Introduction. The new coronavirus infection continues to be an urgent health problem worldwide. At the moment, the consequences of the transferred COVID-19 need to be studied.Objective. To study the clinical features, the severity of lung damage in patients with different body weights, 12 weeks after a new coronavirus infection with lung damage.Materials and methods. The prospective study included 52 patients (28 women, 24 men, aged 63.4 ± 13.3 years [30–84 years], hospitalized in the therapeutic department of the Sechenov University UKB No. 1 3 months after COVID-19 with lung damage > 50%. The need for respiratory support, the degree of lung tissue damage were assessed according to high-resolution computed tomography (HRCT), the results of spirometry with DLCO, data from a 6-minute walking test (6MWT). The analysis of the indicators was carried out taking into account the body mass index (BMI), which was used as a criterion for determining overweight and obesity.Results. In obese patients, 12 weeks after the disease, shortness of breath and cough were more common. It was revealed that a high BMI significantly affected the diffusion capacity of the lungs in patients after COVID-associated pneumonia, the preservation of pathological patterns according to the results of HRCT. Conclusions. Obesity is not only a risk factor for the severe course of COVID–19, but also in many ways the reason determining the long-term rehabilitation of patients after infection.
Перикардит является проявлением многих инфекционных и неинфекционных заболеваний, это-основная сложность, с которой может столкнуться клиницист, поэтому нередко установить этиопатогенетическую природу процесса в кратчайшие сроки не представляется возможным. В статье приводится клиническое наблюдение пациента 53-х лет с пароксизмами фибрилляции предсердий, асимптомной фебрильной лихорадкой, артралгиями и признаками экссудативного перикардита. Данные симптомы манифестировали после перенесенной вирусной инфекции, а длительность заболевания до обращения к докторам факультетской терапевтической клиники Университетской клинической больницы №1 г. Москвы составила 8 мес. По результатам лабораторных тестов у пациента наблюдались признаки анемии, лейкопении, тромбоцитоза и повышения уровня антинуклеарных антител. Были рассмотрены следующие концепции этиопатогенеза: онкологический процесс с паранеопластическим синдромом, системное заболевание соединительное ткани, инфекционное заболевание, множественная миелома, которые в дальнейшем были исключены. Хронизация процесса в виде постепенной нормализации температуры и острофазовых показателей, изменения характера перикардита на констриктивный позволила клиницистам предположить туберкулезный характер перикардита, после получения положительных результатов T-SPOT и диаскин-теста пациенту было назначено противотуберкулезное лечение. После нескольких месяцев проведения противотуберкулезной терапии наблюдалась положительная динамика в состоянии пациента-нормализовалась температура, эпизоды артралгии не беспокоили, пароксизмы фибрилляции предсердий стали редкими. Таким образом, эмпирически и лабораторно был поставлен диагноз туберкулезного миоперикардита с атипичной манифестацией. Особенностью данного клинического случая является нетипичная клиническая картина и отсутствие первичного очага инфекции, что не позволило клиницистам поставить диагноз в короткие сроки. Ключевые слова: туберкулезный перикардит, туберкулезный миокардит, фибрилляция предсердий, лихорадка неясного генеза.
Aim. Syncopal condition in young people are a relatively frequent and poorly understood medical problem. Non-cardiogenic syncope is not sufficiently studied because often they are not raise fears among doctors or patients, and at the same time their causes are associated with many complex medical and diagnostic aspects. The aim of the presented work is to identify the most significant risk factors in the development of non-cardiogenic syncopal conditions, identify triggers and assess the relationship between these factors, the lifestyle and development of syncope.Material and methods. The article presents the results of a descriptive research, including 1031 young people with a history of syncope episodes. The study took into account the presence of chronic diseases which could become a syncope trigger. External triggers (prolonged upright staying, stuffy room, and so on) were also determined.Results. In a multifactor survey of students living in Russia and abroad, the more frequent occurrence of non-cardiogenic syncopal episodes in young girls compared with young men was found. The effect of longterm upright and oxygen corporal were most likely risk factors for syncope.Conclusion. A significant correlation was found between the onset of reflex syncope and the presence of anemia and autonomic dysfunction syndrome. We proved the absence of a correlation between the level of daily load and the frequency of syncope conditions.
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