Outpatient Conditions Research Articles

Outpatient management of patients conditioned with Fludarabine and Treosulfan prior to allogeneic hematopoietic cell transplantation

BackgroundAllogenic hematopoietic cell transplantation (allo-HCT) with myeloablative conditioning traditionally requires 30 days long hospitalizations after stem cell infusion. However, advancements in supportive and prophylactic care have allowed for a trend towards outpatient management of allo-HCT, potentially leading to improved patient quality of life and increased procedure cost-effectiveness. In 2014, Fludarabine and Treosulfan (FluTreo) conditioning was introduced as a myeloablative regimen with reduced toxicity at Copenhagen University Hospital, Rigshospitalet (CUH). After gaining experience with the regimen, an outpatient program was established. This study shares the outcome of outpatient conditioning with FluTreo allo-HCT at CUH. ObjectiveTo investigate safety and feasibility of outpatient FluTreo allo-HCT. Furthermore, to investigate the potentially enhanced cost-effectiveness of outpatient allo-HCT primarily through reduction in hospitalization days compared to the 30 days hospitalization associated with standard myeloablative conditioning. Study designThis retrospective study included all patients undergoing FluTreo allo-HCT due to malignant diseases (n = 124) at CUH from 2018 to 2022. Patients received outpatient treatment (n = 91) unless certain circumstances required planned hospitalization (n = 33). As conditioning, patients received intravenous Fludarabine 90 mg/m2 and Treosulfan either 30 or 42 g/m2. Statistical analyses included descriptive statistics and Kaplan Meier survival analysis. ResultsThe median duration of hospitalization in the outpatient group was 4 days (Q1-Q3 0-12.5) from day -6 to +28 compared to a median of 28 days (Q1-Q3 26-34) in the inpatient group. 32 (35%) in the outpatient group did not require hospitalization within day +28 after transplantation. The remaining 59 patients (65%) were hospitalized after 12 days (Q1-Q3 7-16 days) from start of conditioning, for a median of 10 days (Q1-Q3 5-18). The outpatient group required significantly less IV antibiotics, IV opioids and parenteral nutrition than the inpatient group, despite no difference in treatment toxicity, acute graft-versus-host disease, or relapse between the groups. The outpatient group experienced no early deaths during the first 3 months after transplantation and 1-year non-relapse mortality was 6%. ConclusionOutpatient allo-HCT with FluTreo conditioning is feasible and safe in a selected group of patients, significantly reducing hospitalization days without compromising patient outcomes. Outpatient FluTreo allo-HCT potentially stands as a more cost-effective and patient-friendly alternative compared to traditional in-patient management.

Оценка эффективности и безопасности применения медицинского изделия «МАВИТ» у пациентов с хроническим простатитом и синдромом хронической тазовой боли

Abstract. Recent studies have shown that chronic prostatitis is one of the most common clinically and socially significant diseases. With chronic prostatitis, mental health suffers no less than with other severe somatic diseases, which sharply reduces the quality of life of men. This was a serious incentive for this study. In outpatient conditions, 50 patients with a confirmed diagnosis of N41 were examined. 1 Chronic prostatitis; R10.2 Pelvic and perineal pain. At the stage of inclusion in the study and treatment, the patient is examined: 1) Study of anamnesis. (NIH-CPS; IPSS; IIEF-5; PHQ-9; GAD-7; EQ–5D–3L) 2) Physical examination (determination of the somatic status of the study subjects) 3) Laboratory examinations were carried out in the laboratories of the clinical bases of the Consultative and Diagnostic Center No2 of the Moscow Health Department, Moscow, 8 Igralnaya Street; Clinical base Central Medical Clinic CMD, Moscow, Perovo metro station, Novogireevskaya st., 3A; Clinical base Clinic «New Medicine», Moscow region, Orekhovo-Zuevo, Lenin st., 44. (urine culture for microflora or urine assessment with a test strip once - before the start of therapy, four-cup test, PSA, CRP, STI screening) 4). Specialized diagnostic tests (ultrasound of the bladder with determination of the volume of residual urine, uroflowmetry, TRUS of the prostate with Doppler mapping). GE LOGIQ V2 ultrasound machine with convex and rectal probe. The obtained research data and interpretation of statistical data allow us to conclude that it is possible to use the MAVIT device according to GIKS.941549.102 TU, manufactured by Yelatma Instrument Plant JSC, according to the selected methods, 7 procedures every 2 months in urological patients with chronic prostatitis and the presence of chronic pelvic pain syndrome in order to relieve pain symptoms, lower urinary tract symptoms. The study also found positive effects on men’s sexual function and a reduction in anxiety disorders. All these positive outcomes in relation to the treatment of the main group of patients allow us to conclude that the MAVIT device may be widely used in the work of a practitioner both on an outpatient basis and in a day hospital.

