Shupyk National Medical Academy of Postgraduate Education

Kiev, Ukraine

Shupyk National Medical Academy of Postgraduate Education

Kiev, Ukraine
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Berezhnoi V.V.,Shupyk National Medical Academy of Postgraduate Education | Heger M.,ISO Pharmaceuticals | Lehmacher W.,University of Cologne | Seifert G.,Charité - Medical University of Berlin
Journal of Comprehensive Pediatrics | Year: 2016

Background: Acute tonsillopharyngitis isamongstthemostcommonreasons for children, adolescentsandyoungadults to consult with a physician. Despite extensive prescription, antibiotic therapy is indicated in less than one-fifth of these cases. New treatment strategies for patients with non-group-A-streptococcal acute tonsillopharyngitis are therefore required. Objectives: EPs 7630 is an extract from the roots of Pelargonium sidoidesDC. After positive clinical study results in children with acute bronchitis, the present study was conducted to demonstrate the efficacy of EPs 7630 in the treatment of acute tonsillopharyngitis in children. Methods: In this double-blind placebo-controlled clinical trial with a group sequential design, the efficacy and tolerability of EPs 7630 were investigated in 6- to 10-year-old patients with acute tonsillopharyngitis, who showed no evidence of group A βhemolytic streptococcus. Treatment duration was 6 days. Primary efficacy variable was change in the sum score of the tonsillitis severity score (TSS) on day 4 compared to baseline. Results: Overall, data on the change of the TSS measured for the EPs 7630 and placebo group were available for 60 and 64 children, respectively. After 4 days of treatment, the TSS had decreased from 9.6±1.2 to 2.8±2.6 points in the active medication group and from 9.5±1.3 to 6.1±4.1 points in the placebo group (P < 0.001), indicating superiority of EPs 7630 over placebo. Conclusions: EPs 7630 was found to be efficacious in the treatment of acute tonsillopharyngitis in children and was very well tolerated. © 2016, Iranian Society of Pediatrics.

PubMed | Perinatal Prevention of AIDS Initiative, Shupyk National Medical Academy of Postgraduate Education and University College London
Type: Journal Article | Journal: BMC infectious diseases | Year: 2016

Ukraines injecting drug use-driven HIV epidemic is among the most severe in Europe with high burden of HCV co-infection. HIV/HCV co-infected individuals are at elevated risk of HCV-related morbidity, but little is known about burden of liver disease and associated factors in the HIV-positive population in Ukraine, particularly among women.Characteristics of 2050 HIV-positive women enrolled into the Ukrainian Study of HIV-infected Childbearing Women were described by HCV serostatus. Aspartate transaminase (AST) to platelet ratio (APRI) and FIB-4 scores were calculated and exact logistic regression models fitted to investigate factors associated with significant fibrosis (APRI >1.5) among 762 women with an APRI score available.Of 2050 HIV-positive women (median age 27.7years, IQR 24.6-31.3), 33% were HCV co-infected (79% of those with a history of injecting drug use vs 23% without) and 17% HBsAg positive. A quarter were on antiretroviral therapy at postnatal cohort enrolment. 1% of the HIV/HCV co-infected group had ever received treatment for HCV. Overall, 24% had an alanine aminotransferase level >41 U/L and 34% an elevated AST (53% and 61% among HIV/HCV co-infected). Prevalence of significant fibrosis was 4.5%; 2.5% among 445 HIV mono-infected and 12.3% among 171 HIV/HCV co-infected women. 1.2% had a FIB-4 score >3.25 indicating advanced fibrosis. HCV RNA testing in a sub-group of 56 HIV/HCV co-infected women indicated a likely spontaneous clearance rate of 18% and predominance of HCV genotype 1, with one-third having genotype 3 infection. Factors associated with significant fibrosis were HCV co-infection (AOR 2.53 95%CI 1.03-6.23), history of injecting drug use (AOR 3.51 95%CI 1.39-8.89), WHO stage 3-4 HIV disease (AOR 3.47 95%CI 1.51-7.99 vs stage 1-2 HIV disease) and not being on combination antiretroviral therapy (AOR 3.08 95%CI 1.23-7.74), adjusted additionally for HBV co-infection, smoking and age.Most HIV/HCV co-infected women had elevated liver enzymes and 12% had significant fibrosis according to APRI. Risk factors for liver fibrosis in this young HIV-positive population include poorly controlled HIV and high burden of HCV. Results highlight the importance of addressing modifiable risk factors and rolling out HCV treatment to improve the health outcomes of this group.

