Pathology Of Cardiovascular System Research Articles

CLINICAL AND LABORATORY CHARACTERISTICS OF PATIENTS WITH CORONAVIRUS INFECTION COVID-19 AND ITS COMORBIDITY

Introduction. The coronavirus disease has reached an alarming epidemic scale with extraordinary morbidity and mortality rates for the entire world population. The majority of patients with COVID–19 note damage to the respiratory tract and state a more severe course of the disease with the development of systemic damage. A more severe course of COVID-19 is associated with the presence of comorbid diseases. Aim. To investigate and analyze clinical and laboratory manifestations and to determine the main comorbidities of patients with COVID-19 infection. Materials and methods. The research was carried out in accordance with bioethical norms and rules. 179 patients with COVID-19 (the main group) and 42 people of the control group were examined. Diagnosis and treatment of the COVID-19 coronavirus infection was carried out taking into account the relevant national recommendations. The average value and standard deviation were statistically determined. The probability of differences was performed using the Mann-Whitney U-test and the Wilcoxon W-test of signed ranks. The threshold value of the level of statistical significance of all calculated features was taken as 0.05 (p=0.05). Results. A high comorbidity with cardiovascular system pathology was found – 40.2%, type 2 diabetes – 22.3%, respiratory system diseases – 20.7%. Disorders of the functional state of the cardiovascular system were determined: pulse values – 91.01±13.44, systolic (127.9±15.19) and diastolic (79.3±11.6) blood pressure. Changes in clinical blood analysis were noted: erythrocytes – 4.38±0.65 x1012/l, hemoglobin – 127.6±21.2 g/l, hematocrit – 0.37±0.07, leukocytes – 10.7±7, 32 x109/l, segmented (65.4±14.8%) and rod-nuclear (9.03±9.99%) neutrophils, platelets – 226.1±90.6 x109/l, lymphocytes – 20.24±12.43%, monocytes – 6.60±4.37% and erythrocyte sedimentation rate (ESR) – 25.4±14.9 mm/h. Significant (almost fourfold) increases in IL-6 levels (24.56±22.9 pg/ml) and blood glucose concentrations (7.40±3.42 mmol/l) were determined. Conclusions. A significant comorbidity of COVID-19 was determined and a significant prevalence of indicators of the functional state of the cardiovascular system and a decrease in the average levels of the quantitative composition of erythrocytes and indicators of hemoglobin and hematocrit were established. Significant leukocytosis, neutrophilia, lymphocytosis and monocytosis, significant excesses of ESR and IL-6 and blood serum glucose were determined, which confirmed the presence of a significant inflammatory reaction in response to infection with COVID-19.

Развитие синдрома алкогольной дислипидемии — фактор нарушения социальной безопасности в Арктическом регионе.

Alcoholism aggravates the nutritional component of developing comorbid somatic pathology risk in the Arctic region. Against the background of alcohol dependence syndrome (ADS) development peculiar changes in lipid metabolism are revealed: a low low-density lipoproteins (LDL) and triglycerides (TG) content, but a high high-density lipoproteins (HDL) content. The revealed changes stimulate the search for new diagnostic approaches, with the help of which it is possible to identify hidden alcohol-associated changes in lipid metabolism and influence the mechanisms of cardiovascular system (CVS) pathology development at different stages. The aim was to identify lipid metabolism disorders in practically healthy individuals and in individuals with alcohol dependence to substantiate the specific clinical and biological syndrome isolation — alcoholic dyslipidemia and to develop an algorithm for detecting hidden alcohol-associated disorders. 208 men were examined: 96 people — with II stage SCA; 112 — practically healthy individuals. The content of total cholesterol, TG, HDL was determined by enzymatic colorimetric method, LDL — by turbidimetric method, concentrations of apolipoproteins (apo-A and apo-B) — by immuno-turbidimetric method, fatty acids — by gas-liquid chromatography. A low content of SFA (pentadecanoic, margarine, arachine, geneicosene), multidirectional changes in MSFA with a low content of myristooleic and eicosene lipid acids, but high palmitooleic and heptadecanoic; PUFA ω-6 linoleic, arachidonic. At the same time, an increase in the content of linoleic lipid acids trans-form was noted, the content of ω-3 PUFA was also lower than that of PP due to α-linolenic (C18:3ω3), docosohexaenoic (DHA), but the content of eicosopentaenoic (EPA) was higher. In narcological patients, weak correlations between LDL, TG and NLC were found, which indicates a lipid acids into LDL and TG integration violation. The absence of interrelations of ω-3 linoleic acid with EPA and DHA forming from it in patients with ADS may indicate anenzymatic processes violation.

