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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Tuluzanovskaya IG, Balashova MS, Senina OS, Sizyakova OM, Leisan kyzy Huseynova G, Mamadshoeva NM, Rozina TP, Zhuchenko NA

Wilson’s disease is a rare autosomal recessive disorder (prevalence 1 : 30,000) caused by pathogenic variants in the ATP7B gene (OMIM 277900). Early diagnosis and pathogenetic therapy enable stable remission. Poor treatment adherence is the key factor adversely affecting the prognosis. This family case study has demonstrated that inadequate attitude towards therapy contributes to the progression of organ damage and increases the risk of disability and mortality. Clinical observation confirms a direct link between compliance with the treatment regimen and clinical outcomes.

Received: 2026-04-13

Published online: 2026-06-09

DOI: 10.24075/brsmu.2026.027

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VIEWS 35

Kunyk DA, Mazunina EP, Mukasheva EA, Ignatieva AV, Kirillova ES, Kurchenko OM, Ivanov RA, Gushchin VA, Reshetnikov VV

The high variability of the influenza virus and the limited flexibility of inactivated vaccines result in a need to develop new, more effective preventive therapeutics. The RNA platform is among the most promising ones for developing new generation vaccines against respiratory infections. The study aimed to compare the immunogenicity of two experimental therapeutics based on classic mRNA and self-amplifying RNA (saRNA) encoding the hemagglutinin (HA) of the A(H1N1)pdm09 influenza virus. BALB/c mice were immunized twice with the RNA-based therapeutics at a dose of 2 µg at a 21-day interval. Humoral immune responses were assessed using the hemagglutination inhibition (HAI) assay. After the second immunization, the geometric mean titers of antibodies against the homologous strain A/Wisconsin/588/2019 were 1 : 2281 (CI: 1 : 1319 – 1 : 3943) for the mRNA vaccine and 1 : 640 (CI: 1 : 404 – 1 : 1014) for the saRNA vaccine. Titers against the antigenically distant strain A/Victoria/4897/2022 in the mRNA group and saRNA group reached 1 : 1810 (CI: 1 : 844 – 1 : 3882) and 1 : 452 (CI: 1 : 246 – 1 : 832), respectively. These antibody titer values were considerably higher than those in the group that received the Ultrix Quadri inactivated split vaccine, which did not exceed 1 : 56 (CI: 1 : 26 – 1 : 121). Despite the higher antibody titers in the HAI assay after immunization with the classic mRNA-based vaccine compared with the saRNA-based vaccine, the differences were not statistically significant. Thus, the mRNA- and saRNA-based vaccines induce a pronounced humoral immune response, confirming that these platforms are promising for the development of new generation vaccines.

Received: 2026-04-10

Published online: 2026-06-08

DOI: 10.24075/brsmu.2026.028

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VIEWS 116

Gordienko II, Kornilov DO, Chernyi SP, Simarzina VM, Rasposienko DY, Slukina AE, Ivasenko MI, Vinokurov DE, Zornikov DL

Bioabsorbable Zn–Mg alloys are considered an alternative to metallic fixators, but data on their biocompatibility at low Mg content remain insufficient. Aim — to evaluate the biocompatibility of Zn–Mg alloys containing 0.5–2 wt.% Mg in vitro and in vivo. Cytotoxicity of Zn–0.5Mg and Zn–1Mg powders (0.15–2.5 mg/mL) was assessed in direct contact with SCP‑1 cells (MTT assay). In vivo, cylindrical implants of four compositions were placed bilaterally into the tibial metaphysis of rabbits (n = 4). Complete blood count was performed on day 7; computed tomography (CT) was performed at 3 and 10 months. At 2.5 mg/mL, cell viability was 12.5 ± 1.0 % (Zn–0.5Mg) and 16.8 ± 1.6% (Zn–1Mg). At 1.25 mg/mL, Zn–1Mg showed no toxicity (101.4 ± 3.3 %), whereas Zn–0.5Mg remained cytotoxic (51.3 ± 4.4 %). Recovery to > 80 % viability was observed at 0.62 mg/mL for Zn–0.5Mg and 0.31 mg/mL for Zn–1Mg. In vivo, all animals maintained normal activity; haematological parameters were within normal range. At 3 months, CT showed stable implants without signs of osteolysis. Cortical bone density was 647.3 ± 5.4 HU, trabecular bone density was 510.5 ± 6.4 HU, comparable to intact bone. At 10 months, implants remained visible. Zn–Mg alloys with 0.5–2 wt.% Mg exhibit dose‑dependent cytotoxicity in vitro and satisfactory biocompatibility in vivo without systemic inflammatory reactions or bone resorption over 10 months. The alloy with 1% Mg has a more favourable cell viability profile.

