Left Atrial Enlargement an Early Predictor for Development of Systolic Dysfunction – Results of a Cross-Sectional Study Conducted in Georgia

Background and Aims: Left ventricular systolic dysfunction, even asymptomatic, is associated with the development of heart failure (HF) and all-cause mortality. Left ventricular ejection fraction (LVEF) is the most commonly used marker of left ventricular systolic function. It is well established that early detection and treatment of reduced LVEF, as well as the aggressive management of predisposing conditions, delays the manifestation of HF. Our study aimed to measure the association between LVEF and other echocardiographic variables in a population with LVEF within the normal range and without symptoms of HF. Methods: We conducted a cross-sectional study in 2008-2009. Results: We analyzed echocardiographic and clinical data of 146 patients: 66.4% were women; mean age was 55 (40 –69 years). LVEF significantly correlated only with left atrium (LA) size (Beta -0.266, p < 0.05). The correlation was inverse and remained significant after adjusting for age, gender, obesity, diabetes, arterial hypertension, left ventricular hypertrophy, pulmonary systolic pressure, mitral regurgitation, and diastolic dysfunction. Conclusions: We found that the earliest structural change associated with LVEF tendency to decrease was LA size. Further research is needed to assess the LA enlargement as an early predictor of systolic dysfunction development

Health service utilization for mental, behavioural and emotional problems among conflict-affected population in Georgia: a cross-sectional study.

BACKGROUND: There is large gap in mental illness treatment globally and potentially especially so in war-affected populations. The study aim was to examine health care utilization patterns for mental, behavioural and emotional problems among the war-affected adult population in the Republic of Georgia. METHODS: A cross-sectional household survey was conducted among 3600 adults affected by 1990s and 2008 armed conflicts in Georgia. Service use was measured for the last 12 months for any mental, emotional or behavioural problems. TSQ, PHQ-9 and GAD-7 were used to measure current symptoms of PTSD, depression and anxiety. Descriptive and regression analyses were used. RESULTS: Respondents were predominantly female (65.0%), 35.8% were unemployed, and 56.0% covered by the government insurance scheme. From the total sample, 30.5% had symptoms of at least one current mental disorder. Among them, 39.0% sought care for mental problems, while 33.1% expressed facing barriers to accessing care and so did not seek care. General practitioners (29%) and neurologists (26%) were consulted by the majority of those with a current mental disorder who accessed services, while use of psychiatric services was far more limited. Pharmacotherapy was the predominant type of care (90%). Female gender (OR 1.50, 95% CI: 1.25, 1.80), middle-age (OR 1.83, 95% CI: 1.48, 2.26) and older-age (OR 1.62, 95% CI: 1.19, 2.21), possession of the state insurance coverage (OR 1.55, 95% CI: 1.30, 1.86), current PTSD symptoms (OR 1.56, 95% CI: 1.29, 1.90) and depression (OR 2.12, 95% CI: 1.70, 2.65) were associated with higher rates of health service utilization, while employed were less likely to use services (OR 0.71, 95% CI: 0.55, 0.89). CONCLUSIONS: Reducing financial access barriers and increasing awareness and access to local care required to help reduce the burden of mental disorders among conflict-affected persons in Georgia

