[Prognostic role of p53 gene polymorphism in risk assessment of anthracycline-induced cardiotoxicity].

AIMS: To study the prognostic significance of polymorphism of the p53 gene (polymorphism Arg72Pro exon 4, rs1042522) on the development of cardiotoxic remodeling of the left ventricle and heart failure. MATERIAL AND METHODS: A total of 176 women with breast cancer who received anthracycline antibiotics as part of polychemotherapeutic treatment regimens were examined. Based on the results of the survey, 12 months after the end of polychemotherapy, patients in the remission of the underlying disease were divided into 2 groups: patients with cardiotoxic remodeling (52 patients) and women with preserved heart function (124 patients). All patients before the start of the course of chemotherapy, in the dynamics of treatment with anthracyclines and after therapy with such were carried out the study of echocardiographic parameters. All the patients were taken genetic material, followed by typing alleles of the gene for the protein p53 (rs1042522). RESULTS: Analysis of echocardiographic parameters in patients 12 months after the completion of polychemotherapy in comparison with those before treatment showed a significant difference in the final systolic (33 mm [31; 35] and 28 mm [26; 31], p<0.00001) and terminal diastolic dimensions (51 mm [49; 54.5] and 44 mm [42; 48.5], p=0.0003), as well as a significant decrease in the left ventricular ejection fraction (54.5% [51.5; 58] and 65.5% [62; 70], p<0.00001) in the group of women with developed anthracycline cardiotoxicity. The presence of the Arg/Arg genotype was associated with the development of cardiotoxic myocardial damage during polychemotherapy (OR=3.86, 95% C.I.=1.45-10.26, p=0.005). The Pro/Pro genotype has proved to be a protective factor (OR=0.26, 95% C.I.=0.09-0.69, p=0.015). The conclusion. Predicting the cardiotoxicity of chemotherapy using the polymorphism of the p53 gene is an effective measure of early pre-symptom diagnosis of an increased risk of anthracyclineinduced cardiotoxicity.

[Early symptoms of exacerbation of schizophrenia: views of patients, relatives and psychiatrists].

The study was carried out using focused interviews in three groups of responders - patients with several exacerbations of schizophrenia, their relatives and their psychiatrists. It has been shown that either patients or their relatives do not recognize the early symptoms of the exacerbation of psychosis. Three opposite approaches of responders to the issues related to awareness of disease and medical intervention were singled out: rational (in psychiatrists), autonomic (in patients) and emotional (in relatives). The authors substantiate the necessity of psychoeducational programs for patients aimed at bringing together interests of patients and psychiatrists with the following impact on the relatives who take the dualistic position with conformal readiness.

[Transformation of individual psychotic forms of alcoholism during the course of the disease (according to the findings of a clinico-epidemiologic study)]. / O transformatsii otdel'nykh psikhoticheskikh form alkogolizma v protsesse zabolevaniia (po dannym kliniko-épidemiologicheskogo issledovaniia).

The results of a clinical-epidemiological study of patients with chronic alcoholic psychoses are presented. The socio-demographic and clinical characteristics of patients with a recurrent and a continuous course of the psychotic forms of alcoholism are reviewed. The paroxysm-like course of the disease was characterized by the shortening of clear intervals between paroxysms and by its transformation into a more consistent and prolonged psychopathological syndrome. Data on disturbances of work-related adaptation in patients with the chronic forms of alcoholism are given. An analysis of the data obtained makes it possible to predict the probability of a change in psychotic states and also the duration of remissions.