Peer-reviewed journal "Acta Biomedica Scientifica"
Scientific Centre for Family Health and Human Reproduction Problems
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Editor-in-chief’s preface to issue 5, 2025
Experience of using a new medical simulator for correcting spasticity of the upper limb in complex rehabilitation of children with hemiplegic cerebral palsy
Background. The hemiplegic form of cerebral palsy (CP) is the most prognostically promising in terms of the possibilities of correction and social adaptation of disabled children. However, the main limitation of successful rehabilitation is severe limb muscle spasticity, because so reducing muscle hypertonicity is a priority task in this disease. The aim. To evaluate the effectiveness of improved method for correcting of upper limb spasticity in children with the hemiplegic form of CP. Materials and methods. An open, non-randomized, prospective, comparative study was conducted involving two groups of patients with spastic hemiplegia with predominant damage to the upper limb, compared to the case-control type. The control group of children (n = 20) was treated using standard methods – drug therapy, exercise therapy, massage, physiotherapy; the main group (n = 20) was additionally prescribed exercises on the new medical simulator "Glove". The study participants in the groups were compared by gender, age and severity of motor impairment. The course in comprehensive rehabilitation lasted 10 days. The effectiveness of the improved method for correcting upper limb spasticity was assessed by studying the dynamics of motor function indices using scales for assessing muscle tone (modified Ashworth scale) and manual skills (Frenchai and ARAT tests, V.G. Bosykh and N.T. Pavlovskaya method). Results. The additional inclusion of training using the new medical simulator for correcting upper limb spasticity "Glove" in the rehabilitation program for children with hemiplegic CP allowed achieving a significantly better treatment result with a significant decrease in muscle tonus, an increase in the volume and accuracy of movements, including in the section of small differentiated acts, with the elimination of the phenomenon of the «learned non-use» phenomenon. Conclusions. The use of a new medical simulator in the complex therapy of children with spastic hemiplegia allows increasing its effectiveness relative to standard rehabilitation methods. However, the question of the long-term effect remains open and requires an assessment of longer-term use of the simulator in the interhospital period.
Pathogenetic mechanisms of blood-brain barrier dysfunction in preeclampsia
Hypertensive disorders during pregnancy are the most difficult and unresolved problems of modern obstetrics. Today, their frequency ranges from 12 to 40 % and has no downward trend. About 60–70 % of maternal deaths in hypertensive disorders occur due to cerebral complications, due to the development of eclampsia, cerebral edema and stroke. Underestimating the severity of the condition, inadequate treatment and delayed delivery are the main causes of maternal morbidity and mortality. Despite significant advances in understanding the main stages of the pathogenesis of preeclampsia, the mechanisms of damage to cerebral vascular endothelial cells, as well as the features of local paracrine and autocrine regulation of cerebrovascular blood flow in proinflammatory and hypoxic conditions remain relevant for further study. This literature review is devoted to the study of the main mechanisms of disruption and/or damage to the blood-brain barrier in preeclampsia. A systematic analysis of modern Russian and foreign literature was carried out using the information databases eLibrary, Scopus, PubMed, MEDLINE and Cochrane Library for the period from January 2010 to December 2024. Information is provided on the role of vascular endothelial growth factor and its receptor system in increasing transcellular transport, as well as close contact proteins in enhancing the paracellular pathway. The mechanisms of impaired autoregulation of cerebral blood flow leading to the development of vasogenic cerebral edema in preeclampsia and eclampsia are described. Understanding the key links in the pathogenesis of damage to the blood-brain barrier in preeclampsia will allow us to further identify reliable and accessible early predictors of the development of cerebral dysfunction in this complication of pregnancy.
Posttranslational modifications and its role in habitual miscarriage: prognosis, diagnosis and new approaches to therapy
The prevalence of recurrent pregnancy loss (RPL) in women ranges from 1 to 5 %. Among the known causes of RPL, the role of post-translational protein modifications (PTMP) has been studied in recent years. These are protein structure transformations that complete the formation of their molecule or participate in the regulation of the functions of this molecule, catalyzed by specific enzymes. The aim. To assess the role of PTMP in the pathogenesis of RPL, as well as to determine potential biomarkers and therapeutic targets of RPL. Material. A search of publications by keywords was conducted in the electronic databases PubMed/MEDLINE and Google Scholar, published before December 2024. Results. PTMB plays an important role in the processes of trophoblast invasion, endometrial decidualization and embryo implantation, which makes them significant for understanding reproductive dysfunction. The use of mass spectrometry to study PTMB opens up new possibilities for the diagnosis and prognosis of RPL. Epigenetic therapy of RPL demonstrates efficacy and a lower probability of side effects compared to traditional methods. Despite significant prospects, research in this area is accompanied by difficulties associated with heterogeneity of terminology and ethical issues. Conclusion. PTMB in the context of RPL can contribute to the improvement of diagnostic and therapeutic strategies in reproductive medicine. Further development of methodologies for studying PTMB is needed.
Under what conditions is uterine myoma in women of reproductive age associated with the use of combined oral contraceptives?
