Introduction: Healthcare-associated infections (HAIs) remain a major public health problem and patient safety threat worldwide. Scant information is available on the occurrence HAI and antimicrobial susceptibility of responsible pathogens in Ukrainian intencive care units (ICUs). The aim: To evaluate the prevalence of HAIs and antimicrobial resistance of the responsible pathogens. Materials and methods: The study included 642 patients and 262 samples isolated from patients with microbiologically proven HAI. The identification and antimicrobial susceptibility of the cultures were determined, using automated microbiology analyzer. Some antimicrobial susceptibility test used Kirby — Bauer antibiotic testing. Interpretative criteria were those suggested by the Clinical and Laboratory Standards Institute. Results: Among 642 patients, 148 HAIs were observed (23.1%). Death during hospitalization was reported in 20.1% HAI cases. Pneumonia (47.3%), blood stream infection (21.6%), and urinary tract infection (14.9) together accounted for 83.8% of all HAIs reported. Most cases of these infections were device-associated. Considering all HAI types together, Klebsiella pneumoniae were most commonly reported, accounting for 21.8% of all organisms, followed by Acinetobacter baumanni (14.3%), Pseudomonas aeruginosa (12.4%) and Escherichia coli (9.4%). 59.8% and 6.6% of Staphylococcus aureus were oxacillin and teicoplanin resistant, respectively. Third-generation cephalosporins resistancewas found in 53.8% of K.pneumoniae and 32.1% of E.coli isolates; and carbapenem resistance in 78.6% of A. baumanni and 29.3% of K. pneumoniae isolates. Conclusions: Infection control priorities in intensive care units should include preventing nosocomial pneumonia, blood stream infection, urinary tract infection and of deviceassociated infections.
The problem of the diabetic foot is one of the most serious complications of diabetes mellitus. There is still an active search for medicines (drugs) that could be used in the complex treatment of trophic lesions in diabetic foot. The period before the development and launch of the drug into the pharmaceutical market need to make marketing research aimed at ensuring that the future drug is competitive. The purpose of the work was to analyze the market of dermatological drugs for the treatment of trophic ulcers in order to determine the marketing opportunities for domestic producers. The research objects were active pharmaceutical ingredients (APIs), which are part of the dermatological registered drugs in Ukraine. Materials for research were official sources of information about drugs registered in Ukraine. Marketing analytical methods were used. To determine the level of tension between manufacturers and the same product, the coefficient of tension. Number of D preparations registered in Ukraine ‒ 452 trade names (January 2018) was established. Medicines wich prodused by Ukraine are slightly higher (55.3%). In groups D01, D03, D06, D07 and D08 the highest number of APIs is determined, which is 25, 36, 33, 29 and 30, respectively. Part API is contained in the drug in combination with other API. In the D01 group, only a small amount of API ‒ 7 is present in combination with other substances, and in group D02 ‒ 6, certain APIs are part of the combined drug. In preparations of D03 4 API are in combination. In group D06, 12 APIs are contained in combination drugs. Most of the established API groups D07 (13) are found in the drug in combination. In the D08 group, part of the API (8) is part of a combined drug. There is a combination of APIs antiseptic or antimicrobial activity, anti-inflammatory effect, local anesthetic and wound healing effect. According to the results of the calculation of the tension indices between the manufacturers of analogues of drugs in group D, the highest competition (Kvi ≥ 0.800) was observed in the groups D01 and D03 (for 4 drugs with Kvi ≥ 0.800), D06 (3 drugs), D07 (8 drugs), D08 (7 drugs). An analysis of the competitiveness of analogue manufacturers has shown that Ukrainian manufacturers are not sufficiently competing in the production of modern analogues of dermatological drugs.
Water is the most common compound of hydrogen and oxygen in the nature. It is a universal solvent of many substances, and therefore chemically pure water does not exist in the nature. The water contained in the body is qualitatively different from ordinary water as it is structured water. Such crystalline structures of water are the matrix of life. Their presence gives possibility of the occurrence of important biophysical processes and biochemical reactions. Insufficient intake of water into the body or its excessive loss leads to dehydration, which is accompanied by thickening of the blood and impairing hemodynamics. Excessive intake of water into the body causes water intoxication. Purpose – to conduct a bibliosemantic analysis of the sources of the literature on the medical and biological functions of water. Research methods – bibliosemantic, analytical, logical methods and generalizion method. Water is the structural basis of cells necessary to maintain their optimal volume. It determines the spatial structure and function of biomolecules. Insufficient intake of water into the body or its excessive loss leads to an impaired hemodynamics. Excessive intake of water into the body causes water intoxication. All disoders of water-salt balance in the body can be divided into two groups: dehydration and hyperhydration. In each group, there are disorders with a decrease, increase, and no change in osmotic pressure (hypotonic, hypertonic, and isotonic disorders, respectively). Water is used in medical and pharmaceutical practice as an excipient, and for the manufacture of allopathic, homeopathic and anthroposophic medicines. The State Pharmacopoeia of Ukraine includes several articles on the use of water depending on the purpose and regulates water quality: 1) highly purified water, water for injections «in bulk» water and sterilised water for injections; 2) purified water: water «in bulk» and water in containers. Cosmetics are presented on the Ukrainian market, the main biologically active compound of which is water, in particular, natural, thermal and micellar. They are widely used in cosmetology. The biomedical function of water in the body is to preserve cell volume, provide turgor to the cells and save the body from temperature fluctuations. Disruption of water-salt balance leads to dehydration or hyperhydration. There are changes with a decrease, increase, and no change in osmotic pressure (hypotonic, hypertonic, and isotonic disorders, respectively). They cause disruption of the life of the whole organism. In pharmaceutical practice, water is widely used for the manufacture of allopathic, homeopathic and anthroposophic medicines. It can be obtained in various ways, but its quality is regulated by the relevant government regulations. In cosmetic practice, water is used not only as a basic solvent, but in the form of natural, micellar and thermal water, where it is a biologically active compound.
