Patient Histories Research Articles

INDUCTION OF CARDIAC ARRHYTHMIAS DURING BICYCLE ERGOMETRY IN THE DIAGNOSIS OF CORONARY HEART DISEASE

HighlightsThe frequency of arrhythmias during bicycle ergometry was compared in patients with and without coronary heart disease. Their diagnostic significance in diagnosing this disease was analyzed separately for men and women. AbstractAim. To determine the diagnostic significance of exercise-induced cardiac arrhythmias (CAs) during bicycle ergometry (BEM) in patients with suspected coronary heart disease (CHD).Methods. For the retrospective study, 384 case histories of patients discharged from the cardiology department between 2011 and 2020 were selected according to the inclusion and exclusion criteria. The data of BEM and coronary angiography were studied. The correlation between the occurrence of induction of different types of CAs during BEM and the presence of coronary artery blood flow abnormalities was investigated. Indicators of the diagnostic significance of CAs in the diagnosis of coronary artery disease, such as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) results, were determined separately for men and women. The statistical significance of the results was assessed.Results. Statistically significant specificity and PPV for the induction of ventricular arrhythmias (VAs) without taking into account rare single monomorphic ventricular extrasystoles (VEs) in the diagnosis of CHD in men were 83.5% and 73.1%, respectively. The same indicators for VAs, excluding all single VEs, were 95.3% and 82.6% in men.Conclusion. The induction of VAs in men on BEM, with the exception of rare single monomorphic VEs, is diagnostically significant in the detection of CHD and allows us to qualify the result of BEM as “positive”. The induction of other CAs on BEM has not shown diagnostic significance in the detection of CHD.

RISK FACTORS FOR THE DEVELOPMENT OF NOSOCOMIAL PNEUMONIA AFTER AORTIC ARCH SURGERY

HighlightsFor the first time, the incidence and timing of the development of postoperative pneumonia in patients undergoing surgical reconstruction of the aortic arch in the post-covid period were studied. Risk factors for pneumonia and predictors of the severe course of the disease in this cohort of patients were identified. The results obtained will make it possible to differentiate patients at risk of developing pneumonia from the general population of patients undergoing surgical reconstruction of the aortic arch for targeted perioperative prevention of this complication. AbstractAim. To study the incidence of nosocomial pneumonia (NP) after aortic arch surgery, and to determine the impact of perioperative factors on the risk for its development and severity of its course.Methods. A retrospective analysis of 66 case histories of patients who underwent aortic arch surgery in 2022 was carried out. The incidence and timing of the development of pneumonia were revealed, the severity of its course was assessed. The impact of the main demographic, clinical, perioperative factors on the risk for the pneumonia development and the severity of its course was studied.Results. The incidence of pneumonia after aortic arch surgery was 24.2%. A relationship between smoking (OR 1.17; 95% CI [0.23; 1.43], p = 0.007), smoking index (OR 0.99; 95% CI [0.92; 1.07], p = 0.002) and the risk of NP developing as well as between the duration of mechanical ventilation and the severity of NP was found with a univariate logistic regression analysis (OR 1.26; 95% CI [1.0; 1.59], p = 0.049).Conclusion. The risk for NP development in patients who underwent thoracic aortic surgery is associated with smoking and smoking intensity in the preoperative period. The predictor of the severe course of NP is the duration of mechanical ventilation.

Demographic and Clinical Characteristics of Uveitis for Adult Patients Attending Mansoura Ophthalmic Center

