Post-Covid Conditions and their Effects on the Cardiovascular System.

Background: Rising global concerns about COVID-19 recently gained more research attention due to the ease of person-to-person transmission, various symptoms after healing, and the shortage of effective antiviral therapy. The study aims to analyze post-COVID conditions and clinical manifestations of cardiovascular lesions in patients recovering from COVID-19 infection. Methods: A practical examination of post-COVID conditions manifestation was conducted in a prospective cohort study, involving 250 patients diagnosed with COVID-19 between June 1, 2021, and August 31, 2021. The study specifically focused on analyzing the cardiovascular effects of COVID-19, utilizing data from a subgroup of 200 patients previously discharged from the hospital with elevated troponin levels. The cardiovascular variables assessed included tachycardia, ischemia, heart attack, myocarditis, hypertension, blood clots, and heart failure. Results: It has been observed that among surviving patients, the following symptoms persisted: anosmia/ageusia (59%), severe dyspnea (36.7%), palpitations and complaints related to the cardiovascular sys-tem (15.8%), headaches (13.2%), arthralgia (11.7%), myalgia (9.8%), and hair problems (≥5%). By the 60th day, a reduction in symptoms by 5-10% was noted, and by the 90th day, a decrease in activity by 25-35% was observed. Patients aged 40-60 years exhibited the highest percentage of cardiovascular diseases (75%). Conclusions: Consequently, the SARS-CoV-2 virus underscores the critical importance of cardiological attention in patient care. Cardiac screening results in individuals with COVID-19 reveal a significant prevalence of serious heart problems, affecting over half of the patients. This emphasizes the necessity for heightened vigilance and specialized cardiac care when managing patients with COVID-19.

[Personalized approach in the diagnostics and treatment of symptomatic epilepsy with déjà vu seizures].

The phenomenon of déjà vu (DV) is of interest, occurring in 97% of healthy individuals, while DV can be a manifestation of a number of pathologies, such as Charles Bonnet syndrome, depression, schizophrenia, or temporal lobe epilepsy. Most cases of DV type epiphenomena are associated with hippocampal sclerosis, while up to 90% of patients with mesial temporal sclerosis are drug resistant. Despite the success of pharmacotherapy, the frequency of «uncontrolled¼ epilepsy in industrialized countries that adhere to modern standards of treatment is from 30 to 40%, and this percentage is higher among patients with symptomatic and cryptogenic forms than among patients with idiopathic epilepsy (respectively: 40% and 26%). In turn, when studying the DV phenomenon and choosing a therapy strategy, it is necessary to establish its origin, determine its clinical significance (whether it is initially pathological or not), and the need for treatment. During the analysis of exome data, a search was made for substitutions in genes associated with arteriovenous malformations, both with autosomal dominant and autosomal recessive types of inheritance. The genes KRIT1, RASA1, IL6, FAM58A, GLML, EPHB4, CCM2, and ELMO2 were analyzed especially carefully. The analysis of genetic data is of great importance in the aspect of preventing cerebrovascular accidents, at the same time, in order to obtain reliable and significant results, in addition to time and financial costs, examination of relatives is also required. Meanwhile, this fact does not mean that every patient needs to conduct a genetic study. The paper presents detailed instructions for supplementing anamnestic information, as well as the results of personalized instrumental and laboratory diagnostics, which made it possible to carry out timely correction of therapy and achieve a prolonged positive effect.

The Effects of Whole Body Gamma Irradiation on Mice, Age-Related Behavioral, and Pathophysiological Changes.

