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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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 26

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 68

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 84

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 114

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 202

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

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VIEWS 162

Nikishina VB, Prirodova OF, Petrash EA, Sevrukova IA

Oculomotor activity (eye movements) is an essential component of visual data acquisition, analysis and use. The aim of this study was to determine the characteristics of oculomotor response to static images in primary school children with mild intellectual disability (ID). Our sample included a total of 49 schoolers (23 children with mild ID and 26 typically developing children). Oculomotor activity was evaluated using a GP3 Gazepoint eye tracker. The participants were presented with 15 visual stimuli: 10 pictorial and 5 mixed (pictures + text) static color images. Children with mild ID generated significantly fewer fixations (р = 0.038) than typically developing children. So, learning materials containing both pictorial and textual images are ineffective because textual elements are completely ignored by children with mild ID. The total duration of gaze fixations was significantly longer (р = 0.029) in typically developing children than in children with mild ID. However, the average duration of a single gaze fixation was longer in children with mild ID. The identified features of oculomotor response can help to optimize the format of instructional materials for primary school children with mild ID.

Received: 2021-01-21

Published online: 2021-02-26

DOI: 10.24075/brsmu.2021.008

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VIEWS 161

An imbalance between the production of reactive oxygen species and their neutralization lies at the core of oxidative stress implicated in ischemic stroke (IS) and the subsequent brain tissue damage. The aim of this study was to investigate the effects of common polymorphic variants of the glutamate cysteine ligase catalytic subunit gene on the extent of brain damage and clinical manifestations in patients with ischemic stroke. A total of 589 ischemic stroke survivors were genotyped for 6 single nucleotide polymorphisms (SNPs) of the GCLC gene, including rs12524494, rs17883901, rs606548, rs636933, rs648595 and rs761142, using a MassARRAY-4 analyzer. The study found that genotypes rs636933-G/A-A/A (р = 0.009) and rs761142-A/C-C/C (р = 0.015) were associated with an enlargement of the cerebral lesion size. Genotypes rs12524494-G/G (р = 0.05) and rs606548-T/T (р = 0.003) were associated with a risk of 2 or more IS episodes. Genotype rs17883901-G/A was associated with early onset of IS (р = 0.004). The study revealed multiple associations of GCLC SNPs with the clinical manifestations of ischemic stroke. Thus, GCLC polymorphisms are important DNA markers affecting the size of the cerebral lesion in patients with ischemic stroke and are associated with age at onset, the number of past strokes and the clinical manifestations of the disease.

Received: 2021-01-21

Published online: 2021-02-23

DOI: 10.24075/brsmu.2021.007

Comments 0

VIEWS 136