In Moscow, 23 people died in a day, all other deaths were recorded in the regions
Photo: Elena Afonina / TASS
During the day in Russia, 93 people died from coronavirus, the operational headquarters reported. Since the start of the epidemic, 9166 patients have become victims of COVID-19 in the country.
The day before, 104 people died from coronavirus.
For a day in the country revealed 6719 new cases of infection. In total, 641,156 cases of coronavirus were detected in Russia, over 403 thousand people recovered.
The increase in the number of patients with COVID-19 in Russia has become minimal in two months
Most deaths from coronavirus are in Moscow (3761, 23 people died per day), St. Petersburg (1105) and Moscow Region (875). Outside the capital and St. Petersburg, the list of regions by the number of epidemic victims looks like this:
Cloving hospital on the basis of the Medical Scientific and Educational Center (ISSC) Moscow State University named after M.V.Lomonosov took the first patients on April 21 and completed his work on June 13. It turned out that it was possible to achieve the best treatment results for COVID-19 in Moscow. Over the entire period, 4 patients died, and among severe patients who got mechanical ventilation, the mortality rate was less than 14% (for comparison, the average for the city and the world was up to 70 – 80%). Eighteen doctors out of 220 employees of the hospital were infected with coronavirus, there were no deaths among the medical staff.
What approaches were used at the University Hospital of Moscow State University to achieve such results? We continue the conversation with the head. Department of Therapy, Faculty of Fundamental Medicine, Moscow State University, Head of the Department of Age-Associated Diseases, Medical Scientific and Educational Center, Doctor of Medical Sciences, Cardiologist Yana Orlova.
MEDICINE FOR COUGH FOR 80 RUBLES
– Most of those who are ill or are afraid to get sick are worried about fibrotic changes in their lungs. They say that you have developed special therapy that can reduce the risk of developing fibrosis. Is it possible?!
– Yes, we launched an appropriate clinical study. There are no final results yet, but we have developed clinical practice.
“What did you do to save the lungs?”
– We used a combination of bromhexine and spironolactone (both are long-known very cheap drugs. – Ed.). Bromhexine is an expectorant that has been prescribed to patients with pneumonia and cough for many years. At the same time, experimental data showed that this drug can block a specific enzyme and impede the penetration of coronavirus into cells. True, it was on this effect that we counted to a lesser extent in inpatients, since such an effect is important mainly in the early stages of the disease. But the expectorant effect of bromhexine really helps patients with COVID. I heard that our colleagues in Peter launched a study of bromhexine for prophylactic purposes. We will wait for the results.
Coronavirus infected 18 doctors from 220 employees of the hospital, there were no deaths among the medical staffPhoto: Ivan MAKEEV
FIBROSIS OBSTACLE
– The second drug – spironolactone – is traditionally widely used in cardiology for the treatment of heart failure, severe hypertension. It has a small diuretic, magnesium and potassium-preserving effect, continues Yana. Orlova. – It has several mechanisms through which it can be useful in coronavirus infection.
Firstly, a mechanism that prevents the development of fibrosis in general in the body. There are works that, in particular, show that spironolactone reduces fibrosis in the heart. At the same time, it is known that the tendency to fibrosis is not local, but systemic – where there is more inflammation, there will certainly be fibrosis. And we see, of course, fibrotic changes in the “covide” in our patients. Therefore, we prescribed spironolactone as a drug for the prevention of this process.
Secondly, this drug blocks sex hormone receptors, in particular testosterone. Some published studies suggest that “high-testosterone” men suffer from “covid” more often and develop more severe fibrotic changes. Therefore, blocking these receptors for several weeks during COVID treatment may be useful in reducing the severity of complications. We are not talking about a longer intake, since male patients are unlikely to agree with a decrease in testosterone levels in the long term.
And perhaps the most important point. In almost all of our patients, we observed hypokalemia (a decrease in potassium levels. – Ed.). With coronavirus infection, potassium is intensely excreted from the body, and scientific articles even suggest that hypokalemia serves as the trigger for a cytokine storm. So spironolactone has a real chance to reduce the risk of this dangerous complication. But the main thing, in my opinion, is that lowering the level of potassium in the body is extremely harmful to the heart and triggers life-threatening rhythm disturbances, increasing the risk of sudden death. We, like all others, replenished potassium with droppers, but it was more effective to retain it in the body with the help of spironolactone.
Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patientsPhoto: Ivan MAKEEV
WHEN PRESCRIBED PATIENTS
– Yana Arturovna, how many patients did you have on average?
– About 10 – 14 days. But someone and 50 days.
– Have you noticed signs by which it can be assumed that the disease in the person brought is likely to go the hard way?