We designed a study with the objective to determine the long-term radiation effects of gamma rays, originating from a single shot of Co60 at a dose of 2 Gy on the 7-month-old male mice of the ICR line in 30 days after the irradiation. The aim of this study was to characterize the behavior of animals using the Open Field test, immuno-hematological status, and morpho-functional changes in the central nervous system of mice. Irradiated animals displayed significantly different behavior in the OF in comparison with the control group. The radiation damage was confirmed by assessing the ratio of leukocytes in the peripheral blood of mice at a later date after exposure to Co60. After irradiation, a decrease in the glioneuronal complex was observed in the irritated group as well as histological changes of brain cells. To sum up, not only was the hematological status of mice altered upon the total gamma irradiation, but also their behavior, which was most probably due to significant alterations in the CNS. Study of influence of ionizing radiation on female mice, comparison between different age groups. Open Field test on the 30 days after 2 Gy of γ-rays and histological analysis indicated changes in behavioral patterns, leucocytes, and brain tissue.

Comparative Analysis of Behavioral Reactions and Morphological Changes in the Rat Brain After Exposure to Ionizing Radiation with Different Physical Characteristics.

The aim of this research was to study behavioral reactions and morphological changes in the brain of adult female Sprague Dawley rats after exposure to 170 MeV and 70 MeV protons and gamma radiation (60Co) at a dose of 1 Gy. The analysis of the behavioral reactions in the T-maze showed that exposure to ionizing radiation with different LETs led to an increase in number of repeated entries into the arms of the maze in the spontaneous alternation test. In the Open Field test a decrease in overall motor activity in the group of irradiated animals (70 MeV protons at the Bragg peak) was observed. A decrease in the number of standing positions was seen in all groups of irradiated animals. Morphological analysis showed the development of early amyloidosis, autolysis of the ependymal layer, an increase in the number of neurodegenerative changes in various structures of the brain, and the development of neuronal hypertrophy on the 30th day after irradiation in the cerebellum and hippocampal hilus. Exposure to protons at a dose of 1 Gy leads to the development of structural and functional disorders of the central nervous system of animals on the 30th day after irradiation. These data indicate a damage of short-term memory, a decrease in motor activity and exploratory behavior of animals. With an increase in LET, there is an increase in the number of amyloid plaques in the forebrain of rats, autolysis of the ependymal layer of the ventricles, and the development of dystrophic changes. Investigations of behavioral reactions and morphological changes in various parts of the brain of adult rats on the 30th day after influence of ionizing radiation with different physical characteristics at a dose of 1 Gy. Various negative patho-morphological and cognitive-behavioral changes observed.

[Sleep disorders in nurses working during the COVID-19 pandemic]. / Rasstroistva sna u meditsinskikh sester, rabotayushchikh v period pandemii COVID-19.

The reorganization of treatment facilities during the COVID-19 pandemic has altered the working conditions of large numbers of the health workers (HW) worldwide. The implementation of professional activities in such realities has led to an increased risk of developing a number of psychological disorders, including insomnia. The percentage of insomnia in HW has increased significantly. The nurses were the most vulnerable, because they are women and they work in an understaffed environment. The influence of shift work and stress conditions on the risk of insomnia, methods of prevention and treatment of this disorder are thoroughly examined in the article.

[COUNTERACTION TO CORRUPTION DURING PUBLIC PROCUREMENT OF MEDICINAL PRODUCTS].

The purpose of the article is to carry out a comparative analysis of common manifestations of corruption and corruption risks during public procurement of medicinal products in Ukraine and foreign countries in order to find effective ways to counteract to such cases. The materials of the research were the provisions of foreign legislation, national regulatory legal acts in the health care sector. Theoretical basis of the article is research focused on various aspects of combating corruption in the field of medicine, ways to prevent and minimize cases of corruption manifestations, improvement of anti-corruption measures during public procurement of medicinal products. The authors of the article have used comparative, comparative and legal, historical and legal, formal and legal methods, methods of formal logic, method of system analysis. It has been concluded that the problem of corruption is not new for public procurement area. However, corruption risks increase significantly during emergency situations. Public procurement of medicinal products is an extremely important and at the same time rather prone procedure to such risks. Threats of corruption manifestations during public procurement of medicinal products affect not only the country's economy, but also the indicators of the public health of the population, its working ability and vital function in the whole. The importance of the studied issue determines the need to strike a balance between the promptness of conducting the procurement of medicinal products, the preservation of anti-corruption measures and the effectiveness of response to emerging threats. Wide coverage of procedures of public procurement of medicinal products with the usage of electronic trading systems together with the demonstrativeness and accountability of such activities, can act as appropriate tools to prevent corruption manifestations. Taking into account the possible manifestations of corruption at each stage of public procurement is an important matter. It allows us to focus on counteraction measures and the proper response of the state to illegal actions.

