The complex relationship between trace elements and skeletal health has received increasing attention in the scientific community. Among these minerals, manganese (Mn) has emerged as a key element affecting bone metabolism and integrity. This review examines the multifaceted role of Mn in bone health, including its effects on bone regeneration, mineralization, and overall skeletal strength. This review article is based on a synthesis of experimental models, epidemiologic studies, and clinical trials of the mechanisms of the effect of Mn on bone metabolism. Current research data show that Mn is actively involved in the processes of bone remodeling by modulating the activity of osteoblasts and osteoclasts, as well as the main cells that regulate bone formation and resorption. Mn ions have a profound effect on bone mineralization and density by intricately regulating signaling pathways and enzymatic reactions in these cells. Additionally, Mn superoxide dismutase (MnSOD), located in bone mitochondria, plays a crucial role in osteoclast differentiation and function, protecting osteoclasts from oxidative damage. Understanding the nuances of Mn’s interaction with bone is essential for optimizing bone strategies, potentially preventing and managing skeletal diseases. Key findings include the stimulation of osteoblast proliferation and differentiation, the inhibition of osteoclastogenesis, and the preservation of bone mass through the RANK/RANKL/OPG pathway. These results underscore the importance of Mn in maintaining bone health and highlight the need for further research into its therapeutic potential.

Toxic elements are considered a significant threat to public health in oil-producing countries. Western Kazakhstan is experiencing serious environmental problems due to the development of the oil and gas industry. This study aimed to assess the concentrations of toxic trace elements—aluminum (Al), arsenic (As), beryllium (Be), cadmium (Cd), mercury (Hg), and lead (Pb)—in the hair of children residing in Kazakhstan’s oil and gas-producing region, and to evaluate the relationship between the concentration of toxic elements and the remoteness of their residence from oil and gas fields. A cross-sectional analysis was conducted involving 1595 school-aged children. Element levels in hair samples were quantified using inductively coupled plasma mass spectrometry (ICP-MS). The association between trace element concentrations and residential distance from oil and gas fields was examined across three distance-based groups and further analyzed through multiple linear regression. The highest concentration of Al = 4.824 μg/g and Hg = 0.096 μg/g was found in the hair of children living close to oil and gas fields (0–16 km). A decrease in levels of Al (−0.072 (CI: −0.109; −0.036)) and Hg (−0.293 (CI: −0.343; −0.243)) is associated with increasing distance from oil and gas fields. As, Cd, and Pb had the lowest median concentrations in the hair of children living near oil and gas fields (0.030, 0.010, and 0.122 µg/g, respectively). There is a tendency for levels of As, Cd, and Pb to increase with distance from the fields (0.064 (CI: 0.039; 0.089), 0.093 (CI: 0.045; 0.141), and 0.244 (CI: 0.202; 0.287), respectively). Our findings indicate the need for biomonitoring of toxic elements to determine long-term temporal trends in the influence of toxic trace elements on the health of the child population of Western Kazakhstan.

