Vol 28, No 7 (2021)

Hypoxia is one of the most frequent and serious types of stress for the human body. Hypoxia during pregnancy has adverse effects on fetal that may have implications not only for antenatal, but also postnatal period and even adulthood. Hypoxia usually occurs due to the placental insufficiency - a process in which there is a progressive decrease of the placental functions, when the transfer of oxygen and nutrients to the fetus through the placenta decreases, which leads to hypoxia and acidosis. Subsequent fetal hypoxemia stimulates the suppression of metabolic responses to preserve available nutrients, resulting in fetal growth restriction. This article presents an overview of modern scientific literature considering an etiology and pathophysiology of fetal hypoxia. Special attention is paid on the methods of evaluating fetal hypoxia in obstetric practice, such as Doppler, measuring lactate from fetal scalp blood testing, CTG monitoring, detection of RNA caused by hypoxia in maternal blood, measurement of the pH of the umbilical cord vessels, ECG-STan, fetal pulsoximetry. A new parameter for assessing the condition of the fetus, called the "non-reassuring fetal status" was observed, and the diagnostic criteria were described thoroughly. This systematic review presents a qualitative analysis of diagnostic methods and predictors of the outcome of pregnancies with acute and progressive fetal hypoxia. The study includes full-text publications in Russian and English on the methods of assessing the state of fetal hypoxia during pregnancy and childbirth, as well as their validity. In total, 548 sources were identified in PubMed, SCOPUS and eLIBRARY.RU databases. After screening, 53 articles were selected and included in the qualitative synthesis.

Introduction: A substantial body of research indicates that starting school is associated with increased anxiety, fears and behavioral disorders among children. However, little is known whether emotional problems in children are associated with school type. Aim: To study whether the emotional health of first-graders in a boarding school is different from that in a regular school in a Russian setting. Methods: Altogether, 48 first-graders from a regular school and 48 first graders from a boarding school in Arkhangelsk participated in a cross-sectional studyWell-being, Activity, Mood (WAM) questionnaire, Phillips school anxiety scale; René Gilles projective method were applied. In addition, "Fears in the houses"; "The Ladder technique", "Houses", "Educational motivation" techniques were used. Subjective well-being was studied using Arkhireeva's questionnaire. Mann-Whitney U-tests were applied to compare central tendencies in two independent groups. The alfa-error level was set at 5 %. Principal component analysis with varimax normalized rotation was used out to identify the most important characteristics of the emotional health of the first-graders. Results: We observed substantial and statistically significant differences in emotional health among the first-graders in different schools. Children attending the boarding school had higher levels of activity (p = 0.004), feeling well (p = 0.005), satisfaction with relationships (p = 0.019), subjective well-being (p = 0.015), learning motivation (p = 0.014). Life management (p = 0.001), attitude towards a teacher (p = 0,022), sociability (p = 0,000) were included in the risk zone in this group. Children from a regular school had higher levels of sociability (p < 0.001), life management (p = 0.001) and emotional warmth towards the teacher (p = 0.022). Areas of concern among these children were psychological tension related to being at school (p = 0.013) and doing homework (p = 0.004), social stress (p = 0.012), proneness to conflict (p = 0.018), frustration related to the need to be successful at school (p = 0.003). Conclusions: Significant differences in first-graders' emotional health by school type were observed. Our results warrant development and implementation of mental- and emotional health promotion programs among schoolchildren, which should take into account the differences between regular- and boarding schools.

Introduction: The leading role in studying adaptation processes is assigned to the analysis of the cardiovascular system activity, myocardial function and its electrical activity, both at rest and during physical load. At the same time, it is important to search for new indicators that characterize the dynamics of the adaptation process. Aim: To study associations between physical activity and the interval-amplitude bioelectric characteristics of the myocardium in residents of the European North of Russia. Methods: Electrocardiograms (ECG) were recorded in 19 healthy female students from Syktyvkar, who were not involved in sports activities. The ECG was recorded at rest and 5 minutes after physical load on a cycle ergometer (1 watt per 1 kg of body weight). Intervalamplitude electrical properties of the myocardium were analyzed on ECG. All the examined were divided into 3 groups depending on resting heart rate. Altogether, 570 cardiac cycles were used for the analysis. Results: The RR interval was 0.95 ± 0.07 s (at low frequency) and 0.63 ± 0.04 s (at high frequency) before physical load and decreased to 0.40 ± 0.03 s and 0.38 ± 0.02 s (p < 0.001) after physical load. Depolarization (RT interval) lasted 0.52 ± 0.02 s (at low frequency) and 0.46 ± 0.01 s (at high frequency) before physical load. After physical load there was a decrease to 0.38 ± 0.03 s at low frequencies and up to 0.36 ± 0.02 s at high frequency (p < 0.001). RD amplitudes before physical load were 1.47 ± 0.10 mV and 1.50 ± 0.12 mV, after physical load 1.16 ± 0.16 mV and 1.1 ± 0.17 mV (at low frequency and high frequency): average decrease by 20% (p < 0.001). Variability of RD amplitudes before and after physical load wais ±0.50 mV. Repolarization (TR segment) before physical load was 0.43 ± 0.07 s (at low frequency) and 0.17 ± 0.04 s (at high frequency F). After physical load it decreased to 0.02 ± 0.01 s (at low frequency and high frequency) (p < 0.001). Conclusions: The decrease in the duration of the PP, RT and TR segments after the load depends on their initial value before the load.

Background: Breast cancer is the most common cancer among women. Incidence of and mortality from breast cancer varies considerably between countries. The evidence from Kazakhstan, however, is almost non-existent in international peer-reviewed literature. Aim: To study incidence of and mortality from breast cancer in Western Kazakhstan and assesse selected determinants of survival among breast cancer patients. Methods: A registry-based historical cohort study. Data on all primary cases of breast cancer in the Aktobe region in 2014-2018 and their follow-up data were obtained from the regional cancer registry. Standardized incidence and mortality data were calculated using Segi world reference population. One- and five-years survival was calculated using actuarial analysis. Factors associated with survival were assessed using multivariable Cox regression. Crude and adjusted hazard ratios (HR) were calculated with 9 5 % confidence intervals (CI). Results: From 2014 to 2018, 891 new cases and 251 deaths from breast cancer were registered in the Aktobe region. Standardized incidence of breast cancer increased from 40.8 to 44.6 per 100,000 while standardized mortality decreased from 12.4 to 8.8 per 100,000 during the study period. Only 16.4 % of cases were diagnosed at stage I, while 21.6 % of cancer cases were detected at stage III or IV. One- and five-year survival estimates based on the registry data was 94.5 % (95 % CI: 92.5-96.5) and 90.2 % (95 % CI: 88.2-92.2), respectively. Patients with stage III (HR = 7.4, 95 % CI: 1.7-31.6) and stage IV (HR = 29.7, 95 % CI: 6.7-131.8) had shorter survival than patients with stage I. Conclusions: Both incidence and mortality of breast cancer in Western Kazakhstan are lower than in most European countries. The incidence has been gradually increasing while no clear pattern on mortality was observed. Surprisingly high level of five-year survival in the study area requires further investigation. The results should be interpreted with caution assuming valid data on cancer-specific mortality and non-differential reporting of deaths across the studied characteristics.