ESTIMATION OF PREVALENCE OF ADVERSE GENOTYPES AND POLYMORPHIC ALLELES OF GENES-CANDIDATES OF ARTERIAL HYPERTENSION IN CHILDREN WITH ENDEMIC GOITER IN ZABAYKALSKY KRAI

This study is devoted to study the prevalence of genotypes and polymorphic alleles of genes-candidates of arterial hypertension in children with endemic goiter (EZ) in the Zabaykalsky Krai. To identify the frequency of occurrence of adverse genotypes and alleles polymorphisms Gly16Arg ADRB2, Gln27Glu ADRB2 and Thr174Met gene AGT, as factors of risk of development of arterial hypertension, were examined 194 children aged 7-11 years with a diagnosis of endemic goiter. The frequency of mutant allele 16Gly genotype Gly16Arg associated with increased agonist-induced suppression of beta-2 adrenergic receptors has not been above (63,2 %) than in the group of healthy children (60,3 %) (p(j2) > 0.05). The frequency of allele Arg16 defining a greater degree of vasodilating effect, was 39.7 % and 36.8 %, respectively (p(x2) > 0.05). Thefrequency characteristics of alleles genotype Gln27Glu in group I were the following: wild type 27Glu 41 %, the mutant allele Gln27 59 %, in the control group 42,2 % (p(χ2) > 0.05) and 57.8 % (pfy2) > 0.05) respectively. The frequency of wild-type Thr174 genotype Thr174Met accounted for 85.3 % in group I and 86.2 % in the control group (p(x2) > 0.05) and the frequency of occurrence ofthe mutated allele 174Met 14.7 % in the group of children with diffuse nontoxic goiter and 13.8 % in healthy children, respectively (pCx2) > 0.05). Significant differences in the distribution of genotypes and alleles between groups are not identified, and the frequency characteristics were comparable with the prevalence in the population and the results of other authors. The distribution of genotypes and frequency of alleles of a gene Gly16Arg and Gln27Glu ADRB2, Thr174Metgene AGT in both groups corresponded to the expected according to the hardy-Weinberg equilibrium in the population sample. The results obtained in the course of molecular-genetic study led to the conclusion that polymorphisms Gly16Arg ADRB2, Gln27Glu ADRB2 and Thr174Met gene AGT are not factors of risk of development of arterial hypertension in children with endemic goiter

Conditions of formation of Vikhoreva river and Ust-Vikhorevsky bay hydrochemical regime (Ust-Ilimsk reservoir)

Relevance. The necessity to control the hydrochemical regime of water bodies significantly affected by anthropogenic impacts. Aim. To study the spatial distribution of major ions and trace element concentrations and identify natural and anthropogenic formation factors of the hydrochemical composition of the Vikhoreva river and Ust-Vikhorevsky bay of the Ust-Ilimsk reservoir. Objects. Waters of the Vikhoreva river before and after inflow of wastewater from the Bratsk industrial zone, waters of the Ust-Vikhorevsky bay (Vikhorevskaya and Burdoyskaya parts) of the Ust-Ilimsk reservoir. Methods. Determination of micronutrients concentrations in water was performed by inductive coupled plasma mass spectrometry, mercury – by atomic absorption method. Cations and anions were determined using standard methods accepted in hydrochemical studies, Sorg – by titrimetric method, oxygen – by iodometric method. Results. In the Vihoreva river water after wastewater inflow from the Bratsk industrial zone, significant transformations of its hydrochemical composition were detected. Along the water area of river decrease of O2 concentrations (up to 0.3 mg O2/l) and increase of Сorg (up to 131 mg/l), SO42– (up to 262 mg/l), K+ (up to 10.6 mg/l), Cl– (up to 220 mg/l), Na+ (up to 240 mg/l), Mn (up to 248.5 mg/l), Cr (up to 7.4 mg/l), to a lesser extent Al (up to 224.1 mg/l), Co (up to 0.26 mg/l), Cu (up to 5.4 mg/l), Zn (up to 43.2 mg/l), Cd (up to 0.126 mg/l), Pb (up to 0.40 mg/l), Hg (up to 0.0032 mg/l) are observed. In surface waters of the Ust-Vikhorevsky bay concentrations of most components of the main ionic composition and trace elements decrease, as compared to the Vikhoreva river water. Maximum concentrations of Mn (511.5 mg/l), Fe (1567.2 mg/l), Co (0.80 mg/l), Pb (0.77 mg/l) were detected in bottom waters. The main ionic composition and trace element concentrations in the Vihoreva river water are determined primarily by anthropogenic factor. At the same time, the hydrochemical regime of the river is effected by natural factors. Inflow of both waters of the highly polluted and forming waters of the channel part of the Ust-Ilimsk reservoir impacts the hydrochemistry of the Ust-Vikhorevsky bay

