Assessment of functional activity reduction – as a criterion for determining disability in patients with rheumatoid arthritis

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). 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: 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. 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

Diabetes mellitus and disability

Diabetes mellitus (DM) is not only a major medical but also an economic problem worldwide. Significant economic costs and social damage caused by the increasing prevalence of diabetes, comorbid pathology, complications, high disability and mortality. In the article we analyzed the indicators of disability in patients with diabetes in Dnepropetrovsk region and in Ukraine and identified methodical approaches to determining the degree of disability. Results of the study showed that the indicators of disability due to diabetes in Dnepropetrovsk region and Ukraine are stable and averages 1.7 and 1.5 per 10 thousand population, respectively, in 2014-2019. Intensive indicator of primary disability due to DM among the employable population in Dnipropetrovsk region is growing every year. It’s become much higher than disability indicator among total adult population. In our study we proposed criteria for determining the signs of disability based on criteria of life limitations

Microbiological features of Staphylococcus aureus isolated from respiratory tract of children with cystic fibrosis

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. 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: 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 Staphylococcusaureus with auxotroph phenotype with the presence of Pseudomonasaeruginosa 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. Conclusions: Infection Staphylococcusaureus 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

Dynamics of Disability Indices and Professional Rehabilitation of Diabetes Patients

Introduction: The article presents results of the study about dynamics of disability indicators due to diabetes mellitus and their peculiarities in Dnipropetrovsk region and in Ukraine and presents recommendations for the professional rehabilitation of such patients and persons with disabilities. Material and Methods: We conducted a retrospective analysis of the dynamics of DM disability according to the data of the Municipal Institution “Regional Clinical Center of Medical and Social Expertise of Dnipropetrovsk Regional Council” and in Ukraine for the period 2016–2019. We analyzed medico‑social cases and referrals for medical and social expertise of patients who were examined by doctors of regional specialized medical and social commissions evaluating patients’ disability. Results: It was determined that the most common reasons for referral of patients with medical expertise were: insufficient glycemic control with the formation of chronic foot ulcers, which led to disorders of the feet musculoskeletal functions - 37.6%; lower limb amputation at different levels - 21.8%; impaired vision - 40.6%. Indicators of disability due to diabetes in Dnipropetrovsk region was stable in 2014-2019, but raised the average level of disability in Ukraine and ranges from 1.5 - 1.7 per 10 thousand population in 2014 vs 1.4-1.5 per 10 thousand in 2019. Persons with 3rd group disability made the largest part among persons with primary disability due to diabetes in 2014-2019: specific gravity ranged from 57.0% in 2018 to 70.5% in 2014. The unfavorable tendency of disability indicators is characterized by an increase of persons who were initially recognized as having disability due to DM with 1st group disability by 2 times from 6.6% - in 2014 to 12.9 - in 2018. Conclusion: This can be explained by the increased number of DM complications and their severity. The indicator of total rehabilitation among of persons who were initially recognized as having disability due to DM in Dnipropetrovsk region in 2014-2019 does not exceed 3%

TGF-β1 and VCAM-1 Serum Concentrations as Diagnostic Biomarkers of Diabetic Kidney Disease Progression

Background and aims: Transforming growth factor-beta 1 (TGF-β1) and vascular adhesion molecule 1 (VCAM-1) have been proposed as promising biomarkers for multiple diseases. TGF-β1 and VCAM-1 are reported to be associated with diabetic kidney disease (DKD) and end stage renal disease in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM)