Saratov State Medical University

The development of “soft skills” applicable to healthcare professionals is a necessary factor for the formation of a highly qualifed specialist engaged in medical activity. Aim. The aim of the survey is to study the formation of “soft skills” while undergraduates at Nursing Institute obtain higher medical education. Materials and methods. It has led to the analysis of four key competencies “4K”. The comparative analysis was used to describe the names of universal competencies included into the Federal State Educational Standard for Bachelor’s degree in “Nursing” and the meaning of “4K” competencies. Fulltime students of Saratov State Medical University named after V.I. Razumovsky majoring in “Nursing” were engaged into the questionnaire. It has been revealed that the development of “4K” competencies is important for medical professional staff. Results. The present study confrmed that the training for “Nursing” at the Bachelor level following the Federal State Educational Standard contributes to the development of “soft skills”. Conclusion. Based on the data obtained from the survey, we may conclude that the four key competencies “4K” are well formed in Bachelor of Nursing. However, the lack of information on the concept and structure of “soft skills” among students has been determined. More detailed information can be found by the use of special educational technologies and methods for mastering the “soft skills”.

Chronic diseases, which form the somatic and social deprivation of patients, imply the provision of integrated medical and social care. National health care systems are actively pursuing processes aimed at overcoming the fragmentation of health care delivery and forming a model of integrated health care. The purpose of the study. Analysis of interaction of medical organizations and continuity in the treatment of patients in rural health care in the Saratov region. Material and methods. The authors conducted a comparative sociological study, which involved 319 physicians working in the district medical organizations of the Saratov region. The study was preceded by the construction of the medical and social portrait of the respondents. Results. The majority (73.7 %) of the respondents assessed the degree of continuity of patient care between inpatient and outpatient facilities in the district of the region as average. Conclusion. The study reveals the peculiarities of the organization of medical care for the rural population, which consist in the limited implementation of the principles of continuity in the management of patients, the presence of barriers to digitalization. The analysis of the degree of interaction between doctors when providing medical care to the rural population in inpatient and outpatient conditions reveals the fragmentation of rural and regional health systems.

Purpose We evaluated gefapixant, a P2X3 receptor antagonist, in participants with recent-onset (≤ 12 months) refractory chronic cough (RCC) or unexplained chronic cough (UCC). Methods Participants (≥ 18 years of age; ≥ 40 mm on a 100-mm cough severity visual analog scale [VAS] at screening and randomization) with chronic cough for < 12 months were enrolled in this phase 3b, double-blind, placebo-controlled, parallel group, multicenter study (NCT04193202). Participants were randomized 1:1 to gefapixant 45 mg BID or placebo for 12 weeks with a 2-week follow-up. The primary efficacy endpoint was change from baseline at Week 12 in Leicester Cough Questionnaire (LCQ) total score. Adverse events were monitored and evaluated. Results There were 415 participants randomized and treated (mean age 52.5 years; median [range] duration 7.5 [1–12] months): 209 received placebo and 206 received gefapixant 45 mg BID. A statistically significant treatment difference of 0.75 (95% CI: 0.06, 1.44; p = 0.034) for gefapixant vs. placebo was observed for change from baseline in LCQ total score at Week 12. The most common AE was dysgeusia (32% gefapixant vs. 3% placebo participants); serious AEs were rare (1.5% gefapixant vs. 1.9% placebo participants). Conclusion Gefapixant 45 mg BID demonstrated significantly greater improvement in cough-specific health status from baseline compared to placebo, in participants with recent-onset chronic cough. The most common AEs were related to taste and serious AEs were rare.

The objective : to study prevalence and patterns of mutations in the katG, inhA, ahpC, rpoB genes associated with Mycobacterium tuberculosis (MTB) resistance to isoniazid (H) and rifampicin (R) in patients with various clinical manifestations of pulmonary tuberculosis (TB). Subjects and Methods . 441 sputum samples collected in tuberculosis patients were tested using biological microchips. Tests were carried out in Group 1 - patients with confirmed bacterial excretion (n = 256) and in Group 2 (n = 185) - patients without bacterial excretion. The same patients were enrolled in Group 3 - patients with acute progressing tuberculosis (n = 52) and Group 4 (n = 99) - patients with localized tuberculosis. Results . In Group 1, DNA of Mycobacterium tuberculosis was found in 79.3% of patients, in Group 2 - in 57.8%. Among all samples, mutations in the genes encoding resistance to isoniazid were detected in 15.5%, resistance to rifampicin - in 58.1%. Resistance to isoniazid was more often caused by mutations in the katG gene (49%) versus the inhA (29%) and ahpC (4.2%) genes. We found 13 most common types of mutations in the rpoB gene associated with resistance to rifampicin. The dominant mutations in both groups were Seu531->Leu mutations - 19.7% in Group 1 and 24.3% in Group 2. In Group 1, mutations in the katG gene (53.7%) were observed more often than mutations in the inhA gene (27.7%). In Group 3, mutations in the katG gene were registered in 30.8%, in the inhA gene - in 25%. There were no statistically significant differences in patterns of mutations in the katG, inhA, ahpC, rpoB genes between Groups 1, 2 and 3, 4. Thus, patients without bacterial excretion and patients with localized tuberculosis are a hidden dangerous reservoir of tuberculous mycobacteria with multiple drug resistance to rifampicin and drug resistance to isoniazid.

Relevance . Bleeding and hemorrhagic shock are the leading cause of potentially preventable deaths in combat casualties. The concept of pre-hospital injury control Remote Damage Control Resuscitation is becoming an integral part of care in the wounded with shock in the field. The significance of prehospital care provision according to the principles of Damage Control Resuscitation is increasing in future “multidomain battlefield”. The objective is to consider the effectiveness and features of prehospital care provision according to the principles of DCR in armed conflicts of the last two decades (in Afghanistan, Iraq, Africa, the Middle East). Methodology . A search was made for scientific articles in the PubMed database and the Scientific Electronic Library (eLIBRARY.ru), published from 2017 to 2022. Results and Discussion . Prehospital care according to the principles of Damage Control Resuscitation includes temporary arrest of bleeding, infusion therapy as part of hemostatic resuscitation and permissive hypotension, adequate respiratory support, prevention and elimination of hypothermia, and prompt evacuation to the stage of surgical care. Effective means to stop bleeding in combat casualties are modern hemostatic tourniquets, pelvic bandage, hemostatic dressings with koalin and chitosan. Resuscitation endovascular balloon occlusion of the aorta is recognized as a promising method for stopping internal bleeding. The basis of hemostatic resuscitation on the battlefield is the earlier transfusion of blood or its components in combination with the introduction of tranexamic acid and calcium preparations. Group O (I) whole blood with low titer anti-A and anti-B antibodies, lyophilized plasma and fibrinogen concentrate offer logistical advantages for combat use. Conclusion . Pre-hospital care according to the principles of Damage Control Resuscitation is effective and can significantly reduce mortality among those injured in combat operations.

In our work, we compare EEG time–frequency features for two types of K-complexes detected in volunteers performing the monotonous psychomotor test with their eyes closed. Type I K-complexes preceded spontaneous awakenings, while after type II K-complexes, subjects continued to sleep at least for 10 s after. The total number of K-complexes in the group of 18 volunteers was 646, of which of which type I K-complexes was 150 and type II K-complexes was 496. Time–frequency analysis was performed using continuous wavelet transform. EEG wavelet spectral power was averaged upon several brain zones for each of the classical frequency ranges (slow wave, [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text] bands). The low-frequency oscillatory activity ([Formula: see text]-band) preceding type I K-complexes was asymmetrical and most prominent in the left hemisphere. Statistically significant differences were obtained by averaging over the left and right hemispheres, as well as projections of the motor area of the brain, p<0.05. The maximal differences between the types I and II of K-complexes were demonstrated in [Formula: see text]-, [Formula: see text]-bands in the occipital and posterior temporal regions. The high amplitude of the motor cortex projection response in [Formula: see text]-band, [Formula: see text] Hz, related to the sensory-motor modality of task in monotonous psychomotor test. The [Formula: see text]-oscillatory activity preceding type I K-complexes was asymmetrical and most prominent in the left hemisphere may be due to the important role of the left hemisphere in spontaneous awakening from sleep during monotonous work, which is an interesting issue for future research.

