Photophoresis of topical steroids in the treatment of severe forms of lichen ruber planus of oral mucosa

The objective of the study is to search for new methods of treatment for lichen ruber planus with high efficacy, few complications and side effects, as well as providing a long-term therapeutic effect. The authors used the method of photophoresis (red LED radiation + topical steroid) in the combination treatment of 40 patients with severe forms of lichen ruber planu

Photophoresis of topical steroids in the treatment of severe forms of lichen ruber planus of oral mucosa

The objective of the study is to search for new methods of treatment for lichen ruber planus with high efficacy, few complications and side effects, as well as providing a long-term therapeutic effec

Carbon emission from Western Siberian inland waters

High-latitude regions play a key role in the carbon (C) cycle and climate system. An important question is the degree of mobilization and atmospheric release of vast soil C stocks, partly stored in permafrost, with amplified warming of these regions. A fraction of this C is exported to inland waters and emitted to the atmosphere, yet these losses are poorly constrained and seldom accounted for in assessments of high-latitude C balances. This is particularly relevant for Western Siberia, with its extensive peatland C stocks, which can be strongly sensitive to the ongoing changes in climate. Here we quantify C emission from inland waters, including the Ob' River (Arctic's largest watershed), across all permafrost zones of Western Siberia. We show that the inland water C emission is high (0.08-0.10 Pg C yr(-1)) and of major significance in the regional C cycle, largely exceeding (7-9 times) C export to the Arctic Ocean and reaching nearly half (35-50%) of the region's land C uptake. This important role of C emission from inland waters highlights the need for coupled land-water studies to understand the contemporary C cycle and its response to warming. Rivers and lakes are thought to be a major conduit of loss for the massive amounts of carbon locked away in high-latitude systems, but such losses are poorly constrained. Here the authors quantify carbon emissions from rivers and lakes across Western Siberia, finding that emissions are high and exceed carbon export to the Arctic Ocean

Using stable isotopes to assess surface water source dynamics and hydrological connectivity in a high-latitude wetland and permafrost influenced landscape

The research has been supported by the NERC/JPI SIWA project (NE/M019896/1); grant issued in accordance with Resolution of the Government of the Russian Federation No. 220 dated 9 April 2010, under Agreement No. 14.B25.31.0001 with Ministry of Education and Science of the Russian Federation dated 24 June 2013 (BIO-GEO-CLIM); grant RFBR No 17-05-00-348a; grant FCP “Kolmogorov” 14.587.21.0036, grant RNF No 15-17-1009, and grant RFBR No 17-55-16008. Stable water isotope data are available in the Natural Environment Research Council (NERC) Environmental Information Data Centre (EIDC) data repository (title: “Stable water isotopes in Western Siberian inland waters”, permanent identifier: https://doi.org/10.5285/ca17e364-638d-4949-befb-b18b3770aec6). We would like to acknowledge the Arctic-GRO and IAEA for their publicly available databases providing supporting data for our analyses. Stream flow data at Nikolskoe was provided by Sergey Vorobiev. Liliya Kovaleva is acknowledged for the artwork in Figure 9. We would like to thank the two anonymous reviewers and the handling editors for their constructive comments that improved the manuscript.Peer reviewedPublisher PD

Features of Medical Care Providing to Patients with Digestive Diseases in the Krasnodar Region during the COVID-19 Pandemic

The aim of the study: optimization the medical care provision to patients with diseases of the digestive system (DD) in the Krasnodar Region during the COVID-19 pandemic.Material and methods. The analysis of the features of the DD course in the Krasnodar Region was carried out according to the data of form C 51 “Distribution of the dead by sex, age groups and causes of death” of the Territorial Federal State Statistics Service in the Krasnodar Region, as well as monitoring the quality of medical care for patients with DD for the period from 2019 to 2021 years.Results. During the COVID-19 pandemic, the routing of gastroenterological patients, dispensary observation and preventive measures have undergone some changes. In the structure of total mortality in the Krasnodar Region, mortality from DD was 21.6 % in 2020 and 4.0 % in 2021. The decrease in the growth of mortality rate, including from DD, in the second year of the pandemic is associated with the completed healthcare systems reformatting. The increase in hospital mortality in patients with gastric and duodenal ulcers, ulcerative colitis, and diverticular disease had a significant impact on mortality rates from DD. The decreasing number of hospitalizations was explained due to the conversion of a number of hospitals into hospitals for the treatment of patients with COVID-19. The hospitalization was mainly carried out for emergency indications and patients with a more severe course of the disease. The pandemic has increased the need for telemedicine: 378 tele-consultations on the gastroenterological profile was carried out in the Krasnodar Region in 2021.Conclusion. Healthcare system workload in the Krasnodar Region increased significantly during the coronavirus pandemic that required a number of structural adjustments. In recent times, the regional health care is returning to the planned mode of providing medical care

High riverine CO2 emissions at the permafrost boundary of Western Siberia

Acknowledgements: The study was part of the JPI Climate initiative, financially supported by VR (the Swedish Research Council) grant no. 325-2014-6898 to J.K. Additional funding from RNF (RSCF) grant no. 18-17-00237, RFBR grant no. 17-55-16008 and RF Federal Target Program RFMEFI58717X0036 ‘Kolmogorov’ to O.S.P. and S.N.K. as well as NERC grant no. NE/M019896/1 to C.S. is acknowledged. The authors thank A. Sorochinskiy and A. Lim for assistance in the field, as well as M. Myrstener, M. Klaus and S. Monteux for advice on data analysis. L. Kovaleva is acknowledged for artwork.Peer reviewedPostprin

Surgical treatment of portal hypertension complications in patients with liver cirrhosis

Objective: Improving the results of surgical treatment of portal hypertension complications in patients with liver cirrhosis.Material and methods: The results of medical care for 328 patients with liver cirrhosis, who were treated in the surgical departments of the central district and city hospitals of the Krasnodar Region, were analyzed. The effectiveness of minimally invasive surgical treatment of portal hypertension complications in 832 patients with liver cirrhosis treated at the Regional Clinical Hospital no. 2 of the Ministry of Health of the Krasnodar Region were also evaluated.Results: The mortality rate in patients with liver cirrhosis, admitted in first-level institutions of medical care due to acute bleeding from esophageal varices, reached 26.3%. In conditions of surgical treatment of complications of portal hypertension in a third-level institution of specialized care it did not exceed 4.7%.Conclusion: The optimal approach to the surgical treatment of patients with liver cirrhosis is to stop the bleeding from esophageal varices at the first stage of medical care and to treat portal hypertension complications using minimally invasive technologies in a multidisciplinary clinic involving a multidisciplinary team of doctors

COVID-19 Pandemic and IBS. Results of the All-Russian Observational Non-interventional Program to Study the Effectiveness of the Drug Kolofort® in Real Clinical Practice in Patients with Irritable Bowel Syndrome After a New Coronavirus Infection (VESNA)

Aim: to study the effectiveness and safety of using the drug Kolofort® in outpatients with irritable bowel syndrome (IBS) after a new coronavirus infection.Materials and methods. An observational non-interventional program was conducted in patients with exacerbation of IBS symptoms after a new coronavirus infection. One hundred forty-one patients took part in the study. The final efficacy analysis included data from 127 study participants. All patients complained of increased/appearing gastrointestinal symptoms that appeared within 1–6 months after the infection (all patients had a history of COVID-19 infection). To assess the presence and severity of symptoms of the disease, the “7 × 7” questionnaire was used before the start of treatment and three months after the start of treatment.Results. At the stage of inclusion in the program, the average total score on the “7 × 7” questionnaire was 17.36, which corresponded to a moderately severe disorder. During the treatment period, the average total score decreased to 6.14, which corresponded to borderline disorder. In addition, significant improvement was observed for each symptom separately. After three months of therapy, doctors rated the overall impression of the treatment on a 5-point Likert scale from “very effective” to “ineffective”. The average score was 4.24. In addition, no serious adverse events were identified while taking the drug.Conclusion. In real clinical practice, the drug Kolofort® demonstrated high clinical efficacy in the treatment of patients with IBS after COVID-19 infection

Profile of Hepatitis B Virus Mutations Associated with HBsAg-Negative Disease in Patients of Hemodialysis Centers

