Objective: To evaluate the possibility of using fibroblast growth factor 21 (FGF 21) as a marker of metabolic disorders and premature aging in polymorbid cardiovascular pathology. Research methods: 199 men aged 35-55 years who were stratified into 3 groups were examined: group A - 117 patients with type 2 diabetes mellitus (type 2 diabetes), polymorbid cardiovascular disease (PCVD), obesity, androgen deficiency and anxiety-depressive disorders (ADD); group B - 55 patients with PCVD, obesity and ADD; group C - control group (n = 27). The examination of patients included a laboratory study of the level of FGF 21, indicators of carbohydrate and lipid metabolism, hormonal status, as well as daily monitoring of blood pressure and ECG. Results and conclusions. When compared with the control group, the level of FGF 21 was 3 times higher in the presence of type 2 diabetes. The most intense increase in FGF 21 levels was observed in groups of patients with several diseases. An increase in the level of FGF 21 in young and middle-aged people is probably due to a compensatory reaction to the existing androgen deficiency, disorders of carbohydrate and lipid metabolism. Strong correlations between FGF 21 and glucose, HDL cholesterol, total testosterone, ALT, and SBP during the day allow FGF 21 to be considered an early marker of cardiovascular disease and premature aging (PA) in young and middle-aged people
Objective: to assess clinical and morphological characteristics and occurrence of micronuclei of mucocytes of the integumentary and epithelium of the gastric mucosa in residents of areas affected by Chernobyl nuclear accident taking into account Helicobacter pylori (Hp) infection and nutritional factors. Methods: a retrospective study was conducted using a micronuclear test in integumentary-pit epithelium to study cytogenetic effects of small doses of ionizing radiation. Results. Mucocytes with micronuclei were predominantly observed in persons permanently residing in radiation contaminated areas since 1986. The occurrence of micronucleation was not statistically associated with Hp infection. No associations were found for the total alpha and beta activity of biopsy specimens of the gastric mucosa and the density of contamination of the territory at 90Sr and 137Cs. Conclusions: Our findings suggest that gastrointestinal pathology in residents of the territories affected by Chernobyl accident seems to have multifactorial origin related not only to the nuclear accident in Chernobyl.
Relevance. Individuals of stressful professions, including the emergency response officers (firefighters and rescuers) of the Ministry of Emergency Situations of Russia, are prone to the early onset of circulatory system diseases (CSD). At in-depth examinations the CSD detection rate in EMERCOM response officers is above 10%. Earlier studies report that CSD risk factors are widespread among EMERCOM of Russia response officers. Therefore, it is relevant to identify the predisposition to CSD as soon as possible in order to maintain good health and longevity among highly qualified professionals of the Ministry of Emergency Situations of Russia.The pathophysiological mechanism underlying progression of atherosclerosis affects complicated interactions between vasculature, immune system and lipid metabolism. Evidence shows that intestinal microbiome exacerbates all compound risk factors for atherosclerosis, both directly and indirectly, thus playing an important role in CSD development.Numerous studies revealed that elevated levels of plasma homocysteine and other aminothiols strongly correlate with manifestations of vascular dysfunction in atherosclerosis, coronary heart disease, myocardial infarction, stroke, and thrombosis, which makes it possible to isolate homocysteine as an independent risk factor for CSD progression.Our objective is to evaluate intestinal microbiome metabolism indicators and plasma aminothiols as early CVD risk markers in emergency response officers of the Ministry of Emergency Situations of Russia.Methodology. A comprehensive clinical and laboratory examination was performed in 96 emergency response male officers of the Russian Ministry of Emergency Situations at a regular medical check-up in the outpatient center of the Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, St. Petersburg. The average age of response officers was (35.9 ± 0.8) years, with average work experience in the EMERCOM of Russia of (8.8 ± 0.5) years. All emergency response officers were split in 3 groups: group 1 included 56 practically healthy males, group 2 - 20 males with risk of CVD development, group 3 - 20 males with established CVD diagnosis. Chromatography with mass-spectrometric determination of short-chain fatty acids (SCFAs), trimethylamine N-oxide (TMAO) and aminothiols was performed in plasma samples from all examined patients.Results and analysis. TMAO level was elevated by 30 % in group 3 compared to group 1. Acetic acid level decrease by 32 % was found in group 2 and by 45 % in group 3 compared to group 1.Plasma valeric and butyric acids were decreased by 1.9 and 2.5 times respectively in group 3 compared to group 1, as well as by 2 times in group 3 compared to group 2. It was found that in group 3 cystine concentration was decreased by 30 % compared to group 1 and reduced glutathione was elevated by 2 times compared to group 2.Conclusion. The revealed changes in the level of SCFA, aminothiols and TMAO in emergency response officers of the Ministry of Emergency Situations of Russia indicate a metabolic imbalance, which expands our understanding of the interactions between the intestinal microbiome and human body. This is fundamentally important for CSD early diagnosis, prevention and correction in emergency response officers of the Russian Ministry of Emergency Situations.
