PECULIARITIES OF NITRATE CONTAMINATION OF PLANT PRODUCTS

The author describes the influence of nitrogen compounds in living organisms on biological processes and the environmental pollution. Peculiarities of accumulation of nitrates in plants are analyzed. The problem of contamination of plant products with nitrates in Georgia is especially emphasized.The following means are used to solve the problem of influence of chemical substances on the environment: modern machinery, developed farming culture, fertilizers, complex chemical means, progressive processing technologies etc

Anticoagulation and bleeding risk in patients with COVID-19

BACKGROUND: There is no current standardized approach to anticoagulation in patients with Coronavirus Disease 2019 (COVID-19) while potential bleeding risks remain. Our study characterizes the patterns of anticoagulation use in COVID-19 patients and the risk of related bleeding. METHODS: This is a single center retrospective analysis of 355 adult patients with confirmed diagnosis of COVID-19 from March 1 to May 31, 2020. Chi-square was used to analyze the relationship between degree of anticoagulant dose and bleeding events by site. Multivariable logistic regression was used to look at factors associated with inpatient death. RESULTS: 61% of patients were being treated with prophylactic doses of anticoagulation, while 7% and 29% were being treated with sub-therapeutic and therapeutic anticoagulation (TA) doses respectively. In 44% of patients, we found that the decision to escalate the dose of anticoagulation was based on laboratory values characterizing the severity of COVID-19 such as rising D-dimer levels. There were significantly higher rates of bleeding from non-CNS/non-GI sites (p = 0.039) and from any bleeding site overall (p = 0.019) with TA. TA was associated with significantly higher rates of inpatient death (41.6% vs 15.3% p \u3c 0.0001) compared to those without. All patients who developed CNS hemorrhage died p = 0.011. After multivariable logistic regression, only age OR 1.04 95% CI (1.01 to 1.07) p = 0.008 and therapeutic anticoagulation was associated with inpatient mortality OR 6.16 95% CI (2.96 to 12.83) p ≤ 0.0001. CONCLUSION: The use of TA was significantly associated with increased risk of bleeding. Bleeding in turn exhibited trends towards higher inpatient death among patients with COVID-19. These findings should be interpreted with caution and larger more controlled studies are needed to verify the net effects of anticoagulation in patients with COVID-19

Coronavirus Disease-19 Infection and Angioedema in African Americans: A Case Series

Rationale: Few case series have described the simultaneous development of angioedema in patients with coronavirus 19 disease (COVID-19). Most of these reports were described in at-risk patients for developing bradykinin angioedema. Therefore, we aim to describe 5 African American patients who developed simultaneous COVID-19 and angioedema. Methods: This was a case series of hospitalized patients with simultaneous angioedema and COVID-19 infection in a single center from May 2020 to February 2022. We used descriptive statistics. The study was approved by the institutional review board. Results: Their median age was 55 years (range 28-66); all patients were African American, and 3/5 were males. All patients developed angioedema within a week of hospitalization. Two subjects had prior history of ACEI-related angioedema but were not exposed to ACEI recently, whereas 1 subject was on chronic lisinopril therapy for the last 3 years. All patients had orofacial involvement; the most common locations were lips (5/5) and tongue (3/5). None had histaminergic features of angioedema (either skin rash or peripheral eosinophilia). 4/5 subjects had respiratory symptoms and chest imaging features of COVID-19 pneumonia, whereas 3/5 subjects developed severe COVID-19 infection. Most patients were treated with standard combination of H1 and H2 blockers, and corticosteroids. A total of 2/5 subjects were intubated; one patient developed refractory tongue swelling, received tracheostomy for extubation, and died due to COVID-19 pneumonia. The median length of angioedema improvement was 44 hours (range 20-168 hours). The median length of hospital stay was 15 days (range 1-49). Conclusion: We described 5 cases of angioedema in COVID-19 patients that shared risk factors and features of bradykinin-related angioedema

Азмаипарашвили Майя Отариевна. Зони відпочинку і можливості для розвитку туризму в Грузії.

