Olfactory disorders of various etiology are an actual problem for a large part of the adult population of the world, according to the results of conducted research, their prevalence is about 19%. Hyposmia, anosmia, or dysosmia are considered the initial symptom in more than 25% of patients, but over time they affect more than 75% of the total number of patients. The main risk factors for the development of olfactory disorders are old age, male gender, head injuries, exposure to toxic substances and infectious diseases of the upper respiratory tract. The purpose of the study is to clarify the immunomorphological features of the olfactory epithelium of the nasal cavity of patients with the 2019 coronavirus disease, taking into account the background pathological changes in the structures of this area for a better understanding of the mechanisms of the development of olfactory dysfunction during infection with the SARS-CoV-2 coronavirus, depending on the presence of aggravating factors. Autopsy material was used for the study, namely fragments of the mucous membrane of the upper parts of the nasal cavity (olfactory epithelium), obtained from 20 deceased (8 women and 12 men) aged 53 to 86 years with a diagnosis of "Coronavirus disease 2019", confirmed by laboratory (polymerase chain reaction) and olfactory disorders of various degrees in the anamnesis. Mucosal samples were stained with standard hematoxylin and eosin and using an immunohistochemical method with antibodies to neuron-specific beta-III tubulin (TuJ-1), olfactory marker protein (OMP) and angiotensin-converting enzyme (ACE-2). The distribution of expression variants of receptors to OMP, TuJ-1 and ACE-2 in sections with signs of structural rearrangement and without signs of structural rearrangement at a magnification of 200x showed a significant difference (p<0.05): the number of OMP-positive cells in sections of the olfactory epithelium of the first group on average was 43.5 in the field of view (16.0-59.0), TuJ-1-positive cells in these sections – 44.5 in the field of view (17.0-61.0), ACE-2-positive cells – 37 in the field of view (14.0-55.0), and in the samples of the olfactory epithelium of the second group, the expression of receptors to OMP was only partially positive (18 (12.0-25.0) cells), TuJ-1 – 17.5 (14.0-24.0) cells, ACE-2 – 14 (9.0-18.0) cells. That is, the occurrence of olfactory disorders under the conditions of infection with the SARS-CoV-2 coronavirus can be both de novo and against the background of previous changes in the structural elements of the olfactory area of the mucous membrane of the nasal cavity. In this case, more vivid symptoms are likely, as well as criticality and irreversibility of pathological changes.

Key words: odorants, olfaction, olfactory epithelium, coronavirus disease 2019 (COVID-19), coronavirus infection, SARS-CoV-2

1. Ajmani GS, Suh HH, Wroblewski KE, et al. Smo­king and Olfactory Dysfunction: a Systematic Literature Review and Meta-Analysis. Laryngoscope. 2017;127:1753-61. doi: https://doi.org/10.1002/lary.26558
2. Williams FMK, Freidin MB, Mangino M, et al. Self-reported symptoms of COVID-19 including symp­toms most predictive of SARS-CoV2 infection, are heritable. Med Rxiv preprint. 2020;23:316-2 doi: https://doi.org/10.1101/2020.04.22.20072124
3. Palmquist E, Larsson M, Olofsson JK, et A Pros­pective Study on Risk Factors for Olfactory Dys­function in Aging. J Gerontol A Biol Sci Med Sci. 2020;75:603-10. doi: https://doi.org/10.1093/gerona/glz265
4. Tong JY, Wong A, Zhu D, et al. The prevalence of olfactory and gustatory dysfunction in COVID-19 patients: a systematic review and metaanalysis. Otolaryngol Head Neck 2020;163:3-11. doi: https://doi.org/10.1177/0194599820926473
5. Xydakis MS, Dehgani-Mobaraki P, Holbrook EH, et al. Smell and taste dysfunction in patients with COVID-19. LancetInfect  2020;20:1015-6. doi: https://doi.org/10.1016/S1473-3099(20)30293-0
6. Yan CH, Faraji F, Prajapati DP, et al. Self-re­ported olfactory loss associates with outpatient clinical course in COVID-19. Int Forum Allergy Rhinol. 2020;10:821-31. doi: https://doi.org/10.1002/alr.22592
7. Mosaad AA, Noha A. Dysosmia in Recovered COVID-19 Patients. J Craniofac Surg. 2023;34:843-4. doi: https://doi.org/10.1097/SCS.0000000000009008
8. Vaira LA, Salzano G, Fois AG, et al. Potential pathogenesis of ageusia and anosmia in COVID-19 pa­tients. Int Forum Allergy Rhinol. 2020;10:1103-4. doi: https://doi.org/10.1002/alr.22593
9. Bilinska K, Jakubowska P, Von Bartheld C, et al. Expression of the SARS-CoV-2 Entry Proteins, ACE2 and TMPRSS2, in Cells of the Olfactory Epithelium: Identi­fication of Cell Types and Trends with Age. ACS Chemical Neuroscience.2020;11:1555-62. doi: https://doi.org/10.1021/acschemneuro.0c00210
10. Chen CR, KachramanoglouC, Li D, et al. Ana­tomy and Cellular Constituents of the Human Olfactory Mucosa: A Review. J Neurol Surg B Skull Base. 2014;75:293-300. doi: https://doi.org/10.1055/s-0033-1361837
11. Meinhardt J, Radke J, Dittmayer C, et al. Olfac­tory transmucosal SARS-CoV-2 invasion as a port of cent­ral nervous system entry in individuals with COVID-19. Nature 2021;24:168-75. doi: https://doi.org/10.1038/s41593-020-00758-5
12. Butowt R, Von Bartheld C. Anosmia in COVID-19: Underlying Mechanisms and Assessment of an Olfactory Route to Brain Infection. The Neuroscientist. 2021;27:582-603. doi: https://doi.org/10.1177%2F1073858420956905
13. Goncalves S, Goldstein BJ. Pathophysiology of Olfactory Disorders and Potential Treatment Strategies. CurrOtorhinolaryngol  2016;4:115-21. doi: https://doi.org/10.1007/s40136-016-0113-5
14. Saussez S, Lechien JR, Hopkins C. Anosmia: an evo­lution of our understanding of its importance in COVID‑19 and what questions remain to be answered. European Archives of Oto-Rhino-Laryngology. 2021;278:2187-91. doi: https://doi.org/10.1007/s00405-020-06285-0
15. Van Riel D, Verdijk R, Kuiken T. The olfactory nerve: a short cut for influenza and other viral diseases into the central nervous system. J Pathol. 2015;235:277-87. doi: https://doi.org/10.1002/path.4461
16. Xu H, Zhong L, Deng J, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa.Int J Oral  2020;12:8. doi: https://doi.org/10.1038/s41368-020-0074-x
17. Ziegler CGK, Allon SJ, Nyquist SK, et al. SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues. Cell. 2020;181:1016-35. doi: https://doi.org/10.1016/j.cell.2020.04.035
18. Zubair AS, McAlpine LS, Gardin T, et al. Neuro­pathogenesis and neurologic manifestations of the coronaviruses in the age of coronavirus disease 2019: a review.JAMA  2020;77:1018-27. doi: https://doi.org/10.1001/jamaneurol.2020.2065
19. Werner S, Nies E. Olfactory dysfunction revisited: a reappraisal of work-related olfactory dysfunction caused by chemicals. Journal of Occupational Medicine and Toxico­lo­gy. 2018;13:28. doi: https://doi.org/10.1186/s12995-018-0209-6
20. Strahova OP, Androsov OI. [Statistical methods of processing the results of medical and biological research]. Lviv; 2021. 164 p. Ukrainian.

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Shponka I.S. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-7561-6489

Usova O.M. Dnipro State Medical University, Dnipro, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-8505-2309

Shponka I.S., Usova O.M. The influence of external factors on the development of olfactory disorders in patients with the coronavirus disease 2019: an immunomorphological assessment. Medicni perspektivi. 2024;29(1):4-9.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300438

Analysis of parameters of purine metabolism in patients with diabetes mellitus type 2

Until recently, the extracellular matrix was considered only a structural component of the organ, which performs exclusively the function of the framework. However, recent studies provide insight into a much broader role of extracellular matrix in metabolic homeostasis, the transmission of intra-organ and tissue signals. Metabolic syndrome and chronic infectious diseases can change the extracellular matrix’s structure in the heart. However, the combined effect of bacterial lipopolysaccharide and metabolic syndrome on extracellular matrix of the heart remains insufficiently elucidated at present. The purpose of this work is to establish the effect of organism stimulation with bacterial lipopolysaccharide on the concentration of different fractions of glycosaminoglycans, the intensity of collagenolysis and the content of sialic acids in the heart of rats under conditions of experimental metabolic syndrome. The study was conducted on 24 sexually mature rats of the “Wistar” line weighing 200-260 g. Animals were divided into 4 groups with 6 animals in each group: control, metabolic syndrome group, lipopolysaccharide injection group and combination of lipopolysaccharide injection and metabolic syndrome group. Metabolic syndrome was modelled by using 20% fructose solution as the only water source. Lipopolysaccharide of S. typhi was administered according to the scheme: the first week, 0.4 μg/kg 3 times intraperitoneally, then once a week 0.4 μg/kg throughout the experiment. Experiment lasted for 60 days. The concentration of glycosaminoglycans, their separate fractions, the content of free L-hydroxyproline and sialic acids was studied in 10% rat heart homogenate. The combined effect of stimulation of the organism with bacterial lipopolysaccharide and metabolic syndrome modeling led to an increase in the total concentration of glycosaminoglycans in the heart of rats by 73.46% compared to the control group. Under these conditions, the concentration of the heparin-heparan fraction of glycosaminoglycans in the heart of rats increased by 188.64% compared to the control group. The content of the keratan-dermatan fraction of glycosaminoglycans increased by 75.34%, and the chondroitin fraction of glycosaminoglycans increased by 17.63%. The concentration of free L-hydroxyproline increased by 167.23%. The content of sialic acids increased by 66.95%. Metabolic syndrome, stimulation of the organism with bacterial lipopolysaccharide and their combination lead to intensification of degradation of the extracellular matrix of the heart of rats due to increased collagenolysis, destruction of proteoglycans and glycoproteins.

Key words: metabolic syndrome, heart, bacterial lipopolysaccharide, extracellular matrix, glycosaminoglycans

1. Karamanos NK, Theocharis AD, Piperigkou Z, et al. A guide to the composition and functions of the extracellular matrix. FEBS J. 2021;288(24):6850-912. doi: https://doi.org/10.1111/febs.15776
2. Liu C, Pei M, Li Q, Zhang Y. Decellularized ex­tracellular matrix mediates tissue construction and regeneration. Front Med. 2022;16(1):56-82. doi: https://doi.org/10.1007/s11684-021-0900-3
3. Frangogiannis NG. The Extracellular Matrix in Ischemic and Nonischemic Heart Failure. Circ Res. 2019;125(1):117-46. doi: https://doi.org/10.1161/CIRCRESAHA.119.311148
4. Park HJ, De Jesus Morales KJ, Bheri S, Kas­souf BP, Davis ME. Bidirectional relationship between cardiac extracellular matrix and cardiac cells in ischemic heart disease. Stem Cells. 2021;39(12):1650-9. doi: https://doi.org/10.1002/stem.3445
5. Frangogiannis NG. Cardiac fibrosis. Cardiovasc Res. 2021;117(6):1450-88. doi: https://doi.org/10.1093/cvr/cvaa324
6. Unamuno X, Gómez-Ambrosi J, Ramírez B, et al. NLRP3 inflammasome blockade reduces adipose tissue inflammation and extracellular matrix remodeling. Cell Mol Immunol. 2021;18(4):1045-57. doi: https://doi.org/10.1038/s41423-019-0296-z
7. Duan A, Shen K, Li B, et al. Extracellular vesicles derived from LPS-preconditioned human synovial me­senchymal stem cells inhibit extracellular matrix degradation and prevent osteoarthritis of the knee in a mouse model. Stem Cell Res Ther. 2021;12(1):427. doi: https://doi.org/10.1186/s13287-021-02507-2
8. Akimov OY, Mykytenko AO, Mischenko AV, Kostenko VO. Influence of bacterial lipopolysaccharide on the degradation of the components of the extracellular matrix of rat biceps femoris muscle during high fructose diet-induced metabolic syndrome. Fiziologichnyi Zhurnal. 2023;69(3):99-105. doi: https://doi.org/10.15407/fz69.03.099
9. Mamikutty N, Thent ZC, Sapri SR, Sahrud­din NN, Mohd Yusof MR, Haji Suhaimi F. The estab­lishment of metabolic syndrome model by induction of fructose drinking water in male Wistar rats. Biomed Res Int. 2014;2014:263897. doi: https://doi.org/10.1155/2014/263897
10. Faizi N, Alvi Y. Biostatistics Manual for Health Research A Practical Guide to Data Analysis. Elsevier Science; 2023. 290 p.
    doi: https://doi.org/10.1016/C2022-0-00374-3
11. Wang Q, Li H, Lu H, et al. SAA1 exacerbates pancreatic β-cell dysfunction through activation of NF-κB signaling in high-fat diet-induced type 2 diabetes mice. Mol Cell Endocrinol. 2023;576:112043. doi: https://doi.org/10.1016/j.mce.2023.112043
12. Al-Roub A, Akhter N, Al-Rashed F, et al. TNFα induces matrix metalloproteinase-9 expression in mono­cytic cells through ACSL1/JNK/ERK/NF-kB signaling pathways. Sci Rep. 2023;13(1):14351. doi: https://doi.org/10.1038/s41598-023-41514-6
13. Kirsten N, Ohmes J, Mikkelsen MD, et al. Impact of Enzymatically Extracted High Molecular Weight Fucoidan on Lipopolysaccharide-Induced Endothelial Activation and Leukocyte Adhesion. Mar Drugs. 2023;21(6):339. doi: https://doi.org/10.3390/md21060339
14. Feng C, Cross AS, Vasta GR. Galectin-1 mediates interactions between polymorphonuclear leukocytes and vascular endothelial cells, and promotes their extravasation during lipopolysaccharide-induced acute lung injury. Mol Immunol. 2023;156:127-35. doi: https://doi.org/10.1016/j.molimm.2023.02.011
15. Allendorf DH, Franssen EH, Brown GC. Lipopo­lysaccharide activates microglia via neuraminidase 1 desialylation of Toll-like Receptor 4. J Neurochem. 2020;155(4):403-16. doi: https://doi.org/10.1111/jnc.15024
16. Shahvali S, Shahesmaeili A, Sanjari M, Karami-Mohajeri S. The correlation between blood oxidative stress and sialic acid content in diabetic patients with nephro­pathy, hypertension, and hyperlipidemia. Diabetol Int. 2019;11(1):19-26.
    doi: https://doi.org/10.1007/s13340-019-00395-9
17. Buijsers B, Maciej-Hulme M, Jacobs M, et al. Glycosaminoglycans and fucoidan have a protective effect on experimental glomerulonephritis. Front Mol Biosci. 2023;10:1223972. doi: https://doi.org/10.3389/fmolb.2023.1223972
18. Ying J, Zhang C, Wang Y, et al. Sulodexide im­proves vascular permeability via glycocalyx remodelling in endothelial cells during sepsis. Front Immunol. 2023;14:1172892. doi: https://doi.org/10.3389/fimmu.2023.1172892
19. Miguez PA, Bash E, Musskopf ML, et al. Control of tissue homeostasis by the extracellular matrix: Synthetic heparan sulfate as a promising therapeutic for periodontal health and bone regeneration. Periodontol 2000. 2023;00:1-22. doi: https://doi.org/10.1111/prd.12515
20. Klisic A, Patoulias D. The Role of Endocan in Cardiometabolic Disorders. Metabolites. 2023;13(5):640. doi: https://doi.org/10.3390/metabo13050640
21. Sullivan RC, Rockstrom MD, Schmidt EP, Hip­pensteel JA. Endothelial glycocalyx degradation during sepsis: Causes and consequences. Matrix Biol Plus. 2021;12:100094. doi: https://doi.org/10.1016/j.mbplus.2021.100094
22. Diaz-Salmeron R, Cailleau C, Denis S, Pon­chel G, Bouchemal K. Hyaluronan nanoplatelets exert an intrinsic anti-inflammatory activity in a rat model of bladder painful syndrome/interstitial cystitis. J Control Release.2023;356:434-47. doi: https://doi.org/10.1016/j.jconrel.2023.03.014 
23. Wang X, Liu D, Li D, et al. Combined treatment with glucosamine and chondroitin sulfate improves rheumatoid arthritis in rats by regulating the gut microbiota. Nutr Metab (Lond). 2023;20(1):22. doi: https://doi.org/10.1186/s12986-023-00735-2
24. Zhang Y, Wang ZL, Deng ZP, Wang ZL, Song F, Zhu LL. An extracellular matrix-inspired self-healing composite hydrogel for enhanced platelet-rich plasma-mediated chronic diabetic wound treatment. Carbohydr Polym. 2023;315:120973. doi: https://doi.org/10.1016/j.carbpol.2023.120973
25. Matsytska YK, Akimov OY, Mykytenko AO. In­fluence of corvitin and metformin on biochemical changes in lacrimal glands of rats during water avoidance stress modeling. Oftalmologicheskii Zhurnal. 2022;97(3):39-44. doi: https://doi.org/10.31288/oftalmolzh202233944
26. Skrypnyk I, Maslova G, Lymanets T, Gusa­chenko I. L-arginine is an effective medication for pre­vention of endothelial dysfunction, a predictor of anthra­cycline cardiotoxicity in patients with acute leukemia. Exp Oncol. 2017;39(4):308-11. doi: https://doi.org/10.31768/2312-8852.2017.39(4):308-311

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Akimov O.Ye. Poltava State Medical University, Poltava, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-4958-3695

Mykytenko A.O. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0002-4205-2699

Kostenko V.O. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0002-3965-1826

Akimov O.Ye., Mykytenko A.O., Kostenko V.O. Influence of organism stimulation with bacterial lipopolysaccharide on the metabolism of the extracellular matrix of the heart of rats under conditions of experimental metabolic syndrome. Medicni perspektivi. 2024;29(1):10-16.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300443

Plasma amino acids spectrum as an important part of metabolomic pattern in patients with coronary artery disease and atrial fibrillation

The using of explosive substances and devices can lead to brain injuries, the diagnosis of which requires the determination of primary biomarkers. Therefore, the aim was to establish and study histopathological and ultrastructural changes in the rats brain after exposure to an air blast wave. The study was carried out on 18 male Wistar rats, which were randomly divided into two groups: sham (n=9) and experimental (n=9). The animals of the experimental group were anesthetized with halothane and gently fixed in a horizontal position on the abdomen with the front part of the rat's muzzle at a distance of 5 cm from the device opening and subjected to an excess pressure of 26-36 kPa. Animals of both groups were decapitated, brains were removed, fixed, histopathological and ultrastructural analyzes were conducted using standard methods. Intergroup differences were assessed by Mann-Whitney U-test. Light microscopy revealed primary lesions in the form of small focal, multifocal hemorrhages, cerebral vessel ruptures and microscopic ruptures of the brain substance. In almost all brain samples, there is a significant saturation of the venous vessels with the presence of erythrocyte stasis. Violation of the blood-brain barrier, the presence of edema of the perivascular space, and petechial hemorrhages in the neuropil were registered ultrastructurally. Based on the study results, a morphological algorithm for assessing primary histostructural intracranial brain injuries and their consequences after exposure to an air shock wave was proposed. The injuries were found to be caused by the direct traumatic effect of the air shock wave. In the acute post-traumatic period, histopathological and ultrastructural changes in the brain can manifest as changes in neurons and in the blood-brain barrier and be accompanied by perivascular multifocal small-focal hemorrhages, neuropil ruptures, edema of pericellular and perivascular spaces, which together can be considered as biomarkers of primary traumatic changes after exposure to an air shock wave.

