Authors explore the influence of Russian aggression on Ukrainian healthcare and humanitarian crises. On 24 February 2022, Ukraine faced an unprovoked brutal Russian invasion resulting in multiple negative consequences. During the three months of full-scale war, Russians damaged more than 600 hospitals and killed at least 12 medics. Access to health care is severely impacted due to security concerns, restricted mobility, broken supply chains, and mass population displacement. Health care continues to come under attack (including attacks against health facilities, transport, personnel, patients, supplies, and warehouses), with a total of 295 attacks on health care, resulting in 59 injuries and 76 deaths, reported between 24 February and 15 June. Ministry of Health reported that 1658 medical workers had been forced to change their residence and employed in other regions of the country. Russian aggression negatively influenced not only the medical system and economics, but it led humanitarian crisis in the whole of Ukraine.

Vasculitis is a clinically diverse group of diseases with histopathological signs of blood vessel inflammation, which contributes to vascular damage and ischemic damage to the affected tissues. Vasculitic neuropathy is a common complication of the primary systemic vasculitides, such as polyartertis nodosa and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, systemic diseases of the connective tissue - systemic lupus erythematosus and Sjogren syndrome, vasculitis associated with infection, most often viral hepatitis C and B and non - systemic vasculitis neuropathy. Vessels of medium and small caliber are involved in the pathological process in these diseases. With all vasculitis, except for those caused by the direct effect of the infectious trigger on the blood vessel walls, the main pathogenetic mechanism is an autoimmune process with the development of vasa nervorum vasculitis - small arteries and vessels that supply peripheral nerves, and the outcome - nerve ischemia. The classic clinical presentation is an acute or subacute painful multifocal neuropathy that has a predilection for the lower extremities, affects two or more named nerves, and progresses in a step wise manner. However, vasculitic neuropathy can manifest in a variety of ways, including asymmetric polyneuropathies and distal symmetric sensory neuropathies, and it also can be slowly progressive, particularly in cases of nonsystemic vasculitic neuropathy (NSVN), a form of vasculitis that clinically remains restricted to peripheral nerves. Nerve biopsy can help establish the diagnosis of a systemic vasculitis, particularly when other organ involvement is not clinically apparent, and is required for diagnosis of NSVN. Neuropathy due to systemic vasculitis should be treated in accordance with the recommendations for the treatment of the underlying disease. In NSVH, the main medicine of choice are glucocrticoids, and in severe/progressive cases, pulse therapy with cyclophosphamide.

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Objective: The present work was led by a multidisciplinary panel of experts and proposes an extensive review on the use of prescription crystalline glucosamine sulfate (pCGS) in the multimodal treatment of osteoarthritis (OA) applicable in Ukraine and other Commonwealth of Independent States (CIS) countries. Methods: A panel of rheumatologists, orthopedic surgeons, and field experts from Ukraine and CIS regions discussed the management of OA. Literature was systematically searched using Medline, EMBASE, CIHNAL, and Cochrane Library databases. The 2-day meeting critically reviewed the available literature, treatment algorithms, pharmacoeconomic aspects, and real-world instances to form a multimodal approach based both on real-life clinical practice and systematic literature research for the management of OA in Ukraine and CIS countries. Expert Opinion: pCGS plays a pivotal role in the stepwise approach to OA treatment. If it is necessary (step 1), the combined use of pCGS with paracetamol and topical nonsteroidal anti-inflammatory drugs (NSAIDs) has been recommended. If symptoms persist, oral NSAIDs and intra-articular (IA) hyaluronic acid or corticosteroids are added to the therapy (step 2) of pCGS in the patients. In case of insufficient relief and severe OA (step 3), pCGS along with oral NSAIDs, IA corticosteroids, and duloxetine have been recommended. Patient stratification with regular monitoring and careful alterations in treatment were advocated. Conclusions: This expert opinion article recommends a modified approach to the existing guidelines incorporating pCGS in treatment modality of OA in Ukraine and CIS countries. Extensive use of pCGS targets early symptomatic relief in OA while limiting the adverse effects due to long-term use of analgesics and NSAIDs.

Despite the rapid development of biological therapy and decisive establishment of such medication in the rheumatic disease management, rheumatoid arthritis (RA) patients are often subjected to orthopedic surgical interventions [1]. Joint endoprosthetics, arthroplasty, arthroscopic debridement, tendon reconstruction, rheumatoid nodule removal, tunnel and wrist canal decompression-all of these procedures , and numerous others, make up a list of orthopedic interventions indicated to treat rheumatoid arthritis. Furthermore, the RA patients undergo surgery due to their somatic conditions much more often than the rest of the population [1]. Perioperative period involves a number of infection-related risks, such as surgical wound infection and pneumonia. Arthroplasty and other interventions involving prosthet