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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Volkova AA, Kalekin RA, Moskaleva NE, Astashkina OG, Orlova AM, Markin PA

In extreme situations, reliable detection of the minimum therapeutic concentrations of psychotropic substances is important, since this allows one to provide adequate resuscitation. The group of benzodiazepine derivatives, which includes bromodihydrochlorophenylbenzodiazepine (phenazepam), is widely used in clinical practice. Along with the positive clinical effect, phenazepam has numerous side effects, capable of causing poisoning, even death. The study was aimed to develop the method for detection of the phenazepam metabolites by high-resolution HPLC–TMS suitable for achieving the aims and objectives of forensic medical expertise in case of the ultra-low urine substance concentrations. Urine of six patients (males and females aged 28–40), who were prescribed phenazepam and took the drug at minimum therapeutic concentrations on an ad hoc basis, was used during the study. Optimum conditions for the analyte chromatography after the urine sample preparation were defined with the phenazepam retention time of 7.05 ± 0.06 min; specific ions (m/z) 179, 183, 206, 242, 271, 285, 320, 348 (main) were defined for identification of phenazepam.

Received: 2022-02-23

Published online: 2022-03-25

DOI: 10.47183/mes.2022.007

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VIEWS 1881

Sivachenko IB, Medvedev DS, Fedorova TA, Tsimbal MV, Steinberg NV, Moiseenko GA

Micropolarization was already proved an effective method for restoring impaired brain functions and improving intracerebral processes in the absence of impairments. Combining stimulation methods is a promising approach: a combination of electrode positioning methods can increase the efficacy of the procedures and find application in various fields, from sports through machinery operation to support of operatives of the Ministry of Emergency Situations, etc. This study aimed to assess the effect of a single combined micropolarization procedure on the functional state of the autonomic nervous system and sensorimotor reactions of conventionally healthy individuals. It involved 31 people and relied on the methods enabling evaluation of sensorimotor reactions, cardiorhythmography with spectral analysis of heart rate variability and pupillary reflexes assessment. Volunteers underwent the combined micropolarization procedure once, the duration of the procedure was 40 minutes. The most effective combinations were transspinal plus transcranial micropolarization with positioning in the region of premotor cortex (short-term shift of the autonomic balance towards parasympathetic influence by 48.7%; optimization of the pupil recovery function by 26.4%; increase in interference immunity by 32.2%) and "solar" plus transcranial micropolarization in the area of the temporal zone of cerebral cortex (15.8% increase of the orthostatic test transition period ratio; 6.2% deceleration of the visual-motor reaction).

Received: 2022-03-02

Published online: 2022-03-24

DOI: 10.47183/mes.2022.006

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VIEWS 2115

Melnikova LI, Kozhanova TV, Ilchenko LYu, Morozov IA, Soboleva NV, Nguyen Thi-Hanh, Kruglova IV, Gordeychuk IV

Biomedical support is aimed at provision of the athletes' training at various stages of the training and competition process. Withholding of access to this process due to health problems resulting from hepatitis virus infection is a demanding task. The study was aimed to assess the detection rate of the hepatitis B virus, hepatitis C virus and TT virus infection markers in highly trained athletes. A total of 384 blood serum samples were collected from 240 males and 144 females aged 14–49 (athletes engaged in playing sports, precision sports, technical sports, etc.) within the framework of the multicenter open-label cross-sectional clinical trial. All athletes answered a questionnaire, which included demographic information, characteristics of sports, information about the infection risk factors, information about the fact of past acute viral hepatitis and vaccination. Markers of infection with hepatitis B virus, hepatitis C virus and TTV were identified in blood serum by enzyme immunoassay. HbsAg was detected in two surveyed athletes. Anti-HBcore (surrogate marker of latent HBV infection) was detected in 7% of samples (27/384); 1% of athletes (4/384) had a positive hepatitis C virus total antibody test (anti-HCV). Аnti-HCV in combination with anti-HBcore was detected in one female athlete (14 years of age, tennis player). DNA of TTV, TTMDV and TTMV was detected in blood serum samples of 89.1%, 83.1% and 85.4% of athletes, respectively. High detection rate of the hepatitis virus markers was observed.

