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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.
Volunteers reported well-being after vaccination with COVID-19
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.
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The disease of the mayor of Bishkek Aziza Surakmatov have been mild, he is in isolation at home, doctors monitor his condition
Aziz Surakmatov
(Photo: Tabyldy Kadyrbekov / RIA Novosti)
Test results for coronavirus mayor of Bishkek Aziza Surakmatov was positive. About it reports the edition 24.kg with reference to the Metropolitan municipality.
The mayor of the city for three days is in isolation, the disease occurs in mild form. Surakmatov is at home, his condition is controlled by the physicians.
According to the mayor, it feels good, but as the publication, he’s got a fever.
The President of Kyrgyzstan has agreed to come to Moscow for the Victory parade
A coronavirus also infected the head of the press service of the Kyrgyz Parliament Ibrahim Noracon uulu. He noted that last Sunday, June 14, his temperature rose, and later he received a positive test result for coronavirus.
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The first 10 days after the onset of symptoms of the disease, the 38-year-old American was feeling quite well. He was not at risk; he had no chronic diseases.
– The man was examined, the disease was mild. The patient had a slight cough. Therefore, he was sent home for treatment, ”says the head of the Department of Vascular Surgery at Westchester Medical Center Sean Wengerter.
And then the incredible happened.
One morning, a man woke up with icy and numb legs. The body was constrained by terrible weakness; there was not even the strength to get out of bed.
The examination showed that the patient had aortic occlusion – a large blood clot formed in the main artery at the place where the artery diverged in two directions – to the right and left leg. Because of this clot, blood enriched with oxygen did not enter the iliac arteries.
“This is extremely dangerous.” From this can die from 20% to 50% of patients, – notes Vangerter. – But such things are not typical for 38-year-olds.
An emergency operation to remove a blood clot could save the patient’s life. But doctors working with patients with COVID-19 are everywhere faced with rather strange and frightening phenomena in infected patients. For example, the formation of blood clots (actually blood clots) of various sizes throughout the body, renal failure, inflammation of the heart muscle and malfunctions of the immune system.
“Coronavirus occurs in each patient in its own way,” notes Scott Brackenridge, associate professor of emergency surgery at the College of Medicine at the University of Florida. – In some cases, the patient has a problem with breathing, in others, the internal organs begin to fail. In children, the immune system as a whole begins to rebel.
Coronavirus is not just a respiratory diseasePhoto: Ivan MAKEEV
MYSTERIOUS STROKES
A new type of coronavirus is considered to be a respiratory virus, although it is already becoming obvious – the infection affects the entire human body. The most common symptoms are fever, pneumonia, and acute respiratory distress syndrome.
In this case, the virus attacks some organs directly. First of all, the mucous membrane of blood vessels, which entails unnatural coagulation of blood.
– COVID-19 provokes a local inflammatory reaction that leads to the formation of blood clots, – explains Wengerter. – This is due to the direct effect of the virus on the arteries.
A number of doctors recorded strokes in young patients with coronavirus, as well as the formation of blood clots in the lungs. Blood clots were found even in the smallest vessels.
“Since each organ feeds on blood vessels, and the virus attacks them first and foremost, we end up with damage to internal organs,” adds Dr. Scott Brackenridge.
Another serious symptom that is observed in some patients who become ill with the new coronavirus is the “co-fingers.” The infected toes swell, becoming red or purple. It is possible that the reason for this is blockage of blood vessels. But doctors say that usually this does not have serious consequences.
Kawasaki Syndrome
One of the most alarming reactions to COVID-19 is observed in children. It has already been named as a children’s multisystem inflammatory syndrome. In newYork Doctors have identified more than 100 cases.
This syndrome is characterized by a rather long fever, inflammatory process, malfunction of one or more internal organs, as well as the general condition, which is usually observed with shock. Pediatricians also compare these symptoms with the syndrome. Kawasaki.
Kawasaki syndrome is a rare disease that affects children aged 3 to 10 years. It is characterized by damage to the medium and small arteries, thrombosis, the formation of aneurysms and rupture of the vascular wall. Cases of infection are rare. However, recently, doctors have noted an increase in the number of patients with this syndrome.
Both childhood multisystem inflammatory syndrome and Kawasaki syndrome lead to an overly aggressive immune system response to coronavirus. This may be accompanied by inflammation of the blood vessels and heart muscle.
KILLER CELLS
However, scientists note that coronavirus is not able to cause a strong immune response, but, on the contrary, suppress the entire immune system. And this can allow the infection to freely attack the internal organs.
Partly this theory was confirmed by Chinese experts, led by Dr. Zhang Zhang. Scientists analyzed samples of immune cells taken from the lungs of 9 patients infected with coronavirus. The results of the study showed an abnormally high level of leukocytes – macrophages and neutrophils responsible for the destruction of harmful pathogen – in severe patients. At the same time, these patients had a rather low level of CD8 T cells, which are called killer cells. They are responsible for killing virus-infected cells.
