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    Study of phenolic compounds of umbellate wintergreen herb and their influence on biochemical indicators of blood and urine in the rat model of chronic kidney disease
    (Science Rise: Pharmaceutical Science, 2024) Khodak, Larisa; Kovregin, Oleksiy; Mykhailenko, Olha; Yudkevich, Tetiana; Lytkin, Dmytro; Ivanauskas, Liudas; Vladymyrova, Inna; Starikov, Volodymyr
    Diseases of the kidneys and urinary tract are a common problem in people of all ages. Kidneys filter blood, removing water-soluble waste from the body, maintain water-salt balance, stabilize blood pressure and PH level. Intoxication, hypothermia, injuries and other causes lead to problems with the kidneys – inflammatory disease, urolithiasis, etc. Therefore, the development of effective herbal remedies that affect the etiopathogenic factors of diseases is urgent.
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    Clinical and laboratory charecteristics of patients with coronavirus infection COVID-19 and its comorbidity
    (Державна наукова установа «Центр інноваційних технологій охорони здоров’я» Державного управління справами, 2024) Yurko, Kateryna; Andrusovych, Inna
    Introduction. The coronavirus disease has reached an alarming epidemic scale with extraordinary morbidity and mortality rates for the entire world population. The majority of patients with COVID-19 note damage to the respiratory tract and state a more severe course of the disease with the development of systemic damage. A more severe course of COVID-19 is associated with the presence of comorbid diseases. Aim. To investigate and analyze clinical and laboratory manifestations and to determine the main comorbidities of patients with COVID-19 infection. Materials and methods. The research was carried out in accordance with bioethical norms and rules. 179 patients with COVID-19 (the main group) and 42 people of the control group were examined. Diagnosis and treatment of the COVID-19 coronavirus infection was carried out taking into account the relevant national recommendations. The average value and standard deviation were statistically determined. The probability of differences was performed using the Mann- Whitney U-test and the Wilcoxon W-test of signed ranks. The threshold value of the level of statistical significance of all calculated features was taken as 0.05 (p=0.05). Results. A high comorbidity with cardiovascular system pathology was found–40.2 %, type 2 diabetes–22.3 %, respiratory system diseases–20.7 %. Disorders of the functional state of the cardiovascular system were determined: pulse values–91.01±13.44, systolic (127.9±15.19) and diastolic (79.3±11.6) blood pressure. Changes in clinical blood analysis were noted: erythrocytes–4.38±0.65 x1012/l, hemoglobin–127.6±21.2 g/l, hematocrit–0.37±0.07, leukocytes–10.7±7, 32 x109/l, segmented (65.4±14.8 %) and rod-nuclear (9.03±9.99 %) neutrophils, platelets–226.1±90.6 x109/l, lymphocytes–20.24±12.43 %, monocytes–6.60±4.37 % and erythrocyte sedimentation rate (ESR)–25.4±14.9 mm/h. Significant (almost fourfold) increases in IL-6 levels (24.56±22.9 pg/ml) and blood glucose concentrations (7.40±3.42 mmol/l) were determined. Conclusions. A significant comorbidity of COVID-19 was determined and a significant prevalence of indicators of the functional state of the cardiovascular system and a decrease in the average levels of the quantitative composition of erythrocytes and indicators of hemoglobin and hematocrit were established. Significant leukocytosis, neutrophilia, lymphocytosis and monocytosis, significant excesses of ESR and IL-6 and blood serum glucose were determined, which confirmed the presence of a significant inflammatory reaction in response to infection with COVID-19.
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    Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
    (Lancet Publishing Group, 2024-04-03) Naghavi, M.; Ong, K.L.; Aali, A.; Sokhan, A.; Wool, E.E.; Murray, C.J.L.
    Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates- with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere.
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    Correlations between clinical, laboratory and instrumental characteristics of patients with COVID-19 infection
    (2024) Andrusovych, Inna
    COVID-19 is a leading disease in terms of prevalence (more than 100 million cases) and mortality (more than 10.0%). Most often, COVID-19 is accompanied by hemostatic disorders (manifestations of COVID-19-associated coagulopathy) and blood coagulation.
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    Тадеуш Рейхштейн: від погромів – до кортизону, вітаміну С і відкриття глюкокортикоїдів
    (2024) Ходош, Эдуард Михайлович; Яковенко, Олег Костянтинович; Сирота, Владислав Валерійович; Khodosh, Eduard; Yakovenko, Oleh; Sirota, Vladislav
    The article presents modern information about the synthesis of glucocorticoids, their mechanisms of action, features of pharmacokinetics and pharmacodynamics. Particular attention is paid to the discoverers of glucocorticoids and steroid hormones in general. Increasing knowledge of the biology of glucocorticoids and glucocorticoid receptors is associated with a better understanding of the molecular mechanisms underlying their clinical applications. A historical analysis of modern ideas about the biology of glucocorticoids is presented, with an emphasis on synthesis, regulation and physiology.
