Association of polymorphisms of cardiovascular system genes with idiopathic recurrent pregnancy loss of Kazakh populations

The interrelation of polymorphic variants of coagulationand cardiovascular system geneswas studied: MTHFR (C677T, A1298C), MTR(А2756G), MTRR (A66G), F5 (А506G), F2 (G20210А),FGB (G455A), ITGB3 (Leu33Pro), PLANH1 (5G/4G); GPIa(C807T), AGTR1 (A1166C), ACE (I/D), eNOS (Glu298Asp)with development of idiopathic form of recurrent pregnancyloss (iRPL) in ethnically homogeneous populationof the Kazakhs. The results of independent replicativeTaqMan genotyping of 302 patients with iRPL and 300women with normal reproduction did not reveal an associationof studied polymorphisms with the developmentof iRPL in the Kazakh population

Effect of mechanical activation on the composition if mineral components in humic acids isolated from carbons

It is shown that the mechanical activation of oxidized and brown coals is accompanied by an increase in the yield of humic acids and in their content of functional groups. It was demonstrated by atomic-emission spectroscopy that, under a high-intensity mechanical treatment, mineral elements are redistributed in the coal substance and incorporated into the structure of humic acids

La expectativa de jubilación como un estrés psicológico que afecta la edad biológica en las persona de la Federación de Rusa

The method of age-related samples is used. Biological age is estimated using a formula including indicators of metabolism, cardiovascular, respiratory, equilibrium systems, and psychological health questionnaire data. The biological age, proper biological age, and relative aging index have been researched. Examinees were adults of 26 - 88 years old, divided into 9 age groups. We’ve founded two types of psychological stress affecting a person’s biological age: stress caused by the expectation of retirement and stress on the retirement. Upon the results of the study, it’s stated that in Russia the biological age of a person is associated with a calendar inverted U-shaped dependence. The peak of relative aging happens on the pre-retirement and post-retirement ages. In women, biological aging begins to intensify in the period of 51-60 years, in men in 46-50 years, in women it stops in the period of 66-70 years, and in men only after 71 years. The maximum of biological consenescence in women occurs immediately after retirement (56-60 years), and in men at the age of the expectation of retirement (56-60 years). Based on the achieved data, it can be concluded that psychological stress caused by the expectation of retirement exists, it’s more severe in men than in women.Se utiliza el método de muestras relacionadas con la edad. La edad biológica se estima utilizando una fórmula que incluye indicadores de metabolismo, cardiovasculares, respiratorios, sistemas de equilibrio y datos de cuestionarios de salud psicológica. Se ha investigado la edad biológica, la edad biológica adecuada y el índice de envejecimiento relativo. Los examinados eran adultos de 26 a 88 años, divididos en 9 grupos de edad. Hemos fundado dos tipos de estrés psicológico que afectan la edad biológica de una persona: el estrés causado por la expectativa de jubilación y el estrés en la jubilación. Sobre los resultados del estudio, se afirma que en Rusia la edad biológica de una persona está asociada con una dependencia de calendario en forma de U invertida. El pico del envejecimiento relativo ocurre en las edades previas y posteriores a la jubilación. En las mujeres, el envejecimiento biológico comienza a intensificarse en el período de 51-60 años, en los hombres en 46-50 años, en las mujeres se detiene en el período de 66-70 años, y en los hombres solo después de 71 años. El máximo de consenso biológico en las mujeres ocurre inmediatamente después de la jubilación (56-60 años) y en los hombres a la edad de la expectativa de jubilación (56-60 años). Con base en los datos obtenidos, se puede concluir que el estrés psicológico causado por la expectativa de jubilación existe, es más severo en los hombres que en las mujeres

Ethnic characteristics of bone remodeling in female patients with type 2 diabetes mellitus

Background: Structural and metabolic disorders of bone tissue in women with T2DM have no clinical manifestations, but they are accompanied by the risk of fractures.Aim: To study the parameters of bone metabolism, BMD and microarchitectonics in female patients with T2DM in the Buryat population.Materials and methods: The observational single-center one-stage controlled study included 73 women with T2DM, which were divided into 2 groups depending on the functional state of the ovaries (reproductive and postmenopausal periods). In each group, subgroups of the Buryat and Russian populations were identified. The first group included 34 patients with T2DM of the reproductive period: 16 from the Buryat population and 18 from the Russian population. The second group consisted of 39 postmenopausal patients with T2DM: 17 from the Buryat population and 22 from the Russian population. The study of BMD in the lumbar spine (L1-L4), femoral neck (Neck), in the proximal femur (Total hip), trabecular bone score (TBS), serum osteocalcin (OC), N-terminal propeptide type 1 procollagen was carried out (P1NP), vitamin D 25 (OH), blood plasma type I collagen C-terminal telopeptide (β-Cross laps) and ionized calcium (iCa).Results: In female patients with T2DM of the reproductive age of the Buryat population, an increase in both markers of osteosynthesis P1NP (p=0.035), OC (p=0.047), and bone resorption β-Cross laps (p=0.040) was found relative to the similar group of the Russian population. In women with T2DM in the postmenopausal period of the Buryat population, there was also an increase in P1NP (p = 0.016), OC (p = 0.048), β-Cross laps (p = 0.020) compared with the group of postmenopausal women in the Russian population. Structural disorders, characterized by a decrease in TBS, were detected only in the postmenopausal period in female patients of the Buryat population compared to women in the Russian population (p = 0.029).Comparative analysis among women with T2DM of the Buryat population, depending on the functional state of the ovaries, showed that activation of bone remodeling with an increase in P1NP (p = 0.019), OC (p = 0.004) and β-Cross laps (p = 0.004) is characteristic of postmenopausal women accompanied by a decrease in BMD Neck (p = 0.006), BMD Total hip (p = 0.003), BMD L1-L4 (p = 0.049) and TBS (p = 0.020) relative to female patients with T2DM in the reproductive period.Conclusion: In women with T2DM in the Buryat population, both in the reproductive and postmenopausal periods, an increase in bone remodeling markers and BMD stability was found when compared with the corresponding groups of patients in the Russian population. The postmenopausal period was characterized by an additional decrease in TBS in patients with T2DM in the Buryat population relative to women in the Russian population

Frequency of hemodynamic response to orthostatic stress in heart failure with reduced ejection fraction, associations with clinical blood pressure

Aim. To assess hemodynamic response to active standing test (AST) with beat-to-beat blood pressure (BP) monitoring, their association with office BP and symptoms of orthostatic intolerance in patients with heart failure (HF).Material and methods. Outpatient HF patients with documented  left ventricular ejection  fraction <40%, followed   up in a HF center  and receiving optimal medical therapy, underwent AST with beat-to-beat  non-invasive BP monitoring.Hemodynamic response was assessed according to the European Federation of Autonomic Societies criteria.Results. The study included 87 patients (mean age, 57±10 years; men, 76%). Normal hemodynamic response to orthostatic stress was observed  in 36 (41,4%) patients. Pathological response prevailed during the first minute of orthostatic stress — initial orthostatic hypotension (OH) (n=29, 33,3%) and delayed BP recovery (n=18, 20,7%).  Classical OH was detected  in 4 (4,6%)  patients. There was no orthostatic hypertension, defined as an increase in systolic BP (SBP) ≥20 mm Hg. According to office BP, hypotension was observed in 19 (21,8%) patients (SBP <90 mm Hg in 4 patients and 90-100 mm Hg in 15), hypertension (SBP >140 mm Hg) in 11 (12,6%) patients. Pathological response to orthostatic stress were more often observed  in office  SBP >140 mm Hg compared  to SBP ≤140 mmHg (90,9% and 53,9%, p=0,020).Orthostatic intolerance was noted in 43 (49,4%) patients and were not associated with the level of office SBP (p=0,398) or pathological responses to orthostatic stress (p=0,758 for initial OH and p=0,248  for delayed  BP recovery).Conclusion. The pathological hemodynamic response in AST with beat-to-beat BP monitoring in ambulatory patients with HF is most often represented  by initial OH and delayed BP recovery associated  with office SBP >140 mmHg. The frequency of symptoms of orthostatic intolerance did not differ between groups depending on the presence of an inadequate response to orthostatic stress

The MPIfR-MeerKAT Galactic Plane Survey II. The eccentric double neutron star system PSR J1208-5936 and a neutron star merger rate update

