Extreme Medicine

ISSN Print 2713-2757 ISSN Online 2713-2765

Extreme Medicine

SCIENTIFIC AND PRACTICAL REVIEWED JOURNAL OF FMBA OF RUSSIA

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Nguyen Thi-Hanh, Melnikova LI, Ilchenko LYu, Kyuregyan KK, Gordeychuk IV, Bondarenko NL

Chronic hepatitis B (CHB) is a common infectious disease that represents one of the main causes of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). CHB is still difficult to treat due to the lack of drugs that completely eliminate hepatitis B virus (HBV) from hepatocytes. The study was aimed to describe the CHB clinical and laboratory features, assess the efficiency of antiviral therapy and identify the factors associated with the response to antiviral therapy. The results of clinical and laboratory assessment, instrumental examination, serological and molecular testing of the patients (n = 201) followed up between 2007–2021 in the Viral Hepatitis Diagnosis and Treatment Center at the Clinical Hospital No. 85 of FMBA of Russia were assessed based on primary sources. Most of the patients in the group were males (56.7%); the HBeAg-negative patients predominated (93%). LC was diagnosed in nine patients (4.5%), among them one patient had HCC. The HBV D genotype was determined in 95.4% of cases, А genotype in 3.1% of cases, and С genotype in 1.5% of cases. After a year of treatment with the nucleos(t)ide analogues (entecavir or tenofovir) 88% of patients showed no viremia and their biochemical parameters were back to normal (88%). The overall seroconversion rate was 41.7% for HBeAg and 3% for HBsAg. Thus, high rates of virological response and enzyme activity normalization were obtained. Low baseline viremia level is an independent prognostic factor of achieving a virological response. The HBsAg level in the end of therapy makes it possible to predict relapse after the treatment cessation.

Received: 2022-12-08

Published online: 2023-03-05

DOI: 10.47183/mes.2023.003

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VIEWS 1290

Sayganov SA, Liubimova AV, Gasanbekov IM, Meltser AV, Lopatin ZV, Aslanov BI

Organization of training in the context of COVID-19 pandemic demanded the development and implementation of active epidemiological surveillance for acute respiratory infections in students and teaching staff of the Medical University. The study was aimed to identify the features of the COVID-19 epidemic process among students and teaching staff in 2020–2022. The analysis of COVID-19 incidence among students and teaching staff in the academic years 2020–2021 and 2021–2022 was carried out. The study was conducted on 6293 students enrolled in the academic year 2020–2021, 6148 students enrolled in the academic year 2021–2022, and 772 teaching staff members. In the academic year 2020–2021, COVID-19 was detected in 681 students, among whom the cumulative incidence (CI) was 10.83 (95% CI: 10.08-11.61) per 100 students, and 79 teaching staff members, among whom the CI was 10.23 (95% CI: 8.09–12.37); in the academic year 2021–2022 infection was detected in 690 students, the CI was 11.44 (95% CI: 10.64–12.24) per 100 students, and 75 teaching staff members, the CI was 9.71 (95% CI: 7.62%–11.80%). In 26.3% affected individuals, COVID-19 was detected when contacting the University outpatient clinic. The incidence among students living in the dormitories did not exceed that among students living in private apartments (p = 0.36), and no outbreaks were reported. There was a strong positive correlation between the incidence among residents of St. Petersburg and the incidence among students (r = 0.77). Over the entire period, probable setting of transmission was determined in 39.9% of infected individuals, contact most often (15.2%) occurred when working in the health care facilities. The incidence of novel coronavirus infection (COVID-19) among students and teaching staff members in the academic years 2020–2021 and 2021–2022 is directly related to their involvement in the COVID-19 epidemic process in St. Petersburg.

Received: 2022-12-11

Published online: 2023-03-03

DOI: 10.47183/mes.2023.005

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VIEWS 1225

Volkova MV, Biryukov SA

There is an inextricable link between exploration and development of the Arctic territories and emergence of associated problems of medical and biological nature. It is necessary to design and develop emergency care and prevention drugs and medical devices for use in the Arctic. This review presents an analysis of additional requirements for drugs intended for the Far North and compares methods of modeling extreme conditions in animals. We outline medical and biological problems of the region highlight key areas of Arctic pharmacology: choice of pharmaceutical form, use of cryoprotectants and design of adaptogens. The study mainly revolves around the search for information on modeling extreme environmental factors in animal experiments, as this is a key stage in preclinical studies of drugs for the Arctic medicine. We present the relevant directions of further work promoting the subject: development of the hypoxia and hypothermia assessment criteria, development of modeling methods employing large laboratory animals, improvement of the equipment used.

Received: 2022-12-06

Published online: 2023-02-26

DOI: 10.47183/mes.2023.004

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VIEWS 1374

Babakov VN, Gorbunov AYu, Gladchuk AS, Kalninya YaK, Shilovskikh VV, Tomilin NV, Sukhodolov NG, Radilov AS, Podolskaya EP

As markers of intoxication, adducts of blood proteins with organophosphorus compounds (OPs) allow establishing the fact of poisoning and, furthermore, enable identification of the OPs by the attached residue. This study aimed to develop a method of specific and selective extraction of blood protein adducts carrying OPs on the surface of a matrix-assisted laser desorption/ionization (MALDI) target functionalized with multimolecular structures based on lanthanum stearate using metal affinity chromatography. We have shown the ability of adsorbent to retain both full-size and dealkylated adducts of blood proteins with OPs. The developed method allowed extraction and identification of peptides of human serum albumin and human butyrylcholinesterase modified with various OPs (after incubation of human blood plasma with OPs in concentrations from 1 to 100 ng/mL), which makes this approach applicable for the purposes of OPs identification in the context of investigation of real cases of intoxication.