Atypical hemolytic uremic syndrome (aHUS), which is characterized by thrombotic microangiopathy, is distinct from Shiga-toxin-induced HUS and thrombotic thrombocytopenic purpura. aHUS is associated with dysregulation of the alternative complement system. Eculizumab, an anti-C5 antibody, is effective in limiting complement activation in patients with aHUS. In recent years, a link has been identified between aHUS and some other complement-mediated nephropathies, in particular C3 glomerulopathy and immune-complex–mediated membranoproliferative glomerulonephritis. A common genetic component may be a unifying factor in these situations. At the same time, the possible combination of aHUS with IgA nephropathy (IgAN) remains poorly understood. We herein report the case of a 10-year-old girl, who was admitted to our hospital with symptoms of jaundice, anemia, thrombocytopenia, and acute kidney injury. Clinical and laboratory assessments led to a diagnosis of atypical hemolytic uremic syndrome (aHUS). The patient was initially treated withplasma exchange and hemodialysis. Eculizumab treatment was initiated on hospital day 6.Remission of her thrombotic microangiopathy was achieved, however during her follow-up, the patient experienced several episodes of acute respiratory infections with macrohematuria. Kidney biopsy was performed and her histological findings were consistent with immunoglobulin A nephropathy (IgAN). The patient showed improvement following treatment with eculizumab and ramipril. This case prompts a discussion on the potential relationship between aHUS and IgAN. Атипичный гемолитико-уремический синдром (аГУС) обусловлен нарушением регуляции системы комплемента, приводящей к повышенной её активации по альтернативному пути. Этот механизм отличает аГУС от других вариантов тромботической микроангиопатии (ТМА), прежде всего таких, как гемолитико-уремический синдром, обусловленный шига-токсином (STEC-ГУС) и тромботической тромбоцитопенической пурпуры (ТТП). Экулизумаб, моноклональное антитело к C5, эффективно блокирует активацию комплемента у пациентов с аГУС. В последние годы была выявлена связь между аГУС и некоторыми другими нефропатиями, развитие которых опосредованно активацией системы комплемента, вчастности C3-гломерулопатией и иммунокомплексным мембранопролиферативным гломерулонефритом. Общий генетический механизм может быть объединяющим фактором в этих ситуациях. В то же время возможное сочетание аГУС с IgA-нефропатией (IgAN) остаётся плохо изученным. В настоящем сообщении мы приводим наблюдение за 10-летней девочкой, которая поступила в нашу больницу с симптомами желтухи, анемии, тромбоцитопении и острого повреждения почек. Клинические и лабораторные исследования привели к диагностике аГУС. Первоначально пациентка получала лечение инфузиями свежезамороженной плазмы, плазмаобменом и гемодиализом. Лечение экулизумабом было начато на 6-й день госпитализации. Была быстро достигнута ремиссия ТМА, однако во время последующего наблюдения у пациентки сохранялись изменения в анализах мочи и отмечалось несколько эпизодов острых респираторных инфекций, сопровождавшихся кратковременными эпизодами макрогематурии. Была проведена биопсия почки. Гистологическое исследование выявило IgAN. С нефропротективной целью был добавлен пероральный рамиприл, что привело к стойкому улучшению анализов мочи. Мы приводим литературные данные, обсуждающие подобные клинические случаи и возможную связь между аГУС и IgAN. Атипиялық гемолитикалық-уремиялық синдром (аГУС) комплемент жүйесінің реттелуінің бұзылуымен байланысты, бұл оның альтернативті жол арқылы шамадан тыс белсендірілуіне әкеледі. Бұл механизм аГУС-ті тромботикалық микроангиопатияның (ТМА) басқа түрлерінен, ең алдымен шигатоксинмен байланысты гемолитикалық-уремиялық синдромнан (STEC-ГУС) және тромботикалық тромбоцитопениялық пурпурадан (ТТП) ерекшелендіреді. Экулизумаб - C5-ке қарсы моноклоналды антидене - аГУС-пен ауыратын науқастарда комплемент белсендірілуін...

Cardiovascular diseases (CVD) remain the leading cause of mortality in both industrialized and developing countries, including Russia. Recent evidence suggests that atherosclerosis, a major precursor to CVD, begins in childhood and adolescence and progresses throughout life due to genetic and modifiable risk factors. This study focuses on new screening methods for early diagnosis of cardiovascular pathology. Purpose: to assess the functional state of the cardiovascular system and adaptive reserves of children and adolescents in the Orenburg region. Methods. The study included 518 children aged 6 to 18 years from urban and rural areas in Orenburg and the Orenburg region. The adaptive capacity and stress levels of their regulatory systems were measured using the “Varikard-Express” software complex (Russia). Additionally, the functional state of the cardiovascular system was evaluated through the “Cardiovisor-06s” computer heart screening system (Russia), which provides 3D heart visualizations (“heart portraits”). Results. Findings revealed significant adaptation disorders, including pronounced stress and disruption of the adaptation process, which were more prevalent among urban residents compared to rural residents (60.57% vs. 39.42%). Age-based analysis indicated that children aged 10-14 exhibited the highest rates of adaptation disorders, with 52.34% experiencing pronounced or sharply pronounced stress of the regulatory system compared to other age groups (p < 0.05). Conclusion. The study identified prevalent deviations in cardiovascular function and adaptive capacity among children and adolescents. More than half of the participants demonstrated varying levels of cardiovascular dysfunction, and over one-third had disruptions in adaptive processes. These findings underscore the importance of early screening for cardiovascular and adaptation-related issues in youth to facilitate timely interventions. Keywords: cardiovascular system, children, physical development, screening evaluation

Human activities in industrialized economies lead to soil contamination with highly neurotoxic heavy metals accumulating in body tissues. Given the urgent environmental issue of heavy metal accumulation in soil and their toxicity to humans, the aim of the study was to analyse the available scientific data on their neurotoxicity. To achieve this aim, evidence-based papers from the relevant open databases over the past five years have been reviewed. According to scientific evidence, cadmium, chromium, lead, and mercury are considered the most common neurotoxic metals that pollute the soil. The heavy metal toxicity to nervous tissue has various mechanisms, such as the impairment of the cell cycle and metabolism and blood-brain barrier disruption. This leads to structural degeneration of the central nervous system. Cadmium, lead, mercury, and chromium can affect the development and functions of the nervous system, resulting in neurotoxicity that can be fatal in cases of acute poisoning. Screening, identification of populations with the increased risk of metal poisoning, and primary prevention in environmentally unfavourable areas are the appropriate actions to solve the problem of heavy metal contamination of the soil and their adverse effect on the body.