Uterine myoma (UM) is a common benign tumor of smooth muscle cells of the myometrium, which is often associated with metabolic disorders. Hormonal contraceptives are used to control the duration and volume of menstrual bleeding in UM. At the same time, data on the relationship between the use of combined oral contraceptives (COCs) and uterine myoma are contradictory. The aim. To identify the relationship between uterine fibroids and the use of combined oral contraceptives in women of reproductive age, taking into account their ethnicity and the presence of metabolic disorders. Materials and methods. The results of a re-analysis of a cross-sectional study conducted earlier in Eastern Siberia (2016–2019) are presented. A total of 1347 women of reproductive age (34.33 ± 6.37 years) were included in the study, of which 198 participants had uterine fibroids. The study methods included a questionnaire survey, general clinical and gynecological examinations, pelvic ultrasound, and statistical analysis. Results. It was found that an increase in the likelihood of detecting uterine fibroids is associated with the use of COCs in the presence of metabolic syndrome and only in the Caucasian subpopulation (OR 3.287; 95% CI (1.490; 7.253)). The use of COCs is a factor associated with uterine fibroids in women with a BMI of more than 30 kg/m2, due to the subpopulation of Caucasian ethnicity, for whom the likelihood of having uterine fibroids is 6 times higher when using COCs than when not using COCs (OR 6.253, 95% CI (1.857; 21.054)). For Caucasians, the association between COC use and uterine fibroids was also demonstrated in patients with a BMI of less than 25 kg/m2 (OR 2.521; 95% CI (1.255; 5.064). Conclusion. In women of reproductive age, the association between uterine fibroids and the use of combined oral contraceptives is observed in women of Caucasian ethnicity. The presence of metabolic disorders is a key co-factor in the association between uterine fibroids and the use of hormonal contraceptives.
The influence of blood groups on predisposition to certain diseases: molecular mechanisms and clinical implications (Brief-Review)
The problem of early diagnosis and detection of diseases predictors of various etiologies is relevant. Blood type can act as such a predictor. The research for the relationship between blood type and predisposition to certain diseases will make it possible to identify risk groups for a particular disease and develop preventive measures. One such predictor could become blood type. The relationship between infectious (Cholera, the plague, tuberculosis, smallpox etc.) and non-communicable (oncological, neurodegenerative, cardiovascular, dental diseases etc.) AB0 blood type and other systems such as Rhesus, Lewis is being discussed. Although considerable advancements have been achieved in investigating the mechanisms that facilitate this connection, the inquiry remains unresolved. This review examines the current state of the problem and the alleged mechanisms of the association of various blood groups with a predisposition to certain diseases. The relationship between blood type and oncological diseases has been most studied. The relationship of blood type is discussed not only with certain diseases, but also with typological personality traits, temperament, and response to stressful factors that can predispose to the development of somatic and mental illnesses. Studying the influence of blood groups on predisposition to the development of dental diseases is largely devoted to the relationship of blood type AB0 with periodontal health. There are studies examining the prevalence of caries in people with different blood types. We analyzed more than 100 articles indexed in RSCI, PubMed, and Scopus, mainly over the past 10 years. Forty eight sources were used for the article, of which 16 were published in the last 5 years. Works published earlier than 2005 were excluded from the analysis.
Circulating immune complexes in the pathogenesis of post-COVID joint syndrome
Background. A common manifestation of the post-COVID syndrome is damage to the articular apparatus. Considering the role of circulating immune complexes in the occurrence of postinfectious and immune lesions of joints, as well as their participation in the immunopathogenesis of the acute period of infection, it can be assumed that they are involved in the formation of joint syndrome after COVID-infection. The aim. To assess the involvement of circulating immune complexes in the pathogenesis of various clinical variants of post-COVID joint syndrome. Materials and methods. Sixty two patients with post-COVID syndrome and complaints of damage to the musculoskeletal system were examined. All patients had suffered coronavirus infection during the previous 12 months. All patients underwent radiographic and ultrasound examination of the joints. In the blood serum the total content of IgM, IgG and IgE was determined. Circulating immune complexes in peripheral blood were determined by precipitation method. Results. The post-COVID joint syndrome in the examined patients manifested itself in four variants, which differed clinically and had different immunological characteristics. High levels of circulating immune complexes were detected in arthralgia, arthritis, and the onset of arthropathy and were accompanied by elevated titers of IgM and IgG. With the progression of arthropathy, the circulating immune complexes content in the blood of patients often corresponds to the borderline level with low IgM and IgG values. An increased IgE titer was recorded in the blood of patients with arthritis, onset and progression of arthropathy, and there were no manifestations of allergy and the allergic history was negative in the majority of the examined. Conclusion. Thus, the immunocomplex mechanism of damage plays an important role in the pathogenesis of arthralgia, arthritis and the onset of osteoarthropathy, but not its progression in post-COVID syndrome. IgE is actively involved in the formation of arthritis, the progression of osteoarthropathy, and especially in its onset.