Received: 2022-02-16

Published online: 2022-03-22

DOI: 10.47183/mes.2022.005

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VIEWS 1913

Takhchidi KhP, Takhchidi NKh, Kasmynina TA, Tebina EP

Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus and one of the major causes of blindness in the developed world. Retinal laser photocoagulation is a gold standard for the treatment of DR. Despite its high efficiency, laser therapy has a number of limitations. The emergence of drugs, designed to inhibit the growth of the newly formed blood vessels, in ophthalmic practice made it possible to change treatment strategy in patients with retinal neovascularization. However, this method also has some adverse effects. Given the limitations on the repeated sessions of laser photocoagulation and the risks of ophtalmic complications after the intravitreal injection of the angiogenesis inhibitors, extraordinary situations, when there are negative results of treatment with the use of the described above techniques in one eye and disease progression in the single eye with preserved vision, become a serious problem when performing treatment. The clinical case reported has shown the feasibility of staged laser treatment in patient with the optic disc peripapillary neovascularization. Therapy has resulted in the regression of the newly formed blood vessels and visual function preservation.

Received: 2022-01-15

Published online: 2022-03-13

DOI: 10.47183/mes.2022.004

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VIEWS 1728

Shipulin GA, Savochkina YuA, Shuryaeva AK, Shivlyagina EE, Nosova AO, Davydova EE, Luparev AR, Malova TV, Yudin SM

The emergence of novel SARS-CoV-2 genetic variants with increased transmissivity and reduced antibody neutralization efficiency is a threat to global public health. Reverse transcription polymerase chain reaction (RT-PCR) with the use of fluorescent probes, which make it possible to detect the single nucleotide substitutions, is a technique suitable for screening the SARS-CoV-2 RNA-containing samples for the already known functionally significant mutations in the S-gene, identification of which allows to define and differentiate the most epidemiologically significant genetic variants. The study was aimed to develop an assay for the large-scale monitoring of the spread of the SARS-CoV-2 top-priority variants. Based on the whole-genome alignment of the SARS-CoV-2 sequences, deposited in the GISAID database, primers and LNA-modified probes were selected to detect mutations in the S gene, typical for the Alpha, Beta/Gamma and Delta variants of concern (VOC). The developed reagent kit for detection of the key mutations in the SARS-CoV-2 S gene by the real time RT-PCR has good analytical and diagnostic characteristics and was authorized as a medical device (reagent) for in vitro use. The results of detecting the VOC and the key mutations with the use of the developed reagent kit were consistent with the data of the whole genome sequencing of 1,500 SARS-CoV-2 RNA samples. The developed reagent kit and the subsequent SARS-CoV-2 RNA sequencing assay used to perform the epidemiological monitoring of SARS-CoV-2 variants made it possible to promptly report the emergence of the Delta genetic variant in Russia, and to trace the dynamic changes in the prevalence of Delta in Moscow Region in April–September 2021.

Received: 2021-12-15

Published online: 2022-02-09

DOI: 10.47183/mes.2022.003

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VIEWS 2174

Galinkin VA, Enikeev AKh, Podolskaya EP, Gladchuk AS, Vinogradova TI, Zabolotnykh NV, Dogonadze MZ, Krasnov KA

