Extreme Medicine

ISSN Print 2713-2757 ISSN Online 2713-2765

Extreme Medicine

SCIENTIFIC AND PRACTICAL REVIEWED JOURNAL OF FMBA OF RUSSIA

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Narutdinov DA, Rakhmanov RS, Bogomolova ES, Razgulin SA, Istomin AV, Shurkin DA

The lack of vitamins and minerals in the body contributes to the development of acquired deficient conditions. The study was aimed to assess micronutrient levels in the military personnel serving in various climatic zones of Russia. Plasma levels of vitamins (D based on 25(OH)D, B12, В9) and minerals (K, Na, total and ionized Ca, P, Mg, Fe), working and nutritional conditions were determined in servicemen in the Arctic (n = 54), Subarctic (n = 57), and temporary climate (n = 58) zones. The 25(OH)D levels were 24.06 ± 6.95, 21.5 ± 12.1(р1–2 = 0.003), and 27.2 ± 15.2 (р1–2 = 0.423, р1–3 = 0.032) ng/ml; deficiency and insufficiency were revealed in 82.3, 86.5, and 63.8% of military personnel. The cobalamin levels were 96.46 ± 20.6, 111.7 ± 59.4 (р1–2 = 0.046), and 125.7 ± 63.2 (р1–2 = 0.002, р1–3 = 0.334) pmol/L; the values below 148 pg/mL were reported for 100.0, 73.6, and 67.2% of surveyed individuals. The folate levels were 3.4 ± 0.4, 3.52 ± 1.54 (р1–2 = 0.657), and 6.49 ± 6.21 (р1–2 = 0.001, р1–3 = 0.009) ng/mL; the decreased levels were reported for 89.8, 81.3, and 44.8% of military personnel. The ionized calcium levels were decreased in 29.4, 50.0, and 67.2% of surveyed individuals, while the iron levels were decreased in 2.0, 1.9, and 3.4%. Elevated potassium (23.5, 29.6, and 8.6%), sodium (32.7 and 27.6% of individuals serving in the Subarctic and temporary climate zones) and total calcium (42.6% of individuals serving in the Subarctic zone) levels were reported. In the Arctic zone, the servicemen worked indoors and outdoors (heavy labour), while in the Subarctic and temporary climate zones they worked indoors (hard labour). In the Arctic zone, meals were organized consisting of the delivered canned foods (general military ration, 4466.7 ± 230.7 kcal/day), while in other zones it was homemade food with the disturbed eating pattern, inadequate consumption of fresh vegetables and fruits. The study updates the directions for prevention of health problems in the military personnel serving in the extreme habitat and working conditions: estimation of body’s vitamin and mineral balance; optimization of the diet with the vegetable protein food products; raising awareness about the issues of individual diet and the use of vitamin and mineral supplements; developing formulations of multicomponent food products for adjustment of body’s vitamin and mineral balance.

Received: 2024-03-23

Published online: 2024-06-28

DOI: 10.47183/mes.2024.031

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VIEWS 369

Gaykova ON, Kozlov AA, Katretskaya GG, Melnikova MV, Melekhova AS, Bondarenko AA, Sokolova YuO, Bazhanova ED

The effects of various toxicants on the body tissues cause tissue abnormalities resulting in dystrophic changes and necrosis. The nervous system is the most vulnerable to the effects of exogenic substances, both chemical and biological, due to high metabolic activity and the cells' incapability of self-renewal. Neurotoxicants lead to disturbances of cellular nutrition and eventually to neurodegeneration. Neurons can die due to both apoptosis and necrosis.

Received: 2024-05-15

Published online: 2024-06-28

DOI: 10.47183/mes.2024.025

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VIEWS 390

Manuvera VA, Brovina KA, Bobrovsky PA, Grafskaia EN, Kharlampieva DD, Lazarev VN

The search for new anticoagulants requires simple and affordable methods for primary determination of their activity. Clotting tests are widely used for laboratory evaluation of the hemostatic system. These are model studies that assess the state of the hemostatic system from a clinical point of view based on the fibrin clot formation time. Reagents and instruments for such tests are produced in Russia, they have low manufacturing cost and are easy to use. However, it is necessary to make a few modifications to the measurement methods to assess the anticoagulant activity. The study was aimed to demonstrate performance of the protocol for testing the solution anticoagulant activity using the modified standard clinical tests involving measurement of the activated partial thromboplastin time (aPTT), prothrombin time (PT), and thrombin time (TT). Reagents for measurement of aPTT, PT, and TT were used, along with the domestically produced heparin and two recombinant anticoagulant proteins from the medicinal leech obtained in our laboratory. Clotting tests were performed with the addition of anticoagulants to the reaction mixture were performed; performance and applicability limits of the methods used were determined. When studying hirudin, heparin, and cysteine-rich anticoagulant of medical leech using measurement of aPTT, TT, and PT, a dose-dependent increase in clotting time was demonstrated. The methods’ compatibility with the use of various common components of buffer solutions used in biochemical tests was determined. It was shown that the slightly modified standard blood clotting tests for determination of hemostatic parameters could be used to test new potential anticoagulants.

Received: 2024-03-27

Published online: 2024-06-28

DOI: 10.47183/mes.2024.026

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VIEWS 391

Ivanov YuV, Stankevich VR, Kakurin OV, Velichko YeA, Smirnov AV, Gornov SV

Timely first aid (FA) for acute conditions makes it possible to improve treatment outcomes and sometimes save human life. Assessing the basic knowledge about FA will help develop a rational system for training and dissemination of knowledge about FA. The study was aimed to perform quantitative and qualitative analysis of mistakes made by residents of Moscow and Moscow Region during assessment of their basic knowledge about FA. The questionnaire consisting of 10 questions (four possible answers, among then one correct) was created. Polling conducted before testing showed that all the respondents had basic knowledge about FA. The total study sample was 946 individuals (aged 15 years and older), it was divided into group based on the fact of having/not having medical education. It was found that the basic knowledge about FA was generally low, mainly due to the respondents having no medical education. Qualitative analysis of the answers revealed a large number of gross mistakes reflecting a high risk of wrong actions leading to deterioration of health of a victim or FA provider. The study confirms the fact of insufficient awareness of various categories of citizens, including healthcare professionals, on the issues of FA, which suggests the need to improve the system for training and dissemination of knowledge about FA across the population.

Received: 2024-05-23

Published online: 2024-06-27

DOI: 10.47183/mes.2024.027

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VIEWS 347

Isaeva EP, Okorokov PL, Zyabkin IV

In children, 90% of all anemia cases are due to iron deficiency. Iron is an essential element so iron metabolism disorders have negative consequences for health. Currently, there are no reliable statistical data on the prevalence of iron deficiency in elite young athletes in the Russian Federation (RF). The aim of this study was to evaluate the prevalence of iron deficiency anemia (IDA) and latent iron deficiency (LID) in young elite athletes. We retrospectively analyzed 802 outpatient records of members of the Russian national sport teams aged 13–18 (mean age is 15.4 ± 2.1 years; 434 (54.1%) girls, 368 (45.9%) boys) in 17 sports, who underwent indepth medical examination including clinical blood tests and serum iron level assays. IDA was diagnosed in 43 young elite athletes (5.4% of all examined athletes). The prevalence of IDA in female adolescents was significantly higher than in male adolescents (8.9% and 1.1%, respectively; p = 0.0001). The prevalence of LID in game sports was significantly higher compared to the other sports. LID was recorded in 186 athletes (23.2%). LID was less common in cyclic sports and was not gender dependent. It can be concluded that young elite athletes have a moderate prevalence of IDA (> 5%). However, since LID was diagnosed in 20% of the athletes, it may be necessary to perform thorough examination for timely screening and correction of iron deficiency in adolescent high performance sports.

Received: 2024-04-16

Published online: 2024-06-27

DOI: 10.47183/mes.2024.024

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VIEWS 406

Gaynutdinov TR, Ryzhkin SA, Shavaliev RF, Vagin KN, Kurbangaleev YaM, Kalimullin FH, Plotnikova EM, Idrisov AM, Ohrimenko SE, Mayorova EN

