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Strategy of planning HIV/AIDS fight in Ukraine: a review 乌克兰艾滋病毒/艾滋病防治规划战略:审查
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-61
V. Stepanenko, S. Ivanov, V. Kamenev
HIV epidemic in Ukraine remains a nationwide problem. The current epidemiological situation does not yet give grounds to talk about a significant decrease in the load associated with HIV/AIDS in Ukraine. Predicting the further spread of the epidemic throughout the country is becoming more and more complicated due to the crisis socio-economic phenomena and the deterioration of the situation in the eastern regions of Ukraine. Objective — to substantiate the ways of optimization of monitoring, diagnosis and treatment of HIV infection as the basis for a strategy of overcoming the HIV/AIDS epidemic in the public health system in Ukraine; expanding treatment of HIV-infected patients using modern approaches and standards; volumes and algorithms of cooperation of specialists from different branches in the provision of treatment services to patients with skin diseases and sexually transmitted infections. Materials and methods. We analyzed: 1) documents of international policy in the field of public health; 2) the latest changes in the documents of the state policy in the field of health care of Ukraine; 3) international strategies and approaches to overcoming the HIV epidemic; 4) WHO strategies for applying public health approaches to tackling the HIV epidemic; 5) the dynamics of the incidence of skin and venereal diseases in Ukraine and the virtual creation of an epidemiological situation in the absence of integrative relations between individual health care services; 6) modeling and forecasting with account of all available relevant data as an important source of information for monitoring national and global HIV epidemics, as well as managing the prevention and treatment programs. Results and discussion. Based on the review of statistical information, key directions are presented for further strengthening of the system of monitoring and evaluation to strengthen the control over the HIV epidemic in Ukraine, as well as optimize specific treatment. At the present stage of the implementation of medical reforms, final revision and improvement are required of existing strategies and policies for organizing a response to the HIV epidemic in Ukraine, as well as the search for new ways and tools that can be mobilized in the health care system by increasing the efficiency of the use of existing resources, introducing new forms of management and coordination of actions. Conclusions. Bringing national standards in line with the best world practices in the field of HIV counteraction contributes to the effective planning of the need for specific therapy in order to ensure a sustainable response to the HIV epidemic in Ukraine, the use of a «treat all» approach with effective and safe antiretroviral therapy. The optimization is based on the principles of public health as having the highest priority and effectiveness in comparison with individual approaches to the prevention, treatment and support of people with chronic diseases. The principle of maintaining balanc
乌克兰的艾滋病毒流行病仍然是一个全国性的问题。从目前的流行病学情况来看,还没有理由说乌克兰与艾滋病毒/艾滋病有关的负担显著减少。由于危机的社会经济现象和乌克兰东部地区局势的恶化,预测这一流行病在全国进一步蔓延变得越来越复杂。目标-证实优化监测,诊断和治疗艾滋病毒感染的方法,作为乌克兰公共卫生系统克服艾滋病毒/艾滋病流行病战略的基础;使用现代方法和标准扩大对艾滋病毒感染者的治疗;不同部门的专家在为皮肤病和性传播感染患者提供治疗服务方面的合作数量和算法。材料和方法。我们分析:1)公共卫生领域的国际政策文件;2)乌克兰卫生保健领域国家政策文件的最新变化;3)克服艾滋病毒流行病的国际战略和办法;4)世卫组织采用公共卫生办法处理艾滋病毒流行问题的战略;5)乌克兰皮肤病和性病发病率的动态以及在个人保健服务之间缺乏综合关系的情况下实际上造成的流行病学状况;6)利用所有现有的有关数据进行建模和预测,作为监测国家和全球艾滋病毒流行情况以及管理预防和治疗方案的重要信息来源。结果和讨论。根据对统计资料的审查,提出了进一步加强监测和评价系统的关键方向,以加强对乌克兰艾滋病毒流行的控制,并优化具体治疗。在实施医疗改革的目前阶段,需要最后修订和改进组织应对乌克兰艾滋病毒流行的现有战略和政策,并通过提高现有资源的使用效率,采用新的管理和协调行动形式,寻找可以在卫生保健系统中动员的新方法和工具。结论。使国家标准与防治艾滋病毒领域的世界最佳做法保持一致,有助于有效规划具体治疗的需要,以确保对乌克兰的艾滋病毒流行病采取可持续的对策,即采用"治疗所有人"的办法,提供有效和安全的抗逆转录病毒疗法。与个人预防、治疗和支助慢性病患者的办法相比,公共卫生的原则是最优先和最有效的,这是优化工作的基础。维持平衡治疗方案的原则有助于在乌克兰资源有限的情况下减少对捐助资金的依赖,并确保实现快速通道目标和遵守艾滋病规划署战略。
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引用次数: 0
Study of clinical features of patients with chronic eczema 慢性湿疹患者临床特征的研究
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-23
L. V. Fomina, A. Dashchuk, E. Dobrzhanska
Objective — s to study the clinical features of chronic eczema (CE) in 96 patients aged 18 to 78 years. Materials and methods. The study was carried out in the city clinical dermatovenerological dispensary No. 5 in Kharkov. All patients gave written informed consent to participate in the study.The majority of them (66.7 %) were between 31 and 50 years old. The duration of dermatosis in 6.3 % of the surveyed persons ranged from 6 months to 1 year, in 33.3 % — from 1 year to 5 years, in 42.7 % — from 5 to 10 years, in 17.7 % — over 10 years. The most frequent causes of exacerbation in 51.1 % were neuropsychiatric trauma and stress, in 15.6 % — dise­ases of internal organs and acute respiratory diseases, in 13.5 % — contact with chemicals. In all patients, dermatosis was recurrent. Most often, the surveyed patients complained of moderate intensity itching (51 %) and severe sleep disturbances (66.7 %). Moderate leukocytosis and accelerated ESR were found in 21.9 % of patients, eosinophilia — in 5.1 %. Results and discussion. 96 patients with chronic eczema aged 18 to 78 years were under observation. The diagnosis of chronic eczema was based on anamnestic data, patients’ complaints of itchy skin of varying intensity, objective examination of the patient, as well as recurrences of dermatosis for more than 1 year. The largest number of patients had dermatosis from 5 to 10 years. Chronic eczema in the observed patients was recurrent. The duration of remission was (4.9 ± 0.2) months. The duration of exacerbation was (6.1 ± 0.2) weeks. To characterize the severity of chronic eczema, a scoring system was used, according to which the average severity was (2.63 ± 0.08) points.According to the degree of skin lesions, the forms of dermatosis were limited and widespread. Patients complained of skin itching of varying intensity: more often itching of moderate intensity, periodic; painful, persistent, with an insurmountable need to scratch; short-term; no itching.Also, patients noted sleep disturbance in the form of difficulty falling asleep, sudden awakening at night and lack of a feeling of rest after waking up in the morning. 39 patients had bad habits (smoking, alcohol abuse).Сlinical analysis of blood revealed moderate leukocytosis, accelerated ESR, eosinophilia, signs of secondary infection. Conclusions. The average age of the patients ranged from 31 to 50 years. All examined patients had recurrent dermatosis. The average degree of its severity was (2.63 ± 0.08) points. Most often, patients complained of moderate intensity itching (51 %) and severe sleep disturbances (66.7 %). In 21.9 % of the examined patients moderate leukocytosis and accelerated ESR were revealed, in 5.1 % — eosinophilia.
目的探讨96例18 ~ 78岁慢性湿疹(CE)患者的临床特点。材料和方法。这项研究是在哈尔科夫市临床皮肤性病诊所第5号进行的。所有患者均给予参与研究的书面知情同意。其中年龄在31 ~ 50岁之间的占66.7%。6.3%的被调查者皮肤病病程为6个月至1年,33.3%为1年至5年,42.7%为5年至10年,17.7%为10年以上。最常见的恶化原因是神经精神创伤和压力(51.1%),15.6%(内脏疾病和急性呼吸系统疾病),13.5%(接触化学品)。所有患者均有皮肤病复发。最常见的是,调查患者抱怨中度瘙痒(51%)和严重的睡眠障碍(66.7%)。21.9%的患者有中度白细胞增多和ESR加速,5.1%的患者有嗜酸性粒细胞增多。结果和讨论。对96例18 ~ 78岁慢性湿疹患者进行观察。慢性湿疹的诊断是根据患者的记忆资料、患者对不同程度皮肤瘙痒的主诉、患者的客观检查以及1年以上的皮肤病复发情况。5 ~ 10岁的患者患皮肤病的人数最多。观察患者慢性湿疹复发。缓解期为(4.9±0.2)个月。加重时间为(6.1±0.2)周。慢性湿疹的严重程度采用评分系统,平均严重程度为(2.63±0.08)分。根据皮肤病变的程度,皮肤病的形式是有限的和广泛的。患者主诉皮肤瘙痒强度不等:多为中等强度、周期性瘙痒;痛苦的,执着的,有一种无法克服的需要去挠;短期;没有瘙痒。此外,患者注意到睡眠障碍,表现为入睡困难,夜间突然醒来,早晨醒来后缺乏休息的感觉。39例患者有不良生活习惯(吸烟、酗酒)。Сlinical血液分析显示中度白细胞增多,ESR加速,嗜酸性粒细胞增多,继发感染的迹象。结论。患者平均年龄31 ~ 50岁。所有患者均有复发性皮肤病。其严重程度平均为(2.63±0.08)分。最常见的是,患者抱怨中度瘙痒(51%)和严重睡眠障碍(66.7%)。21.9%的患者有中度白细胞增多和ESR加速,5.1%的患者有嗜酸性粒细胞增多。
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引用次数: 0
Tasks, shortcomings and reservations in the process of reforming the specialized dermatovenereological sector of health care 皮肤性病专科医疗改革中的任务、不足与保留
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-5
V. Kravchenko, V. Stepanenko, A. Dashchuk, A. V. Kravchenko
Objective — to draw the attention of the Ukrainian health care management, the National Health Care Service (NHCS) and dermatovenereologists to urgent issues of reforming the industry, identifying shortcomings in the reform and presenting the views of experienced professionals on correcting organizational measures.Official statistics was used based on the materials of leading specialists of Kharkiv Research Institute of Dermatology and Venereology, scientific and practical institutions of Ukraine, the forecast of «GlobalData» analytical and statistical company on the trend of syphilis in the world, the results of discussion of current reform issues with leading specialists in dermatovenereology.The interpretation of the modern epidemiological panorama of skin and venereological pathology, the current state of organizational and material support of