Abstract. The healthcare sector is faced with the need to find new innovative and multidisciplinary approaches for the prevention and treatment of Covid, post-Covid, long-Covid, chronic, comorbid disorders. The results of 30 years of experience in the use of halotherapy in the treatment of pulmonary pathology indicate that the authors of the article have established the optimal level of use of halotherapy in pathological pulmonary
processes. At the same time, clinical experience provides evidence for the optimal method of using
the halotherapy method in pulmonary nosologies. The method of using salt therapy in exudative
pleurisy, in fibrinous pleurisy, in fibrotic processes in the lungs has been theoretically substantiated,
developed, and implemented in clinical practice. It has been proven that halotherapy is an effective
treatment method for bronchial asthma, chronic obstructive pulmonary diseases, acute respiratory
viral infections, fibrinous and exudative pleurisy. The therapeutic effect of this method is observed only when using halogenerators with the ability to grind salt in the range of 1-5 microns. Halotherapy sessions in patients with bronchial asthma with mild and moderate severity lead to the development of nonspecific hyposensitization, which in turn provides long-term remission of attacks and reduces the need for
glucocorticosteroid drugs. Halotherapy has a confirmed immunomodulatory effect and activates local and T-cell immunity. It requires further study of the experience of halotherapy, conducting marketing, pharmacoeconomic and comparative analysis.
Keywords: halotherapy, pulmonary pathologies, thoracic pathology, bronchial asthma, fibrinous
pleurisy, post-covid syndrome, patient.
УДК 616.24-002-053.2:578.834](0.083.96)
Objective — to determine the features of pathogenesis in patients with the pulmonary form of SARS-CoV-2. To establish, based on clinical examination data and electron microscopy, that vasculitis of the respiratory
system is the main pathophysiological and pathomorphological factor in lung tissue damage in COVID-19.
Materials and methods. A total of 692 patients aged 18 to 73 years with severe SARS-CoV-2 were examined. The control group consisted of 50 patients (25 women and 25 men) aged 25—70 years with a moderately severe clinical course of SARS-CoV-2. 58 patients underwent immunological tests, which included the study of O-lymphocytes and D-lymphocytes, circulating small and large immune complexes. A group of 30 people who died of COVID-19 pneumonia underwent a pathohistological examination of tissue samples. A group of 10 people who died of COVID-19 pneumonia underwent electron microscopic examination of tissue samples.
Results and discussion. Immunological examination revealed an increase in the number of O-lymphocytes (53.3 ± 1.3), an increase in the number of D-lymphocytes (4.9 ± 0.7), which highlights the impairment of T-cells of immunity; the predominance of the total mass of an increased level of small CICs (71.3 ± 2.5), which indicates a particularly «malignant» autoimmune component with damage to the connective tissue structure, primarily the vessels of the lungs, and therefore the vessels of epithelial organs, and an increase in the number of large CICs, which explains the material basis of allergic complications that accompany the severe course of
SARS. Ultrastructural electron microscopic examination of the respiratory tract of patients who died from respiratory failure in COVID-19 revealed the development of degenerative changes in the capillaries and endothelium, characterised by the expansion of the tubules of the granular endoplasmic reticulum, the destruction of ribosomes, the appearance of vacuoles in the cytoplasm surrounded by a double-contour membrane and containing small virion-like bodies, the basement membrane of haemocapillaries was hetero-geneously thickened. The development of venulitis was recorded, which is characterised by the accumulation of neutrophils in the vessel wall, pronounced degenerative changes in the endothelium, accompanied by the
destruction of cytoplasmic organelles, vacuolisation of the cytoplasm and its heterogeneous osmophilia, the appearance of heterogeneous microvilli on the lumenal surface of the endothelium, and heterogeneous thickening of the cytoplasmic membrane. Ultrastructural changes in the vascular endothelium in COVID-19 indicate the primary occurrence of acute vasculitis as a pathogenetic dominant in COVID-19 pneumonia. Conclusions. Clinical manifestations and ultrastructural pathomorphological studies conducted by us reliably indicate that the primary pathogenetic basis of atypical pneumonia in COVID-19 syndrome is the occurrence of acute vasculitis with predominant damage to the vessels of the pulmonary system. The
«malignant» course of COVID-19 syndrome involves the transformation of acute vasculitis into systemic vasculitis with subsequent unpredictable damage to a number of systems (respiratory, cardiovascular, hepatobiliary, genitourinary).
Keywords SARS-CoV-2, COVID-19, vasculitis, pneumonia, pulmonary system, coronavirus infection, pathomorphology, electron microscopic changes, fatalities, forensic medicine.
