Background The incidence of the highly morbid and potentially lethal gangrenous cholecystitis was reportedly increased during the COVID-19 pandemic. The aim of the ChoCO-W study was to compare the clinical findings and outcomes of acute cholecystitis in patients who had COVID-19 disease with those who did not. Methods Data were prospectively collected over 6 months (October 1, 2020, to April 30, 2021) with 1-month follow-up. In October 2020, Delta variant of SARS CoV-2 was isolated for the first time. Demographic and clinical data were analyzed and reported according to the STROBE guidelines. Baseline characteristics and clinical outcomes of patients who had COVID-19 were compared with those who did not. Results A total of 2893 patients, from 42 countries, 218 centers, involved, with a median age of 61.3 (SD: 17.39) years were prospectively enrolled in this study; 1481 (51%) patients were males. One hundred and eighty (6.9%) patients were COVID-19 positive, while 2412 (93.1%) were negative. Concomitant preexisting diseases including cardiovascular diseases (p < 0.0001), diabetes (p < 0.0001), and severe chronic obstructive airway disease (p = 0.005) were significantly more frequent in the COVID-19 group. Markers of sepsis severity including ARDS (p < 0.0001), PIPAS score (p < 0.0001), WSES sepsis score (p < 0.0001), qSOFA (p < 0.0001), and Tokyo classification of severity of acute cholecystitis (p < 0.0001) were significantly higher in the COVID-19 group. The COVID-19 group had significantly higher postoperative complications (32.2% compared with 11.7%, p < 0.0001), longer mean hospital stay (13.21 compared with 6.51 days, p < 0.0001), and mortality rate (13.4% compared with 1.7%, p < 0.0001). The incidence of gangrenous cholecystitis was doubled in the COVID-19 group (40.7% compared with 22.3%). The mean wall thickness of the gallbladder was significantly higher in the COVID-19 group [6.32 (SD: 2.44) mm compared with 5.4 (SD: 3.45) mm; p < 0.0001]. Conclusions The incidence of gangrenous cholecystitis is higher in COVID patients compared with non-COVID patients admitted to the emergency department with acute cholecystitis. Gangrenous cholecystitis in COVID patients is associated with high-grade Clavien-Dindo postoperative complications, longer hospital stay and higher mortality rate. The open cholecystectomy rate is higher in COVID compared with non -COVID patients. It is recommended to delay the surgical treatment in COVID patients, when it is possible, to decrease morbidity and mortality rates. COVID-19 infection and gangrenous cholecystistis are not absolute contraindications to perform laparoscopic cholecystectomy, in a case by case evaluation, in expert hands. Graphical abstract

Investigation of phagocytic activity and cytokine production by monocytes and neutrophils has been carried out in 35 patients with chronic fatigue syndrome. Chronic fatigue syndrome is associated with a decrease of phagocytic activity and phagocytic index and at increase of the production of IL-1, IL-6, IL-8, tumor necrosis factor alpha and interferon alpha.

The aim of the study – to investigate the taxonomic composition, qualitativemicroecological indicators (index of constancy, frequency of occurrence, indices of speciesrichness of Margalef, species diversity of Whittaker and species dominance of Simpsonand Berger-Parker) and the immunosuppressive effect of causative agents of calculouspyelonephritis on the activity of the complement system, lysozyme and inhibition of themain immunoglobulin classes (IgM, IgA).Material and methods. Microbiological (bacteriological and mycological) urineexamination was carried out in 30 men aged 37-65 years (48.81 ± 4.27 years), patientswith calculous pyelonephritis. The ecological method was used to reveal the mechanismsof colonization of the biotope by microbiota. The adhesive properties were studied onnative human erythrocytes of group I (0I). Anti-immunoglobulin activity was studied bythe method described in the work of I.S. Gaidash, etc.Results. Out of 30 samples of the research material, 34 strains of opportunistic gramnegative and gram-positive bacteria were isolated and identifed. The majority (86.67%)had a monoculture of enterobacteria, enterococci, associations consisting of two taxonswere found in 13.33% of patients. It has been shown that 97.06% of isolated and identifedstrains from the urinary tract exhibit adhesive activity of varying degrees of activity. Onestrain of S. saprophyticus also exhibits adhesive activity (the average adhesion index is1.83 ± 0.09), which is considered as a non-adhesive strain. All strains of enterobacteriaand gram-positive cocci that persist on the mucous membrane of the urinary tract ofmen with infectious and inflammatory processes of the urinary tract with calculouspyelonephritis inhibit (P <0.05) immunoglobulins of class A (IgA).Conclusions. The infectious and inflammatory process on the mucous membranes of theurinary tract in men with calculous pyelonephritis is caused by facultative anaerobicgram-negative enterobacteria and gram-positive cocci. The presence of an infectious andinflammatory process is confrmed by an acceleration of the erythrocyte sedimentationrate by 76.67% and other clinical and laboratory studies. Pathogenicity factors arerevealed in isolated and identifed opportunistic taxons, that determine the initial stagesof the infectious and inflammatory process (cytoadhesion and colonization of the urinarytract mucosa), inhibit the functional activity of class A and M of immunoglobulins.

The article presents results of microbiological examination of 72 samples of colon contents of patients with chronic hepatitis C (control group is consisted of 87 samples of colon contents of the healthy people) and studied ecological changes in taxonomic composition of the investigated biotope. It has been established that patients with chronic hepatitis C form a tendency to elimination of Bifidobacteria and Lactobacilli from colon cavity (decrease in the index of constancy on 9.94 % and frequency of occurrence on 57.14 %), as well as Eubacteria (on 3,88 % and by 2 times, respectively) and an increase in the persistence of Peptostreptococci, Clostridia, Proteus, Staphylococci and yeast-like fungi of the genus Candida, which creates conditions for contamination and persistence in the investigated biotope of pathogenic and conditionally pathogenic Enterobacteria (EPEC, E. coli Hly+, E. coli Lac-, Cytrobacter, Enterobacter, Serratia), Peptococcus.

Мета роботи-визначити популяційний рівень головної мікробіоти та дріжджоподібних грибів роду Candida у практично здорових жінок і в жінок, які хворі на вульвовагінальний кандидоз. Матеріали та методи. Протягом 10 років обстежили 270 жінок, які хворі на вульвовагінальний кандидоз, репродуктивного віку від 19 до 34 років і 73 практично здорових жінки. Визначали популяційний рівень головної мікробіоти та дріжджоподібних грибів роду Candida у вульвовагінальному вмісті. Виділення дріжджоподібних грибів роду Candida здійснювали шляхом посіву вульвовагінального вмісту на тверде живильне середовище Сабуро та на середовище Сабуро з додаванням циклогексиміду, надалі з чистою культурою проводили «проростковий тест», ідентифікацію до виду зі встановленням у кожному індивідуальному випадку популяційного рівня. Результати. За аналітичними показниками мікробіоценозу визначили співіснування представників екосистеми «макроорганізм-мікробіота» та порівняли зміни мікроекології вульвовагінального вмісту у практично здорових жінок і в жінок, які хворі на вульвовагінальний кандидоз. Вивчаючи популяційний рівень дріжджоподібних грибів роду Candida у вульвовагінальному вмісті жінок, які хворі на вульвовагінальний кандидоз, виявили, що домінуючим видом є C. albicans, популяційний рівень якого відрізняється від інших видів, а саме: