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The literature review presents data from a limited number of available studies conducted over the last two decades on immunological deficiency in congenital heart defects (CHDs), which is the cause of frequent infectious complications before and after cardiac surgery. Several studies based on screenings at various levels indicate the presence of primary and secondary immunodeficiency in CHDs, in particular about 13 genetic syndromes in which CHD is combined with immunodeficiency. The available data suggests a greater severity of immunological disorders in patients with critical CHDs, cyanotic CHDs, and conotruncal defects with T-cell dysfunction and deficiency of immunoglobulins (especially the IgG class, mainly IgG4) than in patients with shunts and obstructive defects. To identify defects in the T- and B-cell components of the immune system, quantification of the DNA of T-cell receptor excision circles (TRECs) and K-deleting recombination excision circles (KRECs)-by-products of the maturation of T- and B-cell receptors- has proven helpful in the world practice of neonatal screening. It allows the evaluation of a number of functionally mature T- and B-cells. In Russia, however, its widespread use started only in 2023. Data on the use of this assay in infants with CHDs are represented by isolated case reports. In Russia, a combination of CHD and primary immunodeficiency was found in 37% of cases in the Sverdlovsk Region. We conducted our own study of 200 children with CHD; 5% of cases were syndromic forms of CHD. 48.5% of children were admitted to the cardiac surgery clinic in critical condition. A decrease in the TREC level was detected in 23.5% of cases, including all children with syndromic CHD. In the group of patients with immunological disorders, there were significantly more children with cyanotic CHD, children admitted in critical condition, and children with conotruncal defects. Infectious complications in the postoperative period (sepsis, pneumonia, tracheobronchitis, postoperative wound infection) were observed significantly more often in 47 children with reduced TREC levels compared to children with normal TREC levels (P = .00000, in 36% and 3.6%, respectively). The analysis of publications confirms the prognostic value of TREC and KREC screening for targeted preoperative preparation to reduce postoperative complications and decrease the risk of mortality in CHDs.

A prospective study of 92 patients over 70 years old with myocardial infarction was carried out. All patients were diagnosed and determined the severity of geriatric syndromes, including fragility, using specialized scales on the 5th day of hospitalization. The comorbidity was assessed with the calculation of the Charlson Comorbidity Index, levels of NT-proBNP, ST-2, FGF-21, VEGF in blood serum by enzyme immunoassay. In the studied cohort of patients, marked comorbidity, high prevalence of prefragility and fragility in combination with other geriatric syndromes were revealed. Patients over 70 years old with myocardial infarction and fragility showed significantly higher levels of myocardial stress and fibrosis, which is prognostically unfavorable sign for the given group of patients. NT-proBNP and ST-2 levels have significant correlation with major geriatric syndromes and could be the markers of fragility development among elderly and senile patients with myocardial infarction. Проведено проспективное исследование, включившее 92 пациента старше 70 лет с инфарктом миокарда. Всем пациентам проводили выявление и определение тяжести гериатрических синдромов, в том числе синдрома старческой астении, с использованием специализированных шкал на 5-е сутки госпитализации. Оценивали коморбидный фон с расчетом индекса Чарлсон, уровень NT-proBNP, ST-2, FGF-21, VEGF в сыворотке крови методом ИФА. В обследуемой когорте пациентов установлена выраженная коморбидность, высокая распространенность преастении и астении в сочетании с другими гериатрическими синдромами. У пациентов старше 70 лет с инфарктом миокарда и синдромом старческой астении выявлен достоверно более высокий уровень миокардиального стресса и фиброза, чем у той же категории пациентов без синдрома старческой астении, что является прогностически неблагоприятным признаком. Уровень NT-proBNP и ST-2 значимо коррелировал с основными гериатрическими синдромами и может являться маркером развития синдрома старческой астении у пациентов пожилого и старческого возраста с инфарктом миокарда.

Metagenomic studies of soil microbocenoses are extremely relevant nowadays. The study of pollution impact on soil microbiomes is of particular interest. The structure of microbial communities in soils with different levels of pollution by polycyclic aromatic hydrocarbons (PAHs) and potentially toxic elements (PTEs) was studied. High bacterial biodiversity was found in all the studied soil samples, but its lowest values are found in soil samples taken on the territory of technogenically polluted Lake Atamanskoye. Assessment of soil pollution showed the highest content of polycyclic aromatic hydrocarbons (PAHs) and potentially toxic elements (PTEs) for the soils Lake Atamanskoye. The high content of pollutants negatively affects the abundance of representatives of the phyla Actinobacteria, Planctomycetes, Verrucomicrobia, and Nitrospirae. Such phyla as Proteobacteria, Candidate Divisions TM7, OD1, WPS-2, Chlamydiae, Cyanobacteria are characterized by positive direct correlation with the content of pollutants, especially with PAHs. A cooperative effect of decrease in the number of Actinobacteria and Proteobacteria with an increase in Armatimonadetes probably corresponds to PTEs contamination. The proportion of Candidate Division OD1, Chlamydiae, Cyanobacteria, and Candidate Division WPS-2 was increased in the soil microbiome under the influence of severe combined pollution. Pollutants negatively affect the abundance of dominant unclassified_o__Gaiellales and unclassified_o__WD2101 genera. Iamia, Salinibacterium, Arthrobacter, Kaistobacter, Thiobacillus genera are characterized by a low abundance, but they are presumably the most resistant to soil pollution. It was revealed that the level of soil pollution largely determines the composition and diversity of bacterial communities in the soils of the studied territories. Operating taxonomic units have been established that have prognostic value for assessing the state, level of soil pollution, and their biological safety.

