Bicuspid aortic valve and sport

Objective: to evaluate the clinical manifestations of the pathology of the aortic valve in athletes of the initial stage of sports training and to analyze the literature data on the admission of persons with bicuspid aortic valve to training and competition. Materials and methods: 5000 athletes of the initial stage of sports training at the age of 10-12 years were examined. Examination of athletes included electrocardiography at rest and exercise, echocardiography and Holter monitoring. Anatomical features of the aortic valves were revealed in 7 (0.14%) athletes: 6 (0.12%) athletes with bicuspid aortic valve, 1 athlete (0.02%) with quadrileaflet aortic valve. The literature review included analysis of publications on the subject from two electronic library databases: Elibrary and PubMed. Results: conducted studies did not confirm the assumption of dilatation of the ascending aorta under the influence of intense physical exertion in athletes with the pathology of the aortic valve. The analysis of publications showed contradictory opinions of the researchers. Conclusions: the clinical cases, literature data, as well as the official recommendations of the American Heart Association and the American College of Cardiologists (2015) on admission of patients with aortic diseases to sports and competitions showed that in the absence of significant hemodynamic disturbances, dilatation of left ventricle and aorta root with normal ECG parameters and tolerance to physical activity, patients with bicuspid aortic valve could be allowed to exercise without restriction. However, these athletes must be under strict dynamic control of the heart

Pathophysiological relation between the systemic inflammation and the state of small airways in mild asthma with obesity

The aim of present study was to establish the relationship between the level of blood serum cytokines and indexes of pulmonary function as well as to identify the markers of evolving dysfunction of small airways in obese patients with partially controlled mild bronchial asthma. We have examined 53 patients with mild asthma of partially controlled clinical course complicated with obesity (I-II degree). The control group consisted of 25 healthy volunteers. All participants underwent spirometry, bodyplethysmography. Tumor necrosis factor alpha (TNFα), interferon gamma (IFNγ), interleukins (IL) IL2, IL-4, IL-6, IL-10, IL-17A were determined in blood serum. In the patients with partially controlled mild asthma, an increase in IL-17A by 55.8%, and IL-4 by 44.9% was detected, regardless of body mass. According to the results of cluster analysis, two sub-groups were discerned, depending on the state of the small airways and the levels of pro- and anti-inflammatory cytokines. The dysfunction of small airways was shown to be accompanied by hypercytokinemia being more common in bronchial asthma with predominant Th1-and Th17-immune responses. We have revealed an association between IL-17A, IL-6 levels and functional indices reflecting the state of the small airways, as well as correlation between IFNγ and the indices of bronchial obstruction. The features of pulmonary function were found to be dependent on the cytokine status in mild asthma with obesity. Two immuno-functional variants were identified, differing in activity of systemic inflammation, type of immune response, and functional state of the small airways. The revealed relationships allow us to consider IL-17A, IL-6 and IFNγ as markers of small airways dysfunction in mild asthma of partially controlled clinical course associated with obesity

Features of interpretation of the results of studies of ABО and Rhesus antigens and antibodies in patients with hematological diseases

Aim. To assess the aspects of interpretation of pre-transfusion tests in patients with hematological diseases. Material and Methods. We performed an analysis of the results of serological studies of ABО, Rh blood groups in blood samples of 857 patients with oncohematological diseases. ABO blood group determination and typing of D, C, c, E, e, К antigens were carried out using a gel agglutination test. Results. The decrease in strength of the agglutination of standard red blood cells by the patient’s anti-A and/or anti-B antibodies was observed in 112 patients (13.07% of the total number of patients). Abnormal agglutination strength in ABO and Rh antigens testing was observed in 17 patients (1.98% of the total number of patients), among them were 7 patients with acute myeloid leukemia (AML), 6 - with сhronic myeloid leukemia (CML), 2 – myelodysplastic syndrome (MDS), 2 – polycythemia vera (PV). Double populations of red blood cells were mainly detected in patients with MDS (45.61 %), aplastic anemia (AA) (27.27 %), primary myelofibrosis (PMF) (22.73 %), acute leukemia (AL) (22.2 %). In most cases double populations were associated with previous transfusions of blood products, meanwhile, three patients from this group (two patients with CML and one patient with PV) had never received blood transfusions before. Conclusion. Differences in anti-A and anti-B antibodies content were much more common in patients with lymphoproliferative disorders (LPDs) than in patients with myeloproliferative neoplasms (MPNs) (85.71% and 8.04%, respectively), while decrease of expression of red blood cell antigens was more typical for MPNs and did not occur in patients with LPDs

