Charlson comorbidity index in predicting deaths in COVID-19 patients

Aim. To assess the clinical performance and factors associated with inhospital mortality in patients with coronavirus disease 2019 (COVID-19).Material and methods. Our results are based on data from hospital charts of inpatients hospitalized in the Asinovskaya District Hospital in the period from March 11, 2020 to December 31, 2020, with a verified COVID-19 by polymerase chain reaction. The study included 151 patients, the median age of which was 66,2 (50- 92) years (women, 91; 60,3%). The study endpoints were following hospitalization outcomes: discharge or death. Depending on the outcomes, the patients were divided into 2 groups: the 1st group included 138 patients (survivors), while the 2nd one included 13 patients (death). To objectify the severity of multimorbidity status, the Charlson comorbidity index was used. The final value was estimated taking into account the patient age by summing the points assigned to a certain nosological entity using a calculator table.Results. Hypertension was recorded in the majority of patients — 79,5%, chronic kidney disease — in 61,1%. The prevalence of type 2 diabetes and coronary artery disease was high — 31,8% each. Prior myocardial infarction was diagnosed in 11,3% of cases. The prevalence of percutaneous coronary intervention and coronary bypass surgery was 5,3% and 3,3%, respectively. Stroke was detected in 9,3% of participants. Prior chronic pulmonary pathologies in COVID-19 patients were rare (asthma — 3,3%, chronic obstructive pulmonary disease — 2,0%). In order to predict the death risk in COVID-19 patients, a logistic regression analysis was performed, which showed that age and Charlson comorbidity index were the most significant predictors.Conclusion. Independent factors of inhospital mortality were age and Charlson’s comorbidity index. The risk assessment model will allow clinicians to identify patients with a poor prognosis at an earlier disease stage, thereby reducing mortality by implementing more effective COVID-19 treatment strategies in conditions with limited medical resources

Risk factors for heart failure in patients with COVID-19

Aim. To establish risk factors for heart failure (HF) in patients with coronavirus disease 2019 (COVID-19).Material and methods. Medical records of 151 patients treated in an infectious disease hospital from November 3, 2020 to February 2, 2021 with a confirmed diagnosis of COVID-19 were retrospectively selected. The collection of clinical, history and laboratory data were carried out by analyzing electronic medical records. We analyzed information on age, sex, body mass index, smoking, and comorbidities. Following laboratory studies were analyzed: complete blood count, biochemical blood tests, coagulation profile, acute phase proteins (C-reactive protein (CRP), ferritin, lactate dehydrogenase (LDH)), procalcitonin. The diagnosis of HF was confirmed by clinical performance, echocardiography, and elevated levels of the N-terminal pro-brain natriuretic peptide (NT-proBNP). The risk of HF was taken as the endpoint of the study.Results. The studied sample of patients was divided into two groups depending on HF: the 1st group included 46 patients with HF, the 2nd group — 105 patients without HF. The median age was 66,2 (50-92) years (women, 91 (60,3%)). Laboratory indicators, such as the levels of CRP, LDH, procalcitonin, creatinine, bilirubin, differed significantly from each other, and the median values were higher in patients with HF. The neutrophil-to-lymphocyte ratio (NLR) showed significant intergroup differences: in the group of patients with HF, the median was 4,97% vs 3,62% (p=0,011) in the group of patients without HF. There were following most significant predictors increasing the HF risk: age ≥66 years (odds ratio, 8,038, p<0,001), procalcitonin level, which increases the HF risk in patients by 3,8 times (p><0,001), NLR ≥4,11% (p=0,010), thrombocytopenia ≤220×109/l (p=0,010), history of chronic kidney disease (CKD) (p=0,018). Conclusion. The following predictors of HF were established: age ≥66 years, procalcitonin ≥0,09 ng/ml, NLR ≥4,11%, thrombocytopenia ≤220×109/l, history of CKD, LDH ≥685 U/l and creatinine ≥102 µmol/l, international normalized ratio ≥1,19, QTc interval ≥407,5 ms, bilirubin ≤10,7 µmol/l. It is worth noting that the best accuracy values are demonstrated by the Random Forest algorithm (88,5% on the validation set), but the mathematical model of the neural network turned out to be the most sensitive (90,0% on the validation set). Keywords: novel coronavirus infection, heart failure, prognosis>˂0,001), procalcitonin level, which increases the HF risk in patients by 3,8 times (p˂0,001), NLR ≥4,11% (p=0,010), thrombocytopenia ≤220×109/l (p=0,010), history of chronic kidney disease (CKD) (p=0,018).Conclusion. The following predictors of HF were established: age ≥66 years, procalcitonin ≥0,09 ng/ml, NLR ≥4,11%, thrombocytopenia ≤220×109/l, history of CKD, LDH ≥685 U/l and creatinine ≥102 µmol/l, international normalized ratio ≥1,19, QTc interval ≥407,5 ms, bilirubin ≤10,7 µmol/l. It is worth noting that the best accuracy values are demonstrated by the Random Forest algorithm (88,5% on the validation set), but the mathematical model of the neural network turned out to be the most sensitive (90,0% on the validation set)

