RESUMO
Despite the global presence of social media platforms, the reasons why people like and share content are still poorly understood. We investigate how group identity mentions and expressions of ingroup solidarity and outgroup hostility in posts correlate with engagement on Ukrainian social media (i.e., shares, likes, and other reactions) before and after the 2022 Russian invasion of Ukraine. We use a dataset of 1.6 million posts from Ukrainian news source pages on Facebook and Twitter (currently X) and a geolocated sample of 149 thousand Ukrainian tweets. Before the 2022 Russian invasion, we observe that outgroup mentions in posts from news source pages are generally more strongly associated with engagement than negative, positive, and moral-emotional language. After the invasion, social identity mentions become less strongly associated with engagement. Moreover, post-invasion ingroup solidarity posts are strongly related to engagement, whereas posts expressing outgroup hostility show smaller associations. This is the case for both news and non-news social media data. Our correlational results suggest that signaling solidarity with one's ingroup online is associated with more engagement than negativity about outgroups during intense periods of intergroup conflicts, at least in the context of the Russian-Ukrainian war.
Assuntos
Identificação Social , Mídias Sociais , Ucrânia/epidemiologia , Mídias Sociais/estatística & dados numéricos , Humanos , Federação Russa/epidemiologiaRESUMO
OBJECTIVE: To analyze learning curves and appropriate experience on the features of mini-bypass surgery in 341 obese patients. MATERIAL AND METHODS: A total of 341 laparoscopic mini-gastric bypass surgeries performed by one surgeon were studied. The median age of patients was 40.5 [34; 48.3] years. There were 284 (83.2%) women and 57 (16.8%) men. The median BMI was 45 [40;52] kg/m2. RESULTS: The period of MGB development consisted of 138 interventions. Surgery time was 120 [100; 130] min and 90 [82.5; 100] mins after development of this technique (p=0.001). Complications occurred in 5 (1.5%) patients (1 patient with Clavien Dindo grade IIIA and 4 ones with grade IIIB). Of these, there were 3 patients with stapler suture defects. There were no complications only in the 4th quartile of surgeries. Surgical experience significantly affects postoperative outcomes. Surgery time was more influenced by surgical skill rather technique of anastomosis imposing. CONCLUSION: Polynomial regression objectively characterizes development of surgical skills lasting 138 interventions. MGB is safe for morbid obesity with a complication rate of 1.5% and no mortality.
Assuntos
Derivação Gástrica , Laparoscopia , Curva de Aprendizado , Obesidade Mórbida , Duração da Cirurgia , Complicações Pós-Operatórias , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Derivação Gástrica/métodos , Derivação Gástrica/efeitos adversos , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Laparoscopia/métodos , Laparoscopia/efeitos adversos , Competência Clínica , Índice de Massa Corporal , Federação Russa/epidemiologia , Resultado do TratamentoRESUMO
OBJECTIVE: To determine the current status and main factors influencing the level of emergency laparoscopic surgery in the Russian Federation. MATERIAL AND METHODS: A retrospective nationwide analysis included patients ≥18 years old undergoing surgery for acute cholecystitis (AC), acute appendicitis (AA), perforated ulcer (PU) and ileus. The database of the chief surgeon of the Russian Ministry of Health for 2018 - 2022 was used. To investigate possible reasons influencing the level of emergency laparoscopic surgeries, we performed online survey of medical organizations connected to the electronic reporting system. RESULTS: Over five years, the incidence of laparoscopic surgeries for AC increased from 52.6% to 70.5% (p<0.001), for AA from 25.1% to 41.0% (p<0.001), for PU from 9.4% to 13.2% (p<0.001) and for ileus from 5.9% to 8.5% (p<0.001). The percentage of emergency laparoscopic surgeries in rural hospitals (level I) was 14.8%, level II hospitals - 40.2%, level III - 67.7% (p<0.001). We obtained responses from 1.982 (84.9%) out of 2.335 hospitals included in the database. Significant differences were revealed in equipment of hospitals of different levels with laparoscopic surgical systems and proportion of surgeons proficient in laparoscopic techniques (p<0.001). The same factors influence laparoscopy in different federal districts to a greater extent than their geographic and demographic characteristics. CONCLUSION: Laparoscopic emergency procedures became more widespread, but vary widely between regions, urban and rural. Availability of laparoscopic surgery is influenced by availability of equipment and trained surgeons, geographic distance and population density, level of hospital and ability to maintain acquired skills and increase experience in appropriate surgeries.
