THE ESTIMATION OF THE SOMATIC SIGNIFICANCE OF HYPERVENTILATION SYNDROME IN THE STUDIED WITH DIFFERENTIATED CARDIOLOGICAL STATUS

В статье представлены данные оригинального исследования по оценке фактической частоты встречаемости и значимости в формировании тяжести соматического состояния организма у трех групп обследуемых с различным кардиологическим статусом - условно здоровых лиц молодого возраста, пациентов пожилого возраста с хронической сердечной недостаточностью и пациентов с нестабильной стенокардией, протекающей на фоне сахарного диабета второго типа. Установлено, что во всех трех группах фактическая встречаемость гипервентиляционного синдрома является выше таковой, чем это считалось ранее на уровне традиционных представлений. Помимо этого, его присутствие имеет соматическую значимость для обследуемых с любым кардиологическим статусом, причем она возрастает по мере увеличения тяжести вовлечения в патологический процесс сердечно-сосудистой системы. Для условно здоровых лиц молодого возраста он вызывает субклинические негативные последствия, для пациентов с хронической сердечной недостаточностью - умеренные клинически значимые негативные последствия, для пациентов с нестабильной стенокардией на фоне сахарного диабета второго типа - выраженные клинические негативные последствия в виде ухудшения течения и исходов заболевания. Полученные результаты отличает новизна и практическая значимость, что позволяет рекомендовать их к дальнейшему учету в практике специалистов клиники внутренних болезней The article presents data from an original study to assess the actual frequency of occurrence and significance in the formation of the severity of the somatic state of the body in three groups of subjects with different cardiac status - conventionally healthy young people, elderly patients with chronic heart failure and patients with unstable angina pectoris occurring against the background of type 2 diabetes mellitus. It was found that in all three groups the actual incidence of hyperventilation syndrome is higher than it was previously thought at the level of traditional ideas. In addition, its presence has somatic significance for subjects with any cardiac status, and it increases as the severity of involvement in the pathological process of the cardiovascular system increases. For conventionally healthy young people, it causes subclinical negative consequences, for patients with chronic heart failure - moderate clinically significant negative consequences, for patients with unstable angina pectoris associated with type 2 diabetes mellitus - pronounced clinical negative consequences in the form of worsening of the course and outcomes of the disease. The results obtained are distinguished by their novelty and practical significance, which makes it possible to recommend them for further consideration in the practice of specialists in the clinic of internal diseases

Mid-Diastolic Events (L Events): A Critical Review

Mid-diastolic events (L events) include three phenomena appreciable on echocardiography occurring during diastasis: mid-diastolic transmitral flow velocity (L wave), mid-diastolic mitral valve motion (L motion), and mid-diastolic mitral annular velocity (L’ wave). L wave is a known marker of advanced diastolic dysfunction in different pathological clinical settings such as left ventricle and atrial remodeling, overloaded states, and cardiomyopathies. Patients with L events have poor outcomes with a higher risk of developing heart failure symptoms and arrhythmic complications, including sudden cardiac death. The exact mechanism underlying the genesis of mid-diastolic events is not fully understood, just as the significance of these events in healthy young people or their presence at the tricuspid valve level. We also report an explicative case of a patient with L events studied using speckle tracking imaging of the left atrium and ventricle at the same reference heartbeat supporting the hypothesis of a post-early diastolic relaxation or a “two-step” ventricular relaxation for L wave genesis. Our paper seeks to extend knowledge about the pathophysiological mechanisms on mid-diastolic events and summarizes the current knowledge.

The Trunk Rotation may Differentially Affect Lung Volume and Respiratory Muscle Strength in Males and Females

It is known that gender affect pulmonary function, associated with anatomical differences between male and female. However, the effects of trunk rotation on respiratory variables and its differences between males and females remain unclear. We examined the effects of gender and physical characteristics on postural changes in healthy young people. In this study, 9 males and 11 females (22 ± 1 year old for both males and females) were enrolled. We measure the vital capacity (VC), inspiratory capacity (IC), tidal volume (VT), expiratory reserve volume (ERV), inspiratory reserve volume (IRV), and force vital capacity (FVC) and respiratory muscle (PImax and PEmax) with rest posture in the sitting position (rest posture) in sitting position and 30° trunk rotation both genders in the sitting position (rotational posture). The value of VC, IC, ERV, IRV, FVC, or FEV1.0 for males were significantly higher than that for females in both postures. Further, PEmax was more affected by rotational posture in male than in female. On the other hand, PImax showed a significant decrease in the rotational posture only in females. This study indicated that the effect of rotational posture on PImax and PEmax, a measure of respiratory muscle strength, may be different between males and females. These finding may provide important insights on gender differences in respiration in daily living.

The relationship of psychological health and psychological culture of university students

На сегодняшний день важной задачей образования является воспитание психологически здорового поколения молодых людей с развитой психологической культурой. Цель статьи – выявление наличия взаимосвязи между психологическим здоровьем и психологической культурой студентов вуза. Авторами статьи сформулирована следующая гипотеза: между психологическим здоровьем и психологической культурой студентов вуза существуетвзаимосвязь. В статье проанализированы сущность понятий «психологическое здоровье», «психологическая культура» с позиций разных авторов, рассмотрены показатели психологического здоровья, критерии развития психологической культуры. Результаты исследования авторов показывают, что между психологическим здоровьем и психологической культурой студентов существует взаимосвязь. Полученные результаты позволяют сделать следующее заключение: развивая культуру студентов, общество получает психологически здоровых молодых людей, которые в свою очередь будут ориентированы на сохранение и дальнейшее развитие культуры общества. Today, an important task of education is the upbringing of a psychologically healthy generation of young people with a developed psychological culture. The purpose of the article is to identify the relationship between psychological health and psychological culture of university students. The authors of the article formulated the following hypothesis: there is a relationship between psychological health and psychological culture of university students. The article analyzes the essence of the concepts of "psychological health", "psychological culture" from the positions of different authors, considers indicators of psychological health, criteria for the development of psychological culture. The results of the authors' research show that there is a relationship between psychological health and psychological culture of students. The results obtained allow us to draw the following conclusion: by developing the culture of students, society receives psychologically healthy young people, who in turn will be focused on the preservation and further development of the culture of society.

Participatory Design of a Mobile App to Safeguard Mental Resilience in the Context of Drug Use in Young Adults (Preprint)

BACKGROUND Existing mental health apps are largely not aimed at generally healthy young people who may be experimenting with addictive subbstances and mind-altering experiences. It is unknown whether healthy young people would make use of and benefit from an app that could lower the risk of mental breakdowns associated with drug use and engagement in mind-altering spiritual experiences. OBJECTIVE The objective of this study was to examine the interest and expectations of young people regarding a proposed smartphone app designed to help protect and promote mental health and resilience in the face of risks associated with substance abuse. METHODS The study was based on agile system development and had three empirical sub-studies. Study 1 comprised a feasibility survey among 339 Israelis aged 18-30. This survey examined the potential interest of young people in this type of app. Study 2 was a participatory design study involving seven focus groups of 5-7 participants each (a total of 38 young people aged 18-35). Persona development, open discussion, and a technology acceptance model questionnaire were used to elicit users' expectations and requirements for the app, and to understand the perceived usefulness and usability of the proposed features. Study 3 comprised in-depth interviews with experts in the field of youth mental health and drug use, to enlist their professional opinion regarding the value of such an app and recommendations about the features it should include. RESULTS The mockup for the proposed app had five key features: personalized assessment of risk for a drug-associated mental crisis, support for self-monitoring, useful information (eg, warning signs and first-aid guidelines), resilience-building exercises, and a support center. Participants rated highly the usefulness of all five main features and 24 of the 25 specific features we proposed within those main categories. Participants also suggested additional features as well as a new user persona we had not considered: the parents or family members of the young person. The focus groups highly rated the perceived usability of the app. Most experts saw value in all the main features and suggested specific knowledge sources for the app’s content. Finally, participants of both the feasibility study and the participatory design study expressed moderate to high interest in using the app for self-help, and high interest in using the app to help their friends. CONCLUSIONS The findings provide preliminary encouraging support for the five main features suggested by the research team, and reinforce recommendations for mHealth apps found in the literature. The findings emphasize the insight that this kind of app should be designed primarily for use by individuals seeking to help others.

