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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Gavisova AA, Shevtsova MA, Lvova PO, Biryukova DA, Ibragimova MH, Novoselova AV, Yushina MN, Chagovets VV, Frankevich VE

Diminished ovarian reserve (DOR) represents a relevant issue of reproductive medicine that is often associated with infertility and reduced efficacy of IVF programs. The changes in amino acid metabolism can play a role in the DOR pathogenesis as manifestations of the folliculogenesis and oogenesis epigenetic alterations. The study was aimed to assess alterations of amino acid metabolic pathways in blood plasma and follicular fluid and estimate their clinical significance in DOR. A total of 115 infertile women aged 25–42 years were included in the study. Groups were formed based on the ovarian reserve and age. Amino acid levels in blood plasma and follicular fluid were assessed by high performance liquid chromatography–mass spectrometry (HPLC-MS); bioinformatics analysis of amino acid metabolic pathways was performed. We revealed significant changes in the phenylalanine, tyrosine and tryptophan biosynthesis (effect = 0.5; p = 0.026), alanine, aspartate and glutamate metabolism (effect = 0.114; p = 0.013), and arginine biosynthesis (effect = 0.289; p < 0.001) pathways playing a role in folliculogenesis, oogenesis, and embryogenesis. The detected differences in the amino acid levels in various body fluids made it possible to construct the logistic regression models confirming DOR with the 88% probability based on the amino acid levels in follicular fluid (sensitivity 88%, specificity 84%) and 82% probability based on plasma levels (sensitivity 65%, specificity 91%). The findings can be used for further research focused on the pathogenesis of infertility associated with DOR and for selection of the most optimal diagnostic and treatment tactics.

Received: 2024-03-27

Published online: 2024-04-30

DOI: 10.24075/brsmu.2024.016

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VIEWS 734

Borisova OYu, Andrievskaya IYu, Pimenova AS, Gadua NT, Chagina IA, Borisova AB, Chaplin AV, Alekseeva IA, Kafarskaya LI

Vaccination is an effective means of preventing pertussis infection. The purpose of this work was to improve vaccines available in the Russian Federation in general and actualize vaccine strains used for the production thereof in particular. We studied B. pertussis strains isolated in Moscow, Voronezh, Novosibirsk, Ulyanovsk and Chelyabinsk regions, and eight production strains part of the adsorbed diphtheria-pertussis-tetanus (DPT) vaccine. Multilocus antigenic sequence typing (MAST) and whole genome multilocus sequence typing (wgMLST) were used for genotyping. We studied cultural morphological, enzymatic, serological, and genotypic properties of the candidate B. pertussis strains, and compared their genotypic properties to those of B. pertussis vaccine strains from the current composition of the DPT vaccine. Candidate strains belong to four genotypes: ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-2/prn2, ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-2/prn9, ptxА1/ptxВ2/ptxС2/ptxР3/fim2-1/fim3-1/prn1 and ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-1/prn2. Current vaccine strains were from other six genotypes: ptxА2/ptxВ1/ptxС1/ptxР1/fim2-1/fim3-1/prn1, ptxА2/ptxВ2/ptxС1/ptxР2/fim2-1/fim3-1/prn1, ptxА4/ptxВ1/ptxС1/ptxР2/fim2-1/fim3-1/prn1, ptxА2/ptxВ2/ptxС1/ptxР1/fim2-1/fim3-1/prn1, ptxА4/ptxВ2/ptxС1/ptxР2/fim2-1/fim3-1/prn1 and ptxА1/ptxВ2/ptxС1/ptxР1/fim2-1/fim3-1/prn1. With the help of wgMLST, we established affiliation of all candidate strains of B. pertussis to ST2.

