36 Months Survivability And Its Predictors In Patients With Chronic Heart Failure And Decreased Fraction Of Left Ventricular Ejection Depending On Sex

Aim of the work: to compare survivability parameters during 36 months and their predictors among men and women with chronic heart failure and decreased fraction of left ventricular ejection.Materials and methods: the research included 356 patients with CHF (NYHA ІІ –ІV) with decreased LVEF<40 %, 18–75 years old. Using Kaplan-Meier method, there was analyzed the survivability in men and women during 36 months, then there were analyzed independent factors that influenced survivability terms depending on sex using the multiple logistic regression.Results. Our analysis of the survivability of patients with CHF with decreased LVEF demonstrated that the cumulative survival after 3 years of observation was 49 and 51 % for men and women, respectively. The curves of 36 months survivability didn\u27t reliably differ. At the analysis of factors, associated with the bad prognosis, there were observed differences between groups of men and women with CHF. Thus, in men the predictors of 36 month survival were: the thickness of the right ventricle wall, size of the right atrium, end-diastolic volume and end-systolic volume of LV, indices of EDV and ESV of LV, urinary acid level, value of LVEF. In women the predictors of survivability during 3 years were the following parameters: BMI, DM type 2 in an anamnesis, end-diastolic size of LV, end-systolic size of LV, blood glucose level, LVEF.Conclusion. The survivability of men and women with CHF with decreased LVEF during 36 months didn\u27t reliably differ and was 49 and 51 % respectively. But predictors of the lethal outcome in men and women essentially differed during 36 months, and their number is essentially higher in men

ON THE BEST APPROXIMATION OF THE INFINITESIMAL GENERATOR OF A CONTRACTION SEMIGROUP IN A HILBERT SPACE

Let $A$ be the infinitesimal generator  of a strongly continuous contraction semigroup in a  Hilbert space $H$.   We give an upper estimate for the best approximation of the operator $A$ by bounded linear operators with a prescribed norm  in the space $H$ on the class $Q_2 = \{x\in \mathcal{D}(A^2) : \|A^2 x\| \leq 1\}$,  where $\mathcal D(A^2)$ denotes the domain of $A^2$

COVID-19-related cardiac lesion: The questions of pathogenesis and diagnostics

Coronavirus infection is still a topic of interest in the medical community today. Among the heterogeneous clinical manifestations of this disease, lesions of cardiac structures often occur. They are mainly inflammatory in nature and can be acute or delayed. Aside from myocarditis, coronavirus infection can induce cardiac injuries, including acute coronary syndrome, thromboembolic events, heart failure, and heart rhythm disturbances. It is well known that the prognosis for patients with cardiac lesions significantly worsens; timely diagnosis and treatment initiation play an important role in preventing severe complications. This review presents the most recent literature data on the pathogenesis of cardiac lesions in COVID-19 patients and discusses the rational diagnosis of this pathology using modern techniques, such as laboratory, functional imaging (cardiac magnetic resonance is the most important of these), and invasive ones. It is now established that diagnosing myocarditis caused by coronavirus infection differs fundamentally from diagnosing other types of myocarditis. Furthermore, the main aspects of inflammatory heart lesions associated with COVID-19 vaccination are discussed, as this complication occurs more frequently than is commonly believed. It is often used as a rationale for refusing vaccination; however, this decision may severely affect the individual and the population

Results of the COVID-19 mental health international for the general population (COMET-G) study.

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them

Hospitality industry: foreign experience in applying innovative technologies in the field of sales and marketing.

<p>The current state of the tourism and hospitality sector has been seriously influenced by a number of external factors, including the pandemic and long-term restrictions caused by COVID-19 (in some cases, a ban on flights to other countries), as well as the unstable economic and political situation in the world. At the same time, most experts agree that only one positive feature can be identified from all this – the tourism and hospitality sector will now work in a new way. Despite various external restrictions and threats, tourism and hotel business continues to develop in almost all countries. New tourist areas have begun to appear, and travelers are becoming increasingly interested in trips to little-known tourist centers. The year 2023 marked a new stage in the development of the tourism and hospitality sector: the number of travelers has increased, their needs have changed, the boundary between business and tourist trips has practically disappeared, which has led to the emergence of new offers from all market participants. In accordance with dynamically changing market conditions, all participants in the tourism market are forced to adapt to new realities, becoming the initiators of intra-organizational innovation processes. The authors of the article determined the relevance of introducing marketing innovations in the hotel business, considered the importance of innovative marketing in the work of the hotel. The theoretical aspects of the topic of the article are supported by modern examples from practice.</p&gt

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

Aim. 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. Materials and methods. 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; p0.001, 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. Conclusion. 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