Vol 77, No 4 (2022)

GASTROENTEROLOGY: CURRENT ISSUES

Modern Radiation Diagnostics and Intelligent Personalized Technologies in Hepatopancreatology

Kаrmаzаnovsky G.G., Kondratyev E.V., Gruzdev I.S., Tikhonova V.S., Shantarevich M.Y., Zamyatina K.A., Stashkiv V.I., Revishvili A.S.

Abstract

Timely instrumental diagnosis of diseases of the hepatopancreatoduodenal region, especially of an oncological nature, is the key to successful treatment, improving prognosis and improving the quality of life of patients. At the moment, the possibilities of radiation diagnostics make it possible to identify and evaluate the nature of the blood supply to the neoplasm, its prevalence, cellularity, and in the case of MRI studies with hepatospecific contrast agents, also evaluate the functional activity of liver cells. Nevertheless, the steady development of methods for treating cancer patients, in particular, chemotherapy, and a personalized approach to the choice of patient management tactics require a detailed assessment of the morphological types of certain neoplasms. The need for dynamic monitoring of the results of treatment, monitoring of accidentally detected, potentially malignant neoplasms, and the development of screening programs determine the steady increase in the number of CT and MR examinations performed annually in the world and in our country. These factors have led to the application of texture analysis or radiomics and machine learning algorithms. At the same time, such techniques as radiography, ultrasound, CT and MRI with extracellular and tissue-specific contrast enhancement, and MRI-DWI do not lose their significance. The ongoing research allows the Federal State Budgetary Institution National Medical Research Center of Surgery named after A.V. Vishnevsky of the Ministry of Health of Russia to implement the concept of preoperative non-invasive diagnosis and differential diagnosis of surgical and oncological diseases of the hepatopancreatoduodenal region and apply the knowledge gained in planning surgical treatment. Implementation of the problem of post-processor data processing of radiation diagnostics of surgical and oncological diseases of the hepatopancreatoduodenal region using radiomics and AI technologies is important and extremely relevant for modern medicine.

Annals of the Russian academy of medical sciences. 2022;77(4):245-253
pages 245-253 views

INFECTIOUS DISEASES: CURRENT ISSUES

COVID-19 in Russia: Epidemiology and Molecular Genetic Monitoring

Akimkin V.G., Semenenko T.A., Ugleva S.V., Dubodelov D.V., Kuzin S.N., Yacyshina S.B., Khafizov K.F., Petrov V.V., Cherkashina A.S., Gasanov G.A., Svanadze N.K.

Abstract

Background. The COVID-19 pandemic has exposed health problems, but at the same time has become a powerful impetus for the development of new scientific research in the field of epidemiology, clinic of infectious diseases, diagnostics, bioinformatics and digital methods. On the basis of the Central Research Institute of Epidemiology of Rospotrebnadzor, new unique test systems for the detection of SARS-CoV-2 RNA based on real-time PCR based on loop isothermal amplification (IT) technology have been developed, which allows you to examine samples 3–4 times faster than those developed previously. The Central Research Institute of Epidemiology of Rospotrebnadzor has developed and put into operation the Russian Platform for Aggregation of Information on Virus Genomes (VGARus). The VGARus database contains information about the nucleotide sequences of the SARS-CoV-2 viruses and their mutations, and the SOLAR Integration Platform has been created to quickly transfer the results of PCR studies to all interested citizens of the Russian Federation.

Aims – to study the manifestations of the epidemic process of COVID-19 and the prevalence of genovariants of the SARS-CoV-2 virus in the Russian Federation.

Methods. A retrospective epidemiological analysis of the incidence of COVID-19 was carried out from March 30, 2020 to May 17, 2022 in the Russian Federation. The database was formed on the basis of the materials of the Rospotrebnadzor report form No. 970 “Information on cases of infectious diseases in persons with suspected new coronavirus infection”, data from the WHO, the domestic information portal Stopkoronavirus.rf and the Yandex DataLens data visualization and analysis service were used, information on SARS-CoV-2 genovariants in the VGARus database.

