The inspiratory activity of respiratory center and respiratory muscles strength after COVID-19.

The respiratory pump that provides pulmonary ventilation includes the respiratory center, peripheral nervous system, chest and respiratory muscles. The aim of this study was to evaluate the activity of the respiratory center and the respiratory muscles strength after COVID-19 (COronaVIrus Disease 2019). Methods. The observational retrospective cross-sectional study included 74 post-COVID-19 patients (56 (76%) men, median age - 48 years). Spirometry, body plethysmography, measurement of lung diffusing capacity (DLCO), maximal inspiratory and expiratory pressures (MIP and MEP), and airway occlusion pressure after 0.1 sec (P0.1) were performed. In addition, dyspnea was assessed in 31 patients using the mMRC scale and muscle strength was assessed in 27 of those patients using MRC Weakness scale. Results. The median time from the COVID-19 onset to pulmonary function tests (PFTs) was 120 days. The total sample was divided into 2 subgroups: 1 - P0.1 <= 0.15 kPa (norm), 2 - > 0.15 kPa. The lung volumes, airway resistance, MIP, and MEP were within normal values in most patients, whereas DLCO was reduced in 59% of cases in both the total sample and the subgroups. Mild dyspnea and a slight decrease in muscle strength were also detected. Statistically significant differences between the subgroups were found in the lung volumes (lower) and airway resistance (higher) in subgroup 2. Correlation analysis revealed moderate negative correlations between P0.1 and ventilation parameters. Conclusion. Measurement of P0.1 is a simple and non-invasive method for assessing pulmonary function. In our study, an increase in P0.1 was detected in 45% of post-COVID-19 cases, possibly due to impaired pulmonary mechanics despite the preserved pulmonary ventilation as well as normal MIP and MEP values.Copyright © Savushkina O.I. et al., 2023.

The inspiratory activity of respiratory center and respiratory muscles strength after COVID-19

The respiratory pump that provides pulmonary ventilation includes the respiratory center, peripheral nervous system, chest and respiratory muscles. The aim of this study was to evaluate the activity of the respiratory center and the respiratory muscles strength after COVID-19 (COronaVIrus Disease 2019). Methods. The observational retrospective cross-sectional study included 74 post-COVID-19 patients (56 (76%) men, median age – 48 years). Spirometry, body plethysmography, measurement of lung diffusing capacity (DLCO), maximal inspiratory and expiratory pressures (MIP and MEP), and airway occlusion pressure after 0.1 sec (P0.1) were performed. In addition, dyspnea was assessed in 31 patients using the mMRC scale and muscle strength was assessed in 27 of those patients using MRC Weakness scale. Results. The median time from the COVID-19 onset to pulmonary function tests (PFTs) was 120 days. The total sample was divided into 2 subgroups: 1 – P0.1 ≤ 0.15 kPa (norm), 2 – > 0.15 kPa. The lung volumes, airway resistance, MIP, and MEP were within normal values in most patients, whereas DLCO was reduced in 59% of cases in both the total sample and the subgroups. Mild dyspnea and a slight decrease in muscle strength were also detected. Statistically significant differences between the subgroups were found in the lung volumes (lower) and airway resistance (higher) in subgroup 2. Correlation analysis revealed moderate negative correlations between P0.1 and ventilation parameters. Conclusion. Measurement of P0.1 is a simple and non-invasive method for assessing pulmonary function. In our study, an increase in P0.1 was detected in 45% of post-COVID-19 cases, possibly due to impaired pulmonary mechanics despite the preserved pulmonary ventilation as well as normal MIP and MEP values. © Savushkina O.I. et al., 2023.

The inspiratory activity of respiratory center and respiratory muscles strength after COVID-19.

