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Пульс - медицинский центр
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Реагирование на такие эпидемические вызовы очень сложны как организационно, так и финансово. Результат оценивается с течением времени при хорошо организованном эпидемиологическом надзоре. Согласно утвержденному плану реагирования на вспышку полиомиелита, возникшему в начале октября 2021 г., удалось только 1 февраля 2022 г. начать 1-й тур кампании. Он должен был длиться 3 недели и имел целью вакцинировать ИПВ 140 тыс. детей в возрасте от 6 мес. до 6 лет, пропустивших вакцинацию согласно Календарю. Практически к концу 3-й недели 1-го тура по состоянию на 18.02.2022 г. было провакцинировано лишь 28% детей от запланированного количества. Поэтому решили продлить 1-й тур еще дополнительно на 2 недели, что снова не было исполнено в связи с началом войны. Таким образом, фактически реагирования на вспышки полиомиелита не произошло.
Considering that a similar picture took place in previous years, in Ukraine there was an accumulation of a layer susceptible to poliomyelitis among the child population. In addition, since April 2016, the oral (live) polio vaccine (OPV), which is used in Ukraine, since the 3rd vaccination, does not contain type 2 poliovirus (two-component OPV, which is now used worldwide, contains only polioviruses). ). type ov1 and 3). This also contributes to a decrease in both individual and population immunity to type 2 poliovirus. The result was an outbreak of poliomyelitis caused by vaccine-derived type 2 poliovirus (a vaccine-derived virus that acquired neurovirulent properties during circulation in a low immune population.). There was no adequate response to this outbreak, namely additional vaccination rounds for children under 6 years of age to stop the circulation of the vaccine-related virus. In January 2022, a new outbreak emerged.
If a patient tests positive for SARS-CoV-2 and/or develops COVID-19, discontinuation of biologics should be considered until the patient clears the infection. JAK inhibitors (tofacitinib and others) selectively affect the intracellular JAK/STAT signaling system, which mediates the action of many cytokines involved in the pathogenesis of ulcerative colitis. Unlike genetically engineered biological drugs, inhibition
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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