Disease Clinic Research Articles

Diagnostic value of haematological parameters in neonatal sepsis cases

Aim: In this study, we aimed to investigate whether haematological parameters could be used in the early diagnosis of neonatal sepsis in neonates diagnosed with sepsis clinically. Material and Method: This study was performed retrospectively from the patient records on 138 newborn infants who were diagnosed with neonatal sepsis and admitted to Konya Beyhekim State Hospital Children's Health and Diseases Clinic, Neonatal Intensive Care Unit, between January 2014 and January 2016. Gender, type of delivery (normal vaginal delivery, cesarean section), birth weight, body weight at hospital admission, age at hospital admission, gestational age, duration of hospitalization, accompanying complaints/symptoms, risk factors in the baby and mother were recorded from patient record files. Patients with proven sepsis with positive blood culture results, and who were diagnosed with sepsis clinically without blood culture positivity were included in the study group. Results: It was determined that 138 (19.43%) newborn infants of the 710 admitted to our unit were diagnosed with neonatal sepsis diagnosis. Of these patients, 82 (59.4%) were male and 56 (40.6%) were female. Male to female ratio was 1.46. While 127 patients were diagnosed with clinical sepsis, 11 (7.97%) of them were haemoculture-proven. The mean birth weights of the patients were 3082,14 ± 423,90 g and 12 (8,69%) patients were below 2500 g. The average body weight of hospitalized patients was 3042,36 ± 422,09 g. Conclusion: This study once again revealed that haematological parameters are still very valuable in the early diagnosis of newborn infants diagnosed with sepsis.

Досвід використання енісаміуму йодиду в клініці гострих респіраторних захворювань: огляд літератури

Досвід використання енісаміуму йодиду в клініці гострих респіраторних захворювань: огляд літератури

Effects of Derinat on ischemia-reperfusion-induced pressure ulcer mouse model

Sodium salt of deoxyribonucleic acid (DNA), Derinat, isolated from the soft roes of Russian sturgeon, has been utilized as an immunomodulator for the treatment of reactive oxygen species (ROS)-associated diseases in clinics. Here we show that treatment with Derinat has an anti-inflammatory and anti-oxidative effects on cutaneous ischemia-reperfusion (IR) injury in pressure ulcer (PU) model mice. Dorsal skin damage and dermal edema in mild PU model mice were attenuated by treatment with Derinat. Immunohistochemical and biochemical analyses showed that Derinat suppressed IR-induced oxidative damage, i.e. accumulation of 8-hydroxy-2′-deoxyguanosine (8-OHdG), and related inflammatory factors such as cyclooxygenase 2 (COX-2) and IL-6 receptor (IL-6R) in dorsal skin from PU model mice. We also verified that phospholyated/non-phosphorylated ratio of extracellular signal-regulated kinase (Erk) and p38 mitogen-activated protein kinase (MAPK) increased after IR, which were attenuated by Derinat. We then compared the effect of Derinat with that of salmon DNA and other PU therapeutic agents, prostaglandin E1 (PGE1) and basic fibroblast growth factor (bFGF), by using severe PU model mice. The effects of Derinat and salmon-DNA were compatible with those of PGE1 and bFGF. These results suggest that Derinat other fish-derived DNA formulation could be effective enough and become intriguing new therapeutic options.

Current Perspectives on Role of MSC in Renal Pathophysiology.

In the course of the development and worsening of kidney disease, the treatments available are expensive and may cause adverse effects such as immune rejection, inadequate renal resources, or post-operative complications. Therefore, there is an urgent to develop more effective treatments. The advent of mesenchymal stem cells (MSCs) represents a new direction in this context. The current use of MSCs for the treatment of kidney disease has mostly involved experimental studies on animals and only a few clinical trials have been conducted. This review focused on the mechanisms of MSC involvement from different sources in the improvement of renal pathophysiology in recent years. These mechanisms include homing to damaged kidney tissue, and differentiating into or fusing with the innate cells of the kidney. The paracrine or endocrine action through secreting protective cytokines and/or releasing microvesicle from MSCs also plays a critical role in amelioration of kidney disease. With modern engineering technology like microRNA delivery and a combinational therapy approach such as reduction of renal fibrosis in obstructive nephropathy with MSCs and serelaxin, MSC may make great contribution to the improvement of renal pathophysiology. However, the therapeutic effects of MSC are still controversial and several problems remain unsolved. While it is too early to state that MSCs are useful for the treatment of renal diseases in clinic, it is thought that solutions to the existing problems will enable effective modulation of the biological characteristics of MSCs, thereby providing new and effective approaches for the treatment of renal diseases.