THERAPEUTIC EQUIVALENCE OF ORIGINAL CLOPIDOGREL (PLAVIX) AND ITS GENERIC (EGITROMB). RESULTS OF COMPARATIVE RANDOMIZED CROSS-OVER BLIND STUDY

Aim. To study therapeutic equivalence (efficacy, safety and tolerability) of original clopidogrel (Plavix) and its generic (Egitromb) in patients of high cardiovascular risk. Material and methods. Thirty one patients with coronary heart disease and indications for clopidogrel therapy were involved into the randomized cross-over blind study. Half of the patients received original clopidogrel (75 mg daily) during the first 2 weeks and then they received generic clopidogrel in the same dose during next 2 weeks. Another half of the patients received the drugs in reverse order. Antiplatelet activity of Plavix and Egitromb was estimated by effects on ADP-induced platelet aggregation initially and after 2 weeks of treatment with each drug. Study blinding was provided by the following approach: doctors of cardiology clinic performed clinical monitoring and drug distribution; coded blood samples for platelet aggregation assessment were studied in independent laboratory of thrombosis; statistical data analysis was performed by biostatistics expert in other research center. Results. 2-week therapy with each drug led to a significant decrease of ADP-induced platelet aggregation which remained low after switching from original drug to generic and vice versa. Aggregation dynamics did not depend on the first administered drug. There were no significant differences between aggregation changes as a result of treatment with original or generic drug. No one adverse event was observed in association with both drugs therapy. Conclusion. Generic drug Egitromb (Egis, Hungary) and original clopidogrel Plavix (Sanofi-Aventis, France) have equivalent antiplatelet effect

Determination of Fluorescence Polarization and Absorption Anisotropy in Molecular Complexes Having Threefold Rotational Symmetry

The current work concerns investigation of the polarization properties of complex molecular ensembles exhibiting threefold (C3) rotational symmetry, particularly with regard to the interplay between their structure and dynamics of internal energy transfer. We assume that the molecules or chromophores in such complexes possess strongly overlapped spectra both for absorption and fluorescence. Such trimeric structures are widely found in biological preparations, as for example the trimer of C-phycocyanin (C-PC). Higher order aggregates, e.g. hex-amers and three-hexamer rods, are also investigated and compared with the trimer case. The theory addresses both steady-state and 8-pulse excitation and establishes some links between them. Monochromophoric, bichro-mophoric and trichromophoric molecular complexes are individually examined. For steady-state excitation, analytical formulas are reported for the degree of fluorescence polarization and absorption anisotropy. It is shown that the polarization is dependent on the chromophore inclination relative to the symmetry axis, the relative efficiencies of absorption and fluorescence by chromophores of different spectral types, and the rates of energy equilibration. To assess the validity of the theory, it has been applied to C-PC aggregates. Here it was found that different C-PC aggregates provide practically identical polarization response. For S-pulse excitation we give analytical formulas for determination of the fluorescence depolarization, and also the depolarization associated with absorption recovery, both for a monochromophoric trimer and some particular cases of bichromophoric trimer. More complicated systems are analyzed by computer modeling. Thus it transpires that the initial polarization anisotropy r(t = 0) takes the value 0.4 for all considered aggregates; the long-time limit r(t →∞) has about the same value as is associated with steady-state excitation. We also show that with steady-state excitation the degree of fluorescence polarization is practically equal for various C3 aggregates of C-PC, and that the major factor determining the polarization is the chromophore orientation relative to the symmetry axis

Оптимальное соотношение основных механизированных работ при прямоточном внесений удобрений

