Risk factors associated with fatal thrombosis in hospitalized coronavirus disease 2019 (COVID-19) patients on anticoagulant therapy.

BACKGROUND: The purpose of this study was to determine the factors that increase the risk of fatal thrombotic events in hospitalized coronavirus disease 2019 (COVID-19) patients receiving standard therapy according to the National Clinical Practice Guidelines (National Guidelines). MATERIALS AND METHODS: In this case-control study, cases included 83 adults with COVID-19 who had died from thrombosis and controls comprised 83 COVID-19 patients with comparable criteria who survived. Data was abstracted by reviewing the medical records of selected patients and analyzed using Statistica. Parametric and non-parametric tests, as appropriate, were used to compare continuos variables between cases and controls, whereas Chi-square test was employed to compare categorical variables. Odds ratio (OR) was also calculated to measure the strength of association of case status and various independent variables. RESULTS: Fatal outcomes were higher in patients with chronic tubulointerstitial nephritis, (OR = 2.4, 95% CI 1.2-4.9); obesity, (OR = 2.1, 95% CI 0.5-8.6); and coronary heart disease (OR = 1.6, 95% CI 0.8-3.2). In the group with a D-dimer level from 250 to 1000 ng/ml, a statistically significant moderate positive correlation was found between the day of death and D-dimer level (P = 0.026). The lack of use of the PADUA Prediction Score for the risk of venous thromboembolism scale (PADUA Scale) and control of laboratory parameters (APTT and D-dimer) were associated with increased risk of fatal outcome. Overall, 19.2% cases and 8.4% of controls had no coagulation control; (OR = 2.6, 95% CI 1-6.7). CONCLUSION: Chronic tubulointerstitial nephritis, obesity, and coronary heart disease were associatied with fatal thrombosis. A slight elevation of D-dimer level, lack of the PADUA Scale and laboratory monitoring in the management of hospitalized patients with COVID-19. was associated with an increased risk of thromboembolism.

Assessment of medical and losses due to socially significant diseases in the East Kazakhstan Region.

AIMS: The aim of the research was assessment of the medical and social losses due to socially significant diseases (malignant neoplasms and diseases of the circulatory system) in population living in the ecologically unfavorableregion of Kazakhstan (East Kazakhstan Region (EKR)). MATERIALS AND METHODS: The materials for the research were provided by the Department of Statistics, the Republican Center of Electronic Health Care and the Regional Oncology Center for 5 years depth (2011-2015 yy.). Statistical data of the entire population of the region was analyzed. Years of Life Lost (YLL), YLL due to death integral indicators were calculated according to the standardized methodology recommended by the World Health Organization (WHO). RESULTS AND CONCLUSION: Significant premature loss of years due to socially significant diseases in the study region was observed in the research group of 45-69 years with a gender prevalence in male. The fraction of direct economic loss as a result ofhealth losses due to circulatory system diseases and malignant neoplasms averaged about 5% of the Gross Domestic Product (GDP). The medical and social losses of years depend on a number of social and economic factorsin the region (environmental pollution, population income, centralized water supply and the fraction of economically active population).

The Incidence of Malignant Tumors in Environmentally Disadvantaged Regions of Kazakhstan

Objective: To explore the prevalence of malignant tumors in the adult population through 2003-2014 in parts of the Aral Sea region: a zone of ecological disaster, a zone of ecological crisis and a zone of precritical conditions. Methods: The long-time average annual levels of cancer morbidity stratified by zones of the Aral Sea region and trends of long-time average annual incidence indicators of malignant tumors were identified. Leading cancer localizations in the adult population was established and associations between cancer incidence and environmental pollution were analyzed. In addition, associations between individual risk factors and cancer incidence in the adult population was established. Correlations between a hazard index and the cancer incidence in the adult population were calculated. Results: In all three Aral Sea regions, as well as in Zhanaarkinskii district, leading cancer in adult population was esophageal, stomach, tracheal, lung, hepatobiliary, and breast. Long-time average annual levels of cancer morbidity in adult population living in the Aral sea region is 1.5 times higher comparing to the control region. In particular, long-time average annual levels of cancer morbidity in adult population living in the zone of ecological disaster was 57.2% higher, in the zone of ecological crisis - 61.9% higher, and in the zone of precritical condition ­ 16.8% higher. Long-time average annual levels in the adult population of the Aral Sea region significantly exceeded control levels for brain and central nervous system cancer, cancer of bone and articular cartilage, and thyroid cancer. Conclusion: It has was established that the total cancer morbidity depended on the total hazard index associated with the inhalation of nickel and the combined cadmium intake (r=0.8).