[The survival prediction of hospitalized patients with COVID-19: the role of chitotriosidase level in peripheral blood].

AIM: To assess the relationship between plasma chitotiosidase (CHIT) level and mortality in hospitalized patients with COVID-19. MATERIALS AND METHODS: 347 hospitalized patients with COVID-19 were enrolled in our single-center cohort prospective observational study. On the first day of hospitalization the patients were assessed by the level of CHIT in the venosus blood to addition to default laboratory examinations. The primary endpoint was all-cause death. The survival after hospital discharge were assessed via phone calls on 90 and 180 days since inclusion to the study (NCT04752085). RESULTS: Our study included 347 patients. The first symptoms appeared in 7 days [5; 7] before hospitalization; 283 (84.3%) patients had less than 50% of the involvement of the lung tissue to the inflammation process (CT 0-2); 36 (10.4%) patients had died since the start of our investigation; 30 (83.3%) of them died during hospitalization, others -no later than 60 days; 68 (19%) people didn't answer during phone call. The survivor's activity of the enzyme in the deceased was significantly lower in compare to deceased patients (90.5 [40.2; 178.0] nmol/h/mL vs 180.0 [77.2; 393.2] nmol/h/mL; p=0.001). Survivor of the patients with a higher level of the activity of the CHIT (more than 171 nmol/h/mL) was statically significantly lower. CONCLUSION: Rising of the CHIT's activity more than 171 nmol/h/mL might be an early independent predictor of the bad prognosis of the patients, who were hospitalized with COVID-19 infection.

[Impact of kidney biopsy on the management of patients in the rheumatology department: retrospective study].

BACKGROUND: Kidney involvement is a common manifestation of the systemic autoimmune rheumatic diseases. Kidney biopsy is the gold standard for the diagnosis of kidney diseases, however this method has not yet become the standard-of-care in rheumatology practice. AIM: To assess the diagnostic value of kidney biopsy in the management of patients of the rheumatology department. MATERIALS AND METHODS: In this retrospective observational study we analyzed the medical documentation including kidney morphology findings in the patients of the Department of Rheumatology at Tareev Clinic of Internal Diseases. All patients included in the research had signs of kidney involvement and had undergone needle biopsy of the kidney or re-evaluation of the kidney tissue received previously. RESULTS: From June 2016 to October 2021, 3110 patients were admitted to the rheumatology department. Among them 63 (2%) underwent kidney biopsy and were included in the study. Twenty (32%) were male. Mean age was 42.513.9 years. The most common preliminary diagnoses before kidney biopsy were ANCA-associated vasculitis (n=17), systemic lupus erythematosus (n=12), and AA-amyloidosis associated with inflammatory joint diseases (n=7). In 14 (27%) patients diagnosis was unspecified at the time of biopsy. Among 49 patients with established preliminary diagnosis morphological findings were in line 38 (78%) with the pre-liminary diagnosis. However, in 11 (22%) patients morphological findings resulted in the change of the diagnosis. In all 14 patients with unspecified condition kidney biopsy helped to establish clinical diagnosis. Ultrasound evaluation demonstrated hematoma formation in 18 (31%) patients, and among them two required blood component transfusions. CONCLUSION: Our study demonstrates significant value and safety of kidney biopsy in the patients with autoimmune rheumatic conditions. We suggest that kidney biopsy should be implemented in the management of this category of patients.

[An objective relation approach in the modeling of dispensary registration of patients with tuberculosis].

The designing of an integrated information system of a tuberculosis dispensary (TD) has resulted in the construction and introduction of a model that is based on the concept of a uniform patient card, combines information on dispensary registration (DR) and striking off, as well as on the shifting of the TD-attached contingents between different DR groups. The system also contains a logic group that includes formalized descriptions of a tuberculous process. In addition, this model serves to integrate geoinformation technologies, as other information technologies (such as digital image acquisition, postprocessing, storage, and transmission) into its based information systems. This integrated information system permits a real-time quantitative analysis of the basic indices of the tuberculosis epidemic situation, which is necessary while planning tuberculosis-controlling measures, controlling their implementation, and correcting them at all levels.

[Circadian rhythm of arterial pressure and state of target-organs in patients with mild and moderate hypertension]. / Sutochnyi ritm arterial'nogo davleniia i sostoianie organov-mishenei u bol'nykh s miagkoi i umerennoi formami gipertonicheskoi bolezni.