GENDER-DEPENDENT HEMOSTASIS PROFILE IN APPARENTLY HEALTHY YOUNG PEOPLE

The objective of the study is to reveal the parameters of red blood cells, rheology, endothelin level, Willebrand factor, tPA-PAI-1 complex, antithrombin III, procoagulantive mechanisms of the hemostatic system and fibrinogen in medical students in the process of learning, taking into account gender differences. Materials and Methods. We examined 100 relatively healthy people (50 men and 50 women who did not have any complaints, were not under regular medical check-up, and did not have any proven diagnoses). The absence of diseases was confirmed by medical documentation, since all study participants underwent an annual preventive examination for admission to study. The volunteers were 18–30 years old. Results. Women had a higher endothelin level if compared with healthy men, which led to less powerful vasoconstriction and increased procoagulant blood activity. At the same time, higher levels of both procoagulant, anticoagulant and fibrinolytic blood activity were recorded. A significantly lower concentration of the tPA-PAI-1 complex and a change in the vWF index were also noted. In addition, relatively healthy women showed greater activity of VIIIa factor, higher resistance of Va factor to active protein C, and significantly higher fibrin content if compared with healthy men. Key words: sex differences, rheology, endothelin level, Willebrand factor, tPA-PAI-1 complex, AT III, procoagulantive mechanisms of the hemostatic system and fibrinogen. Цель. Выявить особенности показателей красной крови, реологии, уровня эндотелина, фактора Виллебранда, комплекса tPA-PAI-1, антитромбина III, прокоагулянтных механизмов системы гемостаза и фибриногена у студентов медицинских вузов с учетом половых различий в процессе обучения. Материалы и методы. Было обследовано 100 относительно здоровых (не предъявлявших жалоб, не состоявших на диспансерном учете и не имевших установленных диагнозов) человек (50 мужчин и 50 женщин). Отсутствие заболеваний подтверждалось медицинской документацией, так как все участники исследования проходили ежегодный профилактический осмотр для допуска к учебе. Возраст добровольцев составлял от 18 лет до 30 лет. Результаты. У женщин отмечался более высокий уровень эндотелина по сравнению со здоровыми мужчинами, что приводило к менее мощной вазоконстрикции и усилению прокоагулянтной активности крови. При этом были зарегистрированы более высокие значения как прокоагулянтной, так и противосвертывающей и фибринолитической активности крови. Одновременно с этим отмечена достоверно более низкая концентрация комплекса tPA-PAI-1, изменение показателя vWF. Кроме того, у относительно здоровых женщин была зафиксирована большая активность фактора VIIIа, более высокая резистентность фактора Vа к активному протеину С, а также достоверно более высокое содержание фибрина по сравнению со здоровыми мужчинами. Ключевые слова: половые различия, реология, уровень эндотелина, фактор Виллебранда, комплекс tPA-PAI-1, АТ III, прокоагулянтные механизмы системы гемостаза и фибриногена.

P056 Using Polysomnography in Young People with Borderline Personality Disorder: A Pilot and Feasibility Study

Introduction Few studies have assessed sleep in young people (aged 15–25 years) with BPD using polysomnography. The feasibility of using polysomnography in this population might be questioned due to polysomnography’s invasiveness, anxiety and sensory sensitivities in BPD, and misconceptions that individuals with BPD are uncooperative and non-compliant. This study aimed to provide pilot sleep quality and architecture data and assess polysomnography feasibility. Method Participants were 13 females aged 15–25, 7 (Mage = 19.97, SD = 3.15) with BPD and 6 age-matched healthy controls (Mage = 20.13, SD = 3.31). Participants completed two non-consecutive nights of polysomnography monitoring (second night’s data were used in analyses). Participants were given the option of completing polysomnography monitoring at home or in a sleep laboratory. Results Young people with BPD displayed less arousals across the night and specifically during NREM sleep compared with healthy young people. All other sleep parameters were comparable across groups. There was considerable heterogeneity among participant preferences for in-home vs. sleep laboratory-based monitoring, due to comfort, safety, convenience, interest in seeing a sleep laboratory, or their living situation (eg. presence of bed partner at home). Anxiety was identified as a potential barrier to polysomnography research in this population. Discussion There were some indications of more consolidated sleep in BPD, which might reflect a greater sleep need in this population. The feasibility and tolerability of in-home and sleep laboratory-based polysomnography were demonstrated. Future protocols should incorporate ways to minimise anxiety, for example through providing a choice of monitoring location.