Acute Viral Diseases Research Articles

POSSIBLE HEALTH CONSEQUENCES FOR NEWBORNS FROM MOTHERS WHO SUFFERED COVID-19 DURING PREGNANCY

According to the WHO statement dated March 11, 2020, the coronavirus infection SARS-CoV-2 has reached the scale of a pandemic and is currently a world health problem. A special group of the population that requires increased attention is pregnant women due to the fact that pneumonia occupies the third place in the structure of indirect causes of maternal mortality. Pregnant women whose immune system has changed appeared to be at an increased risk of infection. Pregnancy is a risk factor for the development of a more severe course of acute respiratory viral diseases and influenza. To date, the issue of intrauterine transmission of coronavirus disease remains completely unexplored, which causes fear among pregnant women for the future generation. Addition of a new coronavirus infection SARS-CoV-2 has a negative impact on pregnancy, childbirth and the postpartum period, the health of newborns, especially in patients with a burdened obstetric history. Pregnancy itself and childbirth do not affect the course of COVID-19, but the infection addition can complicate the course of gestation, causing respiratory distress syndrome, premature birth and spontaneous miscarriages, congenital pneumonia and antenatal death of newborns born from covid-positive mothers. The literature published from December 1, 2019 to July 30, 2021 was searched in several databases, including PubMed, Web of Science, Google Scholar and the WHO COVID-19 database, of which 52 articles were selected for detailed consideration. The relevant literature was searched to understand the issues of infection transmission to newborns from infected mothers and the clinical manifestations of the disease in the former. As a result, it was found that newborns can become infected with SARS-Cov-2 in close contact with infected patients or asymptomatic virus carriers. However, based on the data of modern literature, it is impossible to unequivocally answer the questions posed, more facts are needed to solve the problem. The practical significance of the work is that the results of the study should be used for further studying the consequences of COVID-19 for the health of newborn children.

Rational mucolytic therapy in respiratory diseases: clinical interpretation of pharmacological properties for informed choice

Respiratory diseases remain a common group of diseases in the practice of general physicians and pulmonologists. Currently, there are various treatment protocols for patients with respiratory diseases, where one of the pharmacological groups is mucolytic drugs. They affect the physical and chemical properties of sputum by splitting complex mucins, which leads to its liquefaction. Indications for use of drugs of this group are clinical conditions, in which there is a cough with thick, viscous, difficult to detach sputum. The article discusses the possibility of treating several respiratory diseases with mucolytic therapy, provides a comparative characteristic of drugs of this pharmacological group. The clinical and pharmacological effects of erdosteine are discussed in detail: mucolytic, antioxidant, anti-inflammatory, immunomodulatory. These properties of the drug are extremely important in clinical practice conditions, because in addition to the mucolytic properties themselves, the patient has many adverse processes due to inflammation. All this is associated with additional damaging factors regarding the tissues and may also indicate an increased risk of complications. Thus, the multipurpose effects of the mucolytic erdosteine in various respiratory tract diseases are presented. In addition to acute respiratory viral diseases, the clinical experience of using erdosteine in chronic obstructive pulmonary disease is discussed in detail. The most important indicator to assess the effectiveness of drugs used in this disease is the reduction in the number of exacerbations per year and the severity of the course of the exacerbation. The conclusions, which are given according to the results of a number of studies, determine significant advantages in the use of erdosteine as mucolytic therapy.

THE RESULTS OF THE USE OF BIOTECHNOLOGICAL DRUGS IN VETERINARY MEDICINE, PROMISING FOR MEDICINE (PART 1)

