We aim to identify possible biological, social, and economic factors that could influence the prevalence of foodborne botulism (FB). The objective of this article is to assess epidemiological peculiarities of FB in Ukraine from 1955 to 2018 using national epidemiological surveillance data. This article presents an epidemiological descriptive population-based study of the epidemiology of FB using correlation analysis. From 1955 to 2018, 8614 cases of botulism were recorded in Ukraine causing 659 deaths. The distribution of types of botulism toxins is represented by type A (7.97%), B (59.64%), suspected as C (0.56%), E (25.47%), others (5.33%), and unidentified (1.04%). From 1990 to 2015, the rate correlation between Human Development Index (HDI) and incidence of botulism was −0.75 ± 0.20. Homemade canned meat and fish continue to be the leading causes of botulism in Ukraine. Cases related to commercial food were rare or absent, but in recent years (2017–2018), their percentage has increased to 32.56%. The HDI and botulism have an inverse mathematical correlation and predictable logical relationship: with an HDI increase, the incidence of FB decreased. In general, food botulism in Ukraine is related to traditional socioeconomic factors related to cultural food habits. In the face of declining living standards and uncertainty that food products will be physically or economically available, homemade preservation increases. Home food preservation is a major cause of botulism in Ukraine. The elimination of FB is possible in Ukraine only with the complete cessation of home canning and state control over the manufacture and sale of commercial canned products.
Background Although anesthesiologists are one of the leaders in patient safety, anesthesia in low and low-middle income countries still need improvement in safety mesures with evidence-based practice application. The study aim was to audit the safety principles implementation in the Ukrainian anesthesiologist`s practice. Methods The study was held in March 2021-Februrary 2022 by filling out an online questionnarie. The link to the survey was distributed through Ukrainian Anesthesiologists Association (UAA) members emails and also published on UAA webpage and facebook page. The email was sent to 1000 UAA members. Results Summary 210 respondents took part in the study. Among the respondents, 79.1% of respondents are aware of the Helsinki Declaration on Patient Safety in Anesthesiology, but only 40,3% declared that the principles of this Declaration had been implemented in their medical institutions. Even though most of the respondents declared that the quality of the work has improved with the application of the Helsinki Declaration, 16% stated, that there is no positive impact. Most of the medical institutions include mandatory perioperative monitoring, while 17% of hospitals have no access to pulse oximetry for all patients in the operating room and intensive care unit. Concerning using clinical protocols, the one on the treatment of massive bleeding is used in 60.3% of cases, on infection control in 60.5%. In relation to checklists, 28.2% of respondents have never heard about the WHO Safe Surgery checklist. Checklists for equipment inspection are used in only 27.8% of medical institutions. 72.8% hospitals keep records of anaesthesia complications. Conclusion The study showed that significant positive steps are being taken to improve patient safety in Ukraine, where most hospitals comply with the minimum standarts of monitoring during anesthesia. Although there are many challenges for improvement, more hospitals need to implement WHO Safe Surgery and equipment checklists, protocols etc. These areas are a priority for further development in Ukraine. Trial registration Clinicaltrials.gov NCT05175976 on 04/01/2022.
The purpose of the study was to review modern recommendations regarding the monitoring of patients during procedural sedation and analgesia as well as to assess its conformity to the modern standards in Ukraine. Materials and methods. Recommendations from European, American, British and Australian organizations which cover the topic of procedural sedation and analgesia or levels of anesthesia that conform to the procedural sedation corresponding to ASA, the standard monitoring during anesthesia, and were published between 2003 and 2023 have been reviewed. From 17 till 20th of March a survey has been conducted. Throughout the survey, participants have anonymously filled a questionnaire via Google-Form. The link to the questionnaire was shared by the Department of Anesthesiology and Intensive Care of the Institute of Postgraduate Education of Bogomolets National University with support provided by Association of Anesthesiologists of Ukraine through social networks such as Facebook and Instagram on the official pages of the Department of Surgery, Anesthesiology, and Intensive Care of the Institute of Postgraduate Education of the Bogomolets National Medical University. Results. A total of 284 doctors took part in the survey. Among them 280 (98.5 %) have been working in Ukraine during the survey, 4 (1.5 %) have been excluded from the analysis. Pulse oximetry was regularly used by 278 (99.2 %), automatic arterial pressure measurement by 222 (79.4 %), manual measurement of arterial pressure by 35 (12.5 %), ECG-monitoring by 95 (34.2 %), capnography by 35 (12.5 %), thermometry by 10 (3.5 %), electroencephalography by 4 (1.6 %) of the doctors (Fig. 3). 36 (12.8 %) of the respondents have informed about the absence of technical means to conduct ECG-monitoring, 172 (62.5 %) have conducted it in a selective manner. The results are presented in form of descriptive statistics and diagrams. Conclusion. Procedural sedation is a safe method provided that modern safety standards are systematically followed. Full monitoring is a prerequisite for timely response to critical events and mitigation of their consequences. Reporting problems of any degree of criticality that occurred during sedation helps to optimize local practices and has a positive effect on the quality of medical care. Introduction of routine capnography, electrocardiography and thermometry are prioritized goals when it comes to increasing the quality of monitoring in Ukraine.