ABSTRACT Aim The aim of this research is to evaluate the demographic attributes and clinical manifestations of uveitis in adult patients frequenting the Mansoura Ophthalmic Center. Methods Utilizing a cross-sectional, prospective, analytical study design, this research engaged adult patients visiting the outpatient uveitis clinic at the Mansoura Ophthalmic Center. Comprehensive case evaluations involved collecting detailed patient histories, examining ophthalmic records, and conducting thorough ocular examinations. These examinations encompassed the assessment of visual acuity, slit-lamp examination, and fundus examination. Furthermore, selected cases underwent optical coherence tomography (OCT) and fundus fluorescein angiography (FFA). Results The Study involved an examination of 411 eyes belonging to 254 uveitic patients. In the Egyptian context, anterior uveitis surfaced as the most prevalent form of uveitis. The average Best-Corrected Visual Acuity (BCVA) among the cases studied was 0.797 ± 0.77 LogMAR, with the majority of cases demonstrating vision superior to 0.3 LogMAR. Notably, the principal causes of vision loss were generally reversible. Macular edema was identified as the leading cause of vision loss, representing 20.7% of cases as evidenced by OCT. The ratio of non-infectious to infectious uveitis stood at 92.2% to 7.8%. The most commonly observed etiologies of non-infectious uveitis included Behçet’s disease (33.3%), Vogt-Koyanagi-Harada (VKH) syndrome (19.7%), idiopathic causes (19.2%), and ankylosing spondylitis (AS) (11.9%). Conversely, the most frequent infectious etiologies were trematode-induced uveitis (2.9%), herpetic uveitis (1.7%), toxoplasmosis (1.5%), tuberculosis (TB) (1.5%), and brucellosis (0.2%). Conclusions This study conclusively indicates that anterior uveitis is the predominant anatomical type of uveitis in Egypt. Further, etiological diagnoses of uveitis should particularly emphasize Behçet’s disease, VKH syndrome, and ankylosing spondylitis.

Features of the course of COVID-19 in patients with type 2 diabetes mellitus

To identify the features of the course of COVID-19 in patients with type 2 diabetes mellitus (T2DM), depending on the intake of hypoglycemic therapy at the prehospital stage, in conjunction with the functional state of the kidneys. A retrospective analysis of 291 case histories of patients with COVID-19 and T2DM hospitalized in the infection department of Semashko Regional Clinical Hospital from January to December 2021, including the main clinical and laboratory parameters.Results. Among hospitalized patients with COVID-19, patients with T2DM had a higher mortality rate. An analysis of the case histories of deceased patients with COVID-19 and T2DM showed that at admission, body mass index (BMI), C-reactive protein, and creatinine were higher than those of survivors and amounted to BMI - 33 [30; 39] and 33 [28; 36] kg/m3; p=0.039, C-reactive protein - 77 [47.5; 106.0] and 57 [27.0; 89.0] mg/l; p=0.015, in terms of creatinine level - 89 [70.0; 144.0] and 82 [66.0; 101.0] µmol/l; p=0.039, respectively. It was found that in the second week of hospitalization in the group of deceased patients with COVID-19 and T2DM, the creatinine level was statistically significantly higher than in surviving patients and amounted to 94.5 [71.5; 141.0] and 72.5 [57.0; 88.0] µmol/L; p<0.001, respectively. The probability of death in hospitalized patients with type 2 COVID-19 and T2DM depended on BMI and creatinine levels at the second week of hospitalization. Patients with prehospital correction of hyperglycemia dipeptidyl peptidase-4 inhibitors (iDPP-4)/ glucagon-like peptide-1 receptor agonists (agGLP-1)/ sodium-glucose co-transporter 2 inhibitors (iSGLT-2) had significantly lower creatinine levels at week 2 of hospitalization. In patients with moderate to severe COVID-19 with concomitant T2DM, special attention should be paid to the combination of high BMI and creatinine in the second week of hospitalization, which is a prognostically unfavorable predictor of death in such patients.

Outcome of Low Dose of Tamoxifen for Ocular Manifestations in Breast Cancer Patients

Background: Tamoxifen, a non-steroidal triphenylethylene estrogen antagonist, serves as a crucial therapy, both alone and in conjunction with other treatments, for disseminated breast carcinomas due to its proven efficacy and minimal adverse effects in oncology. Despite its extensive use, ocular toxicity reports linked to tamoxifen remain relatively scarce in available literature. Given the limited studies in the Bangladeshi context, this investigation aims to explore ocular manifestations in breast cancer patients undergoing prolonged low-dose tamoxifen therapy for over two years. Methods: This longitudinal study was conducted at Dhaka Medical College Hospital between October 2019 and July 2020, involving 45 patients undergoing low-dose tamoxifen treatment for more than two years post-surgical intervention for breast carcinoma. Detailed patient histories were obtained, and thorough ophthalmic examinations were performed for each participant. Data were meticulously recorded in separate case files and analyzed using SPSS 22 to ensure accuracy and reliability. Observations and Results: The average age of the patients was 51.16 (±8.82) years, and 11.10% of the respondents exhibited ocular manifestations. These manifestations primarily comprised cataracts (6.70%), retinitis (2.20%), and optic neuritis (2.20%). Regarding eye-related conditions, cataracts are evident in patients 01, 02, and 03, while retinitis is observed in patients 04 and 05. Optic neuritis is specifically noted in patient 05. The data highlights occurrences of these conditions in relation to the duration of Tamoxifen treatment and the patients' ages, potentially suggesting associations worthy of further exploration regarding the impact of Tamoxifen on eye health in this demographic. Conclusion: This study revealed that approximately one-tenth of the patient cohort undergoing tamoxifen therapy for over two years experienced ocular manifestations. However, further in-depth investigations are strongly ...

Papillary thyroid microcarcinoma: impossible to operate observe – where to put a comma?

Objective. To evaluate the efficiency of diagnostics and treatment in patients with microcarcinomas of the thyroid gland at the State Medical Institution "RCOD of the Ministry of Health of the Republic of Tatarstan named after Professor. M.Z. Sigal" for 2020-22.&#x0D; Materials and methods. MIS "BARS. Healthcare – MIS" of oncological dispensary, outpatient charts and medical histories of patients operated on for thyroid microcarcinomas were used.&#x0D; Results. In the study group, all patients had papillary microcarcinoma. Women over 45 years of age prevailed. Women of fertile age accounted for 41.7%. The combination of microcarcinoma with thyroid adenomas, colloidal goiter and AIT was detected in 78.6% of patients. The organ capsule invasion occurred in 35.7% of patients, metastases to regional lymph nodes – in 19%. Thyroidectomy was performed in 66.7% of patients; 12 (28.6%) patients underwent I-131 therapy.&#x0D; Conclusions. Due to the fact that papillary microcarcinoma of the thyroid gland is often found in women of fertile age, and develops against the background of another thyroid pathology complicating diagnostics, it sprouts an organ capsule in 35.7% and gives metastases to regional lymph nodes in 19%, therefore requires a timely diagnostics and radical treatment.

Algorithm for physical rehabilitation of patients with multiple sclerosis: practical experience

BACKGROUND: Multiple sclerosis is a pressing problem of modern society and healtcare. The high risk of disability of the able-bodied population, together with the observed trend of increase in morbidity and decrease in the age of onset of the disease, create a number of economic and social difficulties. It is well known that current medical treatment of multiple sclerosis is most effective in reducing the frequency of exacerbations and disability progression, but does not affect the already established residual manifestations, indicators of disability progression objectified by magnetic resonance imaging data.&#x0D; AIM: Evaluation of the effectiveness of using the algorithm for choosing a method of physical rehabilitation, according to the selected models of patients with multiple sclerosis.&#x0D; MATERIALS AND METHODS: The medical histories of patients aged from 31 to 58.8 (average age 48.9±8.6) years who were in hospital treatment were analyzed (n=504; men — 34%, women — 66%), of which 56% had no disability, 11% had disability group I, 25% had disability group II, and 8% had disability group III.&#x0D; RESULTS: An algorithm for working with patients in this category was developed from the perspective of functioning in the categories of the International Classification of Functioning, Disability and Health, and Assessment of Impairments, which is a huge part of the medical rehabilitation protocol for patients with multiple sclerosis.&#x0D; CONCLUSION: The proposed models of patients, including pronounced disorders, make it possible to systematize and standardize the process of rehabilitation measures, improve the quality of provided medical services and provide the population with qualified rehabilitation care.

