Eduard Khodosh

Kharkiv National Medical University

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Yaroslav Dziublyk

National Academy of Medical Sciences of Ukraine

Oleh Yakovenko

Royal Brompton Hospital

Tetiana Yakovenko

North-Western State Medical University named after I.I. Mechnikov

ОА

О А Ефремова

Kharkiv National Medical University

Olivier Hermine

Hôpital Necker-Enfants Malades

ЕВ

Е В Ефименко

Gilles Devouassoux

Université Claude Bernard Lyon 1

Elliot Israel

Brigham and Women's Hospital

Oleksii Korzh

Kharkiv National Medical University

Olga Godlevska

Kharkiv Medical Academy of Postgraduate Education

Cooperative Institutions

Kharkiv National Medical University

Belgorod National Research University

Kharkiv Medical Academy of Postgraduate Education

Inserm

National Academy of Medical Sciences of Ukraine

Lesya Ukrainka Volyn National University

Helios Klinikum Emil von Behring

Royal Brompton Hospital

Shupyk National Healthcare University of Ukraine

Kharkiv Regional Clinical Psychiatric Hospital No 3

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Позагоспітальна пневмонія: морфологічні та клініко-променеві характеристики легеневого інфільтрату

Eduard Khodosh

Community-acquired pneumonia, being a common diagnosis, often requires a differential approach in patients with pulmonary infiltrate, respiratory tract infections, and sepsis. To make a diagnosis, the infiltrate should be visualized on radiographs or computed tomography. The clinical picture of community-acquired pneumonia varies from a mild, characterized by fever, cough and shortness of breath, to severe, accompanied by sepsis and respiratory failure. For the most part of patients with community-acquired pneumonia, the etiology is unknown at the time of diagnosis, therefore empirical treatment is aimed at the most likely pathogens. Pathogens causing community-acquired pneumonia may vary depending on the severity of the disease, local epidemiology, and risk factors. For most outpatients with mild forms of community-acquired pneumonia, the range of potential pathogens is limited. On the contrary, for severe patients requiring hospitalization, potential pathogenic microorganisms are more diverse, and the initial treatment regimens are often wider. Due to the wide range of clinical features, community-acquired pneumonia can be a part of the differential diagnosis of almost all respiratory diseases. Our understanding of community-acquired pneumonia clinical picture serves first of all as a guide for investigations, and not a formal record in the medical history. Before the diagnosis, each new patient with community-acquired pneumonia must be investigated with account of all associations of triggering conditions and various symptoms and syndromes. One way or another, but a doctor must confirm the preliminary pneumonia diagnosis, assess the injury extent and location of treatment, and administer rational antibiotic therapy.

Etiology

10.30978/utj2020-2-60

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Особенности клинического течения хронической обструктивной болезни легких у больных с сопутствующей ишемической болезнью сердца

Актуальные проблемы медицины (2020)