PubMed | Hospital Santa Marta, Hospital Universitario La Paz, European Society of Cardiology, University of Banja Luka and 15 more.
Type: | Journal: European journal of preventive cardiology | Year: 2016

European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) IV in primary care was a cross-sectional survey carried out by the European Society of Cardiology, EURObservational Research Programme in 2014-2015 in 71 centres from 14 European countries. The main objective was to determine whether the 2012 Joint European Societies guidelines on cardiovascular disease (CVD) prevention in people at high CVD risk have been followed in clinical practice.Patients without a history of atherosclerotic disease started on either blood pressure and/or lipid and/or glucose-lowering treatments were identified and interviewed at least six months after the start of medication.Medical notes of 6700 patients were reviewed, and 4579 patients (58.7% women; mean age 58.8 (standard deviation (SD) 11.3) years) interviewed (interview rate 68.3%). Overall, 16.6% were smokers, 39.9% were overweight (body mass index (BMI)25 and <30kg/mThe EUROASPIRE IV survey shows that large proportions of patients at high CVD risk have unhealthy lifestyle habits and uncontrolled blood pressure, lipids and diabetes. The present data make it clear that more efforts must be taken to improve cardiovascular prevention in people at high CVD risk.

Khalangot M.,Shupyk National Medical Academy of Postgraduate education | Khalangot M.,Komisarenko Institute of Endocrinology and Metabolism | Kovtun V.,Komisarenko Institute of Endocrinology and Metabolism
Current Diabetes Reviews | Year: 2014

Background: Retrospective evaluations of mortality risks in cohorts of patients with type 2 diabetes (T2D), receiving oral glucose-lowering drugs (OGLDs) gave conclusions about association between certain OGLDs and mortality that do not exactly agree with each other. Different approaches were used: recording the outcomes depending on the first prescription, later changes were ignored or receiving one of OGLDs according to data of last documented visit before the end of observation period; without change of OGLD during the whole observation; treatment intervals - period from onset of treatment to onset of the next drug treatment, or until outcome. Impact of each study approach was not evaluated yet. We conducted such comparative analysis using the database of Ukrainian Diabetes Register. Methods: All-cause mortality in retrospective cohorts of 36 449 type 2 diabetes patients treated with glibenclamide, gliclazide or metformin monotherapy all of which were included at least in one of evaluation models: “first prescription” - 2 862 /257, “last prescription” - 34 818 / 4 224; “unchanged” - 8 786/680 and “treatment intervals” - 13 546/3 142 T2D patients / death cases respectively, were evaluated using Cox regression with gender, age, and diabetes duration adjusting. We compared the mortality risk (Hazard ratios -HRs) associated with Gliclazide or Metformin versus Glibenclamide monotherapy. Results: Gliclazide or metformin-treated patients demonstrated lesser mortality risk than glibenclamide-treated ones in all four evaluation models, but age and duration stratification can influence this phenomenon in case of “first prescription model”. In case of “without change OGLD” model the increase of mortality risk in glibenclamide-treated group is the most evident when comparing to gliclazide-treated, rather than to metformin-treated one. When comparing gliclazide vs metformin mortality risk for this model, gliclazide-treated patients demonstrated lesser mortality risk than metformintreated ones: gender, age and diabetes duration adjusting HR = 0.51 (0.35-0.72), p<0.001. Conclusion: Different approaches used for mortality analysis in observation studies of T2D patients can present discrepant results. © 2014 Bentham Science Publishers.

