FISHBURNE's METHOD AND THE CLASSICAL METHOD OF PHARMACOECONOMIC ANALYSIS IN THE EVALUATION OF ANTIBIOTIC TREATMENT OF ACUTE AND RECURRENT BRONCHITIS IN CHILDREN

Objective: This study was performed in order to estimate clinical effectiveness of antibiotic therapy in acute and recurrent obstructive bronchitis. For estimation the following was used: the Fishbern method of antibiotics distribution according to clinical effectiveness levels with the help of weighted coefficients and classical cost–efficiency†pharmacoeconomic analysis of the given antibiotic therapy. Then, for the first time ever, the obtained results of both methods were combined.Methods: Materials were presented by the data on antibiotic therapy, given for patients who were hospitalized to the in-patient medical facilities due to acute or recurrent obstructive bronchitis. Medical records of 2 259 patients were included in the study. The patients were 0 to 18 y old. In order to determine the weighed coefficients of each used antibiotic with subsequent distribution according to the levels of clinical effectiveness the Fishbern method was applied. Three levels of clinical effectiveness were used in this study, i.e. high, medium and low. The cost–efficiency†pharmacoeconomic analysis was applied to combine costs and efficiency of the compared therapy courses in acute and recurrent obstructive bronchitis.Results: Finally we found out that the highest probability of positive effect of cephalosporins group agents was associated with the use of Cefotaximum. (Biosynthesis). From the pharmacoeconomic point of view the most effective in treating acute and recurrent obstructive bronchitis in children in the in-patient facilities was Ceftriaxonum (Synthesis). Out of protected penicillins group, we used Amoxicillin/clavulanic acid–original drug Augmentin (Smithkline Beecham Pharmaceuticals) and generic drug Amoxiclav (Lek d. d). Augmentin effectiveness was 0.591, and Amoxiclav effectiveness–0.530. Cost of Augmentin treatment course was 106.26 rub. (1.68 US$), cost of Amoxiclav treatment course–103.50 rub.(1.63 US$). Augmentin use turned out to be the most reasonable. Augmentin treatment course was characterized by lower ICER coefficient versus Amoxiclav. We found out that from the pharmacoeconomic point of view Azitromicin (Vertex Ltd.) treatment turned out to be the most reasonable of the whole macrolides antibiotics for treatment of acute and recurrent obstructive bronchitis. However, according to the Fishbern clinical effectiveness classification this antibiotic belonged to the group with medium effectiveness level. The group with high effectiveness level included Sumamed, Azitral, Hemomicin, Clacid, Zitrocin and Clabax. Clacid and Clabax were excluded during the pharmacoeconomic analysis. The highest value of ICER coefficient was obtained for Sumamed and made up 39,367.50 rub. (621.53 US$). The highest level of clinical effectiveness was characteristic for Sumamed as well. Besides Sumamed was an original drug of azitromicin. According to the obtained data Azitral and Hemomicin had the lowest values of ICER coefficient (1151.67 rub. (18.18 US$) and 1812.22 rub. (28.61 US$) respectively). Therefore based on the clinical economic analysis these medical agents turned out to be the most suitable.Conclusion: The results of the pharmacoeconomic analysis showed that the most effective drugs in treatment of acute and recurrent obstructive bronchitis in children in in-patient facilities appeared to be the following: out of cephalosporins-Ceftriaxonum (Synthesis), out of protected penicillins-Augmentin (Smithkline Beecham Pharmaceuticals), out of macrolides-Azitromicin (Vertex Ltd.). According to the Fishbern classification, these drugs belonged to the group with medium level of effectiveness.Â

ROLE OF "ATYPICAL" MICROORGANISMS ON THE FORMATION OF BRONCHIAL ASTHMA IN CHILDREN WITH ACUTE AND RECURRENT OBSTRUCTIVE BRONCHITIS