Eduard Khodosh N. I. Obolonkova M.F. Kiselevich Ksenia Aleinikova Eduard Khodosh

Взаимодействие между легким и сердцем – обширная и сложная с клинической точки зрения тема, поскольку расстройства одного часто влияют и способствуют расстройствам другого. Выявление хронической обструктивной болезни легких (ХОБЛ) у пациентов с известной ишемической болезнью сердца (ИБС) и наоборот очень важно из-за более низкого качества жизни, более высокой госпитализации и в итоге более высокой смертности таких больных. Настоящий анализ фокусируется на сердечно-сосудистом вкладе в симптомы ХОБЛ и их связи с диагностическим статусом пациентов и эхокардиографическими данными. Цель исследования: изучить особенности клинического течения ХОБЛ у больных с сопутствующей ишемической болезнью сердца (ИБС) и особенности лечения. Материалы и методы. Среди 117 обследованных было выделено три группы: первую группу (42 пациента) – составили больные с сочетанием стабильной ИБС (хроническая сердечная недостаточность I–II ФК) и ХОБЛ; вторую (40 больных) – больные со стабильной ИБС без сопутствующей ХОБЛ; третью группу сравнения (35 пациентов) составили больные с ХОБЛ без ИБС. Группы были репрезантивны по возрасту и по длительности заболевания (от 5 до 14 лет). В ходе исследования у всех больных была собрана информация по следующим пунктам: демография, клинические проявления, проводимая терапия, выполнялись электрокардиография (ЭКГ), эхокардиографические и спирометрические методы обследования. Кроме того, определялась модифицированная шкала выраженности одышки Британского совета по медицинским исследованиям (modified Medical Research Council) (mMRC) и проводился тест оценки ХОБЛ (ТОХ) с помощью «Респираторного вопросника госпиталя Святого Георгия» (SGRQ) http://www.healthstatus.sgul.ac.uk/sgrq/sgrq-downloads. Исследование показало, что пациенты с сочетанием стабильной ИБС и ХОБЛ имеют большую частоту пульса и дыхания в отличие от лиц только со стабильной ИБС. Также ХОБЛ привносит в клиническую картину снижение объемных спирографических показателей, достоверно учащает суправентрикулярную экстрасистолию и блокаду правой ножки пучка Гиса по данным ЭКГ. Анализ назначения лекарств выявил различие вариантов лечения и схем лечения в зависимости от преобладания клинической картины. Показано, что пациенты с коморбидным течением в 45,2 % случаях не получали терапию в соответствие с GOLD или национальными рекомендациями по лечению ХОБЛ. Это свидетельствует о том, что врачи недооценивали анамнез и симптомы ХОБЛ при преобладании симптомов ИБС. И наоборот,при преобладании симптомов ХОБЛ 73,8 % пациентов также не получали достаточной терапии ИБС.

10.18413/2687-0940-2020-43-3-337-350

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Radiology screening scale for usual interstitial pneumonia as an additional tool for establishing the diagnosis of pulmonary fibrosis in patients with post-COVID-19 ILD.

Oleh Yakovenko Yaroslav Dziublyk Eduard Khodosh Tetiana Yakovenko Alla Hrytsiuk

2019-20 coronavirus outbreak

10.1183/13993003.congress-2024.pa3410

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Efficacy and Safety of Masitinib in Corticosteroid-Dependent Severe Asthma: A Randomized Placebo-Controlled Trial

Journal of Asthma and Allergy (2022)

Lavinia Davidescu G. Ursol Oleksii Korzh Vikrant Deshmukh L. M. Kuryk

Masitinib is an oral tyrosine kinase inhibitor that selectively targets mast cell activity and platelet-derived growth factor receptor (PDGFR) signaling, both of which are implicated in various mechanisms of asthma pathogenesis.Assessment of masitinib as an add-on to standard maintenance therapy as compared with placebo in the treatment of oral corticosteroid-dependent severe asthma.We conducted a randomized (2:1), placebo-controlled study of masitinib (6 mg/kg/d) in adults with severe asthma uncontrolled by high dose inhaled corticosteroids and long-acting beta-adrenoreceptor agonists plus oral corticosteroids (OCS) (≥7.5 mg/d). No minimum baseline blood eosinophil count was specified. Following a protocol amendment, the primary endpoint was reduction of annualized severe asthma exacerbation rate adjusted for the overall time on treatment (SAER). Subgroup analysis according to yearly cumulative OCS intake was also performed, a higher OCS dose indicating more severe asthma that is harder to control.Following an average exposure of approximately 13 months, masitinib (n = 240) reduced the SAER by 35% relative to placebo (n = 115) (rate ratio (RR) 0.65 (95% CI [0.47-0.90]; P = 0.010)). For patients with eosinophil ≥150 cell/µL, masitinib (n = 181) reduced SAER by 38% relative to placebo (n = 87); RR 0.62 (95% CI [0.42-0.91]; P = 0.016). Benefit of masitinib was shown to increase in the most severely affected patients (OCS intake of >1000 mg/year), with a significant (P < 0.01) reduction in SAER of 50%-70%. Safety was consistent with the known masitinib profile.Orally administered masitinib reduces the risk of asthma exacerbations in severe asthma patients, with an acceptable safety profile. Masitinib may potentially provide a new treatment option for oral corticosteroid-dependent severe asthma.

