Peculiarities of the disease and prevalence of chronic cystitis among the female population of Ukraine in the regional aspect

The study uses data from state and industry official statistics for 2008-2017. Absolute and relative indicators of morbidity and prevalence of chronic cystitis among the female population of Ukraine, its regions and areas were analyzed taking into account two five-year periods for comparative assessment of the nature and intensity of dynamic processes. It is revealed that the number of patients with chronic cystitis (СC) registered in Ukraine is at the expense of women, which are 3-3.5 times more in number than men, with their characteristic more intensive growth (for 10 years by 3.6% against 0.4% among the adult population in the country). The first three places in the structure belong to the Southeastern region, Kyiv, Western region, the next – Central, Southern, Northeastern regions. Levels of the prevalence of the disease among women (100 thousand) are higher than the average in Ukraine and have a high growth rate (for 10 years by 13.5% from 232.2 to 263.6 against 9.3% from 171.5 to 187.5, respectively). Typical for Ukraine persistent increase in patients with the first diagnosis of chronic cystitis (0.8%, 2.1% and 2.8%, respectively, in the first, second periods and 10 years to 15112 in 2017) is also formed by this category (women's growth was 3.4%, 12.4%, and 5.0%, respectively, to 11.295). A similar situation was also identified in the analysis of the level of morbidity (per 100 thousand). In Ukraine, its growth rate for the last five years was 9.6% against 1.8% for the previous year, for 10 years – 11.9%, and the value reached 43.4 in 2017 against 38.8 in 2008. Among women, its levels are higher than the average in Ukraine (in 2017 – 59.2 against 56.1 in 2008), and the increase was more intense (by 6.2% and 11.3% over the periods; for 10 years – by 11.98%).

Epidemiological features of chronic cystitis in the capital megapolis

The paper presents the results of the analysis for 2008–2017 of the prevalence and incidence of chronic cystitis in the adult population of Kiev based on the data of state, sectoral statistical reports (F.F. No. 12, 20). Two five-year periods are highlighted, the justification for which was the well-known territorial changes in the country; the corresponding indicators served as a comparison, which made it possible to identify the features of the dynamics of the studied processes. As a result of 10 years of observation, it was revealed that for the city of Kiev, which ranks second in the structure of the prevalence and incidence of chronic cystitis in Ukraine, a decrease in the number of registered patients (by 7.3%) with a simultaneous increase in newly diagnosed patients (by 15.6%; by 25.6% of men and 13.2% of women), in contrast to their overall growth in the country as a whole (by 0.4% and 2.8%, respectively). Prevalence rates (per 100 thousand) after an increase in the first five years are replaced by a decrease in the next period (621.2 to 687.9 versus 627.8 to 533.4). Among women, they were 3.5-4.8 times large; in 2017 – 862.8 versus 176.6 among men. The peculiarity of the incidence was manifested by its increase among women and men in 2013–2017 against the background of a decrease in the previous years; in 2017, the indicators per 100 thousand reached 88.5; among women – 127.2, men – 41.5. The observed situation of an increase in the incidence of chronic cystitis among the adult population of the capital with a simultaneous decrease in the prevalence allows us to evaluate it as a result of the provided adequate specialized care and, at the same time, indicates the need to study the causes, negative factors, as the basis for the improvement and implementation of disease prevention.

Personalized Metabolic Profile by Synergic Use of NMR and HRMS

A new strategy that takes advantage of the synergism between NMR and UHPLC–HRMS yields accurate concentrations of a high number of compounds in biofluids to delineate a personalized metabolic profile (SYNHMET). Metabolite identification and quantification by this method result in a higher accuracy compared to the use of the two techniques separately, even in urine, one of the most challenging biofluids to characterize due to its complexity and variability. We quantified a total of 165 metabolites in the urine of healthy subjects, patients with chronic cystitis, and patients with bladder cancer, with a minimum number of missing values. This result was achieved without the use of analytical standards and calibration curves. A patient’s personalized profile can be mapped out from the final dataset’s concentrations by comparing them with known normal ranges. This detailed picture has potential applications in clinical practice to monitor a patient’s health status and disease progression.

Characteristics of the Incidence and Prevalence of Chronic Cystitis Among the Male Population in Ukraine

The work is devoted to the dynamics of morbidity and prevalence of chronic cystitis among the male population of Ukraine for 10 years (2008–2017). The primary documents were the reported forms of official statistics. The special feature of the study was a comparative analysis of two periods of five-years. The approach was justified by the possibility to trace the nature and intensity of changes, and was also of interest in terms of known territorial changes in the country. It was found that among the total number of registered as well as first-time patients with chronic cystitis in Ukraine, a quarter of them were men. Over the years there has been a decrease in the number of cases. At the same time its rate among the latter is lower than among those registered, which is more pronounced in the last five years. This finding may suggest that the situation is likely to change in the near future towards an increase in the number of cases among men. The first three places in the number of men with chronic cystitis are occupied by the Southeastern, Western, Southern regions. The incidence and prevalence rates (per 100,000) among men are half as high as the corresponding rates among the adult population as a whole. The values of the latter have been decreasing over the years, while the incidence rate increased between 2013 and 2017. Each region has its own peculiarities, which are manifested both by the levels of width in the regions which make up their structure and by the nature of their dynamics. The first identified men with CC usually accounted for one quarter of the total number of cases. Each region is distinguished by the number of first-time offenders. The situation in Ukraine is defined by the Southeastern, Southern regions and Kiev, where the rates are higher than the Ukrainian average and aer increasing.

