Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period

GEOGRAPHICAL STUDY OF LOCAL HISTORY IN THE SCHOOL BY MEANS OF INFORMATION AND COMMUNICATION TECHNOLOGIES

In article presents a methodology for the use of ICT in copyright elective courses on local history in the geographical context of cultural , student -activity , the competency and system approaches . Formulated and substantiated goal elective course - the formation of information-communicative competence geokraevedcheskoy . Performed pairing its formation with the course content and types of workshops involving complication types of tasks on the use of ICT

The dietary paradox in food allergies: yesterday's mistakes, today's evidence and lessons for tomorrow.

During the last decades the prevalence of food allergies has significantly increased among children and antigen avoidance still remains the standard care for the management of this condition. Most reactions are IgE-mediated with a high risk of anaphylaxis requiring emergency medications in case of inadvertent ingestion. Recent studies showed that continuous administration of the offending food, rather than an elimination diet, could promote the development and maintenance of oral tolerance. Indeed, intestinal transit of food proteins and their interaction with gut-associated lymphoid tissue (GALT) is the essential prerequisite for oral tolerance. On the contrary, low-dose cutaneous exposure to environmental foods in children with atopic dermatitis and altered skin barrier facilitates allergic sensitization. The timing and the amount of cutaneous and oral exposure determine whether a child will have allergy or tolerance. Furthermore, previous preventive strategies such as the elimination diet during pregnancy and breastfeeding, prolonged exclusive breastfeeding and delayed weaning to solid foods did not succeed in preventing the development of food allergy. On the other hand, there could be an early narrow window of immunological opportunity to expose children to allergenic foods and induce natural tolerance. Finally, the gradual exposure to the offending food through special protocols of specific oral tolerance induction (SOTI) may be a promising approach to a proactive treatment of food allergy

EVALUATION OF THE SHORT-TERM AND DELAYED RISKS OF THE ABNORMAL SUMMER 2010 HEAT IMPACT IN SEVERAL DISTRICTS OF NIZHNY NOVGOROD OBLAST, CLOSE TO WILDFIRES, ON THE MORBIDITY AND MORTALITY OF INHABITANTS

The influence of abnormal summer heat (AH) in the year 2010 on morbidity and mortality in Russian Federation regions is not studied good enough. Nizhny Novgorod Oblast was one of the most involved and harmed.Aim. Retrospective assessment of short- and long-term influence of AH and fires of the summer 2010 on the course of cardiovascular diseases living in several districts of Nizhny Novgorod Oblast.Material and methods. Totally, 779 inhabitants of Vyksunsky district of Nizhny Novgorod Oblast were included. The analysis of outpatient charts was done (data 2010-2014), questionnaires were used.Results. The period of AH (PAH) was followed by the increase of mortality from external causes (p<0,01) comparing to the summer 2011. Mortality in September-December 2010, cardiovascular as from other reasons, was significantly lower that during the same period in 2011 (p<0,05). Combination endpoints (CEP) were more common for PAH comparing to the same period of 2011 and 2012, and September-December 2010. CEP were lower in September-December 2010 than in 2012. Quantity of cardiovascular complications (CVC) in PAH did not differ from average for this period of the year, and was lower than in fall-winter period of 2011 and 2012. More CVC in PAH developed in cardiovascular patients, with arterial hypertension, post infarction cardio sclerosis, cerebrovascular disease. An independent risk factor for CEP in PAH were age, for CVC — functional class of chronic heart failure. Predictors of life quality worsening in PAH: male sex, smoking, living close to roads and on upper floors, higher education. With better life quality in PAH were associated the presence of climat-control of even ventilator, higher body mass index and taking of angiotensin-converting enzyme inhibitor.Conclusion. AH led to the increase of general mortality but did not led significantly to increase of cardiovascular morbidity and CV complications. With the highest risk of complications during the heat were associated: existence of arterial hypertension, post infarction cardio sclerosis, chronic heart failure, cerebrovascular disease, older age

