Treatment outcomes and risk factors for an unsuccessful outcome among patients with highly drug-resistant tuberculosis in Ukraine.

OBJECTIVES: To describe demographics, clinical features, and treatment outcomes of patients with highly drug-resistant tuberculosis (TB) in Ukraine, and to evaluate risk factors for an unsuccessful outcome. METHODS: Data from patients with multi-, pre-extensively, or extensively drug-resistant TB were collected prospectively from TB dispensaries in 15 out of 24 Ukrainian oblasts (regions) from 2020 to 2021. Treatment outcomes were evaluated using WHO definitions. Risk factors for an unsuccessful outcome were identified using a multivariable logistic regression model. RESULTS: Among 1748 patients, the overall proportion of successful outcomes was 58% (95% confidence interval [95% CI] 56-60) (n = 1015/1748), ranging from 65% (95% CI: 62-69) (n = 531/814) for multidrug-resistant TB to 54% (95% CI: 49-58) (n = 301/563) for pre-extensively drug-resistant TB and 49% (95% CI: 44-55) (n = 183/371) for extensively drug-resistant TB. Results were similar across oblasts, with few exceptions. The strongest risk factors for an unsuccessful outcome were extensively drug-resistant TB (adjusted OR [aOR] 3.23; 95% CI: 1.88-5.53), total serum protein below 62 g/L in adults and below 57 g/L for children and adolescents (aOR 2.79; 95% CI: 1.93-4.04), psychiatric illness (aOR 2.79; 95% CI: 1.46-5.33), age at TB diagnosis >65 years (aOR 2.50; 95% CI: 1.42-4.42), and alcohol misuse (aOR 2.48; 95% CI: 1.89-3.26). DISCUSSION: The overall proportion of successful outcomes among Ukrainians treated for highly drug-resistant TB was 58%, notably better compared with previous years, but still low for extensively drug-resistant TB. Risk factors for unsuccessful outcomes highlight that addressing socioeconomic factors in TB management is crucial. Efforts in maintaining TB dispensaries during and following the ongoing war are highly warranted.

ASSOCIATION OF CASPASE-8 LEVELS WITH RESPIRATORY PARAMETERS AND PRESENCE OF HYPERTENSION IN COPD PATIENTS.

OBJECTIVE: The aim: To investigate the association between hypertension and serum Caspase-8 levels in COPD patients. PATIENTS AND METHODS: Materials and methods: 95 COPD patients (GOLD 2nd grade, group B) were included in the study: 47 non-hypertensive COPD patients formed the main group, and 48 patients with concomitant COPD and hypertension formed the comparison group. Patients underwent examination according to GOLD 2022 Guidelines. Caspase-8 serum levels were measured by ELISA. RESULTS: Results: Performed analysis showed that an increase in Caspase-8 serum levels was significantly associated with the presence of concomitant hypertension in both univariate and multivariate analyses. A significant association was also found regarding FEV1 levels but not FVC. CONCLUSION: Conclusions: Both presence of concomitant hypertension and spirometry parameters, which indicate the severity of COPD, can be considered strong predictors of the intensification of apoptosis in COPD patients.

PROGNOSTIC POTENTIAL OF LYMPHOCYTE-TO-MONOCYTE RATIO AND CASPASE-8 IN PREDICTION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE DEVELOPMENT.

OBJECTIVE: The aim: To investigate the prognostic potential of lymphocyte-to-monocyte ratio and caspase-8 levels in prognosis of COPD development in healthy individuals. PATIENTS AND METHODS: Materials and methods: 77 individuals were involved into the study: 47 with COPD and 30 healthy volunteers. Patients underwent examination according to GOLD 2022 Guidelines. Caspase-8 serum levels were measured by ELISA. Lymphocyte-to-monocyte ratio was calculated. RESULTS: Results: In crude and adjusted models lymphocyte-to-monocyte ratio and caspase-8 were associated with COPD development (respectively OR = 0.371 [95.0 % CI 0.217-0.634], p<0.006 and OR = 12.823 [95.0 % CI 2.104-78.134], p = 0.006). Additionally, systolic blood pressure had direct association with COPD (OR = 1.196 [95.0 % CI 1.028-1.391], p = 0.021). Noteworthy, diastolic blood pressure showed significant reverse association in univariate but not in multivariate analysis: OR = 0.850 [95.0 % CI 0.743-0.974] (p = 0.019) and OR = 0.820 [95.0 % CI 0.665-1.012] (p =0.064). CONCLUSION: Conclusions: Decreased lymphocyte-to-monocyte ratio and increased caspase-8 levels are important predictors of COPD development and can serve as an additional tool for early diagnosis of COPD in healthy individuals.

Mental Health and Work-Related Behaviors in Management of Work Requirements of University Lecturers in Ukraine-An Age Group Comparison.

BACKGROUND: There are only a few national and international studies on the health of third-level professor lecturers at universities and colleges. Work-related diseases are important and relevant for occupational medicine. The aim of the study was to examine the mental health and work-related behavior and experience patterns of Ukrainian university lecturers in age group comparisons. METHODS: Data were collected from 81 Ukrainian university lecturers (General Health Questionnaire (GHQ-12), Questionnaire on Work-Related Behavior and Experience Patterns (AVEM)). The university lecturers were split into 4 age groups. RESULTS: 9.9% of higher education lecturers reported impaired mental health (GHQ-12). In all, 64.8% of the total sample showed AVEM risk patterns. There were differences in age groups (third age group scoring lower than the first age group on the GHQ total score). The first age group had significantly lower opinions of the subjective importance of work on their personal lives compared to the third and fourth age group, while the second age group had significantly lower opinions compared to the fourth age group. All individuals with impaired mental health in GHQ-12 had AVEM risk patterns. CONCLUSIONS: These results offer novel insights into the health of Ukrainian university lecturers. Occupational healthcare practitioners should take them into consideration in order to initiate appropriate interventions.