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Laparoscopia , Humanos , Federação Russa/epidemiologia , Laparoscopia/métodos , Laparoscopia/estatística & dados numéricos , Masculino , Feminino , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , Apendicite/cirurgia , Apendicite/epidemiologia , Colecistite Aguda/cirurgiaRESUMO
OBJECTIVE: To analyze the complications following endoscopic hemithyroidectomy and to develop the principles of tissue dissection for safe surgical intervention. MATERIAL AND METHODS: The results of surgical treatment of 136 patients were studied. The main group consisted of 44 patients who underwent endoscopic hemithyroidectomy through a «gasless¼ axillary approach (EH group). The first control group consisted of 45 patients who underwent minimally invasive video-assisted hemithyroidectomy (MIVAH group). The second control group consisted of 47 patients who underwent open hemithyroidectomy (OH group). RESULTS. O: Verall complication rate was significantly higher in the EH group (20.5% vs. 6.4% in the OH group and 4.4% in the MIVAH group; p<0.05). In the EH group, Clavien-Dindo grade I complications occurred in 11.4% of cases. There were no similar complications in the control groups (p<0.05). Clavien-Dindo grade II complications occurred in 9.1% of patients in the EH group, 4.3% in the OH group and no similar events were identified in the MIVAH group (p>0.05). Clavien-Dindo grade III complications occurred in 1 (2.1%) case in the OH group and 2 (4.4%) cases in the MIVAH group. There were no Clavien-Dindo grade III complications in the EH group. Thus, minor complications prevailed in the EH group. Their incidence decreased along with accumulation of experience. Moreover, endoscopic procedure is safer regarding the risk of severe complications. CONCLUSION: Endoscopic hemithyroidectomy is safe, and the proposed principles of tissue dissection can further increase surgical safety.
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Complicações Pós-Operatórias , Tireoidectomia , Humanos , Tireoidectomia/métodos , Tireoidectomia/efeitos adversos , Feminino , Masculino , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Pessoa de Meia-Idade , Adulto , Endoscopia/métodos , Endoscopia/efeitos adversos , Cirurgia Vídeoassistida/métodos , Cirurgia Vídeoassistida/efeitos adversos , Dissecação/métodos , Dissecação/efeitos adversos , Avaliação de Processos e Resultados em Cuidados de Saúde , Neoplasias da Glândula Tireoide/cirurgia , Federação Russa/epidemiologia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversosRESUMO
OBJECTIVE: To evaluate the safety and advisability of repeated liver resection (RLR) for recurrent intrahepatic cholangiocarcinoma (ICC). MATERIAL AND METHODS: The results of RLR for ICC recurrence (n=10) were retrospectively analyzed between 1999 and 2023. The control group consisted of patients undergoing primary liver resection for ICC (n=195). RESULTS: Surgery time (p=0.001) and blood loss (p=0.038) were lower in the RLR group. There were no blood transfusions (0 vs. 31.8%, p=0.034) and 90-day mortality (0 vs. 3.2%, p=1.0) in the same group. The risk of complications (30.0% vs.45.6%, p=0.517) and adverse events grade ≥ III (20.0% vs. 17.9%, p=1.0) was similar in both groups. Multifocal intrahepatic nodes were more common in the RLR group (60% vs. 37.9%, p=0.193), while there were no negative factors such as lymph nodes involvement (0 vs. 34.4%, p=0.032) and invasion of surrounding structures (0 vs. 38.5%, p=0.015). Dimensions of the largest node were smaller in repeated resection (2 vs. 8 cm, p<0.0001). Incidence of R0 resections (80.0% vs. 82.1%, p=1.0) was comparable. Long-term results were similar: five-year overall survival 17.2% and 34.7% (p=0.912), three-year disease-free survival 20.0% and 26.5% (p=0.421). CONCLUSION: Similar results of repeated and primary liver resections confirm advisability of RLR for intrahepatic recurrence of ICC.
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Neoplasias dos Ductos Biliares , Colangiocarcinoma , Hepatectomia , Recidiva Local de Neoplasia , Humanos , Colangiocarcinoma/cirurgia , Masculino , Feminino , Hepatectomia/métodos , Hepatectomia/efeitos adversos , Pessoa de Meia-Idade , Neoplasias dos Ductos Biliares/cirurgia , Neoplasias dos Ductos Biliares/patologia , Recidiva Local de Neoplasia/epidemiologia , Estudos Retrospectivos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Reoperação/estatística & dados numéricos , Reoperação/métodos , Idoso , Federação Russa/epidemiologia , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Duração da Cirurgia , Avaliação de Processos e Resultados em Cuidados de SaúdeRESUMO