Epidemiological profiles and causes of sudden deaths of various ages in Ethiopia: an autopsy-based study

Background Sudden death is an important global public health issue. An autopsy is an important source of epidemiological data, as the considerable causes of sudden death remain hermetic until postmortem examination. This study is devoted to evaluating the sociodemographic, behavioral, clinical and pathological characteristics of sudden deaths of various ages in Ethiopia. Methods This is an observational, prospective, descriptive study that included all sudden deaths observed over 1 year at St. Paul’s Hospital and Millennium Medical College, Addis Ababa, Ethiopia. Results Sudden death (n = 568) accounted for 11.5% of all autopsied cases. There were 482 males and 86 females (M:F ratio of 5.6:1) and a mean age of 44.81±17.349. The peak age group was the fourth and fifth decades, accounting for 43.9% of the cases. Chronic substance abuse and a history of prior illness were declared in 40.1% and 38% of victims of sudden death, respectively. Cardiovascular (36.1%), respiratory (32.6%), and gastrointestinal system (19.5%) pathologies were the most common causes. The leading underlying causes of sudden death were ischemic heart disease and pneumonia. Most (86.6%) sudden deaths occurred outside of a hospital setting. Conclusions Most of the causes of sudden death in Ethiopia can be prevented and treated. The majority of sudden deaths are silent without preexisting symptoms. Therefore, it is vital to develop public health measures that will help educate the community about the importance of recognizing the manifestation of various clinical conditions and the need to seek immediate clinical help. Furthermore, efforts should be made to make healthcare facilities accessible and affordable with adequate diagnostic and management capacity. Documentation of autopsy-based data could provide important epidemiological information to guide medical services, prevention efforts, and control measures.

PREDICTIVE FACTORS AND CLINICAL AND PARACLINICAL FEATURES OF URINARY TRACT DYSFUNCTION IN PRETERM INFANTS

PREDICTIVE FACTORS AND CLINICAL AND PARACLINICAL FEATURES OF URINARY TRACT DYSFUNCTION IN PRETERM INFANTS

COVID-19-induced cardiovascular complexities

This study aimed to investigate the features of the clinical course of COVID-19 in combination with the pathology of the cardiovascular system (CVS). A prospective study was carried out. The main group (n=150) consisted of patients with changes in the cardiovascular system associated with COVID-19, i.e. newly diagnosed CV pathology, and patients with exacerbation of cardiac pathology against the background of COVID-19. The comparison group (n=154) included patients with COVID-19, but without any significant concomitant cardiac pathology. The average age of patients in the main group was 67.7 years (from 47 to 86 years), in the comparison group of 66.1 years (from 48 to 88 years). The study groups were representative and did not differ statistically in the nature of COVID-19 symptoms and the degree of lung involvement. Among the cardiac pathology, progressing or first occurring against the background of infection with COVID-19, in most cases, arterial hypertension of II-III degree (60.0%), coronary heart disease (48.7%), arrhythmias (23.3%) were diagnosed. Echocardiographic abnormalities included right ventricular dysfunction (22.7%), left ventricular contractility disorders (18.7%), with decreased ejection fraction (17.3%), diastolic dysfunction (14.0%), and toxic myocarditis (7.3%). The most significant risk factors were the presence of a burdened medical history (RR=10.39), elevated body mass index over 30 (RR=2.63) and diabetes mellitus (RR=1.55). In patients with COVID-19 in combination with CVS pathology, a relatively high incidence of acute onset (64.0% vs. 44.2%; p<0.001), respiratory failure (83.7% vs. 62.0%; p<0.001), admission to the intensive care unit (25.3% vs. 11.7%; p=0.004), development of acute respiratory distress syndrome (20.0% vs. 9.1%; p=0.012), hospital mortality (10.7% vs. 2.7%; p=0.006). Cardiac manifestations of COVID-19 included focal or global myocardial inflammation, ventricular dysfunction, heart failure, and arrhythmias. A high frequency of acute onset of the disease, respiratory failure and hospital mortality is determined.

