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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Zemlyakov IYu, Zhdanov DS, Bureev ASh, Golobokova EV, Kosteley YV

Stroke prevalence is one of the most acute problems in the medical and social aspects of society: strokes are the second most common in the mortality statistics of the population. In the Russian Federation, stroke occurs annually in almost 500,000 people and is the first among the causes of death from neurological diseases and the second most common cause of death after heart disease. The most common consequences of stroke are motor disorders of varying severity, manifested as changes in muscle tone, paresis and paralysis, and impaired walking function. This paper is an overview of the current state of robotic rehabilitation devices used for post-stroke limb paresis and of expected trends of their development. The existing variants of their construction, conditions of kinesiotherapy sessions for obtaining the greatest effect are considered. The authors are of the opinion that the nearest prospect for the development of high-tech devices of this type is not only complex stationary universal complexes for clinics, but also simple mobile specialized simulators with remote medical control for outpatient use.

Received: 2023-11-01

Published online: 2023-12-28

DOI: 10.47183/mes.2023.054

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VIEWS 862

Baranova TI, Rybyakova TV, Dmitrieva MO, Anisimov DA, Tarasova MS, Ogannisyan MG

Winter swimming implies extreme cold stress, which can cause respiratory disorders, arrhythmias, and elevated blood pressure even in generally healthy people. Pre-training examinations for athletes practicing winter swimming should include additional criteria evaluating reaction of the cardiovascular system (CVS) to cold water. This study aimed to determine the risk of pathological abnormalities in the examined individuals exhibiting different CVS reactions to immersion in cold water. We assessed reactivity of CVS with the help of a cold-hypoxic test (CHT), following a previously developed algorithm. The subjects of the analysis were CVS reactions to CHT and physical data collected after swimming in cold water. The study involved 255 female and 205 male participants, all of them almost healthy, aged 18–25 years. They participated in testing in a laboratory setting. Poly-Spektr-8/E cardiograph was used to record ECGs, and GraphPad Prism 8 package for Windows 10 for statistical analysis. Findings: in highly reactive and reactive participants, CHT causes lengthening of the PQ interval, with its value in the initial state (IS) equal to 158 ± 7.2, and with CHT — 178 ± 9.1 (p < 0.01); in subjects of he paradoxical type, CHT, against the background of higher pulse, triggered increase of QTc, which in the IS was 405 ± 7.1, with CHT — 420 ± 7.5 (p < 0.05). As for blood pressure, on average, CHT made it grow, SBD by 17.4 ± 4.3 mmHg, DBP by 12.9 ± 3.1 mmHg (p < 0.05). Swimmers adapted to cold, when swimming in cold water, had QTc above normal in 50% of cases: e.g., if IS of QTc was 434 ± 24 s, after swimming it increased to 492 ± 25 s. After a 200 m swim at t = 1.5–2 °C, the average blood pressure in the group, compared to IS, increased, with SBD growing by 16.9 ± 3.1 mmHg, and DBP — by 12.3 ± 2.3 mmHg (p < 0.05). Having analyzed the data, we conclude that CHT can be the basis of additional criteria extending examinations for athletes seeking admittance to cold water swimming.

Received: 2023-10-17

Published online: 2023-12-26

DOI: 10.47183/mes.2023.053

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VIEWS 731

Blinova EA, Korechenkova AV, Nikiforov VS, Akleyev AV

DNA methylation plays an important role in carcinogenesis; there are many studies that investigate the degree of methylation of the entire genome, gene promoters, and non-coding elements in cancer cells, but much less information about changes of the methylation patterns in blood cells and links with the development of malignant neoplasms (MN). This study aimed to investigate the degree of methylation of promoter regions of cell cycle control and apoptosis genes (BAX, MDM2, TP53, NFkB1) in peripheral blood cells of persons chronically exposed to radiation with MN developing latently. The study included 200 persons chronically exposed to radiation from the Techa River, contaminated with nuclear wastes dumped into it. The level of methylation was assessed by real-time PCR. The participants were divided into exposed and control groups; comparing them, we found that in the former, the distribution of exposed individuals with latent MN by the degree of methylation of promoter regions of BAX, MDM2 and NFkB1 genes was significantly different from that in the latter (p < 0.001; p < 0.001; p = 0.004, respectively). It was established that, compared to the control group, the share of the test group participants with subsequent MN who had up to 10% of the BAX gene promoter regions methylated was significantly higher, and amounted to 98%, while in the control group this figure did not exceed 73% (p < 0.00001).