Cell and serum nucleases are considered as a natural biological barrier, one of the first links in the body’s antiviral defense: nucleases act on viruses that the usual immunological barrier cannot resist. Inactivation of the enzymatic properties of nucleases also leads to the loss of their antiviral activity. It was found that the nucleases do not inactivate the native virus outside the cell and act mainly on the virus that multiplies in the cells. There is a direct dependence of the antiviral activity of endonuclease on the concentration of the enzyme in the medium. The first antiviral drug created on the basis of the Serratia marcescens endonuclease was called bacterial endonuclease. Its technology was developed by joint research of NIKTI BAS of the Ministry of Medical Industry (Berdsk, Novosibirsk region) and ICIG SB of the USSR Academy of Sciences in 1973–1984. Serratia marcescens endonuclease is capable of cleaving the nucleic acids of both RNA and DNA-containing viruses. The enzyme inhibits the reproduction of vesicular stomatitis and smallpox vaccine viruses in chicken fibroblast cell culture, respectively. It was the first antiviral drug in the history of beekeeping, designed to prevent acute and chronic paralysis and other viral diseases of bees. The drug was also intended as an antiviral agent for a wide range of diseases in various organisms. The effectiveness of bacterial endonuclease as a means of prevention and treatment of respiratory viral diseases in calves was studied. The research was carried out at the industrial complex for growing heifers of the Gosnensky state farm in the Leningrad region on calves of a black-and-white breed of 20–60 days old. For the experiments, we used bacterial endonuclease produced by the Vyshnevolotsky Plant of Enzyme Preparations or NICTI BAS of the Ministry of Medical Industry. In the future, NIKTI BAV together with Diafarm LLC developed a second – generation antiviral drug, endoglucin, based on bacterial endonucleosis. Production experiments to study its effect as a therapeutic and prophylactic agent for respiratory diseases of calves were conducted during 2007– 2011. in the agricultural complex «Prichulymsky» of the Achinsky district of the Krasnoyarsk Territory with the participation of the Department of Epizootology and Parasitology of the Faculty of Veterinary Medicine of KrasGAU and in CJSC «Suzdalskoye» of the Dovolensky district of the Novosibirsk region. Prophylactic use of endoglucin in calves with bronchopneumonia can reduce the incidence from 2.2 to 3.1 times. The drug endoglucin in combination with drugs indicated for the treatment of pulmonary pathology, has therapeutic effectiveness in bronchopneumonia of calves.

TREATMENT OF ODONTOGENIC INFLAMMATORY DISEASES IN FREQUENTLY ILL CHILDREN

Epidemiological studies indicate that, on average, every child suffers from 3 to 5 episodes of acute respiratory viral infectious diseases (ARVI) per year. The greatest incidence of acute respiratory infections is observed in young children, preschoolers and primary school children. Children of the first 3 years of life get SARS within a year 2-2. 5 times more often than children aged 10 years and older. Recurrent respiratory infections lead to violations of the functional state of the body, can cause a breakdown of adaptation and cause the development of chronic pathology [Klyuchnikov S. O. with savt., 2017].

PATTERNS IN WOUND HEALING PROCESS AFTER BRANCIAL CLEFT CYST EXCISION IN CHILDREN

The course of the wound healing process after surgical intervention on brancial cleft cyst excision should be considered as a stereotyped inflammatory-reparative reaction of the body, characterized by staged aseptic inflammation, regeneration and fibrosis. Clinically and even morphologically, it is difficult to determine the stages of the wound healing process in the temporal aspect, since they are consistent and interconnected.
 Purpose. The paper is aimed at evaluation of the wound healing process according to clinical indicators in children after branchial cleft cyst excision.
 Methods and Material. 26 children aged from 5 to 17 years old with branchial cleft cysts have been examined and treated. In the postoperative period, the nature, amount of exudate and its cell composition has been determined; skin contact thermometry has been performed at 4 points around the wound at a distance of 1 cm.
 Results. The first manifestations of the disease coincided with the course of acute respiratory viral diseases in 8 children (30.8%); association with ENT pathology was observed in 3 (11.5%) children and the cystic masses emerged spontaneously in 15 cases (57.7%). They were localized with almost the same incidence on the left and right, but the vast majority (21 cases (80.7%)) was located anteriorly the sternocleidomastoid muscle and in 5 (19.3%) cases behind it. Ultrasound examination, made in 21 patients (80.8%), has revealed the presence of cystic masses with clear contours, hypoechoic structure and fine-grained inclusions, and the wall thickness varied from 1 to 3 mm. In 5 doubtful cases (19.2%) a puncture biopsy was performed.
 On 1st day after surgery, hyperemia around the wound was moderate in 15 children (57.7%); it was insignificant in 8 (30.8%) children and it was absent in 3 (11.5%) children. At the same time all children experienced collateral edema of various localization and painful modality. In the impression smears, a significant number of neutrophils, a moderate number of lymphocytes and erythrocytes was detected, which were prominent against the background of a loose substrate. The temperature of the wound area was 36.24 ± 0.07˚C, which was higher compared to the control group (34.71 ± 0.12˚C).
 On 3rd day, the corolla of hyperemia around the wound was not detected in 18 patients (69.2%), and its narrowing was recorded in 6 (23.1%) cases and it was persistent in 2 (7.7%) cases. On palpation, severe, moderate and weak pain on the wound area was experienced by 2 (7.7%), 15 (57.7%) and 9 (36.4%) children, respectively. The cytograms of the exudate showed a reduced quantity of neutrophils, erythrocytes and lymphocytes. Two children showed elevated quantity of destructured neutrophils and local temperature to 37.21 ± 0.16 ° C, which required medical adjustments.
 A narrow corolla of hyperemia around the wound, slight edema and moderate pain was detected on 7th day only in 2 children. In all patients, palpation revealed tissue compaction along the wound canal, onset of epithelialization, and the cytograms revealed the presence of sporadic neutrophils. The temperature of the skin around the wound reached 35.74 ± 0.11˚C, which was almost similar to controls (34.21 ± 0.08˚C). In all cases, the wounds healed with primary tension.
 Thus, the nature of the dynamics of wound healing after brancial cleft cyst extirpation in children can be successfully controlled by the prominence of the main clinical signs, the findings of the study of cellular composition of wound exudate and local temperature measuring.
 The perspectives of further research are associated with availability and simplicity of the methods in terms of their application in everyday clinical practice.

