The local repolarization heterogeneity in the murine pulmonary veins myocardium contributes to the spatial distribution of the adrenergically induced ectopic foci

An atrial tachyarrhythmias is predominantly triggered by a proarrhythmic activity originate from the pulmonary veins (PV) myocardial sleeves; sympathetic or adrenergic stimulation facilitates PV proarrhythmia. In the present study the electrophysiological inhomogeneity, spatiotemporal characteristics of the adrenergically induced ectopic firing and sympathetic nerves distribution have been investigated in a murine PV myocardium to clarify mechanisms of adrenergic PV ectopy. Electrically paced murine PV demonstrate atrial-like pattern of conduction and atrial-like action potentials (AP) with longest duration in the mouth of PV. The application of norepinephrine (NE), agonists of α- and β-adrenergic receptors (ARs) or intracardiac nerves stimulation induced spontaneous AP in a form of periodical bursts or continuous firing. NE- or ARs agonists-induced SAP originated from unifocal ectopic foci with predominant localization in the region surrounding PV mouth, but not in the distal portions of a murine PV myocardium. A higher level of catecholamine content and catecholamine fiber network density was revealed in the PV myocardial sleeves relative to LA appendage. However, no significant local variation of catecholamine content and fiber density was observed in the murine PV. In conclusion, PV mouth region appear to be a most susceptible to adrenergic proarrhythmia in mice. Intrinsic spatial heterogeneity of AP duration can be considered as a factor influencing localization of the ectopic foci in PV. © 2019, The Physiological Society of Japan and Springer Japan KK, part of Springer Nature.18-34-00931The study is supported by RFBR 18-34-00931 grant. AP Action potentials AR Adrenergic receptors EAD Early afterdepolarization DAD Delayed afterdepolarization DD Diastolic depolarization SAP Spontaneous action potentials RMP Resting membrane potentials LA Left atria LAA Left atria appendage PKA Proteinkinase A PV Pulmonary veins PNS Postganglionic nerves stimulation NCX Natrium-sodium exchanger NE Norepinephrine PHE Phenylephrine ISO Isoproterenol

Analysis of clinico-genetic peculiarities and prevalence of hereditary diseases in Kirov and Kirov region

The article deals with the clinical and genetic features of phenylketonuria, galactosemia and cystic fibrosis. The prevalence of these diseases in the Kirov region for 2017 is shown. The analysis of medical records of patients on certain grounds (compliance with diet, metabolic diseases, or prescribed treatment, the presence of deviations in the health indicators of children) was conducted. Based on the results of the medical genetic analysis, data on the genotypes of patients are presented.В статье рассмотрены клинико-генетические особенности фенилкетонурии, галактоземии и муковисцидоза. Показана распространенность данных заболеваний в Кировской области на 2017 год. Проведен анализ медицинских карт больных по некоторым признакам (соблюдение диеты при метаболических болезнях или назначенного лечения, наличие отклонений в показателях здоровья детей). По результатам молекулярно-генетического анализа представлены данные о генотипах больных

СТРУКТУРНО-ВЕЩЕСТВЕННАЯ МОДЕЛЬ СТАНОВЛЕНИЯ КИМБЕРЛИТОВОЙ ТРУБКИ НЮРБИНСКАЯ (СРЕДНЕ-МАРХИНСКИЙ РАЙОН ЯКУТСКОЙ АЛМАЗОНОСНОЙ ПРОВИНЦИИ)

The paper presents the results of comprehensive study of the primary diamond deposit of the Nyurbinskaya pipe in the Yakutian diamondiferous province. It is established, that the pipe is confined to the fault junction of four directions and is composed of the kimberlite of four phases. Analysis of different faults and tectonic fracturing allowed to reconstruct the tectonic stress fields acting at the stage of the kimberlite body formation and to determine their occurrence sequence in time. The data obtained about regularities of the Nyurbinskaya pipe compositional structure and results of geologo-structural studies are combined in a single structural-compositional model of the deposit formation. Peculiarities of the fault network operation during the deposit formation stage are confirmed by experimental results using polarization-optical method. The model allowed to formulate the basic structural characteristics of the prospecting works object within which the formation of kimberlite body type of the Nyurbinskaya pipe is possible and to determine the elements of the fault network which are promising for the kimberlite pipes discovery.В статье представлены результаты комплексного изучения коренного месторождения алмазов трубка Нюрбинская. Установлено, что трубка приурочена к узлу разломов четырех направлений и сложена кимберлитами четырех фаз. Анализ разноранговых разрывных нарушений и тектонической трещиноватости позволил восстановить поля тектонических напряжений, действовавшие на этапе формирования кимберлитового тела и определить последовательность их проявления во времени. Полученные данные о закономерностях вещественного строения трубки Нюрбинской и результаты геолого-структурных исследований объединены в рамках единой структурно-вещественной модели формирования месторождения. Особенности функционирования разрывной сети на этапе формирования месторождения подтверждены результатами экспериментов с использованием поляризационно-оптического метода. Полученная модель позволила сформулировать признаки, определяющие основные структурные характеристики объекта поисковых работ, в пределах которого возможно формирование кимберлитовых тел типа трубки Нюрбинской, и на их основании выделить те элементы разломной сети (разломные узлы), которые являются перспективными для обнаружения кимберлитовых трубок