Key words: cerebral cortex, hippocampus, blast-induced brain injury, rats, histopathology, ultrastructure, digital morphometry, ImageJ

1. 1. Guilhaume-Correa F, Pickrell AM, Vande Vord PJ. The imbalance of astrocytic mitochondrial dyna­mics following blast-induced traumatic brain injury. Biome­dicines. 2023;11(2):329. doi: https://doi.org/10.3390/biomedicines11020329
   2. Nonaka M, Taylor WW, Bukalo O, et al. Beha­vioral and myelin-related abnormalities after blast-induced mild traumatic brain injury in mice. J Neurotrauma. 2021;38(11):1551-71. doi: https://doi.org/10.1089/neu.2020.7254
   3. Ou Y, Clifton BA, Li J, et al. Traumatic brain in­jury induced by exposure to blast overpressure via ear canal. NeuralRegen  2022;17(1):115-21. doi: https://doi.org/10.4103/1673-5374.314311
   4. Huwer H, Hadizamani Y, Moehrlen U, et al. Ex Vivo pulmonary oedema after In Vivo blast-induced rat lung injury: time dependency, blast intensity and beta-2 adrenergic receptor role. Biomedicines. 2022;10(11):2930. doi: https://doi.org/10.3390/biomedicines10112930
   5. Barnes DE, Byers AL, Gardner RC, et al. As­sociation of mild traumatic brain injury with and without loss of consciousness with dementia in US military vete­rans. JAMA 2018;75(9):1055-61. doi: https://doi.org/10.1001/jamaneurol.2018.0815
   6. Griffiths DR, Law LM, Young C, et al. Chronic cognitive and cerebrovascular function after mild trau­matic brain injury in rats. J Neurotrauma. 2022t;39(19-20):1429-41. doi: https://doi.org/10.1089/neu.2022.0015
   7. Race NS, Andrews KD, Lungwitz EA, et al. Psy­chosocial impairment following mild blast-induced traumatic brain injury in rats. Behav Brain Res. 2021;412:113405. doi: https://doi.org/10.1016/j.bbr.2021.113405
   8. Shi QX, Chen B, Nie C, et al. A novel model of blast induced traumatic brain injury caused by compressed gas produced sustained cognitive deficits in rats: invol­vement of phosphorylation of tau at the Thr205 epitope. BrainRes  2020;157:149-61. doi: https://doi.org/10.1016/j.brainresbull.2020.02.002
   9. Kawoos U, Abutarboush R, Gu M, et al. Blast-induced temporal alterations in blood-brain barrier properties in a rodent model. Sci Rep. 2021;11(1):5906. doi: https://doi.org/10.1038/s41598-021-84730-8
   10. Bishop R, Won SJ, Irvine KA, et al. Blast-induced axonal degeneration in the rat cerebellum in the absence of head movement. Sci 2022;12(1):143. doi: https://doi.org/10.1038/s41598-021-03744-4
   11. Pavlovic D, Pekic S, Stojanovic M, Popovic V. Traumatic brain injury: neuropathological, neurocognitive and neurobehavioral sequelae. Pituitary. 2019;22(3):270-82. doi: https://doi.org/10.1007/s11102-019-00957-9
   12. Kuriakose M, Younger D, Ravula AR, et al. Sy­ner­gistic role of oxidative stress and blood-brain barrier per­meability as injury mechanisms in the acute patho­physiology of blast-induced neurotrauma. Sci Rep. 2019;9(1):7717. doi: https://doi.org/10.1038/s41598-019-44147-w
   13. Schwab N, Leung E, Hazrati LN. Cellular senes­cence in traumatic brain injury: evidence and perspectives. Front Aging Neurosci. 2021;13:742632. doi: https://doi.org/10.3389/fnagi.2021.742632
   14. Yalciner BZ, Kandemir M, Taskale S, et al. Modi­fied visual magnetic resonance rating scale for evaluation of pa­tients with forgetfulness. Can J Neurol Sci. 2019;46(1):71-8. doi: https://doi.org/10.1017/cjn.2018.333
   15. Sparks P, Lawrence T, Hinze S. Neuroimaging in the diagnosis of chronic traumatic encephalopathy: A systematic review. Clin J Sport Med. 2020;30,1:S1-S10. doi: https://doi.org/10.1097/JSM.0000000000000541
   16. National Advisory Committee for Laboratory Ani­mal Research. Guidelines on the care and use of animals for scientific purpose. Singapore; 2022. 145 p.
   17. Percie du Sert N, Hurst V, Ahluwalia A, et al. The ARRIVE guidelines 2.0: updated guidelines for reporting animal research. PLoS Biol. 2020;18(7):e3000410. doi: https://doi.org/10.1371/journal.pbio.3000410
   18. Kozlova YuV, Abdul-Ohly LV, Kosharnyi AV, Ky­tova IV, Korzachenko MA, inventors. [Device for stu­dying the effect of the shock wave of an explosion on the body]. Patent Ukraine U202100358. 2021 Mar 24. Ukrainian.
   19. Elder GA, Gama Sosa MA, De Gasperi R, et al. The neurovascular unit as a locus of injury in low-level blast-induced neurotrauma. Int J Mol Sci. 2024;25(2):1150. doi: https://doi.org/10.3390/ijms25021150
   20. Bagriy MM, Dibrova VA, Popadynets OG, Gri­schuk MI. [Methods of morphological research]. Vin­nytsia: Nova knyha; 2016. 328 р. Ukranian.
   21. Danilov VY. [Statistical data processing: tutorial]. Kyiv; 2019. 156 p. Ukranian.
   22. Logsdon AF, Lucke-Wold BP, Turner RC, et al. Low-intensity blast wave model for preclinical assessment of closed-head mild traumatic brain injury in rodents. J Vis Exp.2020;165:10.3791/61244. doi: https://doi.org/10.3791/61244
   23. Gama Sosa MA, De Gasperi R, Pryor D, et al. Late chronic local inflammation, synaptic alterations, vascular remodeling and arteriovenous malformations in the brains of male rats exposed to repetitive low-level blast over­pressures. Acta Neuropathol Commun. 2023;11(1):81. doi: https://doi.org/10.1186/s40478-023-01553-6
   24. Ma X, Aravind A, Pfister BJ, et al. Animal models of traumatic brain injury and assessment of injury severity. Mol 2019;56(8):5332-45. doi: https://doi.org/10.1007/s12035-018-1454-5
   25. Przekwas A, Garimella HT, Tan XG, et al. Biome­chanics of blast TBI with time-resolved consecutive pri­mary, secondary, and tertiary loads. Mil Med. 2019;184:195-205. doi: https://doi.org/10.1093/milmed/usy344
   26. Chen B, Tjahja J, Malla S, et al. Astrocyte viability and functionality in spatially confined microcavitation zone. ACS Appl Mater Interfaces. 2019;11(5):4889-99. doi: https://doi.org/10.1021/acsami.8b21410
   27. Fievisohn E, Bailey Z, Guettler A, VandeVord P. Primary blast brain injury mechanisms: current knowledge, limitations, and future directions. J Biomech Eng. 2018;140(2). doi: https://doi.org/10.1115/1.4038710
   28. Russell AL, Richardson MR, Bauman BM, et al. Differential responses of the HPA axis to mild blast traumatic brain injury in male and female mice. Endocrinology.2018;159(6):2363-75. doi: https://doi.org/10.1210/en.2018-00203
   29. Belding JN, Englert RM, Fitzmaurice SJ, et al. Potential health and performance effects of high-level and low-level blast: a scoping review of two decades of research. Front 2021;12:628782. doi: https://doi.org/10.3389/fneur.2021.628782
   30. Friedman LK, Peng H, Zeman RJ. Cannabidiol re­duces lesion volume and restores vestibulomotor and cognitive function following moderately severe trau­matic brain injury. Exp Neurol. 2021;346:113844. doi: https://doi.org/10.1016/j.expneurol.2021.113844
   31. Gallo V, Motley K, Kemp SPT, et al. Concussion and long-term cognitive impairment among professional or elite sport-persons: a systematic review. J Neurol Neurosurg 2020;91(5):455-68. doi: https://doi.org/10.1136/jnnp-2019-321170
   32. Ratliff WA, Mervis RF, Citron BA, et al. Effect of mild blast-induced TBI on dendritic architecture of the cortex and hippocampus in the mouse. Sci Rep. 2020;10(1):2206. doi: https://doi.org/10.1038/s41598-020-59252-4
   33. Han EX, Fernandez JM, Swanberg C, et al. Lon­gitudinal auditory pathophysiology following mild blast-induced trauma. J Neurophysiol. 2021;126(4):1172-89. doi: https://doi.org/10.1152/jn.00039.2021
   34. Marsh JL, Bentil SA. Cerebrospinal fluid cavita­tion as a mechanism of blast-induced traumatic brain injury: a review of current debates, methods, and findings. Front Neurol. 2021;12:626393. doi: https://doi.org/10.3389/fneur.2021.626393

Look through:

Kozlov S.V. Dnipro State Medical University, Dnipro, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-7619-4302

Kozlova Yu.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-1364-1910

Bondarenko N.S. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-3933-7535

Bondarenko O.O. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-9739-9219

Kozlov S.V., Kozlova Yu.V., Bondarenko N.S., Bondarenko O.O. Histopathological and ultrastructural changes in the rats brain after air shock wave impact. Medicni perspektivi. 2024;29(1):16-26. 
DOI: https://doi.org/10.26641/2307-0404.2024.1.300497

Risks of psychological traumatization and stress adaption of medical staff working under war conditions (analytical literature review)

Blastocystis sp. are the most common, unicellular, anaerobic parasites of the intestinal tract of many animal and human species that can cause various digestive diseases. Metronidazole has long been used as a first-line treatment for blastocystosis, but recent clinical and in vitro studies have demonstrated its low efficacy against Blastocystis sp. The aim of this study was to determine the in vitro sensitivity of Blastocystis sp. clinical isolates to carbonic acid hop extracts and alcohol hop extracts in comparison with metronidazole. Five cultures of Blastocystis sp. were isolated from faecal samples from patients with irritable bowel syndrome with predominant diarrhoea (IBS-D, Rome IV). The parasites were identified by microscopy of faecal smears permanently stained with trichrome, Wheatley’s modification and Heidenhain’s iron-haematoxylin. Blastocystis sp. was cultivated at 37°C under anaerobic conditions on RPMI-1640 with antibiotics and horse serum, taking into account their growth characteristics. To detect the anti­blastocystic activity hop extracts and metronidazole were tested in the range from 1000 μg/ml to 1 μg/ml.The presence and number of viable Blastocystis sp. cells were determined after 24, 48, 72 and 96 hours. Blastocystis sp. cells were counted in a hemocytometer using the trypan blue dye exclusion test. All experiments were performed in triplicate. According to the results of in vitro sensitivity of 5 clinical isolates of Blastocystis sp. to the action of carbonic acid hop extract, alcohoicl hop extract and metronidazole, a direct positive pattern in the dose-response and contact time-response effects was established. Alcoholic hop extract showed the highest level of antiblastocystic activity with indicators (for 72-hour parasite cultures) of the minimum inhibitory concentration (which inhibits the parasite cultures growth by 50%) (2.8±0,8) μg/ml and the minimum lethal concentration (which destroys parasite cells by 100%) – 8 μg/ml, being 2.4 and 4.5 times lower than the minimum inhibitory concentration and 8 and 62.5 times lower, than the minimum lethal concentration for hop extract and metronidazole, respectively (p<0.05). It has been shown that alcoholic hop extract (≥16 μg/ml) causes gradual morphological changes in Blastocystis sp. cells, leading to their complete destruction.In contrast to metronidazole, subinhibitory concentrations of hop extract (<2 μg/ml) do not stimulate the proliferation of Blastocystis sp. cells in vitro.

Key words: anti-Blastocystis activity, hop extracts, metronidazole

1. Rudzinska M, Sikorska K. Epidemiology of Bla­stocystis infection: A review of data from Poland in relation to other reports. Pathogens. 2023;12(8):1050. doi: https://doi.org/10.3390/pathogens12081050
2. Stensvold CR, Tan KSW, Clark CG. Blastocystis. Trends Parasitol. 2020 Mar;36(3):315-6. doi: https://doi.org/10.1016/j.pt.2019.12.008
3. Ajjampur SSR, Tan KSW. Pathogenic mecha­nisms in Blastocystis spp. – Interpreting results from in vitro and in vivo studies. Parasitol Int. 2016;65(6):772-9. doi: https://doi.org/10.1016/j.parint.2016.05.007
4. Deng L, Wojciech L, Gascoigne NRJ, Peng G, Tan KSW. New insights into the interactions between Blastocystis, the gut microbiota, and host immunity. PLoS Pathog. 2021 Feb 25;17(2):e1009253. doi: https://doi.org/10.1371/journal.ppat.1009253
5. ICD-11 for Mortality and Morbidity Statistics. Version: 05/2021 [Internet]. 2021 [cited 2023 Oct 01]. Available from: https://icd.who.int/browse11/l-m/en#/
   http://id.who.int/icd/entity/1184241320
6. Shirvani G, Fasihi-Harandi M, Raiesi O, Bazar­gan N, et al. Prevalence and molecular subtyping of Blastocystis from patients with irritable bowel syndrome, inflammatory bowel disease and chronic urticaria in Iran. Acta Parasitol. 2020;65(1):90-6. doi: https://doi.org/10.2478/s11686-019-00131-y
7. Peña S, Carrasco G, Rojas P, Castillo D, et al. Deter­mination of subtypes of Blastocystis sp. in Chilean patients with and without inflammatory bowel syndrome, a preli­minary report. Parasite Epidemiol Control. 2020;8:e00125. doi: https://doi.org/10.1016/j.parepi.2019.e00125
8. Vielma JR. Blastocystosis: epidemiological, clini­cal, pathogenic, diagnostic, and therapeutic aspects. Invest Сlin. 2019 Mar;60(1):53-78. doi: https://doi.org/10.22209/IC.v60n1a06
9. Butters C, Yeoh DK, Curtis N. Parasites in Human Stool: to ignore or not to ignore ? Pediatr Infect Dis J. 2019 June;38(6S):S47-S51. doi: https://doi.org/10.1097/INF.0000000000002323
10. Rojas-Velázquez L, Moran P, Serrano-Váz­quez A, et al. The regulatory function of Blastocystis spp. on the immune inflammatory response in the gut micro­biome. Front Cell Infect Microbiol. 2022 Aug 31;12:967724. doi: https://doi.org/10.3389/fcimb.2022.967724
11. Badparva E, Kheirandish F. Blastocystis ho­minis: A Pathogenic Parasite. Arch Clin Infect Dis. 2020;15(4):e97388. doi: https://doi.org/10.5812/archcid.97388
12. Batista L, Pérez JJ, Rosinach M, Gonzalo V, et al. Low efficacy of metronidazole in the eradication of Blastocystis hominis in symptomatic patients: Case series and systematic literature review. Gastroenterol Hepatol. 2017 Jun-Jul;40(6):381-7. doi: https://doi.org/10.1016/j.gastrohep.2016.11.003
13. Rajamanikam A, Kumar S, Samudi C, Kudva M. Exacerbated symptoms in Blastocystis sp.-infected pa­tients treated with metronidazole: two case studies. Parasitol Res. 2018 Aug;117(8):2585-90. doi: https://doi.org/10.1007/s00436-018-5948-x
14. Rajamanikam A, Hooi HS, Kudva M, et al. Resis­tance towards metronidazole in Blastocystis sp.: A pathogenic PLoS One. 2019 Feb;14(2):e0212542. doi: https://doi.org/10.1371/journal.pone.0212542
15. Cobuccio LG, Laurent M, Gardiol C, Wam­pfler R, et al. Should we treat Blastocystis sp.? A double-blind placebo-controlled randomized pilot trial. J Travel Med. 2023 Jan;30(1):taac143. doi: https://doi.org/10.1093/jtm/taac143
16. El-Sayed NM, Masoud NG. Medical Plants as Natural Anti-parasitic Agents Against Blasocystis species. Cur Pharmac Design. 2023;18(1):2-15. doi: https://doi.org/10.2174/2772434418666221124123445
17. Ojuromi OT, Ashafa AO. An overview of some me­dicinal plants and isolated active compounds with potential antiprotozoal activity. Trop J Pharmac. Res. 2020;19(7):1551-63. doi: https://doi.org/10.4314/tjpr.v19i7.30
18. Mokhtar AB, Ahmed SA, Eltamany EE, Kara­nis P. Anti-Blastocystis Activity In Vitro of Egyptian Herbal Extracts (Family: Asteraceae) with Emphasis on Artemisia ju­daica. Int J Environ Res Public Health. 2019 May;16(9):1555. doi: https://doi.org/10.3390/ijerph16091555
19. Astray G, Gullón P, Gullón B, Munekata PES, Lo­renzo JM. Humulus lupulus L. as a Natural Source of Func­tional Biomolecules. Applied Sciences. 2020;10(15):5074. doi: https://doi.org/10.3390/app10155074
20. Liu M, Hansen P, Wang G, Qiu L, et al. Pharma­colo­gical Profile of Xanthohumol, a Prenylated Flavonoid from Hops (Humulus lupulus). Molecules. 2015 Jan;20(1):754-79. doi: https://doi.org/10.3390/molecules20010754
21. Jiang CH, Sun TL, Xiang DX, Wei SS, Li WQ. Anti­cancer Activity and Mechanism of Xanthohumol: A Prenylated Flavonoid From Hops (Humulus lupulus L.). Front Pharmacol. 2018 May;9:5309. doi: https://doi.org/10.3389/fphar.2018.00530
22. Frölich S, Schubert C, Bienzle U, Jenett-Siems K. In vitro antiplasmodial activity of prenylated chalcone derivatives of hops (Humulus lupulus) and their interaction with haemin. J Antimicrob Chemother. 2005 Jun;55(6):883-7. doi: https://doi.org/10.1093/jac/dki099
23. Bocquet L, Sahpaz S, Bonneau N, et al. Phenolic Compounds from Humulus lupulus as Natural Antimicrobial Products: New Weapons in the Fight against Methicillin Re­sistant Staphylococcus aureus, Leishmania mexicana and Try­panosoma brucei Strains. Molecules. 2019 Mar;24(6):1024. doi: https://doi.org/10.3390/molecules24061024
24. Srinivasan V, Goldberg D, Haas GJ. Contributions to the Antimicrobial Spectrum of Hop Constituents. Econ Bot. 2004;58(sp1):S230-S238. doi: https://doi.org/10.1663/0013-0001(2004)58[s230:cttaso]2.0.co;2
25. Garcia LS, Campbell JL, Fritsche TR, Hummer B, et al. Procedures for the Recovery and Identification of Parasites from Intestinal Tract; Approved Guideline - Second Edition. CLSI document M28-A2. Clinical and Laboratory Standards Institute. 2005;25(16):111.
26. Pokhill S, Tymchenko O, Chigirinskaya N, Kosty­ria I, et al. [Regularities of primary growth of Blastocystis sp. in five types of nutrient media]. Annals of Mechnikov’s Institute. 2021;4:45-53. Ukrainian. doi: https://doi.org/10.5281/zenodo.5761243
27. Strober W. Trypan Blue Exclusion Test of Cell Via­bility. Curr Protoc Immunol. 2015 Nov;111:A3.B.1-A3.B.3. doi: https://doi.org/10.1002/0471142735.ima03bs111
28. Ragavan AD, Govind SK. Modified Fields' stain: ideal to differentiate Dientamoeba fragilis and Blastocystis sp. Parasitol Res. 2015 Mar;114(3):1163-6. doi: https://doi.org/10.1007/s00436-014-4296-8
29. Sio SWS, Puthia MK, Lee ASY, et al. Protease acti­vity of Blastocystis hominis. Parasitol Res. 2006;99(2):126-30. doi: https://doi.org/10.1007/s00436-006-0131-1
30. Franklin F, Rajamanikam A, Raju CS, et al. Hig­her amoebic and metronidazole resistant forms of Bla­stocystis sp. seen in schizophrenic patients. Parasites & Vectors. 2022 Sep;15(1):313. doi: https://doi.org/10.1186/s13071-022-05418-0 

Look through:

Pokhil S.I. SI "I. Mechnikov Institute of Microbiology and Immunology of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
https://orcid.org/0000-0002-2298-9652

Kazmirchuk V.V. SI "I. Mechnikov Institute of Microbiology and Immunology of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
https://orcid.org/0000-0002-6014-6728

Tymchenko O.M. SI "I. Mechnikov Institute of Microbiology and Immunology of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
https://orcid.org/0000-0003-3548-1011

Yevsiukova V.Y. SI "I. Mechnikov Institute of Microbiology and Immunology of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-8688-6732

Melnyk A.L. SI "I. Mechnikov Institute of Microbiology and Immunology of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine
https://orcid.org/0000-0001-8378-3765

Pokhil S.I., Kazmirchuk V.V., Tymchenko O.M., Yevsiukova V.Y., Melnyk A.L. Anti-blastocystis activity of hop extracts in vitro. Medicni perspektivi. 2024;29(1):26-33.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300778

Risks of psychological traumatization and stress adaption of medical staff working under war conditions (analytical literature review)

The article focuses on the analysis of "most common methods providing health care to migrants and refugees and on the other hand on the analysis of "most common health problems" of refugees and migrants especially in Europe after the outbreak of war in Ukraine. Stemming from the conflict since 2014, it has triggered the most significant wave of refugees in contemporary history. The method of analysis is a "literature review" created from available sources in Medline, Scopus, PubMed, and Web of Science, focusing on data systematization within the GAJU 101/2022/S project funded by the South Bohemian University in České Budějovice, Czech Republic. The search strategy included keywords such as "Ukrainian migrants," "refugees," "health data," "central registry," "healthcare crisis," and "aid provision," employing logical operators. We examined 41 literary sources from both Czech and international publications, as well as official institution websites. The study identifies the complex interplay between migration and health, revealing diverse needs among migrants and refugees. It emphasizes the necessity of developing effective healthcare policies, particularly in crisis situations. Understanding the implementation of legal provisions for healthcare access is crucial for adapting healthcare systems in Europe. Upholding the principles of the Universal Declaration of Human Rights during information gathering ensures equal access to medical assistance regardless of individuals' status or financial standing. Therefore, further research in this direction should not only deepen our understanding of the migration-health relationship but also translate knowledge into policies for improving healthcare conditions for migrants and refugees in Europe. 

Key words: Ukrainian migrants, refugees, health-related data, central register, health care crisis, care provision 

1. World Bank. GDP per capita (current US$) [Internet]. 2022 [cited 2023 Oct 17]. Available from: https://data.worldbank.org/indicator/NY.GDP.PCAP.CD?end=2021&locations=CZ-EU&start=1970&view=chart
2. UNHCR – the UN Refugee Agency. UNHCR - the UN Refugee Agency 2022 [Internet]. 2022 [cited 2023 Oct 17]. Available from: https://www.unhcr.org/
3. United Nations High Commissioner for Refugees Ukraine refugee situation, operational data portal [In­ternet]. 2022 [cited 2023 Oct 17]. Available from: https://data2.unhcr.org/en/situations/ukraine  
4. WHO Ukraine crisis. Public health situation ana­lysis: refugee-hosting countries [Internet]. 2022 [cited 2023 Oct 17]. Available from: https://apps.who.int/iris/bitstream/handle/10665/352494/WHO-EURO-2022-5169-44932-63918-eng.pdf?sequence=3&isAllowed=y
5. International Organization for Migration. IOM, UN Migration [Internet]. 2022 [cited 2023 Oct 17]. Available from: https://www.iom.int/
6. Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of NonInternational Armed Conflicts (Protocol II) [Internet]. 1977 [cited 2023 Oct 17]. Available from: https://www.ohchr.org/en/instruments-mechanisms/instruments/protocol-additional-geneva-conventions-12-august-1949-and-0
7. Convention (IV) relative to the Protection of Ci­vilian Persons in Time of War. Geneva, from 1949. International Humanitarian Law Databases [Internet]. [cited 2023 Oct 17]. Available from:
   https://ihl-databases.icrc.org/en/ihl-treaties/gciv-1949
8. [5/2022 Coll. Law on certain measures in con­nection with the armed conflict on the territory of Ukraine caused by the invasion of the troops of the Russian Federation. Laws for people – Collection of laws of the Czech Republic in the current consolidated version]. [Internet]. 2022 [cited 2023 Oct 17]. Czech. Available from: https://www.zakonyprolidi.cz/cs/2022-65#p7-2
9. Ministry of the Interior of the Czech Republic [Internet]. 2022 [cited 2023 Oct 17]. Available from: https://www.mvcr.cz/mvcren/
10. [Quarterly Migration Report for Q2 2022 – Current migration information. Homepage – Ministry of the In­terior of the Czech Republic]. [Internet]. 2022 [cited 2023 Oct 17]. Czech. Available from: https://www.mvcr.cz/migrace/clanek/ctvrtletni-zprava-o-migraci-za-2-ctvrtleti-2022.aspx
11. [New conditions for payment of health insurance for refugees: the state will no longer pay it for everyone – Ministry of Health. Ministry of Health]. [Internet]. 2022 [cited 2023 Oct 17]. Czech. Available from: https://www.mzcr.cz/tiskove-centrum-mz/nove-podminky-uhrad-zdravotniho-pojisteni-uprchliku-stat-jej-uz-nebude-platit-vsem/
12. [VZP clarified the prediction: the costs of health care for refugees could be fully covered from income – VZP ČR. VZP CR]. [Internet]. 2022 [cited 2023 Oct 17]. Czech. Available from:
    https://www.vzp.cz/o-nas/aktuality/vzp-zpresnila-predikci-naklady-na-zdravotni-peci-o-uprchliky-by-mohly-byt-plne-pokryty-z-prijmu
13. Lewtak K, Kanecki K, Tyszko P, Goryński P, Ko­sińska I, Poznańska A, Rząd M, Nitsch-Osuch A. Hospi­talizations of Ukrainian Migrants and Refugees in Poland in the Time of the Russia-Ukraine Conflict. Int J Environ Res Public Health. 2022 Oct 16;19(20):13350. doi: https://doi.org/10.3390/ijerph192013350
14. Jaeger FN, Berger C, Buettcher M, Depallens S, Heininger U, Heller Y, et al. Paediatric refugees from Ukraine: Guidance for health care providers. Swiss Medical Weekly. 2022;152(2122). doi: https://doi.org/10.4414/SMW.2022.w30200
15. Maternik M, Andrunevych R, Drożdż D, Czau­derna P, Grenda R, Tkaczyk M. Transition and mana­gement of Ukrainian war refugee children on kidney replacement therapy. Pediatr Nephrol. 2022 Sep 6. doi: https://doi.org/10.1007/s00467-022-05726-8
16. Vasylyev M, Skrzat-Klapaczyńska A, Bernar­di­no JI, Săndulescu O, Gilles C, Libois A, et al. Unified European support framework to sustain the HIV cascade of care for people living with HIV including in displaced populations of war-struck Ukraine. Lancet HIV. 2022 Jun;9(6):e438-e448. doi: https://doi.org/10.1016/S2352-3018(22)00125-4 Erratum in: Lancet HIV. 2022 May 31; PMID: 35576942
17. Piotrowicz K, Semeniv S, Kupis R, Ryś M, Pere­ra I, Gryglewska B, et al. Disease burden in older Ukrai­nian refugees of war: a synthetic reanalysis of public records data. Lancet Healthy Longev. 2022 Oct;3(10):e667-e673. doi: https://doi.org/10.1016/S2666-7568(22)00187-8
18. Calam R, El-Khani A, Maalouf W. Editorial Pers­pective: How can we help the children of Ukraine and others affected by military conflict? Child Adolesc Ment Health. 2022 Sep;27(3):294-6. doi: https://doi.org/10.1111/camh.12581
19. Vuorio A, Sajantila A, Kovanen PT, Budowle B. Maleficent comrades: War in Ukraine and COVID-19. Disaster Med Public Health Prep. 2023;17:e280. doi: https://doi.org/10.1017/dmp.2022.227
20. Malchrzak W, Babicki M, Pokorna-Kałwak D, Doniec Z, Mastalerz-Migas A. COVID-19 Vaccination and Ukrainian Refugees in Poland during Russian-Ukrainian War-Narrative Review. Vaccines (Basel). 2022 Jun 16;10(6):955. doi: https://doi.org/10.3390/vaccines10060955
21. Greenaway C, Fabreau G, Pottie K. The war in Ukraine and refugee health care: considerations for health care providers in Canada. CMAJ. 2022 Jul 11;194(26):E911-E915. doi: https://doi.org/10.1503/cmaj.220675
22. Kowalska JD, Rukhadze N, Sojak L, Bociaga-Jasik M, Sedlacek D, Matulionyte R, et al. Preliminary report on the provision of HIV care to war refugees with HIV who are migrating from Ukraine: data from the ECEE Network Group. AIDS. 2022 Nov 1;36(13):1887-90. doi: https://doi.org/10.1097/QAD.0000000000003355
23. Guzik B, Bernacik A, Pulka A, Kaczmarska A, Guzik TJ, Grodzicki T. The backstage of the Russian-Ukrainian war: refugees in urgent need of cardiovascular management. Cardiovasc Res. 2022 Sep 20;118(12):e85-e88. doi: https://doi.org/10.1093/cvr/cvac127
24. Hodes M. Thinking about young refugees' mental health following the Russian invasion of Ukraine in 2022. Clin ChildPsychol  2022 Sep 7:13591045221125639. doi: https://doi.org/10.1177/13591045221125639
25. Marchese V, Formenti B, Cocco N, Russo G, Tes­ta J, Castelli F, et al. Examining the pre-war health burden of Ukraine for prioritisation by European countries receiving Ukrainian refugees. Lancet Reg Health Eur. 2022 Mar 18;15:100369. doi: https://doi.org/10.1016/j.lanepe.2022.100369
26. Uwishema O, Sujanamulk B, Abbass M, Fawaz R, Javed A, Aboudib K, et al. Russia-Ukraine conflict and COVID-19: a double burden for Ukraine's healthcare system and a concern for global citizens. Postgrad Med J. 2022 Aug;98(1162):569-71. doi: https://doi.org/10.1136/postgradmedj-2022-141895
27. Rzymski P, Falfushynska H, Fal A. Vaccination of Ukrainian Refugees: Need for Urgent Action. Clin Infect Dis. 2022 Sep 29;75(6):1103-8. doi: https://doi.org/10.1093/cid/ciac276
28. Namdar AB, Keikha M. The Russo-Ukrainian war crisis and vaccination of Ukrainian refugees as an urgent need. Vacunas.2022 Sep-Dec;23(3):247-8. doi: https://doi.org/10.1016/j.vacun.2022.06.005
29. Vignier N, Halley des Fontaines V, Billette de Villemeur A, Cazenave-Roblot F, Hoen B, Chauvin F, et al. Public health issues and health rendezvous for migrants from conflict zones in Ukraine: A French practice guideline. Infect Dis Now. 2022 Jun;52(4):193-201. doi: https://doi.org/10.1016/j.idnow.2022.04.006
30. Śniadecki M, Boyke Z. A shared fate: adapting and personalising medical care from the perspective of a refugee reception country. Global Health. 2022 Oct 21;18(1):88. doi: https://doi.org/10.1186/s12992-022-00880-y
31. Fatyga E, Dzięgielewska-Gęsiak S, Muc-Wierz­goń M. Organization of Medical Assistance in Poland for Ukrainian Citizens During the Russia-Ukraine War. Front Public 2022 Jul 7;10:904588. doi: https://doi.org/10.3389/fpubh.2022.904588
32. Beauté J, Kramarz P. Public health surveillance in countries hosting displaced people from Ukraine. Euro Surveill.2022 Jun;27(22):2200430. doi: https://doi.org/10.2807/1560-7917.ES.2022.27.22.2200430
33. Su Z, McDonnell D, Cheshmehzangi A, Ahmad J, Šegalo S, Pereira da Veiga C, et al. Public health crises and Ukrainian refugees. Brain Behav Immun. 2022 Jul;103:243-5. doi: https://doi.org/10.1016/j.bbi.2022.05.004
34. Jain N, Prasad S, Bordeniuc A, Tanasov A, Shirinskaya AV, Béla B, et al. European Countries Step-up Humanitarian and Medical Assistance to Ukraine as the Conflict Continues. J Prim Care Community Health. 2022 Jan-Dec;13:21501319221095358. doi: https://doi.org/10.1177/21501319221095358
35. Dziedzic A, Riad A, Tanasiewicz M, Attia S. The increasing population movements in the 21st century: A call for the E-register of health-related data integrating health care systems in Europe. Int J Environ Res Public Health. 2022;19(21):13720. doi: https://doi.org/10.3390/ijerph192113720
36. Scott R, Forde E, Wedderburn C. Refugee, mig­rant and asylum seekers’ experience of accessing and receiving primary healthcare in a UK City of Sanctuary. J ImmigrMinor  2022;24(1):304-7. doi: https://doi.org/10.1007/s10903-021-01227-2
37. Van HemelrijckM, Fox L, Beyer K, Feda­raviciute E, George G, Hadi H, et al. Cancer care for Uk­rainian refugees: Strategic impact assessments in the early days of the conflict. J Cancer  2022;34(100370):100370. doi: https://doi.org/10.1016/j.jcpo.2022.100370
38. Wareńczak-Florczak Ż, Urbański B. What chal­lenges does the humanitarian crisis and large number of refugees from Ukraine pose for Polish oncology? Rep Pract Oncol Radiother. 2022;27(3):566-70. doi: https://doi.org/10.5603/RPOR.a2022.0051
39. Schwartz L, Nakonechna M, Campbell G, Brun­ner D, Stadler C, Schmid M, et al. Addressing the mental health needs and burdens of children fleeing war: a field update from ongoing mental health and psychosocial support efforts at the Ukrainian border. Eur J Psy­chotraumatol.2022;13(2):2101759. doi: https://doi.org/10.1080/20008198.2022.2101759
40. Javanbakht Addressing war trauma in Uk­rainian refugees before it is too late. Eur J Psy­cho­traumatol.2022;13(2):2104009. doi: https://doi.org/10.1080/20008066.2022.2104009
41. Cojocaru E, Cojocaru C, Cojocaru E, Oancea CI. Health risks during Ukrainian humanitarian crisis. Risk Manag Healthc Policy. 2022;15:1775-81. doi: https://doi.org/10.2147/RMHP.S375021

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Shuranova L. University of South Bohemia, České Budějovice; Oblastni nemocnice Příbram, Příbram, Czech Republic,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0002-5611-0490

Vacková J. University of South Bohemia, České Budějovice, Czech Republic
https://orcid.org/0000-0002-0241-1052

Hellerová K. University of South Bohemia, České Budějovice, Czech Republic
https://orcid.org/0009-0007-3409-7401

Faltová B. University of South Bohemia, České Budějovice, Czech Republic
https://orcid.org/0000-0002-0030-697X

Vistořín R. University of South Bohemia, České Budějovice, Czech Republic
https://orcid.org/0009-0003-9860-8793

Švestková R. University of South Bohemia, České Budějovice, Czech Republic
https://orcid.org/0000-0003-1999-1724

Prokešová R. University of South Bohemia, České Budějovice, Czech Republic
https://orcid.org/0000-0002-8602-8463

Shuranova L., Vacková J., Hellerová K., Faltová B., Vistořín R., Švestková R., Prokešová R. Healthcare support for ukrainian refugees in the Czech Republic: a literature review. Medicni perspektivi. 2024;29(1):34-43. 
DOI: https://doi.org/10.26641/2307-0404.2024.1.300498

Risks of psychological traumatization and stress adaption of medical staff working under war conditions (analytical literature review)

Determining the optimal antipsychotic drugs, its effective dose, duration of therapy, form, and route of administration play a key role in the treatment of schizophrenia. In addition, special attention should be paid to the effectiveness of using different forms of antipsychotic drugs, in particular, the orally disintegrating form as exemplified by olanzapine. To study the peculiarities of a personalized approach in the use of antipsychotic drugs to achieve more effective results in treating schizophrenia, a content analysis was conducted using Ukrainian and English-language publications for the past 15 years. The search was conducted using the PubMed and CrossRef databases. An important conclusion is that the optimal therapeutic formula or drug should be selected individually, considering the specific patient's clinical condition. However, the most important factor in achieving successful results is the individually selected form and dose of the antipsychotic drugs. In addition to the patient's mental state, the choice of antipsychotic therapy is influenced by the spectrum of side effects, individual sensitivity to the active substance, pharmacological history, economic factors, etc. This is especially true for patients with insufficient adherence to treatment, which can often arise due to the side effects of drugs. In this case, it is important to correctly select both the active substance and the appropriate route of administration. Personalized selection of antipsychotic drugs also involves dynamic monitoring of changes in the patient's clinical condition, allowing for timely diagnosis of drug side effects, dose adjustments, or changes in the route of administration. These measures help increase patient adherence to treatment and improve their health-related quality of life.

Key words: schizophrenia, primary psychotic episode, treatment, personalized approach, antipsychotics, olanzapine, orodispersible form

1. Zhai J, Guo X, Chen M, Zhao J, Su Z. An in­vestigation of economic costs of schizophrenia in two areas of China. Int J Ment Health Syst. 2013;7:26. doi: https://doi.org/10.1186/1752-4458-7-26
2. Wang L, Shi F, Guan X, Xu H, Liu J, Li H. A Sys­tematic Review of Methods and Study Quality of   Economic Evaluations for the Treatment of Schizophrenia. Front Public Health. 2021;9:689123. doi: https://doi.org/10.3389/fpubh.2021.689123
3. Mizuno Y, McCutcheon RA, Brugger SP, Ho­wes OD. Heterogeneity and efficacy of antipsychotic treatment for schizophrenia with or without treatment resistance: a meta-analysis. Neuropsychopharmacology. 2020;45:622-31.
   doi: https://doi.org/10.1038/s41386-019-0577-3
4. GBD 2019 Mental Disorders Collaborators. Glo­bal, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2022;9:137-50. doi: https://doi.org/10.1016/S2215-0366(21)00395-3
5. Nucifora FC, Woznica E, Lee BJ, Cascella N, Sawa A. Treatment Resistant Schizophrenia: Clinical, Biological, and Therapeutic Perspectives. Neurobiol Dis. 2019;131:104257. doi: https://doi.org/10.1016/j.nbd.2018.08.016
6. Fond G, Falissard B, Nuss P, Collin C, Duret S, Rab­bani M, et al. How can we improve the care of patients with schizophrenia in the real-world? A population-based cohort study of 456,003 patients. Mol Psychiatry. 2023 Jul 21:1-9. doi: https://doi.org/10.1038/s41380-023-02154-4
7. Asanova A, Khaustova O. Typical difficult si­tuations in doctor-patient interactions. Psychosomatic Medicine and General Practice. 2018;3:e0303125. doi: https://doi.org/10.26766/pmgp.v3i3.125
8. Tiihonen J, Tanskanen A, Taipale H. 20-Year Na­tionwide Follow-Up Study on Discontinuation of Anti­psychotic Treatment in First-Episode Schizophrenia. Am J Psychiatry.2018;175:765-73. doi: https://doi.org/10.1176/appi.ajp.2018.17091001
9. Asanova А. Personalized approach in the treat­ment of mental disorders: Long-term prospects for the use of low doses of psychotropic drugs. PMGP [Internet]. 2020 Aug 28 [cited 2023 Dec 3];5(2). Available from: https://e-medjournal.com/index.php/psp/article/view/239
10. Starzer M, Hansen HG, Hjorthøj C, Albert N, Nordentoft M, Madsen T. 20-year trajectories of positive and negative symptoms after the first psychotic episode in patients with schizophrenia spectrum disorder: results from the OPUS study. World Psychiatry. 2023;22:424-32. doi: https://doi.org/10.1002/wps.21121
11. Goff DC, Falkai P, Fleischhacker WW, Gir­gis RR, Kahn RM, Uchida H, et al. The Long-Term Eff­ects of Antipsychotic Medication on Clinical Course in Schizophrenia. AJP2017;174:840-9. doi: https://doi.org/10.1176/appi.ajp.2017.16091016
12. Demyttenaere K, Detraux J, Racagni G, Vans­teelandt K. Medication-Induced Akathisia with Newly Approved Antipsychotics in Patients with a Severe Mental Illness: A Systematic Review and Meta-Analysis. CNS Drugs.2019;33:549-66. doi: https://doi.org/10.1007/s40263-019-00625-3 
13. de Filippis R, Staltari FA, Aloi M, Carbone EA, Ra­nia M, Destefano L, et al. Effectiveness of SGA-LAIs on Clinical, Cognitive, and Social Domains in Schi­zophrenia: Results from a Prospective Naturalistic Study. Brain 2023;13:577. doi: https://doi.org/10.3390/brainsci13040577
14. Sherzad Qadir Z, Ball PA, Morrissey H. Efficacy and Tolerance of Antipsychotics Used for the Treatment of Patients Newly Diagnosed with Schizophrenia: A Systematic Review and Meta-Analysis. Pharmacy (Basel). 2023;11:175. doi: https://doi.org/10.3390/pharmacy11060175
15. Moncrieff J, Gupta S, Horowitz MA. Barriers to stopping neuroleptic (antipsychotic) treatment in people with schizophrenia, psychosis or bipolar disorder. Ther Adv Psychopharmacol. 2020;10:2045125320937910. doi: https://doi.org/10.1177/2045125320937910
16. Sabe M, Zhao N, Crippa A, Kaiser S. Antipsy­chotics for negative and positive symptoms of schi­zophrenia: dose-response meta-analysis of randomized controlled acute phase trials. NPJ Schizophr. 2021;7:43. doi: https://doi.org/10.1038/s41537-021-00171-2
17. McAdam MK, Baldessarini RJ, Murphy AL, Gar­dner DM. Second International Consensus Study of Antipsy­chotic Dosing (ICSAD-2). J Psychopharmacol. 2023;37:982-91. doi: https://doi.org/10.1177/02698811231205688
18. Yu C-L, Carvalho AF, Thompson T, Tsai T-C, Tseng P-T, Hsu C-W, et al. Comparison of antipsychotic dose equivalents for acute bipolar mania and schi­zophrenia. BMJ Ment Health. 2023;26:e300546. doi: https://doi.org/10.1136/bmjment-2022-300546
19. Tani H, Takasu S, Uchida H, Suzuki T, Mi­mu­ra M, Takeuchi H. Factors associated with successful antipsychotic dose reduction in schizophrenia: a systematic review of prospective clinical trials and meta-analysis of randomized controlled trials. Neuropsychopharmacol. 2020;45:887-901. doi: https://doi.org/10.1038/s41386-019-0573-7
20. Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med. 2021;12:443-52. doi: https://doi.org/10.1007/s41999-021-00479-3
21. Bozzatello P, Bellino S, Rocca P. Predictive Fac­tors of Treatment Resistance in First Episode of Psychosis: A Systematic Review. Front Psychiatry. 2019;10:67. doi: https://doi.org/10.3389/fpsyt.2019.00067
22. Joo SW, Kim H, Jo YT, Ahn S, Choi YJ, Choi W, et al. Comparative effectiveness of antipsychotic mono­therapy and polypharmacy in schizophrenia patients with clozapine treatment: A nationwide, health insurance data-based study. Eur Neuropsychopharmacol. 2022;59:36-44. doi: https://doi.org/10.1016/j.euroneuro.2022.03.010
23. Leucht S, Schneider‐Thoma J, Burschinski A, Pe­ter N, Wang D, Dong S, et al. Long‐term efficacy of antipsychotic drugs in initially acutely ill adults with schizophrenia: systematic review and network meta‐analysis. World 2023;22:315-24. doi: https://doi.org/10.1002/wps.21089
24. Stroup TS, Gray N. Management of common ad­verse effects of antipsychotic medications. World Psychiatry.2018;17:341-56. doi: https://doi.org/10.1002/wps.20567
25. Yoshida K, Takeuchi H. Dose-dependent effects of antipsychotics on efficacy and adverse effects in schi­zophrenia. Behavioural Brain Research. 2021;402:113098. doi: https://doi.org/10.1016/j.bbr.2020.113098
26. Foster A, King J. Antipsychotic Polypharmacy. Focus (Am Psychiatr Publ). 2020;18:375-85. doi: https://doi.org/10.1176/appi.focus.20190047
27. Valsecchi P, Garozzo A, Nibbio G, Barlati S, Des­te G, Turrina C, et al. Paliperidone extended-release in the short- and long-term treatment of schizophrenia. Riv Psichiatr.2019;54:43-58. doi: https://doi.org/10.1708/3142.31245
28. Paris G, Bighelli I, Deste G, Siafis S, Schneider-Thoma J, Zhu Y, et al. Short-acting intramuscular second-generation antipsychotic drugs for acutely agitated patients with schizophrenia spectrum disorders. A systematic review and network meta-analysis. Schizophrenia Research. 2021;229:3-11. doi: https://doi.org/10.1016/j.schres.2021.01.021
29. Kolli P, Kelley G, Rosales M, Faden J, Serde­nes R. Olanzapine Pharmacokinetics: A Clinical Review of Current Insights and Remaining Questions. Pharm­ge­nomicsPers  2023;16:1097-108. doi: https://doi.org/10.2147/PGPM.S391401
30. Ostuzzi G, Bertolini F, Del Giovane C, Te­de­schi F, Bovo C, Gastaldon C, et al. Maintenance Treatment With Long-Acting Injectable Antipsychotics for People With Nonaffective Psychoses: A Network Meta-Analysis. AmJ  2021;178:424-36. doi: https://doi.org/10.1176/appi.ajp.2020.20071120
31. Kraemer S, Chartier F, Augendre-Ferrante B, Psarra V, D’yachkova Y, Beselin A, et al. Effectiveness of two formulations of oral olanzapine in patients with schizophrenia or bipolar disorder in a natural setting: results from a 1-year European observational study. Hum Psychopharmacol.2012;27:284-94. doi: https://doi.org/10.1002/hup.2224
32. Novick D, Montgomery W, Treuer T, Koyana­gi A, Aguado J, Kraemer S, et al. Comparison of clinical outcomes with orodispersible versus standard oral olan­zapine tablets in nonadherent patients with schizophrenia or bipolar disorder. PatientPrefer  2017;11:1019-25. doi: https://doi.org/10.2147/PPA.S124581
33. Kishimoto T, Hagi K, Nitta M, Kane JM, Cor­rell CU. Long‐term effectiveness of oral second‐generation antipsychotics in patients with schizophrenia and related disorders: a systematic review and meta‐analysis of direct   head‐to‐head comparisons. World Psychiatry. 2019;18:208-24. doi: https://doi.org/10.1002/wps.20632
34. Zhao J, Jiang K, Li Q, Zhang Y, Cheng Y, Lin Z, et al. Cost-effectiveness of olanzapine in the first-line treatment of schizophrenia in China. J Med Econ. 2019;22:439-46. doi: https://doi.org/10.1080/13696998.2019.1580714
35. Ascher-Svanum H, Furiak NM, Lawson AH, Klein TM, Smolen LJ, Conley RR, et al. Cost-effectiveness of several atypical antipsychotics in orally disintegrating tablets compared with standard oral tablets in the treatment of schizophrenia in the United States. J Med Econ. 2012;15:531-47. doi: https://doi.org/10.3111/13696998.2012.662923
36. Perkins AJ, Khandker R, Overley A, Solid CA, Chekani F, Roberts A, et al. The impact of antipsychotic adherence on acute care utilization. BMC Psychiatry. 2023;23:64. doi: https://doi.org/10.1186/s12888-023-04558-6
37. Stürup AE, Nordentoft M, Jimenez-Solem E, Os­ler M, Davy JW, Christensen TN, et al. Discontinuation of antipsychotics in individuals with first-episode schi­zophrenia and its association to functional outcomes, hos­pitalization and death: a register-based nationwide follow-up study. Psychological Medicine. 2023;53:5033-41. doi: https://doi.org/10.1017/S0033291722002021
38. Xiao J, Mi W, Li L, Shi Y, Zhang H. High relapse rate and poor medication adherence in the Chinese popu­lation with schizophrenia: results from an observational survey in the People’s Republic of China. Neuropsychiatr Dis 2015;11:1161-7. doi: https://doi.org/10.2147/NDT.S72367
39. Weiden PJ, Kozma C, Grogg A, Locklear J. Par­tial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatr Serv.2014;55:886-91. doi: https://doi.org/10.1176/appi.ps.55.8.886
40. Vidarsdottir S, Roelfsema F, Streefland T, Holst JJ, Rehfeld JF, Pijl H. Short-term treatment with olanzapine does not modulate gut hormone secretion: olanzapine disin­tegrating versus standard tablets. Eur J Endocrinol. 2010;162:75-83. doi: https://doi.org/10.1530/EJE-09-0433
41. Kusumi I, Honda M, Uemura K, Sugawara Y, Ko­hsaka M, Tochigi A, et al. Effect of olanzapine orally disin­tegrating tablet versus oral standard tablet on body weight in patients with schizophrenia: a randomized open-label trial. Prog Neuropsychopharmacol Biol Psychiatry. 2012;36:313-7. doi: https://doi.org/10.1016/j.pnpbp.2011.11.004
42. Weston-Green K, Huang X-F, Lian J, Deng C. Ef­fects of olanzapine on muscarinic M3 receptor binding density in the brain relates to weight gain, plasma insulin and metabolic hormone levels. Eur Neuropsy­chophar­macol.2012;22:364-73. doi: https://doi.org/10.1016/j.euroneuro.2011.09.003
43. Pandey A, Kalita KN. Treatment-resistant schizo­phrenia: How far have we traveled? Front Psychiatry. 2022;13:994425. doi: https://doi.org/10.3389/fpsyt.2022.994425
44. Antosik-Wójcińska A. Olanzapine ODT – who is this alternative for? A simple guide in questions and ans­wers. Psychiatria Spersonalizowana. 2022;1(2):88-91.
45. Hobbs D, Karagianis J, Treuer T, Raskin J. An in vitro analysis of disintegration times of different formu­lations of olanzapine orodispersible tablet: a preliminary report. Drugs R D. 2013;13:281-8. doi: https://doi.org/10.1007/s40268-013-0030-8

