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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Nakatis YaA, Ratnikov VA, Kashchenko VA, Lodygin AV, Mitsinskaya AI, Mitsinskii MA, Akhmetov AD

The spread of caused by SARS-CoV2 acute respiratory infection associated with severe life-threatening complications has necessitated transformation of most general hospitals into infectious diseases hospitals in order to provide specialized care to infected patients, as well as the change of surgical care provision strategy. The example of surgical service reorganization has been reported for the general clinic transformed into the infectious diseases hospital capable of providing care both during the COVID-19 pandemic and after the outbreak has abated.

Received: 2020-10-18

Published online: 2020-11-29

DOI: 10.47183/mes.2020.015

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VIEWS 2681

Eremeev AV, Zubkova OA, Ruchko ES, Lagarkova MA, Sidorov VS, Ragozin AO

Repair of cartilage defects associated with injury or pathology is a clinically relevant problem. Chondral tissue, especially articular cartilages, has a poor regenerative potential. Inflammation triggers the growth of connective tissue, which cannot exert the normal function of the hyaline cartilage. This contributes to the progression of the pathology and eventually raises the need for surgery. At present, there are no pharmaceutical drugs capable of restoring the damaged cartilage. However, advances in cell-based technology hold promise for regenerative medicine. Reports describing fabrication of autologous cartilage transplants pose a special interest. A registration dossier of a biomedical cell product must contain the product’s specifications, presenting the basic characteristics of the product that can be used to assess its quality. This review looks at a few basic parameters that can be used to verify the authenticity of the cell product derived from autologous chondrocytes and describe its specifications.

Received: 2020-09-02

Published online: 2020-11-20

DOI: 10.47183/mes.2020.014

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VIEWS 2618

Abramov VG, Gaygolnik TV, Fetisov AO, Pinzhina VN, Osipova TM, Bezdenezhnykh AF, Morozov DN

Introduction. This article describes the extrapulmonary manifestations of COVID-19 and proposes a simple and quick patient self-completed questionnaire for identifying such symptoms in the affected patients.Materials and methods: The study was conducted in 93 patients who gave consent to participate. The questionnaire included questions about age and sex, 3 open-ended questions and 92 tick-a-box closed-ended questions about the possible symptoms. All symptoms listed in the closed-ended section of the questionnaire can be classified into 9 major domains (groups): pain, febrility, respiratory symptoms, neurological symptoms, digestive symptoms, skin symptoms, renal and urological symptoms, cardiac symptoms, apathy and asthenia.Results and discussion: Apathy, asthenia, fever, and respiratory symptoms were the most common. manifestations of COVID-19. Less frequent were neurological, digestive and cardiovascular symptoms. However, with apathy, asthenia and headache included in the neurological domain, neurological symptoms ranked first in their prevalence (97.75%). Symptoms indicating kidney and skin involvement were significantly less common.Conclusions: Extrapulmonary manifestations of the disease were observed in the majority of our patients. The authors plan to continue their research and aim to compare the results of laboratory and instrumental tests with presenting complaints, investigate the associations between the received therapy and the complaints, and propose optimization strategies for the management of COVID-19 patients (inviting specialty physicians to work with COVID-19 hospital teams during an escalating epidemic and providing specialized consultations to patients as the epidemic subsides).

Received: 2020-07-09

Published online: 2020-09-22

DOI: 10.47183/mes.2020.013

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VIEWS 2726

Ushakov IB, Parfyonov AN, Bondarenko RA, Komarevtsev VN

The authors formulated a hypothesis about an important link in the pathogenesis of COVID-19, in which the increasing hypoxia and an acute response of the body like a general adaptation syndrome, accompanied by systemic pathological changes, including dangerous disorders of rheology and blood coagulation, play a key role.

Received: 2020-07-19

Published online: 2020-08-19

DOI: 10.47183/mes.2020.012

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VIEWS 2788

Shuryaeva AK, Malova TV, Davydova EE, Savochkina YuA, Bogoslovskaya EV, Mintaev RR, Tsyganova GM, Shivlyagina EE, Ibragimova ASh, Nosova AO, Shipulin GA, Yudin SM

Late in December 2019, an outbreak of an unknown coronavirus, later identified as SARS-CoV- 2, emerged in the city of Wuhan, China. It causes a dangerous respiratory coronavirus disease in humans - COVID-19.Objective. To detect cases of the disease and prevent its spread across the Russian Federation it is necessary to create an effective diagnostic test system. Material and methods. Based on the analysis of the alignment of the SARS-CoV-2 nucleotide sequences, primers and a probe for RT-PCR were selected, and the analysis conditions were optimized. Results. The diagnostic system was developed and registered in the shortest possible time in real-time RT-PCR format for detecting SARS-CoV-2 coronavirus RNA in smears from the nasopharynx and oropharynx, sputum and feces. The high specificity of the system was verified on a representative set of viruses and microorganisms, the analytical sensitivity was 1x103 copies / ml in smears from the mucous membrane of the nasopharynx and oropharynx and sputum, 5x104 copies / ml in fecal samples. Diagnostic sensitivity and specificity established during clinical trials on samples from patients with confirmed COVID-19 infection, from patients with a different etiology of a disease and clinically healthy people were to 100% (range 94.2-100% with a confidence level of 95%).

Received: 2020-07-15

Published online: 2020-08-19

DOI: 10.47183/mes.2020.011

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VIEWS 3061

Mozgovoy ED, Udalov YuD, Ochkolias MV

Highly virulent SARS-CoV-2 emerged in Wuhan, China, and rapidly spread across the globe afflicting 14.5 million and killing over 600,000 people. The key factors affecting the severity of COVID-19 include advanced age and respiratory failure requiring mechanical ventilation (MV). Mortality rates estimated for mechanically ventilated patients with SARS-CoV-2-induced respiratory failure are 76.4% in the 18-65 age group and 97.2% in individuals over 65 years. At present, extracorporeal membrane oxygenation (ECMO) remains a life-saving method of choice. It is essentially a lung bypass system for direct oxygenation of the blood. It is an invasive and costly procedure performed only at specialized medical care facilities. China, USA, Germany, France and Israel have already launched large-scale research and clinical studies of non-invasive approaches to improving the efficacy of oxygen therapy in patients with complicated viral pneumonia, such as hyperbaric oxygen therapy (HBOT). HBOT is a well-established treatment for anaerobic and aerobic infections accompanied by soft tissue necrosis, carbon monoxide poisoning, stubborn wounds, including non-healing diabetic ulcers, complications of radiation therapy, stroke sequelae, brain injuries, decompression sickness, and other conditions. The use of HBTO in patients with viral infection, pulmonary edema and pneumonia is supported by the laws of physics and clinical/physiological effects in response to the exposure of elevated air pressure and hyperoxic environment. This review provides rationale for using hyperbaric oxygenation therapy in patients with SARS-CoV-2-induced viral pneumonia and presents the first data on the beneficial effects of HBTO in Chinese patients with COVID-19 complications.

Received: 2020-06-28

Published online: 2020-08-18

DOI: 10.47183/mes.2020.010

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VIEWS 3103

Arinina EE, Tairova RT, Berdalin AB, Gujev SS, Glotova NA, Rubleva YuV, Bulatova MA, Polyaev BB, Terechov DA, Belousov VV, Shamalov NA

Glucocorticoid therapy for a cytokine storm is one of the mainstays of managing the novel coronavirus disease COVID-19. The aim of this study was to evaluate the efficacy of methylprednisolone at different stages of medical care: in an intensive care unit (ICU) vs. a medical ward setting. Methylprednisolone therapy was delivered to 54 patients, amounting to 9% of the total patients hospitalized to the Federal Center of Brain Research and Neurotechnology of FMBA, Russia. Twenty-eight patients received methylprednisolone in the ICU setting; 26 patients, in a medical ward setting. The control group comprised 14 patients. Methylprednisolone was administered continuously, intravenously at 250 mg per day over the course of 3 days; the total dose was 750 mg. The analysis revealed a significant reduction in mortality in the group receiving methylprednisolone in a medical ward setting (7.7%) in comparison with the group receiving the drug in ICU (67.9%) and the control group (42.9%, р<0.001). The need for mechanical ventilation was lower in the group receiving methylprednisolone in a medical ward (2 (7.7%), 20 (71.4%) and 7 (50%) cases, respectively, р<0.001). Thus, preventive anti-inflammatory methylprednisolone therapy for delivered in a medical ward setting reduces hospital mortality and the need for MV in patients with COVID-19-induced pneumonia.

Received: 2020-07-14

Published online: 2020-08-17

DOI: 10.47183/mes.2020.009

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VIEWS 2783

Nikiforov VV, Suranova TG, Komarevtsev VN, Khlutkov SYu, Skvortsova VI

The article presents a brief epidemiological characteristic of a new coronavirus infection. The risks of infection of medical workers and measures to counter the drift and spread of COVID-19 in medical organizations are considered.

Received: 2020-06-19

Published online: 2020-08-11

DOI: 10.47183/mes.2020.008

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VIEWS 2783