Blood groups and secretory state in COVID-19

INTRODUCTION: Despite the achievements of modern medicine, healthcare system is lacking in knowledge about the new coronavirus infection caused by the SARS-CoV-2 virus. AIM: To establish the relationship of the new coronavirus infection with the blood group according to the AB0 blood system in the Samara region and assess the secretory status of the oral fluid in patients with COVID-19. MATERIALS AND METHODS: This study was conducted from June 2019 to December 2020, and included 89 healthy individuals (38% males, 62% females, average age 24 ± 2.5 years) and 92 patients with COVID-19 (24% males and 76% females, average age 55.68 ± 1.83 years). The material for the study was oral fluid and venous blood. Determination of the blood group according to the AB0 system was carried out by a cross method, the secretory status of saliva according to the I. Vidas method. Descriptive methods were used for statistical data processing (arithmetic mean, error of the mean), calculation of the percentage of a whole number using computer programs IBM SPSS Statistics 23 and Microsoft Office Excel 2010. RESULTS: The distribution by blood group in patients with COVID-19 was as follows: A (II) blood group was found in 43.5%, O (I) in 36.9%, B (III) in 17.4%, AB (IV) in 2.2%. Rh-positive status was determined for 92.4%. Among secretory representatives, antigen A was secreted in 92.1%, and antigen B was secreted in 7.9% of cases. Antigens A and B were absent in the oral fluid of patients with AB (IV) blood group. CONCLUSIONS: This study confirmed the prevalence of A(II) blood group carriers among patients with COVID-19. In this case, the secretion of antigen A into the oral fluid is 92.1%. Group A antigen, being a glycoprotein, can act as a factor facilitating the mechanism of penetration of the SARS-CoV-2 into the human body. The results of the study indicate the need for a personalized approach at the stage of diagnosis and monitoring of the treatment of new coronavirus infection, as well as taking into consideration the blood group to develop preventive measures for COVID-19.

Complex approach to assessment of functional status of patients with chronic obstructive pulmonary disease

BACKGROUND: Considering the economic costs of managing patients with chronic obstructive pulmonary disease (COPD), as well as the high mortality and disability rate, it is necessary to improve the diagnosis of the disease, to look for new approaches to assessing the functional status of patients. AIM: Is to study the functional status of patients with COPD. MATERIALS AND METHODS: A comprehensive approach was applied to assess the functional status of patients: the data of the 6-minute walk test (6MWT), heart rate variability (HRV) was studied, ergoreflex was assessed according to HRV data. 64 patients with COPD and 41 male volunteers without respiratory diseases older than 40 years were examined. Statistical processing of the obtained results was carried out using the licensed package of applied statistical programs Excel 2010 and Statistica 10. RESULTS: The group of patients with COPD and the respondents of the control group were comparable in terms of body mass index, heart rate, respiratory rate, index of indicators of activity of regulatory systems (p > 0.05). As expected, during the 6MWT, differences were obtained between the studied groups in terms of the distance covered (p < 0.01). Similarly, the results of the study of the function of external respiration showed a statistically significant difference in all the studied parameters (p < 0.01). The results obtained confirmed the presence of impaired respiratory function in the group of patients with COPD. Analysis of HRV values, when conducting a test with external peripheral vascular occlusion, confirmed ergoreflex hyperactivity in patients with COPD. CONCLUSION: The integration of methods for routine clinical diagnostics of patients condition (spirometry, 6-minute walk test, assessment of autonomic status) and the introduction of the study of ergoreflex activity made it possible to expand the understanding of the functional state of patients with COPD and is of great interest for further research.

The use of polyetheretherketone for the manufacture of removable implant dentures

INTRODUCTION: The industry of temporary prosthetics for dental implantation in the postoperative period at the present stage of the development of dentistry has achieved significant results. However, up to now, there are still cases of insufficient effectiveness of temporary prosthetics, which is expressed in a reduced service life and a violation of the retention of temporary structures, the need for a relatively large number of corrections of their basis, as well as inflammatory and atrophic changes in the mucous membrane of the prosthetic bed and loss of bone tissue in the jaws in the projection of the mechanical pressure of the prosthesis. AIM: To determine the effectiveness of the use of polyetheretherketone for the manufacture of immediate prostheses based on temporary dental implants. MATERIALS AND METHODS: Dental implants in the upper jaw were installed in 76 patients with a diagnosis of full absence of teeth. For temporary rehabilitation for the period of osteointegration, temporary implants were installed in the amount of 2 pieces and temporary removable dentures were made. RESULTS: The use of polyetheretherketone revealed a 25% decrease in dentures breakdowns, an increase in the number of temporary implants viability by 37.5%, and a decrease in bone tissue atrophy by 19% to 22%. CONCLUSIONS: It is advisable to use polyetheretherketone for the manufacture of removable implant dentures.

Age dynamics of the need for outpatient medical care for conditions that determine the basic value of the need in women with the diseases of the circulatory system

INTRODUCTION: The results obtained from the analysis of age dynamics are insufficient for development a program of reducing morbidity and, ultimately, mortality, since a need of medical care already indicates a problem; so prevention and screening programs should surpass the emergence of these problems. AIM: To analyze the age dynamics of the need for outpatient medical care for conditions that determine the basic value of the need in women with diseases of the circulatory system. MATERIALS AND METHODS: We used data on 780,000 visits during one year to medical organizations that provide medical care on an outpatient basis. We studied the probability of an episode and the dynamics of the frequency of episodes depending on age in six five-year age groups: 31 to 35 years, 36 to 40 years, 41 to 45 years, 46 to 50 years, 51 to 55 years, and 56 to 60 years. The dynamics of the frequency of episodes was modeled by a mathematical function with the largest value of the approximation coefficient. The dynamics of the frequency of episodes was modeled by a mathematical function with the largest value of the approximation coefficient. RESULTS: The dynamics of the need for outpatient medical care for hypertensive diseases [Diseases characterized by high blood pressure] (I10 – I15), ischemic heart diseases (I20 – I25) and vascular diseases of the brain (I60 – I69) is characterized by an increasing trend in demand indicators throughout the studied age period. The greatest increase in indicators is observed in the age groups of 31–40 years for ischemic heart diseases and vascular diseases of the brain and 41–50 years for hypertensive conditions. The greatest increase in demand is observed for coronary heart diseases (I20 – I25). The total amount of resources required increases more than 350 times over the 30-year age period, despite the stable value of the average duration of treatment. The increase in the total amount of resources required for vascular diseases of the brain is 30 times. The lowest growth gradient is registered in relation to hypertensive conditions (10-fold growth). As a critical age period, it is most appropriate to consider the age of a woman under 35 years. CONCLUSION: Mathematical modeling is optimally performed using power functions for hypertensive conditions and vascular diseases of the brain and exponential functions for ischemic heart diseases. All the proposed models are characterized by high approximation coefficients.

Anti-apoptotic effects of 2-pyrrolidone derivatives in cerebral ischemia

INTRODUCTION: Uncontrolled course of apoptosis reactions underlies a wide range of pathological processes, including ischemic events. AIM: To evaluate the anti-apoptotic properties of some racetams in experimental brain ischemia in rats. MATERIALS AND METHODS: Cerebral ischemia was modeled in Wistar rats by irreversible occlusion of the middle cerebral artery. The test-compounds and the reference drug piracetam were administered per os at a dose of 250 mg/kg. After 72 hours of the ischemic period, the activity of apoptotic systems in the brain tissue was evaluated by determining the concentration of the apoptotic-inducing factor (AIF), caspase-3, ionized calcium, the latent opening time of the mitochondrial transition permeability pore and the zone of brain necrosis. RESULTS: The study showed that the use of the studied compounds contributed to a decrease in the intensity of reactions, both caspase-dependent and caspase-independent apoptosis, which was reflected in a decrease in the concentration of AIF and caspase-3 by 32.4% (p < 0.05); 34.6% (p < 0.05); 31.1% (p < 0.05), and 41.9% (p < 0.05); 39.1% (p < 0.05); 34.5% (p < 0.05) when PirPr, PirAc and PirBut were administered, respectively. Also, the use of the studied substances led to an increase in the latent period of opening the mitochondrial transition permeability pore, a decrease in the concentration of intracellular calcium and the zone of brain necrosis. At the same time, the pharmacological effect of the administration of the compound PirAc exceeded the effect of piracetam and other test substances. CONCLUSIONS: Based on the results obtained, it can be assumed that the studied racetams have neuroprotective action, realized through suppression of the reactions of apoptosis.

