояние на симптомной стороне было меньше, чем на асимптомной. Это позволяет сделать вывод о влиянии данного фактора на развитие тригеминальной невралгии

COVID-19 у больных муковисцидозом

Since the beginning of the COVID-19 epidemic, the European cystic fibrosis society (ECFS) has decided to launch a special ECFS-COVID-19 program to collect information on the of COVID-19 characteristics in the patients with cystic fibrosis (CF). The results of the program should help timely and efficiently provide the patients with CF with the necessary care. Initially, it was assumed that COVID-19 would be severe in CF patients. The aim. Тo assess the prevalence and characteristics of COVID-19 in patients with cystic fibrosis (CF) in the Russian Federation (RF). Methods. 6 cases (4 children and 2 adults) of COVID-19 in Russian CF patients were analyzed. Results. There are 405,843 infected with SARS-CoV-2 in Russia, the incidence of coronavirus infection in Russia was 1.4 cases per 1 thousand people. According to the Ministry of Health of the RF, as of December 2019, there were 3,931 patients with CF (2,823 children and 1,108 adults). The incidence of COVID-19 was 1.5 per 1000 patients with CF (1.4 : 1,000 for children and 1.8 : 1,000 for adults). The incidence was not higher than in the General population. The diagnosis of COVID-19 was confirmed in 4 boys and 2 women, 3 of the patients were infected with Pseudomonas aeruginosa and 2 – with Achromobacter spp. Mild disease was seen in 5 patients including all the children. Pneumonia was registered in 3 patients. One child with COVID-19 had abdominal syndrome. 2 patients – 1 adult and 1 child – needed in-patient care. Additional antibiotics were given to 4 patients, 2 of them received i/v antibiotics. One adult patient was on the lung transplantation waiting list. This woman had long-term oxygen therapy and BiPAP noninvasive respiratory support before the infection with SARS-CoV-2, FEV1 was 24 %pred. Conclusion. Despite the fact that patients with CF are at risk of severe COVID-19, to date, in the described cases, COVID-19 infection has not led to a significant deterioration of the symptoms of CF. Not a single fatal outcome in Russian patients with CF has been recorded.С начала эпидемии COVID-19 Европейским обществом по муковисцидозу (European Cystic Fibrosis Society – ECFS) инициирована специальная программа наблюдения ECFS-COVID-19 для сбора информации по особенностям течения COVID-19 у пациентов с муковисцидозом (МВ). Ожидается, что данная программа должна помочь своевременно и качественно оказывать необходимую помощь пациентам с МВ. Первоначально предполагалось, что на фоне МВ COVID-19 протекать будет тяжело. Целью исследования явилась оценка распространенности и течения COVID-19 у пациентов с МВ в Российской Федерации. Материалы и методы. Проанализированы 6 (4 ребенка и 2 взрослых) случаев заболевания COVID-19 у российских пациентов с МВ. Результаты. В Российской Федерации SARSCoV-2 инфицированы 405 843 человека, заболеваемость коронавирусной инфекцией составила 1,4 случая на 1 тыс. населения. Учитывая численность пациентов в регистре МВ (по данным Министерства здравоохранения Российской Федерации, на декабрь 2019 г. в регистр включен 3 931 пациент: 2 823 ребенка и 1 108 взрослых), заболеваемость SARS-CoV-2 составила около 1,5 на 1 тыс. пациентов с МВ (1,4 : 1 000 – для детей и 1,8 : 1 000 – для взрослых), что не превышает таковую в общей популяции. Заболеваемость COVID-19 на 01.08.20 среди пациентов с МВ составила 3,8 (0,38 %) на 1 тыс. пациентов (2,1 : 1 000 – для детей и 8,8 : 1 000 – для взрослых). Диагноз COVID-19 подтвердился у 4 детей (все мальчики) и 2 взрослых женщин, при этом 3 больных были инфицированы Pseudomonas aeruginosa, 2 – Achromobacter spp. В легкой форме заболевание протекало у 4 из 6 пациентов, включая всех детей, пневмония зарегистрирована у 3 пациентов. У одного из 4 детей с COVID-19 отмечался абдоминальный синдром при отсутствии респираторных проявлений; 2 пациента (1 взрослый и 1 ребенок) нуждались в стационарном лечении. Антибактериальная терапия назначена 4 пациентам, двум из них – внутривенно. Одна взрослая пациентка, объем форсированного выдоха за 1-ю секунду у которой составлял 24 %долж. , зарегистрирована в листе ожидания на трансплантацию легких, до заражения SARS-CoV-2 у нее проводились длительная кислородотерапия и неинвазивная респираторная поддержка BiPAP. При подтверждении коронавирусной инфекции она была выписана из больницы. Заключение. Несмотря на то что пациенты с МВ находятся в группе риска тяжелого течения заболевания, на сегодняшний день в описанных случаях COVID-19 инфекция не привела к значительному ухудшению состояния по основному заболеванию. У российских пациентов с МВ не зарегистрировано ни одного летального исхода

