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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Pikina AS, Golubinskaya PA, Ruchko ES, Kozhenevskaya EV, Pospelov AD, Babayev AA, Eremeev AV

Despite the prospects of the approach to cell therapy of cartilage damage in humans involving autologous chondrocytes, similar technologies are just beginning to be introduced into medical practice in the Russian Federation. In this regard, the development of biomedical cell products (BCPs) for cartilage tissue repair is quite topical, while the use of organoid technology is the most close to the native tissue conditions. According to requirements of legislation of the Russian Federation, it is necessary to assess biodistribution characterizing migration potential of the cells, their tropism for body tissues following implantation within the framework of preclinical trials. The study was aimed to assess biodistribution of novel BCP based on human chondrocytes in the form of chondrospheres after subcutaneous implantation in Balb/c nude mice. Implantation to 12 mice was performed during the first phase, along with administration of saline to 12 control animals. Weighting and follow-up were conducted for 90 days. Then mice were withdrawn from the experiment to collect samples of organs and tissues for histological analysis of the implant, estimation of its viability, integration. During the second phase biodistribution was assessed by PCR in order to detect human DNA in the organ and tissue samples. Chondrospheres successfully integrated in the tissues surrounding the inoculation zones and formed cartilage tissue. No significant (p < 0.05) changes in weight were reported. No human DNA found in chondrosphere implantation zones was detected in the samples collected from other organs and tissues. BCP demonstrated no biodistribution across other tissues and organs of mice 90 days after implantation, which suggested that the product developed was safe.

Received: 2023-11-05

Published online: 2023-12-31

DOI: 10.47183/mes.2023.057

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VIEWS 406

Sharagin PA, Tolstykh EI, Shishkina EA

The red bone marrow (RBM) exposure due to bone-seeking radionuclides can lead to grave medical consequences. In particular, the increased risk of leukemia in people exposed due to contamination of the Techa River in 1950s is associated with the RBM exposure due to 89,90Sr. Improvement of the internal RBM dosimetry methods includes the development of computational phantoms that represent 3D models of the skeletal sites. Modeling radiation transport within such phantoms enables estimation of conversion factors from the radionuclide activity in the bone to the RBM dose rate. This paper is an extension study focused on generating a set of computational phantoms representing skeletons of individuals of different ages. The aim was to develop a computational phantom representing a 5-yearold child for internal RBM dosimetry from incorporated beta emitters. The phantoms of the skeletal sites with active hematopoiesis were created using the original Stochastic Parametric Skeletal Dosimetry (SPSD) method. With this method, every such site represented a set of smaller phantoms of simple geometric shape. RBM distribution across the skeleton, bone size, characteristics of bone micro-architecture, as well as density and chemical composition of the simulated media (RBM, bone) were determined based on the published data. As a result, a computational phantom of the major skeletal sites with active hematopoiesis representing a 5-year-old child was generated that included 43 phantoms of bone fragments. Linear dimensions of phantoms were within 3–75 mm. Micro-architecture parameters varied greatly: BV/TV ratio —13–52%, Tb. Th. — 0.09–0.29 mm, Tb. Sp. —0.48–0.98 mm.

Received: 2023-10-23

Published online: 2023-12-31

DOI: 10.47183/mes.2023.061

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VIEWS 428

Lipatov VA, Lazarenko SV, Severinov DA, Denisov AA, Chupakhin EG, Aniskina EN

Various local hemostatics (based on collagen, gelatin, cellulose, etc.) are used to stop bleeding from parenchymal organs of the abdominal cavity. In the context of an acute in vivo experiment, this study aimed to comparatively assess the time and volume of bleeding from a trauma of abdominal cavity's parenchymal organs covered with a new collagen-based spongy hemostatics combined with Na-CMC. We used new multicomponent polymer sponge implants (MPSI) based on marine collagen and carboxymethyl cellulose sodium salt, Na-CMC; the components were mixed in the ratios of 15/85, 25/75, 50/50. Hemostatic activity of the samples was assessed by bleeding time and blood loss volume. For the experiments, rats underwent laparotomy and resection of the left lobe of liver (series 1) and lower pole of spleen (series 2). In both series of experiments, the controlled parameters (bleeding time and blood loss volume) were smallest in group 6, where the MPSI were 50/50 Na-CMC/collagen. The hypothesis of higher efficacy of composite local hemostatic agents (namely, made of Na-CMC and deep-sea squid collagen) in cases of trauma of the parenchymal organs was confirmed experimentally, and same experiment has also shown that collagen in the composition of MPSI boosts bleeding arrest (for liver injury, the smallest blood loss and hemorrhage control time was 41 s, for spleen injury — 57 s, respectively; p ≤ 0.05).

Received: 2023-11-11

Published online: 2023-12-31

DOI: 10.47183/mes.2023.063

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VIEWS 420

Gulko SV, Babadjanova GYu

Latex, made from Hevea brasiliensis sap, is the material used to make many medical products, including catheters, balloons and gloves. Hundreds of allergens from natural rubber latex have been identified, and 15 of them were numbered, from Hev b1 to Hev b15. Natural proteins in rubber cause both asymptomatic sensitization and type I IgE-mediated hypersensitivity. Treatment of latex makes use of chemical antioxidants that can also bring about type IV hypersensitivity reactions. Latex allergy is one of the most common causes of anaphylaxis in the operating room, and its prevalence has been growing since 1980s, together with the popularity of latex gloves. It is a well-known problem among medical professionals, with gloves and inhaled aerosol particles being the sources thereof. This study aimed to review the current scientific research and practical data in this only partially investigated area. In addition, increasing the awareness of doctors and patients minimizes the existing risks of latex allergy.

Received: 2023-11-08

Published online: 2023-12-31

DOI: 10.47183/mes.2023.064

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VIEWS 425

Glazanova TV, Shilova ER, Bessmeltsev SS

The treatment of multiple myeloma is inextricably linked to the need for assessment and monitoring of the minimal residual disease (MRD). Assessment of the MRD allows evaluating the efficacy of therapy and obtaining significant prognostic information; it is an indicator of the degree of eradication of the tumor clone. The methods for detecting residual tumor cells evolve constantly, which translates into updates of the criteria reflecting the scale of response to therapy. There is no single MRD detection technique; common recommendations suggest seeking for pathological cells both intramedullary and extramedullary. This review describes current MDR determination methods, including imaging, next generation multiparametric flow cytometry, and methods based on DNA analysis — allele-specific oligonucleotide polymerase chain reaction and next generation sequencing. We compare their advantages, limitations, disadvantages, clinical significance, and show the necessary sensitivity thresholds of the described methods and the conditions that make this or that approach ideal in the context of detection of MRD.

Received: 2023-11-16

Published online: 2023-12-31

DOI: 10.47183/mes.2023.062

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VIEWS 420

Solonin SA, Belova MV, Tereshkina NE, Kasholkina EA, Tyurin IA, Godkov MA, Potskhveriya MM

The spread of COVID-19 in Russia has led to restrictive measures. The stress associated therewith had a noticeable psychoemotional effect on the population, which could not but affect the numbers and patterns of acute chemical poisonings (ACP). This study aimed to investigate the patterns of ACP in Moscow in the context of the COVID-19 pandemic. We analyzed data describing cases admitted with ACP to N.V. Sklifosovsky Research Institute for Emergency Medicine in 2019–2021, factoring in the dynamics COVID-19 prevalence as diagnosed with RT-PCR tests. The results of the analysis were processed using nonparametric methods and GraphPad Prism 9 software. Within the considered period, 2020 was the peak year. The number of acute poisonings (AP) with ethanol and its surrogates in 2020 was 109.7% greater than in 2019 (both sexes; the figure for women alone was 286.2%). Male patients suffered AP with drugs and corrosive substances more often than female (p < 0.0001). The number of drug abuse cases in 2019–2021 varied slightly, increasing by 2.4 and 6.7% annually. Synthetic narcotic substances were most common: methadone, cathinones, psychostimulants, and mixtures of substances. We discovered parallel trends in dynamics of ethanol intoxication and COVID-19 cases, and no such between drug poisonings and the said morbidity. Thus, the identified specifics of ACP patterns in the capital of Russia associated with the COVID-19 pandemic are a spike in alcohol abuse (especially among women), and lack of noticeable effect of the disease on use of drugs.

Received: 2023-10-06

Published online: 2023-12-29

DOI: 10.47183/mes.2023.052

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VIEWS 488

Bobrov MP, Voitenkov VB, Ekusheva EV, Kiparisova ES

Encephalitis is a group of acute infectious diseases affecting the substance of the brain. They often lead to disability or death, and, therefore, require urgent medical attention. The article discusses the etiology, pathogenesis, and clinical picture of encephalitis, with special attention to the course of this disease after the COVID-19 pandemic. We note the growing number of encephalitis cases, especially of autoimmune variety and those caused by herpes. The possible reason behind this trend is the disruption of operation of the immune system brought by COVID-19, which manifests as a cytokine storm, neuroinflammation, and autoimmune reactions. There are cases of COVID-19-dependent encephalitis described. The pathways taken by SARS-CoV-2 to penetrate into the cells of the central nervous system have not yet been fully studied, although there are hypotheses that this happens both trans-synaptically through mechanoreceptors and chemoreceptors of the respiratory system into the medulla oblongata, and through receptors of the angiotensin converting enzyme 2.

Received: 2023-11-03

Published online: 2023-12-29

DOI: 10.47183/mes.2023.059

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VIEWS 400

Grishina GV, Krobinets II, Kasyanov AD, Sidorkevich SV

The problem of iron deficiency among donors is relevant and directly affects the provision of hemocomponents to the blood service. Donors, being a risk group for the development of iron deficiency, are examined before donation, including a study of hemoglobin levels. However, there is no information about the state of iron stores, when depleted, iron deficiency anemia develops. In turn, anemia is a contraindication to donation and, therefore, leads to medical exemptions from donation. The purpose of the study was to evaluate the main indicators of iron metabolism in donors of blood and (or) blood components at risk of developing latent iron deficiency. The examination of 174 donors included a hemogram, assessment of the level of hemoglobin, serum ferritin (SF), transferrin, and soluble transferrin receptors. When assessing the intensity of changes in reserve and transport iron indicators, 228 deviations from the reference range were analyzed. The criterion for the risk of developing iron deficiency was hemoglobin values at the lower limit of normal (130–135 g/l in men and 120–125 g/l in women) and the threshold level of ferritin (30 μg/l in male donors and 20 μg/l in women). The risk group included 58.3% of young donors — women who donate blood 1–2 times during the year (p < 0.01) and 66.6% (p < 0.01) of donors — men who donate blood regularly throughout 4 and > years. The average ferritin level in male donors was 27.37 μg/l (p < 0.02) and lower than the reference values. It is concluded that it is advisable to assess the indicators of iron metabolism in donors in the case of borderline hemoglobin levels, in women of reproductive age after 2 blood donations and in men with the number of donations ≥ 10. To replenish the iron depot in the body, when iron deficiency is detected in donors, it is necessary to consider the issue of prevention.

Received: 2023-11-09

Published online: 2023-12-28

DOI: 10.47183/mes.2023.055

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VIEWS 416