Received: 2022-11-11

Published online: 2023-01-28

DOI: 10.47183/mes.2023.002

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VIEWS 1373

Polstyanoy AM, Polstyanaya OYu, Rendashkin IV, Yakimenko ON, Tutsenko KO, Sadovsky MG, Chernova AA

Reproductive organ transplantation was considered as a potential method for treatment of the ovarian factor, tubal factor, and uterine factor infertility before the advent of advanced assisted reproductive technologies. Uterus transplantation can be considered as the method for treatment of absolute uterine factor infertility similar to transplantation of non-vital organs. However, the clinical use of uterus transplantation in humans causes a lot of problems. The study was aimed to develop a program for assessment of various surgical tissue revascularization techniques for restoration of reproductive function in experimental animals with uterine factor infertility. Chinchilla rabbits (n = 20) were selected for experiments because of the fact that all mammals have similar structure of the organs. The innovative technique involving the use of ovarian arteries instead of uterine arteries (as in the standard protocol) was used in laboratory animals to develop the surgical protocol for transplantation of reproductive tissues. The animal study results show that hemodynamic characteristics of blood supply to the transplanted uterus remain unchanged. This makes it possible to use the surgical method in the experiments on the uterus transplant from a deceased donor. The proposed uterus transplantation protocol ensures high transplant survival rate and normal blood supply to the transplant, along with the reduced risk of injury to the donor and reduced complexity of the surgical procedure.

Received: 2022-09-22

Published online: 2023-01-20

DOI: 10.47183/mes.2023.001

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VIEWS 1216

Baklaushev VP, Samoilova EM, Kuznetsova SM, Ermolaeva EV, Yusubalieva GM, Kalsin VA, Lipatova AV, Troitsky AV

Monoclonal antibodies (mAbs) are the most promising and most intensively replenished type of bioactive pharmaceuticals. Currently, there are over 100 different mAbs approved by the FDA and other regulating agencies for treatment of oncological, infectious, systemic, autoimmune and other diseases. Design of antibodies neutralizing pathogens of socially significant infections, such as HIV, hepatitis viruses, SARS-CoV-2, is a separate direction. The SARS-CoV-2 pandemic has shown how urgent it is to have a technological platform enabling production of fully human antibodies. The development of recombinant DNA technology and antibody phage display enabled compilation of libraries of antigen-binding fragments and screening with target antigens. This review discusses the advantages and disadvantages of phage display, including use of single-domain antibody technology based on the heavy chain variable domain. We describe the state-of-the-art (and practical results of its application) technology enabling production of human antibodies by sorting and sequencing the genome of individual memory B cells, using monoclonal virus-neutralizing antibodies against SARS-CoV-2 as an example. The prospects of further development of the recombinant human antibody production technology are discussed; in particular, we consider creation of sequences of variable fragments of antibodies with the help of artificial intelligence.

Received: 2022-11-29

Published online: 2022-12-30

DOI: 10.47183/mes.2022.049

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VIEWS 1621

Bureev ASh, Golobokova EV, Zhdanov DS, Kosteley YV, Koshelev RV, Seleznev AI, Fomenko EA

This study aimed to develop a method allowing to improve safety of use of robotic medical rehabilitation devices by designing and testing an algorithm for calculation of the angular positions of rehabilitation robotic manipulators or robotic prostheses and allowing to reproduce the natural arc of a human arm under control of a CVS. The Introduction section supports the urgency of development of the methods granting control over positioning of robotic manipulators with the help of a computer vision system (CVS) and thus guarantee safety of patients and medical personnel in the context of work with medical robotic rehabilitation devices. The Materials and Methods section contains a brief description of the robotic arm used in this study, a description of the existing approaches to calculation of angular positions of drives, and a description of the proposed algorithm. The final sections compare application of the proposed algorithm and existing methods of calculation of angular positions of drives of robotic manipulators (robotic prostheses) and outline the possible directions for further improvement.

Received: 2022-12-06

Published online: 2022-12-30

DOI: 10.47183/mes.2022.050

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VIEWS 1340

Derevoyedov AA, Zholinsky AV, Feshchenko VS, Vykhodets IT, Stashchuk KA, Pavlova AA

The anti-doping efforts on the part of medics should be constantly improved, which means the exploration and analysis of ways to increase the effectiveness of such efforts should be constant. SWOT analysis (Strengths, Weaknesses, Opportunities, Threats) is one of such ways. It investigates internal problems and resources of an organization and the influence of external factors. This study aimed to improve the anti-doping efforts based on the analysis of their strengths and weaknesses, taking into account external threats and directions of development. We have conducted an express SWOT analysis of anti-doping work in medical organizations of the Federal Medical Biological Agency of Russia and compiled a simple matrix. The factors under consideration are internal, which can be controlled, and external, which are often uncontrollable but should be accounted for. We identified the most significant factors influencing organization of this line of work, compiled the SWOT matrix that allows assessing the possible resources for intensifying the anti-doping work, determined its strengths and weaknesses, threats and opportunities imposed by the environment in this activity takes place in. The express SWOT analysis enabled evaluation of the factors that have the greatest impact on the organization of anti-doping work. Informational and educational programs, including workshops for medics and monitoring of their level of knowledge, can be the key line of activity in the context of such efforts.

Received: 2022-11-24

Published online: 2022-12-30

DOI: 10.47183/mes.2022.048

Comments 0

VIEWS 1251