Results. When analyzing the manifestations of the COVID-19 epidemic process in the Russian Federation for 2020–2022. Two stages have been identified. The first stage was characterized by the rapid spread of the SARS-CoV-2 virus from megacities to other regions of the country and the use of non-specific prevention measures. The beginning of the second was due to the evolution of the SARS-CoV-2 virus and a change in its biological properties, followed by a change in the prevailing genovariants on the territory of the Russian Federation.

Conclusion. As a result of the study, it was found that with each subsequent increase in the incidence of COVID-19, there was a decrease in the severity of the course and the proportion of pneumonia in the structure of the clinical forms of the disease.

Annals of the Russian academy of medical sciences. 2022;77(4):254-260
pages 254-260 views

CARDIOLOGY AND CARDIOVASCULAR SURGERY: CURRENT ISSUES

The Relationship between Inflammation and Hemostasis Disorders in Cardiovascular and Infectious Diseases

Bykov V.V., Vengerovskii A.I., Udut V.V.

Abstract

Thrombosis and inflammation develop concomitantly during inflammatory, cardiovascular and infectious diseases. Thrombosis induces inflammation and immune system disruption, while inflammation leads to increased hemostasis a vascular thrombosis. Combined use of anti-inflammatory and antithrombotic drugs often leads to adverse effects, for example, nonsteroidal anti-inflammatory drugs induce gastric ulcers, aggravated by bleeding. Vascular endothelial dysfunction plays an important role in the development of thrombosis and inflammation, therefore, research and development of drugs improving endothelial function is a promising approach to preventing thrombotic events arising from inflammation or infectious disease.

Annals of the Russian academy of medical sciences. 2022;77(4):261-266
pages 261-266 views

NEUROLOGY AND NEUROSURGERY: CURRENT ISSUES

Modern Neurosurgery — the Multidisciplinary Integration of Competences an Technologies

Usachev D.Y., Konovalov A.N., Potapov A.A., Pronin I.N., Konovalov N.A., Golanov A.V., Danilov G.V., Kobyakov G.L., Shkarubo A.N.

Abstract

Modern neurosurgery is based on the complex integration of basic and applied neurosciences and technologies. A significant number of different diagnostic and therapeutic approaches are used to prolong a patient’s life and preserve its quality to the maximum. At the same time, neurosurgery is the only clinical discipline providing direct access to the living human brain. A large body of information on the nervous system state and pathology, routinely generated in neurosurgery, attract specialists from the related medical and biological sciences. Such close cooperation of physicians, biologists, chemists, physicists, mathematicians, engineers, and other specialists ensures rapid and continuous improvement of neurosurgical treatment. This article highlights the spectrum of technologies in modern neurosurgery, the research tasks facing this specialty, and briefly the activities of the National Medical Research Center for Neurosurgery named after academician N.N. Burdenko — the leading neurosurgical institution of the Russian Federation — in priority clinical and scientific areas.

Annals of the Russian academy of medical sciences. 2022;77(4):267-275
pages 267-275 views

PEDIATRICS: CURRENT ISSUES

Non-Invasive Prenatal Testing: the International Experience of Medical and Economic NIPT Efficiency Evaluation

Kaplanova M.T., Galaktionova A.M., Baranova E.E., Sagaydak O.V., Belenikin M.S., Denisov A.G.

Abstract

Non-invasive prenatal testing (NIPT) is a molecular genetic method of cell-free fetal DNA fetal chromosomal abnormalities risks assessing. Currently, NIPT is quite widespread throughout the world, and its clinical efficacy — high sensitivity and specificity — has been repeatedly proven. At the same time, the decision to include NIPT in the algorithm of prenatal diagnostics carried out with public funds depends on its cost-effectiveness, which should be assessed separately for each country or territory due to different costs and different models of inclusion. This article presents the different countries approaches to the assessment of the medical and economic efficiency of NIPT.

Annals of the Russian academy of medical sciences. 2022;77(4):276-284
pages 276-284 views

PHYSIOLOGY: CURRENT ISSUES

Study of Generation of Singlet Oxygen in Human Saliva in vitro Under the Action of Nanosecond Pulsed Laser Radiation

Yanushevich O.O., Maev I.V., Bazikyan E.A., Chunikhin A.A.

