[Alcohol-related mortality in the assessments of hospital unit physicians and pathologists: analysis of accounting medical documents].

AIM: To make a comparative analysis of the data available in the accounting medical documents drawn up at a multidisciplinary hospital on the level and structure of alcohol-related mortality (ARM) and to evaluate the efficiency of its accounting. MATERIALS AND METHODS: Accounting medical documents, such as 453 inpatient cards (Form 003/y), 453 postmortem protocols (cards) (Form 013/H-80), and 453 death certificates (Form 106/y-08), were chosen as the basis for the study. The data of the final clinical and postmortem diagnoses in the patients who had died at hospital and their primary cause of death were comparatively analyzed. RESULTS: According to Form 003/y, ARM was 5.5%; the detection rate of alcohol-related disease (ARD) was 11% (95% confidence interval (CI), 8.3 to 14.3%); according to Form 013/H-80, ARM was 7.1% (95% CI, 4.9 to 9.8%) and the detection rate of ARD was 12.6% (95% CI, 9.7 to 16%). The consistency of the diagnoses of ARD as a main cause of death, made by hospital unit physicians and pathologists, is estimated as the mean--the Cohen's kappa coefficient (kappa) is 0.570) (p < 0.001). CONCLUSION: The results of the investigation suggest that there are 3 types of ARM, which differ in its level and structure: ARM in the assessments of hospital unit physicians; that in the assessments of pathologists, and that according to the death certificates drawn up. The consistency index for the diagnosis of ARD as a main cause of death indicates that the hospital unit physicians only determine the etiology of alcohol-related cause of death, without identifying it specifically.

[Socio-demographic status of elderly and senile age people died from alcohol-attributable states in Arkhangelsk].

To determine the characteristics of the socio-demographic status of elderly and senile age people died of alcohol-attributable states in Arkhangelsk, data from the medical certificate of death was analyzed. Data of death for persons who died in the city of Arkhangelsk in the period from 1 July 2011 to 30 June 2012 (one year) were copied out. The vast majority of alcohol conditioned deaths among men occurs in middle (working) age, 1/3 of women--over the age of 60 years. The alcohol-attributable mortality revealed the transformation of the structure of women over the age of 60 years compared with the mature age. Gender and age significantly affect the probability of death from alcohol only attribute states after 60 years. The results of the study indicate a different impact on the character of the individual sociodemographic factors on the probability of death from alcohol-attributable states in elderly and senile age.

[On the problem of registration of mortality associated with alcohol consumption among the population in the forensic medical practice].

The objective of the present study was the comparative analysis of the data obtained from the available medical documentation with a view to estimating the effectiveness of taking into account the mortality associated with alcohol consumption. The data subjected to the analysis included the age and the gender of the deceased subjects, complete forensic medical diagnoses from 1607 expert reports and acts of forensic medical expertise of the corpses (form 171/y), and information about the cause of death (item 19) from the relevant medical death certificates (form 106y/08). The mortality associated with alcohol consumption estimated based on the expert reports and acts of forensic medical expertise of the corpses (form 171/y) amounted to 6.7% (95% CI: 5.5- 8.1%); the occurrence of pathology attributable to alcohol consumption was estimated at 7.2% (95% CI: 5.9-8.5%) of the total number of deaths. It was shown that forensic medical experts do not employ in the full measure the diagnostic potential of the International Classification of Diseases (ICD-10) when having to deal with the mortality associated with alcohol consumption. The results of the study confirm the qualitative transformation of the alcohol attributable mortality structure associated with the transfer of information from the expert reports and acts of forensic medical expertise of the corpses (form 171/y) to the medical death certificates (form 106/y-08).

[The mortality because of conditions related to alcohol consumption].

The article presents the systematization of data concerning alcohol-depended mortality as a occurrence with complicated structure. It is established that grouping of alcohol-depended mortality on isolated components is conditioned by different nature of unhealthy consumption of alcohol in the development of alcohol-depended conditions as a conditional and/or supporting factor. Among other causation factors article points out the input of pattern of alcohol consumption into the value of risk of development of alcohol-attributive conditions and two-way impact of unhealthy alcohol consumption at the risk of development of particular alcohol-attributive conditions.

[Prevention of beer dependence in adolescents in educational institutions].

The authors have systematized approaches to the prevention of beer dependence in adolescents and presented the inner structure of prevention in educational institutions in terms of consecutive steps. The author's methods for adolescence beer dependence diagnosis are described. Different forms of preventive work with adolescences and their parents allowing to combine flexibly the preventive methods with the participation of cross-functional specialists are presented.

[Effectiveness of the medical-psychological rehabilitation of combatants].

To analyze treatment effectiveness, authors examined 199 combatants during the first days and in 1.5 month after their return from combat zones. Stages and content of medical-psychological rehabilitation, including psychopharmacotherapy and psychotherapy, are described. The significant improvement in clinical and social-psychological characteristics of patients was revealed. The reduction of main psychopathological symptoms was identified in patients with adaptation disorders as well as with post-traumatic-stress disorders. The necessity of rehabilitation for all combatants after their return from combat zones has been grounded.

