From the Editor
Science knows no boundaries; it is international in nature. General principles of knowledge of the laws of nature, common to living and nonliving world, unite scientists from different countries and scientific schools. IJBM looks at the educational mission as its main purpose in order to attract the cooperation of scientist of modern medicine, while at the same time, IJBM hopes to become a platform for testing ideas of young scientists who are just starting their career in science. In this aspect, IJBM adds great importance to the social support of talented young scientists. IJBM is open to independent views; it discusses critical issues in biomedicine with scientists from different countries. This issue is a collection of scientific works of talented and original scientists from the CIS countries. Further, we hope that our Journal will eliminate the objective difficulties that exist for young researchers to access to scientific journals. We hope that the material published in the IJBM will facilitate the integration of academic research and everyday medical practice.
In the first article, Dr. Polupanov and colleagues examined the influence of autonomic dysfunction, Gln27Glu polymorphism of b2-adrenergic receptor gene, and I/D polymorphism of angiotensin-converting enzyme genes on target organs in Kyrgyz patients with essential hypertension (EH). The authors observed a significant reduction in the heart rate variability and decreased response in LF (low frequency) component during the tilt-test in hypertensive patients. Tilt-test in patients with complications of EH had shown inverse response of LF component during the orthostatic test. They noted that that this response during the test could be regarded as an unfavorable prognostic sign, predisposing cardiac and cerebral complications in patients with EH. Moreover, the authors observed an association between the Gln27Glu polymorphism of b2-adrenergic receptor gene and the I/D polymorphism of angiotensin-converting enzyme (ACE) gene with blood pressure. Further, they observed an association between I/D polymorphism of ACE gene and stroke in patients with EH. Future prospective studies may provide more convincing information, perhaps if linked to outcome trials. Dr. Kashtalyan and colleagues studied hemodynamic predictors of pregnancy-induced hypertension. Gestational hypertension or pregnancy-induced hypertension (PIH) is the most complicated problem. However, after many years of research, there is no clear answer to what triggers PIH. The authors offer clinically applicable method for predicting the pregnancy-induced hypertension. They showed that at 10-14 weeks of pregnancy complicated by subsequent gestational hypertension, the hemodynamic changes in the renal arterial line, as well as the increase in peripheral vascular resistance in the main trunk of the renal and segmental arteries were determined. Two further articles are devoted to cardiac arrhythmia. Atrial fibrillation (AF) is the most common form of cardiac arrhythmia. It is triggered by many conditions such as thyroid dysfunction, cardiac disease, alcohol, and pulmonary disease. Patients with chronic obstructive pulmonary disease (COPD) are susceptible to many insults that can lead to an acute deterioration superimposed on chronic disease. Dr. Melnichenko and colleagues examined the factors associated with the development of atrial fibrillation in chronic obstructive pulmonary disease. They investigated the cardiovascular, hormonal and bronchial obstruction markers and their possible relation to AF risk in COPD patients. Among COPD patients, the greater risk of developing AF was detected in subjects with obesity, systemic arterial hypertension, enlarged heart chamber size at baseline and initial elevated levels of the renin-angiotensin-aldosterone system. Pulmonary hypertension and bronchial obstruction also appeared to exert less influence when compared with other investigated parameters. Plasma renin activity and right ventricular diameter were found to be the most reliable markers of AF risk in COPD patients. Their findings called for a further study on the factors associated with the development of atrial fibrillation in COPD patients. The following article, by Dr. Jalolov and Dr. Kurbanov, addresses the issue of clinical efficacy in the treatment of paroxysmal supraventricular tachycardias. Paroxysmal supraventricular tachycardias are a major therapeutic problem and one of the most frequently occurring arrhythmias. The authors suggest an individual approach to antiarrhythmic therapies (AAT) in patients with paroxysmal tachycardia (PT). They observed that method of chronic intracardiac electrophysiological investigation, based on repeated induced PT and tachyarrhythmia by background per oral AAT during their "saturation", allowed an increase in the efficacy of the treatment in the remote period. It will be interesting to follow the