Kemerovo State University

Highlights This analytical review aims to examine the features of the epidemic process of healthcare-associated infections in cardiac surgery. Based on the data described, risk-oriented technologies are considered an effective system for preventing infectious adverse events. Abstract The review is dedicated to a comprehensive analysis of the epidemic process of healthcare-associated infections in cardiac surgery. Despite the rapid development of high-tech and minimally invasive methods for treating circulatory system diseases, the problem of infectious complications after heart surgery remains extremely acute. Cardiac surgery patients present in severe condition, and the surgeries themselves carry a high risk of complications, characterized by significant prevalence, mortality, and colossal economic damage. The main forms of healthcare-associated infections, their pathogens, as well as risk factors and modern prevention approaches are described in detail. Priority is given to risk-oriented technologies as the most effective system for preventing adverse events in cardiac surgery.

Highlights Sequential extracorporeal therapy is a multi-organ support strategy for the treatment of critical illnesses that pathogenetically addresses the underlying cause of organ failure. This article reports a rare case of sequential extracorporeal therapy, which significantly prolonged the life of a patient with severe multiple organ failure after orthotopic heart transplantation. Abstract This article describes a clinical case of a 52-year-old man with ischemic cardiomyopathy, chronic left ventricular aneurysm, multiple myocardial cicatricial changes, diabetes mellitus and postcholecystectomy syndrome, who underwent orthotopic heart transplantation. After surgery he had developed sepsis and septic shock due to nosocomial pneumonia, pancreatic necrosis, acute renal and liver failure. Postoperative period was complicated by a crisis of rejection of the donor heart and pulmonary embolism. We used therapeutic plasma exchange, prolonged renal replacement therapy with the use of CytoSorb, Jafron and Toraymyxin sorption columns, as well as extracorporeal membrane oxygenation in the treatment process. As a result of progression of multiple organ failure, the patient died, but thanks to targeted use of extracorporeal technologies it was possible to prolonge the patient's life for 42 days. Consistent use of various methods of extracorporeal therapy has demonstrated its effectiveness, but further studies are needed to standardize their use in the aim to determine the target group of patients and select the optimal technology.

The cheese-making suitability of milk depends on several factors, including the genetic potential of dairy cattle and environmental conditions. This article examines the systemic relationships between animal genotype, molecular regulatory mechanisms, environmental factors, and processing technologies. A comprehensive analysis of these elements allows for the formulation of practical measures to ensure stable raw material quality. Genetic factors serve as the primary and limiting condition: breed and gene polymorphism significantly influence the composition, structure, and functional properties of milk proteins and fats. These genes include κ-casein (CSN3), β-casein (CSN2), αs1-casein (CSN1S1), β-lactoglobulin (LGB), lipogenic enzyme DGAT1, and mastitis resistance genes. While genetic potential defines biological limits, breeding for technologically valuable alleles remains a core strategy. Paratypical factors either implement or suppress the genetic program through various mechanisms, exerting a profound regulatory impact, which occurs via complex signaling and epigenetic modifications that fine-tune gene expression in mammary epithelial cells in response to resource availability and external stressors. Subclinical mastitis and stress trigger biochemical shifts that impair cheese-making suitability. However, the physiological and seasonal variability of raw materials can be managed through systematic interventions. For instance, colostrum and late-lactation milk must be excluded from cheese production; meanwhile, year-round uniform calving and mandatory milk maturation can smooth quality fluctuations. Ultimately, reliable raw material quality depends on an integrated approach that combines targeted genetic selection, molecular-based environmental management, and rigorous technological standards. Such a system minimizes the natural heterogeneity of milk, ensuring the predictability of the cheese-making process