Use of transport and technological means is carried out according to the direct-flow scheme and includes stage-by-stage performance as the main standard-setting operations (fertilizers transportation, movement and their distribution across a field), and auxiliary (return from a field and loading of fertilizers). The method of comparison of main types of operations at fertilizers application is given. An estimation criterion is a ratio of cargo movements on a road and across a field, proportionality coefficient between movement of freight and a fertilizers distribution area across the field. These indicators depend on transportation distances and doses of fertilizers application, and also on technology factor that is freight moving frequency across the field. The last characteristic is taken as the optimized parameter. An extremum of this indicator was searched due to a classical method. Optimum values of estimated indicators with the accounting of a variation of a ratio of load capacity and operating width of technical means are received. Concrete combinations of transportation distances and doses of fertilizers application are specified. The authors defined conditions of effective use of tractor and perspective automobile transport and technological means. They recommended to use the automeans allowing to change operating width. Realization of the stated methodological approach will make it possible to select an optimum ratio of the mechanized operations at direct-flow fertilizers application, to exclude additional cargo movements across the field, to cut fuel consumption, to increase productivity. Productivity of transport and technological means increases by 2.0; 1.3 and 1.15 times respectively to length of furrow 3; 9 and 27 km at fertilizers application by a dose of 0.06 kg per sq.m.Использование транспортно-технологических средств осуществляется по прямоточной схеме и включает поэтапное выполнение как основных нормообразующих работ (перевозку удобрений, перемещение и распределение их по полю), так и вспомогательных (возвращение средств с поля и погрузку удобрений). Приведен метод сопоставления основных видов работ при внесении удобрений. В качестве оценочных критериев приняты соотношение грузоперемещений по дороге и по полю, коэффициент пропорциональности между перемещением груза по полю и площадью распределения удобрений. Эти показатели зависят от расстояний транспортировки и доз внесения удобрений, а также от технологического фактора - плотности перемещений груза по полю. Последняя характеристика принята за оптимизируемый параметр. Поиск экстремума этого показателя проводили классическим методом. Получены оптимальные значения оценочных показателей с учeтом варьирования соотношения грузовместимости и ширины захвата технических средств. Указаны конкретные сочетания расстояний перевозки и доз внесения удобрений. Определены условия эффективного использования тракторных и перспективных автомобильных транспортно-технологических средств. Рекомендовано использовать автосредства, позволяющие изменять ширину захвата. Реализация изложенного методологического подхода к выбору оптимального соотношения механизированных работ при прямоточном внесении удобрений позволит исключить дополнительные грузоперемещения по полю, снизить расход топлива, повысить производительность. Показали, что производительность транспортно-технологических средств возрастает в 2,0; 1,3 и 1,15 раза соответственно для длины гона 3; 9 и 27 км при внесении удобрений дозой 0,06 кг/кв.м

Hypertension control during the COVID-19 pandemic: results of the MMM2021 in Russia

Repetitive quarantines and social restrictions during the coronavirus disease 2019 (COVID-19) pandemic have negatively affected the population health in general, and the control of hypertension (HTN) in particular.Aim. To evaluate the control of HTN in the Russian population during the COVID-19 period based on the results of screening for HTN May Measurement Month 2021 (MMM2021).Material and methods. During May-August 2021, 2491 participants from 11 Russian regions took part in the screening. Participation was voluntary without restrictions on sex. All participants were over 18 years of age. During the screening, blood pressure (BP) was measured three times using automatic and mechanical BP monitors. In addition, a questionnaire was filled out on behavioral risk factors, comorbidities and therapy. HTN was diagnosed with systolic BP ≥140 mmHg and/ or diastolic blood pressure ≥90 mmHg and/or taking antihypertensive therapy. The questionnaire included questions about prior COVID-19, vaccinations and their impact on the intake of antihypertensive drugs.Results. The analysis included data from 2461 respondents aged 18 to 92, of which 963 were men (39,1%). The proportion of hypertensive patients was 41,0%, while among them 59,0% took antihypertensives and 30,9% were effectively treated. In comparison with pre-pandemic period according to MMM2018-2019, the higher proportion of HTN patients in the Russian sample was revealed during MMM2021 (41,0% vs 31,3%, p<0,001) with a comparable proportion of patients receiving antihypertensive therapy (60,7% vs 59,0%, p=0,05) and treatment efficacy (28,7% vs 30,9%, p=0,36). Monotherapy was received in 44,7% of cases, while dual and triple combination therapy — in 30,9% and 14,1%, respectively. The majority of respondents (~90%) did not adjust their antihypertensive therapy during the COVID-19 pandemic.Conclusion. According to HTN screening in Russia, there is persistent ineffective control of HTN, which may be due to both the worsening pattern of behavioral risk factors, limited access to healthcare during COVID-19, and the inertia of physicians and low adherence of patients due to the asymptomatic HTN course in the majority

Application of Surface wave methods for seismic site characterization

Surface-wave dispersion analysis is widely used in geophysics to infer a shear wave velocity model of the subsoil for a wide variety of applications. A shear-wave velocity model is obtained from the solution of an inverse problem based on the surface wave dispersive propagation in vertically heterogeneous media. The analysis can be based either on active source measurements or on seismic noise recordings. This paper discusses the most typical choices for collection and interpretation of experimental data, providing a state of the art on the different steps involved in surface wave surveys. In particular, the different strategies for processing experimental data and to solve the inverse problem are presented, along with their advantages and disadvantages. Also, some issues related to the characteristics of passive surface wave data and their use in H/V spectral ratio technique are discussed as additional information to be used independently or in conjunction with dispersion analysis. Finally, some recommendations for the use of surface wave methods are presented, while also outlining future trends in the research of this topic