ISSN Print 2713-2757    ISSN Online 2713-2765
Extreme Medicine

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Gastric cancer (GC) usually has an unfavorable prognosis: the five-year survival rate is 20–30% in most world regions. Timely diagnosis and prevention of risk factors may reduce mortality from GC. This review discusses the meta-analyses of 40 endogenous and exogenous factors associated with GC. GC is significantly associated with family history; dietary preferences (increased consumption of roast and smoked red meat, hot foods, pickles, salt (over 5–6 g/day), nitrates (over 20 mg/L drinking water); lifestyle (smoking, opium use, strong alcohol, beer, stress); some diseases including gastroesophageal reflux disease, diabetes mellitus, obesity, and autoimmune disorders; infections (Helicobacter pylori, human papillomavirus, Epstein-Barr virus); ionizing radiation, and professional hazards. Data suggesting associations between the risk of GC and the consumption of coffee, tea, high-fat foods, simple carbohydrates, folic acid, sleep duration, and blood cholesterol turned out to be conflicting due to the inconsistencies of the results between cohort and case-control studies. About 3% of all gastric cancers are linked to hereditary syndromes associated with pathogenic variants of CDH1, STK11, SMAD4, BMPR1A, TP53, MYH, APC, PTEN, ATM, BRCA1, and some other genes.
Taking into account the gut–lung microbiota axis, the new probiotic treatment methods for COVID-19 are currently being discussed. There are effective medicinal preparations of domestic manufacture in the Russian Federation, the immobilized probiotics. The study was aimed to determine the effectiveness of the mixed immobilized probiotic containing the immobilized B. bifidum and lactobacilli L. plantarum (100 million CFU per dose) or the simple immobilized probiotic containing the immobilized B. bifidum (500 million CFU per dose) in the complex therapy of patients with COVID-19. During the open-label, prospective, observational study 70 patients with confirmed diagnosis of COVID-19 received complex treatment which included the immobilized probiotics. All patients were discharged from the hospital with imporoved health status, as well as with improved instrumental and laboratory indicators: body temperature returned to normal in all patients; shortness of breath, cough, feeling of chest tightening, myalgia and headache disappeared; the patients regained sense of smell and taste; the weakness decreased or disappeared (pathognomic symptom for COVID-19). The dynamics of clinical, laboratory and instrumental indicators reflecting the course of the novel coronavirus infection demonstrates the effectiveness of the used complex therapy. The immobilized probiotics may be recommended for the complex treatment of patients with COVID-19.

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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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