Improve business process efficiency by value engineering

This article is devoted to the problems of business processes optimization by value engineering (FCA) method. The business processes analysis is particularly relevant in modern conditions. The purpose the investigation is to adapt the value engineering to the business process. The FCA is a universal and highly efficient method of parameters optimization and other structural, technological, organizational, economic characteristics of a product, work or services. The hypothesis of the applying a value engineering to a business process possibility is considered. The article discusses FCA tools as an example of a metal rolling business delivery process. A business process model is being constructed as an object structural element model. The functions decomposition is carried out. Functions are classified into basic and auxiliary on the basis of the level. In the article the significance and functional costs are determined. A functional-cost diagram is constructed to identify the functions with the most deviations needing improvement. The FCA stages are accompanied by graphical illustrations, tables that illustrate the logic of applying the method to the business process. As a result, an optimal business-process concept with the lowest cost is being developed. © Published under licence by IOP Publishing Ltd

Diagnosis of Neonatal Alloimmune Thrombocytopenia: Determination of the Specificity of Antiplatelet Alloantibodies in the Maternal Blood Plasma Using a Molecular and Genetic Method

Background: Thrombocytopenia occurs in 1-5 % of newborns (platelet count < 150 × 109/L). Low platelet count of 50 × 109/L leads to the hemorrhagic syndrome, with one of its causes being neonatal alloimmune thrombocytopenia resulting from incompatibility between the mother and the fetus with human platelet antigens (HPA) inherited from the father and absent in the mother, which leads to the formation of maternal antibodies. Anti-HPA-1a, anti-HPA-5b, anti-HPA-3a, and anti-HPA-3b antibodies are clinically significant as they destroy fetal/neonatal platelets causing severe complications (intracranial hemorrhage in 20 % of cases and prenatal or postnatal death in 10 % of cases). Adequate diagnosis is a key to a successful treatment approach, which largely depends on the thrombocytopenia cause.   Objective: To determine the alloimmune nature of neonatal thrombocytopenia and the specificity of antibodies in the mother’s blood.   Materials and methods: We studied blood samples of parents (21 pairs) of newborns with thrombocytopenia in Saint Petersburg, Russian Federation. We used flow cytometry to determine alloantibodies in the maternal plasma after incubation with paternal platelets and staining with Goat F(ab’)2 Anti-Human IgG-FITC and CD41-PE monoclonal antibodies. Allosensitization index was calculated as the percentage of IgG-positive cells to the number of cells fixing anti-CD41 antibodies. At the value of ≥ 15 %, antiplatelet alloantibodies were considered present in a sample. We used a molecular detection system of the FluoVista analyzer (Inno-Train, Germany) for genetic testing with allele-specific primers. Alleles of genes encoding the expression of HPA-1, HPA-2, HPA-3, HPA-4, HPA-5, HPA-6, HPA-9, and HPA-15 antigens were determined by a real-time polymerase chain reaction using a set of HPA-FluoGene reagents (Inno-Train, Germany). Genomic DNA was isolated using the DNA-sorb-B set (AmpliSens, Russian Federation).   Results: We found that 8 of 21 (38 %) mothers had antibodies against paternal platelets. During genotyping in mother/father pairs, incompatible combinations of platelet antigens were revealed: HPA-1b/HPA-1a in 9 pairs (HPA-1a antigen absent on the maternal platelets and present on the paternal platelets), of which 5 mothers (55%) had antibodies with a probable specificity to anti-HPA-1a; HPA-1a/HPA-1b incompatibility in 4 pairs, with 2 (50 %) mothers having antibodies with an anti-HPA-1b specificity. HPA-3a/HPA-3b incompatibility was observed in 4 pairs, with antibodies (probably anti-HPA3b) in 1 mother (25%). HPA-2a/HPA-2b, HPA-5a/HPA-5b, HPA-15a/HPA-15b, HPA-15b/HPA-15a incompatibilities were detected (1 case each in 21 pairs), with no antibodies found in mothers. The probable specificity of the antibodies was distributed as follows: 62 % for anti-HPA-1a, 25% for anti-HPA-1b, and 13 % for anti-HPA-3a.   Conclusions: We confirmed the immune nature of neonatal thrombocytopenia and determined the probable specificity of maternal alloantibodies in 8 of 21 cases

