[Surgical treatment of patients with abdominal aortic aneurysm and ischaemic heart disease]. / Khirurgicheskoe lechenie bol'nykh s anevrizmami infrarenal'nogo otdela aorty i ishemicheskoi bolezn'iu serdtsa.

Presented herein are the results of treatment of 137 patients with infrarenal aneurysms of the abdominal portion of the aorta in a combination with ischaemic heart disease. Severity of lesions to the coronary bed and the risk of cardiac complications were assessed according to the SYNTAX score. Depending on severity of angina pectoris and the clinical course of infrarenal aortic aneurysms, we used different tactical approaches to operative treatment of patients. In a low risk of coronary complications, we performed isolated prosthetic repair or endoprosthetic reconstruction of the abdominal aorta. In patients with haemodynamically significant lesions of the coronary bed and positive non-invasive tests, the first stage consisted in coronary artery bypass grafting or stenting of coronary arteries taking into account the risk of cardiac complications according to the SYNTAX Score. The second stage consisted in prosthetic repair or endoprosthetic reconstruction of the abdominal aorta. The terms of the second stage differed and were determined by the course of abdominal aortic aneurysms. In symptomatic large aneurysms (more than 8 cm), prosthetic repair of the abdominal aorta was carried out within 2 weeks after previous stenting of coronary arteries. Simultaneous myocardial revascularization and abdominal aortic reconstruction were performed only in patients with severe angina pectoris, lesions of the trunk of the left coronary artery, three-vessel lesions of the coronary bed, high risk of cardiac complications according to the SYNTAX Score and a complicated or symptomatic course of an infrarenal aortic aneurysm. During implantation of stent grafts into the abdominal aorta there were neither lethal outcomes nor cardiac complications. In open operations, the 30-day mortality rate amounted to 2.2%, with the 5-year survival rate of 92%.

[Peculirities of physical development and state of the cardiovascular system in young males from various districts of Northeast of Russia].

The comparative research was carried to study basic indices of physical development and cardiovascular system in Aboriginals and north-born Europeans of different areas of Russia's northeast (Chukotsky Autonomous District, Magadan Region). According to most examined morphofunctional characteristics no significant differences were found between the groups of subjects that testify to the formation, under the current social conditions, of convergent adaptation processes typical for the two ethnic cohorts from the observed areas of residing. High percentage of asthenia in body constitution of young residents from Magadan Region was common and mostly demonstrated by Aboriginals of the Magadan city.

[THE SEASON DYNAMICS OF MAIN INDICES OF LIPID AND CARBOHYDRATE METABOLISM IN STUDENTS ABORIGINES AND CAUCASIANS OF THE NORTHERN-EAST OF RUSSIA].

The article presents analysis of main indices of lipid specter and level of glucose in blood of aborigines and Caucasians during winter and spring seasons. The study covered 184 male youths aged from 17 to 21 years (18.2±0.8) studying in the North-Eastern state university (Magadan). The study was implemented using portable biochemical express-analyzer CardioChek PA (USA) by means of capillary blood sampling taking in morning hours on an empty stomach from finger 10-12 hours later after last food intake. The purpose of study was to compare characteristics of season variations of main characteristics of lipid and carbohydrate metabolism in aborigines and natives of the North-East of Russia from among Caucasians in102 generation (autochthonic population). The results of biochemical analyses, obtained in various seasons, demonstrated that average values of all analyzed characteristics of lipid profile approximated to lower limit of normal variation of indication. By all appearance, this is related to substrate energy inadequacy and with lipid alimentary deficiency in particular observed in examined students during analysis of their dietary intake where percentage of fat was in the limits of 65-70 g per day. The analysis of carbohydrate metabolism in male youths of different ethnic groups established that level of glucose was at the higher limit of reference intervals of normoglycemia. At that, in the group of aborigines season reorientation in analyzed values of metabolic profile were observed related to decreasing of level of glucose in blood while in group of Caucasians similar tendency was not observed. Apparently, the given season dynamics of metabolic processes in young aborigines indicates to efficiency of their evolutionary fixed mechanisms of adaptation developed in conditions of the North-East of Russia.

[HEART RATE VARIABILITY CHANGES DEMONSTRATED BY INDIVIDUALS WITH DIFFERENT VEGETATIVE REGULATION TYPES IN ORIGIN UNDER RERESPIRATION SESSION].

The studied in the paper is how breathing in isolated space (rerespiration) influences heart rate variability, arterial pressure indices, and composition of the expired gas in individuals with different vegetative regulation types in origin. Found that, the values and vector of the changes in low frequency indices of the power of heart rate spectrum before and within the process of rerespiration have been highly informative when assessing the leading type of vegetative regulation. The structure of intersystem correlations in the examined male subjects has specific features either at rest (baseline) or at breathing test that testifies to different mechanisms of maintaining functional abilities in sympathicotonic and vagotonic individuals undergoing hypoxic-hypercapnic gas mixture breathing.

[AGE DYNAMICS OF THE MAIN SOMATOMETRIC PARAMETERS IN ADOLESCENT STUDENTS BORN IN THE CITY OF MAGADAN].

In the period from 2005 to 2013 the age dynamics of indices of physical development was studied in 1466 adolescent students aged from 17 to 21 years born in Magadan. Studies have shown that the growth of the body length in boys in Magadan stopped at 17 years, whereas in the period of 19, 20 and 21 years, an increase in the body mass and chest circumference relative to the length of the body was detected, which, in turn, lead to an increase in the strength of the physique. All of the surveyed youths were characterized by a proportional and harmonious types of physical development.

