Infective endocarditis and COVID-19: the impact of SARS-CoV-2 infection on diagnostics, course, and prognosis

Aim. To study the impact of coronavirus disease 2019 (COVID-19) pandemic on hospitalization rates, diagnosis, and outcomes of infective endocarditis (IE) with a subanalysis of IE course in combination with COVID-19.Material and methods. This prospective cohort study included 168 patients with definite or probable IE (DUKE 2015) hospitalized in the V.V. Vinogradov City Clinical Hospital from July 2017 to July 2022. All patients underwent a conventional examination in accordance with current clinical guidelines. We studied clinical, paraclinical and etiological parameters, as well as outcomes.Two clinical observations of the combination of IE and COVID-19 are presented.Results. When assessing the local registry of patients with IE, a trend towards an increase in hospitalizations rate of IE in 2021-2022 was shown, with a decrease during the period of long-term lockdowns in Moscow and a subsequent surge after their cancellation. Patients with IE during the COVID-19 pandemic had a more favorable clinical profile, a 2-fold increase in IE diagnosis (due to late hospitalization), frequent detection of Staphylococcus aureus MSSA (32,6%), and frequent surgical treatment (up to 87,6% with a combination of IE and COVID-19), as well as high in-hospital mortality, but without a tendency to increase (30,4%). Clinical observations of IE and COVID-19 combination are presented, which demonstrates the contribution of COVID-19 as the only risk factor for native tricuspid valve IE in a patient without predisposing causes, as well as a factor in the unfavorable prognosis for native aortic valve IE after the addition of COVID-19, which led to lethal outcome.Conclusion. The present study demonstrates the profile of patients with IE and COVID-19 depending on the epidemiological situation of COVID-19 and the association with SARS-CoV-2 infection. The data obtained make it possible to discuss the potential relationship between COVID-19 and IE. The "endocarditis team" determines the timely implementation of surgery and the absence of an increase in inhospital mortality, regardless of the epidemiological situation

Cholera: Analysis and Assessment of Epidemiological Situation around the World and in Russia (2013–2022). Forecast for 2023

The aim of the review was to analyze and assess the epidemiological situation on cholera in the world and Russia in 2013–2022 and to make a forecast for 2023. Over the period of 2013–2022, 500 administrative territories affected by cholera were identified in various regions of 71 countries of Asia, Africa and America (the Caribbean region) with formation of 69 endemic foci in 16, 41 and 12 countries, respectively. In 2022, 1 209 301 cases of cholera were registered in 36 countries of the world. The intensity of epidemic process in Asian countries (Syria, Lebanon) increased. Unfavorable epidemiological situation on the African continent persisted. Epidemics and large outbreaks, which began in 2021–2022 due to emergency situations (ES) of social and natural character, continued. The prediction of the stability of the epidemiological situation on cholera in the territories of constituent entities of the Russian Federation (RF), given for 2022, has been confirmed. In 2022, 43 non-toxigenic strains of Vibrio cholerae О1 were isolated from surface water bodies, 8 V. cholerae nonO1/nonO139 strains – from humans. Similarity of those strains with genetically closely related ones isolated in the course of monitoring in previous years in Russia, Donetsk People’s Republic (DPR) and Zaporozhye Region was demonstrated. In 2023, the risks of importation of the infection into RF are retained. It is associated with the intensification of epidemic processes in Asian, African and Caribbean region countries. The extended border with Ukraine, to where importation of cholera from endemic countries is possible, contributes to increased degree of threat. Bioterrorism is also not excluded. The consequences of a possible cholera epidemic complication in DPR, Lugansk People’s Republic, Zaporozhye and Kherson Regions are exacerbated by social emergencies resulting in disruption of infrastructure, interruptions in water supply, etc. In the absence of implementation of the risks of importation of this infection on the territory of RF, a stable epidemiological situation on cholera will be retained. Detection of non-toxigenic V. cholerae O1 strains (including probability of clonal complexes formation), as well as strains of non-O1/non-O139 serogroups, which can be etiological factors of sporadic cases or outbreaks of diarrheal diseases, in surface water bodies is predicted

Cholera: Trends in the Development of the Epidemic Process in 2021, Forecast for 2022

The aim of the work was to summarize the results of cholera monitoring in 2021, to assess current trends in the development of the epidemic process, and to predict the epidemiological situation in the Russian Federation for 2022. It was established that within the period of 2012–2021, 4117264 cases of cholera with the spread of infection across 83 countries on all continents were registered in the world and there was a downward trend in the incidence in Asia and Africa. The dynamics of monthly morbidity in 2021 was associated with emergencies as factors of epidemiological risk. Epidemics and outbreaks of cholera were documented against the background of COVID-19 pandemic and laid a double burden on healthcare systems. At the same time, based on the overview of the results of cholera monitoring in the constituent entities of the Russian Federation, it was shown that the forecast of epidemic well-being given for 2021 was fully justified. It has been determined that the increase in the number of non-toxigenic strains of Vibrio cholerae O1 (67) isolated from water bodies compared to 2020 (25) is mainly due to the appurtenance of a number of isolates to clonal complexes. The study of phylogenetic relation has demonstrated that the detection of strains with genotypes which were previously identified in the isolates evidences the persistence potential. The identification of strains with new genotypes, which were earlier established in the strains circulating in other territories, pointed at the possibility of the occasional importations. The forecast of the epidemiological situation on cholera in Russia for 2022 is associated with the continuous existence of risks of introduction. If these epidemiological risks are not realized, a favorable epidemiological situation is predicted regarding this infection in the country. It is expected that the detection of epidemiologically insignificant strains of V. cholerae O1 in environmental water bodies, along with their clones and/or clonal complexes, will remain, including strains that may be an etiological factor in sporadic cases or outbreaks of disease

