Impact of cranioskeletal trauma on the development of endogenous intoxication syndrome in rats of different ages.

OBJECTIVE: Aim: The aim of the study was to determine the impact of cranioskeletal trauma (CST) on the development of endogenous intoxication syndrome in rats of different ages. PATIENTS AND METHODS: Materials and Methods: The experiments involved 147 white male Wistar rats of different age groups. The first experimental group included sexual immature rats aged 100-120 days. The second group includes sexually mature rats aged 6-8 months. The third group included old rats aged 19-23 months. In all experimental groups, CST was modelled under thiopentalonatrium anaesthesia. The control rats were only injected with thiopentalonatrium anaesthesia. The animals were withdrawn from the experiments under anaesthesia after 1, 3, 7, 14, 21 and 28 days by total bleeding from the heart. In blood serum, the content of fractions of molecules of middle mass was determined at a wavelength of 254 and 280 nm (MMM254, MMM280). RESULTS: Results: As a result application of CST in rats of different age groups, an increase in the serum content of MMM254 and MMM280 was observed with a maximum after 14 days and a subsequent decrease by 28 days. At all times of the experiment, the indicators were statistically significantly higher compared to the control groups. The degree of growth of the MMM254 fraction after 1, 7 and 14 days was statistically significantly higher in sexual immature rats, and after 21 and 28 days - in old rats. In old rats after 21 and 28 days of the post-traumatic period, the content and degree of growth of the MMM280 fraction in the blood serum were also significantly higher. CONCLUSION: Conclusions: Modelling of CST in rats of different age groups is accompanied by the development of endogenous intoxication syndrome, which is manifested by the accumulation of MMM254 and MMM280 fractions in the blood serum with a maximum after 14 days of the experiment. The content of the serum fraction of MMM254 in sexual immature rats in the dynamics of experimental CST exceeds other age groups after 1, 7 and 14 days, in old rats the content of the studied MMM fractions is significantly higher after 21-28 days.

VENOUS THROMBOEMBOLISM - PECULIARITIES OF COURSE IN EMERGENCY SURGERY DURING COVID-19 PANDEMIC.

OBJECTIVE: The aim: To perform a comparative analysis of VTE in patients with acute surgical abdominal pathology before and during the COVID-19 pandemic. PATIENTS AND METHODS: Materials and methods: Retrospective study covered 53062 patients operated in the surgical clinic (Lviv city emergency hospital) in 2000-2019. Prospective analysis was based on the results of treatment of 546 patients operated at the same surgical clinic from April 2020 (1st surgical patient with COVID-19) till December 2021. The study analyzed 48 (8.8%) patients operated for acute abdominal pathology and confirmed diagnosis of COVID-19. RESULTS: Results: In the 1st group, heparin prophylaxis was used in 42.3% of patients, of which non-fractionated heparin were used in 58.6% and low molecular weight heparin - in the remaining patients. From 2020 to 2021, pharmacoprophylaxis was used in 84.5% of cases, of which 67.2% - low molecular weight heparins, 20.1% - non-fractionated heparins and 12.7% - modern oral anticoagulants. The results were unexpected: with a significant increase in the ve¬nous thromboembolism prevention in the 2nd group, a decrease in the number of episodes of thromboembolic complications was not observed. In contrast, pulmonary artery embolism was recorded in 10.6% of patients in the 1st group and 23.5% - in 2nd group, which is a 2.2-fold increase in fatal cases of venous thrombosis (p<0.05) in patients with COVID-19. CONCLUSION: Conclusions: Increase of mortality due to pulmonary artery embolism more than twicefold in patients with COVID-19 operated for acute surgical abdominal pathology is an objective evidence of a potentiated, uncontrolled risk of venous thromboembolism and requires further in-depth study.

INFORMATION AND COMMUNICATION TECHNOLOGIES IN PUBLIC MANAGEMENT OF THE HEALTHCARE INSTITUTIONS NETWORK DURING COVID-19 PANDEMICS.

