Journal «MEDICINA» 1/2024

Laser speckle flowgraphy (LSFG) is non-invasive method with high reproducibility determining the parameters of ocular blood flow. The purpose of this work is to study the blood circulation of the optic nerve head and the peripapillary region of the retina in patients with POAG against the background of post-COVID-19 syndrome using LSFG. Material and methods. The study included 40 patients with advanced stage POAG who had COVID-19 within the previous 3 months, split into 2 subgroups depending on the severity of the disease (mild or moderate). The comparison group consisted of 20 individuals with an advanced stage of POAG who did not have COVID-19. Both groups were comparable in age, gender, general condition, systemic and previous eye diseases. Optic nerve head blood flow was measured using the LSFG-NAVI device (Japan), pulse wave indicators (Skew, BOS, BOT, RR, FR, FAI, ATI and RI) tissue and vascular areas were assessed using LSFG Analyzer software. Results. Reliably significant (p≤0.05) changes in pulse wave parameters were identified in patients of the 2nd subgroup – advanced stage of POAG, post-COVID-19 syndrome after moderate COVID-19. For the microvasculature of the optic nerve head and the peripapillary retina, significant (p≤0.05) changes were revealed in most of the studied pulse wave parameters in patients of the 2nd subgroup; indicators BOT, BOS and FAI decreased, and Skew and RI increased, changes in these indicators were 12%, 8%, 10% and 13%, 13%, respectively. Conclusion. Quantitative and qualitative assessment of the microcirculation of the optic nerve head and the peripapillary region of the retina can be carried out using the modern LSFG method, which allows for rapid analysis of the parameters of the pulse wave of the hemodynamics of the eye, as well as identification of vascular disorders.

Key words: post-COVID-19 syndrome, primary open-angle glaucoma, ocular blood flow, LSFG, pulse wave indicators

Background. Studying the user experience of eventual target groups for digital services is important both for assessing the feasibility of using information and communication technologies in the case and for involving patients in the activities of therapeutic groups and communities in social media. Study aim. To study the influence of socio-demographic characteristics of patients undergoing inpatient treatment in a drug treatment facility on their use of personal computers/laptops. Materials and methods. Cross-sectional study using a specially designed questionnaire of a non-deterministic sample of addiction patients (n = 1168) hospitalized at the Moscow Scientific and Practical Center for Addictions. Statistical analysis was conducted in IBM SPSS 25.0. Study results. Statistically significant differences were noted in the use of personal computers and laptops depending on the age, level of education and economic activity of respondents. Conclusions. Predictors of active use of computers and laptops by patients are: young age; employment; higher education. The results of the study can be used to target addiction clinic patients according to socio-demographic parameters in order to implement telemedicine approaches in the process of their outpatient support.

Key words: addiction clinic, patient, information and communication technologies, socio-demographic characteristics, personal computer, laptop

Diabetes mellitus is associated with increased susceptibility to infectious diseases. This is due to the fact that uncontrolled hyperglycemia is accompanied by impaired innate and adaptive immune response, micro- and macroangiopathies, neuropathy, and decreased urine antibacterial activity. Furthermore, complications of diabetes mellitus such as neuropathy and peripheral vascular disease can lead to skin ulceration with secondary bacterial infections. Bacteria can invade any organ of the human body, with the most common foci of infection in diabetes mellitus being the urinary tract, respiratory tract, skin, and soft tissues. Some infectious diseases are specific to patients with diabetes mellitus, such as malignant external otitis media, foot infections, and nasopharyngeal mucormycosis. Infectious processes may be the first manifestations of diabetes mellitus or provoking factors for inherent complications such as diabetic ketoacidosis and hypoglycemia. Glucose control can be an alternative tool in infection control not only in patients with diabetes mellitus. In addition, controlling hyperglycemia offers the potential to improve the outcome of some infectious diseases.

Key words: diabetes mellitus, DM, hyperglycemia, infectious diseases, mucormycosis, pneumonia

COVID-19 is characterized by an unpredictable course, comorbidity, and high mortality in some patients. The article describes a case of the development of viral-bacterial pneumonia caused by SARS-CoV-2 and Fusobacteria, complicated by the development of gangrene of the lower lobe of the right lung with areas of decay. Case description. The patient was admitted for inpatient treatment, brought in by an ambulance team for emergency indications, complaining of pain when coughing, shortness of breath, body temperature increase up to 38.50C. Computed tomography of the chest: signs of viral-bacterial pneumonia. Infiltration in the region of the lower lobe of the right lung with melting lung tissue was determined. The diagnosis of COVID-19 was confirmed by PCR examination of nasopharyngeal swab. Diagnosis: New coronavirus infection COVID-19, severe course. Complications of the main disease: Bilateral viral-bacterial pneumonia. Gangrenous abscess of the left lung. On the background of the started treatment, a lethal outcome occurred. Autopsy revealed signs of viral-bacterial pneumonia and a decaying cavity with purulent contents, diffuse destructive changes with hemorrhages. Conclusion. The patient died as a result of viral-bacterial pneumonia, complicated by the development of gangrene of the lower lobe of the right lung with areas of decay and abscess formation and acute respiratory failure.

