Extreme Medicine
SCIENTIFIC AND PRACTICAL REVIEWED JOURNAL OF FMBA OF RUSSIA

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Introduction. This article describes the extrapulmonary manifestations of COVID-19 and proposes a simple and quick patient self-completed questionnaire for identifying such symptoms in the affected patients.Materials and methods: The study was conducted in 93 patients who gave consent to participate. The questionnaire included questions about age and sex, 3 open-ended questions and 92 tick-a-box closed-ended questions about the possible symptoms. All symptoms listed in the closed-ended section of the questionnaire can be classified into 9 major domains (groups): pain, febrility, respiratory symptoms, neurological symptoms, digestive symptoms, skin symptoms, renal and urological symptoms, cardiac symptoms, apathy and asthenia.Results and discussion:  Apathy, asthenia, fever, and respiratory symptoms were the most common. manifestations of COVID-19.  Less frequent were neurological, digestive and cardiovascular symptoms. However, with apathy, asthenia and headache included in the neurological domain, neurological symptoms ranked first in their prevalence (97.75%). Symptoms indicating kidney and skin involvement were significantly less common.Conclusions: Extrapulmonary manifestations of the disease were observed in the majority of our patients. The authors plan to continue their research and aim to compare the results of laboratory and instrumental tests with presenting complaints, investigate the associations between the received therapy and the complaints, and propose optimization strategies for the management of COVID-19 patients (inviting specialty physicians to work with COVID-19 hospital teams during an escalating epidemic and providing specialized consultations to patients as the epidemic subsides).
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Late in December 2019, an outbreak of an unknown coronavirus, later identified as SARS-CoV- 2, emerged in the city of Wuhan, China. It causes a dangerous respiratory coronavirus disease in humans - COVID-19.Objective. To detect cases of the disease and prevent its spread across the Russian Federation it is necessary to create an effective diagnostic test system. Material and methods. Based on the analysis of the alignment of the SARS-CoV-2 nucleotide sequences, primers and a probe for RT-PCR were selected, and the analysis conditions were optimized. Results. The diagnostic system was developed and registered in the shortest possible time in real-time RT-PCR format for detecting SARS-CoV-2 coronavirus RNA in smears from the nasopharynx and oropharynx, sputum and feces. The high specificity of the system was verified on a representative set of viruses and microorganisms, the analytical sensitivity was 1x103 copies / ml in smears from the mucous membrane of the nasopharynx and oropharynx and sputum, 5x104 copies / ml in fecal samples. Diagnostic sensitivity and specificity established during clinical trials on samples from patients with confirmed COVID-19 infection, from patients with a different etiology of a disease and clinically healthy people were to 100% (range 94.2-100% with a confidence level of 95%).
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Highly virulent SARS-CoV-2 emerged in Wuhan, China, and rapidly spread across the globe afflicting 14.5 million and killing over 600,000 people. The key factors affecting the severity of COVID-19 include advanced age and respiratory failure requiring mechanical ventilation (MV). Mortality rates estimated for mechanically ventilated patients with SARS-CoV-2-induced respiratory failure are 76.4% in the 18-65 age group and 97.2% in individuals over 65 years. At present, extracorporeal membrane oxygenation (ECMO) remains a life-saving method of choice. It is essentially a lung bypass system for direct oxygenation of the blood. It is an invasive and costly procedure performed only at specialized medical care facilities. China, USA, Germany, France and Israel have already launched large-scale research and clinical studies of non-invasive approaches to improving the efficacy of oxygen therapy in patients with complicated viral pneumonia, such as hyperbaric oxygen therapy (HBOT). HBOT is a well-established treatment for anaerobic and aerobic infections accompanied by soft tissue necrosis, carbon monoxide poisoning, stubborn wounds, including non-healing diabetic ulcers, complications of radiation therapy, stroke sequelae, brain injuries, decompression sickness, and other conditions. The use of HBTO in patients with viral infection, pulmonary edema and pneumonia is supported by the laws of physics and clinical/physiological effects in response to the exposure of elevated air pressure and hyperoxic environment.  This review provides rationale for using hyperbaric oxygenation therapy in patients with SARS-CoV-2-induced viral pneumonia and presents the first data on the beneficial effects of HBTO in Chinese patients with COVID-19 complications.