Acute Infection of Viral Pathogens and Their Innate Immune Escape.

Viral infections can cause rampant disease in human beings, ranging from mild to acute, that can often be fatal unless resolved. An acute viral infection is characterized by sudden or rapid onset of disease, which can be resolved quickly by robust innate immune responses exerted by the host or, instead, may kill the host. Immediately after viral infection, elements of innate immunity, such as physical barriers, various phagocytic cells, group of cytokines, interferons (IFNs), and IFN-stimulated genes, provide the first line of defense for viral clearance. Innate immunity not only plays a critical role in rapid viral clearance but can also lead to disease progression through immune-mediated host tissue injury. Although elements of antiviral innate immunity are armed to counter the viral invasion, viruses have evolved various strategies to escape host immune surveillance to establish successful infections. Understanding complex mechanisms underlying the interaction between viruses and host’s innate immune system would help develop rational treatment strategies for acute viral infectious diseases. In this review, we discuss the pathogenesis of acute infections caused by viral pathogens and highlight broad immune escape strategies exhibited by viruses.

Antibody sugars are bittersweet.

Antibodies that lack specific sugar modifications can worsen acute viral diseases

АКТИВНОСТЬ АЛЬФА-АМИЛАЗЫ СЛЮНЫ И УРОВЕНЬ ГИГИЕНЫ РОТОВОЙ ПОЛОСТИ ПРИ НЕКОТОРЫХ КЛИНИЧЕСКИХ СОСТОЯНИЯХ

Subject. Changes in the activity of certain saliva enzymes, due to certain factors and in certain clinical conditions of the human body, can affect oral hygiene, as well as indirectly on the activity of the carious process. Of particular interest is the enzyme — alpha-amylase, which is due to its ability to cleave dextrans and levans, which are the basis of the matrix of the bacterial film. The article presents data on changes in the activity of saliva alpha-amylase in microecological disorders in the intestine and acute respiratory viral diseases, as well as its effect on the level of oral hygiene.
 The goal — the assessment of changes in the activity of saliva alpha-amylase in microecological disorders in the intestine and acute respiratory diseases, taking into account the level of oral hygiene.
 Methods. To determine the activity of alpha-amylase, a set of reagents "Amylase-Vital" was used according to the manufacturer's instructions, proportionally reducing the volume of reagents for the procedure in titration plates. The volunteers, divided into groups with severe acute respiratory syndrome, microecological intestinal disorders, and a control group, received mixed saliva and evaluated their oral hygiene status.
 Results. The inverse relationship between the severity of intoxication syndrome in severe acute respiratory syndrome and the level of saliva alpha-amylase activity is shown. In addition, a correlation was established between an increase in human body temperature and a decrease in the activity of alpha-amylase. There is also a link between the presence of decompensated intestinal dysbiosis in humans and the activity of the enzyme. The dependence between the decrease in the activity of the studied enzyme and the increase in biofilm formation on the organs of the oral cavity was revealed.
 Conclusions and Relevance. The conducted studies open up a promising direction for the development of additional diagnostic criteria based on the determination of the activity of saliva alpha-amylase. In addition, the data obtained on the deterioration of oral hygiene indicate the need for a comprehensive approach to the treatment of patients in this category with the mandatory involvement of a dentist.