Look through:

Khaustova O.O. Bogomolets National Medical University, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-8262-5252

Asanova A.E. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0001-9326-0618

Dzeruzhynska N.O. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0003-0427-7472

Matiash M.M. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-4248-060X

Khaustova O.O., Asanova A.E., Dzeruzhynska N.O., Matiash M.M. Peculiarities of personalized selection of antipsychotic drugs for schizophrenia treatment. Medicni perspektivi. 2024;29(1):43-52. 
DOI: https://doi.org/10.26641/2307-0404.2024.1.300499

Risks of psychological traumatization and stress adaption of medical staff working under war conditions (analytical literature review)

Spatial 3D modeling has become one of the modern and most accurate evidential methods of research, carving out its niche in various fields of medical science and practice. Therefore, our focus has been on laying the groundwork for its implementation in the process of conducting forensic medical examinations of gunshot injuries, which have garnered significant attention from all forensic physicians, particularly after unprovoked aggression from Russia and the onset of active hostilities in our country. The aim of the study was to improve the forensic medical diagnosis of projectile type in injuries from automatic firearm AKS-74U chambered in 5.45x39 mm caliber by utilizing spatial 3D modeling of specific elements within the wound channel. The entire series of experimental shots was conducted using an AKS-74U firearm, with a bullet caliber of 5.45x39 mm. As the research material, Roma Plastilina Number 1 ballistic clay, manufactured in the USA, was used for conducting standardized ballistic tests according to NIJ (National Institute of Justice) and HOSDB (Home Office Scientific Development Branch) standards. The series of experiments consisted of 15 gunshots; then the physical characteristics of the bullet, main morphological elements of the wound of skin and different portions of wound channel were investigated (195 measurements in general). The morphological features of individual elements within the wound channel were measured using conventional measurement tools, and also after their 3D modeling using graphic editors such as "Agisoft Photoscan" and "3ds max." Direct and strong correlations (ranging from 0.60 to 0.72) have been established between the initial velocity, kinetic energy, specific energy of bullet, and the diameter of the entry wound in 3D modeling, as well as the diameters of the wound channel in its central portion, measured both by conventional measuring tools and based on the results of their 3D modeling (р=0,02). Furthermore, inverse correlation relationships of moderate strength (ranging from -0.63 to -0.66) have been detected between the initial velocity, kinetic energy, specific energy, and the presence of abrasion collar around the entry wound (р=0,03). The created conditions allow to conduct the differentiation in diagnosing the type of projectile, the identification and study of new characteristics of key elements in firearm-related injuries, and improvement in measurement accuracy. They also enhance clarity and objectivity during the execution of forensic medical examinations in cases of combat-related firearm injuries.

Key words: forensic medical examination, firearm injuries, 3D modeling, automatic firearms

1. Bondar VS, Pets DM. [Legal expert provision of pre-criminal investigation of crimes in the field of firearms and ammunition: theoretical issues]. Naukovyi visnyk Uzhho­rod­skoho natsionalnoho universytetu. 2019;57(2):83-91. Uk­rainian. doi: https://doi.org/10.32782/2307-3322.57-2.18
2. Peter MR, Ernest EM, Bellal J, Andrew T, Viraj P, et al. Gunshot wounds: A review of ballistics, bullets, weapons, and myths. Journal of Trauma and Acute Care Surgery. 2016;80(6):853-67. doi: https://doi.org/10.1097/TA.0000000000001037
3. Stefanopoulos PK, Mikros G, Pinialidis DE, Oiko­nomakis IN, Tsiatis NE, Janzon B. Wound ballistics of military rifle bullets: An update on controversial issues and associated misconceptions. Journal of Trauma and Acute Care Surgery. 2019;87(3):690-8. doi: https://doi.org/10.1097/TA.0000000000002290
4. Kuslii Yu, Khomuk N, Bohdanova A, Surko I, Serheieva Yu. [The current state of expert research of domestic firearms and cartridges for them in Ukraine]. Sudovo-medychna ekspertyza. 2021;2:31-8. Ukrainian. doi: https://doi.org/10.24061/2707-8728.2.2021.4
5. Mishalov VD, Khokholieva TV, Petroshak OIu, Hurina OO, Bachynskyi VT, et al. [Features of harmful damages caused by current arrangements of contemporary arrangements. Expenses and perspectives of research]. Sudovo-medychna ekspertyza. 2018;1:53-7. Ukrainian. doi: https://doi.org/10.24061/2707-8728.1.2018.14
6. Kyshkan P, Savka I. [3D-modeling of an experi­menal wound channel caused by a piercing-cutting object with bilateral blade grinding]. Sudovo-medychna eksper­tyza. 2021;2:74-83. Ukrainian. doi: https://doi.org/10.24061/2707-8728.2.2021.9
7. Franchuk VV. [3d-technologies in medicine and forensic medical practice: current status and prospects for implementation]. Sudovo-medychna ekspertyza. 2022;1:35-9. Ukrainian.
   doi: https://doi.org/10.24061/2707-8728.1.2022.5
8. Grabherr S, Baumann P, Minoiu C, Fahrni S, Man­gin P. Post-mortem imaging in forensic investigations: current utility, limitations, and ongoing developments. Research and Reports in Forensic Medical Science. 2016;6:25-37. doi: https://doi.org/10.2147/RRFMS.S93974
9. Chiara V. Forensic 3D documentation of skin injuries. International Journal of Legal Medicine. 2017;131(3):751-9.
   doi: https://doi.org/10.1007/s00414-016-1499-9
10. Schweitzer W, Thali M, Aldomar E, Ebert L. Overview of the use of 3D printing in forensic medicine. Rechtsmedizin. 2020;30:292-9. doi: https://doi.org/10.1007/s00194-020-00412-1
11. Kyshkan P, Savka I. Practical value of 3D mode­ling method of experimental wound channel during forensic examination of stab wound. Medical Science. 2021;25(110):907-16.
12. Mukaka MM. Statistics corner: A guide to ap­propriate use of correlation coefficient in medical research. Malawi Medical Journal. 2012 Sep;24(3):69-71. PMID: 23638278; PMCID: PMC3576830.
13. Nishshanka MB, Paranirubasingam P, She­pherd C. A forensic-based study on low angled AK rifle bullet entry wounds using a porcine model. J Forensic Leg Med. 2020 Aug;74:102025. doi: https://doi.org/10.1016/j.jflm.2020.102025
14. Hejna P, Šafr M, Kramář R, Kučerová ŠP, Zá­topková L, Sairaj RT, et al. Reversed configuration of the muzzle imprint mark in a pistol contact entrance wound mimicking a non-suicidal act. Forensic Sci Int. 2022 Jun;335:111132. doi: https://doi.org/10.1016/j.forsciint.2021.111132
15. Pircher R, Glardon M, Perdekamp MG, Pollak S, Geisenberger D. Rearward movement of the slide in semi-automatic pistols: a factor potentially influencing the con­figuration of muzzle imprint marks in contact shots. Int J Legal Med. 2019 Jan;133(1):169-76. doi: https://doi.org/10.1007/s00414-018-1978-2
16. Flis M, Flis A. Differentiation of shots from hun­ting weapons with threaded barrels depending on the type of projectiles – forensic opinions. Arch Med Sadowej Kryminol. 2021;71(3-4):117-29. doi: https://doi.org/10.4467/16891716AMSIK.21.008.15618
17. Lux C, Kettner M, Federspiel JM, Ramsthaler F, Verhoff MA. Atypical wound trajectory after a tangential pistol shot. Int J Legal Med. 2023 Mar;137(2):595-600. doi: https://doi.org/10.1007/s00414-022-02905-y

Look through:

Zmiyevska Y.G. Bukovinian State Medical University, Chernivtsi, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
http://orcid.org/0009-0008-5771-0114

Tryubner K. Institute of Forensic Medicine, Essen, Germany , е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9106-8470

Savka I.G. Bukovinian State Medical University, Chernivtsi, Ukraine, е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
http://orcid.org/0000-0002-2969-1306

Zmiyevska Y.G., Tryubner K., Savka I.G. Improvement of forensic medical diagnosis of projectile type injuries from automatic firearm chambered in 5.45 mm caliber through spatial 3D modelingя. Medicni perspektivi. 2024;29(1):53-59.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300596

Methabolic reaction on the cerebral ischemia during carotid artery surgery

The main factors of an unfavorable prognosis, are life-threatening heart rhythm disorders which determine the severity of the clinical course of myocarditis, in addition to impaired contractility and dilatation of the left ventricle (LV). The aim of the study was to assess the frequency and nature of arrhythmias and establish predictors of their long-term persistence, assess the severity of anxiety and depression, changes in heart rate variability in combatants on the background of changes in the structural and functional state of the left ventricle during a 6-month follow-up. The study included 52 male servicemen (combatants) with acute myocarditis (AM) with an average age of 33.4±2.5 years. All patients were assessed by Questionnaire according to the Hospital Anxiety and Depression Scale (HADS) and underwent 24 hour ECG monitoring, transthoracic echocardiography and cardiac magnetic resonance (CMR) with late enhancement using gadovist. At the onset of AM frequent supraventricular (30.7% of cases) and frequent ventricular (42.3% of cases) extrasystolic arrhythmia, as well as paroxysms of non-sustained ventricular tachycardia (26.9% of cases) on the background of heart rhythm variability disorders were recorded. After 6 months, there was an improvement in the structural and functional state of the heart, which was characterized by a decrease in dilatation and an improvement of LV systolic function, a decrease in the volume of the inflammatory lesion and the total number of affected LV segments revealed on cardiac MRI, which was associated with a decrease in the number of ventricular rhythm disorders and reduction of clinical manifestations of anxiety according to the HADS scale. The obtained data indicate that the persistence of supraventricular rhythm disorders is associated with the long-term presence of anxiety and low values of standard deviation of RR intervals (SDNN) and root mean square of successive differences between normal heartbeats (RMSSD). Also predictors of persistence of non-sustained ventricular tachycardia paroxysms were established – SDNN value ≤80.0 ms, LV end-diastolic volume index ≥95 ml/m², total number of affected LV segments ≥6 segments, presence of delayed contrasting in ≥3 LV segments, pre­sence of ≥12 points on the HADS scale and predictors of atrial fibrillation – SDNN value ≤80.0 ms, RMSSD value ≤12.0 ms, total number of affected segments of LV≥6 seg. and ≥12 points on the HADS anxiety scale, determined at the onset of AM.

Key words: acute myocarditis, heart rhythm disorders, combatants, 6-month follow-up

1. Ammirati E, Frigerio M, Adler DE, Basso C, Bir­nie DH, Brambatti M, et Management of Acute Myo­carditis and Chronic Inflammatory Cardiomyopathy. Circ  Heart Fail. 2020;13:e007405. doi: https://doi.org/10.1161/CIRCHEARTFAILURE.120.007405
2. Younis A, Matetzky S, Mulla W, Masalha E, Afel Y, Chernomordik F, et al. Epidemiology characte­ristics and outcome of patients with clinically diagnosed acute myocarditis. Am J Med. 2020;133:492-9. doi: https://doi.org/10.1016/j.amjmed.2019.10.015
3. Lynge TH, Nielsen TS, Gregers Winkel B, Tfelt-Hansen J, Banner J. Sudden cardiac death caused by myo­carditis in persons aged 1-49 years: a nationwide study of 14 294 deaths in Denmark. Forensic Sci Res. 2019;4:247-56. doi: https://doi.org/10.1080/20961790.2019.1595352
4. Peretto G, Sala S, Rizzo S, Palmisano A, Espo­sito A, De Cobelli F, et al. Ventricular arrhythmias in myocarditis: characterization and relationships with myo­cardial inflammation. J Am Coll Cardiol. 2020;75:1046-57. doi: https://doi.org/10.1016/j.jacc.2020.01.036
5. Kovalenko V, Nesukay E, Cherniuk S, Kozliuk A, Kirichenko R. [Diagnosis and treatment of myocarditis. Re­commendations of All-Ukrainian association of cardio­logy]. Ukrainian cardiologic journal. 2021;32(3):67-88. Ukrainian. doi: https://doi.org/10.31928/1608-635X-2021.3.6788
6. Philippot A, Dubois V, Lambrechts K, Grogna D, Robert A, Jonckheer U, et al. Impact of physical exercise on depression and anxiety in adolescent inpatients: A randomized controlled trial. J Affect Disord. 2022;301:145-53. doi: https://doi.org/10.1016/j.jad.2022.01.011
7. Mitchell C, Rahko PS, Blauwet LA, Canaday B, Finstuen JA, Foster MC, et al. Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Exami­nation in Adults: Recommendations from the American Society of Echocardiography. Journal Am Soc Echocar­diography.2018;32(1):1-64. doi: https://doi.org/10.1016/j.echo.2018.06.004
8. Peretto G, Sala S, Rizzo S, De Luca G, Campo­chiaro C, Sartorelli S. Arrhythmias in myocarditis: state of the art. Heart Rhythm Case Reports. 2019;16(5):793-801. doi: https://doi.org/10.1016/j.hrthm.2018.11.024
9. Ferreira VM, Schulz-Menger J, Holmvang G, Kra­mer CM, Carbone I, Sechtem U, et al. Cardiovascular magnetic resonance in nonischemic myocardial inflam­mation: Expert recommendations. J Am Coll Cardiol. 2018;72(24):3158-76. doi: https://doi.org/10.1016/j.jacc.2018.09.072
10. Pisică D, Dammers R, Boersma E, Volovici V. Tenets of Good Practice in Regression Analysis. A Brief Tutorial. World Neurosurg. 2022;161:230-9.e6. doi: https://doi.org/10.1016/j.wneu.2022.02.112
11. Pavlova I, Graf-Vlachy L, Petrytsa P, Wang S, Zhang S. Early evidence on the mental health of Ukrainian civilian and professional combatants during the Russian invasion.European  2022;65(1):E79. doi: https://doi.org/10.1192/j.eurpsy.2022.2335
12. Vinkers CH, Kuzminskaite E, Lamers F, Gil­tay EJ, Penninx BWJH. An integrated approach to under­stand biological stress system dysregulation across depres­sive and anxiety disorders. J Affect Disord. 2021;283:139-46. doi: https://doi.org/10.1016/j.jad.2021.01.051
13. Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, et 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task force on clinical practice guidelines and the heart rhythm society. Circulation. 2018;138:e272-e391. doi: https://doi.org/10.1161/CIR.0000000000000549
14. Jeong S, Ahn KO, Shin SD, Song KJ, Kim JY, Lee EJ. Association of recent major psychological stress with cardiac arrest: a case-control study. Am J Emerg Med. 2018;36:100-4. doi: https://doi.org/10.1016/j.ajem.2017.07.039
15. Phadumdeo VM, Weinberg SH. Heart rate variabi­lity alters cardiac repolarization and electromechanical dynamics.J Theor  2018;442:31-43. doi: https://doi.org/10.1016/j.jtbi.2018.01.007
16. Kovalenko V, Nesukay E, Fedkiv S, Cherniuk S, Kirichenko R. [Dynamics of structural and functional heart state parameters and heart rhythm disorders in patients with myocarditis during 12-months of observation]. Ukrainian cardiologic journal. 2018;1:73-9. Ukrainian.
17. Tschöpe C, Ammirati E, Bozkurt B, Caforio ALP, Cooper LT, Felix SB, et al. Myocarditis and inflammatory cardiomyopathy: current evidence and future directions. NatRev  2021;18(3):169-93. doi: https://doi.org/10.1038/s41569-020-00435-x
18. Matusik PS, Matusik PT, Stein PK. Heart rate variability and heart rate patterns measured from wearable and implanted devices in screening for atrial fibrillation: potential clinical and population-wide applications. Euro­peanHeart  2023;44:1105-7. doi: https://doi.org/10.1093/eurheartj/ehac546
19. Sessa F, Anna V, Messina G, Cibelli G, Monda V, Marsala G, et al. Heart rate variability as predictive factor for sudden cardiac death. AGING. 2018;10(2):166-77. doi: https://doi.org/10.18632/aging.101386
20. Perek S, Nussinovitch T, Cohen R, Gidron Y, Raz-Pasteur A. Ultra Short Heart Rate Variability Predicts Clinical Outcomes in Patients with a Clinical Presentation Consistent with Myocarditis: A Derivation Cohort Ana­lysis. J Clin Med. 2023;12:89. doi: https://doi.org/10.3390/jcm12010089

