Apical hypertrophic cardiomyopathy as a mask of acute coronary syndrome: a case series

Apical hypertrophic cardiomyopathy (HCM) or Yamaguchi syndrome is a relatively rare subtype of HCM characterized by a left ventricular apex localization of the hypertrophy. In this case, chest pain can be erroneously interpreted as a manifestation of coronary artery disease. This article presents two cases of apical HCM in patients admitted with a diagnosis of acute coronary syndrome. Electrocardiogram revealed repolarization disorder and giant T wave inversion (up to 10 mm) in the precordial leads. Transthoracic echocardiography revealed local symmetric hypertrophy of the left ventricular apex, which made it possible to diagnose apical HCM. The coronary arteries in both patients were intact. The presented cases demonstrate a variant of apical HCM with chest pain as the leading clinical syndrome, which can often be the cause of overdiagnosis of acute coronary syndrome

Изменчивость гидрохимических характеристик поверхностных вод пролива Шокальского по результатам наблюдений на научно-исследовательском стационаре «Ледовая база Мыс Баранова» в 2018–2019 гг.

In connection with the progressing climate change in the Arctic, it is extremely important to conduct systematic long-term monitoring in the high-latitude Arctic. An important place in the network of monitoring stations is occupied by the research Station «Cape Baranov» Ice base», located on Severnaya Zemlya (in the area of the Shokalsky Strait). The article presents the results of hydrochemical observations at the Ice base from December 02, 2018 to July 15, 2019. 35 hydrochemical stations were operated from the ice of the strait in the seawater layer of 0–110 m. A significant temporal variability of the characteristics in the upper layer (0–10 m) has been recorded. Four phases of variability of the hydrochemical parameters (HP) have been identified. In December (phase 1) the HP values indicate the presence of surface waters, the origin of which we associate with the transformed river waters (TRW) of the Ob and Yenisei, coming from the Kara Sea. From January to mid-April (phase 2) the highest salinity levels and homogeneous HP are observed due to intensive vertical mixing of waters in the autumn-winter period. At the end of April — May (phase 3) there is a slight desalination of the surface layer in the Shokalsky Strait, with HP pointing to the presence of TRW. From June to July, 15 (4th phase), there is a sharp decrease in the salinity, an increase in oxygen and pH, as well as a drop in the concentration of all the biogenic elements. Such HPs indicate both additional desalination from ice and snow melting and the beginning of phytoplankton bloom. An estimation has been carried out of the proportion of TRW and waters formed during sea ice melting. The average integral proportion of TRW in the water column is ~ 4 %, and for melt water this indicator is close to zero. The influence of ice formation on the hydrochemical characteristics of the surface layers is most noticeable in the 1st and 3rd phases. During the period of strong desalination of the surface waters (May —July), the TRW proportion can reach 10 % or more. From July, the contribution of the melting of sea ice is comparable to that of TRW.В соответствии с программой систематического долгосрочного мониторинга климата Арктики на НИС «Ледовая база Мыс Баранова» в 2018–2019 гг. в проливе Шокальского выполнено наблюдение гидрохимических характеристик поверхностных вод и проведен анализ причин их временной изменчивости. Выделены 4 фазы изменчивости характеристик поверхностных вод, обусловленных влиянием речного стока, процессами вертикального перемешивания, образования и таяния льда и функционированием фитопланктона в весенне-летний период. Выполнена оценка доли речных и талых вод в составе поверхностного слоя вод пролива: доля речных вод в столбе воды составляет ~ 4 %, для талых вод этот показатель близок к нулю. В периоды сильного распреснения поверхностных вод (май — июль) доля речных вод достигает десяти и более процентов

