Pulmonary function after COVID-19 in early convalescence phase. The aim of the study is to investigate the influence of Coronavirus disease 2019 (COVID-19) on pulmonary function in early convalescence phase.

Materials and methods. The study included 44 patients (35 male) after COVID-19 without concomitant bronchopulmonary pathology, with a median age of 47.5 years. All patients underwent standard pulmonary function tests (PFTs): spirometry, body plethysmography, diffusion test. Besides, dyspnea on the mMRC scale was assessed, oxygen saturation level (SpO2 ) was measured. Depending on degree of lung damage determined using high-resolution computed tomography (CT), the patients were divided into 2 groups: group 1 (22 patients) — CT 1 and CT 2, group 2 (22 patients) — CT 3 and CT 4.

Results. The medians of standard PFTs parameters were in normal values. However, there were statistically significant differences between groups: VC, FVC, FEV1 and TLC were lower in second group. Diffusing capacity was reduced in 52% of patients. Statistical significant correlations were established between lung damage by CT and the parameters of VC, FVC, FEV1 , TLC, IC and DLCO.

Conclusion. The degree of functional disorders of lungs depended on the extent of abnormal CT. Impaired diffusing capacity were detected in more than half of the COVID-19 patients in early convalescence phase.

The article is devoted to the practical aspects of pulse oximetry. Pulse oximetry is a photoplethysmographic method for determining heart rate and the percentage of oxyhemoglobin in arterial blood. The method allows you to objectively evaluate arterial hypoxemia, therefore, it can be used in functional diagnostics and in the daily practice of interns of any specialization. The article briefly presents the history of pulse oximetry and a description of the technique. Particular attention is paid to the accuracy of measurements and reference values of pulse oximetry. The functional significance ofpulse oximetry is also considered here. Several sections are devoted to practical issues: interpretation of the results of pulse oximetry in the diagnosis of arterial hypoxia, in the differential diagnosis of shortness of breath, the diagnostic value of the phenomenon of desaturation. A large section is devoted to the importance of pulse oximetry in viral pneumonia COVID-19

The article discusses the diagnostic and pathophysiological aspects of the study of the lungs diffusion capacity.

Tertiary care centers in Russia were subdivided on two categories during recent COVID-19 outbreak and counter infection measures, undertaken by the government. In the first category were the centers, providing medical care solely to the COVID-19 cases; in second hospitals worked with all other cases, excluding COVID-19 ones. COVID-19-oriented centers are taking strict protective measures against the infection, with medical and other staff working in the individual biohazard protection suits, full disinfection at the border between the clean and unclean zones, thorough medical supervision over the health of all the employees. In the second category centers observation regime was implemented, with the obligatory medical masks and disposable lab coats. wearing, as well as thorough medical supervision over the health of all the employees. These different regimes determine some features of clinical neurophysiology in these centers. In the case of electroencephalography (EEG) main point is the real need of the procedure in the certain clinical situation. In COVID-19 cases all functional tests should be excluded from the protocol; procedure have to be performed in shortest time possible. EEG is performed according to good clinical practice and consensus protocols with thorough and strict disinfection of the devise and all cables, caps etc. If the patient was in the prone position during the procedure, this should be noted for the neurophysiologist. Conduction studies may be performed in the possible coronavirus-associated Guillain–Barré syndrome or critical illness polyneuropathies. Needle myography may be needed only in the rare cases of coronavirus-associated acute myelitis, in all other cases conduction studies are more than enough.

The article shows that in the daily activities of nursing staff of functional diagnostics departments (offices), it is necessary to strictly observe the requirements and rules for the prevention of infections associated with medical care, especially during the COVID-19 pandemic. The types of personal protective equipment (PPE) of medical personnel (MP), as well as current effective methods of disinfection, rules for collecting medical waste in a complex epidemiological situation are presented.

The article discusses the experience of teaching and conducting spirometry of general practitioners as part of the RESPECT study (RESearch on the PrEvalence and the diagnosis of COPD and its Tobacco-related aetiology). A total of 33 trained in spirometry general practitioners performed a study of 3119 patients. Quality criteria met 84.1% of spirometric studies. The analysis of the most common mistakes made by doctors during the forced expiratory maneuver is included. The most frequent errors were expiration exhalation of less than 6s (54%), non-maximal effort throughout the test and lack of reproducibility (11.3%). Independent predictors of poor spirogram quality were male gender, obstruction (FEV1 /FVC<0.7), and the center where the study was performed. The number of good-quality spirograms ranged from 96.1% (95% CI 83.2–110.4) to 59.8% (95% CI 49.6–71.4) depending on the center. Subsequently, an analysis of the reasons behind the poor quality of research in individual centers was conducted and the identified shortcomings were eliminated. The poor quality of the spirograms was associated either with the errors of the doctors who undertook the study or with the technical malfunctions of the spirometer.

