Predictors of a severe course and mortality in patients with COVID-19-associated pneumonia.

INTRODUCTION: Severe and critical forms of SARS-CoV-2 pneumonia are associated with high morbidity and mortality. Numerous research studies have been conducted around the world to investigate various variables (demographic, clinical, laboratory, etc.) in an attempt to understand the relationships between them and the course and outcome of patients with COVID-19 infection and pneumonia.

The COVID-19 pandemic's impact on rheumatic disease patients' satisfaction with access to medical services.

The COVID-19 hurt various lifestyle aspects, especially the treatment and follow-up of patients with chronic diseases such as autoimmune inflammatory rheumatic diseases (RD). The new circumstances changed the frequency of medical examinations and the way patients with rheumatic diseases are followed up. The objective is to study the impact of COVID-19 on RD patients' satisfaction with access to medical services. A national multicenter observational cross-sectional anonymous online survey was conducted on patients with RD using a specially developed web-based platform and structured questionnaire https://rheumatologycovid19.bg/ . The study was carried out with the support of intra-university project №6/2022 MU-Plovdiv. 1288 patients participated, with an average age of 47.03 (SD ± 12.80 years), of whom 992 (81.6%) were women. The questionnaire contained 41 questions grouped into 5 panels. Descriptive statistics were used-mean, alternative analysis, logistic regression and Decision Tree using the CRT (classification and regression trees) method. The study found that RD patients' satisfaction with access to medical services was influenced by communication type and the frequency of visits to the rheumatologist, difficulties in prescribing and finding medicines and the presence of comorbidities. The likelihood of patients' satisfaction with their rheumatologist was 5.5 and 3 times higher for in-person and other means of communication, respectively, compared to those without any communication. The relative share of patients who communicated by phone was larger (59%) compared to pre-pandemic (41%), where direct contact with the physician prevailed (80%). The results of the study confirmed the need to optimize remote access to medical care for patients with RD during the pandemic.

Anthropological Characteristic of the Distribution of Adipose Tissue in Bulgarian Females with Type 2 Diabetes Mellitus.

BACKGROUND: The complex study of adipose tissue in women with type 2 diabetes mellitus (T2DM) is of importance for the clinical course and prognosis of the disease. AIM: To study the distribution of adipose tissue in Bulgarian females with T2DM. PATIENTS AND METHODS: The study included 92 women with T2DM (age range 40-60 years). The control group consisted of 40 age-matched women. Measurement parameters: height, weight, 9 skinfolds (sf) - sfTriceps, sfBiceps brachii, sfForearm, sfSubscapular, sfXrib, sfAbdomen, sfSuprailiaca, sfThigh, and sfCalf; bioelectrical impedance analysis - % body fat tissue and visceral fat tissue. Calculated indexes: body mass index (BMI), the ratio sfTrunk to sfLimbs, the ratio skin folds upper half of body/skin folds lower half of body, fat mass and subcutaneous fat mass. RESULTS: Statistically significant differences were found in the means of sfTriceps, sfXrib, sfThigh, sfCalf, % body fat tissue, visceral fat tissue, and fat mass and subcutaneous fat mass between the diabetic and healthy women. The body composition of diabetic females aged 40-60 years contained a larger adipose component than controls. Visceral adipose tissue which determines the body composition is a reliable indicator of the health risks in diabetic women. CONCLUSION: The pattern of subcutaneous adipose tissue distribution in diabetic females aged 40-60 yrs was primarily in the upper torso region and less so in the limbs. In the controls adipose tissue is accumulated primarily in the limbs and in the lower part of the body.