Association between variants of PNPLA3 (rs738409), UCP2 (rs660339) and HFE (rs1800562, rs1800730, rs1799945) genes and changes in the functioning of the lipid peroxidation – antioxidant defense system in plasma in non-alcoholic fatty liver disease patients
Currently reaching epidemic proportions, non-alcoholic fatty liver disease (NAFLD) particularly affects individuals of employable age. The pathogenesis of NAFLD involves a combination of hereditary factors and external influences that collectively disrupt lipid and carbohydrate metabolic pathways and impair the balance between lipid peroxidation and antioxidant protection mechanisms. To date, there has been limited exploration of the possible relationship between these pathological changes and specific variants of the PNPLA3, UCP2, and HFE genes. The aim. To examine the association between some markers of the LPO-AOD system in plasma depending on polymorphic variants of the PNPLA3, UCP2 and HFE genes. Materials and methods. For this study, we collected whole blood samples from 116 patients with NAFLD (65 with steatosis and 51 with steatohepatitis) and 100 healthy volunteers. All participants had peripheral venous blood collected for subsequent molecular genetic and biochemical analysis. Results. Our findings indicate that in steatosis, catalase activity was elevated in carriers of the rs660339 TT genotype, while SOD activity was reduced in those with the rs738409 GG variant. For steatohepatitis patients, ceruloplasmin levels were altered in opposite directions based on genotype: the rs1800730 TT variant was associated with lower levels, whereas the rs660339 TT genotype was linked to higher levels. Conclusions. Polymorphisms rs738409 of the PNPLA3 gene, rs1800730 of the HFE gene and rs660339 of the UCP2 gene are associated with an imbalance in the LPOAOD system, which may be caused by an increase of the iron level and a change in the antioxidant activity of the UCP2 protein, as well as an increase in the production of prooxidants.
Fatal case of hemorrhagic fever with renal syndrome associated with hantavirus Seoul
Seoul orthohantavirus is one of the causative agents of hemorrhagic fever with renal syndrome (HFRS) in the Russian Far East. Foci of SEOV in Norway rats have been identified in the cities of Vladivostok and Khabarovsk. The aim. Study of a clinical case of HFRS with a fatal outcome, from Komsomolsk-on-Amur in 2025. Materials and methods. Samples of blood serum and autopsy material (blood, lung, spleen, liver, kidney tissues) from a resident of Komsomolsk-on-Amur with a clinical diagnosis of HFRS were examined using enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction (RT-PCR) followed by sequencing. Results. The laboratory studies confirmed the clinical diagnosis. Antibodies to hantaviruses in a titer of 1:3200 (IgM) and 1:1600 (IgG) were detected by the ELISA in the blood serum. SEOV RNA was detected in blood serum and autopsy material (blood, lung, spleen, liver, kidney tissues) studying by the RT-PCR and using the OM-Screen-GLPSRV test system. Analysis of genome fragments showed high homology of SEOV from Komsomolsk-on-Amur with virus strains previously identified in Khabarovsk, as well as those widespread in China. Genetic evidence of human infection, associated with the Seoul virus circulating in the city of Komsomolsk-on-Amur has been obtained, and two hypotheses have been put forward for the formation of the focus: importation with infected rats from China or Khabarovsk, and the possible existence of a mainland variant of the virus in a vast territory, including the eastern regions of China and Khabarovsk Krai. Conclusion. Third urban focus of Seoul hantavirus was detected in Russia. The fatal outcome of HFRS could be caused by a comorbidity: chronic alcohol intoxication with multiple organ manifestations.
Indicators of immunocompetent blood cells of experimental animals immunized against plague on the background of immunomodulation
The strategy of specific prophylaxis of plague for epidemic indications accepted in the Russian Federation, while having positive experience, needs to be improved. The solution to one of the problems is the use of vaccines together with adjuvants. The ability of the selenium-containing preparation 974zh to increase the immunogenicity of live plague vaccine was demonstrated. The aim of the work. To evaluate the subpopulation composition of blood cells in animals immunized by Y. pestis EV on the background of immunomodulation. Materials and methods. In the study we used 100 white mice. Blood served as a material for the study. The phenotype of lymphocytes was determined on a flow cytofluorimeter using antibodies to markers CD45, CD44, CD3, CD19, CD4, CD8, CD25, CD62L, I-A/I-E (MHC II). Results. Evaluation of cellular immunity revealed a statistically significant increase in monocytes on day 7 and a decrease in lymphocytes on day 3 in mice immunized with Y. pestis EV at doses of 103 CFU and 104 CFU in combination with 974zh. When co-injected with Y. pestis EV (103 CFU) and 974zh, unlike Y. pestis EV at different doses, no decrease in CD3+CD4+CD8-CD25+ cells was detected. Conclusion. Thus, the adjuvant property of 974zh has been established, contributing to an increase in the immunogenic properties of the Y. pestis EV vaccine strain, regardless of the dose. The use of Y. pestis EV at a dose of 103 CFU to reduce the bacterial load is appropriate.
Comparative Analysis of Morphometric Data on Internal Diameters of Segments Forming Bifurcations in Corrosion Casts of Human Coronary Arteries and Their Calculation Using Contemporary Methods
Background. The study of human coronary arteries (HCA) as a fractal system composed of arterial bifurcations (AB) has proven promising and effectiveness in the development of digital methods for diagnosing and treating vascular pathology. However, at present, there is no consensus among researchers regarding the theory of the optimal structure of HCA bifurcations and the methodology for calculating the internal diameters of arterial segments (AS) that form these bifurcations under normal conditions. Objective. To conduct a comparative analysis of morphometric data from real normal HCA and contemporary numerical modeling methods for calculating diameters of segments forming AB. Methods. A comparative study was carried out on the internal diameters of 2,072 AS comprising 1,078 AB from 60 corrosion casts of HCA obtained from hearts of both sexes, aged 36 to 74 years, without signs of pathology. Morphometric measurements were compared with values calculated using established equations, proposed by Mette S. Olufsen and G. Finet. Results. It was found that the internal diameters of AS forming HCA bifurcations, obtained by morphometry of corrosion casts and by calculations using the equations of Mette S. Olufsen and G. Finet, differ significantly. Conclusion. For numerical modeling of realistic HCA geometry as a fractal structure composed of heterogeneous AB, the use of the equations proposed Mette S. Olufsen and G. Finet would not be appropriate. At present, there is no universally accepted theory of the optimal structure of HCA bifurcations, and consequently, no established technology for numerical modeling of realistic vascular geometry.