Coronary atherosclerosis progression in patients after coronary stenting, depending on a cardiology follow-up strategy

Aim. To compare the prevalence of coronary atherosclerosis in patients after coronary stenting (CS) receiving outpatient and remote cardiology follow-up during a one-year study.Material and methods. We enrolled 279 patients aged 61,5±9,5 years with class ≥II stable angina or silent ischemia after CS. Three groups were formed: group 1 (n=96) — outpatient visits before CS, 1, 3, 6 and 12 months after CS. Group 2 (n=95) — remote monitoring: patients were followed up by a primary care physician with the involvement of a cardiologist via remote communication (e-mail, telephone, Skype) 1, 3, 6 and 12 months after CS. Group 3 (n=88) were followed up by a primary care physician and contacted with the study coordinator before and 12 months after CS. After 12 months, all patients underwent stress-induced myocardial ischemia testing. In case of a positive or uncertain test result, coronary angiography (CA) was performed.Results. Stress-induced myocardial ischemia 12 months after CS was verified in 58 patients (21%): 19 patients (19,8%) — group 1; 9 patients (9,5%) — group 2; 30 patients (34,1%) — group 3 (p<0,05). Repeat CA was performed in 96 patients (34,4% of the total number of patients). Restenosis was detected in 8 (2,9%) patients, coronary atherosclerosis progression — in 38 (13,6%), combination of restenosis and atherosclerosis progression — in 4 (1,4%) patients. Coronary atherosclerosis progression was significantly more frequent in group 3: 10,4%, 9,5% and 21,6% in groups 1, 2 and 3, respectively (p<0,05). The incidence of stent restenosis was comparable: 2,1%, 3,2% and 3,5% in groups 1, 2, and 3, respectively.Conclusion. Coronary atherosclerosis progression was the main reason for repeated revascularizations 12 months after the CS. Outpatient and remote cardiology follow-up is associated with a lower incidence of coronary atherosclerosis progression and repeated CA during 12-month follow-up after CS

Prophylaxis of scoliosis using “elbow limiter” device in younger schoolchildren

This article is devoted to the growing problem of childhood and adolescent scoliosis, one of the main reasons for which is the incorrect placement of the child’s elbows on the working surface. Based on this, the devices for the prevention and treatment of scoliosis, which are currently available all over the world, are analyzed. The device was designed "Elbow Limiter". Presents data from a survey of parents of schoolchildren regarding the possibility of using the device in schools and / or at home.Данная статья поcвящена нарастающей проблеме детского и подpосткового cколиоза, одной из главных причин которого является непpавильное расположeние локтей ребенка на рабочей поверхности. На основании этого проанализированы приспособления для профилактики и лечения сколиоза, имеющиеся на сегодняшний день во всем мире. Был сконструирован прибор «Локтевой лимитер». Представлены данные опроса родителей школьников относительно возможности использования прибора в школах и/или дома

Цитомегаловирусная инфекция у детей первых месяцев жизни: варианты течения, современные подходы к терапии (клинические случаи)

