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Background The pandemic of the new coronavirus infection has challenged the medical community for quickly finding and implementing effective methods of treatment In the absence of a vaccine or specific therapy with proven effectiveness, the usage of convalescent plasma can be the one of perspective methods An important aspect of this technology is the efficient and safe preparation of convalescent plasma To date, in the world literature there are practically no publications about donor recruitment and the specifics of the preparation of convalescent plasma Purpose of the research Presentation of the experience of organizing a workflow for recruiting donors and stockpiling of convalescent plasma with a high titer of virus-neutralizing antibodies to SARS-CoV-2 Methods The analysis of the work of the Blood Service of the Moscow Department of Health for stockpiling of COVID-19 convalescent plasma has been executed In total it has been stockpiled 1240 doses The normative documentation has been developed by a working group on the basis of the current federal legislation of Russian federation and been approved by the Moscow Department of Health The titer of neutralizing antibodies (VNA) has been determined as the basic method for assessing the immunological viability of convalescent plasma The main characteristics of donors, the characteristics of the disease course, the results of preliminary testing for the presence of specific antibodies by ELISA and CLIA methods has been compared with VNA titers in the stockpiled convalescent plasma Results Due to a Moscow Health Department’s order No 325 dated 01 04 2020 (a basic local regulatory document) it has been developed a regulation for the stockpiling, examination, storage, safety and transfering of fresh frozen pathogen-reduced plasma of COVID-19 convalescent donors to medical organizations of the Moscow Health Department For arranging an interaction with donors it has been created a call-center For effective preliminary selection, it has been formed a donor characteristics list, which has been combined with screening of specific antibodies by ELISA and CLIA methods Conclusions Developed a system of recruiting donors and procurement process of convalescent plasma for treatment СOVID-19, which includes the necessary regulations, algorithms for the selection and recruitment of donors, the registry of donors and recipients, algorithms, efficiency and safety of convalescent plasma Обоснование Пандемия новой коронавирусной инфекции поставила перед медицинским сообществом задачу быстрого поиска и внедрения эффективных методик лечения В условиях отсутствия вакцины и средств специфической терапии с доказанной эффективностью в качестве одной из перспективных методик рассматривается трансфузия реконвалесцентной плазмы (РП) Важным аспектом данной технологии является заготовка эффективного и безопасного компонента На сегодняшний день публикации по рекрутингу доноров и особенностях заготовки РП в мировой литературе практически отсутствуют Цель исследования - Анализ опыта организации рабочего процесса по привлечению доноров и заготовке РП с высоким титром вируснейтрализующих антител к SARS-CoV-2 Методы Проведен анализ работы Службы крови Департамента здравоохранения г Москвы (ДЗМ) по заготовке РП COVID-19 Всего заготовлено 1240 доз Нормативная документация разработана рабочей группой на основании действующего федерального законодательства и утверждена ДЗМ Как базовая методика оценки иммунологической состоятельности РП, определен титр вируснейтрализующих антител (ВНА) Проведено сопоставление основных характеристик доноров, особенностей течения заболевания, результатов предварительного тестирования на наличие специфических антител методами ИФА и ИХЛА с титрами ВНА заготовленной РП Результаты Работа по заготовке, обследованию, хранению, обеспечению безопасности и передаче в медицинские организации ДМЗ свежезамороженной патогенредуцированной плазмы доноров-реконвалесцентов COVID-19 была организована на основании приказа ДЗМ от 01 04 2020 № 325 как базового локального нормативного документа Для оптимальной коммуникации с состоявшимися донорами и привлечения реконвалесцентов использовались ресурсы колл-центра Для эффективного предварительного отбора доноров применялись анализ характеристик донора (плазма с наибольшими значениями титра ВНА ожидаема от доноров-мужчин, переболевших с признаками явной вирусной пневмонии) и результаты скрининга специфических антител методами ИФА и ИХЛА Заключение Разработана система обеспечения рекрутинга доноров и процесса заготовки РП для лечения СOVID-19, включающая необходимые нормативные документы, алгоритмы отбора и привлечения доноров, реестр доноров и реципиентов, алгоритмы обеспечения эффективности и безопасности РП

