ANATOMIC AND MORPHOLOGICAL SIGNS OF A DIFFUSE-GENERALIZED HYPERTROPHIC CARDIOMYOPATHY

Aim. Based on the instrumental, histological and genetic studies to show the role and significance of intracardial anomalies and morphological specifics of the special form of hypertrophic cardiomyopathy (HCM), that the authors name as diffuse-generalized. Material and methods. A clinical, instrumental, histological and molecular-genetic study was conducted with 16 enrolled patients with diffuse-generalized form of HCM, who underwent complex surgical interventions: by transaortal approach the extended myoectomy of interventricular sept, and by intraatrial approach — parietal resection of papillary muscles, and universal chordal-sparing mitral valve replacement.Results. There was no in-hospital mortality. The long-term results for up to 5 years show that all patients moved from the IV-III NYHA to I-II NYHA functional classes. Morphological study showed that in the base of myocardial mass increase in HCM there is neither hypertrophy, but hyperplasia of cardiomyocytes. All 16 patients showed significant signs of myxomatous mitral valve degeneration.Conclusion. Diffuse-generalized type of HCM is due to spread hyperplasia process in myocardium. The invented radical remodeling operation abolishes intraventricular severe changes of pressure and increases diastolic volume of the left ventricle, preventing diastolic dysfunction development

Vectors, molecular epidemiology and phylogeny of TBEV in Kazakhstan and central Asia

BACKGROUND: In the South of Kazakhstan, Almaty Oblastʼ (region) is endemic for tick-borne encephalitis, with 0.16–0.32 cases/100,000 population between 2016–2018. The purpose of this study was to determine the prevalence and circulating subtypes of tick-borne encephalitis virus (TBEV) in Almaty Oblastʼ and Kyzylorda Oblastʼ. METHODS: In 2015 we investigated 2341 ticks from 7 sampling sites for the presence of TBEV. Ticks were pooled in 501 pools and isolated RNA was tested for the presence of TBEV by RT-qPCR. For the positive samples, the E gene was amplified, sequenced and a phylogenetic analysis was carried out. RESULTS: A total of 48 pools were TBEV-positive by the RT-qPCR. TBEV-positive ticks were only detected in three districts of Almaty Oblastʼ and not in Kyzylorda Oblastʼ. The positive TBEV pools were found within Ixodes persulcatus, Haemaphysalis punctata and Dermacentor marginatus. These tick species prevailed only in Almaty Oblastʼ whereas in Kyzylorda Oblastʼ Hyalomma asiaticum and D. marginatus are endemic. The minimum infection rates (MIR) in the sampling sites were 4.4% in Talgar, 2.8% in Tekeli and 1.1% in Yenbekshikazakh, respectively. The phylogenetic analysis of the generated sequences indicates that TBEV strains found in Almaty Oblastʼ clusters in the Siberian subtype within two different clades. CONCLUSIONS: We provided new data about the TBEV MIR in ticks in Almaty Oblastʼ and showed that TBEV clusters in the Siberian Subtype in two different clusters at the nucleotide level. These results indicate that there are different influences on the circulating TBEV strains in south-eastern Kazakhstan. These influences might be caused by different routes of the virus spread in ticks which might bring different genetic TBEV lineages to Kazakhstan. The new data about the virus distribution and vectors provided here will contribute to an improvement of monitoring of tick-borne infections and timely anti-epidemic measures in Kazakhstan