Fast Track to Full Online Education in the Medical Field: Evaluating Effectiveness and Identifying Problems From the COVID-19 Experience

The research explores the key issues specific to the online learning format. The scholars surveyed 1540 students and teachers to collect the data. The purpose was to identify and find solutions to the distance learning problems in medical faculties. The research highlighted that 68% of students were dissatisfied with communication. Many educators have introduced ineffective teaching methods. Inadequate application of the programs prevents educators from introducing effective situation modelling, presenting medical and clinical case scenarios. It should ensure effective online communication with patients and other medical practitioners. The majority of students (62%) and teachers (68%) reported problems in these areas. The proposed online learning methods can be effective in teaching subjects such as general surgery, anatomy, pathological anatomy, topographic anatomy and operative surgery, and pathophysiology. The results can help educators to improve medical education. © 2022 IGI Global. All rights reserved.

[Diagnostic and treatment difficulties in kidney damage in the patient with generalized sarcoidosis during COVID-19. Case report].

The presented clinical observation reflects the difficulties of differential diagnosis of progressive kidney damage in a patient with sarcoidosis who has undergone a new coronavirus infection. The differential circle included interstitial nephritis as an exacerbation of the underlying disease, acute drug-induced kidney injury, acute glomerulonephritis. Nephrobiopsy confirmed the diagnosis of acute sarcoid tubulointerstitial nephritis with acute tubular necrosis. Timely administration of corticosteroids led to the control of the sarcoidosis process, restoration of kidney function.

Clinical outcomes of patients with COVID-19 admitted for respiratory support to the intensive care units in Russia

Aim. To evaluate mortality and risk factors for death in patients with COVID-19 who required admission to intensive care units (ICU) for respiratory support in Russia.Material and methods. In a retrospective study, we collected medical records of the consecutive ICU patients submitted by the local COVID-19 hospitals across Russia to the Federal Center at the Sechenov University (Moscow) betweenMarch 16 to May 3, 2020. All patients have completed their hospital stay (death or recovery). Diagnosis of SARS-CoV-2 pneumonia was established both by polymerase chain reaction (PCR) and CT. In patients with inconclusive or negative results of PCR, the SARS-CoV-2 pneumonia was defined as severe acute respiratory infection with typical CT findings and no other obvious aetiology. We used Cox proportional hazards regression model adjusted for age, sex and other risk factors to estimate hazard ratios (HR) and 95% confidence intervals (CI).Results. We studied 1522 ICU patients with SARS-CoV-2 induced acute respiratory distress syndrome (ARDS), including 864 males and 658 females at the median age of 62 years. Nine hundred twenty two records (60.1%) were submitted from Moscow and Moscow province, and 600 records (39.4%) were received from the hospitals located in 70 regions of Russia. SARS-CoV-2 was verified by PCR in 995 (65.4%) patients. Among 1522 patients enrolled in the study,995 patients (65.4%) died, and 527 (34.6%) patients recovered. The most common causes of death were ARDS (93.2%), cardiovascular events (3.7%) and pulmonary embolism (1.0%). The mortality rate was low in patients with less severe pneumonia requiring oxygen therapy (10.1%). However, it increased significantly in patients who were placed on noninvasive or invasive ventilation (36.8% and 76.5%, respectively). Risk of death increased with age, and in males older than 50 years it was significantly higher than in females of similar age. In a unvariate analysis, arterial hypertension, coronary artery disease (CAD), history of stroke, atrial fibrillation, type 2 diabetes, obesity and malignancies were associated with an increased risk of death. However, only CAD (HR1.257, 95% CI 1.064-1.485, p=0.007), type 2 diabetes (HR1.300, 95% CI 1.131-1.494, p<0.0001) and obesity (HR1.347,95% CI 1.166-1.556, p<0.0001) retained statistical signicance in multiple factor analysis.Conclusion. In ICU patients with COVID-19, severity ofARDS (i.e. requirement in mechanical ventilation), age, malegender, CAD, obesity and type 2 diabetes were associatedwith a higher risk of death. Цель. Изучение летальности и факторов рискасмерти больных с COVID-19, госпитализированных для респираторной поддержки в отделения реанимации и интенсивной терапии(ОРИТ) лечебных учреждений Российской Федерации.Материал и методы. Ретроспективноеисследование было выполнено в Федеральномдистанционном консультативном центре анестезиологии и реаниматологии для взрослыхпациентов с COVID-19 на базе Первого МГМУим. И.М. Сеченова. В исследование включаливсех пациентов с известными исходами (смертьот любых причин или выздоровление) SARS-CoV-2 пневмонии, осложнившейся острым респираторным дистресс синдромом (ОРДС),которые были проконсультированы с 16 мартапо 3 мая 2020 г. Факторы риска смерти анализировали с помощью многофакторной регрессионной модели Кокса.Результаты. В исследование были включены 1522 пациента, 864 (56,8%) мужчины и 658(43,2%) женщин. Медиана возраста - 62 года.922 (60,6%) больных находились в ОРИТ стационаров Москвы и Московской области, 600(39,4%) - лечебных учреждений в 70 регионахРоссийской Федерации. У 995 (65,4%) больных диагноз SARS-CoV-2 инфекции был подтвержден с помощью ПЦР. Умерли 995 (65,4%)пациентов, выжили 527 (34,6%). Основнымипричинами смерти были ОРДС (93,2%), сердечно-сосудистые осложнения (3,7%) и тромбоэмболия легочной артерии (1,0%).Летальность была низкой у пациентов, находившихся на оксигенотерапии (10,1%), изначительно повышалась у больных, которыхприходилось переводить на неинвазивную(36,8%) или инвазивную (76,5%) вентиляциюлегких. Риск смерти увеличивался с возрастоми в возрастных группах старше 50 лет у мужчинбыл достоверно выше, чем у женщин. В однофакторных моделях заболеваниями, ассоциировавшимися с развитием летального исхода,были артериальная гипертония, ИБС, инсульт,фибрилляция предсердий, сахарный диабет 2типа, ожирение и солидные опухоли, однако вмногофакторной модели, построенной по всемпризнакам с коррекцией по полу и возрасту,статистическое значение сохранили толькоИБС (отношение рисков [ОР] 1,257, 95% доверительный интервал [ДИ] 1,064-1,485,p=0,007), сахарный диабет 2 типа (ОР 1,300,95% ДИ 1,131-1,494, p<0,0001) и ожирение(ОР 1,347, 95% ДИ 1,166-1,556, p<0,0001).Заключение. Основными факторами рискасмерти больных с COVID-19, переведенных вОРИТ для респираторной поддержки, былитяжесть ОРДС, прежде всего необходимость вИВЛ, пожилой возраст, мужской пол, а такжеИБС, ожирение и сахарный диабет 2 типа.