[The functioning of call-center in conditions of COVID-19 pandemic].

In conditions of persisting high morbidity of COVID-19, issues related to prompt and timely medical care of population remains actual ones. The purpose of the study to analyze activities of the call-center of the Ministry of Health Care of the Udmurt Republic related to organization of medical care of COVID-19 patients in the Udmurt Republic. MATERIALS AND METHODS: The statistical (descriptive statistics) and descriptive methods were applied. The indicators of functioning of the call-center of the Ministry of Health Care of the Udmurt Republic in 2020-2022 were analyzed. The psychological characteristics of telephone counseling were studied. The satisfaction of medical organizations and citizens with services of call-center operators was assessed. THE RESULTS: The main principles of telephone counseling are confidentiality, maintenance of framework of working conversation, respect to personality of addressee. In 2020 the call center phone line received 34160 calls, in 2021 - 128339 calls, in 2022 - 65618 calls. In 25 months of operation the call-center operators received 228,117 calls from citizens related to issues of new coronavirus infection. The number of patient calls to the hot-line increases significantly when incidence of new coronavirus infection increases (r=0.885; p<0.05). Most frequently (25.1%) citizens contacted the call-center of the Ministry of Health Care of the Udmurt Republic due to inability to reach the polyclinic and on issues related to primary before-doctor care. The second place in terms of frequency (18.5%) took issues related to PCR-test results. The third place (14.1%) took issues related to duration of quarantine for patients and persons residing with them, possibility for children to attend preschool and educational institutions. The number of outgoing calling in 2020 was 16146, in 2021 - 89269 and in 2022 9936 calls. During 25 months of operation, call-center operators made 204,782 calls to citizens to monitor their health status and invite them to vaccinations and health screenings. More than half of outgoing calls (58.3%) were related to audio-monitoring of patients undergoing outpatient treatment with making-up of electronic protocol. CONCLUSIONS: During the period of increasing of COVID-19 morbidity, the call-center becomes an independent structural unit of organizing patient care. The medical organizations and citizens are satisfied with functioning of the call-center of the Ministry of Health Care of the Udmurt Republic organized in order of improving the organization of medical care of patients with COVID-19.

Exact transparent boundary condition for the multidimensional Schrödinger equation in hyperrectangular computational domain.

In this paper an exact transparent boundary condition for the multidimensional Schrödinger equation in a hyperrectangular computational domain is proposed. It is derived as a generalization of exact transparent boundary conditions for two-dimensional (2D) and 3D equations reported before. An exact fully discrete (i.e., derived directly from the finite-difference scheme used) 1D transparent boundary condition is also proposed. Several numerical experiments using an improved unconditionally stable numerical implementation in the 3D space demonstrate propagation of Gaussian wave packets in free space and penetration of a particle through a 3D spherically asymmetrical barrier. The application of the multidimensional transparent boundary condition to the dynamics of the 2D system of two noninteracting particles is considered. The proposed boundary condition is simple, robust, and can be useful in the field of computational quantum mechanics, when an exact solution of the multidimensional Schrödinger equation (including multiparticle problems) is required.

Catalytically Competent Conformation of the Active Site of Human 8-Oxoguanine-DNA Glycosylase.

8-Oxoguanine-DNA N-glycosylase (OGG1) is a eukaryotic DNA repair enzyme responsible for the removal of 8-oxoguanine (oxoG), one of the most abundant oxidative DNA lesions. OGG1 catalyzes two successive reactions - N-glycosidic bond hydrolysis (glycosylase activity) and DNA strand cleavage on the 3'-side of the lesion by ß-elimination (lyase activity). The enzyme also exhibits lyase activity with substrates containing apurinic/apyrimidinic (AP) sites (deoxyribose moieties lacking the nucleobase). OGG1 is highly specific for the base opposite the lesion, efficiently excising oxoG and cleaving AP sites located opposite to C, but not opposite to A. The activity is also profoundly decreased by amino acid changes that sterically interfere with oxoG binding in the active site of the enzyme after the lesion is everted from the DNA duplex. Earlier, the molecular dynamics approach was used to study the conformational dynamics of such human OGG1 mutants in complexes with the oxoG:C-containing substrate DNA, and the population density of certain conformers of two OGG1 catalytic residues, Lys249 and Asp268, was suggested to determine the enzyme activity. Here, we report the study of molecular dynamics of human OGG1 bound to the oxoG:A-containing DNA and OGG1 mutants bound to the AP:C-containing DNA. We showed that the enzyme low activity is associated with a decrease in the populations of Lys249 and Asp268 properly configured for catalysis. The experimentally measured rate constants for the OGG1 mutants show a good agreement with the models. We conclude that the enzymatic activity of OGG1 is determined majorly by the population density of the catalytically competent conformations of the active site residues Lys249 and Asp268.

