International classification of functioning, disability and health with long-term consequences of cranio-brain injury.

OBJECTIVE: Aim: To describe health status and related functioning of patients with different severity of traumatic brain injury (TBI) in past medical history in Ukraine and determining the feasibility of using the International Classification of Functioning, Disability and Health (ICF) Brief Core Set for TBI. PATIENTS AND METHODS: Materials and Methods: A total of 102 patients, who were treated in the neurological department of Dnipropetrovsk regional clinical hospital and State Institution ≪Ukrainian State Scientific Research Institute of Medical and Social Problems of Disability of Health Ministry of Ukraine≫, had been examined. Patients were divided into three groups: mild, moderate and severe TBI in past history and evaluated using ICF Brief Core Set for TBI. RESULTS: Results: Тhe most common problems in the functioning and health of patients in remote period of TBI, along with the influencing factors have been identified in the study. The most frequent categories from ≪Body Functions≫ and ≪Activity and Participation≫ sections in which patients had alterations were: memory functions, emotional functions, sensation of pain, functions of attention, brain structure, complex interpersonal interactions, family relationships. The increase in the amount and severity of disturbances with increasing severity of TBI had been established in all categories, except complex interpersonal interactions and family relationships. CONCLUSION: Conclusions: Patients of all groups identified the family and close relatives, healthcare service and social welfare services, as the most frequent relieving factors of life activity. The use of the ICF Brief Core Set for assessing the subjects with TBI in past history provides a convenient procedure to standardize and structure functioning description. Information collected by the ICF Brief Core Set may be used for different purposes: clinical assessment, administration of medical services, planning and implementation of rehabilitation and evaluation of results, in scientific research, reports and health care statistics.

ASSESSMENT OF FUNCTIONAL ACTIVITY REDUCTION - AS A CRITERION FOR DETERMINING DISABILITY IN PATIENTS WITH RHEUMATOID ARTHRITIS.

OBJECTIVE: The aim: To analyze the assessment of the decrease in working capacity degree in patients with rheumatoid arthritis in accordance with modern diagnostic disease criteria and social approaches to disability definition in the world (the decline degree of vital activity). PATIENTS AND METHODS: Materials and methods: We analyzed the dynamics of primary disability caused by musculoskeletal system and connective tissue diseases (the main disease - RA) in Ukraine in 2016-2020. We analyzed the data of medical and social cases of 433 patients with RA (referral for medical and social examination, Form 088/o). We studied the degree of reduction of their efficiency. Statistical processing was performed using descriptive and variational statistics methods. The results were calculated on a personal computer using the licensed programs STATISTICA 6.1 (StatoftInc., Serial № AGAR909E415822FA). RESULTS: Results: It is shown that in Ukraine in 2016-2020 the primary disability had a tendency to increase. The article defines the approaches to medical and social examination of patients with rheumatoid arthritis to determine the ability to work and signs of disability. The article emphasizes the importance of a thorough study of medical data, data on the functional state of the affected joints using functional tests, determining the state of the patient's social activity according to the assessments of questionnaires based on the principles of evidence-based medicine. CONCLUSION: Conclusions: The problem of RA is a relevant in the world and in Ukraine. The dynamics of primary disability caused by musculoskeletal system and connective tissue diseases (the main disease - RA) in Ukraine in 2016-2020 shows a growth trend: from 5.8 to 7.1 per 10 thousand population. Carrying out medical and social examination of RA patients to determine the state of working capacity and signs of disability requires careful study of medical data, data on the functional state of the affected joints with functional tests and determining the state of social activity of the patient according to questionnaires. In patients with RA, the most important data for determining violations of vital signs and the presence of functional disability are: disease activity, its course, the presence of lesions of internal organs and the completeness and quality of treatment methods recommended from the standpoint of evidence-based medicine.

MICROBIOLOGICAL FEATURES OF STAPHYLOCOCCUS AUREUS ISOLATED FROM RESPIRATORY TRACT OF CHILDREN WITH CYSTIC FIBROSIS.

OBJECTIVE: The aim: To determine the prevalence rate of Staphylococcus aureus infection among children with Cystic Fibrosis in the Dnieper region, to provide microbiological characteristics of the isolates and to elevate their susceptibility to antimicrobials. PATIENTS AND METHODS: Materials and methods: Sputum, tracheobronchial lavage waters and/ or deep smear from the posterior pharyngeal wall were taken from children with genetically confirmed Cystic Fibrosis. Bacteriological method was the main. The first screening for small colony variants of Staphylococcus aureus was carried out after 48 hours of incubation. The antimicrobials susceptibility testing was determined by disk-diffusion method according to the EUCAST 2019. Microsoft Office Excel 2010 was used for statistical data processing. RESULTS: Results: Twenty one children were enrolled in the survey. The culture of Staphylococcus spp. was obtained from all patients with 40.8% positive for Staphylococcus aureus. Small colony variants appeared with the prevalence rate 21.6% after 48 hours of incubation. The frequency of associations between Staphylococcus aureus with auxotroph phenotype with the presence of Pseudomonas aeruginosa was significantly higher than with wild-type group. The 3d-generation aminoglycosides, the 3d-generation fluoroquinolones, linezolid, rifampicin and tetracyclines showed the best antimicrobial activity, however, resistance to cefoxitin and gentamicin was significantly higher in auxotroph-modified group. CONCLUSION: Conclusions: Infection Staphylococcus aureus is common among children. The appearance of auxotrophs registered after treatment with aminoglycosides and/ or co-trimoxazole and co-infection Pseudomonas aeruginosa. Isolates of Staphylococcus aureus showed good chemotherapeutic sensitivity, but tendency in increasing resistance registered for auxotroph-modified phenotype.