Копинг-стратегии и отношение к здоровью у пациентов кардиологического профиля

Highlights. The importance of psychological assessment and psychological support in Cardiology Departments has been demonstrated. For the first time, predominant coping strategy in cardiac patients was revealed.Background. Why do patients with the same disease, disease course, prognosis and treatment have different outcomes? One hypothesis points to the influence of internal resources used in coping with the disease. A.B. Smulewicz in 1984 identified the association between the clinical symptoms and mental state of the patient.Aim. To determine characteristics of coping behavior and attitude toward health in cardiac patients from Surgical and Therapeutic Departments.Methods. 122 patients admitted to the State Autonomous Healthcare Institution “N.A. Semashko Republican Clinical Hospital” were included in the study. The 1st group consisted of in-patients from the Department of Surgical Treatment of Heart Rhythm Disorders and Electrical Cardiac Stimulation (61 patients); the 2nd group consisted of patients from the 1st Cardiology Department (61 patients). A questionnaire developed by R. Lazarus and S. Falkman in 1988 was used to determine coping strategies, and a questionnaire developed by R. A. Berezovskaya in 2005 was used to assess attitudes towards health.Results. Active coping strategy predominates in surgical patients, and distancing and avoidant strategies predominate in therapeutic patients. Correlation between characteristics of coping strategy and attitudes toward health was analyzed: active coping strategies are accompanied by high behavioral, cognitive, and emotional aspects. An inverse correlation is noted in distancing and avoidant coping strategies.Conclusion. Psychological comfort and correct attitude of patient to his/her disease is an important part of rehabilitation that highlights the significance of psychometric testing in cardiac patients.Основные положения. Доказана важность психологических скринингов и штатной психологической помощи в кардиологических отделениях. Впервые выявлен преобладающий копинг у кардиологических больных хирургического и терапевтического профиля.Актуальность. Одной из гипотез, объясняющих, почему пациенты с одинаковым заболеванием, течением, прогнозом и условиями лечения имеют разный исход, является влияние внутренних психологических резервов в борьбе с болезнью. Еще в 1984 г. А.Б. Смулевич выявил взаимосвязь соматического клинического синдрома и психического состояния пациента.Цель. Определение характерного копинга и отношения к здоровью у больных кардиологического отделения хирургического и терапевтического профиля.Материалы и методы. В исследование вошли 122 пациента многопрофильного республиканского медицинского центра ГБУЗ РК «РКБ имени Н.А. Семашко»: первую группу составили больные, находившиеся на стационарном лечении в отделении хирургического лечения сложных нарушений ритма сердца и электрокардиостимуляции (61 человек); вторую группу – пациенты 1-го кардиологического отделения (61 человек). Методика определения копинг-стратегий включала опросник Р. Лазаруса и С. Фолкман 1988 г. «Способы совладающего поведения». Для изучения особенностей отношения к здоровью использован опросник, разработанный Р.А. Березовской в 2005 г.Результаты. У пациентов хирургического профиля преобладала стратегия активных действий, у больных терапевтического отделения – дистанцирование и бегство-избегание. Отмечена корреляция между характерным копингом и отношением к здоровью: стратегии активных действий сопровождаются высоким поведенческим, когнитивным и эмоциональным аспектами. Обратная корреляция выявлена при типах дистанцирования и бегства-избегания.Заключение. Психологический комфорт и правильное отношение пациента к болезни служит важным этапом реабилитации, что подтверждает значимость психометрического скрининга у больных кардиологического профиля. Для скрининг-тестов и дальнейшей коррекции целесообразно введение в работу кардиологических отделений штатного психотерапевта

A case-control study of GST polymorphisms and arsenic related skin lesions

BACKGROUND: Polymorphisms in GSTT1, GSTM1 and GSTP1 impact detoxification of carcinogens by GSTs and have been reported to increase susceptibility to environmentally related health outcomes. Individual factors in arsenic biotransformation may influence disease susceptibility. GST activity is involved in the metabolism of endogenous and exogenous compounds, including catalyzing the formation of arsenic-GSH conjugates. METHODS: We investigated whether polymorphisms in GSTT1, GSTP1 and GSTM1 were associated with risk of skin lesions and whether these polymorphisms modify the relationship between drinking water arsenic exposure and skin lesions in a case control study of 1200 subjects frequency matched on age and gender in community clinics in Pabna, Bangladesh in 2001–2002. RESULTS AND DISCUSSION: GSTT1 homozygous wildtype status was associated with increased odds of skin lesions compared to the null status (OR1.56 95% CI 1.10–2.19). The GSTP1 GG polymorphism was associated with greater odds of skin lesions compared to GSTP1 AA, (OR 1.86 (95%CI 1.15–3.00). No evidence of effect modification by GSTT1, GSTM1 or GSTP1 polymorphisms on the association between arsenic exposure and skin lesions was detected. CONCLUSION: GSTT1 wildtype and GSTP1 GG are associated with increased risk of skin lesions

Interleukin-6 promoter polymorphism interacts with pain and life stress influencing depression phenotypes

Interleukin-6 (IL-6) has emerged as a potent biomarker for depression as its elevated plasma levels in patients with clinical depression have been confirmed by meta-analyses. Increased plasma IL-6 concentration was associated with various psychological stress factors and physical disorders accompanied by pain. Another modulator of the IL-6 level is rs1800795, a promoter polymorphism in the IL-6 gene which is able to influence its expression rate. Therefore, we examined in a Hungarian population sample of 1053 volunteers with European origins if rs1800795 polymorphism can affect depression symptoms measured by Zung Self-rating Depression Scale (ZSDS), and Brief Symptom Inventory (BSI). We also investigated the interactions of the polymorphism with reported painful physical conditions and Recent Negative Life Events (RLE) measured by the List of Life Threatening Experiences. Rs1800795 significantly interacted with both RLE and painful condition on depressive symptoms measured by ZSDS and BSI using different heritability models, while no main effects of the polymorphism were identified. After correction for multiple testing only the rs1800795 x RLE interaction effect (recessive model) remained significant on the BSI score, while both RLE and painful conditions significantly interacted on the ZSDS. In conclusion, the functional IL-6 rs1800795 polymorphism in interaction with various stress factors increases the risk of depression and has a greater impact on symptoms measured by the ZSDS. Thus, IL-6 and other cytokines may be more relevant in the development of somatic symptoms compared to affective signs of depression, delineating a specific genotype-phenotype relationship in this heterogeneous disorder

Functional characterization of the complement receptor type 1 and its circulating ligands in patients with schizophrenia

<p>Abstract</p> <p>Background</p> <p>Whereas the complement system alterations contribute to schizophrenia, complement receptors and regulators are little studied. We investigated complement receptor type 1 (CR1) expression on blood cells, the levels of circulating immune complexes (CIC) containing ligands of CR1, C1q complement protein and fragments of C3 complement protein (C1q-CIC, C3d-CIC), and CR1 C5507G functional polymorphism in schizophrenia patients and controls.</p> <p>Results</p> <p>We found an increased C1q-CIC level and CR1 expression on blood cells, elevated number of CR1 positive erythrocytes and reduced number of CR1 positive lymphocytes and monocytes in patients compared to controls. No difference in the levels of C3d-CIC between groups was observed. Higher CR1 expression on erythrocytes in CC genotype versus CG+GG for both groups was detected, whereas no difference was observed for other cell populations. Our results indicated that schizophrenia is associated with the increased CR1 expression and C1q-CIC level.</p> <p>Conclusions</p> <p>Our study for the first time indicated that schizophrenia is associated with the increased CR1 expression and C1q-CIC level. Further studies in other ethnic groups are needed to replicate these findings.</p