The complex analysis of risk factors, influencing on the progression of chronic obstructive ulmonary disease.

AIM: The aim of the study is the analysis of risk factors, influencing on the progression of chronic obstructive pulmonary disease. MATERIALS AND METHODS: 259 patients with chronic obstructive pulmonary disease (COPD) I and III stages, mean age 54,3±11,7 and the duration of the disease 10,1±5,7. Patients were divided into 2 groups: I group (n=119) - with III stage of disease, II group (n=140) - COPD with I stage. 30 healthy were involved in control group. The risk factors of progression of COPD were determined with the use of regressive and correlative analyses. RESULTS: The level of markers of systemic inflammation in serum of patients with COPD: TNF-α (RR 3,25); IL-8 (RR 2,1); hs-CRP (RR 3,52) in combination with traditional risk factors (long course of the disease (RR 2,3), age (RR 1,65), smoking (RR 1,65), and also obesity (RR 2,45), early menopause (RR 3,52), hereditary respiratory predisposition (RR 3,05), and also coexisting cardiovascular pathology increase the risk of COPD progression several times. . CONCLUSION: According to the results of this trial, unmodified risk factors such as hereditary predisposition, early menopause, long course of the diseases and coexisting cardiovascular pathology contribute significantly on progression of COPD. The relative risk increases with increasing of concentration of markers of systemic inflammation (TNF-α, IL-8 and hs-CRP), that correlate with clinical manifestations of COPD: cough, shortness of breath on VAS in mm.

[Early diagnosis of mild acute pancreatitis]. / Rannyaya diagnostika legkogo ostrogo pankreatita (s kommentariem).

AIM: to analyze the efficacy of early detection of patients with mild acute pancreatitis. MATERIAL AND METHODS: 61 patients with acute pancreatitis who do not require intensive care were analyzed. Severity of condition was assessed using integral scales, i.e. modified index of severe pancreatitis severity (MITOP), BISAP, HAPS, SOFA, SIRS, CTSI and Atlanta classification (2012). RESULTS: Verification of mild course of disease according to MITOP scores ≤0.23 and BISAP scores ≤1 for the first 24 hours after admission and CTSI scores ≤3 within first 72 hours had high accuracy [AUC (CI 95%) 0.79 (0.66-0.91); 0.76 (0.66-0.87) and 0.99 (0.97-1.00) respectively], sensitivity and specificity (88.8 and 43.7%; 71.1 and 75.0%; 100 and 83.3% respectively). CONCLUSION: MITOP and BISAP scales are reliable to diagnose early mild acute pancreatitis. Their high positive diagnostic value (81.6 and 88.8%) allows to detect patients who do not require intensive care.

[Diagnosties of pulmonary-renal syndrome in young patients with suspected community-acquired pneumonia].

In patients of young age atical clinical course of community-acquired pneumonia may mask of interstitial lung disease causing systemic vasculitis. Lung damage occurs in the form of vasculitis with perivascular infiltration, interstitial pneumonia symptoms and various sequential processes up to necrosis of the lung tissue and pleurisy. A distinctive feature of vascular pneumonia is probability of development of plurivisceral damage with simultaneous involvement of heart, kidney, abdominal, skin, joints and hepatolienal syndromes into tfe pathohogical process. At suspicion on development of systemic vasculitis it requires to perform differential diagnosis with the use of immunological tests and X-ray examination of the chest. Lung disease in systemic vasculitis worsens prognosis and necessitates urgent therapeutic measures.

[Low-intensity laser radiation applied in occupational pathology].