Лечение фибрилляции предсердий на догоспитальном этапе: клинико-экономические аспекты

Objective: to retrospectively study the results of emergency medical care for patients with uncomplicated attacks of atrial fibrillation and to provide a clinical and economic assessment of their prehospital management tactics. Material and methods. A comparative retrospective study was conducted to examine the results of emergency medical care rendered to 1200 patients with uncomplicated atrial fibrillation attacks lasting as long as 24 hours. Ambulance call and outpatient cards and inpatient case reports were used. A clinical and economic assessment of the prehospital management tactics for the patients was made. Results. The prehospital therapy of atrial fibrillation was found to be ineffective in the first hour of observation. In more than 90% of cases, an atrial fibrillation attack was eliminated by the end of the first 24 hours regardless of which antiarrhythmic agent had been used. Conclusion. The proposed prehos-pital management tactics for patients with uncomplicated atrial fibrillation attacks lasting as long as 24 hours make it possible to decrease the length of stay of a called ambulance team and to enhance its efficiency, without reducing the clinical effect of performed antiarrhythmic therapy. Key words: atrial fibrillation, emergency medical care, prehospi-tal stage, clinical and economic analysis.Цель исследования — провести ретроспективное изучение результатов оказания неотложной медицинской помощи больным с неосложненными приступами фибрилляции предсердий и дать клинико-экономическую оценку тактики их ведения на догоспитальном этапе. Материал и методы: проведено сравнительное ретроспективное изучение результатов оказания неотложной медицинской помощи 1200 больным с неосложненными приступами фибрилляции предсердий длительностью до 24 ч. Использованы карты вызовов бригад скорой помощи, амбулаторные карты поликлиник, истории болезни стационаров. Дана клинико-экономическая оценка тактики ведения больных на догоспитальном этапе. Результаты. Установлено, что терапия фибрилляции предсердий на догоспитальном этапе малоэффективна в первый час наблюдения. Более чем в 90% случаев приступ фибрилляции предсердий был устранен к концу первых суток независимо от примененного антиаритмического препарата. Заключение. Предлагаемая тактика ведения больных на догоспитальном этапе с неосложненными приступами фибрилляции предсердий длительностью до 24 часов позволяет при снижении экономических затрат, не снижая клинического эффекта от проводимой антиаритмической терапии, сократить время пребывания бригады скорой медицинской помощи на вызове, повысить ее оперативность. Ключевые слова: фибрилляция предсердий, неотложная медицинская помощь, догоспитальный этап, клинико-экономический анализ