Clinical endpoint

10.2147/jaa.s337284

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ENVIRONMENT AS A FACTOR OF SUCCESSFUL PREGNANCY IN THE PATIENT WITH RELAPSES OF WEGENER'S GRANULOMATOSIS

Hygiene of populated places (2019)

V.S. Krutko Petro Poteiko Oleksiy Popov Eduard Khodosh О.С. Шевченко

Wegener granulomatosis

Factor (programming language)

10.32402/hygiene2019.69.250

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Диагностические признаки для вероятностной оценки риска обострений хронической обструктивной болезни легких

Научные ведомости Белгородского государственного университета. Серия: Медицина. Фармация (2016)

Е В Ефименко О А Ефремова Eduard Khodosh

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Development and Approval of a Multidimensional Model of the Clinical Effectiveness of Treatment Technologies for Patients With a Mild COVID-19 Associated With Comorbidities

Innovative Biosystems and Bioengineering (2024)

О.К. Yakovenko Serhii O. Soloviov MykhailoP Smetiukh Oleksandr Khanin Eduard Khodosh

Background. Today's latest infection, COVID-19, remains an urgent problem of the Ukrainian healthcare system, which requires further efforts to develop effective treatment strategies, especially considering the potential exacerbation of comorbidities. Objective. Develop and approve a multivariate model of the effectiveness of the treating mild COVID-19 in patients with comorbidities, using Aminocaproic acid in comparison to nirmatrelvir/ritonavir and symptomatic therapy as examples. Methods. The modeling was based on the results of a clinical study involving three groups of patients with mild COVID-19. Clinical symptoms and quality of life were dynamically evaluated through standardized questionnaires. Regression analysis was used to analyze the dynamics of clinical symptoms and identify general patterns and their correlation with quality of life. Results. Modeling the dynamics of individual clinical symptoms allowed for the examination of recovery trends in mild COVID-19 patients under different drug treatments. Aminocaproic acid demonstrated a faster alleviation of primary respiratory symptoms compared to alternative treatments. Regression analysis highlighted that cough, sore throat, and general fatigue exert the most significant negative impact on the quality of life. These symptoms contribute to the decline in both physical and psychological health and limit activity during the disease course. Conclusions. This study presents a novel, multidimensional model considering both the dynamics of individual clinical symptoms and patients' quality of life. The developed model was validated with retrospective data from mild COVID-19 patients with comorbidities. A multidimensional simulation of the clinical effectiveness of the use of aminocaproic acid, nirmatrelvir/ritonavir, or symptomatic treatment supports the preferential use of aminocaproic acid over other treatment methods. The quality-of-life modeling has enhanced our systematic understanding of the interplay between a set of clinical symptoms and overall patient condition, providing a rational foundation for treatment and care decisions.

2019-20 coronavirus outbreak

10.20535/ibb.2024.8.1.299055

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Late Breaking Abstract - Masitinib in severe asthma: Results from a randomized, phase 3 trial

05.01 - Airway pharmacology and treatment (2020)

Lavinia Davidescu Pascal Chanez G. Ursol Oleksii Korzh Vikranth Deshmukh

Background: Study AB07015 evaluated oral masitinib (6 mg/kg/d) in severe persistent asthma, uncontrolled by high-dose ICS/LABA and oral corticosteroids (OCS) (≥7.5 mg/d), irrespective of baseline eosinophil levels. Method: Eligible adult patients (pts) were treated for 36 weeks (with possible blinded extension until at least week-96). Primary endpoint was reduction of annualized severe asthma exacerbation rate (SAER) for overall exposure (W0–W96). A key subgroup was defined as pts with initial eosinophil count of ≥150 cells/µL (EOS). Subgroup analysis according to cumulative OCS intake was also performed, a higher dose indicating more severe asthma that is harder to control. Results: MAS (n=240) showed a significant 35% reduction in SAER relative to placebo (PBO, n=115) with a rate ratio (RR) of 0.64 ([95%CI[0.47–0.90];p=0·0103]). For the EOS subgroup, MAS (n=181) showed a significant 38% reduction in SAER (n=87); RR=0.62 ([95%CI[0.42–0.91];p=0·0156). Benefit of MAS increased in pts who had a higher cumulated use of OCS (see Table). In pts receiving an annualized cumulative OCS intake of >1000 mg, SAER was significantly reduced by 51% in the primary analysis population (p=0·0060), and by 71% in the EOS subgroup (p=0·0003). Safety was consistent with the known MAS profile and no new safety signals were observed. Incidence of ≥1 adverse event was 83.4% for MAS vs 82.0% for PBO. Conclusion: Masitinib demonstrated a positive benefit/risk ratio in uncontrolled severe asthma, regardless of baseline eosinophil level. Benefits were greatest in pts with the highest OCS dose dependency.