Look through:

Nesukay E.G. SI "National Scientific Center "The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Sciences of Ukraine", Kyiv, Ukraine
https://orcid.org/0000-0003-0904-7406

Kovalenko V.M. SI "National Scientific Center "The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Sciences of Ukraine", Kyiv, Ukraine, е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-3802-9207  

Cherniuk S.V. SI "National Scientific Center "The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Sciences of Ukraine", Kyiv, Ukraine
https://orcid.org/0000-0002-7151-5437

Kirichenko R.M. SI "National Scientific Center "The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Sciences of Ukraine", Kyiv, Ukraine
https://orcid.org/0000-0003-0564-8052

Frolov A.I. SI "National Scientific Center "The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Sciences of Ukraine", Kyiv, Ukraine
https://orcid.org/0009-0008-5071-8156

Slyvna A.B. SI "National Scientific Center "The M.D. Strazhesko Institute of Cardiology, Clinical and Regenerative Medicine of the National Academy of Sciences of Ukraine", Kyiv, Ukraine
https://orcid.org/0009-0001-5598-9069

Nesukay E.G., Kovalenko V.M., Cherniuk S.V., Kirichenko R.M., Frolov A.I., Slyvna A.B. Dynamics of heart rhythm disorders in combatants with acute myocarditis during a 6-month follow-up. Medicni perspektivi. 2024;29(1):59-66.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300500

Impact of type 2 diabetes mellitus on low-grade inflammation in patients with ST-elevated myocardial infarction

WHO has recog­nized that COVID-19 is a global pandemic. In the conditions when COVID-19 continues to spread rapidly throughout the world, covering different groups of the population, and despite the fact that the existing standards of care for these patients are constantly updated, it is urgent to continue the search for new, more effective methods of treatment. Currently, the treatment of patients with COVID-19 remains difficult, since the drugs that have a harmful effect on the virus are at the stage of development and testing. Remdesivir, favipiravir, hydroxychloroquine with or without azithromycin, ivermectin, lopinavir/ritonavir were recommended among the agents for etiotropic therapy. But at present, the WHO notes that there is no evidence to recommend any specific antiviral treatment against COVID-19. The results obtained by conducting multicenter randomized clinical trials, which were conducted in 30 countries of the world and included 11,266 people of different ages, mostly adults and elderly. Unfortunately, the use of plasma from the blood of people who have contracted COVID-19 does not save the lives of seriously ill patients from the need to be connected to a ventilator and does not increase their chances of survival. This is also reported by WHO. In treatment, emphasis is placed on the application of pathogenetic therapy. The main measures of non-specific individual and collective prevention with the introduction of quarantine are briefly given. The article is intended mainly for doctors who work with patients with COVID-19 and contact persons. Treatment of patients with COVID-19, as a rule, is pathogenetic, since there are no specific antiviral drugs. The decision regarding medical care in an outpatient clinic setting is made after a clinical assessment of the patient's condition and an assessment of home security. People who are at risk of developing complications should be referred for inpatient treatment.

Key words: COVID-19, treatment, patients

1. Kupferschmidt K, Cohen J. Race to find COVID-19 treatments accelerates. 2020;367:1412-3. doi: https://doi.org/10.1126/science.367.6485.1412
2. Andreychyn MA, Nychyk NA, Zavidniuk NH, Iosyk II, Ischuk IS. [Treatment of patients with COVID-19 at the current stage. Infectious diseases]. Infektsiini khvoroby.2020;3:5-17.  doi: https://doi.org/10.11603/1681-2727.2020.3.11548
3. Dubrov SO, Slavuta HB, Havrylenko OO, Po­niatovskyi PL. [Nutritional therapy of patients with COVID-19. Overview of recommendations]. Pain, anaes­thesia & intensive care. 2020;2(91):9-2. Ukrainian. doi: https://doi.org/10.25284/2519-2078.2(91).2020.205595
4. Salasc F, Lahlali T, Laurent E, Rosa-Calatrava M, Pizzorno A. Treatments for COVID-19: Lessons from 2020 and new therapeutic options. Current Opinion in Pharmacology.2022;62:43-59. doi: https://doi.org/10.1016/j.coph.2021.11.002
5. Sheahan TP, Sims AC, Graham RL, Mena­chery VD, Gralinski LE, Case JB, et al. Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses. Science translational medicine. 2017;9(396):eaal3653. doi: https://doi.org/10.1126/scitranslmed.aal3653
6. Grein J, Ohmagari N, Shin D, Diaz G, Asperges E, Castagna A, et al. Compassionate Use of Remdesivir for Patients with Severe Covid-19. N Engl J Med. 2020 Jun 11;382(24):2327-36. doi: https://doi.org/10.1056/NEJMoa2007016
7. Ansems K, Grundeis F, Dahms K, Mikolajews­ka A, Thieme V, Piechotta V, et al. Remdesivir for the treatment of COVID‐19. Cochrane Database of Systematic Reviews.2021;8:CD014962 doi: https://doi.org/10.1002/14651858.CD014962
8. FDA approves first treatment for COVID-19. U.S. Food and Drug Administration [Internet]. 2020 [cited 2023 Oct 21]. Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-covid-19
9. Swadi AA, Shlash RF, Dibby HJ, Kadhim SAA, Abas MS. Efficacy of Tocilizumab among Severe COVID-19 patients. HIV Nursing. 2022;22(2):376-9.
10. Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, et al. Experimental treatment with favipiravir for COVID-19: an open-label control study. Engineering. 2020;6(10):1192-8. doi: https://doi.org/10.1016/j.eng.2020.03.007
11. Chen C, Zhang Y, Huang J, Yin P, Cheng Z, Wu J, et Favipiravir versus arbidol for COVID-19: a rando­mized clinical trial. MedRxiv. 2020;03(17):20037432. doi: https://doi.org/10.1101/2020.03.17.20037432
12. Elgazzar A, Eltaweel A, Youssef SA, Hany B, Hafez M, Moussa H. Efficacy and safety of ivermectin for treatment and prophylaxis of COVID-19 pandemic. Re­search 2020 Dec 28. doi: https://doi.org/10.21203/rs.3.rs-100956/v2
13. Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, et al. A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. New England Journal of Medicine. 2020 May 7;382(19):1787-99. doi: https://doi.org/10.1056/NEJMoa2001282
14. Ramos-Rincon JM, López-Carmona MD, Cobos-Palacios L, López-Sampalo A, Rubio-Rivas M, Martín-Escalante MD, et al. Remdesivir in very old patients (≥80years) hospitalized with COVID-19: real world data from the SEMI-COVID-19 Registry. Journal of Clinical Medicine. 2022;11(13):3769. doi: https://doi.org/10.3390/jcm11133769
15. Xu X, Han M, Li T, Sun W, Wang D, Fu B, et al. Effective treatment of severe COVID-19 patients with tocilizumab. Proceedings of the National Academy of Sciences.2020;117(20):10970-5. doi: https://doi.org/10.1073/pnas.2005615117
16. Maraolo AE, Crispo A, Piezzo M, Di Gennaro P, Vitale MG, Mallardo D, et al. The use of tocilizumab in patients with COVID-19: a systematic review, meta-ana­lysis and trial sequential analysis of randomized controlled studies. Journal of clinical medicine. 2021;10(21):4935. doi: https://doi.org/10.3390/jcm10214935
17. Rianty AD. Studi in silico senyawa yang terkan­dung dalam tanaman artemisin (artemisia annua l.) sebagai anti SARS-COV-2 [dissertation]. Universitas BTH Tasi­kmalaya; 2022.
18. Oliva JE, Zelaya S, Dominguez R. Opciones tera­péuticas contra el Covid-19. San Salvador; INS; 2021. 30 p.
19. Zhang T, Wu Q, Zhang Z. Probable pangolin origin of SARS-CoV-2 associated with the COVID-19 outbreak. Current Biology. 2020;30(7):1346-51. doi: https://doi.org/10.1016/j.cub.2020.03.022
20. Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2; Coronavirus Disease-19). Clinical and Experimental 2020;63(4):119. doi: https://doi.org/10.3345/cep.2020.00493
21. Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. New England Journal of Medicine. 2020;382:1199-207. doi: https://doi.org/10.1056/NEJMoa2001316
22. Chan JFW, Yuan S, Kok KH, To KKW, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet.2020;395(10223):514-23. doi: https://doi.org/10.1016/S0140-6736(20)30154-9
23. Burke RM, Midgley CM, Dratch A, Fenster­sheib M, Haupt T, Holshue M, et al. Active monitoring of persons exposed to patients with confirmed COVID-19-United States, January-February 2020. MMWR Morbidity and Mortality Weekly Report. 2020;69(9):245-6. doi: https://doi.org/10.15585/mmwr.mm6909e1
24. Guo ZD, Wang ZY, Zhang SF, Li X, Li L, Li C, et Aerosol and surface distribution of severe acute respi­ratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020. Emerg Infect Dis. 2020;26(7):1583-91. doi: https://doi.org/10.3201/eid2607.200885
25. Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B, et Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerging Microbes & Infections. 2020;9(1):386-9. doi: https://doi.org/10.1080/22221751.2020.1729071
26. Rothe C, Schunk M, Sothmann P, Bretzel G, Fro­eschl G, Walrauch C, et al. Transmission of 2019- nCoV infection from an asymptomatic contact in Germany. New England Journal of Medicine. 2020;382(10):970-1. doi: https://doi.org/10.1056/NEJMc2001468
27. Mizumoto K, Kagaya K, Zarebski A, Chowell G. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosur­veillance.2020;25(10):2000180. doi: https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000180
28. Nishiura H, Kobayashi T, Miyama T, Suzuki A, Jung S, Hayashi K, et al. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Int J Infect 2020 May;94:154-5. doi: https://doi.org/10.1016/j.ijid.2020.03.020
29. Hui DS. Super-spreading events of MERS-CoV infection.The  2016;388(10048):942-3. doi: https://doi.org/10.1016/S0140-6736(16)30828-5
30. Schwartz DA. An analysis of 38 pregnant women with COVID-19, their newborn infants, and maternal-fetal transmission of SARS-CoV-2: maternal coronavirus infections and pregnancy outcomes. Arch Pathol Lab Med. 2020 Jul 1;144(7):799-805. doi: https://doi.org/10.5858/arpa.2020-0901-SA
31. Pneumonia of unknown cause – China. World Health Organization [Internet]. 2020 [cited 2023 Oct 21]. Available from: https://www.who.int/emergencies/disease-outbreak-news/item/2020-DON229
32. Wölfel R, Corman VM, Guggemos W, Seil­maier M, Zange S, Müller MA, et al. Virological asses­sment of hospitalized patients with COVID-2019. Nature. 2020;1-5. doi: https://doi.org/10.1038/s41586-020-2196-x
33. Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. Jama.2020;323(18):1775-6. doi: https://doi.org/10.1001/jama.2020.4683
34. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama.2020;323(13):1239-42. doi: https://doi.org/10.1001/jama.2020.2648
35. Xie J, Tong Z, Guan X, Du B, Qiu H, Slutsky AS. Critical care crisis and some recommendations during the COVID-19 epidemic in China. Intensive Care Medicine. 2020;46(5):837-40.
    doi: https://doi.org/10.1007/s00134-020-05979-7
36. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama.2020;323(11):1061-9. doi: https://doi.org/10.1001/jama.2020.1585
37. Song F, Shi N, Shan F, Zhang Z, Shen J, Lu H, et al. Emerging 2019 novel coronavirus (2019-nCoV) pneu­monia. Radiology.2020;295(1):210-7. doi: https://doi.org/10.1148/radiol.2020200274
38. Zhu T, Wang Y, Zhou S, Zhang N, Xia L. A com­parative study of chest computed tomography features in young and older adults with Corona Virus disease (COVID-19). Journal of Thoracic Imaging. 2020 Jul;35(4):W97-W101. doi: https://doi.org/10.1097/RTI.0000000000000513
39. Soldati G, Smargiassi A, Inchingolo R, Buon­sen­so D, Perrone T, Briganti DF, et al. Proposal for inter­national standardization of the use of lung ultrasound for COVID-19 patients; a simple, quantitative, reproducible method. Journal  of Ultrasound in Medicine. 2020;7(39):1413-9. doi: https://doi.org/10.1002/jum.15285
40. Sheahan TP, Sims AC, Graham RL, Mena­che­ry VD, Gralinski LE, Case JB, et al. Broadspectrum anti­viral GS-5734 inhibits both epidemic and zoonotic coro­naviruses. Science Translational Medicine. 2017;9(396):5653. doi: https://doi.org/10.1126/scitranslmed.aal3653
41. Lescure FX, Bouadma L, Nguyen D, Parisey M, Wicky PH, Behillil S, et al. Clinical and virological data of the first cases of COVID-19 in Europe: a case series. The Lancet Infectious Diseases. 2020;6(20):697-706. doi: https://doi.org/10.1016/S1473-3099(20)30200-0
42. Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, et al. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clinical Infectious Diseases. 2020 Jul 28;71(15):732-9. doi: https://doi.org/10.1093/cid/ciaa237
43. Cortegiani A, Ingoglia G, Ippolito M, Giarra­tano A, Einav S. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. Journal of Critical Care. 2020;57:279-83. doi: https://doi.org/10.1016/j.jcrc.2020.03.005

Look through:

Moskaliuk V.D. Bukovinian State Medical University, Chernivtsi, Ukraine
https://orcid.org/0000-0002-4104-8153

Balaniuk I.V. Bukovinian State Medical University, Chernivtsi, Ukraine
https://orcid.org/0000-0003-1146-4065

Andrushchak M.O. Bukovinian State Medical University, Chernivtsi, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0001-5003-9622

Sirota B.V. Bukovinian State Medical University, Chernivtsi, Ukraine
https://orcid.org/0000-0002-2654-5602

Honcharuk L.M. Bukovinian State Medical University, Chernivtsi, Ukraine
https://orcid.org/0000-0002-5761-1238

Сhernetska N.V. Bukovinian State Medical University, Chernivtsi, Ukraine
https://orcid.org/0000-0002-5156-1313

Ilika V.V.  Bukovinian State Medical University, Chernivtsi, Ukraine
https://orcid.org/0000-0002-3714-9883

Moskaliuk V.D., Balaniuk I.V., Andrushchak M.O., Sirota B.V., Honcharuk L.M., Сhernetska N.V., Ilika V.V. Assessment of the efficiency of treatment of patients with COVID-19 (literature review). Medicni perspektivi. 2024;29(1):67-74.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300502

Рrevention of contrast-induced nephropathy during interventional treatment of acute coronary syndrome

Nowadays, knowledge about the causal relationships between concomitant chronic diseases and the course of coronavirus infection (COVID-19) can make a huge contribution to saving the lives of patients. Determining the impact of concomitant pathology on the severity of the course of COVID-19 will contribute to the identification and assessment of the risk of deterioration of the condition, as well as the implementation of preventive measures in high-risk individuals (vaccination). The aim of the work was to assess the influence of age and sex on the presence of comorbid pathology and the course of the disease in patients who were hospitalized with community-acquired viral pneumonia associated with COVID-19. We carried out a retrospective analysis of the case histories of 260 patients with community-acquired pneumonia associated with coronavirus disease, who were treated in the therapeutic departments of the Covid Center of ME “Dnipropetrovsk regional clinical hospital named after Mechnikov” DRC in 2020-2021. (September-December 2020, January- December 2021), single-center study. All patients included in the analysis underwent general clinical and laboratory methods of research regulated by national recommendations for the management of patients with COVID-19, PCR tests (polymerase chain reaction) for verification of coronavirus disease, CT(computed tomography)/radiography of the lungs. Comorbidity was assessed as the development of the disease before the onset / verification of coronavirus disease according to a patient survey recorded in medical records. One or more comorbid conditions were recorded in 195 (75%) patients. Multimorbidity was recorded in 111 (56.9%) patients from the total number of patients with COVID-19 and comorbid pathology. Analyzing the influence of gender in patients with comorbid pathology, men were significantly more likely to have coronary artery disease (CAD) (p=0.04) and chronic obstructive pulmonary disease (COPD) (p=0.04). A significant difference in age among hospitalized patients with a diagnosis of COVID-19 was revealed, depending on sex (p<0.001). So at the age of up to 65 years, male patients predominated (60.4%), over the age of 65 years – women (68.9%). There was no significant difference in the frequency of occurrence of moderate severity and severe course of the disease of COVID-19, depending on age and sex. At the age of over 65, the presence of type 2 diabetes (p<0.001), hypertension (p<0.001), coronary artery disease (p<0.001) and COPD (p<0.001) was significantly more common.

Key words: coronavirus disease, COVID-19, comorbid conditions, concomitant pathology, age, sex

1. Guan WI, Ni ZY, Hu Y, et al. Clinical characte­ristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20. doi: https://doi.org/10.1056/NEJMoa2002032
2. Coronavirus disease (COVID-19) Weekly Epide­miological Update of World Health Organization [Inter­net]. 2021 [cited 2023 Jun 28]. Available from: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20210621-weekly-epi-update-1/pdf?sfvrsn=b6d49a76_4
3. Deng SQ, Peng HJ. Characteristics of and public health responses to the coronavirus disease 2019 outbreak in China. Journal of Clinical Medicine. 2020;9(2):575. doi: https://doi.org/10.3390/jcm9020575
4. Peng YD, Meng K, Guan HQ, et al. Clinical cha­racteristics and out-comes of 112 cardiovascular disease patients infected by 2019-nCoV. Chinese Journal of Cardiology. 2020;48(6):450-5. doi: https://doi.org/10.3760/cma.j.cn112148-20200220-00105
5. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet.2020;395(10223):497-506. doi: https://doi.org/10.1016/S0140-6736(20)30183-5
6. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infec­ted pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. doi: https://doi.org/10.1001/jama.2020.1585
7. Yang J, Zheng Y, Gou X, et al. Prevalence of co­morbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis. Int J Infect Dis. 2020;94:91-5. doi: https://doi.org/10.1016/j.ijid.2020.03.017
8. Zaki N, Alashwal H, Ibrahim S. Association of hy­pertension, diabetes, stroke, cancer, kidney disease and high-cholesterol with COVID-19 disease severity and fata­lity: A systematic review. Diabetes Metab Syndr. 2020;14(5):1133-42. doi: https://doi.org/10.1016/j.dsx.2020.07.005
9. Tang N, Li D, Wang X, et al. Abnormal coagu­lation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. J Thromb Haemost.2020;18(4):844-7. doi: https://doi.org/10.1111/jth.14768
10. Chen Y, Gong X, Wang L, Guo J. Effects of hupertension, diabetes and coronary heart disease on COVID-19 diseases severity: a systematic review and meta-analysis. medRxiv. 2020;03(25):20043133. doi: https://doi.org/10.1101/2020.03.25.20043133
11. Zaikov SV. [COVID-19 and comorbid chronic di­seases]. Infusion & Chemotherapy. 2020;3:5-10. Ukrai­nian. doi: https://doi.org/10.32902/2663-0338-2020-3-5-10
12. [“Amendments to the Standards of Medical Care” Coronavirus Disease (COVID19). Order of the Ministry of Health of Ukraine dated 23.04.2020 No 953, approved by the order of the Ministry of Health of Ukraine dated 28.03.2020 No. 722]. [Internet]. 2020 [cited 2023 Jun 28]. Ukrainian. Available from: https://moz.gov.ua/uploads/4/20303-dn_20200423_953_dod.pdf
13. [“Amendments to the Protocol of provision of Medi­cal Care for the treatment of coronavirus disease (COVID-19)”. Order of the Ministry of Health of Ukraine dated 11.11.2021 No 2495, approved by the order of the Ministry of Health of Ukraine dated 02.04.2020 No 762]. [Internet]. 2021 [cited 2023 Jun 28]. Ukrainian. Available from: https://zakon.rada.gov.ua/rada/show/v2495282-21/print
14. R Core Team R: A language and environment for statistical computing. R Foundation for Statistical Com­puting, Vienna, Austria. Scientific Research An Academic Publisher [Internet]. 2020 [cited 2023 Jun 28]. Available from: https://www.R-project.org/
15. Palaiodimos L, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108:154262 doi: https://doi.org/10.1016/j.metabol.2020.154262

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Kuryata O.V. Dnipro State Medical University, Dnipro, Ukraine 
https://orcid.org/0000-0001-7642-0077

Semenov V.V. Dnipro State Medical University, Dnipro, Ukraine 
https://orcid.org/0000-0003-3363-0159

Fetkhi S. Dnipro State Medical University, Dnipro, Ukraine 

Frolova Ye.O. Dnipro State Medical University, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0002-8546-1601

Kuryata O.V., Semenov V.V., Fetkhi S., Frolova Ye.O. Comorbidity and extra pulmonary manifestations in hospitalized patients with coronavirus disease (COVID-19) depending on age and sex. Medicni perspektivi. 2024;29(1):74-81.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300503

Study of the association of polymorphisms of the folate cycle enzyme gene with the degree of cognitive and affective disorders in patients in the post-covid period

Primary dysmenorrhea is one of the types of gynecological pathology, the frequency of which is 45-53% in girls and young women aged 13 to 45 years, which is not given enough attention in diagnosis and treatment. The pathogenesis takes into account the increased secretion of prostaglandins F2α and E2 in the period from the beginning of pregnancy to birth, which cause pelvic pain. The diagnosis is based on the patient's history, symptoms, examination, the treatment is aimed at improving the quality of life by prescribing nonsteroidal anti-inflammatory drugs, hormonal contraceptives and the use of non-medicinal means. Purpose: to specify some links in the pathogenesis of primary dysmenorrhea and, taking into account its multicomponent nature, to evaluate the effectiveness of the proposed treatment. Under observation there were 68 women who were divided into 2 groups: 34 women with primary dysme­norrhea (main group) and 34 healthy women (control group). The diagnosis of primary dysmenorrhea was established on the basis of complaints of patients about painful menstruation and accompanying symptoms during consultations with a gynecologist and endocrinologist. Treatment of patients in the main group was carried out with the drug, which includes Vitex agnus castus L, indinol-3-carbinol, 3,3-diindolyl-methane, extract of passionflower, California Eschscholzia. In women with typical symptoms, dysmenorrhea can be diagnosed on the basis of medical information without physical pelvic examination, empirical treatment should be initiated, including nonsteroidal anti-inflammatory drugs and/or oral contraceptives, because it is a functional condition resulting from an imbalance in the hormonal regulation of myometrial contraction. As a result of the proposed treatment, pain disappeared completely in 70% of patients (23/34), as well as vegetative-vascular (from 18 to 2% of patients), vegetative (from 10 to 1% of patients), metabolic and endocrine disorders (from 15 to 2% female patients), disorders of the emotional and mental sphere (from 25 to 10% of patients). Improvement in quality of life was noted by 80% (26/34) of patients, improvement in working capacity – by 70% (23/34) of patients, after 2 months – by 95% (31/34) and 85% (28/34), respectively, after 3 months all examined patients with primary dysmenorrhea noted an improvement in the quality of life and an increase in work capacity. Sexually active women with symptoms of inflammatory processes of the genital tract, severe dysmenorrhea should undergo pelvic examination. In view of safety and high therapeutic efficiency, the drug based on Vitex agnus castus can be offered for the treatment over the period lasting at least for3 months for girls and young women aged 13 to 45 years with primary dysmenorrhea.