Modern approaches to rehabilitation of patients using removable laminar dentures

The demand for dental orthopedic assistance in Russia makes more than 60% of the number of examined patients. With this, a share of use of removable dentures for rehabilitation of patients with partial or complete absence of teeth makes 40.2% of all types of prosthetics. Removable prosthetics remains an actual treatment option for patients with partial or complete absence of dentitions, along with use of non-removable structures including those with support on dental implants. Improvement of approaches to manufacture and design of dentures led to a considerable increase in the variants of combinations of materials and methods of their manufacture, and there appeared a possibility to optimize denture structures due to the ability to compensate for atrophic processes of the bone tissue. All this permits an orthopedist to achieve satisfactory results in treatment with use of removable dentures. In the given literature review, modern views on the variants of orthopedic rehabilitation of patients with use of removable laminar dentures are presented including their technological, functional, operational, phonetic, chewing peculiarities, and information on modern materials for manufacture of dentures is given. Based on the literature data, it can be concluded that despite active development of the technological component of the manufacture of removable dentures, the basic principles of their design, methods of evaluation of the effectiveness and comfort of use have not undergone significant changes. However, there are a significant number of factors whose influence on the success of orthopedic rehabilitation with removable dentures has not been fully studied. For example, orthopedic dentists often do not analyze the volume of atrophy of the bone tissue of the jaws and design the basis of a dental prosthesis without taking these parameters into account. Another important issue that remains not considered is taking into account the design and architectonics of the resulting prosthesis and its effect on the speed and direction of respiratory flows in the oral cavity. All this creates a technological window that allows, due to compliance with the physiological requirements of the factors described above, to significantly increase the functional properties of the denture, to facilitate the patients habituation to the prosthesis by reducing the adaptation period. The research conducted in this area of knowledge will permit to obtain both new scientific data and develop a number of practical recommendations aimed at improvement of the quality of orthopedic rehabilitation using removable dentures made of various materials.

Organization of medical and economic control of the volume and cost of medical care in the system of compulsory health insurance in 2021

The article is devoted to the current problem of interaction in fulfilling the obligations of all participants of compulsory health insurance to pay for and provide medical care in accordance with the amendments made to Federal Law No. 326-FL of 29 November 2010 (as amended on 08 December 2020) «On Compulsory Health Insurance in the Russian Federation» and entered into force on January 1, 2021. The authors focus on the issue of granting of the territorial compulsory health insurance fund new powers to conduct medical and economic control and abolishing these powers from medical insurance organizations. According to the amendments, all volumes of medical care provided to the insured population of the subject of the Russian Federation, both on the territory of insurance and outside it, as well as medical care provided outside the territory of insurance, are the subject of medical and economic control by the territorial fund. Starting from 2021, the form of the contract for the provision and payment of medical care for compulsory health insurance, approved by Order of the Ministry of Health of the Russian Federation No. 1417n of 30 December 2020, has also changed. Unlike the previous form of contract concluded between an insurance medical organization and a medical organization, the current document provides for the participation of three parties in contractual relations: the territorial fund, insurance medical organizations, medical organizations. The agreement contains provisions providing for the obligation of the territorial fund to carry out medical and economic control of registers of accounts and accounts submitted by medical organizations to pay for medical care provided within the framework of the basic and territorial compulsory health insurance programs. The article presents the results of the control carried out with the analysis of the identified violations in the provision by medical organizations of the Ryazan region of invoices and registers of invoices for payment of medical care provided for January 2021, identifies problematic points in the information interaction between participants of compulsory insurance in the implementation of this function of the territorial fund.

Reproductive health and reproductive culture of university students: tactics of preventive activities