Currently, severe combined abdominal trauma ranks third among all causes of mortality In Russia, second only to cardiovascular and oncologic diseases. In the period from 2019 to 2020 in our country, a slight decrease in traumatism is noted due to a decrease in the number of traffic accidents as the main cause of combined and multiple trauma. The number of abdominal injuries from the total number of injuries In Russian regions ranges from 1.5 to 36.5% and is accompanied by a high level of disability (25-80% in combined trauma and 5-8% in isolated trauma). Despite modern medical advances, lethality in combined trauma of abdominal organs varies from 10.7 to 69.7%, with closed abdominal trauma accounting for up to 6% of fatal outcomes. OBJECTIVE: Improving treatment outcomes in patients with closed abdominal trauma through comprehensive diagnosis of SCN and optimization of enteral therapy in patients with closed abdominal trauma. MATERIAL AND METHODS: The study included 40 patients (29 (72.5%) men and 11 (27.5%) women), who underwent examination and treatment at the State Budgetary Institution "Research Institute of SP. Im. N.V. Sklifosovsky Research Institute of St. Petersburg State Medical Center with the diagnosis: Closed abdominal trauma. The age of the patients varied from 25 to 81 years (Mean age was 49.6±13.1). To evaluate the effectiveness of intensive therapy, the patients were divided into 2 groups: the comparison group (n=26) included patients who were treated with complex conservative therapy. Patients of the main group (n=14) conservative therapy was supplemented with the use of ER to restore the functional activity of the intestine under the control of ultrasound and assessment of the degree of intra-abdominal hypertension, as well as with Intestamine to stimulate the intestinal trauma. RESULTS: In the course of the study it was found that, as a result of complex enteral therapy in the patients of the main group, starting from the 7th day of stay in the ORIT, positive dynamics was observed, consisting in a statistically significant decrease in the levels of lactate, ALT, AST, LDH, and CRP. By the 14th day there was also a statistically significant decrease in leukocyte and PCT levels. The lethality in the main group amounted to 7.2%, n=1. At the same time, in patients of the comparison group only by the 7th day there was a decrease in concentration of CRP (p=0.065), by the 10th day - ALT (<0.001) and by the 14th day there was a decrease in leukocytes level (p=0.038). Lethality in this group amounted to 23.1%, n=6. CONCLUSION: Timely initiation of pathogenetic enteral therapy contributes to faster normalization of clinical and laboratory parameters, protection of intestinal barrier function, prevention of complications associated with bacterial translocation and bacterial overgrowth syndrome, increase in immunoresistance of the organism.
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Traumatismos Abdominais , Ferimentos não Penetrantes , Humanos , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Ferimentos não Penetrantes/complicações , Ferimentos não Penetrantes/terapia , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/fisiopatologia , Federação Russa/epidemiologia , Traumatismo Múltiplo/complicações , Traumatismo Múltiplo/diagnóstico , Traumatismo Múltiplo/terapia , Traumatismo Múltiplo/mortalidade , Adulto , Nutrição Enteral/métodos , Nutrição Enteral/estatística & dados numéricos , Síndrome , Enteropatias/diagnóstico , Enteropatias/terapiaRESUMO
BACKGROUND: Patients with diabetes mellitus (DM) are at risk for a higher incidence and severity of COVID-19, as well as its adverse outcomes, including post-Covid syndrome. AIM: to assess the incidence of cardiorenal complications in patients with type 1 and type 2 diabetes (T1DM/T2DM) who have had COVID-19, and to analyze the structure and severity of disorders according to examination data at the Diamobil mobile medical diagnostic and treatment center. MATERIALS AND METHODS: a cohort of T1DM and T2DM patients examined in Diamobil (n=318), with a confirmed anamnesis of COVID-19 (n=236). The time interval between COVID-19 and the visit to Diamobil was 8.7/8.2 months for T1DM/T2DM. The parameters of the last visit before COVID-19 recorded in the Federal Register of Diabetes (FRD) were used as initial data. RESULTS: Clinical characteristics of patients with T1DM/T2DM: age - 49.2/64.5 years, duration of DM - 22/11 years, proportion of women - 64/73%, respectively. After analysis the data from visits before and after COVID-19 there weren't statistically significant differences in HbA1c levels for both types of DM (before 9.0/8.3%; after 8.4/8.2%, respectively), there was the intensification of glucose lowering therapy (the proportion of patients with T2DM on 2 and 3 component therapy increased by 4.3% and 1.6%, the proportion of patients on insulin therapy by 16%). After COVID-19, there was a statistically significant decrease in glomerular filtration rate (GFR) in T1DM from 88.1 to 62 ml/min/1.73 m2; with T2DM from 74.7 to 54.1 ml/min/1.73 m2. When assessing acute diabetic complications, there was an increase in the frequency of coma in T1DM by 1.5 times, severe hypoglycemia in T1DM by 3 times, and in T2DM by 1.7 times. Analysis of the frequency of cardiorenal complications before and after COVID-19 showed a total increase of 8.5% in T1DM, by 13.2% in T2DM, of which myocardial infarction, ischemic heart disease, and CHF increased in T1DM in the range from 1.5 to 5 times, with T2DM by 1.3 times, the frequency of CKD with T1DM by 1.5 times, with T2DM by 5.6 times. CONCLUSION: There was a decline of kidney filtration function (decrease in GFR) and an increase in the frequency of cardiovascular complications in both types of diabetes in post-Covid period while patients achieved a stable HbA1c levels by intensifying therapy during the COVID-19 infection. This fact reflects combined damage to the kidney and cardiovascular system as a part of the post-Covid syndrome and determines a key set of measures for the development of preventive strategies.
