INTERROGATIVE SENTENCES IN DOCTOR – PATIENT COMMUNICATION IN ENGLISH: SELECTION CRITERIA

Background. Communication between doctor and patient is an important component of the treatment process. The main task of the doctor is to collect all the necessary information about the patient’s problem and the history of its occurrence, to clarify all the circumstances of the situation and to offer options for action. In order to solve this problem, it is necessary to use certain speech means that should help the doctor get all the information and get what they want from the patient. Questions are one of the means that determine the effectiveness of interaction. Purpose. The purpose of the study of this article is to analyze the interrogative sentences used in the doctor – patient dialogues in English, to determine their communicative load, to identify the most frequent constructions and to describe the criteria for choosing the types of interrogative sentences. Materials and methods. The material of the study was the scripts of conversations between doctors and patients in English, presented in open sources. In the course of the study, a continuous sample of interrogative sentences used by the doctor was carried out. The questions were divided into types according to their grammatical structure, the communicative load of each type was determined. The most and least frequent types of questions are singled out, possible grounds for such a pattern are identified. Results. The article describes the main types of questions in English in terms of their grammatical structure: general, special, alternative and disjunctive. The results of own research based on the material of audio recordings and their scripts of conversations between doctors of various specialties and their patients at various stages of the treatment process are presented. In the process of research, each type of questions was analyzed in the context of their use in order to describe their communicative load. This approach made it possible to identify criteria for selecting certain types of questions, which are determined by the target settings of the communicative “doctor-patient” situation. Practical implications. The results of the study can be applied in the practice of teaching Medical English, in the professional activities of healthcare professionals when communicating with patients, in theoretical courses on English grammar

A Comparison of the Dynamics of S100B, S100A1, and S100A6 mRNA Expression in Hippocampal CA1 Area of Rats during Long-Term Potentiation and after Low-Frequency Stimulation

The interest in tissue- and cell-specific S100 proteins physiological roles in the brain remains high. However, necessary experimental data for the assessment of their dynamics in one of the most important brain activities, its plasticity, is not sufficient. We studied the expression of S100B, S100A1, and S100A6 mRNA in the subfield CA1 of rat hippocampal slices after tetanic and low-frequency stimulation by real-time PCR. Within 30 min after tetanization, a 2–4 fold increase of the S100B mRNA level was observed as compared to the control (intact slices) or to low-frequency stimulation. Subsequently, the S100B mRNA content gradually returned to baseline. The amount of S100A1 mRNA gradually increased during first hour and maintained at the achieved level in the course of second hour after tetanization. The level of S100A6 mRNA did not change following tetanization or low-frequency stimulation

NEW DATA ON THE GEOLOGICAL STRUCTURE OF THE SYNNYR ULTRA-K INTRUSIVE FORMATION

The Synnyrsky massif is the largest intrusive containing ultra-potassium syenites, synnyrites, which are raw materials for the production of potash fertilizers and aluminum. An extensive complex of geological and geochemical studies has been carried out, including exploratory drilling, which was carried out on the massif for the first time. The data obtained made it possible to significantly change the idea of the structure of the massif, including a different look at the regularities of the placement of potash-alumina ores, significantly increasing the ore potential and the reliability of its assessment. The present study discusses the existence within the Synnyrsky complex of the third, previously undetected, large intrusive phase, which has its own geological and geochemical features

КРИПТОСПОРИДИОЗ У ВИЧ-ИНФИЦИРОВАННЫХ ПАЦИЕНТОВ: ДИАГНОСТИКА И КЛИНИКО-ЛАБОРАТОРНАЯ ХАРАКТЕРИСТИКА

The representatives of genus Cryptosporidium were found in 17 of 99 (17, 2%) HIV patients in Clinical Infectious Diseases Hospital named after S.P. Botkin. The restriction fragment length polymorphism (RFLP) assay identified two types of these agents Сriprtosporidium parvum in 11 (64,7%) and C. hominis in 6 (35,3%) patients. The level of CD4+ lymphocyte in the patients having cryptosporidiosis was significantly lower than in patients without cryptosporidiosis. In patients with cryptosporidiosis prolonged diarrhea were found at significantly higher rate. Also the patients with cryptosporidiosis demonstrated malnutrition and weight loss, but not at significantly higher rates. The present study is one of the first describe of cryptosporidiosis in Russia. риптоспоридии были обнаружены у 17 из 99 (17,2%) ВИЧ-инфицированных пациентов Клинической инфекционной больницы им. С.П. Боткина, Санкт-Петербург. С помощью полимеразной цепной реакции (ПЦР) и рестрикционного анализа методом полиморфизма длин рестрикционных фрагментов (ПДРФ) были выделены два вида возбудителей: Сriprtosporidium parvum у 11 (64,7%) и C. hominis – у 6 (35,3%) пациентов. У пациентов с криптоспоридиозом уровень CD4(+) лимфоцитов был достоверно ниже, чем у пациентов без криптоспоридиоза. У пациентов с криптоспоридиозом достоверно чаще наблюдались длительные (>10 дней) диареи. Нарушения всасывания питательных веществ и снижение массы тела выявлялись у пациентов с криптоспоридиозом, но достоверных отличий от пациентов без криптоспоридиоза по этим признакам выявлено не было. Данное исследование является одним из первых описаний криптоспоридийной инфекции у ВИЧ-положительных пациентов в России