Cytomegalovirus infection (CMVI) in newborns and infants can occur in various clinical forms requiring a differentiated therapy. We present the peculiarities of two different variants of CMVI course generalized with a manifest clinical picture and characteristic shifts in laboratory analyzes in a child aged 2.5 months with a combined genetic pathology, and latent intrauterine in a child aged 5 days leading to the development of neurosensory hearing loss. The difficulties in diagnosing a suppressed (latent) form of the disease and choosing a therapeutic approach have been highlighted. A successful result of etiopathogenetic therapy with ganciclovir in a child with postnatal generalized CMVI has been presented. The therapeutic efficacy and safety of off-label ganciclovir preparations and anti-cytomegalovirus immunoglobulin have been confirmed. The advisability of including ganciclovir in the management protocol of children with latent forms of CMVI is discussed.Цитомегаловирусная инфекция (ЦМВИ) у новорожденных и детей первых месяцев жизни может протекать в различных клинических формах, требующих дифференцированной терапии. Представлены особенности двух различных вариантов течения ЦМВИ — генерализованной с манифестной клинической картиной и характерными сдвигами в лабораторных анализах у ребенка в возрасте 2,5 мес с сочетанной генетической патологией и латентной внутри- утробной у ребенка в возрасте 5 дней, приведшей к развитию нейросенсорной тугоухости. Освещены трудности диагностики стертой (латентной) формы болезни и выбора тактики лечения пациента. Представлен успешный результат этиопатогенетической терапии препаратом ганцикловира у ребенка с постнатальной генерализованной ЦМВИ. Подтверждены терапевтическая эффективность и безопасность off-label препаратов ганцикловира и противоцитомегаловирусного иммуноглобулина. Обсуждается целесообразность включения ганцикловира в протокол ведения детей с латентными формами ЦМВИ.ИСТОЧНИК ФИНАНСИРОВАНИЯ Не указан.КОНФЛИКТ ИНТЕРЕСОВ Авторы заявили об отсутствии конфликта интересов, который необходимо обнародовать

Analysis of radial artery occlusion causes and methods of its prevention after interventions using radial access. Results of the APRIORI study

Aim. To study predictors of radial artery occlusion (RAO) and ways to prevent it after interventions using radial access.Material and methods. The study consisted of prospective and retrospective parts. The total number of included patients was 2284. Patients undergoing interventions by radial access in various medical organizations were retrospectively considered. The prospective study included 1284 patients who were subject to interventional treatment. Patients were randomized into two groups as follows: in group 1, hemostasis was performed within 4 hours, in group 2 — >6 hours. All patients underwent a bedside Barbeau test with a pulse oximeter and an ultrasound of access arteries to determine the radial artery patency/occlusion.Results. The RAO rate in the retrospective part was 21,8%, while in the prospective one — 10,1% with long-term hemostasis and 1,4% with short-term hemostasis (p<0,001). Predictors of RAO were type 2 diabetes (odds ratio (OR), 1,9, 95% confidence interval (CI), 1,1-3,4, p=0,03) and an increase in hemostasis duration by 1 hour (OR, 1,2, 95% CI, 1,1-1,3, p<0,001). When analyzing the retrospective part, the predictors of RAO were body mass index (OR, 1,06, 95% CI, 1,02-1,09, p=0,002), female sex (OR, 0,6, 95% CI, 0,4-0,9, p=0,02), smoking (OR, 1,38, 95% CI, 1-1,91, p=0,047). The administration of statins in different dosages, as well as antihypertensive and anti-ischemic agents, did not have a significant effect on the RAO rate.Conclusion. The main predictors of RAO were type 2 diabetes, an increase in hemostasis duration, female sex, smoking, and the artery-to-introducer diameter ratio. Taking statins, anti-ischemic and antihypertensive agents does not have a protective effect on RAO rate