Pharmacoeconomic analysis of costs for radiopaque agents and a method to minimize them

The aim of the work is to minimize the costs of a multidisciplinary hospital in the city of Volgograd for radiopaque substances.&#x0D; Materials and research methods: In the first part, the costs of the hospital for the purchase of x-ray contrast medications were studied and the average cost of direct costs for radiopaque agents for one coronary angiography procedure was determined. In the second part, a comparative analysis of the cost of radiopaque agents presented on the Russian market was carried out on the basis of the State Register of Selling Prices.&#x0D; Results of the study and their discussion: A retrospective analysis of 147 case histories of patients undergoing percutaneous coronary intervention showed that the average volume of radiopaque drug during coronary angiography was (126.19 36.35) ml. In 66 (44.9 %) patients, more than 100 ml was used per procedure. For one coronary angiography procedure, on average (126 ml of contrast), 1927.8 rubles were spent for a radiopaque preparation. Among the radiopaque drugs recommended for coronary angiography, according to the state register of maximum ex-works prices, Iohexol preparations 350 mg/ml of Russian production had the lowest cost.&#x0D; Conclusions: Procurement of domestic preparations Iohexol 350 mg/ml, 100 ml bottles will reduce the cost of percutaneous coronary intervention.

Diabetes at a Glance: Assessing AI Strategies for Early Diabetes Detection and Intervention

For the early identification of diabetes, a chronic illness that affects millions of people globally, artificial intelligence (AI) shows enormous promise. AI algorithms can recognize diabetes signs and give patients and healthcare providers early warnings by examining a variety of data sources, such as medical records, patient histories, and lifestyle factors. AI's capacity to evaluate sizable and intricate datasets is one of its main advantages in the diagnosis of diabetes. AI is capable of taking into account a broad range of variables that could lead to diabetes, such as age, BMI, food preferences, physical activity, and genetic predisposition. Artificial intelligence (AI) systems can recognize early indicators of diabetes and forecast the risk of developing the condition by analysing patterns and relationships among these variables. AI can also be applied to customize diabetic care and screening. Healthcare providers can improve patient outcomes and lessen the burden of disease by customizing suggestions and treatment options for each patient. AI can assess a patient's risk of diabetes by looking into their lifestyle choices and medical history. Healthcare providers can focus treatments and preventative actions to lower the chance of illness onset by identifying high-risk individuals can identify early indicators of diabetes by analysing blood glucose levels, demographic data, and lifestyle factors. Because of this, medical practitioners may be able to intervene early on, when the illness is most amenable to treatment systems that can monitor blood glucose levels and examine patient histories to create customized diabetic treatment programs. This can involve individualized prescription schedules, workout programs, and food advice. All things considered, AI has the power to completely transform the way people with diabetes are managed by giving patients and healthcare providers individualized data-driven insights. The use of AI in clinical practice is fraught with difficulties, such as privacy issues and a dearth of standardized data, yet the advantages in identifying and treating diabetes are substantial.

Deep learning-based natural language processing for detecting medical symptoms and histories in emergency patient triage

ObjectiveThe manual recording of electronic health records (EHRs) by clinicians in the emergency department (ED) is time-consuming and challenging. In light of recent advancements in large language models (LLMs) such as GPT and BERT, this study aimed to design and validate LLMs for automatic clinical diagnoses. The models were designed to identify 12 medical symptoms and 2 patient histories from simulated clinician–patient conversations within 6 primary symptom scenarios in emergency triage rooms. Materials and methodWe developed classification models by fine-tuning BERT, a transformer-based pre-trained model. We subsequently analyzed these models using eXplainable artificial intelligence (XAI) and the Shapley additive explanation (SHAP) method. A Turing test was conducted to ascertain the reliability of the XAI results by comparing them to the outcomes of tasks performed and explained by medical workers. An emergency medicine specialist assessed the results of both XAI and the medical workers. ResultsWe fine-tuned four pre-trained LLMs and compared their classification performance. The KLUE-RoBERTa-based model demonstrated the highest performance (F1-score: 0.965, AUROC: 0.893) on human-transcribed script data. The XAI results using SHAP showed an average Jaccard similarity of 0.722 when compared with explanations of medical workers for 15 samples. The Turing test results revealed a small 6% gap, with XAI and medical workers receiving the mean scores of 3.327 and 3.52, respectively. ConclusionThis paper highlights the potential of LLMs for automatic EHR recording in Korean EDs. The KLUE-RoBERTa-based model demonstrated superior classification performance. Furthermore, XAI using SHAP provided reliable explanations for model outputs. The reliability of these explanations was confirmed by a Turing test.