COVID-19-induced cardiovascular complexities

This study aimed to investigate the features of the clinical course of COVID-19 in combination with the pathology of the cardiovascular system (CVS). A prospective study was carried out. The main group (n=150) consisted of patients with changes in the cardiovascular system associated with COVID-19, i.e. newly diagnosed CV pathology, and patients with exacerbation of cardiac pathology against the background of COVID-19. The comparison group (n=154) included patients with COVID-19, but without any significant concomitant cardiac pathology. The average age of patients in the main group was 67.7 years (from 47 to 86 years), in the comparison group of 66.1 years (from 48 to 88 years). The study groups were representative and did not differ statistically in the nature of COVID-19 symptoms and the degree of lung involvement. Among the cardiac pathology, progressing or first occurring against the background of infection with COVID-19, in most cases, arterial hypertension of II-III degree (60.0%), coronary heart disease (48.7%), arrhythmias (23.3%) were diagnosed. Echocardiographic abnormalities included right ventricular dysfunction (22.7%), left ventricular contractility disorders (18.7%), with decreased ejection fraction (17.3%), diastolic dysfunction (14.0%), and toxic myocarditis (7.3%). The most significant risk factors were the presence of a burdened medical history (RR=10.39), elevated body mass index over 30 (RR=2.63) and diabetes mellitus (RR=1.55). In patients with COVID-19 in combination with CVS pathology, a relatively high incidence of acute onset (64.0% vs. 44.2%; p<0.001), respiratory failure (83.7% vs. 62.0%; p<0.001), admission to the intensive care unit (25.3% vs. 11.7%; p=0.004), development of acute respiratory distress syndrome (20.0% vs. 9.1%; p=0.012), hospital mortality (10.7% vs. 2.7%; p=0.006). Cardiac manifestations of COVID-19 included focal or global myocardial inflammation, ventricular dysfunction, heart failure, and arrhythmias. A high frequency of acute onset of the disease, respiratory failure and hospital mortality is determined.

Hemostasis System in Airline Passengers and Pilots

This review contains the results of the studies of the hemostasis system in airline passengers and crew members, as well as ground-based model experiments simulating the effect of specific flight factors. According to most researchers, flight factors shift the coagulation balance towards increasing the procoagulant potential. However, the occurrence of thrombotic conditions in passengers is associated with the individual presence of certain endogenous risk factors, such as age, constitution, the diseases of the cardiovascular system and hereditary pathology of the hemostasis system, some types of hormone therapy. Aircraft pilots whose flight time significantly exceeds that of passengers have described cases of thrombosis. No mention of cases of hemorrhagic conditions in civil aviation flight personnel has been found in the available literature.

Evaluation of the causes of chest pain and its relationship with the cardiovascular system in COVID-19 patients

Aim: Chest pain is one of the most common complaints of patients in the emergency departments during the pandemic and non-pandemic period. Because the cause of chest pain can range, from an ordinary, harmless muscle pull to serious cardiac complication ultimately leading to cardiac arrest. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells through angiotensin converting enzyme 2 receptors, leading to coronavirus disease (COVID-19)-related pneumonia, and also causing acute cardiac injury and chronic damage to the cardiovascular system. COVID-19 contributes to the development of serious cardiovascular complications such as acute coronary syndrome, myocarditis, stress-cardiomyopathy, arrhythmias, cardiogenic shock, and cardiac arrest. In this study, it was aimed to determine the effects of COVID-19 on the cardiovascular system by evaluating the causes of chest pain in COVID-19 patients who applied to the emergency department with chest pain. Methods: This retrospective study was conducted by examining the files of COVID-19 patients who applied to a district emergency department with chest pain. Results: The files of 102 COVID-19 patients were reviewed. The most common causes of CP were musculoskeletal system (39.2%), respiratory system (23.5%), CVS diseases (20.6%), idiopathic causes (8.8%), gastrointestinal system diseases (7%, 9). Cardiac causes are non ST-segment elevation myocardial infarction (NSTMI), arrhythmia, ST-segment elevation myocardial infarction (STEMI) and unstable angina pectoris (USAP), respectively. Troponin value was higher in patients with cardiac chest pain (p=0.02), and ferritin value was higher in patients with pneumonia (p=0.01). Conclusions: Chest pain or chest tightness is common in patients with active COVID-19. Although the causes of chest pain are due to musculoskeletal pathologies, both COVID-19 and cardiac origin chest pains due to direct cardiovascular system pathologies should be kept in mind.