Lipopolysaccharide-binding systems in the pathogenesis of vascular complications in patients with type 1 diabetes mellitus
Rationale. Disturbance of glycemia in type 1 diabetes mellitus (DM1) leads to the development of oxidative stress and damage to the barrier organs for lipopolysaccharide (LPS), which is accompanied by its increased translocation into the systemic bloodstream, inducing vascular damage. The aim. Determination of the influence of the level of major lipopolysaccharidebinding systems on the risk of macro- and microvascular complications of DM1. Materials and methods. The study included 92 patients with a verified diagnosis of type 1 diabetes mellitus. Patients underwent examination of biomaterial (blood plasma) by enzyme-linked immunosorbent assay (ELISA) to determine the level of lipopolysaccharide-binding protein (LBP), bactericidal permeability-increasing protein (BPI) and sCD14, as well as a marker of systemic inflammation – CRP. ROC-analysis with ROC-curve construction was used to assess the quality of the prognostic model efficiency, as well as to find the optimal point (cut-off point) of the threshold value of the level of the investigated markers. Results. ROC-analysis revealed statistically significant patterns of relationship between peripheral blood LBP level and risk of arterial hypertension (AH) in patients with DM1 (p = 0.014), as well as relationship between peripheral blood LBP and sCD14 level and risk of diabetic nephropathy (DN) in patients with DM1 (p = 0.042 and p = 0.048). Conclusion. We have revealed a statistically significant influence of LBP and sCD14 concentrations on the development of vascular lesions in DM1, with a decrease in the level of the main LPS-binding systems accompanied by an increased risk of AH and DN. Lipopolysaccharide of Gram-negative flora plays an important role in the development of complications of DM1, which is largely due to the peculiarities of the response to LPS under conditions of hyperglycemia and dysfunction of the normal response to LPS, accompanied by protective reactions and subsequent clearance of LPS.
Serum phospholipid and selected oxylipin levels in second-trimester pregnant women with COVID-19
Background. The inflammatory response in coronavirus disease 2019 (COVID-19) markedly alters lipid metabolism. However, the phospholipid and oxylipin profile of pregnant women with COVID-19, stratified by disease severity, remains insufficiently studied. The aim. To assess second-trimester serum levels of phospholipids, arachidonic acid, and the oxylipins 12- and 15-hydroxyeicosatetraenoic acids (12-HETE, 15-HETE) in women with COVID-19 according to clinical severity. Methods. The study enrolled 88 pregnant women at 14–16 weeks of gestation with confirmed COVID-19. Patients with moderate disease (n = 42) formed subgroup 1; those with mild disease (n = 46), subgroup 2. A control group comprised 40 second-trimester pregnant women without COVID-19. Serum phospholipids were quantified by thin-layer chromatography; 12-HETE and 15-HETE by enzyme-linked immunosorbent assay; and arachidonic acid by gas–liquid chromatography. Results. Compared with the mild-disease subgroup, women with moderate COVID-19 and control group showed significantly higher serum concentrations of sphingomyelin, lysophosphatidylcholine, arachidonic acid, 12-HETE, and 15-HETE, and lower levels of phosphatidylcholine and phosphatidylethanolamine (p < 0.001 for all comparisons). Conclusion. The development of COVID-19 in second-trimester pregnant women is associated with severity-dependent alterations in serum phospholipids, arachidonic acid, and oxylipins. These changes may reflect the intensity of pulmonary inflammation and underscore the need to optimise therapeutic approaches in this patient population.
Diagnostic capabilities of computer accommodography in middleaged (presbyopic) individuals
Background. Presbyopia research aims to improve the quality of life of the aging population by correcting near vision and timely addressing accommodative disorders in presbyopes, particularly when combined with hypermetropic and myopic refraction. The aim. To assess the parameters of computer accommodography in individuals aged 45–59 with presbyopia combined with hypermetropic and myopic refraction. Methods. A cross-sectional study was conducted on a random sample of Arkhangelsk population aged 45–59 (n = 69), including ophthalmological examination with a comprehensive accommodation assessment. Data of 127 eyes were analysed. Participants were divided into five groups: those diagnosed with myopia (mild, moderate, and high degree), those with presbyopia (with emmetropia), and those with presbyopia accompanied by hypermetropia (refraction up to 3.0 D inclusive). Results. In 32.3% of cases (41 eyes), no ocular pathology was detected except for presbyopia. Myopic refraction was found in 46.5% of cases (59 eyes), with an average refraction of 3.26±0.13 D in this group. When comparing groups on quantitative accommodogram parameters, the highest microfluctuation coefficient (up to +3.0 D inclusive) was in participants with moderate myopia and in those with age-related presbyopia combined with hypermetropia, the lowest – in participants with presbyopia (with emmetropia) and in groups with mild and high myopia (p = 0.028). Microfluctuation coefficient was the most stable was in individuals without visual organ pathology, with the exception of age-related presbyopia, and among participants with mild myopia (p = 0.017). Conclusion. The use of computer accommodography in ophthalmological practice can significantly expand diagnostic capabilities for identifying accommodative changes in middle-aged individuals.