[Functional features of the nervous system in adolescents using inhalants].

The study of features of the nervous system functioning with a complex of physiological methods in adolescents using inhalants has detected the significant functional asymmetry of hemispheres, imbalance and lability of nervous processes, domination of medium-weak and weak response of the nervous system, low speed of response, poor dynamics of nervous processes, disturbance of regulation and control of psychic activity. It has been proposed to use assessment of the functional status of the nervous system during inhalant in medical-diagnostic practice for development of individual correction programs.

[Epidemiological characteristic of non-psychotic mental disorders in elderly persons in Arkhangelsk region].

The epidemiological characteristic of non-psychotic mental disorders (NMD) in elderly persons in the Arkhangelsk region in 1999-2010 has been studied. The results of the study show that the NMD prevalence among the elderly persons in the Arkhangelsk region was 07-1.1%; in the morbidity dynamics, there has been registered an increase in the number of the NMD cases among the elderly persons with the increase peak in 2007 and the tendency of development beginning from 2009. In NMD structure the organic nonpsychotic disorders and neurotic and somatoform disorders predominated. Since 2010, a tendency of a decrease in the share of organic non-psychotic disorders (up to 58.5%), an increase in the share of neurotic and somatoform disorders (up to 32.2%) and personality disorders (up to 4.2%) are observed. An analysis of specificity of psychotherapy delivery has been done, a necessity of registration of the NMD prevalence and structure, the comorbide pathology, the age and social-economic characteristics of the elderly persons has been grounded.

[A new method of producing biologically active nanocomplexes by non-covalent conjugation of proteins with viral particles].

Currently, a range of biologically active molecules have been attached to plant and bacterial viras nanoscaffolds, yielding stable nanoparticles that display multiple copies of the desired molecule. In this paper we propose a new method of non-covalent attachment of peptides to the surface of virios. We have demonstrated that this method is efficient in a model system that includes tobacco mosaic virus particles, synthetic polycation (quaternized poly(4-vinylpyridine) carrying ethyl ethyl pendant radicals) and polypeptide of interest. This principle of step-by-step binding to the surface of virions was used for electrostatic association with hydrophilic fragment of influenza virus haemagglutinin.

[Quality of life and biological age of elderly persons with alcohol dependence in conditions of European North].

The data of the assessment of quality of life of persons at the involutional age suffering from alcohol dependence in comparison with features of their physiological age have been presented. Quicker aging among the persons with alcohol dependence traced in parallel with their low social functioning and quality of life have been detected; it has been shown that in the elderly women, alcoholization accelerates aging in greater degree.

[Effectiveness of cortexin in the complex treatment of patients with chronic alcohol encephalopathy and polyneuropathy].

Investigation of therapeutic effectiveness of cortexin in chronic alcohol encephalopathy and chronic alcohol polyneuropathy was conducted in an open randomized study. The aim of the study was to compare these disorders with diabetic and professional polyneuropathy. Cortexin was prescribed in dose 10 mg/d intramuscular during 10 days, along with standard therapy. The group of patients consisted of 15 people with alcohol disorders, 15 people with diabetic polyneuropathy and 15 people with professional polyneuropathy. The control group included 15 patients with alcohol disorders who did not receive cortexin. Encephalography (EEG) and electroneuromyography (ENMG) were used in addition to the clinical examination. Cortexin had the positive effect on clinical symptoms, EEG and ENMG. The drug was well-tolerated, no side-effects were observed.

[The burnout syndrome in communicative professional workers].

To study the specific features of the burnout syndrome (BOS) in communicative professional workers, the authors examined 138 communicative workers (94 females and 44 males); of them there were 51 physical education masters, 43 elementary school teachers, 20 consulting shop assistants, and 24 legal officers. BOS was detected in more than two thirds of elementary school teachers and more than a third of physical education masters, consulting shop assistants, legal officers, and practitioners. The completely developed BOS was most frequently encountered in elementary school teachers (in every four individuals), slightly less frequently in practitioners, consulting shop assistants, and legal officers (in every ten persons). The highest BOS levels were observed in elementary school teachers having a service length of less than 5 years and in legal officers and practitioners having a service length of more than 10 years. The paper provides evidence for the expediency of complex preventive measures for the representatives of these professions and for psychological support of their professional activities.

[Main risk factors of psychosomatic diseases].