Ossified pseudomeningocele after the removal of an intradural neurinoma in the lumbar spine. A case report and literature review

The study objective is to describe a case of ossified pseudomeningocele after spinal surgery and to develop an optimal treatment strategy for this disorder.Materials and methods. We report a case of ossified pseudomeningocele developed after the removal of an intradural neurinoma in the lumbar spine in a female patient treated in the Clinic for Nervous Diseases, University Clinical Hospital No. 3 of the I.M. Sechenov First Moscow State Medical University in 2017. We also reviewed research literature describing this pathological condition.Results. Upon admission, the patient was diagnosed with paresis of the left foot occurring in ankle joint dorsiflexion (score 4), absence of the Achilles reflex on the left side, and hypoesthesia of two first toes of the left foot. Magnetic resonance imaging revealed a postoperative cyst of irregular shape located in soft tissues at the level of L vertebral body and compressing the dural sac. The patients underwent surgery that included separation of the pseudomeningocele cavity from the dural sac and placement of an external lumbar drainage. In the postoperative period, we observed a complete regression of neurological symptoms.Conclusion. Since ossified pseudomeningocele in the lumbar spine is extremely rare, an optimal treatment strategy has not been developed so far. We believe that maximum possible excision of the cyst wall and anastomotic sealing with a muscular or fat flap with biological glue followed by flap fixation from the extradural space is a simple and robust method of decompression and separation of the anastomosis. To eliminate the cavity in soft tissue of the paravertebral space, we recommend reconstruction of epidural fat with additional sealing using biological glue. To prevent anastomosis recurrence, we recommend placing an external lumbar drainage.

Comparative comprehension on the anti-rheumatic Chinese herbal medicine Siegesbeckiae Herba: Combined computational predictions and experimental investigations

Ethnopharmacological relevanceSiegesbeckiae Herba (SH) is a traditional anti-rheumatic herbal medicine in China. The SH-derived product is the first licensed traditional herbal medicinal product for the management of rheumatism-induced joint and muscle pain in United Kingdom. The authenticated plant origins listed in the official Chinese Pharmacopeia for SH include Siegesbeckia orientalis L. (SO), S. pubescens Markino (SP) and S. glabrescens Markino (SG). Although the therapeutic effects of these SH species in treating rheumatoid arthritis (RA) are similar, their difference in chemical profiles suggested their anti-rheumatisms mechanisms and effects may be different. Aim of the studyThis study was designed to comparatively comprehend the chemical and biological similarity and difference of SO, SP and SG for treating rheumatoid arthritis based on the combination of computational predictions and biological experiment investigations. Materials and methodsThe reported compounds for SO, SP and SG were obtained from four chemical databases (SciFinder, Combined Chemical Dictionary v2009, Dictionary of Natural Products and Chinese academy of sciences Chemistry Database). The RA-relevant proteins involved in nuclear factor-kappa B (NF-κB), oxidative stress and autophagy signaling pathways were collected from the databases of Kyoto Encyclopedia of Genes and Genomes and Biocarta. The comparative comprehension of SH plants was performed using similarity analysis, molecular docking and compounds-protein network analysis. The chemical characterization of different SH extracts were qualitatively and quantitatively analyzed, and their effects on specific RA-relevant protein expressions were investigated using Western blotting analysis. ResultsChemical analysis revealed that SO contains mainly sequiterpenes and pimarenoids; SP contains mainly pimarenoids, sequiterpenes, and kaurenoids; and SG contains mainly pimarenoids, flavonoids and alkaloids. Moreover, coincided with the predicted results from computational analysis, different SH species were observed to present different chemical constituents, and diverse effects on RA-relevant proteins at the biological level. ConclusionsThe chemical and biological properties of SO, SP and SG were different and distinctive. The systematic comparison between these three confusing Chinese herbs provides reliable characterization profiles to clarify the pharmacological substances in SH for the precise management of rheumatism/-related diseases in clinics.

CLINICAL AND EPIDEMIOLOGICAL CHARACTERISTICS OF HEMORRHAGIC FEVER WITH RENAL SYNDROME IN THE SAMARA REGION

Aim - to study clinical and epidemiological characteristics features of hemorrhagic fever with renal syndrome. Materials and methods. A retrospective comparative analysis of the results of clinical and epidemiological examination of HFRS patients was carried out in two groups: with moderate (n=106) and severe (n=22) forms of the disease, who were hospitalized in the clinic of infectious diseases of Samara State Medical University in 2017. Results. A significant predominance of the air-dust pathway of infection in severe forms of the disease was revealed. Most patients were young men in both groups. Clinical features of the current course of HFRS was the presence of subfebrile temperature in the polyuric period; absence of hemorrhagic syndrome in the majority of patients with HFRS, presence of severe asthenovegetative syndrome in the period of convalescence with severe headache, especially in severe form of the disease.

Patient experience at a dedicated multidisciplinary non-alcoholic fatty liver disease (nafld) clinic encompassing cardiovascular risk assessment and management. a new model of care?

Patient experience at a dedicated multidisciplinary non-alcoholic fatty liver disease (nafld) clinic encompassing cardiovascular risk assessment and management. a new model of care?

Cardiovascular risk assessment in patients attending a pioneering specialist multidisciplinary non-alcoholic fatty liver disease (nafld) clinic: a clinical effectiveness study

Cardiovascular risk assessment in patients attending a pioneering specialist multidisciplinary non-alcoholic fatty liver disease (nafld) clinic: a clinical effectiveness study

Therapeutic effect of human amniotic epithelial cells in murine models of Hashimoto's thyroiditis and Systemic lupus erythematosus

Background aimsThe chronic inflammation of autoimmune diseases develops repetitive localized destruction or systemic disorders, represented by Hashimoto's thyroiditis (HT) and Systemic lupus erythematosus (SLE) respectively. Currently, there are no efficient ways to treat these autoimmune diseases. Therefore, it is critically important to explore new therapeutic strategies. The aim of this study was to investigate the therapeutic efficacy of human amniotic epithelial cells (hAECs) in murine models of HT and SLE. MethodsExperimental autoimmune thyroiditis (EAT) was induced in female CBA/J mice by immunization with porcine thyroglobulin (pTg). hAECs were intravenously administered at different time points during the disease course. MRL-Faslpr mice, a strain with spontaneously occurring SLE, were intravenously administered hAECs when their sera were positive for both anti-nuclear antibodies (ANAs) and anti-double-stranded DNA (anti-dsDNA) antibodies. Two weeks after the last cell transplantation, blood and tissue samples were collected for histological examination and immune system analysis. ResultshAECs prevented lymphocytes infiltration into the thyroid and improved the damage of thyroid follicular in EAT mice. Correspondingly, hAECs administration reduced anti-thyroglobulin antibodies (TGAb), anti-thyroid peroxidase antibodies (TPOAb) and thyroid stimulating hormone (TSH) levels. SLE mice injected with hAECs appeared negative for ANAs and anti-dsDNA antibodies and showed reduced immunoglobulin profiles. Mechanically, hAECs modulated the immune cells balance in EAT and SLE mice, by downregulating the ratios of Th17/Treg cells in both EAT and SLE mice and upregulating the proportion of B10 cells in EAT mice. This was confirmed by in vitro assay, in which hAECs inhibited the activation of EAT mice-derived splenocytes. Moreover, hAECs improved the cytokine environment in both EAT and SLE mice, by suppressing the levels of IL-17A and IFN-γ and enhancing TGF-β. ConclusionThese results demonstrated the immunoregulatory effect of hAECs for inflammation inhibition and injury recovery in HT and SLE murine models. The current study may provide a novel therapeutic strategy for these autoimmune diseases in clinic.