Evaluation of the effectiveness of combination treatment for Coats’ retinitis
The aim of this study is to evaluate the efficacy of a combined treatment modality for Coats’ disease, integrating anti-angiogenic therapy with retinal laser photocoagulation. The presented clinical case illustrates the advantages of a combined, staged treatment approach for Coats’ disease. A marked increase in exudative manifestations within the macular region and along the inferior-temporal vascular arcade, observed following the initial session of retinal laser photocoagulation (which included barrier and delimiting applications to the macula), would have precluded subsequent laser intervention without a significant risk of complications. Consequently, the administration of anti-VEGF agents as adjuvant therapy proved optimal for establishing favorable conditions for the next stage of laser photocoagulation. Given that the clinical course of Coats’ disease in adult patients is frequently associated with hypercholesterolemia, performing a lipid profile and initiating appropriate corrective measures for any identified dyslipidemia is essential. This management also contributes to the reduction of cholesterol exudation. Thus, the implemented combined, staged treatment regimen in this patient resulted in the stabilization of the pathological process and the preservation of high visual acuity. Conclusion. Laser photocoagulation remains the primary treatment for Coats’ disease. However, the use of anti-VEGF agents, either as neoadjuvant or adjuvant therapy, facilitates the stabilization of the pathological process and aids in the preservation of the patient’s maximum potential visual function.
Pterygopalatine block effectiveness in postoperative period after donor cornea transplantation
Keratoplasty is a surgical procedure for corneal transplantation, in which a donor graft replaces the patient’s damaged cornea. Despite its high efficacy, the procedure carries a risk of postoperative complications (high level of intraocular pressure (IOP) and inflammatory reaction), which contribute to the development of pain syndrome and increase the risk of graft rejection due to the disruption of immune privilege. The aim. To evaluate the efficacy of analgesia and the anti-inflammatory effect of pterygopalatine block (PPB) in the early postoperative period in patients after penetrating keratoplasty. Material and methods. The study included 56 patients divided into two groups: Group 1 (n = 28) received PPB with 0.5 % levobupivacaine (4 ml) for 3 days, Group 2 (n = 28) received standard analgesia with NSAIDs (ketoprofen) and intraocular pressure-lowering medications (acetazolamide, timolol). Subjective pain sensations (NRS – numeric rating scale), the presence of discomfort and foreign body sensation in the eye, ocular hypertension, and the level of cytokines (IL-6, IL-8, IL-10) in the patients’ tear fluid were assessed on days 1, 3, and 5 after surgery. Results. In Group 1, the mean pain level on the NRS was 1.2 ± 0.6 points (7.14 % of patients), while in Group 2 it was 2.9 ± 1.2 points (21.4 %) (p ≤ 0.05). On day 1 after surgery, in Group 1, the levels of IL-6 and IL-8 increased by 4.3 and 1.5 times, respectively (p = 0.002; p = 0.001), whereas in Group 2 they increased by 4.9 and 2.1 times (p = 0.001, p = 0.002). The concentration of IL-10 in Group 1 increased to 2.61 ± 2.3 ng/ml on day 1 and to 3.08 ± 2.6 ng/ml on day 3 (p = 0.0011; p = 0.0015), while no significant changes were observed in Group 2. The IL-6/IL-10 and IL-8/IL-10 ratios were significantly lower in Group 1 on day 3 (112.18 ± 78.55) compared to Group 2 (313.96 ± 109.87) (p = 0.0000). The correlation between IL-8 and IOP on day 3 was r = 0.8 (p = 0.0000) in Group 2 and r = 0.6 (p = 0.0049) in Group 1. Conclusion. After donor cornea transplantation, pterygopalatine block modulates the cytokine profile with a pronounced anti-inflammatory effect, making it an effective component of comprehensive postoperative treatment. It contributes to reduced pain and improved IOP control in patients.
Corneal ulcer as the first manifestation of HIV infection: a clinical case
Background. Corneal ulcers are among the severe diseases that are difficult to treat. Most cases of corneal ulcers are caused by infectious etiology in the presence of predisposing risk factors, such as wearing contact lenses, eye injuries, chronic diseases of the accessory apparatus of the eye, dry eye syndrome. Of particular importance at present is the increase in cases of corneal ulcers among HIV-infected patients. HIV leads to thinning of the cornea and the formation of an ulcerative defect, and systemic immunodeficiency contributes to the rapid addition of a secondary infection. The aim. Description of a clinical case of a corneal ulcer with perforation as the first sign of HIV infection. Materials and methods. To assess the clinical case, we used a retrospective analysis of the patient’s medical history and the results of laboratory research methods. Results. This clinical example demonstrates the possibility of the occurrence of a corneal ulcer with perforation against the background of immunodeficiency caused by HIV-positive status. The patient came with a corneal ulcer complicated by perforation and fibrinous-plastic iridocyclitis. The localization of the ulcer at the limbus, the absence of loose infiltration of the edges, and high visual functions determined the gentlest surgical tactics in the form of suturing the ulcer defect by applying corneo-limbal sutures without separating the conjunctiva. Conclusion. Timely drug therapy and surgical treatment led to the closure of the ulcer defect and restoration of visual functions. The postoperative course was smooth and had no peculiarities, despite the HIV-positive status of the patient and the lack of therapy for the underlying disease, since a corneal ulcer with perforation was the first manifest sign that forced the patient to seek medical help.
