Proof-of-Concept Study of Liposomes with a Set of SARS-CoV-2 Viral Peptidic T-Cell Epitopes as a Vaccine

Abstract: Potential nonameric epitopes of CD8+ T lymphocytes were selected from the composition of structural, accessory, and nonstructural proteins of the SARS-CoV-2 virus (13 peptides) and a 15-mer epitope of CD4+ T lymphocytes, from the S-protein, based on the analysis of publications on genome-wide immunoinformatic analysis of T-cell epitopes of the virus (Wuhan strain), as well as a number of clinical studies of immunodominant epitopes among patients recovering from COVID-19 disease. The peptides were synthesized and five compositions of 6–7 peptides were included in liposomes from egg phosphatidylcholine and cholesterol (~200 nm size) obtained by extrusion. After double subcutaneous immunization of conventional mice, activation of cellular immunity was assessed by the level of cytokine synthesis by splenocytes in vitro in response to stimulation with relevant peptide compositions. Liposomal formulation exhibiting the best result in terms of the formation of specific cellular immunity in response to vaccination was selected for further experiments. Evaluation of the protective efficacy of this formulation in an infectious mouse model showed a positive trend in the frequency of occurrence of hyaline-like membranes in the lumen of the alveoli, as well as a somewhat lower severity of microcirculatory disorders. The latter circumstance can potentially help reduce the severity of the disease and prevent its adverse outcomes. A method to produce liposome preparations with peptide compositions for long-term storage is under development. © 2022, Pleiades Publishing, Ltd.

Assessment of newborn health dynamics after the Russian Federation transition to international criteria for live births and stillbirths

To assess the state of children’s health in obstetric care organizations after Russia transition to international statistics on live births and stillbirths, we studied the main indicators of newborn health in the dynamics from 2013 to 2020. It was found that between 2013 and 2020 the morbidity of newborns decreased by 6.3% (from 337.2‰ to 316.3‰;p<0.05), neonatal mortality by 45.7% (from 3.5‰ to 1.9‰;p<0.05), stillbirth rate by 45.6% (from 10.9‰ to 5.5‰;p<0.05), and hospital mortality of newborns born sick and ill by 40.0% (from 1.0% to 0.6%;p<0.05). Assessment of the distribution of live-born infants by birth weight showed that changes in this parameter of physical development during the period under study had no statistically significant differences (p>0.05). The assessment of the impact of the COVID-19 pandemic on newborn health revealed slight shifts in the distribution of children born alive by birth weight and a 6.8% increase in the stillbirth rate compared to the pre-pandemic level. Thus, in the period from 2013 to 2020 the share of children discharged from obstetric hospitals who were healthy has increased due to the reduction in morbidity and mortality of newborns. The analysis showed that there was an improvement in the health indicators of newborns in the Russian Federation.

The results of mobile tecnologies using for achieving and maintenance of asthma control in children

Background: The treatment with controller medication, regular monitoring of symptoms and lung function is required for achieving and maintenance of asthma control in children. The telemedicine technologies using have benefits for distance monitoring, especially during the COVID-19 pandemic. The aim of the study was to analyze the efficacy of our developed mobile technology called MedQuizBot, to evaluate the patient adherence and satisfaction with it. Method: The 6 month prospective observation study of 68 children with asthma (4 to 17 ages) was conducted. All patients were offered to use MedQuizBot via Telegram messenger. Patients had to enter their peak expiratory flow (PEF) values daily and complete asthma control tests (ACT) monthly from March to September 2020 year. MedQuizBot sent notifications to enter data. All patients were able to send e-messages to the doctor via Telegram. Results: 41 patients agreed to use MedQuizBot for the asthma symptoms monitoring. Poor adherence to data entry was mostly detected: ACT was completed 1.5 times, CACT-1.8 times in average. Uncontrolled asthma was observed 7 times more often in children >12 y.o. (27%), than in children under 12 y.o (4%). PEF values were entered by 21 patients (51%). Patients <12 y.o., who completed the test with the parents, entered data 7 times more often, than adolescents. 70% of patients had good asthma control. The data were entered 2.5 times more often during the lockdown in Moscow, caused by COVID-19 pandemic and high tree pollen season in spring compared to summer 2020 (609 and 263 interactions, respectively). 5 patients (12%) sent questions to the doctor about their symptoms (cough, shortness of breath, nasal congestion or sneezing) and received the answers with recommendations. Most patients (92%) noted the satisfaction with MedQuizBot using, its effectiveness in achieving asthma control and would agree to use it again. Conclusion: Among various telemedicine technologies, the use of messengers for monitoring asthma patients seems to be the most effective. MedQuizBot was effective in achieving asthma control and is especially needed for monitoring the patients with insufficient disease control, during pollen allergens exposure, acute respiratory diseases, pandemic, poor access to health care.

