卷 24, 编号 5 (2022)

Jellyfish are the simplest animals that have lived in the oceans for 700 million years. They are 95% water, endowed with stinging cells containing a neurotoxic poison. Poison in 70 known species of jellyfish can affect humans. In most cases and for most species, the bite is not fatal, but can cause a person from mild skin irritation to excruciating pain. Often, with a harmless appearance, a jellyfish poses a real threat to human health, and in some cases to his life. Timely and proper medical care will reduce the manifestations of the toxic effects of jellyfish venom, and in some cases save the life of the victim.

Cercarial dermatitis is a worldwide disease (popularly called «itch of swimmers», «fever of bathers»). The number of outbreaks of the disease has been steadily increasing in recent years, including in the Russian Federation, which makes it possible to consider cercarial dermatitis as a complex, urgent ecological, medical and social problem. Cercariosis is caused by the penetration into the human skin of cercaria larvae (parasites of waterfowl - trematode worms of the family Schistosomatidae). Specific methods of diagnosis and treatment have not been developed. In order to avoid meeting with parasites, you need to carefully choose a place for bathing.

The dependence of the level of happiness on the observance of the circadian rhythm of the brain (according to bedtime) and the circadian rhythm of the intestine (according to the habit of morning defecation) was studied in 156 young doctors (112 women and 44 men) aged 18-24 years. A validated questionnaire was used for weekly monitoring of bowel rhythm and setting bedtime, as well as for determining the level of happiness on a 10-point visual analog scale. A regular bowel rhythm with a stool frequency of at least 7 times a week (Euenteria) was found in 78 physicians (50%) and an irregular bowel rhythm with a frequency of 3-6 times a week (Bradyenteria) was found in 78 physicians (50% of respondents). It was found that 56% of the surveyed medical students did not comply with the regime of timely (up to 24:00 h) bedtime, and persons with euenteria were less likely to disrupt this rhythm than those with bradyenteria. In persons with bradyenteria, the absence of the habit of morning defecation was almost 3 times more common than in persons with euenteria. The level of happiness in individuals with a daily bowel rhythm and timely bedtime was 1.4 times higher than in individuals with a stool frequency of 3-4 times a week (defecation every other day) and late bedtime.

Teaching the methods of cultural cooperation between the nurses, their patients and their colleaques of various levels of culture, education, experience, age and personal characteristics is one of the ethical and moral problems of a contemporary medical team [1-3]. Teaching the basic principles of effective communication, rules of behavior in a conflict (ideally, preventing destructive interaction) is possible with joint efforts of teachers at all stages of receiving medical education [4, 5]. This was emphasized in the WHO report [6] and supported by the International Nursing Council and International Confederation of Midwives. The quality of health care is influenced not only by organizational, administrative and legal requirements, but also by personal characteristics of nurses, which are aggravated by the epidemiological situation with the Covid-19 pandemic [7-10].

Relevance: coagulopathy is a serious complication of coronavirus infection (COVID-19), while the use of anticoagulants is a mandatory component of patient therapy and is associated with an increased risk of hemorrhagic complications and hematomas of various localization. Objective: to evaluate the effectiveness of the integrated use of high-frequency ultrasound examination of the skin and laser Doppler imaging in the diagnosis (detection, assessment of the condition) and monitoring of hematomas in patients with COVID-19 with the involvement of nursing staff in the study. Materials and methods: in 2019 - 2022 the study was conducted of patients with confirmed coronavirus infection who are being treated in an infectious diseases hospital with subcutaneous hematomas (soft tissues), including 37 women (56%), 29 men (44%), mean age 48±3.5. All patients were examined according to a single diagnostic algorithm, which included 4 stages: Stage 1. Examination of hematomas by specialists (infectionist and surgeon) with a conclusion (n=66). Stage 2. Examination of hematomas using an ultrasound linear probe with a frequency of 7-13 MHz (n=66). Stage 3. Investigation of hematomas using a high-frequency (48 MHz) ultrasonic probe with the evaluation of standard parameters with the measurement of the pixel index (n=66). Stage 4. The study of hematomas using laser doppler imaging with an assessment of the rate, perfusion and blood flow concentration in the study area (n=66). The patients were divided into groups according to the hematoma development (with or without complications). Results and Discussion: to assess the effectiveness of using a comprehensive diagnostic algorithm, we monitored the trend of natural development of hematomas in patients with COVID-19. Correlation of data of high-frequency ultrasound diagnostics corresponds to r=0.86; laser Doppler imaging r=0.76; complex diagnostic algorithm r=0.91 (sensitivity 88%, specificity 91%). Conclusions: high-frequency ultrasound examination of the skin and laser doppler imaging can be used in combination to detect, assess the condition and monitor the development of subcutaneous hematomas in patients with COVID-19.