Fundamental and Clinical Medicine最新文献

{"title":"Prototyping neural networks to evaluate the risk of adverse cardiovascular outcomes in the population","authors":"L. Bogdanov, E. Komossky, V. V. Voronkova, D. E. Tolstosheev, G. V. Martsenyuk, A. S. Agienko, E. Indukaeva, A. Kutikhin, D. Tsygankova","doi":"10.23946/2500-0764-2021-6-4-67-81","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-4-67-81","url":null,"abstract":"Aim. To develop a neural network basis for the design of artificial intelligence software to predict adverse cardiovascular outcomes in the population.Materials and Methods. Neural networks were designed using the database of 1,525 participants of PURE (Prospective Urban Rural Epidemiology Study), an international, multi-center, prospective study investigating disease risk factors in the urban and rural areas. As this study is still ongoing, we analysed only baseline data, therefore switching prognosis and diagnosis task. Because of its leading prevalence among other cardiovascular diseases, arterial hypertension was selected as an adverse outcome. Neural networks were designed employing STATISTICA Automated Neural Networks (SANN) software, manually selected, cross-validated, and transferred to the original graphical user interface software.Results. Input risk factors were gender, age, place of residence, concomitant diseases (i.e., coronary artery disease, chronic heart failure, diabetes mellitus, chronic obstructive pulmonary disease, and asthma), active or passive smoking, regular use of medications, family history of arterial hypertension, coronary artery disease or stroke, heart rate, body mass index, fasting blood glucose and cholesterol, high- and low-density lipoprotein cholesterol, and serum creatinine levels. Our neural networks showed a moderate efficacy in the virtual diagnostics of arterial hypertension (84.5%, or 1,289 successfully predicted outcomes out of 1,525, area under the ROC curve = 0.88), with almost equal sensitivity (83.6%) and specificity (85.3%), and were successfully integrated into graphical user interface that is necessary for the development of the commercial prognostication software. Cross-validation of this neural network on bootstrapped samples of virtual patients demonstrated sensitivity of 82.7 – 84.7%, specificity of 84.5 – 87.3%, and area under the ROC curve of 0.88 – 0.89.Conclusion. The artificial intelligence prognostication software to predict adverse cardiovascular outcomes in the population can be developed by a combination of automated neural network generation and analysis followed by manual selection, cross-validation, and integration into graphical user interface.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91009352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Оpen globe injury in children: epidemiology and predictors of an adverse outcome","authors":"E. Gromakina, K. M. Saidzhamolov, V. G. Moses, Natalia V. Tyunina, K. B. Moses","doi":"10.23946/2500-0764-2021-6-4-132-141","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-4-132-141","url":null,"abstract":"Here we aimed to analyse the prevalence, clinical  course, and current approaches to the prevention and treatment of open globe injury in children as well as its complications: hyphema, retinal detachment, traumatic uveitis, and endophthalmitis. Currently, children are responsible for the 10-15% of open globe injuries. In developed countries, open globe injury is the leading cause of monocular blindness in children. Open globe injury mainly affects boys (60−70% cases), yet severe injuries are rare, and closed globe injury is the most common type of eye injury. Most injuries are accidental and occur at home in daily life (50−60%), outdoors (20−35%), at school (1−5%), or while playing sports (1−3%). Open globe injury most often affects cornea and is associated with a high risk of early and late complications and poor outcomes. Wearing of protective glasses during sports and active recreation is recognised as an efficient tool for primary prevention of open globe injury in children. The main problems in prevention of complications of open globe injury are the lack of specialised care in low-income countries and the limited awareness of parents.