Communicative Situation of Oral Professional Communication within English-Language Medical Discourse

The article is devoted to scientific and professional communication between specialists in one of the fields, namely the medical discourse. The research is based on English texts of the dialogues of the doctors from the TV series “House” and “ER” as well as the texts of scientific and medical discussions, freely available on the Internet. The objective characteristics of the communicative situation are identified and described. It is proved that the dominants of communicative situation of scientific and professional communication are institutional character, formality / informality of the situation, communicative goal, language of scientific and professional communication, communication modus. Special attention is given to professional language subsystem. The typology of physician’s professional language is proposed with the identification of groups of vocabulary related to medical terminology and medical jargon. The latter group includes medical slang and professionalisms. Variation is observed in switching terminology busy code to the code based on the medical parlance. The novelty of the research lies in the fact that medical professional communication qualifies as equal status communication because it is a collaboration of specialists. The author divides the situation of symmetric and asymmetric communication modes. The features of such communicative events as discussion of private clinical case and medical research discussion are commented. Each of them has a list of signs that determine the peculiarities of communicative behaviour of the participants of the situation

Desquamated endothelial cells and nitrogen oxide as markers of endothelial damage and dysfunction in osteoarthritis of female workers in manual labor

The markers of endothelial dysfunction in female patients with osteoarthritis (manual labor workers) have been investigated, the presence of the following symptoms has been revealed: increase of desquamated endothelial cells content, reducing the concentration of the nitrogen oxide in comparison with a reference group; all this leads to disruption of the haemostasis microcirculation and the disease progression.У пациенток с остеоартрозом (работниц физического труда) исследованы маркеры эндотелиальной дисфункции, выявлено наличие следующих признаков: увеличение содержания десквамированных эндотелиоцитов, снижение концентрации оксида азота по сравнению с контрольной группой, что приводит к нарушению микроциркуляции, гемоваскулярного гомеостаза и к прогрессированию заболевания

Toxicity of laser irradiated photoactive fluoride PrF3 nanoparticles toward bacteria

© Published under licence by IOP Publishing Ltd. The article is devoted to exploration of biological effects of crystalline PrF3 nanoparticles toward Salmonella typhimurium TA 98 bacteria under the laser irradiation. Obtained results show bactericidal activity of PrF3 nanoparticles and optimal parameters of laser irradiation (power of laser irradiation, wavelength, diameter of the laser spoil, and exposure time) have been found under which the effects of bactericidal activity become the most significant. Survival of bacterial cells under laser irradiation with wavelength 532 nm in colloidal solution of PrF3 nanoparticles was 39%, 34%, 20% for exposure times 5 minutes, 15 minutes and 30 minutes, correspondingly

β-Adrenergic Inhibition of Contractility in L6 Skeletal Muscle Cells

The β-adrenoceptors (β-ARs) control many cellular processes. Here, we show that β-ARs inhibit calcium depletion-induced cell contractility and subsequent cell detachment of L6 skeletal muscle cells. The mechanism underlying the cell detachment inhibition was studied by using a quantitative cell detachment assay. We demonstrate that cell detachment induced by depletion of extracellular calcium is due to myosin- and ROCK-dependent contractility. The β-AR inhibition of L6 skeletal muscle cell detachment was shown to be mediated by the β2-AR and increased cAMP but was surprisingly not dependent on the classical downstream effectors PKA or Epac, nor was it dependent on PKG, PI3K or PKC. However, inhibition of potassium channels blocks the β2-AR mediated effects. Furthermore, activation of potassium channels fully mimicked the results of β2-AR activation. In conclusion, we present a novel finding that β2-AR signaling inhibits contractility and thus cell detachment in L6 skeletal muscle cells by a cAMP and potassium channel dependent mechanism

Differential immuno-reactivity to genomic DNA, RNA and mitochondrial DNA is associated with auto-immunity

© 2015 S. Karger AG, Basel. Background: Circulating auto-reactive antibodies are hallmark features of auto-immune diseases, however little is known with respect to the specificity of such bio-markers. In the present study, we investigated the specificity of anti-nucleic acid antibodies in the blood of subjects with systemic lupus erythematosus (SLE) and healthy controls. Methods: Sera from 12 SLE cases and 8 controls were evaluated for immuno-reactivity to purified RNA, DNA and mitochondrial DNA (mtDNA) by enzyme-linked immuno-sorbent assay (ELISA). Results: As expected, immuno-reactivity to total nucleic acids was significantly higher in subjects with SLE when compared to healthy controls, however a clear distinction was observed among the various nucleic acid sub-types, with sera from SLE subjects displaying the greatest immuno-reactivity to RNA followed by mtDNA and then total DNA. Conclusion: The identification of auto-reactive antibodies can serve as highly sensitive biomarkers, although their specificity may not always allow diagnostic certainty. The knowledge that auto-antibodies in subjects with SLE display differential immuno-reactivity may help to improve existing diagnostics and may lead to a better understanding of the pathogenesis of auto-immune disorders