BACKGROUND: Statistics shows a decrease in the birth rate in Russia. This is alarming fact that obliges to take some measures, including preventive ones. Since the reproductive health of students will determine demographic indicators for many years to come, it is very important to choose methods of prevention in one direction or another, taking into account modern technical trends and hobbies of young people. AIM: To explore the knowledge of students of different specialties in matters of reproductive health, reproductive culture. To suggest the way of preventive measures based on the data obtained. MATERIALS AND METHODS: The study involved students from the Ural, Moscow and St. Petersburg universities. 537 questionnaires were processed. The questionnaire indicated the social status of the participants (gender, age, university profile). According to the latter criterion, the sample was divided into four groups: natural sciences, medical sciences, technical sciences, and humanities. An anonymous survey was conducted in the “Google form”. The respondents answered questions about the most pressing problems of reproductive health and reproductive culture. RESULTS: 64% of the respondents assess their reproductive health as good; the most popular source of information on contraception for university youth is the Internet. According to the analysis of the data obtained, in the event of an unwanted pregnancy, only 24% of the women surveyed would have the pregnancy kept, which may indicate a low reproductive culture of students. CONCLUSION: To take attention to reproductive health and prevention issues among students in accessible terms, blogging on social networks by specialists in the field of obstetrics and gynecology, urology and andrology, senior medical students or clinical residents can be proposed.

Peculiarities of diet, physical activity and body weight of medical university students during COVID-19 restrictive measures

BACKGROUND: Pandemics of new coronavirus infection (COVID-19) introduced additional corrections in the style of life of students. Introduction of restrictive measures, transfer to distance learning produce an ambiguous effect on the vital activity of a human including his physical health and diet. AIM: To evaluate the impact of COVID-19 restrictive measures on nutrition, physical activity and body mass of medical students. MATERIALS AND METHODS: Sociological, analytical, statistical methods were used. According to the results of a questionnaire survey of 167 third-year students of the medical faculty of Smolensk State Medical University, a comparative assessment of nutrition, physical activity and body weight before the introduction of COVID-19 restrictive measures and in 3 4 months after self-isolation is presented. The reliability of differences in the shares of the characteristic was assessed by the value of Fishers angular transformation coefficient (φ). RESULTS: Diets of medical students were unbalanced both before and during COVID-19 restrictive measures. Changes in the diet during the period of self-isolation took place in 54.2% of the respondents. The number of students with 4 meals a day increased 1.6 times, and with 5 meals 12.9 times. The share of respondents with 2 meals a day decreased 6.3 times. Daytime food intake decreased 1.7 times, and 2.8 times more often the respondents did not have a fixed time of food intake. All medical students refused a full breakfast both before and during the period of self-isolation. The predomination of evening meals decreased 2.4 times. Home-made dishes were consumed 1.2 times more often, semi-finished products 2.4 times less often, and consumption of fast food decreased by 4.2%. Physical activity during the period of self-isolation significantly decreased in every fifth student. Every fourth respondent noticed increase in the body weight. CONCLUSION: Restrictive measures did not change the preferences in the choice of food products by medical students and the habits of not eating breakfast, and imbalanced diets. The positive impact of restrictive measures for COVID-19: increase in use of freshly prepared meals, the frequency of meals, and limitation of the possibility to eat in fast food restaurants. The negative effect of self-isolation: frequent infringement of the diet, increased daily amount of fast food consumed, decrease in physical activity, increase in body weight.

Prospects of using cilostazol in combined treatment of patients with obliterating atherosclerosis of lower limb arteries

Despite intensive study of pathophysiology, of molecular and cell mechanisms of progression of atherosclerosis, development and introduction of a wide range of new conservative and surgical treatment methods, until now the diseases of lower limb arteries (DLLA) are one of the most urgent problems of the modern vascular surgery and medicine in general. Intensive development of roentgen-endovascular methods of treatment for the diseases of lower limb arteries has led to a considerable revision of the tactics of management of this category of patients in the recent years. Despite the achievements of roentgen-endovascular surgery, frequency of obstructions after surgical revascularization of limbs remains high, both in early and late postoperative periods. It should also be noted that despite the intensive development of methods of therapy of patients with DLLA, frequency of limbs amputation in this category of patients remains high. One of the urgent problems of management of patients with DLLA after endovascular treatment is the problem of restenosis. In the recent years, new efficient methods of pharmacotherapy of DLLA have been developed and introduced into clinical practice, which allows significant improvement of medical prognosis in this category of patients and improvement of the outcomes. It should be noted that standard approaches to antithrombotic therapy in patients after endovascular surgeries based on use of antiaggregant drugs, can only decrease the rate of thrombotic complications, but not of restenosis, which, from the point of view of pathophysiology, is mainly hyperproliferative condition. Among promising approaches to treatment of restenosis, there is use of cilostazol, efficiency of which after endovascular surgeries on coronary and peripheral arteries has been proven in a number of studies.