The article analyses recent studies dedicated to elderly patients with acute coronary syndrome (ACS) with senile asthenia syndrome - frailtyand without it. The presence of frailty in an elderly patient with ACS is associated with marked comorbidity and long-lasting hospitalization, high risk of adverse cardiovascular events, including recurrent myocardial infarction, as well as death from all causes, either during the current hospitalization or within a year after the discharge from the hospital. However, the evidence concerning the influence of frailty on the risk of bleeding is controversial. В статье анализируются исследования последних лет, посвященные пожилым пациентам с острым коронарным синдромом (ОКС) и синдромом старческой астении (ССА) и без него. Наличие ССА у пожилого пациента с ОКС ассоциировано с выраженной коморбидностью и длительностью госпитализации, высоким риском развития неблагоприятных сердечно-сосудистых событий, в том числе повторного инфаркта миокарда, а также смерти от всех причин как в течение текущей госпитализации, так и в течение одного года после выписки из стационара. Однако данные о влиянии ССА на риск развития кровотечения противоречивы.

Women make up an increasing proportion of the physician workforce in anaesthesia, but they are consistently under-represented in leadership and governance. We performed an internet-based survey to investigate career opportunities in leadership and research amongst anaesthesiologists. We also explored gender bias attributable to workplace attitudes and economic factors. The survey instrument was piloted, translated into seven languages, and uploaded to the SurveyMonkey&#xae; platform. We aimed to collect between 7800 and 13 700 responses from at least 100 countries. Participant consent and ethical approval were obtained. A quantitative analysis was done with &#x3c7;2 and Cramer's V as a measure of strength of associations. We used an inductive approach and a thematic content analysis for qualitative data on current barriers to leadership and research. The 11 746 respondents, 51.3% women and 48.7% men, represented 148 countries; 35 respondents identified their gender as non-binary. Women were less driven to achieve leadership positions (P<0.001; Cramer's V: 0.11). Being a woman was reported as a disadvantage for leadership and research (P<0.001 for both; Cramer's V: 0.47 and 0.34, respectively). Women were also more likely to be mistreated in the workplace (odds ratio: 10.6; 95% confidence interval: 9.4-11.9; P<0.001), most commonly by surgeons. Several personal, departmental, institutional, and societal barriers in leadership and research were identified, and strategies to overcome them were suggested. Lower-income countries were associated with a significantly smaller gender gap (P<0.001). Whilst certain trends suggest improvements in the workplace, barriers to promotion of women in key leadership and research positions continue within anaesthesiology internationally.

Polycyclic aromatic hydrocarbons (PAHs) are widely distributed environmental toxicants primarily formed during the incomplete combustion of organic materials (for example, coal, oil, gasoline and wood). Power energy plants are the main sources of organic contaminants including PAHs. The purpose of the present research was to study the Novocherkassk Electric Power Station (NEPS) emission effects of PAHs accumulation in soils. The regional levels, types (groups) and spatial distribution of 16 priority PAHs were investigated. The monitoring sites were located on fallow lands of the 20&#x202f;km around NEPS. PAHs extraction from collected soil samples was performed using the ecologically clean express-method of subcritical water extraction. The total PAHs content gradually increased in soil of the studied territories during 2016-2017 due to an increase in contaminants emission. Accordingly 16 priority PAHs were determined in the soil samples collected from the sites located to the northwest from NEPS in direction of predominant winds. The 5-km zone situated in direction of predominant winds was highly subjected to PAHs contamination, with maximal accumulation at a distance of 1.6&#x202f;km from the source. The ratio of high- and low-molecular weight PAHs content in soils of monitoring sites was taken as an index of environmental soil contamination. The high-molecular weight PAHs concentration prevailed in monitoring sites soils situated in direction of predominant winds from NEPS, while the concentration of low-molecular weight PAHs prevailed in the monitoring sites soils situated around NEPS. Soil properties also influenced PAHs accumulation. Polyarenes content in Haplic Chernozems and Haplic Chernozems (Stagnic) was higher versus Fluvisols. This study provides the understanding and model the fate of PAHs in regional technogenic landscape.

The aim of the article is to justify the application of low-level laser therapy (LLLT) to prevent the development of endothelial dysfunction in COVID-19 patients. The results of treating and rehabilitating patients with COVID-19 and prevention of the disease using low-level laser therapy (LLLT) are evaluated. A literature review is conducted on mechanisms of vascular homeostasis regulation, biomodulating effect of laser light, and LLLT methods for preventing endothelial dysfunction. A total of 106 patients were treated in two COVID-19 healthcare centers in Russia. 22 patients with SARS (+) pneumonia at the stage of resolving the pathological lesion were admitted to rehabilitation using pulsed IR laser. 14 patients with acute forms of COVID-19 were treated using LASMIK device: wavelength 904&#x2009;nm, pulsed mode, externally and ILBI-525 (intravenous laser blood illumination) + LUVBI (ultraviolet laser blood illumination). 70 persons underwent preventive courses of noninvasive LLLT. It was shown that LLLT is effective in preventing the development of endothelial dysfunction. Clinical experience demonstrated good tolerability of the treatment, improvement in sputum discharge, and an improvement in overall health. The severity of general hypoxia decreased by the 5th procedure. The procedures for prevention of the disease were well tolerated; there were no cases of COVID-19. Low-level laser therapy is a justified treatment method that promotes lung tissue regeneration and mitigates the consequences of the disease. The obtained results confirm that LLLT can be used for the effective prevention and treatment of COVID-19 patients.

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