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    Global, regional, and national burden of HIV/AIDS, 1990–2021, and forecasts to 2050, for 204 countries and territories: the Global Burden of Disease Study 2021
    (Elsevier Ltd, 2024-11-25) Carter, Austin; GBD 2021 HIV Collaborators
    Background As set out in Sustainable Development Goal 3.3, the target date for ending the HIV epidemic as a public health threat is 2030. Therefore, there is a crucial need to evaluate current epidemiological trends and monitor global progress towards HIV incidence and mortality reduction goals. In this analysis, we assess the current burden of HIV in 204 countries and territories and forecast HIV incidence, prevalence, and mortality up to 2050 to allow countries to plan for a sustained response with an increasing number of people living with HIV globally. Methods We used the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 analytical framework to compute age-sex-specific HIV mortality, incidence, and prevalence estimates for 204 countries and territories (1990–2021). We aimed to analyse all available data sources, including data on the provision of HIV programmes reported to UNAIDS, published literature on mortality among people on antiretroviral therapy (ART) identified by a systematic review, household surveys, sentinel surveillance antenatal care clinic data, vital registration data, and country-level case report data. We calibrated a mechanistic simulation of HIV infection and natural history to available data to estimate HIV burden from 1990 to 2021 and generated forecasts to 2050 through projection of all simulation inputs into the future. Historical outcomes (1990–2021) were simulated at the 1000-draw level to support propagation of uncertainty and reporting of uncertainty intervals (UIs). Our approach to forecasting utilised the transmission rate as the basis for projection, along with new rate-of-change projections of ART coverage. Additionally, we introduced two new metrics to our reporting: prevalence of unsuppressed viraemia (PUV), which represents the proportion of the population without a suppressed level of HIV (viral load <1000 copies per mL), and period lifetime probability of HIV acquisition, which quantifies the hypothetical probability of acquiring HIV for a synthetic cohort, a simulated population that is aged from birth to death through the set of age-specific incidence rates of a given time period. Findings Global new HIV infections decreased by 21·9% (95% UI 13·1–28·8) between 2010 and 2021, from 2·11 million (2·02–2·25) in 2010 to 1·65 million (1·48–1·82) in 2021. HIV-related deaths decreased by 39·7% (33·7–44·5), from 1·19 million (1·07–1·37) in 2010 to 718000 (669000–785000) in 2021. The largest declines in both HIV incidence and mortality were in sub-Saharan Africa and south Asia. However, super-regions including central Europe, eastern Europe, and central Asia, and north Africa and the Middle East experienced increasing HIV incidence and mortality rates. The number of people living with HIV reached 40·0 million (38·0–42·4) in 2021, an increase from 29·5 million (28·1–31·0) in 2010. The lifetime probability of HIV acquisition remains highest in the sub Saharan Africa super-region, where it declined from its 1995 peak of 21·8% (20·1–24·2) to 8·7% (7·5–10·7) in 2021. Four of the seven GBD super-regions had a lifetime probability of less than 1% in 2021. In 2021, sub-Saharan Africa had the highest PUV of 999·9 (857·4–1154·2) per 100000 population, but this was a 64·5% (58·8–69·4) reduction in PUV from 2003 to 2021. In the same period, PUV increased in central Europe, eastern Europe, and central Asia by 116·1% (8·0–218·2). Our forecasts predict a continued global decline in HIV incidence and mortality, with the number of people living with HIV peaking at 44·4 million (40·7–49·8) by 2039, followed by a gradual decrease. In 2025, we projected 1·43 million (1·29–1·59) new HIV infections and 615 000 (567000–680000) HIV-related deaths, suggesting that the interim 2025 targets for reducing these figures are unlikely to be achieved. Furthermore, our forecasted results indicate that few countries will meet the 2030 target for reducing HIV incidence and HIV-related deaths by 90% from 2010 levels. Interpretation Our forecasts indicate that continuation of current levels of HIV control are not likely to attain ambitious incidence and mortality reduction targets by 2030, and more than 40 million people globally will continue to require lifelong ART for decades into the future. The global community will need to show sustained and substantive efforts to make the progress needed to reach and sustain the end of AIDS as a public threat.
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    Особливості надання паліативної допомоги хворим на туберкульоз
    (2024) Князевич, В.М.; Петренко, В.І.; Терлеєва, Я.С.; Норейко, С.Б.; Тодоріко, Л.Д.; Підвербецька, О.В.; Разнатовська, О.М.; Шевченко, О.С.; Царенко, А.В.