But doctors are reassuring, noting that they have drugs that can thin the blood, and also help the work of white blood cells that resist infection.
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(ANSA) – PESCARA, MAY 3 – “All people who for any reason are present in the Abruzzo region (residents and non-residents) are required – for the next 15 days – to wear the mask even in open spaces where it is not possible to keep distances social. ” And the provisions of ordinance no. 54 signed in the afternoon by the governor of Abruzzo, Marco Marsilio. The provision also establishes that “all persons from other regions are obliged, for the next 15 days or until a different provision: to monitor their body temperature daily and to promptly notify the territorially competent Siesp of any temperature above 37.5; maintenance of social distancing of at least one meter and use of the mask and hand hygiene, even in public areas open to the public in the regional territory, as well as in closed spaces and at home.
Children under the age of six are not subject to this obligation. “(ANSA).
RESERVED REPRODUCTION © Copyright ANSA
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Photo: Mario Tama / Getty Images
The ozone hole over the Arctic, which reached a “record size” in March, closed. This is reported by the World Meteorological Organization (WMO), which is a UN agency.
According to the organization, the destruction of the ozone layer in March was caused by both ozone-depleting substances in the atmosphere and very low temperatures in the stratosphere in winter. As a result, the level of ozone depletion became very high, breaking the 2011 record. Nevertheless, a month later the situation changed dramatically.
The ozone hole over Antarctica has decreased to a record size in 37 years
“The ozone hole closed in April with increasing temperature in the stratosphere, which led to the influx of ozone-rich air from the lower atmosphere,” the WMO explained.
According to Reuters, an official representative of the WMO office, Claire Nullis, at a briefing in Geneva, said that this phenomenon is in no way associated with a decrease in environmental pollution in the context of the COVID-19 pandemic.
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Photo: Kirill Zykov / AGN “Moscow”
Almost throughout Russia during the growing season of the year, during which the growth and development of plants takes place, the air temperature is expected to be higher than the climatic norm. This is stated in the message of Roshydromet received by RBC.
As noted, in some Russian regions an increased likelihood of an abnormally high temperature is predicted when daily values will exceed 30 degrees Celsius in the temperate latitudes of the country and 35 degrees in the South.
Weather forecaster promised Muscovites warming to plus 23 degrees in early May
Forecasters also explain that in the north of the country conditions will develop for cloudy and dry weather, which can cause an increase in temperature to extremely high values and the formation of a high level of fire hazard.
According to weather forecasters, 2019 was the second warmest year in more than a century and a half of weather observations. The fifth anniversary from 2015 to 2019 and the decade from 2010 to 2019 became the warmest in the history of observations, specified in Roshydromet.
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A team of researchers made up of geologists from the University of California recorded a “leak” on Earth after analyzing the planet’s inner layers and determined that the nucleus may leak heavy iron.
The researchers suggest that a significant drop in temperature from the planet’s liquid iron core to the outer rock mantle pushes the heavier iron isotopes toward the planet’s surface, while the lighter ones remain inside the core.
The boundary between the liquid iron core and the rocky mantle is located about 2,900 kilometers below the Earth’s surface. In that transition, the temperature falls by more than 1,000 degrees from the hottest core to the coldest mantle, explains the portal Science daily.
“The results suggest that iron from the core has been seeping into the mantle for billions of years,” said study lead author Charles Lesher.
The experiments, carried out at high temperatures and pressures, could explain why there are more heavy isotopes of iron in mantle rocks than in chondrite meteorites, the primary material in the early solar system.
Lesher also highlights that the findings may help scientists better understand the physical and chemical processes that take place between the layers that make up Earth, as well as better interpret seismic images of the deep mantle.
According RTComputer simulations by geologists show that the iron in the core can even reach the surface. They contend that this phenomenon could explain the high levels of iron deposits found in volcanic eruptions off the coasts of Samoa and Hawaii.
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They drooled. Sweat. Coughed. Sometimes kept a log of their symptoms. They managed their fear or considered making a will. But they survived. With or without antibiotics. With or without the famous chloroquine of which the Marseille professor Didier Raoult extols the merits. “98% of people recover”, recalls Jérôme Salomon, the director general of health who, since March 17, gives every day the number of Covid-19 patients discharged from the hospital, while comforting the litany of deaths (Wednesday evening, there were nearly 31 000 “cured” discharged from hospital). With data from the hospital environment, “We must add the probable tens of thousands of cured people in town“, Underlines the general direction of health.
Are these survivors now immune? If yes, for how long? The question remains thorny (read page 6-7). Have they all been really infected with the virus? If some have been tested, many have had to rely on a diag
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