Received: 2023-10-03

Published online: 2023-12-25

DOI: 10.47183/mes.2023.051

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VIEWS 731

Vakunenkova OA, Ivnitsky JuJu, Danilova OA, Schäfer TV, Rejniuk VL

Radiation exposure of recipients before hematopoietic stem cell transplantation can cause gastrointestinal (GI) stasis. It is associated with complications of myeloablative radiation therapy: delayed vomiting, excess bacterial growth, endotoxicosis, systemic inflammation, and sepsis. The study was aimed to assess the possibility of GI stasis prevention by intragastric administration of cystamine dihydrochloride when using radiation-induced myeloablation. The severity of GI stasis, levels of enterocyte markers in the small intestinal tissues and the indicator of intestinal endotoxicosis, urinary indican excretion, were assessed in rats 72 h after the single total-body X-ray exposure to the dose of 9.64 Gy (1.1 LD99/30); the animals’ whole body oxygen consumption was recorded daily. Irradiation caused GI stasis with predominant gastric stasis, the 1.5–4.8-fold decrease in the cholinesterase and alkaline phosphatase activity in the small intestinal tissues, doubled the urinary indican excretion, the whole body oxygen consumption reduction by 17–32%. Cystamine administration generally prevented gastric stasis, but had no significant effect on the characteristics of radiation-induced enterocytopenia and did not prevent accumulation of chyme in the caecum, hyperindicanuria, radiation-induced spleen hypotrophy, and decrease in gas exchange rate. Cystamine is promising for testing in large animals as a selective agent for emergency prevention of gastric stasis during myeloablative radiation therapy.

Received: 2023-09-29

Published online: 2023-12-07

DOI: 10.47183/mes.2023.050

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VIEWS 797

Patrakeeva VP, Schtaborov VA, Alesich RS

Tolerance to food antigens is essential for body’s sustainable development under constant antigenic load. Specific IgG against food antigens have been extensively studied in the literature over the recent years. The presence of those associated with various disorders and introduction of elimination diets for certain food products result in good treatment outcomes related not only to the gastrointestinal tract. Investigation of the impact of the long-term IgG-mediated hypersensitivity to food antigens associated with the increased blood-brain barrier permeability is also relevant when studying pathogenesis of the central nervous system disorders. However, identification of specific IgG in the generally healthy people having no history of allergy or inflammation currently provides no clear understanding of their nature and functional significance. Specific IgG are of great interest in terms of predicting the development of functional disorders, remission and treatment of disorders, changes in susceptibility to food antigens at certain age. The results of specific IgG studies are equivocal, which confirms the need to study their structure, epitopes capable of activating autoimmune processes considering the combined effects of medication, environmental conditions and social living conditions. The paper provides the analysis of the currently available research focused on studying specific IgG against food antigens. The data on identification of specific IgG in individuals with various disorders are provided, as well as the gender-related and age-related differences in antibody detection, the relationship between the antibody levels and the rate of food product consumption.