Autoimmune skin disease among dermatology outpatients in Botswana: a retrospective review.

There is a paucity of data describing autoimmune skin diseases in sub-Saharan Africa and in HIV positive cohorts. We describe the incidence of autoimmune skin diseases in public dermatology clinics in Botswana. New patient records from public dermatology clinics were reviewed retrospectively for the period of September 2008 to December 2015. New diagnoses of cutaneous lupus erythematosus, systemic lupus erythematosus (SLE) with cutaneous involvement, dermatomyositis, systemic sclerosis, lichen sclerosus, bullous pemphigoid, pemphigus foliaceus, pemphigus vulgaris, and pemphigus vegetans were identified. Demographic data were recorded, and incidence was determined. A total of 262 patients were diagnosed with autoimmune skin disease (4% of all new patients) with an incidence rate of 28.8 (per 1,000,000). Cutaneous lupus was the most common diagnosis with discoid lupus occurring most frequently (12.6). The incidence of systemic sclerosis (2.2), morphea (1.6), lichen sclerosus (1.5), SLE with cutaneous involvement (1.3) and dermatomyositis (1.2) was relatively lower. Bullous pemphigoid was the most common bullous disease (3.8). Pemphigus foliaceus (0.9), pemphigus vulgaris (0.6), and pemphigus vegetans (0.2) were observed at a lower rate. At least 19.8% of these patients were also HIV positive. The incidence of autoimmune skin diseases in Botswana is lower compared to other published studies in other geographic areas, which may be reflective of a younger population, barriers to access, genetic differences, and a lack of comparative studies in sub-Saharan Africa. The hygiene hypothesis and helminth infections may also contribute to these differences. Further studies are needed to understand these disorders in this region.

A totally recombinant fibrin matrix for mesenchymal stem cell culture and delivery.

Mesenchymal stem cells (MSCs) have been widely studied for tissue engineering and treating diseases in laboratories, clinical trials, and clinics. Fibrin matrices are often used to culture MSCs or increase the retention of MSCs at the injection site. However, fibrins made with the human plasma derived fibrinogen have high cost and risk of human pathogen transmission. In this article, we studied if fibrin matrices made with recombinant human fibrinogen, recombinant human thrombin, and recombinant human factor XIII could be used to culture and deliver MSCs. We systematically investigated the relationships between the fibrin matrix formulation, its nanostructure, and the behaviors of the cells in the matrix including the cell morphology, viability, and growth. We found that the fibrinogen concentration significantly affected the matrix structure and cell behaviors. We then used an optimized fibrin matrix to deliver human MSCs into mice subcutaneously. We found that the matrix could significantly enhance the retention of MSCs at the injection site. To our best knowledge, this is the first study on using fibrin matrices made with entirely recombinant proteins for culturing and delivering MSCs. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 106A: 3135-3142, 2018.

The ileum-liver Farnesoid X Receptor signaling axis mediates the compensatory mechanism of 17α-ethynylestradiol-induced cholestasis via increasing hepatic biosynthesis of chenodeoxycholic acids in rats