Pharmacological Insights and Clinical Applications of Ciprofol: A Narrative Review.

Ciprofol (HSK3486) is a novel intravenous anaesthetic developed as an alternative to propofol, offering a safer and more effective option in anaesthesia. It works primarily by modulating the gamma-aminobutyric acid (GABA) receptors in the central nervous system, leading to sedation and hypnosis. Ciprofol's unique pharmacological properties include a rapid onset of action, shorter duration, and reduced cardiovascular and respiratory depression compared to propofol, making it particularly suitable for outpatient and day surgery procedures.Molecular changes in ciprofol appear to be superior to those of other cibenzolines; it is more potent and has a stable hemodynamic effect. It has been used in primary surgery, inpatients and outpatients, and even for sedation of intensive care patients. The reported clinical data indicate that ciprofol is a powerful sedative that is characterised by a high-enough speed of emergence from the state of anaesthesia, which is necessary for outpatient conditions and intensive operating modes. It can be considered a new and important perspective in the technology of intravenous anaesthetics with its improved pharmacological characteristics and clinical effects. With the further accumulation of clinical data, ciprofol will undeniably become an essential agent in today's anaesthetic practice and contribute to an enhancement of healthcare efficiency by providing a more secure approach to numerous kinds of surgical interventions. The purpose of the current study is to provide a review of the pharmacology and clinical use of ciprofol, a new intravenous anaesthetic agent. Various studies demonstrate the functionality and safety profile of ciprofol, which solidifies it as a potential contender for propofol. Regarding respiratory depression, hypoxemia, and injection pain during hysteroscopy, ciprofol was shown to be a relatively safer option than propofol. Ciprofol can, therefore, be recommended for intravenous anaesthesia because of its effectiveness and safety, which has been clearly demonstrated. Randomised trials uniformly report the ability to achieve quicker onset of sedation and lower risk with the agent compared to propofol. These findings imply that ciprofol has many benefits concerning a variety of applications in patients due to a lower rate of adverse reactions and increased patient comfort.

Dermatovenereology in the Russian Federation: results of 2023

The article presents information on dynamics of dermatovenerological service resources, indicators of the population of the Russian Federation provision with dermatovenerologists and dermatovenerological beds, main performance rates and results of dermatovenereological medical care providing in outpatient, inpatient and day hospital conditions for the period 2019–2023. The dynamics of sexually transmitted infections (syphilis, gonococcal infection, trichomoniasis, chlamydial infection, anogenital herpetic viral infection and anogenital venereal warts) incidence in the Russian Federation, as well as contribution of foreign citizens to the syphilis incidence rates are analyzed. The dynamics of prevalence and incidence rates of diseases of the skin and subcutaneous tissue in the Russian Federation in 2019–2023, as well as dynamics of prevalence and incidence of atopic dermatitis, psoriasis, contact dermatitis, localized scleroderma, discoid lupus erythematosus among children aged 0–17 years and adults 18 years and older are presented.

Stability of intravenous medicines – evidence of maximum temperature reached in both summer and winter within soft shell elastomeric pumps

ObjectiveElastomeric devices or pumps are a valuable tool to deliver outpatient parenteral therapy and have been used for administration of chemotherapy, antibiotics and pain medication. A key determinant of effective...