The history of the flora and vegetation of Georgia

Paleobotanical investigations have been carried out in Georgia (South Caucasus) since the early 20th century. In this work, we bring together the great body of research on fossil material from Georgia’s Phanerozoic deposits to provide descriptions of the floras, plant communities and paleogeographic conditions of past geological epochs. The paleofloras of Western Georgia, from the stratotypical region of Eastern Paratethys, are considered in particular detail as the Black Sea deposits provide a continuous fossil record spanning the entire Neogene and Quaternary. These sediments, dated biostratigaphically using marine fauna, contain rich paleobotanical material of both macrobotanical remains and palynomorphs. Pollen and spore assemblages from complete sections of various Upper Miocene, Pliocene, Pleistocene and Holocene stages have been interpreted using the landscape-phytocenological method, providing an almost uninterrupted reconstruction of vegetation and climate dynamics in Georgia. The work also contains complete flora lists of various stratigraphical units, palynological diagrams, maps of fossil localities and paleogeographical maps of Georgia.Introduction -- the paleozoic -- The Carboniferous -- the mesozoic -- The Jurassic -- The Early Jurassic -- The Middle Jurassic -- The Cretaceous -- the cenozoic -- The Paleogene -- The Eocene -- The Oligocene -- The Neogene -- The Miocene -- The Lower Miocene -- The Middle Miocene -- The Upper Miocene -- The Sarmatian -- The Meotian (Western Georgia) -- The Pliocene and Eopleistocene (Western Georgia) -- The Pliocene -- The Pontian -- The Kimmerian -- The Kuyalnician (Egrissian) -- The Eopleistocene -- The Gurian -- The Pliocene and Eopleistocene (Eastern Georgia) -- The Pliocene -- The Akchagilian -- The Eopleistocene -- The Apsheronian -- The Pleistocene (Western Georgia) -- The Chaudian -- The Old Euxinian and Uzunlarian -- The Karangatian and New Euxinian -- The Holocene -- Conclusion -- რეზიუმე -- References

Urotensin-2 Receptor Antagonist - Palosuran Decreases Blood Pressure And Plasma Renin Concentration In Laboratory Rats With Renovascular Hypertension

We were aimed to study effects of the Urotensin-2 receptor antagonist - Palosuran on blood pressure and plasma rennin concentration in laboratory rats with renovascular hypertension (2 kidneys + 1 clip).  Blood pressure was measured using noninvasive “tail cuff“ method.Studies have shown that in experimental rats palosuran (10 mg/kg/daily, during 4 weeks) reveal hypotensive effect. Blood pressure was decreased even after administration NO-synthase inhibitor - L-NAME (10 mg/kg, single dose), supposedly due to its urotensin-2 receptor antagonistic properties.In hypertensive rats plasma renin concentration was increased progressively compared to the data of healthy rats. In palosuran-treated hypertensive rats  renin concentration was significantly lower than in untreated hypertensive rats. Decreased renin concentration was maintained after administration of L-NAME, except during the late-onset of treatment.It could be concluded that in experimental rats with renovascular hypertension the vasodilatatory effect of palosuran outweighs the inhibitory effect of L-NAME on NO production and urotensin-induced endothelium-independent vasoconstrictive effect, especially at the early stages and early onset of treatment of hypertension. Palosuran might represent a new therapeutic option in individuals with hypertension disease

Mental health services by different state programs and providers.

<p>SPMH, State Program for Mental Health.</p><p>Mental health services by different state programs and providers.</p

Type of care used among individuals who contacted formal health services for any mental health, emotional or behavioural problems during last 12 months by presence of current mental disorder symptoms.

<p>¹ = Screened with symptoms of one of more of possible PTSD (TSQ score >6), depression (PHQ-9 score of ≥10), anxiety (GAD-7 score of ≥10.</p><p>Type of care used among individuals who contacted formal health services for any mental health, emotional or behavioural problems during last 12 months by presence of current mental disorder symptoms.</p

Correlates of service utilization, multivariate logistic regression, final model.

<p>Separate regression model run for (1) socio-demographic variables and current PTSD and current depression symptoms; (2) socio-demographic variables and comorbidity. The results for socio-demographic variables, PTSD symptoms and depression symptoms are shown from the first model. There were no statistically significant difference in the results of socio-demographic variables between the first and the second model.</p><p>¹ = TSQ score >6.</p><p>² = PHQ-9 score of ≥10.</p><p>³ = GAD-7 score of ≥10.</p><p>* p < 0.05.</p><p>** p < 0.01.</p><p>*** Co-morbidity is current symptoms more than 1 disorder of PTSD, depression and anxiety.</p><p>Correlates of service utilization, multivariate logistic regression, final model.</p