Patients that are having Covid-19 Disease After the First Dose of Covid-Vaccine

There is no effective treatment for the Covid-19 disease that is still impacting the whole world. It considered that vaccines, one of the effective means to prevent infectious diseases, will play a significant role in protecting from the Covid-19 Disease. Vaccinations generals performed before exposure. We aimed to follow the clinical and laboratory progress of patients who got Covid-19 after the first dose of the Covid-19 vaccine and to evaluate the changes that may occur in antibody formation. 13 patients, who received the first dose of COVID 19 vaccine Coronovac as of 14.01.2021 when vaccination started in Adıyaman University Training and Research Hospital/Turkey, who had symptoms after the vaccine and whose real-time PCR found to be positive, were included in the study. After the first dose of the Covid-19 vaccine, 13 patients exam. Three of our patients were female, and 10 of them were male. The average age was 38.8. British variant detected in 4 of our patients; 1 of them was female. Contact times differed between 3 and 5 days. The most common symptoms were muscle-joint pain (53.8), weakness-fatigue (46.2), fever (38.5), and headache (30.8). Three of our patients, being one female, received inpatient treatment. Furthermore, our five patients who checked regarding Sars cov-2 IgG became positive in the first month. No adverse changes in the course of the illness observed in the patients were RT-PCR positive after the first dose of the Covid-19 vaccine. Antibody response detected at the end of the first month. Vaccination is an effective method for taking infectious diseases under control but adhering to personal protective measures still maintains their importance.

SARS-CoV-2 screening in patients in need of urgent inpatient treatment in the Emergency Department (ED) by digitally integrated point-of-care PCR: A clinical cohort study

Patients in need of urgent inpatient treatment were recruited prospectively. A rapid point of care PCR test (POC-PCR; Liat) for SARS-CoV2 was conducted in the ED and a second PCR-test from the same swab was ordered in the central laboratory (CL-PCR). POC-PCR analyzers were digitally integrated in the laboratory information system. Overall, 160 ED patients were included. A valid POC-PCR-test result was available in 96.3% (n=154) of patients. N=16 patients tested positive for SARS-CoV-2 (10.0%). The POC PCR test results were available within 102 minutes (median, IQR: 56-211), which was significantly earlier compared to the CL PCR (811 minutes; IQR: 533-1289, p < 0.001). The diagnostic accuracy of the POC- PCR test was 100%. The implementation and digital LIS integration was successfully done. Staff satisfaction with the POC process was high. The POC-PCR testing in the emergency department is feasible and shows a very high diagnostic performance. Trial registration: DRKS00019207

Morphological evaluation of anal canal wound healing after combined operations for combined anorectal pathology

The urgency of the problem of postoperative wound healing after combined operations for combined pathology of the anal canal and rectum is quite high and contributes to the introduction into the practice of coloproctologists of new modern surgical technologies for the treatment of this pathology. The aim of the study was to conduct a comparative morphological assessment of postoperative wound healing in patients with combined pathology of the anal canal and rectum after combined operations using modern high-frequency electrosurgical and radiosurgical technologies. The results of surgical treatment of 689 patients with combined pathology of the anal canal and rectum using high-frequency electrosurgery and radiowave surgery with morphological assessment of wound healing on 3, 5, 7, 14, 21 days of the postoperative period, which were divided into 4 study groups. Using of “Surgitron” and “KLS Martin” devices for the treatment of patients with combined pathology of the anal canal and rectum was accompanied by the formation of the thinnest layers of coagulation necrosis in tissues with a depth of 0.189±0.085 mm and 0.194±0.090 mm respectively and as result patients of the first and fourth study groups had the shortest duration of inpatient treatment, which was 3-5 days and the average time of wound healing, which was 14-15 days. Patients in these study groups had the lowest inflammatory neutrophil reaction in postoperative wounds on day 3, which rapidly disappeared by day 5, on days 7-14 they had active reparative processes with the appearance of fibroblasts and connective tissue fibers, and on 21 day squamous epithelial cells, which indicated the processes of active epithelialization of wounds. The effect on the tissues of the devices “EFA” and “ERBE ICC 200” was deeper than in the above groups, forming a layer of coagulation tissue necrosis with a depth of 0.208±0.097 mm and 0.302±0.107 mm respectively, which was accompanied by patients of the third and second study groups with longer terms of inpatient treatment, which amounted to 5-7 days and increase the duration of wound healing, which amounted to 16-19 days. Patients in the 2nd and 3rd study groups showed a more pronounced inflammatory neutrophilic reaction in postoperative wounds on the 3rd day, which did not disappear until the 5th day and in half of the cases the presence of a significant number of segmental neutrophils and bacterial accumulations persisted. On days 7-14 they had weak reparative processes with the appearance of single fibroblasts and a small number of connective tissue fibers and on the 21st day single squamous epithelial cells, which indicated slow processes of wound epithelization. Using of radio-wave surgery and high-frequency electrosurgery devices promotes active epithelialization of tissues preventing scar strictures of the anal canal and improves the rehabilitation of patients in the postoperative period.

