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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Zozul YuN, Kiselev SM, Laschenova TN, Shlygin VV, Akhromeev SV, Gimadova TI, Malakhova AN, Shashkova OB, Oskina KYu

The Regional center of conditioning and long-term storage of radioactive waste is being constructed in Primorsky Krai, where radioactive waste (RW) management сoncerns have been especially acute. The project involves intensification of activities related to RW management, as well as to building the new technology block for RW reprocessing, storage facility and boiler house. The study was aimed to perform environmental impact assessment of the territories in the vicinity of the Regional center of conditioning and long-term storage of radioactive waste prior to the facility commissioning. Radiation situation was assessed by radiometric and spectrometric methods; the levels of heavy metals were evaluated by atomic absorption spectrometry. Heavy metal (lead, nickel, copper, etc.) and arsenic levels exceeding or, in certain cases, similar to maximum permissible concentration (MPC) were found in soil and ground. Radiation situation is characterized by background levels of artificial radionuclides 137Cs and 90Sr in environmental media. Quality of water in wells and boreholes was largely compliant with the requirements established for groundwater used in decentralized water supply systems, with the exception of boreholes, in which the arsenic levels exceeding MPC were detected. The average annual public dose was 0.046 mSv excluding natural regional background radiation, which was below the dose limit. Carcinogenic health risks induced by radiation and chemical factors was 4×10–6 and 6×10–6 respectively. The obtained results form the basis for setting reference values of environmental contamination prior to the Regional center of conditioning and long-term storage of radioactive waste commissioning and can be used for regulatory supervision during the facility operation.

Received: 2021-07-15

Published online: 2021-08-27

DOI: 10.47183/mes.2021.022

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VIEWS 1928

Belov SE, Gubsky IL, Lelyuk VG, Boyko AN

The search for highly sensitive and highly specific biomarkers of MS, including neuroimaging biomarkers, continues. One of such biomarkers is the central vein sign detectable on SW and T2-weighted MR images. The sensitivity and specificity of methods used for central vein sign detection vary. This article describes two clinical cases of patients with similar neurological symptoms which required making differential diagnosis between multiple sclerosis and secondary demyelination in the presence of a systemic disorder (systemic lupus erythematosus). In addition to routine MR sequences, we used SWI generated by a 3T scanner. The lesions with the central vein sign were counted; the proportion of perivenular lesions was determined. In the multiple sclerosis case, all the lesions were perivenular; the proportion of lesions with the central vein sign in the patient with secondary demyelination in the presence of systemic lupus erythematosus was 16.7%. The use of SW images improved the informative value of the analysis.

Received: 2021-07-15

Published online: 2021-08-18

DOI: 10.47183/mes.2021.021

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VIEWS 2171

Melnikov MV, Rogovskii VS, Lopatina AV, Sviridova AA, Volkov AI, Boyko AN

Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system involving autoimmune mechanisms. MS has been treated as a disorder mediated mainly by T cells for a long time. However, recent findings demonstrate that B lymphocytes are of crucial pathogenetic significance in MS. In patients with MS, B cells can possess both pro-inflammatory and anti-inflammatory effects. The paper reports the main mechanisms of B lymphocyte involvement in the pathogenesis of MS. Diagnostic value of assessing humoral immune parameters in individuals with demyelinating diseases and modern possibility of B cell function modulation are discussed.

Received: 2021-07-17

Published online: 2021-08-16

DOI: 10.47183/mes.2021.020

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VIEWS 2148

Karmishin AM, Nosov NYu, Postupailo VB, Zhigarlovskiy BA, Kruglov AA, Petukhov AN

The level and duration of protective immunity are often analyzed qualitatively or semi-quantitatively. The same strategy is applied to the analysis of antibody dynamics. At some point in time t after exposure or immunization, the presence of immunity against the infection is inferred from the level of specific antibodies by comparing it to a reference value. This approach does not account for the stochastic nature of human disease after exposure to a pathogen. At the same time, it is not fully clear what antibody level should be considered protective. The aim of this study was to develop a mathematical model for quantitative determination of protective immunity against SARS-CoV-2 and its duration. We demonstrate that the problem of describing protective immunity in quantitative terms can be broken down into 2 interrelated problems: describing the quantitative characteristics of a pathogen’s virulence (in our case, the pathogen is SARS-CoV-2) and describing the dynamics of antibody titers in a biological organism. Below, we provide solutions for these problems and identify parameters of the model which describes such dynamics. Using the proposed model, we offer a theoretical solution to the problem of protective immunity and its duration. We also note that in order to quantitatively determine the studied parameters in a homogenous population group, it is necessary to know 5 parameters of the bivariate probability density function for correlated continuous random variables: the infective dose of the pathogen and the antibody titer at which the disease develops and which are still unknown.

