Annals of the Russian academy of medical sciences

The development of accessible and sensitive methods for mutations analysis leading to tumor and for evaluation of patients’ individual genetic characteristics is essential for molecular genetic studies both in clinical and epidemiological research. The Central Research Institute of Epidemiology has developed a set of techniques for the qualitative detection of germinal mutations and single nucleotide polymorphisms, as well as for the quantification of the mutant alleles of somatic mutations using pyrosequencing and real-time PCR. The methods allow identifying the most common mutations in the Russian Federation in the BRCA1, BRCA2, NBN, and CHEK2 genes, responsible for hereditary tumor syndromes, and polymorphisms in the TTC34, MIR146A, CYP1A1, MICA, PAX8, MTHFR, HLA-DQB1, and HLA-DQA1 genes associated with an increased risk of cervical cancer, and in genes involved in drug biotransformation. Quantitative methods are designed to determine somatic mutations in the BRAF, KRAS, HRAS, NRAS, JAK2, MPL and CALR genes in the solid tumors and in hematology. The developed set of scientific and diagnostic techniques is being employed for analysis of genetic polymorphisms and mutations in Russian population. Some of the techniques are available as reagent kits and are used in practice.

In oncology, there is a significant gap in access to advanced treatment methods, such as CAR-T therapy. Despite its high efficacy in treating refractory forms of cancer, CAR-T therapy often faces challenges due to high production costs and complex regulatory conditions. This article analyzes the global experience in CAR-T cell production and regulation, the experience of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology, and Immunology, and the prospects for CAR-T therapy development in Russia. The study identifies key factors for the successful implementation of this technology and develops recommendations for enhancing the regulatory framework and infrastructure. Special attention is given to organizing decentralized CAR-T cell production in medical centers, which we believe ensures quicker access to therapy and the development of local expertise. The study emphasizes the importance of refining the regulatory framework and continuing efforts to improve regulatory conditions and workforce training. The prospects for CAR-T therapy development in Russia are associated with expanding access to this innovative method, which can significantly improve patients’ quality of life and enhance the effectiveness of cancer treatment.

Childhood obesity remains one of the leading health problems. Recommendations for diet therapy and lifestyle changes are not always followed by patients and often do not lead to weight loss. The use of the drug liraglutide is promising in the treatment of childhood obesity. Aims — to evaluate the effectiveness and safety of using a glucagon-like peptide-1 analogue (liraglutide) in the treatment of obesity in children. Methods. A single-center prospective uncontrolled study of the use of liraglutide in children aged 12–18 years with constitutionally exogenous obesity for 12 months was conducted. The dynamics of BMI SDS (a reduction of 0.25 units or more), the presence or absence of obesity complications, complaints, and changes in laboratory indicators during the use of the drug were evaluated. Statistical analysis of the data was carried out with calculations of the arithmetic mean (M), standard deviation (SD), 95% confidence intervals, as well as the median and interquartile range (Me [25; 75]). Results. The study included 68 patients aged 12–18 years with obesity of varying degrees: 14 (20.6%) patients with grade II obesity, 40 (58.8%) children with grade III obesity, and 14 (20.6%) patients with morbid obesity. Comorbid conditions were present in 61 (89.7%) children. Non-alcoholic fatty liver disease (in 60.3% of children) and carbohydrate metabolism disorders (in 41.1% of cases) were more frequently registered in children with morbid obesity (p < 0.05). A reduction in BMI SDS was observed in 76.5% of patients, including 47 children who had a reduction of more than 0.25 kg/m². Three (4.4%) children maintained their weight (BMI SDS dynamics ± 0.05), and 7 (10.3%) patients increased their body mass. After 12 months of therapy, body weight decreased from 100,5 ± 19,7 to 99,2 ± 20,5 kg (р < 0,001), an average reduction of 6 kg (5,7%), and BMI SDS from 3,49 ± 0,66 to 2,82 ± 1,12 kg/m² (р < 0,001), an average reduction of 0,67 kg/m² (19.2%). The incidence of arterial hypertension decreased from 30.9 to 4.8% (p < 0.004), carbohydrate metabolism disorders from 41.1 to 19.4% (p = 0.004), dyslipidemia from 20.6 to 9.7%, and non-alcoholic fatty liver disease from 60.3 to 50%. Gastrointestinal side effects were reported by 10 (14.7%) patients during planned dose escalation, and in 5 patients (7.4%), the maximum tolerable dose was 2.4 mg. Conclusions. Liraglutide has shown good efficacy in the treatment of obesity in children — positive body weight dynamics at the end of therapy after 8–12 months was achieved in 76.5% of patients, 4.4% of children stabilized body weight. The decrease in patients’ body weight was accompanied by an improvement in metabolic parameters and a decrease in the detection of obesity complications. Gastrointestinal side effects were noted in 14.7% of patients during dose escalation and did not require discontinuation of therapy thereafter.

