Polypharmacy in comorbid patients with COVID-19

The aim of the study was to establish a correlation between the structure of drug prescriptions in patients diagnosed with COVID-19 and the degree of respiratory failure. The study performs data from the medical records of 53 patients. In patients under 65 years of age with respiratory insufficiency of the 1st and 2nd degree, specialists prescribe an average of 7 drugs. Patients over 65 years of age with respiratory insufficiency of the 1st degree receive an average of 11 drugs, and with the 2nd degree-9 drugs. The therapy is selected for each patient, taking into account individual needs, in accordance with the temporary recommendations of the Ministry of Health of the Russian FederationЦель работы установление корреляции между структурой лекарственных назначений у пациентов с диагнозом “COVID-19” и степенью дыхательной недостаточности. В ходе исследования были проанализированы данные медицинских карт 53 пациентов. Пациентам до 65 лет с дыхательной недостаточностью 1 и 2 степени специалистами было назначено в среднем 7 препаратов. Пациентам старше 65 лет при дыхательной недостаточности 1 степени в среднем 11 препаратов, а со 2 степенью – 9 препаратов. Терапия подбирается каждому пациенту с учётом индивидуальных потребностей в соответствии с временными рекомендациями Министерства здравоохранения Р

Антигенное разнообразие вирусов гриппа А и В, выделенных от детей в г. Санкт-Петербурге в период с 2013 по 2015 г.

Purpose of the study: study of the circulation, isolation and antigenic analysis of influenza viruses A and B in St.-Petersburg in the children aged 0–18 in the seasons 2013–2015.Materials: nasal swabs from children-inpatients from Saint-Petersburg.Methods: virus isolation in MDCK cell culture and chicken embryos, antigenic analysis with the hemagglutination inhibition (HAI) test with the set of hyper-immune rat antisera to the epidemic and reference strains, antigenic cartography.Results: The epidemic seasons 2013–2015 were characterized by the co-circulation in children in St.-Petersburg of influenza sub-types А(H1N1)pdm09, A(H3N2), and B of Yamagata lineage (B yam). In the season 2014–2015 the low activity of epidemic process was observed with the predominant sub-type A(H3N2) and in the next season – 2014–2015 with the more pronounced epidemic activity – the pre-dominance of B yam viruses. Antigenic analysis of influenza viruses А(H1N1)pdm09 which circulated in children revealed their antigenic homogeneity and full correspondence with vaccine strain A/California/07/09. As for А(H3N2) viruses, two antigenic groups were established: strains similar to A/St.-Petersburg/80/14 (sub-clade 3C.2a) and strains similar to A/Switzerland/9715293/13 (sub-clade 3C.3a). А(Н3N2) strains of the season 2013-2014 were similar to the vaccine strain. However isolates of the season 2014-2015 did not fit to the vaccine strain because in the children were predominant strains similar to the evolution branch A/St.-Petersburg/80/14 while according the WHO recommendations the influenza vaccine contained the strain A/Texas/50/12. Antigenic analysis of influenza viruses B showed their homogeneity and all they were B/Phuket/3073/13-like. Influenza strains B also incompletely corresponded to the vaccine strain – B/Massachusetts/2/12 belonging to the different genetic sub-clade. That might be the reason of enhanced morbidity of children with influenza B in the last season.Conclusion: The obtained results stress the urgency for the wide coverage of human population with the epidemic studies, virus isolation in different time periods and geographic regions and their etiological studies with the modern techniques. Only in these conditions we can assure high efficiency of flu seasonal vaccines.Цель исследования: особенности циркуляции, выделение и антигенный анализ вирусов гриппа А и В в Санкт-Петербурге в 2013–2015 гг. от детей от 0 до 18 лет.Материалы исследования: назальные мазки от детей из стационаров и закрытых детских учреждений Санкт-Петербурга.Методы: выделение вирусов на культуре клеток MDCK и куриных эмбрионах, антигенный анализ методом реакции торможения гемагглютинации (РТГА) с набором гипериммунных крысиных антисывороток к эталонным и эпидемическим штаммам гриппа, антигенная картография.Результаты: в эпидемические сезоны 2013–2015 гг. в г. Санкт-Петербурге среди детей была выявлена совместная циркуляция вирусов гриппа А(H1N1)pdm09, A(H3N2), B Ямагатской линии (B yam), причем в сезоне 2013–2014 гг. при общей невысокой активности эпидемического процесса преобладали вирусы A(H3N2), а в следующем эпидемическом сезоне – 2014–2015 гг. – при более высокой интенсивности эпидемии – вирусы В yam. Антигенный анализ вирусов А(H1N1)pdm09, циркулировавших среди детей, выявил их антигенную однородность и полное соответствие вакцинному штамму А/Калифорния/07/09. Зафиксирован антигенный дрейф вирусов А(H3N2), выявлены 2 антигенные группы: вирусы, подобные А/Санкт-Петербург/80/14 (генетическая подгруппа 3С.2а) и вирусы, подобные А/Швейцария/9715293/13 (подгруппа 3С.3а). Вирусы А(Н3N2) сезона 2013–2014 гг. были подобны вакцинному штамму. В то же время изоляты сезона 2014–2015 гг. не соответствовали вакцинному штамму, поскольку среди детей в основном выявлены штаммы, подобные эволюционной ветви А/Санкт-Петербург/80/14, а в вакцину по рекомендации ВОЗ был включен штамм А/Техас/50/12. Антигенный анализ вирусов гриппа В yam показал их однородность, они были подобны эталонному вирусу В/Пхукет/3073/13. Вирусы В также антигенно не полностью соответствовали вакцинному компоненту, поскольку данные вирусы были подобны штамму В/Пхукет/3073/13, а в состав вакцины входил штамм В/Массачусетс/2/12, принадлежащий к другой генетической подгруппе, что могло привести к повышению заболеваемости детей гриппом типа В в данном сезоне. Заключение: для своевременного правильного выбора штаммов, входящих в состав сезонных противогриппозных вакцин, по-прежнему актуальной остается задача как можно более широкого охвата населения эпидемиологическими исследованиями, выделения вирусов в разные периоды эпидемического сезона и в разных географических регионах, их антигенный и генетический анализ современными методами

VISUALIZATION OF THE EXCITATION PROCESS IN THE FROG'S NERVES

Aim. Visualization of the excitation process in the frog's nerves.Materials and methods. Observations were carried out on 30 immobilized frogs. Vagosympathetic trunks and sciatic nerve were  allocated from the frogs. Ligatures were placed on the right  vagosympathetic trunk crossing it. A scanner of the gas discharge  visualization camera of the CELSY device, which created a high- frequency electromagnetic field (1024 Hz), was installed above the  nerves. The scanner with a highly sensitive camera shot a 60-second video (the frequency of frame-by-frame shooting to 1000 frames per second), during which the edge luminescence (Kirlian effect) and the  glow spots were recorded inside the nerve. The  electrocardiogram (ECG) was synchronously recorded in the I  standard lead. The processing of the obtained results was carried out according to the area of the glow spot, the area of the highest luminescence brightness, the direction of the movement of  the foci of the luminescence, and the linear velocity of the movement of the glow foci.Results. Foci of the internal luminescence appeared only in the high-frequency electromagnetic field in the sciatic nerve of the frog  when the nerve was stimulated by electrical impulses, which resulted in the contraction of the frog's foot. Glow foci of the brain  synchronous to the heart rhythm and preceding the tooth of the V- wave on the frog’s ECG were observed at the central end of the cut  of the frog’s vagosympathetic trunk. Conclusion. Visualized foci of luminescence in the nerve reflect the neural activity

Certification and potential future use of the reference standard designed for the test system for determination of the fractional (antigenic) composition of human serum products by immunoelectrophoresis

The article gives an account of certification performed for a new batch of a Reference standard to be used with the test system for determination of the fractional (antigenic) composition of human serum products by immunoelectrophoresis -industry reference standard (IRS) 42-28-77 - in accordance with existing requirements. A candidate reference standard was represented by a batch of normal human serum intended for diagnostic purposes (more than 500 donors) and a batch of immunoelectrophoresis serum against human serum proteins (antiserum against human serum proteins). In accordance with the certification programme, the fractional (antigenic) composition of the reference standard was determined by immunoelectrophoresis using «KliniTest-EF» buffer and 0.05 M borate buffer solution and the modes stipulated in the general monograph 1.8.2.0002.15 Agar gel immunoelectrophoresis. The reaction between the antiserum against human serum proteins and the normal human serum components of the reference standard produced at least 15 precipitation lines. The study demonstrated that the bromphenol blue dye could be used together with «KliniTest-EF» buffer to assess albumin migration, and the pyronin B dye could be used together with «KliniTest-EF» buffer and 0.05 M borate buffer solution to assess immunoglobulin migration. The study confirmed the applicability of the certified reference standard designed for the test system for determination of the fractional (antigenic) composition of human serum products by immunoelectrophoresis, and set the criteria for its use in the context of human serum products identification (species specificity) testing not only by immunoelectrophoresis, but also by agar-gel immunodiffusion