Key words: primary dysmenorrhea, pathophysiology, diagnosis, treatment, combined herbal remedies

1. Fartushok TV, Semenyna HB, Yurchyshyn OM, Komissarova OS. Ways to improve natural fertility. Wiadomosci lekarskie. 2021;74(1):144-9. doi: https://doi.org/10.36740/WLek202101128
2. Armour M, Parry K, Manohar N, Holmes K, Fer­folja T. The prevalence and academic impact of dys­menorrhea in 21,573 young women: A systematic review and meta-analysis. J Women Health. 2019;28:1161-71. doi: https://doi.org/10.1089/jwh.2018.7615
3. Bajalan Z, Moafi F, Baglooei M, Alimoradi Z. Mental health and primary dysmenorrhea: A systematic review. J Psychosom Obstet Gynecol. 2018;40:1-10. doi: https://doi.org/10.1080/0167482X.2018.1470619
4. Burnett M, Lemyre M. No. 345-Primary dysme­norrhea consensus guideline. J Obstet Gynaecol Can. 2017;39:585-95. doi: https://doi.org/10.1016/j.jogc.2016.12.023
5. Escobar LK. Two new species of Passsiflora (Passifloraceae) from Northern South America. Phytologia.2019;69:364-7. doi: https://doi.org/10.5962/bhl.part.9803
6. Femandez-Martinez E, Abreu-Sanchez A, Velar­de-Garcia JF, Iglesias-Lopez MT, Perez-Corrales J. Living with restrictions. The perspective of nursing students with primary dysmenorrhea. Int J Enviromental Res Publ Health. 2020;17(22):8527. doi: https://doi.org/10.3390/ijerph17228527
7. Heskes AM, Sundram TCM, Boughton BA, Jen­sen NB, Hansen NL. Biosynthesis of bioactive diter­penoids in the medicinal plant Vitex agnus castus. Plant J. 2018;93(5):943-8. doi: https://doi.org/10.1111/tpj.13822
8. Li AD, Bellis EK, Girling JE, Jayasinghe YL, Grover SK. Unmet needs and experiences of adolescent girls with heavy menstrual bleending and dysmenorrhea: A qualitative study. J Pediatr Adolesc Gynecol. 2020;33:278-84. doi: https://doi.org/10.1016/j.jpag.2019.11.007
9. Matthewman G, Lee A, Kaur JG, Daley AJ. Phy­sical activity for primary dysmenorrhea: A systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2018;219:e1-e255. doi: https://doi.org/10.1016/j.ajog.2018.04.001
10. Rafieian-Kopaei M, Movahedi A. Systematic Review of Premenstrual, Postmenstrual and Infertility Disorders of Vitex Agnus Castus. Electron Physician. 2017;9(1):3685-9. doi: https://doi.org/10.19082/3685
11. Rafique N, Al-Sheikh MH. Prevalence of primary dysmenorrhea and its relationship with body mass index. J Obstet Gynaecol Res. 2018;44:1773-8. doi: https://doi.org/10.1111/jog.13697
12. Ali Esmail Al-Snafi. Eschscholzia Californica: A Phytochemical and Pharmacological – Review. Indo Am J P Sci. 2017;4(02):257-63. doi: http://doi.org/10.5281/zenodo.344931
13. Ryan SA. The treatment of dysmenorrhea. Pediatr Clin Am. 2017;64:331-42. doi: https://doi.org/10.1016/j.pcl.2016.11.004
14. Sogame M, Naraki Y, Sasaki T, Seki M, Yokota K. Quality assessment of medicinal product and dietary supplements containing Vitex agnus castus by HPLC fingerprint and quantitative analyses. Chem Pharm Bull (Tokio). 2019;67(6):527-33. doi: https://doi.org/10.1248/cpb.c18-00725
15. Quan VV, Mechler A. In silico study of the radical scavenging activities of natural indol-3-carbinols. J Chem Int Model. 2020;60(1):316-21. doi: https://doi.org/10.1021/acs.jcim.9b00917
16. Islamova OH. [An innovative approach to the treatment of menstrual cycle disorders in women of reproductive age]. [Internet]. Health-ua.com. 2021 [cited 2023 Jun 21]. Available from: https://health-ua.com/multimedia/userfiles/files/2021/Akush_5_2021/Akysh_5_2021_st28-29.pdf
17. Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. 2016 Oct 4;4:2050312116671725. doi: https://doi.org/10.1177/2050312116671725
18. Prydannykova YuE. Statistical Methods for Stu­dying the Causality between Economic Growth and Material Welfare of Population. Scientific Bulletin of the National Academy of Statistics, Accounting and Audit. 2017;3:16-25. doi: https://doi.org/10.31767/nasoa.3.2017.02

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Fartushok T.V. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6571-0108

Fartushok N.V. Lviv Medical University, Lviv, Ukraine
https://orcid.org/0000-0003-2824-8473

Fartushok T.V., Fartushok N.V. Primary dysmenorrhea: pathophysiology, improvement of diagnostic and treatment possibilities. Medicni perspektivi. 2024;29(1):81-89. DOI: https://doi.org/10.26641/2307-0404.2024.1.300504

COVID-19 and arterial hypertension: whether normal blood pressure is a sign of a benign course of COVID-19

Birth defects (BD) are an important cause of neonatal mortality and can be associated with premature birth. The study aimed to develop a prognostic model for congenital malformations in mothers with a history of preterm delivery, using logistic regression analysis. The study included 665 mothers of children with BD, of which 432 (65%) had a history of preterm delivery (main group), and 233 (35%) had term delivery (control group). Variables examined included pregnancy history, genetic factors, and biochemical markers. Statistical analysis found significant associations between BD and preterm delivery, intrauterine malformations, miscarriages, MTHFR polymorphism, and HLA antigens. The logistic model showed good predictive performance. The area under the ROC curve was 0.769 for pregnancy history, 0.699 for miscarriages, and 0.630 for intrauterine malformations, indicating moderate predictive ability. A statistical relationship was found between BD risk and pregnancy history, intrauterine malformations, miscarriages, and genetic factors. The resulting logistic model may help predict BD risk in mothers with a preterm delivery history.

Key words: regression analysis, fetal anomalies, statistical analysis, logistic model, neonatal mortality

1. Impellizzeri P, Nascimben F, Di Fabrizio D, Anto­nuccio P, Antonelli E, Peri FM, et al. Pathogenesis of birth defects: Possible role of oxidative stress. American Journal of Perinatology. 2022;39(8):816-23. doi: https://doi.org/10.1055/s-0040-1721081
2. Congenital disorders [Internet]. World Health Organization; 2023 [cited 2023 Jul 19]. Available from: https://www.who.int/news-room/fact-sheets/detail/birth-defects
3. Svyatova GS, Mirzakhmetova DD, Berezina GM, Murtazaliyeva AV. Genetic Factors of Idiopathic Recur­rent Miscarriage in Kazakh Population. Journal of Repro­duction and Infertility. 2022;23(1):39-45. doi: http://dx.doi.org/10.18502/jri.v23i1.8451
4. Mamedaliyeva NM, Kurmanova AM, Lok­shin VN, Kurmanova GM, Issenova S. Clinical and immu­nological parallels in pregnancy loss. Gynecological Endocrinology. 2017;33:5-7. doi: 10.1080/09513590.2017.1404238
5. Şahin Uysal N, Şahin Fİ, Terzi YK. The impact of developmental genes in non-syndromic cleft lip and/or palate. Journal of the Turkish German Gynecological Association. 2023;24:57-64. doi: https://doi.org/10.4274/jtgga.galenos.2022.2021-10-7
6. Lejeune S, Sfeir R, Rousseau V, Bonnard A, Ge­las T, Aumar M, et al. Esophageal atresia and respiratory morbidity. Pediatrics. 2021;148(3):e2020049778. doi: https://doi.org/10.1542/peds.2020-049778
7. Pakkasjärvi N, Syvänen J, Wiro M, Koskimies-Virta E. Amelia and phocomelia in Finland: Characte­ristics and prevalences in a nationwide population-based study. Birth Defects Research. 2022;114(20):1427-33. doi: https://doi.org/10.1002/bdr2.2123
8. Kase JS, Visintaine P. The relationship between birth defects and preterm birth. Journal of Perinatal Medi­cine.2007;35(6):538-42. doi: https://doi.org/10.1515/JPM.2007.132
9. Bergman JEH, Barišić I, Addor MC, Braz P, Ca­vero-Carbonell C, Draper ES, et al. Amniotic band synd­rome and limb body wall complex in Europe 1980-2019. American Journal of Medical Genetics. Part A. 2023;191(4):995-1006. doi: https://doi.org/10.1002/ajmg.a.63107
10. Gunn-Charlton JK. Impact of comorbid prema­turity and congenital anomalies: A review. Frontiers in Physiology.2022;13:880891. doi: https://doi.org/10.3389/fphys.2022.880891
11. Straub L, Huybrechts KF, Bateman BT, Mogun H, Gray KJ, Holmes LB, et al. The impact of technology on the diagnosis of birth defects. American Journal of Epidemiology. 2019;188(11):1892-901. doi: https://doi.org/10.1093/aje/kwz153
12. Heuvelman H, Abel K, Wicks S, Gardner R, John­stone E, Lee B, et al. Gestational age at birth and risk of intellectual disability without a common genetic cause. European Journal of Epidemiology. 2018;33(7):667-78. doi: https://doi.org/10.1007/s10654-017-0340-1
13. Bashir A. Birth defects: Prenatal diagnosis and management. American Journal of Biomedical Science & Research. 2019;2(1):24-7. doi: https://doi.org/10.34297/AJBSR.2019.02.000565
14. Suluba E, Shuwei L, Xia Q, Mwanga A. Conge­nital heart diseases: Genetics, non-inherited risk factors, and signaling pathways. Egyptian Journal of Medical Human Genetics. 2020;21:11. doi: https://doi.org/10.1186/s43042-020-0050-1
15. Boateng E, Abaye D. A review of the logistic reg­ression model with emphasis on medical research. Journal of Data Analysis and Information Processing. 2019;7(4):190-207. doi: https://doi.org/10.4236/jdaip.2019.74012
16. Begimbekova LM, Alieva EN, Suleimenova ZhU, Tastanbekova ShA, Baikubekova AU. Optimization of prenatal diagnosis of birth defects of the fetus and issues of prognosis. Bulletin of the Kazakh National Medical University. 2015;2:6-8.
17. Panic N, Leoncini E, de Belvis G, Ricciardi W, Boccia S. Evaluation of the endorsement of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement on the quality of published syste­matic review and meta-analyses. PLoS One. 2013;8(12):e83138. doi: https://doi.org/10.1371/journal.pone.0083138
18. Poorolajal J, Cheraghi Z, Irani AD, Rezaeian S. Quality of cohort studies reporting post the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Epidemiol Health. 2015;37:e2015015.
19. Shapiro SS, Wilk MB. An analysis of variance test for normality (complete samples). Biometrika. 1965;52(3/4):591-611. doi: https://doi.org/10.1093/biomet/52.3-4.591
20. Massey FJ. The Kolmogorov-Smirnov test for goodness of fit. Journal of the American Statistical As­sociation. 1951;46(253):68-78. doi: https://doi.org/10.1080/01621459.1951.10500769
21. Fisher RA. Statistical methods for research wor­kers. Genesis Publishing Pvt Ltd; 1925.
22. Kruskal WH, Wallis WA. Use of ranks in one-cri­terion variance analysis. Journal of the American statistical Association. 1952;47(260):583-621. doi: https://doi.org/10.1080/01621459.1952.10483441
23. Pearson KX. On the criterion that a given system of deviations from the probable in the case of a correlated system of variables is such that it can be reasonably sup­posed to have arisen from random sampling. The London, Edinburgh, and Dublin Philosophical Magazine and Journal of Science. 1900;50(302):157-75. doi: https://doi.org/10.1080/14786440009463897
24. Cox DR. The regression analysis of binary sequences. Journal of the Royal Statistical Society: Se­ries B (Methodological). 1958;20(2):215-32. doi: https://doi.org/10.1111/j.2517-6161.1958.tb00292.x
25. Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology. 1982;143(1):29-36. doi: https://doi.org/10.1148/radiology.143.1.7063747
26. Rundell K, Panchal B. Preterm labor: Pre­ven­tion and management. American Family Physician. 2017;95(6):366-72.
27. Chiabi A, Mah EM, Mvondo N, Nguefack S, Mbuagbaw L, Kamga KK, et al. Risk factors for premature births: A cross-sectional analysis of hospital records in a Cameroonian health facility. African Journal of Repro­ductive Health. 2013;17(4):77-83.
28. Daliri S, Safarpour H, Bazyar J, Sayehmiri K, Karimi A, Anvary R. The relationship between some neonatal and maternal factors during pregnancy with the prevalence of birth defects in Iran: A systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 2019;32(21):3666-74. doi: https://doi.org/10.1080/14767058.2018.1465917
29. Kuhle S, Brown MM, Dodds L, McDonald SD, Woolcott CG. Health care utilization in the first 7 years in children with fetal growth abnormalities: A retrospective cohort study. The Journal of Pediatrics. 2023;252:154-61. doi: https://doi.org/10.1016/j.jpeds.2022.08.012
30. Kamble V, Patil S, Bhatia T, Thaware P, Ma­thur P. The epidemiological study of congenital anomalies and their possible risk factors in teaching hospital in MGM. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2015;4(5):1396-99. doi: https://doi.org/10.18203/2320-1770.ijrcog20150717
31. Zhang M, Sun Y, Zhao X, Liu R, Yang BY, Chen G, et al. How parental predictors jointly affect the risk of offspring congenital heart disease: A nationwide multicenter study based on the china birth cohort. Frontiers in Cardiovascular Medicine. 2022;9:860600. doi: https://doi.org/10.3389/fcvm.2022.860600
32. Kamble V, Patil Sh, Bhatia T, et al. The epidemio­logical study of congenital anomalies and their possible risk factors in teaching hospital in MGM Kalamboli, Navi Mum­bai. International Journal of Reproduction. 2015;4(5):1396-99. doi: https://doi.org/10.18203/2320-1770.ijrcog20150717
33. Modzelewski J, Pokropek A, Jakubiak-Proć M, Muzyka-Placzyńska K, Filipecka-Tyczka D, Kajdy A, et al. Large-for-gestational-age or macrosomia as a clas­sifier for risk of adverse perinatal outcome: A retrospective cross-sectional study. The Journal of Maternal-Fetal & Neonatal Medicine. 2022;35(25):5564-71. doi: https://doi.org/10.1080/14767058.2021.1887127
34. Rekawek P, Liu L, Getrajdman C, Brooks C, Pan S, Overbey J, et al. Large-for-gestational age diag­nosed during second-trimester anatomy ultrasound and association with gestational diabetes and large-for-gestational age at birth. Ultrasound in Obstetrics & Gynecology. 2020;56(6):901-5. doi: https://doi.org/10.1002/uog.21930
35. Li H, Luo M, Luo J, Zheng J, Zeng R, Du Q, et al. A discriminant analysis prediction model of non-syndromic cleft lip with or without cleft palate based on risk factors. BMC Pregnancy and Childbirth. 2016;16(1):368. doi: https://doi.org/10.1186/s12884-016-1116-4
36. Gander J, Sui X, Hazlett LJ, Cai B, Hébert JR, Blair SN. Factors related to coronary heart disease risk among men: Validation of the Framingham risk score. Preventing Chronic Disease. 2014;11:E140. doi: https://doi.org/10.5888/pcd11.140045
37. Wang N, Guo H, Jing Y, Zhang Y, Sun B, Pan X, et al. Development and validation of risk prediction models for large for gestational age infants using logistic reg­ression and two machine learning algorithms. Journal of Diabetes. 2023;15(4):338-48. doi: https://doi.org/10.1111/1753-0407.13375 

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Mammadzada G. Scientific Research Institute of Obstetrics and Gynecology, Department of Neonatology, Baku, Republic of Azerbaijan, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-5153-7068

Mammadzada G. A model for predicting birth defects of the fetus based on risk factors in mothers with a history of premature birthі. Medicni perspektivi. 2024;29(1):90-100.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300506

Peculiarities of ambulatory blood pressure monitoring in patients who have suffered from COVID-19

Varicocele is a venous anomaly characterized by the enlargement of the plexus of veins in the testicle. In pediatric cases, indications for surgical intervention in varicocele include palpable dilatation of the enlargement of the plexus veins, intermittent pain in the ipsilateral testicle, and a 20% reduction in size of the ipsilateral testicle compared to the contralateral healthy one. The limitations of evaluating these criteria and the need to assess semen parameters prompt clinicians to explore new diagnostic methods for timely surgical interventions in adolescents. One such promising study involves Near-infrared reflectance spectroscopy (NIRS) in the Near-infrared range. The aim of the research is to evaluate the diagnostic capabilities of NIRS in children with varicocele to determine the indications for surgical intervention. The study included 65 boys aged 11 to 17 years with left-sided grade III varicocele (main group) and 29 healthy boys as a control group. Monitoring of regional oxygen saturation (rSO₂) of testicular tissues was conducted using optical spectroscopy. NIRS examination of testicular tissues in both study and control groups showed statistically homogeneous data for regional oxygen saturation in the healthy (right) testicle. However, the NIRS study revealed significantly lower oxygen saturation (rSO₂) in the testicular tissue of the left testicle in patients with varicocele compared to the control group. The diagnostic significance of the difference in bilateral NIRS monitoring Δ rSO₂ >13% reliably characterized the presence of testicular hypotrophy by more than 20% compared to the healthy contralateral side (AUC=0.64, 95% CI (0.505-0.775), sensitivity – 79%, specificity – 50%, p=0.042). Δ rSO₂ >11% values indicated disturbances in spermogram related to oxidative stress (AUC=0.702, 95% DI (0.51-0.88), sensitivity – 82%, specificity – 61%, p=0.031). Therefore, NIRS study data have potential valuable information for the diagnosis and selection of treatment for varicocele in children. The research utilizing Near-infrared Reflectance Spectroscopy revealed a significant potential of this method for diagnosing and assessing the impact of varicocele on the microcirculation of testicular tissue in children. The diagnostic significance of the difference in bilateral monitoring using this non-invasive technique in determining the state of testicles and the possibility of addressing the question of the necessity of surgical intervention is established.

