A new coronavirus COVID-19 has led to the development of a global pandemic. It is characterized by a high risk of developing pneumonia and multiple organ failure along with its capability to influence the central nervous system. The main methods of instrumental assessment of the functional state of the brain are electroencephalography (EEG) and somatosensory evoked potentials (SEPs), which have been routinely used with patients in critical care units.

We recorded the EEGs and short-latency SEPs of 31 COVID-19 patients, all were treated at the N. V. Sklifosovsky Research Institute of Emergency Care in 2020. The combined data was used to analyse the following outcome.

We detected abnormal EEGs in 23 COVID-19 patients (74 %). Seven (30.4 %) patients showed EEGs consisting of diffuse non-specific slowing, 4 patients had lateralized hemispheric slowing (17.4 %) and one patient (4,3 %) had frontal intermittent delta activity (FIRDA). Three (13 %) patients in comas had “burst-suppression» pattern, three (13 %) had isoelectric EEGs and two (8,7 %) had areactive alpha rhythm, regarded as an electrographic manifestation of alpha coma. Two patients had evidence of epileptiform discharges (9 %), triphasic waves were presented in one patient (4.3 %).

EEG and SEPs with the median nerve stimulation in COVID-19 patients do not reveal specific changes, nevertheless they are informative instrumental methods for assessing the functional state of the brain to identify biomarkers of epileptic seizures and to prognosticate survival and recovery in comatose patients.

This article is devoted to the analysis of the most frequent cardiac complications in patients with severe community-acquired pneumonia caused by COVID-19 viral infection. The study found that cardiac complications developed in 25% of patients with COVID-19 pneumonia. The most common complication was supraventricular rhythm disturbances. Atrial fibrillation and flutter proceeded with pronounced hemodynamic changes. Myocardial injury, given the increase in cardiospecific troponin T, could be suspected in 38% of patients. Differential diagnosis between ACS and myocarditis caused the greatest difficulties.

In order to determine the clinical significance of exercise stress echocardiography in patients with severe to moderate aortic stenosis, a stress-induced increase in the mean pressure gradient across the aortic valve was recorded and myocardial contractile reserve was assessed using a number of parameters (ejection fraction, global longitudinal strain, elasticity index). It was found that, with normal values of EF at rest in patients with severe and moderate aortic stenosis, the deficit in contractile function was revealed using the GLS index, which demonstrated a decrease in both groups at the peak of exercise. A decrease in contractile reserve by both parameters (EF and GLS) was found in the group of patients with severe AS, which, combined with a significant stress-induced increase in the gradient on the aortic valve (≥18–20 mm Hg), an increase in pulmonary artery pressure (>  60 mm Hg) and decrease in systemic systolic blood pressure (>20 mm Hg) should be considered as a predictors of a poor prognosis of the natural course of aortic valve disease, and patients with similar stress test results should be possible candidates for surgical aortic valve replacement. A decrease in the in the LV elasticity index augmentation at the peak of exercise, strongly correlated with changes in other considered parameters of contractility and the metabolic power of exercise (MET), significantly complements the functional characteristics of the lesion for choosing the optimal management strategy. Consequently, exercise stress echocardiography is an indispensable diagnostic tool for determining the prognosis and timing of surgery in patients with aortic stenosis.

Aim. Study electrocardiographic (ECG) and vectorcardiographic (VCG) indicators for various types of structural-  geometric remodeling of the left ventricle (LV) in patients with arterial hypertension (AH).

Material and research methods. The analysis was performed in 336 people, including 264 patients with AH, mean age 61.02 ± 7.61 years and 72 practically healthy individuals (57.18 ± 6.47). The ECG indicators of heart rate and duration of P, QRS, RR, PQ, QT, QT corrected according to the Bazett, Friderici and Sagie formulas (QT_CB, QT_CF, QT_CS) were assessed. Echocardiography was used to calculate myocardial mass (LVMM) and LVMM index (LVMI), relative wall thickness (RWT). In the own plane of the VCG: the area of the QRS loop (SQRS), the magnitude of the geometric vector (maxQRS) were determined.

Results. Correlation analysis showed the presence of a positive relationship between LVM and LVMI with SQRS (r = 0.49 and r = 0.38), maxQRS (r = 0.28 and r=0.33) and with QRS duration (r = 0.50 and r = 0.43). The groups of patients with concentric (CG) and eccentric (EH) hypertrophy in comparison with controls and patients with AH without LVH gave significantly higher values of absolute QT, QT_CF, QT_CS. There was a positive correlation between QT and QTС with LVMM, LVMI and no relationship with RWT.

Conclusions. In LVH, the duration of QRS and SQRS in its own plane increased. The highest SQRS values were observed in patients with CG of the left ventricle in comparison with EG. Patients with CG and EG did not differ in QRS duration. In patients with AH and LVH, the duration of absolute and corrected values of the QT interval was significantly longer than in patients without LVH. The QT interval lengthened with an increase in LVMM and LVMI. QT duration did not depend on the type of LV hypertrophy — concentric or eccentric.

Background. Ischemic heart disease (CHD) holds a leading position in the structure of causes of general mortality and in the structure of mortality from cardiovascular diseases. We extended the standard echocardiography with assessment of thoracic aorta elasticity to identify markers of the thoracic aorta elasticity worsen associated with coronary atherosclerosis. When analyzing the data, we identified different clinical characteristics of study participants as one of the main reasons for the difficulty in comparing the data with the results of previous studies, which made it necessary to highlight age and gender characteristics of indicators.

Aim. To analyze age and gender characteristics of thoracic aorta elasticity indices in patients with coronary atherosclerosis.

Material and methods. An observational analytical cross- sectional clinical trial was conducted from 2016 to 2019. Our study included 109 patients aged 39 to 82 years (mean age 65 ± 9 years, median 66 years), who were divided into 2 groups according to the results of invasive coronarography: 64 patients with coronary atherosclerosis and 45 patients without angiographic signs of coronary atherosclerosis. In the group with coronary atherosclerosis average age was 66 ± 8 years (median 66 years). In the group without coronary atherosclerosis average age was 64 ± 9 years (median 66 years). During transthoracic echocardiography, the following were obtained: coefficient of distensibility, compliance coefficient, elasticity (stiffness) module of Peterson, stiffness index of the ascending thoracic aorta; systolic velocity S, early diastolic velocity E, late diastolic velocity A of the near wall of the ascending aorta, flow velocity propagation (FVP) of the descending thoracic. Analysis of age and gender characteristics of thoracic aorta elasticity indices in patients with coronary atherosclerosis was done.

Results. An increase in the stiffness index of the ascending thoracic aorta associated with coronary atherosclerosis occurs in the age group 39–66 years, a decrease in the coefficients of extensibility and compliance, an increase in Peterson’s modulus of elasticity (stiffness) of the as cending thoracic aorta — in the age group 67–82 years. A decrease in the E velocity of the near wall of the ascending thoracic aorta and FVP, associated with coronary atherosclerosis, occurs regardless of belonging to the age group, a decrease in the S velocity — in the age group 39–66 years. A decrease in the compliance coefficient of the ascending thoracic aorta, velocity S of the near wall of the ascending thoracic aorta, associated with coronary atherosclerosis, occurs only in men, an increase in the stiffness index — only in women. A decrease in the extensibility coefficient, an increase in the Peterson’s modulus of elasticity (stiffness), a decrease in the E velocity, and a decrease in CRP associated with coronary atherosclerosis occur regardless of gender.

Conclusion. Worsening of the thoracic aorta elasticity in patients with coronary atherosclerosis, assessed using echocardiographic technologies, depends on gender and age.

Objective: to evaluate the indicators of electrical activity of the brain using frequency- spectral analysis and data of three- dimensional localization of sources of pathological activity for an approach to the analysis of possible neurophysiological mechanisms of the brain of patients whose EEG recorded the phenomenon of ‘burst- suppression’.

Material and methods: 45 electroencephalograms recorded in 22 patients (average age 51.05; 11 women, 11 men) were analyzed. In 12 patients, the EEG study was performed in dynamics from 1 to 8 times. At the time of the first registration, the ‘burst- suppression’phenomenon was recorded in the EEG of all patients. The level of wakefulness of all patients, with the exception of patients who were under anesthesia, was 3 points on the Glasgow coma scale.