Received: 2024-04-09

Published online: 2024-04-30

DOI: 10.24075/brsmu.2024.017

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VIEWS 803

Vlasova AV, Kulichenko TV, Smirnova EV

The POPI criteria (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions) for assessment of treatment of comorbidities, complications and underlying conditions in children that are accepted as the only existing instrument for detection of potentially inappropriate prescriptions, make it possible to evaluate prescriptions in children at the inpatient and outpatients stages of care provision, similar to the Beers criteria for adults. The study was aimed to assess the structure and rate of potentially inappropriate prescribing in the pediatric anesthesiology and resuscitation department of the multidisciplinary children's hospital based on the adapted version of POPI criteria for non-antibiotic concomitant therapy of nosocomial infections. We analyzed 305 cases of non-antibiotic medication prescription per 100 patients included. The rate of potentially inappropriate prescribing was 31 cases (10.5%), among which potentially inappropriate medication was prescribed in 29 cases (9.5%), and potentially missed medication took place in three cases (1%). The highest rate of potentially inappropriate prescribing was reported for respiratory diseases. Assessment of concomitant therapy in the critically ill children with infections revealed no significant effects on the rate of adverse reactions to antibiotics in children. In the context of implementing medical information systems (MIS) and prescription sheets, integration of the adapted POPI criteria is topical in terms of maintaining the quality and safety of drug therapy for treatment of concomitant diseases, conditions, and complications in children.

Received: 2024-02-21

Published online: 2024-04-30

DOI: 10.24075/brsmu.2024.018

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VIEWS 810

Nikishina VB, Petrash EA, Engel EYa, Simonenko IA, Shagina ED

Functional assessment of higher mental functions in case of intoxication or during treatment will make it possible to identify predictors of the symptoms of hepatic encephalopathy associated with portal hypertension. The study was aimed to determine the diagnostic predictors of the emergence of the earliest symptoms of hepatic encephalopathy in adolescents with portal hypertension. The study involved 60 adolescents aged 13–17 years: 28 males, 32 females. The experimental group included 30 adolescents with the diagnosis К76.6 Portal hypertension, unspecified form. The control group included 30 adolescents with normal somatic status, who had no mental disorders, traumatic brain injuries or severe infectious diseases of the brain (based on the records of the annual check-up). The studied groups were matched by sex, age, and social status. The proprietary method, Tobii EyeX hardware and software system (GazeControl software), and Cambridge Face Memory Test for Children (CFMT-C) were used. It has been found that recognition of single face images, multiple face images, and multiple face images camouflaged with noise by adolescents with portal hypertension is associated with the greater efforts (manifested in the increased number and duration of gaze fixations), than recognition of the above by adolescents with normal somatic status. The accuracy of recognition of single face images, multiple face images, and multiple face images camouflaged with noise shown by adolescents with portal hypertension experiencing the toxic effects associated with manifestations of hepatic encephalopathy is significantly reduced compared to that shown by adolescents with normal somatic status. The results obtained can be considered as the diagnostic predictors allowing one to trace the changes in the hepatic encephalopathy severity at various stages of treatment (including after surgical intervention).

Received: 2024-03-11

Published online: 2024-04-30

DOI: 10.24075/brsmu.2024.015

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VIEWS 752

Kolomiets KV, Afashagova ZR, Erendzhenova DE, Bashirova AS, Falchari VV, Babayeva NE, Aliyeva AD, Kurmalieva RZ, Fedoseyev YB

Breast cancer (BC) remains the main oncological pathology in the female population. Liver metastases in such cases mean an extremely unfavorable prognosis of the course of the disease. The key predictor of clinical outcome of metastatic BC is the molecular biological subtype of the tumor. The main goals of treatment of metastatic BC are to increase life expectancy, alleviate tumor-related symptoms, and maintain or improve patients' quality of life. Transarterial chemoembolization (TACE) enables new ways of liver metastases control. This article presents a case of application of TACE in combination with hormone therapy and selective inhibitors of CDK4/6 in a patient with unresectable liver metastases seeded by hormone-receptor positive (ER+/PR‒) breast carcinoma with an unknown Her2 status (2+). The approach allowed achieving regression of the oncological process in the liver to the point of unclear CT visualizations of metastatic foci, and proper disease control in the course of 28 months.