Experience of Using Biomodeling in Training Obstetricians and Gynecologists in the Technique of Office Hysteroscopy

The leading place in the structure of gynecological diseases is occupied by intrauterine pathology, the "gold standard" of treatment of which is therapeutic hysteroscopy. Conducting hysteroscopy in outpatient conditions in the absence of anesthesia significantly reduces the workload of the inpatient unit, but requires high-quality training of specialists due to the labor intensity of the manipulation and the lack of opportunity to acquire skills intraoperatively. The use of biomodels for training allows specialists to master this technique in a short time.

Severe Hypertriglyceridemia in Patients with Type 2 Diabetes Mellitus Participating in the AMD Annals Initiative.

Background: Familial chylomicronemia syndrome (FCS) is a rare inherited condition due to lipoprotein lipase deficiency, characterized by hyperchylomicronemia and severe hypertriglyceridemia. Diagnosis is often delayed, thus increasing the risk of acute pancreatitis and hospitalization. Hypertriglyceridemia is a common finding in patients with type 2 diabetes (T2D), who may harbor FCS among the most severe forms. Aim of the Study: We investigated the prevalence and clinical characteristics associated with severe hypertriglyceridemia in a range indicative of FCS, in a large population of subjects with T2D. Methods: Within the large population of the AMD Annals Initiative, patients with T2D with a lipid profile suggestive of FCS [triglycerides >880 mg/dL and/or high-density lipoprotein (HDL)-cholesterol <22 mg/dL or non-HDL-cholesterol ≤70 mg/dL] and their clinical features have been identified. Results: Overall, 8592 patients had triglyceride values >880 mg/dL in a single examination, 613 in two examinations, and 34 in three or more measurements. Patients with high triglyceride levels were mostly male (80%), with a relatively young age (54 years), short duration of diabetes (6.3 years), and elevated hemoglobin A1c (HbA1c) levels (9.4%). By stratifying this group of patients according to the severity of hypertriglyceridemia, more severe hypertriglyceridemia (triglyceride levels ≥2000 mg/dL) was associated with an even younger age (52 vs. 54 years), even higher mean HbA1c values (10.0% vs. 9.4%), and significantly higher HDL-cholesterol levels (37.9 vs. 32.4 mg/dL; P < 0.0001). Patients with persistently elevated triglyceride levels (n = 34), on three measurements, had a younger age; lower body mass index, HbA1c, and HDL-cholesterol levels; more frequent use of fibrates and insulin; and a higher prevalence of major cardiovascular events. Conclusions: Severe hypertriglyceridemia is a frequent condition in outpatients with T2D participating in the AMD Annals Initiative, and it is associated with male sex, young age, short disease duration, and a worse glycemic profile. Among patients with persistent severe hypertriglyceridemia, hidden FCS may be present.

The Effect of Prone Position on Patients with Covid-19: Case Study

Purpose: Evaluation of the prone position in the awake patient with a nasal cannula and diagnosed with Covid-19 in improving oxygen saturation. Methodology: Case study of a patient diagnosed with Sars Cov-2, Covid-19 through a pulmonary Ct with bilateral pneumonia and initial value of C-Reactive protein=38.01mg/l. This patient was treated in outpatient conditions (at home) in the period of October 2020. Result: The standard deviation in terms of oxygen uptake from day one to day eight had significant improvements from SD=94±1.8Sa(O2) to SD=95.7±2.0Sa(O2). Also, nasal cannula oxygen levels had significant reductions from SD=4.1±0.4 liters on day 1 to SD=1.2±0.2 liters. The pvalue results are significant with a value of p=&lt;0.001, so the prone position was better compared to the supin position. Conclusion: The prone position in our patient's case was effective in improving blood oxygen saturation. Received: 2 June 2024 / Accepted: 25 July 2024 / Published: 29 July 2024

Comparative characteristics of the effectiveness of drugs for the treatment of alopecia areata in childhood

Alopecia areata (АА) is an autoimmune inflammatory disease with an established genetic predisposition, which is based on the lesion of hair follicles, leading to persistent or temporary hair loss. To date, treatment of АA in children, is limited to the use in most cases of external hormonal therapy in the form сream or the prescription of intradermal injections of GCS in outpatient conditions. However, data on the effectiveness of this group of drugs in severe forms of AA flow are not fully studied. There is an open question of the choice of the most preferred drug in patients simultaneously with a severe flow of AA and a severe form of atopic dermatitis. Another interesting variant of treatment of AA is the drug Dupilumab. (blocker IL-4 and IL-13). The mechanism of action of dupilumab at АA remains unknown, and its effect on TH-type 2 is assumed.Purpose of the study. To conduct a comparative performance characterization of: external GCS (Clobetazole) and injectable GCS (Betamethazone) for treatment of AA in children; Tofacitinib treatment for children with alopecia and the presence or absence of atopic dermatitis in the form of a concomitant disease; use of Dupilumaba to treat children with AA.Materials and methods. The research sample includes 420 patients. By the nature of the lesion, we considered three types of alopecia: spotted, total and universal. Patient data is taken from the register of AA patients in children. [13]. The effectiveness of the treatment was assessed on the scale SALT [14]. Patients were monitored for six months.Results. Use of intradermal injections GKS (Betamethazone), more effective than outdoor GKS (Clobetazole). In patients with atopic dermatitis, the efficacy of Tofacitinib for AA treatment is reliably higher than in patients without atopic dermatitis. Dupilumab may be a drug of choice for treating patients with a total and universal form of AA.Conclusion. Additional randomized controlled trials are needed to assess the long-term efficacy of drugs such as Tofacitinib and Dupilumab.

Complex clinical and cytological diagnosis of eye adnexa epithelial tumors

Purpose. Studying clinical and cytological signs of malignant epithelial genesis tumors of eye adnexa. Material and methods. In 2015–2020, 308 patients aged from 23 to 87 (58.0 ± 6.7) years with suspected malignant neoplasms of eyelid skin and conjunctiva were cytologically examined. The material for cytological examination was obtained by scraping (n = 271; 88 %), imprinting (n = 27; 8.8 %), and fine needle aspiration biopsy (n = 10; 3.2 %) if the neoplasm was more than 10 mm thick. Preparations were processed and fixed according to the standard technique using panchromic Pappenheim staining. Results. The cytological analysis confirmed the clinical diagnosis and the epithelial genesis of the malignant neoplasm in 273 (88.7 %) patients. The benign nature of the tumor was confirmed in 17 patients (5.5 %) and the non-tumor nature of the process was confirmed in 11 patients (3.6 %). In the group of malignant tumors, basal cell cancer prevailed, affecting 240 patients (87.9 % of all malignant tumors). 27 patients (9.9% ) had squamous cell cancer, 4 patients had meibomian gland cancer in 4 patients, and 2 patients had undifferentiated cancer. Benign tumors included papillomas (n = 11), while tumor-like lesions included atheromas (n = 3) and granulation polyps (n = 3). Non-tumor lesions involved productive inflammation of the chalazion type (n = 7), or chronic inflammation of a reactive nature (n = 4). 22 patients had histological examination to check the diagnosis, in all cases the histological outcome coincided with the cytological diagnosis. Conclusion. The comprehensive clinical and cytological study allowed us to specify cytomorphological characteristics of epithelial tumors of the eye adnexa: the basal cell cancer and its varieties according to the clinical forms of the tumor, squamous cell cancer and meibomian gland cancer, and papilloma. The complex clinical and cytological method of diagnostics is easily applicable in out-patient conditions, allowing us to specify the diagnosis during the initial visit, which considerably reduces the time required for full patient’s examination.

Analysis of staffing of the regional health system by dental surgeons in 2019–2021