This paper presents the experience and features of the organization and provision of specialized and hightech medical care to victims of the Chernobyl accident in the framework of the activities of the Union State in the Nikiforov Russian Center of Emergency and Radiation Medicine EMERCOM of Russia. It reveals the features of the morbidity, disability and mortality of the injured in the accident at the Chernobyl nuclear power plant. The paper presents the data on the types and amount of medical assistance provided to victims of the Chernobyl accident for the period from 2007 to 2018 as well as the features of the organization of rendering specialized, including hi-tech, medical assistance and medical rehabilitation to participants of liquidation of consequences of the Chernobyl accident and inhabitants of the radioactively contaminated territories.
The research of degree of incidence of genomic changes (of micronuclei) in mucous cells of gastric superficial-foveolar epithelium in contaminated and not contaminated mucous of stomach was made. Histopathological research of micronuclei and helicobacter was made in gastric biopsy specimen of patients with diagnosis-chronical gastritis (ICD-10K29.3) in group of patients who lived in radiation contaminated areas and in groups of people, who had no factors of radiation influence in anamnesis. People, who lived in the radiation contaminated areas, whose mucous was infected by Helicobacter pylori, had the highest frequency of mucous cells with micronuclei. In the group of patients from radiation contaminated areas with HP-associated gastritis frequency of appearance of mucous cells with micronucleus in the mucous of stomach have five time more, than patients, whose mucous of stomach was not infected (p < 0.001). Therefore, we can suggest, that Helicobacter pylori can success in mutagenic effect of radiation factor.
The purpose of the study is to summarize the experience and identify the features of the organization and provision of specialized medical care (SpMP) to victims of the Chernobyl accident on the basis of the A. M. Nikiforov All-Russian centre of emergency and radiation medicine of EMERCOM of Russia. Materials and methods of research. Materials of the study were the data on types and volume of specialized medical assistance in 2014-2020 on the basis of the Centre; on the leading classes of diseases demanding specialized medical care in remote period to those affected by the Chernobyl accident. Research results and their analysis. 1. The system of organization of specialized medical care for victims of the Chernobyl accident in the framework of the Union State of Russia – Belarus includes 5 main stages: planning, coordination, information and analytical, hospital and final – analytical stages. 2. The main reasons for hospitalization of victims of the Chernobyl accident were diseases of the circulatory system, of the digestive system and of the musculoskeletal system and connective tissue. 3. When providing therapeutic SpMP, special attention was paid to the diagnosis and correction of comorbid pathology; when providing surgical SpMP, to individual selection of anesthetic aids, the use of minimally invasive endoscopic surgical interventions and prevention of postoperative complications. 4. The main reasons for medical rehabilitation were diseases of the Central nervous system and sensory organs, diseases of the cardiovascular system, musculoskeletal system and peripheral nervous system.
In operation own data and analytical arguing about possibility of application replacement hormonal of therapy (RHT) Livial at patients with climacteric cardiopathies are represented. In an outcome of researches is installed, that Livial promotes improving systole of myocard and reduces a degree it hypertrophy; normalization intracardial and intravascular bloodstream, improving active activw relaxing of the left ventricle and rise of elasticity large arterys. The tendency to normalization, and on early stages climacteric climacteric hypertension - normalization arterial of pressure, and also - improving trofics of the myocard, rise of its electrical stability and lowering arithmogenic is observed; an amplification anticoagulation and lowering procoagulation of a potential of blood with improving oj microcirculation. Obtained data specify validity and necessity RHT of Livial at the women with climacteric cardiopathies.
The aim of the study was to study and evaluate the clinical and morphological characteristics of the pathology of the gastroduodenal zone of the digestive tract in the population of the radioactively contaminated areas in the immediate and remote observation periods after the Chernobyl accident. Methods: esophagogastroduodenoscopy, cytological examination of gastrobioptate, micronucleus test, dosimetric evaluation of gastrobioptates. To solve the problems of the interrelation of the accident factors at the Chernobyl and the state of the mucous membrane of the upper digestive tract, a medical statistical evaluation of the frequency dependence of the pathology of the upper gastrointestinal tract and environmental factors of the accident in the near and distant period was carried out. Results: it has been established that the main morphological types describing the state of the gastric and duodenal mucosa in the examinees are: erosive, edematic, fibrotic changes on the background of Hp infection, as well as the development of inflammatory cell infiltration. The frequency of occurrence of micronuclei in mucosal mucosa does not depend on the frequency of infection of Helicobacter pylori, as well as the total alpha and beta activity of biopsy specimens of the gastric mucosa, the density of contamination of the territory at90Sr and137Cs. The relationship between the frequency of gastroduodenal pathology and the levels of contamination of the territory of permanent residence by90Sr and137Cs, as well as statistical regularities of the evaluation of the total alpha and beta activity of gastrobioptates in residents of the radiation contaminated areas for a long period of observation are not statistically significant. Conclusions: the nature and clinical picture of the pathology of the upper digestive tract, the dynamics of the pathological process from inflammatory-dystrophic to atrophic changes in the gastric mucosa, the absence of a connection between this pathology and the indicators of ecological problems according to the isotope composition of the territories, I testify that the reason for the above-mentioned regularities may be the effect complex of factors of the Chernobyl accident.
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