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BACKGROUND: The work of the teaching staff and department head is associated with great emotional stress, prolonged attention strain, and possibility of computer radiation exposure that affects vision. AIMS: To characterize the state of health of teachers of higher medical and postgraduate educational organizations. MATERIALS AND METHODS: During the study, content analysis, analytical methods, direct observation, organizational experiment, copying data from information and statistical documents, expert assessments, and questionnaire and personalized survey were conducted. In total, 1209 questionnaires were processed during the study (each teacher and head filled out 3 questionnaires). The main importance was on the state of health. RESULTS: Various diseases, regardless of the workplace, were detected in 76.6% of the interviewed department heads and 75.6% of the teachers. Risks for morbidity with central nervous, cardiovascular, and musculoskeletal diseases increased with work experience, indicating the relationship between morbidity and professional activities of teachers and department heads. The results showed that teachers and department heads do not always undergo regular medical examinations, which causes health deterioration and subsequently negatively affects the desire to improve their competencies. CONCLUSIONS: Insufficient preventive work in various educational organizations contributes to high levels of morbidity among doctors, especially nervous system disorders, leading to the syndrome of psycho-emotional burnout in the department heads of medical higher and postgraduate educational organizations.

COVID-19 disease does not only lead to impaired respiratory function. Post-COVID complications are multiple with the involvement of many body systems, including the musculoskeletal system and the peripheral nervous system. Diseases of the musculoskeletal system include myalgia, myositis, rhabdomyolysis, acute arthralgia, arthritis, bone osteoporosis. Damage to the peripheral nervous system caused by coronavirus infection includes plexopathy due to lying down, poly-neuropathy, GuillainBarre syndrome. This descriptive literature review discusses the effects of COVID-19 on the musculoskeletal system and the peripheral nervous system of patients. Data are presented on the use of diagnostic tools such as computed tomography, magnetic resonance imaging, and ultrasound scans to detect pathology.

Sergey N Avdeev,1 Alexander A Vizel,2 Vladimir N Abrosimov3 ,† Andrey A Zaicev,4 Galina L Ignatova,5 Rustem F Khamitov,2 Marina P Mikhaylusova,6 Julia S Shapovalova,7 Elena F Pavlysh,8 Basil I Trofimov,9 Alexander V Emelyanov,10 Tatiana I Martynenko,11 Vladimir A Martynenko,12 Natalia E Kostina,13 Danila A Chizhov,14 Olga Yu Chizhova,10 Natalia A Kuzubova,15 Elena V Makova,16 Ekaterina V Makarova17,18 1I.M. Sechenov First Moscow State Medical University, Moscow, Russia; 2Kazan State Medical University, Kazan, Russia; 3Ryazan State Medical University Named After Academician I.P. Pavlov, Ryazan, Russia; 4The Main Military Clinical Hospital Named After Academician N.N. Burdenko, Moscow, Russia; 5Regional Clinical Hospital No. 4, Chelyabinsk, Russia; 6Pirogov Russian National Research Medical University, Moscow, Russia; 7Chelyabinsk Road Clinical Hospital “Russian Railways”, Chelyabinsk, Russia; 8Nikiforov’s All-Russian Center for Emergency and Radiation Medicine of the Emergencies, St. Petersburg, Russia; 9I.P. Pavlov First Saint Petersburg State Medical University, St. Petersburg, Russia; 10North-Western State Medical University Named After I.I. Mechnikov, St. Petersburg, Russia; 11Regional State City Hospital No. 5, Barnaul, Russia; 12Regional State Clinical Hospital, Barnaul, Russia; 13Voronezh Regional Clinical Hospital No. 1, Voronezh, Russia; 14St. Petersburg State City Polyclinic No. 106, St. Petersburg, Russia; 15St. Petersburg State Vvedenskaya City Clinical Hospital, St. Petersburg, Russia; 16State Samara City Hospital No. 4, Samara, Russia; 17Privolzhsky Research Medical University, Nizhny Novgorod, Russia; 18State City Clinical Hospital No. 10, Nizhny Novgorod, Russia†Professor Vladimir Abrosimov passed away on January 22, 2019Correspondence: Sergey N AvdeevI.M. Sechenov First Moscow State Medical University, 8– 2, Trubetskaya St., Moscow, 119991, RussiaTel +7-495-465-74-15Fax +7-495-465-52-64Email serg_avdeev@list.ruBackground: Chronic cough declines quality of life and increases risk of complications in patients with chronic obstructive pulmonary disease (COPD). Reducing cough severity and associated negative effects is important therapeutic goal in COPD. Rengalin with anti- and protussive activity is based on technologically processed antibodies to bradykinin, histamine and morphine.Aim: To evaluate efficacy and safety of Rengalin in treatment of cough in patients with COPD.Methods: Patients (n=238, mean age 64.3± 8.2 years) with stable COPD and persistent cough despite maintenance therapy (anticholinergics, beta-2-adrenergic agonists, inhaled corticosteroids) were included and randomized in the study. The severity of cough assessment (according to the “Cough Severity Score”), COPD impact on patient’s life (COPD Assessment Test, CAT), and spirometry were performed at screening. Patients took Rengalin or Placebo 2 tablets 2 times daily for 4 weeks. The endpoints were proportion of patients who responded to treatment, dynamics of cough severity, and severity of COPD symptoms. Intention-to-treat (per protocol) analysis was performed.Results: Positive response to Rengalin was recorded in 83.6 [85.7]% (vs 72.6 [72.7]% in Placebo group, p=0.0422 [p=0.0163]). Double decrease of cough severity was reported in 42.2 [43.8]% in Rengalin group (versus 32.7 [32.7]% in Placebo; p=0.1373 [p=0.0907]). The total CAT score decreased by 3.3± 4.2 [3.6± 3.9] points (versus 2.5± 4.1 [2.5± 4.2] in Placebo group); the difference between groups was 0.79± 4.16 [1.04± 4.02] points (p=0.0870 [p=0.0416]). The number of patients with adverse events (AEs) in Rengalin (n=13) and Placebo (n=12) groups did not have significant differences (p=1.00). No AEs with certain relationship with study drug were registered.Conclusion: Rengalin is an effective and safe drug in patients with stable COPD and persistent cough, despite stable doses of maintenance therapy according to the GOLD guidelines. Four-week therapy decreases severity of cough by two times in more than 40% of patients.Trial Registration: ClinicalTrials.gov (id: NCT03159091).Keywords: cough, cough management, chronic obstructive pulmonary disease, treatment, Rengalin