The features of antibacterial therapy in children

At present, the use of antibacterial drugs is one of the most frequently recommended methods of treating a large number of infectious diseases. However, in clinical practice, excessive use of antibiotics, unreasonable antibiotic therapy, and inappropriate combinations are quite common, which creates the risk of unwanted side effects, increases the cost of treatment and leads to an increase in microorganism resistance. That is why, in modern medicine, the problem of rational antibiotic therapy, i.e. the adequate use of antibacterial drugs, compliance with strict indications for their use, certain schemes and principles of use, and the creation of protocols for antibiotic therapy in pediatric practice, remains relevant. Antibacterial drugs should be prescribed for inflammatory diseases of bacterial etiology and for perioperative prophylaxis. Antibiotics should not be used in the treatment of uncomplicated acute viral respiratory diseases, since they do not have an antiviral effect, do not reduce fever, and do not prevent the development of bacterial complications. The purpose of this work is to form a methodological approach to the use of antibacterial drugs in pediatrics based on existing Russian recommendations.

Post-COVID syndrome: A reflection and opinion paper

RESUMENUn elevado porcentaje de las personas que han padecido COVID refieren, tras la recuperación de la fase aguda de la enfermedad, una serie de manifestaciones clínicas tanto subjetivas como objetivas que se prolongan más allá de 3 semanas e incluso de 3 meses del cuadro clínico original. No existe todavía una nomenclatura consensuada para referirse a este cuadro, pero quizá la más usada es la de síndrome post-COVID. El Comité Científico sobre COVID del Colegio de Médicos de Madrid ha discutido este problema con una aproximación multidisciplinar en la que han participado, internistas, infectólogos, psiquiatras, neumólogos, cirujanos, geriatras, pediatras, microbiólogos, médicos de familia y otros especialistas, tratando de acopiar la información existente y discutiéndola en el grupo.Las manifestaciones clínicas son muy variables y oscilan entre cuadros de simple cansancio y persistencia de lesiones pulmonares fibrosantes con alteraciones objetivas de la función pulmonar. El síndrome post-COVID parece particularmente frecuente y grave en aquellos adultos que han precisado ingreso en Unidades de Cuidados Intensivos y tiene un comportamiento peculiar en un grupo muy reducido de niños.El síndrome post-COVID, de existencia indudable, no es, a primera vista, claramente diferenciable del que se produce tras otras enfermedades víricas agudas y tras estancias prolongadas en UCI por enfermedades de otra naturaleza. Por tanto, ofrece oportunidades excelentes de investigación para clarificar su patogenia y posiblemente la de otras entidades afines.Es posible que progresivamente se produzca una demanda asistencial incrementada entre los millones de personas que han sufrido y superado el COVID agudo para la cuál las autoridades sanitarias debieran diseñar mecanismos de gestión ágil de una asistencia que posiblemente requerirá de grupos multidisciplinares bien coordinados.Este documento, estructurado en preguntas sobre distintos aspectos del síndrome post-COVID, intenta poner en escena el estado actual de este problema.

Revisiting Pleiotropic Effects of Type I Interferons: Rationale for Its Prophylactic and Therapeutic Use Against SARS-CoV-2.

