[Opportunities to improve the prognosis of the course of COVID-19 for at-risk patients].

AIM: To evaluate the efficacy and safety of a combination of virus neutralizing monoclonal antibodies in the treatment of patients with confirmed COVID-19 and risk factors for disease progression and severe disease course. MATERIALS AND METHODS: The study was carried out in the Sokolniki temporary hospital of the Inozemtsev City Clinical Hospital. A retrospective comparative case-control study included 400 patients hospitalized for confirmed COVID-19 infection from November 01, 2022 to March 31, 2023. Patients were divided into two groups depending on the treatment given: the first control group (n=200) and the second group (n=200), where patients received a single intramuscular injection of tixagevimab + cilgavimab within the first days of hospitalization. RESULTS: When analyzing the concomitant pathology, C-reactive protein level and CT scans at the time of hospitalization, it was revealed that patients in the tixagevimab + cilgavimab treatment group were more severe compared to the control group. On the 2nd day of hospitalization, there was a decrease in the level of C-reactive protein in the control group by 36.2%, in the group receiving tixagevimab + cilgavimab - by 45.2%; p<0.05. Standard treatment was supplemented with antibacterial therapy in 47 (23.5%) patients of the first group and in 32 (16.0%) patients of the second group, which was due to the accession of bacterial infection; p<0.05. Significant differences were found in the duration of hospitalization, which averaged 8.0±0.21 bed-days in group 1 and 6.4±0.13 (p<0.05) bed-days in group 2. No adverse reactions to intramuscular injection of tixagevimab + cilgavimab were detected. CONCLUSION: The use of a combination of neutralizing monoclonal antibodies in patients with COVID-19 reduce the average bed-day in hospitalization of patients with comorbid pathology and/or immunodeficiencies and high risk of progression of infection.

[Self-expanding nitinol stents for bleeding from esophageal varices in patients with portal hypertension]. / Lechenie krovotecheniya iz varikozno rasshirennykh ven pishchevoda nitinolovym stentom u bol'nykh portal'noi gipertenziei.

Blakemore probe-obturator was previously preferable for primary hemostasis in patients with bleeding from esophageal varices. Currently, Danis self-expanding nitinol stent became an effective alternative. According to some manufacturers, Danis stent has some advantages over balloon tamponade. We report implantation of nitinol stent for hemostasis in a patient with multiple recurrent bleeding and ineffective endoscopic manipulations. A method of stent fixation for prevention of distal migration as the most common complication is described.

[Aneurysm of the thoracic aorta with esophageal perforation].

Aneurysms of a chest department of an aorta with esophageal perforation two cases are presented and a lethal outcome. Difficulties in diagnostics have been caused by rare occurrence of the given pathology, insufficient experience of clinical physicians, and also absence during supervision of characteristic attributes Aortoesophageal Fistula.

[Non-Hodgkin's lymphoma of the stomach. A case report].

Clinical supervision diffuse large B-cell lymphoma of the stomach at the patient of young age is presented. Difficulties of the differential diagnostics of lymphom have been caused by macroscopical polyphormism. With the purpose of verification of disease are used the chromoendoscopy and immunohistochemical research.

[Diagnosis and treatment policy in trauma of duodenum]. / Diagnosticheskaia i lechebnaia taktika pri travme dvenadtsatiperstnoi kishki.

Experience of treatment of 70 patients aged from 17 to 71 years with trauma of duodenum (TD) was analyzed. Majority of them was men -- 57 (81.4%). Open TD were seen in 61.4% cases, closed -- in 38.6%. There were no pathognomonic symptoms. X-ray examination of abdominal cavity is the important procedure permitted to suspect TD. Diagnostic algorithm in abdominal trauma for exclusion of TD before surgery was developed. Yellow-green imbibition, mass of air vesicles in retro-abdominal space, hematomas in duodenal zone were the indications for revision of duodenum during surgery. Hematoma of duodenal wall was indication for it revision for exclusion of penetrating wound. In 55 (77.1%) patients with wounds penetrating into duodenum (or disruption of duodenum) suture of defects was performed. "Exclusion" of duodenum was performed in 20 (28.6%) patients when there was threat of sutures insufficiency. Lethal outcome was seen in 20 (28.6%) patients including 13 (18.6%) cases during first day due to combined injuries and massive blood loss. Developed algorithm and treatment policy permitted to improve results of this severe variant of abdominal trauma.