AIM: To assess the state of target-organs in males with mild and moderate forms of essential hypertension (EH) in normal and disturbed 24-h rhythm of arterial pressure (AP). MATERIAL AND METHODS: Target-organs were examined in 70 males aged 30-62 years (mean age 49 +/- 1 years) with mild (n = 54) or moderate (n = 16) EH. The following tests were performed: ophthalmoscopy, echo-CG with estimation of the left-ventricular myocardial mass index (LVMMI), duplex scanning of the carotid arteries (DS), AP monitoring, measurements of plasma creatinine, relative density of the urine, glomerular filtration rate, examination of the neurological status. Circadian rhythm of AP was evaluated by a night fall (NF) of systolic pressure (SP). Patients with inadequate NF of SP (< 10%) entered group 1, those with normal NF of SP (10% < NF SP < 20%) were allocated to group 2. RESULTS: Patients of group 1 had a significantly higher LVMMI, more frequent occurrence of left ventricular hypertrophy and carotid artery affection (local thickening "intima-media"). In group 1 there was also a complex of unfavourable changes in AP circadian profile, especially at night. CONCLUSION: Mild/moderate EH with insufficient NF of SP is associated with more pronounced and frequent changes in the target-organs (left-ventricular hypertrophy, "intima-media" thickeing). Insufficient NF of AP initiates higher pressor load on the target-organs, on the one side, and reflects defective regulation which affects target-organs, on the other. Both these factors contribute to damage of the target-organs.

[Blood pressure variability (based on 24-hour monitoring data) in mild arterial hypertension]. / Variabel'nost' arterial'nogo davleniia (po dannym 24-chasovogo monitorirovaniia) pri miagkoi arterial'noi gipertonii.

To evaluate the condition of target organs in patients with mild arterial hypertension (MAH) under normal and high arterial pressure variability (APV), the authors examined 84 MAH males aged 40-60 and 14 matched healthy controls. At 24-h monitoring it was revealed that 32% of MAH patients had high variability of daytime and night arterial pressure which occurred more frequently in atherosclerotic lesion of extracranial carotid artery portions. MAH patients with high APV against those with normal APV develop carotid artery atherosclerosis 3.5 times more frequently, vascular disorders of the fundus of the eye stage II with angiosclerosis and thickening of the interventricular septum 2.5 and 1.8 times more frequently, respectively.

[Atherosclerosis of the major arteries of the head and the content of lipoprotein(a) in the blood plasma]. / Ateroskleroz magistral'nykh arterii golovy i soderzhanie lipoproteida(a) v plazme krovi.

It is established that atherosclerotic patients with impaired major arteries of the head have high concentration of blood lipoprotein (a) following ischemic disorder of cerebral circulation. Irrespectively of the clinical picture, atherosclerosis of the major head arteries correlated in severity with blood levels of lipoprotein (a). It is suggested that lipoprotein (a) can serve an essential biochemical marker of major head arteries atherosclerosis.

[Baroreflex control and circadian variability of arterial blood pressure in patients with "mild" hypertension and hemodynamically insignificant atherosclerotic lesions of the carotid arteries]. / Baroreflektornyi kontrol i sutochnaia variabelnost AD u bolnykh s "miagkoi" arterialnoi gipertoniei i gemodinamicheski neznachimym ateroskleroticheskim porazheniem sonnykh arterii.

Sinocarotid baroreflex control by means of the neck chamber technique (-40 mm Hg, 4 min) and blood pressure monitoring with a SpaceLabs 90207 system were performed in 45 patients with mild essential hypertension who were divided into 2 groups: (1) those with hemodynamically insignificant carotid atherosclerotic lesions (n = 19) and (2) those without them (n = 26). Group 1 patients showed a decreased cardiochronotropic component of baroreflex control, higher blood pressure variability and less pronounced nocturnal blood pressure fall. The above facts are likely to contribute to progression of essential hypertension and aggravation of target organ lesions.

[Treatment of disorders of the homeostatic system in patients with colonic obstruction of tumor etiology]. / Lechenie narushenii v sisteme gomeostaza bol'nykh s obturatsionnoi neprokhodimost'iu obodochnoi kishki opukholevoi étiologii.

Data obtained in examination of 195 patients are analysed. The most marked changes in the homeostasis system in patients with intestinal obstruction due to cancer of the colon are related to hydro-ion and protein metabolism, acid-base equilibrium, and blood toxic properties. This requires purposeful preoperative management which allows the results of operative treatment to be improved. Characteristic changes of the absorptive property of the small intestine are of principal importance in the genesis of intoxication in these patients. The authors emphasize the important role of decompression of the intestine and intestinal lavage in the complex of therapeutic measures.