BACKGROUND: Providing qualified personnel to medical organizations is one of the priorities of the development of the health system. Improvement of staffing of dentists is relevant, as it enables increased availability and quality of dental care. Accessibility and quality of medical care involves the availability of the required number of medical personnel and level of their qualifications, achieved through the licensing of medical activities and certification and accreditation of medical personnel. AIM: To analyze the staffing of dental surgeons in medical organizations subordinate to the Ministry of Health of the Krasnodar Territory. MATERIALS AND METHODS: This study included dental surgeons of state medical organizations of the Krasnodar Territory in 2019–2021. The present study uses statistical data of reporting forms of medical organizations of Krasnodar Krai «Information about medical organization» (N 30) for the studied period. Statistical processing of the material was performed using the Microsoft Office software package applying analytical, logical, and statistical methods of research. RESULTS: Analysis of the staffing of dental surgeons in medical organizations of the Krasnodar Territory for 2019–2021 showed an increase in established posts in general for organizations and providing medical assistance in ambulatory conditions, a decrease in established posts in the hospital and occupied posts in general by organizations, as in outpatient conditions, and in stationary. Moreover, a decrease was noted in the number of individuals employed as primary workers in general positions in the medical organizations of the province and in outpatient and inpatient medical care and in the number of individuals employed as primary employees, having the highest category and simultaneously increasing with the first and second categories. Further, the study found a decrease in the number of persons in the main occupations with professional certification, an increase in the number of persons with accreditation certificates, and a decrease in the number of physical persons and of employed dental surgeons in medical organizations of the Krasnodar Territory, owing to the reduction in both outpatient and inpatient conditions. CONCLUSION: Analysis of staffing of the regional healthcare system by dental surgeons for 2019–2021 was conducted.

An adaptive approach to developing a Long COVID rehabilitation program.

As more people became infected with the SARS-CoV-2 virus, it was anticipated that 10-20% of these individuals would develop a post-viral illness that would affect their ability to work and participate in daily activities and reduce quality of life. To support these patients, Unity Health Toronto opened the Outpatient Post-COVID Condition Rehabilitation Program in June 2021, with the aim of teaching patients how to manage their ongoing symptoms, and to maximize their independence and function. The program incorporated a multidisciplinary, patient-centred approach that leveraged group education and a virtual platform to allow patients from across Ontario to learn from one another and share experiences. Over the twoyears of the program, the multidisciplinary team continuously adapted to the new research on Long COVID and evolving needs of patients. This article will outline the development and evolution of the program.

Biochemical predictors of preclinical arteriosclerosis in patients with chronic obstructive pulmonary disease after COVID-19

This article presents the findings of an open, comparative, prospective study aimed to investigate the state of vascular endothelial function in patients with chronic obstructive pulmonary disease (COPD) who have recovered from COVID-19, and to assess the potential for long-term prediction of preclinical atherosclerosis development.Materials and methods. A total of 133 COPD patients were examined under outpatient conditions: the main group (n=90), with a history of COVID-19, and a comparison group (n=43). Participants were examined twice: V1 - initial examination from 3 weeks to three months post-infection, V2 - a follow-up examination 12 months after the first visit. Based on the CAVI index values at point V2, the main group was divided into 2 subgroups. The state of vascular endothelial function was assessed using volume sphygmomanometry and by determining the concentration of biochemical markers in the blood.Results. In the main group at point V2, the studied parameters of arterial stiffness were significantly higher compared to the comparison group (aortic pulse wave velocity, cardio-ankle vascular index (CAVI) on the right and left, augmentation indices on the brachial and carotid arteries). At point V1, in the 1st subgroup (R-CAVI≥8.5 units), the concentration of biomarkers such as endothelin-1, total homocysteine, monocyte chemoattractant protein, vascular endothelial growth factor, C-reactive protein, interleukin-6,10 was significantly higher than in the 2nd subgroup (R-CAVI&lt;8.5 units). Conclusion. Taking into account the results obtained, a mathematical model for predicting preclinical atherosclerosis in COPD patients 12 months after COVID-19 was developed, which can be applied by clinicians in the long-term assessment of cardiovascular risk. Key words: chronic obstructive pulmonary disease, COVID-19, sphygmomanometry, predictors, prognosis, CAVI index&gt; ˂ 8.5 units).Conclusion. Taking into account the results obtained, a mathematical model for predicting preclinical atherosclerosis in COPD patients 12 months after COVID-19 was developed, which can be applied by clinicians in the long-term assessment of cardiovascular risk.

Patient acceptance of teleneurology across neurologic conditions.