PATIENT TRANSFER FROM HEMODIALYSIS TO PERITONEAL DIALYSIS: A SINGLE CENTER EXPERIENCE

INTRODUCTION Peritoneal dialysis and hemodialysis are complementary ways of treating end-stage renal failure. Changing the dialysis modality from hemodialysis to peritoneal dialysis is a rare and poorly studied phenomenon. MATERIALS AND METHODS Retrospective cohort study conducted on the population of adult patients with end-stage chronic renal failure who were treated at the Nephrology Clinic of the Clinical Center of the University of Sarajevo in the period from 2006 to 2023. A total of 109 adult patients, whose medical documentation was complete and who were in the peritoneal dialysis program at the Nephrology Clinic of the Clinical Center of the University of Sarajevo during the observed period, were included in this study. One group started the treatment with peritoneal dialysis, and the other with hemodialysis. Demographic data were collected for each patient: age, gender, underlying kidney disease, comorbidities (heart disease and diabetes), duration of treatment modality, data on modality change, complications and treatment outcomes. Data from physical and electronic patient histories were used. RESULTS Total of 109 adult patients were included in this study. They are divided into two groups. Group 1 (n=99) in which peritoneal dialysis was the first treatment modality and Group 2 (n=10) in which haemodialysis was the first treatment modality, but in which patients, after a certain time, were transferred to peritoneal dialysis. The median age of patients in Group 1 was 60 (-/-14.07) years and 54 (-/+12.23) years for Group 2. Within Group 1 the most common cause of terminal renal failure was diabetic nephropathy (n=40, 40.4%) and nephroangiosclerosis (n=24, 24.24%). The mean age of onset of peritoneal dialysis was 60 (-/-14.07) years, while the mean age of cessation of peritoneal dialysis was 63 (±13.69) years. The average duration of peritoneal dialysis treatment was 38.36(±34.14) months. During the stay at peritoneal dialysis, death was recorded in 63 patients (62.38%). The number of patients who replaced peritoneal dialysis treatment with hemodialysis was 26. The most common reason for switching to haemodialysis was insufficiency of peritoneal dialysis (n=13, 14%). After switching to haemodialysis, the average length of staying on it was 10.22 months. The reason for discontinuation of haemodialysis was death (n=17, ) or transplantation (n=1, 3.7%). Kaplan-Meier test shown worse outcome in patients with haemodialyis first than peritoneal dialysis first. CONCLUSION Changing the dialysis modality carries with it a high risk of mortality, especially in the first month. Changing the way of active treatment with dialysis speaks in favor of severe comorbidities.

Accuracy of patient-reported spell duration: A comparative study

Clinicians rely heavily on patient histories to make medical diagnoses, most of which are inherently subjective and prone to inaccuracies. The aim of this study is to compare the subjective versus objective duration of spells through a retrospective chart review of patients admitted to the epilepsy monitoring unit at our tertiary care medical center. One hundred patients were analyzed. Differences in the accuracy of subjective estimations versus objective duration were compared by age, sex, focal versus generalized, location (frontal versus non-frontal), and spell type (focal aware versus impaired awareness and epileptic versus non-epileptic). Our data show that patients are poor subjective estimators, with 73% of patients overestimating the duration of their spells. We did not find differences in estimated duration by age, sex, seizure location or spell type. A notable exception was patients with generalized convulsive seizures, who accurately reported spell duration to within 17 s. This is likely because these seizures are stereotypical, and patients/family time them. Moreover, patients with non-epileptic spells were worse estimators of their spell duration than those with epileptic spells. In addition, although the prefrontal lobe plays a role in time estimation, we did not find that patients with frontal lobe seizures were worse estimators than those with non-frontal seizures, but invasive monitoring can more precisely localize seizures within areas of the frontal lobe responsible for time estimation. Our data emphasize the importance of not relying solely on patient-reported time estimation in diagnosing and developing treatment plans and instead instructing patients to time their spells.