The file contains experimental data used in the article «Cytokine Profiles in the Lymphocytes of Patients with Arterial Hypertension and COVID-19» Fomenko Iryna, Biletska Liliia, Sklyarova Helen, 3Sklyarov Eugene, Vari G. Sandor, Kobylinska Lesya
Patient’s blood was used for this study. The control group consisted of 20 healthy individuals. Group 1 included 25 patients with AH admitted to the hospital with a hypertensive crisis, and Group 2 included 25 patients with AH and polysegmental pneumonia associated with coronavirus infection. ELISA determined cytokine levels. Lymphocytes were isolated from blood in a Ficoll density gradient.
Concentrations of the cytokines (IL-1β, IL-2, IL-6, IL-7, IL-8, IL-25, and IL-32α) were measured according to the manufacturer’s instructions: Human IL-1 beta ELISA Kit (ab214025), Abcam, Cambridge, UK; for IL-1β; Human IL-2 ELISA Kit (ab270883), Abcam, Cambridge, UK; for IL-2; Human IL-6 ELISA Kit (ab178013), Abcam, Cambridge, UK; for IL-6, Human IL-7 ELISA Kit (ab46031), Abcam, Cambridge, UK; for IL7; Human IL-8 ELISA Kit (ab214030), Abcam, Cambridge, UK; for IL-8; Human IL-25 ELISA Kit (ab272200), Abcam, Cambridge, UK; for IL25 and Human IL-32α ELISA Kit (ab267616), Abcam, Cambridge, UK. Absorbance was measured at 450 nm using a microplate reader (StatFax). The serum level of each cytokine was calculated according to the standard curves and expressed as pg/mL.
Background
Multiple sclerosis (MS) affects the health-related quality of life (HR-QoL) of patients. Constantly changing living and functioning conditions and patient expectations force continuous monitoring of HR-QoL.
Objective or hypothesis
The main aim of the study was to analyze HR-QoL among MS patients (MS), compared to a control group of healthy people (HG). Another aim was indication of the spheres in the SF-36 that were assessed the worst by patients.
Methods
The study was conducted in a group of 78 patients with MS and on 106 healthy individuals (HG). The SF-36 questionnaire was used to assess QoL. The analysis used Kruskal Wallis test, U-Mann Whitney’s test, student’s t-test, ANOVA, and a correlation coefficient.
Results
The biggest significant differences in the average level of HR-QoL between MS and HG were noted in the physical functioning. Men in this area, both with MS (34.4±22.9) and in HG (97.6±4.7), indicated a higher HR-QoL compared to women (29.7±24.4; 95.5±13.5, respectively). The analysis of the impact of disease symptoms on HR-QoL indicated a significant influence of fatigue and visual impairment on MCS, PCS, and ILQ. Motor coordination disorders and decreased well-being significantly reduced the HR-QoL in MCS. Sexual dysfunction significantly reduces HR-QoL in PCS (p=0.002) and ILQ (p=0.008). Motor coordination disorders significantly worsened HR-QoL in ILQ (p=0.040).
Conclusions
The greatest difference in HR-QoL between MS and HG was noted in the case of physical functioning. Including aspects aimed at minimizing chronic fatigue and improving visual function in the treatment strategy and rehabilitation program for patients will improve the quality of life of these patients, increase satisfaction with treatment, and maintain an appropriate level of compliance with pharmacotherapy.
The aim of the study was to ascertain the current state of surgical care as resulting from the reformation of medicine and education in Ukraine and to recommend ways of advancing it. The research included the processing and analysis of the annual reports of the Urology department of the Municipal City Clinical Emergency Hospital in Lviv during 2010-2019. The main statistical indicators of rendering the surgical aid (surgical activity, the structure of surgical interventions, mortality and structure of mortality, which are used in quantitative assessment of quality of medical aid and submitted in the annual reports) were analyzed in this work.
The study has identified the main problems of surgical work of the healthcare facilities in the section of the Urology department of the Clinical Emergency Hospital in Lviv, the most important of which are the low indicator of surgical activity and the presence of postoperative mortality. The main mortality reasons of the patients of the Urology department of this hospital are neglected oncopathology or other concomitant pathology, multiple organ failure, septic condition.
The key points towards resolving these problems are the further development of the material-technical base of the hospital and improvement of the overall quality of medical staff training, both during the undergraduate and postgraduate training of specialists, which will allow the improvement of the quality of rendering medical aid nationwide.