MORTALITY RISK ASSESSMENT AMONG PATIENTS, HOSPITALIZED FOR COVID-19.

In Georgia, the number of confirmed cases of Coronavirus were 1,85,5289. Among them, 17 132 patients died. Information on risk factors for mortality is insufficient. The purpose of our research is to evaluate clinical features of heavy patients with severe COVID and determine prognostic factors of outcome. Factors associated with critical COVID-19 included older age and certain chronic medical conditions. The clinical material of 250 chronically ill COVID-19 patients admitted to the intensive care unit was retrospectively studied. We divided the patients into two groups. The dead and the survivors. Demographic data, comorbidities, chronic diseases, results of ultrasound, cardiography, computed tomography and laboratory characteristics were studied. In patients with chronic diseases, in the intensive care unit during COVID-19, the relative chance of survival decreases: CRP3 - OR=0.98(95% CI:0.97-0.99Hydrothorax- OR=0.24(95% CI:0.06-0.95); Sepsis/Septic shock - OR=0.07(95% CI:0.01-0.39); WBC - OR=0.86(95% CI:0.74-0.99); Mechanical lung ventilation - OR=0.01(95% CI:0.00-0.05)); increase survival relative chance- pO2 - OR=1.03(95% CI:1.0-1.06). Predictors of mortality in patients with chronic diseases: coagulation characteristics, inflammatory markers, sepsis, and artificial lung ventilation. Risk factors for covid-19 mortality need to be studied to increase pandemic preparedness.

PSYCHOSOMATIC ASPECTS IN PATIENTS WITH DERMATOLOGIC DISEASES.

The aim of our study was to find out the magnitude of anxiety and depression in our common dermatological patients and its correlation with age, sex. For this purpose, we used Hospital Anxiety and Depression Scale HADS. The psychometric validity of HADS has been established by validating the questionnaire against the structured psychiatric interviews. A study of anxiety and depression in patients with dermatologic diseases was conducted on the basis of outpatients department in 211 patients with dermatologic diseases; among them were 107 male and 104 female, aged 16 to 75 years. Among them were patients with Acne, Alopecia Areata, Psoriasis, Vitiligo, Neurodermatitis, Scabies, Eczema and Other diseases (Atopic Dermatitis, Chronic Urticaria, Lichen Planus, Herpes Zoster, Melasma, Warts and Etc.). Based on studies of patients reveals that 65.4% of them are anxiety, depression - 56.2%, both anxiety and depression in 24.7%, there figures higher than the dates of other authorizes. As a result of a direct link research risk disorder depressive spectrum with sex, age; in woman anxiety and depression occurs more frequently than men, and anxiety occurs more frequently in young age. Especially there are hight frequencies of manifestation of abuse in patients with Psoriasis (anxiety - 83.3%, depression - 69.4%, both - 38.8%), Eczema (anxiety - 73.3%, depression - 56.6%, both - 26.7%), Acne (anxiety - 78.4%, depression - 54%, both - 21.6%), Vitiligo (anxiety - 66.7%, depression - 60%, both - 33.3%). Our study noticed higher dates of anxiety and depression than the dates of other outhorizes.

Safety of patients--actual problem of modern medicine (review).

Safety of patients is actual problem of up-to-date medicine. The current successful treatment of various sicknesses is achieved by implementation in clinical practice such medical preparations (medications), which are characterized with the high therapeutic activity, low toxicity and prolonged effects. In spite of evidence of the pharmacotherapeutical advances, the frequency of complications after medication has grown - that is why the safety of patients is the acute actual problem of medicine and ecological state of human population today.

[Sporadic pancreatic head sarcoidosis: a rare clinical case analysis].

Systemic sarcoidosis is an autoimmune disease with a prevalence of 40 per 100,000 people and which mostly affects young adults. It is characterized by non-caseous granulomatous changes of interstitial tissue, predominantly in the lungs. Extrapulmonal sarcoidosis has been described in every organ, but is present only in 1-5% with pancreatic involvement. Furthermore, sarcoidosis leading to a symptomatic mass in the pancreas is extremely rare and must then be differentiated in particular from cancer and pancreatitis. For therapy, it is crucial to find the right diagnosis before planning an operation--otherwise overtreatment by surgery may be an unwanted consecution.