AIM: To reveal main risk factors (RF) of psychosomatic diseases and to design models of prediction of each nosological entity. MATERIAL AND METHODS: For design of a model of predicting the risk of different nosological entities of psychosomatic diseases, a standard linear regression model was used. The study included 482 patients with arterial hypertension (AH, n = 96), ischemic heart disease (IHD, n = 99), duodenal ulcer (DU, n = 60), bronchial asthma (BA, n = 52), diabetes mellitus type 1 (DM-1, n = 84) and 2 (DM-2, n = 91). RESULTS: The stress factor was essential in the onset of all the diseases and was registered in more than 90% cases. The other leading prognostic RF in AH were the following: heredity, age, hypodynamics, history of craniocerebral traumas. In IHD--AH, age over 50, dislipidemia, behavior pattern 1. In DU--alcoholism, malnutrition, Helicobacter pylori infection. In BA--reaction to atopic and infection allergens, physical and meteorological factors, allergic diseases. In DM-1--heredity and prior virus infections. In DM-2--obesity, IHD, AH, dislipidemia. CONCLUSION: A stress factor plays an important role in development of all the diseases studied. This confirms a psychosomatic nature of these diseases and point to necessity of rendering psychotherapeutic and psychological aid to such patients at early stages of the disease. The models proposed for prognosis of the risk to develop psychosomatic diseases can predict probability of the disease onset.

[Higher mental functions of the workers of the Ministry of Internal Affairs under extreme professional activities].

Mental (cognitive) processes were analyzed in officers from different subdivisions of internal affairs bodies during their service. The study parameters were found to be in the normal range, but at the same time there were significant differences between occupational groups. The more the length of service was, the more verbal information was kept in mind in officers from criminal investigation and inquiry departments and district militia inspectors. With more service, there is an increase in mental fatigue and a reduction in the level of combinatorial analysis in all study groups. The findings enhance the capacities of solving the problems of occupational selection, staff arrangement, timely psychological correction and prevention of mental diseases.

[Specificity of high psychic functions in children with impaired intellectual and speech development].

Babies and preschoolers with impaired psychic and speech development underwent psychological and psychophysiological examinations. The purpose was to detect comparative peculiarities of psychic processes of the higher nervous activity and to evaluate objectively the cognitive and thought processes in children with different levels of intellectual development. The results can be used in the differential diagnosis of impairments of the psychic and intellectual development as well as in the detection of individual specific features of a child while defining a scope of medical, psychological and pedagogical aid.

[Algorithm of life quality evaluation for patients with psychosomatic diseases]. / Algoritm otsenki kachestva zhizni u bol'nykh s psikhosomaticheskimi zabolevaniiami.

AIM: To elaborate the algorithm for evaluation of quality of life (QL) in patients with psychosomatic diseases. MATERIAL AND METHODS: AMPI, Spilberger-Khanin anxiety test, the procedures 'general state, activity, mood" and "personality differential". RESULTS: The algorithm of QL evaluation comprises a questionnaire consisting of 48 questions divided into 3 blocks. Quality of the somatic state was assessed by restrictions in exercise, self-care, everyday activity. A psychological component of QL was determined by the presence of depression, anxiety, emotional effects on everyday and professional activity; the social component--by relations in office, family, medical personal. The procedure was standardized, so QL should be considered as high at 97-144 points, good 87-96, satisfactory 44-86, unsatisfactory results were at 26-43 points, poor--at 0-25 points. CONCLUSION: The proposed technique of QL of psychosomatic patients proved its validity and reliability. Therefore, it can be recommended for design of psychosocial and medical rehabilitative measures as well as for assessment of efficacy of these measures.

[Distribution of excess body weight among female residents of Arkhangelsk]. / Rasprostranennost' izbytochnoi massy tela sredi zhenskogo naseleniia Arkhangel'ska.

The prevalence of obesity was studied among the female population of Arkhangelsk. A total of 1920 females aged 4 to 60 years were examined. The age of 4 to 7 years were ascertained to be the riskiest period for obesity among children and adolescents. Among girls aged 8 to 11 years, as well as in adolescence and youth, a third had insufficient body weights. 43.7% of the females aged 21 years of older had obesity and adiposity, which requires efforts to implement preventive measures to correct their weight.

[Quality of life in psychosomatic diseases]. / Kachestvo zhizni pri psikhosomaticheskikh zabolevaniiakh.

To study life quality (LQ) in psychosomatic diseases, 104 patients (58 females and 46 males) with these diseases were examined. Among them there were 35 patients with coronary heart disease (CHD), 28 with arterial hypertension (AH), 21 with type 2 diabetes mellitus (DM), 20 with duodenal peptic ulcer (PU). A matched group comprised 26 patients with acute pneumonia (AP). Low LQ was determined according to all 3 components: somatic, mental, and social. The lowest LQ was noted in patients with CHD, AH, and DM, indicating severity of these diseases accompanying marked changes in all spheres of life. PU was characterized by higher values that showed a fair LQ and that were due to a more favorable course of the disease. Patients with AP had a high LQ, which suggests that this acute disease does not lower LQ or accompany pronounced changes in human life. By and large, paychosomatic patients' LQ depended on age, severity, stage, and duration of a disease, disability.