Patient acceptability with outpatient teleneurology has been reported within specific conditions, but less is known about acceptability across neurologic conditions. The study objective was to compare the acceptability of teleneurology between patients with various neurological conditions and determine what other factors influence acceptability. This was a prospective study of Veterans who completed new outpatient teleneurology visits with the Department of Veterans Affairs National Teleneurology Program. Visits were conducted via video to home or video to the outpatient clinic. Patient acceptability was assessed via telephone interview two weeks post-visit. Acceptability was a summed score (3-21) of three 7-point Likert questions (higher = more acceptable). Clinical diagnosis categories were based on the neurologists' ICD10 diagnosis code. Acceptability score was modeled using a censored Tobit model controlling for demographics, type of tele-visit, medical comorbidity, and ICD10 category. In FY 2021, 277 of 637 (43.5%) patients completed an interview with analyzable acceptability data. Of these 277, 70 (25.3%) had codes indicating headache, 46 (16.6%) movement disorder, 45 (16.2%) general symptoms, and 116 (41.9%) for all other categories. Mean patient acceptability was 18.3 (SD 3.2). There was no significant difference in scores between these groups. The only factor independently related to acceptability was medical comorbidity, with higher comorbidity associated with higher acceptability scores. Patients find their outpatient teleneurology experience highly acceptable independent of neurologic condition. Those with more comorbidity report higher acceptability. Use of teleneurology may be useful and acceptable across many outpatient neurologic conditions including for more medically complex patients.

Comparison of perception of stress and consumption of anxiolytics in hospital and out-hospital conditions: a cross-sectional study.

The workplace is a place where medical workers are exposed to extreme stress, particularly during medical emergencies or events of epidemic or pandemic proportions. Anxiolytic therapy is often used to overcome professional challenges. Deepening knowledge about the prevalence of the use of anxiolytics and the perception of stress among medical workers enables the timely recognition of problems and the preparation of measures to improve the working conditions and quality of life of medical workers. The study's primary objective was to investigate whether there were differences in the usage of anxiolytics among healthcare professionals in and out of the hospital. In addition to the main objective, there are other objectives that have been established: To examine whether there are statistically justified differences in stress perceptions between hospital and outpatient healthcare professionals; 2. To examine the stress factors in the workplace in both hospital and outpatient settings. To compare the frequency of taking anxiolytics with respect to various variables (age, seniority, occupation and level of education); 4. determines the impact of working conditions on stress perception and life satisfaction in healthcare professionals. The design of research: Cross-sectional research. The research involved 159 healthcare professionals in Slavonski Brod: 96 employees of the General Hospital "Dr. Josip Benčević" and 63 employees of the Health Center and the Institute for Emergency Medicine of Brodsko-Posavina County. Respondents were able to participate in the study by filling out questionnaires online. The questionnaire was designed to be voluntary and anonymous and contained 53 questions. Statistically significant differences were shown in the perception of stress, which is greater in hospital staff, than in the difference between stressors in the workplace, where hospital staff showed higher values in all categories, but three factors are more significant differences: "Organization of the workplace and financial issues," "Conflicts and communication at work" and "Professional and intellectual requirements." There are significant differences in the frequency of using anxiolytics with the assistance of a psychiatrist. Working conditions have a much greater impact on the perception of stress and life satisfaction in hospital staff, while in hospital staff only a weak link between the perception of stress and life satisfaction is expressed. Anxiolytics are consumed by 27.10% of hospital workers and 23.80% of outside-the-hospital workers. The consumption of anxiolytic drugs by healthcare professionals in hospital and outpatient conditions does not make a significant difference, but they do have statistically significant differences in their perception of stress.

Urinary Tract Infections (UTIs): Laboratory diagnosis - The role of artificial intelligence and smart diagnosis

Background: Urinary tract infections (UTIs) are prevalent outpatient conditions affecting up to 50% of individuals, with diagnostic errors common in clinical settings. The traditional reliance on clinical criteria alone yields a diagnostic error rate of about 33%, necessitating improved diagnostic methods. Aim: This mini-review evaluates the role of artificial intelligence (AI) and smart diagnostic tools in enhancing UTI diagnosis, particularly within vulnerable populations. Methods: A comprehensive literature review was conducted, assessing 782 articles, of which 14 met the inclusion criteria for AI applications in UTI diagnosis. These studies were categorized based on their focus: uncomplicated UTIs, complicated UTIs, and specific demographic groups. Results: The review revealed that 12 studies employed machine learning techniques while 2 utilized deep learning. The most frequently used models included artificial neural networks (ANNs) and extreme gradient boosting (XGBoost). Key variables influencing predictive models encompassed demographic data, anamnesis, and comorbidities. Notably, models for diagnosing uncomplicated UTIs achieved accuracy rates of up to 98.3%, while approaches for complicated UTIs demonstrated area under the curve (AUC) values ranging from 0.71 to 0.904. AI models were particularly effective in stratifying high-risk subgroups, including pregnant women and children, with models achieving AUCs of 0.82 and 0.83 for specific populations.

