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ЛНМУ імені Данила Галицького

УДК: 616.988:578.834]-07:616.15-097-07]-036-053.2(477.83)

Abstract

Aim. The research aims at analyzing the kinetics of IgA, IgM, and IgG to SARS-CoV-2 in children based on the severity of COVID-19 and age.

Materials and Methods. The conducted prospective study involved 88 children (mean age 9.4 years) with COVID-19, admitted to the "Lviv Regional Pediatric Clinical Hospital "OKHMATDYT" from 2020 to 2021. The participants included 36 males (40.90%), and 52 females (59.10%) in the observation group. Diagnosis verification relied on clinical manifestations of the disease, with the detection of SARS-CoV-2 RNA from nasal mucus using the PCR method. The values of IgA, IgM, and IgG to S and N proteins of SARS-CoV-2, determined by the ELISA method at different times of the infectious process in 380 blood serum samples, were analyzed.

Results and Discussion.The research findings of IgM to SARS-CoV-2 in the first week of illness revealed a median value of 0.24 [0.14; 1.39], increasing to 0.49 [0.30; 2.87] in the second week. The highest median value of IgA to SARS-CoV-2 is 0.33 [0.24; 1.00] was found from 15 to 30 days, after 30 days it was 0.24 [0.20; 0.28].

The increase in the median value of IgG-N to SARS-CoV-2 was observed from the second week of the illness, reaching 1.13 [0.52; 3.17], with its maximum value at 5.68 [2.39; 8.86] within the period up to three months. Severe COVID-19 was diagnosed in 27 children (30.68%), comprising 15 females (55.56%) and 12 males (44.44%). In the majority of hospitalized children, IgM values at different degrees of disease severity were positive from the first to the seventh day of illness. In children with a severe course of SARS-CoV-2, the median value of IgM in blood serum during this period was 1.39 [1.36; 4.07]. There was a statistically significant difference between the IgG levels for moderate and severe forms on days 15-30 of the illness: 0.54 [0.21; 1.89] compared to 5.55 [4.99; 5.80], respectively (p<0.05). In patients with both moderate and severe forms of the disease, median values of IgG to N SARS-CoV-2 were positive throughout the study period. A significant increase in the median value of IgG to N SARS-CoV-2 was observed in females from day 31 to day 90. In severe cases of the disease, the median value of IgG to SARS-CoV-2 from three to six months was 9.40 [7.80; 10.60], which was higher than in patients with a moderate form of the disease - 8.72 [8.64; 8.97] (p<0.05).

Conclusions. Serological studies enable the investigation of the immune response to SARS-CoV-2, determination of seroconversion, and characterization of the course of COVID-19, being crucial for epidemiological research. The levels of IgM, IgA, and IgG to SARS-CoV-2 depend on the disease's severity and the patient's age.

Keywords: COVID-19, IgM, IgA, IgG, SARS-CoV-2, children.