Modern opportunities for assessing the left ventricle remodeling

Aim: To compare the results of distributing left ventricular (LV) remodeling patterns according to two classifications and identify their advantages and disadvantages. Materials and methods. The study involved 2019 patients, aged from 18 to 94 years with a mean of 57.6 ± 16.4 years, 51 % males, apparently healthy and with cardiovascular and respiratory system pathology. Echocardiography was performed using an Esaote MyLab Seven device (Italy) according to generally accepted standards. The distribution of patients according to four classic LV remodeling patterns and according to the classification proposed by W. Gaasch and M. Zile was studied. Statistical analysis was performed using Statistica for Windows 13.0 (StatSoft Inc., USA; license No. JPZ804I382130ARCN10-J). Qualitative variables were given as absolute and relative frequency (n (%)). Results. The distribution of patients according to 4 classic LV remodeling patterns was as follows: 53.0 % had normal LV geometry; 10.2 % – concentric remodeling; 15.6 % – concentric hypertrophy; 21.2 % – eccentric hypertrophy. At the same time, in the group of normal LV geometry, 25.2 % of people had LV dilatation. When distributing the patients by remodeling patterns according to the W. Gaasch and M. Zile classification, the following data were obtained: 26.9 % of people had normal LV geometry, concentric remodeling – 10.2 %, concentric hypertrophy – 12.4 %, mixed hypertrophy – 3.1 %, physiological and dilated hypertrophy – 11.8 %, eccentric hypertrophy – 5.5 %, eccentric remodeling – 11.4 %. In addition, 3 more groups of patients were formed, who did not have a terminological definition based on the W. Gaasch and M. Zile classification and, in total, accounted for 18.6 % of the examined. Conclusions. The missing options of dilated left ventricle should be recognized as a limitation of the classic classifications of left ventricular remodeling patterns. The imposition of additional criteria covering the cavity dilatation in determining the left ventricular remodeling patterns improves the assessment of the patient’s prognosis and contributes to a more individual selection of pathogenetic therapy.

Mechanisms of thyroid hypofunction influence on the formation of the cardiovascular system pathology

Mechanisms of thyroid hypofunction influence on the formation of the cardiovascular system pathology

Decision Making Support System for the Diagnostics of the Cardiovascular System Pathologies by the X-ray Images of the Chest

The lack of universal (generalized) data sets, as well as the lack of annotated data, creates the need to study the possibilities of neural network approaches for specific data sets. The importance of building algorithms for detecting extrapulmonary pathologies on chest X-ray images is dictated by the great social significance of many diseases of this group (for example, cardiovascular diseases), given the availability of such images, due to the widespread use of minimally invasive and relatively cheap X-ray diagnostic methods. One of the most impor tant issues in solving the problems of automating the classification of medical images is data preparation. As a result of work on the image base, the performance of the final algorithm has been increased from 75 to 95 %. The processing of the entire volume of the obtained images and their diagnostics for a wide list of pathologies are difficult for medical institutions because of the limited resources. In this regard, it is advisable to use the automation of segmentation and recognition processes, which even at the first stages of development of the technology makes it possible to redistribute the attention of doctors, focusing on potentially pathological cases and returning attention to cases mistakenly identified as non-pathological.

