A. V. Zagrebelnaya, O. V. Shcheblykina, A. A. Bolgov
Pulmonary hypertension is a condition characterized by a progressive increase in pressure in the pulmonary circulation. The simplest and most common experimental model of pulmonary hypertension is the monocrotaline model. It is based on the process of transformation of monocrotaline in the liver by cytochrome P450 into endothelial toxic monocrotaline pyrrole, which in turn, damaging the endothelium of the pulmonary vessels, leads to circulatory disorders in the pulmonary circulation and the formation of pulmonary hypertension. Thus, additional prestimulation of cytochrome P450 may increase the stability and representativeness of the monocrotaline model. The purpose of this work was to determine differences in morphological changes in the myocardium and pulmonary vessels of rats in which pulmonary hypertension was modeled using monocrotaline with and without additional stimulation of liver enzymes. Material and methods. The study was conducted on 24 mature male Wistar rats. The animals were divided into 4 groups of 6 rats. Group 1 was represented by intact animals. In groups 2, 3 and 4, modeling of pulmonary hypertension in rats was carried out with a single subcutaneous injection of an aqueous-alcohol solution of monocrotaline at a dose of 60 mg/kg. In order to induce cytochrome P450 in groups 3 and 4, animals were intragastrically administered phenobarbital for one and three days, respectively. Results and discussion. The area of cardiomyocyte nuclei in the groups with one- and three-day preliminary stimulation of liver enzymes was 22.78 ± 3.4 and 23.63 ± 3.72 µm2 , respectively, significantly different from the corresponding values of the control group and group 2. Similar results were revealed when determining the index of the thickness of the medial membrane of small-caliber pulmonary arteries – 58.32 ± 10.02 and 76.44 ± 18.55 % in the groups with one- and three-day preliminary stimulation, respectively. In addition to quantitative changes, qualitative changes were also noted: with additional activation of cytochrome P450, interstitial fibrosis and myocarditis more intensively formed in the myocardium, and signs of “monocrotaline syndrome” more rapidly arose and progressed in the lungs. Conclusions. Based on the data obtained, it can be assumed that preliminary cytochrome P450 causes an increase in the stability, reproducibility and severity of morphological changes in the monocrotaline model of pulmonary hypertension.
{"title":"Morphological features of changes in target organs during pharmacological monocrotaline-induced modeling of pulmonary hypertension in rats under conditions of preliminary stimulation of liver enzymatic systems","authors":"A. V. Zagrebelnaya, O. V. Shcheblykina, A. A. Bolgov","doi":"10.18699/ssmj20240315","DOIUrl":"https://doi.org/10.18699/ssmj20240315","url":null,"abstract":"Pulmonary hypertension is a condition characterized by a progressive increase in pressure in the pulmonary circulation. The simplest and most common experimental model of pulmonary hypertension is the monocrotaline model. It is based on the process of transformation of monocrotaline in the liver by cytochrome P450 into endothelial toxic monocrotaline pyrrole, which in turn, damaging the endothelium of the pulmonary vessels, leads to circulatory disorders in the pulmonary circulation and the formation of pulmonary hypertension. Thus, additional prestimulation of cytochrome P450 may increase the stability and representativeness of the monocrotaline model. The purpose of this work was to determine differences in morphological changes in the myocardium and pulmonary vessels of rats in which pulmonary hypertension was modeled using monocrotaline with and without additional stimulation of liver enzymes. Material and methods. The study was conducted on 24 mature male Wistar rats. The animals were divided into 4 groups of 6 rats. Group 1 was represented by intact animals. In groups 2, 3 and 4, modeling of pulmonary hypertension in rats was carried out with a single subcutaneous injection of an aqueous-alcohol solution of monocrotaline at a dose of 60 mg/kg. In order to induce cytochrome P450 in groups 3 and 4, animals were intragastrically administered phenobarbital for one and three days, respectively. Results and discussion. The area of cardiomyocyte nuclei in the groups with one- and three-day preliminary stimulation of liver enzymes was 22.78 ± 3.4 and 23.63 ± 3.72 µm2 , respectively, significantly different from the corresponding values of the control group and group 2. Similar results were revealed when determining the index of the thickness of the medial membrane of small-caliber pulmonary arteries – 58.32 ± 10.02 and 76.44 ± 18.55 % in the groups with one- and three-day preliminary stimulation, respectively. In addition to quantitative changes, qualitative changes were also noted: with additional activation of cytochrome P450, interstitial fibrosis and myocarditis more intensively formed in the myocardium, and signs of “monocrotaline syndrome” more rapidly arose and progressed in the lungs. Conclusions. Based on the data obtained, it can be assumed that preliminary cytochrome P450 causes an increase in the stability, reproducibility and severity of morphological changes in the monocrotaline model of pulmonary hypertension.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141679280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Dolich, N. E. Komleva, V. A. Medentsov, S. Mazilov, I. Zaikina
The aim of the study is to analyze the prevalence of functional and structural disorders of the musculoskeletal apparatus (MSA) and postural balance in adolescents in the Saratov region. Material and methods. The condition of the musculoskeletal system in adolescents of the Saratov region (n = 555) was studied as part of a one-stage study. The prevalence of pain complaints in various structures of the musculoskeletal system, body type, posture, shape of the pelvis and feet, the presence of trigger points, the function of the hip and shoulder joints, the volume of movement in various parts of the spine were analyzed. To assess the postural balance, the indicators of the statokinesiogram were studied. Results. A high prevalence of complaints of pain in the structures of the musculoskeletal system has been established. The most common structural changes are: scoliotic posture disorder, the shape of the shoulders, chest, shoulder blades, pelvis, feet. Among the functional disorders – limited mobility in the hip and shoulder joints, in the thoracic and lumbar spine. Trigger points were found mainly in the trapezius, pectoralis minor, scalenus, quadratus lumborum, sternocleidomastoid muscles. Statistically significant correlations were found between the parameters of the statokinesiogram and complaints of pain in the spine, structural and functional disorders of the musculoskeletal system. Conclusions. The results of the study indicate the need for an interdepartmental integrated approach to the prevention of diseases of the musculoskeletal system in adolescents. An important condition is the quality of preventive medical examinations, a personalized approach to physical education, optimization of the ergonomics of classrooms in schools, training the population in movement hygiene, and increasing commitment to a healthy lifestyle.
