Asymptomatic cholelithiasis in bariatric practice

Background: The need for simultaneous cholecystectomy for asymptomatic cholelithiasis in patients undergoing bariatric intervention has not been proven. The experience of managing patients with obesity and concomitant disease cholelithiasis is presented. Aim: to determine the indications for simultaneous cholecystectomy and bariatric surgery in the combination of morbid obesity and a asymptomatic cholelithiasis. Methods: The results of observation of 37 patients with initially asymptomatic cholelithiasis were analyzed: 27 patients underwent bariatric surgery and simultaneous cholecystectomy, and 10 patients underwent only bariatric surgery. The immediate and long-term results of the treatment, the quality of life of patients and the cost of the treatment were assessed. Results: During 12 months of the follow-up, none of the patients who underwent simultaneous cholecystectomy developed any complications. Of the 10 patients in the observation group, 3 were operated on. Two patients underwent laparoscopic cholecystectomy for acute cholecystitis and one patient was operated on for choledocholithiasis with obstructive jaundice. The greatest improvement in the quality of life was observed in the gastric bypass group with simultaneous cholecystectomy. The treatment cost per patient was lower in that group, too. Conclusion: In the presence of asymptomatic cholelithiasis in a patient with morbid obesity, bariatric intervention and simultaneous cholecystectomy prevents the development of complications of cholelithiasis and thereby potentially improves the quality of life and reduces the cost of medical care

Diversity of CRISPR loci in <i>Yersinia pseudotuberculosis</i> strains and their association with pathogenicity factors

Introduction. Heterogeneous microbial populations exist in the nature due to exchange of genetic material containing in extrachromosomal and transposable elements. Structures controlling horizontal gene transfer may affect development of pathogen genetic variants. The aim of the study is to analyze molecular genetic characteristics of CRISPR-loci in Yersinia pseudotuberculosis strains circulating in Russia and their association with pathogenicity factors. Materials and methods. We studied 56 strains of Y. pseudotuberculosis isolated from different sources in Russia during 19352014 from various sources in different regions of Russian Federation and in other countries. DNA fragments with CRISPR-loci were isolated and amplified by PCR, and subjected to Sanger sequencing. PCR was used to determine chromosomal genes of superantigen ypmA/C, pathogenicity islands HPI, YAPI, and plasmids pYV and pVM82. Results. Analysis of CRISPR-loci in Y. pseudotuberculosis showed that spacer content varies in strains depending on serotype, set of pathogenicity factors, and isolation place. The most variable loci are YP1 and YP3, locus YP2 is homogeneous. Locus YP1 varies in strains that differ by presence of plasmid pVM82, while content of locus YP3 depends on presence of plasmid pVM82 and adhesion pathogenicity island YAPI. Conclusion. Strains of Y. pseudotuberculosis circulating in Russia have a huge diversity of pathogenicity factors and CRISPR spacer content. Most of Russian strains differ by molecular markers from strains isolated in other countries. High variability is defined by ability to get new genetic elements in horizontal gene transfer. In bacteria, CRISPR-Cas system provides immunity against mobile genetic elements and can participate in formation of Y. pseudotuberculosis pathogenic potential

Mineral Nutrition of Naturally Growing Scots Pine and Norway Spruce under Limited Water Supply

The deterioration of plant mineral nutrition during drought is a significant factor in the negative influence of drought on plant performance. We aimed to study the effects of seasonal and multiyear water shortages on nutrient supply and demand in Scots pine and Norway spruce. We studied pine and spruce trees naturally grown in the Bryansk region (Russia). The dynamics of several nutrients (K, Ca, Mg, P, Fe, Mn, Zn, and Ca) in wood, needles, and bark of current-year twigs and the dynamics of the available pools of these elements at different soil depths were analysed. To assess the physiological consequences of changes in element concentrations, lipid peroxidation products and photosynthetic pigments were measured in the needles. Water shortage increased the wood concentrations of all elements except for Mn. In pine, this increase was mainly due to seasonal water deficit, whereas in spruce, multiyear differences in water supply were more important. This increased availability of nutrients was not observed in soil-based analyses. In needles, quite similar patterns of changes were found between species, with Mg increasing almost twofold and Fe and Mn decreasing under water shortage, whereas the remainder of the elements did not change much under differing water supplies. Neither the concentrations of photosynthetic pigments nor the contents of lipid peroxidation products correlated with element dynamics in needles. In summary, water shortage increased the availability of all elements except Mn for the plant; however, needle element contents were regulated independently of element availability for plants