Background and purposeEstrogen-induced intrahepatic cholestasis is one of the most common pathogenic factors for liver diseases in clinic. It is, however, regrettable that effective medical therapies to ameliorate or reverse this cholestasis are limited. Fortunately, the novel insights now allow us to target crucial transporters, enzymes and their regulatory pathways therapeutically by restoring disrupted bile acids (BAs) transport and signaling thus ameliorating cholestasis. Additionally, it has been found that a compensatory effect could have been developed under the condition of estrogen-induced in cholestasis. Hence, exploring the molecular mechanism of the adaptive changes counteracting the cholestasis would be one of the approaches for development of new therapeutic targets. MethodsParameters of BAs in different specimens, mRNA expressions of transporters, enzymes and farnesoid X receptor (Fxr) signaling pathways that relate to BAs homeostasis in liver and ileum were measured in rats with 7-day and 14-day 17α-ethynylestradiol (EE)-induced cholestasis, and the molecular docking and HepaRG cells studies for verification were also evaluated. Key resultsIt has been found that the depression of “ileal Fxr-Fgf15 (fibroblast growth factor 15)-hepatic Cyp7a1 pathway” in coordinated with activation of “hepatic Fxr-Shp (small heterodimer partner)-Cyp8b1 pathway” as well as up-regulation of Cyp27a1 expression synergistically promoting the hepatic biosynthesis of chenodeoxycholic acids (CDCAs) that are the potent agonists of Fxr, contribute to the Bsep up-regulation mediated the bile flow restoration to alleviate the cholestasis. ConclusionThese findings suggest that the adaptive regulation of Fxr-mediated ileum-liver signaling axis on Cyp7a1/Cyp8b1 might be the potentially novel targets for amelioration or treatment of estrogen-induced cholestasis, and we expect that this study would be of great value to provide a cue for patients with estrogen-induced cholestasis.

A novel electrochemical biosensor for ultrasensitive detection of serum total bile acids based on enzymatic reaction combined with the double oxidation circular amplification strategy

Serum total bile acids (TBA) level is used as a sensitive and reliable index for hepatobiliary diseases in clinics. Herein, a novel electrochemical biosensor was fabricated using enzymatic reaction coupling with the double oxidation circular amplification strategy for the detection of human serum TBA. With the catalysis of 3α-hydroxysteroid dehydrogenase (3α-HSD), 3α-bile acids reacted specifically with nicotinamide adenine dinucleotide (NAD+). And then, the reduced nicotinamide adenine dinucleotide (NADH) was produced. After that, the NADH reacted with the electron mediator of tris(2,2'-bipyridine) ruthenium(Ⅲ) (Ru(bpy)33+), which was then transformed to Ru(bpy)32+. Ultimately, Ru(bpy)32+ was further oxidized to Ru(bpy)33+ under a certain voltage, which was detected by the chronoamperometry assay. The detection was performed using a disposable unmodified screen-printed carbon electrode (SPCE) without sample preparation. The proposed biosensor showed high sensitivity and accuracy with the linear range from 5.0 to 150.0 pmol/L in 106-fold dilution serum. The established method had a good correlation with the enzymatic cycling method (r = 0.9372, P < 0.001, n = 72) commonly used in clinic. The electrochemical biosensor is simple, ultrasensitive and without sample pretreatment, showing great potential for point-of-care testing (POCT) of serum TBA in clinical samples. In addition, the biosensor is cost-effective with a small volume of samples, especially suitable for those who have difficulties in blood collection, such as infants, children and some small animals.

Automatic characterization of stride parameters in canines with a single wearable inertial sensor.

Background and objectiveGait analysis is valuable for studying neuromuscular and skeletal diseases. Wearable motion sensors or inertial measurement units (IMUs) have become common for human gait analysis. Canines are important large animal models for translational research of human diseases. Our objective is to develop a method for accurate and reliable determination of the timing of each stride in dogs using a wearable IMU.MethodsWe built a wireless IMU sensor using off-the-shelf components. We also developed a MATLAB algorithm for data acquisition and stride timing determination. Stride parameters from 1,259 steps of three adult mixed breed dogs were determined across a range of six height-normalized speeds using the IMU system. The IMU results were validated by frame-by-frame manual counting of high-speed video recordings.ResultsComparing IMU derived results with video revealed that the mean error ± standard deviation for stride, stance, and swing duration was 0.001 ± 0.025, -0.001 ± 0.030, and 0.001 ± 0.019 s respectively. A mean error ± standard deviation of 0.000 ± 0.020 and -0.008 ± 0.027 s was obtained for determining toe-off and toe-touch events respectively. Only one step was missed by the algorithm in the video dataset of 1,259 steps.ConclusionWe have developed and validated an IMU method for automatic canine gait analysis. Our method can be used for studying neuromuscular diseases in veterinary clinics and in translational research.

Influenza A H1N1 virus infection among pregnant women in a tertiary hospital in Belgrade, Serbia.

