Introduction. Currently, psychopathological symptoms are noted in a third of patients with COVID-19, according to published systematic reviews. Aim. To study psychocognitive function in comorbid patients depending on the coronavirus infection caused by SARS-CoV-2.

Material and methods. The observational analytical cohort study included 223 patients with AF and comorbidity (ischemic heart disease, arterial hypertension, obesity, type 2 diabetes mellitus) aged 60–74 years, who were divided into 2 groups: 1st –  123 patients without COVID –19 and 2nd – 110 patients with a history of COVID-19 and the presence of PCS. The group of patients with a history of COVID-19 was retrospectively divided into 2 groups depending on the intake of sulodexide; patients in the subgroups were comparable. The work assessed psychological disorders (anxiety and depression) and cognitive status using specialized scales «HADS» and «SPMSQ».

Results. In patients with COVID-19, compared with patients from group 1, there is a more pronounced depressive syndrome (p<0.001); subclinical depression in 26% of patients (p<0.001) and the absence of the latter in group 1; clinically pronounced depression was found in 15% (p=0.007). At the same time, the severity of subclinical symptoms of anxiety syndrome was noted in patients without COVID-19, and clinically significant anxiety was more often observed in recovered patients, although statistical significance was not achieved. When assessing cognitive function, it was found that moderate dysfunction was observed in patients with COVID-19 significantly more often (p=0.001). In the sulodexide group, only mild cognitive dysfunction was detected (14%), and the majority of patients taking sulodexide had no cognitive dysfunction.

Conclusion. Thus, in comorbid elderly patients in the post-COVID period, an increase in the number of people with psychocognitive disorders was noted. In this regard, long-term follow-up of patients who have undergone COVID-19 is necessary, both for the dynamic assessment of underlying diseases and the analysis of psychocognitive status. In addition, it should be noted that the drug sulodexide, consisting of a heparin-like fraction and dermatan sulfate, has many pharmacodynamic (anti-inflammatory, angioprotective, anticoagulant, antifibrotic) and pharmacokinetic advantages (safety, the possibility of oral administration) can effectively prevent the development of cognitive dysfunction, which requires even further in-depth research.

This article discusses the relevance and prospects of using metabiotics and targeted metabiotics in the complex therapy of acute respiratory diseases. The metabiotics (postbiotics) include bacterial metabolites and/or signaling molecules with a known chemical structure that optimize the composition and functions of the indigenous microbiota, including improving human immunity and metabolism. Bacterial metabolites of Bacillus subtilis SA44 and Lactobacillus rhamnosus CRL1505 strains demonstrate high efficiency in the treatment of patients with respiratory diseases. It is important to use targeted metabiotics, i.e. metabiotics that contribute to the restoration and maintenance of the microbiota of the respiratory organs and human immunity. Targeted metabiotics, as a rule, contain not only bacterial metabolites, but also additional substances with positive effects aimed at optimizing the functioning of a particular organ or system. An example of a targeted metabiotic for the treatment of acute respiratory diseases is a three-component Biocomplete® Bronchobiotic complex, which includes inactivated bacteria of the species Lactobacillus rhamnosus CRL1505 (the metabiotic, is an antagonist of opportunistic and pathogenic microorganisms, promotes immunity), inulin (the prebiotic, serves as nutrition for the indigenous flora) and thyme extract (has expectorant, anti-inflammatory and bactericidal, antioxidant effect).

The study aim was to investigate bone mineral density (BMD) and body composition in old patients with amputated lower limbs.

Materials and methods. This work is a cross-sectional study, which enrolled 31 patients, who underwent amputation of one of the lower extremities. The mean age of the study patients was 73.4±9.0 years, ranging from 60 to 101 years. The majority of study patients were men (77.4%). 41.4% of patients underwent amputation of the left lower limb, 58.6% – right. The time from amputation to enrollment in the study ranged from 4 to 444 months, with a median of 30 months. Bone mineral density in the lumbar spine and proximal femurs was analyzed by dual energy x-ray absorptiometry.

Results. Osteoporosis in the proximal part of the left femur was registered in 51.7% of patients, osteopenia – in 17.2%, normal BMD – in 31.1% of cases. Osteoporosis in the proximal part of the right femur was observed in 64.0% of patients. In the lumbar spine, osteoporosis was found only in 6.9% of patients. The mean T-score in the lumbar spine reached +0.38 SD, in the proximal left femur – -1.5 SD, in the left femur neck – -2.1 SD, in the proximal right femur – -2.0 SD, in the right femur neck – -2.1 SD. In the case of amputation of the left lower limb, the left femur BMD averaged 710.8±239 mg/cm3, the left femur T-score – -2.6±1.6SD, the T-score in the left femur neck – –3.0±1.3 SD, with the intact left leg – 980.1±194 mg/cm3,–0.8±1.5SD,–1.5±1.2SD, respectively (p=0.002, p=0.005 and p=0.006). In case of amputation of the right lower limb, the right femur BMD reached 743.8±268 mg/cm3, right femur T-score – -2.4±1.7SD, the T-score in the right femur neck – -2.4±1.7SD, with the intact right leg – 909.9±211.0 mg/cm3, -1.2±1.5SD, -1.5±1.5SD, respectively (p=0.09, p=0.06 and p=0.1). The likelihood of developing osteoporosis in the left femur with amputation of the left leg increased by 9.8 times, compared with patients who had a preserved left lower limb (odds ratio=9.8; 95% CI=1.1–93.5; p=0.02). In patients with amputation of the left leg, inverse correlation was registered between bone mineral density and the time from the moment of amputation to inclusion in the study (r= -0.65, p=0.03).