Introduction. The genus Astragalus L. is one of the largest genera of flowering plants and includes at least 3,270 species. Individual species of this genus have long been used in traditional and scientific medicine. In recent years, species of the genus Astragalus L. have attracted attention because of the detection of a wide range of neurobiological effects in its representatives. The review presents an analysis of the literature data on experimental and partly clinical studies of various neurobiological effects of extracts and chemical compounds of species of this genus and the prospects for their use in medicine. Text. A variety of neuroprotective effects of these compounds has been established. In many cases, inhibition of oxidative stress, which plays an important role in the development of a number of neurodegenerative diseases, has been noted as a neuroprotective mechanism. Chemical compounds contained in representatives of this genus protect brain neurons from ischemic damage, the effects of neurotoxins and glutamate, and beta-amyloid deposition. These substances have been found to inhibit increased acetylcholinesterase activity and dimyelination processes. These compounds also improve cognitive functions, including memory and learning. Their anticonvulsant effect has been established. Of particular interest is the data indicating the possibility of using some chemical compounds contained in representatives of the genus Astragalus L. in therapy of mental diseases, particularly schizophrenia. Conclusion. The analysis of experimental works for the last ten years shows that extracts and chemical compounds of species of the genus Astragalus L. have a very heterogeneous spectrum of neurobiological action and, probably, may find application in the future as therapeutic agents in neurological and psychiatric practice. Unfortunately, in contrast to a large number of preclinical experiments, clinical trials of these compounds are sporadic. It is also noteworthy that less than one percent of the species of this genus have been investigated to date with respect to neurobiological activity. Thus, more extensive research, clinical trials, studies to standardize and establish therapeutic doses for humans of extracts and chemical compounds of species of the genus Astragalus L. are needed.

Introduction. Despite the relevance of the managerial decision-making problem including those in healthcare institutions, there are virtually no studies that analyze its trend. This research is an attempt to eliminate this gap. The objective of this study is to evaluate the characteristics of managerial decision-making in healthcare institutions considering the trend in the professional activities of their managers. Material and methods. An expert survey method included an analysis of the answers of thirty six healthcare managers to the questions of an anonymous questionnaire covering a 10-year period of managerial activity. Results. We determined the positive changes in the competence of healthcare managers, in particular their theoretical knowledge (the first three years of managerial activity), practical skills (four years), foresight of the course of events — forecasting (five years), gaining confidence (5.2 ± 0.6 years), and a 10-year trend in managerial decision-making in healthcare institutions that refers to their quality (up to the ninth year), formulation (from the second year to the end of the observation), implementation (from the second to the ninth), reasons for non-fulfillment (ninth and tenth years), the significance of innovative solutions (from the second to the sixth years), expediency implementation of optimization directions (from the fifth to the eighth years). Limitations. Quantitative and qualitative characteristics of the sample statistical population surveyed are limited — the opinion of healthcare managers who met the requirements for experts was assessed. Conclusion. This research is the first evaluation of the characteristics of managerial decision-making in healthcare institutions in the trend in professional healthcare management activity; it is of great scientific and practical importance and opens up prospects for optimizing the process under consideration.

Introduction. Promising sources of biologically active compounds (BAS) are extracts obtained from various morphological parts of plants of the numerous genus Astragalus L. One of the main groups of BAS isolated from plants of this genus are flavonoids, saponins, and polysaccharides. Sufficiently studied are Astragalus membranaceus (Fisch.) Bunge) and Astragalus mongholicus Bge., whose extracts have a wide range of pharmacological activity. Expansion of the nomenclature of medicinal plant materials and the study of BAS groups that determine the main pharmacological effects are topical studies in pharmacognosy. From this point of view, little-studied species of Astragalus ( Astragalus henningii (Stev.) Klok., Astragalus testiculatus Pall., Astragalus varius S.G. Gmel., Astragalus dasyanthus Pall.), massively growing in the Volga region, are of interest. Aim. Isolation and identification of 5 aglycones of flavonoids in hydrolysates of water-alcohol extracts from Astragalus herb: A. henningii , A. testiculatus , A.varius , A . dasyanthus by HPLC/UV. Materials and methods. The objects of the study were the herb of four types of Astragalus ( A. henningii , A. testiculatus , A.varius , A. dasyanthus ), harvested during the period of mass flowering in the Saratov region and dried to an air-dry state. To study the composition of phenolic compounds, extraction was carried out with 70 % ethanol in the ratio of raw material : extracting agent 1 : 10 by infusion for 7 days. Acid hydrolysis was carried out with hydrochloric acid 37 % with heating for 40 min. The resulting hydrolysates were analyzed on an Agilent 1260 chromatograph (Agilent Technologies, USA) with a diode array detector, manual sample injection (Agilent G1328C manual injector, Agilent Technologies, USA) and an Agilent OpenLab CDS chromatographic data collection and processing system using an individually selected elution gradient of the mobile phase (0.1 % solution of orthophosphoric acids/acetonitrile). Compounds in the hydrolysates were identified by the retention times and UV spectra of a mixture of reference standards (RS) of quercetin, isorhamnetin, luteolin, kaempferol, and apigenin. Results and discussion. An elution gradient was selected for one time determination of 5 aglycones of flavonoids with a single analysis time of 13 minutes. These conditions made it possible to identify compounds in the hydrolyzates of water-alcohol extracts of four types of Astragalus . Luteolin, quercetin and apigenin were found in hydrolyzates of A. henningii , A. testiculatus and A. varius ; isorhamnetin and kaempferol were found in A. henningii and A. varius . None of the analyzed aglycones was found in the A. dasyanthus hydrolyzate. Conclusion. After preliminary selection of the optimal conditions for the chromatographic separation of a mixture of 5 aglycones of flavonoids, hydrolysates of four types of Astragalus were analyzed. The data obtained indicate the prospects for further study of the chemical composition of Astragalus and confirm the expediency of their use for obtaining of new herbal remedies.

Introduction. Recently, the anticancer activity of representatives of the genus Artemisia L. has been actively studied, and most studies are devoted to Artemisia annua L., which has been used since ancient times in the folk medicine of several countries as an antimalarial and anticancer agent. The similarity of the chemical composition predetermines the study of the anticancer activity of other species of the genus Artemisia L. The information about this is still not fully presented in scientific publications, is very diverse and sometimes even contradictory. Review of modern studies of anticancer activity of species of the genus Artemisia L., generalization of available data and providing information for future research is relevant. Text. The article presents a review of experimental data on the study of anticancer activity of representatives of the genus Artemisia L. It is noted that the main mechanism of such activity is apoptosis. Apoptosis is triggered by the increase of reactive oxygen species (ROS) inside cancer cells, reduction of mitochondrial membrane potential, activation of pro-apoptotic and, on the contrary, inhibition of anti-apoptotic proteins, as well as by formation of membrane bubbles, cell compression and by activation caspase. Conclusion. In the presented review, about 30 species of the genus Artemisia L. With the presented degree of study of this area, a number of questions remain unresolved. The most studied with respect to cytotoxic activity are Artemisia absinthium L. and Artemisia vulgaris L. In this aspect, the study of other closely related species of the genus Artemisia L. Also relevant is the study of cytotoxicity of representatives of the genus Artemisia L. on normal cell cultures and in comparison with positive control. In addition, a detailed study of the pool of secondary metabolites of different species of the genus Artemisia L. remains significant in order to reliably determine the components responsible for the manifestation of anticancer action. The pronounced effectiveness against cancer cells and, at the same time, a weak effect on healthy cells of the body of representatives of the genus Artemisia L. opens up the prospect of their use as sources of partner drugs with a synergistic effect and means of augmentation of antitumor therapy.

Experts of The Union of Pediatricians of Russia have developed current clinical guidelines for management of children with community-acquired pneumonia, which were approved by the Scientific and Practice Council of Ministry of Public Health of the Russian Federation in January 2022. Particular attention is paid to the etiological structure, modern classification, diagnostic tests and flagship approaches to antibacterial therapy of community-acquired pneumonia in children based on the principles of evidentiary medicine.