Received: 2026-05-07

Published online: 2026-06-04

DOI: 10.24075/brsmu.2026.026

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VIEWS 101

Saadoon SJ, Atiyah AM, Ibrahim AH, Mostafa FM

Secondary hyperparathyroidism (SHPT) is a common and progressive complication of chronic kidney disease (CKD), often intensifying as patients reach dialysis. Although alfacalcidol and other active vitamin D analogs are often used, improper administration can raise the risk of hypercalcemia and hyperphosphatemia. This study aimed to assess, using clinical criteria indicated by guidelines, whether alfacalcidol should be prescribed to hemodialysis patients with SHPT. Records of 136 adult patients treated in An-Naseria hemodialysis units were reviewed and analyzed using SPSS (version 26). The appropriateness of prescribing alfacalcidol was evaluated in accordance with KDIGO 2017 guidelines, taking into account levels of phosphate, calcium, and parathyroid hormone (PTH). Patients were divided into groups based on whether their prescriptions were appropriate or possibly inappropriate. Patients were 55.1% male and had an average age of 51.42 ± 11.5years. The majority of patients exhibited biochemical values (phosphate: 79.4%, calcium: 74.3%, and PTH: 77.2% normal) within goal ranges. 72 patients (52.9%) were categorized as potentially inappropriate for alfacalcidol medication, whereas 64 patients (47%) were recognized as having appropriate indications based on criteria consistent with guidelines. The mean PTH levels of patients in the appropriate group were substantially higher (923.14 ± 379.59 pg/mL) than those in the inappropriate group (274.71 ± 179.69 pg/mL, р < 0.001). Age, sex, calcium, and phosphate levels did not significantly correlate with prescription appropriateness. This cohort may have a significant percentage of alfacalcidol prescriptions that may not follow current guidelines. The sensible use of vitamin D analogs in hemodialysis patients may be improved by better adherence to evidence-based guidelines and routine biochemical monitoring.

Received: 2026-04-13

Published online: 2026-05-30

DOI: 10.24075/brsmu.2026.025

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VIEWS 307

Arinin FR, Naranov UA, Politaeva PV, Likhovtsova ES, Fedoreeva LA, Kopyl EV, Nabieva TD, Kutsenko EV, Rustamova AR

Here we present a rare case of inflammation in the Meckel's diverticulum with the ectopic pancreatic tissue in a 18-year-old patient. Laparoscopy converted to laparotomy was performed. The inflamed Meckel's diverticulum was found during intraoperative revision, which was the reason to perform segmental resection of the affected area of the small intestine with the construction of an enteroenteric anastomosis. Pathological examination of surgical material revealed mature exocrine tissue of the pancreas without any signs of cellular atypia, which confirmed the presence of pancreatic heterotopia in the Meckel's diverticulum. The reported case demonstrates rarity of such combination of abnormalities, highlights diagnostic difficulties at the preoperative stage, and draws attention to the need for thorough intraoperative revision of the small intestine, as well as for mandatory morphological verification to establish the final diagnosis and determine further patient management tactics.

Received: 2026-04-09

Published online: 2026-05-24

DOI: 10.24075/brsmu.2026.024

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VIEWS 265

Olkova MV, Koshel SM, Ponomarev GYu, Alimov AA

The exploration of ATM gene haplotype evolutionary variability and its geographic dissemination across Eurasia enables the utilization of these data to predict the distribution of diseases associated with alleles comprising these haplotypes. The study aimed to identify the ATM gene haplotypes unique to Eurasia based on the panel of 28 polymorphic loci determining two major “yin-yang” haplotypes. The analysis was conducted using individual genotype data for 28 ATM gene loci across 41 groups of indigenous Eurasian populations. Haplotypes were identified using the Haploview 4.1 software. Phylogenetic analysis was performed in RStudio using the pegas and geneHapR packages. Cartographic visualization of ATM haplotype frequencies was implemented using the GeneGeo cartographic package. The H7j haplotype was identified in indigenous peoples of North Eurasia, which suggests its localized origin. The maximum H7i frequency was reported for Finno-Ugric peoples of the north and indigenous peoples of the northern Eurasia. The highest H8j haplotype frequency is observed in populations of southern China and Japan, which probably indicates the place of its origin. The remaining haplotypes are rare, these are typical for small geographic regions: H6j is sporadically distributed across Asia, H8i is localized to Transcaucasia, and H9i is found in two meta-groups of Eastern European peoples. The data obtained suggest the presence of the ATM gene haplotypes specific for the population of Eurasia, emphasize the contribution of intragenic recombination in shaping the gene haplotype diversity, and highlight the importance of the geographic and demographic context for preservation and spread of distinct genetic variants.

