Role of catestatin in development and decompensation of heart failure: a literature review

The current literature review covers the role of sympathetic nervous system activation (SNS) and the significance of a new biomarker catestatin (CST), which is a chromogranin A-derived peptide, for assessing prognosis of patients with heart failure (HF). This review details the works devoted to CST metabolism and its role in clinical conditions with excessive catecholamine production, including the ability to counterbalance the adverse effects of SNS on cardiovascular system. The paper also presents the central results of studies on HF patients and shows the correlation of the CST level with HF functional class and stage. In addition, particular attention is paid on the possibilities and potential benefits of assessing the CST in addition to conventional management of patients hospitalized due to acute decompensated heart failure

EXTRAPULMONARY TUBERCULOSIS IN SIBERIA AND FAR EAST

Extrapulmonary tuberculosis still remains a mysterious problem greatky due to significant degree of divergence in definitions.Materials and methods. Extrapulmonary tuberculosis incidence and its structure have been analyzed for Siberian and Far Eastern Federal Districts for the last 10 years – from 2006 to 2015.Results. In 2006 in Siberian and Far Eastern Federal Districts there were 871 patients suffering from isolated extrapulmonary tuberculosis, the structure of the forms was as follows: tuberculosis of central nervous system (CNS) – 5.7%; bone and joint tuberculosis – 28.7%; urogenital tuberculosis – 35.9%; tuberculosis of peripheral lymph nodes – 15.8%; ocular tuberculosis – 5.2%, other forms – 8.7%. Starting from 2008 ocular tuberculosis was excluded from reporting, despite the fact that the number of such patients was almost the same as the number of CNS tuberculosis cases. 10 years later in 2015 isolated forms of tuberculosis were diagnosed in 699 (-172) people, forms were the following: CNS tuberculosis – 10.6%, double increase; bone and joint tuberculosis – 39.8%, 1.5 fold increase; urogenital tuberculosis – 24.5%, 1.5 fold decrease respectively. Number of those suffering from tuberculosis of peripheral lymph nodes remained the same – 14.2%, other forms inclusive tuberculosis of salivary glands, pancreas, gall bladder, intestine, breast, skin etc. increased respectively up to 11%.Conclusions. The problem of extrapulmonary tuberculosis in Russia as in the whole world still needs to be resolved. Extrapulmonary tuberculosis incidence greatly depends on the number of properly trained specialists and sufficient technical facilities of dispensaries. The following changes are to be made to Form 8: firstly, urological and genital tuberculosis cases are to be recorded separately; secondly, all forms are to be recorded separately according to HIV status

CASE OF LEFLUNOMIDE-INDUCED CLINICAL AND MORPHOLOGICAL REGRESSION OF AA-AMYLOIDOSIS AND REMISSION OF ADULT-ONSET STILL'S DISEASE

The paper describes a long-term observation and discusses the possible mechanism of leflunomide-induced clinical and morphological regression of AA-amyloidosis diagnosed at a nephrotic stage in the presence of adult-onset Still's disease

Sociological Research of the Adherence of Medical Students to Employment by Specialty Received at a University

Background. A significant number of medical students refuse to work on a specialty obtained in medical universities after its completion or during the first years of professional activity.Purpose of the study: to conduct a sociological study of the adherence of students of a medical university to employment in a specialty received at a university, as well as factors of its motivation.Methods. A sociological survey of graduate students of ISMU was conducted using specially designed questionnaires.Results. It was revealed that more than 5 % of students do not plan to work on the received specialty after graduating from a medical university. Only every fourth respondent after graduation is going to return to his place of permanent residence, one of four intends not to return, and half have not yet decided on the choice of a further place of work and residence. Work with undergraduates about bringing them to the territory of the initial residence is organized by the administration of municipal entities and medical organizations poorly. Meanwhile, the requirements of graduates presented to a potential employer in terms of the level of wages and the creation of conditions for residence and professional activity are not overstated.Conclusion. Working with graduates and taking specific steps to implement their requirements is the most logical option for joint activities of medical universities, health authorities, administrations of medical organizations and local self-government bodies to create favorable conditions for securing young professionals in their chosen field of activity

