A comprehensive analysis of anthropometric indicators in preschool children suffering from recurrent respiratory infections.

OBJECTIVE: Aim: To determine the state of relationship between anthropometric indicators and susceptibility to recurrent respiratory infections in preschool children. PATIENTS AND METHODS: Materials and Methods: A total of 143 children (73 boys and 70 girls) aged 12-59 months, undergoing inpatient treatment on acute respiratory infection, were involved in the clinical study. The number of acute respiratory infection episodes during a previous year of their lives was taken into account. Besides, the basic indicators of physical development were assessed in the children, including: 1) body weight; 2) body length; 3) chest circumference; 4) body mass index; 5) body surface area; 6) Vervek's index. RESULTS: Results: Cross-tabulation and rank correlation analysis did not demonstrate any interdependence between the susceptibility of the children examined to recurrent respiratory infections and their anthropometric indicators. Simultaneously, linear regression analysis showed that in the children aged 12-23 months, resistance index depended on their age and body length. The relative importance of the combined effect of the two above-mentioned indicators among all other potential risk factors for recurrent respiratory infections was 32.2%. CONCLUSION: Conclusions: The detailed analysis of the findings outlined the methodological basis for further studies of the association between the incidence of acute respiratory infections in preschool children and their physical development. Multivariate statistical calculations of various risk factors for recurrent respiratory infections, including abnormal anthropometric indicators, are likely to increase the informational value of subsequent examinations.

Peculiarities of clinical signs, course and treatment of musculoskeletal system lesions in post-COVID syndrome.

Introduction: Post-COVID syndrome (PCS) is a frequent phenomenon of patients who have suffered from an acute attack of COVID-19 infection, and it is characterized by a wide range of symptoms from different organs and systems including the musculoskeletal system (MSS). However, peculiarities of MSS lesions have not been sufficiently studied to date, in particular, in the aspect of the therapeutic process. We aimed to investigate peculiarities of MSS lesions in patients with PCS. Material and methods: Observations were carried out in 142 patients with PCS and MSS lesions. The age of patients was 36-67 years. Up-to-date methods of disease verification were used. An acute period of COVID-19 in all the patients was of moderate severity without oxygen support. Results: Musculoskeletal system lesions in patients with PCS were found to appear 1-4 weeks after the experienced acute period of COVID-19 infection. Against the background of significant arthralgia (100%) in 93 (65.5%) patients manifestations of acute arthritis were detected, the frequency of which increased with age. Musculoskeletal system lesions were found against the background of dominating PCS manifestations from the cardiovascular and digestive systems. Deterioration of the course and results of treatment of diseases caused by an age-related polymorbid background was determined. Certain difficulties in the treatment of MSS lesions by means of non-steroidal anti-inflammatory drugs and limitation in the use of glucocorticosteroids are caused by severe gastroduodenopathy and arterial hypertension. Long-term, up to 6 months, administration of L-arginine, L-carnitine and quercetin in the rehabilitation complex improved the overall results of treatment of PCS manifestations including arthropathy. Conclusions: Musculoskeletal system lesions in patients with PCS are not the main constituent of this syndrome. Difficulties in the treatment of arthropathy are due to the signs of gastroduodenopathy and arterial hypertension. Additional administration of L-arginine, L-carnitine and quercetin is reasonable.

POSTOPERATIVE INFECTIONS AFTER GYNECOLOGICAL SURGERIES IN UKRAINE.

OBJECTIVE: Aim: To determine the current prevalence of surgical site infections (SSIs) after gynecological surgeries and antimicrobial resistance of causing pathogens in Ukraine. PATIENTS AND METHODS: Materials and Methods: Multicenter prospective observational cohort study was conducted from January 2020 to December 2022 in nine hospitals from eight regions of Ukraine. Definitions of HAIs were adapted from the Centers for Disease Control and Prevention's National Healthcare Safety Network. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST. RESULTS: Results: A total 12.2% (420/3450) patients who undergoing gynecological surgeries were found to have SSIs. The difference in SSI rates between the three subgroups by route of surgery was not statistically significant, being 12.0% for the abdominal group,11.1% for the vaginal group, and 12.5% for the combined group. The most common causing pathogens of SSIs was Escherichia coli, Pseudomonas aeruginosa, Enterobacter spp., Streptococcus spp., and Klebsiella pneumoniae. Many Gram-negative pathogens isolated from SSI cases were found to be multidrug resistant. CONCLUSION: Conclusions: This study showed that SSIs remains the common complication after gynecological procedures in Ukraine. Best practices should be established and followed to reduce the risk of SSIs associated with gynecologic surgery. Optimizing the antibiotic prophylaxis and empirical antimicrobial therapy may reduce the burden of SSIs in gynecological surgeries, but prevention is the key element.

URINARY TRACT INFECTIONS IN PREGNANT WOMEN IN UKRAINE: RESULTS OF A MULTICENTER STUDY (2020-2022).

OBJECTIVE: The aim: To obtain the first national estimates of the current prevalence rate of urinary tract infections (UTIs) in pregnant women and antimicrobial resistance of causing pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: Prospective multicentre cohort study was conducted from January 2020 to December 2022. The study population consisted of 36,876 pregnant women from 17 regions of Ukraine. Antibiotic susceptibility was done by the disc diffusion test as recommended by European Committee on Antimicrobial Susceptibility Testing guidelines. RESULTS: Results: A total 29.5% pregnant women were found to have UTIs. Among these cases, 36.5% Asymptomatic bacteriuria, 51.7% Cystitis and 11.8% Pyelonephritis were observed. Of all cases, 87.9% were defined as healthcare-acquired UTIs and 12.1% community-acquired UTIs. The most common uropathogen was Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa. Many uropathogens isolated from UTI cases were found to be multidrug resistant. CONCLUSION: Conclusions: UTIs in pregnant women in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics. Optimizing the management and empirical antimicrobial therapy may reduce the burden of UTIs in pregnant women, but prevention is the key element.

CATHETER-ASSOCIATED URINARY TRACT INFECTIONS AFTER CAESAREAN SECTION IN UKRAINE: RESULTS A MULTICENTER STUDY (2020-2022).

OBJECTIVE: The aim: To obtain the first national estimates of the current prevalence rate of catheter-associated urinary tract infections (CAUTIs) after caesarean section (CSEC) and antimicrobial resistance of causing pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: Prospective multicentre surveillance was conducted from January 2020 to December 2022 in 15 women hospitals of Ukraine. Definitions of CAUTIs were adapted from the CDC/NHSN. Antibiotic susceptibility was done by the disc diffusion test as recommended by European Committee on Antimicrobial Susceptibility Testing guidelines. RESULTS: Results: A total of 15,892 catheterized women undergoing primary CSEC and 13.6% CAUTI were identified. The most common uropathogen was Escherichia coli, Proteus mirabilis, and Enterococcus species followed by Providencia stuartii and Pseudomonas aeruginosa. Many uropathogens isolated from CAUTI cases were found to be multidrug resistant. CONCLUSION: Conclusions: This study showed that CAUTIs in catheterized women undergoing primary CSEC in Ukraine is a common occurrence and many cases are caused by pathogens that are resistant to antibiotics. Optimizing the management and empirical antimicrobial therapy may reduce the burden of CAUTIs in catheterized women undergoing primary CSEC, but prevention is the key element.

SPICES: MODERN VIEWS ON THE APPLICATION THROUGH THE PRISM OF POLY- AND COMORBIDITY OF PATIENTS AND INFECTIOUS PANDEMICS (LITERATURE REVIEW AND DISCUSSION).

OBJECTIVE: The aim: To substantiate the need of wider use of species in dietician rehabilitation of patients with poly- and comorbidity, postcovid syndrome based on the analysis of the latest scientific achievements with the study of their pharmacological properties. PATIENTS AND METHODS: Materials and methods: The information search in printed and electronic editions, search scientific bases with application of methods of the analysis, comparison and generalization of information data is carried out. CONCLUSION: Conclusions: New scientific data on the pharmacological properties of spices give grounds to use them more widely in the rehabilitation of patients with poly- and comorbidities and infectious processes.

