The article reflects the results of the work of the psychiatric and psychotherapy services of the Hospital for war veterans converted into an infectious hospital in the context of the new coronavirus infection (COVID-19) pandemic. The aim of our study was to determine the frequency and nature of mental disorders in patients treated in hospital for a new coronavirus infection (COVID-19) between April and June 2020. The case histories of patients who received psychotherapy or psychiatric care in addition to the treatment of the underlying disease were studied retrospectively. The study included 557 patients, 266 men, 291 women, the average age was 62.36+18.65 years. The work used clinical and psychological methods using the international classification of diseases 10 revision (ICD-10), the diagnosis of a new coronavirus infection (COVID — 19) was carried out in accordance with the Temporary guidelines of the Ministry of health of the Russian Federation. As a result of data evaluation, it was revealed that the proportion of patients requiring consultation or treatment by a psychiatrist or psychotherapist was 557 (7,10%) patients of the total number of hospital admissions, of which emergency psychiatric care was indicated in 58 (10,41%) of cases. The transition of the hospital to an infectious diseases hospital mode has set new challenges for the psychiatric and psychotherapy service, which required organizational measures, therapeutic issues and confirmed the need for participation of mental health specialists in providing full-fledged medical care in the treatment of somatic disorders.
One of the effective mechanisms of internal affairs bodies' managing is said to be public control on the police activity. An analysis of the police activity which, in its turn, is characterized by mistrust and low satisfaction with activity of law enforcement officials proves the necessity to find effective ways to improve such situation. The authors of the given article consider that there are enough mechanisms to manage in the internal affairs bodies but not all of them are effectively applied. It is public control that is of great importance as it allows citizens to analyze, evaluate the activity of police officers as well asto identify issues require to be solved at once both by the public and the heads of the internal affairs bodies. The study of the legal basis allows the researcher to consider that at present there are all the formal conditions to perform public control. However, this is not enough. In fact there isanothersituation. On the one hand, we can see formal approach of the heads of the territorial internal affairs bodies to perform public control as a mechanism toimprove the police activity; on the other hand, there is low self-organization of the population expressed in poor legal literacy and social activity as well as underdeveloped forms of civil participation in public life. Based on the results of the regional sociological studies the authors of the article conclude that it is necessary to intensify cooperation with the public on informing about the possibilities to perform public control on the police as well as developing a system of indicators to evaluate the activity of public councils and publicmonitoring committee that perform public control to increase the efficiency of their activities, about necessity to provide responsibility of the heads of the territorial internal affairs bodies for ignoring sociological information to have been received. The article deals with not only a critical assessment of the police's interacting with the population, but also new approaches related to usage of public control as an effective mechanism to manageby the internal affairs bodies, which helps increasing citizens' trust in police officers.
Based on the example of seasonal epidemics of respiratory viral infections, it is partially possible to model the outcomes of neurological complications from Covid‑19, taking into account the pathogenetic features of the virus effect on the vascular wall and nerve cells. The accumulated experience of doctors of various specialties makes it possible to prevent such life-threatening complications as ACVA, PATE, intoxication, and sepsis. From the first days of the disease, it is necessary to conduct dynamic monitoring of blood rheology, the level of systemic oxygenation, use anticoagulants in preventive doses in patients at the early stages of the disease, conduct therapy aimed at reducing the risk of cytokine storm development.