Key words: COVID-19, viral-bacterial pneumonia, pulmonary gangrene, pulmonary edema, respiratory failure

Due to the increasing degree of patients' participation in the treatment process, there is a need to realize the possible risks of decisions and take responsibility for them. The paper investigates the issues of individual risk management by the patient in the process of his interaction with the health care system. The methodological basis of the study was the analysis of scientific publications and generalized practical experience. The main stages of the treatment process have been consecutively considered. Possible risks are identified and qualitatively assessed, ways to reduce them are proposed. The complexity and diversity of risk management tasks facing the patient in case of his active participation in the treatment process are shown.

Key words: risk management, patient, healthcare system, treatment process, risk reduction

Objective. To determine the pathologic role of highly dispersed e-cigarette aerosol on lung cells, respiratory epithelium, and the immune system. Results. A systematic analysis of scientific literature in the databases: PubMed, ResearchGate, Medscape, and Cochrane Library was performed. The search was conducted using the following keywords: e-cigarette, vape, juul, lung, airway, respiratory, respiratory, cough, methacholine, nasal, alveoli, immune, bronchial, tracheal, bronchoalveolar, nicotine, propylene glycol, vegetable glycerol, macrophages, epithelium, spirometry and SPF1. Based on the literature review, the following conclusion was reached: studies show measurable adverse biological effects on the bronchopulmonary apparatus in humans, animals, and in vitro. The pathologic effects of e-cigarettes have similarities to the effects of tobacco smoke on the pulmonary parenchyma. Conclusion. Analysis of the literature makes it possible to come to the conclusion that current knowledge of these pathologic effects is insufficient to determine whether exposure to e-cigarettes is less pathologic for the respiratory system than exposure to combustible tobacco products.

Key words: electronic cigarettes, vapes, high-disperse aerosol, lung cancer, pneumonitis

The purpose of the study is to analyze research publications on sexual dysfunction, modern possibilities of diagnosis and treatment of this condition in women with neurological diseases. Material and methods. The search for literary sources was carried out in the electronic databases PubMed Central, MEDLINE, Science Direct, Cochrane Library in the period from 2000 to 2023. Conclusions. Sexual dysfunction (SD) is a fairly common problem affecting on average about 60% of female patients suffering from various neurological diseases. The presence of SD significantly impairs physical, psychological and social parameters of women's health. The number of studies dealing with the problem of SD is quite limited. It should be noted that the development of differentiated comprehensive rehabilitation programs for patients with SD is a qualitatively new approach and is potentially effective in the management of SD. However, there is currently insufficient data for the application of complex methods of recovery and treatment of SD, which implies further study of the effectiveness of various methods of correction of SD in clinical trials.

Key words: sexual dysfunction, quality of life, neurological diseases, physical rehabilitation, young and middle-aged women, multiple sclerosis, spinal cord injury, Parkinson disease, stroke, traumatic brain injury

Treatment of orthopedic diseases is a pressing problem. Autologous conditioned serum is used in the treatment of osteoarthritis and exhibits a pronounced analgesic effect and improves joint function without significant side effects, even in cases resistant to other treatments. Autologous conditioned serum is also successfully used for meniscus pathology, tendon diseases, and osteochondrosis. Treatment with autologous conditioned serum is not only an effective method, but is also economically affordable.

Key words: orthopedic diseases, autologous conditioned serum, treatment

Due to the fact that modern scientific publications describe the different impact of religiosity on mental health, it seems relevant to conduct a scientific study on the comparative analysis of the impact of religion on mentally healthy people and persons with mental and behavioral disorders. Materials and methods: A questionnaire and a survey of 1,038 adult residents (510 patients with mental and behavioral disorders and 528 healthy individuals) permanently residing in Lugansk city was carried out on a voluntary basis. The questionnaire included a total of 67 questions and consisted of several sections, one of which (section VI) was questions concerning religiosity (faith in God, visiting religious temples, observing religious holidays, following Christian commandments). After the questionnaire, a separate clinical interview was conducted with patients suffering from mental and behavioral disorders who believe in God. Calculation of the specific weight of individuals according to the respective options for answering the questions was carried out. Results: it was found that in the group of patients with mental and behavioral disorders, there were significantly more persons who convincingly believe in God and frequently use prayer compared to mentally healthy people. Moreover, it was proved that religiosity has a positive effect on the mental state of patients. Preventive measures are recommended. 

Key words: religiosity, mental disorders, mental health, comparative analysis, prevention