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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Vechorko VI, Anosov VD, Silaev BV

Emergency surgery in the infectious diseases hospital is an urgent problem during the COVID-19 pandemic. Municipal Clinical Hospital No.15 named after O. M. Filatov has been providing emergency surgical care after conversion, from March 27, 2020 until now. The hospital’s medical staff has built up extensive experience: 194 surgical procedures were carried out in April, and 289 surgical procedures were carried out in May 2020. The paper reports the experience of emergency surgery at the stage of conversion to an infectious diseases hospital. Among all hospitalized patients, 482 (5.29%) people had acute surgical pathology requiring emergency surgery. Among patients who underwent urgent surgery, 472 (98%) people had the caused by COVID-19 community-acquired pneumonia of various degrees of severity. The paper discusses some features of acute surgical pathology and complications identified in patients with COVID-19. The surgical care features in the hospital after conversion are proper epidemiological regime implementation, minimization of the number of staff in the operating room, possible minimization of the number and reduction of the duration of surgical procedures. The most important challenge during the COVID-19 pandemic is medical staff safety.

Received: 2020-06-15

Published online: 2020-06-29

DOI: 10.24075/brsmu.2020.038

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VIEWS 4763

Milushkina OYu, Popov VI, Skoblina NA, Markelova SV, Sokolova NV

Transition to distance education in spring 2020 led to the overuse of information and communication technologies by the participants of the educational process. The aim of this study was to characterize the patterns of using electronic devices in high school students, their parents, and teachers in the settings of traditional brick-and-mortar education and distance learning. We created online questionnaires that were used to survey 200 high school students, 389 teachers and 251 parents before the transition to distance learning and also 658 teachers and 500 parents after the transition. Statistical analysis was conducted using Student’s t test, χ2, and Pearson’s contingency coefficient; relative risks were calculated using fourfold contingency tables. Differences were considered significant at p ≤ 0,05. After the transition to distance learning, the number of electronic devices used by each student increased for 96.6% of the surveyed students; the average screen time also increased. About 80% of the surveyed parents reported that their children had more health complaints; of them, 60% reported symptoms typical of computer vision syndrome. We established a correlation between the readiness to cut down on screen time and the subjective assessment of vision as perfect or good by the respondents (Pearson’s contingency coefficient 0.3; p ≤ 0.05). Our study confirms the relative risk for subjectively assessing one’s vision as satisfactory or poor in individuals who use ED on a daily basis; the risk is 1.13 for students, 1.41 for parents, and 1.27 for teachers (p ≤ 0.05). The study proves that eliminating screen time from daily activities for at least one day per week is an effective measure for preventing vision disorders.

Received: 2020-05-14

Published online: 2020-06-28

DOI: 10.24075/brsmu.2020.037

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VIEWS 4903

Semeshkin AA, Vechorko VI, Silaev BV, Levchuk NN, Polikarpova SV, Averkov OV

Immunity against the novel coronavirus infection in neonates born to mothers with PCR-confirmed COVID-19 is an understudied field of research. The aim of this study was to analyze the levels of IgM and IgG antibodies against SARS-CoV-2. The study was carried out in 20 mothers aged 19 to 39 years and 21 neonates (including a pair of twins). Babies born to mothers with elevated IgM and IgG against SARS-CoV-2 also had elevated IgG. There is a hypothesis that anti-SARS-CoV-2 IgM are not passed on to the child across the placenta. In all cases studied in this work, neonates were PCR-negative for the virus, which suggests the absence of vertical COVID-19 transmission. Further research is needed.

Received: 2020-05-26

Published online: 2020-06-26

DOI: 10.24075/brsmu.2020.036

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VIEWS 4201

This paper briefly presents the known data on the immune response to SARS-CoV-2, and also analyzes the possibilities and limitations of serological testing for antibodies that should be accounted for when planning population studies and interpreting their results.

Received: 2020-06-01

Published online: 2020-06-23

DOI: 10.24075/brsmu.2020.035

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VIEWS 5794

Prikhodko VA, Sysoev YuI, Poveryaeva MA, Bunyat AV, Karev VE, Ivkin DYu, Sukhanov DS, Shustov EB, Okovityi SV

Non-alcoholic fatty liver disease (NAFLD) is a chronic condition characterized by disturbed carbohydrate and lipid metabolism and often complicated by psychoneurological symptoms, including anxiety, depression, memory deficit, and asthenia. Most studies of pharmacotherapy candidates for NAFLD focus on the ability of the tested drugs to restore the biochemical functions and morphology of the liver while their potential effects on the co-existing conditions remain overlooked. The aim of this paper was to investigate the effects of empagliflozin and L-ornithine L-aspartate (OA) on behavior, memory, and physical performance in C57BL/6 mice with experimentally induced NAFLD (6 months of a Western diet + weekly carbon tetrachloride injections). The disease affected animal behavior (locomotion speed decreased by 38% and 35%, p < 0.01; rearing increased by 432% and 279%, p < 0.05 etc.), induced long-term memory deficit (latency to find the target box increased by 108% in the Barnes maze, the number of errors increased by 439%, p < 0.05), and compromised physical performance (swimming time in the forced swim test dropped by 50%, p < 0.05 etc.). When administered during the high-calorie diet period, both drugs reduced anxiety (empagliflozin: the number of grooming bouts rose by 160%, p < 0.05 and 2173%, p < 0.01; time spent in the light compartment in the light/dark box test increased by 275%, p < 0.05, etc.; OA: time spent in the open arms of the maze increased by 267%, p < 0.05), and promoted memory retention in mice with NAFLD. OA improved physical performance (swimming time in the forced swimming test improved by 106%, p < 0.05, etc.). Thus, empagliflozin and OA can have a beneficial effect on cognitive functions, as well as behavior, and ameliorate asthenia in NAFLD.