In recent years, infrastructural characteristics of urban and rural environments are considered as possible determinants of cardiovascular diseases and their complications development in addition to traditional risk factors. Objective. To evaluate the contribution of residential area infrastructure to the development of combined endpoint of cardiovascular pathology in the population of one of the constituent entities of the Russian Federation. Materials and methods. A two-stage prospective clinical and epidemiological study was carried out at the Research Institute for Complex Issues of Cardiovascular Diseases (Kemerovo) in 2017—2021. During the first stage (2017—2019), 1600 persons living in Kemerovo and surrounding rural areas underwent medical check-up, examination and survey using the NEWS scale. At the second stage (2020—2021), 1034 subjects, or 64.6% of all participants in the first stage, underwent a repeated examination. Fatal and non-fatal cardiovascular events were considered as combined endpoint (CEP). Logistic regression analysis and classification trees were used. Results. It has been found that the perceived characteristics of the population residence area on scale B, reflecting the availability of basic infrastructure [OR=1.53; p=0.046], and scale D, characterizing pedestrian infrastructure [OR=2.21; p=0.001], increase the odds ratio of CEP. The relationships were statistically significant for persons aged 45—70 and female s ubjects. Of the infrastructure parameters, the following criteria made the greatest contribution to the development of CEP: large number of intersections in the neighborhood (100 conditional scores); walking inaccessibility of working places (90); safety of pedestrian areas related to road traffic (73); state of streets in the residential area (57); lack of interesting places in the vicinity that can be seen on walks (51); heavy traffic making walking difficult (47). Conclusion. The study results proved the contribution of infrastructural characteristics of the residence area to the development of fatal events and non-fatal cardiovascular events of the population through the example of one constituent entity of the Russian Federation.

The citric acid cycle disruptions are implicated in the pathogenesis of chronic diseases, including diabetes, obesity, cancer, and cardiovascular conditions. Numerous publications link TCA cycle disorders to oncological, neurodegenerative, and osteoporotic diseases, and specific single-nucleotide polymorphisms have been proposed as potential markers. Nevertheless, lifestyle and diet have been strongly linked to risk factors for mitochondrial dysfunction; thus, preventive measures that minimize these risks are a relevant field of research. This review summarizes 45 years of relevant publications on the TCA cycle, its genetics and epigenetics, and the restorative potential of certain nutrients. The review includes articles in English and Russian, registered in PubMed, Elsevier, eLIBRARY.RU. The genes encoding the TCA cycle enzymes have been collected and presented. Information is provided that a number of changes in the expression of these genes, for example, Arg18Trp, Ser87Leu, Ala252Thr, and Leu357Val of the ACO2 gene, leads to the development of neurodegenerative diseases; mutations rs121913499, rs121913500 in the IDH1, IDH2 genes, rs1270341616 and the DLST gene lead to the development of cancer. There is evidence that through epigenetic modifications, nutrition affects the activity of the TCA cycle. Niacin, α-lipoic acid, succinic acid, resveratrol, curcumin, arginine, leucine, quercetin, ursolic acid, and alternol affect the regulation of the TCA cycle at the genetic level. Further research into the effects of plant metabolites, vitamins, and bioactive supplements on the TCA cycle may improve the existing preventative and therapeutic diets.

Introduction: Today, scientists are searching for alternative approaches to preventing metabolic diseases, particularly non-alcoholic fatty liver disease, which reduces the healthy life expectancy of the working population. Fungi, such as Hericium coralloides (Scop.) Pers., are promising raw materials for extracting bioactive substances with preventative potential. Materials and Methods: This review covered review and research articles published over the last 42 years and indexed in the databases of the eLIBRARY.RU, the National Center for Biotechnology Information, and Scopus. Results and Discussion: It has been established that H. coralloides is valued for its nutritional properties due to its rich protein, fat, and mineral composition. It is in demand for pharmaceutical purposes due to its content of bioactive metabolites. The most studied metabolites are lovastatin and ergothioneine. The activity of these biologically active substances against NAFLD has been confirmed by studies in vitro and in vivo. Market analysis revealed that most dietary supplements contain fungal mycelium or its extract. It is preferable to use pure metabolites of H. coralloides as nutrients in dietary supplements and functional foods, since it allows the scientists to standardize their doses, target the therapeutic effect (immunity, neuroprotection, or antitumor), and reduce the required intake of the product. Since this fungus is a rare species in nature, its biomass should be grown in vitro for industrial use. Conclusions: Further research will focus on developing methods for extracting H. coralloides metabolites and assessing their biopotential in vivo and clinical studies.