Механизмы кардиотоксического действия амитриптилина

Objective: to study the mechanisms of toxic action of amitriptyline on the myocardium. Material and methods. Investigations were conducted using the hearts from 30 outbred albino rats, which had been isolated and perfused according to the procedure described by Fallen et al. There were two series of experiments: 1) amitriptyline was added in a dose of 250 ng/ml to Krebs-Henseleit solution (Group 1); 2) the agent was added at another concentration (1250 ng/ml) to the solution passing through the coronary bed (Group 2). The animals were anesthetized with thiopental sodium (25 mg/kg) peritoneally. Results. Amitriptyline depresses myocardial contractility, which is particularly obvious with high-rate pacing. This manifests itself as reduced contractile velocity and force-power parameters and elevated left ventricular diastolic pressure. Amitriptyline lowers the efficacy of glucose and increases the release of enzymes into the coronary duct. Conclusion. Hypoergosis, membrane destruction, and cardiomyocyte ion pump failure have been shown to underlie negative chronotropic and inotropic effects in amitriptyline poisoning. Key words: amitriptyline, acute poisoning, isolated heart, myocardial damage.Цель исследования — изучить механизмы токсического действия амитриптилина на миокард. Материал и методы. Исследования проведены на изолированных, перфузируемых по методу Fallen et al. сердцах 30 белых беспородных крыс. Выполнено две серии экспериментов: в одной серии в раствор Кребса-Хензелайта был добавлен амитриптилин в дозе 250 нг/мл (I группа), в другой концентрация амитриптилина в растворе, проходившем через коронарное русло, составила 1250 нг/мл (II группа). Животных наркотизировали тиопенталом натрия (25 мг/кг внутрибрюшинно). Результаты. Амитриптилин угнетает сократительную функцию миокарда, что особенно отчетливо выражается при навязывании ритма высокой частоты. Это проявляется снижением скоростных и силовых показателей сократимости и ростом диастолического давления в левом желудочке. Амитриптилин снижает эффективность использования глюкозы и увеличивает выделение ферментов в коронарный проток. Заключение. Показано, что в основе отрицательного хроно-инотропного эффекта при отравлении амитриптилином лежит гипоергоз, мембранодеструкция и недостаточность ионных насосов кардиомиоцитов. Ключевые слова: амитриптилин, острое отравление, изолированное сердце, повреждение миокарда

Особенности оказания неотложной медицинской помощи больным с фибрилляцией предсердий на догоспитальном этапе: клинико-экономические аспекты

Comparative retrospective study of emergency care rendering results for 1200 patients with uncomplicated fibrillation attacks was carried out and their management tactics clinic-economic assessment at a pre-admission stage was done. It has been found that therapy for atrial fibrillation is unproductive in the first hour of observation at a pre-admission stage. Atrial fibrillation attack was eliminated to the end of the first day regardless of used antiarrhythmic preparation in more than 90% of the cases. Proposed management tactics for patients with uncomplicated atrial fibrillation attacks until 24 hours of duration at a pre-admission stage allows by cost lowering and clinical effect of conducting antiarrhythmic therapy maintenance to shorten an emergency team stay time and increase its operative turnover.Проведено сравнительное ретроспективное изучение результатов оказания неотложной медицинской помощи 1 200 больным с неосложненными приступами фибрилляции предсердий и дана клинико-экономическая оценка тактики их ведения на догоспитальном этапе. Установлено, что терапия фибрилляции предсердий на догоспитальном этапе малоэффективна в первый час наблюдения. Более чем в 90% случаев приступ фибрилляции предсердий был устранен к концу первых суток независимо от примененного антиаритмического препарата. Предлагаемая тактика ведения больных на догоспитальном этапе с неосложненными приступами фибрилляции предсердий длительностью до 24 ч позволяет при снижении экономических затрат, не снижая клинического эффекта от проводимой антиаритмической терапии, сократить время пребывания бригады скорой медицинской помощи на вызове, повысить ее оперативность