The respiratory pump that provides pulmonary ventilation includes the respiratory center, peripheral nervous system, chest and respiratory muscles. The aim of this study was to evaluate the activity of the respiratory center and the respiratory muscles strength after COVID-19 (COronaVIrus Disease 2019). Methods. The observational retrospective cross-sectional study included 74 post-COVID-19 patients (56 (76%) men, median age - 48 years). Spirometry, body plethysmography, measurement of lung diffusing capacity (DLCO), maximal inspiratory and expiratory pressures (MIP and MEP), and airway occlusion pressure after 0.1 sec (P0.1) were performed. In addition, dyspnea was assessed in 31 patients using the mMRC scale and muscle strength was assessed in 27 of those patients using MRC Weakness scale. Results. The median time from the COVID-19 onset to pulmonary function tests (PFTs) was 120 days. The total sample was divided into 2 subgroups: 1 - P0.1 <= 0.15 kPa (norm), 2 - > 0.15 kPa. The lung volumes, airway resistance, MIP, and MEP were within normal values in most patients, whereas DLCO was reduced in 59% of cases in both the total sample and the subgroups. Mild dyspnea and a slight decrease in muscle strength were also detected. Statistically significant differences between the subgroups were found in the lung volumes (lower) and airway resistance (higher) in subgroup 2. Correlation analysis revealed moderate negative correlations between P0.1 and ventilation parameters. Conclusion. Measurement of P0.1 is a simple and non-invasive method for assessing pulmonary function. In our study, an increase in P0.1 was detected in 45% of post-COVID-19 cases, possibly due to impaired pulmonary mechanics despite the preserved pulmonary ventilation as well as normal MIP and MEP values.Copyright © Savushkina O.I. et al., 2023.

Right ventricular myocardial dysfunction in patients (pts) after severe coronavirus disease (COVID-19)

Aim: To study the systolic function (SF) and diastolic function (DF) of the heart and to assess subclinical myocardial right ventricular (RV) dysfunction in pts after severe COVID-19. We examined 23 males aged 46-70 years (mean age - 58.8 +/- 12.6 yrs) discharged after COVID-19 (50-75% of the parenchymal damage) with exertional dyspnea. We performed transthoracic echocardiography (TTE) with assessment of RV global longitudinal strain (RV-GLS) and right ventricular free wall longitudinal strain (RVLS) using speckle tracking echocardiography. Result(s): The SF of the RV assessed by the excursion of the tricuspid valve ring (TAPSE) was preserved (2.1 +/- 0.6 cm) in all pts under study after severe COVID-19. The left ventricular (LV) ejection fraction was also preserved (62.1 +/- 4.7%) in all pts. TTE revealed normal ventricular and atrial dimensions: LV end-diastolic volume index (62.5 +/- 8.4 ml/m2) and RV end-diastolic diameter (2.7 +/- 0.6 cm), left atrial (LA) volume index (26.7 +/- 3.1 ml/m2) and right atrial (RA) volume index (20.2 +/- 4.5 ml/m2). LV DD was also detected: Grade I in 17 (74%) pts, and Grade II in 6 (16%) pts. Moderate pulmonary hypertension (PH) was present in all pts (time of acceleration of systolic flow in the pulmonary artery (AcT - 85.0 +/- 7.9 msec) as a consequence of significant pulmonary parenchymal involvement. We found reduced RV-GLS (-17.4 +/- 2.7%) and free wall RVLS (-18.9 +/- 3.1%) in 23 (100%) pts. Conclusion(s): Preserved LV and RV SF with Grade 1 and Grade 2 LV DD and moderate PH were established in pts after severe COVID-19. RV wall motion abnormalities with reduced RV-GLS and free wall RVLS were found, indicating the presence of subclinical RV myocardial dysfunction.

What do medical professionals really think about vaccination?