    Узагальнено дані літературних джерел (електронна база даних медичних публікацій PubMed) щодо сучасних концепцій надання паліативної допомоги. Проаналізовано новітні дані офіційної статистики щодо надання паліативної допомоги хворим на туберкульоз в Україні. Мета аналізу — визначити проблемні питання й аспекти, які потребують удосконалення, в галузі надання паліативної допомоги хворим на туберкульоз в Україні. Проблема туберкульозу є досі актуальною. Попри значні досягнення в боротьбі з туберкульозом, ефективність лікування цього захворювання в Україні не досягає цільового показника ВООЗ. Особливе занепокоєння викликає проблема туберкульозу з лікарською стійкістю. Хворі на туберкульоз та їхні родини стикаються з низкою викликів, пов’язаних із захворюванням (фізичних, соціально-економічних, психологічних), які знижують якість їхнього життя й потребують комплексного підходу до вирішення. Згідно із сучасними концепціями важливою складовою ведення хворих на туберкульоз, особливо лікарсько-стійкий, є паліативна допомога. Концепція паліативної медицини передбачає максимально ранній початок надання паліативної допомоги пацієнтам, які мають показання, паралельно з радикальною терапією, із поступовим збільшенням обсягу застосування заходів паліативної допомоги аж до повного заміщення радикального лікування в міру прогресування захворювання. Рання інтеграція паліативної допомоги у хворих на туберкульоз поліпшує якість життя пацієнтів та їхніх родин і сприяє підвищенню прихильності хворого до етіотропного лікування. Для подальшого розвитку та вдосконалення системи паліативної допомоги при туберкульозі на державному рівні необхідно вирішити такі питання: забезпечення інтеграції послуг паліативної допомоги на всіх рівнях медичної допомоги; зміцнення та розширення кадрового потенціалу з питань паліативної допомоги; удосконалення та впровадження керівних документів із питань інтегрованої паліативної допомоги при туберкульозі на всіх рівнях допомоги; інтеграція паліативної допомоги в систему програмного управління лікарсько-стійким туберкульозом із першого дня після встановлення діагнозу; забезпечення сталого всеосяжного доступу хворих на туберкульоз до основних лікарських засобів для надання паліативної допомоги; підвищення якості надання психологічної допомоги пацієнтам та їхнім родинам.
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    Predicting the risk of death in patients with covid-19 infection
    (2024) Andrusovych, Inna
    The article presents the associations of clinical, laboratory, and clinical and instrumental features of patients with COVID-19 with increased risks of death and survival. The final model for predicting the risks of developing a lethal outcome in COVID-19 was determined, which has high classification qualities (optimal threshold value of the calculated model is equal to -1.6149; sensitivity – 97.1%; and specificity – 82.6%. The purpose of our study was to determine the risks of developing fatal outcomes in patients with COVID-19 based on their clinical, laboratory and instrumental features. The study was performed at the Department of Infectious and Pediatric Infectious Diseases, Parasitology, Phthisiology and Pulmonology of the Kharkiv National Medical University in accordance with the current bioethical norms and rules. All patients signed informed consent. 179 patients with COVID-19 aged 20–88 years (average age was [58.75±13.82] years) were observed. Medical and statistical calculations were performed using the IBM SPSS 25.0 software package. The associations of indicators with the binomial dependent variable were calculated using multiple logistic regression analysis with the calcula-tion of β coefficients. The significance of differences was determined using the Mann-Whitney U-test with a threshold of statistical significance p=0.05. Based on the results, the final prog-nostic model of the risk of developing a lethal outcome of COVID-19 indicates an increased risk of death in COVID-19 with increasing age (by 13.9%), leukocyte count (by 14.4%), D-dimers (by 0.001%) on day 5–7. According to the model, an increase in the probability of sur-vival in COVID-19 was significantly proved with an increase in hemoglobin (by 6.1%) at the day of hospitalization, monocyte count (by 17.1%) on day 5–7 and the use of ceftriaxone (by 87.8%).
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    Зв’язок факторів постембріонального онтогенезу з ефективністю хіміопрофілактики туберкульозу у дітей
    (ГО «Всеукраїнська асоціація інфекціоністів», 2024) Бодня, Катерина Ігорівна; Зосімов, Анатолій Миколайович; Асоян, Ірина Миколаївна; Навєт, Тетяна Іванівна; Кондратюк, Вадим Валентинович; Bodnia, Kateryna; Zosimov, Anatoly; Asoyan, Irina; Navet, Tatiana; Kondratyuk, Vadim
    Дитячий організм як функціональна система формується, починаючи з внутрішньоутробного періоду. Тому аналіз навіть віддалених у часі ситуацій дозволяє виявити фактори, які впливають на функціонування дитячого організму у теперішньому часі і, можливо, на ефективність хіміопрофілактики туберкульозу у дітей.