Post-synaptic scaffold protein TANC2 in psychiatric and somatic disease risk

Understanding the shared genetic aetiology of psychiatric and medical comorbidity in neurodevelopmental disorders (NDDs) could improve patient diagnosis, stratification and treatment options. Rare TANC2 (Tetratricopeptide Repeat, Ankyrin Repeat and Coiled-Coil Containing 2) disrupting variants were disease-causing in NDD patients. This post-synaptic scaffold protein, essential for dendrite formation in synaptic plasticity, plays an unclarified but critical role in development. We here report a novel homozygous-viable Tanc2 disrupted function model where mutant mice were hyperactive and had impaired sensorimotor gating consistent with NDD patient psychiatric endophenotypes. Yet, a multi-systemic analysis revealed the pleiotropic effects of Tanc2 outside the brain such as growth failure and hepatocellular damage. This was associated with aberrant liver function including altered hepatocellular metabolism. Integrative analysis indicates that these disrupted Tanc2 systemic effects relate to interaction with Hippo developmental signalling pathway proteins and will increase the risk for comorbid somatic disease. This highlights how NDD gene pleiotropy can augment medical comorbidity susceptibility underscoring the benefit of holistic NDD patient diagnosis and treatment for which large-scale preclinical functional genomics can provide complementary pleiotropic gene function information.

Bridging late-life depression and chronic somatic diseases: a network analysis

The clinical presentation of late-life depression is highly heterogeneous and likely influenced by the co-presence of somatic diseases. Using a network approach, this study aims to explore how depressive symptoms are interconnected with each other, as well as with different measures of somatic disease burden in older adults. We examined cross-sectional data on 2860 individuals aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen, Stockholm. The severity of sixteen depressive symptoms was clinically assessed with the Comprehensive Psychopathological Rating Scale. We combined data from individual clinical assessment and health-registers to construct eight system-specific disease clusters (cardiovascular, neurological, gastrointestinal, metabolic, musculoskeletal, respiratory, sensory, and unclassified), along with a measure of overall somatic burden. The interconnection among depressive symptoms, and with disease clusters was explored through networks based on Spearman partial correlations. Bridge centrality index and network loadings were employed to identify depressive symptoms directly connecting disease clusters and depression. Sadness, pessimism, anxiety, and suicidal thoughts were the most interconnected symptoms of the depression network, while somatic symptoms of depression were less interconnected. In the network integrating depressive symptoms with disease clusters, suicidal thoughts, reduced appetite, and cognitive difficulties constituted the most consistent bridge connections. The same bridge symptoms emerged when considering an overall measure of somatic disease burden. Suicidal thoughts, reduced appetite, and cognitive difficulties may play a key role in the interconnection between late-life depression and somatic diseases. If confirmed in longitudinal studies, these bridging symptoms could constitute potential targets in the prevention of late-life depression.

Labor safety of medical personnel in medical organizations of stationary type

The aim of the research is to study the safety system of nursing personnel in medical institutions of the stationary type. Results. The most important conditions forthe effectivework of nursing personnel are: medical care of personnel, the availability of office equipment at the workplace, small mechanization for caring for patients with sufficient provision of personal protective equipment, tools, antiseptics and disinfectants. Conclusion. A harmful psychophysiological production factor in the professional activities of nursing personnel is also manifested in significant intellectual and emotional stress, which, over time, also cause the development of any somatic disease in specialists.

Somatic Disease in Survivors of Childhood Malignant Bone Tumors in the Nordic Countries

Survivors of malignant bone tumors in childhood are at risk of long-term adverse health effects. We comprehensively reviewed cases of somatic diseases that required a hospital contact in survivors of osteosarcoma and Ewing sarcoma. In a population-based cohort study, 620 five-year survivors of osteosarcoma (n = 440) or Ewing sarcoma (n = 180), diagnosed before the age of 20 years in Denmark, Finland, Iceland, and Sweden during 1943–2008, were followed in the national hospital registers. Overall rates of hospital contacts for any somatic disease and for 12 main diagnostic groups and 120 specific disease categories were compared with those in a matched comparison cohort (n = 3049) randomly selected from the national population registers. The rate of hospital contact for any somatic disease was 80% higher in survivors of malignant bone tumors than in comparisons and remained elevated up to 30 years after diagnosis. The rate of hospital contacts was higher after Ewing sarcoma (rate ratio (RR) 2.24; 95% confidence interval (CI) 1.76–2.85) than after osteosarcoma (RR 1.67; 95% CI 1.41–1.98). Elevated rates were observed for 11 main diagnostic groups, including infections, second malignant neoplasms, and diseases of the skin, bones, and circulatory, digestive, endocrine, and urinary systems. Survivors of malignant bone tumors in childhood are at increased risk of somatic diseases many years after diagnosis. This comprehensive study contributes new insight into the risk of late effects in survivors of osteosarcoma and Ewing sarcoma, which is an essential basis for optimal patient counseling and follow-up care.

External and internal orientation of personality of patient with a severe somatic disease

This article reveals the features of externality-internality in the context of experiencing a high-intensity stressor making a diagnosis that is associated with a threat to life. Part of the results of a comprehensive research project aimed at studying people diagnosed with meningioma (n = 64, from 30 to 70 years of age, Me = 54) is presented. All respondents signed an informed consent form before starting the study. Methods: Freiburg Personality Inventory, World Assumptions Scale, Impact of Event Scale. We used median analysis, K-means method, Kruskal-Wallis H test, Mann-Whitney U test (p < 0.05). The results show that in a difficult life situation associated with the diagnosis of meningioma, people with an external orientation, sociable and socially courageous, have low rates of posttraumatic stress and are characterised by a high degree of self-regulation, control, positive self-acceptance and a focus on justice, which is not typical for people who are shy, unsociable, and prone to an internal orientation. Ambivalent style, which includes different communication strategies, is typical for people with moderate rates of psychotraumatisation, lower self-regulation and self-rejection.