The object of research are Georgian Resort - Recreational areas  and  tourism opportunities. Nature has richly rewarded Georgia with tourist recreational resources in the areas. There is no such a places in the world where such a variety of scenery can be seen. That's why Georgia whit its unique natural economic conditions – has the opportunity to become a strong tourist country. We believe that such a country as Georgia, which is one of the major tourist potentials of its untouched, wild and varied, remarkably attractive nature,  is particularly important to assess the value of natural resources, tourism and recreation.Объектом исследования является характеристика   курортно-рекреационных районов Грузии  и рассмотрение  туристических возможностей на этих территориях.Природа щедро вознаградила Грузию туристическими рекреационными ресурсами.  В мире не найти  таких мест, где на такой малой территории, как наша страна, имеется столь  различный ландшафт. Поэтому Грузия, располагающая такими уникальными природно-экономическими условиями, имеет возможность стать сильной туристической страной. В мире найдется мало стран, награжденных такими природно-климатическими и рекреационно-бальнеологическими ресурсами. Мы считаем, что страна, как Грузия, которая является одним из основных туристических возможностей своей первозданной, дикой и разнообразной, удивительно привлекательной природы, это особенно важно для оценки стоимости природных ресурсов, туризма и отдыха / учреждения.Об'єктом дослідження є характеристика курортно-рекреаційних районів Грузії та розгляд туристичних можливостей на цих територіях.Природа щедро винагородила Грузію туристичними рекреаційними ресурсами. У світі не знайти таких місць, де на такій малій території, як наша країна, мається настільки різний ландшафт. Тому Грузія, що розташовує такими унікальними природно-економічними умовами, має можливість стати сильною туристичною країною. У світі знайдеться мало країн, нагороджених такими природно-кліматичними та рекреаційно-бальнеологічними ресурсами.Ми вважаємо, що країна, як Грузія, яка є одним з основних туристичних можливостей своєї первозданної, дикої і різноманітною, дивно привабливою природи, це особливо важливо для оцінки вартості природних ресурсів, туризму і відпочинку / установи.run:yes'> В мире не найти  таких мест, где на такой малой территории, как наша страна, имеется столь  различный ландшафт. Поэтому Грузия, располагающая такими уникальными природно-экономическими условиями, имеет возможность стать сильной туристической страной. В мире найдется мало стран, награжденных такими природно-климатическими и рекреационно-бальнеологическими ресурсами. Мы считаем, что страна, как Грузия, которая является одним из основных туристических возможностей своей первозданной, дикой и разнообразной, удивительно привлекательной природы, это особенно важно для оценки стоимости природных ресурсов, туризма и отдыха / учреждения.

GEORGIAN RESORT - RECREATIONAL AREAS AND PROSPECTS OF TOURISM DEVELOPMENT

The object of research is the Georgian resort-recreational areas characterization and consideration of tourism opportunities in these areas. Nature has generously rewarded Georgia with tourist recreational resources. In the whole world one can’t find such other place, with such a huge number of different landscapes inside the small area like our country. That's why Georgia possessing these unique natural and economic conditions has the chance to become a strong touristic country. There aren’t too many countries in the world with such natural, climatic and recreational-balneological resources.

Post-partum occurrence of Wunderlich syndrome and microangiopathic haemolytic anaemia (MAHA): a case report

