Prerenal kidney damage in patients with local cold injury

Introduction. Important links in the pathogenesis of cold alterations are vascular damage and powerful systemic alterations. The presence of premorbid pathology and the duration of the wound process negatively affects to the function of most organs and systems, including the kidneys. Renal insufficiency in patients with frostbite develops in the acute period of cold damage. This is indicated by a decrease in the amount of urine and an increase in creatinine levels in victims with frostbite. In this regard, the identification and analysis of the dynamics of new markers of renal dysfunction in patients with frostbite is promising both from a scientific and practical point of view.The aim. To investigate the dynamics of changes in serum creatinine, NGAL and cystatin C levels in patients with local cold trauma.Materials and methods. The study included 60 patients with frostbite of the III–IV degree of distal limb segments. The study was carried out depending on the volume of the lesion and the timing from the moment of cryoalteration.The results of the study. In patients with grade III–IV frostbite, an increase in the level of lipocalin and serum creatinine was detected in the blood. The concentration of lipocalin and serum creatinine is directly proportional to the volume of cold-affected tissues. Indicators of lipocalin and serum creatinine decrease in the late stages of cryopreservation. The level of cystatin C significantly decreases during all periods of frostbite; the concentration of the latter does not depend on the severity of cryopreservation

Особенности патологической анатомии легких при COVID-19

The research aim is to study the morphological features of COVID-19 in the lungs of patients who died in Moscow from March 20 to June 6, 2020. Methods. Autopsy material of the lungs from 123 deceased (54 women, 69 men) with COVID-19 coronavirus infection (confirmed by PCR) was analyzed, the median age was 71 (30 – 94) years, and the duration of the disease was 14 (3 – 65) days. In all cases, the patient’s medical records and autopsy reports were analyzed. Macro- and microscopic changes in the lungs were evaluated in all the observations. Results. The pathology of the lungs in COVID-19 corresponds to various phases of diffuse alveolar damage (DAD). The exudative phase of DAD was detected in 54 (43.9%), the proliferative phase – in 21 (14.63%), and their combination – in 51 (41.46%) of the deceased. Histological features of different phases of DAD are described. Conclusion. An analysis of autopsy material revealed a mismatch between the duration of the course of the disease and the phase of diffuse alveolar damage. A significant portion of the dead found a combination of exudative and proliferative phases of the disease. Histological signs that indirectly indicate a violation of the coagulation system during COVID-19 are described.Целью статьи явилось изучение особенностей морфологических изменений в легких у умерших от COVID-19 в Москве за период 20.03.20–06.06.20. Материалы и методы. Проанализирован аутопсийный материал легких умерших от коронавирусной инфекции COVID-19 больных (n = 123: 54 женщины, 69 мужчин; средний возраст – 71 (30–94) год; продолжительность заболевания – 14 (3–65) суток), подтвержденной методом полимеразной цепной реакции. Проанализированы медицинские карты всех стационарных больных и все протоколы вскрытий. По данным всех наблюдений оценены макро- и микроскопические изменения в легких. Результаты. Патоморфологические изменения в легких соответствовали различным фазам диффузного альвеолярного повреждения (ДАП). Экссудативная фаза ДАП выявлена у 54 (43,9 %), пролиферативная – у 21 (14,63 %), их сочетание – у 51 (41,46 %) умершего. Описаны патогистологические особенности изменений в разные фазы заболевания. Заключение. При анализе аутопсийного материала установлено несоответствие между продолжительностью течения заболевания и фазой ДАП. У значительной части умерших обнаружено сочетание экссудативной и пролиферативной фазы заболевания. Описаны гистологические признаки, косвенно указывающие на нарушение системы коагуляции в течении COVID-19

Ecotoxicological hazard assessment of deicing chemicals for higher plants

The article presents data on ecotoxicological hazard assessment of different types of deicing chemicals for higher plants. The assessment was carried out according to a specifically developed rapid test on oats seeds. The phytoeffect was determined by comparing the lengths of the seedling roots placed in a solution of deicing chemicals and was calculated by the effect size of root growth inhibition comparing with proof sample. The safest composition of deicing chemicals was determined

Parameters of the school environment as a factor that affects the health of pupils

The article studies the influence of environmental factors on the children′s organism of whose health is an indicator of the ecological situation. School buildings and facilities in many respects do not meet the standards imposed on such institutions. In this research, measurements were made of physical factors of the school environment, assess the health status of students

Метод вымывания азота при множественном дыхании и структурные изменения бронхолегочной системы у взрослых больных муковисцидозом