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"187 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74882856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging and diagnostic accuracy of outpatient and inpatient hysteroscopy","authors":"Y. Frolova, S. I. Yelgina","doi":"10.23946/2500-0764-2021-6-4-106-112","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-4-106-112","url":null,"abstract":"Aim. To compare the results of visualisation and diagnostic accuracy during outpatient and inpatient hysteroscopy in women with endometrial disease.Materials and Methods. We performed a retrospective analysis of patients with uterine diseases who underwent outpatient hysteroscopy at Kemerovo City Clinical Hospital №4 (n = 300) or inpatient hysteroscopy within the hospitals (n = 300) in Kemerovo from 2018 to 2020. Confirmation of endometrial disease was carried out by manual vacuum aspiration.Results. Indications, imaging, and diagnostic accuracy did not differ for most endometrial diseases in outpatient and inpatient hysteroscopy, yet inpatient hysteroscopy was the option of choice in women with infertility (p = 0.035). Diagnostic accuracy of outpatient and inpatient hysteroscopy was highly concordant, albeit outpatient hysteroscopy more often revealed adenomyosis and uterine malformation and less often identified endometrial polyps.Conclusion. Outpatient and inpatient hysteroscopy are equally efficient, although outpatient hysteroscopy has its benefits in detecting adenomyosis and uterine malformation and be less informative in diagnosing endometrial polyps.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75241547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for death in patients with severe COVID-19 admitted to an intensive care unit","authors":"N. Osyaev, Natalia V. Ivannikova, G. Vavin, V. G. Moses, O. Gruzdeva, A. Kutikhin","doi":"10.23946/2500-0764-2021-6-4-22-44","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-4-22-44","url":null,"abstract":"Aim. Severe COVID-19 is accompanied by reduced blood oxygen saturation, systemic inflammatory response syndrome and multiple organ failure, all causing a significant deterioration of homeostasis associated with death. Here we aimed to study the risk factors for death in patients with severe COVID-19 who have been admitted to an intensive care unit.Materials and Methods. The study included 144 consecutive patients with severe COVID-19 who have been admitted to an intensive care unit of Kuzbass Clinical Hospital from August to December 2020. Groups of survivors and non-survivors were equal in number (n = 72) and matched by gender (36 men and women) and age (median age 64 years, interquartile range 56-70 years in survivors and 58-69 years in non-survivors). Complete blood count, urinalysis, biochemical analysis, coagulation testing, and measurement of anti-SARS-CoV-2 IgM/IgG were carried out in all patients immediately upon the admission to intensive care unit.Results. Risk factors for death in severe COVID-19 at the admission to intensive care unit were arterial hypertension, chronic heart failure, peripheral atherosclerosis, impaired renal homeostasis (reduced glomerular filtration rate, elevated serum creatinine and urea, proteinuria, hematuria), augmented fasting blood glucose and lactate, neutrophilia (in men), lymphopenia and increased neutrophil-to-lymphocyte ratio (in women), and decreased IgM/IgG to SARS-CoV-2 (in women).Conclusion. We found both independent and gender-specific risk factors for death due to COVID-19.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84075412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insulin gene expression and functional activity of insulin signaling pathway in Alzheimer's disease","authors":"Y. Gorina, E. Khilazheva, Y. Komleva, O. Lopatina, A. Salmina","doi":"10.23946/2500-0764-2021-6-4-8-21","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-4-8-21","url":null,"abstract":"Aim. To study the insulin (INS) gene expression, insulin and lactate levels, expression of Fe65 adapter protein, and level of oxidative DNA damage marker γH2AX in different brain areas in the experimental model of Alzheimer's disease.Materials and Methods. Male, 4-month-old C57BL/6 mice received either intrahippocampal injection of β-amyloid (C57BL/6 + Aβ 1-42) or phosphate-buffered saline (C57BL/6 + PBS). Insulin (INS) gene expression in the hippocampus and amygdala was assessed by means of reverse transcription-polymerase chain reaction. Levels of lactate and insulin in different brain areas were measured by enzyme-linked immunosorbent assay. Expression of Fe65 adapter protein and γH2AX in the hippocampus was studied by immunofluorescence staining followed by confocal microscopy.Results. We found an overexpression of the INS gene in the hippocampus and amygdala, an increase in lactate level in the hippocampus, and slightly increased insulin level in the amygdala of mice with Alzheimer's disease as compared with the control group. Neurodegeneration was accompanied by an elevated endothelial expression of Fe65 adapter protein (p= 0.04) and γH2AX in hippocampal neurons (p = 0.04).Conclusion. Alzheimer's disease neurodegeneration is accompanied by a disrupted insulin signaling and impaired glucose metabolism in the hippocampus and amygdala. This further leads to a neuronal accumulation of γH2AX and impaired amyloid precursor protein proteolysis because of insulin inability to inhibit its interaction with the Fe65 adapter protein and to prevent formation and deposition of β-amyloid.