Aim. To evaluate the diagnostic value of heart-type fatty acid-binding protein (H-FABP) introduction to standard cardiac biomarkers in diagnostics of myocardial infarction (MI) early after clinical symptoms onset. Material and methods. Patients aged 18 years and older admitted to the hospital with acute coronary syndrome (ACS) during first 6 hours after ACS symptoms onset were enrolled into the study. At hospitalization level of biomarkers of myocardial damage (creatine phosphokinase-MB fraction - CPK-MB, troponin T) and qualitative tests on FABP were assessed in all patients. Serum troponin T concentration measured in 12 hours after the hospitalization was used to confirm diagnosis of MI. Moreover , diagnosis of MI was verified by echocardiography with the assessment of local reduction in myocardial contractility. Results. 101 patients were included into the study (27% female; aged 59.9±12.4). At the moment of hospitalization 71 (70%) patients were diagnosed with ACS with ST-segment elevation, and 30 (30%) patients - ACS without ST-segment elevation. In total, period between clinical symptoms onset and hospitalization was 3.6±1.4 hours. Analysis of diagnostic value of tests during the first 6 hours after ACS symptoms onset showed higher sensitivity of H-FABP in comparison with troponin T and CPK-MB (72.5, 56.2 and 49.5%, respectively). Specificity of these tests during the first 6 hours after onset of clinical signs of ACS was 90, 100 и 90%, respectively. Sensitivity and specificity were 87.7 and 100.0%, respectively , when H-FABP , troponin T and CPK-MB were used in combination as a “block test” in patients hospitalized during the first 6 hours after ACS symptoms onset. Sensitivity and specificity were 74.3 и 100.0%, respectively , when “block test” was used in patients hospitalized during the first 3 hours after ACS symptoms onset; between 3 and 6 hours after ACS symptoms onset sensitivity and specificity of tests reached 100%. Conclusion. “Block test” with H-FABP , troponin T and CPK-MB early after ACS symptoms onset is more sensitive in comparison with separate use of the tests.

The pathophysiological mechanisms of brain lesions after craniocerebral trauma (CCT) are associated with the effects of primary and secondary damaging factors. Here, we studied the changes in the indices of oxidative stress, including the content of malondialdehyde (MDA), the total antioxidant activity (TAA), the MDA/TAA coefficient, albumin, and the levels of the markers of secondary damage, such as nitric oxide (NO x ) and glucose in the blood serum of patients with CCT of moderate severity. A total of 29 patients with CCT were examined on days 1, 3, and 5 of their stay in a hospital. On day 5 of the posttraumatic period, we observed the exhaustion of the antioxidant system expressed in the increased MDA/TAA coefficient and decreased TAA in patients with CCT of moderate severity. The NO x level was decreased on day 1 and on days 3 and 5 it was similar to the norm. The glucose level was normal during the entire observation period. A significant positive correlation between the MDA/TAA index and traumatic subarachnoid hemorrhage was revealed on day 5, which reflected the relationship between oxidative stress and the lesion volume. This should be taken into account for the selection of a therapeutic approach.

The development of cerebral vasoconstriction in subarachnoid hemorrhage (SAH) induced by the rupture of an aneurism of brain vessels impairs cerebral circulation. Treatment with normobaric hyperoxia may be used as an effective approach to oxygen delivery to the injured brain tissue. The purpose of the present study was to evaluate the effects of normobaric hyperoxia on oxidative stress and factors of endogenous vascular regulation in eight patients who suffered from non-traumatic SAH and remained in critical condition. The intensity of oxidative stress was assayed by measuring malonic dialdehyde and the total antioxidant activity in the blood serum. Endothelium functions were evaluated using the content of the stable metabolites of nitric oxide and the activity of angiotensin-converting enzyme in the blood serum. The data from eight patients who suffered from non-traumatic SAH showed an enhancement of oxidative stress, which influenced the functions of the vascular endothelium and resulted in an imbalance in the endogenous regulation of vascular tone. Treatment with normobaric hyperoxia was not associated with intensification of free-radical processes in patients who suffered from non-traumatic SAH and did not influence intracranial and arterial pressure.