This is a case of a 27-year-old primigravida with monochorionic diamniotic twin gestation who was admitted to the hospital for induction of labour. Her postpartum course was complicated by microangiopathic haemolytic anemia (MAHA). The etiology for the MAHA was initially thought to be secondary to pre-eclampsia and vitamin B12/folate deficiency. However, she had persistent anemia and further workup demonstrated that she had a left renal cell carcinoma (RCC) with perinephric haemorrhage consistent with Wunderlich syndrome. This case was intriguing because of its unusual presentation and the several diagnostic and therapeutic challenges along the way. Abbreviations: MAHA: microangiopathic haemolytic anaemia; RCC: renal cell carcinoma; BP: blood pressure; WS: Wunderlich syndrome; CT: computed tomography; LFTs: liver function tests; LDH: lactate dehydrogenase; HELLP: haemolysis elevated liver enzymes, low platelets; DIC: disseminated intravascular coagulation; PLASMIC: score for TTP – includes platelet count 2.5%, haptoglobin undetectable, or indirect bilirubin >2mg/dL), active cancer, history of solid organ transplant, mean corpuscular volume (MCV) 6; TTP: thrombotic thrombocytopenic purpura; APLA- anti-phophospholipid antibody; BMI: body mass index; TMAs: thrombotic microangiopathies; HUS: haemolytic uremic syndrome; vWF: von Willebrand facto

When a Seemingly Harmless Prescription Turns into Toxicity

Valacyclovir neurotoxicity is commonly seen in the elderly and those with impaired renal function. Differential diagnosis can be challenging as a myriad of medical conditions, including herpes zoster virus associated encephalitis, may present in a similar fashion. We present a case of a 71-year-old male who presented with altered mental status in the setting of recent herpes zoster eruption. His condition was attributed to valacyclovir neurotoxicity, and initiation of appropriate supportive therapy was met with complete resolution of symptoms and normalization of cognitive function

LABVIEW IN THE RESEARCH OF FRACTAL PROPERTIES OF THE TOPOLOGY OF NETWORKS AND STOCHASTIC PROCESSES

The advancement and utilization of computer technologies for studying and diagnosing the technical state of dynamic systems are closely linked to scientific and technological progress. Among these technologies, fractal technologies hold a prominent position [1]. Time series data, which record changes in controlled parameters over time, are commonly used for diagnosing technical objects and systems. The use of fractals will also be of interest in assessing the resonant frequency characteristics of oscillatory systems [3]. The informational characteristics of topologically distributed networks (e.g., computer, cellular) significantly depend on their geometry, node placement, and inter-node distances. The fractal dimension, a fundamental characteristic of networks, plays a crucial role in this context [2]. The research paper presents a methodology for modeling and synthesizing large networks using the node density function, which follows a power function with a fractal dimension. This characteristic aligns with Zipf's law of population distribution around urban centers. The paper also provides fractality degree indices for the network diagram. Software tools such as LabVIEW play a significant role in scientific research and experiment automation

Outcomes among ST-Elevation Myocardial Infarction (STEMI) patients with cardiogenic shock and COVID-19: A nationwide analysis

Background: There is paucity of data regarding the characteristics and outcomes of patients admitted for ST Elevation Myocardial Infarction (STEMI) complicated by cardiogenic shock (CS) with concomitant Coronavirus Disease 2019 (COVID-19) infection. Methods: Using the National Inpatient Sample (NIS) Database for the year 2020, we conducted a retrospective cohort study to investigate the outcomes of patients who sustained STEMI-associated cardiogenic shock (STEMI-CS) with concomitant COVID-19 infection looking at its impact on in-hospital mortality and secondarily at the in-hospital procedure and intervention utilization rates as well as hospital length of stay. Results: We identified a total of 22,775 patients with STEMI-CS, of which 1.71 % (n = 390/22,775) had COVID-19 infection. Using a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, concomitant COVID-19 infection among STEMI-CS patients was found to be an independent predictor of overall in-hospital mortality compared to those without COVID-19 (adjusted OR 2.10; 95 % confidence interval [CI], 1.30–3.40). STEMI-CS patients with concomitant COVID-19 infection had similar in-hospital utilization rates for percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), extracorporeal membrane oxygenation (ECMO), percutaneous and durable left ventricular device, intra-arterial aortic balloon pump (IABP), renal replacement therapy (RRT), mechanical ventilation, as well as similar hospital lengths of stay. Conclusion: Concomitant COVID-19 infection was associated with higher in-hospital mortality rates among patients with cardiogenic shock related to STEMI but had similar in-hospital procedure and intervention utilization rates as well as hospital length of stay