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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Dvornikov AS, Minkina OV, Grebenshchikova EG, Vvedenskaya EV, Mylnikova IS

COVID-19 pandemic has made changes to conventional health care. In view of the need for “social distancing”, telemedicine services became most in demand, which constituted a reform of the previous doctor-patient relationship format; dermatology was no exception. Increased use of teledermatology (TD) all over the world elevated the relevance of the set of challenges related to teledermatology potential and limits, particularly in the light of the expectations of the technology broader application during the post-pandemic period. The review addresses the issues related to accounting for quality of health care, understanding the social and humanitarian context of TD, as well as the impact on professional education.

Received: 2021-08-17

Published online: 2021-08-31

DOI: 10.24075/brsmu.2021.041

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VIEWS 2459

Soldatov VO, Kukharsky MS, Soldatova MO, Puchenkova OA, Nikitina YuA, Lysikova EA, Kartashkina NL, Deykin AV, Pokrovskiy MV

Retinal damage is an optional sign in a number of neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS). The aim of this work was to assess the structural and functional state of the retina in a murine model of ALS caused by overexpression of the aberrant FUS protein [1-359]. The retinal examination was carried out on 12 transgenic and 13 wild-type mice of 2.5–3 months of age. The study revealed not statistically significant higher level of ophthalmoscopic violations in FUS[1-359] mice. Moreover, gene expression assay confirmed an increased expression of the inflammatory genes Vegfa, Il1b, Il6, Icam1, Tnfa. However, despite the detected structural and functional abnormalities, western blot analysis and quantitative PCR did not detect the expression of the protein and mRNA products of the FUS transgene in the retina of FUS[1-359] mice.

Received: 2021-08-19

Published online: 2021-08-31

DOI: 10.24075/brsmu.2021.043

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VIEWS 2211

Yasko BA, Kazarin BV, Gorodin VN, Chugunova NA, Pokul LV, Skripnichenko LS, Skorobogatov VV

In light of the ongoing COVID-19 pandemic, it is becoming increasingly important to address the problem of resourcefulness in the healthcare personnel of COVID-19 red zones. The aim of this study was to assess hardiness and the state of vital resources in physicians continuously working in red zones and to test a hypothesis that that long-term work in a COVID-19 red zone adversely affects the resourcefulness, reducing resistance to stress. Group 1 (n = 94) consisted of physicians with a history of employment in a COVID-19 red zone between May 2020 and June 2021; group 2 (n = 77) comprised physicians who were not involved in managing COVID-19 patients. The tests showed that hardiness and its components (commitment, control and challenge) were at high levels in group 2 (59.7%; 67.5%; 61.0%; 20.9%, respectively). The index of resourcefulness (RI; 1.24) reflected the prevalence of personal gains over losses in group 1 over the past year. In this group, there were no sex differences in the results. By contrast, hardiness was significantly reduced in 31.9% of the respondents in group 1 (red zone). Working in the red zone had a devastating effect on all hardiness components: the ratio of the percentages of high to low values was 8.5/27.7 for commitment, 9/6/34.0 for control and 10.6/35.1 for challenge. RI was reduced (0.77). The most pronounced loss of resources was observed in female physicians. The study found a significant mutual impact between challenge and the state of personality resources in red zone staff, which may indicate activation of proactive coping strategies and the acceptance of new professional experience.