The effect of physical activity on electrophysiological processes in the ventricular myocardium in child-athletes

Maladaptation processes in the cardiovascular system in child athletes are associated with changes in electrophysiological processes in the myocardium. To identify risk groups for the development of the cardiovascular system pathology among this contingent, it is possible to use a non-invasive technique: ECG dispersion mapping.Purpose. To identify changes in electrophysiological processes in the myocardium of the left and right ventricles in child athletes in response to physical activity.Material and methods. 279 healthy children without chronic disease aged from 12 to 18 years were under observation. A group of 209 children involved in sports has been identified. The gender distribution is as follows: 153 boys (73%) and 56 girls (27%). The reference group included 70 children not involved in sports. All child athletes had access to the training and competition process. Within the study group, 4 subgroups were allocated in accordance with sports: A subgroup — children attending the football section (51 boys); B — basketball (37 boys and 22 girls); C — volleyball (29 boys and 27 girls); D — martial arts (36 boys and 7 girls). All children underwent dispersion mapping of the electrocardiogram using the Cardiovisor software and hardware complex before and after the exercise test. The processes of depolarization and repolarization in the myocardium of the left and right ventricles were analyzed on the basis of G3–G6 indices. Statistical processing of the results was carried out using MS Excel, Stata.Results. The analysis of electrophysiological processes in the myocardium of the left and right ventricles in child athletes showed statistically significant differences in comparison with the reference group. In all G3-G6 indicators in the main group, a moderate deviation was noted, while all values in the reference group were within normal limits in more than 92%. Moderate physical exertion led to the registration of both moderate and pronounced electrophysiological disturbances in the myocardium, especially in children engaged in highly dynamic sports, namely basketball.

Оцінка стану тканин пародонта у хворих із соматичною патологією

The purpose of the study was to investigate the influence of concomitant somatic pathology on periodontal tissues. Materials and methods. 104 patients, aged 28–46 years, with diseases of periodontal tissues, who had somatic pathology, were involved in the study. The examined persons were divided into groups: 35 persons (group 1) with pathology of the hepatobiliary system, 37 persons (group 2) with pathology of the gastrointestinal tract, and 32 persons (group 3) with pathology of the cardiovascular system. The comparison group included 30 people with periodontal tissue diseases without somatic pathology. To determine the depth and prevalence of the inflammatory process of the gums the Svrakov’s number indicator was used. Oral hygiene was assessed according to the Silness-Loe and Stallard indices. The papillary-marginal-alveolar index (C. Parma, 1960) was determined to assess the severity of gum inflammation. Bleeding gums were assessed by the gum's papilla bleeding index according to Muhllemann. Statistical processing of the research results was carried out with a computer program for variational and statistical analysis of medical and biological research data “GraphPad Prism 5”. Results and discussion. Patients with diseases of periodontal tissues against the background of somatic pathology had the highest percentage of chronic generalized periodontitis of the II degree, in contrast patients of the comparison group had the highest percentage of chronic generalized periodontitis of the initial – I degree. Svrakov's number in patients with periodontal disease against the background of somatic pathology significantly (р ˂0.05) exceeded the indicators of patients of the comparison group. At the same time, there is no significant difference between the results of groups 1, 2 and 3. The highest values of the indexes of Silness-Loe and Stallard were recorded in patients with the cardiovascular system pathology, which significantly (p<0.05) exceeded the data in the comparison group, but did not significantly differ from the results of patients with pathology of hepatobiliary system and gastrointestinal tract. The papillary-marginal-alveolar index data were the highest in patients with hepatobiliary system pathology (64.25 ± 8.19%), which significantly (p<0.05) exceeded the results of the comparison group and in individuals of groups 2 and 3. The highest indicator of the bleeding index is 1.98 ± 0.22 points in patients of the 1st group, which significantly exceeds the indicators in the group of people without somatic pathology and in the group of patients with pathology of gastrointestinal tract and cardiovascular system. Conclusion. The conducted studies show that the presence of somatic pathology contributes to the development of periodontal tissue diseases, and certainly aggravates their course, which is proven by the results of the index assessment