Conclusion. Preliminary results of this study demonstrate a decrease in bone mineral density in the proximal femur of the amputated limb. Further studies are needed to study BMD in amputees and to elucidate the pathogenetic basis of the relationship between BMD and other clinical and laboratory parameters in this group of patients.

An increase in the survival rate of patients who had cancer in childhood determines the need to study the long-term consequences of the treatment. Long-term complications may develop from various organs and systems: active studies of the toxicity of chemotherapy are carried out in the field of pharmacogenetics, respiratory, cardiovascular, sensorineural and endocrine systems, as well as skin, central nervous system, immune system and others. The treatment of acute leukemia carried out in childhood can significantly reduce the quality of life, cause cognitive and psychoemotional disorders. Experts in the field of pediatric hematology-oncology proposed to create an indicator called «survival without pronounced toxicity». A group of scientists initiated an international project to study the outcomes of childhood malignant tumors. Among the long-term consequences, it is planned to assess the quality of life and the development of complications. The study of long-term complications of leukemia treatment will allow us to develop algorithms for the prevention and follow-up of these patients.

The flow of labor migrants to Russia is steadily growing. The rules for providing medical care to foreign citizens on the territory of the Russian Federation depend on their status. Among the morbidity of migrant workers, infectious diseases, venereal diseases, tuberculosis, injuries, intoxication are leading. This increases the risks to the health of Russians, and also puts an economic burden on the healthcare system of the Russian Federation. The purpose of our study was to study risk factors in migrant workers hospitalized with acute coronary syndrome. The study included 50 migrant workers and 107 Russian citizens hospitalized with acute coronary syndrome. Analysis of risk factors for cardiovascular diseases revealed that in migrant labor patients, the development of acute coronary syndrome occurred at a younger age. There were significantly more smokers among migrant labor patients, they had a lower body mass index, type 2 diabetes mellitus and a previous acute myocardial infarction were significantly less common in the anamnesis. Analysis of clinical and laboratory data of patients hospitalized with acute coronary syndrome revealed that the main risk factors for cardiovascular diseases among migrant workers are smoking and lipid metabolism disorders.

Retinopathy of prematurity is one of the most severe diseases that lead to permanent blindness from early childhood. The frequency of retinopathy of prematurity in neonatology closely correlates with the degree of maturity of the child’s body.

Goal. To conduct a analysis of the correlation of the degree of oxygenation, the number of blood transfusions with the severity of progressive retinopathy in newborns. The study included 40 premature infants diagnosed with retinopathy of newborns who were being treated in the neonatal intensive care unit. Conducted: clinical and diagnostic examination of patients; analysis of the dependence of the degree of oxygenation, the number of blood transfusions, gestational age, inotropic support and the severity of retinopathy.

Materials and methods. Out of 40 patients diagnosed with neonatal retinopathy, 6 children were operated on.

Results and discussion. The study showed that all the operated children were born at a gestation period of less than 29 weeks, were treated with antibacterial and inotropic drugs. There was no direct relationship between the number of blood transfusions and the risk of developing a severe form of the disease with further surgical treatment. In 40% of cases, children who developed retinopathy of stages 1 and 2 did not receive transfusion of erythrocyte suspension at all. At the treatment stage, all operated patients received a gas-air mixture with an oxygen content above 45%, as well as inotropic and vasopressor support with epinephrine and norepinephrine. Statistical analysis has shown that the number of blood transfusions is not the leading factor in the decision to refer a child for surgery. Among children with a gestation period of less than 29 weeks, retinopathy of varying severity was found in all infants; in the group of children aged 30–35 weeks, the disease developed only in 45% of patients.

Conclusion. The conducted studies have shown that the parameter number of hours spent using IVL (the parameter artificial lung ventilation) is informative, and parameters such as weight and gestational age are significant.

It is necessary to note the importance of additional parameters. Among the operated children, the condition of severe asphyxia was suffered by 45.5% of children in group A, in Weight groups severe asphyxia was in 28% of cases. Statistical analysis showed that children who required surgical treatment received catecholamine therapy at the initial stages. The most unfavorable percentage of oxygen supplied with the air mixture starts from 40–45%. The children who required surgical treatment received catecholamine therapy at the initial stages.

In this study, spectral parameters in patients with various forms of atrial fibrillation and the effect of the class III antiarrhythmic drug amiodarone on these parameters were studied. The use of spectral analysis of heart rate variability (hereinafter referred to as HRV) when choosing a drug for the treatment of arrhythmia and arterial hypertension is becoming increasingly widespread in experimental and clinical practice. This method, thanks to the mathematical analysis of the time and frequency characteristics of heart rate variability, allows you to get an idea of slow oscillatory processes that constantly exist in the body and have the properties of autowaves. The use of this method gives an idea of the role of various departments of the autonomic nervous system (sympathetic and parasympathetic), as well as the implementation of humoral mechanisms in the implementation of the chronotropic function of the heart.

The basis of a healthy lifestyle is not only the rejection of bad habits, but also an increase in physical activity (FA). The importance of FA for medical university students is due to the fact that their future profession involves promoting a healthy lifestyle, including FA, among the population. The purpose of the study included studying the FA of medical university students in different courses of study. An online survey of 306 medical university students was conducted using a Scale of Exercise Benefits/barriers. It was found that a greater number of benefits from physical education and a smaller number of barriers were revealed in 1st-year students and a progressive change in this ratio in older students. The analysis of the FA of medical students revealed that 1st year students devote more time to physical activity (sports) in comparison with undergraduates. The main reason for the low FA among students is the lack of free time. During the COVID-19 pandemic, with the transition to online education, students noted a decrease in FA and dissatisfaction with physical education in remote mode. Based on the data obtained, it was concluded that in order for medical students to adequately provide counseling to their patients in the future, medical universities should develop programs that stimulate medical students to greater FA.