Features of the course of coronavirus infection in patients after thoracic and cardiac surgery

Objective: To study the features of the coronavirus infection course in cardiosurgical and thoracic patients to determine the factors potentially affecting the possibility of lethal outcome. To identify the predictors of fatal outcome based on the analyses of the features of the coronavirus infection course in this category of patients.Material and methods: During the analyzed period 80 patients from the departments of thoracic surgery and cardiac surgery were transferred to the infectious diseases department: 20 patients from the cardiac surgery department (CSD) – group 1; 60 patients from the thoracic surgery departments (TSD) – group 2. A control group number 3 consisting of 59 non-thoracic and non-cardiosurgical patients was also formed. According to the disease outcome the patients were divided into two groups: group 1 – fatal outcome, group 2 – recovery.Results: Out of 80 patients, lethal outcome was recorded in 25 cases: 22 patients of the thoracic profile (36% of the total number of transferred from this department) and 3 patients of the cardiosurgical profile (15% of the total number of those transferred from the cardiac surgery department). 20 out of 20 cardiac patients had been operated on the day before, 49 out of 60 thoracic patients also underwent surgery. 3 people from the group of non-operated patients transferred from departments of thoracic surgery died. Moreover, after pneumonectomy, fatal outcome was recorded in 7 out of 8 cases (87.5%).Conclusion: During the analyses of indicators it was revealed that the number of fatal outcomes in patients of the thoracic profile with COVID-19 infection is higher than of the cardiosurgical profile and in the infectious diseases department. Presumably, this is due to the fact that coronavirus infection affects the lungs to a greater extent, and in patients with a thoracic profile (in particular, those who have undergone resection interventions), the volume of the lung parenchyma is initially reduced. This is confirmed particularly by the highest percentage of fatal outcomes after pneumonectomy. Cardiosurgical patients after surgical interventions do not have a reduction in the functioning lung parenchyma, which creates an additional “reserve” for recovery. Moreover, men predominate among patients of the thoracic profile, with the survival rate lower in all groups compared to women. Patients transferred from thoracic departments showed higher rates of systemic inflammation, which indicates a more severe course of the viral infection and the possible development of complications.When analyzing the predictors of lethal outcome, the following factors were identified: male gender and, in general, a more severe course of a viral infection (low saturation, a high percentage of lung lesions on CT, more pronounced changes in laboratory screening). The studied factors are associated with a large number of fatal outcomes in thoracic and cardiac surgery patients. Among the factors that do not affect the prognosis are diabetes mellitus, stroke and myocardial infarction in history.Thus, patients diagnosed with coronavirus infection that developed after thoracic surgery had the most unfavorable prognosis. The revealed patterns are of interest for optimizing the routing of this category of patients in order to prevent coronavirus infection

Thyroid cancer risk in Belarus among children and adolescents exposed to radioiodine after the Chornobyl accident

BACKGROUND: Previous studies showed an increased risk of thyroid cancer among children and adolescents exposed to radioactive iodines released after the Chornobyl (Chernobyl) accident, but the effects of screening, iodine deficiency, age at exposure and other factors on the dose-response are poorly understood. METHODS: We screened 11 970 individuals in Belarus aged 18 years or younger at the time of the accident who had estimated (131)I thyroid doses based on individual thyroid activity measurements and dosimetric data from questionnaires. The excess odds ratio per gray (EOR/Gy) was modelled using linear and linear-exponential functions. RESULTS: For thyroid doses \u3c5 \u3eGy, the dose-response was linear (n=85; EOR/Gy=2.15, 95% confidence interval: 0.81-5.47), but at higher doses the excess risk fell. The EOR/Gy was significantly increased among those with prior or screening-detected diffuse goiter, and larger for men than women, and for persons exposed before age 5 than those exposed between 5 and 18 years, although not statistically significant. A somewhat higher EOR/Gy was estimated for validated pre-screening cases. CONCLUSION: 10-15 years after the Chornobyl accident, thyroid cancer risk was significantly increased among individuals exposed to fallout as children or adolescents, but the risk appeared to be lower than in other Chornobyl studies and studies of childhood external irradiation

ВАРИАНТЫ И ПЕРСПЕКТИВЫ ПЕРЕПРОФИЛИРОВАНИЯ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ ДЛЯ ИСПОЛЬЗОВАНИЯ В ТЕРАПИИ ОНКОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ

Recently many new approaches for repurposing or repositioning of the clinically used drugs have been developed. Drug repurposing  allows not only to use known schemes for the synthesis of  biologically active compounds, but also to avoid multiple studies that  are necessary for drug approval process – analysis of  pharmacokinetics, carcinogenicity, acute and chronic toxicity,  including cardiotoxicity, nephrotoxicity, allergenicity etc. It makes  possible to reduce the number of experimental studies as well as  costs of investigations. In cancer research drug repurposing includes screening for medicines used nowadays for the treatment of patients with non-cancer diseases which possess anticancer activity or able to enhance the effects of the standard anticancer chemotherapy, and  search for new applications of known anticancer drugs for the  treatment of different cancer types. Scientific rationale for the search of the compounds with potential anticancer properties among drugs  with different applications is based on the multiple cross-talks of  signaling pathways, which can inhibit cell proliferation. Modern  advances in genomics, proteomics and bioinformatics, development  of permanently improving databases of drug molecular effects and  high throughput analytical systems allow researchers to analyze  simultaneously a large bulk of existing drugs and specific molecular targets. This review describes the main approaches and  resources currently used for the drug repurposing, as well as a  number of examples.В настоящее время появились новые программы по перепрофилированию или перепозиционированию лекарственных средств, используемых в медицинской практике.  Перепрофилирование препаратов позволяет не только использовать отработанные схемы  синтеза биологически активных соединений, но и избежать проведения исследований,  необходимых для внедрения новых лекарственных препаратов в медицинскую практику, по  фармакокинетике, канцерогенности, острой и хронической токсичности, в том числе  кардиотоксичности, нефротоксичности, аллергенности и т.д. Это создает возможность сократить объем необходимых исследований и снизить затраты на них. В онкологии  программы перепрофилирования лекарственных средств включают как поиск препаратов,  обладающих противоопухолевой активностью или потенцирующих действие  противоопухолевых препаратов, среди известных и широко применяемых лекарственных  средств, используемых для лечения неонкологических заболеваний, так и анализ  возможности использования уже известных противоопухолевых препаратов для лечения  каких-либо новых нозологических форм заболевания. Основанием для поиска  противоопухолевых свойств среди препаратов иного назначения является тот факт, что  сигнальные пути в клетке характеризуются большим количеством перекрестных  взаимодействий и некоторые из них могут ингибировать пролиферацию опухолевых клеток.  Современные достижения геномики, протеомики, биоинформатики, появление объемных баз данных по молекулярным эффектам лекарственных препаратов, мощных аналитических систем и их постоянное совершенствование уже позволяет исследователям  одновременно проанализировать большое количество существующих препаратов в  применении к конкретной молекулярной мишени. В обзоре рассмотрены основные подходы  и ресурсы, использующиеся в настоящее время для перепрофилирования лекарственных  препаратов, а также приведен ряд примеров

ISSN exercise & sport nutrition review: research & recommendations

Sports nutrition is a constantly evolving field with hundreds of research papers published annually. For this reason, keeping up to date with the literature is often difficult. This paper is a five year update of the sports nutrition review article published as the lead paper to launch the JISSN in 2004 and presents a well-referenced overview of the current state of the science related to how to optimize training and athletic performance through nutrition. More specifically, this paper provides an overview of: 1.) The definitional category of ergogenic aids and dietary supplements; 2.) How dietary supplements are legally regulated; 3.) How to evaluate the scientific merit of nutritional supplements; 4.) General nutritional strategies to optimize performance and enhance recovery; and, 5.) An overview of our current understanding of the ergogenic value of nutrition and dietary supplementation in regards to weight gain, weight loss, and performance enhancement. Our hope is that ISSN members and individuals interested in sports nutrition find this review useful in their daily practice and consultation with their clients

Children after Caesarean section: how to improve their adaptation and reduce the risk of pathological conditions

In the article, the authors cite modern data on the frequency of Caesarean section in obstetric practice, report the peculiarities of adaptation of children born by Caesarean section surgery, which is characterized by a high frequency of borderline conditions, pathological loss of body weight, functional disorders of the gastrointestinal tract, higher morbidity in the subsequent period. In addition, the authors note that mothers of these children are more likely to have hypogalactia, which is largely responsible for impaired adaptation in infants and their transfer to artificial feeding. Referring to the published works, the authors offer various options to improve the process of adaptation in this contingent of children

COMPLEX TREATMENT PRINCIPLES OF THE PATIENTS WITH THE ABNORMAL UTERINE BLEEDINGS IN THE PUBERTAL PERIOD

Aim. To increase the effectiveness of the classical approach to the therapy of abnormal uterine bleeding by the phased use of personalized treatment regimens in conjunction with the methods of the physiotherapeutic methods.Materials and methods. The case maps of the girls of the pubertal period previously treated (archival material) with the verified diagnosis of abnormal uterine bleeding of the pubertal period (AUBPP) were subjected to analysis. A database was created, of which 367 cases were selected; patients were treated in two classical stages. In the second group, 367 girls were selected for treatment and supervision that met the required criteria and agreed to participate in the study. In this group, the rehabilitation stage was carried out using personified schemes, which included non-pharmacological physiotherapy procedures, selected taking into account the type of bleeding.Results. The applied method of personalized treatment of patients with AUBPP under ultrasound control allowed reducing the number of relapses AUBPP.Conclusion. The use of personalized regimens for the treatment of abnormal uterine bleeding in the pubertal period supplemented by a complex of physiotherapy procedures, selected taking into account the bleeding peculiarities and conducted under dynamic ultrasound control, showed a significant reduction in the period of restorative treatment and rehabilitation of patients

Differential diagnosis of neonatal jaundice

Jaundice is one of the most common symptoms of the neonatal period which in most cases is not associated with a serious illness. For example, jaundice in healthy newborns which does not affect the child's development. Nevertheless, in 2% of cases the causes of jaundice should be investigated, especially if it is long-term and extends beyond the neonatal period. Underestimating the history and late examination lead to diagnostic errors which sometimes cannot be corrected. The risk of direct hyperbilirubinemia should be taken into account which may be caused by malformations of the biliary tract development or other congenital and acquired diseases of the hepatobiliary system, for the treatment of which cholagogues can be successfully used. The prognosis for the biliary tract anomalies is directly related to the promptness of diagnosis and surgery. Understanding the difference between direct and indirect hyperbilirubinemia in infants is necessary for timely examination and treatment of the infant

Chloride diarrhea in a child 8 months old

Chloride diarrhea is a rare genetically determined disease caused by mutations of the SLC26A3 gene and characterized by the appearance of persistent watery diarrhea from the first days of the child’s life. The disease is accompanied by the development of hypokalemic hypochloraemic alkalosis. Features of the clinical aspects and metabolic disorders in congenital chloride diarrhea determine the need for differential diagnosis with a wide range of pathological conditions, which often leads to late diagnosis and increases the risk of complications. The article presents the clinical analysis of a patient with congenital chloride diarrhea, the criteria for diagnosing the disease, the possible errors in the diagnostic search process, describes the tactics of the child’s management