ЗНАЧЕНИЕ ГРУДНОГО ВСКАРМЛИВАНИЯ В ПРОФИЛАКТИКЕ ОТДАЛЕННЫХ НАРУШЕНИЙ МЕТАБОЛИЗМА: ОБЗОР ЛИТЕРАТУРЫ

The literature review is dedicated to the preventive role of breastfeeding in preserving long-term health of individuals and the population in whole. The issue is urgent due to high prevalence of multifactor metabolic diseases (obesity, pancreatic diabetes, hypertonic disease etc.) in adolescents and adults; these socially significant have started to set on in younger persons in the recent years. The article presents results of the studies dedicated to the association between the nature of the infant's feeding and risk of metabolic pathology conducted in the recent decades in various countries. Most works put premature infants in the high risk group, as the diets involving special formulas contributing to "catching-up" growth of neonates with low birth weight are statistically significantly associated with high risk of long-term cardiovascular diseases. According to numerous studies, artificial feeding significantly increases the risk of excess weight and obesity, hypertonic disease and atherogenic dyslipidemia. Possible mechanisms of realization of hereditary susceptibility to metabolic disorders in the setting of artificial feeding are enhanced insulin burst paired with further development of insulin resistance; preventive role of breast milk is associated with the hormones therein, which program the individual's metabolism. Along with that, breastfeeding provides metabolic and immunological programming by means of forming optimal intestinal microbiota in a child. All the studies indicate importance of prolonged breastfeeding during infancy, which is why medical administrative support provided by medical personnel of medical and preventive facilities is important for preventing hypolactasia. District pediatricians and nurses not only control, but also organize the process of breastfeeding; when necessary, they recommend special devices intended to optimize lactation (breast pumps, nipple shields); if breast latching is not feasible – feeding with extracted breast milk using bottles and pacifiers reproducing natural breast sucking mechanism. Обзор литературы посвящен оценке профилактической роли грудного вскармливания в обеспечении отдаленного здоровья индивидуума и популяции в целом. Актуальность проблемы обусловлена высокой распространенностью мультифакториальных метаболических заболеваний (ожирения, сахарного диабета, гипертонической болезни и др.) у подростков и взрослых; в последние годы отмечена тенденция к омоложению возраста дебюта этих социально-значимых заболеваний. Приводятся результаты исследований, выполненных в последние десятилетия в различных странах и посвященных связи характера вскармливания ребенка на первом году жизни со степенью риска реализации метаболической патологии. В большинстве работ указывается, что в группе особого риска находятся недоношенные дети, поскольку диеты с использованием специальных смесей, способствующих «догоняющему» росту маловесных новорожденных, статистически достоверно были связаны с высоким риском отдаленных сердечно-сосудистых заболеваний. Искусственное вскармливание, как установлено многочисленными исследованиями, значимо повышает риск формирования избыточного веса и ожирения, а также гипертонической болезни, атерогенной дислипидемии. К возможным механизмам реализации наследственной предрасположенности метаболических расстройств на фоне искусственного вскармливания относят усиленный выброс инсулина с последующим формированием инсулинорезистентности; профилактическая роль грудного молока связывается с наличием в нем гормонов, обладающих программирующим воздействием на метаболизм индивидуума. Наряду с этим метаболическое и иммунологическое программирование при грудном вскармливании осуществляется через формирование оптимальной микробиоты кишечника ребенка. Все исследования свидетельствуют о важности пролонгирования грудного вскармливания на протяжении первого года жизни, поэтому в профилактике гиполактазии важную роль играет медико-организационная поддержка, которую оказывают медицинские работники лечебно-профилактических учреждений. Участковый педиатр и медицинская сестра не только контролирует, но и организуют процесс грудного вскармливания; при необходимости рекомендуют специальные приспособления, оптимизирующие лактацию (молокоотсосы, накладки для соска), в случае невозможности прикладывания к груди — вскармливание сцеженным грудным молоком с использованием бутылочек и сосок, воспроизводящих механизм естественного сосания из груди

Population genomics of post-glacial western Eurasia.

Western Eurasia witnessed several large-scale human migrations during the Holocene <sup>1-5</sup> . Here, to investigate the cross-continental effects of these migrations, we shotgun-sequenced 317 genomes-mainly from the Mesolithic and Neolithic periods-from across northern and western Eurasia. These were imputed alongside published data to obtain diploid genotypes from more than 1,600 ancient humans. Our analyses revealed a 'great divide' genomic boundary extending from the Black Sea to the Baltic. Mesolithic hunter-gatherers were highly genetically differentiated east and west of this zone, and the effect of the neolithization was equally disparate. Large-scale ancestry shifts occurred in the west as farming was introduced, including near-total replacement of hunter-gatherers in many areas, whereas no substantial ancestry shifts happened east of the zone during the same period. Similarly, relatedness decreased in the west from the Neolithic transition onwards, whereas, east of the Urals, relatedness remained high until around 4,000 BP, consistent with the persistence of localized groups of hunter-gatherers. The boundary dissolved when Yamnaya-related ancestry spread across western Eurasia around 5,000 BP, resulting in a second major turnover that reached most parts of Europe within a 1,000-year span. The genetic origin and fate of the Yamnaya have remained elusive, but we show that hunter-gatherers from the Middle Don region contributed ancestry to them. Yamnaya groups later admixed with individuals associated with the Globular Amphora culture before expanding into Europe. Similar turnovers occurred in western Siberia, where we report new genomic data from a 'Neolithic steppe' cline spanning the Siberian forest steppe to Lake Baikal. These prehistoric migrations had profound and lasting effects on the genetic diversity of Eurasian populations