Model of the life cycle of the information security system

When building an information security system, one of the key problems is the creation of regulatory documents. Regulators in the field of information security determine the list of necessary documentation mainly in relation to protection mechanisms (authentication, anti-virus protection, etc.) and practically do not take into account the stages of the life cycle of information security tools and personnel of the organization. The article proposes an approach to formalization of the list of information security management processes that need regulation. This approach allows the formation of information security policy to take into account the processes of personnel management and the complex of software and hardware information security, which is necessary to ensure a high level of security of critical information infrastructure

The role of fatty acids and lipid inflammatory mediators in the development of small airway dysfunction in asthma complicated with obesity

Background. Small airway involvement is important in determining the phenotypes of bronchial asthma. Establishing the mechanisms of dysfunction of small airways will make it possible to predict the course and control bronchial asthma.The aim. To study the relationship between the modification of the composition of fatty acids, lipid inflammatory mediators (eicosanoids, plasmalogens) and the functional state of small airways and to identify lipid biomarkers for the development of small airway dysfunction in bronchial asthma associated with obesity.Materials and methods. The study included 85 patients with mild, partially controlled asthma. Of these, 39 patients with normal body weight (Group 1) and 46 patients with grade 1–2 obesity (Group 2). The control group consisted of 30 healthy volunteers. The function of the small airways was assessed according to spirometry and body plethysmography. The composition of fatty acids and plasmalogens in blood plasma was assessed by gas chromatography-mass spectrometry. In the blood serum, the content of thromboxane B2 and leukotriene B4 was determined. Statistical processing was performed using the Statistica 6.1 program (StatSoft Inc., USA). Relationships between pairs of traits were examined using the Spearman correlation test (r). Differences were considered statistically significant at p < 0.05.Results. In the combined course of asthma and obesity, dysfunction of the small airways develops against the background of generalized bronchial obstruction. A violation of lipid metabolism was revealed, manifested by an increase in the levels of saturated, monoenoic, n-6 polyunsaturated fatty acids against the background of a deficiency of n-3 polyunsaturated fatty acids and phospholipids with an alkenyl bond – plasmalogens. It has been shown that bronchial asthma, aggravated by obesity, occurs against the background of increased synthesis of inflammatory lipid mediators – eicosanoids (thromboxane B2 and leukotriene B4). Evaluation of the correlation relationships between the studied lipids and the function of small airways revealed a high degree of relationship between their participants.Conclusion. An important pathogenetic link in the formation of small airway dysfunction in bronchial asthma aggravated by obesity is a violation of fatty acid metabolism and plasmalogen synthesis, an increase in the formation of inflammatory lipid mediators

Study of trends in the life of society based on two world pandemics (“Black Death” / plague, coronavirus)

Представлен сопоставительный анализ экономических, социальных и психологических последствий эпидемий бубонной чумы в XIX в. и вируса COVID-19 в XXI в. Сделан вывод о сходных паттернах поведения людей в разные эпохи.A comparative analysis of the economic, social and psychological consequences of the bubonic plague epidemics in the 19th century and the COVID-19 virus in the 21st century is presented. The conclusion is made about similar patterns of human behavior in different eras

Strusture, biomass and production of the biotic component of the ecosystem of an growing eutrophic reservoir