Received: 2023-09-12

Published online: 2023-11-27

DOI: 10.47183/mes.2023.049

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VIEWS 1083

Narutdinov DA, Rakhmanov RS, Bogomolova ES, Razgulin SA, Potekhina NN

Adaptation to the extreme living conditions of the North causes dyslipidemia, a risk factor for cardiovascular diseases (CVD), in people working there. This study aimed to assess the level of lipids and C-reactive protein (CRP), a marker of inflammation in CVD cases, in the blood of men staying in the Arctic and Subarctic zones of Russia. Accordingly, the sample was divided into two group, Arctic and Subarctic, the former included 51 participants, aged 35.7 ± 0.6 years, the latter — 54 individuals, aged 34.2 ± 0.9 years (p = 0.167); the duration of their work/stay in the Arctic and Subarctic zones was 7.1 ± 0.2 and 6.4 ± 0.6 years (p = 0.447), respectively. We sampled blood of the participants and measured triglycerides, total cholesterol, low (LDL) and high (HDL) density lipoproteins, atherogenic index (AI), CRP content. Arctic group had higher levels of triglycerides (1.71 ± 0.03 and 1.38 ± 0.14 mmol/l, p = 0.021), total cholesterol (6.15 ± 0.08 and 5.47 ± 0.14 mmol/l, p =0.001), HDL (1.5 ± 0.06 and 1.1 ± 0.04 mmol/l, p = 0.001); the values of LDL did not differ significantly between the groups (4.07 ± 0.08 and 4.1 ± 0.15 mmol/l, p = 0.88), and AI and CRP values (3.41 ± 0.18 and 4.18 ± 0.2, p = 0.007; 3.41 ± 0.18 and 4.91 ± 0.22 mg/l, p = 0.006, respectively) were greater in the Subarctic group. By triglycerides, dyslipidemia was diagnosed in 49.0% and 18.4% of Arctic and Subarctic participants, respectively, by total cholesterol — in 98.0% and 57.8%, by LDL — in 94.1% and 88.0%. As for HDL, their level was lower than normal in 2.0% of the Arctic group subjects and 36.7% of the Subarctic group subjects, which means a higher risk of cardiovascular diseases in the Subarctic region. The level of CRP indicated that 90% of the Arctic group participants were at risk of CVD (moderate risk for 23.5%, high risk for 66.7%), and in the Subarctic group this number was 100% (moderate risk for 7.7%, high risk for 88.5%). The likely reasons behind this are the specifics of nutrition and living conditions. Program of prevention of CVD in the Arctic zone should include lipid profile and CRP tests as part of every periodic medical examination, regardless of age. It is necessary to implement dyslipidemia alimentary correction measures.

Received: 2023-09-09

Published online: 2023-11-24

DOI: 10.47183/mes.2023.048

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VIEWS 1044

Krivoshchapova YaV, Vozilova AV

It is well-known that ionizing radiation is among factors increasing the rate of chromosomal rearrangements. The inversion rate was poorly understood due to difficulty of inversion identification by the conventional differential staining method. A comprehensive study of chromatin and its complex rearrangements has become possible with the use of the high-tech molecular genetic method, fluorescence in situ hybridization (FISH). The study was aimed to assess frequency of inversions involving the chromosome telomeric regions in 36 residents of the South Urals, almost all of them were affected by combined chronic exposure. The calculated individualized cumulative external and internal doses were 0.0001–4.7 Gy. Inversions were identified by fluorescence staining of the chromosome telomeric region. It was found that chromatid inversions were more abundant than chromosomal variants (9 : 0.3 per 100 cells (p < 0.001). No relationship between the studied parameters and the absorbed dose, sex and age at the time of the examination was revealed.

Received: 2023-08-08

Published online: 2023-11-21

DOI: 10.47183/mes.2023.047

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VIEWS 822

Fomina EV, Senatorova NA, Bakhtereva VD, Yarmanova EN, Kozlovskaya IB

The prospects of deep space exploration necessitate modification of the principles and methods underlying the system designed to prevent negative impact of weightlessness on the human body. This work aimed to determine how fast running, as part of locomotor training during a space flight (SF), helps maintain physical ability of a person. The study involved 10 cosmonauts; their physical performance was assessed at all stages of the SF with the help of the Individual Strategies Test (IST). The parameters registered when the participants were doing the IST included heart rate (HR), gas exchange, capillary blood lactate concentration. The cosmonauts were divided into two groups based on the differences in the mean distance covered while fast running on a treadmill (single session). Group A (n = 4) run 949 m/day on average, group B (n = 6) — 2669 m/day. After SF, HR in group A increased at speeds from 5 to 8 km/h (p < 0.05), pulmonary ventilation indicators grew at speeds from 8 to 15 km/h (p < 0.05), and the capillary blood lactate concentration measured during the post-test recovery period increased by 37% (p = 0.03). Moreover, after SF, the pulse sum recorded under load and during recovery was 14% (p = 0.02) and 15% (p = 0.03) in group A, respectively, while in group B we registered no differences. Thus, our hypothesis that fast running triggers sensory reactions simulatingEarth conditions for the body, which consequently activates physiological mechanisms counteracting the negative effects of weightlessness, has been confirmed in a space experiment.

Received: 2023-06-15

Published online: 2023-11-19

DOI: 10.47183/mes.2023.046

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VIEWS 846