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Research objectives: to determine the activity of vascular placental growth factors, apoptosis and necrosis of neutrophils in the blood of pregnant women with post-COVID syndrome. Methods and materials. 30 pregnant women (the main group) with SARS-CoV-2, positive Ig A, M or G to SARS-CoV-2 at 30–34 weeks of pregnancy took part in the study. The control group consisted of 30 women with physiological pregnancy. Blood neutrophils were studied by flow cytofluorometry. The proportion of neutrophils that were at the stage of apoptosis and necrosis was determined. The correlation of these indicators with the uncomplicated course of the gestational process during the physiological course of pregnancy and with the development of gestational complications against the background of post-COVID syndrome was determined. In the third trimester of pregnancy, we collected blood samples to determine the effect of SARS-CoV-2 infection on placental angiogenesis. We evaluated a panel of biomarkers: vascular endothelial growth factor (VEGF), placental growth factor PlGF, and interleukin-32α (IL-32α). Results. In pregnant women of the main group with a complicated course of pregnancy accompanied by post-COVID syndrome, apoptosis was at the level of 24.30 ± 0.50% of neutrophil cells, which was significantly different from the control group (4.45 ± 0.25%) (р < 0.001). The level of late apoptosis, necrosis of neutrophils increased 4 times – from 4.20 ± 0.65 to 16.80 ± 0.54% (р < 0.001). The concentration of IL-32α in pregnant women of the control group was 67.27 ± 5.63 pg/ml. Post-COVID syndrome caused an increase in this indicator in the main group by 2.8 times compared to the control group (188.36 ± 25.22 pg/ml) (p < 0.001). In the III trimester, the concentration of VEGF reached maximum values in the main group and was 192.20 ± 10.02 pg/ml, which is 2 times higher than in the control group at the same time (95.30 ± 5.65 pg/ml), (p < 0.001). In the control group the level of PIGF at full-term pregnancy was 144.53 ± 15.55 pg/ml. In women with postpartum syndrome, PIGF significantly decreased and was 43.92 ± 4.81 pg/ml, which was only 30% of the PIGF value in women with an uncomplicated pregnancy (p < 0.001). Conclusions. The development of metabolic disorders and apoptotic changes in the placental tissue are confirmed at the morphological level in the form of destructive and necrotic changes in the microcirculatory channel of the placenta. An increase in the level of annexin-positive neutrophils and activation of the degree of neutrophil necrosis is accompanied by fetoplacental dysfunction, by violation of the balance of placental growth factors and is an important marker for predicting of fetal growth retardation in pregnant women with post-COVID syndrome.

Summary. COVID-19 pandemic became a game-changer player in the whole world. The severe course of disease manifests with clinical signs of viral pneumonia with an advanced respiratory failure, which can later lead to the development of acute respiratory distress syndrome (ARDS) and fatal consequences. Correct understanding of the key pathophysiological determinants of complications and hypoxemia will contribute to the most rational pharmacotherapy. The aim of the study – to analyze and systematize data on the pathogenesis of ARDS in coronavirus disease and its pharmacological correction. Understanding the key links will make possible not only to identify certain aspects of the treatment, but also to prevent the development of complications. Materials and Methods. Publications of foreign and Ukrainian specialists were analyzed, including databases Medscape/PubMed. Results. An analysis of the key links in the pathogenesis of ARDS, induced by C|OVID-19, the role of the cytokine storm in the progression of the disease and development of arterial hypoxemia and respiratory failure was carried out. An overview of the development and "evolution" of approaches to the treatment of the disease was conducted, starting from attempts to use chloroquine derivatives at the beginning of pandemic to etiotropic treatment with antiviral drugs (such as remdesivir, the combination of lopinavir/ritonavir and paxlovid); biosimilars – monoclonal antibodies and their combinations; prevention and treatment of thrombosis and microthrombosis, which may develop as a result of endothelial dysfunction in such patients, especially in the presence of comorbid pathology (for example, hypertension, diabetes mellitus, obesity). The latest recommendations and American and European protocols for the treatment of coronavirus disease are summarized. Conclusions. The review of the most popular and available medicines and pharmacotherapy for COVID 19 was performed. It indicates the necessity and rationality of finding new, more efficient and less toxic drugs to fight the infection and its complications

