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Mcdonald H.,London School of Hygiene and Tropical Medicine | Borinskya S.,Vavilov Institute of General Genetics | Kiryanov N.,Izhevsk State Medical Academy | Gil A.,London School of Hygiene and Tropical Medicine | And 3 more authors.
Addiction | Year: 2013

Aims: To assess the performance of a range of biomarkers of alcohol consumption in a heavy-drinking population of working-aged Russian men. Design: Cross-sectional study of men originally sampled at random from a population register. Setting: Izhevsk, a Russian city with a population of 650000 people. Participants: A total of 1023 men aged 27-59 years living in Izhevsk who took part in a health check examination in 2008-2009. Measurements: Self-reported alcohol consumption, hazardous drinking behaviours, socio-economic position, anthropometric measurements plus blood levels of alcohol biomarkers [carbohydrate-deficient transferrin (CDT, gamma-glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and mean cell volume of erythrocytes (MCV)] and hepatitis B and C status. Findings: In the year before interview there was a high prevalence of high-risk alcohol consumption indicated by consumption of non-beverage alcohols (5%), problem drinking behaviours (4.4%) and alcohol consumption exceeding an average 40g per day (12.6%). All biomarkers were associated strongly with total beverage alcohol consumption even after adjustment for confounders. CDT performed best as an alcohol biomarker, with a sensitivity of 67% and specificity of 71% for detecting an average consumption of more than 40g per day versus less. For all biomarkers sensitivity was considerably lower than specificity. Hazardous drinking patterns per se were not well detected by any of the biomarkers, all with sensitivity below 60%. Conclusions: In a Russian population with high levels of alcohol consumption, carbohydrate-deficient transferrin (CDT) might be the most sensitive and specific biomarker for detecting ethanol consumption above 40g/day. A biomarker reflecting hazardous drinking patterns has yet to be established. © 2013 Society for the Study of Addiction. Source

Cook S.,London School of Hygiene and Tropical Medicine | Leon D.A.,London School of Hygiene and Tropical Medicine | Kiryanov N.,Izhevsk State Medical Academy | Ploubidis G.B.,London School of Hygiene and Tropical Medicine | De Stavola B.L.,London School of Hygiene and Tropical Medicine
PLoS ONE | Year: 2013

Background:Acute alcohol-related dysfunctional behaviours, such as hangover, are predictive of poor health and mortality. Although much is known about the association of education with alcohol consumption, little is known about its association with these dysfunctional behaviours.Methods:The study population was 1,705 male drinkers aged 25-54 years resident in the city of Izhevsk, Russia who participated in a cross-sectional survey (2003-6). Structural equation modelling was used to examine the relationships between education, beverage and non-beverage alcohol intake, drinking patterns, and acute alcohol-related dysfunction score among these drinkers.Results:Dysfunction was related to all other drinking variables, with the strongest predictors being spirit intake, non-beverage alcohol consumption and drinking patterns. There was a strong relationship between education and acute dysfunction which was not explained by adjusting for alcohol intake and drinking patterns (mean adjusted dysfunction score 0.35 SD (95% CI 0.10, 0.61) lower in men with higher versus secondary education).Conclusions:Although by definition one or more aspects of alcohol consumption should explain the educational differences in alcohol-related dysfunction, detailed information on drinking only partly accounted for the observed patterns. Thus beyond their intrinsic interest, these results illustrate the challenges in constructing statistical models that convincingly identify the pathways that link educational differences to health-related outcomes. © 2013 Cook et al. Source

Dimov A.S.,Izhevsk State Medical Academy
Cardiovascular Therapy and Prevention (Russian Federation) | Year: 2015

Prevention of the diseases, particularly cardial pathology, has its very significant controversies. The idea of the risk factors did not give the expected results. Causality of the majority of diseases is still unknown or not fully understood. This leads to inability of predicting. The article provides the reader with theoretical and practical experience evaluation of the XX century upon the problem of causality (etiology) of diseases. The original definition of causality is expressed and vindicated as its applied significance. Source

Ruys T.P.E.,Erasmus Medical Center | Roos-Hesselink J.W.,Erasmus Medical Center | Pijuan-Domenech A.,Hebron University | Vasario E.,SantAnna Hospital | And 8 more authors.
Heart | Year: 2015

Objectives In the general population, planned caesarean section is thought to be safer in high-risk situations as it avoids the greater risk of an emergency caesarean section. Only limited data exist on the optimal mode of delivery in women with structural heart disease. We investigated the relationship between mode of delivery and pregnancy outcome in women with preexisting heart disease. Methods The Registry on Pregnancy and Cardiac Disease is an on-going, global, prospective observational registry of women with structural heart disease. We report on 1262 deliveries, between January 2007 and June 2011. Results The caesarean section was planned in 393 women (31%): 172 (44%) for cardiac and 221 (56%) for obstetric reasons of whom 53 delivered by emergency caesarean section. Vaginal delivery was planned in 869 (69%) women, of whom 726 (84%) actually delivered vaginally and 143 (16%) had an emergency caesarean section. Perinatal mortality(1.1 vs 2.7, p=0.14) and low apgar score (11.9 vs 10.1, p=0.45) were not significantly different in women who had a caesarean section or vaginal delivery; gestational age(37 vs 38 weeks p=0.003) and birth weight (3073 vs 2870 g p<0.001) were lower in women delivered by caesarean section compared with women delivered by vaginal delivery. In those delivered by elective or emergency caesarean section, there was no difference in maternal mortality (1.8% vs 1.5%, p=1.0), postpartum heart failure (8.8% vs 8.2% p=0.79) or haemorrhage (6.2% vs 5.1% p=0.61). Conclusions These data suggest that planned caesarean section does not confer any advantage over planned vaginal delivery, in terms of maternal outcome, but is associated with an adverse fetal outcome. Source

Gaisin I.R.,Izhevsk State Medical Academy
Terapevticheskii Arkhiv | Year: 2012

Aim. To investigate cardiorenal correlations in pregnant patients with arterial hypertension. Material and methods. Risk factors (RF), initial stages, progression, andfinal stage of both cardiovascular disease (CVD) and chronic kidney disease (CKD) were analysed in a cohort of 159pregnant women with hypertensive disorders versus a cohort of 32 healthy pregnant controls. Cardiorenal continuum factors were investigated in patients with different ways of gestational hypertension (HT) diagnosis: 13 with isolated clinic HT (ICHT), 11 - isolated ambulatory HT (IAHT), and 18 - HT found by all three blood pressure (BP) measurement modalities (clinic, ambulatory, and home BP).Results. A novel cardiorenal continuum exists in pregnant women with HT where chronic IIT (essential HT) on the one hand and pre-eclampsia on the other hand may lead through the common RF and initial stages (subclinical organ damage) to the stage ofprogression (CVD, CKD) and to the final stage (cardiovascular events and renal failure). The number of RF, signs of subclinical organ damage, and total cardiovascular risk progressively increase from the condition of being normotensive on clinic, home, and 24-hour definitions to the condition of being found hypertensive by one, two and all three BP measurement methods, forming the continuum "healthypregnant women - ICHT- IAHT-gestational HT" in which each item is almost the same as the ones next to it hut the last is veiy different from the first. Conclusion. Assessment of the cardiorenal state in all pregnant women allows to compose the cline "healthy pregnants - gestational HT- stage I essential HT- stage II essential HT-pre-eclampsia - essential HT with superimposed pre-eclampsia" with growing risk of CVD and CKD and a potential danger of cardiovascular events (complications) and chronic renal failure. Source

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