Left Atrium Involvement in Lymphoma Patients: Single Center Observational Study

Aim. To assess the structure and performance of left atrium (LA) before and after 3 cycles of anticancer treatment in lymphoma patients, as well as the incidences of supraventricular arrhythmia (SVA) and the levels of biomarkers of inflammation.Material and Methods. This is a prospective observational study of patients with confirmed diagnosis of lymphoma [n=23; 57% men; median age 52 (34;64) years], who had no prior polychemotherapy. The comparison group included persons without lymphoma [n=18; 50% men; median age 43 (37; 54) years] comparable with the main group in terms of sex, age and risk factors for cardiovascular diseases. Patients with lymphoma underwent 24h-ECG monitoring and advanced transthoracic echocardiography at baseline and after 3 cycles (within 3 months) of anticancer treatment. Biomarkers of inflammation were measured. The results were compared with the data of the comparison group.Results. In lymphoma patients, LA reservoir, conduit, and booster function were found to be impaired at baseline but were comparable with these in matched controls. After 3 cycles of anticancer treatment, a trend to reduction of LA booster and conduit strain was found. The proportion of those with SVA was significantly higher in lymphoma patients before chemotherapy compared to those after anti-cancer treatment or controls: 57% vs 10% and 33% respectively (p<0.05). Lymphoma patients had a higher number of premature ventricular beats at baseline than after treatment or in control [183 (14;841) vs 38 (14;94) and 9 (4;38) respectively]. There were no associations found between the parameters of LA structure and function and SVA. Moderate positive correlation between ESR and supraventricular premature complexes was found (rS=0.44; p<0.05). A positive correlation between LA contractile function and inflammatory biomarkers were revealed: LA active ejection fraction (LA EFact) and ESR (rS=0.42, p<0.05); LA volume index and β-globulin (rS=0.43, p<0.05); LA EFact and neuregulin-1β (rS=0.42, p<0.05); LA expansion index and neuregulin-1β (rS=0.55, p<0.05).Conclusions. In lymphoma patients, LA phasic strain parameters were impaired regardless of anticancer treatment. The associations between inflammatory biomarkers with SVA and parameters of LA performance were found

