[Digital health: elderly use of electronic services.]

Since the first decade of the XXI century the digitalization of the healthcare system in Russia has been actively carried out according to interrelated federal and regional projects. The older generation has well-established habits and prefers traditional channels for obtaining information and services - by phone and during a personal visit, and moreover, they are even afraid to use electronic services. The vulnerability of the elderly was especially exacerbated during the CODID-19 pandemic and after, when strict restrictive measures on freedom of movement were introduced and many services began to be provided remotely. The article presents the results of pilot studies conducted in two medical institutions of St. Petersburg. The analysis also used the unique objective data of the state information system of St. Petersburg in the field of healthcare on the dynamics of changes in the indicators of the use by the population of St. Petersburg of various channels of access to the doctor's appointment service. The main objective of the study was to study the specifics of the use of digital health services as a factor affecting the status and social well-being of the elderly in Russia. In conclusion, recommendations are given on minimizing the social risks of older people feeling alienated, eliminating digital inequality when introducing medical remote electronic services.

ST elevation in the anterior precordial leads during right ventricular infarction: lessons learned during primary coronary angioplasty--a case report.

ST elevation in the anterior leads may be due to isolated right ventricular infarction associated with occlusion of a nondominant or codominant right coronary artery. The authors report a case of isolated right ventricular infarction from a dominant right coronary artery's proximal occlusion in the presence of collateral circulation provided by the left coronary artery. Extensive damage occurred owing to compromise of the collateral circulation during primary coronary angioplasty. This is an unusual angiographic pattern for isolated right ventricular infarction. The potential consequences of percutaneous interventions to collateral vessels is discussed.

Is it safe to administer thrombolytic therapy to myocardial infarction patients soon after laparoscopic cholecystectomy?

Thrombolytic therapy is usually contraindicated after abdominal surgery because of the risk of bleeding. We report a case of a 73-year-old woman who was admitted because of anterior wall acute myocardial infarction (AMI) two weeks after laparoscopic cholecystectomy. She was treated with streptokinase, aspirin and heparin and subsequently developed a hematoma at the site of the removed gallbladder. Our observation suggests that thrombolytic therapy for anterior AMI, two weeks after laparoscopic cholecystectomy, should be considered as a relative contraindication and an optional treatment in this life-threatening situation.

[A method for the accelerated determination of the virulence of Y. pestis cultures in the epizootiological examination of natural plague foci]. / Sposob uskorennogo opredeleniia virulentnosti kyl'tur Y. pestis pri épizootologicheskom obsledovanii prirodnykh ochagov chumy.

The author proposes a method of accelerated virulence definition during epizootiological examination of plague causative agents. This method is based on studying the growth of Y. pestis culture in five media composed of standard components. The method was tested in the conditions of field mobile medical laboratory.