{"title":"Assessment of the state of the musculoskeletal system and postural balance in adolescents","authors":"V. Dolich, N. E. Komleva, V. A. Medentsov, S. Mazilov, I. Zaikina","doi":"10.18699/ssmj20240313","DOIUrl":"https://doi.org/10.18699/ssmj20240313","url":null,"abstract":"The aim of the study is to analyze the prevalence of functional and structural disorders of the musculoskeletal apparatus (MSA) and postural balance in adolescents in the Saratov region. Material and methods. The condition of the musculoskeletal system in adolescents of the Saratov region (n = 555) was studied as part of a one-stage study. The prevalence of pain complaints in various structures of the musculoskeletal system, body type, posture, shape of the pelvis and feet, the presence of trigger points, the function of the hip and shoulder joints, the volume of movement in various parts of the spine were analyzed. To assess the postural balance, the indicators of the statokinesiogram were studied. Results. A high prevalence of complaints of pain in the structures of the musculoskeletal system has been established. The most common structural changes are: scoliotic posture disorder, the shape of the shoulders, chest, shoulder blades, pelvis, feet. Among the functional disorders – limited mobility in the hip and shoulder joints, in the thoracic and lumbar spine. Trigger points were found mainly in the trapezius, pectoralis minor, scalenus, quadratus lumborum, sternocleidomastoid muscles. Statistically significant correlations were found between the parameters of the statokinesiogram and complaints of pain in the spine, structural and functional disorders of the musculoskeletal system. Conclusions. The results of the study indicate the need for an interdepartmental integrated approach to the prevention of diseases of the musculoskeletal system in adolescents. An important condition is the quality of preventive medical examinations, a personalized approach to physical education, optimization of the ergonomics of classrooms in schools, training the population in movement hygiene, and increasing commitment to a healthy lifestyle.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Shesternya, A. A. Savchenko, I. V. Kudryavtsev, A. A. Masterova, A. Borisov
Immune relationships involved in a wide range of immunopathological conditions, including ankylosing spondylitis (AS), are formed due to the characteristics of the subset composition of follicular T helper cells (Tfh) and B lymphocytes. Expression of the HLA-B27 antigen can change the reactivity of cells of the immune system and, accordingly, their interaction and participation in the immunopathogenesis of AS. The aim of this study was to investigate the characteristics of the subset composition of Tfh and B cells in HLA-B27-positive and negative patients with AS. Material and methods. 66 patients (17 women and 49 men) aged 20–58 years with a diagnosis of AS were examined. Molecular genetic research on HLA-B27 expression was carried out using the quantitative PCR method with real-time detection. The subset composition of Tfh and B cells was studied using flow cytometry. Results. An increase in the amount of Tfh2 in the blood is observed in all patients with AS. The number of Tfh1 was reduced in HLA-B27-positive AS patients, but Tfh17 cell content was increased. Changes in the subset composition of B lymphocytes, which were found only in patients with an HLA-B27-positive form of the disease, manifest themselves primarily as an imbalance in the distribution of B cell memory. Only negative correlations of Tfh1 and Tfh17 content with “double-negative” B cell and plasmablast precursors percentage are detected in HLA-B27-negative AS patients. Tfh1 cell number correlate negatively with naïve and activated naïve B cell content in HLA-B27-positive disease, Tfh2 cell percentage – with memory B cell fraction number. CCR6+ Tfh and Tfh17 have positive regulatory effects on plasmablast precursors. Conclusions. The subset composition of Tfh characterizes the dominance in the immunopathogenesis of AS of the direction of the regulatory influence of follicular T helper cells on B lymphocytes regardless of the carriage of the HLA-B27 gene in AS patients. High levels of Tfh type 17 are also detected in HLA-B27-positive patients. The relationships between the subsets of Tfh and B cells in HLA-B27-negative AS patients characterize the presence of processes aimed at inhibiting B cells. The influence of Tfh1 is aimed at suppression of B-cell immunity in HLA-B27-positive AS while Tfh2 and Tfh17 stimulate B-cell mechanisms.
由于滤泡 T 辅助细胞（Tfh）和 B 淋巴细胞亚群组成的特点，形成了与包括强直性脊柱炎（AS）在内的多种免疫病理状况有关的免疫关系。HLA-B27 抗原的表达可改变免疫系统细胞的反应性，从而改变它们之间的相互作用，并参与强直性脊柱炎的免疫发病机制。本研究旨在探讨HLA-B27阳性和阴性强直性脊柱炎患者Tfh和B细胞亚群组成的特点。材料与方法研究对象为 66 名确诊为强直性脊柱炎的 20-58 岁患者（17 名女性和 49 名男性）。采用实时检测的定量 PCR 方法对 HLA-B27 表达进行了分子遗传学研究。使用流式细胞术研究了 Tfh 细胞和 B 细胞的亚群组成。结果显示所有强直性脊柱炎患者血液中的 Tfh2 数量都有所增加。在HLA-B27阳性的强直性脊柱炎患者中，Tfh1的数量减少了，但Tfh17细胞的含量却增加了。B淋巴细胞亚群组成的变化只出现在HLA-B27阳性的强直性脊柱炎患者中，主要表现为B细胞记忆分布的不平衡。在HLA-B27阴性的强直性脊柱炎患者中，Tfh1和Tfh17的含量与 "双阴性 "B细胞和浆细胞前体的百分比仅呈负相关。在HLA-B27阳性疾病中，Tfh1细胞数量与幼稚和活化幼稚B细胞含量呈负相关，Tfh2细胞百分比与记忆B细胞分数数量呈负相关。CCR6+ Tfh和Tfh17对浆细胞前体有积极的调节作用。结论无论强直性脊柱炎患者是否携带HLA-B27基因，Tfh亚群的组成都表明，在强直性脊柱炎的免疫发病机制中，滤泡T辅助细胞对B淋巴细胞的调控作用方向占主导地位。在 HLA-B27 阳性的患者中还检测到高水平的 17 型 Tfh。在HLA-B27阴性的强直性脊柱炎患者中，Tfh亚群与B细胞之间的关系表明存在旨在抑制B细胞的过程。在 HLA-B27 阳性强直性脊柱炎患者中，Tfh1 的影响旨在抑制 B 细胞免疫，而 Tfh2 和 Tfh17 则刺激 B 细胞机制。
{"title":"The subset composition of follicular T helpers and B lymphocytes in patients with ankylosing spondylitis depending on HLA-B27 status","authors":"P. Shesternya, A. A. Savchenko, I. V. Kudryavtsev, A. A. Masterova, A. Borisov","doi":"10.18699/ssmj20240319","DOIUrl":"https://doi.org/10.18699/ssmj20240319","url":null,"abstract":"Immune relationships involved in a wide range of immunopathological conditions, including ankylosing spondylitis (AS), are formed due to the characteristics of the subset composition of follicular T helper cells (Tfh) and B lymphocytes. Expression of the HLA-B27 antigen can change the reactivity of cells of the immune system and, accordingly, their interaction and participation in the immunopathogenesis of AS. The aim of this study was to investigate the characteristics of the subset composition of Tfh and B cells in HLA-B27-positive and negative patients with AS. Material and methods. 