Assuntos
COVID-19 , Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , SARS-CoV-2 , Humanos , COVID-19/complicações , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Masculino , Diabetes Mellitus Tipo 1/complicações , Pessoa de Meia-Idade , Idoso , Adulto , Federação Russa/epidemiologia , Incidência , Síndrome Cardiorrenal/etiologia , Síndrome Cardiorrenal/epidemiologia , Síndrome de COVID-19 Pós-AgudaRESUMO
The purpose of this study was to determine the contribution of genetic factors, i.e., the level of expression and polymorphisms of Toll-like receptors (TLR), to the susceptibility of latent tuberculosis infection in a Russian cohort of individuals infected with HIV. The patients (n = 317) with confirmed HIV infection were divided into two groups according to the results of the STANDARD E TB-Feron test: 63 cases with a latent TB infection and 274 controls without LTBI. Total DNA and RNA were isolated from whole-blood samples. SNP genotyping and expression levels of five TLR genes (TLR1, TLR2, TLR4, TLR6, and TLR8) were determined by means of real-time PCR. There were no significant differences in the expression levels of the TLRs between the case and control groups. In addition, we did not observe any significant association between the analyzed SNPs and the susceptibility of Latent tuberculosis infection (LTBI) in patients with HIV. However, patients from an entire cohort with the rs4986790-GG (TLR4) and rs5743708-GG (TLR2) genotypes were characterized by lower CD4 T-cell counts compared to carriers of alternative alleles. Moreover, we found a significant risk of a hazardous drop in the CD4 T-cell count below 350 cells/mm3 associated with the rs4986790-G (TLR4) allele. Latent tuberculosis infection in individuals infected with HIV does not significantly modify the level of TLR gene expression.
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Predisposição Genética para Doença , Infecções por HIV , HIV-1 , Tuberculose Latente , Polimorfismo de Nucleotídeo Único , Receptores Toll-Like , Humanos , Infecções por HIV/complicações , Infecções por HIV/genética , Infecções por HIV/virologia , Masculino , Tuberculose Latente/genética , Feminino , Adulto , Receptores Toll-Like/genética , Pessoa de Meia-Idade , HIV-1/genética , Genótipo , Alelos , Federação Russa/epidemiologia , Contagem de Linfócito CD4 , Estudos de CoortesRESUMO
OBJECTIVE: Amid the COVID-19 pandemic in the Russian Federation, social care providers received incentives such as bonuses and welfare payments. The study examines the association between COVID-19 pandemic indicators and distribution of incentives to care providers in Russia. METHODS: To test the hypotheses, regression analysis is employed. RESULTS: Hypothesis H1, regarding the correlation between the COVID-19 case rate in a specific region of the Russian Federation and the actual monetary amount of bonus payments compensating for challenging working conditions of care workers in that region is supported. Hypotheses H2-H3, regarding the relationship between the COVID-19 cases/recovery rate and the monetary amount of special welfare payments to care workers distributed across the country during a given calendar month are also supported. Hypothesis H4, pertaining to the relationship between the Fiscal Year End and the monetary amount of special welfare payments distributed throughout the country to care providers during a given calendar month, is likewise supported. CONCLUSION: There is a correlation between payments to social care providers and coronavirus pandemic indicators (Tab. 5, Ref. 31). Text in PDF www.elis.sk Keywords: welfare payment, bonus, care providers.
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COVID-19 , Assistência de Longa Duração , COVID-19/economia , COVID-19/epidemiologia , Humanos , Federação Russa/epidemiologia , Assistência de Longa Duração/economia , SARS-CoV-2 , Motivação , Pandemias/economiaRESUMO
Highly pathogenic avian influenza A(H5N1) virus was detected in dead seals on Tyuleniy Island in eastern Russia, in the Sea of Okhotsk. Viruses isolated from dead northern fur seals belong to clade 2.3.4.4b and are closely related to viruses detected predominantly in the Russian Far East and Japan in 2022-2023.
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Virus da Influenza A Subtipo H5N1 , Filogenia , Animais , Federação Russa/epidemiologia , Virus da Influenza A Subtipo H5N1/genética , Virus da Influenza A Subtipo H5N1/patogenicidade , Virus da Influenza A Subtipo H5N1/classificação , Virus da Influenza A Subtipo H5N1/isolamento & purificação , Otárias/virologia , Infecções por Orthomyxoviridae/virologia , Infecções por Orthomyxoviridae/veterinária , Infecções por Orthomyxoviridae/epidemiologia , Influenza Aviária/virologia , Influenza Aviária/epidemiologiaRESUMO
INTRODUCTION: African swine fever (ASF) is a contagious viral disease that affects pigs and wild boars, with a mortality rate of up to 100% in susceptible animals. The virus has been circulating in Europe and Asia since its introduction in 2007. Initially, all studied isolates were identified as genotype II, but in 2021 genotype I was reported in China. Later in 2023, the first recombinant virus of genotype I and II was identified in China, with an isolate dating back to 2021, this was followed by the detection of 6 recombinant isolates in Vietnam. METHODS: In this study, an ASFV isolate from the Primorsky Region of Russia obtained from a domestic pig was analyzed by sequencing several genome markers as well as the full genome. Eight pigs were infected with the isolate to assess its virulence. RESULTS: Virus replication in cell culture showed hemadsorption, while sequencing of genome markers clustered the isolate into both genotype I and genotype II. The whole-genome sequence showed that the Russian isolate shared a 99.99% identity with recombinant isolates described earlier in China. Experimental animals developed ASF disease after the introduction of a low dose of the virus (10 HAU50) and died within 7 days post-infection, presenting an acute form of the disease. CONCLUSION: This is the first report on recombinant ASFV in Russia's territory. The results once again confirm the transboundary nature of the disease, demonstrating the vulnerability of the global pig industry underscoring the need for developing new ASF vaccines effective against recombinant strains and emphasizing the importance of continuous molecular monitoring to detect emerging threats promptly.