dermato-venereology institutions are presented. Some specific shortcomings and miscalculations in the process of reforming are revealed from the point of view of experienced specialists in the field, the authors’ vision of ways to improve the organization and activity of the dermatovenereological service of the country is presented.The need for correction in the process of reforming the specialized dermatovenereological service by resolving the urgent issue of organization in the areas of round-the-clock bed stock within reasonably adjusted limits and their financial and material support is substantiated. Calculations of the needs of round-the-clock inpatient beds in the regions should be carried out in the NHCS with the participation of the leadership of the Ukrainian Association of Dermatovenereologists and Cosmetologists (UADVC). The reforming of the dermatovenereology service should become a truly effective compo­nent of the generally progressive system of health care reform, taking into account the international medical and statistical forecasts.
目的:引起乌克兰卫生保健管理、国家卫生保健服务(NHCS)和皮肤性病学家对行业改革的紧迫问题的注意,确定改革中的缺点,并提出经验丰富的专业人员对纠正组织措施的意见。官方统计数据是基于哈尔科夫皮肤病和性病研究所的主要专家,乌克兰的科学和实践机构,“GlobalData”分析和统计公司对世界梅毒趋势的预测,以及与皮肤性病学主要专家讨论当前改革问题的结果。解释现代流行病学全景皮肤和性病病理,组织和物质支持皮肤性病机构的现状。从该领域经验丰富的专家的角度,揭示了改革过程中的一些具体缺点和误判,并提出了作者对改善国家皮肤性病服务组织和活动的方法的看法。通过在合理调整的范围内解决24小时病床存量领域的紧迫组织问题及其财政和物质支持,在皮肤科性病专科服务改革过程中进行纠正的必要性得到证实。在乌克兰皮肤性病学家和美容师协会(UADVC)领导的参与下,应在国家卫生保健中心对各地区24小时住院病床的需求进行计算。考虑到国际医学和统计预测,皮肤性病服务的改革应该成为普遍渐进的医疗改革体系中真正有效的组成部分。
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引用次数: 0
Awareness and knowledge of sexually transmitted diseases among population in Georgia (epidemiological survey) 格鲁吉亚人口对性传播疾病的认识和知识(流行病学调查)
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-56
M. Shvelidze, N. Durglishvili, V. Kvirkvelia, G. Gagua, К. Kolyadenko
Sexually transmitted infections (STIs), often known as sexually transmitteddiseases, are still a major public health concern across the world. According to WHO estimates, sexually transmitted diseases (STIs) have an annual incidence of 357 million cases among which chlamydia (131 million), gonorrhoea (78 million), syphilis (5.6 million) and trichomoniasis (143 million), half of those among young people aged 15—24. Every day, almost one million people worldwide develop an STI, and the majority of them are ignorant of their infection status, making them a source of infection for others. The frequency and consequences of this on the health and socioeconomic condition of whole nations, particularly African countries, have long been regarded as a serious emergency. The epidemiology of STIs, the history and physical findings, screening standards, and the overall approach to combat STIs are all covered in this article. Infections covered in terms of causation, epidemiology, and risk factors include gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and trichomoniasis. For a variety of reasons, the worldwide illness burden represented by STI remains unclear. First, many STIs are asymptomatic; second, diagnostic procedures are unavailable in some of the most affected nations; and finally, surveillance systems are non-existent or very poor in many parts of the world. According to the World Health Organization, there were 340 million new cases of syphilis, gonorrhoea, chlamydia infection, and trichomoniasis in 1999. In the European Union, there has been an increase in the incidence of gonorrhoea and syphilis in recent years. The survey instrument was an online self-administered anonymous questionnaire conducted in Georgia using Google survey software, which automatically populates and saves digital responses to a secure database protecting participant confidentiality throughout the surveying process. The survey was conducted in 2019. The opportunity to participate in the questionnaire was one-time. The question naire for this study was developed based on a review of literature.Health education, early diagnosis and treatment, screening for asymptomatic infections, contact inquiry, and immunization for illnesses for which a vaccine is available should all be used in STI prevention and control. In general, the studies reported low levels of knowledge and awareness of sexually transmitted diseases. Although, as shown by some of the findings on condom use, knowledge does not always translate into behavior change, adolescents’ sex education is important for STD prevention, and the school setting plays an important role.