66 patients (17 women and 49 men) aged 20–58 years with a diagnosis of AS were examined. Molecular genetic research on HLA-B27 expression was carried out using the quantitative PCR method with real-time detection. The subset composition of Tfh and B cells was studied using flow cytometry. Results. An increase in the amount of Tfh2 in the blood is observed in all patients with AS. The number of Tfh1 was reduced in HLA-B27-positive AS patients, but Tfh17 cell content was increased. Changes in the subset composition of B lymphocytes, which were found only in patients with an HLA-B27-positive form of the disease, manifest themselves primarily as an imbalance in the distribution of B cell memory. Only negative correlations of Tfh1 and Tfh17 content with “double-negative” B cell and plasmablast precursors percentage are detected in HLA-B27-negative AS patients. Tfh1 cell number correlate negatively with naïve and activated naïve B cell content in HLA-B27-positive disease, Tfh2 cell percentage – with memory B cell fraction number. CCR6+ Tfh and Tfh17 have positive regulatory effects on plasmablast precursors. Conclusions. The subset composition of Tfh characterizes the dominance in the immunopathogenesis of AS of the direction of the regulatory influence of follicular T helper cells on B lymphocytes regardless of the carriage of the HLA-B27 gene in AS patients. High levels of Tfh type 17 are also detected in HLA-B27-positive patients. The relationships between the subsets of Tfh and B cells in HLA-B27-negative AS patients characterize the presence of processes aimed at inhibiting B cells. The influence of Tfh1 is aimed at suppression of B-cell immunity in HLA-B27-positive AS while Tfh2 and Tfh17 stimulate B-cell mechanisms.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
U. Saginbaev, V. V. Lyutsko, T. Akhmedov, S. Rukavishnikova
Age-associated diseases (AAD) remain an urgent issue for individuals of different age groups. In the context of the recently completed COVID-19 pandemic, there is an acceleration of aging processes. From a clinical point of view, the early manifestation of AAD corresponds to accelerated aging. The study of AAD epidemiological characteristics in the aspect of different age groups seems very relevant. Aim of the study was to investigate the epidemiological characteristics of AAD (on the example of hypertensive diseases and type 2 diabetes mellitus) at the federal, district and regional levels. Material and methods. The materials were the statistical collections of the Ministry of Health of Russia for 2011–2021. An assessment of the incidence rate, trend, rate of increase/decrease in incidence, the ratio of the incidence rate among people over working age to the incidence rate of the adult population (age-specific incidence index, ASII) was carried out. Units of observation: hypertensive diseases; type II diabetes mellitus. Results and discussion. In 2011–2021, an unfavorable upward trend in morbidity was observed at the federal (Russian Federation), district (the North-West Federal District) and regional (Saint-Petersburg) level. However, in terms of the rate of increase in morbidity and ASII, specific features were found for the considered nosologies: hypertensive diseases were characterized by an increase in ASII, and for type 2 diabetes, on the contrary, a decrease in VID (“rejuvenation” of AAD).
{"title":"Analysis of epidemiological characteristics of age-associated diseases (hypertensive diseases and type 2 diabetes) in 2011–2021: federal, district and regional level","authors":"U. Saginbaev, V. V. Lyutsko, T. Akhmedov, S. Rukavishnikova","doi":"10.18699/ssmj20240322","DOIUrl":"https://doi.org/10.18699/ssmj20240322","url":null,"abstract":"Age-associated diseases (AAD) remain an urgent issue for individuals of different age groups. In the context of the recently completed COVID-19 pandemic, there is an acceleration of aging processes. From a clinical point of view, the early manifestation of AAD corresponds to accelerated aging. The study of AAD epidemiological characteristics in the aspect of different age groups seems very relevant. Aim of the study was to investigate the epidemiological characteristics of AAD (on the example of hypertensive diseases and type 2 diabetes mellitus) at the federal, district and regional levels. Material and methods. The materials were the statistical collections of the Ministry of Health of Russia for 2011–2021. An assessment of the incidence rate, trend, rate of increase/decrease in incidence, the ratio of the incidence rate among people over working age to the incidence rate of the adult population (age-specific incidence index, ASII) was carried out. Units of observation: hypertensive diseases; type II diabetes mellitus. Results and discussion. In 2011–2021, an unfavorable upward trend in morbidity was observed at the federal (Russian Federation), district (the North-West Federal District) and regional (Saint-Petersburg) level. However, in terms of the rate of increase in morbidity and ASII, specific features were found for the considered nosologies: hypertensive diseases were characterized by an increase in ASII, and for type 2 diabetes, on the contrary, a decrease in VID (“rejuvenation” of AAD).","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Abduvosidov, V. Shestakova, A. M. Perevedentseva, I. Chekmareva, S. M. Chudnykh, L. M. Baranchugova, A. G. Alekseev, M. M. Kokoev
Nowadays, the palm of superiority in elective surgery belongs to the problem of hernias. According to the literature worldwide, more than 20 million patients undergo surgical treatment for hernia of the anterior abdominal wall every year, most of whom undergo alloplasty using various kinds of nets. The study of the influence of methods for fixing implants and the emerging local inflammatory response of tissues on the frequency of relapses after allognioplasty is devoted to isolated works. Aim of the study was to investigate in an experiment the characteristics of the reaction of local tissues when implanting a rigid monofilament mesh polypropylene implant with a shape memory effect, and a classic mesh endoprosthesis made of monofilament polypropylene (PP) with various methods of fixing implants. Material and methods. An experimental study on 60 white male Wistar rats was performed to identify tissue reaction features around the PP mesh. Group 1 animals (n = 30) were implanted with a rigid mesh monofilament PP implant (Herniamesh, Italy) with shape memory effect, group 2 animals (n = 30) – with a classic mesh endoprosthesis made of monofilament PP for soft tissue repair ESFIL® standard (Lintex, Russia). Biopsies were examined at 1, 2, 3 months after implantation of the PP mesh. Results. A morphological study showed that 1 month after the implantation of a rigid mesh monofilament PP implant, the inflammatory reaction is less obvious than when implanting a classical PP endoprosthesis. This reaction contributed to the earlier germination of collagen fibers around the rigid implant monofilaments. At 2 and 3 months after the implantation of PP nets in both groups of animals, there were no advantages as the regenerate formed. Conclusions. When introducing PP mesh with suture fixation and rigid monofilament PP mesh without fixation, there is a natural response to the integration of the endoprosthesis, which is characterized by aseptic inflammation followed by pronounced fibrosis around the implant. Such processes, occurring in response to the implantation of synthetic polypropylene nets, increase local mechanical tissue resistance, and can create additional strength against recurrence of inguinal hernias.