The effect of piracetam on behavioral reactions of adult rats and morphological changes in the brain after whole body fractionated gamma irradiation: an exploratory study.

This research was aimed at examining the effect of piracetam on behavioral reactions and morphological changes in the brain of adult rats after fractionated gamma irradiation with a total dose of 5 Gy. Fractionated gamma irradiation led to a decrease in freezing behavior in the Open Field and leukopenia. These behavioral and hematological disorders were accompanied by a cell decrease in the cross-sectional area of granular layer of the dentate gyrus, an increase in the number of Fluoro Jade B-positive cells, and an increase in the number of irreversible changes in the cerebral cortex. The administration of piracetam immediately after irradiation for 14 days maintained the freezing behavior at the level of intact animals and decreased in general motor activity. Also, an increase in morphometric parameters and a decrease of neurodegeneration were observed. We found a statistically significant decrease in the number of Fluoro Jade B-positive cells in comparison with the group of irradiated animals. The drug had no leukoprotective effect on laboratory animals, and led to the emergence of inconclusive trends in the alternation of the arms of the T-labyrinth. Piracetam application showed positive behavioral and morphological changes in rodents and might have a neuroprotective effect in brain tissue after gamma irradiation. Since it is the first experiment with piracetam we attempted, this exploratory study serves to provide more insight into the potential neuroprotection activity of piracetam, and following research is necessary.

[Method for the Molecular Cytogenetic Visualization of Fragile Site FRAXA].

Fragile X syndrome is one of the most common reasons for human hereditary mental retardation. It is associated with the expansion of CGG repeats in the 5'-untranslated region of the FMR1 gene, which results in the suppression of its expression and the development of the disease. At present, methods based on PCR and Southern blot analysis are used for diagnostics of the fragile X syndrome. The presence of a fragile site FRAXA on the X chromosome is typical for patients with this pathology. We developed a method of visualizing this site in cell cultures obtained from patients using the fluorescent in situ hybridization (FISH) and the combination of two probes. The method allows one to detect five types of signals on the X chromosome, three of which are normal, while two are associated with the emergence of fragile site FRAXA. An analysis of the distribution of all signal types in cell lines from healthy individuals and patients with fragile X syndrome demonstrated that the method allows one to determine differences between lines with a high statistical significance and that it is applicable to detecting cells that are carriers of the syndrome.

PO-56 - Subsequent clot properties depend on the storage time of platelet concentrates.

INTRODUCTION: Despite platelets properties varies during storage, transfused platelets are included in blood clot in the same way as well as native. We assume that after transfusion the prevalence of platelets with changed activity lead to worse quality of blood clot in vivo. AIM: The aim was the in vitro study of platelet-dependent clot properties that are formed from some stored platelet concentrates (PCs). MATERIALS AND METHODS: Twenty-six PCs in autologous plasma and 24 PCs in platelet additive solution SSP+ (MacoPharma, France) (70vol.%) were analized by thromboelastography with and without platelets activation, and by standard aggregometry. The testing were carried out at the day of proceeding, after 24 hours, and at 3rd and 5th days of storage. We used Trima Accel (Terumo BCT, USA) for the proceeding of platelets apheresis. RESULTS: We found that clot demonstrated gradual reduction of elasticity and deformability starting from second day to fifth day in stored PCs suspended in autologous plasma. From the third storage day platelets lost their meaning for clot properties. The platelets apheresis with next re-suspending in SSP+ solution leads to the depression for platelets aggregability. Actived platelets had no impact to clot properties during full storage time. Total decline of clot quality including low elasticity and impaired deformability were found starting from 3rd storage day compared to the day of proceeding. CONCLUSIONS: We assume that such properties of clot as both elasticity and deformability are forming in PCs at the day of proceeding. Further clot changes observed in PCs does not depend directly from platelets aggregability because clot forming are under other influences. The last are determined mainly by the coagulation what was no included in this study. Also obtained results confirms the 5th-days storage as a benefit independent from PCs proceeding method.