The authors present results of treatment including laser radiation in patients with various occupational diseases. Evidence is that low-intensity laser radiation appears effective in occupational pathology. The treatment is based on blood circulation improvement.

[PULMONARY THROMBOEMBOLISM IN WOMEN USING ORAL HORMONAL CONTRACEPTIVES].

Pulmonay thromboembolism is a common difficult-to-diagnose pathology not infrequently with a lethal outcome. There are many factors leading to hypercoagulation. One of them is intake of hormonal contraceptives to which doctors sometimes do not pay due attention. This paper reports two cases of acute coagulopathy with massive pulmonary thromboembolism in young women using these agents during a long period.

[Influence of melatonin and diclofenac on circadian rhythm of locomotor activity in rats with local inflammatory arthritis].

Inflammatory arthritis is accompanied by disorganization of the circadian rhythm of locomotion in rats. Control saline injections increased the rhythm disturbances. Chronic administration of melatonin (5 mg/kg) attenuated these chronopathological shifts. Diclofenac demonstrated much lower positive chronopharmacological activity than did melatonin.

[Effect of heat shock on courtship behavior, sound production, and learning in comparison with the brain content of LIMK1 in Drosophila melanogaster males with altered structure of the LIMK1 gene].

In this paper we present results of a comprehensive analysis of the effect of heat shock at different stages of ontogenesis (adult stage, development of the mushroom bodies and the central complex) on courtship behavior (latency, duration and efficacy of courtship), sound production (pulse interval, dispersion of interpulse interval, the percentage of distorted pulses, the mean duration of the pulse parcels), learning and memory formation compared with the content of isoforms LIMK1 in Drosophila melanogaster male with altered structure of the limk1 gene. The heat shock is shown to affect the behavior parameters and LIMK1 content in analyzed strains of Drosophila. The most pronounced effect of the heat shock was observed at the stage of development of the central complex (CC). Heat shock at CC and adult restores the ability of learning and memory formation in the mutant strain agn(ts3), which normally is not able to learn and form memory. Correlations between changes of content of isoforms LIMK1 and behavioral parameters due to heat shock have not been established.

[Contemporary aspects of clinical manifestations, diagnosis and treatment of occupational microfibrosis].

Upper extremities occupational diseases resulting from physical overstrain are widely spread types of occupational pathology. The most common disease is myofibrosis. Seen nowadays, significant use of manual work in physical labour occupations cause high level of occupational morbidity due to physical overstrain. Review of previous studies showed that in spite of topicality the problem still lacks attention. Therefore the use of modern methods of occupational myofibrosis diagnosis such as contrast myography and ultrasound study, development of early diagnostic criteria, more accurate determination of severity degree and the process dynamics gets growing social and priority importance.

[Occupational myofibrosis - main aspects of clinics, diagnosis and treatment].

Occupational chronic myofibrosis is a disease resulting from physical overstrain and functional overload of upper extremities and shoulder girdle and beeing the most prevalent occupational diseases related to the so-called "working hand". Myofibrosis occur among persons employed actually in all industries, building and agriculture and may develop as an isolated disease or combined with other occupational diseases of musculoskeletal and peripheral nervous systems. Today problems of diagnostics, especially at the early stage of the disease, and the development of knew methods of treatment are still topical.

[Low-intensity laser radiation in preventive measures].

Results of preventive measures introduction in 524 PC users, 98 jewelry polishers and 64 metallic ship hull assemblers are given. The use of preventive measures, based on low-intensity laser radiation, was shown to prevent development of visual overfatigue and occupational musculoskeletal system diseases.

Exact transparent boundary condition for the three-dimensional Schrödinger equation in a rectangular cuboid computational domain.

We report an exact transparent boundary condition (TBC) on the surface of a rectangular cuboid for the three-dimensional (3D) time-dependent Schrödinger equation. It is obtained as a generalization of the well-known TBC for the 1D Schrödinger equation and of the exact TBC in the rectangular domain for the 3D parabolic wave equation, which we reported earlier. Like all other TBCs, it is nonlocal in time domain and relates the boundary transverse derivative of the wave function at any given time to the boundary values of the same wave function at all preceding times. We develop a discretization of this boundary condition for the implicit Crank-Nicolson finite difference scheme. Several numerical experiments demonstrate evolution of the wave function in free space as well as propagation through a number of 3D spherically symmetrical and asymmetrical barriers, and, finally, scattering off an asymmetrical 3D potential. The proposed boundary condition is simple and robust, and can be useful in computational quantum mechanics when an accurate numerical solution of the 3D Schrödinger equation is required.