The pandemic distribution of SARS-CoV-2 together with its particular feature of inactivating the interferon-based endogenous response and accordingly, impairing the innate immunity, has become a challenge for the international scientific and medical community. Fortunately, recombinant interferons as therapeutic products have accumulated a long history of beneficial therapeutic results in the treatment of chronic and acute viral diseases and also in the therapy of some types of cancer. One of the first antiviral treatments during the onset of COVID-19 in China was based on the use of recombinant interferon alfa 2b, so many clinicians began to use it, not only as therapy but also as a prophylactic approach, mainly in medical personnel. At the same time, basic research on interferons provided new insights that have contributed to a much better understanding of how treatment with interferons, initially considered as antivirals, actually has a much broader pharmacological scope. In this review, we briefly describe interferons, how they are induced in the event of a viral infection, and how they elicit signaling after contact with their specific receptor on target cells. Additionally, some of the genes stimulated by type I interferons are described, as well as the way interferon-mediated signaling is torpedoed by coronaviruses and in particular by SARS-CoV-2. Angiotensin converting enzyme 2 (ACE2) gene is one of the interferon response genes. Although for many scientists this fact could result in an adverse effect of interferon treatment in COVID-19 patients, ACE2 expression contributes to the balance of the renin-angiotensin system, which is greatly affected by SARS-CoV-2 in its internalization into the cell. This manuscript also includes the relationship between type I interferons and neutrophils, NETosis, and interleukin 17. Finally, under the subtitle of “take-home messages”, we discuss the rationale behind a timely treatment with interferons in the context of COVID-19 is emphasized.

COVID-19: Famotidine, Histamine, Mast Cells, and Mechanisms.

SARS-CoV-2 infection is required for COVID-19, but many signs and symptoms of COVID-19 differ from common acute viral diseases. SARS-CoV-2 infection is necessary but not sufficient for development of clinical COVID-19 disease. Currently, there are no approved pre- or post-exposure prophylactic COVID-19 medical countermeasures. Clinical data suggest that famotidine may mitigate COVID-19 disease, but both mechanism of action and rationale for dose selection remain obscure. We have investigated several plausible hypotheses for famotidine activity including antiviral and host-mediated mechanisms of action. We propose that the principal mechanism of action of famotidine for relieving COVID-19 symptoms involves on-target histamine receptor H2 activity, and that development of clinical COVID-19 involves dysfunctional mast cell activation and histamine release. Based on these findings and associated hypothesis, new COVID-19 multi-drug treatment strategies based on repurposing well-characterized drugs are being developed and clinically tested, and many of these drugs are available worldwide in inexpensive generic oral forms suitable for both outpatient and inpatient treatment of COVID-19 disease.

Methodological approaches to epidemiological and immunological assessment of the state of adaptive immunity in athletes to acute respiratory viral diseases under the condition of the COVID - 19 coronavirus pandemic and high physical activity

Insufficient adaptive immunity can significantly negatively affect both the health and sports activities of athletes, especially in the event of epidemics of acute infectious viral diseases and pandemic coronavirus COVID - 19. This is the basis for determining ways to assess the state of adaptive immunity in athletes under conditions of.
 Objective of the study: based on the analysis of scientific, scientific and methodological literature and other sources of information to develop methodological approaches to assessing the degree of adaptation of adaptive immunity to acute respiratory viral diseases in the presence of pandemic coronavirus COVID - 19 and high physical activity.
 Research methods: methods of theoretical analysis of scientific literature are used: generalizations, abstractions, formalizations.
 Research results and conclusions: methodological approaches to the assessment of the degree of adaptation of adaptive immunity to acute respiratory viral diseases in the conditions of the COVID - 19 coronavirus pandemic and high physical activity have been developed. It is concluded that the developed methodological approaches can be applied in practice.

Chronic rhinitis in children is not a local problem

Allergic rhinitis is the most common pathology among all allergic diseases. The article presents the epidemiologic and pathogenetic issues of the allergic rhinitis. The underdiagnosis of allergic rhinitis and its underestimation as a systemic pathology were observed in various countries. The importance of allergic rhinitis in paediatric practice, its impact on the quality of life, studies, and cognitive abilities is considered. The extranasal manifestations of the disease, as well as the role of allergic rhinitis in the development of increased respiratory viral morbidity are assessed. The differences between allergic and vasomotor rhinitis (non-allergic non-infectious rhinopathy) are analysed. Frequent interdependence and interaction of the allergic and vasomotor rhinitis are stressed. The signs of nonspecific hyperreactivity of the upper respiratory tract affected by the allergic rhinitis are presented. The role and importance of decongestants in the treatment of both allergic and vasomotor rhinitis are discussed in detail. Vasoconstrictors would help reduce hyperemia and nasal mucosa oedema, reduce the level of mucus secretion, improve the drainage of paranasal sinuses, normalizing the pressure in them. The use of a combination drug – a sympathomimetic combined with a local antihistamine agent would be the most appropriate treatment for patients with AR. The use of intranasal combination therapy for allergic rhinitis is justified: a sympathomimetic phenylephrine combined with a blocker of H1-histamine receptors dimethindene. The insights into the safety and efficacy of above drug combination in paediatric practice are presented. The use of a combination intranasal drug based on phenylephrine and dimethindene in patients with allergic rhinitis is justified in paediatric practice as both symptomatic and pathogenetic treatment. It is also advisable to administer it to treat acute respiratory viral diseases, in the post-viral period with situational exacerbations of the vasomotor component.