性传播感染(STIs),通常被称为性传播疾病,仍然是世界各地的一个主要公共卫生问题。据世卫组织估计,性传播疾病的年发病率为3.57亿例,其中衣原体病(1.31亿例)、淋病(7800万例)、梅毒(560万例)和滴虫病(1.43亿例),其中一半发生在15-24岁的年轻人中。全世界每天有近100万人感染性传播感染,其中大多数人不知道自己的感染状况,使他们成为他人的感染源。这种情况的频繁发生及其对整个国家,特别是非洲国家的健康和社会经济状况的影响,长期以来一直被视为一种严重的紧急情况。这篇文章涵盖了性传播感染的流行病学、历史和物理发现、筛查标准以及与性传播感染作斗争的总体方法。在病因、流行病学和危险因素方面涵盖的感染包括淋病、沙眼衣原体、阴道毛滴虫、梅毒和滴虫病。由于各种原因,性传播感染所代表的全球疾病负担仍不清楚。首先,许多性传播感染是无症状的;其次,在一些受影响最严重的国家没有诊断程序;最后,在世界许多地方,监测系统不存在或非常差。根据世界卫生组织的数据,1999年有3.4亿梅毒、淋病、衣原体感染和滴虫病的新病例。在欧洲联盟,近年来淋病和梅毒的发病率有所上升。调查工具是在格鲁吉亚使用谷歌调查软件进行的在线自我管理匿名问卷,该调查软件自动填充并将数字回答保存到安全数据库中,在整个调查过程中保护参与者的机密性。该调查于2019年进行。参与问卷的机会是一次性的。本研究的问卷调查是在文献综述的基础上编制的。健康教育、早期诊断和治疗、无症状感染筛查、接触询问以及对已有疫苗的疾病进行免疫接种,都应用于性传播感染的预防和控制。总的来说,这些研究报告说,人们对性传播疾病的认识和认识水平较低。虽然,正如一些关于避孕套使用的调查结果所显示的那样,知识并不总是转化为行为的改变,但青少年的性教育对预防性病很重要,学校环境也起着重要作用。
{"title":"Awareness and knowledge of sexually transmitted diseases among population in Georgia (epidemiological survey)","authors":"M. Shvelidze, N. Durglishvili, V. Kvirkvelia, G. Gagua, К. Kolyadenko","doi":"10.30978/ujdvk2021-4-56","DOIUrl":"https://doi.org/10.30978/ujdvk2021-4-56","url":null,"abstract":"Sexually transmitted infections (STIs), often known as sexually transmitteddiseases, are still a major public health concern across the world. According to WHO estimates, sexually transmitted diseases (STIs) have an annual incidence of 357 million cases among which chlamydia (131 million), gonorrhoea (78 million), syphilis (5.6 million) and trichomoniasis (143 million), half of those among young people aged 15—24. Every day, almost one million people worldwide develop an STI, and the majority of them are ignorant of their infection status, making them a source of infection for others. The frequency and consequences of this on the health and socioeconomic condition of whole nations, particularly African countries, have long been regarded as a serious emergency. The epidemiology of STIs, the history and physical findings, screening standards, and the overall approach to combat STIs are all covered in this article. Infections covered in terms of causation, epidemiology, and risk factors include gonorrhea, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and trichomoniasis. For a variety of reasons, the worldwide illness burden represented by STI remains unclear. First, many STIs are asymptomatic; second, diagnostic procedures are unavailable in some of the most affected nations; and finally, surveillance systems are non-existent or very poor in many parts of the world. According to the World Health Organization, there were 340 million new cases of syphilis, gonorrhoea, chlamydia infection, and trichomoniasis in 1999. In the European Union, there has been an increase in the incidence of gonorrhoea and syphilis in recent years. The survey instrument was an online self-administered anonymous questionnaire conducted in Georgia using Google survey software, which automatically populates and saves digital responses to a secure database protecting participant confidentiality throughout the surveying process. The survey was conducted in 2019. The opportunity to participate in the questionnaire was one-time. The question naire for this study was developed based on a review of literature.Health education, early diagnosis and treatment, screening for asymptomatic infections, contact inquiry, and immunization for illnesses for which a vaccine is available should all be used in STI prevention and control. In general, the studies reported low levels