Rhinocerebral Form of Invasive Mycosis in COVID-19 Patients: Clinical Course, Diagnosis, Treatment Experience

Background. The incidence of invasive mycoses is reported to increase among patients with a history of new coronavirus infection COVID-19. Adhesion and damage of endothelial cells by zygomycetes lead to fungus angioinvasion, release of a large number of fungal proteases, lipases and mycotoxins, as well as vascular thrombosis, subsequent necrosis of tissues.Objectives. Improvement of the diagnosis and treatment for COVID-19 associated invasive mycosis.Methods. Examination and treatment of 143 patients with invasive mycosis of the maxillofacial area in the period from August 2021 to May 2022 at the Maxillofacial Unit of Regional Clinical Hospital of Emergency Medical Care, Krasnodar Krai, Russia. The diagnosis was confi rmed by cytological, culture-based methods, as well as pathomorphological study of surgical specimen. Follow-up monitoring was carried out in 1, 3, 6 months, with repeated CT and MRI investigations. The group under follow-up monitoring included 91 patients. The incidence of signs was determined via descriptive statistics methods in proportion of the total number of observations and expressed as a percentage. Statistika 12.5 and Excel 2010 (Windows 10) were used in the study, the graphical representation of the material was made in the same programs.Results. Manifestation of invasive mycoses of the maxillofacial area occurred during the early convalescent period of coronavirus infection in specialized infectious hospitals or within two weeks after discharge from the hospital. A typical clinical picture includes rhinocerebral zygomycosis with the development of fungal osteomyelitis of the upper jaw, nasal bones, zygomatic bone, ethmoidal labyrinth bones, sphenoid bone, frontal bone. 17 cases (11.9%) had a lethal outcome as a result of disseminated form of fungal infection caused by Mucorales (14 patients), Aspergillus (3 patients) with damage to the brain, lungs, kidneys and fatal massive necrotic lesions of the craniofacial area. An integrated approach embraced early antifungal therapy (Amphotericin B) as well as surgical debridement of the lesions and provided a positive effect in treatment.Conclusion. Invasive fungal infections require prompt diagnosis and early prescription of antifungal therapy (prior to histological confi rmation of diagnosis) to minimize consequences and prevent fatal outcome. Due to the nonspecifi c nature of clinical symptoms and diffi culties of early diagnosis of invasive zygomycosis and aspergillosis, it is necessary to be alert to potential invasive aggressive mycoses in immunocompromised patients who have a history of a new coronavirus infection COVID-19

METHODOLOGICAL BASIS OF FORMATION AND DEVELOPMENT TOURIST AND HOTEL-RESTAURANT CLUSTERS IN REGIONS

Монографія містить наукові дослідження авторів. Може бути корисна для керівників, інженерів, юристів, економістівта інших працівників підприємств і організацій, а також викладачів, здобувачів, аспірантів, магістрантів і студентів вищих навчальних закладів

DYNAMICS OF MORPHOLOGICAL CHARACTERISTICS OF THE WOUND PROCESS IN PATIENTS WITH ODONTOGENIC FLEGMONS IN ANTIOXIDANT THERAPY

Aim. This research was designed to conduct a morphological analysis of the purulent wound exudate in the complex treatment of patients with odontogenic phlegmon of maxillofacial area (MA) by the antioxidant “Rexod” and antihypoxant “Mafusol”.Materials and methods. The objects of the study were 62 patients (aged 18 to 50 years) with odontogenic phlegmon who were divided into 3 groups. Group I (n=20) – the traditional treatment was supplemented by the intravenous drip injection of the antioxidant "Rexod"; group II (n=21) – the traditional treatment was combined with the intravenous injection of the antioxidant "Rexod" and antihypoxicant "Mafusol"; Group III (n=21) had the traditional treatment. The debridement of the purulent wound included a treatment with 0.06% sodium hypochlorite solution in all groups of patients in the first phase of the wound process; in the second phase the patients in all main groups were treated with the "Soderm" ointment dressings; in the comparison group were used the bandages with methyluracil ointment. In the third phase the gel "Kontraktubeks" was used to prevent the formation of rough scar tissue. There was carried out a morphological examination of smearsimprints of the wound exudate.Results. The microscopic analysis of the cellular landscape of the exudate revealed a significant number of polynuclears which are probably the segmented neutrophilic leukocytes and typical eosinophils; the number of mononuclear cells represented by typical lymphocytes was 4 times less; a single presence of macrophages, plasmocytes, fibroblast-like and epithelioid cells. The signs of degeneration were identified in the cells of histiogenic origin.Conclusion. As a result, there was revealed a gradual increase of overall amount of cells in the wound exudate in all study groups during the treatment, however, this process was pronounced to a greater extent in the patients of group I and II. The obtained result indicates the direct dependence of the activation of reparative processes in the wound from the applied medicines

MICROBIOLOGICAL CHARACTERIZATION OF THE BACTERIAL FLORA IN PATIENTS WITH PHLEGMON OF THE MAXILLOFACIAL SCOPE

The study describes the microbiological state of the patients with phlegmon of the maxillofacial scope. Most of the samples contained Staphylococcus aureus (52,63%). A lot of them produced beta-lactamase and were resistant to penicillin unprotected with inhibitors. Most effective antibiotics, tested during the study, were: azithromycin (90,24%), clindamycin (78,05%) and ciprofloxacin (75,61%)

The morphological characteristics of the dynamics of purulent inflammation process when an optimizing surgical treatment of heavy phlegmons of head and neck is being used

The dynamics of the process of inflammation and regeneration in the region of pathological sead and in the operating wound when the original surgical treatment of heavy phlegmons of head and neck of odontological and non-odontological origion have been investigated. More than 500 histological preparations made of biopsical materials, which was taken out from is 50 patients have been examined. The analysis showed that the optimizing surgical treatment modifies the dynamics of the process, which takes place in the wound and it permits to close an operating wound quickly and to gat its healing by the type of initial surface tension

Estimation of the current of sharp purulent inflammatory processes by means of algorithms of the computer analysis of images

The study describes the automatic algorithm for image analysis based on software Cellprofiler. For the main example of the principal implementation of the analysis process agar culture swabs of Staphylococcus aureus were taken. The proposed algorithms of recognition of microbial elements were verified and showed a significantly higher efficiency compared to the visual method of counting by the laboratory specialist

Muon pairs and upper limit for upsilon production by 280 GeV muons

The high mass \u3bc+\u3bc 12 pairs produced by 280 GeV \u3bc+ on a carbon target are studied in a search for the Y production. The high mass continuum in the region 2\u201318 GeV is interpreted in terms of QED pair production and of \u3bc pairs originating from the decay of hidden and open charm particles as well as of hadrons (\u3c0, K) from deep inelastic interactions. The upper limit for the upsilon production by muons is found to be, at the 90% confidence level, \u3c3\u3b3\ub7(\u3b3\u2192\u3bc+\u3bc 12)<13\ub710 1239 cm2/nucleon