– Such studies were carried out in the world, our clinical practice confirmed them. Men certainly get worse than women; the elderly are heavier than the young; overweight people are heavier than overweight patients. Men with a classic male type of baldness, a lot of facial hair, we can say brutal men get sick harder.
– Under what conditions did you discharge patients?
– We acted as close as possible to the recommendations Ministry of Health: so that the temperature for three days was not higher than 37.5 degrees; so that C-reactive protein (an indicator of inflammation) is lower than 10 mg / l, and saturation, that is, the level of oxygen in the blood, is higher than 96%.
“HEAD OF EPIDEMIOLOGY DEPARTMENT OF ITSELF WORKED AT SANPROPUSNIK”
– How often do you get sick doctors and nurses?
– In the first month no one got sick at all. We have a very powerful epidemiological service. The head of the sanitary-epidemiological department, a senior researcher, correctly organized the whole process, and for the first two weeks she personally worked in the sanitary inspection room at the exit from the “red zone” and helped doctors and nurses who were exhausted after the shift safely remove protective clothing.
Then both people’s fatigue and viral load accumulated. By the middle of the second month, sick people began to appear. There were no seriously ill patients. We treated part of the staff in our observation, part of it was treated at home. In total, 18 people were infected from the medical staff (less than 10%).
– Doctors take something for prevention? Vitamins C, D, Zinc?
– I saw the recommendations of American nutritionists, they speak out positively about taking zinc, melatonin and vitamin C. There were somewhat conflicting data on vitamin D. But we did not give any such recommendations to our employees. We have all the prevention was associated with minimizing contacts and other measures of epidemiological safety.
Physicians are the heroes of our time.“If you think that you are special and that a pandemic will not affect you, you are deeply mistaken,” listen to what the doctors who are fighting with coronavirus say
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Volunteers participating in the clinical trials of the coronavirus vaccine have not yet identified any negative health effects. This was stated by the doctor anesthetist-resuscitator of the branch of the main military clinical hospital named after N.N. Burdenko Oleg Chikhlyaev, reports “Red Star”.
According to him, doctors regularly examine the test participants who received a test injection against COVID-19. “Their health is good, they have no active complaints. Temperature, blood pressure, pulse, respiration rate are within normal limits, ”said Chikhlyaev.
Volunteers after the introduction of the vaccine are quarantined. Hospital specialists several times a day check the pressure, temperature and examine the injection site. No adverse reactions to the drug were observed in the military.
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Tests of the Russian coronavirus vaccine vaccine began on June 18, when doctors introduced one component of the drug to nine volunteers, and nine more to the other.
Scientists have identified a reliable remedy for chronic diseases of metabolism
Effective way of struggle against diabetesPhoto: Ivan MAKEEV
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Prolonged physical exercises and playing sports is an effective way to avoid and even to some extent to overcome some chronic diseases associated with metabolism, e.g., diabetes or metabolic syndrome. To such conclusion scientists from the Karolinska Institute in Sweden and the University of San Diego in the United States as a result of their research, reported in the journal Cell Reports.
The experiment involved eighteen people engaged in Jogging, Cycling and other endurance exercises at least 15 years and seven men, who regularly perform strength exercises.
The researchers found that frequent physical activity changes the activity (expression) 1 711 metabolic genes in women and 1,097 genes in men. That is, the endurance training significantly improves processes associated with the tricarboxylic acid cycle (Krebs cycle), which plays a key role in metabolism.
Those who performed strength training had only 26 genes, which changed their activity. However, this does not mean, however, training does not have any effect. They can directly affect the activity of proteins and not on gene expression.
Experts also compared the obtained results with the data about the change of gene activity in people with metabolic syndrome and type II diabetes.
By the way, the subjects periodically performed exercises for about 6-12 months, after which the situation with the expression of the genes was similar to that observed in the new study, people performing endurance exercise for many years.
The United States believes that Russia has a project to split NATO. This idea is representative of the country’s arms control expressed in response to a tweet with the words Maria Zakharova on the destabilizing activity of NATO in the EU
Marshall Billingsley
(Photo: Hussein Malla / AP)
Russia is a “parallel project”, trying to divide NATO. About this in his Twitter wrote to the special representative of the U.S. arms control Marshall Billingsley.
This message he added to reticu post of the Russian foreign Ministry with the words of his official spokesman Maria Zakharova. “At the meeting in Vienna, Russia participated in the discussion of the destabilizing effects of military activity of NATO in Europe, emphasizing the end “mission on the exchange of nuclear weapons” and the withdrawal of US nuclear weapons from European countries,” — said in a tweet the Ministry of foreign Affairs.
Arguing about Moscow’s attempt to split NATO, Billingsley said that “this will not happen”. “Russia should concentrate on real things: secret extensions [оружия] China,” added the special representative of the United States.
The United States proposed to include in the new Treaty, the nuclear arsenals of Russia and China
Negotiations between Russia and USA on strategic stability and arms control was held in Vienna on 22 June. The Russian delegation was represented by Deputy foreign Minister Sergei Ryabkov.
Bertoneri in combination with chemotherapy affects the DNA of cancer cells, not allowing her to recover.
Photo: depositphotos.com
Specialists from the Institute of cancer research UK are looking for new ways to fight cancer. British scientists have focused on the ability of cancer cells to restore DNA. In the course of studies has identified the ATR protein, which is responsible for the repair of cells, which were exposed to the drug personaltab. Scientists did not expect so much positive effect, because the British drug in combination with chemotherapy 70% decreased the growth of aggressive tumors. Experts believe that made a breakthrough in the treatment of severe forms of cancer, because patients with such diagnoses have experienced a new drug.
The success of the operation personeria is that chemotherapy also affects the DNA of tumors makes them more sensitive to the ingredients of the new drug. To date, the side effects of the drug are mild and do not go to any comparison with the benefit from personaltime. Scientists are going to continue to create tools that act on the DNA of cancer tumors.
– Has long been known that overweight people have lowered immunity, says head of the Department of endocrinology of the medical faculty Russian national research medical University. N. And. Pirogov Tatiana Demidova. Research and practice show that in these patients increases the risk of atherosclerosis sharply increases the risk of heart attacks, strokes and heart failure. Increased risk of endocrinological, oncological diseases, joint diseases, psychological disorders.
Epidemic COVID has added another item to the list of high threats to people who are overweight. It turned out that when infected with coronavirus patients with obesity more often require hospitalization, fall into the ICU, on the ventilator (artificial lung ventilation). Alas, is growing and the risk of death.
– If the original messages from China on the most severe cases COVID it was mainly about the older people with severe chronic diseases, according to the latest data from Europe and USA the risk group includes people with obesity – says Tatiana Demidova.
FACTS AND FIGURES
In what diseases most often develop complications due to coronavirus
90% of patients admitted with severe COVID-19 US hospitals, were the following comorbidities:
– hypertension — 49.7%,and
– obesity or 48.3%,
– chronic lung disease — 34,6%,
– diabetes type 2 diabetes was 28.3%,
– cardiovascular disease — 27,8%.
Thus, obesity is second among the States in which CouId be severe.
CORONAVIRUS, INFLUENZA, AND HIV, “LIKE” ADIPOSE TISSUE
Visceral adipose tissue, that is, one that is in the abdomen, is, in fact, highly individual body, experts explain. This body affects the immune, endocrine system and metabolism in the body as a whole.
– People who are overweight fat cells are much larger. So, is synthesized in much more of various hormones and inflammatory cells. Among them, including interleukin-6, interleukin-1, tumor necrosis factor, and others, – says Tatiana Demidova. Often in the body, there is a creeping inflammation.
At the same time observed that many viral infections and especially COVID-19 amplify the effects cytokines and lead to the extension of the generalization of inflammation. “It was proved that adipose tissue serves as a reservoir for some viruses, such as influenza, HIV and cytomegalovirus. Also, according to the latest data, it can be activated and coronavirus,” adds Demidov.
INSULATION NEEDS TO BE LONGER?
Studies have shown one more feature of coronavirus. As it turned out, he is able to spread rapidly in adipose tissue surrounding internal organs – lungs, liver, kidneys, heart, etc. because Of this, developing severe damage to these vital organs and people with excess weight, excess amount of adipose tissue increases the risk of death from multiple organ failure.
There is evidence that such patients are also unable to stay longer carriers of the virus, require longer hospital stay and isolation, said Tatyana Demidova.
AFTER INFECTION — DIABETES
There is evidence and that not less than one-third of patients hospitalized with COVID-19 in China, European countries and the United States, the infection resulted in damage of the pancreas. This was confirmed by elevated enzymes amylase and lipase, and glucose levels in the blood plasma.
– This is a very disturbing circumstance. Since we talking about high risk of developing diabetes type 2 diabetes in people with the original obesity after recovery from infection, says Dr. Demidov.
It is not excluded that after the break the pace of the epidemic COVID, we will see a worldwide surge in the incidence of diabetes, experts say.
So now, when the opportunity walks, sports, seasonal ripe fruits and vegetables rich in fiber, doctors suggest the obese individuals to exert their maximum effort for getting rid of really dangerous extra pounds.
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MEANWHILE
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It can be found already everywhere. In the streets, on the sidewalks, the lawns. “Sometimes within a metre of the bin “, laments Didier Tournoux, chief of service, cleanliness of the city of Besançon (Doubs). It recognises “between 30 and 50 surgical masks” picked up every day by its officers. “Psychologically, it’s not easy having to clean up potentially contaminated items “, he adds, disappointed of this lack of civility, after weeks to to recognize the work of garbage collectors.