{"title":"Comparative morphological analysis of connective tissue response to polypropylene endoprosthesis implantation","authors":"K. Abduvosidov, V. Shestakova, A. M. Perevedentseva, I. Chekmareva, S. M. Chudnykh, L. M. Baranchugova, A. G. Alekseev, M. M. Kokoev","doi":"10.18699/ssmj20240314","DOIUrl":"https://doi.org/10.18699/ssmj20240314","url":null,"abstract":"Nowadays, the palm of superiority in elective surgery belongs to the problem of hernias. According to the literature worldwide, more than 20 million patients undergo surgical treatment for hernia of the anterior abdominal wall every year, most of whom undergo alloplasty using various kinds of nets. The study of the influence of methods for fixing implants and the emerging local inflammatory response of tissues on the frequency of relapses after allognioplasty is devoted to isolated works. Aim of the study was to investigate in an experiment the characteristics of the reaction of local tissues when implanting a rigid monofilament mesh polypropylene implant with a shape memory effect, and a classic mesh endoprosthesis made of monofilament polypropylene (PP) with various methods of fixing implants. Material and methods. An experimental study on 60 white male Wistar rats was performed to identify tissue reaction features around the PP mesh. Group 1 animals (n = 30) were implanted with a rigid mesh monofilament PP implant (Herniamesh, Italy) with shape memory effect, group 2 animals (n = 30) – with a classic mesh endoprosthesis made of monofilament PP for soft tissue repair ESFIL® standard (Lintex, Russia). Biopsies were examined at 1, 2, 3 months after implantation of the PP mesh. Results. A morphological study showed that 1 month after the implantation of a rigid mesh monofilament PP implant, the inflammatory reaction is less obvious than when implanting a classical PP endoprosthesis. This reaction contributed to the earlier germination of collagen fibers around the rigid implant monofilaments. At 2 and 3 months after the implantation of PP nets in both groups of animals, there were no advantages as the regenerate formed. Conclusions. When introducing PP mesh with suture fixation and rigid monofilament PP mesh without fixation, there is a natural response to the integration of the endoprosthesis, which is characterized by aseptic inflammation followed by pronounced fibrosis around the implant. Such processes, occurring in response to the implantation of synthetic polypropylene nets, increase local mechanical tissue resistance, and can create additional strength against recurrence of inguinal hernias.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141679185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Shilov, E. N. Berezikova, S. Mayanskaya, I. V. Pankova, B. B. Pinkhasov, A. A. Popova, D. Z. Tabdaeva, A. D. Vikhreva
This study demonstrates the relationship between IgG titer to cytomegalovirus (CMV) and the proinflammatory cytokine TNF-α and IL-1β concentration, the prognosis after hospitalization of patients due to decompensation of chronic heart failure (CHF) during 24 months of observation. Material and methods. We examined 132 patients with CHF of ischemic etiology (age 59.0 [54.0; 63.5] year, median [lower quartile; upper quartile]), hospitalized for CHF decompensation. Patients were included in the study after stabilization of CHF decompensation before discharge from the hospital. Subsequently, patients were prospectively monitored for 24 months. Upon inclusion in the study, TNF-α, IL-1β plasma concentration was determined, before discharge from the hospital and after 24 months – the titer of IgG antibodies to CMV. Results. The titer of IgG to CMV in the cohort of patients was 1356 [835; 1931] units/ml. Patients were divided into tertiles 1, 2 and 3 with an antibody titer of less than 923, from 923 to 1811 and more than 1811 units/ml, respectively (44 persons in each group). Individuals from the tertile 3 group were more likely to have IV functional class CHF (p = 0.025), and also had a higher content of pro-inflammatory cytokines (p = 0.001 for TNF-α and p = 0.019 for IL-1β), and the number of hospitalizations due to decompensation of CHF, worsening functional class of CHF and deaths during 24 months of observation than in patients of tertile 1. Conclusions. With an increased level of IgG to CMV in patients with CHF, there is an increase in the concentration of pro-inflammatory cytokines and the risk of adverse cardiovascular events within 24 months after an episode of CHF decompensation compared to patients with lower antibody levels. The activity of the inflammatory process, which is influenced by CMV infection, on the background of immunosuppression in patients with CHF, is likely an important trigger for the progression of cardiovascular pathology and mortality.