Using our own data and data from the literature, we assessed the total biomass of the biotic component of the ecosystem of the Ivankovo Reservoir (Upper Volga, Russia), a eutrophic reservoir which is becoming overgrown with macrophytes. The biotic component of freshwater ecosystems is formed by communities of multicellular and unicellular organisms and viruses in the water layer (plankton) and bottom sediments (benthos) and also macrophytes and autotrophic and heterotrophic organisms growing on their surface (epiphyton). The biomass of the biotic component of the Ivankovo Reservoir equaled 39,853 tons С. Plankton, benthos and macrophytes with epiphyton equaled 3.6%, 41.6% and 54.8% of the total biomass respectively. We determined the contribution of higher aquatic plants, algae, cyanobacteria, heterotrophic bacteria, viruses, protozoans, multicellular invertebrates and fish to the formation of total biomass. The largest share was taken up by higher aquatic plants (54.5%). The second largest share was taken by heterotrophic bacteria (37.4%), most of which live in the bottom sediments. The high concentration of bacteria and invertebrates in the bottom sediments indicate significant provision of the organic substrates from the water column. The biomass of fish, the highest trophic link in the reservoir, equaled 15.0% of the biomass of their potential food substrates, invertebrate animals, and 0.7% of the total biomass of the biotic component. The greater part of the autochthonous organic compound in the reservoir is formed as a result of activity of phytoplankton, which provides 69.4% of total primary production of macrophytes, phytoepiphyton, phytoplankton and phytobenthos. The total primary production during the vegetation period was approximately forty times higher than the annual production of the fish. Currently, the share in the phytoplankton of large colonial cyanobacteria not consumed by zooplankton, the share of non-heterocystic species of cyanobacteria capable of heterotrophic feeding and the share of mixotrophic flagellates is increasing. Eutrophication of the reservoir is significantly stimulated by the development of macrophytes, and, presumably, the contribution of macrophytes to the total primary production of the reservoir will continue to increase

Features of immune response in different phenotypes of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is considered a heterogeneous disorder exhibiting different phenotypes. Chronic systemic inflammation is an important link in the COPD pathogenesis. The studies of immune response in the context of clinical and functional phenotypes seems relevant. Objective of our work was to study the features of immune response in clinical and functional phenotypes of COPD.Eighty-three COPD patients of different severity grade and 22 apparently healthy volunteers were examined. After determining the COPD phenotype by clinical and functional signs, the patients were divided in two groups, i.e., 38 subjects with bronchitis, and 45 patients with emphysematous phenotype. Clinical, functional and laboratory research was carried out in standard mode. Static lung volumes and respiratory capacities were investigated, i.e., functional residual capacity, residual lung volume, total lung capacity, bronchial resistance on inspiration and expiration to assess phenotype of the disease. Subpopulations of Th1 and Th17 lymphocytes were determined by the level of blood serum cytokines, tumor necrosis factor (TNFá), interleukins (IL) IL-4, IL-10, IL-17A, IFNã).Different features of immune response were revealed in bronchitic and emphysematous phenotypes of the COPD patients. Activation of inflammatory process with differentiation of naive T lymphocytes along the Th1-dependent pathway was found in 68% of cases with bronchitis and 16% of patients with emphysematous phenotypes. As compared with control group, the patients showed a statistically significant increase in the level of TNFá, IFNã, along with decrease in IL-4. Development of immune response by the Th17 type was found in 32% of cases with bronchitis, and 84% of cases with emphysematous phenotypes. Its emergence was associated with increased IL-17A and IL-10 levels, and a decrease in IFNã/IL-17A compared to the control. Differentiation of T helper cells towards Th1 pathway of immune response has been shown to predominate in bronchitic phenotype and at early stages of the disease. The Th17 type of immune response prevailed with increasing severity of the disorder. In emphysematous phenotype of COPD, the Th17-pathway of immune response develops at early stages of the disease. Some relationships are revealed between the systemic inflammation indexes and functional parameters of external respiration. An inverse relationship between TNFá and the OOL/OEL ratio in Th1 type of immune response has been shown. A direct correlation was found between the level of IL-17A and the parameters of external respiration function (FEV1, FEV1/FVC), as well as between IFNã/IL-17A and functional residual capacity in Th17 type of immune response.The type of immune response is associated with severity of the disease, as well with clinical and functional phenotype of COPD. Progression of the disease, broncho-obstructive disorders and hyperinflation are associated with increased levels of cytokines that provide cell polarization along the Th17 pathway. Determination of COPD phenotype and the type of immune response already at an early stage of the disease will enable prediction of its course and justify the choice of phenotype-oriented therapy