COVID-19-associated coagulopathy: a clinical case

Background. Comorbid patients with a new coronavirus disease (COVID-19) often have thrombosis or bleeding in different periods of the disease. Early diagnosis of these complications and adequate therapy of these patients are complicated due to the peculiarities of the disease in comorbidity. Anticoagulation regimens in patients with COVID-19 are still unclear. The protocol of efficacy and safety the intermediate or therapeutic dose of low-molecular-weight heparins  is not clear and complete. It is very important to organize an individual approach for correction of the anticoagulants doses, taking into account the coagulation tests and the activity of inflammatory markers.Clinical case description. We report a 71-year-old white male with COVID-19 pneumonia. Acute respiratory distress syndrome and atrial fibrillation were diagnosed in ten days of the disease. Therapeutic anticoagulation was started upon the admission. As early as in the 20th day of the disease a gluteal hematoma developed. Hence, prophylactic regimen of anticoagulation was started, but the worsening of dyspnea at rest, decreasing in SpO2 values to 82% according to pulse oximetry, and thrombelastographic hypercoagulability were observed after two days of such anticoagulation treatment. The patient has been receiving daily low-molecular-weight heparins injections in therapeutic doses for the following two weeks, and then the doctors have switched him to new oral anticoagulants. Patient was discharged to continue ambulatory anticoagulant’s treatment.Conclusion. It is clear that the optimal choice of anticoagulation strategy in comorbid patients with concomitant COVID-19 remains challenging and requires randomized trials. Until the guidelines develop the effective anticoagulation strategy for various phenotypes of COVID-19 patients, the clinicians’ knowledge, experience and creative thinking will be apply to choose effective anticoagulant’s treatment on individual basis

Gottron’s Carcinoid Papillomatosis: Case Report

Introduction. Gottron’s papillomatosis is a rare benign type of dermatosis with pseudoepitheliomatous hyperplasia of the epidermis, first described as an independent disease by the German dermatologist H.A. Gottron. Invasive epidermal growth and hyperkeratosis reveal no signs of malignancy. Chronic venous insufficiency and lymphedema can be associated with various secondary skin lesions: the formation of ulcers, hyperkeratosis and skin papillomatosis, as well as infectious complications. Skin papillomatosis may be a manifestation of paraneoplastic syndrome, which requires a careful differential diagnosis. Timely treatment of complications in a patient with concomitant somatic pathology performed by a multidisciplinary team of specialists is necessary to improve the prognosis. Considering the relative rarity of Gottron’s papillomatosis and the lack of awareness among practicing physicians regarding the differential diagnosis of this disease, we present this clinical analysis.Description of a clinical case. Patient L., 42 years old (body mass index — 76.5 kg/m2) with chronic lymphovenous insufficiency, lymphedema, erysipelas of the right lower limb associated with unspecified skin papillomatosis, was urgently hospitalized in a health care institution “City Clinical Hospital No. 3” of Grodno (Republic of Belarus), consulted by a multidisciplinary team of clinicians including a therapist, a cardiologist, a dermatologist, an endocrinologist, an infectious disease specialist, and a surgeon. Taking into account the clinical status of the patient and the retrospective analysis of archival records of previous examinations performed on the patient in the health care institution “Grodno University Clinic”, the type of dermatosis was determined as Gottron’s papillomatosis of both lower extremities. In terms of the clinical diagnosis of the patient, complex therapy was initiated in a hospital setting, which was then continued at the outpatient stage.Conclusion. Adequate long-term treatment of morbid obesity and chronic lymphovenous insufficiency is necessary to prevent serious complications. According to the academic literature, timely diagnosis of such a rare dermatosis as Gottron’s papillomatosis, as well as the prescription of adequate therapy determine the possibility of regression in the early stages of the disease

BEHAVIORAL RISK FACTORS FOR THE HEALTH DISORDER OF PREGNANT WOMEN AND THEIR OPTIMIZATION IN MATERNITY CONSULTATION CLINICS

Target-oriented activities significantly increase the effectiveness of primary prevention. The aim of the study was to identify behavioral risk factors for the health of pregnant women and the ways to optimize them in maternity consultation clinics. Material and methods. We analyzed the data of the survey (2016) of pregnant women (N = 472, the sample is representative of the republican one) using the methods of parametric and nonparametric statistics of the Microsoft Excel programs of the Microsoft Office XP package and Statistica 6.0. Results. The main social characteristics of a pregnant woman and lifestyle factors have been determined. It was established that having a history of pregnancy, although it affected the self-evaluation of health and one’s own knowledge, did not become a factor that was significant for a favorable change in health-saving behavior. There were revealed such behavioral risk factors for health as low physical activity, lack of fresh air, smoking and drinking alcohol. Conclusion. It is obvious that there is a need to strengthen the control over the activities of the maternity schools at the maternity consultation clinics aimed at the formation of motor skills necessary during pregnancy and the organization of special physical exercises for pregnant women. It is also necessary to enhance the monitoring of pregravidal training in maternity consultation clinics and territorial polyclinics

Реєструвальні матеріали для лазерної термолітографії

The results of analysis on the photosensitive properties of materials with nonlinear exposition characteristic have been performed. It is shown that some photo(thermo)sensitive materials allow to register the image of elements having sizes less than the diameter of exposing beam. The results of laser writing to inorganic photoresists are presented. Fig.: 3. Refs: 21 titles.Представлены результаты анализа свойств фоточувствительных материалов с нелинейной экспозиционной характеристикой. Показано, что существует ряд фото(термо)чувствительных ма-териалов, позволяющих регистрировать изображения, размеры которых меньше диаметра экспонирующего луча. Представлены результаты лазерной записи на неорганических фоторезистах. Ил.: 3. Библиогр.: 21 наим.Представлено результати аналізу властивостей фоточутливих матеріалів з нелінійною експозиційною характеристикою. Показано, що існує низка фото(термо)чутливих матеріалів, що дозволяють реєструвати зображення, розміри елементів яких менше діаметра експонуючого променя. Представлено результати лазерного запису на неорганічних фоторезистах. Іл.: 3. Бібліогр.: 21 найм