Personalized metabolic profile by synergic use of NMR and HRMS

A new strategy that takes advantage of the synergism between NMR and LC-HRMS (SYNHMET), and that allows to obtain a unique list of the absolute concentrations of 164 metabolites in urine, is presented. Metabolite identification and quantification by this method in one of the most difficult biofluids to characterize, due to complexity and variability, is more accurate than what can be obtained using the two techniques separately. This result is achieved without the need for chemical reactions to cross-check the data between the two types of spectra, nor the use of analytical standards and calibration curves. The fact that the absolute rather than relative concentration is obtained allows the final dataset to be used to determine a patient's personalized profile. The number of quantifiable metabolites by the application of this method can be expanded in the future with further analysis. We will illustrate the use of SYNHMET in the study of urine samples from healthy subjects, patients with chronic cystitis and bladder cancer.

Lymphoplasmacytic hemorrhagic cystitis in dog: case report

Hematuria is a relatively common manifestation in dogs and cats secondary to disorders of the urinary tract, such as bacterial cystitis and urolithiasis, with its treatment being limited to the elimination of the primary cause. However, when hematuria is persistent or capable of causing significant hematological disorders, other less common causes should be investigated. A dog, pit bull, male, 12 years old, was admitted in the Hospital Veterinário da Universidade de Uberlândia (Veterinary Hospital of the Federal University of Uberlândia) with a major complaint of severe urinary bleeding 10 days ago. Laboratory tests showed normocytic and normochromic anemia, associated to intense hematuria. Ultrasound images revealed alterations compatible with chronic cystitis. Based on the results of the laboratory and imaging tests, treatments with antibiotic therapy associated to blood transfusions were started and the animal was referred for bladder biopsy. The histopathologic examination revealed lymphoplasmacytic hemorrhagic cystitis, a rare and very aggressive disease, which presents similar descriptions in human beings, but not yet described in dogs.

Morphological assessment of the mucous membranes of the bladder and vagina in chronic cystitis in women

The study involved 107 women aged 20 to 52 years with chronic recurrent cystitis (57 of them with leukoplakia) developing under conditions of a pathogenic and/or opportunistic infection. All patients underwent a conventional clinical and instrumental examination. Biopsy samples for culture-based and microscopic examination were taken from the area of the Pawlik’s trigone of the vagina and the Lieutaud’s trigone of the urinary bladder, in case of leukoplakia — from the field of visually healthy tissue. The carried out cytomorphological analysis and assessment of pathological processes in the adjacent tissues suggest that the infection from the vagina penetrates through the intersynaptic clefts, interstitial cell nests, the blood and lymphatic microcirculatory system into the bladder, causing cystitis inherent changes — from initial morphological forms to rough ones, up to leukoplakia. A complex of clinical, functional and pathomorphological changes that fit into the framework of the chronic cystovaginitis concept was identified.

Prevention and treatment of non-complicated infections of the lower urinary tract in pregnant women

Aim: to assess the efficacy of biologically active additive Cystenium II as a component of combined antimicrobial treatment of acute cystitis or exacerbation of chronic cystitis and asymptomatic bacteriuria (ASB) in pregnant women. Patients and Methods: 65 pregnant women with urinary tract infections were enrolled. Group 1 included 22 women with acute cystitis or exacerbation of chronic cystitis and group 2 included 20 women with ASB. These women received standard antimicrobial therapy (fosfomycin trometamol 3 g) and Cystenium II (1 tablet twice daily with food for 14 days). The control group included 23 women with acute cystitis or exacerbation of chronic cystitis or ASB who received standard antimicrobial therapy only. Treatment results were evaluated after 14 days and 2 months. Results: complete resolution of cystitis occurred on days 2 and 3 in group 1 and days 4 and 5 in group 2. Eradication of causative agent as demonstrated by inoculation of urine samples after 14 days was reported in 77.3% of women in group 1, 70% of women in group 2, and 61% of women in group 3. Total treatment efficacy in group 1 was 81.9%, i.e., exacerbations of chronic cystitis were diagnosed in 3 women (13.6%), acute pyelonephritis in 1 woman (4.5%). Total treatment efficacy in group 2 was 90%, i.e., recurrence of ASB was diagnosed in 2 women (10%). Meanwhile, treatment efficacy in the control group was 56.5%, i.e., clinical exacerbation of chronic cystitis was diagnosed in 6 women (26%). Moreover, in 4 women (17.4%), the disease was complicated by acute pyelonephritis. Conclusions: Cystenium II for acute cystitis or exacerbation of chronic cystitis and ASB in pregnant women improves treatment success and also maintains the effect. KEYWORDS: cystitis, asymptomatic bacteriuria, pregnancy, treatment, cranberry, prevention of recurrences. FOR CITATION: Nashivochnikova N.A., Krupin V.N., Leanovich V.E. Prevention and treatment of non-complicated infections of the lower urinary tract in pregnant women. Russian Journal of Woman and Child Health. 2021;4(2):119–123. DOI: 10.32364/2618-8430- 2021-4-2-119-123.