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Vírus da Febre Suína Africana , Febre Suína Africana , Genoma Viral , Genótipo , Filogenia , Sus scrofa , Animais , Vírus da Febre Suína Africana/genética , Vírus da Febre Suína Africana/patogenicidade , Vírus da Febre Suína Africana/isolamento & purificação , Febre Suína Africana/virologia , Febre Suína Africana/epidemiologia , Federação Russa/epidemiologia , Suínos , Genoma Viral/genética , Sus scrofa/virologia , Recombinação Genética/genética , Sequenciamento Completo do Genoma/métodosRESUMO
AIM: To study the clinical status and data of laboratory and instrumental examination of patients with non-obstructive ischemic heart disease (IHD) and multifocal atherosclerosis (MFA) included in the KAMMA registry. MATERIAL AND METHODS: The subanalysis included 1,893 IHD patients who underwent coronary angiography (CAG) and ultrasonic examination of peripheral arteries. Based on the CAG data, patients were divided into two groups: group 1, patients with obstructive coronary atherosclerosis (CA) (maximum stenosis ≥50% and/or history of percutaneous coronary intervention/coronary artery bypass grafting, n=1728; 91.3%) and group 2, patients with non-obstructive CA (maximum stenosis <50%, n = 165; 8.7%). RESULTS: A comparative analysis based on the degree of coronary obstruction in patients with verified IHD who were included in the KAMMA registry showed that 8.7% of them had coronary artery stenosis of less than 50%. The overwhelming majority of patients with non-obstructive CA had MFA affecting the brachiocephalic arteries in 94.3% and the lower extremity arteries in 40.2%. Among patients with non-obstructive IHD, women predominated; risk factors such as smoking and type 2 diabetes mellitus were less frequent in this group than in the obstructive IHD group. Patients with non-obstructive CA more frequently had a history of dyslipidemia; they had higher total cholesterol and non-high-density lipoprotein cholesterol; and they more frequently received moderate-intensity statin therapy than patients with obstructive CA (55.8% vs. 34.5%). Characteristic features of patients with non-obstructive CA were less severe IHD and less frequent history of acute coronary syndrome. However, the incidence of stroke, peripheral arterial thrombosis, and chronic arterial insufficiency of the lower extremities did not differ in groups 1 and 2, whereas the incidence of paroxysmal atrial fibrillation was higher in the non-obstructive IHD group. CONCLUSION: IHD patients without coronary obstruction also require assessment of the peripheral arterial status, as they may have advanced MFA, which should be taken into account when choosing the "aggressiveness" of therapy.
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Angiografia Coronária , Doença da Artéria Coronariana , Sistema de Registros , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Federação Russa/epidemiologia , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/complicações , Angiografia Coronária/métodos , Idoso , Fatores de RiscoRESUMO
PURPOSE: This study was performed to assess the prevalence of the vascularized foveal zone, including macular-foveal capillaries (MFC) and congenital retinal macrovessels (CRM), and to analyze the structural characteristics of the macular area in patients with MFC. MATERIAL AND METHODS: The first phase of the study evaluated the prevalence of MFC and CRM. Optical coherence tomography angiography (OCT-A) was performed, and OCT-A images of the foveal avascular zone were analyzed. In the second phase, two groups were formed: the MFC group (12 eyes, 9 patients, mean age 43.8±10.7 years) and the control group (18 eyes, 17 patients, mean age 43.0±11.8 years). A comparative analysis was performed assessing central retinal thickness (CRT), thickness of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), and foveal pit depth. RESULTS: MFCs were detected in 45 eyes from a total sample of 1031 eyes of 536 patients. The presence of CRM was recorded in three eyes of three patients. RNFL thickness was significantly higher in the MFC group in the inferior parafoveal sector (26.50 [26.00; 29.50] and 24.50 [21.75; 26.50] µm; p=0.022) and in the foveal zone (15.50 [14.00; 16.00] and 12.00 [11.00; 14.00] µm; p=0.017). Additionally, patients with MFC had a higher thickness of GCL and IPL in the fovea, inferior, nasal, and temporal parafoveal sectors. The depth of the foveal pit was significantly lower in the MFC group compared to the control group (83.0 [77.4; 101.6] and 128.0 [107.5; 147.05] µm; p=0.001). CONCLUSION: The prevalence of MFC was 4.36% (calculated per number of eyes), while the prevalence of CRM - 0.29%. The macular area in patients with MFC had increased thickness of the inner retinal layers and decreased depth of the foveal pit, suggesting potential disruption in the natural process of ganglion cell migration and apoptosis during embryogenesis.