КОНЦЕПТУАЛЬНЫЕ ПОДХОДЫ К ЭКСПРЕСС-ВЫЯВЛЕНИЮ CAMPYLOBACTER SPP. В МЯСЕ УБОЙНЫХ ЖИВОТНЫХ

The modern approach to quality assurance of food products based on the ISO 9000 standards indicates the need for the implementation of quality management systems in processing plants. According to the analysis of scientific publication databases (Science Direct and Web of Science), it is established that only 0.5–1.7% of publications are related to studying meat of slaughter animals (except for birds) concerning the presence of Campylobacter. The priority method of investigation is PCR. Ready-to-use PCR test system was developed for the detection of Campylobacter spp. on the basis of selected gene-specific primers to bacteria of Campylobacter genus. Specificity of the test system is established for Gram-negative bacteria of Salmonella, Escherichia, and Proteus genera, and for oxidase-positive Aeromonas. Gene-specific primers for Campylobacter were selected and ready-to-use PCR test system was developed on their basis. It was found that the selected primers have 100% convergence to the genome of Campylobacter genus bacteria, the PCR efficiency is not less than 95%, and the detection limit is not more than 1× 104 CFU/g. When estimating the specificity of the primers, it was taken into account that the bacteria of Campylobacter genus may be incorporated in a consortium with intestine microbiome, mainly with Enterobacteriaceae and lactic acid bacteria. However, Bolton’s enrichment medium is selective and, during the cultivation process, suppresses the growth of Gram-positive lactic acid bacteria. It was found that the selected primers were 100% specific and did not give false positive reactions with this group of microorganisms. The developed test system was successfully validated in a cycle of qualitative tests in the FEPAS system and implemented into laboratory practice. It was proved that the developed test system may be used both in screening at the stages of Campylobacter enrichment and in identification of pure culture of the microorganism.Современный подход формирования качества продуктов питания, основанный на стандартах ИСО серии 9000, указывает на необходимость внедрения систем менеджмента качества на перерабатывающих предприятиях. Согласно анализу баз данных научных публикаций Science Direct (by Scopus) и Web of Science установлено, что исследованию мяса убойных животных (кроме птицы) на наличие бактерий рода Campylobacter посвящено только 0,5–1,7% публикаций. Приоритетным методом исследования является ПЦР. Разработана готовая к применению ПЦР тест-система для выявления Campylobacter spp. на основе подобраных родоспецифичных праймеров к бактериям рода Campylobacter. Специфичность тест–системы установлена в отношении грамотрицательных бактерий родов Salmonella, Escherichia, Proteus, а также оксидазоположительных Aeromonas. Были подобраны родоспецифичные праймеры к бактериям рода Campylobacter и на их основе разработана готовая к применению ПЦР тест-система. Установлено, что подобранные праймеры имеют 100% сходимость к геному бактерий рода Campylobacter, эффективность ПЦР составляет не менее 95%, предел обнаружения не более 1× 104 КОЕ/г. При оценке специфичности праймеров учитывалось, что бактерии рода Campylobacter могут находиться в консорциуме, обоснованным микробиомом желудочно-кишечного тракта, в основном с бактериями семейства Enterobacteriaceae и молочнокислыми бактериями. Однако среда обогащения Болтон является селективной и в процессе культивирования подавляет рост Грамположительных молочнокислых бактерий. Установлено, что подобранные праймеры обладают 100% специфичностью и не дают ложноположительных реакций с указанной группой микроорганизмов. Разработанная тест-система была успешно проверена в раунде сличительных испытаний в системе FEPAS и внедрена в лабораторную практику. Доказано что разработанную тест-систему можно использовать как при скрининге на этапах обогащения бактерий рода Campylobacter, так и при идентификации чистой культуры микроорганизма

Стентирование коронарных артерий при остром коронарном синдроме

To study the long-term results of coronary arterial stenting in relation to the baseline clinical and angiographic findings and the presence of acute coronary syndrome at the moment of a procedure, the authors made a retrospective comparison of groups of patients undergone balloon angioplasty with a stent being inserted. The findings indicate that while choosing the tactics of treatment for patients with coronary heart disease (CHD) and assessing the risk of development of poor outcomes of coronary stenting, it is necessary to take into account a combination of factors significantly affecting the occurrence of coronary events and the development of restenosis after surgery (smoking, acute coronary syndrome at the moment of a procedure, serum triglyceride levels, extent of coronary bed affliction, type of stenosis, diameter of a revas-cularized vessel) and to apply, where possible, the minimal effective exposure principle to achieve the optimal result of a procedure.С целью изучения отдаленных результатов стентирования коронарных артерий в зависимости от исходных клинических и ангиографических данных и наличия острого коронарного синдрома на момент проведения процедуры было проведено ретроспективное сравнение групп пациентов, которым была выполнена процедура баллонной ангиопластики с постановкой стента. Полученные данные показывают, что при выборе тактики лечения пациентов с КБС и оценке риска развития неблагоприятных исходов коронарного стентирования необходимо учитывать совокупность факторов, достоверно повлиявших на возникновение коронарных событий и развитие рестенозов после вмешательства (курение, фактор наличия острого коронарного синдрома на момент выполнения процедуры, уровень ТГ сыворотки крови, распространенность поражения коронарного русла, тип стеноза, диаметр реваскуляризируемого сосуда), а также по возможности применять для достижения оптимального результата процедуры принцип минимального эффективного воздействия