Assessment of the parameters of the fatty acid spectrum of blood serum in relation to hormonal status in obese adolescents
Rationale. The development and implementation of new high-tech mass spectrometric diagnostic methods into laboratory practice has determined the possibility of a global analysis of the human lipidome, in particular, for a detailed study of its fatty acid component and assessment of the role of individual free fatty acids (FFA) in the pathogenesis of obesity and associated diseases. Objective. To identify the features of changes in the parameters of the fatty acid spectrum of blood serum and establish their relationship to hormonal status indicators in adolescents with obesity. Materials and methods. A total of 27 adolescents aged 10–18 years with obesity (SDS BMI 2.0-3.9) were examined. The control group consisted of 27 adolescents with normal weight with comparable characteristics by gender and age. SDS BMI was calculated using the WHO Anthroplus calculator. The concentration of hormones and peptides in the blood serum was measured by ELISA. The mobile fatty acid pool of blood serum was assessed by chromatography-mass spectrometry on an Agilent 7000B detector. Results. In adolescents with obesity of 1–3 degrees, elevated levels of insulin and C-peptide, decreased concentration of GLP-2 and fatty acid imbalance (decreased proportion of GLA, DGLA, DPA, DHA, AA and increased content of ALA, OA, POA, BA, MA, PA, MAA), as well as a low risk index for the development of a subintimal inflammatory reaction are recorded in the blood. In the group with obesity, direct and negative correlations were established between the content of individual hormones and fatty acids, which were absent between the corresponding parameters in the group of healthy individuals. Conclusion. The established endocrine-metabolic changes in adolescents with obesity are pathogenetic factors of a complex of compensatory-adaptive reactions accompanying low-intensity inflammation.
Psychoemotional state and hormonal status of adolescent girls in the post-covid period
Introduction. Post-COVID syndrome (PCS) in children and adolescents represents a relevant medical and social problem. Adolescent girls may be particularly vulnerable to the development of psychoemotional and endocrine disorders associated with PCS due to hormonal changes during the pubertal period. The aims. To assess the psychoemotional status and hormonal profile in adolescent girls depending on the presence of post-COVID syndrome symptoms, and to establish correlations between psychoemotional indicators and hormone concentrations of the hypothalamic-pituitary-thyroid-adrenal axis in the post-COVID period. Materials and methods. A total of 126 girls aged 11–16 years were examined: 44 with PCS symptoms (main group); 40 without PCS symptoms (comparison group); and 42 conditionally healthy girls (control). The main group was divided into subgroups depending on the time period after COVID-19: 3–5 (n = 11), 6–9 (n = 12), 11–12 (n = 10), and 13–24 months (n = 11). Psychoemotional status was assessed using the SAN (Well-being, Activity, Mood) scale, BDI-1A, and A.M. Prikhozhan’s Manifest Anxiety Scale. Concentrations of TSH, free T4, and cortisol were determined by enzyme-linked immunosorbent assay. Results. Girls with PCS symptoms showed more pronounced forms of depressive symptomatology, increased anxiety, and reduced activity and well-being. Elevated levels of TSH and cortisol were observed compared to control groups. The differences persisted throughout the entire post-COVID period with maximum severity at 6–12 months after COVID-19. Correlations were established between the severity of depressive symptoms and TSH concentration (p = 0.002), and between anxiety and cortisol (p = 0.001) in respondents throughout the post-COVID period. Conclusion. The established correlations between psychometric indicators and hormone concentrations indicate the involvement of neuroendocrine mechanisms in the pathogenesis of psychoemotional manifestations of PCS. The results substantiate the need for comprehensive examination of adolescent girls with PCS symptoms for timely diagnosis and correction of disorders.
Psychometric properties analysis of the Hospital Anxiety and Depression Scale (HADS) on a sample of Russian-speaking students
Background. Universal and student-specific stressors can lead to the development of anxiety and depression. The Hospital Anxiety and Depression Scale (HADS) has proven effective in various populations. However, measuring anxiety, depression, and stress in the student population may have its own peculiarities, which create a need for a tailored tool to assess anxiety and depression levels among young people studying in higher education institutions. The aim. Assessment of the psychometric properties, including the factor structure, reliability, and external validity of the HADS in Russian-speaking students. Materials and methods. The sample consisted of 891 students, including 198 males (22 %) and 693 females (78 %), aged 16 to 37 years (mean age is 19.8, median age – 19.0, SD = 2.13). Results. The Cronbach’s alpha for the “Anxiety” subscale was 0.73, for the “Depression” subscale it was 0.62, and for the overall questionnaire it was 0.79. Principal Component Analysis confirmed the alignment of the questionnaire’s structure with the original two-factor model proposed by the authors. Both the full model and a reduced model (excluding item 6) derived from confirmatory factor analysis demonstrated similar model fit indices. Based on the comparison of principal component and confirmatory analyses, it was decided to exclude item 6 from the questionnaire while retaining item 11 in the second factor. Conclusions. The analysis concluded that the Hospital Anxiety and Depression Scale exhibits satisfactory psychometric properties and can be used for screening emotional distress among students.
