Репозитарій

Pediatric tuberculosis is a health problem of special significance because it is a marker for current transmission of tuberculosis in society.

The research aimed at analyzing the peculiarities of detection and course of pediatric extrapulmonary tuberculosis (EPTB) taking into account the profile of drug resistance. A retrospective study of medical charts of children with EPTB (n = 47; 1st group) and pulmonary tuberculosis (PTB) (n = 49; 2nd group) aged 0-15 for 2013-2020 has been conducted. 2 subgroups with EPTB were identified separately: resistant (EPRTB) (n = 23) and sensitive (EPSTB) (n = 24).

Results and discussion. The frequency of EPTB was 9.8%. Tuberculosis of peripheral LN (40.5%), CNS (27.7%), bones and joints (23.4%) was significantly more often diagnosed, than other lesions. Almost half of children with EPTB had a miliary distribution. In 44.7% of children with EPTB contact with a patient with tuberculosis was not established. EPRTB was significantly more common among children under 1 and up to 3 years of age than EPSTB. The resistance to combination of HR (73.6%) was found more often than to HRES (10.5%), HRS, H and Z (5.3% each; p<0.01). In 73.9% of children with EPRTB was detected when seeking medical care, in 13.0% the time to diagnosing lasted 6 months. Among children with EPRTB, gradual course was more frequent and in 47.8% intoxication syndrome was dominating. 78.3% of children with EPRTB were not vaccinated.

Conclusion. The above indicates the need to intensify preventive measures against tuberculosis among children, especially at risk groups, make monitoring of contacts and their treatment.

UDC 616-002.5-053.2(477.83)

Pediatric tuberculosis (TB) is a serious infectious disease that affects many children worldwide and is more likely to be extrapulmonary than adult TB.
The purpose — to analyze the profile of drug resistance of Mycobacterium tuberculosis and clinical features of extrapulmonary resistant (EPR) TB among children from Lviv region, Ukraine.
Materials and methods. We analyzed all cases of EPR TB (n=23) and extrapulmonary sensitive (EPS) TB (n=24) among 478 medical charts of children, who were hospitalized in the Lviv Anti-TB hospital during 2013–2020.
Results. It was found out that EPR TB was diagnosed significantly more often at the age of 1 year and up to 3 years old than EPS TB and significantly less often — among children aged 4–7 years. The children with EPR TB were significantly more likely to live in rural areas and they were significantly more likely to be from families with less than 2 children, compared to EPS TB. The children with EPR TB were more often diagnosed with meningeal and central nervous system (CNS) TB, less often — with TB of the bones and joints, only they had TB of the intestine, compared to EPS TB. Miliary pulmonary TB and the predominance of bilateral process were more common at EPR TB. Among children with EPR TB, rifampicin-resistant TB was significantly more common found than the risk of multidrug-resistant TB (MDR-TB) and monoresistant TB. The resistance profile of MDR-TB showed that 17.4% are resistant to the combination of HR (H-isoniazid, R-rifampicin), 8.6% - to HRES (E-ethambutol, S-streptomycin), 4.3% – to НRS. Among 43.5% of children with EPR TB the contact with a TB patient was not established. At the same time, only a third of children who had came into contact with bacterial exсretors were under dispensary observation and only about 9% received chemoprophylaxis.
Conclusions. In order to prevent the development of EPR TB, it is necessary to improve TB prevention measures among the most vulnerable segments of the population.

In etiopathogenetic terms, premature birth is considered as a clinical syndrome characterized by polyetiological factors, the participation of the fetus in pathogenesis, a variety of clinical symptoms, and the involvement of genetic and environmental factors. At the same time, there is increasing evidence that the composition of a woman’s vaginal microbiota significantly affects her sexual and reproductive health, including the risk of adverse pregnancy outcomes, including miscarriage and preterm birth. The purpose of the work was to assess the state of the vaginal microbiota in women with risk factors and the threat of spontaneous premature birth. 150 women of reproductive age took part in the study. The inclusion criteria for the study were the presence of risk factors for preterm birth or the threat of preterm birth. Determination of the pH of vaginal contents, molecular biological, and bacterioscopic methods were used to assess the state of the vaginal microbiota.

