Annals of the Russian Academy of Medical Sciences

Despite significant advances in antiretroviral therapy (ART), HIV/AIDS continues to pose a serious global public health threat. According to 2021 statistics, there were 1.5 million new HIV infections worldwide, with approximately 38.4 million people living with the virus. While ART has transformed HIV into a manageable chronic condition, a preventive vaccine remains the most promising solution for controlling the epidemic, particularly in developing countries with limited healthcare resources. This review focuses on the attenuated vaccinia virus strain NYVAC as a promising recombinant vector platform for HIV vaccine development. Therefore this recombinant vector was used as share in strategy immunization prime/boost in common with DNA-vaccines. As vector’s virus NYVAC is attenuated and safe for man with immunodeficiency as considerate for creation of vaccines, in main, against AIDS. Only in alone clinical trial RV144 was received modest positive response against challenge by human deficiency virus. Therefore, comparative characteristic of immune responses, inducing by recombinant vector ALVAC, used in this trial, with recombinant vector NYVAC with identical conditions, reveal preference vector NYVAC. It triggers research about substitution vector ALVAC on NYVAC, preserved regimen mimicking that of the RV144: two prime / two boost, using only one vector, insertion maximum quantity genes of antigenic determinants human immunodeficiency virus, addition protein gp120 for enhance quantity envelope proteins. Besides this, replication-restricted strain NYVAC has been modified by reincorporation in her genome of the earlier deleted genes K1L and C7L with generation vector’s virus NYVAC-C-KC, which replicate in human cells — keratinocytes and dermal fibroblasts. Again receiving strain NYVAC-C-KC, additionally modified by deleting immunomodulate gene B19R an inhibitor of the type I interferon response with generated new vector’s virus NYVAC-C-KC-∆ B19R, which expressed greater quantity antigenic determinants of human immunodeficiency virus by increasing time reproduction in human cells. All this properties of new vector’s virus NYVAC, most probably, positive plead on effectivity vaccine against HIV infection.

Background. The World Health Organization (WHO) recommends conducting regional operational studies of fully oral modified shorter treatment regimens for multidrug/rifampicin-resistant tuberculosis in different countries to achieve an indicator of tuberculosis treatment effectiveness. Aims — to evaluate the efficacy and safety of 9-month, fully oral four-component treatment regimen for patients with MDR and pre-XDR-TB in two administrative regions of the Russian Federation. Methods. In frame of operational research conducted in the Arkhangelsk and Vladimir regions, 167 MDR-TB patients started 9-month treatment. Based on results of drug susceptibility testing of mycobacteria to fluoroquinolones, 134 participans received therapy with combination of levofloxacin (Lfx), bedaquiline (Bdq), linezolid (Lzd), clofazimine (Cfz), one patient — with levofloxacin (Lfx), bedaquiline (Bdq), delamanid (Dlm), clofazimine (Cfz), and 32 patients with — bedaquiline (Bdq), linezolid (Lzd), delamanid (Dlm) and clofazimine (Cfz). The molecular genetic verification of MDR-TB was 98.2%. HIV and hepatitis C co-infection was confirmed for 13.2% and 16.8% of participants, respectively. Adults, two teenagers and a pregnant woman participated in the study. Results. Favorable treatment outcomes were registered for 137 (82%) patients. Two of them had recurrence of the active TB disease. 15 (9%) patients were lost-to-follow-up, 7 (4.2%) patients had failure outcomes, and 8 (4.8%) patients died during treatment. On average, the culture conversion occurred after the first month of treatment. Active safety monitoring revealed 483 adverse events in 167 patients, the most frequent were: hepatotoxic reaction (in 89 patients, 53.3%), anemia (in 62 patients, 37.1%), QT prolongation (in 41 patients, 24.6%), polyneuropathy (in 45 patients, 26.9%). The frequency of serious adverse events was 9.5% of total number of adverse events. Conclusions. The results of an operational study of fully oral 9-month four-component treatment regimens demonstrate the achievement of WHO tuberculosis treatment effectiveness indicators (more than 80%), and low level of serious adverse events. They can be recommended for the national clinical guidelines.

Background. Malignant ischemic stroke (MIS) in the middle cerebral artery (MCA) is the most severe form of ischemic stroke, accompanied by the occurrence of numerous (cerebral and extracerebral) complications. Aims — to determine the spectrum and frequency of complications of malignant ischemic stroke in the middle cerebral artery (MCA) and evaluate their impact on the course and outcome of the disease. Methods. 48 patients with MCI in the MCA-supplied territory, age: 44 to 90 years, average age — 71.4 ± 1.8 years. 58.3% of the participants were female. 79.2% received conservative treatment only, 21% underwent decompressive hemicraniectomy. Results. Extracerebral complications during hospital confinement were registered in 87.5% of patients with MCI in the MCA-supplied territory, cerebral (dislocation syndrome) — in 100%. The most common extracerebral complications are the development of nosocomial pneumonia (73% of patients) and anemia (56.2%). Conclusion. Malignant ischemic stroke in the MCA is accompanied by the inevitable development of numerous complications that require a multidisciplinary approach to the treatment of this category of patients. The determining predictors of the unfavorable course and outcome of IIS are cerebral.