ANALYSIS OF CHANGES IN COMPONENTS OF THE SYSTEM OF LIPID PEROXIDATION AND ANTIOXIDANT DEFENSE IN MILITARY POPULATION

The article presents the analysis of inspection results of the military personnel who passed a medical examination at the initial military registration, with the call to military service and recognized as health fit for military service. The aim of the research was to study the dynamics of changes in the components of lipid peroxidation and antioxidant defense system of the soldiers during the primary adaptation to military service. Materials and methods: 34 young men (recruits), called up for military service, and 18 military personnel who have served 6 months. As material for biochemical research we used blood plasma and hemolysate. Modern spectrophotometric, fluorometric and statistical methods have been used. Results. In recruits, we noted increased activity of lipids oxidation, low level of blood antioxidant activity and reduced glutathione. In 6 months of the military service we found decreased contents of TBA-active products and improving of the overall antioxidant activity of the blood. Conclusions. Analysis of the data shows significant changes in the indices of lipid peroxidation and antioxidant defense system. The ratio of the activity of oxidation and antioxidant components not only reflects, but also largely determines the rate of metabolism and adaptive capabilities of the organism. The study found that young people, who were recognized as fit for military service due to health criteria for military medical commissions by military commissioners and were called up for military service, have low adaptive capacity and reach the stage of “satisfactory adaptation” only after 6 months of service

Exposure of vanadium as a factor of adverse activation of lymphocytes

We have estimated effect of vanadium influence on apoptosis of peripheral blood lymphocytes among workers. Immunologic assessment have allowed establishing that people working under the conditions of vanadium exposure have significantly increased quantity of annexin-positive cells indicating apoptosis in comparison with a reference group of people. We have identified statistically significant adverse mobilization of lymphocytes in respondents who have been working under conditions of the hazardous industry over 10 years. Therefore, the level and duration of the vanadium exposure influenced by the length of em plopent increase the immune system dysfunction degree.Проведена оценка влияния ванадия на клеточную гибель лимфоцитов периферической крови у работающих. Оценка иммунного статуса позволила установить, что у работающих в условиях экспозиции ванадием количество аннексин-позитивных клеток, свидетельствующих об апоптозе, достоверно повышается по отношению к группе сравнения. Выявлена статистически значимая негативная активация лимфоцитов у обследуемых, чей стаж в условиях вредного производства превышал 10 лет. Таким образом, уровень и длительность экспозиции ванадием, определяемая стажем работы, усугубляет степень дисфункции иммунной системы

A RARE CASE OF MAXILLARY SINUS METASTASIS OF RENAL CELL CARCINOMA

The paper describes a rare case of maxillary sinus metastasis of renal cell carcinoma in a 50-year-old man 7 years after nephrectomy. The tumor appeared as bleeding leading to anemia. The diagnostic difficulties associated with differences in X-ray and biopsy morphological data are considered. A correct diagnosis could be established during planned histological examination of the removed tumor. Adjuvant immunotherapy was performed. Examination following 8 postoperative months revealed no signs of progressive disease. The authors give a literature review

Dietary intake in indigenous adolescents in rural Buryatia, Russia

Background. The diet of adolescents is an important factor in their future health. The diet is formed under the influence of biological, personal, family, socio-economic, environmental, and cultural factors.The aim: to study the diet of adolescents in rural areas of Buryatia and compare the dietary intake of the Russian and Buryat ethnic groups.Materials and methods. The study included 92 rural adolescents 11–17 years old (44 boys, 48 girls); 49 of them were Buryats, 43 – Russians. Dietary intake was assessed by the food record method. The intake of energy, macronutrients (proteins, fats and carbohydrates) and micronutrients (major groups of vitamins and trace elements) of the diet was determined. The values obtained were compared with references to daily energy and nutrient intake, and between groups of adolescents of different ethnicity.Results. The diets of rural adolescents were not balanced. Only 7.6 % of adolescents include fish in their diet. Milk and dairy products are consumed by 38 % of the respondents. Daily energy intake was significantly lower the recommended guidelines. The diet is characterized by a deficiency of vitamins of groups A, C, and D, group B (with the exception of cobalamin), niacin, biotin, essential trace elements (calcium, phosphorus, iodine), high sodium intake. A significant deficiency of dietary fiber has been noted. The Buryats showed a shift in the ratio of proteins, fats and carbohydrates in the diet towards carbohydrates (1 : 1.2 : 5.3).Conclusion. The results indicate significant disturbances in the composition of the diet in rural adolescents in Buryatia, more pronounced in the Asian subgroup. This can be a rationale for the development of targeted nutrition monitoring programs aimed at preserving the health of the youth