Ретроспективный анализ восстановительного лечения в условиях соматического отделения коморбидных пациентов, перенесших COVID-19

Purpose: TTo study the practice and features of rehabilitation treatment in a somatic hospital for comorbid patients who have suffered pneumonia associated with COVID-19. Effective medical rehabilitation of SARS CoV-2 survivors is critical to recovery and optimization of emergency and specialty care outcomes. The new coronavirus infection and the severe pathology associated with it are more common in people of older age groups, burdened by many concomitant diseases, and occurs with damage to many organs and systems. The consequences of the disease pose the need for practical healthcare to carry out urgent and large-scale rehabilitation and preventive measures using for these purposes, in accordance with the requirements of the procedure for the rehabilitation of adults, approved by the Ministry of Health of the Russian Federation capabilities of specialized therapeutic hospitals. Underestimation of the capabilities of this approach leads to unjustifiably delayed use and, most importantly, loss of quality of rehabilitation treatment. The COVID-19 disease itself, damage to organs and systems, and the reaction of concomitant pathology with it have not yet been fully studied (G.E. Ivanova et al., 2020) and these patients often have to go through a broad search for optimal treatment and rehabilitation regimens. Material and methods:80 case histories of patients (57 women and 23 men) who had pneumonia associated with the new coronavirus infection COVID-19 were studied. The time from the onset of the disease was 2 months, the average age of patients was 55 years. The study included patients who had mild, moderate, and severe pneumonia and in 85% of cases had one or another concomitant pathology. Each patient was assigned an individual rehabilitation program, consisting of “respiratory block” procedures, including therapeutic exercises, hyperbaric oxygenation, laser therapy, magnetic therapy, manual massage, psychotherapy, dietary nutrition and physiotherapeutic procedures, also aimed at concomitant pathology. All patients received drug treatment. Restorative treatment of patients who had pneumonia associated with COVID-19 and had a concomitant disease was carried out with a rehabilitation routing scale value of 2-3 points. Conclusions: When developing individual medical rehabilitation programs for patients who have suffered COVID-19, procedures aimed at concomitant pathology should also be taken into account and highlighted. It is advisable to observe this group of patients in the somatic department of a multidisciplinary hospital. With this approach, clear positive dynamics were noted, both in the main and concomitant pathologies.

Brain-Storming to Detect Brain Disorders

Abstract: Brain disorders represent a significant and growing global health challenge, encompassing a spectrum of conditions ranging from neurodegenerative diseases, like Alzheimer's and Parkinson's, to various neuropsychiatric disorders. Timely and accurate detection of brain disorders is crucial for enabling prompt interventions, tailoring appropriate treatments, and improving the overall quality of life for affected individuals. This research paper explores an innovative and interdisciplinary approach to enhance the process of brain disorder detection through the integration of brainstorming techniques and advanced machine learning algorithms. The research delves into the adaptability and effectiveness of brainstorming techniques for brain disorder detection, leveraging diverse data sources such as clinical records, genetic information, and patient histories. The study presents various brainstorming techniques that are utilised to analyse, identify and arrive at the best possible methodology that can be used for the detection of brain disorders.

CORONET online risk assessment tool and Charlson comorbidity index in predicting fatalities in cancer patients with COVID-19

Purpose of the study. Сomparing and evaluating the prognostic potential of the CORONET online risk assessment tool and the Charlson Comorbidity Index in predicting mortality in cancer patients with COVID-19.Materials and methods. The results are drawn from the data of 168 case histories of cancer patients who were undergoing inpatient treatment for COVID-19 at the University Clinical Hospitals of Sechenov University between March 2020 and February 2022. The study was conducted as part of the program of the world-class research center “Digital Biodesign and Personalized Healthcare” of Sechenov University, with participation in the ESMO-CoCARE Registry project. Patients with a history of solid or hematologic malignancies were included in the study; their treatment period before the study was 5 years or less. The age ranged from 37 to 100 years, the median age was 69 years. The CORONET online risk assessment tool and the Charlson comorbidity index were used to objectify the severity of multimorbidity status and prognosis of fatal outcomes in cancer patients with COVID-19.Results. It was demonstrated that statistically significant effects on the prognosis of mortality in patients with cancer were: age, percentage of saturation on admission, treatment in intensive care units (ICU), National Early Warning Score 2 (NEWS2) distress syndrome severity scale score, computed tomography (CT) assessment of disease course severity, decreased blood albumin and platelet counts, and increased blood neutrophil counts in both categorical and immediate indicator value formats. In addition, it was determined that as the number of comorbidities increased, the probability of mortality increased significantly, odds ratio (OR) = 2.162 (CI 95 % 1.016–4.600; p = 0.045). The CORONET calculator score yields one of the highest OR values among all established statistically significant predictors,20.410 (CI 95 % 4.894–85.113; p &lt; 0.001). For oncopathology in COVID-19 patients, the Charlson index score shows statistical significance as a predictor of mortality, OR =1.396 (CI 9 5 % 1.105–1.765; p = 0.005).Conclusion. The obtained advantages in using the CORONET online decision support tool over the Charlson comorbidity index in predicting mortality in cancer patients with COVID-19 are recognized as convincing.

