Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

P127

To determine diagnostic importance of DNA methylation in patients with chronic atrophic gastritis and induction of “Correa” cascade for gastric cancer prevention. Material and methods: This present study included 80 patients with chronic atrophic gastritis associated with Helicobacter pylori. Diagnoses were confirmed by endoscopic, morphologic, serologic examinations. Age of patients varied from 17 to 78 years old. There were 52 (65%) males and 28 (35%) females. The control group consisted of 32 patients with morphological verified diagnosis of stage I–II gastric cancer. Examination with the purpose to determine hypermethylation of DNA was performed simultaneously in biopsy materials and blood plasma. Provoking factors of hypermethylation in 4 tumors’ genes, APE, E-Cadherin, T1MP3, hMLHI were determined by quantitative methylation with use of Polymerase Chain Reaction. To evaluate the level of methylation we compared the analysis’ results of biopsy and blood plasma tests. Blood serum samples and biopsy specimens were collected at diagnosis until the therapy is started. All patients with chronic atrophic gastritis infected with H. pylori underwent anti-H. pylori therapy according to the protocol. Chronic atrophic gastritis was found at morphologic examination in 40 (50%) patients according to “Correa” cascade. 36 (45%) patients had intestinal metaplasia, and 4 (5%) patients had dysplasia. Reaction was considered to be positive in cases, when the level of methylation in genes listed above was higher in blood serum than in biopsy materials. Results: High concentrations of methylated APE, T1MP3 and hMLIH in genes were found in blood serum of 8 (10%) patients. In the control group, all 32 patients with gastric cancer had high methylation level in blood serum. In the remaining 72 (90%) patients, no high concentration of DNA methylation was found. After the 2-nd course of anti-H. pylori therapy, patients underwent morphologic and endoscopic examinations according to the protocol. Eradication of H. pylori was determined in 86% patients who received therapy. Intestinal metaplasia decreased from 45% to 25% (20 patients). Mild dysplasia was found in 1.2% of cases. Repeated analysis of methylation level showed its decrease after anti-H. pylori therapy in 4 (50%) out of 8 patients. Conclusion: Genetic tests show that DNA methylation in patients with chronic atrophic gastritis has high diagnostic importance. Anti-H. pylori therapy at the different stages of “Correa” cascade has high level of induction in transforming into non invase gastric cancer

Development Of TECHNOLOGY For Obtaining Fireproof Heat Insulating Materials Based On Silicate-polymer Compositions

The research work presents the research results on the technology development for obtaining fireproof tile materials with effective heat insulation properties. The main components used to produce insulating tile materials were readily available raw materials such as standard natrium liquid glass, silicone, hydrochloric acid, epoxy resin, the mineral dolomite and wallastonite, thermovermiculite, as well as other special additives. Based on the work performed, the entire technological cycle of obtaining tile materials has been developed. In the work developed two types of tile material differing in the component composition. The first, tile material with a porous silicate composition and the second tile material, which is derived from, as the main component of thermovermiculite. The technological process weight of obtaining the two types of tile materials consists of several steps. At the first stage of research in the laboratory conditions developed compositions of these materials and then in the next few stages of research developed a full technological cycle of obtaining tile heat-insulating materials. Research samples of tile materials obtained by the developed technology showed that the samples of these materials meet the state standards requirements for physical-mechanical and fire-technical properties

Reconstructive and Restorative Interventions at the Proximal End of the Thigh and Pelvic Bones in Destructive Pathological Dislocation of the Hip in Children After Hematogenous Osteomyelitis

It is generally known that children tend to get injured more easily than adults. Moreover, these injuries they get in growing period may leave for long in the forms of disability. This paper is about reconstructive and restorative interventions at the proximal end of the thigh and pelvic bones in destructive pathological dislocation of the hip in children after hematogenous osteomyelitis. After hematogenous osteomyelitis of the proximal end of the femur, destruction of the head and neck of the femur is often observed, up to their destruction. The optimal age for surgical treatment of pathological dislocation of the hip, according to our data, is 4-5 years of age of the child, because by this time the process of ossification of the structures of the hip joint ends in most patients, and early surgical intervention often causes severe secondary deformities, up to their destruction

The Choice of Surgical Tactics for the Treatment of Children with Destructive Pathological Dislocation of the Hip After Hematogenous Osteomyelitis

A surgical approach to the treatment of destructive pathological dislocation of the hip in children has been substantiated, depending on age, the severity of destruction of the proximal femur and acetabulum. Reconstructive - restorative operations in most patients ensure the stability of the hip joint and thereby improve the patient's gait and statics, reduce the pelvic misalignment and eliminate the Trendelenburg symptom. The experience of surgical treatment of patients with pathological hip dislocations has shown that the most favorable outcomes are achieved with the use of open reduction of the stump of the head or neck of the femur with intertrochanteric detorsion shortening and varizing osteotomy with rotational pelvic osteotomy according to Salter and acetabular plasty according to Pemberton

Experience of Surgical Treatment of Comminuted Fractures of the Distal End of the Femur

The incidence of fractures of the distal femur ranges from 6 to 25% of all fractures of the femur, according to different authors. The most severe of these are intertarsal and supracondylar fractures, which account for up to 42% of all hip fractures, of which type C fractures account for up to 50%. The complex anatomical structure of the distal femur, the condition of the bone tissue, and the mechanogenesis of the injury determine the location, nature, and severity of the fracture. In recent decades, there has been an increase in trauma in general and this localisation in particular due to medical disasters. Because these fractures often occur at working age, the proportion of this population in the population is increasing