The aim of this work was to assess the functional and structural disorders of the bronchopulmonary system detected by high-resolution computed tomography (HRCT) in adult patients with cystic fibrosis (CF), and to determine the correlation between them.Methods. A cross-sectional study included patients with CF (n = 54: 20 male and 34 female; median age 25 years) and healthy volunteers (n = 32: 12 male, 20 female; median age 25 years). A complex study of the pulmonary function test (PFT) was carried out; it included spirometry, bodyplethysmography and measurement of the diffusing lung capacity for carbon monoxide (DLCO), nitrogen leaching in multiple respiration (NLMR) and HRCT. Dyspnea was assessed using the Modified Research Council Scale (mMRC). NLMR measurements were performed using the Easy-One Pro module, MBW (NDD Medizintechnik AG, Switzerland). Analysis of HRCT data according to the Bhalla classification was performed by two independent, experienced radiologists.Results. The mean value (± SD) of the forced expiratory volume for 1 second (FEV1) was 63 ± 26% of the proper value, forced vital capacity of the lungs (FVC) was 86 ± 20% of the proper value, the ratio of FEV1/FVC was 61 ± 15%; residual lung volume (RLV) was 220 ± 71% of the proper value, the ratio of RLV/ total lung capacity (TLC) was 48 ± 13%, intrathoracic gas volume was 150 ± 33% of the proper value, DLCO was 80 ± 16% of the proper value, lung clearance index (LCI) was 16.9 ± 5.0; moment ratio (MR2) was 54.7 ± 34.1. Bronchoectases with predominant lesions of > 9 segments and bronchial lesions from V generation and more distal were found in all patients. Peribronchial infiltration and mucoid plugs were also diagnosed in almost all patients (94 and 96%, respectively), while bronchogenic cysts or abscesses, atelectasis/consolidation, bullae or emphysema were rarely detected (in 30, 35, 20, and 17% of cases, respectively). The parameters of NLMR were statistically significantly correlated with both the PFT parameters and the HRTC data.Conclusion. In adult patients with CF, there is a significant unevenness of pulmonary ventilation, progressing as structural damage to the bronchopulmonary system increases and the PFT worsens. With a statistically significant increase in MR, the involvement of not only the central, but also peripheral airways in the pathological process is emphasized. It has been established that in adult CF patients there is a strong correlation between LCI and the severity of structural changes, detected by HRCT, comparable in strength and significance to FEV1. Целью данной работы явилась оценка функциональных и структурных нарушений бронхолегочной системы, выявленных с помощью компьютерной томографии высокого разрешения (КТВР) у взрослых пациентов с муковисцидозом (МВ), и определение корреляции между ними.Материалы и методы. В поперечное исследование были включены больные МВ (n = 54: 20 мужчин, 34 женщины; медиана возраста – 25 лет) и здоровые добровольцы (n = 32: 12 мужчин, 20 женщин; медиана возраста – 25 лет). Проводились комплексное исследование функции внешнего дыхания (ФВД) – спирометрия, бодиплетизмография и измерение диффузионной способности легких по монооксиду углерода (DLCO), вымывания азота при множественном дыхании (ВАМД) и КТВР. Одышка оценивалась по модифицированной шкале одышки (Modified Research Council – mMRC). Измерения ВАМД проводились с использованием модуля Easy-One Pro, MBW (NDD Medizintechnik AG, Швейцария). Анализ данных КТВР в соответствии с классификацией по шкале Bhalla выполнялся двумя независимыми опытными врачами-рентгенологами.Результаты. Среднее значение (± SD) объема форсированного выдоха за 1-ю секунду (ОФВ1) составило 63 ± 26 %долж., форсированной жизненной емкости легких (ФЖЕЛ) – 86 ± 20 %долж., соотношения ОФВ1 / ФЖЕЛ – 61 ± 15 %; остаточного объема легких (ООЛ) – 220 ± 71 %долж., соотношения ООЛ / общая емкость легких (ОЕЛ) – 48 ± 13 %, внутригрудного объема газа – 150 ± 33 %долж., DLCO – 80 ± 16 %долж., индекса легочного клиренса (LCI) – 16,9 ± 5,0; отношения моментов (MR2) – 54,7 ± 34,1. У всех больных выявлены бронхоэктазы с преимущественным поражением > 9 сегментов и поражение бронхов от V генерации и дистальнее. Перибронхиальная инфильтрация и мукоидные пробки также диагностированы практически у всех пациентов (94 и 96 % соответственно), в то время как бронхогенные кисты или абсцессы, ателектазы / консолидация, буллы или эмфизема выявлялись достаточно редко (30, 35, 20 и 17 % случаев соответственно). Параметры ВАМД статистически значимо коррелировали как с параметрами ФВД, так и данными КТВР.Заключение. У взрослых больных МВ присутствует значительная неравномерность легочной вентиляции, прогрессирующая по мере нарастания структурных повреждений бронхолегочной системы и ухудшения ФВД. При статистически значимом увеличении MR подчеркивается вовлечение в патологический процесс не только центральных, но и периферических дыхательных путей. Установлено, что у взрослых больных МВ существует сильная корреляционная связь между LCI и выраженностью структурных изменений, определяемых с помощью КТВР, сопоставимая по силе и значимости с ОФВ1.

May Measurement Month 2019: adherence to treatment and hypertension control in Russia

The International Society of Hypertension and the World Hypertension League initiated a blood pressure screening study called May Measurement Month 2019 (MMM19) to improve the detection of elevated blood pressure (BP) and to assess BP control in patients with hypertension (HTN).Aim. To assess adherence to treatment of the hypertensive population according to MMM19 campaign in Russia.Material and methods. During May 2019, 5394 people from 21 regions of Russia took part in the screening. Participation was voluntary and did not imply gender restrictions; all subjects were over 18 years of age. During the screening, BP was measured three times using electronic and mechanical sphygmomanometers, as well as a questionnaire on the diabetes, history of cardiovascular events, smoking, and alcohol consumption was filled. Information was also collected on the date of last BP check and the administration of statins, acetylsalicylic acid and antihypertensive drugs. Data on height and body weight was obtained from respondents.Results. The analysis included data from 5274 participants aged 18 to 96 years (men — 1834 (34,8%)). Median age was 25 years, quartiles — 20 and 49 years. According to MMM19 data, the proportion of HTN patients in the Russian population was 31,9%, and with the exception of participants under 25 years old — 51,5%. Patients with HTN over 25 years old take antihypertensive therapy in 73,6%; 38,6% are characterized by irregular drug intake. Only 11,8% of men and 17,2% of women reach the target blood pressure <130/80 mm Hg. Only 20-30% of patients who used 4-5 antihypertensives reached the target BP level.Conclusion. According to MMM19 in Russia, only a third of high-risk patients measured BP over the past 12 months. There is also low adherence to antihypertensive therapy and inadequate control of HTN. Patients with HTN and a history of cardiovascular events are more likely to take antihypertensives regularly