Objective: This study was undertaken to determine the link between the presence of atypical†infections in patients with acute obstructive andrecurrent obstructive bronchitis (AOB/ROB) and bronchial asthma (BA) development based on the concept of risk.Methods: The materials for the study were the data records of patients hospitalized with AOB or ROB and whose analysis was performed to identifyantibodies to atypical†microflora (796 patients). The study period was 4 years from 2008 to 2011. In the analyzed period, immunosorbent assay forthe detection of antibodies to atypical†microflora (Chlamydophila pneumoniae, Mycoplasma pneumoniae, Mycoplasma hominis) was performed. Theconcept of risk identification was based on the determination of the absolute risk, attributable risk (AtR), relative risk, population attributable risk, aswell as on the definition of the standard errors for each type of risk and the confidence interval.Results and Conclusion: Methodical aspects of determining the relationship between the presence of atypical†infections in patients with AOBor ROB and BA development were based on the concept of risk. The analysis showed a direct link between the increase of cases of BA formationagainst the backdrop of atypical†infections. Therefore, the performed analysis of atypical pathogens influences on BA occurrence in patients withAOB/ROB which indicates direct dependence increase of BA incidence on atypical infection. In experimental group, Frequency of event is 14.84% inexperimental group. Frequency of event is 1.67% in control group. The risk factor increases probability of event by 13.17%, the risk factor increasesprobability of event by 13.17%. Presence of atypical infection leads to increase of BA incidence by 8.9 times. Number needed to harm (NNH) is 7.59,i.e., in the presence of atypical infection in patients with AOB/ROB, each eighth exposed person develops BA in addition to background level of BAincidence.Keywords: Acute obstructive bronchitis, Recurrent obstructive bronchitis, Bronchial asthma, The concept of risk, Risk factor, The absolute risk,Relative risk, Attributable risk, Population attributable risk, Number needed to harm

Species composition of helminths in lake frogs <i>Pelophylax ridibundus</i> (Pallas, 1771) in rivers of the Belgorod Region

The purpose of the research is to identify the species composition of helminths in lake frogs (Pelophylax ridibundus (Pallas, 1771)) caught in rivers of the Belgorod Region.Materials and methods. We studied frogs collected using a hydrobiological net in the rivers in fve Belgorod Region districts during the spring-summer 2016–2019. Species identifcation was performed according to morphological characteristics. The sex of the studied frogs was determined by gonads, and the age was determined based on size data. To assess infection of P. ridibundus with individual helminth species and their distribution, we used standard parameters for parasitological survey, namely, the prevalence, the amplitude of infection intensity, and the abundance index.Results and discussion. As a result of helminthological studies of 122 lake frogs, 17 helminth species were identifed which were widely specifc among representatives of the Ranidae family. Presumably, the identifed species form the basis of the species composition of frog helminths in rivers of the Region. Most of these types of helminths occur throughout the springsummer season without pronounced seasonal dynamics. It was noted that the number of helminth species simultaneously parasitizing in one frog increased with age. Opisthioglyphe ranae is the most often numerically dominant species in the examined areas of the Belgorod Region; and Diplodiscus subclavatus, Pleurogenes claviger and Codonocephalus urnigerus mtc have high abundance at some stations

Helminthes of mouse-like rodents in the Belogorye State Nature Reserve (Russia)

The study was conducted in 2016-2017 on three sites in the Belogorye State Nature Reserve (Russia) located in the forest-steppe zon

Fiber orientation in viscous fluid flow with and without vibration

This early-stage investigation is related to determination of flow speed gradients of fresh steel fiber-reinforced concrete (SFRC). They are assumed to be the key parameters for computer modeling of orientation of steel fibers in form casting process. The aim of the research is to elaborate a computer model for evaluation of steel fiber orientation in casting process, which would provide an attractive possibility to predict concrete mechanical properties, optimization of casting process and costs due to proper use of ingredients. Fiber orientation in FRC is important for ensuring the best mechanical properties in the places where it is necessary. Task can be solved as: to obtain optimal fiber concentration and orientation or to use appropriate casting approach of concrete with the goal to obtain required mechanical properties in appropriate locations of the composite element. As an example the paper considers the case of trench filling by fiber concrete. Simulations provided distributions of vertical and horizontal velocities in real-time scale. Behavior of a single fiber in an inclined container with a viscous transparent liquid (potato-starch solution) was analyzed in order to confirm the possibility to obtain orientation of fibers on the basis of velocity gradients in viscous fluid. For precise modeling of potato-starch liquid, coefficient of dynamic viscosity was determined. The experiments performed on fibers in an inclined container demonstrated satisfactory agreement with the simulation results. Performed analysis indicates that velocity gradients can be applied for determination of position and orientation of fibers in fabrication of fiber-reinforced concrete product

The multistatutory nature of the adjective "Right" in adjectival English lexicon

This article provides an outline on an adjective in modern English language, and in particular, the multistatus lexical item “right”, which carries different meanings in different variants of combinatorics. The authors analyse the combinations used with the adjectival lexical item “right” and identify categories that determine the semantic content of each given statemen

One-shot optimization for vehicle dynamics control systems: towards benchmarking and exploratory landscape analysis