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76559319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of legionellosis into fatal outcomes of pneumonia in Irkutsk","authors":"A. D. Botvinkin, V. Svistunov, E. A. Sidorova, A. E. Makarova, N. A. Kravchenko, L. A. Stepanenko, T. Bayanova, M. V. Lemeshevskaya, T. Balandina, O. S. Gibteva, E. Andaev, S. Balakhonov","doi":"10.23946/2500-0764-2021-6-4-82-89","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-4-82-89","url":null,"abstract":"Aim. To study the diagnosis of legionellosis in patients who died because of pneumonia in Irkutsk (2016-2018).Materials and Methods. We performed 65 autopsies of patients who died from pneumonia in Irkutsk (2016-2018), studied their case histories, and interrogated 510 tap water samples for Legionella pneumophila by means of inoculation and polymerase chain reaction.Results. Among 65 fatal pneumonia outcomes registered in Irkutsk during 2016-2018, legionellosis has been confirmed in three cases (4.6%). Two of these patients were at the late stages of HIV infection while the third, 74-yearold, patient had multiple comorbid conditions. Nosocomial infection was suspected in one of these cases. None of these three patients left Irkutsk during the last month of their life. The assumed transmission factor was tap water, as Legionella pneumophila was found in tap water samples collected in 2013 and 2015.Conclusion. Patients with severe pneumonia need screening for legionellosis to perform the correct treatment, particularly during COVID-19 pandemic.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75976789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological features of acute respiratory infections in dentists","authors":"D. Ivanov, O. M. Drozdova","doi":"10.23946/2500-0764-2021-6-4-90-97","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-4-90-97","url":null,"abstract":"Aim. To study the incidence of acute respiratory infections (ARI) in medical staff of dental clinics.Materials and Methods. We performed a descriptive, retrospective epidemiological study of ARI incidence by means of conducting an anonymous survey of 1,081 dentistry practitioners (358 in specialised dental clinics and 723 employees of polyclinics) in Kemerovo (2020). ARI included COVID-19, community-acquired pneumonia, and other common respiratory viral infections. The questionnaire included 12 questions about ARI, age, gender, working experience, and position.Results. The incidence of ARI in dentistry practitioners in specialised dental clinics was 2.6-fold higher as compared with those working in polyclinics [379.52 per 1,000 (95% CI = 327.10-434.11) and 146.19 per 1,000 (95% CI = 120.56-174.93), respectively, p = 0,00001], regardless of age. Prolonged and close contact with the patients along with an intensive use of aerosol-generating technologies were associated with a 2.3-fold times higher incidence of ARI in dental therapists in comparison with dental surgeons. Female dentists suffered from ARI 1.8-fold more frequently than males [410.91 per 1,000 (95% CI = 352,18-471,58) and 228.07 per 1,000 (95% CI = 127.40-358.36), p = 0,01] but most women worked as dental therapists that could confound such association. ARI incidence was not associated with age, work experience, and position (p = 0.22).Conclusion. Dentistry practitioners working in specialised clinics more frequently experienced ARI than those working in polyclinics. Dental therapists were at higher risk of ARI in comparison with dental surgeons, potentially due to the active use of aerosol generating technologies and prolonged close contact with the patients during treatment. Other factors were not among the major determinants of ARI incidence in dentistry practitioners.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86595620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgM, IgA, IgG, and complement components as pre-operative markers for the development of multiple organ dysfunction syndrome in patients with infective endocarditis in early postoperative period","authors":"A. Ponasenko, M. Khutornaya, A. Tsepokina, Y. Kudryavtseva","doi":"10.23946/2500-0764-2021-6-3-35-45","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-3-35-45","url":null,"abstract":"Aim. Here, we studied whether the immunoreactivity in pre-operative period defines early postoperative complications in patients with infective endocarditis (IE).Materials and Methods. We consecutively enrolled 110 patients with subacute IE (80 with native-valve IE and 30 with prosthetic valve IE) who underwent a heart valve replacement, then measuring the levels of IgM, IgA, IgG, and complement components in their serum and evaluating their correlation with an adverse early postoperative outcome.Results. Compared with patients< 50 years of age, those ≥ 50 years of age had 2-foldand 3-foldhigher prevalence of systemic inflammatory response syndrome and multiple organ dysfunction syndrome in the early postoperative period. Notably, these numbers correlated with increased С3d and С5а along with reduced Ig М and IgG. IgМ below 9.5 mg/mL and IgG below 2.0mg/mL indicated a 3-foldhigher risk of multiple organ dysfunction syndrome (OR = 3.07, 95% CI = 1.96-4.04, р=0,001).Conclusion. Serum IgM, IgG, and complements factors C3d and C5a may be used as prognostic markers of multiple organ dysfunction syndrome in the early postoperative period.