Background: vaccination against COVID-19 alleviates the course of infection and its burden for health systems. However, despite unambiguous expert's relation to vaccination it still remains controversial between medical professional in Ukraine. Aim(s): to establish the attitude of medical professionals, including medical students and residents, to vaccination. Material(s) and Method(s): we anonymously interviewed 155 medical professionals using Google Forms. 97 respondents were medical students, 38 were residents, 20 were licensed medical doctors. 10 respondents also worked at medical university as teachers. Result(s): 143 (92,2%) interviewees were vaccinated against COVID-19. 3 (2%) respondents were unvaccinated due to fear of side effects, others 9 (5,8%) had contraindications or COVID-19 recently. 125 (80,7%) considered vaccination beneficial for general population whereas 4 (9%) persons marked vaccination as unbeneficial, 16 (10,3%) refrained from answering. 120 (77,5%) interviewees considered vaccination beneficial for themselves whereas 24 (15,5%) marked it as personally disadvantageous and 11 (7%) refrained from answering. It is remarkably that no one declared fear of dismissal from job as a reason for vaccination as well as fundamental position against vaccination as a cause to restrict. As for Concerns, answerers mentioned lack of COVID-19 vaccines investigations, including possible negative sequences for descendants. Conclusion(s): the vast majority of respondents were vaccinated and supposed vaccination to be beneficial for themselves and for society. Nevertheless, there is still a need for additional education as some respondents announced unreasonable fears towards vaccination.

Three Managerial Solutions for E-learning Technologies Related to the Covid-19 Pandemic

The purpose of this experimental study is to prepare management solutions for University authorities regarding e-learning technologies related to the COVID-19 pandemic. The research methods were literature review, sociology, and statistics. 349 Polish and Ukrainian respondents participated in this study. For the first time, the student's needs and the university's offers in e-learning technologies were empirically measured. The alternative hypothesis was accepted. The authors accepted the Alternative hypothesis. This is the first study that revealed the University offers in elearning technologies do not meet the students' e-learning needs in Poland and Ukraine. The significance level of 99.0% was accepted. It shows that the decisions are correct in about 99.0% of cases. And the decisions are not correct in about 1.0% of all the cases. Finally, there were prepared three managerial solutions for e-learning technologies related to the Covid-19 pandemic. Two of them have practical significance whereas the other one has theoretical significance. Disciplinary: Education (HEI Education Management, Education Technologies). (c) 2022 INT TRANS J ENG MANAG SCI TECH.

[Strategic directions for the competitiveness of primary health care organizations].

The article analyzes the impact of the pandemic COVID-19 in 2020 on the state of competition in the medical services market and the competitiveness of primary care organizations, and identifies prospects for the development of the medical services market. The SWOT-analysis and analysis of complaints and statements of citizens on the quality of medical services made it possible to comprehensively assess the strengths and weaknesses of organizations, external opportunities and threats, specify the positions of medical organizations in the medical services market and determine strategic directions for the development and ensuring the competitiveness of primary medical organizations. The results of the study allowed the authors to propose strategic directions for ensuring the competitiveness of the primary medical organization, namely, the creation of mechanisms for material and intangible incentives for medical personnel; improving the quality of health services; modernization of the medical diagnostic base of the primary medical organization.

Cough in the post COVID period: Clinical examples

Among the extensive list of manifestations of post COVID syndrome, cough is often found. Most researchers interpret its character as post infection. In some patients, post infection cough becomes productive, and combined mucoactive therapy is required for effective treatment. Since the onset of the pandemic, clinical descriptions of spontaneous pneumothorax have accumulated in the literature. The risk of this complication is present even in patients who are not burdened with chronic lung diseases, as well as those who are breathing spontaneously. The study of the mechanisms of development of spontaneous pneumothorax in COVID-19 is necessary for the development of further therapeutic and preventive measures. Traction bronchiectasis occurs in 27 – 52.5% of cases of new coronavirus infection. Changes in the structure of the bronchi predispose to chronic cough and recurrent infections. Respiratory viral infection has been considered in the past as a trigger for bronchial asthma. There is controversy over the new coronavirus. Asthma has been suggested as a protective factor in COVID-19, due to the specific inflammation profile that protects patients. In some patients who have had COVID-19, the cough is due to hyperventilation syndrome. To explain it, a hypothesis of impaired respiratory control was proposed. The paper presents clinical examples illustrating a wide range of pathological conditions accompanied by cough. Possible relationships between cough and previous coronavirus infection are discussed. © 2021 Medical Education. All rights reserved.