Key words: varicocele, Near-infrared reflectance spectroscopy, diagnosis, subinguinal microsurgical varicocelectomy, adolescents

1. Zundel S, Szavay P, Stanasel I. Management of adolescent varicocele. Semin Pediatr Surg. 2021 Aug;30(4):151084. doi: https://doi.org/10.1016/j.sempedsurg.2021.151084
2. Bertolotto M, Freeman S, Richenberg J, Bel­field J, Dogra V, Huang DY, et al. Members of the ESUR-SPIWG WG. Ultrasound evaluation of varicoceles: systematic literature review and rationale of the ESUR-SPIWG Guidelines and Recommendations. J Ultrasound. 2020 Dec;23(4):487-507. doi: https://doi.org/10.1007/s40477-020-00509-z
3. Dieamant F, Petersen CG, Mauri AL, Con­mar V, Mattila M, Vagnini LD, et al. Semen parameters in men with varicocele: DNA fragmentation, chromatin packa­ging, mitochondrial membrane potential, and apoptosis. JBRA Assist Reprod. 2017 Dec 1;21(4):295-301. doi: https://doi.org/10.5935/1518-0557.20170053
4. Su JS, Farber NJ, Vij SC. Pathophysiology and treatment options of varicocele: An overview. Andrologia. 2021 Feb;53(1):e13576. doi: https://doi.org/10.1111/and.13576
5. Silay MS, Hoen L, Quadackaers J, Undre S, Bo­gaert G, Dogan HS, et al. Treatment of Varicocele in Chil­dren and Adolescents: A Systematic Review and Meta-analysis from the European Association of Urology/European Society for Paediatric Urology Guidelines Panel. Eur Urol. 2019 Mar;75(3):448-61. doi: https://doi.org/10.1016/j.eururo.2018.09.042
6. Macey MR, Owen RC, Ross SS, Coward RM. Best practice in the diagnosis and treatment of varicocele in children and adolescents. Therapeutic Advances in Urology.2018;10(9):273-82. doi: https://doi.org/10.1177/1756287218783900
7. Kaba A, Kaba E, Ardıç C. A Rare Cause of Unex­plained Left Flank Pain: Nutcracker Syndrome. Konuralp Medical 2023;15(2):273-6. doi: https://doi.org/10.18521/ktd.1106258
8. Laher AE, Swart M, Honiball J, et al. Near-infrared spectroscopy in the diagnosis of testicular torsion: valuable modality or waste of valuable time? A systematic review. ANZ journal of surgery. 2019;90(5):708. doi: https://doi.org/10.1111/ans.15402
9. Antomonov MJ, Korobeinikov GV, Hmel­nyt­ska IV, Harkovliuk-Balakina NV. [Mathematical methods of processing and modeling the results of experimental research: a study guide]. Kyiv: Olimpiiska literatura; 2021. 216 p. Ukrainian.
10. Stothers L, Shadgan B, Macnab A. Urological ap­plications of near infrared spectroscopy. Can J Urol. 2008 Dec;15(6):4399-409. PMID: 19046493.
11. Vivas-Acevedo G, Lozano JR, Camejo MI. Effect of varicocele grade and age on seminal parameters. Urologia internationalis. 2010;85(2):194-9. doi: https://doi.org/10.1159/000314226
12. Vlasov A. Features of cerebral oximetry indicators in different types of combined anesthesia in children with con­genital surgical pathology. Emergency medicine. 2021;17(1):44-9.
    doi: https://doi.org/10.22141/2224-0586.17.1.2021.225720
13. Chen K-Y, Wanniarachchi H, Lang Y, et al. Neural correlates of newsvendor-based decision making in the human brain: An exploratory study to link neuroeconomics with neuroimaging using fNIRS [Internet]. 2020 [cited 2023 Jul 19]. 21 р. doi: https://doi.org/10.1101/2020.02.08.940197

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Digtiar V.A. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-3182-2512

Vernihora D.G. Dnipro State Medical University, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6159-0866

Zavorotnya Yu.V. Dnipro Regional Clinical Oncology Dispensary, Dnipro, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0007-1305-5958

Gladkiy A.P. Regional Family Health Medical Center, Dnipro, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-3085-9399

Kaminska M.O. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-5895-9562

Digtiar V.A., Vernihora D.G., Zavorotnya Yu.V., Gladkiy A.P., Kaminska M.O. Application of Near-infrared reflectance spectroscopy in the diagnosis of varicocele in children and adolescents. Medicni perspektivi. 2024;29(1):101-108.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300597

Segmental ischemia and indocyanine green navigation: impact on perioperative parameters in laparoscopic vs. open partial nephrectomy

Obesity-induced dysregulation of hypothalamic neurons is not completely eliminated by restoring body weight, therefore the most urgent task of modern precision medicine is to predict the trajectory of development of metabolic disorders associated with obesity in children. The aim of the study was to determine the level of association of single-nucleotide variants of genes that determine eating behavior – Neuronal growth regulator 1, Fat mass and obesity associated gene, Glucagon-like peptide-1 receptor, ghrelin, leptin receptor, cholecystokinin, in the development of metabolically unhealthy obesity. 252 obese children aged 6-18 years were examined. The main group (n=152) consisted of children with metabolically unhealthy obesity (MUO) according to Identification and prevention of Dietary- and Lifestyle-induced Health Effects in Children and Infants 2014 criteria. The control group (n=100) consisted of children with metabolically healthy obesity (MHO). All children underwent a general clinical, immunobiochemical examination at the Synevo laboratory (Ukraine). Whole-genome sequencing (CeGat, Germany) was performed in 31 children of the primary and 21 children of the control group. Static analysis: variance analysis ANOVA, method of estimating data dispersion, ROC-analysis, method of testing statistical hypotheses. The level of single nucleotide variants association of anorexigenic hormone genes with MUO that exceeded the threshold accepted by 75% of the available data was, respectively, in ascending order: leptin receptor (LEPR) rs1137101 (40.38%), Glucagon-like peptide-1 receptor (GLP1R) rs1126476 (40.38%), GLP1R rs2235868 (42.31%), GLP1R rs1042044 (42.31%), LEPR rs3790435 (48.08%), cholecystokinin (CCK) rs754635 (50%), LEPR rs2186248 (55.76%), GLP1R rs6918287 (55.76%). Genotypes of the GLP1R gene, such as CC rs10305421 determine insulin resistance (F=5.6); GA/AA rs3765468 – meta-inflammation (F=5.8); AA rs6918287 – basal hyperglycemia (F=6.3) and triglyceridemia (F=51.3), p<0.05. Single-nucleotide variants of the gene GLP1R rs6918287, LEPR rs2186248, CCK rs754635 of the anorexic hormones that control eating behavior are highly associated with the presence of metabolically unhealthy obesity in children.

Key words: single nucleotide variants of genes, genes of anorexigenic hormones, metabolically healthy obesity, metabolically unhealthy obesity

1. Jebeile H, Kelly AS, O'Malley G, et al. Obesity in children and adolescents: epidemiology, causes, asses­sment, and management. Lancet Diabetes Endocrinol. 2022;10(5):351-65.
   doi: https://doi.org/10.1016/S2213-8587(22)00047-X
2. Wang H, Akbari-Alavijeh S, Parhar RS, et al. Partners in diabetes epidemic: A global perspective. World J Diabetes. 2023;14(10):1463-77. doi: https://doi.org/10.4239/wjd.v14.i10.1463
3. Chen J, Spracklen CN, Marenne G, et al. The trans-ancestral genomic architecture of glycemic traits. Nat. 2021;53:840-60. doi: https://doi.org/10.1038/s41588-021-00852-9
4. Vujkovic M, Keaton JM, Lynch JA, et al. Disco­very of 318 new risk loci for type 2 diabetes and related vascular outcomes among 1.4 million participants in a multi-ancestry meta-analysis. Nat Genet. 2020;52(7):680-91. doi: https://doi.org/10.1038/s41588-020-0637-y
5. Reisinger C, Nkeh-Chungag BN, Fredriksen PM, et al. The prevalence of pediatric metabolic syndrome—a critical look on the discrepancies between definitions and its clinical importance. Int J Obes. 2021;45:12-24. doi: https://doi.org/10.1038/s41366-020-00713-1
6. Crovesy L, Rosado EL. Interaction between genes involved in energy intake regulation and diet in obesity. Nutrition.2019;67-68:110547. doi: https://doi.org/10.1016/j.nut.2019.06.027
7. Lister NB, Baur LA, Felix JF, et al. Child and adolescent obesity. Nat Rev Dis Primers. 2023;9(1):24. doi: https://doi.org/10.1038/s41572-023-00435-4
8. Beutler LR, Corpuz TV, Ahn JS, et al. Obesity causes selective and long-lasting desensitization of AgRP neurons to dietary fat. Elife. 2020;9:e55909. doi: https://doi.org/10.7554/eLife.55909
9. Flores-Dorantes MT, Díaz-López YE, Gutiérrez-Aguilar R. Environment and Gene Association With Obe­sity and Their Impact on Neurodegenerative and Neurode­velopmental Diseases. Front Neurosci. 2020;14:863. doi: https://doi.org/10.3389/fnins.2020.00863
10. Draznin B, Aroda VR, Bakris G, et al. American Diabetes Association Professional Practice Committee. 6. Glycemic targets: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022;45(Suppl 1):83-96. doi: https://doi.org/10.2337/dc22-S006
11. Santaliestra-Pasías AM, González-Gil EM, Pa­la V, et al. Predictive associations between lifestyle behaviours and dairy consumption: The IDEFICS study. Nutr Metab Cardiovasc Dis. 2020;30(3):514-22. doi: https://doi.org/10.1016/j.numecd.2019.10.006
12. Tagi VM, Samvelyan S, Chiarelli F. An update of the consensus statement on insulin resistance in children 2010. Front Endocrinol (Lausanne). 2022 Nov 16;13:1061524. doi: https://doi.org/10.3389/fendo.2022.1061524
13. Elkins C, Fruh Sh, Jones L, et al. Clinical Practice Recommendations for Pediatric Dyslipidemia. Journal of Pediatric Health Care. 2019;33(4):494-504. doi: https://doi.org/10.1016/j.pedhc.2019.02.009
14. Flynn JT, Kaelber DC, Baker-Smith CM, et al. Subcommittee on Screening and Management of High Blood Pressure in Children. Clinical Practice Guideline for Scree­ning and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017;140(3):e20171904. Pediatrics.2018;142(3):e20181739. doi: https://doi.org/10.1542/peds.2018-1739
15. Ahrens W, Moreno LA, Marild S, et al. IDEFICS consortium. Metabolic syndrome in young children: definitions and results of the IDEFICS study. Int J Obes (Lond). 2014 Sep;38(Suppl 2):S4-14. doi: https://doi.org/10.1038/ijo.2014.130
16. Liao X, Li M, Zou Y, et al. An Efficient Trimming Algorithm based on Multi-Feature Fusion Scoring Model for NGS Data. IEEE/ACM Trans Comput Biol Bioinform. 2020;17(3):728-38. doi: https://doi.org/10.1109/TCBB.2019.2897558
17. Sanaullah A, Zhi D, Zhang S. d-PBWT: dynamic positional Burrows-Wheeler transform. Bioinformatics. 2021;37(16):2390-7. doi: https://doi.org/10.1093/bioinformatics/btab117
18. Shin DM, Hwang MY, Kim BJ, et al. GEN2VCF: a converter for human genome imputation output format to VCF format. Genes Genomics. 2020;42(10):1163-8. doi: https://doi.org/10.1007/s13258-020-00982-0
19. Mose LE, Perou CM, Parker JS. Improved indel detection in DNA and RNA via realignment with ABRA2. Bioinformatics.2019;35(17):2966-73. doi: https://doi.org/10.1093/bioinformatics/btz033
20. Landrum MJ, Lee JM, Benson M, et al. ClinVar: improving access to variant interpretations and supporting evidence. Nucleic Acids Res. 2018 Jan 4;46(D1):D1062-D1067. doi: https://doi.org/10.1093/nar/gkx1153
21. Karczewski KJ, Francioli LC, Tiao G, et al. The mutational constraint spectrum quantified from variation in 141,456 humans. Nature.2020;581:434-43. doi: https://doi.org/doi.org/10.1038/s41586-020-2308-7
22. Liu X, Li C, Mou C, et al. dbNSFP v4: a com­prehensive database of transcript-specific functional predictions and annotations for human nonsynonymous and splice-site SNVs. Genome Med. 2020;12(1):103. doi: https://doi.org/10.1186/s13073-020-00803-9
23. Buniello A, MacArthur JAL, et al. The NHGRI-EBI GWAS Catalog of published genome-wide asso­ciation studies, targeted arrays and summary statistics 2019. Nucleic Acids Res. 2019 Jan 8;47(D1):1005-12. doi: https://doi.org/10.1093/nar/gky1120
24. Schoch CL, Ciufo S, Domrachev M, et al. NCBI Taxonomy: a comprehensive update on curation, resources and tools. Database (Oxford). 2020;2020:baaa062. doi: https://doi.org/10.1093/database/baaa062
25. Agapito G, Milano M, Cannataro M. A Python Clustering Analysis Protocol of Genes Expression Data Sets. Genes(Basel). 2022;13(10):1839. doi: https://doi.org/10.3390/genes13101839
26. Abaturov A, Nikulina A. Associations of GHRL gene variants with the development of obesity and metabolic disorders in children. Child's health. 2023;18(4):13-9.
    doi: https://doi.org/10.22141/2224-0551.18.4.2023.1596
27. Nikulina A. Significance of the rs754635 variant of the cholecystokinin gene in the development of obesity in children. Modern Pediatrics. Ukraine. 2023;5(133):17-23. doi: https://doi.org/10.15574/SP.2023.133.17
28. Lagou V, Jiang L, Ulrich A, et al. GWAS of random glucose in 476,326 individuals provide insights into diabetes pathophysiology, complications and treat­ment stratification. Nat Genet. 2023;55(9):1448-61. doi: https://doi.org/10.1038/s41588-023-01462-3
29. Rupp AC, Tomlinson AJ, Affinati AH, et al. Sup­pression of food intake by Glp1r/Lepr-coexpressing neurons prevents obesity in mouse models. J Clin Invest. 2023;133(19):e157515. doi: https://doi.org/10.1172/JCI157515
30. Melchiorsen JU, Sorensen KV, Bork-Jensen J, et al. Rare Heterozygous Loss-of-Function Variants in the Human GLP-1 Receptor Are Not Associated With Cardio­metabolic Phenotypes. J Clin Endocrinol Metab. 2023;108(11):2821-33. doi: https://doi.org/10.1210/clinem/dgad290
31. Steinsbekk S, Belsky D, Guzey IC. Polygenic Risk, Appetite Traits, and Weight Gain in Middle Child­hood: A Longitudinal Study. JAMA Pediatr. 2016 Feb;170(2):e154472. doi: https://doi.org/10.1001/jamapediatrics.2015.447

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Nikulina A.O. Dnipro State Medical University, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.,
https://orcid.org/0000-0001-8713-6768

Nikulina A.O. Significance of single-nucleotide variants of anorexigenic hormone genes in childhood obesity. Medicni perspektivi. 2024;29(1):108-114.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300508

Metformin as an adjuvant option for systemic treatment of breast cancer

There were studied results of the impact of increased consumption of proteins and L-carnitine in the nutrition program of full-term newborns with perinatal diseases on the results of physical development and inpatient treatment features. The purpose of the work was to study the correlations between short-term higher consumption of protein and carnitine by full-term newborns and the results of their physical development, the duration of hospital care development. The vital signs of 59 full-term newborns were studied in a randomized controlled trial in the period 2017-2020. The main critical disease of the perinatal period in newborns of both groups was found to be hypoxic-ischemic encephalopathy of a moderate degree in 86.7% and 86.2%, without a statistically significant difference. One group (n=30) received nutrition with mother's milk or formula, the second group (n=29) received similar nutrition with fortification with a protein and L-carnitine supplement during the hospital stay. At the beginning and at the end of the treatment, physical development of the newborns was studied and correlations between the obtained data were investigated. Newborns of both groups did not differ in characteristics at the beginning of the study. The proportions of the newborns' weight corresponded to the limits of the 50% percentile. The group with increased consumption of protein and carnitine, fortification group (FG) demonstrated better indicators of physical development, they regained body mass faster. Body mass of the newborns of the fortification group goup was 3966.9±439.1 g, compared to the standard nutrition (SN) group, with indicators being 3554.6±452.3 g, at p=0.003. The rate of increase in body length in FG was twice that of the SN group. Consumption of a larger dose of protein was accompanied by a shorter stay in the intensive care unit – 10.0 (8.0; 12.0) days versus 12.0 (11.0; 16.0) days, with U=235.0; p=0.002; earlier discharge from the hospital – 21.0 (19.0; 27.0) days versus 26.5 (22.0; 31.0) days, with U=267.0, p=0.01. Carnitine supplementation in the FG group led to an increase in the level of free carnitine in the blood plasma samples taken before the discharge from the hospital. The study of correlations revealed a positive correlation between the consumption of a full dose of proteins and the total increase in height (R=0.3, p<0.05), the increase in body weight (R=0.3, p<0.05). A negative correlation was found between the protein level and the duration of treatment in the hospital (R= -0.3, p<0.05). The level of free carnitine had a positive effect on the increase in body length (R=0.51, p<0.05), daily weight gain (R=0.3, p<0.05). A poor increase in body length was associated with a longer duration of respiratory support: the correlation had an inverse direction R= -0.4, p<0.05. Improving nutritional strategies has significant prospects for improving care development of full-term babies with critical perinatal states.

Key words: hypoxic-ischemic encephalopathy, newborns, children, carnitin, physical development, breast milk, correlations

1. Amissah EA, Brown J, Harding JE. Protein supple­mentation of human milk for promoting growth in preterm in­fants. Cochrane Database Syst Rev. 2020;2020(9):CD00433. doi:https://doi.org/10.1002/14651858.cd000433.pub3
2. Hoogewerf M, ter Horst HJ, Groen H, Nieu­wen­huis T, Bos AF, van Dijk MWG. The prevalence of feeding problems in children formerly treated in a neonatal intensive care unit. J Perinatol. 2017;37(5):578-84. doi:https://doi.org/10.1038/jp.2016.256
3. Yalçın N, Kaşıkcı M, Çelik HT, Demirkan K, Yiğit Ş, Yurdakök M. Development and validation of ma­chine learning-based clinical decision support tool for identifying malnutrition in NICU patients. Sci Rep. 2023;13(1):5227.
   doi:https://doi.org/10.1038/s41598-023-32570-z
4. Moltu SJ, Bronsky J, Embleton N, Gerasimidis K, Indrio F, Köglmeier J, et al. Nutritional management of the critically ill neonate: A position paper of the ESPGHAN Committee on nutrition. J Pediatr Gastroenterol Nutr. 2021;73(2):274-89. doi: https://doi.org/10.1097/mpg.0000000000003076
5. van Puffelen E, Vanhorebeek I, Joosten KFM, Wouters PJ, Van den Berghe G, Verbruggen SCAT. Early versus late parenteral nutrition in critically ill, term neonates: a preplanned secondary subgroup ana­lysis of the PEPaNIC multicentre, randomised control­led trial. Lancet Child Adolesc Health. 2018;2(7):505-15. doi: https://doi.org/10.1016/s2352-4642(18)30131-7
6. Fenton TR, Al-Wassia H, Premji SS, Sauve RS. Higher versus lower protein intake in formula-fed low birth weight infants. Cochrane Database Syst Rev. 2020;2020(6):CD003959. doi: https://doi.org/10.1002/14651858.cd003959.pub4
7. Kiserud T, Benachi A, Hecher K, Perez RG, Car­valho J, Piaggio G, et al. The World Health Orga­nization fetal growth charts: concept, findings, inter­pretation, and application. Am J Obstet Gynecol. 2018;218(2):S619-29. doi: https://doi.org/10.1016/j.ajog.2017.12.010
8. Koletzko B, Demmelmair H, Grote V, Tot­zauer M. Optimized protein intakes in term infants support physiological growth and promote long-term health. Semin Perinatol. 2019;43(7):151153. doi: https://doi.org/10.1053/j.semperi.2019.06.001
9. Manninen S, Silvennoinen S, Bendel P, Lanki­nen M, Schwab US, Sankilampi U. Carnitine intake and serum levels associate positively with postnatal growth and brain size at term in very preterm infants. Nutrients. 2022;14(22):4725. doi: https://doi.org/10.3390/nu14224725
10. Fenton TR, Nasser R, Eliasziw M, Kim JH, Bilan D, Sauve R. Validating the weight gain of preterm infants between the reference growth curve of the fetus and the term infant. BMC Pediatr. 2013;13(1):92. doi: https://doi.org/10.1186/1471-2431-13-92
11. Richter M, Baerlocher K, Bauer JM, Elmadfa I, Heseker H, Leschik-Bonnet E, et al. Revised reference values for the intake of protein. Ann Nutr Metab. 2019;74(3):242-50. doi: https://doi.org/10.1159/000499374
12. Members of the who multicentre growth reference study group. Food Nutr Bull. 2004;25(1_suppl_1):S13-4. doi: https://doi.org/10.1177/15648265040251s103
13. Chace DH, Pons R, Chiriboga CA, McMahon DJ, Tein I, Naylor EW, et al. Neonatal blood carnitine con­centrations: Normative data by electrospray tandem mass spectometry. Pediatr Res. 2003;53(5):823-9. doi: https://doi.org/10.1203/01.pdr.0000059220.39578.3d
14. Çam H, Yildirim B, Aydin A, Say A. Carnitine levels in neonatal hypoxia. J Trop Pediatr. 2005;51(2):106-8. doi: https://doi.org/10.1093/tropej/fmh089
15. Whitfield J, Smith T, Sollohub H, Sweetman L, Roe CR. Clinical effects of l-carnitine supplementation on apnea and growth in very low birth weight infants. Pediatrics. 2003;111(3):477-82. doi: https://doi.org/10.1542/peds.111.3.477
16. Younge NE, Newgard CB, Cotten CM, Gold­berg RN, Muehlbauer MJ, Bain JR, et al. Disrupted matu­ration of the Microbiota and metabolome among extremely preterm infants with postnatal growth failure. Sci Rep. 2019;9(1):8167.
    doi: https://doi.org/10.1038/s41598-019-44547-y
17. Cormack BE, Jiang Y, Harding JE, Crowther CA, Bloomfield FH. Relationships between neonatal nutrition and growth to 36 weeks’ corrected age in ELBW babies-secondary cohort analysis from the ProVIDe trial. Nutrients. 2020;12(3):760. doi: https://doi.org/10.3390/nu12030760
18. Fivez T, Kerklaan D, Mesotten D, Verbruggen S, Wouters PJ, Vanhorebeek I, et al. Early versus late paren­teral nutrition in critically ill children. N Engl J Med. 2016;374(12):1111-22. doi: https://doi.org/10.1056/nejmoa1514762
19. Tuzun F, Yucesoy E, Baysal B, Kumral A, Du­man N, Ozkan H. Comparison of INTERGROWTH-21 and Fenton growth standards to assess size at birth and extrauterine growth in very preterm infants. J Matern Fetal Neonatal Med. 2018;31(17):2252-7. doi: https://doi.org/10.1080/14767058.2017.1339270
20. Bewick V, Cheek L, Ball J. Statistics review 7: Correlation and regression. Critical Care. 2003;7:451-9. doi: https://doi.org/10.1186/cc2401

Look through:

Anikin I.O. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-1125-0123

Varynskyi B.O. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-1551-8879

Stryzhak L.S. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
https://orcid.org/0000-0002-4204-2159

Serhieieva L.N. Classical private university, Zaporizhzhia, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-3207-0698

Snisar V.I. Dnipro State Medical University, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-1304-4665

Anikin I.O., Varynskyi B.O., Stryzhak L.S., Serhieieva L.N., Snisar V.I. Impact of protein and carnitine consuption on outcomes of care development of full-term newborns with critical perinatal diseases. Medicni perspektivi. 2024;29(1):115-126.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300780

Clinical, neurological, laboratory and neuropsychological features of the course of cerebrovascular diseases in patients infected with SARS-CoV-2

There is a close relationship between the condition of periodontal tissues and maloccluson. Timely functional diagnosis of changes that occur in periodontal tissues during orthodontic tooth movement is an important link in the prevention of periodontal diseases during orthodontic treatment. At the present time, special attention is paid to the problem of the influence of "war stress" on the maxillo-facial system of a human. Aim of the was work to study the changes in the state of periodontal supporting tissues in orthodontic patients according to periotestometry data during the last 15 years and in the conditions of martial law. Periotestometry of teeth in orthodontic patients was performed before the start of treatment with the Periotest device. All patients were divided into 4 groups according to the results in different years of the study. A total of 136 patients participated in the study. The biggest discrepancies when comparing periotestometry indicators were found between the data of the control and fourth group (in conditions of martial law) and an increase in the indicators of tooth mobility with a statistically significant difference of p<0.001 was proven. When comparing the indicators of groups 2 and 4 for most teeth, the statistically significant difference was from p<0.05 to p<0.001. When comparing the data of the tooth periotest in patients of groups 3 and 4, the indicators of tooth mobility also increased, although within the limits of statistical error (p>0.05). Over the past 15 years, a steady trend to increase in the mobility of all teeth on both jaws has been established. The largest changes in indicators were found in the dynamics of the fifteen-year follow-up (2008 to 2023) between people with an orthognathic bite of the control group and patients of the 4th group with malocclusion. Such changes may be related to the social and psycho-emotional stress that a person constantly experiences in conditions of martial law.