PO-59 - Hemorheologic disturbances as thrombosis risk factor in patients with some myeloproliferative neoplasms.

INTRODUCTION: In today's antithrombotic prevention we forget that hemorheologic abnormalities are part of Virchow's triad. Isn't this one of reasons that venous thromboembolism (VTE) including catheter-related thrombosis (CRT) retain high frequency despite of modern antithrombotic therapy? AIM: The aim was to investigate rheological behavior of blood in patients with some myeloproliferative neoplasms. MATERIALS AND METHODS: The study included 16 adults with Polycythemia Vera (PV), 42 young with acute lymphoblastic leukemia (ALL), and 67 healthy donors as control group. Of patients 38% had thrombosis. We measured plasma viscosity, and whole blood viscosity (WBV) by shear rate from 300 to 5 s-1. Then indices were calculated for erythrocyte aggregation, and deformability, and non-Newtonian behavior of blood. Hematocrit, erythrocytes count, erythrocyte indices, leukocyte count, fibrinogen and B-type natriuretic peptide (BNP) were analyzed simultaneously. RESULTS: Increased WBV revealed totally in PV-patients but not by all shear rates in ALL-patients. Unlike donor, in patients WBV values had no equivalence under sequential one sample measurements with a decrease and then an increase of shear rates. We speculated this difference becomes diagnostic meaning like one and by its size. WBV dependent on leukocytes count, on MCH and mainly on MCV. Forty percent of patients had elevated BNP assuming subclinical cardiac dysfunction. The latter explains discoordinated changes in shear stress values required for fully reversible erythrocyte aggregation. As a result, residual units like "erythrocyte-erythrocyte" and/or "erythrocyte-leukocyte" interferes blood stream and violates mechanically blood flow in small vessels. Moreover in PV-patients but not in ALL-patients we found loss of non-Newtonian behavior of blood later than in control group. Both myeloproliferative neoplasms lead to increased erythrocyte aggregation but not impair deformability of red blood cells. In total these facts explains chronic hypoxia in these patients. CONCLUSIONS: Patients with some myeloproliferative neoplasms has abnormal blood flow properties. Revealed hemorheologic disturbances could be as a trigger to start of VTE or to growth of blood clot in the area of permanent venous catheter. These non-hemocoagulation conditions leaded for thrombus formation makes hemorheologic therapy looking attractive for antithrombotic management. The choice of targeted methods requires to continue this study.

Level of overall hemostasis potential in donor and patient plasma in pathology.

Coagulation potential (CP), overall hemostasis potential (OHP) and fibrinolysis potential (FP) in plasma of donors and patients with myocardial infarction (MI), stroke (St) and hip joint diseases (HJD) have been investigated using M. Blomback's global hemostasis assay. Plasma samples of the patients were analyzed with APTT reagent in the presence or absence of t-PA. It was found that the ratio of values of СP, OHP and FP in plasma of patients to those of donors plasma were 78, 60 and 123% at MI; 157, 155 and 162% at St; 128, 131 and 124% at HJD. CP to FP ratio that indicated balance between coagulation and fibrinolytic systems activities were 4.13, 2.5, 4.0 and 4.26 in plasma of donors and MI, St and HJD patients, respectively. These results are evidence of increased fibrinolytic activity in plasma of MI patients. Lag-periods of plasma clotting of MI, St and HJD patients were prolonged by 2.3, 7.2 and 1.5-fold, respectively. Pearson's correlation analysis between parameters, obtained in vitro studies using global hemostasis assay, and concentrations of the molecular markers (soluble fibrin and D-dimer), which formed in vivo in plasma of MI, St and HJD patients, did not reveal any relationship between them.