Tropical and Boreal Forest Atmosphere Interactions : A Review

This review presents how the boreal and the tropical forests affect the atmosphere, its chemical composition, its function, and further how that affects the climate and, in return, the ecosystems through feedback processes. Observations from key tower sites standing out due to their long-term comprehensive observations: The Amazon Tall Tower Observatory in Central Amazonia, the Zotino Tall Tower Observatory in Siberia, and the Station to Measure Ecosystem-Atmosphere Relations at Hyytiala in Finland. The review is complemented by short-term observations from networks and large experiments. The review discusses atmospheric chemistry observations, aerosol formation and processing, physiochemical aerosol, and cloud condensation nuclei properties and finds surprising similarities and important differences in the two ecosystems. The aerosol concentrations and chemistry are similar, particularly concerning the main chemical components, both dominated by an organic fraction, while the boreal ecosystem has generally higher concentrations of inorganics, due to higher influence of long-range transported air pollution. The emissions of biogenic volatile organic compounds are dominated by isoprene and monoterpene in the tropical and boreal regions, respectively, being the main precursors of the organic aerosol fraction. Observations and modeling studies show that climate change and deforestation affect the ecosystems such that the carbon and hydrological cycles in Amazonia are changing to carbon neutrality and affect precipitation downwind. In Africa, the tropical forests are so far maintaining their carbon sink. It is urgent to better understand the interaction between these major ecosystems, the atmosphere, and climate, which calls for more observation sites, providing long-term data on water, carbon, and other biogeochemical cycles. This is essential in finding a sustainable balance between forest preservation and reforestation versus a potential increase in food production and biofuels, which are critical in maintaining ecosystem services and global climate stability. Reducing global warming and deforestation is vital for tropical forests.Peer reviewe

Drug induced skin reactions characteristics in multifield emergency hospital

This prospective study was carried out in a period of 1 year on the basis of the multifield emergency hospital in the departments of therapy, urology and purulent surgery. On the basis of data of the screening method and the method of spontaneous messages a group of 347 patients with skin reactions, which potentially associated with the intake of medicines was highlighted in. Among them, there were 179 patients with non drug associated skin reactions and 168 patients with drug-induced skin reactions. The most common cutaneous drug reactions (CDR) were: acute urticaria, angioedema; drug toxidermia; allergic dermatitis; hemorrhagic vasculitis. Mostly СDR were caused by the following groups of drugs: b-lactam antibiotics; fluoroquinolones; drugs, improving cerebral blood flow; rentgencontrasting substances

Changes in prescribing antithrombotic therapy in patients with atrial fibrillation and myocardial infarction in 2016-2019

Aim. To study the changes in prescribing antithrombotic therapy (ATT) among patients with myocardial infarction (MI) and atrial fibrillation (AF), hospitalized in a cardiology hospital in 2016-2017 and 2018-2019.Material and methods. The study included 362 patients with MI and AF in 20162017 — 106 patients, of which 104 were included in the analysis, in 2018-2019 — 256 patients. The median age of patients hospitalized in 2016-2017 was 70,0 (61,0; 78,0) years, in 2018-2019 — 71 (65,0; 79,3) years (p=0,09). There were 60 men (55,6%) in 2016-2017 and 143 (55,8%) in 2018-2019 (p=0,90).Results. In 2016-2017, 80 (76,9%) patients were prescribed dual antiplatelet therapy (DAPT), 17 (16,3%) — therapy with oral anticoagulants (OAC), while 7 (6,7%) of them were as part of triple ATT, 9 (8,7%) — as part of dual ATT (OAC+antiplatelet agent), and 1 (1,0%) — as monotherapy.In 2018-2019, 97 (37, 9%) patients were prescribed DAPT, 140 (54,7%) — OAC therapy, while 115 (44,9%) of them were as part of triple ATT 25 (9,8%) — as a part of dual ATT (OAC+antiplatelet agent). Among all cases of OAC prescription in 2016-2017 and 2018-2019, warfarin was prescribed in 11 (64,7%) and 51 (36,4%) patients,respectively (p=0,02), while rivaroxaban — in 6 (35,3%) and 88 (62,9%) patients, respectively (p=0,03). In 2018-2019, one patient was prescribed dabigatran etexilate.Conclusion. The study revealed that the prescription rate of triple ATT at discharge in 2018-2019 increased 6,7 times compared to 2016-2017 and amounted to 44,9% (n=115) (p<0,001). The prescription rate of OAC in 2018-2019 also increased 3,4 times compared to 2016-2017 and amounted to 54,7% (n=140) (p<0,001)