Analyzing the quality of life and emotional state of pregnant women
Pregnancy is an important stage in a woman’s life, accompanied by significant physiological and psychological changes. During this period, the psychoemotional state of a pregnant woman is influenced by many factors, among which the quality of life and family relationships occupy a special place. The aim. To assess the impact of quality of life and family relationships on the psychoemotional state of pregnant women. Materials and methods. The study involved 78 pregnant women who were registered for pregnancy and childbirth at the KSC RAS hospital in Apatity, Murmansk region in 2023–2024 and gave birth at the beginning of December 2024. The average age was 31,3 ± 0,8 years. The control group included 58 non-pregnant women, mean age 32,7 ± 0,6 years. We used the SF-36 questionnaire and the pregnant woman questionnaire developed by the Central Research Institute of Healthcare Organization and Informatization of the Russian Ministry of Health. The results. The results showed that the physical function (r = 0.48, p < 0.05) has an effect on the pregnant woman’s psychological state. Fatigue affects sleep quality (r = 0.35, p < 0.001) and increases anxiety (r = 0.43, p < 0.001). Intra-familial relationships (r = -0.42 p < 0.05) have a significant influence on the emotional background of pregnant women. Support of the partner, harmonious relations in the family contribute to reduce stress and increase the level of psychological comfort. In addition, there is a relationship between psycho-emotional condition and family status (r = 0.36, p < 0.05), number of children (r = -0.32, p >< 0.05) and average per capita income (r = -0.31, p < 0.05). The emotional background of the pregnant woman is negatively impacted by complicated obstetric anamnesis, including miscarriages, complicated abortions, infectious and inflammatory diseases during pregnancy, and exacerbation of chronic extragenital diseases. Conclusion. To improve the psychoemotional state of a pregnant woman, fullfledged psychological support is necessary at all stages of pregnancy and childbirth, including consultations and trainings with the development of social support measures and strengthening the institution of the family.
Ethnopharmacological characteristics of Piper betle from Indonesian-Asian region and prospects of its use in biomedical purposes
Rationale. Piper betle of the family of Piperaceae, (P. betle) is a liana growing in the tropics of the Indonesian-Asian region, has long been actively used in folk medicine as a source of remedies for a variety of health problems. At the same time, the methods and purposes of using P. betle in folk medicine vary from region to region, and the effectiveness of its impact on human remains fully underestimated. The aim of the study. To systematize and analyze modern literature data on the pharmacological potential of the medicinal plant Piper betle, growing in the countries of Madagascar, India, Bali and China of the Indonesian-Asian region. Materials and methods. The search and analysis of data were carried out in international and regional databases (PubMed, Scopus, Web of Science, Science Direct, and Google Scholar) for the period from 1996 to 2025. Results. The analysis of scientific literature data showed that the target fragment of metabolome (TFM) of Peper betle is characterized by a complex composition of biologically active compounds (BAS), which varies significantly from region to region. BAS of the TFM of this plant are responsible for various types of pharmacological activity, which justifies its use in traditional medicine and growing interest to the medical scientific community. It was found that within the range of P. betle growth, the chemical composition of TFM varies in terms of the content of alkaloids, terpenes, phenolic compounds, including flavonoids and volatile components. Conclusion. P. betle is a promising object for further research in the field of phytopharmacology and reproductive medicine. Obviously, in-depth preclinical and clinical studies are needed to confirm the identified effects based on literature sources. At the same time, the collected literature data can contribute to future research in the field of pharmacology in order to create new promising drugs.
Tuberculosis is not an obstacle to kidney transplantation
Background. Monitoring patients with chronic kidney disease during preparation for kidney transplantation, in the immediate postoperative period and then over the years is a unique opportunity to verify the effectiveness of anti-tuberculosis therapy. The aim. To analyse the results of long-term observation of patients with chronic kidney disease stage 5 (CKD stage 5), who received a course of anti-tuberculosis therapy before kidney transplantation. Materials and methods. The analysis of the results of long-term observation of 7 patients with CKD stage 5 who had tuberculosis (TB) while receiving renal replacement therapy (RRT) using the method of programmed hemodialysis and continued observation by a phthisiatrician at the stages of preparation for kidney transplantation and for a year after, was carried out. Results. At the time of tuberculosis diagnosis, the observed multicomorbid patients had been on programmed hemodialysis for an average of 2.9 years. Anti-tuberculosis therapy was administered according to individualized regimens. The average waiting period for kidney transplantation for these patients was 3.6 years. Kidney transplantation was performed successfully in all 7 observed patients, after that all patients received three-component immunosuppressive therapy (tacrolimus, mycophenolate mofetil, methylprednisolone). Control examination to exclude reactivation of tuberculosis was carried out once every 6 months on a planned basis or upon complaints. The average follow-up period for recipients was 3.9 years. Reactivation of tuberculosis after kidney transplantation was recorded in only one patient. Thus, in 6/7 (85.7 %) patients with CKD with tuberculosis infection, kidney transplantation and administration of immunosuppressive therapy were performed without reactivation of tuberculosis. Conclusions. The long-term absence of tuberculosis reactivation in the majority of patients (85.7 %) against the background of not only renal failure, but also immunosuppressive therapy after kidney transplantation was achieved through an individual approach to the treatment and management of each patient with CKD and interdisciplinary interaction of doctors.