{"title":"Cytomegalovirus antibody level and progression of chronic heart failure","authors":"S. Shilov, E. N. Berezikova, S. Mayanskaya, I. V. Pankova, B. B. Pinkhasov, A. A. Popova, D. Z. Tabdaeva, A. D. Vikhreva","doi":"10.18699/ssmj20240320","DOIUrl":"https://doi.org/10.18699/ssmj20240320","url":null,"abstract":"This study demonstrates the relationship between IgG titer to cytomegalovirus (CMV) and the proinflammatory cytokine TNF-α and IL-1β concentration, the prognosis after hospitalization of patients due to decompensation of chronic heart failure (CHF) during 24 months of observation. Material and methods. We examined 132 patients with CHF of ischemic etiology (age 59.0 [54.0; 63.5] year, median [lower quartile; upper quartile]), hospitalized for CHF decompensation. Patients were included in the study after stabilization of CHF decompensation before discharge from the hospital. Subsequently, patients were prospectively monitored for 24 months. Upon inclusion in the study, TNF-α, IL-1β plasma concentration was determined, before discharge from the hospital and after 24 months – the titer of IgG antibodies to CMV. Results. The titer of IgG to CMV in the cohort of patients was 1356 [835; 1931] units/ml. Patients were divided into tertiles 1, 2 and 3 with an antibody titer of less than 923, from 923 to 1811 and more than 1811 units/ml, respectively (44 persons in each group). Individuals from the tertile 3 group were more likely to have IV functional class CHF (p = 0.025), and also had a higher content of pro-inflammatory cytokines (p = 0.001 for TNF-α and p = 0.019 for IL-1β), and the number of hospitalizations due to decompensation of CHF, worsening functional class of CHF and deaths during 24 months of observation than in patients of tertile 1. Conclusions. With an increased level of IgG to CMV in patients with CHF, there is an increase in the concentration of pro-inflammatory cytokines and the risk of adverse cardiovascular events within 24 months after an episode of CHF decompensation compared to patients with lower antibody levels. The activity of the inflammatory process, which is influenced by CMV infection, on the background of immunosuppression in patients with CHF, is likely an important trigger for the progression of cardiovascular pathology and mortality.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim of the study was to analyze the frequency and dynamics of schizophrenia, schizotypal disorder and autism in children and adolescents in Moscow and in the Kabardino-Balkarian Republic (KBR) for 2021–2022 to determine the need for appropriate support measures for this population group. Material and methods. The dynamics of primary and general morbidity of mental diseases, including children and adolescents, as well as primary and general morbidity of schizophrenia (F20), schizotypal disorder (F21) and autism among children and adolescents in Moscow and in the KBR for 2021–2022, corresponding to the ICD-10 codes, are considered. Results and discussion. There is an increase in the overall incidence of mental illness in 2021 and 2022 both in Moscow (an increase of 8.4 %) and in the KBR (an increase of 0.3 %), of which among the child population (10.9 and 2.2 %, respectively). An enhancement of the primary incidence of mental illness in Moscow was revealed with an increase of 23.7 %, in the KBR with an increase of 1.1 %, among the child population corresponding values were 29.4 and 10.6 %. The overall incidence of schizophrenia decreased by 1.1 % in Moscow and by 0.5 % in the KBR, among the child population – by 1.3 and 21.3 %, respectively. The overall incidence of schizotypal disorder enhanced by 9.1 % in Moscow, by 8.1 % in the KBR, among the child population – by 7.9 and 0 %, respectively. A decrease in the primary incidence of schizophrenia was revealed by 0.1 % in Moscow, by 91 % in the KBR. Among the child population it increased by 25.6 % in Moscow and decreased by 100 % in the KBR, as well as number of newly diagnosed cases of schizophrenia. The primary incidence of schizotypal disorder rose by 34.1 % in Moscow, by 16.7 % in the KBR, among the child population it decreased by 1 % and hasn’t changed, respectively. It is possible to note an increase in the total incidence of autism in 2021–2022 both in Moscow (by 21.1 %) and in the KBR (by 9.4 %), while the number of newly diagnosed cases of autism in Moscow increased by 26.3 %, then in the CBD it decreased by 66.8 %. Conclusions. A diagnostic bias was revealed – a decrease in the number of patients diagnosed with schizophrenia (F20) and a significant increase in the number of patients diagnosed with schizotypal disorder (F21). The statistical data obtained mainly indicate an improvement in the diagnosis of autism in childhood in Moscow and a decrease in the incidence of autism in the KBR.
{"title":"Regional features of the frequency and dynamics of the prevalence of schizophrenia, schizotypal disorder and autism in children and adolescents in Russia (statistical data for 2021–2022)","authors":"L. Z. Attaeva, I. V. Makarov","doi":"10.18699/ssmj20240321","DOIUrl":"https://doi.org/10.18699/ssmj20240321","url":null,"abstract":"Aim of the study was to analyze the frequency and dynamics of schizophrenia, schizotypal disorder and autism in children and adolescents in Moscow and in the Kabardino-Balkarian Republic (KBR) for 2021–2022 to determine the need for appropriate support measures for this population group. Material and methods. The dynamics of primary and general morbidity of mental diseases, including children and adolescents, as well as primary and general morbidity of schizophrenia (F20), schizotypal disorder (F21) and autism among children and adolescents in Moscow and in the KBR for 2021–2022, corresponding to the ICD-10 codes, are considered. Results and discussion. There is an increase in the overall incidence of mental illness in 2021 and 2022 both in Moscow (an increase of 8.4 %) and in the KBR (an increase of 0.3 %), of which among the child population (10.9 and 2.2 %, respectively). An enhancement of the primary incidence of mental illness in Moscow was revealed with an increase of 23.7 %, in the KBR with an increase of 1.1 %, among the child population corresponding values were 29.4 and 10.6 %. The overall incidence of schizophrenia decreased by 1.1 % in Moscow and by 0.5 % in the KBR, among the child population – by 1.3 and 21.3 %, respectively. The overall incidence of schizotypal disorder enhanced by 9.1 % in Moscow, by 8.1 % in the KBR, among the child population – by 7.9 and 0 %, respectively. A decrease in the primary incidence of schizophrenia was revealed by 0.1 % in Moscow, by 91 % in the KBR. Among the child population it increased by 25.6 % in Moscow and decreased by 100 % in the KBR, as well as number of newly diagnosed cases of schizophrenia. The primary incidence of schizotypal disorder rose by 34.1 % in Moscow, by 16.7 % in the KBR, among the child population it decreased by 1 % and hasn’t changed, respectively. It is possible to note an increase in the total incidence of autism in 2021–2022 both in Moscow (by 21.1 %) and in the KBR (by 9.4 %), while the number of newly diagnosed cases of autism in Moscow increased by 26.3 %, then in the CBD it decreased by 66.8 %. Conclusions. A diagnostic bias was revealed – a decrease in the number of patients diagnosed with schizophrenia (F20) and a significant increase in the number of patients diagnosed with schizotypal disorder (F21). The statistical data obtained mainly indicate an improvement in the diagnosis of autism in childhood in Moscow and a decrease in the incidence of autism in the KBR.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. M. Gorbunova, O. Gerasimenko, I. Shpagin, M. S. Medvedkina, V. N. Maksimov, Y. Nikolaev