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Highly virulent SARS-CoV-2 emerged in Wuhan, China, and rapidly spread across the globe afflicting 14.5 million and killing over 600,000 people. The key factors affecting the severity of COVID-19 include advanced age and respiratory failure requiring mechanical ventilation (MV). Mortality rates estimated for mechanically ventilated patients with SARS-CoV-2-induced respiratory failure are 76.4% in the 18-65 age group and 97.2% in individuals over 65 years. At present, extracorporeal membrane oxygenation (ECMO) remains a life-saving method of choice. It is essentially a lung bypass system for direct oxygenation of the blood. It is an invasive and costly procedure performed only at specialized medical care facilities. China, USA, Germany, France and Israel have already launched large-scale research and clinical studies of non-invasive approaches to improving the efficacy of oxygen therapy in patients with complicated viral pneumonia, such as hyperbaric oxygen therapy (HBOT). HBOT is a well-established treatment for anaerobic and aerobic infections accompanied by soft tissue necrosis, carbon monoxide poisoning, stubborn wounds, including non-healing diabetic ulcers, complications of radiation therapy, stroke sequelae, brain injuries, decompression sickness, and other conditions. The use of HBTO in patients with viral infection, pulmonary edema and pneumonia is supported by the laws of physics and clinical/physiological effects in response to the exposure of elevated air pressure and hyperoxic environment.  This review provides rationale for using hyperbaric oxygenation therapy in patients with SARS-CoV-2-induced viral pneumonia and presents the first data on the beneficial effects of HBTO in Chinese patients with COVID-19 complications.
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The paper reports the experience of implementing psychological support measures for healthcare workers of infectious hospitals for patients with COVID-19 during a pandemic. The results of an empirical study of the relationship between the anxiety and depression symptoms prevalence, severity and specificity, and the social status and occupational burnout factors in healthcare workers living in metropolis (Krasnoyarsk) and closed territorial district (Zelenogorsk) or seconded to the Severo-Yeniseysky District of the Krasnoyarsk Territory, are presented. The phases of the psychological support activities implementation are described. A comparative analysis of the employees’ involvement in various infectious diseases hospitals was carried out.<b>Material and methods</b>The survey sample included 126 subjects (21 men and 105 women) engaged in the provision of medical care in three infectious diseases hospitals for patients with COVID-l9 in the Krasnoyarsk Territory. To achieve the goals and objectives of the study, the following methods were used: psychodiagnostic testing using the BDI scale, STAI test and MBI questionnaire, and statistical data processing (Spearman rank correlation coefficient, Wilcoxon-Mann-Whitney U-test). We invited 284 medical workers to participate in the psychological support activities.<b>Results and conclusion</b>The prevalence of sub-threshold depression among medical specialists varied between 5.5 and 30.9% depending on the infectious diseases hospital for patients with COVID-19 location. Severe depressive symptoms were detected in 4.46% of the total number of subjects. A low level of state anxiety was detected in less than 30% of respondents. It was confirmed that younger and less experienced employees were more susceptible to depersonalization and cognitive-affective symptoms of depression. Employees who had no children demonstrated higher level of state and trait anxiety. Moreover, despite the prevalence of alarming and depressive symptoms, the low involvement and unwillingness of healthcare workers to participate in psychological support activities were noted.
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Dear researcher!
Richard FEYNMAN Cargo cult science
American physicist Richard P. Feynman, a Nobel laureate, was always very scrupulous about the quality of a research study. During his commencement address at the California Institute of Technology in 1974, he talked about scientific integrity and honesty and warned young researchers “not to fool” themselves. A must-read for anyone who believes he/she is a true scientist.
Ivan PAVLOV On the Russian mind
In 1918, Russian physiologist Ivan Pavlov, a Nobel laureate, delivered two lectures: on the mind in general and the Russian mind in particular; on those mind qualities that determine the success of a research work and on how these qualities are present in the Russian mind. Pavlov's thoughts are an effective vaccine against poor intellectual work.