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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Ershov PV, Veselovsky EM, Konstantinova YuS

Gastric cancer (GC) usually has an unfavorable prognosis: the five-year survival rate is 20–30% in most world regions. Timely diagnosis and prevention of risk factors may reduce mortality from GC. This review discusses the meta-analyses of 40 endogenous and exogenous factors associated with GC. GC is significantly associated with family history; dietary preferences (increased consumption of roast and smoked red meat, hot foods, pickles, salt (over 5–6 g/day), nitrates (over 20 mg/L drinking water); lifestyle (smoking, opium use, strong alcohol, beer, stress); some diseases including gastroesophageal reflux disease, diabetes mellitus, obesity, and autoimmune disorders; infections (Helicobacter pylori, human papillomavirus, Epstein-Barr virus); ionizing radiation, and professional hazards. Data suggesting associations between the risk of GC and the consumption of coffee, tea, high-fat foods, simple carbohydrates, folic acid, sleep duration, and blood cholesterol turned out to be conflicting due to the inconsistencies of the results between cohort and case-control studies. About 3% of all gastric cancers are linked to hereditary syndromes associated with pathogenic variants of CDH1, STK11, SMAD4, BMPR1A, TP53, MYH, APC, PTEN, ATM, BRCA1, and some other genes.

Received: 2020-10-26

Published online: 2020-12-19

DOI: 10.47183/mes.2020.023

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VIEWS 2583

Bomshteyn NG, Bolotov YuV, Kim IA, Trukhin DV

Taking into account the gut–lung microbiota axis, the new probiotic treatment methods for COVID-19 are currently being discussed. There are effective medicinal preparations of domestic manufacture in the Russian Federation, the immobilized probiotics. The study was aimed to determine the effectiveness of the mixed immobilized probiotic containing the immobilized B. bifidum and lactobacilli L. plantarum (100 million CFU per dose) or the simple immobilized probiotic containing the immobilized B. bifidum (500 million CFU per dose) in the complex therapy of patients with COVID-19. During the open-label, prospective, observational study 70 patients with confirmed diagnosis of COVID-19 received complex treatment which included the immobilized probiotics. All patients were discharged from the hospital with imporoved health status, as well as with improved instrumental and laboratory indicators: body temperature returned to normal in all patients; shortness of breath, cough, feeling of chest tightening, myalgia and headache disappeared; the patients regained sense of smell and taste; the weakness decreased or disappeared (pathognomic symptom for COVID-19). The dynamics of clinical, laboratory and instrumental indicators reflecting the course of the novel coronavirus infection demonstrates the effectiveness of the used complex therapy. The immobilized probiotics may be recommended for the complex treatment of patients with COVID-19.

Received: 2020-12-08

Published online: 2020-12-15

DOI: 10.47183/mes.2020.021

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VIEWS 2831

Katuntsev VP, Sukhostavtseva TV, Kotov AN, Baranov MV

Reduced orthostatic tolerance (OT) is a serious concern facing space medicine. This work sought to evaluate the effects of intermittent hypoxic training (IHT) on OT in humans before and after 3 days of head-down bed rest (HDBR) used to model microgravity. The study was carried out in 16 male volunteers aged 18 to 40 years and included 2 series of experiments with 11-day and 21-day IHT administered on a daily basis. During the first IHT session, the concentration of oxygen in the inspired gas mixture was 10%; for other sessions it was adjusted to 9%. OT was assessed by a 20-minute-long orthostatic tilt test (OTT) conducted before and after HDBR. Before HDBR, orthostatic intolerance was observed in 3 participants, while after HDBR, it was observed in 9 of 16 volunteers (p < 0.05). During OTT conducted after HDBR, the heart rate (HR) exceeded control values by 26.8% (p < 0.01). Preexposure to any of the applied IHT regimens led to a reduction in the number of volunteers with orthostatic intolerance. After the 11-day IHT program, there was a less pronounced increase in HR during OTT before HDBR; with the extended IHT regimen, less pronounced changes were observed for HR, systolic, diastolic and mean blood pressure (BP). The increase in HR during OTT after HDBR was significantly lower in the group that had completed the 11-day IHT program, while BP remained stable. The changes in HR and systolic BP were less pronounced in the group that had completed the 21-day IHT program than in the control group (p < 0.05). Thus, IHT reduced the risk of orthostatic disorders and mitigated changes in cardiovascular parameters during the orthostatic test.

Received: 2020-10-07

Published online: 2020-12-14

DOI: 10.47183/mes.2020.022

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VIEWS 2431

Laptev DS, Petunov SG, Nechaykina OV, Bobkov DV, Radilov AS

COVID-19 is a disease characterized by damage to the lower respiratory tract, development of the acute respiratory distress syndrome, in severe cases — multiple organ failure, including acute heart failure and cardiomyopathy. This study aimed to evaluate the effectiveness of the developed COVID-19 pathogenetic therapy and complications prevention agents using the ex vivo isolated lung and heart models. Isolated organs of white rats were used for the research; the dynamics of functional indicators were analyzed. An amino acid-peptide complex (APC) from a thermally treated milk protein hydrolyzate was used as the experimental COVID-19 pathogenetic therapy and complications prevention agent. Introduction of the APC to the isolated cardiopulmonary complex perfusate slowed down development of pulmonary edema in the experimental group; the organ's weight was 1.5 times less than in the control group (p = 0.0158). We have also registered an airway resistance downtrend. APC supported contractile activity of the isolated myocardium suffering ischemia-reperfusion: the growth of the left ventricular end diastolic pressure was 34% smaller than that registered in the control group (p < 0.05). The APC's cardioprotective effect relies on the endothelium-dependent mechanisms. The ex vivo method is highly informative. It allows assessing reactivity of the isolated organs exposed to biologically active substances and determining the possibilities of compensating for functional changes.