PubMed | Bogomolets National Medical University, Shupyk National Medical Academy of Postgraduate Education and Komisarenko Institute of Endocrinology and Metabolism
Type: | Journal: Diabetology & metabolic syndrome | Year: 2016

Whereas an increase of neck circumference (NC) had been recently identified as a new independent cardiovascular disease (CVD) and metabolic syndrome risk factor, similar assessments concerning screen-detected diabetes mellitus (SDDM) have not been made. Thyroid gland volume (ThV) can potentially affect NC however the significance of this influence concerning the risk of NC-related disease is unknown.We performed a ThV-adjusted evaluation of NC within a population-based investigation of SDDM and impaired glucose regulation (IGR) prevalence. This study contains fasting plasma glucose (FPG) and 75g 2-h glucose tolerance test results (2-hPG) of 196 residents of Kyiv region, Ukraine, randomly selected from the rural population older than 44 y.o. who were not registered as diabetes mellitus patients. Standard anthropometric (height; weight; blood pressure; waist, hip circumferences), NC and ultrasonography ThV measurements were performed, hypotensive medication, CVD events and early life nutrition history considered. HbA1c was measured, if FPG/2-hPG reached 7.0/11.1mmol/l respectively; HbA1c level 6.5% was considered to be SDDM diagnostic; IGR if FPG/2-hPG reached 6.1/7.8 but less than 7.0/11.1mmol/l respectively.Neck circumference among women with normal FPG/2-hPG was 35 (33-36)cm, IGR 36 (34.5-38)cm, SDDM HbA1c<6.5% 42 (40-43)cm, HbA1c>6.5% 42.5 (40-44)cm, p<0.001, and for men from the same groups 38.5 (36.5-41.5)cm; 39 (37-42)cm; 42 (40-43)cm; 42.5 (40-44)cm, p=0.063; medians (QI-QIII). Gender-adjusted logistic regression OR for SDDM HbA1c>6.5% vs. normal FPG/2-hPG category depending of NC as a continued variable, equaled to 1.60 (95% CI 1.27-2.02) per cm. Additional adjusting by ThV, body mass or waist/hip index, high blood pressure, acute CVD events, or starvation history did not significantly influence this risk.Neck circumference is a new risk factor of SDDM that is independent from other indicators of adipose tissue distribution as well as from the ThV.

Bagkeris E.,University College London | Malyuta R.,Perinatal Prevention of AIDS Initiative | Volokha A.,Shupyk National Medical Academy of Postgraduate Education | Cortina-Borja M.,University College London | And 3 more authors.
The Lancet HIV | Year: 2015