Pregnant women are at higher risk of developing severe influenza. Our aim was to analyze clinical course and risk factors for fatal outcome in pregnant women with influenza (H1N1) infection. This retrospective study enrolled eleven pregnant women with confirmed Influenza A (H1N1) infection treated in the Clinic for Infectious and Tropical Diseases, Belgrade, Serbia in a 6-years period. The mean age of pregnant women was 28.9 ± 5.2 years, and mean gestational age was 23.1 ± 7.0 weeks. Nine (81.8%) pregnant women had pneumonia (six had interstitial and three had bacterial pneumonia). Pregnant women developed pneumonia more often than other women in the reproductive period, but without statistical significance (81.8% vs. 65.7%, p = 0.330, OR (95% CI) 2.35 (0.47-11.80)). Nine (81.8%) pregnant women recovered. None of them experienced preterm delivery or abortion. Two women (18.2%) died due to acute respiratory distress syndrome. In one of them fetal death occurred one day before she died. The other one was performed caesarean section three days before death. Her newborn and children of all recovered women were healthy at birth. Prolonged time to initiation of oseltamivir and higher body mass index were statistically significantly associated with fatal outcome (p = 0.002, and p = 0.007, respectively). Gestational week of pregnancy, the etiology of pneumonia and comorbidity were not found to be risk factors for death (p = 0.128, p = 0.499 and p = 1.000, respectively). Pregnant women with H1N1 infection are at higher risk of pneumonia and death than other women in the reproductive period. Early antiviral therapy reduces the risk of unfavorable outcome.

Prevalence of Selected Zoonotic Diseases and Risk Factors at a Human-Wildlife-Livestock Interface in Mpumalanga Province, South Africa.

A lack of surveillance and diagnostics for zoonotic diseases in rural human clinics limits clinical awareness of these diseases. We assessed the prevalence of nine zoonotic pathogens in a pastoral, low-income, HIV-endemic community bordering wildlife reserves in South Africa. Two groups of participants were included: malaria-negative acute febrile illness (AFI) patients, called febrilers, at three clinics (n = 74) and second, farmers, herders, and veterinary staff found at five government cattle dip-tanks, called dip-tanksters (n = 64). Blood samples were tested using one PCR (Bartonella spp.) and eight antibody-ELISAs, and questionnaires were conducted to assess risk factors. Seventy-seven percent of febrilers and 98% of dip-tanksters had at least one positive test. Bartonella spp. (PCR 9.5%), spotted fever group (SFG) Rickettsia spp. (IgM 24.1%), Coxiella burnetii. (IgM 2.3%), and Leptospira spp. (IgM 6.8%) were present in febrilers and could have been the cause of their fever. Dip-tanksters and febrilers had evidence of past infection to Rickettsia spp. (IgG 92.2% and 63.4%, respectively) and C. burnetii (IgG 60.9% and 37.8%, respectively). No Brucella infection or current Bartonella infection was found in the dip-tanksters, although they had higher levels of recent exposure to Leptospira spp. (IgM 21.9%) compared to the febrilers. Low levels of West Nile and Sindbis, and no Rift Valley fever virus exposure were found in either groups. The only risk factor found to be significant was attending dip-tanks in febrilers for Q fever (p = 0.007). Amoxicillin is the local standard treatment for AFI, but would not be effective for Bartonella spp. infections, SFG rickettsiosis, Q fever infections, or the viral infections. There is a need to revise AFI treatment algorithms, educate medical and veterinary staff about these pathogens, especially SFG rickettsiosis and Q fever, support disease surveillance systems, and inform the population about reducing tick and surface water contact.