Received: 2021-08-12

Published online: 2021-08-30

DOI: 10.24075/brsmu.2021.042

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VIEWS 2117

Takhchidi KhP, Gliznitsa PV, Svetozarskiy SN, Bursov AI, Shusterzon KA

Retinal diseases remain one of the leading causes of visual impairments in the world. The development of automated diagnostic methods can improve the efficiency and availability of the macular pathology mass screening programs. The objective of this work was to develop and validate deep learning algorithms detecting macular pathology (age-related macular degeneration, AMD) based on the analysis of color fundus photographs with and without data labeling. We used 1200 color fundus photographs from local databases, including 575 retinal images of AMD patients and 625 pictures of the retina of healthy people. The deep learning algorithm was deployed in the Faster RCNN neural network with ResNet50 for convolution. The process employed the transfer learning method. As a result, in the absence of labeling, the accuracy of the model was unsatisfactory (79%) because the neural network selected the areas of attention incorrectly. Data labeling improved the efficacy of the developed method: with the test dataset, the model determined the areas with informative features adequately, and the classification accuracy reached 96.6%. Thus, image data labeling significantly improves the accuracy of retinal color images recognition by a neural network and enables development and training of effective models with limited datasets.

Received: 2021-07-27

Published online: 2021-08-28

DOI: 10.24075/brsmu.2021.040

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VIEWS 2498

Lazishvili GD, Egiazaryan KA, Nikishin DV, Voroncov AA, Klinov DV

Investigation of the efficacy of collagen membranes used in the full-thickness hyaline cartilage defect surgery is extremely urgent from the point of view of everyday healthcare. However, there is no information about the collagen membrane transformation timeframe, patterns and type of tissue the membrane transforms into, nor on the quality of the newly formed cartilage, which hinders the use of collagen membranes in clinical practice. This study aimed to investigate the biological potential of collagen membranes and their capacity to transform into cartilage tissue. The study involved four pigs as subjects. We induced a full-thickness cartilage defect on their right hind limb joint and implanted an Ortokeep collagen membrane to remedy it. Two full-thickness cartilage defects were induced on the left hind limb joints of the animals, one was treated with an implanted Chondro-Gide collagen membrane, the other remained without a membrane. The animals were withdrawn from the experiment at 2, 3, 4, 6 months after the operation. This report contains results of the macroscopic and microscopic analyses revealing the character of cartilage tissue regeneration at various timepoints post-surgery. The collagen membranes proved to have a high biological potential and a capacity to transform into cartilage tissue. The cartilages were identifiable from the 3rd month of the study. Their thickness was growing significantly (p < 0.05) up to the 4th month post-surgery, gaining 18.7% in group 1 and 12.8% in group 2; afterwards, the formed tissue "matured". We have shown that the AMIC technique allows significant (p < 0.05) reduction of the bone tissue destruction area.

Received: 2021-07-19

Published online: 2021-08-20

DOI: 10.24075/brsmu.2021.038

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VIEWS 2222

Malgina NV, Dolgina TYu, Epifanova AD, Rodoman GV

Due to advances in medical science, the frequency of surgical interventions that once ended in end-stoma formation has decreased significantly. An ostomy is a life-saving surgery performed when there are no other options. Unfortunately, the number of patients with life-threatening conditions requiring colostomy or ileostomy is growing. A stoma in itself is a cause of social alienation; stoma-associated complications reduce the quality of life and debilitate the patient. The aim of this study was to assess the effectiveness of hybrid intraperitoneal mesh repair of paracolostomy hernia using a modified EUROQOL 5D-5L questionnaire. Sixty patients with paracolostomy hernias included in the study were divided in 2 groups (30 persons per group). The experimental group (10 (33%) men and 20 (67%) women) and the control group (11 (37%) men and 19 (63%) women) were comparable in terms of sex (р = 0.787) and age (66.5 (62.2; 72.0) years vs. 65.0 (61.25; 71.75) years, respectively; р = 0.246). Patients included in the control group underwent a classic Sugarbaker procedure; the experimental group underwent hybrid intraperitoneal mesh repair. The quality of life of the patients was evaluated before surgery and then 1 and 2 years after surgery using a modified EUROQOL 5D-5L questionnaire. Hybrid intraperitoneal mesh repair proved to be effective in the early and late postoperative periods. Based on the significant improvement of the patients’ quality of life after hybrid intraperitoneal mesh repair, we conclude that this technique is an effective surgical treatment for paracolostomy hernias.