Sputnik Light and Sputnik V Vaccination Is Effective at Protecting Medical Personnel from COVID-19 during the Period of Delta Variant Dominance

Medical personnel are a group of people that often encounter infectious agents, leading to greater risk of contracting infectious diseases. Specific prevention of diseases in this group is a priority. The epidemiological effectiveness of COVID-19 prevention in the group of medical workers due to the emergence of new variants of concern of the SARS-CoV-2 virus has not been studied in sufficient depth. We conducted a study of the effectiveness of vaccine use to protect medical workers at a large medical center for obstetrics and gynecology in Moscow. Sputnik V and Sputnik Light were the main vaccines used for the prevention of COVID-19. The vaccines are based on a variant of the S-protein of the SARS-CoV-2 virus, with adenovirus serotypes 5 and 26 as the vector for delivery. Vaccination of employees occurred during the period in which the Delta variant was spreading. The overall epidemiological effectiveness was 81.7% (73.1&ndash;87.6%) during the period in which the Delta variant was dominant. During the period from the beginning of vaccination (26 November 2020) until 8 February 2022, the overall effectiveness was 89.1% (86.9&ndash;91.0%). As expected, the highest effectiveness during this period was obtained in the group that received the third and fourth doses&mdash;96.5% (75.0&ndash;99.5%). The severity of COVID-19 in the vaccinated group was significantly lower than in the unvaccinated group

Revaccination in Age-Risk Groups with Sputnik V Is Immunologically Effective and Depends on the Initial Neutralizing SARS-CoV-2 IgG Antibodies Level

Vaccination against COVID-19 has occurred in Russia for more than two years. According to the Russian official clinical guidelines to maintain tense immunity in the conditions of the ongoing COVID-19 pandemic, it is necessary to use booster immunization six months after primary vaccination or a previous COVID-19 contraction. It is especially important to ensure the maintenance of protective immunity in the elderly, who are at risk of severe courses of COVID-19. Meanwhile, the immunological effectiveness of the booster doses has not been sufficiently substantiated. To investigate the immunogenicity of Sputnik V within the recommended revaccination regimen and evaluate the effectiveness of booster doses, we conducted this study on 3983 samples obtained from individuals previously vaccinated with Sputnik V in Moscow. We analyzed the level of antibodies in BAU/mL three times: (i) six months after primary immunization immediately before the booster (RV), (ii) 3 weeks after the introduction of the first component of the booster (RV1), and (iii) 3 weeks after the introduction of the second component of the booster (RV2). Six months after the primary vaccination with Sputnik V, 95.5% of patients maintained a positive level of IgG antibodies to the receptor-binding domain (RBD) of SARS-CoV-2. The degree of increase in the specific virus-neutralizing antibodies level after revaccination increased with a decrease in their initial level just before the booster dose application. In the group of people with the level of antibodies up to 100 BAU/mL six months after the vaccination, a more than eightfold increase (p p p p < 0.05), regardless of the previous COVID-19 infection. Thus, revaccination is most effective in individuals with an antibody level below 500 BAU/mL, regardless of the vaccinee age and COVID-19 contraction. For the first time, it has been shown that a single booster dose of the Sputnik vaccine is sufficient to form a protective immunity in most vaccinees regardless of age and preexisting antibody level

Dynamics of SARS-CoV-2 Major Genetic Lineages in Moscow in the Context of Vaccine Prophylaxis

