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Responding to such epidemic challenges is very difficult both organizationally and financially. The result is evaluated over time with well-organized epidemiological surveillance. According to the approved polio outbreak response plan, which arose in early October 2021, it was only possible to start the 1st round of the campaign on February 1, 2022. It was supposed to last 3 weeks and was aimed at vaccinating 140,000 children from 6 months of age with IPV. up to 6 years who missed vaccination according to the Calendar. Almost by the end of the 3rd week of the 1st round, as of February 18, 2022, only 28% of the planned number of children were vaccinated. Therefore, we decided to extend the 1st round for an additional 2 weeks, which again was not performed due to the outbreak of war. Thus, there was no actual response to polio outbreaks.

Учитывая, что аналогичная картина имела место и в предыдущие годы, в Украине произошло накопление среди детского населения слоя восприимчивых к полиомиелиту. Кроме того, начиная с апреля 2016 г., оральная (живая) полиомиелитная вакцина (ОПВ), которая в Украине используется, начиная с 3-й прививки , не содержит полиовирус типа 2 (двухкомпонентная ОПВ, которая теперь применяется в мире, содержит только полиовирусы). тип ов1 и 3). Указанное также способствует снижению как индивидуального, так и популяционного иммунитета к полиовирусу типа 2. Следствием стала вспышка полиомиелита, вызванная вакцинородственным полиовирусом типа 2 (вирусом вакцинного происхождения, что в процессе циркуляции в низко иммунной популяции приобрел свойства нейровирулент .). На эту вспышку не было адекватного реагирования, а именно проведение дополнительных туров вакцинации детей в возрасте до 6 лет, чтобы прекратить циркуляцию вакцинородственного вируса. В январе 2022 г. возникла новая вспышка.

Treatment with corticosteroids (especially prednisolone ≥20 mg/day or equivalent) is associated with an increased risk of infection. However, it is unclear whether corticosteroid therapy is associated with an increased risk of developing COVID-19 or its complications. Data on budesonide, a topical corticosteroid with low systemic bioavailability, show that these drugs are associated with significantly fewer side effects compared to systemic corticosteroids and their side effects are close to placebo. If possible, corticosteroids should be avoided and a rapid dose reduction considered, and a switch to budesonide is recommended. This must be taken into account, taking into account the risk of exacerbation of CKD. If a patient with COPD is in contact with a person with COVID-19 or develops COVID-19, it is recommended to gradually reduce the dose of corticosteroids, the use of budesonide is preferred, but taking into account the severity of COPD and the risk of exacerbation.

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The most common diseases associated with hypertension include: obesity, primarily abdominal obesity (AO), type 2 diabetes mellitus (DM), coronary heart disease (CHD), arrhythmias and conduction disorders, chronic kidney disease (CKD), cerebrovascular diseases , joint diseases, chronic obstructive pulmonary disease, sleep apnea syndrome, thyroid disease and other endocrine diseases. In this regard, the 2018 European Society of Hypertension and European Society of Cardiology guidelines emphasized the need for careful stratification of cardiovascular and overall risk of complications in order to select the most optimal antihypertensive therapy.


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