The study is relevant due to the fact that the decrease in microbial toxicity observed during the radio-inactivation of microorganisms is accompanied by synthesis of radioprotective substances and exertion of the radioprotective effects associated with administration of such microbial agents to exposed animals. The study was aimed to assess radioprotective efficacy of the exposed Staphylococcus aureus variants. The study showed that the Staphylococcus aureus culture treated with a single dose of gamma radiation (30–40 kGy) ensured protection of 55–66% of the lethally irradiated animals. Multiple exposures of the test microorganism to the gradually increasing doses of gamma radiation induced an even larger increase in radioresistance resulting from the synthesis of endogenic radioprotectors, particularly peroxidase, the antioxidant enzyme, and IL1β cytokine, ensuring interception of the radiation-induced toxic radicals and thereby preventing postexposure pancytopenia in the bone marrow. The experiments involving white mice exposed to the absolutely lethal gamma radiation doses (7.9 Gy, LD100/30) showed that a single subcutaneous administration of the St. aureus radioresistant variant (strain 209R70) in a dose of 2 × 108 bacterial cells per animal 3 days after the exposure ensured the 77.7% survival rate, while 100% of untreated animals died. Based on the findings it was concluded that inclusion of the exposed agents of microbial origin would make it possible to increase the efficacy of the combination radioprotectors.

Received: 2024-05-10

Published online: 2024-06-26

DOI: 10.47183/mes.2024.023

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VIEWS 369

Blinova EA, Korechenkova AV, Yanishevskaya MA, Akleyev AV

In the context of additional radiation exposure, single nucleotide polymorphisms in the genes encoding the antioxidant system enzymes can contribute to the oxidative stress enhancement, damage to DNA, and therefore lead to the increase in the risk of malignant neoplasm (MN) development. The study was aimed to determine the association of the СYBA (rs4673), GPX1 (rs1050450), MPO (rs2333227), CAT (rs7943316), SOD2 (rs4880) polymorphic loci with the risk of MN development in individuals affected by low dose rate chronic radiation exposure considering intergenic interactions and the radiation dose. Two groups of individuals were included in the study: exposed individuals with no MNs — 384 people with the mean accumulated dose to the red bone marrow (RBM) of 796.95 ± 35.97 mGy; exposed individuals with the history of MNs — 227 people with the mean accumulated dose to RBM of 520.06 ± 38.72 mGy. Amplification of the rs4880, rs2333227, rs7943316, rs4673, rs1050450 polymorphic loci was performed with real time PCR. Compliance with the Hardy–Weinberg equilibrium was reported for all gene polymorphisms. It has been found that the rs4880*С (SOD2) and rs1050450*Т (GPX1) alleles are associated with the risk of MN development in accordance with the dominant (OR = 1.49 (1.02–2.18), р = 0.04) and recessive (OR = 2.00 (1.11–3.62), р = 0.02) inheritance modes, respectively. An interfactor interaction model with the 100% reproducibility and 66% accuracy (р = 0.001) has been obtained that includes the SOD2 (rs4880), СYBA (rs4673) polymorphisms and the factor of accumulated dose to RBM. Thus, polymorphic loci of the genes regulating the oxidative status of the cells are associated with the increased risk of MN development in individuals, who have experienced chronic radiation exposure with predominant exposure of RBM.

Received: 2024-03-25

Published online: 2024-06-26

DOI: 10.47183/mes.2024.022

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VIEWS 406

Gulyaev SA, Klimanov SG, Germashev GA, Khanukhova LM, Garmash AA

Modern application of mathematical methods for analyzing EEG recordings is limited due to the phenomenon of information averaging. In these conditions, it is important to find the most likely method for improving the quality of diagnosis of paroxysmal pathological patterns that have a short “life”, such as outbreaks and subclinical paroxysms. The purpose of the study was to evaluate the possibility of excluding interictal activity from a long-term EEG study in order to achieve its information “enrichment” by forming conditional sequences of pathological changes representing its main clinical task. Forty people of different ages and both sexes were examined. The control group included 20 patients aged 12–67 years with direct detection of spike-wave activity on the EEG. The comparison group consisted of 20 patients aged 10–66 years with no spike-wave activity in the recording. It has been shown that interictal data obtained in patients with epileptiform phenomena are not of significant interest for the main group of clinical studies. The exclusion of these data leads to the “enrichment” of information due to the sequential placement of paroxysmal patterns and makes it possible to obtain not only more compact results of examinations of the pathological component, but also to form a basis for developments using technologies for their subsequent mathematical analysis.

Received: 2024-03-12

Published online: 2024-06-26

DOI: 10.47183/mes.2024.020

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VIEWS 411