Findings collected over two and a half years of the COVID-19 pandemic demonstrated that the level immunity resulting from vaccination and infection is insufficient to stop the circulation of new genetic variants. The short-term decline in morbidity was followed by a steady increase. The early identification of new genetic lineages that will require vaccine adaptation in the future is an important research target. In this study, we summarised data on the variability of genetic line composition throughout the COVID-19 pandemic in Moscow, Russia, and evaluated the virological and epidemiological features of dominant variants in the context of selected vaccine prophylaxes. The prevalence of the Omicron variant highlighted the low effectiveness of the existing immune layer in preventing infection, which points to the necessity of optimising the antigens used in vaccines in Moscow. Logistic growth curves showing the rate at which the new variant displaces the previously dominant variants may serve as early indicators for selecting candidates for updated vaccines, along with estimates of efficacy, reduced viral neutralising activity against the new strains, and viral load in previously vaccinated patients

Assessment of Diagnostic Specificity of Anti-SARS-CoV-2 Antibody Tests and Their Application for Monitoring of Seroconversion and Stability of Antiviral Antibody Response in Healthcare Workers in Moscow

Anti-SARS-CoV-2 antibody testing is an efficient tool to assess the proportion of seropositive population due to infection and/or vaccination. Numerous test systems utilizing various antigen composition(s) are routinely used for detection and quantitation of anti-SARS-CoV-2 antibodies. We determined their diagnostic specificity using archived true-negative samples collected before the onset of the COVID-19 pandemic. Using test systems demonstrating 98.5&ndash;100% specificity, we assessed the dynamics of SARS-CoV-2 seroconversion and durability of anti-spike (S) antibodies in healthcare professionals (n = 100) working in Moscow during the first two cycles of the pandemic (May 2020 to June 2021) outside of the &ldquo;red zone&rdquo;. Analysis revealed a rapid increase in anti-SARS-CoV-2 seropositivity from 19 to 80% (19/100 and 80/100, respectively) due to virus exposition/infection; only 16.3% of seroconversion cases (13/80) were due to vaccination, but not the virus exposure, although massive COVID-19 vaccination of healthcare workers was performed beginning in December 2020. In total, 12.7% (8/63) remained positive for anti-SARS-CoV-2 IgM for &gt;6 months, indicating unsuitability of IgM for identification of newly infected individuals. All except one remained seropositive for anti-S antibodies for &gt;9 months on average. Significant (&gt;15%) declines in anti-SARS-CoV-2 antibody concentrations were observed in only 18% of individuals (9/50). Our data on the high seropositivity rate and stability of anti-SARS-CoV-2 antibody levels in healthcare personnel working outside of the &ldquo;red zone&rdquo; indicate their regular exposition to SARS-CoV-2/an increased risk of infection, while a low frequency of vaccine-induced antibody response acquired after the start of vaccination points to vaccine hesitancy

DataSheet_1_Estimation of anti-orthopoxvirus immunity in Moscow residents and potential risks of spreading Monkeypox virus.docx

WHO has declared the outbreak of monkeypox as a public health emergency of international concern. In less than three months, monkeypox was detected in more than 30 000 people and spread to more than 80 countries around the world. It is believed that the immunity formed to smallpox vaccine can protect from monkeypox infection with high efficiency. The widespread use of Vaccinia virus has not been carried out since the 1980s, which raises the question of the level of residual immunity among the population and the identification of groups requiring priority vaccination. We conducted a cross-sectional serological study of remaining immunity among Moscow residents. To do this, a collection of blood serum samples of age group over 30 years old was formed, an in-house ELISA test system was developed, and a virus neutralization protocol was set up. Serum samples were examined for the presence of IgG antibodies against Vaccinia virus (n=2908), as well as for the ability to neutralize plaque formation with a Vaccinia virus MNIIVP-10 strain (n=299). The results indicate the presence of neutralizing antibody titer of 1/20 or more in 33.3 to 53.2% of people older than 45 years. Among people 30-45 years old who probably have not been vaccinated, the proportion with virus neutralizing antibodies ranged from 3.2 to 6.7%. Despite the higher level of antibodies in age group older than 66 years, the proportion of positive samples in this group was slightly lower than in people aged 46-65 years. The results indicate the priority of vaccination in groups younger than 45, and possibly older than 66 years to ensure the protection of the population in case of spread of monkeypox among Moscow residents. The herd immunity level needed to stop the circulation of the virus should be at least 50.25 – 65.28%.</p