→ INVESTIGATION. The mask is recyclable is not for tomorrow
To attempt to break the phenomenon, Brune Poirson, secretary of State for the ecological transition, has announced that all of jet masks, gloves, cigarette butts, as well as the deposits of wild garbage would expose him now to a fine of 135 € (compared to 68 €). Increased repression hailed by Didier Tournoux, as defenders of the environment, who worry about the impact of the crisis of the Covid on the waste and the proliferation of plastics (number of masks are made of polypropylene).
“The health challenge outweighs any “
The legitimacy of the actions barriers is not in question, but some behaviors are a challenge. The incivility, of course, while the ministerial recommendations are clear (after use masks, gloves, or handkerchiefs should be thrown in a bag securely closed, and himself disposed of with household waste residual). But not only that. “We see some drift, which is related to the fact that the health challenge outweighs everything, even some common sense “, note Laura Châtel, in Zero Waste France.
The head of the advocacy cited several examples. “The systematic use of wipes for the household, the return of plastic bottles in companies to the place of the water fountains company, the refusal of the containers personal in stores, etc “. In some dental offices, in addition to gestures barriers conventional, patients are invited to place their personal belongings in a trash bag… that will be discarded a few minutes later, after the consultation.
A delicate balance to find
Difficult to find the right balance between protecting health and the planet. But for Laura, Châtel, it should be “reconcile various imperatives, by being more clear on some of the recommendations. The blur enhances the excess on the outside packaging or the use of single-use in the restoration. Of course, she continues, the health risk immediate is real, but the ecological risk is also… “. Threats to the fauna, the flora, but also human health, since the microplastics scattered on a large scale can be found everywhere, including in our food chain.
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The situation is all the more frustrating that significant progress had been made : european directive of 2018 on single-use objects, the law on circular economy of February 2020 in France, awareness campaigns, etc, However, the environmental consultant Christian Zelosi shows himself reassuring. “We are in a strong trend, with long-term strategies and heavy investments for industrial, notes the specialist in consumer products. There will be no retreat on the single-use. “
It is also the analysis of Matthew de Chanaleilles, the president of Tri-o Greenwishes, accompanying large groups in the management of their waste. “In business, good habits will not be challenged “, believes the latter. It ensures that the quality of sorting among its clients “has not been started since the beginning of the crisis “ – and if the masks are found in the bins yellow, the phenomenon remains “marginal “according to him. On his side, Laura Buxton is pleased that the european Commission as the French government have “good view “ in the face of various pressures to amend or repel the environmental regulations, in particular in the field of circular economy.
Yet another reversal in the scientific debates around the hydroxychloroquine. The molecule shows “no beneficial effect “ for the sick of the Covid-19, according to the officials of the clinical trial british Recovery, which were announced Friday, June 5 in a press release on the judgment “immediate “ the inclusion of new patients for this treatment.
Recovery, clinical trial a major of which the results were very expected, was one of the only ones not to have suspended his tests on hydroxychloroquine after a controversial paper in the Lancet, who pointed to the ineffectiveness or even adverse effect of the molecule to treat the Covid-19.
Global Divisions
The researchers of Recovery have made clear that they had decided to make public these “preliminary results because they have important consequences for the management of patients and public health “. The study of the scientific journal The Lancet had caused the arrest of several clinical trials on the hydroxychloroquine, in particular, the european Discovery (Europe, coordinated by the Inserm).
“It is disappointing that the treatment is ineffective,” commented Peter Horby, senior in charge of the test. ” Mais this allows us to focus on care and research on drugs most promising “, he added.
While this treatment has been prescribed heavily in many countries “in the absence of reliable information “, “these findings should change medical practice around the world “, has chimed in his assistant Martin Landray.
Published on may 22nd, the conclusions of The Lancet had, among others, also pushed France to banish the molecule of its treatments against the Covid-19 whereas the world health Organization announced Wednesday, June 3, to resume its clinical trials with hydroxychloroquine. Discovery plans to do the same.
Wednesday, 3 June, another clinical trial conducted in the United States and Canada, at least of patients that Recovery, had also concluded that the molecule was ineffective in the prevention of Covid-19.
I make the assumption – likely – that my wife and I are not the only ones to have noticed that our bank account decreased less quickly than usual since March 17, by the combined effect of an unchanged income and consumption reduced by force of circumstances. At the same time I hear, I read, I know that many are in a strictly opposite situation with incomes which have dried up and expenses which have increased, in particular for food. Like all of us, they saw nothing coming and are not responsible for what happens and yet upsets their balance. Do not hesitate too long, redistribute to charities all or part of these forced savings which would border on indecency if they joined the savings books without flinching.
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No matter how hard I try, I can’t say mass in the absence of people. And then the confinement arrived … …