Is it always easy for children with mild asthma?

Bronchial asthma is the most common chronic disease of children, the worst way is their quality of life. Compliance in the treatment of children is very important, since the actual effect of a drug is determined by both the effective drugs and patient adherence and correct use. A relevant test is the use of mild asthma, which is able to control bronchial hyperreactivity associated with exercise, cold air, and other nonspecific irritants (smoke, odors, etc.). Planning of baseline therapy for children with mild asthma aged 5 years old and younger is particularly problematic for paediatricians due to high incidences of acute respiratory viral diseases and viral-induced exacerbations of bronchial asthma among them. In these children, allergen-specific immunotherapy, long-acting B-agonists, the use of many metered-dose inhaled glucocorticosteroids. are not recommended.Montelukast, an oral antileukotriene drug, has advantages in the treatment of children with mild asthma with virus-induced exacerbations, with asthma of physical exertion and severe bronchial hyperreactivity, especially when combined with allergic rhinitis, as well as in special clinical cases, when parents refuse to use ICS for treatment children with mild asthma or inability to use them for some reason. The use of montelukast for mild asthma in children in the current context of the COVID-19 pandemic also has advantages that pediatricians can use when observing these children in the pediatric area, taking into account contraindications.

Clinical Study of Herpes Zoster In children CLINICAL STUDY OF HERPES ZOSTER IN CHILDREN

This disease is one of the acute viral diseases due to the reactivation of the virus that causes chicken pox (chickenpox). This study was done to determine the age and gender of the infected, as well as the location of the infection and the type of clinical signs of the infected. injury . (31) cases of infection were recorded during the one-year period of the study, the average age of the injured was 6.6 years, the number of males was 17 (54.8%) and the number of females (14) (46.2%). The injuries are as follows: the chest area (12) 38.7%) the lumbar region and the sacrum (14) (45.2%), the neck area (5) (16.1%), and for clinical signs the numbers were as follows: acute vesicular rash (22) (71%), covered or covered rash (8) (25.8%), post-infection neuritis (1) (3.2%)

Оценка антибиотикочувствительности штаммов Moraxella catarrhalis, выделенных от пациентов с осложненным течением острых респираторных вирусных инфекций и других острых респираторных заболеваний

In recent years, acute respiratory viral infections (ARVIs) and other acute respiratory diseases (ARDs) have acquired some new characteristics of the disease course. The structure of complications has changed, in particular, such complications as community-acquired pneumonia (CAP) and lesions to the upper respiratory tract have become significantly more common. CAP remains one of the main causes of death in patients with ARVIs and other acute respiratory infections due to bacterial resistance to antibiotics. Objective. To assess drug sensitivity of Moraxella catarrhalis strains isolated from patients with complicated ARVIs or ARDs. Materials and methods. Drug susceptibility assessment was performed using the disk diffusion method (DDM) and gradient diffusion method (E-test). The production of β-lactamases was evaluated using nitrocephine, a chromogenic substrate. Results. Isolated strains of M. catarrhalis were resistant to third-generation cephalosporins and sensitive to fourth- and fifthgeneration cephalosporins. More than 70% of M. catarrhalis strains developed resistance to macrolides; 8% of strains were resistant to amoxiclav. All isolated M. catarrhalis strains were sensitive to respiratory fluoroquinolones, carbapenems, and ampicillin-sulbactam. Key words: Moraxella catarrhalis, complications of acute viral infections, bacterial sensitivity to antibiotics