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"220 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75894725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene-specific features of tick-borne borreliosis in Russia","authors":"S. Rudakova, N. Rudakov, S. Shtrek, O. E. Teslova, N. E. Kaneshova","doi":"10.23946/2500-0764-2021-6-3-94-99","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-3-94-99","url":null,"abstract":"Aim. To study the gene-specific composition of Borrelia spp. in ixodid ticks inhabiting the foci of ixodid tick-borne borreliosis (ITBB) in the south of Western Siberia.Materials and Methods. The gene-specific composition of Borrelia spp. in ixodid ticks was determined by inoculation on a BSK-H nutrient medium, real-time polymerase chain reaction, and sequencing (1148 specimens of ixodid ticks collected from vegetation and 2183 specimens withdrawn from humans).Results. Infection of ticks with borrelia ranged from 22.4% in the Altai Republic to 56.9% in the Novosibirsk Region. There were no significant differences in the levels of Borrelia infection between two major ixodides, I. persulcatus and I. pavlovskiy (average infection levels 40.0% and 38.8%, respectively). At least five gene species of pathogenic Borrelia (B. garinii, B. afzelii, B. bavariensis, B. miyamotoi, and B. spielmanii) have been identified. The GenBank database contains 45 nucleotide sequences of the intergenic spacer rrf (5S)-rrl (23S). Prevalence of gene species B. garinii and B. afzelii in different ticks (I. persulcatus and I. pavlovskiy) did not differ significantly, yet B. garinii was found to be more frequent than B. afzelii. The frequency of infection of I. persulcatus ticks with B. miyamotoi was significantly (3.5-fold) as compared to those of B. garinii and B. afzelii. In D. reticulatus ticks, the DNA of B. spielmanii and B. miyamotoi was detected.Conclusion. It is necessary to continue studies to assess the role of the meadow ticks D. reticulatus in the circulation of different Borrelia spp. in various natural foci within the Russian Federation.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87915899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum markers of cardiac fibrosis suffering from heart failure with preserved left ventricular ejection fraction upon ST-segment elevation myocardial infarction","authors":"A. V. Оsokina, V. Karetnikova, O. Polikutina, O. Gruzdeva, T. P. Solodilova, S. N. Kosareva, A. V. Motova, T. Pecherina, O. Barbarash","doi":"10.23946/2500-0764-2021-6-3-46-55","DOIUrl":"https://doi.org/10.23946/2500-0764-2021-6-3-46-55","url":null,"abstract":"Aim. Currently, there is no method which accurately predicts an adverse outcome of heart failure with a preserved left ventricular ejection fraction (HFpEF) upon ST-segment elevation myocardial infarction (STEMI). Here we studied the prognostic significance of procollagen type I C-terminal propeptide (PICP) and procollagen type III N-terminal propeptide (PIIINP) in patients with post-STEMI HFpEF.Material and Methods. The study included 83 patients (60 men and 23 women) with post-STEMI HFpEF (left ventricular EF ≥ 50%) and 20 ageand gender-matched healthy controls. Serum concentrations of PICP and PIIINP were measured on the 1st day of hospitalization using enzyme-linked immunosorbent assay with the following calculation of PICP/PIIINP ratio.Results. Serum PICP and PIIINP on the 1st day of STEMI significantly (3.4-fold) exceeded the values of the control group and were as follows: PIIINP: 26.0 (18.9; 34.9) ng/mL (р = 0.047); PICP: 609.0 (583.0; 635.0) ng/mL (р = 0.049).Conclusion. Elevated values of procollagens indicate that cardiac fibrosis commences within the 24 hours after STEMI onset. The pivotal role of cardiac fibrosis in the formation of diastolic dysfunction suggests the usefulness of serum procollagens to predict the development of HFpEF in a long-term period upon STEMI.","PeriodicalId":12493,"journal":{"name":"Fundamental and Clinical Medicine","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82715553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}