High frequency stimulations change the phase-locking relationship between neuronal firing and the rhythms of field potentials

Deep brain stimulation (DBS) has been successfully used to treat a variety of brain diseases in clinic. Recent investigations have suggested that high frequency stimulation (HFS) of electrical pulses used by DBS might change pathological rhythms in action potential firing of neurons, which may be one of the important mechanisms of DBS therapy. However, experimental data are required to confirm the hypothesis. In the present study, 1 min of 100 Hz HFS was applied to the Schaffer collaterals of hippocampal CA1 region in anaesthetized rats. The changes of the rhythmic firing of action potentials from pyramidal cells and interneurons were investigated in the downstream CA1 region. The results showed that obvious θ rhythms were present in the field potential of CA1 region of the anesthetized rats. The θ rhythms were especially pronounced in the stratum radiatum. In addition, there was a phase-locking relationship between neuronal spikes and the θ rhythms. However, HFS trains significantly decreased the phase-locking values between the spikes of pyramidal cells and the θ rhythms in stratum radiatum from 0.36 ± 0.12 to 0.06 ± 0.04 ( P < 0.001, paired t-test, N = 8). The phase-locking values of interneuron spikes were also decreased significantly from 0.27 ± 0.08 to 0.09 ± 0.05 ( P < 0.01, paired t-test, N = 8). Similar changes were obtained in the phase-locking values between neuronal spikes and the θ rhythms in the pyramidal layer. These results suggested that axonal HFS could eliminate the phase-locking relationship between action potentials of neurons and θ rhythms thereby changing the rhythmic firing of downstream neurons. HFS induced conduction block in the axons might be one of the underlying mechanisms. The finding is important for further understanding the mechanisms of DBS.

К ВОПРОСУ О ВЫДЕЛЕНИИ ГРУППЫ РИСКА НАЛИЧИЯ ПСИХИЧЕСКИХ РАССТРОЙСТВ В ПРАКТИКЕ КАРДИОЛОГИЧЕСКОГО ОТДЕЛЕНИЯ

Differential diagnosis of somatic and somatoform pathology is a pressing issue in general practice. The aim of this&#x0D; study was to develop an algorithm for identification of the patients with indications for psychiatrist’s consultation and&#x0D; possible psychotropic therapy at the stage of admission to multi-disciplinary hospital.&#x0D; Material and methods. Regression analysis of data of 1031 patient hospitalized in the cardiology department of a&#x0D; multiprofile hospital was done with the aim of identifying factors determining the recommendation for receiving&#x0D; psychotropic therapy at discharge.&#x0D; Results. An algorithm for allocation among patients of cardiological profile individuals that require a multidisciplinary&#x0D; approach to treatment involving experts in the field of mental health is proposed. Factors included in the formula were&#x0D; labile or paroxysmal hypertension, the number of associated (non-cardiological) diagnosis, female gender and heart&#x0D; rate or heart rhythm disorders with the debut at the age below 55 or 50 years: I = 8 × L + D + 3 × F + 3 (6) × H.&#x0D; Conclusion. The revealed pattern may be useful in the clinic of internal diseases for screening of patients with a high&#x0D; contribution of the emotional state the severity of the condition. The doctors of the hospitals of somatic (therapeutic)&#x0D; profile should pay more attention to the psycho-emotional condition of patients with labile hypertension, early onset of&#x0D; cardiac arrhythmias, and large number of comorbidities. Patients that meet the criteria are likely to need a consultation&#x0D; of a psychotherapist or psychiatrist because of the presence of psychosomatic or other mental disorders.

Does Problem Focused Coping Buffer the Effects of Trait Anxiety on Depressive Symptoms of Chronic Urticaria Patients?

ABSTRACTThe present study examined the moderating role of problem-focused coping in trait anxiety—depressive symptoms' relationship in patients with chronic urticaria (CU). Eighty-eight CU patients, who applied to an outpatient clinic of Clinical Immunology and Allergic Diseases, filled out a questionnaire set including State-Trait Anxiety Inventory, Ways of Coping Inventory, and Beck Depression Inventory. The results suggested that CU patients high on trait anxiety reported more depressive symptoms, and the ones using more problem-focused coping (PFC) strategies reported less depressive symptoms. Also, PFC strategies moderated trait anxiety-depressive symptoms relation. Accordingly, PFC strategies did not lead to any significant difference in CU patients who were low on trait anxiety in terms of the level of depressive symptoms. However, CU patients with high trait anxiety experienced significantly less depressive symptoms if they used more PFC strategies. The findings were discussed in the light of the relevant literature.