An Experimental DUAL Model of Advanced Liver Damage

Individuals exhibiting an intermediate alcohol drinking pattern in conjunction with signs of metabolic risk present clinical features of both alcohol-associated and metabolic-associated fatty liver diseases. However, such combination remains an unexplored area of great interest, given the increasing number of patients affected. In the present study, we aimed to develop a preclinical DUAL (alcohol-associated liver disease plus metabolic-associated fatty liver disease) model in mice. C57BL/6 mice received 10% vol/vol alcohol in sweetened drinking water in combination with a Western diet for 10, 23, and 52 weeks (DUAL model). Animals fed with DUAL diet elicited a significant increase in body mass index accompanied by a pronounced hypertrophy of adipocytes, hypercholesterolemia, and hyperglycemia. Significant liver damage was characterized by elevated plasma alanine aminotransferase and lactate dehydrogenase levels, extensive hepatomegaly, hepatocyte enlargement, ballooning, steatosis, hepatic cell death, and compensatory proliferation. Notably, DUAL animals developed lobular inflammation and advanced hepatic fibrosis. Sequentially, bridging cirrhotic changes were frequently observed after 12 months. Bulk RNA-sequencing analysis indicated that dysregulated molecular pathways in DUAL mice were similar to those of patients with steatohepatitis. Conclusion: Our DUAL model is characterized by obesity, glucose intolerance, liver damage, prominent steatohepatitis and fibrosis, as well as inflammation and fibrosis in white adipose tissue. Altogether, the DUAL model mimics all histological, metabolic, and transcriptomic gene signatures of human advanced steatohepatitis, and therefore serves as a preclinical tool for the development of therapeutic targets.Supported by EXOHEP-CM (S2017/BMD-3727), Ramón y Cajal (RYC-2014-15242 and RYC-2015-17438), NanoLiver-CM (Y2018/NMT-4949), COST Action (CA17112), AMMF (2018/117), ERAB (EA 18/14), MINECO Retos (SAF2016-78711 and SAF2017-87919-R), and German Research Foundation (DFG NE 2128/2-1, SFB 1382-403224013/A02, and SFB/TRR57/P04). FJC is a Gilead Research Liver Scholar. The research group belongs to the validated Research group Ref. 970935 “Liver Pathophysiology”, 920631 “Lymphocyte immunology”, 920361 “Immunogenética e inmunología de las mucosas” and IBL-6 (imas12-associated). FG and KZ are Chinese Scholarship Council (CSC) fellows. O.E.-V is supported by Beca FPI (associated to MINECO SAF2017-87919R) and R.B.-U. by Contratos predoctorales de personal investigador en formación UCM-Banco Santander (CT63/19)

Вопросы тройной терапии в лечении хронической обструктивной болезни легких. Комментарии к алгоритму. Резолюция Совета экспертов от 13.06.18 (Владивосток)

Minimizing the risk of exacerbations of chronic obstructive pulmonary disease (COPD) along with symptoms control are the most important therapeutic tasks in COPD. The effective solution of this problem is still being discussed. The prevention of COPD exacerbations is of social and economic importance and should be the primary concern in the treatment of this disease. Unresolved problems in the treatment of COPD are low patient compliance to therapy and side effects of medication. According to recent guidelines, in case of persistent COPD exacerbations with patients receiving long-acting bronchodilators (LABA), the use of inhaled corticosteroids (ICS) must be considered; this reduces the incidence of moderate and severe COPD exacerbations, especially if a patient has a history of bronchial asthma or blood and/or sputum eosinophilia. Availability of LABA/LAMA and ICS/LABA fixed combinations in Russia provides two possible options to administer a free triple combination consisting of a single LAMA plus ICS/LABA or ICS plus LAMA/LAMA. According to multiple trials, the use of fixed combinations could provide twice improvement in the patient adherence to the therapy, which therefore leads to higher efficiency. The main complaint about ICS with COPD patients is an increased risk of pneumonia as well as the development of systemic adverse reactions typical for corticosteroids. However, the use of extra-fine ICS could significantly reduce the risk of pneumonia compared with fine-particle inhalators and also increases the effectiveness of therapy as the pathological process in COPD mainly involves the small airways.Важнейшей задачей терапии хронической обструктивной болезни легких (ХОБЛ), наряду с контролем над симптомами, является уменьшение риска обострений. Эффективное решение данной задачи до сих пор обсуждается. Предотвращение обострений ХОБЛ имеет социальную и экономическую значимость и должно являться первостепенной задачей при лечении данного заболевания. Нере - шенными проблемами в лечении ХОБЛ являются низкая приверженность пациентов терапии и побочное действие лекарственных средств. Согласно актуальным клиническим рекомендациям, при сохранении обострений ХОБЛ у пациентов, принимающих комбинированную терапию длительно действующими бронходилататорами, следует рассматривать возможность использования ингаляционных глюкокортикоcтероидов (иГКС), при приеме которых снижается частота среднетяжелых и тяжелых обострений ХОБЛ, особенно при наличии бронхиальной астмы в анамнезе или эозинофилии крови или мокроты. Наличие на российском рынке фиксированных комбинаций длительно действующих β2-агонистов (ДДБА) / длительно действующих М-холинолитических препаратов (ДДАХП) и иГКС / ДДБА позволяет использовать 2 возможные опции для формирования свободной тройной комбинации – добавление к фиксированной комбинации иГКС / ДДБА монопрепарата ДДАХП и монопрепарата иГКС – к фиксированной комбинации ДДБА / ДДАХП. По данным многочисленных исследований, использование фиксированных комбинаций позволяет улучшить приверженность пациентов терапии приблизительно в 2 раза, что, в свою очередь, приводит к улучшению эффективности терапии. Основными претензиями к иГКС-содержащим препаратам при лечении больных ХОБЛ являются увеличение риска пневмоний, а также развитие системных нежелательных реакций, характерных для приема ГКС. Однако при использовании экстрамелкодисперсных лекарственных препаратов не только значимо снижается риск развития пневмонии по сравнению с препаратами, генерирующими более крупные частицы, но и увеличивается эффективность терапии, поскольку малые дыхательные пути являются основным местом развития патогенетического процесса при ХОБЛ

