OPTIMIZATION OF INTERDEPARTMENTAL ELECTRONIC INTERACTION OF THE MILITARY COMMISSARIAT IN THE ORGANIZATION AND CONDUCT OF MEDICAL EXAMINATION OF CITIZENS SUBJECT TO CONSCRIPTION

The military commissariat requests information characterizing their state of health in order to study the state of health of citizens subject to conscription before the next conscription of citizens for military service. An interdepartmental request for this information's provision to medical organizations and institutions of medical and social expertise is encouraging to be issued in the form of an electronic document using a unified system of interdepartmental electronic interaction, taking into account the trends in the development of the public administration system. Interdepartmental interaction optimization through creation of an electronic interaction mechanism will allow military commissariats to promptly exchange information in real-time characterizing the citizens' state of health subject to conscription for military service with medical organizations of the state and municipal health care system, and federal state institutions of medical and social expertise. The direct connection of the military commissariat to the state information system in the field of healthcare of the subject of the Russian Federation by means of cryptographic protection of information will contribute to improving the quality as well as deceasing the medical examination time of citizens subject to conscription, thus improving the efficiency of providing medical services to citizens in medical organizations. The public administration system was successfully reoriented to provide state and municipal services in a remote format during the unstable epidemiological situation caused by the pandemic of a new coronavirus infection. Optimization of interdepartmental electronic interaction will allow military commissariats to take additional preventive measures to avoid infection and avert the spread of a new coronavirus infection during the recruitment campaign. Modern digital technologies and solutions are able to provide a qualitative leap in the organization of conscription of citizens for military service, which can be implemented without significant financial costs in the short term. However, there is a growing need to involve a proper number of participants of the military command and other state authorities in solving this complex problem. All rights reserved © Eco-Vector, 2022.

Mechanisms of Damage to the Cardiovascular System in COVID-19

The review article is devoted to the analysis of the literature on the various mechanisms of damage to the cardiovascular system in COVID-19. The article briefly outlines the epidemiology and urgency of the COVID-19 problem, describes the features of the clinical picture of heart muscle damage in COVID-19. The pathophysiology, morphology and pathogenetic mechanisms of myocardial involvement in cases of SARS-CoV-2 lesion are considered in detail. The authors present a diagram of various mechanisms of myocardial damage in COVID-19, which includes mediated damage to the heart muscle through angiotensin-converting enzyme 2, myocardial damage caused by hypoxemia, microvascular heart damage, and systemic inflammatory response syndrome. A detailed scheme of cardiomyocyte infection with the involvement of cytokines, which ultimately leads to myocardial remodeling and dilated cardiomyopathy, is presented. The pathophysiological foundations of the development of sudden cardiac death in COVID-19, which include the mechanisms of life-threatening arrhythmias, acute coronary syndrome, and heart failure, are considered. The authors analyzed scientific studies of the toxic effects of COVID-19 drug treatment on the heart muscle, in particular, antiviral, antibacterial, antimalarial agents. Their potential benefits and harms, as well as the likelihood of developing cardiovascular events, in particular sudden cardiac death, were assessed. © 2021 Izdatel'stvo Meditsina. All rights reserved.

Psychological and psychiatric aspects of unusual living conditions caused by the COVID-19 pandemic