investigative studies in this area. Dr. Nikishin and colleagues provided a thoughtful consideration of the distinctive features of the clinical course for acute myocardial infarction (AMI), treatment tactics, and clinical outcomes in elderly patients of the Central Asian region. The clinical course and prognosis of patients with acute myocardial infarction (MI) have been studied extensively. Numerous studies demonstrated that age is strongly associated with morbidity and mortality after AMI, even after thrombolytic therapy. Thus, more attention has been paid recently to the study of the specific characteristics of the elderly population with AMI. Data received in their study were correlated with the world data regarding in-hospital prognosis of elderly patients with AMI. There was no difference in the frequency of painful and painless myocardial infarction and adequacy of treatment with beta-blockers, statins, antiplatelet drugs, and ACEI. The main problem in treating the elderly patients is that they have lower probability in achieving myocardial reperfusion (due to delay in seeking medical attention and lower efficacy of thrombolytic therapy) and therefore, there is a higher occurrence of heart failure. The following article, by Dr. Karnitsky and Dr. Sagin, addresses the role of psychological stress in the development of chronic pain syndrome in patients with osteoarthrosis. Chronic pain may be seen as a fundamental challenge in medicine. It is a complex problem that needs to be understood in a multi-dimensional way for effective management. The data obtained by the authors confirmed the assumption that the psychological stress is one of the significant factors leading to the development of chronic pain syndrome in patients with osteoarthrosis. Their findings called for a study on the full assessment of the patient, preferably multi-disciplinary. The management should be holistic, rigorous in the application of conventional therapies and ready to admit an improved understanding of psychological and social techniques. Dr. Soroka and colleagues studied the risk factors for developing renal amyloidosis in patients with rheumatoid arthritis. Amyloid A (AA) amyloidosis is the most common form of systemic amyloidosis worldwide. In developing countries, the most common cause of AA amyloidosis is chronic infection; in industrialized societies, rheumatic diseases, such as rheumatoid arthritis (RA), are the usual stimuli. The United States is a major exception to this since immunoglobulin-related amyloid light chain type (AL) of amyloidosis is more frequent than AA as the cause of systemic amyloid deposition. The authors found that the risk of developing secondary amyloidosis in Belarusian patients with RA significantly depends on SAA1 genotype and the presence of C. trachomatis infection. The variation in the occurrence of amyloid in a particular disease in different geographic locales may reflect the genetic background, differences in the treatment of the primary disease, or factors that are not currently understood. Two further articles are devoted to the basic science direction. Dr. Kerimkulova investigated the processes of myocardial remodeling in hypertensive patients on the basis of pathoanatomical studies. Thus, the autopsy has shown that left ventricular hypertrophy (LVH) has been observed in almost all cases, whereas right ventricular hypertrophy (RVH) has been observed in 78.2% of the cases. Among hypertensive patients who died, there are individuals with a strong degree of RVH which is greater among males when compared with the females. In hypertension, the risk of adverse cardiovascular events, including heart failure, is increased in the presence of LVH. However, only limited findings are available on the function and structure of the right ventricle. It will be interesting to follow the investigative studies in this area. The final paper is devoted to endothelial dysfunction. Endothelial dysfunction is recognized as a key mechanism in the pathophysiology of atherosclerosis. Dr. Nevzorova and colleagues evaluated the endothelium-dependent and endothelium-independent reactions of the cerebral arteries in rat models caused by prolonged tobacco smoking in vivo. Prolonged cigarette smoking in rats resulted in the development of endothelial dysfunction in the cerebral vessels that is characterized by an impaired endothelial vasomotor function as a clear predominance of the abnormal constrictor responses. Two months post-smoking cessation, the vasomotor disturbances of the vascular endothelium of the rats were not only found to be preserved but also exacerbated by an increase in pathological vasoconstriction. Smoking is one of the most significant risk factors for cardiovascular diseases, bronchopulmonary diseases, and cancer. Future study on the vascular dysfunction mechanisms which being the commonest damaging factor in chronic smoking conditions is of special interest.