CHARACTERIZATION OF AVIAN INFLUENZA H5N8 VIRUS STRAINS THAT CAUSED THE OUTBREAKS IN THE RUSSIAN FEDERATION IN 2016–2017

Objective of the study is to investigate biological properties of avian influenza virus strains that caused the outbreaks in Russia in 2016–2017.Materials and methods. The study was performed using advanced virological and molecular-biological methods in state-of-the-art equipment.Results and conclusion. In 2016, the outbreaks among wild birds and poultry caused by highly pathogenic avian influenza H5N8 virus have occurred in the territory of the Russian Federation. In May, 2016 an outbreak of H5N8 among wild birds was registered in the territory of the Republic of Tyva. In October-November, 2016 influenza virus H5N8 was isolated in the territory of the Republics of Tatarstan and Kalmykia, Krasnodar and Astrakhan Regions of Russia. In 2017 avian influenza H5N8 has become widespread in European part of Russia and caused multiple outbreaks among wild birds and poultry. Results of the investigations of the isolated strains show that all of them are highly pathogenic and belong to the clade 2.3.4.4. Molecular-genetic and virological analysis has revealed the differences between the viruses isolated in 2016–2017 and the virus of the same clade 2.3.4.4 that was isolated in 2014

Оценка продолжительности жизни реципиентов сердца с трансмиссивным атеросклерозом коронарных артерий

Introduction. Heart transplantation (HT) is an extreme treatment for chronic congestive heart failure. One of the ways of reducing deficit of donor organs was to expand the criteria for selection of donors in favor of heart retrieval from older donors. This became one of the causes increasing the risk of donor-transmitted coronary atherosclerosis (DTCA). The impact of endovascular DTCA correction on postoperative survival of heart recipients remains poorly studied. Objective: to estimate the life expectancy of heart recipients with donor-transmitted coronary atherosclerosis. Materials and methods. The life expectancy of 518 heart recipients who underwent coronarography during the first week after HT was evaluated. When hemodynamically significant stenosis of the coronary arteries was detected, percutaneous coronary intervention (PCI) was performed as planned. The average age of recipients was 46.92 ± 1 year (10 to 72 years). 90% of them were men. Recipients’ initial UNOS status was distributed as follows: UNOS 1a – 217 people, UNOS 1b – 89 and UNOS 2 – 212. Two groups were formed based on coronary angiography results. Group 1 included patients with DTCA signs, Group 2 was the control group (without DTCA). The first group was divided into 2 subgroups – a subgroup with DTCA signs, but without hemodynamically significant lesions (without PCI), and a subgroup with DTCA, where PCI was performed (PCI). Results. The age of recipients in both groups (DTCA and without DTCA) did not differ – 47.54 ± 1.01 and 46.64 ± 0.64 years, respectively. Donors were older in the DTCA group (50.2 ± 0.7 years) than in the control group (41 ± 0.5 years) (p = 0.0005). Survival in the control group averaged 58.25 ± 1.17 months, and in the DTCA group – 53.16 ± 0.36 months (p = 0.033). The difference in life expectancy of patients who underwent PCI (51.18 ± 2.9 months) and patients of the control group (58.25 ± 1.17 months) was not statistically significant (p = 0.88). In the group where graft showed signs of atherosclerotic changes in the coronary arteries, the cause of donor brain death from cerebrovascular accident was more common than in the control group. Conclusion. The risk of DTCA is associated with the donor’s age and the death of the donor brain from vascular causes. Endovascular correction of atherosclerotic lesions of coronary arteries makes it possible to neutralize the impact of transplant coronary artery stenosis on long-term outcome of HT surgery.Введение. Радикальным методом лечения хронической застойной сердечной недостаточности признается трансплантация сердца (ТС). Одним из путей снижения дефицита донорских органов стало расширение критериев отбора доноров в пользу изъятия сердца у доноров более старшего возраста, что явилось одной из причин увеличения риска выявления трансмиссивного атеросклероза коронарных артерий трансплантата (ТАКАТ). Остается мало изученным влияние эндоваскулярной коррекции ТАКАТ на послеоперационную выживаемость реципиентов сердца. Цель работы: оценить выживаемость реципиентов сердца с трансмиссивным атеросклерозом. Материалы и методы. Выполнена оценка продолжительности жизни 518 реципиентов сердца, которым в течение первой недели после ТС выполняли коронарографию. При выявлении гемодинамически значимого стенозирования коронарных артерий выполняли чрескожное коронарное вмешательство (ЧКВ) в плановом порядке. Средний возраст реципиентов составил 46,92 ± 1 год (от 10 до 72 лет). Мужчин было 90%. Исходный статус реципиентов по UNOS распределился следующим образом: UNOS 1a – 217 человек, UNOS 1b – 89 и UNOS 2 – 212. По результатам коронароангиографии сформированы две группы. В группу 1 входили пациенты с признаками ТАКАТ, группа 2 была контрольной (без ТАКАТ). Первая группа была разделена на 2 подгруппы – подгруппа с признаками ТАКАТ, но без гемодинамически значимого поражения (без ЧКВ), и подгруппа с ТАКАТ, где выполнено ЧКВ (ЧКВ). Результаты исследования. Возраст реципиентов в группах ТАКАТ и без ТАКАТ не различался и составлял 47,54 ± 1,01 и 46,64 ± 0,64 года соответственно. Возраст доноров был больше в группе ТАКАТ (50,2 ± 0,7 года) по сравнению группой сравнения (41 ± 0,5 года) (р = 0,0005). Выживаемость в группе сравнения составила в среднем 58,25 ± 1,17 месяца, а в группе ТАКАТ – 53,16 ± 0,36 месяца (p = 0,033). Различие в продолжительности жизни пациентов, которым было выполнено ЧКВ (51,18 ± 2,9 месяца), и пациентов группы сравнения (58,25 ± 1,17 месяцев) не было статистически достоверным (р = 0,88). В группе, где в трансплантате присутствовали признаки атеросклеротических изменений коронарных артерий, причина смерти мозга доноров в результате нарушения мозгового кровообращения встречалась чаще, чем в группе сравнения. Заключение. Риск ТАКАТ ассоциирован с возрастом донора и смертью мозга донора от сосудистых причин. Эндоваскулярная коррекция атеросклеротического поражения коронарных артерий позволяет нивелировать влияние стенозирования венечных артерий трансплантата на отдаленный результат операции ТС