Received: 2020-05-22

Published online: 2020-06-22

DOI: 10.24075/brsmu.2020.034

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VIEWS 5317

Shchagina OA, Semenova NA, Bessonova LA, Larshina EA, Beskorovainiy NS, Zakharova EYu, Ryzhkova OP, Poliakov AV

Microcephaly-capillary malformation syndrome (MICCAP: OMIM 614261) is a severe monogenic disorder inherited in an autosomal recessive manner caused by mutations in the STAMBP gene. There are less than 20 published cases of the syndrome to date. The paper reports three new cases of rare MICCAP syndrome. The cause of the disorder was confirmed in three affected individuals from two unrelated families by pedigree analysis, biochemical analysis, RFLP analysis and automated Sanger sequencing. The two brothers were homozygous for the potentially pathogenic STAMBP gene variant c.188A>G (p.Tyr63Cys). Clinical phenotype of the girl from the second family resulted from the combination of two genetic disorders: galactosemia caused by the compound heterozygosity for the pathogenic GALT gene variants (c.563A>G and c.855G>T), and MICCAP caused by the STAMBP gene variants (c.204-5C>G and с.668_669delCA), one of which originated de novo. The prevalence of microcephaly-capillary malformation syndrome in Russia is evaluated, it is one per 120,000 people (CI: 1/356 724–1/62 691). The carrier frequency is one per 173 people. The target STAMBP gene analysis makes the genetic confirmation of the MICCAP syndrome quicklier. When determining the tactics of diagnosis and therapy in each particular case, the possibility of combination of two rare genetic disorders in one patient should be considered.

Received: 2020-05-18

Published online: 2020-06-19

DOI: 10.24075/brsmu.2020.033

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VIEWS 4505

Shamina OV, Kryzhanovskaya OA, Lazareva AV, Alyabieva NM, Mayanskiy NA

The increasing use of colistin in the clinic has led to the emergence and spread of colistin resistance. According to the literature, antibiotic resistance can have a metabolic cost, resulting in poor adaptation and survival, i.e. reduced bacterial fitness. The aim of this study was to investigate molecular mechanisms underlying resistance to colistin and their effect on the bacterial fitness of carbapenem-resistant (carba-R) strains of K. pneumoniae isolated from the patients of Moscow hospitals in 2012–2017. Of 159 analyzed carba-R isolates, 71 (45%) were resistant to colistin (minimum inhibitory concentration over 2 mg/L). By conducting Sanger sequencing, we were able to identify the mechanisms underlying colistin resistance in 26 (37%) isolates. Growth curves were constructed by measuring optical density at 600 nm wavelength for 15 hours. The competitive growth of colistin-resistant (col-R) K. pneumoniae isolates was assessed relative to the colistin-susceptible (col-S) isolate. Col-R and col-S cultures harvested in the exponential phase were combined at the ratio of 1:1, incubated in the Luria-Bertani medium and plated onto Luria-Bertani agar plates with 10 mg/L colistin and without it. The competition index was calculated as the ratio of grown col-R and col-S colonies. Resistance to colistin did not affect the growth kinetics of K. pneumoniae, but did reduce the competitive ability of the bacteria as compared to the col-S isolates. However, some col-R isolates were more competitive than the col-S strains of the same sequence type. Further research is needed to elucidate the effects of colistin resistance on bacterial fitness.

Received: 2020-05-18

Published online: 2020-06-12

DOI: 10.24075/brsmu.2020.032

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VIEWS 4407

Belykh NA, Akhkyamova MA, Gusev VV, Lvova OA

Dopa-responsive dystonia (DRD) is a rare progressive genetically heterogenous disorder with pediatric onset. DRD is 3 times as prevalent in women than in men. This article reports a clinical case of DRD in a young female presenting with paraparesis, foot dystonia (more pronounced in the right foot) and pronounced walking impairment, who was admitted for emergency treatment to a Neurology Unit. Based on the additional tests, which included a levodopa trial and Sanger sequencing, the patient was diagnosed with DRD. Levodopa caused a considerable improvement of the symptoms. The article describes the clinical features of the disease, talks about its differential diagnosis, genetic predisposition and treatment strategy.

Received: 2020-05-14

Published online: 2020-06-05

DOI: 10.24075/brsmu.2020.031

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VIEWS 4237