Distance learning opportunities during the COVID-19 epidemic

Aim. To compare the results of using traditional and distance education technologies in the training of obstetricians and gynecologists in the continuing medical education cycles. Methods. The effectiveness of the use of traditional and distance learning technologies in the training of obstetrician-gynecologists on the continuing medical education cycles was assessed based on Bashkir State Medical University. The study included an assessment of the knowledge of obstetricians and gynaecologists trained in the 36-hour program. Two study groups were selected. The group I included 28 doctors, whose training and knowledge assessment was carried out mainly using traditional education technologies. The group II consisted of 30 doctors, whose training and knowledge assessment was carried out using distance education technologies. The final effectiveness of the use of the studied technologies was evaluated based on the analysis of the final test results and the solution of situational clinical tasks as a General interview. The research results processing was performed by IBM SPSS Statistics Version 25.0. Results. The study revealed that the use of distance learning technologies does not lead to a decrease in the physician's level of training: 70.0% in group I, 60.7% in group II (chi2=0.11, df=1, p=0.74). Meanwhile, the distance learning format causes difficulties for doctors of the older age group: in group I, there is a direct moderate correlation between age and performance (r=0.497, p=0.007), in group II - a noticeable inverse correlation (r=-0.689, p <0.001). Conclusion. Based on the results of the study, it is necessary to take a differentiated approach to the formation of groups for distance learning in the future. Цель. Сравнить результаты применения традиционных и дистанционных образовательных технологий в рамках обучения врачей акушеров-гинекологов на циклах непрерывного медицинского образования. Методы. На базе кафедры акушерства и гинекологии с курсом дополнительного профессионального образования Башкирского государственного медицинского университета проведена оценка результативности применения традиционных и дистанционных образовательных технологий в рамках обучения врачей акушеров-гинекологов на циклах непрерывного медицинского образования. Исследование включало оценку знаний врачей акушеров-гинекологов, прошедших обучение по программе 36 часов. Было выделено две исследуемые группы. Первая группа включала 28 врачей, обучение и оценку знаний которых осуществляли преимущественно с использованием традиционных образовательных технологий. Во вторую группу вошли 30 врачей, обучение и оценку знаний которых проводили с использованием дистанционных образовательных технологий. Итоговую результативность применения исследуемых технологий оценивали на основании анализа результатов итогового тестирования и решения ситуационных клинических задач в форме общего собеседования. Результаты исследования были обработаны с помощью пакета статистических программ IBM SPSS Statistics Version 25.0. Результаты. В ходе исследования выявлено, что применение дистанционных образовательных технологий не приводит к снижению степени обученности врачей: в первой группе она составила 70,0%, во второй группе - 60,7% (chi2=0,11, df=1, p=0,74). Между тем, дистанционный формат обучения вызывает затруднения у врачей старшей возрастной группы: в первой группе между возрастом и результативностью обучающегося существует прямая умеренная корреляционная связь (r=0,497, p=0,007), во второй группе - заметная обратная корреляционная связь (r=-0,689, p <0,001). Вывод. С учётом полученных результатов исследования в дальнейшем следует дифференцированно подходить к формированию групп для дистанционного обучения.

CORONAVIRUS DISEASE 2019 IN A PATIENT WITH CADASIL SYNDROME: A CASE REPORT

We present a case report of a patient with a previously identified cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), who was admitted due to coronavirus disease 2019 (COVID-19), confirmed by polymerase chain reaction and computed tomography. Examination and treatment of these patients presents certain difficulties due to the large number of thromboembolic complications caused by a combination of congenital and infectious angiopathies. CADASIL syndrome and COVID-19 were manifested by the progression of neurological symptoms and increasing cognitive impairment. During therapy, there was a positive change with a gradual regression of these disorders. Представлен клинический пример пациентки с выявленной ранее доминантной артериопатией с субкортикальными инфарктами и лейкоэнцефалопатией (CADASIL - cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy), поступившей в клинику с новой коронавирусной инфекцией (COVID-19), подтвержденной данными ПЦР и компьютерной томографии. Обследование и терапевтическое лечение этих пациентов представляет определенные трудности в связи с большим числом тромбоэмболических осложнений, обусловленных сочетанием врожденной и инфекционно-обусловленной ангиопатий. CADASIL-синдром и новая коронавирусная инфекция, вызванная вирусом SARS-CoV-2, проявлялись прогрессией неврологической симптоматики и нарастающими когнитивными нарушениями. На фоне терапии отмечалась положительная динамика в виде постепенного регресса данных нарушений.