HAEMAGGLUTINATION TECHNIQUES TO EVALUATE SPECIFIC SAFETY OF HUMAN INTRAVENOUS IMMUNOGLOBULINS

The safety issues of human intravenous immunoglobulin preparations are particularly important in modern pharmacotherapy for immunodeficiencies, hematologic and neurologic diseases, like as at transplant centers. Upon massive infusions of these media some complications are detected that are associated with spontaneous activation of complement system accompanied by production of anaphylatoxins, as well as activation of kallikrein/kinin, plasmin, and blood coagulation systems, changed blood rheology, initiation of intravascular hemolysis. For distinct groups of patients, these complications may be due to presence of some anti-erythrocyte antibodies (e.g., anti-A and anti-B haemagglutinins, anti-D antibodies) in the intravenous human immunoglobulin preparations. In the present review article, we show development of current quality standards for human intravenous immunoglobulins based on determination of antibody contents. Antibodies to erythrocytes represent a special safety index aiming to minimize risk of possible adverse effects connected with transfusions of human blood preparations. Different haemagglutination tests were compared to assess contents of anti-A, anti-B haemagglutinins and anti-D antibodies for specific safety of human intravenous immunoglobulins. Analysis of haemagglutination techniques for evaluation of human intravenous immunoglobulin preparations revealed their relative advantages and disadvantages. Various modifications of the methods are discussed, thus allowing to optimize process of quality control for these preparations based on detection of haemagglutinins and anti-D antibodies. We demonstrate a necessity to adjust regulations and to improve evaluation techniques for haemagglutinin determination in human immunoglobulin preparations at amounts of 100 mg/ml of protein. Special features of Russian national quality standards for human immunoglobulin preparations are considered with respect to assessment of haemagglutinins and anti-D contents. One may conclude that haemagglutination methods present the most informative and economically substantiated approach when assessing specific safety of human intravenous immunoglobulins by measuring contents of anti-A, anti-B haemagglutinins, and anti-D antibodies

Contemplation of the possibility of extending the shelf life of human immunoglobulin reference standard used for determination of anticomplementary activity

The article gives an account of the stability study performed for two batches of human immunoglobulin reference standard (RS) used for determination of anticomplementary activity (industry reference standard, IRS 42-28-430). The first batch of human immunoglobulin reference standard used for determination of anticomplementary activity showed sustainable results during 30 months of storage at (5±3) °C which makes it possible to extend the RS shelf life from 18 months (corresponding to the initial monitoring period) to 30 months from the date of determining the certified parameter, given the acceptable range of more than 50 % for the positive control and less than 50 % for the negative control. Based on the results obtained, the re-certification was performed for the second RS batch after 18 months of storage. The main certified parameter (anticomplementary activity) of the negative control was within the range of 41.6±7.2 %, and of the positive control 75.7±6.8 % for the confidence level of 0.95. Therefore, the shelf life of the second batch of the human immunoglobulin reference standard used for determination of anticomplementary activity (IRS 42-28-430) was extended until February 2018, which makes 30 months

Antigenic variability of influenza viruses A and B isolated from children in Saint-Petersburg in the period 2013–2015

Purpose of the study: study of the circulation, isolation and antigenic analysis of influenza viruses A and B in St.-Petersburg in the children aged 0–18 in the seasons 2013–2015.Materials: nasal swabs from children-inpatients from Saint-Petersburg.Methods: virus isolation in MDCK cell culture and chicken embryos, antigenic analysis with the hemagglutination inhibition (HAI) test with the set of hyper-immune rat antisera to the epidemic and reference strains, antigenic cartography.Results: The epidemic seasons 2013–2015 were characterized by the co-circulation in children in St.-Petersburg of influenza sub-types А(H1N1)pdm09, A(H3N2), and B of Yamagata lineage (B yam). In the season 2014–2015 the low activity of epidemic process was observed with the predominant sub-type A(H3N2) and in the next season – 2014–2015 with the more pronounced epidemic activity – the pre-dominance of B yam viruses. Antigenic analysis of influenza viruses А(H1N1)pdm09 which circulated in children revealed their antigenic homogeneity and full correspondence with vaccine strain A/California/07/09. As for А(H3N2) viruses, two antigenic groups were established: strains similar to A/St.-Petersburg/80/14 (sub-clade 3C.2a) and strains similar to A/Switzerland/9715293/13 (sub-clade 3C.3a). А(Н3N2) strains of the season 2013-2014 were similar to the vaccine strain. However isolates of the season 2014-2015 did not fit to the vaccine strain because in the children were predominant strains similar to the evolution branch A/St.-Petersburg/80/14 while according the WHO recommendations the influenza vaccine contained the strain A/Texas/50/12. Antigenic analysis of influenza viruses B showed their homogeneity and all they were B/Phuket/3073/13-like. Influenza strains B also incompletely corresponded to the vaccine strain – B/Massachusetts/2/12 belonging to the different genetic sub-clade. That might be the reason of enhanced morbidity of children with influenza B in the last season.Conclusion: The obtained results stress the urgency for the wide coverage of human population with the epidemic studies, virus isolation in different time periods and geographic regions and their etiological studies with the modern techniques. Only in these conditions we can assure high efficiency of flu seasonal vaccines