Chlorhexidine bigluconate (CНX) is widely used as a disinfectant, but it is not effective against spore-forming microorganisms, as well as viruses. In this work, a method has been found to increase the biocidal activity of chlorhexidine by using it as part of a complex including ethylenediaminetetraacetic acid (EDTA) and zinc chloride. The structure of the three-component complex СНX-EDTA-zinc is proved by the MALDI-MS method. The biocidal activity of the chlorhexidine complex has been studied in vitro and in vivo experiments. It is shown that the complex is significantly superior to chlorhexidine alone, both in terms of activity level and in the breadth of biocidal action. In relation to the studied bacterial and fungal strains, the СНX-EDTA-Zn complex was 4–5 times more active than chlorhexidine bigluconate. In concentrations from 1.0 mg/ml to 0.008 mg/ml (depending on the type of micro-organism), in vitro the complex showed both bacteriostatic and bactericidal effects against the main pathogens of bacterial diseases of birds. In clinical conditions, the complex has shown high efficiency in the treatment of dermatitis in small domestic and farm animals. Also, in vitro and in vivo, the complex showed unexpectedly high antitubercular activity comparable to that of monofloxacin, including on drug-resistant strains of mycobacteria. in vitro experiments involving polio virus and adenovirus have shown that the СHX-EDTA-Zn complex possesses virulent action.

Received: 2021-12-27

Published online: 2022-02-07

DOI: 10.47183/mes.2022.002

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VIEWS 1831

Schäfer TV, Ivnitsky JuJu, Rejniuk VL

Cyclophosphamide is used for the treatment of lymphoma, leukaemia, some solid tumours, and autoimmune disorders. When carrying out myeloablative cytostatic therapy, the doses of cyclophosphamide are prescribed, which cause irreversible pancytopenia. Early toxic effects of such doses are manifested by asthenic and emetic syndromes, limiting the treatment tolerance. Administration of cyclophosphamide in a dose of ≥ 600 mg/kg is accompanied by hyperammonaemia and symptoms, specific to the acute ammonium salt intoxication. Endotoxemia, resulting from the increase in the intestinal barrier permeability due to the impaired gastrointestinal motility, is considered the possible mechanism underlying these phenomena. The study was aimed to test this hypothesis. Radiographic assessment of the rat gastrointestinal peristalsis was performed within 25 h after administration of cyclophosphamide in a dose of 1000 mg/kg, which was equivalent to myeloablative dose for humans. Intraperitoneal, subcutaneous or intragastric administration of cyclophosphamide slowed down the gastrointestinal transit of bariumsulfate. In the case of subcutaneous cyclophosphamide injection, a moderate effect was observed. In the case of cyclophosphamide administered by gavage, the effect was manifested by a complete halt of transit. Thus, modelling myeloablative cytostatic therapy with cyclophosphamide in rats is associated with gastrointestinal stasis. The changes reported may promote the entry of the gut microbial products into the bloodstream and ensuing endotoxemia.

Received: 2021-12-14

Published online: 2022-01-31

DOI: 10.47183/mes.2022.001

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VIEWS 2323

Zyabkin IV, Grachev NS, Frolov SV, Polev GA, Magomedova AM, Ataeva DM, Galkina TA

Nasal breathing is of great importance for professional athletes because of the peculiarities of carbon dioxide metabolism in the body. Problems with nasal breathing caused by post-traumatic deformities of the nose can be successfully corrected with the help of rhinoseptoplasty, but the possibility of performing this surgery on patients under 18 years of age is a discussed matter. This study aimed to analyze the results of the effect functional rhinoseptoplasty has on nasal breathing, consider rhinoseptoplasty as the preferred method of treatment for adolescents with post-traumatic deformities of the structures of the nose. The study involved 15 professional athletes aged 15–18 years with post-traumatic deformities of the external nose and troubled nasal breathing. Five of them (33.3%) were female, 10 (66.7%) were male; all underwent open rhinoseptoplasty. The NOSE and SCHNOS questionnaires were used to assess the symptoms of nasal obstruction before and after surgery. Post-surgery, all patients subjectively noted that their nasal breathing improved, which was confirmed by the filled questionnaires. There were no significant complications registered during the follow-up period. Functional rhinoseptoplasty is a viable surgical option for adolescents under 18 years of age.

Received: 2021-12-13

Published online: 2021-12-23

DOI: 10.47183/mes.2021.047

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VIEWS 1910