РЕДКИЙ СЛУЧАЙ ПЕРВИЧНО-МНОЖЕСТВЕННОЙ ОПУХОЛИ У НОСИТЕЛЬНИЦЫ МУТАЦИИ В ГЕНЕ BRCA1: BRCA-АССОЦИИРОВАННЫЙ РАК ЯИЧНИКОВ И КАРЦИНОИД ЛЁГКОГО

Inherited mutations in the BRCA1 and BRCA2 genes more often provoke the development of metachronous tumors compared to the general population. Women who carry inherited BRCA1 mutations have an increased risk of developing not only breast and ovarian cancers, but they have also increased risks of developing other types of cancers, such as  cervical cancer, endometrial (uterine), ovarian, pancreatic, prostate, and salivary gland  cancers. Common views on the pathogenesis of hereditary cancers imply that the development of the tumor is always preceded by the loss of the remaining (normal) allele of the involved gene. Nevertheless, there is reliable information that some BRCA1-associated ovarian cancers demonstrate retention of the second BRCA1copy. We report a rare case of the development of neuroendocrine cell carcinoma- metachronous ovarian cancer and lung carcinoid tumor in the patient with the BRCA1 gene mutation. In addition, the tumor demonstrated loss of heterozygosity at the BRCA1 locus (loss of the wild-type allele).Наследственные мутации в генах BRCA1 и BRCA2 чаще провоцируют развитие метахронных опухолей по сравнению с общей популяцией. У носительниц в гене BRCA1 фатально повышен риск развития рака молочной железы и яичников, а также других неоплазий: рака шейки матки, эндометрия, маточной трубы, поджелудочной железы, яичек, предстательной железы, слюнных желез. Общепринятые представления о патогенезе наследственных раков подразумевают, что развитию опухоли всегда предшествует утрата оставшегося (нормального) аллеля вовлечённого гена. Тем не менее существуют достоверные сведения о том, что некоторые BRCA1-ассоциированные РЯ демонстрируют сохранность второй копии BRCA1. В работе впервые описан клинический случай развития нейроэндокринной опухоли – метахронного рака яичника и карциноида лёгкого у больной, носительницы мутации в гене BRCA1. Кроме того, в опухоли продемонстрирован феномен потери гетерозиготности в локусе гена BRCA1 (утрата аллеля дикого типа)

Determination of “borderline resectable” pancreatic cancer – A global assessment of 30 shades of grey

Background: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a poor prognosis. Accurate preoperative assessment using computed tomography (CT) to determine resectability is crucial in ensuring patients are offered the most appropriate therapeutic strategy. Despite the use of classification guidelines, any interobserver variability between reviewing surgeons and radiologists may confound decisions influencing patient treatment pathways. Methods: In this multicentre observational study, an international group of 96 clinicians (42 hepatopancreatobiliary surgeons and 54 radiologists) were surveyed and asked to report 30 pancreatic CT scans of pancreatic cancer deemed borderline at respective multidisciplinary meetings (MDM). The degree of interobserver agreement in resectability among radiologists and surgeons was assessed and subgroup regression analysis was performed. Results: Interobserver variability between reviewers was high with no unanimous agreement. Overall interobserver agreement was fair with a kappa value of 0.32 with a higher rate of agreement among radiologists over surgeons. Conclusion: Interobserver variability among radiologists and surgeons globally is high, calling into question the consistency of clinical decision making for patients with PDAC and suggesting that central review may be required for studies of neoadjuvant or adjuvant approaches in future as well as ongoing quality control initiatives, even amongst experts in the field

Towards framing the global in Global Development: prospects for development geography

This paper examines data in the public sphere on the global scope of geography’s UKRI Global Challenges Research Fund (GCRF) projects. Building on decolonial critiques of development research, I argue that geography should frame ‘the global’ of global research as a sphere of ethical choices in research design and practice. The distribution of funded projects in the UKRI Gateway data suggests geographers succeed where they extend on the more worthy aspects of the discipline’s Area Studies legacy. The discipline’s engagements with Early Career Researchers, international colleagues, and the development sector, however, have potentially been reshaped by GCRF and thus need closer examination. While the UK government has brought the GCRF programme to a close, further work on these themes should inform the next iteration of global research. The ethical choices which make research global will remain fundamental to equitable design and impact in Global Development projects, thus scholars in development geography should prepare to make their projects more transparent and accountable