[Hypoxic training in rehabilitation of patients at the early stages of recovery after SARS-CoV-2 pneumonia]. / Rol' gipoksicheskikh trenirovok v reabilitatsii patsientov na rannikh srokakh vosstanovleniya posle pnevmonii, vyzvannoi virusom SARS-CoV-2.

OBJECTIVE: To evaluate efficacy and safety of hypoxic-hyperoxic therapy in rehabilitation after SARS-CoV-2 pneumonia. MATERIAL AND METHODS: There were 44 patients aged 49-75 years in early recovery period after previous SARS-CoV-2 pneumonia (ICD-10 U07.1 and U07.2). Patients were divided into 2 groups depending on treatment strategy: group 1 (n=23) - rehabilitation treatment with therapeutic exercises, massage and physiotherapy; group 2 (n=21) - basic procedures with hypoxic-hyperoxic therapy. RESULTS: At initial evaluation, we found positive tendencies of rehabilitation in both groups. There were no side effects associated with hypoxic-hyperoxic therapy in the second group. Patients positively perceived this method of rehabilitation. There were significant between-group differences in exercise tolerance (p<0.05). These data indicate more favorable physical recovery in the second group and similar improvement of psycho-emotional status in both groups. CONCLUSION: Hypoxic-hyperoxic therapy is effective and safe approach in rehabilitation of patients with previous SARS-CoV-2 pneumonia. It is necessary to continue searching for effective methods of rehabilitation and develop accurate rehabilitation methods for various groups of patients.

[The role of systemic ozone therapy in the rehabilitation of patients after COVID-19]. / Rol' sistemnoi ozonoterapii v reabilitatsii patsientov, perenesshikh COVID-19.

OBJECTIVE: To evaluate the effectiveness and safety of ozone therapy in rehabilitation of patients with previous COVID-19. MATERIAL AND METHODS: A randomized controlled clinical trial included 51 patients aged 29 - 78 years with SARS-CoV-2 pneumonia (J12.8). Patients were divided into 3 comparable groups depending on the complex of rehabilitation. In the first (control) group (n=17), a 10-day course included daily breathing exercises and physiotherapy for the lungs (drug electrophoresis and low-frequency magnetotherapy). In the second (main) group (n=18), rehabilitation was combined with daily intravenous infusions of ozonized saline with ozone concentration of 2.0 mg/l within 5 days with subsequent standard rehabilitation. In the third group (n=16), patients received 5 ozone therapy procedures every other day. To determine the effectiveness and safety of systemic ozone therapy in rehabilitation of patients with previous COVID-19, we analyzed oxygen saturation, laboratory data (D-dimer and C-reactive protein), need for oxygen support before and after rehabilitation course. Complaints and quality of life throughout the rehabilitation program were assessed using the EQ-5D questionnaire. RESULTS: All patients had positive changes of all parameters. There were no adverse reactions throughout the rehabilitation program and 2 months later. We observed higher effectiveness of rehabilitation with systemic ozone therapy. Moreover, daily ozone therapy had a better effect on laboratory parameters compared to ozone therapy every other day. CONCLUSION: Ozone therapy is safe and effective in complex rehabilitation of patients with previous COVID-19. Further studies of large samples are needed to determine indications and appropriate criteria for this rehabilitation program.

Stereospecific diaza-Cope rearrangement as an efficient tool for the synthesis of DPEDA pyridine analogs and related C2-symmetric organocatalysts.

A simple and efficient synthesis of enantiomerically pure (1S,2S)-1,2-di(pyridin-2-yl)- and (1R,2R)-1,2-di(pyridin-4-yl)-ethane-1,2-diamines from commercial picolinaldehyde or isonicotinaldehyde and 2,2'-((1S,2S)-1,2-diaminoethane-1,2-diyl)diphenol (HPEN) via a stereospecific diaza-Cope rearrangement has been developed. Diamine (R,R)-2b was readily converted to novel diastereomeric ionic group-supported bis-prolinamides (R,S)-1b and (R,R)-1b which appeared to be efficient organocatalysts of asymmetric cross-aldol reactions in aldehyde/aldehyde, ketone/ketone or ketone/aldehyde reagent systems under neat conditions to afford corresponding aldols in high yields and with up to 99% ee. Furthermore, catalyst (R,S)-1b could be reused over 15 times in the same or similar catalytic reactions exhibiting close to original activity and a high level of stereoinduction.

C2-Symmetric pyrrolidine-derived squaramides as recyclable organocatalysts for asymmetric Michael reactions.

Novel C2-symmetric N,N'-bis-[(pyrrolidin-2-yl)methyl-squaramide] TFA salts bearing (R,R)- or (S,S)-1,2-di(pyridin-2-yl)ethane spacer groups were synthesized and applied, in combination with TEA, as efficient organocatalysts for asymmetric reactions between cyclohexanone derivatives and ß-nitrostyrenes to afford the corresponding Michael adducts in high yields with good to excellent enantioselectivity. The catalytic procedure is readily scalable and recyclable over four times without a negative impact on the selectivity of the reaction. Some of the prepared compounds are valuable precursors to useful bioactive molecules.

[Anesthesiological support during nephrectomy in living related donors].

International demands exist for the patients safety guaranteeng, in the live donors of organs peculiarly, who consciously agreed to be operated on with the organ excision for the patient sake. That's why it is important to elaborate optimal measures of safety for such operative intervention, including anesthesiological support for donors of kidney. Advantages of modern anesthetics application, ingalation introduction of sevofluran and intravenous injection of propophol over standard analgesia were discussed. The investigation was conducted in 53 live familial donors of kidney. Application of the recommended tactics have permitted to reduce the risk of occurrence and rate of complications in these patients.

[Investigation of simple and complex prelamination of vascularized flaps in experiment].

Prelamination, permitting improvement not esthetics only, but also function of the damaged region, to create necessary, by contents and configuration, vascularized complexes of tissues, is applied for effective treatment of complex defects in tissues. In experiment on laboratory animals for prelamination of vascularized flaps were applied separate and combined placement of mucosal and cartilaginous autotransplants. Results of the investigation witness possibility and efficacy of creation of content--component complexes of tissues, owing necessary characteristics for their further application in the clinic during performance of reconstructive interventions.

[Multiple organ failure in patients after surgical removal of insulinoma]. / Poliorgannaia disfunktsiia u bol'nykh posle operativnogo udaleniia insulinomy.

There were 96 patients with various nonpurulent pancreatic gland diseases examined. Postoperative disorders of function of myocardium, liver, kidneys, hormonal-metabolic state, inflammatory and reactive processes in blood, mostly pronounced after partial pancreatic resection conduction, were observed in 49 patients with organic hyperinsulinism having a background of initial changes in homeostasis.

[Features of anesthesia in surgical removal of insulinoma]. / Osobennosti provedeniia narkoza pri operativnom udalenii insulinomy.

Presence of endocrine disorders, malfunction of liver and kidneys requests special approach application concerning general anaesthetic use in patients with the hormone producing insulinomas. There were 44 patients examined, in whom tumor was removed. Sodium hydroxybutyrate application while introducing anaesthesia promoted the haemodynamics stabilization. Arduan dosage ought to be reduced because of it possible cumulation in blood due to hepatorenal disorders existing in this patients. The dominance of the blood glucagon at the end of operation and the glucagon-insulin coefficient shift causes the tachycardia and the shock index increase. The proposed direct binasal stimulation of respiration after the anaesthesia conduction promoted rapid muscle tone and respiratory movements restoration in patients.