According to statistics, 1.2 million Ukrainians suffer from diabetes, and 201626 people being registered and requiring insulin (PI). In Ukraine, a system of reimbursement is introduced, which provides for the dispatch of PI from pharmacies. Thus, in the process of providing patients with diabetes with insulin, pharmacies play a significant role and, accordingly, provide them with pharmaceutical assistance. Insulin is used to treat both type 1 and type 2 diabetes mellitus. Successful treatment requires confidence that the insulin will work properly. Improper storage can lead to a decrease in insulin activity, which will affect its ability to effectively and predictably control the patient's blood sugar. It is important to provide the patient with correct recommendations for storing insulin when dispensed from the pharmacy. The purpose of the work was to develop practical recommendations for pharmacy workers and patients with diabetes mellitus regarding the storage of PI. The objects of study were electronic and paper sources of information, Instructions for the use of PI. Content analysis and methods of bibliosemantic, marketing, generalization analyzes were applied. Marketing research of PIs whose names are subject to reimbursement on dispensing from pharmacies showed that the number of trade names is 33 names, and taking into account the dosage form – 71. In the bottles are represented 39.4% of drugs, in cartridges – 33.8% and in pre-filled syringes pens – 26.8%. PIs are supplied to the Ukrainian pharmaceutical market by domestic manufacturers, foreign companies and joint ventures. In this case, PIs in bottles are manufactured mainly by domestic manufacturers (16 preparations), cartridge forms – mainly by foreign companies (14 preparations), and pre-filled syringe pens – only by foreign companies (19 preparations). The joint ventures produce only 7 items in vials and cartridges. On the basis of the analysis of documents from different countries, the latest scientific researches and instructions for the use of PI, detailed recommendations have been developed, both for pharmacy workers and for patients with diabetes mellitus, for insulin storage. Attention is drawn to the high risk of exposure to temperature during storage and to the prevention of these risks. The recommendations are developed from the point of view of practical application. Separately formulated tips for storing insulin while traveling. The guidelines are designed to provide pharmaceutical assistance to patients with diabetes at an appropriate level with the release of PI. The issue of proper storage of PIs should be included in the undergraduate and postgraduate training of physicians, nurses, pharmacists and pharmacists. Government agencies should promote a coherent approach to the delivery of medical and pharmaceutical care through the development of national recommendations.
Мета: аналіз динаміки асортименту препаратів інсуліну (ПІ) в Україні, які підлягають відшкодуванню за системою реімбурсації (2016 - 2021 рр.) Розробити рекомендації провізорам для надання консультації пацієнтам при відпуску ПІ. Матеріали і методи дослідження. Наукові та офіційні джерела інформації щодо інсулінів. Застосовано бібліосемантичний, маркетинговий, аналітичний, графічний, узагальнюючий аналізи. Результати дослідження й обговорення. Маркетингове дослідження продемонстровало стабільний асортимент ПІ, які входять до програми реімбурсації в Україні. Порівняльний аналіз за період 2016 - 2021 рр. показав позитивну динаміку (підвищення на 9,2 %) найменувань ПІ за рахунок збільшення іноземних пропозицій. Сьогодні асортимент ПІ, які підлягають відшкодуванню включає 71 найменування, при цьому, включено іноваційні інсуліни, а кількість найменувань ПІ у шприц-ручках подвоєна. Опрацьовано інформацію для розробки рекомендацій при відпуску ПІ. Висновок. Дослідженення показало стабільність асортиментного забезпечення ПІ за програмою реімбурсації в Україні. З позицій практичного застосування розроблено рекомендації для аптечних працівників при наданні фармацевтичної допомоги хворим на цукровий діабет, які застосовують інсулін.
Military action is a global health problem. Disruption of health care and inadequate pharmaceutical provision can lead to serious complications and even death of the patient, making the population particularly vulnerable. Emergency care always focuses on injuries, infectious diseases and other acute conditions, and chronic diseases, including diabetes, have historically been a low priority. The aim of the work was to study the needs and problems of patients with diabetes, which arose during the martial law in the dynamics and to outline the main aspects of recommendations for improving the treatment of patients with diabetes in humanitarian crisis. Materials and methods. The analysis of the needs and problems of patients with diabetes was studied by a questionnaire (February‒May 2022). People with diabetes and members of their families took part in the study. Relevant official documents and international recommendations about providing diabetic care to the population during crisis situations are analyzed. Content analysis, bibliosemantic, analytical, generalizing analyzes were used. The studied needs and problems of patients with diabetes during martial law and their dynamics depending on time. Restrictions on medical care and rapid resumption of the pharmacy, which released, including insulin, have been established. The dynamics of actions on medical and pharmaceutical provision of patients with diabetes were analyzed, which showed that the health care system was not ready for martial law, but the Government took urgent appropriate actions on medical and pharmaceutical provision of patients with diabetes, which allowed to provide continuous treatment of patients with diabetes. The acute problem of not being able to supply the necessary drugs, including insulin, clean water, food to the occupied territories, creates a critical situation for the population in these regions, including those with diabetes, which can be fatal. Based on the elaboration of international documents, the main aspects of recommendations for improving the medical and pharmaceutical provision of patients with diabetes in emergencies are outlined.
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