Characteristics of brain lesions found using MRI imaging in patients with post-COVID with signs of cognitive decline.

OBJECTIVE: Aim: To describe and evaluate abnormalities of the brain in post-COVID patients with neurologic symptoms and cognitive deficits using MRI imaging of the brain. PATIENTS AND METHODS: Materials and Methods: We included 21 patients with a previous positive PCR testing for SARS-CoV-2 and one or more of the following symptoms: memory and cognitive decline, dizziness, anxiety, depression, chronic headaches. All patients had MRI imaging done at onset of symptoms, but after at least 1 year after positive testing for COVID-19 based on the patient's previous medical history. RESULTS: Results: All of the patients complained of lack of concentration, forgetfulness, hard to process information. 15 patients suffered from confusion, 10 from anxiety. Of the 21 patients 14 had isolated chronic headaches, 3 had isolated dizziness, 4 patients had both symptoms upon inclusion. All patients underwent MRI imaging as a part of the diagnostic workup and had varying degrees of neurodegeneration. CONCLUSION: Conclusions: Our data correlates with existing research and shows tendency for cognitive decline in post-COVID patients. This provides groundwork for further research to determine correlation between acceleration of neurodegeneration and post-COVID.

ASSESSMENT OF CARDIOVASCULAR DISEASE RISK FACTORS IN PATIENTS WITH CORONARY HEART DISEASE COMBINED WITH NONALCOHOLIC FATTY LIVER DISEASE.

OBJECTIVE: The aim: To study the risk factors of cardiovascular diseases in patients with coronary heart disease with stable angina pectoris II functional class in combi¬nation with NAFLD. PATIENTS AND METHODS: Materials and methods: The study included 245 patients with a diagnosis of CHD, stable angina pectoris II functional class (FC), who were being treated at the Communal Nonprofit Enterprise «Central City Clinical Hospital¼ of Uzhhorod City Council. We singled out 2 groups of patients: group 1 (n=145) - patients with CHD with stable angina pectoris II FC in combination with NAFLD and group 2 (n=100) - patients with CHD with stable angina pectoris II FC. RESULTS: Results: Analysis of the frequency of occurrence of CVD risk factors in patients with CHD showed that among patients of group 1 there are 50% more people with abdominal obesity, excess body and dyslipidemia. The reliability between the groups in the occurrence of hypertension and type 2 diabetes was not revealed. The obtained results confirm the data that the prevalence of NAFLD increases with increasing body weight and a high degree of obesity increases the risk of its development. CONCLUSION: Conclusions: The most frequent risk factors for CVD in patients with coronary artery disease in combination with NAFLD are hypertension, obesity, and dyslipidemia.

[Dynamics of staphylococcus aureus antibiotic resistance to fluoroquinolones in vitro in patients with overweight].

OBJECTIVE: Introduction:S. aureus is the main pathogen of skin, soft tissue and otorhinolaryngological infections as well as the cause of osteomyelitis, meningitis and endocarditis. In recent years the importance of S. aureus mediated infections has grown not only because of their widespread, but also due to their antibiotic resistance. Recent observations showed that the resistance is developed to each new antibacterial agent after 5 years of its intensive use. Based on the studies conducted in Ukraine, it is known that the resistance of S. aureus to fluoroquinolones varies in different regions and ranges from 4-6% to gatifloxacin to 45.2-49% to norfloxacin and pefloxacin. Considering that in the overwhelming majority of cases antibacterials are prescribed empirically, an important background for successful antibiotic therapy is taking into account the regional and mostly the local antimicrobial resistance patterns. The aim of the study was to evaluate the antibiotic resistance profile of S. aureus isolates to fluoroquinolones and its changing during 2011-2016. PATIENTS AND METHODS: Materials and methods: 355 S. aureus strains isolated from adult with overweight (IBM=25,0-29,9) who were treated in Uzhhorod medical settings due to bacterial tonsillitis or pharyngitis during 2011-2016 were included in the study. After isolation of a pure culture, susceptibilities were tested by using the disk diffusion method. The following antimicrobial disks were tested on Müller-Hinton agar (Biolife, Italy): ofloxacin (5 µg), ciprofloxacin (5 µg), levofloxacin (5 µg), gatifloxacin (5 µg), Sparfloxacin (10 µg), pefloxacin (10 µg), and norfloxacin (10 µg). Research methods were used with respect for human rights, according to the current legislation in Ukraine in accordance to international ethical requirements and do not violate the ethical standards in science and standards for conducting biomedical research. RESULTS: Results: Analysis of S. aureus resistance to fluoroquinolones found that this parameter remained at a relatively low level and, in majority of cases, did not exceed 12%. However, constant increasement of antimicrobial resistance was noticed during 2011-2016. Thus, the S. aureus resistance to norfloxacin, levofloxacin and ciprofloxacin increased significantly from 0.00%, 0.00% and 1.54% in 2011 to 11.76%, 13.73% and 9.80% in 2016 respectively. Resistance to ofloxacin and gatifloxacin in 2011-2016 rised from 3.08% and 0.00% to 11.76% and 1.96%, respectively, but this difference was not statistically significant. The S. aureus susceptibility to fluoroquinolones fluctuated within 80-90% during 2011-2016 and gradually decreased. For instance, susceptibility to norfloxacin, ofloxacin and levofloxacin decreased significantly from 93.85%, 96.92% and 100.0% to 80.39%, 88.24% and 84.31% respectively over the past 6 years. However, for pefloxacin there was a significant increase in susceptibility from 90.77% to 100.00% during the investigated period. The prevalence rates of intermediate resistant S. aureus isolates during the study period was negligible and in majority of cases this type of strains were not detected at all. CONCLUSION: Conclusion: Relatively low rates of resistance and high rates of susceptibility aloud to recommend fluoroquinolones for the empirical therapy of S. aureus caused infections. However, the gradual increase of resistance to these antibiotics, requires strict compliance with the antimicrobial stewardship.

[Clinical and endoscopic efficacy of vedolizumab in patients with ulcerative colitis].

OBJECTIVE: Introduction: Ulcerative colitis (UC) is a chronic recurrent idiopathic inflammatory bowel disease that is characterized by a continuous or wave-like course with multifactorial etiopathogenesis. In recent decades, the number of patients with this pathology has been steadily increasing. Therefore, timely detection of UC at the diagnostic stage for the further qualified assistance providing is one of the most important tasks in modern gastroenterology. In recent years, a new group of drugs that can be an alternative to the surgical method of treatment has appeared. These are biological drugs, one of which is vedolizumab. The aim: to study the changes in clinical and endoscopic parameters in patients with ulcerative colitis, in response to the biological therapy with vedolizumab. PATIENTS AND METHODS: Materials and methods: 38 patients with ulcerative colitis were included in this study that lasted 52 weeks. 15 patients of the control group received standard therapy with 5-aminosalicylic acid (5-ASA). 23 patients in the study group received the vedolizumab infusions. RESULTS: Results: Clinical response was observed in 16 (69.6%) and 23 (100.0%) patients of the study group at the 6th and 52nd weeks respectively. In control group the clinical response was present in 5 (33.3%) and 9 (60,0%) patients at the 6th and 52nd weeks respectively. Mucosal healing at the 52nd week was observed in 22 (95.7%) patients in the study group and 7 (46.7%) patients in the control group. CONCLUSION: Conclusions: Patients who were treated with vedolizumab experienced significant improvement in clinical and endoscopic parameters 52 weeks after treatment initiation compared to the control group.