Abstract

Background. The development of new laser devices for use in the treatment of complex dental pathology and microsurgery of the oral cavity with unique parameters with the ability to generate nanosecond pulsed radiation in a quasi-monochromatic radiation band is necessary. The high peak output power per pulse allows laser light to penetrate deeper into biological media without significant heating. The possibility of excitation of singlet oxygen without the use of endogenous photosensitizers is an indisputable advantage of such laser generators.

Aims — study of singlet oxygen generation in human oral fluid in vitro depending on the parameters of nanosecond pulsed laser radiation with a wavelength of ~1265 nm.

Methods. We used a laser device with a main infrared (IR) emitter with a wavelength approximately corresponding to the oxygen absorption maximum (~1265 nm) with the generation of nanosecond pulsed radiation. A study was carried out to study the generation of singlet oxygen in the human oral fluid and the washing out of the oral fluid by the fading of the trap in solutions under the action of laser radiation before irradiation, after 30 and 60 min. The laser radiation parameters were set as follows: power 1 W, nanosecond pulsed radiation with a pulse duration of 400 ns and a frequency of 0.5, 1.0, 1.5 and 2.0 MHz in comparison with the continuous radiation mode.

Results. It has been established that nanosecond laser radiation leads to the oxidation of a chemical singlet oxygen trap solubilized with sodium dodecyl sulfate (0.05 M SDS) detergent in the oral fluid and saliva flushing from the oral cavity. In pulsed nanosecond modes, laser radiation is more efficient than in continuous mode. With an increase in the repetition frequency, an increase in the effect by an average of 10% compared to a lower frequency was observed and the effect with a maximum frequency of 2.0 MHz was almost 50% higher than when using continuous radiation in all studies. A decrease in optical density at 414 nm was reliably observed in samples with oral fluid washing, the effect was 0.07 ± 0.01 for 60 min of exposure. In the oral fluid, the effect with the same parameters was slightly lower and amounted to 0.05 ± 0.03.

Conclusions. The rate of fading of the trap in the saliva wash turned out to be 1.3 times faster than in water with detergent, which may indicate the activation of photoacceptors and their oversaturation with oxygen when using aqueous dilution of the oral fluid. The maximum effect was observed when using laser radiation with a pulse repetition rate of 2.0 MHz.

Annals of the Russian academy of medical sciences. 2022;77(4):285-290
pages 285-290 views

EPIDEMIOLOGY: CURRENT ISSUES

COVID-19 in Russia: Evolution of Views on the Pandemic. Report II

Starodubov V.I., Beregovykh V.V., Akimkin V.G., Semenenko T.A., Ugleva S.V., Avdeev S.N., Zykov K.A., Trofimova T.N., Pogosova N.V., Perekhodov S.N., Kuzin S.N., Yacyshina S.B., Petrov V.V., Khafizov K.F., Dubodelov D.V., Gasanov G.A., Svanadze N.K., Cherkashina A.S., Sinitsyn E.A., Rvacheva A.V., Sergeeva N.V., Polosova T.A., Zykova A.A., Zelenin D.A., Gorbenko M.Y., Rodyukova I.S., Chaus N.I., Snitsar A.V.

Abstract

Over the two years of the novel coronavirus infection (COVID-19) pandemic, there has been an evolution of views in various fields of medicine, which has led to a powerful development of scientific research in the field of epidemiology, clinic, diagnosis and therapy of COVID-19. This article discusses the evolution of views and approaches to the study of the clinic and therapy of COVID-19. The symptoms and aggravation of the course of cardiovascular diseases with COVID-19 have been established. The main strategy for organizing surgical care for patients with COVID-19 is indicated. The main criteria for the treatment of COVID-19, the need to prescribe SGCS on an individual basis, and the need to search for new methods of anti-inflammatory therapy for COVID-19, one of which may be the use of alkylating drugs in ultra-low doses, are described.

Annals of the Russian academy of medical sciences. 2022;77(4):291-306
pages 291-306 views

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