We evaluated the impact of prototype agents effective against plankton and sessile cultures of 65 microorganism clinical strains with bacterioscopic and bacteriological research methods. It has been established that the developed prototypes of thin-film coatings containing the physical mixture of bound Ca 10 (PO 4 ) 6 (OH) 2 +CuO; С 6 H 9 NO 5 wt%+СuO with CuO concentration of 9-10 wt% at an exposure time of 60 and 120 minutes have the greatest antimicrobial effect on plankton cultures. CuO concentration of 9-10 wt% within the physical mixture of bound Ca 10 (PO 4 ) 6 (OH) 2 +CuO; С 6 H 9 NO 5 wt%+СuO causes a decrease in the mass of biofilms preformed by microorganism clinical strains at an exposure time of 24 hours, thereby exerting an antimicrobial effect on them.

Flavonoid-containing Gratiola officinalis extract has been studied in relation to breast carcinoma and human cervical cancer cells in encapsulated and native form. Encapsulation was realized in polymer shells, which were formed by the layer-by-layer method using sequential adsorption of poly(allylamine hydrochloride) and poly(sodium 4-styrenesulfonate) on the destructible cores. The extract was prepared by the author’s method and characterized using high performance liquid chromatography. By means of optical and fluorescent microscopy, cell changes under the action of pure and encapsulated extracts were comprehensively studied, and statistical analysis was carried out. Cells were stained with propidium iodide, acridine orange, and Hoechst 33258. A fluorescence microscope with a digital video camera were used for cell imaging. The encapsulated extract caused 100% death of breast cancer SKBR-3 cells and 34% death of cervical cancer HeLa cells and prevented the formation of autophagosomes in both cultures. Analysis of the viability and morphological features of tumor cells under the action of microencapsulated extract allows us to consider microencapsulation as an effective strategy for delivering Gratiola officinalis extract to tumor cells and a promising way to overcome the protective autophagy.

Introduction: Headache disorders have been linked with enhanced atherosclerosis, cortical spreading depression, endovascular dysfunction, vasoconstriction, neurogenic inflammation, hypercoagulability, and cervical artery dissection. We aimed to evaluate the risk of cardiovascular and cerebrovascular disorders amongst patients with status migrainosus and migraine with aura. Methods: We planned a cross-sectional observational study from nationwide inpatient data from 2016-2018. Patients with status migrainosus with intractable migraine, migraine with aura, migraine without aura (simple migraine) were identified and compared with population without no migraine (control) using ICD-10-CM codes. Chi-square test) and mix-effect multivariate survey logistic regression analysis adjusted for vascular events were performed to identify prevalence and risk of association between cerebrovascular and cardiovascular disorders and migraine. Results: We identified 1184130 migraineurs out of which 60140 had status migrainosus with intractable migraine, 45285 had migraine with aura, and 16860 had migraine without aura. Prevalence of identified acute ischemic stroke (AIS) (5.5% vs no-migraine: 1.71%), transient ischemic attack (TIA) (3.99% vs 0.38%), subarachnoid hemorrhage (SAH) (0.13% vs 0.08%), angina (0.07% vs 0.06%) was higher in patients with migraine with aura compared to non-migraineurs. (p<0.0001) In regression analysis, migraine with aura was associated with higher odds of AIS (aOR: 3.7, 95%CI 3.4-4.1) and TIA (11.8, 10.5-13.2). In risk adjusted effect modification analysis, patients with AIS (1.5, 1.2-1.9) and TIA (3.0, 2.1-4.3) had higher odds of severe and extreme disability (APR DRG Severity) in patients with migraine with aura compared to patients with intractable migraine. Conclusion: We found that the patients with migraine with aura had higher risk of stroke than patients with intractable or simple migraine. More prospective studies should be planned to evaluate the effect of long-term management of migraine with aura to mitigate the burden of cerebrovascular events and associated disability. Further studies should be directed towards identifying the relationship between migraine and cardiovascular disorders.