[Pineal hormone melatonin in low doses potentiates psychotropic and chronotropic activity of tofisopam in rats].

Combination with a low dose of pineal hormone melatonin increased the anxiolytic effect of tofisopam (subthreshold dose) in open-field and cross-maze tests, as well as its chronotropic activity in time-course of forced swimming test in rats.

[The laboratory diagnostics of fat embolism].

The examination was applied to 598 patients with polytrauma and patients after surgery on bones and joints on the subject of various diseases of locomotor apparatus. All patients were tested on fat embolism in blood serum and cerebrospinal fluid. The modificated Guard's technique was applied. The test data permitted to develop the method of express diagnostics of oil embolism. It is established that fat liquorglobulia is a pathognomonic symptom of cerebral form of fat embolism.

[Syphilitic mesaortitis].

A rise in the incidence of latent and late forms of neuro- and visceral syphilis significantly complicates diagnostics of the disease in patients admitted to emergency medicine clinics. Syphilis is believed to be a cause of roughly 0.5% of all cardiopathies. Late syphilitic lesions of the cardiovascular system (cardiovascular syphilis) occur in 0.25-0.96% patients in need of therapeutic treatment, 93.4% of them present with mesaortitis but its life-time diagnosis is possible only in 10% of the cases. Syphilitic lesions in the aorta are especially well apparent at the points of its branching into coronary arteries of the heart and aortic arch. One of the main consequences of syphilitic aortitis is the narrowing of coronary arteries frequently complicated by atherosclerosis, coronary thrombosis, and the resulting myocardial infarction. Another severe complication of syphilitic aortitis is progressive aortic valve insufficiency (in 25-50% of the patients) related to dilatation of the valve ring affected by inflammation. Some patients develop bacterial endocarditis of the aortic valve. Close localization of the coronary artery junction and the aortic valve account for a combination of aortic valve insufficiency and coronary insufficiency in patients with syphilitic process in the initial part of aorta. A case report is presented.

[Medical and socio-economic effects of early rehabilitation of patients with acute cerebral vascular accidents].

Acute ischemic brain injury (stroke, stroke), a leader among the causes of morbidity and mortality in the world. This pathology is one of the most pressing health and social problems that cause enormous economic damage to society, due to the high fatality rate, significant disability and social maladjustment of patients, which is based in most cases are the motor and cognitive impairment. Despite the fact that, currently established risk factors and pathophysiological basis of this disease, the availability of effective methods of diagnosing illness, still a practicing neurologist in some cases difficult to find adequate therapy that could effectively reach a well-established neurological deficit. Therefore the search for treatments that effectively reduce the health and social consequences of vascular damage to the brain, is one of the priority areas of neurology.

[Optimization of medical-diagnostic process in patients with traumatic brain injury during early rehabilitation].

The problem of cardiovascular disease and cancer, the effects of traumatic brain injury is now one of the major health and social problems. Every year in Ukraine registered 200 thousand cases of the victims of traumatic brain injury. Of these, 30% of people then have persistent signs of disability that results in a disability, sometimes painful existence the patient and his relatives. Therefore, in order to bring man back into society after a traumatic brain injury, to the rehabilitation phase of treatment, immediately after the stabilization of the patient.

[Clinical case of management of a patient with Guillain-Barre syndrome].

Syndrome of Giyena-Barre can arise up in any age, in different regions, for men more frequent, than for women. There are descriptions of clinical supervisions of syndrome in domestic literature, combining with the defeat of the nervous system as a result of different pathogens which are procatarxiss in the start of mechanisms of immune attack on the albumens of mielina. However this disease continues to remain one of most heavy, requiring neyroreanimacionnykh measures, that causes the necessity of development of new methods of treatment in same queue.