Heart failure and osteoporosis: common pathogenetic components

This literature review reflects modern ideas about the combination of heart failure (HF) and osteoporosis, common risk factors for these diseases, and pathophysiological mechanisms of metabolic bone diseases in HF. Despite a growing number of studies on the combined cardiovascular and skeletal system pathology, the relationship between a decrease in bone mineral density and HF risk remains poorly understood. Both conditions are common causes of disability, death, prolonged hospitalizations and a significant reduction in quality of life, while its combination exacerbates their course and increases the incidence of adverse outcomes, which is a heavy burden for a patient and health care in general. Keywords: heart failure, osteoporosis, bone mineral density, bone metabolism.

ANALYSIS OF RISK FACTORS AND CLINICAL AND PARACLINICAL MANIFESTATIONS OF GASTROINTESTINAL DYSFUNCTION IN NEWBORNS IN PERINATAL PATHOLOGY

In recent decades, there has been a worldwide trend toward increasing rates of functional and organic pathology of the gastrointestinal (GI) tract in children. Presently, diseases of digestive organs rank second in frequency among pathologies of the pediatric population after acute respiratory diseases. Development of functional disorders of the gastrointestinal tract in children in the first year of life is mainly caused by anatomic and physiological characteristics of the digestive system, as well as high sensitivity and ease of damage of all its parts. Current literature suggests that children born to mothers during difficult pregnancy or childbirth are at increased risk for developing this pathology.Objective of the study: To determine perinatal risk factors and clinical and paraclinical features of gastrointestinal functional disorders in newborns with perinatal pathology.Materials and methods. The study enrolled 82 full-term infants with severe perinatal pathology, with clinical manifestations of gastrointestinal dysfunction (Group I), and 50 healthy infants (Group II) as a comparison group. Exclusion criteria for the study were: congenital malformations, low birth weight, clinical manifestations of infection. To assess metabolic disorders, a comprehensive assessment of the biochemical blood spectrum with the level of total protein and albumin, total bilirubin and its fractions, glucose, urea and uric acid, cholesterol and triglycerides; activity of AlAT, AsAT, LDH, LF, GGTP. Biochemical studies were performed using a Cormay ACCENT biochemical analyzer (Poland, Cormay reagents).Results and discussion. Disorders of postnatal adaptation of newborns are noted in the conditions of mothers’ somatic disadvantages, implementation of unfavorable factors during pregnancy and labor. Analysis of somatic anamnesis, antenatal and intrapartum problems has made it possible to identify the main causes of neonatal adaptation disorders in the early neonatal period. The most important, taking into account maternal anamneses, in the patients of the main group were: cardiovascular system pathology in 30 (36, 59%) cases, urinary system pathology in 22 (26, 83%) cases, endocrine system pathology in 17 (20, 73%) cases, digestive system pathology in 11 (13, 41%) cases, and respiratory system pathology in 8 (9, 76%) cases; gynecological pathology was diagnosed in 16 (19, 51%). The antenatal period was complicated by: placental dysfunction in 10 (12.20%) cases, hydramnios in 8 (9.76%) cases, fetal distress in 10 (12.20%) cases, and cord entanglement around the neck in 5 (6.10%) cases. Overall, there were 14 (17.07%) cases with a poor obstetric history. Caesarean section was performed in 24 (29.27%) cases, vacuum-assisted delivery in 4 (4.88%) cases.The list of diseases responsible for the severity of the newborn's condition was presented according to the main diagnosis: 66 (80.5%) cases had central nervous system involvement in the form of hypoxic-ischemic lesion/neonatal encephalopathy, 27 (32.9%) cases had severe respiratory distress, 13 (15.9%) cases had moderate asphyxia and 11 (13.4%) cases had severe asphyxia, 10 (12.2%) cases had moderate respiratory distress and 2 (2.4%) cases had hemolytic disease in newborn. All patients of the main group also had concomitant diagnoses. The condition of the main group neonates was characterized by more severe somatic and neurological status disorders, formation of MOD syndrome with the development of signs of food intolerance due to complex disorders of the gastrointestinal system. Complex disorders of food tolerance were observed in 71 (86,59%) children, regurgitation/stasis - in 66 (80,49%) neonates, paresis/weak intestinal peristalsis - in 47 (57,32%) patients, flatus - in 3 (3,66%) cases, meconium retention - in 3 (3.66%) cases, isolated absence of sucking reflex/ wobbly sucking was found in 3 (3.66%) cases, enlargement of liver and spleen - in 1 (1.22%) patient. The complex of serum biochemical studies showed significant dysmetabolic changes, which to some extent explain the pathophysiological mechanisms of gastrointestinal dysfunction. In particular, revealed violations of protein-synthetic function of the liver and delays in the production and excretion of bile, enzyme deficiency and cytolytic syndrome.Conclusions. Disorders of the digestive system in newborns is one of the manifestations of general body dysfunction in conditions of hypoxia with the implementation of unfavorable factors of pregnancy and childbirth in the mother.Clinical signs of food intolerance in newborn infants are regurgitation/stasis, paresis/weak intestinal peristalsis, flatus, meconium retention, absence of sucking reflex/wobbly sucking, enlarged liver and spleen.Complex serum biochemical studies in newborns with gastrointestinal disorders showed impaired protein-synthetic liver function, delayed production and excretion of bile, enzymatic insufficiency and cytolytic syndrome.