ANALYSIS OF VACANCIES AND JOB OFFERS FOR DOCTORS IN STATE MEDICAL ORGANIZATIONS OF THE IRKUTSK REGION

The analysis of vacancies and job offers for doctors, especially information on the declared amount of wages and benefits, allows  not only to study the need for personnel, but also to study the level  of motivation of candidates for medical posts. The aim of the study  was to analyze vacancies and job offers for doctors from state  medical organizations of the Irkutsk region. The study was  conducted using the method of continuous statistical analysis of job  offers for physicians posted on the official website of the Ministry of  Health of the Irkutsk region. The public sector of the healthcare  system in the Irkutsk region provides a large number of vacancies  for unemployed doctors and young professionals. Declared in job  advertisements, the salary level of doctors is below the level  reflected in regional state reports on the health of the population and  the organization of health care. There is a lag in the salaries of  medical workers from the average for the region, as well as the  backlog of the Irkutsk region in this indicator from the Russian  Federation. When comparing the municipalities of the region to the  maximum and minimum declared wage levels, it is revealed that the  difference between them is almost fourfold. Although the most  demanded are doctors who provide primary health care, the need for these specialists does not correlate with the level of wages offered to them in vacancy announcements. Fourfold excess of the maximum  declared wage level over the minimum in the municipal formations of the region is not a consequence of taking into account difficult  working conditions in hard-to-reach areas, but is due exclusively to factors of economic nature

Simultaneous Interpreting : Characteristic of Autonomic Provision of Extreme Cognitive Loads

Simultaneous interpreting is one of the most comprehensive and energy-consuming types of cognitive activity. To work successfully, a simultaneous interpreter must have a specific functional state. The aim of our study was to find out the basic mechanisms of this functional state, the effect of the simultaneous interpreting on cognitive function changes, and the main factors influencing the degree of the regulatory systems strain. Materials and Methods. 33 individuals participated in the study: 22 linguists specially trained in simultaneous translation composed the experimental group and 11 language-qualified people having no skills of simultaneous translation represented the control group. In compliance with the study design, the measurements were performed under the conditions similar to the real work of simultaneous interpreters: the participants working in succession performed professional tasks: shadowing in the native and foreign languages (German and English), simultaneous interpretation of the reports from the native language to the foreign, and vice versa. The interpreters were psychologically tested using ApWay.ru Web platform before and after the performance on the professional tasks: computer campimetry, test for a simple sensorimotor activity, Stroop test, and test for emotional disadaptation level. Cardiointervalogram was telemetrically recorded during the entire experiment. Results. Some specific aspects of autonomic provision of simultaneous interpreting have been unraveled. A significantly greater tension of the autonomic regulation is manifested by the simultaneous interpreters compared to the control group. It was most prominent when translation was done from the foreign language. The total level of stress during the performance on the linguistic tasks appeared to be higher in the control group. In the simultaneous interpreters, in contrast to the control group, there was registered a high activity level of the sympathetic and parasympathetic systems and a marked integration of the cardiac rhythm regulation circuits over the entire period of performing the linguistic tasks. The psychological tests have demonstrated a significantly more confident cognitive control relative to the control group. Thus, a specific functional system has been formed in the simultaneous interpreters providing a successful interaction of various information images (or codes) and consolidation of autonomic and cognitive resources during the performance on professional tasks. Lack of the necessary skills and, consequently, of the task-oriented functional system in the participants of the control group resulted in the enhancement of the non-specific (less effective) stress response.Peer reviewe

Electrocardiographic diagnostics of cardiovascular pathology in athletes of youth sports schools

Objective: to evaluate the data of cardiac screening to identify cardiac pathology and determine sports participation among in athletes of Youth Sports Schools in five districts of St. Petersburg. Materials and methods: 9847 young athletes (average age 13.8 ± 4.9 years, 6127 men) were included in the study during 8 months. Clinical protocol uncluded the collection of complaints, anamnesis, family anamnesis, physical examination, ECG in 12 leads. If necessary, Holter monitoring, echocardiography, and an exercise test were performed. Results: typical ECG changes were registered in 60.4% of athletes, borderline in 0.05% and pathological in 3.69%. All athletes with pathological changes were excluded from the training and competitive process for the period of in-depth medical examination. In the end, two athletes were not allowed to continue participation in sport (2 with stressful ventricular arrhythmias). There was not any lethal outcomes for the entire period of the study. Conclusions: cardiological screening using the routine ECG method remains the main tool for identifying a possible pathological substrate and assessing the risk of sudden cardiac death. Early detection of cardiac arrhythmias and conduction disturbances allow to take measures to prevent sudden cardiac death