EEG recording was performed on electroencephalographs ‘Encephalan-  EEGR-19/26’, ‘Mitsar-  EEG-10/70–201’, ‘Mitsar-  EEG-SmartBCI’, ‘Neuron-  Spectrum-5’and ‘Neuron- Spectrum-65’in accordance with the International scheme of arrangement of electrodes 10–20 %. A frequency- spectral analysis of the power of the ‘burst’and ‘suppression’periods was carried out — the fast Fourier transform method was used. The program ‘BrainLoc 6.1’(Russia) was used for localization of equivalent dipole sources of pathological electrical activity of the ‘burst’period.

Results: during the first EEG recording, the ‘burst- suppression’phenomenon was recorded in all patients. In seven patients, the ‘burst’period in the ‘burstsuppression’phenomenon was visually represented by slow-wave oscillations, in 15 patients, the ‘burst’periods resembled epileptiform discharges. In frequency- spectral analysis EEG in all patients in the ‘burst’period, the dominance of the power of slow-wave oscillations (mainly in the delta range) was noted. According to the program ‘BrainLoc 6.1’, equivalent dipole sources of pathological activity of the ‘burst’period were recorded at the level of the thalamus, in the medio- basal parts of the frontal and temporal lobes on both sides. A favorable outcome of the ‘burst- suppression’phenomenon was observed in only five patients of 22, all other patients had an unfavorable outcome.

Conclusion: a favorable outcome of the ‘burst- suppression’phenomenon was observed only in patients under sevorane anesthesia and in some patients after acute poisoning with drugs that affect the central nervous system, while patients after brain anoxia had an unfavorable outcome. In prognostic terms, our data are comparable to the literature data. The changes revealed during the frequency-spectral analysis of the EEG in the form of the dominance of the power of slow-wave oscillations (mainly in the delta range), as well as the localization of the supposed generators of electrical activity in the ‘burst’ period at the level of the thalamus, in the mediobasal parts of the frontal and temporal lobes (according to the ‘BrainLoc 6.1’program), may to some extent be consistent with the data of experimental works and mathematical models of the ‘burst–suppression’phenomenon If the ‘burst-  suppression’ phenomenon is detected during EEG registration, it is advisableto conduct a dynamic EEG study or EEG monitoring.

This article summarizes modern information concerning the aspects of spirometry in children; focuses on the conditions, features of preparation, implementation and analysis of spirometry results in children in order to obtain reliable, reproducible and comparable results in various laboratories; this information is intended for pediatricians, pulmonologists, doctors and secondary medical personnel of functional diagnostics offices.

Interpretation of bronchodilator (BD) test based on reaction of forced expiratory in one second (FEV 1). For assessing bronchodilator responsiveness of lung volumes, airway resistance remains largely unexplored. Therefore, we assessed the response of pulmonary function parameters to BD to reveal the most responsive parameter. 90 patients with chronic airway obstruction (61 male and 29 female; aged 55±11; post-  BD FEV 1 was 63.1+18.3 % predicted) performed spirometry and static lung volume measurements before and after inhalation of BD. We calculated effect size (ES) for each parameter from the difference between two means divided by the standard deviation of baseline score. There was a significant increase both FVC and FEV 1by 8.2 and 12.3 % from baseline (p<0.001). ES were 0.34 for FEV1 and 0.26 for FVC. The ES for lung volumes were from -0.07 (total lung capacity) to -0.31 (residual volume). The ES for sRtot (specific airway resistance) was -0.5 and ES for sGeff (specific effective airway conductance) was 0.95. The parameters of airway resistance and conductance were more responsive for the assessment of pulmonary function changes than spirometry and lung volumes parameters in patients with chronic airway obstruction.

This review is devoted to the thermogaphic hands examination in patients with upper limbs vascular disorders (both arterial and venous), Raynaud’s phenomenon, ischemic heart disease and after surgical interventions on the vessels of the upper extremities, thoracic sympathectomy, as well as a number of more rare diseases and clinical situations. Studies of temperature distributions on the hands of such patients are promising in terms of creating, on their basis, decision support systems in screening, diagnostics and treatment monitoring.