Application of membrane-protectant in the process of increasing the viability of autologous fat graft
Background. Autologous adipose tissue transplantation is becoming increasingly popular in reconstructive surgery, but the main unsolved problem at the moment is the high percentage of partial volume loss due to autograft resorption. The aim. Evaluation of the viability of adipocytes under incubation in solutions of different biochemical compositions, and clinical testing of the effectiveness of an optimized fat graft. Materials and methods. The comparative spectral analysis of the content of ions (mainly oxygen) in the cytoplasm of fat cells grown from solution samples on a solid substrate using a scanning electron microscope in low vacuum was performed. The composition in 3 samples that spent 6 h in artificial solutions was investigated. The EDAX TEAM program was used to analyze the energy dispersive X-ray spectroscopy data. Results. Statistical and morphological analysis of the obtained results revealed differences in the composition of viable cells in the studied samples, varying up to 50 %. The most effective was the solution with dimethyloxobutylphosphonyldimethylate, which demonstrated an optimal level of oxygen ion content (O), as well as pronounced integrity of the cell membrane compared to other samples during electron microscopy and histological examination. Conclusion. One of the key factors is the medication support of the autograft during the initial stages of engraftment after transplantation. By measuring the ionic content of the intracellular matrix, we were able to examine in vitro the effect of solutions of different substances to achieve this goal. For autograft preservation, the best option is a solution with a membrane protector dimethyloxobutylphosphonyldimethylate for its ability to preserve cell homeostasis.
Quantification of background expression of interferon beta in cell culture of Siberian bat (Myotis sibiricus)
Background. The study of the immune response of these mammals to viral infections is necessary to reveal the fundamental mechanisms of the circulation of zoonotic infections in nature. There is a hypothesis about the constantly “on” activity of the interferon pathway proteins, developed evolutionarily in bats to counteract viral infections. We assessed the expression of interferon beta as a marker of the innate immune system in kidney cells of the Siberian bat (Myotis sibiricus, Kastschenko, 1905) MdbK3-14. The aim. Evaluation of the background level of interferon beta (IFN-β) gene expression in bat cells as a marker of the activity of the mammalian innate immune system. Materials and methods. MdbK3-14 cells were grown in 24-well plates. Cell monolayers were detached with trypsin solution and total RNA was isolated. The concentration of mRNA of IFN-β gene transcripts and reference genes beta actin (ACTB) and succinate dehydrogenase subunit A (SDHA) was determined by one-step multiplex RT-qPCR and confirmed by RT-dPCR. Results. Specific primers with a probe for detecting mRNA of the IFN-β gene in bat cells were designed. The detection of SDHA and IFN-β gene transcripts was stable both in RT-qPCR (CV = 0.5 % and CV = 0.2 %, respectively) and in RT-dPCR (CV = 0.8 % and CV = 1.4 %, respectively). In addition, stable detection of ACTB mRNA was achieved using RT-dPCR (CV = 0.8 %), but the average variability value for actin using RT-qPCR exceeded the permissible value (CV = 3.6 % with an acceptable CV ≤ 2 %). The results of quantitative determination in RT-qPCR and RT-dPCR correlated with each other. The expression levels of IFN-β in MdbK3-14 cells averaged 0.97 ± 0.15 relative units in RT-qPCR and 0.13 ± 0.05 relative units in RT-dPCR. Conclusions. In the absence of immune stimulation, background expression of IFN-β occurs in the M. sibiricus kidney cell line.
Morbidity status for selected vaccine-preventable infections in the Irkutsk region in different periods of vaccine prevention
Background. The success of vaccination prevention at the present stage is undeniable. However, the epidemiological features of individual infections dictate the need of optimizing this preventive measure. This study is devoted to the epidemiological analysis of measles and whooping cough morbidity as infections with proven epidemiological effectiveness of the conducted vaccination, but at the same time, characterized by an increase in the incidence rate over the past years. Chickenpox and meningococcal infection are nosological forms, despite the continuing epidemiological, social and economic significance, characterized by a selective approach to vaccination of the population. The aim. Study intensity of the epidemic process of infections with different vaccination strategies using the example of whooping cough, measles, chickenpox, meningococcal infection to justify the optimization of vaccination prevention tactics in the region. Materials and methods. A retrospective epidemiological analysis of the incidence of whooping cough, measles, chickenpox, and meningococcal infection was conducted using previously published data and reporting forms from the Office of Rospotrebnadzor for the period 1955–2023 in the Irkutsk region. Results. The introduction of mass vaccination against whooping cough and measles in the National Immunization Schedule has contributed to a decrease in morbidity. The period 2014–2023 in the region was characterized by an uneven distribution of indicators with an upward trend for these infections (Tgrow. was 15.1 and 18.7 %, respectively). It has been shown that against the background of a selective vaccination strategy against meningococcal infection and chickenpox, a decrease in morbidity is observed until 2021. At the same time, direct correlations are observed between the number of vaccinated and morbidity levels (ρ = 0.952, ρ = 0.842 at p < 0.05, respectively). Conclusion. The obtained results of the study are necessary for optimization of the existing vaccination prevention program in the region. The introduction of revaccination of children, adolescents and adults against whooping cough, cohort vaccination of children against chickenpox and meningococcal infection will reduce the burden of infections with different vaccination strategies at the level of the subject of the Russian Federation.