Characteristics of brain lesions found using MRI imaging in patients with post-COVID with signs of cognitive decline.

OBJECTIVE: Aim: To describe and evaluate abnormalities of the brain in post-COVID patients with neurologic symptoms and cognitive deficits using MRI imaging of the brain. PATIENTS AND METHODS: Materials and Methods: We included 21 patients with a previous positive PCR testing for SARS-CoV-2 and one or more of the following symptoms: memory and cognitive decline, dizziness, anxiety, depression, chronic headaches. All patients had MRI imaging done at onset of symptoms, but after at least 1 year after positive testing for COVID-19 based on the patient's previous medical history. RESULTS: Results: All of the patients complained of lack of concentration, forgetfulness, hard to process information. 15 patients suffered from confusion, 10 from anxiety. Of the 21 patients 14 had isolated chronic headaches, 3 had isolated dizziness, 4 patients had both symptoms upon inclusion. All patients underwent MRI imaging as a part of the diagnostic workup and had varying degrees of neurodegeneration. CONCLUSION: Conclusions: Our data correlates with existing research and shows tendency for cognitive decline in post-COVID patients. This provides groundwork for further research to determine correlation between acceleration of neurodegeneration and post-COVID.

Ocular lesions in patients with ulcerative colitis.

OBJECTIVE: Aim: To analyze the data and evaluate the prevalence of ocular lesions in patients with moderate ulcerative colitis. PATIENTS AND METHODS: Materials and Methods: We observed 112 patients aged 18-75 years old with clinically, endoscopically and histologically confirmed moderate ulcerative colitis which lasted at least 6 months. An ophthalmologic exam was performed to determine the presence of ocular symptoms. RESULTS: Results: Of the 112 patients with moderate ulcerative colitis, 21 (18,75%) had the following ocular lesions: episcleritis - 7 patients (6,25%), keratopathy - 5 patients (4,46%), uveitis - 5 patients (4,46%), cataract - 2 (1,78%) and scleritis - 2 (1.78%). CONCLUSION: Conclusions: Because ocular symptoms in patients with UC are often nonspecific, it may be beneficial to perform ophthalmologic examinations as a routine follow-up component of in such patients.

COVID-19 AND PRIMARY CARE: POSSIBILITIES FOR INCREASING POSITIVE OUTCOMES.

OBJECTIVE: The aim: Determine the most common non-communicable diseases which are associated with an increased rate of moderate and severe COVID-19 infection. Identify the best tools for diagnosing COVID-19 and predicting the deterioration of the disease. PATIENTS AND METHODS: Materials and methods: Publications were processed and analyzed according to the keywords of the topic of work "COVID-19", "non-communicable disease", "obesity", "hypertension", "Comorbidities", "frailty", "diabetes", "chronic obstructive pulmonary disease", "cardio-vascular diseases", "liver diseases", "diagnostic tools", "outcomes" in the databases of PubMed, MEDLINE, Web of Science. CONCLUSION: Conclusions: As a result of the analysis, we found that patients with concomitant obesity, diabetes mellitus, COPD, CVD and liver diseases have an increased the risk of severe forms and death from COVID-19.

EFFECT OF PROLONGED TREATMENT WITH BIOLOGICAL THERAPY IN PATIENTS WITH ULCERATIVE COLITIS WITH CONCOMITENT JOINT DAMAGE.

OBJECTIVE: The aim: Is to compare the effects of tofacitinib, adalimumab and budesonide clinical and laboratory signs of patients with moderate UC with concomitant articular syndrome. PATIENTS AND METHODS: Materials and methods: 100 patients with moderately severe UC. Patients were divided into 2 groups. The I group consisted of patients with UC, which were treated with tofacitinib 10mg bid (TOF; n=28). II group consisted of patients who were treated with adalimumab with a starting dose of 160 mg and 80 mg on the 2nd week of treatment, after which they received a subsequent dosage of 40 mg per week (ADA; n=32). Patients in the III group received budesonide 9mg qd (BUD; n=40). RESULTS: Results: As a result of treatment in the TOF research group, leukocyte and CRP levels decreased compared to readings before treatment (from 13.6±2.4*109/l and 1698 14.0±1.4mg/l to 10.6±1.2*109/l and 11.0±2.1 mg/l respectively, p<0.05). Hemoglobin levels in this group slightly increased (from 104.2±9.2 g/l to 126.1±10.2 g/l, p<0.05). Among ADA patients, there was also an improvement in laboratory signs: leukocyte and CRP levels decreased (from 13.8±2.8*109/l and 16.0±1.2 mg/l to 6.0±2.2*109 /l and 11.8±1.2 mg/l respectively, r<0.05), hemoglobin increased (from 103.8±8.2 g/l to 118.6±8.6 g/l/l r<0.05). CONCLUSION: Conclusions: Tofacitinib and adalimumab in the treatment of patients with ulcerative colitis of moderate severity with concomitant joint damage showed a higher clinical and laboratory effectiveness compared to treatment with budesonide.

NON-ALCOHOLIC FATTY LIVER DISEASE IN THE CONTEXT OF ALTERED GUT MICROBIOTA.

OBJECTIVE: The aim: To analyze the relationship between non-alcoholic fatty liver disease and changes in the gut microbiota. PATIENTS AND METHODS: Materials and methods: The publications of domestic and foreign editions in the databases of the United European Gastroenterology (UEG) Journal, PubMed, MEDLINE, Web of Science were processed and analyzed. CONCLUSION: Conclusions: In recent years, non-alcoholic fatty liver disease was placed among the important diseases in gastroenterology. During this time, more and more data appear on the link between changes in the human intestinal microbiome and the development of metabolic diseases, including NAFLD. Contemporary research has indeed found evidence of such a relationship. Thus, some strains of microorganisms have been identified in more detail, which directly or indirectly affect the development or course of the above-mentioned disease. For a better understanding of the strategies for the treatment of pathologies, it is necessary to delve into the study of etiological factors, therefore, NAFLC cannot be considered a pathology that has been sufficiently studied. Indeed, recent data indicate that the development and severity of the course of the disease are not always associated with the physiological processes already known to us.

Comparison of the effects of tofacitinib and adalimumab on transcolonoscopic ph and calprotectin levels in patients with ulcerative colitis.

OBJECTIVE: The aim: To investigate the transcolonoscopic pH-metry and calprotectin in patients with ulcerative colitis. PATIENTS AND METHODS: Materials and methods: the research included 110 patients both male and female between the ages of 18 to 75 years old, who were treated for UC of medium and severe activity, in active phase. All patients were divided into 3 groups. The first group received standard therapy (ST; n=50), the second group received adalimumab (ADA; n=32), and the third group was treated with tofacitinib (TOF; n=28). The control group consisted of healthy individuals between the ages of 18 and 65 years old. RESULTS: Results: UC patients had lower pH levels in all sections of the large intestine, compared to the control group (р<0,05). Calprotectin level is a better predictor of the course of the disease. CONCLUSION: Conclusions:Tofacitinib, compared to adalimumab and budesonide, has better influence on clinical, endoscopic and laboratory parameters of UC.