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Subgroup analysis

Rate ratio

10.1183/13993003.congress-2020.4612

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Pathomorphological changes in the lungs in severe COVID-19

EMERGENCY MEDICINE (2023)

О.К. Yakovenko Sergey L. Griff S. Hoffmann Oleksandr Khanin Eduard Khodosh

Background. The study of pathogenesis and the search for factors that lead to mortality from severe COVID-19 and disability due to post-COVID interstitial lung disease with permanent physiological and functional deficits is an urgent and unsolved problem today. The purpose was to investigate lung histopathology in patients who died of severe COVID-19 in the acute and post-acute period of the disease, and to determine the significance of histological changes in the lung parenchyma depending on gender, duration of the disease, and the use or non-use of respiratory support. Materials and methods. The study included the results of lung sample analysis in patients with severe COVID-19 who died from June to December 2020 (n = 10) and from January to December 2021 (n = 21). An autopsy was performed in 61.3 % of patients who died in the acute period of the disease (up to the 28th day), and in 38.7 % of those who died in the post-acute period (day 29–84). Respiratory support was used in 58 % (n = 18) of cases in the acute period. Results. Patients with severe COVID-19 who did not survive the acute period of the disease (its average duration was 17.31 days, the average age of the deceased was 66.1 years) and the post-acute period (the average duration of the disease was 43.22 days, the average age of the deceased was 67.8 years) had the following: the presence of hyaline membranes in 70.9 %, capillary stasis in 77.4 %, organizing pneumonia in 41.9 %, pulmonary fibrosis in 32.2 %, hemorrhages in 38.7 %, small vein thrombosis in 25.8 %, histospecific signs of bacterial and fungal co-infection in 16.1 and 3.2 %, respectively, diffuse alveolar damage in 90.3 % of cases (with acute fibrinous and organizing pneumonia in 9.6 %). Conclusions. The risk of capillary stasis is significantly higher in the post-acute than in the acute period of the disease (p = 1.7454). No statistically significant correlation was found between the acute (p = 0.359) and post-acute (p = 0.146) periods and the risk of pulmonary fibrosis. Also, no significant relationship was detected between the use of respiratory support and recorded pulmonary fibrosis in the acute (p = 0.238) and post-acute (p = 0.302) periods. It was found that the histopathological signs of hemorrhages in the lungs are the same in both periods compared to the small vein thrombosis whose risk in the acute period is significantly higher than in the post-acute one (p = 0.05). The risk of bacterial co-infection in the acute period of the disease is significantly lower than the probability of its absence (p = 0.001). The risk of a fatal outcome in the acute period of the disease among men is significantly higher than among women (p = 0.05), while in the post-acute period, there is no statistically significant dependence on gender.

Hyaline

Histopathology

Diffuse alveolar damage

Parenchyma

10.22141/2224-0586.19.4.2023.1594

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Clinical and pathological patterns of diffuse alveolar damage due to COVID-19 in patients requiring respiratory support

Актуальные проблемы медицины (2022)

Eduard Khodosh И. В. Ивахно О. А. Ефремова Natalia I. Obolonkova Tatyana P. Golivets

Аннотация.Острый респираторный дистресс-синдром и дыхательная недостаточность являются основными угрожающими состояниями у больных COVID-19.Основной причиной является, прежде всего, нарушение перфузии легких.Неинвазивная вентиляция легких может устранить гипоксемию и снизить инспираторные усилия.Использование механической вентиляции для предотвращения самоиндуцированного повреждения легких (P-SILI) рассматривается как вариант оптимизации.Ведущей характеристикой прогрессирования COVID-19 является постепенный переход от отека или ателектаза к менее обратимым структурным изменениям легких, а именно к фиброзу.В итоге нарушается механика дыхания, повышается Рсо2 в артериальной крови

Diffuse alveolar damage

2019-20 coronavirus outbreak

10.52575/2687-0940-2022-45-1-39-54

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