[The prevalence of anxiety and depression in different regions of the Russian Federation and its association with sociodemographic factors (according to the data of the ESSE-RF study)].

AIM: To study the prevalence of anxiety and depression by psychometric methods (the Hospital Anxiety and Depression Scale (HADS) in different regions of the Russian Federation (RF), which are characterized by various climatic, geographic, economic, and demographic indicators. SUBJECTS AND METHODS: The investigation used the data of the multicenter epidemiological survey of cardiovascular diseases in different regions of the Russian Federation--the ESSE-RF study. The subjects of the study were representative samples from unorganized male and female populations aged 25-64 years from 10 RF regions. The survey included a total 16,877 people (6244 men and 10,623 women). All the examinees were interviewed using a standard questionnaire. An analysis involved their gender, age, education level, place and region of residence, and income and morbidity level. The HADS validated in Russia was used to rate the level of anxiety/depression. RESULTS: The total prevalence of higher anxiety and depression averaged 46.3 and 25.6%, respectively. Respondents with clinical anxiety/depression constituted more than one third of those who had a higher level of these conditions. In the examined population, the moderate level of anxiety/depression was 7.5 ± 0.06 and 5.1 ± 0.04, respectively. The population of Volgograd, Samara, Saint Petersburg, and Tomsk had the similar values of the moderate level of anxiety/depression (p > 0.05). The lowest level of anxiety/ depression (p < 0.0001) was seen in the dwellers of Tyumen (5.9 ± 0.1 and 3.4 ± 0.1, respectively) and the highest in the Republic of North Ossetia-Alania (NOA) (8.4 ± 0.1 and 6.8 ± 0.1, respectively). These regions showed the lowest and highest prevalence of higher anxiety (22% in Tyumen and 59.8% in the Republic of NOA (p < 0.0001). CONCLUSION: All the 10 selected RF regions differing in demographic, economic, climatic, and geographical parameters are characterized by a high level of anxiety that remains statistically significant after adjusting for gender and age, so are parameters, such as income and morbidity levels are present in only 4 of the 10 regions.

[Marked primary hyperparathyroidism not diagnosed before death]. / Vyrazhennyi pervichnyi giperparatireoz, ne diagnostirovannyi pri zhizni.

A case of primary hyperparathyroidism (PHPT) in a patient 47 years of age diagnosed only at autopsy is reported. PHPT deposits of calcium into the muscles and heart vessels provoked irreversible cardiovascular disorders which caused death. Renal lesions were intravitally diagnosed as isolated urolithiasis but not as manifestations of PHPT. High blood levels of ionised calcium in this patient were thought a laboratory mistake though the above clinical symptoms should have excluded such opinion.

[Polymagnetolaser correction of vegetative and bioelectric imbalance in patients with duodenal ulcer]. / Korrektsiia narushenii vegetativnogo i bioélektricheskogo balansa u bol'nykh iazvennoi bolezn'iu dvenadtsatiperstnoi kishki na osnove polimagnitolazernogo vozdeistviia.

90 patients with duodenal ulcer in exacerbation were divided into two groups. Control patients have received drugs against Helicobacter pylori (Hp). In addition to it, the test subjects were exposed to transcutaneous and reflex magnetolaser impact with consideration of baseline vegetative and bioelectric balance as shown by mathematical analysis of cardiac rhythm and Nakatani acupuncture diagnosis, monitoring of biopotentials of biologically active points. Impacts on general regulation systems in combined differential therapy of ulcer shorten ulcer healing, promote eradication of Hp, improve the condition of gastroduodenal mucosa.

[Methods of assessing the state of the digestive system in mass examinations of rural population]. / Metodika otsenki sostoianiia organov pishchevareniia pri massovykh obsledovaniiakh sel'skogo naseleniia.

On the basis of physician's logic a questionnaire has been elaborated for identifying the most common diseases of digestive system during mass medical check-ups of rural population. 98 combinations of signs were considered in the diagnostic algorithm for making conclusions regarding 11 diseases. The programme elaborated envisages recommendations on the volume of examinations necessary for verification of diagnoses. The questionnaire and rules governing it were verified for 152 patients. By means of mathematical statistics methods the informativeness of the signs used have been assessed. The analysis showed a great diagnostic value of choosing signs on the basis of physician's logic taking into account their pathogenetic correlation. The efficiency of questionnaires have been demonstrated and sufficient under conditions of automated examinations sensitivity (on the average for diseases 78.1%) and specificity (on the average for diseases 70.0%).

[Computer-assisted selection of therapeutic measures in ischemic heart disease and arterial hypertension during mass screening of a rural population]. / Vybor s pomoshch'iu EVM lechebnykh meropriiatii pri ishemicheskoi bolezni serdtsa i arterial'noi gipertonii v usloviiakh massovykh osmotrov sel'skogo naseleniia.

Expert assessments of 537 case histories of patients with various coronary heart diseases made it possible to derive an algorithm for automatic choice of therapeutic and prophylactic measures. This approach was tested within the framework of the automatic system "Cardioscreening". It was shown that there was a good correlation between the automatic choice of therapeutic and prophylactic actions and the strategy of a skilled cardiologist.

[Results of automatic screening for ischemic heart disease and arterial hypertension among the rural population]. / Rezul'taty avtomatizirovannogo vyiavleniia ishemicheskoi bolezni serdtsa i arterial'noi gipertonii sredi sel'skogo naseleniia.

The results of automated screening for coronary disease and arterial hypertension within large-scale preventive checkups of rural populations are reported. A system was developed, on the basis of Rose's questionnaire and the Minnesota Code, for the assessment of resting ECG, using a remote-control advisory panel and new mini-computers of domestic manufacture. A total of 6133 residents from several districts were examined. The efficiency and quality of the operation of the automated screening system was assessed. The use of automated data collection and analysis in conditions of large-scale preventive checkups was shown to be an important contribution towards the objective of universal preventive medical examinations of the population, rural population in particular.

[Use of an additionally intensified ECG in diagnosing ischemic heart disease]. / Primenenie dopolnitel'no usilennoi EKG v diagnostike ishemicheskoi bolezni serdtsa.

The article deals with the use of the additionally intensified ECG while conducting the bicycle ergometric test in 92 patients with coronary heart disease. It has been shown that when additionally intensified ECG is combined with bicycle ergometry the use of such parameters as the value of ST segment depression and the average rate of ST integral increases the resolving capacity of the technique. In patients with a positive result of the test according to the criterion of ST segment depression (0.1 mV or more), the ischemic changes on the additionally intensified ECG are determined one grade earlier than the threshold exercise and precede the anginal attack. In patients with an anginal attack without diagnostically significant changes on the ECG during 1 mV = 10 mm intensification, the employment of additionally intensified ECG makes it possible to identify the ischemic changes and confirm the pain attack by objective findings.

[Possibilities of utilizing integral topography, vectorometry and spectral analysis of the complexograms for the diagnosis of ischemic heart disease]. / Vozmozhnosti ispol'zovaniia integral'noi topografii, vektorometrii i spektral'nogo analiza kompleksogramm dlia diagnostiki ishemicheskoi bolezni serdtsa.

Three approaches to the study of electric and mechanical heart activity were used, which were significant in the diagnosis of various variants of ischemic heart disease. The method of integral topography proved most applicable in the diagnosis of microfocal myocardial infarction. Infarctions which were marked by a typical clinical picture and the corresponding laboratory data (changes in enzymes, leukocytosis, etc)., but could not be sufficiently revealed in the commonly applied 12 leads of the ECG, were successfully identified due to changes in the ST--T zones of the topogram. In the diagnosis of ischemic heart disease attended with disorders of hemodynamics it is advisable to apply the histogram method of identification on the basis of spectral analysis of the complexograms, ballistocardiograms, arteriovenous pulsograms, and phonooscillograms. This method may also be used to assess the stage of circulatory insufficiency. In preventive examination for detecting ischemic heart disease, its painless variants in particular, it is advantageous to use the method of vectorometry of the ECG in in orthogonal leads with the subsequent solution of the diagnostic discrimination polynomials on a computer.