Aim . To evaluate the phenotype of patients with secondary tricuspid regurgitation (STR) associated with acquired left heart defects (AHDs) requiring surgical treatment. Material and methods . We analyze data from a prospective observational registry including patients with AHDs to assess demographic characteristics, the nature of heart valve disease, and comorbidities among 1429 patients aged 18 to 80 years who were referred for surgical correction of noncommunicable AHDs between 2012 and 2023. Results . Among the 1429 patients with primary mitral and/or aortic valve disease, STR was detected in 28,2%. STR was most often associated with mitral valve di­sease (20,08%). STR was more common in women (62,3%) than in men (37,7%) (p<0,001). In addition, 53,6% of patients with STR had AHD due to rheumatic heart disease, while degenerative lesions occurred in 21,3%, and connective tissue dysplasia in 16,1% of patients. The odds of high pulmonary hypertension probability according to echocardiography were 2,5 times higher in patients with STR (95% confidence interval (CI): 1,833-3,420, p<0,001) compared to the group without STR. A multivariate model was used to identify predictors of left heart defects with indications for surgical treatment, including age, female sex, rheumatic origin, absence of degenerative valve disease, presence of atrial fibrillation (AF), lung di­sease, and obesity (area under the receiver operating characteristic (ROC) curve (AUC) =0,779; 95% CI: 0,750-0,808, p<0,001). Conclusion . The proportion of patients hospitalized for surgical treatment of left heart defects with STR is high (up to 30%). The phenotype of these patients is most often represented by elderly women with concomitant AF and pulmonary hypertension. We identified factors associated with left heart defects in patients with STR. These factors include age, female sex, rheumatic origin, absence of degenerative valve disease, presence of AF, lung disease, and obesity.

BACKGROUND: Elevated blood pressure remains one of the most important factors associated with the development of ischemic heart disease, stroke, and other cardiovascular diseases. It is necessary to identify additional factors contributing to its prevalence, including those related to urban infrastructure. AIM: The work aimed to assess the associations between characteristics of residential infrastructure and the risk of hypertension in different population groups of the Kemerovo region. METHODS: The study included 1598 respondents aged 35–70 years residing in the city of Kemerovo and selected rural settlements of the Kemerovo region. Blood pressure was measured in accordance with the 2013 ESH/ESC (European Society of Hypertension and the European Society of Cardiology) guidelines on hypertension. Characteristics of the residential environment were assessed based on respondents’ subjective evaluation of infrastructure parameters (using the Neighborhood Environmental Walkability Scale questionnaire). Depending on participants’ responses, unfavorable infrastructure elements were identified, and composite scales and infrastructure element groups were formed. Statistical analysis was performed using Statistica software, version 10.0.1011.0. The Holm–Bonferroni correction was applied to control for type I error in multiple comparisons. RESULTS: The prevalence of hypertension in the study sample was 66.7% in urban residents and 75.4% in rural residents (p 0.001), with no significant sex differences observed. The study demonstrated that certain characteristics of urban infrastructure were associated with a higher prevalence of hypertension. Among urban residents, hypertension was more common in those living at a greater distance from banks, pharmacies, and public transport stops, as well as in areas with heavy traffic, compared with residents whose neighborhoods lacked these features. Among rural residents, a higher prevalence of hypertension was observed in association with remote bank locations, insufficient sidewalks, and long distances between intersections. In the urban population, hypertension was associated with groups of infrastructure elements characterizing “poorly organized pedestrian infrastructure” and “low aesthetic quality of the residential environment.” No associations between hypertension and these or other groups of infrastructure elements were identified among the rural population. CONCLUSION: Characteristics of residential infrastructure may be associated with the risk of developing hypertension and may represent additional factors contributing to cardiovascular morbidity.