Received: 2021-05-25

Published online: 2021-06-28

DOI: 10.47183/mes.2021.019

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VIEWS 2591

Shachneva MD, Leninskii MA, Savelieva EI

Wipe sampling is widely used for microbiological control purposes. Sanitary and chemical studies also include analysis of samples wiped from the work surfaces during routine and periodic working conditions safety inspections at chemical facilities. The analysis also allows assessing the toxicity and hazard of items/structures that could be in contact with highly toxic substances. This study aimed to investigate the capabilities and limitations of the surface wipe sample analysis method in control of residual contamination of equipment and building structures of a former chemical weapons destruction facilities (CWDF) with sulfur mustard and O-isobutyl-S(2-diethylaminoethyl) methylphosphonothioate (VR), as well as their degradation products. Gas chromatography with tandem mass spectrometry (GC-MS/MS) enabled identification of the sulfur mustard markers, high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS) allowed identifying VR markers. An assessment of the matrix influence on the results of GC-MS/MS and HPLC-MS/MS analysis was carried out. The matrix effect was established to affect the results the most in case of HPLC-MS/MS analysis: for GC-MS/MS analysis of target substances, the matrix factor averaged at 60–80%, for HPLC-MS/ MS it was less than 40%. The average percent sulfur mustard recoveries from three types of surfaces (PVC tiles, laminate and metal plates) was 9 ± 2%, 0.13 ± 0.02% and 0.10 ± 0.03%; in case of VR, the recoveries was 2.7 ± 0.5%, 11.8 ± 0.3% and 0.8 ± 0.1%, respectively. The limits of detection for sulfur mustard by GC-MS/MS and VR by HPLC-MS/MS were established at 0.001 MPL and 0.02 MPL, respectively. The developed approaches were applied to the analysis of wipe samples from the surfaces of the equipment and engineering structures of the former CWDF.

Received: 2021-05-28

Published online: 2021-06-26

DOI: 10.47183/mes.2021.018

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VIEWS 2179

Lobzin YuV, Uskov AN, Skripchenko NV, Vilnits AA, Bekhtereva MK, Babachenko IV

Despite the low incidence, low mortality and relatively mild symptoms of COVID-19 in children, there has been a rise in pediatric patients who develop a condition resembling Kawasaki disease after COVID-19 or contact with individuals infected with SARS-CoV-2. This condition is known as the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 infection (PIMS-TS). This review introduces the reader to the hypotheses of PIMS-TS pathogenesis, provides information about its diagnosis and treatment, presents clinical and laboratory data and describes treatments strategies used in children and adolescents hospitalized to the intensive care unit of the Pediatric Research and Clinical Center for Infectious Diseases. Besides, the review outlines the main diagnostic and prognostic challenges of PIMS-TS.

Received: 2021-06-07

Published online: 2021-06-26

DOI: 10.47183/mes.2021.017

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VIEWS 2370

After elimination of the chemical weapons, it is necessary to relieve the consequences of operation of the chemical weapons destruction facilities (CWDF). This study aimed to assess the results of such relieve activities from the hygienic point of view. The assessment allows considering partial conversion of the CWDFs' infrastructure for civil purposes. At four CWDFs, the sites of contamination of equipment and infrastructural components with degradition products of organophosphorous agents (OPA) and blister agents (BA) were identified. The technologies that enabled analysis of the samples taken were high performance liquid chromatography with tandem mass spectrometry, gas chromatography–mass spectrometry, gas chromatography–tandem mass spectrometry, and atomic absorption spectroscopy with electrothermal atomization. The analysis revealed contamination of building structures, equipment, utility lines, waterproofing, heatinsulating, and other materials inside the CWDF process buildings, regardless of their purpose, with OPA and BA degradation products. In the absence of hygienic standards and information on their toxicity, it was impossible to assess the hazard thereof. In all the samples taken, the residual content of toxic substances was below the limit of detection of the measurement methods applied, i.e., none was found. The article presents a methodology for a stepwise hygienic assessment of the CWDF infrastructure to be converted and develops recommendations for its subsequent safe use. The conclusions state expediency of development of hygienic standards for the OPA and BA degradation products and development and certification of the relevant measurement procedures.

Received: 2021-05-28

Published online: 2021-06-25

DOI: 10.47183/mes.2021.016

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VIEWS 2116

Kucherskoy SA, Alikbaeva LA

As a result of the industrial purification of hydrocarbons from mercaptans, tens of thousands of tons of dialkyl disulphides and their mixtures, the toxicity and hazard of which has not been fully understood, are accumulated annually. The exposure standards have been developed only for dimethyl disulphide. The study was aimed to define toxicometry parameters for diethyl disulphide, disulphide oil, and the mixture of dialkyl disulphides. Toxicology studies involving male outbred rats made it possible to define the median lethal doses and concentrations: diethyl disulphide — after intragastric injection DL50 = 1575 mg/kg, after the 4-hour inhalation exposure CL50 = 18,700 mg/m3, after intraperitoneal injection DL50 = 1134 mg/kg, and after skin application DL50 ˃ 2500 mg/kg; mixture of dialkyl disulphides — after intragastric injection DL50 = 428 mg/kg, after the 4-hour inhalation exposure CL50 = 4510 mg/m3, after intraperitoneal injection DL50 = 212 mg/kg, and after skin application DL50 ˃ 2500 mg/kg; disulphide oil — after intragastric injection DL50 = 448 mg/kg, after the 4-hour inhalation exposure CL50 = 4534 mg/m3, after intraperitoneal injection DL50 = 156 mg/kg, and after skin application DL50 ˃ 2500 mg/kg. The hazard assessment for dialkyl disulphides and their mixtures was performed.

Received: 2021-05-29

Published online: 2021-06-25

DOI: 10.47183/mes.2021.015

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VIEWS 2284