Vol 32, No 5 (2021)

The paper deals with the study and generalization of literature data on the clinical manifestations of a novel coronavirus infection. SARS-CoV-2 has been identified in most countries, but scientists do not know much about it. Physicians constantly face the patients who present difficulties in diagnosis and therapy. The spread of COVID-19 has raised questions for physicians about the definition of the aspects, diagnosis, and management tactics for patients with this disease. SARS-CoV-2 extends rapidly through the body, affecting the respiratory system with the development of pneumonia, acute respiratory failure. The pathogenesis of COVID-19 is mediated by angiotensin converting enzyme-2 receptors. Settling in the body, the virus affects various human organs and systems. The patients can experience a wide range of symptoms, including headaches, muscle aches, fatigue, diarrhea, mental confusion, arrhythmias, seizures, loss of appetite, dyspnea, and many other conditions. However, the disease is asymptomatic or has mild symptoms (mild malaise and low-grade fever) in many infected people. SARS-CoV-2 begins to destroy the body from the upper respiratory tract, attacks the lower respiratory tract, subsequently affecting the heart and blood vessels, gastrointestinal tract, kidneys, skin, central and peripheral nervous systems. Damage to the internal organs can be so serious that it can lead to death. Currently, information about the epidemiology, clinical features, prevention and treatment of this disease is formed by specialists from different countries, but much remains unexplored. Most experts believe that we have seen only the «tip of the iceberg». This means that the world has faced the poorly understood, dangerous disease that changes its forms and manifestations.

The article discusses the problem of dyslidemias as a risk factor for noncommunicable diseases (NCDS) from the perspective of medical prevention and defines them. The role of cholesterol in the functioning of the body and its metabolism is described. Screening groups for hypercholesterolemia are listed, and risk factors for dyslipidemia are noted. A brief description of the main tools used for the treatment of this pathology is given, with emphasis on the use of targeted functional foods. In conclusion, recommendations are given for communication with patients with dyslipidemia.

The paper deals with the responsibility of an anesthesiologist/resuscitator, as an attending physician, for the diagnosis of conditions and diseases requiring anesthetic and resuscitation care. The paper presents proposals to differentiate the powers of an anesthesiologist/ resuscitator and related specialists, which will be able not only to clearly delineate the area of responsibility, but also to improve the quality of medical diagnosis by a professional and individual approach to the patient who is in critical condition.

The incidence of cancer of the uterine body in recent years is in the first place in the structure of genital cancers. Endometrial polyps (PE) are an actual gynecological problem from the point of view of cancer risk, increased in the postmenopausal period. The aim of the study was to conduct a quantitative analysis of the clinical features of the course of PE in postmenopausal patients. Material and methods. A retrospective cohort study was performed on the basis of the gynecological department of the CHUZ «CB «Russian Railways-Medicine» Omsk». The research cohort consisted of 133 postmenopausal women with PE (mean age-59.23±6.34 years) who underwent hysteroscopic polypectomy. Results. The duration of postmenopause was 9.47±6.66 years. PE was dominant in late postmenopausal women (68.4%). Postmenopausal PE patients had asymptomatic course (69.2%), uterine bleeding (30.8%), recurrent PE (15.8%), concomitant tamoxifen treatment (3.8%). According to the hysteroscopy data, single PE (75.2%) with an average size of 15.7±9.4 mm prevailed. The predominance of glandular-fibrous PE (61.7%) is characteristic of glandular PE (36.8%) and adenomatous PE (1.5%). Signs of malignancy of adenomatous PE and cancer in the surrounding endometrium were found in the symptomatic (n=41) and asymptomatic course of the disease (n=92) (p>0.05). Conclusion. In postmenopausal patients with asymptomatic PE and PE associated with postmenopausal bleeding, the disease occurs against the background of precancerous and endometrial cancer (in the polyp or surrounding endometrium) in 3.76% of cases, which requires histological verification when detecting proliferative endometrial processes in postmenopausal ultrasound, regardless of the size of the polyp and the absence of clinical manifestations.

