Urinary Proteomics in Kidney Transplantation

Although kidney transplantation is the best treatment option for end stage kidney disease, it is still associated with long-term graft failure. One of the greater challenges for transplant professionals is the ability to identify grafts with a high risk of failure before initial decline of eGFR with irreversible graft changes. Transplantation medicine is facing an emerging need for novel disease end point-specific biomarkers, with practical application in preventive screening, early diagnostic, and improved prognostic and therapeutic utility. The aim of our review was to evaluate the clinical application of urinary proteomics in kidney transplant recipients at risk for any type of future graft failure.

Machine learning detects SARS-CoV-2 and variants rapidly on DNA aptamer metasurfaces

COVID-19 is detected using reverse transcription polymerase chain reaction (RT-PCR) of nasal swabs. A very sensitive and rapid detection technique using easily-collected fluids like saliva must be developed for safe and precise mass testing. Here, we introduce a metasurface platform for direct sensing of COVID-19 from unprocessed saliva. We computationally screen gold metasurfaces out of a pattern space of 2100 combinations for strongly-enhanced light-virus interaction with machine learning and use it to investigate the presence and concentration of the SARS-CoV-2. We use machine learning to identify the virus from Raman spectra with 95.2% sensitivity and specificity on 36 PCR positive and 33 negative clinical samples and to distinguish wild-type, alpha, and beta variants. Our results could pave the way for effective, safe and quantitative preventive screening and identification of variants.

EXPRESS: Preventive screening for intracranial aneurysms

Background: Subarachnoid hemorrhage from rupture of an intracranial aneurysm (aneurysmal subarachnoid hemorrhage, ASAH) is a devastating subset of stroke. Since brain damage from the initial hemorrhage is a major cause for the poor outcome after ASAH, prevention of ASAH has the highest potential to prevent poor outcome from ASAH. Aim: In this review, we describe the groups at high risk of ASAH who may benefit from preventive screening for unruptured intracranial aneurysms (UIA) followed by preventive treatment of UIAs found. Furthermore, we describe the advantages and disadvantages of screening and advise how to perform counseling on screening. Summary of review: Modelling studies show that persons with two or more affected first-degree relatives with ASAH and patients with autosomal dominant polycystic kidney disease (ADPKD) are candidates for screening for UIAs. One modelling study also suggest that persons with only one affected first-degree relative with ASAH are also likely candidates for screening. Another group who may benefit from screening are persons ≥35 years who smoke(d) and are hypertensive, given their high lifetime risk of ASAH of up to 7%, but the prevalence of UIAs in such persons, and thus the efficiency and cost-effectiveness of screening in this group are not yet known. The ultimate goal of screening is to increase the number of quality years of life of the screening candidates, and therefore the benefits but also many downsides of screening –such as risk of incidental findings, very small UIAs that require regular follow-up, preventive treatment with inherent risk of complications and anxiety- should be discussed with the candidate so that an informed decision can be made before intracranial vessels are imaged. Conclusions: Several groups of persons who may benefit from screening have been identified, but since these constitute only a minority of all ASAH patients, additional high-risk groups still need to be identified. Further research is also needed to identify persons at low or high risk of aneurysmal development and rupture within the groups identified thus far to improve the efficiency of screening. Moreover, if new medical treatment strategies that can reduce the risk of rupture of UIA become available, the groups of persons who may benefit from screening could increase considerably.

AWARENESS OF HUMAN PAPILLOMAVIRUS AND OPPORTUNITIES FOR PREVENTION OF CERVICAL CANCER AMONG WOMEN IN UZBEKISTAN

Knowledge of the risk factors for cervical cancer (CC) and the benefits of cervical cancer prevention motivates women to participate in preventive screening. However, several studies indicate that thereis a significant lack of knowledge about the human papillomavirus (HPV) around the world. This study examines the level of knowledge about the prevention of HPV and cervical cancer in the contextof socio-demographic and behavioral characteristics of women in Uzbekistan.Key words: questioning, cervical cancer, Human Papillomavirus, prevention

Complex program for the prevention of the development and progression of refractive errors in school year children

Aim: to develop a complex preventive and therapeutic program for refractive errors in school year children. Patients and Methods: 1,760 pupils of elementary, secondary, and high school of eight schools of Almaty (1,302 pupils of gymnasiums and 458 pupils of general education schools and sport boarding school) were examined. The 1st step was a preventive screening. The 2nd step was a distant interactive screening by teachers. The 3rd step was an eye examination of schoolers with low vision. The efficacy of the detection of visual impairments in schoolers during preventive and distant computer screening was compared. In addition, significant indicators for visual impairment monitoring in schoolers were identified. A "Program for the Prevention of the Development and Progression of Refractive Errors in Schoolchildren" was developed. To evaluate its efficacy, 140 pupils of general education schools with refractive errors and 1,302 pupils of gymnasiums with refractive errors or their high risk underwent eye examinations. In addition, to compare the effect of wearing glasses/contact lenses with full correction on the quality of life, 31 schoolers aged 12–17 with refractive errors were selected. Results: the rate of visual impairments was 28.4% among the pupils of general education schools and 31.3% among the pupils of gymnasiums. The most common refractive error was myopia (46.9% and 65.4%, respectively). As children moved through their school carrier, the proportion of myopia tended to increase. Accommodative dysfunction ranked second 48.5% and 29.7%, respectively). Time spent on distant screening was twice less compared to time spent on preventive screening. Visual acuity, cycloplegic refraction, reserves of relative accommodation, and axial length (measured by ultrasound) were indicators of visual impairments in children during monitoring. Poor general health was reported in 33% of children who wear glasses and 15% of children who wear contact lenses. Keywords: refractive errors, myopia, accommodation, schoolchildren, distant screening, prevention, vision correction with contact lenses. For citation: Botabekova T.K., Aldasheva N.A., Abdullina V.R. et al. Complex program for the prevention of the development and progression of refractive errors in school year children. Russian Journal of Clinical Ophthalmology. 2021;21(3):135–142 (in Russ.). DOI: 10.32364/2311- 7729-2021-21-3-135-142.

Data from the European registry for patients with McArdle disease and other muscle glycogenoses (EUROMAC)

Background The European registry for patients with McArdle disease and other muscle glycogenoses (EUROMAC) was launched to register rare muscle glycogenoses in Europe, to facilitate recruitment for research trials and to learn about the phenotypes and disseminate knowledge about the diseases through workshops and websites. A network of twenty full and collaborating partners from eight European countries and the US contributed data on rare muscle glycogenosis in the EUROMAC registry. After approximately 3 years of data collection, the data in the registry was analysed. Results Of 282 patients with confirmed diagnoses of muscle glycogenosis, 269 had McArdle disease. New phenotypic features of McArdle disease were suggested, including a higher frequency (51.4%) of fixed weakness than reported before, normal CK values in a minority of patients (6.8%), ptosis in 8 patients, body mass index above background population and number of comorbidities with a higher frequency than in the background population (hypothyroidism, coronary heart disease). Conclusions The EUROMAC project and registry have provided insight into new phenotypic features of McArdle disease and the variety of co-comorbidities affecting people with McArdle disease. This should lead to better management of these disorders in the future, including controlling weight, and preventive screening for thyroid and coronary artery diseases, as well as physical examination with attention on occurrence of ptosis and fixed muscle weakness. Normal serum creatine kinase in a minority of patients stresses the need to not discard a diagnosis of McArdle disease even though creatine kinase is normal and episodes of myoglobinuria are absent.