The article examines the psychological and psychiatric aspects of unusual living conditions caused by the pandemic of the novel coronavirus infection COVID-19. The features of the formation of psychopathological disorders in the population during an unfavorable epidemiological situation are analyzed. Five periods of their development are identified, which were characterized by their specific features depending on the influence of various factors (patterns of development of the infectious process, the nature of its information support, organizational measures taken, etc.). In the study of the psychological and pathopsychological characteristics of the response under conditions of an unfavorable epidemiological situation, it was established that their structure and clinical features had, along with the general patterns (characteristic for each of the periods of the development of the epidemic situation), a number of specific features. In the course of studying the psychological and psychiatric aspects of unusual conditions of existence (forced self-isolation), three groups of people were identified, according to their age and the nature of their professional activities. It was established that the psychological forms of response and the features of psychopathological manifestations in the conditions of an unfavorable epidemiological situation caused by COVID-19 were characterized by heterogeneity and polymorphism and were determined both by the course of the epidemic process and by the influence of various biomedical, socio-psychological, informational, and professional household pathogenic factors. Of particular importance was the fact that the degree of influence of these factors on the mental health of people was largely determined by the gradually increasing asteniс effect of each of them (the “vicious circle”), with the formation of a “favorable asthenic soil” that promotes the development of more marked and persistent mental and psychosomatic disorders. В статье проведено изучение психолого-психиатрических аспектов непривычных условий существования, вызванных пандемией новой коронавирусной инфекции COVID-19. Проанализированы особенности формирования психопатологических нарушений у населения в период неблагополучной эпидемиологической обстановки. Выделены пять периодов их развития, которые характеризовались своими специфическими особенностями в зависимости от влияния разных факторов (закономерностей развития инфекционного процесса, характера его информационного сопровождения, принимаемых организационных мероприятий и т. д.). При исследовании психологических и патопсихологических особенностей реагирования в условиях неблагополучной эпидемиологической обстановки установлено, что их структура и клинические особенности имели, наряду с общими закономерностями (характерными для каждого из периодов развития эпидобстановки), ряд специфических особенностей. В ходе изучения психолого-психиатрических аспектов непривычных условий существования (вынужденной самоизоляции) выделены три группы лиц в зависимости от их возраста и характера профессиональной деятельности. Установлено, что психологические формы реагирования и особенности психопатологических проявлений в условиях неблагополучной эпидемиологической обстановки, вызванной COVID-19, характеризовались неоднородностью и полиморфностью и определялись как течением самого эпидемического процесса, так и влиянием различных медико-биологических, социально-психологических, информационных и профессионально-бытовых патогенных факторов. Особое значение приобретало то обстоятельство, что степень влияния данных факторов на психическое здоровье людей во многом определялось постепенно нарастающим астенизирующим воздействием каждого из них («порочный круг») с формированием «благоприятной астенической почвы», способствующей развитию более выраженных и стойких психических и психосоматических расстройств.

Role of renin-angiotensin-aldosterone system in the interaction with coronavirus SARS-CoV-2 and in the development of strategies for prevention and treatment of new coronavirus infection (COVID-19). [Russian]

The 2019 coronavirus pandemic (COVID-19), due to the new SARS-CoV-2 virus, represents the greatest global public health crisis and an unprecedented challenge to find effective ways to prevent and treat. In the active phase of a pandemic, early results allow these preventive measures to be implemented on a scale compatible with the pandemic. If the results are convincing, their value will be difficult to overestimate, since additional one or two outbreaks of this infection are expected. Clinical data is emerging rapidly from a large number of people afflicted with SARS-CoV-2, which should provide clinicians with accurate evidence of the effectiveness of different preventive and treatment methods. In particular, an active search is underway for cellular mechanisms that SARS-CoV-2 uses to penetrate tissues. These include information about the receptor of the angiotensin-converting enzyme receptor (ACE 2). SARS-CoV-2, a single-stranded envelope RNA virus, attaches to cells via a viral spike (S) protein that binds to the ACE 2. After binding to the receptor, the viral particle uses the receptors of the host cell and endosomes to enter the cells. Human type transmembrane serine protease 2 (TMPRSS 2) facilitates penetration into the cell via protein S. Once inside the cell, viral polyproteins are synthesized that encode the replicate transcriptase complex. The virus then synthesizes RNA through its RNA-dependent RNA polymerase. Structural proteins are synthesized leading to the completion of the assembly and release of viral particles. These stages of the virus life cycle provide potential targets for drug therapy. Current clinical and scientific data do not support discontinuation of ACE inhibitors or angiotensin receptor blockers in patients with COVID-19, and an ongoing discussion is addressed in this review. Copyright © 2020 All-Russian Public Organization Antihypertensive League. All rights reserved.