Relevance.There is no predominant agent in the etiological structure of hemorrhagic vasculitis; instead, several factors play a role, including the activation of herpesvirus infections in the disease development. The objective of the study is determined by contradictory data and a lack of coordinated agreement regarding the etiology of hemorrhagic vasculitis. Objective: To identify the role of herpesvirus infection in the etiology of hemorrhagic vasculitis in children. Materials and methods. A cross-sectional study was conducted for 25 children aged from 2 months to 18 years with hemorrhagic vasculitis, who were on inpatient treatment at Medical Center "Children's Hospital" in Aktobe. All children underwent an enzyme-linked immunosorbent assay (ELISA) for herpesviruses: herpes simplex virus types I, II, (HSV-I, II), Epstein - Barr virus (EBV), cytomegalovirus (CMV), human herpesvirus type 6 (HHV – 6). The received data is processed by descriptive statistics, STATISTICS 10.0. Results The herpesvirus infection was confirmed in 100% of the examined children, with herpes simplex virus I and II types being discovered in 25.9% of cases, Epstein-Barr virus in 28.46% of cases, cytomegalovirus (CMV) in 29.6% of cases, and human herpesvirus 6 (HHV-6) in 16% of cases. Moreover, they did not occur as mono-infections but rather in conjunction with the cytomegalovirus: CMV+ HSV-I, II (16 %); CMV+ EBV (8%); CMV+ HHV-6 (4%); CMV+ EBV+ HHV-6 (32%); CMV+ HSV-I, II + EBV+ HHV-6 (40%). A low concentration of herpesvirus antibodies in the blood of patients with hemorrhagic vasculitis was detected by ELISA anti-CMV IgG (11.62 U / ml), anti-HHV-6 IgG (6.82 U/ml), which indicates unstable immunity, the risk of activation of viral infection and recurrent hemorrhagic vasculitis. Conclusion.According to the study, herpesvirus infections can lead to hemorrhagic vasculitis in children. If vasculitis recurs, it is advised to check for the presence of antibodies to herpesvirus antigens; if so, an infectious neurologist's consultation and etiotropic antiviral therapy are advised. Актуальность. В этиологической структуре геморрагического васкулита нет преобладания какого-либо одного агента, а играет роль совокупность нескольких факторов, в том числе активация герпесвирусных инфекций в развитии болезни. Противоречивые данные, отсутствие единого мнения об этиологии геморрагического васкулита определяет цель исследования. Цель. Определить роль герпесвирусной инфекции в этиологии геморрагического васкулита у детей. Материалы и методы. Одномоментное поперечное исследование проведено 25 детям с диагнозом геморрагический васкулит в возрасте от 2 мес. до 18 лет, которые находились на стационарном лечении в Актюбинском Медицинском Центре «Детском стационаре» г. Актобе. Всем детям проводился иммуноферментный анализ (ИФА) на герпесвирусы: вирус простого герпеса I, II-го типов, (HSV- I, II), вирус Эпштейна – Барр (EBV), цитомегаловирус (CMV), вирус герпеса человека 6-го типа (HHV-6). Полученные данные обработаны описательной статистикой, СТАТИСТИКА 10.0. Результаты. Герпесвирусная инфекция у обследуемых детей подтверждена в 100% случаев, из них вирус простого герпеса І, ІІ-го типов выявлен в 25,9%, вирус Эпштейна – Барр – 28,46%, цитомегаловирус (CMV) – 29,6%, вирус герпеса человека 6-го типа (HHV-6) – 16% случаев. И они не встречались как моноинфекции, а в виде ассоциации с цитомегаловирусом: CMV+ HSV-I, II (16 %); CMV+ EBV (8%); CMV+ HHV-6 (4%); CMV+ EBV+ HHV-6 (32%); CMV+ HSV-I, II + EBV+ HHV-6 (40 %). Выявлено малая концентрация антител герпесвирусов в крови больных с геморрагическим васкулитом методом ИФА анти-CMV IgG (11,62 ЕД/мл), анти-HHV-6 IgG (6,82 ЕД/мл), что свидетельствует о неустойчивом иммунитете, риске активации вирусной инфекции и рецидивирующим течением геморрагического васкулита. Заключение. Исследование показало роль герпесвирусной инфекций в развитии геморрагического васкулита у детей и при рецидивирующем васкулите рекомендуется обследование на наличие антител на антигены герпесвирусов и при их положительном результате рекомендуется консультация инфекциониста о решении этиотропной противовирусной терапии. Өзектілігі. Геморрагиялық васкулиттің этиологиялық құрылымында бір агент басым болмайды, бірақ бірнеше факторлардың жиынтығы, соның ішінде...