Received: 2024-02-19

Published online: 2024-04-29

DOI: 10.24075/brsmu.2024.014

Comments 0

VIEWS 785

Zavorotnyuk DS, Sorokin AA, Bormotov DS, Eliferov VA, Bocharov KV, Pekov SI, Popov IA

Radical tumor resection is still the most effective treatment method for brain tumors. The problems of intraoperative monitoring are currently solved using positron emission tomography, magnetic resonance imaging, and histochemical analysis, however, these require using expensive equipment by highly qualified personnel and are therefore still not widely available. As an alternative, it is possible to use mass spectrometry methods without sample preparation and then the analysis of mass spectrometry data involving the use of machine learning methods. The spectra that are more rich and diverse in terms of peak number are typical for mass spectrometry without sample preparation, therefore the use of this method requires specific pre-processing of experimental data. The study was aimed to develop the methods to determine the optimal parameter values for pre-processing of the data acquired by ambient ionization mass spectrometry. The paper presents two such methods and provides specific parameter values for the data acquired using the Thermo LTQ XL Orbitrap ETD mass spectrometer.

Received: 2024-12-19

Published online: 2024-04-27

DOI: 10.24075/brsmu.2024.013

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VIEWS 748

Egiazaryan KA, Danilov MA, Abdusalamov RM

Injections of platelet-rich plasma are considered to be a promising treatment. Medicines acting on the subchondral bone can improve tissue's structure and slow down destruction of the articular cartilage. This study aimed to analyze the results of intraarticular and intraosseous administration of platelet-rich plasma (PRP) in gonarthrosis cases. One hundred and eighty-seven participants (gonarthrosis stages 1 through 3) were divided into three groups. Group 1 (treatment group) received intraarticular PRP injections, group 2 (comparison group) — intraosseous PRP injections. For assessment purposes, we used the SF-36 survey and visual analog scale. Three months after the treatment, initial pain level decreased in both groups 1 and 2. In group 1, the prevalence of synovitis went down after 3 months, in group 2 — after 6 months (21.9 and 31.3%, respectively; p < 0.05). Six months after the treatment, soft tissue swelling around the joint was registered less often in groups 1 and 2 (8.2 and 8.3%, respectively). As for the physical component of the quality of life, it improved in group 1 after 3 months (70.40%), in group 2 — after 6 months (69.80%); as for the mental component, the dynamics was acknowledged positive 3 months after the treatment in groups 1 and 2 (64.30 and 65.10%, respectively), and 6 months after the treatment (65.10 and 66.40%, respectively). Thus, administration of PRP in gonarthrosis cases attenuate pain and improves the quality of life. In terms of alleviation of the clinical symptoms and improvement of the physical component of patients' lives, intraosseous PRP injections performed significantly better.

Received: 2024-01-30

Published online: 2024-04-19

DOI: 10.24075/brsmu.2024.012

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VIEWS 716

Aptekar IA, Abramova EV, Postnikov MA, Kopetskiy IS, Eremin DA, Postnikova EM, Poluianova EB, Aptekar VI, Muravyov IO

Contemporary approaches to orthodontic treatment are complex: in complicated cases, they combine removable/fixed orthodontic appliances and surgical treatment, i.e., extraction of permanent teeth. In order to prevent negative outcomes and complications that can follow correction of dentofacial abnormalities and deformities, children and adults alike need to be thoroughly examined and prepared to the orthodontic stage of treatment. Many studies point to the relationship between orthodontic treatment and development of somatic dysfunctions. The purpose of this work was to develop an osteopathic disorders correction algorithm that can be introduced to an interdisciplinary protocol uniting efforts by an osteopath and an orthodontist with the aim to improve the quality of specialized orthodontic medical care.

Received: 2024-01-15

Published online: 2024-04-14

DOI: 10.24075/brsmu.2024.011

Comments 0

VIEWS 686