Hip fractures are a common pathology among patients older 50 years and cause disability, reduced duration and quality of life, even with adequate management and surgery. In the perioperative period, the most common complications leading to the death of patients are cardiovascular disease. about a hip fracture. The aim of our study was to determine the safest method of anesthesia in the context of acute myocardial injury during hip fracture surgery. The objectives of the study were to determine the frequency of postoperative myocardial damage in patients with hip fractures; compare the frequency of MINS with different types of anesthesia: general anesthesia (GA), spinal anesthesia (SA) and compartment psoas block with sciatic nerve block. Materials and methods. Randomized controlled trial was conducted from January 2018 to August 2019 in the medical center “Into-Sana” (Odessa, Ukraine). Patients with planned osteosynthesis of the proximal femur were randomized into 3 groups depending on the method of anesthesia: general anesthesia and postoperative systemic analgesia, spinal anesthesia and postoperative systemic analgesia, prolonged compartment psoas block with sciatic nerve block. Results. The study involved 90 patients. Acute postoperative myocardial injury was diagnosed in 17.6 % of cases. Postoperative elevation of troponins was significantly more often diagnosed in groups of patients with spinal anesthesia and general anesthesia compared to the group in which the psoas block compartment was used in combination with the sciatic nerve block. None of the patients had symptoms of myocardial ischemia and were not diagnosed with myocardial infarction. Hypotension was significantly more common in group 2 spinal anesthesia (OR 9 95 % CI 1.9-47, p=0.004) There was a direct moderate association between the intraoperative hypotension and the development of postoperative myocardial injury (r = 0.5). Conclusions. Prolonged compartment psoas block with sciatic nerve block intraoperatively is the safest method of anesthesia in the context of the development of postoperative myocardial injury. Intraoperative hypotension is associated with postoperative myocardial injury
Patient safety in the operative and perioperative period is critically important. The consequences of anesthesia complications have a significant impact on long-term surgical outcomes, quality of life of patients, morbidity and mortality. The purpose of the study was to assess the implementation of the components of the Helsinki Declaration in the practice of Ukrainian hospitals. Materials and methods. The survey was conducted in March-June 2021 by filling out a standard Google form. The link to the survey was distributed on the official page of the Association of Anesthesiologists of Ukraine, through social networks Facebook and Instagram on the official pages of the Department of Surgery, Anesthesiology and Intensive Care of the Institute of Postgraduate Education of the Bogomolets National Medical University. A total of 174 respondents took part in the survey. According to the results, 79.3% of respondents are aware of the Helsinki Declaration on Patient Safety in Anesthesiology. Among the respondents, only 43% stated that the principles of the Helsinki Declaration had been implemented in their medical institutions, and 20.9% about plans to implement the principles in the near future. At the same time, in 36% of medical institutions the principles of the declaration are not used and their implementation is not planned. The Safe Surgery checklist is always used by 18.7% of respondents, sometimes by 18.7%, and 29.2% of respondents have never about a checklist. Only 47% of doctors have an airway table in the operating room, and only 30% document the inspection of equipment before anesthesia. Most physicians noted that they used protocols in their practice, but 10% said they mostly did not. Regarding the report of complications, only 46% of hospitals have a separate form (journal), most doctors only inform the head of complications orally. Measures to improve patient safety in medical institutions in 2012-2014 were implemented by 24.1% of respondents, in 2015-2017 by 19.1%, in 2018 – 10.6%, in 2019-2020 – 10,2% of respondents. Most of the respondents stated that the quality of the department’s work has improved and the level of patient safety has improved after the application of these principles in their work. The study showed that while significant positive steps are being taken to improve patient safety, there are still many challenges and opportunities for improvement.
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