Патология сердечно-сосудистой системы у детей с синдромом Шерешевского — Тернера

Статья посвящена изучению структуры патологии сердечно-сосудистой системы у детей с синдромом Шерешевского — Тернера. Результаты работы основаны на данных обследования 42 больных с синдромом Шерешевского — Тернера в возрасте от 1,5 до 17 лет. Показано, что у 80,9 % больных с синдромом Шерешевского — Тернера отмечаются патологические изменения со стороны сердечно-сосудистой системы разной степени выраженности. Наиболее часто встречаемыми врожденными пороками сердца при синдроме Шерешевского — Тернера являются коарктация аорты, двустворчатый аортальный клапан и дефект межпредсердной перегородки. Синдром Шерешевского — Тернера в 35,6 % случаев ассоциирован с нарушениями электрической работы сердца, в частности с синдромом удлиненного интервала QT. Атерогенные изменения липидного профиля у больных с синдромом Шерешевского — Тернера в 21,4 % случаев наблюдаются с детства.

Патогенетические механизмы повреждения сердечно-сосудистой системы при новой коронавирусной инфекции (COVID-19)

Objective of the study: to analyze and systematize the results of fundamental and clinical studies of recent years devoted to the study of the pathogenetic mechanisms of myocardial and coronary artery damage in patients who have undergone a new coronavirus infection (COVID-19). Materials and methods. The search for scientific information was carried out in domestic (E-Library) and foreign databases (PubMed, Scopus, Oxford University Press, Springer, Web of Science Core Collection). Results. It has been shown that the variety of cardiovascular system pathologies after a coronavirus infection is quite wide: heart failure, arrhythmias, sudden cardiac death, coronary heart disease, coronary microvascular dysfunction with coronary insufficiency, formation of coronary artery and aortic aneurysms, hypertension, labile heart rate and BP response to physical activity, acceleration of atherogenesis processes, venous and arterial thromboembolism. Cardiovascular pathology can develop both in patients after severe and moderate COVID-19, and in oligosymptomatic and asymptomatic individuals. Patients with emerging cardiovascular pathology in the acute period of coronavirus infection, as a rule, are under observation and in this situation changes in therapeutic strategies occur faster. Patients with newly diagnosed cardiovascular pathology after suffering COVID-19 need special attention and timely assessment to exclude or confirm cardiovascular complications. Conclusion. The presented data suggest that the tactics and strategy for the management of cardiovascular diseases in the post-covid period should be based on the timely and modern diagnosis of the onset or decompensation of cardiovascular pathology, competent, in accordance with current recommendations management of cardiovascular pathology with emphasis on the use of therapeutic interventions affecting the pathophysiological mechanisms of long covid.

Unique technologies for organizing medical care for COVID-19 patients with concomitant diseases of the cardiovascular system and surgical pathology

The article describes some of the key elements of unique technologies for organizing medical care for patients with COVID-19 with concomitant diseases of the cardiovascular system and surgical pathology, which, along with ensuring infectious safety, allow to optimize the stream of value creation for these patients. Innovative approaches to managing the production activities of a medical organization are proposed. The goal of the work done by the hospital administration was to create a management model for a state medical organization based on modern methods, including a process-oriented approach and lean healthcare technologies. The relevance of the chosen topic is due to the fact that the activities of healthcare institutions in the context of the global coronavirus pandemic require more flexibility and mobility; therefore, the primary task is to master new management tools for a medical organization, taking into account industry characteristics and consumer needs. Analytical and descriptive methods, sociological survey were used. The article describes our own experience in carrying out structural changes in a medical organization. The use of modern management approaches allows the formation of positive interaction within the workforce and provides active feedback with patients.

Fortification of food with micronutrients: development of methodological and regulatory framework in the Russian Federation

The available scientific literature, domestic and international regulatory codes of normative documents concerning the fortification of various types of food products have been analyzed. The groups of food products of conventional and regular consumption included into the diets of all categories of consumers, recommended for fortification with essential micronutrients, have been determined: wheat and cereal flour (spelt wheat, buckwheat, oat, corn flour, etc.); pastry; milk and dairy products, including ice cream; non-alcoholic soft drinks; mineralized drinking water; fruit and vegetable juices; fat and oil products (vegetable oils, margarines, spreads, mayonnaise); confectionery and sweets (pastry, sugar, chocolate); cereals (breakfast cereals, muesli, ready-to-eat extruded cereals, instant pasta and cereals, mixtures for bakery, flour for sweet pastry); food concentrates (jelly, instant drinks, concentrates of sweet foods, instant food, instant cereal concentrates); table salt. The groups of food products assigned for certain categories of population are used as part of therapeutic diets for patients with various diseases (metabolic disorder syndrome, cardio-vascular system pathology with atherosclerotic vascular injury, type 2 diabetes mellitus, gastrointestinal tract diseases, non-alcoholic fatty liver disease, diabetic nephropathy, etc.), as well as assigned to reduce the risk of diseases developing, the nutrients are recommended for targeted fortification of certain types of food. Examples of micronutrients fortification of sausages and minced meat semifinished products are given below. Requirements for fortification of mass consumption food products and for fortification of foods for special dietary uses are formulated in this article, the amount of fortifying components in the various groups of food products are justified, ensuring their efficiency for improving the micronutrient status and safety of its consumption. Based on the analysis of the available scientific literature, domestic and international regulatory framework of normative documents on fortification of various types of food products, recommendations have been developed for fortification of food with micronutrients.

Diabetic Nephropathy – possibilities of early laboratory diagnostics and course prediction (review of literature)

The medical and social significance of diabetes mellitus is determined by a progressive increase in the incidence of the disease, as well as the development of disabling and reducing the quality of life of macro- and microvascular complications in patients of working age, in particular, with the development of diabetic nephropathy (DN), which develops in one third of patients with type 1 and 2 diabetes. DN is the third leading cause of death after diseases of the cardiovascular system and oncological pathologies. In this regard, the identification of DN at the early stages is an important task both from the standpoint of prevention and a more favorable prognosis of the course of diabetes. This review presents data on the possibilities of early diagnosis of DN using blood and urine biomarkers, as well as information on their diagnostic and prognostic value. The analysis of the interpretation of the indicator of microalbuminuria in type 1 and 2 diabetes was carried out. In addition, the literature data of recent years on the informative value of determining markers of podocyte damage, on the role of oxidative stress products, immune-inflammatory factors, and vascular endothelial growth factor in the process of the onset and development of DN are presented. The possibility of their practical use for the diagnosis of DN in clinical practice is discussed. The literature search for this review was carried out using the databases of the RSCI, CyberLeninka, Scopus, Web of Science, MedLine, PubMed for the period from 2011 to 2021. using the following keywords: diabetes mellitus, diabetic nephropathy, markers of diabetic nephropathy; kidney damage, early diagnosis of diabetic nephropathy.