Impact of renal impairment on atrial fibrillation: ESC-EHRA EORP-AF Long-Term General Registry

Background: Atrial fibrillation (AF) and renal impairment share a bidirectional relationship with important pathophysiological interactions. We evaluated the impact of renal impairment in a contemporary cohort of patients with AF. Methods: We utilised the ESC-EHRA EORP-AF Long-Term General Registry. Outcomes were analysed according to renal function by CKD-EPI equation. The primary endpoint was a composite of thromboembolism, major bleeding, acute coronary syndrome and all-cause death. Secondary endpoints were each of these separately including ischaemic stroke, haemorrhagic event, intracranial haemorrhage, cardiovascular death and hospital admission. Results: A total of 9306 patients were included. The distribution of patients with no, mild, moderate and severe renal impairment at baseline were 16.9%, 49.3%, 30% and 3.8%, respectively. AF patients with impaired renal function were older, more likely to be females, had worse cardiac imaging parameters and multiple comorbidities. Among patients with an indication for anticoagulation, prescription of these agents was reduced in those with severe renal impairment, p <.001. Over 24 months, impaired renal function was associated with significantly greater incidence of the primary composite outcome and all secondary outcomes. Multivariable Cox regression analysis demonstrated an inverse relationship between eGFR and the primary outcome (HR 1.07 [95% CI, 1.01–1.14] per 10 ml/min/1.73 m2 decrease), that was most notable in patients with eGFR <30 ml/min/1.73 m2 (HR 2.21 [95% CI, 1.23–3.99] compared to eGFR ≥90 ml/min/1.73 m2). Conclusion: A significant proportion of patients with AF suffer from concomitant renal impairment which impacts their overall management. Furthermore, renal impairment is an independent predictor of major adverse events including thromboembolism, major bleeding, acute coronary syndrome and all-cause death in patients with AF

Clinical complexity and impact of the ABC (Atrial fibrillation Better Care) pathway in patients with atrial fibrillation: a report from the ESC-EHRA EURObservational Research Programme in AF General Long-Term Registry

Background: Clinical complexity is increasingly prevalent among patients with atrial fibrillation (AF). The ‘Atrial fibrillation Better Care’ (ABC) pathway approach has been proposed to streamline a more holistic and integrated approach to AF care; however, there are limited data on its usefulness among clinically complex patients. We aim to determine the impact of ABC pathway in a contemporary cohort of clinically complex AF patients. Methods: From the ESC-EHRA EORP-AF General Long-Term Registry, we analysed clinically complex AF patients, defined as the presence of frailty, multimorbidity and/or polypharmacy. A K-medoids cluster analysis was performed to identify different groups of clinical complexity. The impact of an ABC-adherent approach on major outcomes was analysed through Cox-regression analyses and delay of event (DoE) analyses. Results: Among 9966 AF patients included, 8289 (83.1%) were clinically complex. Adherence to the ABC pathway in the clinically complex group reduced the risk of all-cause death (adjusted HR [aHR]: 0.72, 95%CI 0.58–0.91), major adverse cardiovascular events (MACEs; aHR: 0.68, 95%CI 0.52–0.87) and composite outcome (aHR: 0.70, 95%CI: 0.58–0.85). Adherence to the ABC pathway was associated with a significant reduction in the risk of death (aHR: 0.74, 95%CI 0.56–0.98) and composite outcome (aHR: 0.76, 95%CI 0.60–0.96) also in the high-complexity cluster; similar trends were observed for MACEs. In DoE analyses, an ABC-adherent approach resulted in significant gains in event-free survival for all the outcomes investigated in clinically complex patients. Based on absolute risk reduction at 1 year of follow-up, the number needed to treat for ABC pathway adherence was 24 for all-cause death, 31 for MACEs and 20 for the composite outcome. Conclusions: An ABC-adherent approach reduces the risk of major outcomes in clinically complex AF patients. Ensuring adherence to the ABC pathway is essential to improve clinical outcomes among clinically complex AF patients