Vol 28, No 1 (2021)

In March 2020, WHO announced a pandemic caused by SARS-CoV-2. To date, there is still lack of knowledge about the pathogen and the clinical course of the disease and the emerging research results require systemic analysis and synthesis. The aim of our review was to analyze publications on clinical and experimental observations, reviews and international experience regarding to the immune response, organ changes, diagnosis and treatment of the new coronavirus infection. This review provides a qualitative synthesis of research papers on SARS-CoV-2 form 2020 and on SARS-CoV and MERS-CoV, which were published from 2005-2020. PubMed was the source of literature for international papers while Russian papers were selected using Russian Science Citation Index database. The structural features of SARS-CoV-2 due to the spine-shaped protein allow the virus to bind to the host receptors via angiotensin-converting enzyme 2. Changing the parameters of the virus-cell interaction helps to reduce the production of type I interferon, which leads to rapid virus replication, activation of the immune response with the development of the "cytokine storm". A key role in the excessive production of cytokines is played by IL-6, which, through both classical signal transduction and activation of the soluble IL-6 receptor, exacerbates excessive cytokine production. The development of endothelitis, sepsis and septic shock against this background are key factors in the pathogenesis of the disease, increasing the risk of death in infected patients. X-ray signs of SARS-CoV-2 infection include multifocal, bilateral, peripheral frost-glass changes, and morphological findings confirm damage to the alveoli, hyaline membrane formation and type II pneumocyte hyperplasia. The information for evidence-based treatment of patients with SARC-Cov-2 is still limited. However, an exponential growth of literature on this disease will soon provide opportunities for both qualitative and quantitative synthesis.

Introduction: Effects of low temperature and excessive physical load on the cardiovascular system are among the issues of human physiology that require better understanding for successful exploration of the Arctic. Aim: To study cardiac rhythm before and after winter marathon (50 km) in men. Methods: Altogether, 15 healthy men took part in this study. Cardiorhytm parameters were measured using "Elox-01S" device before and after a 50 km marathon in winter at -12 0C. Matrices of paired observations before and after the exposure were constructed. The number of k-pares belonging to the to the same population were identified. Wilcoxon test for paired samples was applied for before-after comparisons. Results: Significant differences were revealed in six main parameters of the heart rate at p ≤ 0.05 before and after the marathon. Pairwise comparisons matrices of samples showed an increase in the proportion of chaos, since decreased the number of cardiointervals samples pairwise comparisons for which P ≥ 0.05 (k1 = 15 before and k2 = 11 after the marathon), which seems to be typical for the winter period. Other studies have reported that in women the differences were significant for three parameters only, while in men, all 6 parameters are changed after the winter marathon. The role of chaos increases for the studied parameters after long physical exercise. Conclusion: Our results suggest that heavy physical load in winter may result in increasing of the role of sympathetic neuro-vegetative system and decreasing of the role of the parasympathetic system.

Introduction: Many studies on adaptation of the human body to the effects of cold suggest the presence of evolutional genetic mechanisms of adaptation to the climate of the North. However, the question remains open about the reactions of the human neuromuscular system (NMS) to local hypothermia. Aim: To study the changes of the parameters of the NMS (coordinates xi = xi (t) of the tremorograms) of a group of young women living in the North of the Ugra republic, Russia before and after local cooling of the hand in different seasons. Methods: Kinematograms of tremor of the fingers of the right hand were recorded using a biophysical measuring complex based on the «Tremograph» device. Limb displacement signals x1 = x1 (t) were recorded and processed (obtaining the derivative of x1, i.e., x2 = v (t) = dx1/dt is the coordinate of the finger's speed of movement) using software products applying fast Fourier transformation and Wavelett-analysis. Shapiro-Wilk's tests and Wilcoxon tests were used for statistical analysis of the data. Results: All parameters of tremorograms of the neuromuscular system of women were had skewed distributions. The signal was always unique for each recording interval for every study participant. Medians of the parameters of the tremorograms in a group of women after local hypothermia in the autumn and spring periods of the year were reduced in 85-70 % of cases, but in spring these values were much greater both before and after local cold exposure compared to the autumn period. In 57 % of cases, the coordinates xi = xi (t) of the parameters of tremorograms were statistically different. Conclusions: Our findings suggest that the response of the NMS in women significantly varies across the seasons, which may indicate adaptation of the body to exposure to cold.

Aim: To study expert opinion on the social system benefits for people with autism in Russia and barriers for their inclusive development and life. Methods: Two questionnaire-based surveys were performed in 67 regions of Russia. Pediatricians, neurologists, psychiatrists and other specialists (N = 400 in total) comprised the study base for the first survey. The second survey included psychologists and educators working with children with disabilities (N = 470). The results are presented as proportions. Results: Altogether, 42.4 % of psychologists and educators gave 1 of 5 points to the accessibility of the environment for people with autism. As many as 28.1 %, 22.7 % an 5.7 % provided 2, 3 and 4 points, respectively. Only 1.1 % of responders gave 5 points. Forty-eight per cent of responders indicated that the challenges of early intervention for children with autism and their families have not been addressed at all while 35.9 % responded that that they have been partially addressed. The most common answer (51.3 %) for the measures to support children with autism was "public and private rehabilitation centers for children with autism". Altogether, 17.4 % of the participants answered that there was no special support for children with autism. Conclusions: Professionals working with people with autism conclude that the availability of community resources for this vulnerable group is poor. At the same time, the experts acknowledge positive changes of the situation in Russia, the creation of new institutions to support children with autism and their families, as well as development of inclusive education. A comprehensive national program to improve social environment for people with autism is warranted.

Health literacy is recognized as one of the most important determinants of health on the global level. International comparative population-based surveys on measuring health literacy using unified methodological approaches contribute to decisive national instruments on measurement, monitoring and improvement of health literacy in a population. These studies also contribute to the adaptation of the measures, taking into account the level of health literacy of vulnerable groups in particular. Until today, there was no instrument in the Russian Federation for measuring health literacy at the population level providing internationally comparable data. We attempted to adapt the HLS19 questionnaire developed within the international Health Literacy Survey in 2019 for use in Russia. The adaptation of the questionnaire was based on the European methodology which was tested in several countries of Europe and Asia and included 5 stages: translation from English into Russian, back translation from Russian into English, focus group, expert assessment and field testing. In spite of the fact that the instrument has already been translated into the Russian language and tested in some countries for the Russian-speaking population, a substantial adaptation of the questionnaire was needed taking into account the cultural and linguistic characteristics of the Russian population.