[Age features of hemostatic system in people with insulin resistance and pre-diabetes carbohydrate metabolism disorders].

In pre-diabetes disorders in which pathogenesis the insulin resistance (IR) plays a leading role, the risk of thrombosis due to increased coagulation factors, decreased concentration of physiological anticoagulants and inhibition of fibrinolysis is increased. Similar changes in the hemostatic system with aging are observed. We investigated the characteristics of the hemostatic system in middle-aged and elderly people with IR in the absence and presence of impaired glucose tolerance (IGT). It is shown that IR in middle-aged and elderly people is accompanied by increased content of plasminogen activator inhibitor type-1, which may lead to potential inhibition of fibrinolysis. An indication of significant prothrombotic changes associated with IR in the elderly are reduced a clotting time of blood plasma in the APTT test and elevated levels of soluble fibrin and D-dimer. Intensity of these changes in the hemostatic system is enhanced in the presence of IGT. The results substantiate need for correction of hemostasis by reducing the IR.

[Comparative evaluation of the predictive value of UroVysion and AURKA FISH tests of urine sediment cells for the diagnosis of bladder cancer].

Informative value of two tests based on FISH of exfoliated urothelial cells in urine sediment (AURKA and UroVysion) was compared in the group of patients (31 persons) with the history of bladder cancer. Coincidence in results of both FISH assays was found in 93.5%. These preliminary data offer the possibility of replacing the expensive UroVysion kit by the less expensive AURKA FISH probe and it could be used for monitoring of recurrence in bladder cancer patients.

[Clinical and endoscopic features and treatment problems in patients with perforated duodenal ulcer].

AIM: To compare clinical and endoscopic findings and standard therapy results in duodenal ulcer disease (DUD) patients with and without a history of perforated ulcer. SUBJECTS AND METHODS: One hundred and thirteen patients with recurrent DUD, including 61 patients with uncomplicated DUD (Group 1) and 52 patients with a history of perforated ulcer (Group 2) were examined. Esophagogastroduodenoscopy (EGDS) and 24-hour pH-metry were performed in addition to physical examination. Ulcer scarring was evaluated during control EGDS. RESULTS: 75% of the patients with uncomplicated DUD were observed to have classical pain syndrome and the pain was milder, more extensive, and food-unrelated in the patients who had sustained perforation. Decreased appetite was more common in uncomplicated DUD (35%). EGDS showed that complicated DUD was accompanied by a significantly higher detection rate of erosive esophagitis (20%), gastritis (52%), duodenitis (25%), multiple ulcers (28%), and larger ulcer sizes. 35% of the patients who had experienced duodenal ulcer perforation exhibited an inadequate antisecretory effect of standard omeprazole doses, which was followed by the increase in ulcer scarring time by an average of 1.2 days. CONCLUSION: In the patients with perforated DUD, the history was typified by less pronounced, more extended, and food-unrelated pain, esophageal and gastroduodenal erosive damages, multiple ulcerative defects, large ulcer sizes than in those with uncomplicated DUD, as well as resistance to standard omeprazole dose in one third of the cases, and delayed ulcer scarring.

["High" and "low" gastric ulcers in posthelicobacterial era--is this division vital?].