Study the impact of various combinations of comorbid original diseases in patients infected with COVID-19 later on the disease progression and outcomes of the new coronavirus infection.The ACTIV registry was created on the Eurasian Association of Therapists initiative. 5,808 patients have been included in the registry: men and women with COVID-19 treated at hospital or at home.gov ID NCT04492384.Most patients with COVID-19 have original comorbid diseases (oCDs). Polymorbidity assessed by way of simple counting of oCDs is an independent factor in negative outcomes of COVID-19. Search for most frequent combinations of 2, 3 and 4 oCDs has revealed absolute domination of cardiovascular diseases (all possible variants). The most unfavorable combination of 2 oCDs includes atrial hypertension (AH) and chronic heart failure (CHF). The most unfavorable combination of 3 oCDs includes AH, coronary heart disease (CHD) and CHF; the worst combination of 4 oCDs includes AH, CHD, CHF and diabetes mellitus. Such combinations increased the risk of lethal outcomes 3.963, 4.082 and 4.215 times respectively.Polymorbidity determined by way of simple counting of diseases may be estimated as a factor in the lethal outcome risk in the acute phase of COVID-19 in real practice. Most frequent combinations of 2, 3 and 4 diseases in patients with COVID-19 primarily include cardiovascular diseases (AH, CHD and CHF), diabetes mellitus and obesity. Combinations of such diseases increase the COVID-19 lethal outcome risk.Цель. Изучить влияние различных комбинаций сопутствующих заболеваний, существовавших у пациентов исходно, до инфицирования вирусом SARS-CoV-2, на тяжесть течения и исходы новой коронавирусной инфекции. Материалы и методы. Регистр АКТИВ создан по инициативе Евразийской ассоциации терапевтов. В регистр включены 5808 пациентов: мужчины и женщины с диагнозом COVID-19, находящиеся на лечении в стационаре или получающие лечение на дому. Регистрация регистра: идентификатор ClinicalTrials.gov: NCT04492384. Результаты. Подавляющее большинство пациентов с COVID-19 имеют исходные сопутствующие заболевания (иСЗ). Полиморбидность, оцененная методом простого подсчета иСЗ, является самостоятельным фактором негативного прогноза больных COVID-19. Поиск наиболее часто встречающихся комбинаций из 2, 3, 4 и более СЗ выявил абсолютное доминирование сердечно-сосудистых заболеваний во всех возможных вариантах. Наиболее неблагоприятной при сочетании 2 иСЗ была комбинация, включающая артериальную гипертензию (АГ) и хроническую сердечную недостаточность (ХСН), при сочетании 3 иСЗ комбинация, включающая АГ, ишемическую болезнь сердца (ИБС), ХСН, и при сочетании 4 иСЗ комбинация, включающая АГ, ИБС, ХСН и сахарный диабет. Наличие таких комбинаций приводило к росту риска летального исхода в 3,963, 4,082, 4,215 раза соответственно. Заключение. Полиморбидность, определенная методом простого подсчета заболеваний, может использоваться в реальной практике как фактор риска летальности в остром периоде COVID-19. В состав наиболее часто встречающихся комбинаций из 2, 3, 4 заболеваний у пациентов с COVID-19 входят преимущественно сердечно-сосудистые заболевания (АГ, ИБС, ХСН), сахарный диабет и ожирение. Комбинации этих заболеваний повышают риск летального исхода при COVID-19.

Authors perform a cross-sectional study of functional abilities of the patients with osteoporotic VF. Trunk muscle isometric strength and balance impairments were estimated. The development of osteoporotic VFs is associated with a significant decrease in strength of all the body muscles, especially the deep spinal stabilization system (TE, TF), where the VFs contribute to inappropriate distribution of back muscle strength with TE:TF ration of 1:1 instead of 3:2, observed both normally and in patients with uncomplicated osteoporosis. There is also a deterioration of stabilometry and functional balance assessment tests in patients with pathological VFs, which indicates abnormalities of both static and dynamic balance. The obtained data should be taken into account when developing rehabilitation programmes for patients with osteoporosis who have suffered compression VFs.