[MODERN TRENDS IN THE PHYSICAL DEVELOPMENT AND THE STATE OF THE CARDIOVASCULAR SYSTEM IN YOUNG MEN OF THE CITY OF MAGADAN].

In the conditions of the northern region there was performed the comparative study of indices of the physical development and state of the cardiovascular system in young male European subjects, born in the city of Magadan in the 1-2 generation over a period from 2004 to 2013. The main tendencies of physical development ofyoung male subjects in the city of Magadan were established to be the ongoing acceleration of growth process, asthenization and dysharmonization of the somatotype. It was determined increase of systolic and diastolic pressure during the last decade. Confirmed changes of cardiohemodynamics data on the back of aggravation of physical development and ongoing somatotype asthenization were shown by young male subjects, born in 90-ies of the last century. It was revealed that over the past 10 years there has been an increase in systolic and diastolic blood pressure indices. Established by us the changes in the indices of cardiac hemodynamics on the background of deteriorating physical development and ongoing asthenization of the somatotype appeared to be more pronounced in young men born in the 90-ies of the last century.

[Age-related changes in the heart rate variability and hemodynamics shown by aboriginals in dependence on the leading type of vegetative nervous regulation].

We examined native minority adolescents (aborigines) to study somatometric and cardiohemodynamic characteristics in dependence on the leading type of vegetative nervous system. As result from the study, the age-related morphofunctional changes observed during the examined period of ontogenesis can be considered as heterochronic. Of note that, the hopping periods which occur in changes of somatometric and heart rate variability indices, can differ in dependence on the prevailing type of vegetative nervous system. Found that, the most number of reliable changes in vegetative nervous regulation is typical for vagotonic people at the age of 15, compared to the earlier ages. Apparently, this characterizes the conversion to decrease in activity of parasympathetic and increase in sympathetic component of vegetative regulation experienced by vagotonic examinees in the mentioned period. As regards normo- and sympathotonic examinees, no pronounced age-related change was found at the age of 13-17.

[The influence of orthostatic test on changes of the heart rate variability observed in aboriginals of Magadan region].

255 adolescents, aged 13-17, from the north native minorities underwent an active orthostatic test to study the changes in the heart rate variability accounting for the subjects original vegetative types of the nervous regulation. The analysis of interquartile ranges of the heart rate variability values enabled to find individual peculiarities of regulatory mechanisms of reciprocal relationships between parasympathetic and sympathetic components of the vegetative nervous system. The findings testified that, irrespectively of the age, up to 45% of the examinees had optimal levels of reactivity and balance of the components of the vegetative nervous system. The other reactions covered 4-18%. At the same time, low (paradoxical) or excessive vegetative reactivity could be found in each typified group, but, to a greater extent, it was observed in the sympathetic adolescents. Of note that, the individuals with expressed misbalance of regulatory components were revealed who demonstrated the difference in the heart rate variability indices before and during the active orthostatic test going beyond the ranges of the 10th and 90th percentiles. That can be considered as elevated risks for dysadaptation in those individuals under extra functional exercises.

[Seasonal dynamics of external respiration and gas exchange in the population of northeast Russia].

In conjunction with the MARS-500, a monthly monitoring of several morphofunctional parameters was performed in 19 Caucasoid volunteers born in the Magadan region over the period of 18 months. The standard procedures were used for somatometric examination and evaluation of the respiratory and cardiovascular functions. The greatest straining of these body systems was stated in wintertime. However, during summer both systolic and diastolic pressure was also high when compared with people living in the center and north of European Russia, which may infer a significant effect of seasonal variations in the Magadan environment and climate on human organism throughout the year.

[Functional profiles typical of the male and female residents in different climatic-geographical areas of Magadan region].

Residents of the Extreme North, in total 255 males and 72 females were examined to study morpho-fuctional changes occurring in dependence on the area of residence. It was found that the subjects who recide in the towns of Magadan and Susuman demonstrated adaptive changes in somatometric parameters as well as in functioning of the body cardio-respiratory and gas-transporting systems that can be considered as a compensatory response providing the body energy balance and homeostasis maintenance at the level the unfavourable environmental factors.

[Regularities of physical development of Chukotka children aged 8-12 years].

School children in Chukotka aged 8-12 years were examined to study the characteristics of their physical development and its association with age, sex, and ethnicity. The study demonstrated that the migrants had higher values of body length and body mass, with a step-wise pattern of their increase, higher body fat component content as compared with the aborigines. The migrants showed higher circumferential dimensions, while the growth rate of these parameters was higher in aborigines. Maximal growth rates of extremity diameters were different in specific ethnic groups, while the skeletal mass was greater in migrants. In aborigine boys more active thorax growth was found, while aborigine girls had higher pelvic growth rate. Migrants were shown to have higher muscular and bone mass, than aborigines.

[Social-hygienic factors of health status of the population in the North-Eastern Russia at the present time]. / Sotsial'no-gigienicheskie faktory zdorov'ya naseleniya severo-vostoka Rossii na sovremennom etape.

Besides the pattern of distribution of the basic extensive characteristics reflecting the actual health status of the Chukotka and Magadan district population, adequate mathematical models describing the time course of some of the examined demographic processes were developed in the course of a comprehensive study of the health parameters and demographic structure of the population of the North-Eastern Russia. A prediction of the situation up to the year 2015 was made, using these models. Ranging of the natural and social factors by their influence on the health status and demographic parameters of the Extreme North was carried out.