AIM OF INVESTIGATION: To specify etiopathogenetical characteristics of the disease in case of "high" and "low" gastric ulcers. MATERIALS AND METHODS: 96 patients with relapse of gastric ulcer disease (GUD) were examined, median age 41 +/- 3.1 years, 71.9% of male patients, 28.1% of female patients. The first group included 58 patients with "high" ulcer, the second included 38 patients with pyloroantral ulcer. All patients underwent esophagogastroduodenoscopy and 24-hour intragastric pH-metry prior to the prescription of antisecretory therapy. The results of the examination were compared with data of 100 healthy subjects. RESULTS: Intragastric acidity in case of "high" ulcers, by value of fundal and antral pH and its circadian dynamics, was comparable to that of the healthy people. By the frequency of duodenogastral reflux (DGR) close to normal the total duration was significantly higher because of considerable increase of portion of long and high refluxes. High acidity in corpus and antral region, absence of the normal daily variations, significant increase of night acidity, decrease of DGR frequency and duration were noted by "low" gastric ulcers. CONCLUSIONS: In case of "high" localization of gastric ulcer normal acidity production and unusual high and enduring duodenogastral refluxes are revealed more often; combination of high hyperacidity and pronounced depression of duodenogastral reflux are seen in case of pyloroantral ulcer.

[Simultaneous quantification of soluble fibrin and D-dimer in blood plasma for the assessment of the threat of thrombosis].

Soluble fibrin and D-dimer are the most specific markers of blood coagulation cascade and the threat of thrombosis. Two immunoassay test systems were designed using the fibrin-specific and D-dimer-specific monoclonal antibodies. The clinical trials of the test systems were carried out in Ukraine. The high informative value of soluble fibrin quantification as a prognostic indicator of the threat of thrombosis associated with hip replacement and endoprosthetics of the abdominal aorta was shown. Independent D-dimer quantification is less informative. Simultaneous quantification of soluble fibrin and D-dimer before operation and at different time intervals after it is required for the prediction of postoperative thrombotic complications and monitoring the efficiency of antithrombotic therapy. Only in this case it is possible to get information about the state of the balance between blood coagulation and fibrinolytic systems, and determine the degree of the threat of thrombosis.

[The effect of mixed cultivation of lymphocytes irradiated at a dose of 1 Gy and non-irradiated lymphocytes on the frequency of chromosomal aberration].

The mutual influence of irradiated (1 Gy) and non-irradiated cells was demonstrated on the model of the mixed culture oflymphocytes from opposite gender donors using chromosome aberrations (ChA) as an endpoint. The number of ChA in non-irradiated lymphocytes in mixed cultures with irradiated ones increased as compared to the corresponding monocultures. At the same time, the number of induced ChA decreased in the irradiated lymphocytes cultivated with non-irradiated ones.

[Evaluation of the blood coagulation system after surgeries on abdominal aortic aneurysms].

Basing on data of analysis of the hemostasis system state in the patients, suffering abdominal aorta aneurysm, a tendency for raising of postoperative soluble fibrin and D-dimer content in the blood plasm and reduction of these indices on the third day was noted. The abovementioned markers content depends on the aneurysm size, the fibrin deposits presence, the terms from clinical signs beginning to the certain therapy administration and anticoagulants application. Information about correlation between content of D-dimer and soluble fibrin in the treatment dynamics is important for determination of activation degree in the patients blood coagulation system and the thrombotic complications prognosis.

[Characteristics of duodenogastric reflux in duodenal ulcer patients and its dynamics after Helicobacter pylori eradication].

UNLABELLED: Studying role of duodenogastric reflux (DGR) in pathogenesis and sanogenesis of duodenal ulcer (DU). MATERIAL AND METHODS: 233 DU patients (92 patients with a mild, 45--with modern and 96--with the complicated current of disease) are surveyed. Control group were 100 healthy volunteers. Clinical research, endoscopy and 24-hours pH-metria was carried out. In a year after eradication Helicobacter pylori (Hp) 30 patients are repeatedly surveyed. RESULTS: at healthy acidity more low, and DGR above and more for a long time, than at DU patients. DU was especially supressed at complicated current DU. Eradication Hp was accompanied by acidity normalization only at mild DU, and at complicated DU--is not present. CONCLUSION: at healthy people DGR arises in reply to antrum's acidification and has compensative value, and at DU there is the considerable suppression leading to insufficiency of antrum's alkalization. After eradication Hp normalization DGR is marked only at mild current DU.