Received: 2020-09-15

Published online: 2020-12-12

DOI: 10.47183/mes.2020.020

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VIEWS 2684

Katuntsev VP, Zakharov SYu, Sukhostavtseva TV, Puchkova AA

Adaptation to hypoxia is an important object of medical research. The aim of this study was to investigate the dynamics of blood oxygen saturation (SpO2), arterial blood pressure (BP), red blood cells, reticulocytes, hemoglobin and erythropoietin (EPO) concentrations during intermittent hypoxic training (IHT). The study was conducted in 11 healthy male volunteers; 2 regimens were tested: 11 and 14 days of IHT at FIO2 = 9%. Exposure to the hypoxic gas mixture caused a reduction in SpO2 by an average of 20.4% (p < 0.05), a 22% increase in the heart rate (p < 0.05) and a 4.5% decrease in diastolic BP (p < 0.05) relative to the initial levels. After 11 days of IHT training, the reticulocyte count was increased by 16.6% (p < 0.05), and there was a distinct tendency to elevated red blood cells (p > 0.05) and hemoglobin (p > 0.05). EPO concentrations declined by 44.2% (p < 0.05) relative to the initial level. Extending the regimen to 14 days resulted in a 3.9% increase in red blood cell count (p < 0.05) and a 4.7% elevation of hemoglobin concentrations (p < 0.05), accompanied by the recovery of the initial reticulocyte count. The applied 2-week IHT regimen resulted in the increased red blood cell count and elevated hemoglobin, suggesting an improvement in the oxygen-carrying capacity of the blood. The proposed regimen can be used to improve physical performance of individuals working in extreme environmental conditions.

Received: 2020-09-07

Published online: 2020-11-30

DOI: 10.47183/mes.2020.019

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VIEWS 2603

Daykhes NA, Nazaryan DN, Gileva KS, Mokhirev MA, Lyashev IN, Zakharov GK, Fedosov AV, Potapov MB, Batyrev AV, Karneeva OV

Facial graft transplantation remains the operation of choice for patients with extensive tissue defects in the maxillofacial region. This study aimed to set up an experiment on biological objects, develop and test a combined facial graft cross-transplantation technique, select the anesthetic aid allowing to reduce the risks of perioperative complications, improve survivability of the subjects by reducing the duration of surgical intervention, develop a postoperative therapy and rehabilitation protocol, assess detection of an acute rejection reaction and develop the immunosuppressive therapy protocol. We conducted three series of facial graft transplantation surgeries on 26 minipigs and tested the typical component combinations and flap designs. At all stages of the experiment, we managed to have the subjects surviving for over 30 days without disrupting their vital functions. The immunosuppression procedure was developed and tested. The chosen technique allows transplanting two grafts within a single surgery on one pair.

Received: 2020-10-01

Published online: 2020-11-29

DOI: 10.47183/mes.2020.018

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VIEWS 3047

Takhchidi KhP, Takhchidi NKh, Movsesian MKh

The end of 2019 in China was marked by the breakout of the new Coronavirus Disease (COVID-19) caused by the severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). Gradually, the infection spread around the world and in March 2020, the World Health Organization (WHO) declared Covid-19 a pandemic. The new coronavirus disease 2019 is highly contagious, causing respiratory distress syndrome and poses a huge threat to public health, especially in patients. with serious concomitant diseases such as diabetes mellitus, bronchial asthma, hypertension, etc. Many scientists have put forward the idea that COVID-19 can be transmitted through the eyes through contact and everyday life. Over the past six months, works on the ocular manifestations of coronavirus infection have begun to appear in the literature. We conducted a systematic review of scientific articles from the PubMed, e-Library, Scopus databases in order to conduct a meta-analysis of the effect of coronavirus infection on the eyes and its ophthalmological manifestations.

Received: 2020-09-13

Published online: 2020-11-29

DOI: 10.47183/mes.2020.017

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VIEWS 2609

Korenkova AA, Bahmetjev VV, Gorbunov KS

Some human coronaviruses that share genetic similarity are known to infect other mammals. A host can harbor several coronaviruses, which creates favorable conditions for recombination and eventually results in the emergence of new viral strains and species. This review looks at SARS-CoV-2 in the context of other coronaviruses and their evolution, with a special focus on possible host jumps and adaptation of the virus to its new hosts. To understand these phenomena, it is essential to know the ecological relationships between the host and other organisms. Candidate COVID-19 models are not limited to the organisms and laboratory animals previously used to study SARS and MERS. The diversity of SARS-CoV-2 hosts suggests there is a wide range of candidate animal models for studying COVID-19 that might be suitable for testing drugs and vaccines against this infection. Considering the diversity of coronaviruses, integrated medical, veterinarian and zoological studies might help to speed up the development of tools for combating coronaviral infections and prevent future epidemics.

Received: 2020-10-14

Published online: 2020-11-29

DOI: 10.47183/mes.2020.016

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VIEWS 2709