Intravascular ultrasound (IVUS) is a modern method of visualizing the coronary arteries from the lumenal surface of the vessel [1]. The cross-sections of the intracoronary images make possible the measuring of the coronary artery size and assessing the structure of the vessel [2], which is extremely important in the context of cardiovascular diseases.The uniqueness of ultrasound is based on the fact that diferent layers of the coronary artery wall re"ect ultrasound waves diferently, anatomically preconditioned. Therefore, understanding the anatomical aspect of the vessel structure is the key to interpreting the intracoronary images. Even though IVUS is widely used in the leading clinics [3], for the majority, it is a less accessible procedure [4]. Unfortunately, IVUS remains an innovative procedure for much medical sta! and requires further explanation of coronary vessel morphology. The coronary artery size is variable and impacts the coronary stent implantation and optimization of the results of coronary revascularization [5, 6]. To our knowledge, there is no data on the size of coronary arteries ostia among the Ukrainian population using IVUS
Coronavirus Disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus, which is a contagious respiratory virus causing atypical pneumonia COVID-19 in adult and children with Severe Acute Respiratory Syndrome (SARS). The SARS-CoV-2 genome also encodes four structural (S, E, M and N) and up to six accessory (3a, 6, 7a, 7b, 8, and 9b) proteins. The spike protein (S) is further divided into 2 subunits, S1 and S2 that mediate host cell attachment and invasion. Anti-SARS-CoV-2 Monoclonal Antibodies (mAbs) that target the spike protein have been shown to yield clinical benefits in treating SARS-CoV-2 infection. This article represents a clinical case of a 59-year-old man with Coronavirus Disease (COVID-19) and intracerebral haemorrhage, who was treated with the use of monoclonal antibodies bamlanivimab and etesevimab. Equally, it presents a review of these drugs’ application for COVID-19 treatment in adults
and children
To date, various manifestations of allergic reactions and diseases are registered in 15-35% of the population according to the World Health Organization, and in recent years there has been a constant tendency to increase [1]. The first sign of allergic pathology in children, as a rule, is a food allergy, which is mainly manifested by atopic dermatitis. According to official statistics, the rate of atopic dermatitis in Ukraine is known to range from 3 to 10 per 1000 children [2]. However, the results obtained in some regions of our country according to studies under the standardized international program ISAAC (International Study of Asthma and Allergies in Childhood), exceed the above figures by 5-10 times [3]. This situation can be explained by the presence of terminological differences in the interpretation of atopic dermatitis in children, different methodological approaches to statistical research, clinical and age-related polymorphism of the disease. The development of atopic march can begin with a food allergy, so all efforts of physicians should be directed to prevent the transformation of skin forms into respiratory ones and provide the patient and his/her parents with a full quality of life [4,5]. The “School of Atopy” operates under the auspices of the MNPE “Lviv City Children’s Clinical Hospital” and the Lviv City Children’s Allergological Center, where a model of a multidisciplinary approach to the management of patients with food allergies according to European standards was reproduced. Every patient treated for food allergies goes from diagnosis to treatment. Of course, great emphasis is placed on preventing and predicting the development of atopic march in children and improving the quality of life of patients and their parents.
Acute respiratory tract infections (ARTI) place an enormous impact on patients and primary healthcare system due to their extraordinary incidence. In 2019, the world prevalence of ARTI reached 17.2 billion and accounted for 43.8% of all causes of the global disease burden [1]. Respiratory infections are the most common reason for seeking medical attention, with personal recurrence rates ranging from 2 to 6 times per year [2]. Although usually mild and self-limiting, ARTIs significantly affect work productivity and quality of life [3].
Emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing corona virus disease 2019 (COVID-19) brought a new challenge, being both common and severe, affecting upper and lower airways with considerable constitutional symptoms. As with other respiratory infections, the management of outpatients with mild COVID-19 without risk of progressing to severe disease, remains supportive and include close observation for early recognition of the life-threatening symptoms, reduction the risk of further SARS-CoV-2 transmission, advising on when to seek an in-person evaluation [4]. Absence of the effective specific measures in most COVID-19 cases serves a rationale for exploration of a new complementary approaches, one of which may be the use of probiotics.
Indirect evidence shows that patients with COVID-19 and diarrhea have more severe disease, increased concentration of inflammatory cytokines, markers of tissue damage, suggesting the intestinal cells can serve an additional entry and reservoir for SARS-CoV-2 [5, 6]. As with type II alveolar cells, intestinal and colonic enterocytes express angiotensin I converting enzyme 2 (ACE2), a receptor though which SARS-CoV-2 inoculates the body [7]. Bifidobacteria and lactobacilli adhering to enterocytes can hypothetically interfere with infection process and disease manifestation [8,9,10]. Interestingly that bacteria may potentially downregulate amide and peptide metabolism in the gut including angiotensin-converting enzyme 2 (ACE2) [11, 12]. It may explain the reason that cell cultures exposed to probiotics yielded lesser amount of transmissible gastroenteritis coronaviruses [13]. Additionally, the beneficial effects of probiotics in respiratory infections can be realized via several non-specific mechanisms discussed within the gut-lung axis paradigm [14], including enhancement of innate antiviral immune defense [15]. A recent systematic review of 23 randomized clinical trials involving a total of 6950 participants with ARTI, demonstrated fewer cases, shorter case duration, and reduced antibiotic prescription rates in patients taking probiotics [16].
The objective of this study was to assess the role of short-term ingestion of probiotics in mild symptomatic COVID-19, post-disease symptoms, and humoral immune response to SARS-CoV-2 in outpatients.
Patients with Marfan syndrome and aortic root aneurysm require pre-surgical analysis of aortic root geometry for aortic reconstruction. The aim of this study is to perform the morphometric analysis of the sinus of Valsalva height and correlation between the former, age, weight, height, body mass index (BMI), and body surface area (BSA) in patients with Marfan syndrome and aortic root aneurysm. Data from 34 patients (28 men, 6 women) with Marfan syndrome and an ascending aortic diameter exceeding 45 cm were obtained using computed tomography angiography.Gender-based differences were observed in the height of the left aortic sinus – by 47.23% (36.47±12.48 mm in men against 24.77±4.26 mm in women, р=0.0003). In men, a strong direct correlation has been identified between height and the right aortic sinus height (r=+0.75, р<0.0001), the posterior aortic sinus height (r=+0.71, р<0.0001), and the left aortic sinus height (r=+0.75, р<0.0001). Moderate reverse correlation has been discovered between the sinus of Valsalva height and BMI. No correlations have been identified between weight, BSA and the sinus of Valsalva height (р>0.05). In women, a strong direct correlation (Pearson) has been identified between age and the right aortic sinus height (r=+0.84, p=0.04), between weight and the left aortic sinus (r=+0.73, p=0.04) and between BSA and the left aortic sinus (r=+0.73, р=0.04).Aortic sinus height in men increases with height and decreases with higher BMI and age. Weight and BSA do not affect the sinus of Valsalva height. In women, the sinus of Valsalva height is impacted by age, weight and BSA.