Received: 2021-07-10

Published online: 2021-08-17

DOI: 10.24075/brsmu.2021.037

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VIEWS 2093

Osikov MV, Ageeva AA, Fedosov AA, Ushakova VA

The development of novel local therapies for thermal burns (TB) and their pathogenetic rationale are a pressing challenge. Melatonin (MT) is an endogenous factor of hemostasis regulation with pleiotropic potential. The aim of this study was to assess some parameters of tissue regeneration, the functional state of mast cells and the levels of matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) in the experimentally induced TB treated with the original MT-enriched dermal film (DF). A second-degree burn (3.5% of the total body surface area) was modelled by exposing a patch of skin to hot water. Applications of 12 cm2 DF enriched with 5 mg/g MT were performed every day for 5 days. The following parameters were calculated: the wound area, the rate of wound epithelization, the number of MC in the wound, the intensity of degranulation, and the levels of MMP-9 and VEGF expression. Over the course of treatment, the absolute wound area shrank by 35%, its epithelization rate increased, the number of MC rose, their functional state changed, and the expression of ММР-9 and VEGF increased. A negative correlation was established between the wound area and the expression of ММР-9 and VEGF, as well as between the wound area and the degranulation coefficient. Applications of MT-enriched DF resulted in the reduction of the wound area, higher epithelization rate, an increase in the total MC count and degranulation intensity on days 5 and 10; it also led to a reduction in the total MC count and a loss in degranulation intensity on day 20 (166.87 (154.95; 178.78) un/mm2 vs. 464.84 (452.92; 476.76) un/mm2) in the group of intact animals), an increase in MMP-9 expression on day 5 (14.20 (11.30; 18.10) vs. 3.30 (2.20; 4.40) in the intact group), an increase in VEGF expression on days 5 and 10 (33.00 (30.20; 34.90) vs 25.40 (22.20; 29.30) in the intact group), and a reduction in MMP-9 expression on days 10 and 20 after thermal injury.

Received: 2021-06-28

Published online: 2021-08-07

DOI: 10.24075/brsmu.2021.035

Comments 0

VIEWS 2208

Plotkin DV, Vinogradova TI, Reshetnikov MN, Ariel BM, Zyuzya YuR, Zhuravlev VYu, Sinitsyn MV, Bogorodskaya EM, Yablonsky PK

The prevalence of tuberculous peritonitis that has been observed in the recent decades is the result of lymphohematogenous spread of Mycobacterium tuberculosis (MBT) from lungs and other extrapulmonary sources. It is still unclear why certain organs and anatomical regions get involved in the inflammatory process during generalization of the tuberculosis infection. Why do some cases develop into peritoneal tuberculosis and other into kidney tuberculosis? Thus study aimed to investigate the pathogenesis of tuberculous peritonitis in a reproducible biological model. Tuberculous peritonitis was modeled in 18 rabbits (10 in the test group, 8 in control) by intraperitoneal inoculation of the MBT suspension. In order to suppress peritoneal macrophages and major cytokines, test group rabbits were injected with the TNFα inhibitor and iron (III) hydroxide sucrose complex before being infected, while control group rabbits received no immunosuppressive drugs. Autopsy of the control group animals revealed changes characteristic of pulmonary tuberculosis in 37.5% of cases, with no damage to other organs and systems registered. Conversely, test group rabbits had the signs of tuberculous peritonitis in their abdominal cavities. The results of this study suggest that it is the local immunity of an anatomical area that largely determines whether a secondary focus of extrapulmonary tuberculosis infection will develop there or not. For the peritoneum, a smaller pool of peritoneal macrophages and weaker cytokine production is a necessary and sufficient condition to have tuberculous peritonitis developing therein.

Received: 2021-06-30

Published online: 2021-08-04

DOI: 10.24075/brsmu.2021.036

Comments 0

VIEWS 2298