[The organizational aspects of early diagnostic of metabolic syndrome on the basis of implementation of new genetic, cellular and bio-informational technologies].

The characteristic feature of molecular medicine as medicine based on molecular structure of human genome data, is its individual character. It is focused on correcting pathological process in specific individual considering unique characteristics of its genome. The other most important feature is its expressed preventive direction. The complete genome information can be obtained well before the onset of disease. The appropriate preventive measures can completely eliminate or significantly prevent development of severe disease. The establishment of gene network of every multi-factorial disease, identification of central genes and genes-modifiers in it, analysis of association of their alleles with disease, development on this basis of set of preventive measures for specific patient constitute conceptual and methodological basis of predictive medicine. As a result of the examination, information can be obtained concerning particular risk of disease development. The physician, considering the results of molecular genetic analysis, elaborates tactics of pathogenetically justified preventive therapy, i.e. corrects congenital metabolic defect.

Risk of major congenital malformations following first-trimester exposure to vaginal azoles used for treating vulvovaginal candidiasis: a population-based retrospective cohort study.

OBJECTIVE: To evaluate the risk for major malformations following first-trimester exposure to vaginal azoles. DESIGN: A population-based retrospective cohort study of women exposed to vaginal azoles from the first day of the last menstrual period until the 90th gestational day. SETTING: A combination of four computerised databases: medications, birth, infant hospitalizations, and pregnancy terminations. POPULATION: All women who gave birth or underwent a pregnancy termination at Soroka Medical Center, Beer-Sheva, Israel, between 1999 and 2009. METHODS: Crude and adjusted relative risks for major congenital malformations and for specific malformations according to organ systems were calculated using a multivariate negative binomial regression. Potential confounders were assessed and controlled for included parity, maternal age, ethnicity, maternal diabetes, smoking, and year of birth or pregnancy termination. Additional analysis using propensity score matching was performed for selected malformations. MAIN OUTCOME MEASURES: Major malformations as well as specific malformations according to organ systems. RESULTS: Of 101 615 pregnancies, 1993 (1.96%) were exposed to clotrimazole vaginal tablets and 313 (0.31%) to miconazole vaginal tablets during the first trimester of pregnancy. No association was found between first-trimester exposure to clotrimazole and major or specific malformations. An association was found between miconazole exposure and musculoskeletal malformation in general and other congenital musculoskeletal anomalies in particular. However, no association was detected when propensity score matching was used. CONCLUSIONS: Intrauterine exposure to vaginal azoles during the first trimester of pregnancy was not associated with either major or specific malformations according to organ systems. TWEETABLE ABSTRACT: First-trimester exposure to vaginal azoles is not associated with either major or specific malformations.

[Sex- and age-specific characteristics of arterial hypertension prevalence in type 2 diabetes mellitus patients with obesity].

AIM: To investigate sex- and age-specific characteristics of arterial hypertension prevalence in type 2 diabetics with obesity. MATERIAL AND METHODS: Sex- and age-specific features of hypertension prevalence were studied in 6177 (1345 males and 4832 females) type 2 diabetic obese citizens of the Novgorod region. RESULTS: The highest incidence of mild hypertension was found in obesity degrees I and II (50-68%). Prevalence of moderate and severe hypertension reached 20-31 and 4-5%, respectively, in obesity of degree I and II, 15% in males and 11% in females in obesity degree III. CONCLUSION: In type 2 DM obese patients mild hypertension occurs most frequently. Severe hypertension develops often in males with obesity degree II and III in age groups 50-59 and 60-69 years, in females--in any obesity at the age of 70 and older.

Predictors of attrition in HIV-positive subjects with peripheral neuropathic pain.

The objective of this paper was to identify predictors of attrition in a study designed to assess whether cognitive behavioural therapy (CBT) was more helpful than supportive therapy (SP) in reducing pain associated with peripheral neuropathy in HIV-positive patients. Sixty-one subjects were randomized into either CBT or SP for six weekly one-hour sessions. Twenty-eight subjects dropped out before week six. Demographic variables such as age, gender, ethnicity, socioeconomic status and level of education were not predictive of attrition. However, higher scores on the Hamilton Depression Inventory (HAM-D, 17-item) (t (59) = - 0.09, p<0.05) were predictive. These findings suggest that while dropouts were not more physically ill (e.g. CD4 counts, viral loads and opportunistic infections were not statistically higher), they reported greater psychological distress.

