Aim. Based on the autopsy data, to analyze mortality patterns of the Zabaykalsky Krai population over a three-year period in the group of out-of-hospital sudden cardiac death (SCD).Material and methods. The protocols of deceased persons without evidence for violent death were analyzed with distribution into groups depending on age, sex and cause of death. Descriptive statistics were used for statistical processing.Results. The leading positions (58% of cases) in mortality patterns are occupied by various types of coronary artery disease (CAD). Chronic coronary syndromes were detected in 21%, cardiomyopathy — in 11%, decompensated heart failure — in 7%, myocarditis — in 1% of cases. Acute types of CAD were found in 68,4% in men and 31,6% in women. Among men, the number of such cases increases from 31 to 70 years of age and decreases over 70 years old. Among women, there is an increase in the SCD prevalence in the group over 70 years old.Chronic coronary syndromes were found in 46,4% in men and 53,6% in women. In both groups the number of cases increases with age. The maximum sex differences are observed in the group over 70 years old. The mean age for men is 72,2±8,8 years, for women — 77,2±10,4 years. Blood alcohol was detected in 10,2% of cases. The mean age of the deceased in all age groups of persons with identified blood alcohol was 66,2±12 years.In 1,89% of cases, I46 code (ICD-10) was established. The largest number of deaths among persons of both sexes was registered in the group of 31-40 years old, accounting for 36,8% among men and 13,2% among women. The mean age of the deceased was 35,8±8,4 years. In 28,6% of cases, ethyl alcohol was found in the biological media of the deceased in this group.Conclusion. Acute and chronic types of CAD make a significant contribution to out-of-hospital mortality. The number of SCD in men is higher than in women and is directly proportional to the age increase, reaching a maximum in the group over 70 years old. Ethyl alcohol, an important trigger of SCD, was detected in 10,8% of SCD cases in 2017, and in 15% in 2018 and 2019.
The aim of the research. To study clinical and laboratory features of the new coronavirus infection (COVID-19) in order to develop a model that would allow, taking the publicly available research methods into account, to carry out early diagnosis of severe community-acquired pneumonia against the background of the new coronavirus infection. Material and methods. A total of 82 COVID-19 patients who complied with inclusion and exclusion criteria were enrolled. Depending on the clinical severity, three study groups were formed: group 1 included 13 patients with uncomplicated COVID-19, group 2 consisted of 39 patients with non-severe forms of pneumonia that developed against COVID-19 and group 3 was comprised of 30 patients with COVID-19 complicated by severe pneumonia. The groups were comparable in age and gender. All patients underwent general clinical examination, laboratory tests, including general and biochemical blood analysis, as well as chest computed tomography. Results. The clinical picture in COVID-19 patients differed depending on the disease severity. Coughing and shortness of breath were more often observed in patients with severe pneumonia; sore throat, on the contrary, was more often noted in patients with uncomplicated COVID-19. On admission to the inpatient facility, patients with severe pneumonia had higher body temperature and respiratory rate, with simultaneous decrease in blood oxygen saturation. One half of the patients with severe pneumonia had hypertensive disease in medical history, and one third had ischaemic heart disease. As a rule, uncomplicated COVID-19 patients did not have ischaemic heart disease. It was found through laboratory analysis of blood that groups of patients significantly differed in the levels of neutrophils, lymphocytes, monocytes, basophils and eosinophils. Conclusion. The use of such clinical and laboratory data as acute respiratory failure, fever, the levels of neutrophils, monocytes, lymphocytes, eosinophils and basophils makes it possible to identify patients with more severe pneumonia against the background of COVID-19 even before chest computed tomography.
Aim of the study. To study genetic polymorphisms rs10798 KCNQ1, rs3010396 CASQ2, rs20455 KIF6, rs2298566 SNX19, rs12143842 NOS1AP of subjects who died due to sudden cardiac death in Trans-Baikal Territory. Material and Methods. Over the period of 2017-2020, a total of 2211 autopsy protocols of subjects who died due to SCD were analysed. Th ese patient constituted the 1st study group (n=113). The control group consisted of healthy volunteers (n=70). The groups were comparable in age and gender. Molecular and genetic typing of the studied genes was performed. Results. The CC genotype of the single-nucleotide polymorphism rs3010396 CASQ2 showed statistical signifi cance in comparison with the control group(the chi-squared=26.95, df=2, p=0.001). The TT genotype was predominant in the control group amounting to 60% against 19.5% in the study group. Single-nucleotide polymorphism rs2298566 of gene SNX19 was also observed to be of statistical significance in the group of subjects who died from myocardial infarction. In the group of patients with SCD, rs20455 KIF6 and rs12143842 NOS1AP were of signifi cance along with rs3010396 CASQ2. Conclusion. Single-nucleotide polymorphism rs3010396 of the CASQ2 gene can be a predictor of sudden cardiac death, since in the 1st study group with this genotype showed its statistical signifi cance in all nosological groups. However, in the group, in which sudden cardiac death (cases coded I46.1 according to ICD-10) was indicated as the fi nal diagnosis, in addition to their statistical signifi cance single-nucleotide polymorphisms of the gene KIF6 rs20455, rs12143842 NOS1AP gene were noted; in the group where the cause of death was myocardial infarction, rs2298566 SNX19 gene polymorphism had statistical signifi cance. The results obtained make it possible to consider these polymorphisms as possible predictors of sudden cardiac death in the population of the Trans-Baikal Territory.
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