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Fóvea Central , Vasos Retinianos , Tomografia de Coerência Óptica , Humanos , Fóvea Central/irrigação sanguínea , Fóvea Central/diagnóstico por imagem , Adulto , Feminino , Masculino , Tomografia de Coerência Óptica/métodos , Prevalência , Pessoa de Meia-Idade , Vasos Retinianos/diagnóstico por imagem , Capilares/diagnóstico por imagem , Capilares/patologia , Doenças Retinianas/epidemiologia , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Federação Russa/epidemiologia , Acuidade Visual , Angiofluoresceinografia/métodosRESUMO
Early detection of diabetic retinopathy (DR) is an urgent ophthalmological problem in Russia and globally. PURPOSE: This study assesses the prevalence of asymptomatic retinopathy and attempts to identify risk groups for its development in patients with type 1 and 2 diabetes mellitus (T1DM and T2DM). MATERIAL AND METHODS: The study involved clinics from 5 cities in the Russian Federation and it included 367 patients with DM, 34.88% men and 65.12% women, aged 50.88±20.55 years. 34.88% of patients suffered from T1DM, 65.12% suffered from T2DM, the average duration of the disease was 9.02±7.22 years. 58.31% of patients had a history of arterial hypertension, 13.08% had a history of smoking. The primary endpoint was the frequency of detection of diabetic changes in the eye fundus of patients with T1DM and T2DM in general; the secondary endpoint - same but separately, and for T2DM patients depending on the duration of the disease. The exploratory endpoint was the assessment of the influence of various factors on the development of DR. The patients underwent visometry (modified ETDRS table), biomicroscopy, mydriatic fundus photography according to the «2 fields¼ protocol. RESULTS: The average detection rate of DR was 12.26%, primarily observed in patients with T2DM (13.81%), women (9.26%), in both eyes (8.17%). Among patients with DR, 26 (19.55%) had glycated hemoglobin (HbA1c) level exceeding 7.5% (p=0.002), indicating a direct relationship between this indicator and the incidence of DR. Logistic regression analysis showed that the duration of diabetes of more than 10 years has a statistically significant effect on the development of DR. In the modified model for odds estimation, the likelihood of developing DR is increased by the duration of DM for more than 10 years; increased blood pressure; HbA1c level >7.5%. CONCLUSION: The obtained results, some of which will be presented in subsequent publications, highlight the effectiveness of using two-field mydriatic fundus photography as a screening for DR.
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Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Fundo de Olho , Fotografação , Humanos , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Feminino , Masculino , Pessoa de Meia-Idade , Federação Russa/epidemiologia , Prevalência , Fotografação/métodos , Adulto , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Idoso , Fatores de Risco , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 1/diagnóstico , Diagnóstico PrecoceRESUMO
AIM: To evaluate the prognostic value of GDF-15 in relation the development of bleeding and events in stable CAD patients, receiving combined antithrombotic therapy. MATERIALS AND METHODS: The data was obtained from the prospective registry REGATA, 343 CAD patients (249 males), median age 68 [IQR 62; 75] years) were enrolled. Patients with sinus rhythm and concomitant PAD received acetylsalicylic acid in combination with rivaroxaban 2.5 mg bid (31.8%) or clopidogrel (24.8%). Other 43.4% with concomitant atrial fibrillation (AF) received direct oral anticoagulants in combination with antiplatelet therapy after elective percutaneous coronary interventions. Median follow-up was 12 months [IQR 9.0; 18.0]. The safety end point was major and clinically relevant bleedings (type 2-5) according to the BARC classification. Plasma samples for GDF-15 identification were taken at the inclusion and analyzed using ELISA assay. RESULTS: Frequency of BARC 2-5 bleedings was 16% (BARC 2 - 46; BARC 3 - 9; BARC 4-5 - 0), median GDF-15 level was 1185.0 pg/ml [850.0; 1680.0]. In patients with AF and concomitant MFA, the level of GDF-15 was significantly higher than in the subgroups of patients with only AF or MFA (p=0.0022). According to the quintile analysis, GDF-15 values in the top three quintiles of distribution (cut-off value >943 pg/ml) were associated with higher frequency of bleeding events: 23.2% versus 5.1%; p=0.0001. The multivariable logistic regression model demonstrated that bleeding events were independently associated with GDF-15 level>943 pg/ml (OR 2.65, 95% CI 1.11-6.30; p=0.0275), AF (OR 2.61, 95% CI 1.41-4.83; p=0.0023) and chronic kidney disease (OR 1.92, 95% CI 1.03-3.60; p=0.0401). Clinical factors determining the risk of bleeding events also determined a GDF-15 elevation. CONCLUSION: Assessment of GDF-15 level may improve bleeding risk stratification in CAD patients with concomitant AF and/or PAD receiving combined antithrombotic therapy.