of knowledge and awareness of sexually transmitted diseases. Although, as shown by some of the findings on condom use, knowledge does not always translate into behavior change, adolescents’ sex education is important for STD prevention, and the school setting plays an important role.","PeriodicalId":23420,"journal":{"name":"Ukrainian Journal of Dermatology, Venerology, Cosmetology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82349586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Features of CD-­­phenotype of peripheral blood lymphocytes in adult patients with atopic dermatitis during the exacerbation 成人特应性皮炎加重期外周血淋巴细胞CD表型特征
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-16
O. Aleksandruk
Objective — to study the dynamics of peripheral blood lymphocytic populations in adult patients with atopic dermatitis (AD) with the onset of the disease in childhood, depending on the level of IgE secretion and the method of treatment. Materials and methods. We examined 67 adult patients with AD, which were divided into 4 groups depending on the level of total serum IgE and the basic treatment or treatment in combination with Glycine and Ketotifen. The severity of AD was determined by the SCORAD index. The content of peripheral blood lymphocytes according to the phenotype CD3+, CD4+, CD8+, CD19+, CD65+, HLADR+ and CD95+ was assessed during hospitalization of patients, at the end of the inpatient stage of treatment and after 1 month of outpatient follow-up. The obtained data were compared with the indices of the control group and between the groups of examined patients with AD in the dynamics of their treatment and observation. The results were processed statistically using the methods of parametric and nonparametric statistics. Results and discussion. The indices of the number of cells of peripheral lymphocytic populations of different CD pheno­type in the groups in the dynamics of observation were determined, their relationship with the severity of the course of AD was established, and differences were found depending on the pathogenetic variant of AD. Against the background of an exacerbation of AD, a significant increase in the number of cells in most of the defined populations was revealed, with its gradual decrease as the clinical manifestations of AD subsided. It was established that 1 month after achievement of clinical/subclinical remission, a part of the peripheral blood lymphocytic populations was characterized by higher values compared to the norm. In patients with an IgE-dependent AD variant, aggravation is accompanied by high levels of peripheral lymphocytes with CD3+, CD4+, CD8+, CD19+ and HLA-DR phenotypes, which more often than in the case of an IgE-independent variant of AD, remain above the norm after 1 month of outpatient monitoring. Introduction of glycine and ketotifen to the treatment complex for patients with AD is accompanied by a faster return of peripheral lymphocyte cells to normal values, which is more evident in patients with an IgE-dependent variant of AD. Conclusions. In adult AD patients, the dynamics of the number of peripheral lymphocyte population cells depends on the severity of the disease, its pathogenetic variant and the treatment received by the patient. Against the background of the use of glycine and ketotifen, the normalization of indicators of peripheral lymphocytic populations occurs significantly faster than with only standard basic therapy.