Recurrent urinary tract infection (UTI) is a highly prevalent, costly, and burdensome condition affecting women of all ages, races, and ethnicities without regard for socioeconomic status, or educational level. Modern strategies aimed at preventing recurrent UTI are still not optimal, as evidenced by the relatively high prevalence of this nosology in women. The purpose of this article was to highlight and discuss both the evidence base and a number of unresolved issues in the management of recurrent UTI. The following topics of clinical interest are considered: diagnosis, age-related associations, continuous and intermittent antimicrobial prophylaxis, the effectiveness of modern non-antimicrobial prophylaxis, the potential role of forinal (a complex of D-mannose and cranberry fruit extract) in the prevention of recurrent UTI.

Background. The study of the problem of urolithiasis in recent years has reached a qualitatively new level in connection with the use of a multidisciplinary approach and the principles of evidence-based medicine. In the domestic literature, there are isolated reports on the meaning and methods of correction of metabolic disorders in urolithiasis. There is still no consensus on the feasibility and effectiveness of preventive methods after the removal of stones. The purpose of the study: assessment of the effect of phytotherapy (Urolesan®) on the metabolic status and urine microbiota in patients with urolithiasis — calcium oxalate nephrolithiasis after shock wave lithotripsy. Materials and methods. In 50 patients with calcium oxalate nephrolithiasis aged 18 to 65 (middle age — 41.1 ± 1.6) years, the effect of Urolesan® on the metabolic status (the impact on urine pH, the level of oxalate, calcium, uric acid excretion, indicators of biochemical blood tests), features of urine microbiota and prevention of the recurrent formation of calculi were studied after shock-wave lithotripsy. Results. An analysis of the dynamics of urine pH, measured on days 2, 5, 10, 20, and 30 of treatment with Urolesan®, showed that the patients undergoing a follow-up examination had a gradual increase in urine pH from 5.80 ± 0.04 to 6.13 ± 0.04 on day 5 (p < 0.05) and up to 6.47 ± 0.04 — on day 30 (p < 0.05). The dynamics of oxalate and calcium urine excretion showed that after a month of treatment with Urolesan®, the daily excretion of oxalate decreased by 1.5 times, and calcium — by 1.2 times compared with baseline (p

Objective of the research — to evaluate the efficacy of combined hypouricemic therapy in patients with hyperuricemia, urate nephropathy on the background of concomitant pathology (type 2 diabetes mellitus, hypertension) based on the dynamics of uricemia, uricosuria, the functional state of the kidneys, minimizing and eliminating the risk factors for the progression of chronic kidney disease. Sixty seven patients were involved in the study. Correction of hyperuricemia in patients with urate nephropathy and concomitant pathology (type 2 diabetes mellitus, hypertension) using phytodiuretic agent Urolesan® in combination treatment leads to normalization of metabolic processes, improvement of glomerular filtration rate, and a decrease in the level of albumin excretion.

Визначено ринкову вартість страхових компаній на основі використання ринкового підходу з аналізом сильних та слабких сторін цього підходу, а також із систематизацією внутрішніх і зовнішніх факторів, що визначають вартість страховика. Запропонована методика розрахунку галузевого коефіцієнта на основі визначення привабливості страхової компанії для клієнтів та інвесторів, яка враховує фактори вартості та особливості страхової діяльності, що дає змогу істотно підвищити якість та достовірність показника вартості, оціненого за ринковим підходом.

Проаналізовано та систематизовано сучасні методи оцінювання ризику у страховій діяльності. Розглянуто деякі методи аналізу невизначеностей як інструментарій середньострокового прогнозування та планування діяльності страхових компаній. Виокремлено статистичні та аналітичні методи, методи експертних оцінок, що застосовуються у разі відсутності чи недостатності статистичної бази, а також деякі специфічні методи на перетині статистичних та експертних. Ефективність висновків та формування подальшої стратегії компанії безпосередньо залежить від правильності вибору методу аналізу та оцінки ризику і від якості сформованої статистичної бази.