Establishing Standard of Care in Predicting Serious Complications for Patients Planned to Undergo Allogenic Hematopeotic Stem Cell Transplantation

Background: There is no reliable way to predict the individual risk of suffering from relevant complications during the course of Hematopoetic Stem Cell Transplantation (HSCT), because the huge amount of multidimensional parameters influencing clinical outcome is impossible for a human to compute accurately. Reliable prediction of complications: supports patients and physicians to make informed decisions, simplifies choosing best matched HSCT donors to avoid complications and enables superior, individualized planning of conditioning and prophylaxis. Up to now prediction is not based on evidence but rather experience, which differs amongst physicians. MatchGraft.AI is an artificial intelligence based machine learning tool that predicts the individual risk of acute Graft versus Host Disease, recurrence of basic disease and overall risk of death, using only pre transplant data (Table 1). The model was trained and tested on retrospective data of an international, multicenter cohort. Aim: Explore standard of care of choosing an HSCT donor and compare choice with real world data and MatchGraft.AI. Method: We developed an electronic questionnaire with 200 short patient histories including all parameters Matchgraft.AI is using. Pediatric and adult, benign and malignant cases with different donor types (matched unrelated, matched sibling, haploidentical family donor) are represented. This real world data is derived from a retrospective cohort of pediatric and adult patients of Charité Universitätsmedizin. 50 international experts in HSCT will: 1. choose a donor 2. predict individual risk of acute Graft versus Host Disease, risk of relapse and overall death for 50 individual patients. Cases are randomly allotted according to the physician's specialty (adult/pediatric treater, both). Questionnaires are anonymized. Answers are not traceable to the expert. Personal results compared with real world outcome and MatchGraft.AI can be provided to participants, if they wish. Results: We compare sensitivity and specificity of MatchGraft.AI to the standard of care, which is expert opinion and real world outcome. We examine: 1. whether the choosing of a donor is dependent on the individual physician or consistent throughout different HSCT experts. 2. how precise HSCT experts can predict the occurrence of severe complications for patients planned to undergo HSCT. 3. how well MatchGraft.AI can predict the occurrence of severe complications for patients planned to undergo HSCT in comparison. Conclusion: This study will provide important data about the standard of care in HSCT donor choosing and for the planned prospective study evaluating MatchGraft.AI.

Retrospective analysis of acute abdominal surgical diseases during the COVID­19 pandemic

The aim of the study was to improve the treatment results of acute abdominal surgical diseases during the COVID-19 pandemic. Material and methods. The object of the study was 200 patients who were randomized into 2 groups. The present study was retrospective, based on the analysis of the medical histories of patients hospitalized with clinical manifestations of acute abdominal pathology developed against the background of COVID-19. The present study was retrospective, based on the analysis of the medical histories of patients hospitalized with clinical manifestations of acute abdominal pathology developed against the background of COVID-19. Results. Cardiovascular and endocrinological background conditions were significantly less frequently recorded in the main group of patients. Perhaps the reason for this was that at the height of the pandemic, due to the excessive burden on the healthcare system, doctors did not pay enough attention to the presence of background conditions whuch could complicate the course of the main pathology. Patients in the comparison group were recruited in the post-pandemic period, when the functioning of the health system was normalized. Conclusion. The new SARS-CoV-2 virus will eventually line up with existing viruses and will periodically lead to COVID-19 outbreaks. A thorough analysis of acute abdominal surgical diseases during the COVID-19 pandemic leads to the correct tactics of surgical treatment with background and concomitant pathology. In this regard, the optimal planning of preventive and therapeutic measures requires the establishment of accurate diagnostics.