[A rare tumor-like lesion of the pancreatic head with bile duct obstruction]. / Pankreassarkoidose als seltene Ursache einer Gallengangsobstruktion.

Tumors of the pancreatic head commonly consist of carcinomas whereas other entities are rare exceptions. Extrapulmonary sarcoidosis is well-known but is extremely rare when detected as a mass in the pancreatic head. In general the diagnosis of sarcoidosis requires histologic examination with verification of non-caseous, epithelioid cell-like granulomas. Systemic therapy consists of steroids when the patient exhibits symptoms or in the case of progression of the disease. However, in some cases extended abdominal resections are also required to confirm the diagnosis and/or to treat symptoms.

Most common poisonings and their management--data from Tbilisi.

The purpose of the present study was to evaluate the toxicological aid and efficiency of preventive measures and methods in treatment of acute exogenous intoxications in hospitals in Tbilisi in 1990-2005. Structure of poisoning accidents in Tbilisi, its trends in last decade is analyzed and explained. The data were obtained in Georgian National Center for Disease Control and Medical statistics in Tbilisi. The study revealed that total number of hospitalizations due to acute poisoning in Tbilisi exceeded the number of hospitalizations due to acute myocardial infarction. In 1992-1994 Georgia was in severe social-economic crisis: the cases of acute poisoning increased and the number of hospitalizations had been reduced with concomitant longer hospital stay (in 1992--10.7 hospital days; in 1993-1994--13.7 hospital days), and higher mortality (in 1992--4%; in 1993--5.5%; 1994--5.2%). Low hospitalization rates in 1992-1994 should be explained by late patient referral to hospitals. Longer hospital stay was available due to free hospital care at that time. In 1995 with termination of free medical care number of hospitalized patients with acute intoxication raised annually; hospital stay shortened and mortality rate decreased. In 2003 mortality was reduced by 0.74% in Tbilisi. The prevalence of acute alcoholic intoxication incidence was noticed. Therefore hospital stay decreases. High prevalence of acute alcoholic intoxication was explained by the growth of alcohol consumption; lack of quality control of beverage production resulting in huge amount of unconditioned and counterfeit substances in the market, etc. As to poisonings due to medical substances 42% of cases were intoxications with anticonvulsants, sedative and psychotropic preparations; 17% with cardiovascular drugs; and 10% with narcotic substances. It was found, that poisoning incidence and their outcome significantly depend on social-economical conditions in Georgia. Measures to improve toxicology care in the country are outlined and the ways are ushered to reach it soon.

Overview of HIV epidemiological situation in Georgia.

Georgia still belongs to low HIV epidemic countries and by December 1st, 2008 there are 1825 HIV/AIDS cases registered at the IDACIRC with estimated number 3500 (estimated prevalence 0.09%). Majority of HIV/AIDS patients are male (75%). Four hundred and sixty one patients are under the Antiretroviral (ARV) treatment, including 23 children. Despite of HIV low prevalence, Georgia is considered to be at risk for an imminent epidemic spread of HIV mainly due to wide spread drug use with high risk practices (needle-sharing) and high rate of STIs. The major route of HIV transmission is associated with IDU. At the moment approximately 60% of all reported HIV cases are due to drug injection. However over the last several years heterosexual route of transmission is gaining importance, and increased from 29.1% to 36.1% for last five years. First significant increase of HIV incidence rate was observed from 1999 to 2000 (2.24 times) and 2003 to 2004. From 2004 stabile, but slight increase of incidence rate is presented. Most HIV positive patients are diagnosed at the age from 25 to 45. The highest HIV prevalence rates are found in Western Georgia, particularly Black Sea coast regions--Megrelia and Adjara (with prevalence of 131.11 and 132.03 among adult HIV cases per 100,000 adult population). Enlarging educational activities, prevention interventions, better financing of HIV programs and improvement of capacity building will help the country to keep HIV epidemic in a low prevalence and give country possibility to achieve "Universal Access to HIV Prevention, Treatment, Care and Support" for 2010 year.

[Changes in the cytogenetic indices in the bone marrow cells of white rats undergoing mechanical trauma of various degrees of severity]. / Ob izmeneniiakh nekotorykh tsitogeneticheskikh pokazatelei v kletkakh kostnogo mozga belykh krys pri mekhanicheskoi travme razlichnoi tiazhesti.