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Fator 15 de Diferenciação de Crescimento , Hemorragia , Sistema de Registros , Humanos , Masculino , Feminino , Idoso , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Hemorragia/etiologia , Pessoa de Meia-Idade , Fator 15 de Diferenciação de Crescimento/sangue , Estudos Prospectivos , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/sangue , Quimioterapia Combinada , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/complicações , Fibrinolíticos/administração & dosagem , Fibrinolíticos/efeitos adversos , Aspirina/administração & dosagem , Aspirina/efeitos adversos , Clopidogrel/administração & dosagem , Clopidogrel/efeitos adversos , Prognóstico , Federação Russa/epidemiologia , Inibidores da Agregação Plaquetária/administração & dosagem , Inibidores da Agregação Plaquetária/efeitos adversos , Rivaroxabana/administração & dosagem , Rivaroxabana/efeitos adversos , Intervenção Coronária Percutânea/métodos , Intervenção Coronária Percutânea/efeitos adversosRESUMO
BACKGROUND: Numerous sources reported the increased risk of cerebrovascular accidents (CVA) in individuals with multiple sclerosis (MS), without a single study thus far challenging the conclusion. Before addressing hypothesis on potential cause-effect relationships, a question whether there are indeed frequent comorbidities between MS and CVA needed to be answered. METHODS: Authors designed a study to evaluate substantial populations of four independent neurology centers with the purpose to assess the prevalence of CVA diagnosis in patients with MS, and vice versa. Data of subjects meeting enrollment criteria were entered into a single database. Authors compared obtained data with the MS and CVA prevalences in the populations of specific countries. RESULTS: Of the 1881 subjects' records, the main diagnosis was MS for 51.5% and CVA for 48.5%. The CVA prevalence as a secondary diagnosis among MS subjects was 1.47% in USA cohort and 1.65% in combined USA+ Russian Federation (RF) cohorts, which is lower than known prevalence of stroke in adult population of these regions. The prevalence of MS as a secondary diagnosis among subjects with stroke in USA cohort was 0.4% and in combined USA+RF cohorts was 0.33%, which is higher, but not statistically different from calculated MS prevalence in both USA and RF populations combined. CONCLUSION: Thus, authors found that prevalence of CVA in cohorts with MS of 2 independent centers was at least not higher, than that in general population, which differs from previously published data.
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Esclerose Múltipla , Acidente Vascular Cerebral , Humanos , Esclerose Múltipla/epidemiologia , Feminino , Masculino , Prevalência , Pessoa de Meia-Idade , Acidente Vascular Cerebral/epidemiologia , Adulto , Estados Unidos/epidemiologia , Comorbidade , Federação Russa/epidemiologia , Idoso , Estudos de CoortesRESUMO
OBJECTIVE: We aimed to investigate the prevalence of sleep disturbances and associated factors among Ukrainians 1 year after Russia's full-scale invasion. METHODS: Quota sampling was used to collect online survey data from 2364 adults living in Ukraine aged 18 to 79 years from April 5, 2023, to May 15, 2023. Short sleep duration was defined as sleep duration ≤6 hours and long sleep duration as ≥9 hours. Insomnia was assessed by the Insomnia Symptom Questionnaire. RESULTS: The prevalences of short sleep duration, long sleep duration, and insomnia were 39.4%, 6.9%, and 38.5%, respectively. Short sleep duration and insomnia were both more likely in females (short sleep duration: adjusted odds ratio [aOR] = 1.44; insomnia: aOR = 2.17), individuals with depression (short sleep duration: aOR = 1.61; insomnia: aOR = 7.76), affected by the 2014 Russian invasion (short sleep duration: aOR = 1.37; insomnia: aOR = 1.78), and with more trauma events (short sleep duration: quartile 3 [Q3] versus Q1: aOR = 1.88; Q4 versus Q1: aOR = 1.83; insomnia: Q3 versus Q1: aOR = 2.14; Q4 versus Q1: aOR = 2.32). Insomnia was more likely in Ukrainians with posttraumatic stress disorder (aOR = 2.95), anxiety (aOR = 4.57), and loneliness (aOR = 1.67). Essential public service was associated with short sleep duration (aOR = 1.64). Short sleep duration and insomnia were associated with lower quality of life in physical, psychological, and environmental domains. Insomnia was associated with the social relationships domain. CONCLUSIONS: Sleep health among Ukrainian adults 1 year into the war is concerning, with more than one-third reporting inadequate sleep or insomnia. More studies are needed on impacts and interventions for sleep health during and after the war.
