[Molecular methods for diagnosing novel coronavirus infection: comparison of loop-mediated isothermal amplification and polymerase chain reaction].

INTRODUCTION: Currently, the basis for molecular diagnostics of most infections is the use of reverse transcription polymerase chain reaction (RT-PCR). Technologies based on reverse transcription isothermal loop amplification (RT-LAMP) can be used as an alternative to RT-PCR for diagnostic purposes. In this study, we compared the RTLAMP and RT-PCR methods in order to analyze both the advantages and disadvantages of the two approaches. MATERIAL AND METHODS: For the study, we used reagent kits based on RT-PCR and RT-LAMP. The biological material obtained by taking swabs from the mucous membrane of the oropharynx and nasopharynx in patients with symptoms of a new coronavirus infection was used. RESULTS: We tested 381 RNA samples of the SARS-CoV-2 virus (Coronaviridae: Coronavirinae: Betacoronavirus; Sarbecovirus) from various patients. The obtained values of the threshold cycle (Ct) for RT-PCR averaged 20.0 ± 3.7 s (1530 ± 300 s), and for RT-LAMP 12.8 ± 3.7 s (550 ± 160 s). Proceeding from the theoretical assumptions, a linear relationship between values obtained in two kits was proposed as a hypothesis; the correlation coefficient was approximately 0.827. At the same time, for samples with a low viral load (VL), the higher Ct values in RT-LAMP did not always correlated with those obtained in RT-PCR. DISCUSSION: We noted a significant gain in time for analysis using RT-LAMP compared to RT-PCR, which can be important in the context of testing a large number of samples. Being easy to use and boasting short turnaround time, RT-LAMP-based test systems can be used for mass screening in order to identify persons with medium and high VLs who pose the greatest threat of the spread of SARS-CoV-2, while RT-PCR-based diagnostic methods are also suitable for estimation of VL and its dynamics in patients with COVID-19.

[Monitoring the spread of the SARS-CoV-2 (Coronaviridae: Coronavirinae: Betacoronavirus; Sarbecovirus) variants in the Moscow region using targeted high-throughput sequencing].

INTRODUCTION: Since the outbreak of the COVID-19 pandemic caused by SARS-CoV-2 novel coronavirus, the international community has been concerned about the emergence of mutations altering some biological properties of the pathogen like increasing its infectivity or virulence. Particularly, since the end of 2020, several variants of concern have been identified around the world, including Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2). However, the existing mechanism of detecting important mutations are not always effective enough, since only a relatively small part of all pathogen samples can be examined by whole genome sequencing due to its high cost. MATERIAL AND METHODS: In this study, we have designed special primer panel and used it for targeted highthroughput sequencing of several significant S-gene (spike) regions of SARS-CoV-2. The Illumina platform averaged approximately 50,000 paired-end reads with a length of ≥150 bp per sample. This method was used to examine 579 random samples obtained from COVID-19 patients in Moscow and the Moscow region from February to June 2021. RESULTS: This study demonstrated the dynamics of distribution of several SARS-CoV-2 strains and its some single mutations. It was found that the Delta strain appeared in the region in May 2021, and became prevalent in June, partially displacing other strains. DISCUSSION: The obtained results provide an opportunity to assign the viral samples to one of the strains, including the previously mentioned in time- and cost-effective manner. The approach can be used for standardization of the procedure of searching for mutations in individual regions of the SARS-CoV-2 genome. It allows to get a more detailed data about the epidemiological situation in a region.

[Errors in the diagnosis and treatment of severe craniocerebral injuries complicated by shock]. / Oshibki v diagnostike i lechenii sochetannykh tiazhelykh cherepno-mozgovykh travm, oslozhnennykh shokom.

The frequency and character of errors in the diagnosis and treatment of 239 patients with shock mainly caused by a severe craniocerebral injury combined with other damages were studied. It was established that the percentage of diagnostic errors in these cases was quite high both in the prehospital stage and in the hospital (41 and 23%, respectively). Such injuries take o latent course, masking each other. It is shown that craniocerebral injury and blood loss have an aggravating effect on shock developing in a combined trauma. The advancing cerebral hypoxia in severe shock intensifies the affection of the brain caused by the direct trauma, which makes the diagnosis of craniocerebral and extracranial injuries very difficult. Underestimation of the severity of the developing shock leads to deficient antishock therapy.

[Diagnosis and treatment of primary malignant thyroid tumors in an endemic focus]. / O diagnostike i lechenii pervichnykh zlokachestvennykh opukholei shchitovidnoi zhelezy v éndemicheskom ochage.

In authors' opinion an inadequate knowledge of the clinical course and disparagement of the role of puncture and operation biopsies constitute the causes of hypodiagnosis of primary malignant tumors. An exceptional use of repeated operations in case of "histologic discoveries" of the tumors together with underestimation of radialogic and hormonal treatment should be considered as therapeutic errors.

[Cholecystostomy in elderly patients in light of the immediate and late results]. / Kholetsistostomiia u bol'nykh pozhilogo vozrasta v svete blizhaishikh i otdalennykh rezul'tatov.

Cholecystotomies carried out upon 58 patients aged above 50 have been analyzed 22.4% of the patients died in the immediate postoperative period. In the late postoperative period good and fair results were found in 86.2% out of 21 followed-up patients 4 patients (13.8%) underwent the repeated cholecystostomy or cholecystectomy. The outcome was favorable. Some useful practical recommendations are suggested.

[Peridural anesthesia in operations for toxic goiter]. / O peridural'noi anestezii pri operatsiiakh po povodutoksichieskogo zoba

The authors employed peridural anesthesia in 92 patients with thyrotoxicosis According to their findings peridural anesthesia produced favourable shifts in the status of the cardiovascular system and ventilatory apparatus. Peridural anesthesia is considered to be a more acceptible method of anesthesiological provision in patients with toxic goiter than infiltrationanesthesia and intratracheal fluothane anesthesia.