The MMGPS-L is the most sensitive pulsar survey in the Southern Hemisphere. We present a follow-up study of one of these new discoveries, PSR J1208-5936, a 28.71-ms recycled pulsar in a double neutron star system with an orbital period of Pb=0.632 days and an eccentricity of e=0.348. Through timing of almost one year of observations, we detected the relativistic advance of periastron (0.918(1) deg/yr), resulting in a total system mass of Mt=2.586(5) Mo. We also achieved low-significance constraints on the amplitude of the Einstein delay and Shapiro delay, in turn yielding constraints on the pulsar mass (Mp=1.26(+0.13/-0.25) Mo), the companion mass (Mc=1.32(+0.25/-0.13) Mo, and the inclination angle (i=57(2) degrees). This system is highly eccentric compared to other Galactic field double neutron stars with similar periods, possibly hinting at a larger-than-usual supernova kick during the formation of the second-born neutron star. The binary will merge within 7.2(2) Gyr due to the emission of gravitational waves. With the improved sensitivity of the MMGPS-L, we updated the Milky Way neutron star merger rate to be 25(+19/-9) Myr$^{-1}$ within 90% credible intervals, which is lower than previous studies based on known Galactic binaries owing to the lack of further detections despite the highly sensitive nature of the survey. This implies a local cosmic neutron star merger rate of 293(+222/-103} Gpc/yr, consistent with LIGO and Virgo O3 observations. With this, we predict the observation of 10(+8/-4) neutron star merger events during the LIGO-Virgo-KAGRA O4 run. We predict the uncertainties on the component masses and the inclination angle will be reduced to 5x10$^{-3}$ Mo and 0.4 degrees after two decades of timing, and that in at least a decade from now the detection of the shift in Pb and the sky proper motion will serve to make an independent constraint of the distance to the system

Experience in implementing a program for basic life support and available automated defibrillation in a cancer center

Unified approaches to ensuring the chain of survival can improve the patient’s prognosis both in out-of-hospital and in-hospital cardiac arrest.Aim. To discuss practical issues of introducing a program for the availability of automated external defibrillation in a cancer center.Material and methods. For four years, our healthcare facility has been implementing a training program for basic and advanced life support according to the European Resuscitation Council standards, combined with the creation and development of an infrastructure for the availability of automatic defibrillation. A roadmap and infrastructure were developed for the project implementation.Results. In 2018-2022, 229 employees (114 doctors, 85 nurses and 30 nonmedical workers) were trained under the basic life support program. Fifteen defibrillators were placed in various units. During the specified period, first aid in case of sudden cardiac arrest using an automated external defibrillator before the resuscitation team arrival was independently provided by doctors and nurses of departments three times. To implement training in the continuous education system, the curriculum has passed the examination and accreditation in the edu. rosminzdrav system.Conclusion. The development and implementation of such initiatives requires significant organizational and methodological work, including continuous education system. However, in our opinion, this is an extremely useful tool for improving the safety and quality of medical care

Особенности личностных характеристик реципиентов после трансплантации сердца

Objective: to assess the personal psychological profile of heart transplant recipients as the first stage in the development of post-transplant personalized rehabilitation programs. Materials and methods. From January 2010 to July 2019, 129 HTs were performed (mean age 46.6 ± 14.1 years; 74% (n = 95) were men, 26% (n = 34) were women). All patients in the heart transplant waiting list were examined by a clinical psychologist and a psychotherapist to exclude contraindications to transplant surgery. To assess personal traits, we used the standard multifactorial questionnaire by Cattell R., 16 PF (version A), which included 187 questions. Heart transplantation and absence of post-transplant severe cognitive impairments were the selection criteria for this study. Patients were surveyed before they were discharged from the hospital – 30–60 days following HT: during the period of complete recovery after surgery. In the present study, a retrospective assessment of the results was performed in 107 patients (n = 76 – men; n = 31 – women). Results. Analysis of the personality portrait revealed that over half of recipients were reserved, distant (factor A – schizothymia) and restrained (factor F – restraint; F2 – introvert; F4 – conforming) with lower mental capacity (factor B), and were shy, timid (factor H), with low super ego (factor G: irresponsible, tolerates disorder, flexible, open to change). Our results showed that 47% of patients (n = 18 out of 38 patients, n = 22 are pensioners) with a weak degree of factor C (reactive, affected by feelings) are workers to 42% (n = 29 out of 69, n = 28 – retirees) with a strong degree of the same factor. One year after HT, the number of physically active patients was higher among those with low anxiety compared with high anxiety (41% (18 of 44) and 32% (20 of 63), respectively, p = 0.41). Conclusion. Personality factors are non-modifiable characteristics of patients. They affect human behavior, return to work and to social life, as well as physical and psychological recovery from HT. Knowing the personal traits of recipients would allow to develop a personalized approach to their rehabilitation and a technique for timely examination after HT.Цель. Исследовать личностный психологический портрет пациентов после трансплантации сердца (ТС) в качестве первого этапа разработки персонифицированных программ реабилитации после пересадки сердца. Материалы и методы. С января 2010-го по июль 2019 г. было выполнено 129 ТС (средний возраст – 46,6 ± 14,1 года; 74% (n = 95) – мужчины, 26% (n = 34) – женщины). Одним из пунктов обследования в ЛОТС была консультация клинического психолога и врача-психотерапевта для исключения противопоказаний к операции. Для оценки личностных характеристик мы использовали стандартный многофакторный опросник Р. Кеттелла 16 PF (версия А), включающий в себя 187 вопросов. Критериями отбора в данное исследование были выполненная ТС и отсутствие тяжелых когнитивных нарушений, развившихся в посттрансплантационном периоде. Анкетирование пациентов проводили перед их выпиской из стационара – через 30–60 дней после ТС: в период полного восстановления после операции. В настоящем исследовании была выполнена ретроспективная оценка результатов у 107 пациентов (76 мужчин, 31 женщина). Результаты. При анализе личностного портрета выявлено, что более половины реципиентов были скрытными, недоверчивыми (фактор А – шизотимия) и сдержанными (фактор F – сдержанность; F2 – интроверт; F4 – конформность) с низким интеллектом (фактор В), нерешительными (фактор H – тректия), с низким суперэго (фактор G: безответственный, неорганизованный, непостоянный, переменчивый). По нашим результатам, 47% больных (18 пациентов из 38; 22 – пенсионеры) со слабой степенью развития фактора С («Слабость Я») работают по сравнению с 42% (29 из 69; 28 – пенсионеры) с сильной степенью фактора. Через 1 год после ТС количество физически активных пациентов было больше среди отличающихся низкой тревожностью по сравнению с высоко тревожными (41% (18 из 44) и 32% (20 из 63) соответственно, p = 0,41). Заключение. Личностные характеристики – это немодифицируемые черты больных, которые влияют на их поведение, возвращение к работе и социальной жизни, а также их физическое и психологическое восстановление после ТС. Знание личностных особенностей реципиентов позволит разрабатывать персонифицированный подход к их реабилитации и алгоритм своевременного обследования после ТС