目的-研究儿童发病的成人特应性皮炎(AD)患者外周血淋巴细胞群的动态变化,这取决于IgE分泌水平和治疗方法。材料和方法。我们检查了67例成年AD患者,根据血清总IgE水平和基础治疗或联合甘氨酸和酮替芬治疗分为4组。通过SCORAD指数判断AD的严重程度。在患者住院期间、住院治疗期结束时及门诊随访1个月后,根据外周血淋巴细胞表型CD3+、CD4+、CD8+、CD19+、CD65+、HLADR+、CD95+的含量进行评估。将所得数据与对照组及检查组AD患者的各项指标进行比较,观察其治疗动态。采用参数统计和非参数统计方法对结果进行统计处理。结果和讨论。动态观察各组不同CD表型外周淋巴细胞群细胞数指标,建立其与AD病程严重程度的关系,并根据AD的致病变异发现差异。在阿尔茨海默病病情加重的背景下,大多数定义人群的细胞数量显著增加,随着阿尔茨海默病临床表现的消退,细胞数量逐渐减少。研究发现,在达到临床/亚临床缓解1个月后,一部分外周血淋巴细胞的数值高于正常水平。在ige依赖性AD变异体患者中,病情加重伴随着高水平的外周血淋巴细胞(CD3+、CD4+、CD8+、CD19+和HLA-DR表型),这些细胞比ige依赖性AD变异体患者更常见,在门诊监测1个月后仍高于正常水平。在AD患者的治疗组合中引入甘氨酸和酮替芬,外周血淋巴细胞恢复正常的速度更快,这在ige依赖性AD患者中更为明显。结论。在成年AD患者中,外周血淋巴细胞群细胞数量的动态取决于疾病的严重程度、发病变异和患者接受的治疗。在使用甘氨酸和酮替芬的背景下,外周血淋巴细胞群指标的正常化明显快于仅使用标准基础治疗。
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引用次数: 0
Dermatovenerological service of Ukraine in the context of ongoing reform 正在进行的改革背景下乌克兰皮肤性病服务
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-11
V.M. Volkoslavska, I.Ye. Namli
The problems of preserving the dermatovenerological health of the population are extremely relevant for Ukraine, where diseases of the skin and subcutaneous tissue occupy the 5th place in the structure of morbidity. Objective — study of the structure of the dermatovenerological service in the context of reforming the healthcare system at this stage (end of 2021) and its characteristics. Materials and methods. The results of the analysis of the state of resources of medical institutions of communal ownership of dermatovenerological profile in Ukraine are presented. Results and discussion. Today, in Ukraine, the number of hospital beds for 24-hour hospitals for adults is 188 in the regions (Zaporizhzhia, Rivne, Kharkiv, Cherkasy) and 220 beds in Kyiv city, which is extremely insufficient. There are 24 beds for the pediatric patients in the regions (Luhansk, Rivne, Cherkasy) and in the city of Kyiv — 60. The number of day hospital beds for adults has significantly decreased — to 248 in the regions (Dnipropetrovs’k, Zaporizhzhia, Kyiv, Lviv, Poltava, Kherson, Cherkasy, Chernivtsi and Kramatorsk city), for pediatric patients — 61 (Dnipropetrovs’k, Kropyvnytskyi, Mykolaiv, Poltava regions). In 2021, 11 dermatovenerologic dispensaries were liquidated. Instead of them, dermatovenero­logic centers and subdivisions subordinate to regional hospitals were formed. Thus, there is an unfavorable restructuring of the bed fund of institutions providing dermatovenerological care. Conclusions. A decrease in the number of state and municipal institutions providing free dermatovenerological care will lead to the worsening of the epidemic situation, the spread of sexually transmitted infections and reduction of the availability of specialized dermatovenerological care for the population in a difficult economic and social situation.
保持人口皮肤和性病健康的问题与乌克兰极为相关,在乌克兰,皮肤和皮下组织疾病在发病率结构中占第五位。目的:研究现阶段(2021年底)医疗体制改革背景下的皮肤性病服务结构及其特点。材料和方法。在乌克兰的皮肤性病概况公有制医疗机构的资源状况分析的结果提出。结果和讨论。今天,在乌克兰,各地区(里夫尼、哈尔科夫、切尔卡西)24小时成人医院的床位为188张,基辅市的床位为220张,严重不足。在各地区(卢甘斯克、里夫内、切尔卡西)有24张儿科病床,在基辅市有60张。在第聂伯罗彼得罗夫斯克、基辅、利沃夫、波尔塔瓦、赫尔松、切尔卡西、切尔诺夫茨和克拉马托尔斯克等地区,成人日间医院床位已大幅减少至248张;在第聂伯罗彼得罗夫斯克、克罗皮尼茨基、尼古拉耶夫、波尔塔瓦等地区,儿童日间医院床位为61张。2021年,清算了11家皮肤性病诊所。取而代之的是区域医院下属的皮肤病学中心和分支机构。因此,对提供皮肤性病护理的机构的床位资金进行不利的重组。结论。提供免费皮肤性病治疗的国家和城市机构的数量减少,将导致流行病的恶化,性传播感染的蔓延,以及经济和社会状况困难的人口获得皮肤性病专科治疗的机会减少。
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引用次数: 0
Monitoring of self­assessment by health care workers of the quality of own life during the pandemic of acute respiratory disease caused by SARS-­CoV­-2 coronavirus in 2020 2020年SARS- CoV -2冠状病毒引起的急性呼吸道疾病大流行期间医护人员自我生活质量评估监测
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-33
O. Fedorenko, K. Kolyadenko
Comparative analysis of changes in self-assessment of quality of life (QoL) indicators by young medical students during 2020 revealed certain correlations depending on the time during which they were forced to study and work against the background of the predominantly negative influence of the chronic stressful situation — the need to daily contact with different patients in conditions of many months of quarantine due to pandemic of acute respiratory disease caused by the SARS-CoV-2 coronavirus. The overall negative impact of the infectious pandemic and the resulting fears on public consciousness were quite expected. Medical workers with different clinical experiences and qualifications (nursing students and doctors), quite emotionally reacted to the potential danger of being infected with coronavirus infection due to daily professional contacts with various patients who had somatic diseases, some of which might already be in the incubation period of clinical course of coronavirus pathology. This directly reduces their self-esteem of QOL and, in certain situations, can be a factor that leads to the appearance of psychosomatic disorders in them as a kind of somatic occupational pathology, especially with prolonged (many months) continuation of lockdown restrictions due to the high level of morbidity and mortality of the population. The monitoring of changes in self-esteem of individual components of QoL turned out to be quite dependent both on the expression of individual psychological traits of each tested person and on the time of the survey (spring—late summer—winter 2020—2021).