Received: 2026-04-03

Published online: 2026-05-23

DOI: 10.24075/brsmu.2026.023

Comments 0

VIEWS 245

Mrikaeva OM, Akhmatova FT, Kakaeva MR, Rasukhanova EU, Elmurzaev SS-Kh, Dzhabrailov BKh, Yusupova ST, Tugueva SL, Idrisova SM

Rapid palatal expansion may affect not only maxillary dimensions but also upper airway patency in adolescents; however, the role of tooth-supported and miniscrewassisted appliances remains to be clarified. This study aimed to assess morphological and functional changes in the upper respiratory tract associated with rapid palatal expansion and to compare these changes between the use of Hyrax and MARPE systems. We conducted a prospective pilot study involving 24 adolescents aged 12–16 years with transverse maxillary insufficiency. Fourteen participants received Hyrax appliances, while ten received MARPE devices. Time points: T0 — before treatment, T1 — 6 months after completion of activation. The measured indicators were the volume of the nasal cavity, nasopharynx, and oropharynx, the minimum area of the retropalatal level, and the total nasal resistance at 150 Pa. We also calculated the NOSE score. After treatment, the volume of the nasal cavity increased by 14.6% (p < 0.001), nasopharyngeal volume by 8.9% (p = 0.003), the minimum area of the retropalatal level by 12.1% (p = 0.012), total nasal resistance decreased by 24.7% (p < 0.001), and NOSE score by 35.4 points (p < 0.001). The change in oropharyngeal volume was insignificant (p = 0.091). We established no differences between Hyrax and MARPE groups (p > 0.05). Rapid palatal expansion improved nasal cavity and nasopharynx parameters. Further comparisons of techniques require a priori sample size calculations.

Received: 2026-03-19

Published online: 2026-05-18

DOI: 10.24075/brsmu.2026.022

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VIEWS 273

Demin NA, Achkasov EE, Polyaev BA, Shishkin AA, Medvedeva AI, Ostanin OE

High prevalence of postoperative ventral hernias necessitates the development of effective rehabilitation protocols to restore abdominal muscle function early and reduce recurrence risk. This study aimed to evaluate the effects of electromyostimulation (EMS) of the anterior abdominal wall muscles on physical activity levels and strength performance in patients after surgical treatment for postoperative ventral hernias. We enrolled 128 patients (mean age, 47.9 ± 8.6 years) who underwent open combined component separation surgery with retromuscular mesh implantation. In the treatment group (n = 64), the course of anterior abdominal wall EMS (enabled by COMPEX SP-2.0) started on the 10th day after surgery; in the control group (n = 64), we followed a standard post-surgery protocol. The assessed indicators were the level of physical activity (pedometry, 7 days) and the strength of the trunk muscles (strain dynamometry, registered with a BackCheck 700 device). Six months after surgery, the EMS group showed significantly greater muscle strength gains than the control group: in trunk extension, median strength was 26.9 kg versus 15.4 kg (74.7% increase; p < 0.001); in flexion, it was 15.7 kg versus 8.0 kg (96.3% increase; p < 0.001). The level of physical activity in the EMS group was significantly higher: the median number of steps per week was 27304.5 ± 2903.48 (95% CI 20964.6–33644.5), while in the control group it reached 11173.6 ± 3688.8 (95% CI 10065.4–12281.9) steps. This indicates a recovery to 90.0% of the preoperative level. Thus, an early post-surgery course of EMS of the anterior abdominal wall muscles is an effective rehabilitation method that significantly improves the strength characteristics of the core muscles and restores the levels of physical activity in patients.

Received: 2026-03-29

Published online: 2026-05-13

DOI: 10.24075/brsmu.2026.021

Comments 0

VIEWS 263