OBJECTIVE: The aim was to study the structure, routes and algorithms of telemedical network in Odessa region and its impact on the spread of COVID-19 pandemics. PATIENTS AND METHODS: Materials and methods: We have analysed the data of the official reporting documentation provided by the Department of Healthcare of Odessa region. So the description of legislative acts and structure of telmedical network of Odessa region is given. In more detail, we described functions and capabilities of telmedical network COVID-19 pandemics. CONCLUSION: Conclusions: Studies have shown that Telemedicine can be used in 5 main directions: Triage and decisions regarding hospitalization to hospitals designed for COVID-19 patients or to other hospitals. Outpatient consulting in COVID-19 patients who stay at home. Coordination of activities of different hospitals; provision of specialized consulting. Training of healthcare providers for counter-epidemic measures and management of COVID-19 patients. Routine consulting in patients with chronic disease and in palliative cases. In all this activities significant benefits were founded. But amount of telemedical consultations are quiet low. As in all viral pandemies remote consultations of patients leeds to lowering in amount of infection of COVID-19 patients.

Long-term consequences of primary percutaneous coronary intervention in patients with st-elevation myocardial infarction.

OBJECTIVE: The aim: To investigate long-term effects of primary percutaneous coronary interventions (pPCI) in patients with STEMI basing on the prevalence of clinically relevant endpoints. PATIENTS AND METHODS: Materials and methods: Totally 200 patients with STEMI hospitalized within a period of "therapeutic window" for revascularization were included into the study. 100 patients who additionally to pPCI underwent manual thromboaspiration entered the main group. The comparison group consisted of 100 patients who underwent standard pPCI. RESULTS: Results: Six months after the pPCI, the incidence of either major adverse cardiac events and the combined endpoint did not differ in the main and comparative groups (11.8% vs. 12.5%, p = 0.888 and 18.2% vs. 20.8%, p = 0.658, respectively). There were no significant differences in these endpoints taken separately. In twelve months after procedure, also there were no significant differences between the groups. However, a tendency toward lower incidence of chest pain was observed in the main group (p = 0.08) during this period that was lost in 24 months after pPCI. None of these techniques demonstrated significant advantages during the whole duration of the follow-up period. CONCLUSION: Conclusions: The addition of manual thromboaspiration to the standard pPCI in patients with STEMI and severe thrombosis of the culprit artery did not significantly influence the prognosis.

[The epidemiology of sudden cardiac arrest in prehospital care in the area of the silesian voivodeship].

OBJECTIVE: Introduction: Sudden cardiac arrest (SCA) is a serious medical and social issue. The incidence of SCA varies depending on the location and the circumstances. The aim: A retrospective analysis of non-hospital SCA cases from an epidemiological perspective. The research involved the population monitored by the Voivodeship Rescue Service (VRS) in Katowice. PATIENTS AND METHODS: Material and methods The analysis covered dispatch order forms and emergency medical procedure forms of the VRS in Katowice in 2016 (n = 249 872). The retrospective analysis involved cases of non-hospital SCA in adults (n = 1603). Quantitative parameters have been presented as average values with standard deviation. Non-metric variables have been described by means of structure indicators. A comparative analysis was conducted by means of the Student's T-test for the quantitative variables and the Pearson's chisquared test for the non-metric variables. The statistical significance adopted for the purpose of all analyses was 0.05. RESULTS: Results: There were 1005 men (62.7%), 566 women (35.3%) and 32 cases (2.0%) where gender identification was not reported. Female individuals were generally older than male individuals (p = 0.000). Patients' average age was 65.7 years. The SCA attack rate was 59.37/100 000. SCA cases were usually reported in domestic conditions (71.1%, p = 0.000). In a majority of cases, the incident was witnessed by a third person (about 70.0% of cases, p= 0.000). Most of the SCA cases were reported in the first quarter of the year whereas the lowest number of cases was noticed in the third quarter (28.4 % vs 22.5 %). SCA was most frequent during the day. Restoration of spontaneous circulation was reported in 33.4% of the cases. CONCLUSION: Conclusions: The incidence of SCA is occasional in the context of all analyzed emergency cases in the period under research. However, SCA cases are related with a high risk of failure. Acting according to the currently available knowledge will probably cause an increase of the restoration of spontaneous circulation (ROSC) rate.