Клиническая фармакология антибактериальных препаратов в педиатрии

Currently, the use of antibacterial drugs is one of the most frequently recommended methods for treating a large number of infectious diseases. However, there are many cases of unjustified antibacterial therapy, errors in the use of antibiotics, irrational combinations, and undesirable drug reactions. And that is why the problem of rational antibiotic therapy remains relevant in modern medicine - the rational use of antibacterial drugs, compliance with strict indications for the use of antibiotics, certain schemes and principles of their use, and the creation of protocols for antibacterial therapy in pediatric practice. The purpose — to present the key issues of clinical pharmacology of antibacterial drugs in Pediatrics. Results. A large number of different microorganisms act as etiological factors of frequent, repeated respiratory diseases. Antibacterial drugs should be prescribed for inflammatory diseases of bacterial etiology and for perioperative prevention. Antibiotics should not be used in the treatment of uncomplicated acute viral respiratory diseases, since they do not have an antiviral effect, do not reduce the temperature, and do not prevent the development of bacterial complications. Conclusion. Thus, today a doctor has a large arsenal of antibacterial drugs and faces a very important task — to use this arsenal rationally. When choosing antibiotics, there are problems associated with the presence of a large number of drugs, the proposed combinations and treatment regimens, polypragmasia, ignorance of modern treatment standards, and a low level of knowledge of clinical pharmacology. In the treatment of life-threatening infections, the cost of the antibiotic should not prevail over the factors of effectiveness and safety.

Self-Rated Smell Ability Enables Highly Specific Predictors of COVID-19 Status: A Case–Control Study in Israel

BackgroundClinical diagnosis of coronavirus disease 2019 (COVID-19) is essential to the detection and prevention of COVID-19. Sudden onset of loss of taste and smell is a hallmark of COVID-19, and optimal ways for including these symptoms in the screening of patients and distinguishing COVID-19 from other acute viral diseases should be established.MethodsWe performed a case–control study of patients who were polymerase chain reaction–tested for COVID-19 (112 positive and 112 negative participants), recruited during the first wave (March 2020–May 2020) of the COVID-19 pandemic in Israel. Patients reported their symptoms and medical history by phone and rated their olfactory and gustatory abilities before and during their illness on a 1–10 scale.Results Changes in smell and taste occurred in 68% (95% CI, 60%–76%) and 72% (95% CI, 64%–80%) of positive patients, with odds ratios of 24 (range, 11–53) and 12 (range, 6–23), respectively. The ability to smell was decreased by 0.5 ± 1.5 in negatives and by 4.5 ± 3.6 in positives. A penalized logistic regression classifier based on 5 symptoms had 66% sensitivity, 97% specificity, and an area under the receiver operating characteristics curve (AUC) of 0.83 on a holdout set. A classifier based on degree of smell change was almost as good, with 66% sensitivity, 97% specificity, and 0.81 AUC. The predictive positive value of this classifier was 0.68, and the negative predictive value was 0.97.ConclusionsSelf-reported quantitative olfactory changes, either alone or combined with other symptoms, provide a specific tool for clinical diagnosis of COVID-19. A simple calculator for prioritizing COVID-19 laboratory testing is presented here.

Justification for the choice of excipients for the production of tablets by direct compression based on oregano extract

Topicality. Throat inflammatory diseases are a growing problem that requires the right approach to treatment and prevention. According to the WHO, up to 80 % of the population of Ukraine suffers from acute respiratory viral diseases every year. Sore throat and itching are the symptoms of most acute respiratory illnesses caused by a wide range of infectious and viral pathogens. Therefore, the development of antimicrobial and anti-inflammatory plant-derived medications in the form of local action pills is relevant.Aim. Substantiation and study of the influence of different groups of excipients on the pharmaco-technological parameters of powder masses in the development of tablets based on oregano by direct compression.Materials and methods. The studied materials – dry extract of oregano independently obtained, various excipients that were grouped into certain groups, and also used one of the methods of mathematical planning – analysis of variance.Results and discussion. As a result of the conducted researches the best excipients influencing pharmaco-technological indicators of powder masses and quality of tablets have been defined and chosen.Conclusions. With the help of dispersion analysis, the best excipients that meet the requirements for the quality of pharmaco-technological indicators in the development of tablet dosage forms have been identified and selected.