Saliva versus plasma cytokines as possible predictors of autism severity

The autism spectrum disorders (ASD) are now widely accepted as a pervasive, complex, heterogeneous neurodevelopmental disorders with multiple etiologies, subtypes, and developmental trajectories. There are no available and effective biomarkers for them. Immune dysfunction is seen as an important risk factor contributing to the neurodevelopmental deficit in ASD, and is signified, among other things, by an imbalance of cytokines in the brain and on the periphery. In recent years, saliva has been proposed as a biological material for diagnosing ASD, due to the accessibility and non-invasiveness of the method for its production. However, the question of whether salivary cytokine levels may be used as effective early biomarkers for autism requires further research, including saliva versus plasma/serum comparisons.Aim: a comparative analysis of the levels of cytokines: IL-6, IFNγ, TNFα, IL-1β, IL-4, IL-10, in saliva and blood plasma to identify possible markers of ASD and their severity in children.The study included 11 children with typical neurodevelopment (TDC) and 55 children with ASD, among whom 37 children had mild or moderate autism (according to CARS), and 18 children had severe autism. Samples of unstimulated mixed saliva and venous blood were simultaneously collected from all children. Salivary concentrations of cytokines: IL-6, IFNγ, TNFα, IL-1β, IL-4, IL-10 were determined by multiplex Luminex™ analysis. Plasma levels of cytokines were assessed by ELISA. Differences between groups were tested using the Kruskal-Wallis U-test with post-hoc Conover-Inman comparisons, between samples (saliva/ plasma) are using the Wilcoxon signed-rank test. The correlation between the concentrations of cytokines in plasma and saliva was determined using linear regression by the RMA method.In all examined groups, the levels of IL-6, IFNγ and IL-10 in saliva were significantly lower, and TNFα, IL-1β and IL-4 were higher than the corresponding levels of the same cytokines in plasma. Regardless of health/ disease status, no significant correlations were found between salivary and plasma cytokine levels in children. IL-1β levels were significantly lower and IL-10 levels were higher in the saliva of both groups of children with ASD compared with TDC. No significant differences in salivary cytokine concentrations were found between children with mild and severe ASD.Thus, salivary cytokines can be used as markers of ASD in children, but not the severity of the condition. The absence of correlations in the levels of some pro/anti-inflammatory cytokines between saliva and blood plasma may probably indicate a special immunological status of an ecological niche, the oral cavity

Reaction of hemostasis system in hypercapnic hypoxia after the course of mexidol assessed by the method of thromboelastography

Aim. To study the reaction of hemostasis system to a single effect of hypercapnic hypoxia of maximum intensity in rats and possibility of correcting hemostasis disorders by means of a preliminary course of an antihypoxant - mexidol. Methods. The study involved sexually mature male rats (48 specimens) of the Wistar line with an average mass of 274.0 ± 32.0 g. The rats were kept on a standard diet, food and water were fed once a day between 10 and 11 hours. In the evening, animals underwent a single hypercapnic hypoxia in a special flow chamber. The state of hypercapnic hypoxia of maximum intensity was modeled at O2 content of 5.0 %, CO2 - 5.0 % during a single 20-minute exposure. As a training regimen, a 30-fold course of mexidol was used, the drug was administered intraperitoneally to rats at a dose of 50 mg/kg for 1.5 hours prior to exposure to hypercapnic hypoxia. Results. After a single exposure to hypercapnic hypoxia of maximum intensity, shortening of the onset of clot formation, an increase of alpha angle, and maximum clot density were recorded. Also, the clot formation time shortened and the maximum clot lysis index increased. With a single exposure to hypercapnic hypoxia of maximum intensity after the course of mexidol, a decrease in the maximum clot density was recorded. Conclusion. A single exposure to hypercapnic hypoxia of maximum intensity was characterized by a shift of hemostatic potential toward hypercoagulability along with fibrinolytic system activation. The course use of antihypoxant mexidol, preceding hypercapnic hypoxia of maximum intensity, significantly reduces the risk of clot formation