对2020年期间年轻医学生生活质量(QoL)自我评估指标变化的比较分析显示,在慢性压力状况的主要负面影响背景下,他们被迫学习和工作的时间存在一定的相关性由于SARS-CoV-2冠状病毒引起的急性呼吸道疾病大流行,在长达数月的隔离条件下,每天需要与不同的患者接触。这一传染性流行病的总体负面影响以及由此对公众意识造成的恐惧是完全可以预料到的。具有不同临床经验和资质的医务工作者(护生和医生),由于日常专业接触各种躯体疾病患者,其中一些患者可能已经处于冠状病毒病理临床病程的潜伏期,因此对感染冠状病毒的潜在危险反应相当情绪化。这直接降低了他们对生活质量的自尊,在某些情况下,这可能是导致他们出现心身疾病的一个因素,作为一种躯体职业病理,特别是由于人口发病率和死亡率高,封锁限制持续时间长(数月)。结果表明,对生活质量各组成部分自尊变化的监测很大程度上取决于每个被测者的个人心理特征表达和调查时间(2020-2021年春季-夏末-冬季)。
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引用次数: 0
Molecule which changed the view on skin treatment 分子改变了人们对皮肤治疗的看法
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-44
L.Ya. Fedorich
Objective — to study the modern classification, mechanisms of action and clinical effects of vitamin A derivatives, to analyze retinoid for local treatment of various dermatoses with a universal mechanism of action at the epidermis and dermis levels. Materials and methods. A review of the literature and an analysis of the results of international clinical trials of drugs based on the natural retinoid of the first generation — tretinoin (retinoic acid) is presented. The works of dozens of authors since 1980s to the present day are analyzed. Most sources provide detailed information on the results of topical retinoids in acne therapy, which are the base of clinical guidelines. Long-term (6 months or more) studies of retinoic acid-based preparations carried out in recent decades have discovered the unique clinical effects of tretinoin in the treatment of skin photoaging, actinic keratosis, etc. They are achieved due to the effect of tretinoid on the nuclear receptors of keratinocytes and fibroblasts. Results and discussion. The molecular mechanisms of action of retinoic acid, realizing the cellular and tissue effects of the most studied retinoid, are systematized and grouped in a single review. It has been proven that a unique feature of tretinin is its ability to activate directly all subtypes of RARs- and, indirectly, RARs-nuclear receptors of skin cells. A new modern drug for external use is presented — AltrenoТМ lotion containing micronized 0.05 % tretinoin in combination with sodium hyaluronate, soluble collagen and glycerin. This combination exhibits the expected clinical efficacy in acne therapy and prevents side effects such as dryness, redness and exfoliation. AltrenoТМ is approved for use in children of 9 years of age and older. Conclusions. Tretinoin (retinoic acid) is a modern powerful retinoid with a universal mechanism of action, recommended for the treatment of acne.