The review article is devoted to the diagnosis and clinical significance of early ventricular repolarization phenomenon and syndrome. Just 13 years ago, the phenomenon was recognized as an unambiguous version of the norm. However, the results of a series of multicenter studies have shown that the phenomenon is associated with an increased risk of sudden cardiac death. The following criteria are recognized as criteria for early repolarization: the presence of a notch or a junction wave on the descending part of the R wave with a concomitant (or absent) elevation of the ST segment (at the Jt point); J wave (point) ≥0.1mV peak elevation (at Jp point) in ≥2 adjacent 12-channel ECG leads, except for V1–3 leads; QRS duration, measured in leads with J wave (point) <120 ms. Early repolarization syndrome is a clinical condition involving a combination of the pattern of early repolarization and polymorphic ventricular tachycardia, ventricular fibrillation and/or sudden cardiac death in persons without structural heart disease. Treatment is required in patients with a symptom of ventricular tacharrhythmia or family history early repolarization with sudden cardiac death.

The goal The goal is to study the lateralization of changes in intrahemispheric coherence in accordance with the basic rhythms of electroen- cephalography in healthy young people under the influence of tapping on the wrist in accordance with the author’s technique.

Materials and methods: The conduct of this study was approved by the ethics com- mittee of KrasGMU. prof. V. F. Voyno-Yasenetsky (protocol No. 77/2017 of 06/26/2017). The study of the infl  of wrist tapping according to the author’s technique on the coefficient of intrahemispheric coherence of the cerebral cortex in healthy volunteers (n2=63). Wrist tapping was carried out using the original technique (RF patent No. 2606489 of 01/10/2017). The analysis of intrahemispheric coherence in the pairs F3–T5, T5–O1, F3–O1, F4–T6, T6–O2, F4–O2 was carried out using a com- puter encephalographic complex (Neurocartograph, MBN Moscow).

Results and discussions: According to the studies, it was shown that under the influence of tapping the hand according to the author’s technique, the state of sensory deprivation (closed eyes), statistically signifi changes in hemisphere coherence in theta and beta rhythms were not found, p>0.05, however, we showed a statistically significant (p<0.05) de- crease in hemisphere alpha-rhythm coherence in the right hemisphere in pairs F4–T4 (p=0.0000793) and F4–O2 (p=0.01711824), while the median coherence coeffi  before and after tapping changed from 0.27 to 0.315 and from 0.13 to 0.175, respectively. At that time, we did not find statistically significant changes in the coherence of the hemisphere in similar pairs of the left hemisphere p>0.05. As a result of this study, when the wrist tapping was opened with the eyes of the subjects open, statistically significant changes in the coherence of the hemispheric alpha rhythm were detected only in the F3–O1 pair of the left hemisphere (p = 0.0000147), but not in the right hemisphere. At the same time, when the eyes of the volunteers were closed, there were no statistically significant changes in the coherence of the hemisphere in the theta and beta rhythms in both the left and right hemispheres.

Conclusion. Thus, the use of tapping the wrist according to the author’s technique with the left hand in right-handed people in a state of sensory deprivation is promising for practical use in neurological practice, in particular in the management of patients with epilepsy and panic attacks, since a patient previously trained by the attending physician — neurorehabilitation, can use this the author’s program on his smartphone, in the case of an epileptic aura of focal epileptic seizures or precursors of panic attacks. However, the clinical application of the author’s technique needs detailed research.

Aim. To evaluate the temperature proximal-to-distal dorsalhand gradient (PDG) in patients with altered glucose metabolism.

Methods. Analyzed 120 patients with altered glucose metabolism, divided to three groups: group 1 — abnormal glucose tolerance test (R73) and type 2 diabetes mellitus without complications (E11.9) — 50 pts, 30 m/20 f, mean age 61,5 ± 11,1), group 2 — Type 1 diabetes mellitus [Е10] — 25 pts, 7 m/18 f, mean age 44,4 ± 13,1); group 3 — type 2 diabetes mellitus with multiple complications [Е11.7] and type 2 diabetes mellitus with unspecified complications [Е11.8] — 45 pts, 14 m /31 f., mean age 62,2 ± 10,8). Thermal images were shoot by Russian made thermography camera TVS–300med, 388 x 360 pix, sensitivity 0,03℃. PDG calculated as a difference between mean temp of proximal and distal phalanges of 2–5 fingers and estimated for right or left hand separately.

Results. Two thermography signs were observed: «inverted» PDG, when temperature of distal phalanges is higher than proximal and founded more often in group 1 and «false normal», when temperature of proximal phalanges is higher than distal, and name in this manner, because founded more often in «complicated» groups 2 and 3. Analysis confirmed that group 1 and group 3 pts significantly differed in mean PDG value (p<0,05).

Conclusion. Our results show that thermography examination pointed out variety of dorsal hand signs for altered glucose metabolism and significant difference in mean PDG value for group 1 and 3. Therefore infrared thermography could be suggested as an objective tool for screening and monitoring of disease.