The conducted studies indicate a high risk of preterm birth in the presence of dysbiotic and inflammatory changes in the vaginal microbiota - odds ratio (OR) = 2.962 (95% CI 1.32-6.645). At the same time, for pregnant women with risk factors for preterm birth, OR makes up = 8.120 (95% CI 2.149-30.686), and for pregnant women with diagnosed threatened preterm birth - OR = 10.133 (95% CI 3.149-32.604). Thus, one of the risk factors for the development of spontaneous premature and threatened premature births is changes in the state of the vaginal microbiota, which requires the development of diagnostic and therapeutic measures to prevent premature termination of pregnancy and reduce the frequency of obstetric and perinatal complications.

УДК: 547.789.1:615.012.1]073/.076

Лозинський А.В. Поліфункціональні конденсовані та неконденсовані похідні тіазолу/тіазолідинону: спрямований синтез, фізико-хімічні властивості та біологічна активність  : [ спец.] 226, 22 / А. В. Лозинський - Львів, 2023 - 504 с. - Бібліогр.: с. 429-504 (658 назв).

Дисертаційна робота присвячена спрямованому синтезу нових поліфункціональних конденсованих та неконденсованих похідних тіазолу/тіазолідинону. Розроблено ефективні методи синтезу та хімічної модифікації похідних тіазоло[4,5-b]піридину, тіопіранотіазолу, гібридних молкул із фрагментами антрахінону, індолу, прізолу та диклофенаку у структурі, встановлено їх фізико-хімічні та спектральні характеристики.

В результаті скринінгових досліджень, виділено 57 лікоподібних молекул з високою біологічною активністю. Для поглиблених доклінічних досліджень ідентифіковано 5 потенційних протипухлинних агентів, які характеризуються селективним впливом на пухлинні клітинні лінії на фоні низької цитотоксичності invivo.

У статті представлено сучасні підходи до лікування пацієнтів з хронічним коронарним синдромом (ХКС), згідно Настанов Європейського товариства кардіологів (ЄТК) від 2019 року [1]. Зазначено, що алгоритм лікувального процесу включає фармакологічний менеджмент, який передбачає контроль симптомів та попередження виникнення серцевих подій, пов’язаних із ХКС, з максимальною прихильністю пацієнта та мінімальними побічними подіями. Наведена поетапна тактика тривалої антиангінальної медикаментозної терапії, з врахуванням специфічних базових характеристик пацієнта. Підкреслена важливість антитромботичного лікування (із збереженням балансу між профілактикою ішемічних подій та ризиком кровотечі), застосування гіполіпідемічних та інших препаратів з метою попередження подій. Відмічено, що реваскуляризація міокарда відіграє центральну роль в лікуванні ХКС, сприяючи полегшенню симптомів та покращенню прогнозу, проте завжди є доповненням до медикаментозної терапії. Важливою умовою досягнення успіху в лікуванні ХКС є здоровий спосіб життя пацієнта.

Ключові слова. Хронічний коронарний синдром, антиангінальна медикаментозна терапія, лікування з метою запобігання серцевих подій, реваскуляризація міокарда, здоровий спосіб життя.

This article presents contemporary approaches to treatment in patients with chronic coronary syndromes (CCS), according to European Society of Cardiology (ESC) 2019 guidelines [1]. It is stated that the algorithm of the treatment process includes pharmacological management, which envision control of symptoms and prevention of occurrence cardiac events that are related to CCS with the maximum patient compliance and with minimal side effects. A step-by-step tactics of long-term antianginal drugs therapy are given, taking into account the patient's specific baseline characteristics. The importance of antithrombotic treatment is underlined (with saving of the balance between prevention of ischemic events and the risk of bleeding), applying of lipid-lowering and other drugs to prevent events. It is noted that myocardial revascularization plays central role in the treatment of CCS, contributing to symptom relief and improving prognosis, but it is always a supplement to drug therapy. A healthy lifestyle for the patient is an important condition for achieving success in the treatment of CCS.

Key words. Chronic coronary syndrome,antianginal drugs therapy, treatment to prevent cardiac events, myocardial revascularization, healthy lifestyle.