[Features of chronic pulmonary diseases in workers engaged in the production of high aluminum mullite refractory items]. / Osobennosti khronicheskikh zabolevanii legkikh u rabochikh na proizvodstve vysokoglinozemistykh mullitovykh ogneupornykh izdelii.

The article represents features for differential diagnosis between pulmonary tuberculosis and dust diseases in workers engaged into mullite refractories production. The author suggests possible course of the disease as a new type of chronic pulmonary malady--mullitosis.

[Aspects of silicotuberculosis course in workers of highly aluminous mullite refractories]. / Osobennosti techeniia silikotuberkuleza u rabochikh na proizvodstve vysokoglinozemistykh mullitovykh ogneupornykh izdelii.

The article covers differential diagnostic features of pulmonary tuberculosis and pneumoconiosis in workers engaged into mullite refractories production. The authors suggest that the disease courses as a new form of lung disorder--mullitosis.

Accumulation of metals in vegetation from an alkaline artificial soil.

This research was conducted to determine whether elevated concentrations of metals in biosolids would result in increased accumulation of these metals in plants growing on an alkaline, artificial soil created by addition of municipal sewage biosolids to inorganic waste materials during reclamation of a filled lime settling basin. Accumulation of metals in vegetation growing on this alkaline, artificial soil was compared with accumulation in vegetation growing on a natural, reference soil that had not been amended by biosolids. Although the concentrations of Cd, Cr, Hg, Ni, Ag, and Zn were greater in the artificial soil than in the reference soil, only Cd was found at greater concentrations in vegetation growing on the artificial soil. These greater concentrations were only observed in wheat grass (Agropyron sp.), and not in orchard grass (Dactylis glomerata L.). Also, the accumulation ratio, which is the ratio of the metal concentration in plant tissue to that in the soil, for wheat grass was much lower than other published values. There were no differences in the concentrations of Ba and Pb in the two soils, but the concentrations of these two metals in orchard grass growing on the reference soil were greater than that in either grass on the artificial soil. The differences in plant uptake of metals appear to result from differences in soil pH between the artificial and reference soils. Many metals are generally more soluble and bioavailable at the lower pH of the reference soil (pH = 5.4-6.6) than at the higher pH of the artificial soil (pH = 7.8-8.2). As a result, transfer of metals to vegetation growing on the alkaline, artificial soil is less than that in vegetation growing on the reference soil despite the greater concentrations of metals in the artificial soil.

[Fibrogenicity of dust emitted by highly aluminiferous refractories]. / Fibrogennost' pyli vysokoglinozemistykh mullitovykh ogneuporov.

The authors proved variable clinical and pathogenetic features of disease in workers under long occupational exposure to dust of kaolin and its baking products. Therefore, special experimental studies should cover kaolin and mullite as primary and final product in entire technologic sequence of high-alumina refractories production. Natural refractory clay and mullite dust were administered to rats intratracheally during chronic experiments. Lungs of the rats exposed to mullite dust demonstrated reliable changes of lipid content in 1 month and those of hydroxyproline content--in 3 months. When exposed to intratracheal administration of kaolin and mullite dust, respiratory system develops typical changes--slow development of benign diffuse and sclerotic form of pneumoconiosis that is associated or, more frequently, preceded by chronic dust bronchitis.

[Clinical features of respiratory diseases caused by mullite dust]. / Klinicheskie osobennosti zabolevanii organov dykhaniia pri vozdeistvii mullitovoi pyli.

The authors evaluate clinical peculiarities of chronic bronchitis, silicotuberculosis and pneumoconiosis (mullitosis) in workers exposed to highly aluminiferous clay.

An exploratory study of ethnicity and psychotherapy outcome among HIV-positive patients with depressive symptoms.

