[Epidemiology of Arterial Hypertension in Russian Federation - Importance of Choice of Criteria of Diagnosis].

PURPOSE: Assessment of prevalence of arterial hypertension (AH), need for prescription of antihypertensive therapy (AHT), and efficacy of AHT in Russian population in accordance with novel guideline of the American College of Cardiology/American Heart Association ("American recommendations") on diagnosis and treatment of AH (2017). MATERIALS AND METHODS: Epidemiological study ESSE-RF (ЭССЕ-РФ) was carried out in 12 regions of Russian Federation (RF) with different climatic-geographic characteristics. Number of examined residents of RF aged 25-65 years was 20 652. The sample was stratified by  gender and age. Examination included anthropometry, laboratory tests, blood pressure (BP) measurement with the OMRON tonometer. The SCORE scale was used for evaluation of risk of development of cardiovascular diseases (CVD). In  American recommendations AH was defined as  follows: 1-st degree  - systolic BP (SBP) 130-139  and/or diastolic BP (DBP) 80-89 mm Hg, 2-nd degree - BP ≥140/90 mm Hg and/or presence of AHT. In recommendations of the European Society of Cardiology (2013, 2018) ("European recommendations") AH was defined as BP ≥140/90 mm Hg and/or presence of AHT. RESULTS: We analyzed data of examination of  20 607  participants - 7806 men (37.9%) and 12 801  women (62.1%). According to  European recommendations AH was diagnosed in 10 347  persons (50.2%)  - 3987 men (51.1%) men and 6 360 women (49.7%). According to American recommendations AH was registered in 14 853 persons (72.1%) - 6 059 men (77.6%) and 8 794 women (68.7%). AHT received 6324 persons (61.1% of those with AH); according to American recommendations, the onset of AHT was indicated to additional 620 persons with 1-st degree AH because of high CVD risk. Among all participants with AH (on and without AHT) strengthening of AHT for achievement of target BP level was required in 77.8 and 92.6% of patients according to European and American recommendations, respectively. CONCLUSION: Application of novel criteria of AH diagnosis from 2017 ACC/AHA guideline to Russian population would increase prevalence of AH up to 72.1%. Onset of AHT would be indicated in 13.8% of patients with 1-st degree AH, while in 93% of patients receiving AHT its strengthening would be required.

[Assessment of life quality and job satisfaction of neurosurgeons in the Russian Federation (a sociological study)]. / Otsenka kachestva zhizni i professional'noi udovletvorennosti neirokhirurgov, rabotaiushchikh v RF (sotsiologicheskoe issledovanie).

PURPOSE: The study purpose was to investigate and evaluate factors of career satisfaction among neurosurgeons in the Russian Federation. MATERIAL AND METHODS: During the pilot study, 217 neurosurgeons in the Russian Federation were surveyed in 2016. The survey was conducted through an anonymous voluntary questionnaire. The questionnaire consisted of four sections: 1) demographic data; 2) evaluation of professional stress factors; 3) characteristics of job satisfaction; 4) quality of life indicators. Responses in ordinal scales were evaluated using one-dimensional frequency analysis; factors related to career satisfaction were assessed using correlation and regression analyses. RESULTS: More than 80% of the respondents were males under the age of 40, ordinary doctors, without a scientific degree, with less than 15 years of work experience, performing less than 150 operations a year, and receiving wages less than 60 thousand rubles per month. The most common negative job-related factors of occupational stress included a large amount of work with medical records and insufficient wages. Only 51% of neurosurgeons were in general satisfied with their career. The greatest dissatisfaction in more than 55% of respondents was associated with the lack of time for personal development. More than 83% of respondents considered their legal protection insufficient. A correlation analysis revealed the greatest correlation (about 0.4) between career satisfaction and opportunities for professional growth as well as between mutual understanding with colleagues and confidence in the future. In addition, a regression analysis revealed the following factors: time for doing science, confidence in a stable salary, work on weekends, knowledge of English, and insufficient supply of consumables. CONCLUSION: Career satisfaction of the neurosurgeon depends mainly on working conditions and confidence in career prospects.

Intravital and postmortem diagnostics of myocardial hypertrophy of the left ventricle:identity or convention?

