Репозитарій

UDC 615.03:615.276

The aim. To assess pharmacotherapy of hospitalised patients with coronary heart disease in Ukraine, identify the types of drug-related problems, and recommend interventions to improve the management of cardiac inpatients.

Materials and methods. The objects of the study were 25 medical records of inpatients with coronary heart disease complicated by heart failure and atherosclerotic cardiosclerosis. Methods applied: systematisation, generalisation, comparison, clinical and pharmaceutical approach. The statistical analyses were performed using the SPSS Trial.

Results. A comprehensive retrospective study was conducted to assess the management of cardiovascular diseases. In total, 25 patients were prescribed 62 drugs. It was established that 53.5 % of medicines were "Agents affecting the cardiovascular system"; out of them, 26.9 % were "other cardiac drugs" (C01E) used for enhancing cardiac energy metabolism. The study identified 597 drug-related problems (DRPs) (23.9±12.6 DRPs per patient) with the drug-drug interactions prevalence (62.6 %). Other common groups of DRPs were: (1) no indications for drug administration (8.5 %), and (2) despite indications, the drug was not prescribed (8.2 %). 99 DRPs (16.6 %; 95 % CI:13.7-19.8 %) were associated with "other cardiac drugs". They included 4 types of DRPs: (1) no indications for drug administration (33.3 %); (2) insufficient duration of the treatment (31.3 %); (3) drug-drug interactions (22.3 %); and (4) insufficient dosage or frequency of use (13.1 %).

Conclusion. Our findings suggest that the treatment of cardiac inpatients is associated with numerous DRPs. Thus, we formed a list of recommendations to improve the management of cardiovascular diseases in hospitalised patients

Introduction and objective. Many studies have indicated numerous nutrition mistakes among school-aged children and adolescents in both urban and rural environments. The aim of this study was to assess the nutritional habits of the Polish population, consisting of 7,974 individuals aged 12–17, from rural and urban environments, as well as to identify environmental variations of these habits and to verify the existing information on the incorrect nutrition of school-age children and adolescents.
Materials and method. The research covered a group of 7,974 respondents – school-age adolescents with a similar age structure (12–17 years). The study on subjects from secondary school grades 1 – 3 was conducted in randomly selected schools from 2 random Polish provinces; 5 counties were randomly selected, followed by a choice of 2 communes: one rural and one urban. The research technique was a self-designed survey questionnaire. The obtained results were subjected to statistical analysis using the Pearson Chi 2 and V Cramer test.
Results. The research revealed environment-based differences in subjects’ nutrition. Breakfast was consumed daily by a statistically significantly fewer subjects from the rural environment (36.31%) than from the urban areas (51.32%); second breakfast was consumed by an insignificantly smaller proportion of respondents from the urban environment (40.00%) than from the rural one (46.00%); dinner was eaten daily by 86.00% of urban subjects and 82.00% of rural respondents; afternoon tea and supper were eaten rarely by respondents from both environments. The diet of respondents was dominated by anti-health behaviours.
Conclusions. Most of the respondents displayed incorrect nutritional behaviours. Nutritional mistakes occurred among respondents from both rural and urban environments, with the predominance of the rural areas. 

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- streptomicyne), 4,3 - to HRS. Amound 43?5% of children whith EPR TB the contact whith  aa TB patient was nnot established. At the same time only a third children who had came into contact whith bacterial excretors were dispensary obserwation 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.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institutions. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.

This paper presents a comparative assessment of mortality in Poland and Ukraine, including due to alcohol consumption, by sex, place of residence, and age groups. Mortality from alcohol consumption is and remains one of the health problems of the state’s population. The aim of this study was to establish the difference in mortality, including due to alcohol consumption, in the two neighboring countries. The analysis was conducted in 2008 and 2018 according to statistical institutions in Poland and Ukraine. Data from the codes of the International Statistical Classification of Diseases of the 10th edition: F10, G31.2, G62.1, I42.6, K70, K86.0, and X45 were used to calculate mortality due to alcohol consumption. The share of mortality caused by alcohol consumption in Ukraine in 2008 was 3.52%, and 1.83% in 2018. At the same time, in Poland, there is an increase in this cause of death from 1.72% to 2.36%. Mortality caused by alcohol consumption is the main share of mortality in the section “Mental and behavioral disorders” in both Ukraine, at 73–74%, and Poland, at 82–92%. Changes in the mortality rate in the cities and villages of Ukraine and Poland showed different trends: Poland nated, a significant increase in mortality, while in Ukraine it has halved on average. Overall and alcohol mortality rates in both countries were higher among the male population. The analysis of mortality among people of working age showed that the highest proportion of deaths from alcohol consumption in both countries was among people aged 25–44. Despite the geographical proximity, and similarity of natural and climatic characteristics and population, mortality rates in each country reflect the difference in the medical and demographic situation, and the effectiveness of state social approaches to public health.

ABSTRACT
The aim: To evaluate the dynamics of the interferon and collagen-IV systems in bronchoalveolar lavage in the treatment of chronic obstructive pulmonary disease using the tiotropium bromide medication.
Materials and methods: The study involved 60COPD patients with bronchial obstruction of the II degree before and on days 30 and 60 of therapy using conventional treatment regimens and inhalations of tiotropium bromide a the dose of 18 mcg once a day.The collagen-IV levels in bronchoalveolar fluid were determined by means of enzyme-linked immunoassay using “StatFax 303 Plus” analyzer and “Biotrin Collagen IV EIA” reagents. The level of IFN-γ was identified with the help of enzyme-linked immunoassay using “StatFax 303 Plus” analyzer and “ProKon” reagents (LLC “Protein Contour”, Russia) in bronchoalveolar fluid obtained during fiber-optic bronchoscopy.
Results: When examining GroupI patients on the 30th day we found out that the content of collagen-IV in the bronchoalveolar fluid had decreased by only 10.29% (p <0.05).
Detection of collagen-IV indices in Group II patients on the 30th day of tiotropium bromide use showed the 29.43% (p <0.05) decrease in its content as compared to the initial indices. In Group III patients, the concentration of collagen-IV had a maximum tendency to normalize and made up (24.72 ± 1.15) ng/ml, and decreasedby 2.44 times (p <0.05) as compared to the initial indices. Our examination of 12 patients from the comparison group I on the 60th day of treatment revealed even a slight increase in the content of collagen-IV in the bronchoalveolar fluid, as compared with the data obtained on the 30th day. Theidentified IFN-γ deficiency is indicative for the COPD of the II degree of bronchial obstruction, and its indices were 2.29 times lower than those observed in people from the control group. On day 30, we found out that the content of IFN-γ in Group I patients increased by only 10.29% (p>0.05). Detection of IFN-γ in Group II patients showed 42.27% (p<0,05) increase in its content as compared to the initial indices. The most favorable dynamics of IFN-γ levels in bronchoalveolar contents wasobservedin Group III patients, and at the time of observation itmadeup (1.16 ± 0.08) pg/ml, having 2 times (p<0.05) increasedas comparedtotheinitial indices. However, in contrast to those taking tiotropium bromide, we examined 12 patients from Group I on the 60th day of treatment and found no significant positive dynamics of IFN-γ content in bronchoalveolar fluid as compared to the indices obtained on day 30.
Conclusions: The obtained findings indicate the effect of tiotropium bromide on the reduction of interferon-γ and reduce of collagen-IV levels, which depend on the duration of its use.