The article presents an original method for the automatic assessment of the quality of event-related potentials (ERPs), based on the calculation of the coefficient ε, which describes the compliance of recorded ERPs with some statistically significant parameters. This method was used to analyze the neuropsychological EEG monitoring of patients suffering from migraines. The frequency of migraine attacks was correlated with the spatial distribution of the coefficients ε, calculated for EEG channels. More than 15 migraine attacks per month was accompanied by an increase in calculated values in the occipital region. Patients with infrequent migraines exhibited maximum quality in the frontal areas. The automatic analysis of spatial maps of the coefficient ε demonstrated a statistically significant difference between the two analyzed groups with different means of migraine attack numbers per month.

Aim . To study the cytokine profile of the gingival crevicular fluid (GCF) in children with a juvenile rheumatoid arthritis (JRA). Materials and methods . We examined 20 children with JRA and 10 patients without somatic pathology aged 6 to 16 years old. The condition of periodontal tissues was assessed by periodontal indices – gingival index GI (Loe, Silness, 1963) and gingival bleeding index GBI. Biomaterial sampling from the gingival sulcus was carried out using special endodontic absorbent paper points. Enzyme immunoassay for IL-18, IL-10, IL-1ß, IL-1RA, MCP-1, VEGFs in the GCF was performed using the test kits of Vector-Best LLC (Novosibirsk, Russia). Results . Mean GI index in the JRA group was 0.31 ± 0.10 and in the control group – 0.20 ± 0.05 (p < 0.05), mean GBI index – 19.90 ± 3.14 and 10.80 ± 2.60 respectively (p < 0.05), which was accompanied by a more pronounced degree of inflammation of periodontal tissues. The GCF concentration of IL-18 in the JRA group was 6.70 (4.97–7.92) pg/ml, in the control group – 11.25 (8.70–13.10) pg/ml (p < 0.05), while the concentration of IL-1ß was 15.30 (13.79–17.18) pg/ml in the JRA group and 5.36 (5.32–5.54) pg/ml in the control group. The IL-10 concentration in the JRA group was 3.60 (2.89–4.45) pg/ml, which was comparable to the values of the control group. The concentration of IL-1RA was lower in the JRA group than in the control group: 3638.5 (2397.5–4133.5) pg/ml and 4951.0 (4303.0–5455.0) pg/ml respectively. The total GCF chemokine concentration for MCP-1 was determined at the level of 15.65 (14.15–17.39) pg/ml and 15.50 (12.80–21.20) pg/ml for the main and control groups and for VEGF – 49.60 (41.95–54.50) pg/ml in the JRA group and 12.00 (11.00–13.00) pg/ml in control group. Conclusion . In children with juvenile rheumatoid arthritis, an imbalance of pro- and anti-inflammatory cytokines in GCF plays a role in the development of gingivitis: an increased of IL-1ß concentration – a triggering factor of pro-inflammatory chains, a decreased concentration of IL-1RA – an anti-inflammatory cytokine, an increased concentration of VEGF – a marker of hypoxia.

Investigations into the causes of adverse outcomes of the novel coronavirus infection (COVID-19) have been ongoing since the beginning of the pandemic. There is evidence that coronavirus-induced cardiovascular injury is as important to a risk of adverse outcome as respiratory injury. Many studies have shown that concomitant cardiovascular disease aggravates the course of COVID-19. However, in some patients who did not have cardiovascular diseases before COVID-19, they are detected during hospitalization or after discharge from the hospital. The review examines data on the effect of serum biomarkers of cardiovascular disease determined during COVID-19 on the risk of adverse outcomes in the near and long-term follow-up periods. Among such biomarkers are considered: troponins, N-terminal pro B-type natriuretic peptide, creatine phosphokinase-MB, lactate dehydrogenase, myoglobin, growth stimulation expressed gene 2, pentraxin 3, angiotensin II, as well as D-dimer and homocysteine. Threshold values have been set for some of these biomarkers, which allow predicting the risk of an unfavorable outcome. At the same time, in most prognostic models, these markers are considered in association with cytokine storm indicators and other risk factors.