Algorithms and the Foundations of Software technolog

Antibiotic sensitivity analysis of clinical coagulase-negative staphylococci

Background. The increasing role of coagulase-negative staphylococci in the occurrence of staphylococcal infections leads to the need for close attention to them. Special control is required over the sensitivity of bacteria to antibiotics and the spread of methicillin resistance, as a sign of multiple resistance to antibacterial drugs. It is also important to identify the virulence factors of coagulase-negative staphylococci, which determine their behavior in the environment.The aim. To evaluate the sensitivity of strains of coagulase-negative staphylococci to clinically significant antibiotics daptomycin, vancomycin, linezolid and oxacillin and lantibiotic warnerin.Methods. Determination of the minimal inhibitory concentrations of antibacterial compounds for clinical coagulase-negative staphylococci by standard methods of serial dilutions and disc diffusion. Identification of the phenomenon of decreased susceptibility of bacteria to vancomycin by population analysis and concentration gradient. Lipid analysis by thin layer chromatography. Results. High antibacterial activity of vancomycin, daptomycin and linezolid against clinical strains of coagulase-negative staphylococci was shown. The upper limit of the minimum inhibitory concentrations of vancomycin within the sensitive phenotype and the expansion of the ranges of the minimum inhibitory concentrations of daptomycin and warnerin towards an increase in oxacillin-resistant isolates were revealed. The heterogeneous nature of sensitivity to vancomycin of the cultures of the studied strains and the possibility of their rapid enrichment with subpopulations with reduced sensitivity to this antibiotic have been established. The selection of resistance of coagulase-negative staphylococci to vancomycin was accompanied by an increase in the synthesis of lysylphosphatidylglycerol and a decrease in their sensitivity to cationic peptide compounds.Conclusion. The revealed prevalence of the methicillin-resistant phenotype of clinical strains of coagulase-negative staphylococci, along with the presence in the lipid spectrum of the universal factor of resistance to cationic antibacterial compounds, lysylphosphatidylglycerol, entails the need for new methodological solutions for diagnosing infections caused by coagulase-negative staphylococci

Chiroptera as a Potential Reservoir of Dangerous for Humans Viruses in the territory of the Republic of Guinea. Part 1

Chiroptera is one of the largest in numbers orders of mammals which can take on the role of natural host and vector of various viruses, bacteria, and pathogenic fungi. Over the period of 2007–2013, 248 new viruses pertaining to 24 families were detected in chiropterans. Lately, a range of novel infections that provoked severe diseases in humans were associated with bats-carriers. Presently they are viewed as a potential reservoir of Ebola, Marburg, and Hendra viruses, severe acute respiratory syndrome agents, as well as many other lethal diseases. Chiropterans started drawing particular attention after establishment of the fact that they are involved in circulation of ebolavirus Zaire and possibly participate in the formation of natural foci of this infection. Currently chiropterans are considered to be natural reservoirs of ebolavirus Zaire and some other filoviruses (Filoviridae). Accept from filoviruses, other significant for public healthcare viruses were isolated from chiropterans on the African continent – lyssaviruses (Rhabdoviridae, Lyssavirus), henipaviruses (Paramixoviridae, Henipavirus), and coronaviruses (Coronaviridae, Alphacoronavirus, Betacoronavirus) that can also circulate among chiropterans in West Africa. The data available from literature sources on dissemination of chiropterans in the territory of the African continent, their species diversity, peculiarities of ecology and behavior are analyzed in this paper. The information on the infections for which chiropterans can serve as potential reservoirs is also provided. Specifics of interaction between the population residing on African continent and bats of different species are described too. The review is devoted to the assessment of results of studies on population, ecological, and epidemiological factors contributing to maintenance of circulation of a number of dangerous for humans viruses (filoviruses, lyssaviruses, henipaviruses, and coronaviruses) among African chiropterans. The need for further investigation of the mentioned factors affecting chiropteran populations in the Republic of Guinea is substantiated

Chiroptera as a Potential Reservoir of Dangerous for Humans Viruses in the Territory of the Republic of Guinea. Part 2

Among the viruses transmitted by Chiroptera, filoviruses, lissaviruses, henipaviruses, and coronaviruses pose the major threat to humans. The featured review is devoted to the analysis of the results of studies on the role of African Chiropterans in the circulation sustenance of the viruses. Chronology of investigations on the search of natural reservoir of Filoviruses and the evidence of Chiroptera participation in their circulation are described in the paper. Presented are summarized data on the involvement of chiropterans in the circulation of lissaviruses on the African continent. Given is the information concerning the role of African species of Chiroptera in the circulation of henipaviruses - dangerous for humans viruses of Paramyxoviridae family, associated with chiropterans of South-Eastern Asia. Considered is the possibility of SARS and MERS-like coronaviruses circulation in the populations of certain species of African Chiroptera. Engagement of the Chiroptera from Guinean Republic in maintenance of circulation of the mentioned above viruses in potential natural foci in the territory of the country and possibility of occurrence of dangerous human infection outbreaks is also assessed. The necessity for further investigation of the role of Chiroptera as carriers of the stated viruses to clarify the current epidemiological and epizootiological situation on the viral pathogens in the Republic of Guinea is substantiated