IMPACT OF INFECTIOUS DISEASES ON PUBERTAL TIMING IN UKRAINIAN GIRLS: RESULTS A MULTICENTER STUDY.

OBJECTIVE: The aim: To determine current age at the initiation of puberty for Ukrainian school-aged girls and infections impact to puberty. PATIENTS AND METHODS: Materias and methods: We performed a multicentre cohort study. The analyses are based on data that were collected and evaluated biannually on Ukrainian school girls aged 6-17 years from 5 regions of Ukraine. Pubertal development was classified according to the Marshall and Tanner criteria. RESULTS: Results: Overall, 2,784 girls have been included in the study. Mean age of onset of puberty in Ukrainian girls was 10.1±1.0 yrs. Age of onset of pubic hair was 11.0±1.0 yrs and that of axillary hair was 11.6±1.0 yrs. Mean age in girls of menarche was 12.2±0.9 yrs. There were no significant correlations between age at onset of puberty and body mass index, final height, total peak height velocity, duration of puberty, and peak height velocity. A total of 2,420 infectious diseases were diagnosted. Of these, 64.8% were viral and 35.2% bacterial infections, respectively. Ukrainian girls with infectious diseases (especially viral infections) had older age at pubertal onset and positive association of infections in childhood with late age of menarche. CONCLUSION: Conclusions: Infectious morbidity (especially viral infections) in girls may be associated with later puberty. The lowering of the number of infections in childhood could be an additional factor that contributes to earlier puberty. To reduce infectious diseases, more attention should be paid to the vaccination of children.

PERINATAL INFECTIONS IN UKRAINE: RESULTS OF A MULTICENTER STUDY.

OBJECTIVE: The aim: To obtain the estimates of the сurrent incidence rate of perinatal infections, risk factors, as well as their associated impact on mortality and determine the antimicrobial resistance of responsible pathogens in Ukraine. PATIENTS AND METHODS: Materials and methods: We performed a multicentre retrospective cohort study was based on surveillance data. This study included infants aged 0 to 6 days delivered in 2017-2019 at 11 Ukrainian regional perinatal centers. Definitions of perinatal infections and mortality were used from the CDC/WHO/UNICEF. RESULTS: Results: Of 18,348 liveborn infants, 472 (2.6%) perinatal infections were detected. The incidence of perinatal infection was 25.7 per 1000 live births. The most frequently identified types of infections were: bloodstream infections, 35.6 %, lower respiratory tract infections, 21.4%, Meningitis, 18.2%, Conjunctivitis, 11.9%, skin and soft tissue infections, 6.6%, Dacryocystitis, 3.8%, and urinary tract infections, 2.5%. Early mortality rates from perinatai infections was 51.1%, with an incidence of 13.1 deaths/1000 live births. Potential risk factors the development of perinatal infections and mortality were low birth weight, prematurity, low gestasional age, mode of delivery (manual aid), premature rupture of membranes, preterm premature rupture of membranes, prolonged rupture of membranes, turbid and meconeal amniotic fluid, infection of the mother during labor. resuscitation during delivery, invasive procedure, asphyxia. Main causative agents of perinatal infections were Escherichia coli, Streptococcus agalactiae, Staphylococcus aureus, Klebsiella pneumoniae, CoNS, Enterobacter cloacae, Pseudomonas aeruginosa. CONCLUSION: Conclusions: This study showing that the high incidence rate of perinatal bacterial infections, as well as their associated impact on mortality, and presents a significant burden to the Ukraine.

HEALTHCARE ASSOCIATED INFECTION AFTER LEGAL INDUCED ABORTIONS IN UKRAINE: RESULTS A MULTICENTER STUDY.

OBJECTIVE: The aim: To determine trend of legal induced surgical abortion and to assess the frequency of infection complications after termination of pregnancy in Ukraine. PATIENTS AND METHODS: Materials and methods: We conducted a prospective multicentre cohort study was based on surveillance data of healthcare-associated infection (HAI) after legal induced surgical abortion in women's from January 2017 to 2019 in Ukraine. Definitions of HAI after induced abortion were used from the CDC/ NHSN. RESULTS: Results: The number of surgical abortions in Ukraine increased by 32.8%. A total of 25.9% HAIs were identified after surgical abortion. Of these HAIs, 25.9 were Endometritis, 21.8% Bacterial Vaginitis, 14.3% Parametritis, 13.1% Cervicitis, 9.9% Adnexa utery, 7.8% Salpingitis, 6.3% Chorioamnionitis, and 0.9% other reproductive tract infections. E.coli were most commonly reported, accounting for 25.9% of all organisms, followed by Enterococcus spp. (16.2%), Staphylococcus aureus (15.5%), P. aeruginosa (10.9%), and Enterobacter spp. (10.1%). Antimicrobial resistance in the isolates associated with HAIs showed, among the gram-positive bacteria, that 19.1% and 3.6% of coagulase-negative staphylococci isolates were b-lactam (oxacillin) - and glycopeptide-resistant, respectively. Meticillin resistance was reported in 23.2% of S aureus isolates. Vancomycin resistance was reported in 3.7% of isolated enterococci. Among the gram-negative bacteria, third-generation cephalosporins resistance was found in 33.1% of Klebsiella spp and in 24.1% of E.coli isolates. CONCLUSION: Conclusions: The results of this study revealed high rates of HAIs after surgical abortion and most causing pathogens were associated with resistant to antibiotic strains. This knowledge is essential to develop targeted strategies to surveillance and reduce the incidence of post-abortion infections.

Efficacy, Safety, Pharmacokinetics, and Pharmacodynamics of Filgotinib, a Selective JAK-1 Inhibitor, After Short-Term Treatment of Rheumatoid Arthritis: Results of Two Randomized Phase IIa Trials.

OBJECTIVE: JAK inhibitors have shown efficacy in rheumatoid arthritis (RA). We undertook this study to test our hypothesis that selective inhibition of JAK-1 would combine good efficacy with a better safety profile compared with less selective JAK inhibitors. METHODS: In two 4-week exploratory, double-blind, placebo-controlled phase IIa trials, 127 RA patients with an insufficient response to methotrexate (MTX) received filgotinib (GLPG0634, GS-6034) oral capsules (100 mg twice daily or 30, 75, 150, 200, or 300 mg once daily) or placebo, added onto a stable regimen of MTX, to evaluate safety, efficacy, pharmacokinetics (PK), and pharmacodynamics (PD) of filgotinib. The primary efficacy end point was the number and percentage of patients in each treatment group meeting the American College of Rheumatology 20% improvement criteria (achieving an ACR20 response) at week 4. RESULTS: Treatment with filgotinib at 75-300 mg met the primary end point and showed early onset of efficacy. ACR20 response rates progressively increased to week 4, and the Disease Activity Score in 28 joints using the C-reactive protein (CRP) level decreased. Marked and sustained improvements were observed in serum CRP level and other PD markers. The PK of filgotinib and its major metabolite was dose proportional over the 30-300 mg range. Early side effects seen with other less selective JAK inhibitors were not observed (e.g., there was no worsening of anemia [JAK-2 inhibition related], no effects on liver transaminases, and no increase in low-density lipoprotein or total cholesterol). A limited decrease in neutrophils without neutropenia was consistent with immunomodulatory effects through JAK-1 inhibition. There were no infections. Overall, filgotinib was well tolerated. Events related to study drug were mild or moderate and transient during therapy, and the most common such event was nausea. CONCLUSION: Selective inhibition of JAK-1 with filgotinib shows initial efficacy in RA with an encouraging safety profile in these exploratory studies.