This study analyzes the effectiveness and safety of local insulin therapy in the treatment of corneal epithelial defects (ED). Methods. An analytical study of all available publications on this topic was conducted using PubMed, eLibrary, CENTRAL and manual search. Our criteria were met by 19 scientific articles. Result. This retrospective included 428 eyes. Patients without diabetes accounted for 36%, and patients with diabetes type 1 or 2 accounted for 64%. The size of the corneal ED at the beginning of therapy varied in different studies from 2.2 ± 1.3 to 65.8 ± 20.0 mm². In 94% of cases, complete epithelialization occurred, while the remaining 6% showed a decrease in ED size. The duration of treatment ranged from 60 hours to 62.3 ± 34.6 days. The healing rate averaged 1 month when instillation of insulin drops was used 4 times a day at a low concentration of 0.5–1.0 IU/ml. As a solvent, the greatest effect was achieved with the use of artificial tears. Conclusion. Local insulin therapy in real clinical practice makes it possible to achieve early healing of corneal ED, without causing side effects. This method of treatment allows you to reduce medical costs, as well as the volume of medical care.

With a high level of fundamental research, there is a gap between fundamental and applied research, and there is a discrepancy between the proposed research results and possible integration into industrial production cycles. Within the life cycle of a pharmaceutical product, reliable processes are the foundation for the successful operation of the enterprise. The duration of development of pharmaceutical products and projects for their implementation require the involvement of significant resources and are associated with significant risks. Starting from the earliest stages of project implementation, it is advisable to use universal, fairly simple indicators and metrics that do not depend on the type of technology and systems being developed, which allow for an adequate assessment of their current development. The production readiness level is a unified parameter used as a tool for assessing how close the results of the project’s technology readiness are to market expectations. It includes measuring the maturity of the technologies/product being developed and will allow you to quickly assess the “maturity” of the selected portfolio, assess the current and desired future of the project, improve the quality of planning, implementation and sustainability of the project.

Background. Posterior spinal fusion with multisegmental fixation with pedicle screws is the method of choice in the treatment of patients with severe scoliosis. Malposition of pedicle screws, as a cause of implant-associated complications when using the free-hand technique of their implantation, occurs with a frequency of 1.5 to 50.0%. High risks of implant-associated complications require the widespread implementation of technologies for their prevention, including O-arm navigation and additive technologies. Aims — to compare the accuracy and safety of surgical correction of scoliosis using the free-hand technique, O-arm navigation and additive technologies to reduce the risk of implant-associated complications. Methods. A total of 72 patients operated on for scoliotic deformity were included in the study. Group I included 25 patients (447 screws) operated on using the free-hand technique of transpedicular screw implantation, group II included 25 patients (528 screws) operated on using O-arm navigation, and group III included 22 patients (430 screws) operated on using additive technologies based on 3D printing. A comparative analysis of the frequency and distribution of malpositions was carried out in the groups, as well as a search for relationships between various radiographic parameters. Results. In the free-hand group, the average angle of deformation before surgery was 78.48 ± 18.28, the total frequency of malpositions was 16.6%, including: grade 1 — 2.01%, grade 2 — 6.94%, grade 3 — 7.6%. In the O-arm group, the angle of deformation was 90.84 ± 30.16, a total of malpositions was 4.92%, including: grade 1 — 1.52%, grade 2 — 2.84%, grade 3 — 0.57%. In the 3D printing group, the average angle was 95.36 ± 20.93, a total of malpositions was 6.28%, including: grade 1 — 3.72%, grade 2 — 2.33%, grade 3 — 0.23%. When assessing the relationship between the rotation of the apical vertebra and the Cobb angle of deformation on the frequency of malpositions in the free-hand group, a high degree of direct relationship was found (p < 0.05). No correlation was found between the frequency of malpositions and rotations of the apical vertebra and the Cobb angle of deformation in the O-arm group. In the 3D group, a moderate correlation was observed (p < 0.05). In the free-hand group, 1 neurological complication was noted, in the O-arm and 3D groups, no complications were noted. Conclusions. The use of free-hand — the technique of installing pedicle screws in surgical correction of spinal deformities is relatively safe. However, an increase in the severity of spinal deformity is associated with a high risk of implant-associated complications in severe spinal deformities. The use of O-arm navigation and additive technologies significantly reduces the risk of implant-associated complications, which increases the effectiveness and safety of surgical correction of severe forms of scoliosis.

January 12, 2025 is the 85th anniversary of an outstanding world-renowned scientist, the largest specialist in the field of population genetics, genetic epidemiology, genetics of multifactorial diseases, gene mapping of hereditary diseases, the founder of a new scientific field — genetic epidemiology of hereditary diseases, Honored Scientist of the Russian Federation, Doctor of Biological Sciences, Professor, Academician of the Russian Academy of Sciences Evgeny Konstantinovich Ginter.

February 15, 2025 marked the 75th anniversary of the birth of the country’s leading scientist, innovator, talented leader and teacher in the field of vascular surgery, Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences Alexander Vasilyevich Gavrilenko.