Background: There is enough evidence of the negative impact of excess weight on the formation and progression of res piratory pathology. Given the continuing SARS-CoV-2 pandemic, it is relevant to determine the relationship between body mass index (BMI) and the clinical features of the novel coronavirus infection (NCI). Aim: To study the effect of BMI on the course of the acute SARS-COV-2 infection and the post-covid period. Materials and methods: AKTIV and AKTIV 2 are multicenter non-interventional real-world registers. The АКТИВ registry (n=6396) includes non-overlapping outpatient and inpatient arms with 6 visits in each. The АКТИВ 2 registry (n=2968) collected the data of hospitalized patients and included 3 visits. All subjects were divided into 3 groups: not overweight (n=2139), overweight (n=2931) and obese (n=2666). Results: A higher BMI was significantly associated with a more severe course of the infection in the form of acute kidney injury (p=0.018), cytokine storm (p<0.001), serum C-reactive protein over 100 mg/l (p<0.001), and the need for targeted therapy (p<0.001) in the hospitalized patients. Obesity increased the odds of myocarditis by 1,84 times (95% confidence interval [CI]: 1,13-3,00) and the need for anticytokine therapy by 1,7 times (95% CI: 1,30-2,30).The patients with the 1st and 2nd degree obesity, undergoing the inpatient treatment, tended to have a higher probability of a mortality rate. While in case of morbid obesity patients this tendency is the most significant (odds ratio - 1,78; 95% CI: 1,13-2,70). At the same time, the patients whose chronical diseases first appeared after the convalescence period, and those who had certain complaints missing before SARS-CoV-2 infection, more often had BMI of more than 30 kg/m2 (p<0,001).Additionally, the odds of death increased by 2,23 times (95% CI: 1,05-4,72) within 3 months after recovery in obese people over the age of 60 yearsCONCLUSION. Overweight and/or obesity is a significant risk factor for severe course of the new coronavirus infection and the associated cardiovascular and kidney damage Overweight people and patients with the 1st and 2nd degree obesity tend to have a high risk of death of SARS-CoV-2 infection in both acute and post-covid periods. On top of that, in case of morbid obesity patients this tendency is statistically significant. Normalization of body weight is a strategic objective of modern medicine and can contribute to prevention of respiratory conditions, severe course and complications of the new coronavirus infection.

Objectives. The study aimed to investigate the biological activity of the C 60 /poly-N-vinylpyrrolidone (C 60 /PVP) complex representing a water-soluble fullerene derivative. In vitro and in vivo techniques were used to analyze the effect of the C 60 /PVP complex on the activity of lactate dehydrogenase (LDH) and evaluate changes in the biochemical parameters of blood serum when per os administered to mice. Methods . In order to determine the activity of a commercial LDH preparation and study the kinetics of this process, the standard Warburg photometric method was used. To assess the effect of polyvinylpyrrolidone (PVP) and the C 60 /PVP complex on some biochemical parameters in vivo, a study was conducted on two-month-old male white mongrel mice weighing 20 ± 3 g. Determination of biochemical parameters of blood serum was carried out using a semi-automatic biochemical analyzer according to standard methods. Results. The effect of the C 60 /PVP complex on LDH activity was studied along with changes in the biochemical parameters of mouse blood serum characterizing carbohydrate metabolism. As well as increasing the glucose and pyruvic acid content, the C 60 /PVP complex was found to reduce lactate content and LDH activity in blood serum along with in vitro LDH activity according to the type of mixed inhibition. Conclusions. The C 60 /PVP complex and PVP were shown to exhibit biological activity in vitro and in vivo. The C 60 /PVP complex, representing a mixed-type LDH inhibitor, was shown to inhibit LDH activity, as well as contributing to a decrease in lactate concentration and an increase in the concentration of pyruvic acid and glucose in blood serum when administered per os to mice. The inhibitory effect of PVP on LDH activity was revealed in both in vivo and in vitro investigations. In vivo, PVP contributes to a decrease in the concentration of lactate in the blood. The less pronounced effect of the C 60 /PVP complex as compared to PVP alone may be due to the fact that C 60 molecules are “hidden” in cavities formed in PVP molecules.

The presented clinical case demonstrates the appearance of vivid clinical manifestations of Crohn’s disease after a COVID-19 infection. It was not possible to diagnose the disease in the early stages due to the lack of typical symptoms and the necessary examination. A new coronavirus infection acted as a trigger factor for the progression of Crohn’s disease. The diagnosis was confirmed during instrumental and laboratory studies, adequate therapy was prescribed, which led to a rapid relief of the attack of the disease.