[Risk factors for adverse outcomes in elderly patients with asthma and severe COVID-19 at the hospital and early post-hospital stages].

BACKGROUND: Mortality and COVID-19 related factors are thoroughly analyzed. Given the large number of hospitalized patients, the potential short- and long-term COVID-19 related complications, further research is needed on the possible consequences of hospitalization, especially in higher-risk patients, after prolonged hospitalization and intensive care admission. AIM: To study the clinical course and outcomes of severe COVID-19 in elderly patients with asthma at the hospital and early post-hospital stages. MATERIALS AND METHODS: The study included 131 elderly patients (WHO, 2020) >60 years old, n=131 with asthma, hospitalized for severe COVID-19. Of these, 86 (65.6%) patients survived, 30 (22.9%) died in the hospital, and 15 (14.9%) patients died after discharge from the hospital (in the 90-day post-hospital period). COVID-19 was confirmed by laboratory tests (SARS-CoV-2 PCR RNA test) and/or clinically and radiologically. All patients had a documented history of asthma. Patients were followed up during the hospital stay and for 90 days after discharge. RESULTS: Comparison of outcomes showed that in the groups of patients with a fatal outcome (regardless of the stage), the Charlson comorbidity index, respiratory rate, extent of lung damage assessed by computed tomography, the absolute leukocyte and neutrophil number and the ratio of neutrophils to lymphocytes were statistically significantly higher. The absolute number of eosinophils was lower in these groups. In the group of patients who died during hospitalization, severe (IV-V) asthma (p=0.03), steroid use during the previous year (p=0.02), chronic heart failure with a reduced ejection fraction (p=0.009) were more common, and atopic asthma phenotype was less common (p=0.02). In those who died after discharge, more common were non-invasive ventilation and diabetes mellitus (p<0.001). The multivariate regression analysis model revealed the most significant predictors of mortality at the hospital and early post-hospital stages. CONCLUSION: Adverse outcomes of severe COVID-19 in elderly patients with asthma include hospital and post-hospital mortality. The most significant predictors of mortality are the comorbidity index and low eosinophil count. Hospital mortality is associated with a higher ratio of neutrophils to lymphocytes and lower total protein levels; early (90-day) post-hospital mortality is associated with extensive lung damage shown by computed tomography and diabetes mellitus.

[The incidence of recurrences and metastases of cancer of the corpus uteri and the reasons for their occurrence]. / Chastota retsidivov i metastazov raka tela matki i prichiny ikh vozniknoveniia.

The paper discusses the frequency of recurrences and metastases of endometrial carcinoma in 246 treated cases. Recurrences and metastases were identified in 41 (16.7% +/- 2.4) patients. A relationship between said frequency, on the one hand, and tumor size, extent of invasion through the myometrium and tumor differentiation, on the other, was established.

[Comparative study of the effects of antibodies to S-100 protein and ouabain on neurons of Helix pomatia]. / Sravnitel'noe izuchenie éffektov antitel k belku S-100 i uabaina na neironakh vinogradnoi ulitki.

Ouabain, used in 5.10(-4) M concentration, elicits 12 +/- 5 mV (15 experiments) depolarization of membrane of snail Helix neurons. In 80% of experiments depolarization is not accompanied by changes in membrane conductance, in 20% of experiments the decrease of the membrane conductance is observed. Application of the antibodies to S-100 protein (their concentration in the micropipette being 0.05 mg/ml) induces similar effects. The effects of ouabain and antibodies to S-100 protein are not additive and the main difference in their action lies in the ability of the cell to recover the resting potential of the membrane in the solution containing ouabain.

[Mechanisms of the stimulating effect of brain antibodies on the Ca2 current in the neuron membrane]. / Izuchenie mekhanizmov stimuliruiushchego vliianiia protivomozgovykh antitel na Ca2+-toki neironal'noi membrany.

Antibodies against rat brain microsomes induce a 16 +/- 3% increase in the amplitude of Ca-current (ICa) in snail neurons. Ca-ions block ICa in dose-dependent and potential-dependent manner. Antibodies against microsomes decrease the effectiveness of ICa blockade by Ca-ions: a 85 +/- 10% increase in ICa is observed and I-V curve is normalized. It is suggested that an enhancing effect of antibodies on ICa and the elimination of blocking Ca-effect on ICa are connected with the weakening of divalent cations binding by the anionic groups of calcium channels.

[Nature of the membrane depolarization of a nerve cell during the application of protein S-100 antibodies]. / Izuchenie prirody depoliarizatsii membrany nervnoi kletki pri applikatsii antitel k belku S-100.

Application of antibodies to S-100 protein (the antibody concentration in the micropipette being 0.05 mg/ml) induced 13 +/- 4 mV depolarization of the membrane of snail Helix neurons. Non-immune gamma-globulin used in the control experiments caused no changes in the membrane potential. Antibody-induced depolarization was accompanied by a 2.5 nA inward current which was voltage-independent in the range of membrane potential from 50 to 110 mV. Hyperpolarization observed after the rinsing of antibodies was effectively blocked by a specific blocker of monovalent cation transport, ouabain, at a concentration of 5 X 10(-4) M. The absence of antibody-induced changes in the passive membrane conduction and the activation of electrogenic transport mechanisms after the antibody removal suggest possible involvement of Na, K- ATPase into the effect described.

[Effect of 1 alpha-hydroxycholecalciferol and various dietary phosphorus levels on phosphorus and calcium metabolic indices in rats during hypokinesia]. / Vliianie 1 al'fa-oksikholekal'tsiferola i razlichnogo soderzhaniia fosfora v ratsione na nekotorye pokazateli fosforno-kal'tsievogo obmena u krys pri gipokinezii.

The exposure of rats to hypokinesia and a phosphorus-enriched diet (Ca : P = 1:3) was accompanied by hypocalciemia, hyperphosphatemia, calcium losses from bones and formation of calcificates in the kidneys. The decrease of the phosphorus content in the diet (Ca : P = 1:0.5--1:1) prevented these disorders. The administration of 1 alpha OHD3 at a dose of 0.025 microgram/day arrested hypokinesia-associated hypocalciemia and bone changes. The administration of 1 alpha OHD3 together with a high phosphorus consumption enhanced nephrolithiasis and induced aortal mediacalcinosis in hypokinetic rats. These data indicate that phosphorus consumption should be reduced in order to prevent disorders in phosphorus-calcium metabolism during hypokinesia. They also suggest that administration of 1 alpha OHD3 may be hazardous in case of excessive phosphorus consumption.