Measuring the sustainability of Russia's Arctic cities

How sustainable are Russia's Arctic cities? Russia's far north metropolises are distinctive from other Arctic cities in terms of their large size, efforts to conquer nature, and big business' impact on the urban landscape. The Russian Arctic cities' Soviet-era design gave them compact and dense population structures. Such features led to many benefits for achieving sustainability, including more efficient energy use, a larger number of hospital beds, more numerous cultural amenities, and greater access to public transportation. However, Arctic cities outside of Russia have made progress in their own pursuit of sustainability through on-going investments, business development, educational resources, and solid waste management. By teasing out these distinctions, this article highlights urban features that make it possible for the cities to adapt to changes in the global environment and economy. In doing so, it provides the first multidisciplinary, comparative analysis of 46 Arctic cities employing historical, remote sensing, and quantitative methods. It demonstrates the strengths and weaknesses of the world's Arctic cities in their quest for sustainability and points to where they can learn from each other in adopting best practices

Comparative analysis of echocardiographic and electrocardiographic data of survivors and deceased patients with COVID-19 (sub-analysis of the international register “Dynamics analysis of comorbidities in SARS-CoV-2 survivors”)

Aim. To carry out comparative analysis of echocardiographic and electrocardiographic (ECG) data of survivors and deceased patients with COVID-19 (sub-analysis of the international register “Dynamics analysis of comorbidities in SARS-CoV-2 survivors”).Material and methods. The study presents the results of a sub-analysis of the international AKTIV registry, which was called AKTIV CARDIO. Data were collected from 9 medical centers in the Russian Federation. AKTIV CARDIO included 973 hospitalized patients, of which 50 patients died during hospitalization.Results. Comparative analysis of echocardiographic parameters revealed that 4 parameters differed in deceased patients compared to survivors: left ventricular ejection fraction (LVEF), right ventricular end diastolic dimension (RV EDD), right atrial (RA) short axis diameter and pulmonary artery systolic pressure (PASP). RA short axis diameter was higher in deceased patients compared with survivors (38,0 [36,0; 39,0] versus 35,0 [33,0; 38,0] mm, p=0,011). RV EDD was higher in deceased patients than in survivors (3,0 [29,0; 33,0] vs 28,0 [27,0; 32,0] mm, p=0,019). LVEF was lower in deceased patients compared with survivors (55 [52; 55] vs 60 [56; 65]%, p<0,001). PASP was higher in deceased patients compared with survivors (25 [21; 35] vs 20 [19; 25] mm Hg, p=0,006). Correlation analysis found that the largest number of correlations with markers of the infection severity was observed for RA short axis diameter and RV EDD. A comparative analysis of ECG data revealed that in deceased patients, compared with survivors, atrial fibrillation (AF) (21,4% vs 6,06%, p=0,001) and supraventricular premature beats (14,3% vs 3,36%, р=0,004) occurred more often. In addition, deceased patients had longer QTc interval (440 [416; 450] vs 400 [380; 430] ms, p<0,001).Conclusion. Comparative analysis of echocardiographic data showed that deceased patients have more pronounced right heart remodeling, higher PASP and lower LVEF. Patient survival was related to RV and RA sizes. Right heart enlargement was associated with markers of infection severity. Echocardiographic parameters characterizing the right heart side can probably be independent prognostic factors in the acute COVID-19 period

Past and Future of Permafrost Monitoring: Stability of Russian Energetic Infrastructure

This study is an attempt to suggest a new state system of permafrost monitoring, primarily for energetic infrastructure, based on past approaches and achievements in Russia for over a hundred years of Arctic studies. The methodology of this study is based on general theoretical methods of scientific research. Historical (retrospective analysis of the development of the monitoring system of long-term permafrost in Russia) and logical (inductive generalization) methods were applied. The structure and methods of permafrost monitoring in the Soviet Union and new technologies used nowadays to establish permafrost monitoring systems, taking into account modern Arctic energetic development, have been analyzed

International register “Dynamics analysis of comorbidities in SARS-CoV-2 survivors” (AKTIV SARS-CoV-2): analysis of 1,000 patients

COVID-19 is a severe infection with high mortality. The concept of the disease has been shaped to a greater extent on the basis of large registers from the USA, Spain, Italy, and China. However, there is no information on the disease characteristics in Caucasian patients.Therefore, we created an international register with the estimated capacity of 5,000 patients — Dynamics Analysis of Comorbidities in SARS-CoV-2 Survivors (AKTIV SARS-CoV-2), which brought together professionals from the Russian Federation, Republic of Armenia, Republic of Kazakhstan, and Kyrgyz Republic. The article presents the first analysis of the register involving 1,003 patients. It was shown that the most significant difference of the Caucasian population was the higher effect of multimorbidity on the mortality risk vs other registers. More pronounced effect on mortality of such diseases as diabetes, obesity, hypertension, chronic kidney disease, and age over 60 years was also revealed