Objective: To evaluate the effect of sensitization to Aspergillus spp. the severity and level of control of asthma. Materials and methods: 275 patients with allergic asthma were examined. The levels of total IgE and specific IgE to aeroallergens were determined in the blood serum by the enzyme immunoassay method. Anamnesis, objective examination, and spirometry data were analyzed to assess the reversibility of the obstruction. The Russian-language version of the questionnaire was used: the Asthma Control Test (Asthma Control Test) The data obtained were processed using the Statistica 10 software system. Results: In patients with asthma with sensitization to Aspergillus spp. the course of the disease was uncontrolled, there were low indicators of external respiratory function, a greater number of exacerbations, a higher need for drugs for basic therapy than in the group of patients with asthma without sensitization to Aspergillus spp. (p<0.05), which suggests a more severe course of the disease. The most significant factors that negatively affect the achievement of a controlled course of asthma are: sensitization to Aspergillus spp., fixed airway obstruction, and living in rooms affected by mold fungi. Conclusion: Sensitisation to Aspergillus spp. associated with severe, uncontrolled asthma.

Distal occlusion, especially concurrent with dentition defects, can cause structural and functional changes in the temporomandibular joint (TMJ). The success of treatment for distä occlusion Is determined by the choice of a child’s age for the correction of a dentoalveolar anomaly, by selecting correctly an orthodontic appliance and cooperating well with a patient. Objective. To determine the probability of developing TMJ dysfunction In the retention period after the end of orthodontic treatment In patients with distal occlusion. Subjects and methods. The Investigation enrolled 185 patients of both sexes with distal occlusion, who were divided by age according to the stages of dentition development. After the end of active orthodontic treatment, a follow-up was continued In the retention period, the patients were examined once a year for three years to determine the risk of TMJ dysfunction. Results. Mter early orthodontic treatment In patients with distä occluäon, TMJ structural disorders were detected only In the 15-18year age group. These disorders were Identified In the third year of the retention period; these were Insignificant and had no cllnlcä manifestations. Conclusion. Early orthodontic treatment contributes to the normalization of the relative position of dentitions and to the achievement of physiological occlusion. Further dentoalveolar system development In the patients did not differ from the norm at the later stages of growth.

The paper provides information about the use of electrochemically activated anolyte for disinfection in healthcare facilities. It presents the data of studies that have shown that the agent has a high antimicrobial activity against a broad spectrum of pathogenic microorganisms. The complex of equipment produced by the «Delfin Aqua» for the preparation of the agent Anolyte ANC Super can be recommended for use in the healthcare facilities, which will be able to produce a ready-to-use disinfectant in the required amounts. This agent has a minimum toxicity class and is environmentally friendly, as the product of its natural degradation is fresh water.

Objective: to compare different options for the development of knee joint movements after arthroplasty. Subjects and methods. The investigation involved 130 patients who had undergone knee arthroplasty. According to the postsurgery rehabilitation program, the patients were divided into 4 groups: 1) 25 patients who underwent the core of the rehabilitation program from the first day and active and passive knee flexion exercises from day 3; 2) 25 patients who did knee flexion exercises from day 3 and also received passive movement therapy; 3) 40 patients, in whom movement development was started immediately after surgery; 4) 40 patients, in whom movement development was initiated as soon as possible postsurgery and passive movement therapy was also used. Results. The amount of drainage discharge and the pain visual analogue scale (VAS) scores were higher in Group 4 patients at 1 and 5 days. There was a statistically significant difference in the Knee Society Clinical Rating System (KSS) scores between Groups 1 and 2, Groups 2 and 3, and Groups 2 and 4 at 6 months postsurgery, while that in the WOMAC scores between Groups 1 and 2 at 12 months after arthroplasty. However, no statistically significant difference was found in the KSS scores in the groups at 12 months after arthroplasty. Conclusion. When keeping the adequate balance of the ligamentous apparatus during knee arthroplasty, it is advisable to implement a standard early rehabilitation program without using the hardware techniques. The use of passive movement therapy significantly increases the amount of drainage discharge and worsens pain syndrome.