The actual issues of improvement of organization of screening of skin neoplasms in out-patient conditions

The skin malignant neoplasms constitute one of significant problems of public health. The increasing of morbidity and mortality of melanoma and other types of skin cancers is registered. The early detection of disease assures mortality decreasing and increases survival of patients. The purpose of the study is to develop optimal model of organizational and preventive measures of early diagnostic of malignant skin tumors. The comprehensive study was carried out, which included assessment of survey of patients using questionnaire "Melanoma Diagnosis Day". Also it included identification of level of awareness of physicians about screening, medical records of patients during COVID-19 pandemic, risk groups identification and effectiveness of selecting patient for screening. The total number of observations is 21 581. The selective and continuous observation method was applied and parametric and non-parametric methods as well. The study determined that during COVID-19 pandemic in 2020, there was significant reliable uncompensated decrease in the number of patients with diagnosis of ICD D23, L82, C44 and decrease in the number of detected diseases. The melanoma, basalioma and other skin malignant neoplasms are reliably more common in patients of medium-high risk group, aged 60 years and older and in persons sunburned at the age of 18 years. The assignation of separate specialist to diagnose skin neoplasms allows statistically reliably increase rate of morphological confirmation of malignant neoplasms as compared to common reception by dermatologist. The sociological survey of physicians revealed statistically reliable difference in knowledge between dermatovenereologists, oncologists and physicians of other specialties concerning screening issues. The results of the study permitted to develop complex of organizational measures to improve screening. The model of organizational and preventive measures for early diagnostic of skin malignant tumors in outpatient conditions was proposed.

Prognostic Factors for Predicting Post-COVID-19 Condition in Patients With COVID-19 in an Outpatient Setting.

Although data on post-coronavirus disease 2019 (COVID-19) conditions are extensive, the prognostic factors affecting symptom duration in non-hospitalized patients with COVID-19 are currently not well known. We aimed to investigate the various prognostic factors affecting symptom duration among outpatients with COVID-19. Data were analyzed from 257 patients who were diagnosed with mild COVID-19 and visited the 'post-COVID-19 outpatient clinic' between April and December 2022 after a mandatory isolation period. The symptom duration was measured from diagnosis to symptom resolution. Laboratory and pulmonary function test results from their first visit were collected. The mean age of patients was 55.7 years, and the median symptom duration was 57 days. The development of post-COVID-19 conditions (> 12 weeks) were significantly correlated with not using antiviral drugs, leukocytosis (white blood cell > 10,000/µL), lower 25(OH)D3 levels, forced vital capacity (FVC) < 90% predicted, and presence of dyspnea and anxiety/depression. Additionally, in multivariable Cox regression analysis, not using antiviral drugs, lower 25(OH)D3 levels, and having dyspnea were poor prognostic factors for longer symptom duration. Particularly, vitamin D deficiency (< 20 ng/mL) and not using antivirals during the acute phase were independent poor prognostic factors for both post-COVID-19 condition and longer symptom duration. The non-use of antivirals, lower 25(OH)D3 levels, leukocytosis, FVC < 90% predicted, and the presence of dyspnea and anxiety/depression symptoms could be useful prognostic factors for predicting post-COVID-19 condition in outpatients with COVID-19. We suggest that the use of antiviral agents during the acute phase and vitamin D supplements might help reduce COVID-19 symptom duration.