The aim of this study was to characterize mutations in the hepatitis B virus (HBV) genome associated with HBsAg-negative form of the disease in patients receiving hemodialysis replacement therapy. Materials and methods. We used blood plasma samples obtained from hemodialysis centers in St. Petersburg, Russia – 173 patients and 108 patients from Belgrade, Republic of Serbia. The samples were examined for the presence of serological (HBsAg, antibodies anti-HBs IgG, anti-HBcore IgG) and molecular-genetic (HBV DNA) markers of HBV followed by whole-genome sequencing and determination of clinically significant virus mutations. Results and discussion. Antibodies to hepatitis B were detected in 7.5 % and 11.1 % of patients from St. Petersburg and Belgrade, respectively. HBsAg was identified only in 1.1 % of cases in the group from Russia and in 0.9 % of cases in the group from Serbia. HBV DNA was determined in 2.8 % of the studied samples from both, patients from Saint-Petersburg and Belgrade. Phylogenetic analysis of 9 viral isolates showed that genotype D virus (88.9 %) prevailed as compared to genotype A (11.1 %) in the examined group. Among the samples obtained from patients from St. Petersburg, four belonged to the D2 sub-genotype, one to the D3 genotype. Four samples obtained from Belgrade patients belonged to different sub-genotypes – D1, D2, D3, A2, respectively. When analyzing the nucleotide sequences of the HBV genomes, mutations in the MHR region were detected in all cases, but only in HBsAg-negative isolates, mutations were revealed in the region of 124–147 amino acids, including mutations P120T, R122K, A128V, Q129R, M133I, G145R affecting the recognition of HBsAg by anti-HBs antibodies and associated with the resistance of the virus to the vaccine. The results of this study indicate that transmission of blood-borne viral hepatitis agent in the hemodialysis departments of the Russian Federation and the Republic of Serbia still exists. The prevalence of the latent chronic hepatitis B, coupled with the presence of vaccine escape mutations in all identified cases, indicates the need to pay close attention to the occurrence of the virus mutant variants in hemodialysis centers

Prevalence of occult hepatitis B infection among blood donors in Saint Petersburg

The aim of this study was to assess the prevalence of occult hepatitis B infection among blood donors in St. Petersburg, as well as to characterize the identified virus isolates. The study material was represented by 2800 blood plasma samples collected in 2019 from blood donors living in St. Petersburg. The ELISA study for HBV marker rate consisted of HBsAg, anti-HBs IgG, anti-HBcore IgG. HBV DNA was analyzed by nested PCR with real-time hybridization-fluorescence detection on three targets allowing to determine virus DNA at low viral load, including HBsAg-negative chronic hepatitis B. Hepatitis B serological markers were detected in 69.43% of those surveyed, HBsAg was found in 0.43% of individuals, and all of which donated blood first time. A significant excess of the anti-HBcore IgG antibodies occurrence among primary donors (15.1%) compared with repeated/regular donors (7.48%) was shown. The prevalence of virus DNA in the group was 3.14%, including 2.71% of cases in HBsAg-negative CHB. Based on phylogenetic analysis of 88 isolates, HBV subgenotypes were determined in the following order: D1 and D2, 40.91% each, D3 and A2, 9.09% each. While determining the serological subtype in detected isolates, the serotype ayw3 (52.27%) vs ayw2 (46.59%) and adw2 (10.23%) prevailed. Drug resistance mutations, including compensatory ones, were detected in six examined patients (6.82%). In all genotype D isolates, multiple amino acid substitutions were identified in the RT, SHB, MHB, LHB, and Core regions; mutations in the preCore region were detected in 21.59% samples. In the MHR of the HBV genotype D genome, twenty-six positions were identified in which amino acid substitutions occurred, and all isolates showed modifications at positions 113, 114, 131, 134, 159, 161, 168, in 76 — at position 122, in 68 — at position 127, in 36 — at position 118, in 24 — at position 128. In HBV A2 isolates, mutations T113S, S143T, Y161F were identified. Nine isolates in the preCore region showed a polymorphism including a stop codon W28*W; in five isolates the W28S substitution was shown in the same position, and the W28*S variant was found in one more sample. The high incidence of HBsAg-negative CHB cases among blood donors, as well as the predominance of HBV isolates that simultaneously carry mutations resulting in diagnostic failure of HBsAg tests and prophylactic failure of immunoglobulin or vaccines and virus reactivation, mutations that contribute to disease progression obviously pose a threat to health and require to be further examined