The continuing interest in the problem of vibration disease (VD), especially when combined with arterial hypertension (AH), is due to the steady development of industrial sectors associated with vibration acceleration and the tendency towards the early development of AH. Aim of the study was to investigate the features of clinical, nutritional and anthropometric indicators and frequency of occurrence of Ala16Val (rs4880) polymorphic locus of the manganese superoxide dismutase (MnSOD) gene in VD combined with AH. Material and methods. 431 people were examined, among them 104 patients with VD stage I, 101 – with VD stage I in combination with AH I–II stage, 107 – with AH I–II stage, without contact with vibration, and 119 people working at the same enterprise without contact with vibration, without signs of hypertension. A complex of clinical, anthropometric, laboratory, functional and genetic studies has been carried out. Results. In case of VD comorbid with AH, the frequency of complaints, both general and specific, significantly increases compared to other groups. Body mass index, waist circumference / hip circumference (WC/HC) ratio, fat mass increase, extracellular fluid content with a decrease in active cell mass, musculoskeletal mass and phase angle compared with the control group. An imbalance of nutrition in terms of macro- and micronutrients, an increased content of the fat component in the diet with a deficiency in the diet of omega-3 polyunsaturated fatty acids has been established. In persons with VD and AH, the C/C genotype, which is more common in healthy people, is registered in only 16% of cases, while the polymorphic variant T/T is in 29 %, which exceeds the corresponding value in the control and isolated AH groups by 1.9 and 1.5 times, respectively. Discussion. The common pathogenetic features of VD and AH lead to the development of adipose tissue dysfunction and trophological insufficiency. There is no doubt that hypertension is associated with increased body weight, obesity, and adipocytokine serum concentration. An indicator of a high risk of developing cardiovascular pathology, including heart attack, stroke, is an increase in the WC/HC index. The role of the Ala16Val polymorphism of the MnSOD gene in the formation of AH and some variants of occupational diseases has been shown in a number of studies. Conclusions. The variant of VD, comorbid with AH, is characterized by a significant increase in the frequency of detection of the T/T genotype in the polymorphic locus Ala16Val (rs4880) of the MnSOD gene in combination with an altered nutritional and anthropometric status of such patients. The presence of this polymorphism may be associated with an increased risk of developing concomitant vascular pathologies in VD, however, in combination with malnutrition and associated changes in anthropometric parameters, this risk increases many times over. Thus, early diagnosis of the risk of developing comorbid vascular pathology in VD ca
{"title":"Clinical, nutritional, anthropometric indicators and frequency of occurrence of Ala16Val (rs4880) polymorphic locus of the MnSOD gene in vibration disease comorbid with arterial hypertension","authors":"A. M. Gorbunova, O. Gerasimenko, I. Shpagin, M. S. Medvedkina, V. N. Maksimov, Y. Nikolaev","doi":"10.18699/ssmj20240317","DOIUrl":"https://doi.org/10.18699/ssmj20240317","url":null,"abstract":"The continuing interest in the problem of vibration disease (VD), especially when combined with arterial hypertension (AH), is due to the steady development of industrial sectors associated with vibration acceleration and the tendency towards the early development of AH. Aim of the study was to investigate the features of clinical, nutritional and anthropometric indicators and frequency of occurrence of Ala16Val (rs4880) polymorphic locus of the manganese superoxide dismutase (MnSOD) gene in VD combined with AH. Material and methods. 431 people were examined, among them 104 patients with VD stage I, 101 – with VD stage I in combination with AH I–II stage, 107 – with AH I–II stage, without contact with vibration, and 119 people working at the same enterprise without contact with vibration, without signs of hypertension. A complex of clinical, anthropometric, laboratory, functional and genetic studies has been carried out. Results. In case of VD comorbid with AH, the frequency of complaints, both general and specific, significantly increases compared to other groups. Body mass index, waist circumference / hip circumference (WC/HC) ratio, fat mass increase, extracellular fluid content with a decrease in active cell mass, musculoskeletal mass and phase angle compared with the control group. An imbalance of nutrition in terms of macro- and micronutrients, an increased content of the fat component in the diet with a deficiency in the diet of omega-3 polyunsaturated fatty acids has been established. In persons with VD and AH, the C/C genotype, which is more common in healthy people, is registered in only 16% of cases, while the polymorphic variant T/T is in 29 %, which exceeds the corresponding value in the control and isolated AH groups by 1.9 and 1.5 times, respectively. Discussion. The common pathogenetic features of VD and AH lead to the development of adipose tissue dysfunction and trophological insufficiency. There is no doubt that hypertension is associated with increased body weight, obesity, and adipocytokine serum concentration. An indicator of a high risk of developing cardiovascular pathology, including heart attack, stroke, is an increase in the WC/HC index. The role of the Ala16Val polymorphism of the MnSOD gene in the formation of AH and some variants of occupational diseases has been shown in a number of studies. Conclusions. The variant of VD, comorbid with AH, is characterized by a significant increase in the frequency of detection of the T/T genotype in the polymorphic locus Ala16Val (rs4880) of the MnSOD gene in combination with an altered nutritional and anthropometric status of such patients. The presence of this polymorphism may be associated with an increased risk of developing concomitant vascular pathologies in VD, however, in combination with malnutrition and associated changes in anthropometric parameters, this risk increases many times over. Thus, early diagnosis of the risk of developing comorbid vascular pathology in VD ca","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osteoporosis is a disease associated with a decrease of bone density and quality. Bone tissue is especially sensitive to changes in trace element content in the body. Deficiency of macro- and microelements (silicon, calcium, manganese, etc.) can lead to the development of osteoporosis. The aim of the research was to study the effect of NaBiKat phytoextract on the viability and functional activity of fibroblasts, mesenchymal stem cells (MSCs), osteoblasts and osteoclasts, involved in bone metabolism in osteoporosis. Material and methods. An aqueous solution of the NaBiKat phytocomplex consisting of rice husks and germ film, green tea was used in the work; its content of basic chemical elements was measured using atomic immersion spectral analysis. The cytotoxicity of the phytoextract was evaluated on fibroblasts, MSCs, and osteoblasts of humans using the MTT test. The activity of mitochondria in cells was assessed by staining with a fluorescent dye TMRM. The production of intracellular proteins in osteoblasts and osteoclasts was determined using flow cytometry. Results and discussion. In an aqueous solution of phytoextract, a large amount of sodium, potassium, silicon, manganese, magnesium and a small amount of calcium, iron are found. The phytoextract did not have a cytotoxic effect on fibroblasts and stimulated proliferation of MSCs and osteoblasts up to 112–128 % and up to 130 %, respectively. At maximum concentration, the phytocomplex reduced osteoblast proliferation. Phytocomplex enhanced mitochondria activity in MSCs and osteoblasts, reduced in fibroblasts and osteoclasts. Under its influence, an increase in RANKL synthesis was observed in osteoblasts, the amount of type 1 collagen did not change, and cathepsin K production decreased in osteoclasts, while it did not significantly affect MMP-9 content. Conclusions. The results obtained indicate that an aqueous phytoextract based on rice husk and germ film, green tea leaves is safe for MSCs, fibroblasts, osteoblasts, and osteoclasts in humans and is able to stimulate the functional activity of osteoblasts, as well as reduce the activity of osteoclasts due to the high content of macro- and microelements.
{"title":"Study of the effect of phytoextract based on rice husk and germ film, green tea on the functional properties of cells involved in bone tissue metabolism","authors":"N. Sitnikova, N. Bondarenko, A. O. Kushnarenko","doi":"10.18699/ssmj20240316","DOIUrl":"https://doi.org/10.18699/ssmj20240316","url":null,"abstract":"Osteoporosis is a disease associated with a decrease of bone density and quality. Bone tissue is especially sensitive to changes in trace element content in the body. Deficiency of macro- and microelements (silicon, calcium, manganese, etc.) can lead to the development of osteoporosis. The aim of the research was to study the effect of NaBiKat phytoextract on the viability and functional activity of fibroblasts, mesenchymal stem cells (MSCs), osteoblasts and osteoclasts, involved in bone metabolism in osteoporosis. Material and methods. An aqueous solution of the NaBiKat phytocomplex consisting of rice husks and germ film, green tea was used in the work; its content of basic chemical elements was measured using atomic immersion spectral analysis. The cytotoxicity of the phytoextract was evaluated on fibroblasts, MSCs, and osteoblasts of humans using the MTT test. The activity of mitochondria in cells was assessed by staining with a fluorescent dye TMRM. The production of intracellular proteins in osteoblasts and osteoclasts was determined using flow cytometry. Results and discussion. In an aqueous solution of phytoextract, a large amount of sodium, potassium, silicon, manganese, magnesium and a small amount of calcium, iron are found. The phytoextract did not have a cytotoxic effect on fibroblasts and stimulated proliferation of MSCs and osteoblasts up to 112–128 % and up to 130 %, respectively. At maximum concentration, the phytocomplex reduced osteoblast proliferation. Phytocomplex enhanced mitochondria activity in MSCs and osteoblasts, reduced in fibroblasts and osteoclasts. Under its influence, an increase in RANKL synthesis was observed in osteoblasts, the amount of type 1 collagen did not change, and cathepsin K production decreased in osteoclasts, while it did not significantly affect MMP-9 content. Conclusions. The results obtained indicate that an aqueous phytoextract based on rice husk and germ film, green tea leaves is safe for MSCs, fibroblasts, osteoblasts, and osteoclasts in humans and is able to stimulate the functional activity of osteoblasts, as well as reduce the activity of osteoclasts due to the high content of macro- and microelements.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Y. Sedykh, E. Bazdyrev, D. Tsygankova, O. V. Nakhratova, E. Indukaeva, G. Artamonova, O. Barbarash
The aim of the study is to identify social and economic factors associated with the development of coronary and cerebral ischemic events in urban residents based on the results of a three-year follow-up. Material and methods. The prospective non-interventional observational study included 431 patients. Data on the coronary and cerebral ischemic events in history, and social, economic and demographic data were collected at the baseline. Follow-up appointments were scheduled 3 years later to assess new cases of coronary and cerebral ischemic events. Taking into account the presence or absence of the adverse events in history at the baseline and follow-up visit, four groups of patients were formed. There were 350 (81.2 %) people without a coronary history (group 1), and 81 (18.8 %) with it (group 2). Respondents without a coronary history were divided into a subgroup with the absence of new ischemic (coronary and cerebral) events at the repeat stage, numbering 246 (57.1 %) people (1a), as well as a subgroup with their development – 104 (24.1 %) (1b). Similarly, respondents with a coronary history were divided into a subgroup with the absence of adverse events at the second stage, which included 35 (8.1 %) people (2a), as well as a subgroup with their occurrence – 46 (10.7 %) (2b). Results. At the baseline, only 18.8 % out of 431 patients had coronary events in history. At the follow-up visit, 150 (34.8 %) patients presented with new coronary or cerebral ischemic events: 10.7 % of those cases were fatal, 1.9 % – new cases of myocardial infarction, 3.5 % – cases of stroke, 13.5 % – new cases of angina pectoris, and 5.3 % – other diseases associated with coronary artery disease. One third out of 350 patients without coronary events in history and half of patients with coronary events in history presented with newly developed adverse events. Young respondents (35–49 years old) with no coronary history were 3 times more likely to have coronary and cerebral ischemic events over 3 years than people of the same age, but with previous diseases of the cardiovascular system. During the 3-year followup period, the risk of coronary and cerebral ischemic events in patients with coronary events in history was associated unemployment odds ratio (OR) 2.74 (95 % confidence interval (CI) 1.33; 5.66, p = 0.006), widowhood OR 2.98 (95 % CI 1.32; 6.74, p = 0.008), living in a rural area OR 2.30 (95 % CI 1.16; 4.55, p = 0.017) and female gender OR 2.63 (95 % CI 1.28; 5.43, p = 0.008). Conclusions. The risk of coronary and cerebral ischemic events during the 3-year follow-up period in the population of urban residents is associated with social and economic determinants such as female gender, unemployment, living in a rural area, and widowhood in the presence of a coronary history. 35–49-year-old men without a coronary history should also be considered as a group of special attention for the prevention of adverse events.
