[PERSONS WITH DISABILITIES IN TERMS OF THE SPREAD OF THE NEW CORONAVIRUS INFECTION COVID-19]

One of the vulnerable categories of the population during a pandemic of coronavirus infection is the disabled, both from the point of view of the high risk of a severe course of the disease, and from the point of view of the possibility of significantly limiting everyday, professional and social activities. The article discusses the regulatory and organizational measures taken to ensure the rights of people with disabilities in Russia to prevent the spread of coronavirus infection. The epidemiological situation and features of the spread of coronavirus in long-term care facilities have been analyzed. The mortality rate from COVID-19 among residents of inpatient institutions in the EU countries ranged from 24 to 80%, in Russia the average mortality rate was 2.34 per 100 patients, in St. Petersburg from 1.4% to 2.2% of the number of people living in dependence on the type of institution. Using the example of one of the stationary social service institutions in St. Petersburg, it has been shown that the timely introduction of a set of organizational measures makes it possible to successfully manage the spread of coronavirus among residents and staff of long-term care institutions.

Circadian rhythms of arterial pressure: basic regulatory mechanisms and clinical value

The circadian rhythm of arterial pressure (AP) is not a passive consequence of the impact of exogenous factors. Endogenous mechanisms play an important role in the generation and maintenance of AP rhythm. The adaptation of the exogenous components of AP rhythm to the demands of the environment is modulated by the circadian-time-dependent responsiveness of the biologic oscillator. A neuronal network in the rostral hypothalamus including the suprachiasmatic nucleus is implicated in the generation of AP rhythm, in the modification of the rhythm amplitude (possibly due to homeostatic constraints), and in the regulation of its phase. The central sympathoexcitatory pathway to the upper thoracic cord plays a crucial role in the maintenance of normal circadian AP rhythm. The circadian pattern of AP is influenced also by hormonal factors such as the hypothalamic-pituitary-adrenal and the hypothalamic-pituitary-thyroid axes, the renin-angiotensin-aldosterone system, opioids, and various vasoactive peptides. The circadian variations of AP depend on physiological state--sleep and wakefulness, pregnancy, work, and senescence (primary aging). In some essential hypertensive patients and in patients with secondary hypertension the nocturnal fall in AP is reduced or absent (nondippers). Target-organ damage is more advanced in nondippers than in dippers. The occurrence of cardiovascular events exhibits a prominent circadian pattern, with events more frequent in the morning (06:00-12:00 h).

Effect of forward rapidly rotating shift work on circadian rhythms of arterial pressure, heart rate and oral temperature in air traffic controllers

Twenty-four-hour records of arterial pressure (AP), heart rate (HR), oral temperature (OT) and physical and mental performance were obtained in air traffic controllers during morning (n = 16), afternoon (n = 17) and night (n = 19) shifts. Data were analyzed by the cosinor method. The results obtained during the morning shift were as follows (mesor/amplitude/acrophase): systolic AP (mm Hg)--113.6/10.0/16:03 h; diastolic AP--71.1/8.2/15:19 h; mean AP--85.6/8.8/15:41 h; HR (beats/min)--77.5/8.9/16:00 h; OT (dg C)--36.71/0.21/15:49 h; right-hand grip strength (kg)--49.8/2.0/17:43 h; left-hand grip strength--46.1/2.0/16:08 h; mental performance (calculations/min)--14.9/1.1/16:39 h. During the night shift either no change of the circadian acrophases (HR, right-hand grip strength) or acrophase delays ranging from about 2 h (systolic AP, OT, mental performance) up to 3 h (diastolic and mean AP, left-hand grip strength) were observed. Our data suggest that the shift system studied does not significantly alter the circadian rhythms, and does not induce a desynchronization, particularly as concerns arterial pressure and oral temperature.

Circadian rhythms of arterial pressure, heart rate and oral temperature in truck drivers

Circadian rhythms of arterial pressure (AP), heart rate (HR) and oral temperature (OT) were studied in healthy male truck drivers and in a control group of air traffic controllers. Twenty-four-hour records of systolic and diastolic AP and HR and of OT were obtained from 12 truck drivers both during the outward and homeward journey in Europe and Asia, and from 12 air traffic controllers during a morning shift. Data were analyzed by the cosinor method. The results obtained in the control group were as follows (mesor/amplitude/acrophase): systolic AP (mm Hg): 111.1/6.1/16.51 h; diastolic AP: 68.4%5.6/16.58 h; HR (b.p.m.): 77.07/7.6/17.46 h; OT (dg C): 36.74/0.21/17.26 h. Statistically significant acrophase advances were observed for the circadian rhythms of systolic, diastolic and mean AP and of HR in TD during the outward journey in comparison with the control ATC group. These differences were still present during the homeward journey, in combination with an acrophase delay of the circadian rhythm of OT. Our results supply grounds to suppose that extended working time combined with greater load during a long-lasting trip may act to generate an internal desynchronization of circadian rhythms in long-haul truck drivers.