The influence of traumatic shock on some cytogenetic indices in bone marrow cells was investigated in white mongrel rats. The traumatic shock was caused by the Noble-Collip method. Comparative analyses of cytogenetic indices during trauma of different intensity show that the most acute changes involve the percentage of aberrant metaphases, and of average number of chromosome breaks per cell. Dynamics of changes of cytogenetic indices after a heavy trauma show that the traumatic shock may exert a cytogenetic effect maintaining for 18 hours. The results obtained and the analysis of literary data enables us to suggest that the speed of development of changes, and restoration of cytogenetic indices under various forms of trauma is quite different and may serve another confirmation of the hypothesis above the possibility of increasing the process of mutagenesis at the expense of the violation of homeostasis.

[Gas chromatographic analysis of different classes of psychotropic preparations]. / Gazokhromatograficheskii analiz psikhotropnykh preparatov raznykh klassov.

The authors describe a method for simultaneous extraction of the psychotropic compounds of various classes from a sample of biological material. Discuss the use of different stationary liquid phases, solid supports, and carrier gases in respect to gas chromatographic analysis of the psychotropic drugs. Demonstrate the possibility of analyzing these drugs on a Soviet Tsvet-100 chromatograph with the use of available materials.

[Ionic nature of repeated responses of myocardial fibers]. / Ionnaia priroda povtornykh otvetov miokardial'nykh volokon

Changing ionic composition of the environment and applying exposures which modify the conductivity of electrogenic membrane, the role of entering and leaving currents is studied in the generation of two zones of repeated responses (RR) of cat papillary muscle fibres. The first RR zone activated at a weak depolarization of the membrane (no higher than 30 mV) seems to be concerned with the functioning of the fast Na system. It was not blocked with inderal (2 divided by 5 mg/l), anor with Mn2+ ions (3mM). The second RR zone appearing at a stronger membrane depolarization (higher than 30 mv) is essentially dependent on the activity of the slow Na-Ca-system. It is activated with adrenaline (0.2 mg/l), ions of Sr2+ (5mM), Ba2+ (0.1 mM), Ca2+ (5 divided by 10 mM); blocked with Mn2+ (3 mM), Co2+ (5mM) ions, verapamile (2 divided by 4 mg/l), inderal (2 divided by 4 mg/l). The second RR zone was essentially affected with potassium ions: the 3-fold increase of Ko+ suppressed the RR of the second zone, a 3-fold decrease of Ko+ strengthened them.

[Role of entering currents in the accommodation of myocardial fibers]. / Izuchenie roli vkhodiashchikh tokov v akkomodatsii miokardial'nykh volokon

Varying ionic composition of outher medium and applying specific agents the role of fast and slow systems of entering currents in the accommodation of cats ventricular fibres has been studied. In potential region close to the level of resting potential (membrane depolarization no larger than 20-30mv), accomodation mainly depends on fast sodium currents. It is inhibited with a rise of this current (akonitin 0.1--1 mg) and, on the contrary, it increases when it gets weaker (novacain 2--5 mM). In the region of more positive potentials (membrane depolarization more than by 30 mv) the accommodation is mainly determined by the slow NA--Ca-systems of channels. The agents which strengthen NA--Ca--current (Si2+--5mM, Ca2+--10mM, Ba2+--0.1 mM) reduce the accommodation in the activation region of the Na--Ca--system. The agents which weaken the slow current (Mn2+--3 mM, isoptin--2+5 mg/l, inderal--2 mg/l) produce an opposite effect.

[Evoked automatism (repeated responses) of cat cardiac ventricular fibers].

Repeated responses (RR) of cat papillary muscle fibres have been studied. Threshold current of the occurrence of repeated responses (2t) and saturation current (Is) on the accomodation curve have been determined. Two zones of autooscillations were revealed according to the ratio brage from low levels of the membrane potential (-80 divided by -55 mv). The second RR zone (It is not equal to Is) was activated in more than 70 per cent of preparations in the average from higher levels of the membrane potential (-40 mv and higher). A comparison was carried out between muscle and specialized fibres RR. The experimental data were analysed by the method of phase plane.