Background Women living with HIV are potentially at increased risk of adverse pregnancy outcomes, due to a range of factors, including immunosuppression, use of combination antiretroviral therapy (ART), and injecting drug use. Rates of mother-to-child transmission of HIV in Ukraine have declined to around 2-4%, but little is known about other pregnancy outcomes in this setting. We used data from an observational prospective cohort study to assess pregnancy outcomes among HIV-positive women in Ukraine. Methods The European Collaborative Study (ECS) in EuroCoord is a continuing cohort study, established in Ukraine in 2000. Eligible women are those with a diagnosis of HIV infection before or during pregnancy (including intrapartum) who deliver liveborn babies at seven sites. Maternal sociodemographic, HIV-related, and delivery (mother and infant) data were collected with study-specifi c questionnaires. We used Poisson regression models to identify factors associated with preterm delivery (before 37 weeks' gestation) and small weight for gestational age (less than the tenth percentile of weight for gestational age), based on complete cases. Findings Between January, 2000, and July, 2012, data were collected on 8884 HIV-positive mother and liveborn infant pairs. Median maternal age was 26·5 years (IQR 23·1-30·3). 832 (11%) women had WHO stage 3 or 4 HIV and 1474 (17%) had a history of injecting drug use. 7348 (83%) had received antenatal ART. Among 7435 for whom ART type was available, 4396 (50%) had received zidovudine monotherapy and 2949 (33%) combination ART. Preterm delivery was seen in 780 (9%, 95% CI 8-9) of 8860 births overall and in 77 (9%, 7-11) of 889 babies with small size for gestational age. Factors associated with preterm delivery were history of injecting drug use (adjusted risk ratio 1·64, 95% CI 1·38-1·95), no ART (2·94, 2·43-3·57 vs zidovudine monotherapy), antenatal combination ART (1·40, 1·14-1·73 vs zidovudine monotherapy), WHO stage 4 HIV (2·42, 1·71-3·41 vs WHO stage 1), and being in the most socially deprived group (1·38, 1·11-1·71). Small size for gestational age was associated with history of injecting drug use (adjusted RR 1·39, 95% CI 1·16-1·65), most socially deprived (1·32, 1·09-1·61), no ART (1·60, 1·32-1·94 vs zidovudine monotherapy), and antenatal combination ART (1·33, 1·12-1·60 vs zidovudine monotherapy). Interpretation Some risk factors for adverse pregnancy outcomes were directly associated with HIV and treatment and others were shared with the general antenatal population. Monitoring of pregnancy outcomes in Ukraine will be important as use of antenatal combination ART increases. Funding European Union Seventh Framework Programme, Wellcome Trust.

PubMed | Perinatal Prevention of AIDS Initiative, Shupyk National Medical Academy of Postgraduate Education, University of Bern and University College London
Type: | Journal: BMC pregnancy and childbirth | Year: 2016

Over 3500 HIV-positive women give birth annually in Ukraine, a setting with high prevalence of sexually transmitted infections. Herpes simplex virus Type 2 (HSV-2) co-infection may increase HIV mother-to-child transmission (MTCT) risk. We explored factors associated with HSV-2 seropositivity among HIV-positive women in Ukraine, and its impact on HIV MTCT.Data on 1513 HIV-positive women enrolled in the Ukraine European Collaborative Study from 2007 to 2012 were analysed. Poisson and logistic regression models respectively were fit to investigate factors associated with HSV-2 seropositivity and HIV MTCT.Median maternal age was 27 years (IQR 24-31), 53% (796/1513) had been diagnosed with HIV during their most recent pregnancy and 20% had a history of injecting drugs. Median antenatal CD4 count was 430 cells/mm(3) (IQR 290-580). Ninety-six percent had received antiretroviral therapy antenatally. HSV-2 seroprevalence was 68% (1026/1513). In adjusted analyses, factors associated with HSV-2 antibodies were history of pregnancy termination (APR 1.30 (95% CI 1.18-1.43) for 2 vs. 0), having an HIV-positive partner (APR 1.15 (95% CI 1.05-1.26) vs partners HIV status unknown) and HCV seropositivity (APR 1.23 (95 % CI 1.13-1.35)). The overall HIV MTCT rate was 2.80% (95% CI 1.98-3.84); no increased HIV MTCT risk was detected among HSV-2 seropositive women after adjusting for known risk factors (AOR 1.43 (95% CI 0.54-3.77).No increased risk of HIV MTCT was detected among the 68% of HIV-positive women with antibodies to HSV-2, in this population with an overall HIV MTCT rate of 2.8%. Markers of ongoing sexual risk among HIV-positive HSV-2 seronegative women indicate the importance of interventions to prevent primary HSV-2 infection during pregnancy in this high-risk group.

PubMed | Perinatal Prevention of AIDS Initiative, Shupyk National Medical Academy of Postgraduate Education and University College London
Type: Journal Article | Journal: AIDS and behavior | Year: 2016

Ukraine has one of the largest populations of persons living with HIV in Europe. Data on 2019 HIV-positive married or cohabiting women enrolled in a postnatal cohort from 2007 to 2012 were analysed to investigate prevalence and factors associated with self-reported non-disclosure of HIV status. Median age at enrolment was 27.5 years, with two-thirds diagnosed during their most recent pregnancy. Almost all had received antenatal antiretroviral therapy and 24 % were taking it currently. One-tenth (n = 198) had not disclosed their HIV status to their partner and 1 in 20 (n = 93) had disclosed to no-one. Factors associated with non-disclosure were: unmarried status (AOR 2.99 (95 % CI 1.51-5.92), younger age at leaving full-time education (AOR 0.41 (95 % CI 0.19-0.88) for 19 years vs 16 years) and lack of knowledge of partners HIV status (AOR 2.01 (95 % CI 1.09-3.66). Further work is needed to support disclosure in some groups and to explore relationships between disclosure and psychological factors in this setting, including depression, lack of support and perception of stigma.

Kozovyi R.V.,Ivano Frankivsk National Medical University | Podolska S.V.,Shupyk National Medical Academy of Postgraduate Education | Gorovenko N.G.,Shupyk National Medical Academy of Postgraduate Education
Advances in Gerontology | Year: 2014

Polymorphism of genes of Phase II of xenobiotic biotransformation was studied in 166 long-lived people and in 169 control subjects who live in the Ivano-Frankivsk region. The frequency of the functionally inactive allele of the GSTT1 gene among the long-lived people was 24.70% and in the control group it was 20.12%. The frequency of the functionally inactive allele of GSTM1 in the long-lived people was 46.99 and in the control group it was 54.44%. The area of residence of the subjects was divided into zones with regard to environmental factors: environmentally comfortable, under moderate environmental load, and environmentally uncomfortable. Analysis of the combinations of alleles of glutathione-S-transferase genes revealed an elevated frequency of the GSTM1+/GSTT1+ allele combination in the long-lived people of the uncomfortable zone in comparison to the control group of the same zone: 54.55 and 35.09%, respectively (χ2 = 4.29; OR = 2.22 (1.04-4.75)). The GSTM1-/GSTT1+ combination was significantly more frequent in the control group than in the long-lived people: 21.82 and 43.86%, respectively (χ2 = 6.15; OR = 0.36 (0.16-0.82)). Significant differences were detected between the frequencies of combinations GSTM1+/GSTT1+, GSTM1+/GSTT1-, GSTM1-/GSTT1+, and GSTM1-/GSTT1- in long-lived people of the environmentally comfortable and uncomfortable zones: χ2 = 6.44, OR = 0.36 (0.16-0.80); χ2 = 4.86, OR = 4.89 (1.28-18.72); χ2 = 5.89, OR = 2.82 (1.20-6.58); χ2 = 3.90; OR = 0.19 (0.16-6.58), respectively. © 2014 Pleiades Publishing, Ltd.

PubMed | Ukrainian Academy of Sciences and Shupyk National Medical Academy of Postgraduate Education
Type: Journal Article | Journal: Chemical biology & drug design | Year: 2016

Predictive QSAR models for the inhibitors of B. subtilis and Ps. aeruginosa among imidazolium-based ionic liquids were developed using literary data. The regression QSAR models were created through Artificial Neural Network and k-nearest neighbor procedures. The classification QSAR models were constructed using WEKA-RF (random forest) method. The predictive ability of the models was tested by fivefold cross-validation; giving q(2) = 0.77-0.92 for regression models and accuracy 83-88% for classification models. Twenty synthesized samples of 1,3-dialkylimidazolium ionic liquids with predictive value of activity level of antimicrobial potential were evaluated. For all asymmetric 1,3-dialkylimidazolium ionic liquids, only compounds containing at least one radical with alkyl chain length of 12 carbon atoms showed high antibacterial activity. However, the activity of symmetric 1,3-dialkylimidazolium salts was found to have opposite relationship with the length of aliphatic radical being maximum for compounds based on 1,3-dioctylimidazolium cation. The obtained experimental results suggested that the application of classification QSAR models is more accurate for the prediction of activity of new imidazolium-based ILs as potential antibacterials.

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