Portal vein thrombosis (PVT) in patients with liver cirrhosis is a common complication associated with adverse outcomes. Aim. To build a predictive model for PVT in cirrhotic patients. Materials and methods. A single centre case-control study was carried out. From the database of 1512 cirrhotic patients 94 with newly diagnosed PVT based on contrast-enhanced computed tomography were referred to the Case group. Malignant PVT was an exclusion criterion. Patients without PVT were stratified and matched according to sex, age and etiology of cirrhosis; case-control ratio was 1 : 3–4. The prevalence of PVT in the database, clinical, laboratory, instrumental parameters of the groups were evaluated. Logistic regression model was used to estimate association between variables and PVT. Results and discussion. The overall prevalence of PVT was 6.2% with the highest rates among the patients with HBV infection – 16.7%, nonalcoholic steatohepatitis – 15.6%, alcohol abuse in combination with HCV infection – 11.7%. The best predictive model included variables: Child-Pugh classes B–C (coefficient of regression β=1.853, р=0.001), ascites (β=0.460, р=0.003), hepatocellular carcinoma without vascular invasion (β=2.126, р=0.0001), endoscopic band ligation (β=0.774, р=0.003), azygoportal disconnection (β=2.734, р=0.001), portal hypertensive gastropathy (β=0.793, р=0.017), portal vein diameter (β=0.203, р=0.004), and local factors – ulcerative colitis flare, Clostridium difficile enterocolitis, spontaneous bacterial peritonitis, colorectal cancer, splenectomy, cholecystectomy (β=2.075, р=0.017). The model had accuracy 85.8% (95% CI 81.7–89.4%), sensitivity – 55.1% (95% CI 43.4–66.4%), specificity – 95% (95% CI 91.6–97.3%), and AUC – 0.871 (95% CI 0.826–0.916). Conclusion. Child-Pugh classes B–C, severe portal hypertension, hepatocellular carcinoma without vascular invasion, and local factors were estimated as risk factors of PVT in cirrhotic patients. Keywords: portal vein thrombosis, liver cirrhosis, case-control study, Child-Pugh class, portal hypertension, hepatocellular carcinoma, local factors, logistic regression model

The COVID-19 pandemic is a global public health challenge with understudied effects on antimicrobial usage. We aimed to analyze antimicrobial prescribing patterns in COVID-19 patients in Russian multi-field hospitals by means of the Global-PPS Project developed by the University of Antwerp. Out of 999 patients in COVID-19 wards in six hospitals surveyed in 2021, 51.3% received antimicrobials (79% in intensive care, 47.5% in medical wards). Systemic antivirals and antibiotics were prescribed to 31% and 35.1% of patients, respectively, and a combination of both to 14.1% of patients. The top antivirals administered were favipiravir (65%), remdesivir (19.2%), and umifenovir (15.8%); the top antibiotics were ceftriaxone (29.7%), levofloxacin (18%), and cefoperazone/sulbactam (10.4%). The vast majority of antibiotics was prescribed for treatment of pneumonia or COVID-19 infection (59.3% and 25.1%, respectively). Treatment was based on biomarker data in 42.7% of patients but was targeted only in 29.6% (6.7% for antibiotics). The rate of non-compliance with guidelines reached 16.6%. Antimicrobial prescribing patterns varied considerably in COVID-19 wards in Russian hospitals with groundlessly high rates of systemic antibiotics. Antimicrobial usage surveillance and stewardship should be applied to inpatient care during the COVID-19 pandemic.

Background. The inappropriate and overuse of antimicrobials is a problem worldwide. To target future interventions, a thorough understanding of current behavior reasons is needed. The aim of the study was to explore antibiotic knowledge, attitudes, and behaviors among patients residing in Russia. Methods. In total, 149 semistructured interviews were carried out with respondents using antibiotics without prescriptions. Interviews were used to assess participants practices to treat symptoms of a confirmed/suspected infectious disease and their behaviors, knowledge, and attitudes toward the use of antimicrobials. A directed content analysis was applied. Results. Despite regulation, inappropriate use of antibiotics is a common practice. Knowledge on the mechanism of action and indications for the use of antibiotics was generally low. However, self-diagnosis, self-treatment with antimicrobials, and attempts to purchase antibiotics in pharmacies with no prescription were quite common. Family members and friends were involved in decisions about treatment strategy. Time spent for the doctors visit, fear to be exposed to additional infections in outpatient clinics/hospitals, previous experience with antimicrobial self-treatment, and loyal policy of selling antibiotics influenced the respondents decisions of not going to the doctor. COVID-19 made an impact on antimicrobial self-treatment: there was a substantial complexity in contacting a medical healthcare provider. Most of the respondents did not pay much attention or even noticed informational materials on the proper use of antibiotics. Conclusion. Self-treatment with antibiotics in Russia exists. Conducted information campaigns were not effective enough as the low level of knowledge about antimicrobials and antimicrobial resistance was revealed by the present study.

Objectives: The study aimed to investigate behaviour, knowledge and practices towards antibiotic (AB) use among patients who purchased ABs with a prescription across Russia. Methods: Semi-structured interviews conducted in all eight Federal Districts, Moscow and Saint Petersburg in 2022 by 21 researchers trained specifically for this study. Data were analysed using a directed content analysis approach. Results: In total, 151 respondents were interviewed. Respiratory symptoms were the most common reason for AB prescription. The majority of patients discussed their complaints with family members or friends before consulting the physician and occasionally looked for information on antimicrobial treatment on the internet. The decision to use an AB was usually made by the physician, although patients often anticipated its prescription. Respondents typically chose to go to the nearest drug store to pick up the medicines, not seeking any recommendation from the local pharmacists. The level of knowledge about the effects of ABs was generally low. In most cases, patients were not aware of antimicrobial resistance and rarely recalled any information campaigns targeting prudent AB use. Respondents admitted COVID-19 had an impact on their behaviour: they have become more caring towards their health, but less likely to seek medical care because of the risk of infection. Conclusions: Our findings, in particular low awareness of the population about the effects of ABs and antimicrobial resistance, peculiarities of attitudes and behaviour (significant influence of the environment, tendency to self-diagnose, fairly high level of trust in doctors etc.) can be useful for the development of effective initiatives aiming for prudent AB use.

Sixty-six patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 and pneumonia on chest computer tomography were prospectively recruited. A combined respiratory swab for polymerase chain reaction (PCR), urine sample for pneumococcal and Legionella antigen, and sputum or endotracheal aspirate were collected. Urinary antigen and blood culture tests were negative in all cases as well as the PCR tests for other respiratory viruses and atypical bacterial pathogens. In total, 5 patients (7.5%) had co-infection. By PCR a high prevalence of colonization with bacterial pathogens was found. In conclusion, co -infection is rare in coronavirus disease 2019 patients, and additional examination to identify other pathogens should be performed only in selected cases.