目的:研究维生素A衍生物的现代分类、作用机制和临床疗效,分析类维甲酸在表皮和真皮层面具有普遍作用机制的局部治疗各种皮肤病的疗效。材料和方法。本文综述了基于第一代天然类维甲酸维甲酸(维甲酸)的药物的文献和国际临床试验结果分析。本文分析了20世纪80年代至今数十位作家的作品。大多数来源提供了痤疮治疗局部类维生素a的结果的详细信息,这是临床指南的基础。近几十年来对维甲酸基制剂进行的长期(6个月以上)研究发现,维甲酸在治疗皮肤光老化、光化性角化病等方面具有独特的临床效果。它们是由于类维生素a对角质形成细胞和成纤维细胞的核受体的影响而实现的。结果和讨论。维甲酸的分子作用机制,实现了研究最多的类维甲酸的细胞和组织的影响,被系统化和分组在一个单一的综述。已经证明,维甲酸的一个独特特征是它能够直接激活皮肤细胞的所有RARs亚型,并间接激活RARs核受体。介绍了一种新型外用现代药物AltrenoТМ,该洗剂含有0.05%微细维甲酸、透明质酸钠、可溶性胶原蛋白和甘油。这种组合在痤疮治疗中表现出预期的临床疗效,并防止副作用,如干燥,发红和去角质。AltrenoТМ被批准用于9岁及以上的儿童。结论。维甲酸(维甲酸)是一种现代强大的类维甲酸具有普遍的作用机制,推荐用于治疗痤疮。
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引用次数: 0
30th Anniversary Congress of the European Academy of Dermatologists and Venereologists 欧洲皮肤病和性病学会30周年大会
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-78
Prepared by O.Ye. Fedorenko, K.V. Kolyadenko
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引用次数: 0
Safety and clinical efficacy of bilastine in reduction of pruritus in patients with chronic spontaneous urticaria bilastine减轻慢性自发性荨麻疹患者瘙痒的安全性和临床疗效
Pub Date : 2021-12-08 DOI: 10.30978/ujdvk2021-4-28
A. Bogomolov
Objective — to evaluate the efficacy/safety of bilastine in relieving pruritus in patients with chronic spontaneous urticaria. Materials and methods. This prospective randomized study included 50 adult patients aged 18 to 59 years with chronic spontaneous urticaria and pruritus with an intensity of more than 4 points by the visual analog scale of pruritus assessment in the last 3 days and more than 16 points by the Urticaria activity score 7 (UAS7) which assessed chronic urticaria intensity for the last week.Patients received bilastine orally at a dose of 20 mg once a day for 8 weeks. Patients who did not respond to therapy within the first 2 weeks subsequently received bilastine at a dose of 40 mg per day (two 20 mg tablets) till the end of the study (for 6 weeks). Results and discussion. The mean age of patients was 39.61 years with standard deviation (SD) of 12.33 years. In the group of patients who responded positively to the initial therapy, within 8 weeks, the pruritus intensity scoring level decreased significantly to 0.46 (95 % CI: 0.14—0.78) points (p < 0.05). The patients who received a double dose of bilastine also revealed a decrease in the intensity of pruritus and on average on the 8th week of treatment had 0.48 (95 % CI: 0.26—0.70) points (p < 0.05).The study reported 14 adverse events (AE) that occurred during bilastine treatment in 10 (23.8 %) patients. All of them were classified as mild and the most common was headache, registered in 12 (85.7 %) cases. No moderate or severe AEs were reported during the study. Conclusions. 8 week treatment with bilastine has demonstrated proven clinical efficacy both in reducing the urticaria activity index according to UAS7 and in reducing the intensity of pruritus in the absence of moderate and severe AEs. Patients who did not respond to starting therapy after doubling the bilastine dose also significantly decreased the urticaria activity index according to UAS7 and reduced the intensity of pruritus. At the same time, increasing the dose of the drug did not lead to an increase in the frequency of AEs.
目的:评价bilastine缓解慢性自发性荨麻疹患者瘙痒的疗效和安全性。材料和方法。这项前瞻性随机研究纳入了50例年龄在18 - 59岁的慢性自发性荨麻疹和瘙痒的成年患者,在过去3天内,瘙痒的视觉模拟量表评估强度超过4分,在过去一周的慢性荨麻疹强度评估中,荨麻疹活动评分7 (UAS7)超过16分。患者口服bilastine,剂量为20mg,每天1次,持续8周。在前两周内对治疗没有反应的患者随后接受bilastine,剂量为每天40mg(两片20mg片),直到研究结束(持续6周)。结果和讨论。患者平均年龄为39.61岁,标准差为12.33岁。在初始治疗阳性的患者中,8周内瘙痒强度评分水平显著下降至0.46 (95% CI: 0.14-0.78)分(p < 0.05)。双剂量bilastine组瘙痒强度也有所降低,治疗第8周瘙痒强度平均为0.48 (95% CI: 0.26 ~ 0.70)点(p < 0.05)。该研究报告了10例(23.8%)患者在bilastine治疗期间发生的14例不良事件(AE)。所有病例均为轻度,最常见的是头痛,共有12例(85.7%)。研究期间未报告中度或重度不良事件。结论:8周的bilastine治疗在根据UAS7降低荨麻疹活动指数和在没有中度和重度ae的情况下降低瘙痒强度方面已被证明具有临床疗效。在加倍bilastine剂量后对开始治疗无反应的患者也根据UAS7显着降低了荨麻疹活动指数并降低了瘙痒强度。同时,增加药物剂量并没有导致不良反应发生频率的增加。
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引用次数: 0
期刊
Ukrainian Journal of Dermatology, Venerology, Cosmetology
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