Bulletin of RSMU

ISSN Print 2500–1094 ISSN Online 2542–1204

Bulletin of RSMU

BIOMEDICAL JOURNAL OF PIROGOV UNIVERSITY (MOSCOW, RUSSIA)

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Masyutina AA, Gumenyuk LN, Fatovenko YuV, Sorokina LE, Bayramova SS, Alekseenko AI, Shavrov YuV, Romanova AA, Seydametova DI

The relationship between the gut microbiota and chronic insomnia remains understudied. The aim of this paper was to investigate changes in the taxonomic composition of the gut microbiota and their associations with the levels of cortisol, melatonin and IL6 in patients with chronic insomnia. Our comparative prospective cross-sectional study enrolled 55 patients with chronic insomnia, who formed the main group (female patients: 58.2%, male patients: 41.8%; mean age 31.6 ± 7.4 years), and 50 healthy volunteers, who comprised the control group (females: 68.0%, males: 32.0%; mean age 33.2 ± 6.6 years). The taxonomic composition of the gut microbiota was profiled using 16S rRNA gene sequencing. Plasma cortisol and IL 6 and urine melatonin were measured by means of ELISA. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). In patients with chronic insomnia, the abundance of Faecalibacterium (p = 0.048), Prevotella 9 (p < 0.001) and Lachnospira (p = 0.036) was lower, whereas the abundance of Blautia (p = 0.012) and Eubacteriumhallii (p = 0.003) was higher than in healthy volunteers. Significant correlations were established between the levels of IL6 and the abundance of Faecalibacterium (r = –0.44; p = 0.001) and Blautia (r = 0.42; p < 0.001), as well as between cortisol concentrations and the abundance of Lachnospira (r = –0.41; p = 0.048). The abundance of Faecalibacterium and Blautiaс was correlated with higher PSQI (r = –0.47, p = 0.001; r = 0.45, p < 0.001, respectively). Our study contributed to the pool of data about changes in the gut microbiota and their associations with some endocrine and inflammation markers in patients with chronic insomnia. These data can be exploited to propose new strategies for the diagnosis and personalized treatment of insomnia aimed at normalizing the patient’s gut microbiota.

Received: 2021-03-07

Published online: 2021-04-27

DOI: 10.24075/brsmu.2021.017

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VIEWS 4875

Ishikhov IM, Kolomiets KV, Gamidov FM, Gantsgorn EV

Lacertus fibrosus entrapment of the median nerve at the elbow, or Lacertus syndrome, is a rare pathology, which is difficult to detect by instrumental examination methods. Literary sources provide no information on the syndrome prevalence, as well as on precise diagnosis and treatment algorithms, which makes it difficult to establish the diagnosis and appoint the effective treatment. Lacertus syndrome is characterized by positive scratch collapse test; differential diagnosis is required to distinguish it from carpal tunnel syndrome. Clinical case of bilateral lacertus fibrosus entrapment of the median nerve at the elbow is reported, Lacertus syndrome diagnosis criteria and surgical treatment method are set out. The results of the surgical tactics used are as follows: pain, paresthesia and numbness in the innervation field of the median nerve have vanished, the muscle strength has been restored to level М5 in accordance with MRC muscle strength scale. These results demonstrate high efficiency of the proposed lacertus syndrome surgical treatment.

Received: 2021-03-16

Published online: 2021-04-25

DOI: 10.24075/brsmu.2021.016

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VIEWS 5010

Osmolovsky IS, Zarubina TV, Shostak NA, Kondrashov AA, Klimenko AA

Gout is a chronic systemic disease characterized by the deposition of monosodium urate crystals in various tissues and inflammation. In Russia, time to diagnosis may be as long as 8 years. This leads to serious complications, such as urate nephropathy, and disability. Effective strategies are needed to improve the quality of medical care for gout patients. One of such strategies is creation of an expert system to aid the clinician in establishing the diagnosis and selecting adequate therapy. The cornerstone of an expert system is a knowledge base. The aim of this paper was to develop a medical nomenclature and algorithms for the diagnosis and treatment of gout that will be used to create an expert system in the future. A total of 1,174 entities were selected that laid the basis for 40 diagnostic and 50 treatment algorithms for gout patients. All informational models were verified by the expert panel.

Received: 2021-03-03

Published online: 2021-04-17

DOI: 10.24075/brsmu.2021.014

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VIEWS 4258

Ivashchenko AV, Yablokov AE, Tlustenko VS, Postnikov MA, Popov NV, Tlustenko VP, Tugushev VV, Cherezova NI, Mukhina AA, Belanov GN

In the early 21st century, robot-assisted dental implant surgery became a popular alternative to classic implant placement protocols. Postoperative complications are often provoked by poor compliance with surgical guidelines for implant placement, resulting in the overheating of the osteotomy site. The aim of this study was to measure the temperature of osseous tissue at the dental implant site during classic and robot-assisted dental implant placement performed at different cooling modes. Avital skeletonized mandibles of Vietnamese pot-bellied pigs were used as an experimental model. The recipient bed was prepared following the classic surgical protocol. Three cooling modes were tested: no irrigation, irrigation with sterile saline at 25–30 ml/min and standard 75 ml/min irrigation recommended by the standard surgical protocol. The temperature of the isotonic solution was 25 °С. The study showed that both classic and robot-assisted dental implant placement techniques are safe if there is sufficient irrigation and good compliance with the surgical protocol.

Received: 2021-02-08

Published online: 2021-04-08

DOI: 10.24075/brsmu.2021.013

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VIEWS 4125

Khramov VV, Kogaeva KP, Arkhipova LU, Alekseeva VO, Lukyanova MI

The importance of post-stroke rehabilitation cannot be overestimated. The aim of this study was to assess the effectiveness of a standardized post-stroke rehabilitation program for patients with moderate impairments. A total of 122 stroke survivors participated in the study. Group 1 (the comparison group) consisted of 59 patients undergoing standard rehabilitation. Group 2 (the main group) consisted of 63 patients participating in a specially designed social rehabilitation program. The functional, cognitive, psychological and emotional states and the level of social activity were monitored for 6 months. Group 2 demonstrated more pronounced improvement than group 1 after 6 months of follow-up, confirmed by higher Rivermead (p = 0.011) and SS-QOL (p < 0.05) scores and lower DASH and Beck scores (p = 0.015 and p < 0.001, respectively). In both groups, MMSE (cognitive function) scores slightly increased, but the differences between the groups were insignificant. The proposed post-stroke rehabilitation program is effective in helping patients regain their independence and improve social adaptation. The scales and scores used in the study, especially DASH and SS-QOL, are sensitive to changes in the functional state of stroke survivors with moderate impairments.

Received: 2021-02-25

Published online: 2021-03-31

DOI: 10.24075/brsmu.2021.012

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VIEWS 4056

Gaydin TY, Rozhnova SA

The problem of compulsory licensing (CL) in the pharmaceutical industry is being discussed worldwide. The aim of this paper was to analyze the effects of using CL for pharmaceutical drugs (PD) as part of competitive policies aimed at safeguarding the life and health of the population. Using PEST-analysis, we identify the main political, economic, social and technological problems associated with using CL in the pharmaceutical industry. We demonstrate the potential of CL as a tool for countering the threats to public health caused by the abuse of market dominance by pharmaceutical patent holders. At present, both developers of pharmaceutical innovations (patent-holders) and other entities involved in drug circulation are protected by law. There is ongoing debate about the efficacy of CL as a tool ensuring the implementation of competitive policies aimed at safeguarding the rights to life and health. However, in Russia CL is applied only under exceptional circumstances. An economic balance should be sought between the incentives for innovation, long-term profits from selling PDs and PD accessibility.

Received: 2021-02-09

Published online: 2021-03-09

DOI: 10.24075/brsmu.2021.011

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VIEWS 4307

Lebedin YuS, Lyang OV, Galstyan AG, Panteleeva AV, Belousov VV, Rebrikov DV

A new coronavirus infection caused by the SARS-CoV-2 virus, which appeared in December 2019, has claimed the lives of 2.5 million people in almost a year. The high contagiousness of this virus has led to its wide and rapid spread around the world. As of February 2021, the total number of cases is 111 million people; more than 4 million cases of SARS-CoV-2 infection have been registered in the Russian Federation. To successfully combat the emerging pandemic, it is necessary to quickly diagnose the disease at an early stage, which will prevent the further spread of this virus and prescribe the necessary treatment on time. The aim of the work was to evaluate the use of the SARS-CoV-2 nucleocapsid antigen (N-Ag) and respective antibodies as diagnostic markers in pneumonia patients. The study was conducted at the height of COVID-19 pandemic in Moscow, Russia. It included 425 emergency patients with clinical signs of COVID-19 pneumonia, of which 280 (66%) were positive for either serum N-Ag and/or its respective antibodies. We demonstrate the total prevalence of N-Ag seroconversion in SARS-CoV-2associated pneumonia patients within 3–5 days after hospital admission. The results indicate high feasibility of SARS-CoV-2 serodiagnostics in emergency patients.

Received: 2021-02-11

Published online: 2021-02-28

DOI: 10.24075/brsmu.2021.009

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VIEWS 4537

Syrkasheva AG, Frankevich VE, Dolgushina NV

The association between levels of trace elements, endocrine diseases and reproductive impairments is actively investigated currently. In this connection, it seems relevant to study elemental status (elemental composition of blood and amounts of elements therein) of infertile patients enlisted in programs employing assisted reproductive technologies (ART). This study aimed to analyze trace elements in blood of infertile patients, relationship between the level of such trace elements and parameters of the ART programs they are in. The study included 30 infertile patients aged 18–39 years. Relying on inductively coupled plasma mass spectrometry, we identified concentrations of 31 chemical element in blood of the participants. Two elements out of 31 (antimony and beryllium) were not found in any blood sample; 10 elements (titanium, chromium, cobalt, nickel, arsenic, mercury, barium, gold, vanadium) were detected in some blood samples, the remaining 19 elements were found in all samples. Age of the patients correlated negatively with the level of silicon (r = –0.384; p = 0.036) and positively with the level of molybdenum (r = 0.384; p = 0.036). The level of anti-mullerian hormone was in a significant negative correlation with the level of lithium (r = –0.367; p = 0.046). The level of free thyroxine was in a significant negative correlation with the level of boron (r = –0.402; p = 0.028) and a positively correlated with the levels of iron (r = 0.410; p = 0.024) and silver (r = 0.432; p = 0.017). Considering the embryological cycle, we noted a positive correlation between the level of silicon and the number of blastocysts obtained (r = 0.387; p = 0.034). There was no statistical relationship registered between elemental composition of blood the frequency of pregnancy in ART cycles.

Received: 2021-02-10

Published online: 2021-02-28

DOI: 10.24075/brsmu.2021.010

Comments 0

VIEWS 4727