Introduction. A significant part of scientific publications on ensuring the availability of medicines in Ukrainian scientific and specialized publications is devoted, in particular, to the following issues: selection and optimization of methods for calculating prices for medicines and reference pricing, monitoring of prices for medicines, assessment of the availability of medicines, assessment of health technologies (medical technology assessment). The publications also address the issues of pricing for personalized medicines (extemporaneous manufacturing) and accounting for the release of medicines of different groups. However, the aspects of informatization of medicines price regulation from the point of view of pharmaceutical informatics have not been specifically considered. Therefore, the purpose of the study was to analyze the presented structures of information on nomenclature items of medicinal products in the regulatory legal acts on the regulation of prices for medicinal products in Ukraine. Based on the data obtained: to substantiate the feasibility of using a single identifier of the nomenclature position of a medicinal product in regulatory legal acts, to determine and systematize the format, scope and level of its application; to identify possible ways to reduce the number of regulatory legal acts regulating the prices of medicinal products in Ukraine. Material & methods. The objects of the study were information sources on the state regulation of pricing for medicines: regulatory acts, analytical documents, official websites of government agencies and specialized publications, scientific works of domestic scientists. The following methods were used in the study: descriptive statistics, systematization, grouping and generalization of the results. Results & discussion. The article analyzes the state of information on nomenclature items of medicinal products in the regulatory legal acts of the Ministry of Health of Ukraine on pricing: international nonproprietary names / common names of active pharmaceutical ingredients, names of manufacturers of medicinal products and codes of anatomical, therapeutic and chemical classification. The results of the work are presented as statistical data and examples of nonstandardized names of the above objects. Based on the data obtained, the problems caused by the state of submission of non-standardized information are described and ways to solve them are proposed. Conclusion. The basic method of information structure for recording information about medicinal products in the relevant registers and regulatory acts with regard to unique identifiers of nomenclature items is proposed. The author substantiates the need to create and use unified registers to ensure the possibility of automated generation of information on nomenclature items of medicinal products for regulatory legal acts. The lack of unified standards for the presentation of information on medicinal products in regulatory acts and medicinal product identifiers makes it impossible to use automated methods of information analysis, especially in the time dynamics. This, in turn, makes it impossible to use the results of the analyzes when making forecasts. The current structure of regulation and information provision may lead to cases where information in some regulations contradicts each other. The constant change in the validity of regulatory legal acts makes it impossible to create an up-to-date permanent reference to the latest information, and creates additional difficulties for practicing pharmacists who must comply with the standards and data specified in these legal acts in their daily work. The author substantiates the expediency of creating a single regulatory legal act on the regulation of prices for medicinal products for each of the regulatory authorities/structures. The author proposes to create a single legally approved URL with only relevant information on pricing aspects and the availability of an online chat and a public web forum where experts will provide quick responses to requests from practitioners.
Keywords: information, identification, standardization, regulations, registers, wholesale prices

The aim. To study the biocomplex of surfactants based on rhamnolipids Pseudomonas sp. PS-17 (biocomplex PS) as an emulsifier and co-emulsifier by using the method of modelling the composition of emulsions for use in dermatology.
Materials and methods. The biocomplex PS is a biogenic surface-active complex synthesized by bacteria of the genus Pseudomonas, which is a viscous mass that includes rhamnolipids, which make up to 80 % of the biocomplex, as well as alginate and water. The methods of computer simulation of semi-automated selection of the composition of the oil phase and emulsifiers of medicinal or cosmetic emulsions developed in the MO Excel program were used. In modelling processes, the biocomplex PS was studied as an independent emulsifier in o/w type emulsions, as well as a co-emulsifier of this type of emulsions in combination with type II emulsifiers.
Results. The substantiation of the concentration of emulsifiers in the composition of emulsion medicinal and cosmetic products is mainly carried out based on experimental studies; therefore, it requires a long time and is expensive. To reduce the number of technological experiments in the development of emulsion products stabilized by a biocomplex of surfactants based on biocomplex PS, a method of computer simulation of the composition of emulsions in the MO Excel program was developed and used. A method based on the application of the hydrophilic- lipophilic balance system. Two examples of solving specific problems of choosing a complex emulsifier and the composition of the oil phase components of the emulsion product are given.
Conclusions. The use of a semi-automated modelling system provides a reasoned choice of the composition of the oil phase of the emulsion when using the PS biocomplex as an independent emulsifier or the choice of the ratio between the PS biocomplex and the type II emulsifier when using a complex emulsifier and allows rational experimental study
Keywords: emulsions, emulsifiers, rhamnolipids Pseudomonas sp. PS-17, medicines, cosmetics, hydrophilic-lipophilic balance, emulsions, emulsifiers, rhamnolipids Pseudomonas sp. PS-17, medicines, cosmetics, hydrophilic-lipophilic balance

The aim of the study management of medical institutions in the context of providing medical and preventive care in conditions of COVID-19 is an urgent research problem because it provides detection of management’s effective mechanism in times of crisis. It was to identify the management’s peculiarities of medical institutions in the context of providing medical and preventive care in conditions of COVID-19. The article uses a qualitative content analysis method, a method of comparison, and a method of analysis of countries’ cases in the context of rendering medical and preventive care in Ukraine, Spain, Italy, Germany, and the Czech Republic. The article identifies the main elements of the health system management mechanism during the pandemic, which includes coordinated work by stakeholders to ensure a coordinated response to the emergency. The mechanism includes the organizational, legal, and financial components of cooperation between agencies and ministries of national, regional level, involvement international organizations in the process of development of policy and tactics, management crisis’ strategies. Strategic documents of the national level are one of the main elements of the management’s system.

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