USE OF EFFERENT THERAPY METHODS IN THE TREATMENT OF DESTRUCTIVE PANCREATITIS

Своевременное включение методов эфферентной терапии (гемодиафильтрация, плазмаферез) в комплексную интенсивную терапию сепсиса и септического шока у больных с острым деструктивным панкреатитом, находящихся на стационарном лечении в ЦГКБ г. Алматы, позволило быстро стабилизировать гемодинамику, респираторные нарушения и отказаться от применения адреномиметиков, а также значительно уменьшить клинические проявления тяжелой интоксикации, гипоксии и эндотоксикоза. Timely inclusion of efferent therapy methods (hemodiafiltration, plasmapheresis) in the complex intensive therapy of sepsis and septic shock in patients with acute destructive pancreatitis who are inpatient treatment at the Central city clinical hospital in Almaty, made it possible to quickly stabilize hemodynamics, respiratory disorders and abandon the use of adrenomimetics, as well as significantly reduce the clinical manifestations of severe intoxication, hypoxia and endotoxicosis.

FEATURE OF SURGICAL TREATMENT OF GASTRODUODENAL BLEEDING

Применение принципов комплексного использования эндоскопического гемостаза и использование эрадикационной, антисекреторной терапии у больных с гастродуоденальным кровотечением, находящихся на стационарном лечении в ЦГКБ г. Алматы, позволило улучшить результаты лечения больных, значительно снизить количество осложнений после операций, сократить частоту как общей, так и послеоперационной летальности. The application of the principles of the integrated use of endoscopic hemostasis and the use of eradication, antisecretory therapy in patients with gastroduodenal bleeding who are inpatient treatment at the Central City Clinical Hospital of Almaty, made it possible to improve the results of treatment of patients, significantly reduce the number of complications after surgery, and reduce the incidence of both general and postoperative mortality.

Biomarkers, Inflammation, and Bipolar Disorder: Association Between the Improvement of Bipolar Disorder Severity and the Improvement in C-Reactive Protein Levels After 7 Days of Inpatient Treatment

Introduction: Compared to the general population, people with severe mental illness (SMI) have a poorer health status and a higher mortality rate, with a 10–20-year reduction in life expectancy. Excess mortality and morbidity in SMI have been explained by intertwined components. Inflammatory processes could increase the morbidity and mortality risk in patients with bipolar disorder (BD) because of a bidirectional interaction between BD and conditions related to inflammation. This pilot study aimed to evaluate the relationship between C-Reactive-Protein (CRP) and bipolar disorder severity.Methods: A retrospective observational study was conducted on 61 hospitalized patients with bipolar disorder. CRP was measured at admission to inpatient treatment (T0) and after seven days from the admission (T1). Clinical Global Impression for Depression, Mania and Overall Bipolar Illness were recorded at T0 and T1. Comparisons among the recorded CRP values were determined through the paired t-test. Correlations between CRP and CGI scores were determined through Spearman's correlation coefficient at T0 and T1.Results: A statistically significant decrease in CRP values was observed after 7 days of hospitalization (p &lt; 0.001) and positive significant correlations emerged between CRP and CGI scores at T0 and T1.Conclusion: Patients admitted to the inpatient unit reported a statistically significant decrease of CRP values during the first 7 days of treatment. Although the direction of the relationship between BP severity and inflammation status continues to remain unclear, this study showed a relationship between the improvement of bipolar disease symptoms and the improvement of the inflammatory marker CRP.

THE ROLE OF ASSESSMENT AND CORRECTION OF NUTRITIONAL STATUS IN A COMPREHENSIVE APPROACH TO COVID-19 PATIENT WITH METABOLIC DISORDERS: Review

The article is devoted to the problem of coronavirus disease COVID-19 with emphasis on the nutritional status of patients. An analytical review of recent publications related to aspects of nutritional support for people in outpatient and inpatient treatment for COVID-19 is presented. The article highlights the pathogenetic justification of the relationship between the immune response and metabolic balance of the body, the optimal content of trace elements, vitamins, components of lipid metabolism. The importance of nutrition as a strategy to support human immune function is considered. Methods for determining the adequate energy balance of patients with severe COVID-19 are presented. Groups of foods and key nutrients that may affect the consequences and clinical course of respiratory infections are described. The importance of assessing and optimizing nutritional status to improve the clinical course and consequences of COVID-19 in patients with comorbid pre-existing non-communicable diseases, such as diabetes, cardiovascular disease, obesity with systemic inflammation, is emphasized.