Few data address the relationship between ethnic status and psychotherapy outcome. This study reports data from a four-cell, 16-week controlled clinical trial for HIV-positive patients with depressive symptoms. Patients (N = 101) were randomized to 16 weeks of treatment with interpersonal psychotherapy, cognitive-behavioral therapy (CBT), supportive psychotherapy, or imipramine plus supportive psychotherapy. Analyses found an ethnicity-by-treatment interaction wherein African-American subjects (n = 18) assigned to CBT (n = 4) had significantly poorer outcomes than other patients. This is the first study to uncover an ethnicity-by-specific psychotherapy interaction. Its meaning is unclear. This charged topic requires cautious treatment, particularly given the small sample size in this study, but warrants further research.

Health locus of control, distress, and utilization of protease inhibitors among HIV-positive men.

OBJECTIVE: To investigate the relationship between health locus of control (HLOC), distress, and protease inhibitor (PI) utilization in gay/bisexual men in all stages of HIV illness. METHOD: A total of 173 men participating in a longitudinal study of the psychological effects of HIV illness were administered a number of psychological distress measures and the HLOC scale. The association between the HLOC subscales, distress, and PI utilization was evaluated. RESULTS: In addition to physical symptoms, the attribution of health status to chance or fate significantly predicted depressive symptoms, feelings of hopelessness, and recent life stress. Results also demonstrated a significant relationship between strong, positive beliefs in doctors and other health care professionals and PI utilization. CONCLUSION: The results of this study point to a strong association between beliefs that health status is related to chance or fate and distress. In addition, beliefs in physicians and other health care providers appear to contribute to decisions to initiate PI therapy.

[Catalytic properties of dust as criteria of its occupational hazards]. / Kataliticheskie svoistva pyli kak kriterii ee professional'noi opasnosti.

The catalytic properties of fire clay (kaolin) and mullet dusts versus quartz, asbestos, and coal ones were studied. Kaolin and mullet were found to have different catalytic capacities mainly of forming free radicals. The dust of kaolin increased the level of superoxide anion radical and hydrogen peroxide in the granulocytic suspension and H2O2/O2 ratio to a lesser extent than that of mullet and quartz. Differences in the catalytic capacity of the examined dusts confirm the findings from the investigations of their effects on plasma lipid peroxidation (LPO). Kaolin and quartz were the least in elevating LPO. As compared with kaolin and quartz, the effects of mullet and asbestos were 2.5 and 6.5 higher, respectively. The substances were different in their genotoxicity.

Plans to hasten death among gay men with HIV/AIDS: relationship to psychological adjustment.

This study assessed the prevalence and nature of thoughts and future plans to end one's life in a group of gay men with HIV/AIDS over an 18-month period. HIV-positive men (n = 167) participated in a series of clinical interviews which measured current health status, current and past psychiatric disorders, current levels of distress, and thoughts and plans about ending their lives currently or at some future point. A small number of HIV-positive men (17%) reported serious thoughts or plans to end their lives at some point in the future which were stable over an 18-month period. No differences in psychiatric or medical measures were observed among men with and without thoughts/plans at either assessment point. In the absence of current psychiatric disorders, such thoughts or plans about the future may represent one way to maintain control and independence in the face of the uncertainty of life with HIV illness.

Role of health communications in Russia's diphtheria immunization program.

As part of a broader program in health communication assistance, project staff from Basic Support for Institutionalizing Child Survival worked with staff from Russia's oblast (regional) public health agencies to design and implement communication activities supporting local diphtheria immunization efforts. Because aggressive community outreach efforts and strong administrative sanctions had already achieved impressive adult coverage rates for first doses of diphtheria toxoid vaccine, communication interventions emphasized the need for second and third doses. Outcomes were assessed through vaccination coverage data and more qualitative measures. In one project site, the increase in adult coverage (two or more doses) was very modest. In a second site, with a stronger communications component, coverage increased significantly (from 20% to 80%). Although it is not possible to disentangle completely the effects of communications from other aspects of oblast immunization programs, these and other outcome data suggest that health communications can play an important role in Russia's ongoing mass immunization efforts.

[Characteristics of work conditions in mullitic refractories production]. / Kharakteristika uslovii truda na proizvodstve mullitovykh ogneupornykh izdelii.

Specific feature of occupational medicine in highly aluminiferous mullitic refractories production nowadays is dust factor associated with disintegration, crushing and pressing of fireclays and coal clays. Therefore average shift dust levels increase and considerably exceed the MAC. Calcination process is associated with slightly exceeded MAC for sulphur dioxide and carbon dioxide and MAL for noise.