The effect of preemptive intravenous ibuprofen for pain relief during hysterosalpingography in women with infertility: A randomized, double-blind controlled study

Objectives: HSG is an invasive diagnostic procedure that involves the radiographic evaluation of the genital system after the injection of a radiopaque substance from the cervical canal in infertile women. Preemptive intravenous ibuprofen is commonly used for postoperative pain management. However, only a limited number of studies have reported the intravenous use of ibuprofen for short-term painful procedures. This study aimed to investigate the effectiveness of intravenous ibuprofen for pain management during HSG. Materials and methods: A total of 91 patients planned to undergo HSG due to infertility were included in the prospective, randomized, double-blind study. Patients were assigned into two groups: the ibuprofen group (group I, n = 43) and the control group (group C, n = 48). About 30 min before the procedure, 800 mg ibuprofen in 100 ml saline infusion was administered to the ibuprofen group, whereas 100 ml saline infusion was administered to the control group 30 min before the starting the procedure. Pain scores using a visual analog scale (VAS) during the procedure were evaluated at four-stage; (1) insertion of the speculum (2) holding and traction (3) administration of contrast matter; and (4) 30 min after the procedure. Besides, the patients were evaluated according to a scale with a range of 1–4 in terms of satisfaction. Results: There was no statistically significant difference in terms of demographic data (p&gt;0.05). VAS pain scores in the median (25%-75%) during the administration of contrast agent were lower in group ibuprofen (median, 1; range 1-2) than in group control (median, 5.5; range 5-6) (p&lt;0.001). There was no statistically significant difference between groups in terms of pain scores other stages of HSG (p&gt;0.05). Patient satisfaction was significantly higher in group ibuprofen than in group control (p&lt;0.001). Conclusion: Intravenous ibuprofen can be administered as an alternative approach to decrease pain and increase patient satisfaction in the HSG procedure performed under outpatient conditions. In conclusion; to the best of our knowledge, this is the first study that administered intravenous ibuprofen in the HSG procedure. However, further studies are needed to compare its effectiveness.

Analysis and interpretation of Coronavirus infection children's incidence, contributing factors, risks of complications and their relationship.

Aim: To study and investigate the incidence of Coronavirus infection in children, the course of the disease, the risks of complications and their interrelationships. Materials and Methods: Study included the analysis and observation of children (n=55, aged 14.36±3.62 years) with confirmed Coronerovirus infection, who were observed in the CNE ≪CMCH≫ in Uzhgorod in outpatient conditions. A study of clinical presentations, a clinical and laboratory examination followed by a mathematical analysis of the symptoms data in children with an identified Coronavirus infection and in the dynamics up to week 30 (with survey intervals in 3 weeks) from the diagnosis verification was carried out. Results: A dynamic analysis of the clinical manifestation of symptoms in children with an identified Corona virus infection and within 30 weeks (with survey intervals of 3 weeks) from the beginning of the diagnosis verification was carried out. Complaints from the respiratory system were prevailed. The most long-lasting complaint was observed ≪changes in the sense of taste and smell≫ (from 35(63.6%) to 6(10.9%) up to 18 weeks inclusive. Other complaints ≪Cough, Rhinitis, Shortness of breath, Pain in the chest≫ was observed for 6 weeks. Sore throat, muscular and joint pain were persisted for 3 weeks. Fever was not identified at week 3. Illness with other viral respiratory diseases started at week 9 and was observed until week 30 (from 10(18.2%) to 19(34.5%)) with varying levels. A decrease in cases of IgM identification was observed within 6 weeks (from 55, 100% to 20, 36, 4%). On the 9th week, the presence of IgM was not established. There is also an increase in the number of cases of detection of IgG in patients with a level maximum of 6 weeks. Conclusions: There is a positive effect of the CRP level on the occurrence of symptoms of cough, rhinitis, shortness of breath, chest pain, change in taste and smell, muscle and joint pain (r=0.33-0.55), with the most significant data for the symptom of pain in chest (p=0.00001). Ferritin level interactions mostly had a negative direction (r=-0.35-0.48, p=0.02-0.00001) on the development of symptoms, with the exception of rhinorrhea (r=0.48, p=0.00002) and chest pains (r=0.39, 0.003). According to multiple logistic regression analysis the chance of the symptom of a change in taste and smell increases due to an increasing in the level of Procalcitonin in 1.48 times. The chance of the symptom of shortness of breath increased due to an increasing in the Ferritin level in 1.025 times.