INTRODUCTION: Members of the coronavirus family can affect the human central nervous system, causing various neurological complications in patients with SARS-CoV-2. Proton magnetic resonance spectroscopy (1H-MRS) seems to be a promising technique for assessing the prognosis of persistent neurological manifestations and complications, determining the completeness of a patient’s recovery during long-term follow-up. OBJECTIVE: To study changes in the metabolites profile in the brain with relation to cognitive impairment in patients with COVID-19.MATERIALS AND METHODS: 68 patients with verified COVID-19 and neurological complaints underwent a diagnostic workup, including a psychoneurological assessment and MRI of the brain with multivoxel proton magnetic resonance spectroscopy (1H-MRS), starting in the first 2 weeks from the onset of the disease. In 11 patients, a complex examination was repeated 7–8 months after the onset of the disease. The exclusion criteria were acute severe neurological symptoms, age over 65 years, artificial lung ventilation, lung CT score III–IV, as well as information about pre-Covid neuropsychiatric disorders. As a control group, earlier collected data of 10 healthy volunteers (age 30–67 years) were taken from a local database. Statistics: Intergroup differences in the ratios of metabolites peak areas determined by the 1H-MPC method were assessed using the nonparametric Mann-Whitney test with Bonferroni’s correction for multiple comparisons. Values were considered statistically significant at p<0.05. RESULTS: According to 1H-MRS, all patients with COVID-19 showed metabolic changes in the brain: a statistically significant increase in mI/Cr in the white and gray matter and a diffuse decrease in the levels of Cho/Cr in the supraventricular white matter, even in the absence of any changes in structural MRI. DISCUSSOIN: Patients were divided into three subgroups according to the severity of neurological symptoms that arose with the onset of the coronavirus infection. The most pronounced metabolic changes were found in the group with severe neurological manifestations (NM). At follow-up, a gradual recovery of the metabolite profile was noted, but in our sample group complete normalization was not achieved within the specified time frame. CONCLUSION: The obtained data indicate metabolic changes associated with SARS-CoV-2 infection, as well as the prospects for using the 1H-MPC technique in the diagnosis of neurological complications of the new coronavirus infection, including manifestations of a psychoneurological syndrome associated with COVID-19.><0.05.RESULTS: According to 1H-MRS, all patients with COVID-19 showed metabolic changes in the brain: a statistically significant increase in mI/Cr in the white and gray matter and a diffuse decrease in the levels of Cho/Cr in the supraventricular white matter, even in the absence of any changes in structural MRI.DISCUSSOIN: Patients were divided into three subgroups according to the severity of neurological symptoms that arose with the onset of the coronavirus infection. The most pronounced metabolic changes were found in the group with severe neurological manifestations (NM). At follow-up, a gradual recovery of the metabolite profile was noted, but in our sample group complete normalization was not achieved within the specified time frame.CONCLUSION: The obtained data indicate metabolic changes associated with SARS-CoV-2 infection, as well as the prospects for using the 1H-MPC technique in the diagnosis of neurological complications of the new coronavirus infection, including manifestations of a psychoneurological syndrome associated with COVID-19.
Objective. The aim of the study was to evaluate the effectiveness of the drug Mildronate in the complex therapy of patients with a new coronavirus infection COVID-19 in the acute period and the background of cerebrovascular disease.Material and methods. The material for the study was the medical records of 210 patients (140 women and 70 men) who had COVID-19 coronavirus infection against the background of cerebrovascular pathology in the period from 04.10.2020 to 12.31.2021. 120 patients (75 women and 45 men) received the drug Mildronate as part of complex therapy, 90 patients (55 women 35 men) made up the control group, received complex treatment without the use of the drug Mildronate. Patients in both groups were comparable in age, the average age was 76.5 years (from 50 to 93 years). Groups according to nosological forms were distributed as follows: in the main group – ischemic stroke of various localization – 70 patients (48 women and 22 men), chronic cerebrovascular insufficiency of varying severity – 50 patients (27 women and 23 men); in the control group – ischemic stroke of various localization was in 50 patients (36 women and 14 men), chronic cerebrovascular insufficiency – 40 patients (19 women and 21 men). To correct chronic hypoxia, the drug Mildronate was chosen, which is a blocker of fatty acid oxidation, has a multicomponent effect, stabilizes microcirculation under conditions of ischemia and hypoxia. Also, Mildronate is one of the universal cytoprotectors with a pronounced neuro-, cardio- and angioprotective effect, which goes well with drugs of other pharmacological groups.Results. The drug Mildronate is a blocker of fatty acid oxidation, has a multicomponent effect, stabilizes microcirculation in conditions of ischemia and hypoxia. According to the observations, it can be noted that the neurological status during mildronate therapy has a more significant regression trend with good rehabilitation potential – 56.0% of patients can serve themselves independently, while patients in the control group reached a level of 9 points only in 51.0% of cases. A significant neurological defect remained in the main group in 6.2% of patients, in the control group this figure was 8.8%.
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