AIM: The aim of the study is to assess the compliance of the results of electrocardiographic (ECG) and echocardiographic diagnostic methods of hypertrophy of left ventricular myocardium (LVH) with the postmortem finding of measurement of left ventricular myocardium mass (LVM). MATERIALS AND METHODS: We examined the data of intravital study of anthropometric measurements [age, height, weight, body mass index (BMI)], instrumental results [12-lead ECG, EchoCG], as well as the postmortem finding (direct measurement of LVM at autopsy) in 15 patients of general therapy department. While analyzing ECG we studied as conventional ECG criteria for the detection of LVH as well as the author's own criteria based on two models (regression and discriminant analyses), including voltage, sex and age criteria. Echocardiographic diagnostic method used to calculate LVM (according to ASE formula) and left ventricular mass index (LVMI). Postmortem finding of LVM was carried out according to the standard measurement method. According to the absence of the single conventional postmortem finding of measurement of LVH, we considered three different variants of the postmortem finding of LVH: the criterion of K. Bove et al. (CB); the criterion of A.M. Lifshitz, also called ventricular index (VI) and the criterion of P. Casale - the left ventricular mass index at autopsy (LVMI). RESULTS: Conventional ECG criteria for the detection of LVH showed high specificity (71-100%) using any method of the postmortem finding of measurement, but were characterized by extremely low sensitivity (0-37.5%). Their overall diagnostic accuracy was higher on using K. Bove or A.M. Lifshitz criteria (40-66.7%) and low - on using the criterion of P. Casale (13.3-40%). The author's ECG criteria were less specificity (50-100%) and had higher sensitivity (54-75%), and their diagnostic accuracy remained higher and showed small dependence on the method of the postmortem finding of measurement of LVH (60-66.7%). CONCLUSION: Usually the ECG criteria to diagnose left ventricular hypertrophy were expectedly showed low sensitivity using any method of the postmortem finding of measurement. Meanwhile, the author's own ECG criteria associated with the most sensitive electrocardiographic characteristics to LVH and sex and age-specific indexes of the examined patients exceeded the conventional ECG criteria in sensitivity and diagnostic accuracy.

[Gender Differences of Behavioral Risk Factors in Saint-Petersburg Inhabitants].

BACKGROUND: In developed countries there are significant gender differences in lifetime expectancy that can be explained by behavioral risk factors (RF). OBJECTIVE: The aim of our study was to estimate gender features of behavioral RF in general population of Saint-Petersburg, Russia. METHODS: As a part of all-Russian epidemiology survey ESSE-RF a random sampling of 1600 Saint-Petersburg inhabitants (25-64 y.o.) stratified by age and sex was performed. All participants filled in the questionnaire. Anthropometry (weight, height, body-mass index (BMI), waist circumference (WC) and fasting blood-tests (lipids, glucose by Abbott Architect 8000 (USA)) were performed. RESULTS: There were examined 573 (36%) men and 1027 (64%) women. No gender differences in obesity were found according to BMI criteria--in 178 (31.2%) women and 352 (35.1%) men. Obesity was more often detected in females according to WC criteria: ATPIII--44.1 vs 30.3%; IDF 51.2 vs 66.4% (p < 0.001 for both). Linear regression analysis was performed and age was associated with BMI--1.6 kg/m2/decade, WC in women--5.2 cm/decade and WC in men--2.8 cm/decade, p < 0.001 for all anthropometric parameters. Optimal level of physical activity was equally documented in both genders--540 (61.2%) women and 286 (58.9%) men. Daily intake of sweets was lower in men--228 (39.8%) vs 539 (52.5%) in women (p < 0.001). 810 (50.6%) of trial subjects were non-smokers, 395 (24.7%) were former smokers, and 395 (24.7%) were smokers at the moment of trial. The higher number of female smokers was observed--194 (19.1%). CONCLUSION: A high prevalence of obesity is observed in sample of Saint-Petersburg inhabitants--it is higher among women according to WC criteria regardless of menopause, possibly due to bigger sweets consumption. Males smoke more often and consume less fresh fruits and vegetables which is accompanied by a higher prevalence of hyperglycemia and hypertriglyceridemia.

[Features of clinical course of primary peritonitis in children].

The article presents an analysis of the features of primary peritonitis in children. Medical reports of 182 patients with primary and appendicular peritonitis were analyzed. It was significant, that the sick girls aged 4-7 years often had the primary peritonitis after acute inflammatory processes, which took place a month earlier. Chronic infection foci were noted in these patients. The age-specific features of maturation of the immune and reproductive systems predisposed the disease.

[Immunological features of children with primary peritonitis].

An immunological research of the patients and control group with primary peritonitis was made. The main indices of immune response were in the range of age rates. However, the immune signs of foci of chronic inflammation were revealed in patients after operation. The consequences of disease (an abdominal cavity effusion) were eliminated during surgical interventions, but not the cause of the inflammation. Children with the primary peritonitis should be examined for detection of infection foci.