Primary Terminal Haemochromatosis in a 50 Year-Old Patient

Aim. A clinical description of end-stage hereditary haemochromatosis manifested with chronic alcohol abuse.Key points. A 50-yo patient referred with marked general weakness as a major complaint. The patient had a history of long-term alcohol consumption at toxic doses, putative cirrhosis, paroxysmal atrial fibrillation, type 2 diabetes mellitus. The patient's severity on admission was conditioned by marked hypotension. Further examination aimed at excluding occult gastrointestinal bleeding, adrenal insufficiency, decompensated heart failure. Bronze skin and icteric sclerae were positive. Blood tests revealed severe macrocytic hyperchromic anaemia, thrombocytopae-nia, hyperbilirubinaemia, hypoalbuminaemia, hypocoagulation, elevated transaminases, hyponatraemia, elevated creatinine (CKD DPI 63 mL/min), severe hyperferritinaemia. Faecal occult blood test and EGDS for bleeding were negative. Abdominal ultrasound exposed signs of liver cirrhosis and portal hypertension (ascites, splenomegaly). Echocardiographic evidence of dilated cardiomyopathy of all chambers, a reduced 24% ejection fraction at absent acute myocardial infarction. Primary haemochromatosis was suspected upon high ferritin, transferrin iron saturation and multiple organ dysfunction. Genotyping revealed the HFE 845G > A variant diagnostic of haemochromatosis type 1. Clinical diagnosis: Primary disease: haemochromatosis (homozygous variant HFE 845G > A (A/A)): liver cirrhosis, Child-Pugh class C. Portal hypertension: splenomegaly, ascites. Dilated cardiomyopathy. Diabetes mellitus. Complications: multiple organ dysfunction (SOFA 16). Liver failure: jaundice, hypoalbuminaemia, hypocoagulation. Cardiac rhythm and conduction disorder: paroxysmal atrial fibrillation. Acute cardiac failure with underlying CHF IIb, NYHA class 3. Acute renal failure (anuria) with underlying CKD stage 3 (CKD DPI 63 mL/min). Moderate macrocytic hyperchromic anaemia. Acute and chronic adrenal failure. Despite a cardiovascular and renal failure compensation therapy and albumin transfusion, the patient died. Autopsy revealed a marked organ infiltration with haemosiderin (heart, stomach, liver, pancreas, lungs, kidneys, adrenal glands).Conclusion. The case describes a classical clinical manifestation of haemochromatosis: bronze skin hyperpigmentation, liver cirrhosis, diabetes mellitus, cardiomyopathy, adrenal insufficiency. Terminal haemochromatosis, severe cardiac and renal failure decompensation precluded phlebotomy and chelation therapy. A lethal outcome was conditioned by multiple organ dysfunction with underlying massive haemosiderin deposition in most organs