Норма отображения тонкой кишки при компьютерной томографии

Purpose of the study. Determination of normal thickness and contrast of the wall of the small bowel (SB) depending on the phase of digestion on computed tomography (CT).Material and methods. We examined 358 patients aged 20 to 88 years. According to the results of the survey, patients are divided into two groups. The main group consisted of patients examined on an empty stomach (n = 329), and an additional group consisted of patients examined after eating (n = 29). A CT scan of the abdomen was performed with a cut-off thickness of not more than 2 mm and a bolus contrast enhancement (CE) with a nonionic contrast medium. The results of measurements of the wall thickness of the SB and the intensity of its contrast were subjected to grouping and statistical processing.Results and discussion. According to the results of our study, the average value of the wall thickness of the SB is normally 3.1 ± 1.2 mm, with a tendency to decrease this indicator in the distal direction. The regularities of changes in the thickness and intensity of contrasting of the wall of the SB in the norm depending on the age and the last meal were determined. With increasing age, diffuse thinning of the SB wall occurs. Normally, after eating, there is a thickening of the SB wall to 4.6 ± 1.8 mm and an increase in the intensity of contrast, mediated by an increase in blood supply, with a density gradient of + 10%. After CE, the proximal sections of the SB are contrasting brighter than the distal. The gradient of contrastion of the proximal and distal parts of the SB increases after meals, is maximum in young patients and decreases with age.Conclusion. In order to reliably differentiate the pathological thickening and change the contrasting of the SB wall from the physiological one, it is imperative to ascertain the time and nature of the last meal and to take into account the age of the patient. In "non-contact" patients, an indirect orientation is possible according to the degree of filling of the stomach and SB.Цель исследования: определение нормальной толщины и контрастирования стенки тонкой кишки (ТК) в зависимости от фазы пищеварения при компьютерной томографии (КТ).Материал и методы. Обследовано 358 пациентов в возрасте от 20 до 88 лет. По результатам анкетирования пациенты разделены на 2 группы. Основную группу составили пациенты, обследованные натощак (n = 329), а дополнительную группу – пациенты, обследованные после приема пищи (n = 29). КТ-исследование живота выполнялось с толщиной среза не более 2 мм и болюсным контрастным усилением (КУ) неионным контрастным веществом. Результаты измерений толщины стенки ТК и интенсивности контрастирования подвергались группировке и статистической обработке.Результаты и обсуждение. По результатам нашего исследования среднее значение толщины стенки ТК в норме составляет 3,1 ± 1,2 мм с тенденцией уменьшения данного показателя в дистальном направлении. Достоверно определены закономерности изменения толщины и интенсивности контрастирования стенки ТК в норме в зависимости от возраста и последнего приема пищи. С увеличением возраста происходит диффузное истончение стенки ТК. В норме после приема пищи отмечается утолщение стенки ТК до 4,6 ± 1,8 мм и повышение интенсивности контрастирования, опосредованного повышением кровенаполнения, с градиентом плотности +10%. При проведении КУ начальные отделы ТК в сравнении с конечными контрастируются ярче. Градиент контрастирования начальных и конечных отделов ТК увеличивается после приема пищи, максимален у молодых пациентов и уменьшается с возрастом.Выводы. Для достоверной дифференцировки патологического утолщения и изменения контрастирования стенки ТК от физиологического является обязательным выяснение времени и характера последнего приема пищи и учет возраста обследуемого. У “неконтактных” пациентов возможна косвенная ориентировка по степени заполнения желудка и тонкой кишки

The optical identifcation of events with poorly defined locations: The case of the Fermi GBM GRB140801A

We report the early discovery of the optical afterglow of gamma-ray burst (GRB) 140801A in the 137 deg$^2$ 3-$\sigma$ error-box of the Fermi Gamma-ray Burst Monitor (GBM). MASTER is the only observatory that automatically react to all Fermi alerts. GRB 140801A is one of the few GRBs whose optical counterpart was discovered solely from its GBM localization. The optical afterglow of GRB 140801A was found by MASTER Global Robotic Net 53 sec after receiving the alert, making it the fastest optical detection of a GRB from a GBM error-box. Spectroscopy obtained with the 10.4-m Gran Telescopio Canarias and the 6-m BTA of SAO RAS reveals a redshift of $z=1.32$. We performed optical and near-infrared photometry of GRB 140801A using different telescopes with apertures ranging from 0.4-m to 10.4-m. GRB 140801A is a typical burst in many ways. The rest-frame bolometric isotropic energy release and peak energy of the burst is $E_\mathrm{iso} = 5.54_{-0.24}^{+0.26} \times 10^{52}$ erg and $E_\mathrm{p, rest}\simeq280$ keV, respectively, which is consistent with the Amati relation. The absence of a jet break in the optical light curve provides a lower limit on the half-opening angle of the jet $\theta=6.1$ deg. The observed $E_\mathrm{peak}$ is consistent with the limit derived from the Ghirlanda relation. The joint Fermi GBM and Konus-Wind analysis shows that GRB 140801A could belong to the class of intermediate duration. The rapid detection of the optical counterpart of GRB 140801A is especially important regarding the upcoming experiments with large coordinate error-box areas.Comment: in press MNRAS, 201