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Distúrbios do Início e da Manutenção do Sono , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Adulto , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Ucrânia/epidemiologia , Idoso , Adulto Jovem , Adolescente , Federação Russa/epidemiologia , Prevalência , Depressão/epidemiologia , Sono/fisiologia , Fatores de Tempo , Duração do Sono , População do Leste EuropeuRESUMO
OBJECTIVE: To analyze genome-wide studies devoted to polymorphisms of factors of anterior abdominal wall hernias, to study the association of the most common polymorphism In Russian population. MATERIAL AND METHODS: Searching for literature data was carried out in the RSCI and PubMed databases. We enrolled national and foreign reports. The study on Russian population included 577 people. RESULTS: We found 5 genome-wide studies performed by foreign authors. We identified the loci responsible for genetic predisposition to inguinal hernias: WT1, EFEMP1, EBF2 and ADAMTS6. The Japanese scientists revealed an important role of loci TGFB2, RNA5SP214/VGLL2, LOC646588, HMCN2, ATP5F1CP1/CDKN3. In other studies, loci 1q41 (ZC3H11B), 2p16.1 (EFEMP1), 6p22.1 (MHC region), 7q33 (CALD1) and 11p13 (WT1) determined different hernias. The EFEMP1 gene polymorphism was among genes most associated with anterior abdominal wall hernias in all studies. Analysis of this polymorphism In Russian population revealed significant association with anterior abdominal wall hernias. CONCLUSION: The obtained data on target correction of DNA chains can significantly reduce the incidence of anterior abdominal wall hernias. In turn, this will significantly reduce the cost of surgical treatment and risk of complications with recurrences of hernias. Moreover, identifying the most associated polymorphisms may be valuable to determine the most appropriate surgical treatment.
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Predisposição Genética para Doença , Humanos , Estudo de Associação Genômica Ampla/métodos , Hérnia Abdominal/genética , Hérnia Abdominal/cirurgia , Hérnia Abdominal/epidemiologia , Polimorfismo Genético , Federação Russa/epidemiologiaRESUMO
The article considers issues of how population behavior impacts realization of state anti-epidemic measures and efforts to control pandemic. Materials and Methods. The methodology of the study is based on such methods as text analysis, elastic network and construction of regression equations. The analysis of indicators characterizing state policy measures controlling pandemic was applied according to data from The Oxford COVID-19 Government Response Tracker portal. The behavioral reactions of population were assessed by text analysis of messages in Twitter and VKontakte social networks using the Rulexicon, tonalities dictionary of Russian language. The analysis of mobility was implemented on basis of data from Google Community Mobility Reports (GCMR). The study base includes data of March 12, 2020 - August 1, 2021. It is established that in controlling pandemic the most effective is to apply combination of measures implemented at state level of the Ministry of Health and the Ministry of Economic Development of the Russian Federation that permits to compensate negative effect of quarantine regimen. In the Russian Federation,effect of self-isolation measures, organization of remote work of employees of enterprises, closure of schools, wearing masks is controversial and their incorrect application can contribute to virus propagation. The vaccination measures are also effective in reducing morbidity of disease, but they are characterized by lagging effect. The approval and acceptance by population anti-epidemic measures significantly impact efficiency of pandemic control. The study results can be applied in practice of implementation of anti-epidemic measures as a tool preventing excessive risks of population morbidity and mortality.
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COVID-19 , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Federação Russa/epidemiologia , Pandemias/prevenção & controle , Quarentena , SARS-CoV-2 , Comportamentos Relacionados com a SaúdeRESUMO
The article analyzes age dynamics of initial causes of death according to records in medical death certificates of population of older age groups. Materials and methods. The records of causes of death of 34.914 persons aged 60 years and older were used as primary source of information. The initial cause of death was determined according to the ICD-10 rules. The rate of registration by reason of death was calculated as intensive value per 100 deaths in concrete age and sex group. Each cause was coded according to the ICD-10 rules (revision 2014-2016). The belonging to group was determined by first character (letter) in four-digit code that corresponded to the Class. On the basis of analysis of structure of causes of death, the group A of causes that included five Classes of ICD-10, determined 81.4% of all deaths in population aged 60 years and older. Two Classes: "Diseases of the circulatory system" (Class IX) and "Neoplasms" (Class II) determine in all studied age groups more than a half of all deaths (from 55% to 71% of males and from 59% to 67% in females) and namely they determine mortality rate in older age groups. There are no gender differences in age characteristics of registration rate in these groups (p > 0.05), however age dynamics differ. In case of diseases of circulatory system initial cause of death is increase rate of registration at increasing of age. In case of neoplasms at increasing of age decrease of registration rate as initial cause of death is established. At that, rate of decline is higher than rate of increase that determines certain decrease of structural significance of combined contribution of these two groups of causes at increasing of age. The Group B of causes, including three Classes of ICD-10 "Respiratory diseases" (Class X), "Diseases of the digestive system" (Class XI) and "Diseases of the nervous system" (Class VI), determined in overall 11.9% of all deaths in population aged 60 years and older. The age dynamics of causes of death of population of older age groups exists for certain groups of causes and it should be considered in organizing medical care of population of older age groups.