本研究旨在根据三年的随访结果，找出与城市居民冠心病和脑缺血事件发生相关的社会和经济因素。材料和方法。这项前瞻性非干预性观察研究包括 431 名患者。在基线时收集了历史上冠心病和脑缺血事件的数据，以及社会、经济和人口统计学数据。3 年后进行随访，以评估冠心病和脑缺血事件的新病例。根据患者在基线和随访时是否出现不良事件，将患者分为四组。350人（81.2%）无冠心病史（第1组），81人（18.8%）有冠心病史（第2组）。无冠状动脉病史的受访者被分为重复阶段无新的缺血性（冠状动脉和脑部）事件的亚组，人数为 246 人（57.1%）（1a），以及有新的缺血性（冠状动脉和脑部）事件的亚组--104 人（24.1%）（1b）。同样，有冠心病史的受访者在第二阶段被分为未发生不良事件的亚组（35 人（8.1%））（2a）和发生不良事件的亚组（46 人（10.7%））（2b）。结果在基线阶段，431 名患者中只有 18.8% 的人有冠心病病史。在随访中，150 名患者（34.8%）出现了新的冠状动脉或脑缺血事件：其中 10.7% 的患者死亡，1.9% 的患者新发心肌梗死，3.5% 的患者中风，13.5% 的患者新发心绞痛，5.3% 的患者患有其他与冠状动脉疾病相关的疾病。在 350 名既往无冠心病史的患者中，三分之一的患者和一半既往有冠心病史的患者出现了新的不良反应。没有冠状动脉病史的年轻受访者（35-49 岁）在 3 年内发生冠状动脉和脑缺血事件的几率是同年龄但曾患有心血管系统疾病者的 3 倍。在 3 年的随访期间，有冠心病病史的患者发生冠心病和脑缺血事件的风险与失业几率比（OR）2.74（95 % 置信区间（CI）1.33; 5.66, p = 0.006）、丧偶 OR 2.98 (95 % CI 1.32; 6.74, p = 0.008)、居住在农村 OR 2.30 (95 % CI 1.16; 4.55, p = 0.017)和女性 OR 2.63 (95 % CI 1.28; 5.43, p = 0.008)。结论城市居民在 3 年随访期间发生冠心病和脑缺血事件的风险与社会和经济因素有关，如女性性别、失业、居住在农村地区以及有冠心病史的丧偶者。35-49岁无冠心病史的男性也应被视为预防不良事件的特别关注人群。
{"title":"Socio-economic determinants of risk of ischemic events: results of three-year clinical and epidemiological surveillance","authors":"D. Y. Sedykh, E. Bazdyrev, D. Tsygankova, O. V. Nakhratova, E. Indukaeva, G. Artamonova, O. Barbarash","doi":"10.18699/ssmj20240318","DOIUrl":"https://doi.org/10.18699/ssmj20240318","url":null,"abstract":"The aim of the study is to identify social and economic factors associated with the development of coronary and cerebral ischemic events in urban residents based on the results of a three-year follow-up. Material and methods. The prospective non-interventional observational study included 431 patients. Data on the coronary and cerebral ischemic events in history, and social, economic and demographic data were collected at the baseline. Follow-up appointments were scheduled 3 years later to assess new cases of coronary and cerebral ischemic events. Taking into account the presence or absence of the adverse events in history at the baseline and follow-up visit, four groups of patients were formed. There were 350 (81.2 %) people without a coronary history (group 1), and 81 (18.8 %) with it (group 2). Respondents without a coronary history were divided into a subgroup with the absence of new ischemic (coronary and cerebral) events at the repeat stage, numbering 246 (57.1 %) people (1a), as well as a subgroup with their development – 104 (24.1 %) (1b). Similarly, respondents with a coronary history were divided into a subgroup with the absence of adverse events at the second stage, which included 35 (8.1 %) people (2a), as well as a subgroup with their occurrence – 46 (10.7 %) (2b). Results. At the baseline, only 18.8 % out of 431 patients had coronary events in history. At the follow-up visit, 150 (34.8 %) patients presented with new coronary or cerebral ischemic events: 10.7 % of those cases were fatal, 1.9 % – new cases of myocardial infarction, 3.5 % – cases of stroke, 13.5 % – new cases of angina pectoris, and 5.3 % – other diseases associated with coronary artery disease. One third out of 350 patients without coronary events in history and half of patients with coronary events in history presented with newly developed adverse events. Young respondents (35–49 years old) with no coronary history were 3 times more likely to have coronary and cerebral ischemic events over 3 years than people of the same age, but with previous diseases of the cardiovascular system. During the 3-year followup period, the risk of coronary and cerebral ischemic events in patients with coronary events in history was associated unemployment odds ratio (OR) 2.74 (95 % confidence interval (CI) 1.33; 5.66, p = 0.006), widowhood OR 2.98 (95 % CI 1.32; 6.74, p = 0.008), living in a rural area OR 2.30 (95 % CI 1.16; 4.55, p = 0.017) and female gender OR 2.63 (95 % CI 1.28; 5.43, p = 0.008). Conclusions. The risk of coronary and cerebral ischemic events during the 3-year follow-up period in the population of urban residents is associated with social and economic determinants such as female gender, unemployment, living in a rural area, and widowhood in the presence of a coronary history. 35–49-year-old men without a coronary history should also be considered as a group of special attention for the prevention of adverse events.","PeriodicalId":24058,"journal":{"name":"Сибирский научный медицинский журнал","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141679176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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