Background. The problem of mental disorders and behavioral disorders around the world has existed for many years, but only in recent decades has it begun to receive more attention, as evidenced by the increasing number of studies devoted to this topic. In order to preserve and strengthen the health of the younger generation, it is necessary to constantly study the incidence of mental disorders and behavioral disorders, due to the impact of many different stress factors on them. Aims — to determine the dynamics of the general and primary incidence of mental disorders and behavioral disorders associated with the use of psychoactive substances in the period from 2016 to 2022, and its prognosis in children aged 15–17 years for 2027. Methods. As a statistical source of information, data from the statistical reporting of the Central Research Institute of the Ministry of Health of the Russian Federation on general and primary morbidity, and the incidence of mental disorders and behavioral disorders associated with the use of psychoactive substances in children aged 15–17 years from 2016 to 2022 were used. Results. The general and primary incidence of mental disorders and behavioral disorders associated with the use of psychoactive substances in children aged 15–17 years in all studied regions in the period from 2016 to 2022 is characterized by a decrease. In the Udmurt Republic, the total and primary morbidity from 2016 to 2021 decreased by 27.8 and 25.4%, respectively. From 2021 to 2022, the indicators increased by 22.6 and 38.2%, respectively. According to data for 2022, the total incidence in the Udmurt Republic is 2.0 times higher than in the Russian Federation (RF), 1.9 times in the Volga Federal District (PFD), 1.1 times in the Republic of Bashkortostan, and 1.8 times in the Kirov Region. The primary incidence in the Udmurt Republic is 2.9 times higher than in the Russian Federation, 2.4 times in the Volga Federal District, 2.9 times in the Republic of Bashkortostan and 3.3 times in the Kirov Region. Conclusions. It was found that the overall incidence of mental disorders and behavioral disorders associated with the use of psychoactive substances in children aged 15-17 years in the dynamics from 2016 to 2021 in the Udmurt Republic is characterized by a downward trend of 27.8%, and from 2021 to 2022 by an upward trend of 22.6%. And the incidence rate with a diagnosis established for the first time in life in 2022, in comparison with 2016, is characterized by an upward trend of 17.2%. The forecast of the general and primary morbidity of mental disorders and behavioral disorders associated with the use of psychoactive substances in children aged 15-17 in the Udmurt Republic for 2027 is less than the indicators of 2022 — by 31.5% (682.7 per 100 thousand children of the corresponding age) and 38.1% (381.7), respectively. In general, we believe that high rates of general and newly identified morbidity of mental disorders and behavioral disorders associated with the use of psychoactive substances in the territory of the Udmurt Republic. The decrease in general and primary morbidity in all the studied regions from 2016 to 2020 and its further growth is associated with the epidemiological situation against the background of the COVID-19 pandemic, which led to a decrease in accessibility and appeal due to epidemic restrictions. High rates and an increase in the general and primary incidence of mental disorders and behavioral disorders in the territory of the Udmurt Republic since 2021 are associated with socio-environmental factors among the young population in the region. It is necessary to further scientifically substantiate their identification in order to develop preventive measures.

The problem of antimicrobial resistance (AMR) has become particularly relevant in countries with developed healthcare systems and intensive agriculture over the past 20 years. According to the UN General Assembly on September 22, 2022, antimicrobial resistance (AMR) is already a global problem, causing almost 5 million deaths per year, and by 2050 the annual number of additional deaths worldwide could increase to 10 million persons per year. Currently, to counter the spread of AMR in the world, a partnership of 4 world organizations (WHO, OIE, FAO and UNEP) has been created, leaving the basis for the global concept of “One Health”, which is an integrated, unifying approach aimed at Sustainably balancing and optimizing the health of people, animals and ecosystems. In order to protect the population, the Government of the Russian Federation adopted the “Strategy for preventing the spread of antimicrobial resistance in the Russian Federation for the period until 2030”. The COVID-19 pandemic has impacted the spread of infections caused by multidrug-resistant bacteria worldwide. On the one hand, restrictions and preventive measures introduced in connection with the COVID-19 pandemic, such as reduced travel, distancing, hand hygiene, and environmental treatment, help reduce the spread of infections; on the other hand, the use of antibiotics in patients with COVID-19 is not always justified has exacerbated the public health threat posed by AMR, and as the pandemic progresses throughout the world, the importance of resistance has increased significantly. The resistance of microorganisms to antimicrobial drugs requires improving measures to prevent and limit the spread and circulation of pathogens with antimicrobial resistance, ensuring systemic monitoring of the spread of antimicrobial resistance, and studying the mechanisms of the emergence of antimicrobial resistance.

28 October 2024 turned 70 years old Igor Borisovich Ushakov — Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, Honored Doctor of the Russian Federation, Chief Researcher of the State Research Center — Burnasyan Federal Medical Biophysical Center of Federal Biological Agency (Moscow).

On September 14, 2024, an outstanding scientist in the field of pediatric oncology, Honored Healthcare Worker of the Russian Federation, head of the Department of Pediatric Oncology named after Academician L.A. Durnov, Federal State Budgetary Educational Institution of the Russian Ministry of Health, Advisor to the Director of the L.A. Durnov Research Institute of Pediatric Oncology and Hematology of the Federal State Budgetary Institution “National Medical Research Center of Oncology named after N.N. Blokhina” Ministry of Health of the Russian Federation, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences Vladimir Georgievich Polyakov.

October 18, 2024 marked the 75th anniversary of the birth of the country’s leading scientist, talented leader and teacher in the field of implantology and maxillofacial surgery, Honored Scientist of the Russian Federation, laureate of the Government of the Russian Federation in the field of science and technology, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences Anatoly Alekseevich Kulakov.