The mystery of Gogol’s death

The circumstances of the illness and death of the great writer Nikolai Vasilyevich Gogol are surrounded with riddles and mysticism. Gogol’s abdominal pain disturbed him throughout his life. He was referring to doctors with complaints of breakdown and pain in different parts of his abdomen. Doctors made assumptions of «catarrh of the intestines», which turned into «typhus», the unfavorable course of gastroenteritis and «indigestion» complicated by «inflammation». The writer himself believed that he had an incurable disease, calling it «the devil sitting in his belly». In his last days, Gogol refused food, water and communication, weakened to the limit both morally and physically. One of the doctors found only «catarrh of the intestines», another one diagnosed inanitione ex gastroenteritis (?). The invited doctors noted the state of extreme exhaustion in the absence of fever and any somatic disease. The consilium offered various medical manipulations — from bloodletting to hypnosis and forced feeding. However, leeches, dousing with cold water, mustard plasters, mercury preparation etc. didn’t help him. He lost consciousness and stopped breathing by morning. An autopsy was not performed, that’s why various hypotheses about his death appeared. Gogol’s death is shrouded in myths that the grave was opened twice; that his skull was removed from the coffin during the second burial; that the body in the coffin was in a half‑bent position, etc. The reason for the popular hypothesis of lethargic sleep was Gogol’s testament, in which he asked to bury him only after the appearance of obvious signs of decay. However, the lethargic sleep of the great writer was impossible, at least because of the technology for making the death mask. Many doctors were inclined to consider Gogol’s complaints as a manifestation of hypochondria. However, the renowned oncologist surgeon P. A. Herzen concluded by describing the symptoms of the disease: the writer died of pancreatic cancer. This explains Gogol’s sharp weight loss («the spine was palpated through the stomach») and a complete rejection of food due to the inability to swallow even a small piece. Severe cachexia is typical for patients with pancreatic cancer. Contemporary medical experts held several analytical meetings and drew conclusion that Gogol’s progressive disease with possible development of pancreatic cancer proceeded from pancreatitis.

Large and non-specific somatic disease burdens among ageing, long-term opioid maintenance treatment patients

Objectives To describe and explore somatic disease burdens of ageing long-term patients in opioid maintenance treatment (OMT), a unique population emerging in countries offering OMT as a long-term treatment. Methods We used data from the Norwegian Cohort of Patient in Opioid Maintenance Treatment and Other Drug Treatment Study (NorComt). 156 patients enrolled for at least three of the past five years provided data during structured interviews, including on chronic conditions, somatic treatment received, mental distress (SCL-25), and treatment satisfaction. A somatic disease burden was calculated from a list measuring the recent severity of 16 somatic complaints. A hierarchical multiple linear regression analysis identified correlates of somatic disease burden. Results Over half of patients reported at least seven somatic complaints. Reported somatic disease burden was associated with higher mental distress, more chronic conditions, fewer years in OMT, and treatment dissatisfaction. Age was unrelated, and there were few gender differences. These five variables explained 43.6% of the variance in disease burden. Conclusion Long-term OMT patients experience a large range of somatic complaints, and at non-acute levels. As OMT secures longevity for opioid-dependent persons, the clinical focus must be adjusted from acute to chronic care. Providers must address how to optimize health and quality of life while in treatment, as treatment may last for many years.

POTENTIAL OF NON-DRUG METHODS IN THE TREATMENT OF ANXIETY IN ELDERLY PATIENTS

The results of a study aimed at assessing the potential use of millimeter therapy in the treatment of anxiety in elderly patients are presented. The aim of the study was to assess the potential use of millimeter therapy in the treatment of anxiety in elderly patients. Materials and methods. A comparative study of the effectiveness of EHF-therapy in the treatment of elderly patients with anxiety, against the background of chronic forms of coronary heart disease in the form of angina of tension of the first-third functional classes and arterial hypertension of the first or second degree of the fourth class of risk of cardiovascular complications. The total number of patients was 92 people. (men – 44, women – 48). Patients were divided into 2 groups. Patients of the clinical observation group (n = 45) during treatment of the main somatic disease additionally received EHF-therapy sessions, patients of the control group (n = 47) received only drug therapy for the somatic disease and phytotherapeutic drugs to alleviate anxiety symptoms. To assess the dynamics of anxiety and quality of life, a brief questionnaire SF-36 was used. Results and discussion. Before treatment, patients in the main group had reduced quality of life indicators on the scales: general health (GH) by 31.3 ± 2.0 points, role-based functioning (RP) - by 24.2 ± 3.1 points, pain (P) - by 20.6 ± 4.2 points, physical functioning (PF) - by 23.8 ± 2.0 points, vitality (VT) - by 26.1 ± 4.2 points, psychological health (MH) - by 37 , 8 ± 3.8 points, role-based emotional functioning (RE) - by 30.6 ± 3.5 points and social functioning (SF) - by 32.2 ± 2.1 points. At the end of treatment, there was a positive trend in the quality of life. It was noted that with concomitant alarming symptoms of cardiovascular pathology, the severity of cardiac pain syndrome was significantly (p < 0.05) compared with the value of the indicator before treatment, and indicators of physical and social functioning increased. Findings. It is shown that the inclusion of millimeter therapy in the treatment of anxiety in elderly patients with cardiovascular pathology contributes to a significant improvement in symptoms and quality of life. The inclusion of millimeter therapy in treatment programs improves their effectiveness, which consists in reducing the severity of anxiety symptoms in older people, and increases resistance to stress factors by forming an adequate behavioral stereotype.