Favipiravir does not appear to be a major teratogen: Case series from Türkiye

IntroductionFavipiravir has gained attention during the Coronavirus Disease-2019 pandemic due to its potential antiviral effect against Severe Acute Respiratory Syndrome Coronavirus-2. Favipiravir has been identified as a teratogen in animal studies, but there is limited human data. We aimed to evaluate the pregnancy outcomes of women exposed to favipiravir during the pandemic. Material and methodsPregnant women who were exposed to favipiravir and applied to Marmara University School of Medicine Medical Pharmacology Outpatient Clinic Teratology Information Service between December 2020-September 2021 are included in the study. The demographic information, medical and obstetric histories of patients were acquired during admission, the outcomes of the pregnancies and the characteristics of the infants were gathered by regular phone calls. The infants whose parents consented were evaluated by a pediatrician for general well-being and congenital anomalies. Results22 pregnant women were included in this study. 81.8 % received the recommended favipiravir dose (8000 mg in 5 days), in the first trimester. Two patients were lost to follow-up, there was one elective termination and 19 live births. Congenital anomalies were found in 2 infants, one of whom had 9q34 duplication syndrome. Except for these, all newborns examined by the pediatrician were healthy. DiscussionWithin a limited case series, a subset of the infants exposed to favipiravir prenatally were followed up to 1 year of age. Two infants exhibited congenital malformations that cannot be directly linked to favipiravir due to confounding variables. Considering the limited data published, favipiravir does not appear to be a major teratogen.

Comparative characteristics of the clinical course of a new coronavirus infection depending on the vaccination status

Objective: to provide a comparative analysis of clinical manifestations of the new coronavirus infection in vaccinated and unvaccinated patients. Materials and methods. А retrospective analysis of 160 medical histories of patients with laboratoryconfi rmed diagnosis of coronavirus infection (COVID-19) was presented, including 80 unvaccinated individuals and 80 vaccinated with “EpiVacCorona”, “CoviVac”, and “Gam-COVID-Vac” vaccines. Results. Vaccination against COVID-19 does not completely eliminate the possibility of infection with the virus, but there are a number of significant advantages and diff erences in the course of coronavirus infection among vaccinated patients. The duration of the disease on average was about 2 weeks, and for unvaccinated individuals — 18.1 ± 0.4 days. Vaccinated patients, regardless of the vaccine used, recovered significantly earlier. Signs of polysegmental pneumonia were not observed in 21.3% of vaccinated patients. Respiratory support lasted for 6.0 ± 0.3 days in unvaccinated patients, and for vaccinated individuals with “EpiVacCorona” — 4.4 ± 0.7 days, “CoviVac” — 3.5 ± 0.6 days, “Gam-COVID-Vac” — 3.2 ± 0.4 days, which was signifi cantly lower than the indicators for the control group (p &lt;0.05). Conclusion. Сlinically, COVID-19 in vaccinated patients was milder compared to unvaccinated individuals, who most commonly experienced weakness, coughing, and extensive lung damage.

ABC/VEN – ANALYSIS OF DRUG PROVISION OF SMALL CELL LUNG CANCER CHEMOTHERAPY REGIMENS

This work is aimed at conducting a pharmacoeconomical analysis of chemotherapy for small cell lung cancer using ABC/ VEN analysis to identify the most expensive chemotherapy regimens. A retrospective evaluation of chemotherapy regimens for small cell lung cancer at various stages of the disease was carried out, presented in 408 case histories of patients who were treated from January 2021 to December 2021 in oncological dispensaries of the Voronezh and Lipetsk regions. During the study, the main regimens used in chemotherapy were identified and the most expensive treatment regimen for small cell lung cancer was determined, for which 50-70% of the budget is spent this is the scheme: etoposide + carboplatin and the least expensive group of drugs, for which 5-10% of the budget is spent this is scheme 3: cyclophosphamide 1000 mg/m2 in the 1st day + doxorubicin 50 mg/m2 on day 1 + vincristine 1.5 mg/m2 on day 1.