EUNIS Habitat Classification: Expert system, characteristic species combinations and distribution maps of European habitats

Aim: The EUNIS Habitat Classification is a widely used reference framework for European habitat types (habitats), but it lacks formal definitions of individual habitats that would enable their unequivocal identification. Our goal was to develop a tool for assigning vegetation‐plot records to the habitats of the EUNIS system, use it to classify a European vegetation‐plot database, and compile statistically‐derived characteristic species combinations and distribution maps for these habitats. Location: Europe. Methods: We developed the classification expert system EUNIS‐ESy, which contains definitions of individual EUNIS habitats based on their species composition and geographic location. Each habitat was formally defined as a formula in a computer language combining algebraic and set‐theoretic concepts with formal logical operators. We applied this expert system to classify 1,261,373 vegetation plots from the European Vegetation Archive (EVA) and other databases. Then we determined diagnostic, constant and dominant species for each habitat by calculating species‐to‐habitat fidelity and constancy (occurrence frequency) in the classified data set. Finally, we mapped the plot locations for each habitat. Results: Formal definitions were developed for 199 habitats at Level 3 of the EUNIS hierarchy, including 25 coastal, 18 wetland, 55 grassland, 43 shrubland, 46 forest and 12 man‐made habitats. The expert system classified 1,125,121 vegetation plots to these habitat groups and 73,188 to other habitats, while 63,064 plots remained unclassified or were classified to more than one habitat. Data on each habitat were summarized in factsheets containing habitat description, distribution map, corresponding syntaxa and characteristic species combination. Conclusions: EUNIS habitats were characterized for the first time in terms of their species composition and distribution, based on a classification of a European database of vegetation plots using the newly developed electronic expert system EUNIS‐ESy. The data provided and the expert system have considerable potential for future use in European nature conservation planning, monitoring and assessment