Key words: malocclusion, orthodontic treatment, periotestometry, stress, war in Ukraine, oral health

1. Curtis MA, Diaz PI, Van Dyke TE. The role of the microbiota in periodontal disease. Periodontol 2000. 2020 Jun;83(1):14-25. doi: https://doi.org/10.1111/prd.12296
2. Kuroedova VD, Vyzhenko EE, Makarova AN, Stasiuk AA. Optical density of mandible in orthodontic patients. Wiad Lek. 2018;71(6):1161-4.
3. Sczepanik FSC, Grossi ML, Casati M, Gold­berg M, Glogauer M, Fine N, et al. Periodontitis is an inflammatory disease of oxidative stress: We should treat it that way. Periodontol 2000. 2020 Oct;84(1):45-68. doi: https://doi.org/10.1111/prd.12342
4. Kapila YL. Oral health's inextricable connection to systemic health: Special populations bring to bear multi­modal relationships and factors connecting periodontal disease to systemic diseases and conditions. Periodontol 2000.2021 Oct;87(1):11-6. doi: https://doi.org/10.1111/prd.12398
5. Beregova TV, Neporada KS, Skrypnyk M, Spi­vak MY, Bubnov RV. Efficacy of nanoceria for perio­dontal tissues alteration in glutamate-induced obese rats-Multidisciplinary considerations for personalized dentistry and prevention. EPMA 2017;8(1):43-9. doi: https://doi.org/10.1007/s13167-017-0085-7
6. Tarasenko LM, Neporada KS, Klusha V. Stress-protective effect of glutapyrone belonging to a new type of amino acid-containing 1,4-dihydropyridines on perio­dontal tissues and stomach in rats with different resistance to stress. Bull Exp Biol Med. 2002;133(4):369-71. doi: https://doi.org/10.1023/a:1016250121896
7. Martin C, Celis B, Ambrosio N, Bollain J, Anto­noglou GN, Figuero E. Effect of orthodontic therapy in periodontitis and non-periodontitis patients: a systematic review with meta-analysis. J Clin Periodontol. 2022 Jun;49(Suppl 24):72-101. doi: https://doi.org/10.1111/jcpe.13487
8. Passanezi E, Sant'Ana ACP. Role of occlusion in periodontal disease. Periodontol 2000. 2019 Feb;79(1):129-50. doi: https://doi.org/10.1111/prd.12251
9. Varghese SS. Influence of angles occlusion in periodontal diseases. Bioinformation. 2020 Dec 31;16(12):983-91. doi: https://doi.org/10.6026/97320630016983
10. Hamid S, Dashash M, Latifeh Y. A short-term approach for promoting oral health of internally displaced children with PTSD: the key is improving mental health-results from a quasi-randomized trial. BMC Oral Health. 2021 Feb 10;21(1):58. doi: https://doi.org/10.1186/s12903-020-01385-z
11. Bahaa Aldin Alhaffar MD, Mustafa K, Sabbagh S, Yabrode K, Shebib G, Kouchaji C. Seven years of war in Syria: The relation between oral health and PTSD among children. Indian J Oral Health Res. 2018;4:10-5. doi: https://doi.org/10.4103/ijohr.ijohr_8_18
12. Alhaffar BA, Alawabdi R, Barakat L, Kouchaji C. Oral health and socio-economic status among children during Syrian crisis: a cross-sectional study. BMC Oral Health.2019 Jul 25;19(1):165. doi: https://doi.org/10.1186/s12903-019-0856-8
13. Sheshukova OV, Trufanova VP, Polishchuk TV, Maksymenko AI, Kazakova KS, Mosiienko AS, et al. [Application of the "distraction method" at the dentist's appointment for children affected by martial law]. В: Poltava’s days of public health. All Ukrainian scientific and practical absentee conference with international participation; 2022 May 27; Poltava, Ukraine. Wiad Lek. 2022;75(6):1604. doi: https://doi.org/10.36740/WLek202206132
14. Denha A. [Biophysical indicators of periodontal tissues and fatty body weight of patients with metabolic syndrome in the process of complex orthodontic treatment]. Stomat Bull. 2020;110(1):35-40. Russian. doi: https://doi.org/10.35220/2078-8916-2020-35-1-35-40.
15. Kovach I, Hutarova N. [Results of clinical examination of patients with inflammatory periodontal tissue diseases on the background of orthodontic treat­ment]. Stomat Bull. 2020;110(1):41-5. Ukrainian. doi: https://doi.org/10.35220/2078-8916-2020-35-1-41-45
16. Cunha AC, Freitas AO, Marquezan M, Nojima LI. Mechanical influence of thread pitch on orthodontic mini-implant stability. Braz Oral Res. 2015;29:S1806-83242015000100231.
    doi: https://doi.org/10.1590/1807-3107BOR-2015
17. Seifi M, Matini NS. Evaluation of primary sta­bility of innovated orthodontic miniscrew system (STS): An ex-vivo study. J Clin Exp Dent. 2016;8(3):e255-9. doi: https://doi.org/10.4317/jced.52676
18. Nesterenko OM. [Evaluation of jaw bone remo­deling in adult patients during the retention period of orthodontic treatment] [dissertation]. Poltava: VDNZU UMSA; 2008. Ukrainian.
19. Dovzhenko АV, Kuroedova VD, Halych LB. The evaluation of teeth loosening of the upper jaw in adaptive period of orthodontic treatment by braces. Wiad Lek. 2018;71(1 pt 2):123-7.
20. Welch BL. On the comparison of several mean values: an alternative approach. Biometrika. 1951;38(3-4):330-6. doi: https://doi.org/10.1093/biomet/38.3-4.330
21. Hruzieva TS, Lekhan VM, Ohniev VA, Haliien­ko LI, Kriachkova LV. [Biostatistics]. Vinnytsia: Nova knyha; 2020. 381 p. Ukrainian.
22. Popovych IYu, Petrushanko TO. Activation of the periodontium and the stage of tooth decay. Bull of problems biology and medicine. 2016;1(2):258-60.
23. Kučera J, Marek I, Littlewood SJ. The effect of different bonded retainer wires on tooth mobility im­mediately after orthodontic treatment. Eur J Orthod. 2022 Mar 30;44(2):178-86. doi: https://doi.org/10.1093/ejo/cjab038

Look through:

Vyzhenko Ye.Ye. Poltava State Medical University, Poltava, Ukraine,
е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-2756-5610

Kuroiedova V.D. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0003-1847-6931

Korobov P.S. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0002-2992-3410

Halych L.B. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0001-9649-9675

Vyzhenko Ye.Ye., Kuroiedova V.D., Korobov P.S., Halych L.B. The influence of chronic stress on periodontal tissues in orthodontic patients in conditions of martial law. Medicni perspektivi. 2024;29(1):127-134. 
DOI: https://doi.org/10.26641/2307-0404.2024.1.300783

Psychophysiological components of the activities of operators of nuclear power plants as a factor of accidents in the conditions of the threat of social catastrophe

Periodontal diseases are a component of the global burden of chronic morbidity worldwide. The prevalence of periodontitis increases with age, reaching a high at the age of 40, which has increased medical and social importance. In Ukraine the prevalence of periodontal diseases among people aged 19-24 reaches 30%, 25-30 years – more than 60%, and in the age group 35-44 years and older – varies from 92 to 98%. With the generalized form of periodontitis in young people, considerable degradation of periodontal tissues occurs, while treatment measures are mainly ineffective, with a temporary therapeutic effect that only stabilizes the course of disease. The goal of this literature review was to identify innovative approaches to the reparation and regeneration of affected periodontal tissues that could be used as non-invasive treatment modes. The conducted analysis included studies whose findings were published in 52 English- and Ukrainian-language information sources for the period 1985-2022. The literature search was carried out in the PubMed, Scopus, Google Scholar databases and in the electronic catalog of the National Scientific Medical Library of Ukraine. The results of the literature review confirm the considerable potential of cell therapy supplemented with platelet-rich plasma for the formation of new periodontal tissues, which supported their use to promote the regenerative process. In combination with stem cells, platelet-rich plasma provides a considerable increase in the effectiveness of periodontal disease treatment in young people. The literature search was carried out in PubMed databases (327 sources), Scopus (121 sources), Google Academy (16 articles) and in the electronic catalog of the National Scientific Medical Library of Ukraine (89 records). Out of 537, 52 sources were selected for review. Periodontal tissue disease is an actual problem today. According to the data of the analyzed literature, the use of stem cells in dentistry is actively studied, but there are no recommendations and protocols for their use in periodontology. The analyzed scientific sources, the results of which were published in English- and Ukrainian-language sources, aimed at tissue regeneration, have a significant impact on the creation of new approaches to the treatment of generalized periodontitis. The world experience of using cellular technologies with using stem cells demonstrates the significant potential and positive results of their application to promote the regenerative process in the comprehensive treatment of periodontal diseases. The combination of stem cells and platelet-enriched plasma significantly increases the effectiveness of treatment of periodontal tissue diseases, in particular generalized periodontitis in young people. The use of stem cells and growth factors, which contains platelet-rich plasma, allows you to significantly increase the effectiveness of periodontal disease treatment.

Key words: generalized periodontitis, regenerative technologies, stem cells, platelet-rich plasma

1. Wu L, Zhang SQ, Zhao L, Ren ZH, Hu CY. Glo­bal, regional, and national burden of periodontitis from 1990 to 2019: Results from the Global Burden of Disease study 2019. J Periodontol. 2022 Oct;93(10):1445-54. doi: https://doi.org/10.1002/JPER.21-0469
2. Borysenko AV, Mialkivskyi KO. [Prevalence of pe­riodontal diseases in young people]. Sovremennaia stomatolohyia. 2018;4:85. Ukrainian.
3. Kholodniak OV. [Prevalence and structure of pe­riodontal disease in young aged adults]. Klinichna ta  eksperymentalna patolohiia. 2015;14(3):159-62. Ukrainian.
4. Voronenko YuV, Mazur IP, Pavlenko OV, editors. [Dental care in Ukraine: analysis of the main activity indicators for 2018]. Kropyvnytskyi: Polium; 2019. 175 р. Ukrainian.
5. Kwon T, Lamster IB, Levin L. Current concepts in the management of periodontitis. Int Dent J. 2021 Dec;71(6):462-76. doi: https://doi.org/10.1111/idj.12630
6. Bourgeois D, Bravo M, Llodra JC, Inquimbert C, Viennot S, Dussart C, et al. Calibrated interdental brushing for the prevention of periodontal pathogens infection in young adults – a randomized controlled clinical trial. Sci Rep. 2019 Oct 22;9(1):15127. doi: https://doi.org/10.1038/s41598-019-51938-8
7. Kopchak O, Marchenko N, Kaniura O, Savosko S, Yanishevsky K, Makarenko O, et al. The effect of hyalu­ronic acid on the periodontium in spontaneous perio­dontitis in rats. Int J Morphol. 2021;39(4):1028-35. doi: https://doi.org/10.1902/jop.2015.130685
8. Kopchak O, Yakovenko L, Marchenko N, Кo­vach I, Pavlenko E, Nimenko O, et al. Levels of Hsp60 in periodontal tissue of rats: influence of injections of hyaluronic acid. Medicni perspektivi. 2021;26(2):12-8. doi: https://doi.org/10.26641/2307-0404.2021.2.234382
9. Liu Y, Guo L, Li X, Liu S, Du J, Xu J, et al. Chal­lenges and tissue engineering strategies of periodontal-guided tissue regeneration. Tissue Eng Part C Methods. 2022 Aug;28(8):405-19. doi: https://doi.org/10.1089/ten.TEC.2022.0106
10. Zhang Y, Zhao W, Jia L, Xu N, Xiao Y, Li Q. The application of stem cells in tissue engineering for the regeneration of periodontal defects in randomized controlled trial: a systematic review and meta-analysis. J Evid Based Dent Pract. 2022 Jun;22(2):101713. doi: https://doi.org/10.1016/j.jebdp.2022.101713
11. Novello S, Debouche A, Philippe M, Naudet F, Jeanne S. Clinical application of mesenchymal stem cells in periodontal regeneration: A systematic review and meta-analysis. J Periodontal Res. 2020 Jan;55(1):1-12. doi: https://doi.org/10.1111/jre.12684
12. Citterio F, Gualini G, Fierravanti L, Aimetti M. Stem cells and periodontal regeneration: present and future. Plast Aesthet Res. 2020;7:41. doi: https://doi.org/10.20517/2347-9264.2020.29
13. Seo BM, Miura M, Gronthos S, Bartold PM, Ba­touli S, Brahim J, et al. Investigation of multipotent post­natal stem cells from human periodontal ligament. Lancet. 2004;364(9429):149-55. doi: https://doi.org/10.1016/S0140-6736(04)16627-0
14. Melcher AH. Cells of periodontium: Their role in the healing of wounds. Ann R Coll Surg Engl. 1985;67:130-1.
15. Huang GT, Gronthos S, Shi S. Mesenchymal stem cells derived from dental tissues vs. those from other sources: their biology and role in regenerative medicine. J Dent Res. 2009 Sep;88(9):792-806. doi: https://doi.org/10.1177/0022034509340867
16. Ouchi T, Nakagawa T. Mesenchymal stem cell-based tissue regeneration therapies for periodontitis. Regen Ther. 2020 Jan 15;14:72-8. doi: https://doi.org/10.1016/j.reth.2019.12.011
17. Onizuka S, Iwata T. Application of periodontal ligament-derived multipotent mesenchymal stromal cell sheets for periodontal regeneration. Int J Mol Sci. 2019 Jun 7;20(11):2796. doi: https://doi.org/10.3390/ijms20112796
18. Hernández-Monjaraz B, Santiago-Osorio E, Mon­roy-García A, Ledesma-Martínez E, Mendoza-Núñez VM. Mesenchymal stem cells of dental origin for inducing tissue regeneration in periodontitis: A mini-review. Int J Mol Sci. 2018 Mar 22;19(4):944. doi: https://doi.org/10.3390/ijms19040944
19. Monterubbianesi R, Bencun M, Pagella P, Wolo­szyk A, Orsini G, Mitsiadis TA. A comparative in vitro study of the osteogenic and adipogenic potential of human dental pulp stem cells, gingival fibroblasts and foreskin fibroblasts. Sci Rep. 2019 Feb 11;9(1):1761. doi: https://doi.org/10.1038/s41598-018-37981-x
20. Tassi SA, Sergio NZ, Misawa MYO, Villar CC. Efficacy of stem cells on periodontal regeneration: Systematic review of pre-clinical studies. J Periodontal Res. 2017 Oct;52(5):793-812. doi: https://doi.org/10.1111/jre.12455
21. Zhou LL, Liu W, Wu YM, Sun WL, Dörfer CE, Fawzy El-Sayed KM. Oral mesenchymal stem/progenitor cells: the immunomodulatory masters. Stem Cells Int. 2020;2020:1327405. doi: https://doi.org/10.1155/2020/1327405
22. Ferrarotti F, Romano F, Gamba MN, Quirico A, Giraudi M, Audagna M, et al. Human intrabony defect regeneration with micrografts containing dental pulp stem cells: A randomized controlled clinical trial. J Clin Periodontol. 2018;45(7):841-50. doi: https://doi.org/10.1111/jcpe.12931
23. Seo Y, Shin TH, Kim HS. Current strategies to enhance adipose stem cell function: an update. Int J Mol Sci. 2019 Aug 5;20(15):3827. doi: https://doi.org/10.3390/ijms20153827
24. Zuk PA, Zhu M, Mizuno H, Huang J, Futrell JW, Katz AJ, et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001;7(2):211‐ doi: https://doi.org/10.1089/107632701300062859
25. Argentati C, Morena F, Bazzucchi M, Armentano I, Emiliani C, Martino S. Adipose stem cell translational applications: from bench-to-bedside. Int J Mol Sci. 2018 Nov 5;19(11):3475. doi: https://doi.org/10.3390/ijms19113475
26. Goriuc A, Foia L, Cojocaru K, Diaconu-Popa D, Sandu D, Luchian I. The role and involvement of stem cells in periodontology. Biomedicines. 2023 Jan 28;11(2):387. doi: https://doi.org/10.3390/biomedicines11020387
27. Palumbo P, Lombardi F, Siragusa G, Cifone MG, Cinque B, Giuliani M. Methods of isolation, characte­rization and expansion of human adipose-derived stem cells (ASCs): An overview. Int J Mol Sci. 2018 Jun 28;19(7):1897. doi: https://doi.org/10.3390/ijms19071897
28. Si Z, Wang X, Sun C, Kang Y, Xu J, Wang X, et al. Adipose-derived stem cells: Sources, potency, and implications for regenerative therapies. Biomed Phar­macother. 2019 Jun;114:108765. doi: https://doi.org/10.1016/j.biopha.2019.108765
29. Romano IR, D'Angeli F, Vicario N, Russo C, Ge­novese C, Lo Furno D, et al. Adipose-derived mesen­chymal stromal cells: A tool for bone and cartilage repair. Biomedicines. 2023 Jun 21;11(7):1781. doi: https://doi.org/10.3390/biomedicines11071781
30. Ayanoğlu FB, Elçin AE, Elçin YM. Evaluation of the stability of standard reference genes of adipose-derived mesenchymal stem cells during in vitro proliferation and differentiation. Mol Biol Rep. 2020;47(3):2109‐ doi: https://doi.org/10.1007/s11033-020-05311-y
31. Cho YD, Kim KH, Ryoo HM, Lee YM, Ku Y, Seol YJ. Recent advances of useful cell sources in the periodontal regeneration. Curr Stem Cell Res Ther. 2019;14(1):3-8. doi: https://doi.org/10.2174/1574888X13666180816113456
32. Mannino G, Russo C, Maugeri G, Musumeci G, Vicario N, Tibullo D, et al. Adult stem cell niches for tissue homeostasis. J Cell Physiol. 2022 Jan;237(1):239-57. doi: https://doi.org/10.1002/jcp.30562
33. Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;10(4):225-8. doi: https://doi.org/10.1097/00008505-200110000-00002
34. Al-Hamed FS, Mahri M, Al-Waeli H, Torres J, Bad­ran Z, Tamimi F. Regenerative effect of platelet concentrates in oral and craniofacial regeneration. Front Cardiovasc Med. 2019 Sep 3;6:126. doi: https://doi.org/10.3389/fcvm.2019.00126
35. Xu J, Gou L, Zhang P, Li H, Qiu S. Platelet-rich plasma and regenerative dentistry. Aust Dent J. 2020 Jun;65(2):131-42. doi: https://doi.org/10.1111/adj.12754
36. Kovach IV, Hutarova NV. [Microcirculation in periodontal tissues after the use of platelet-rich plasma in patients with chronic catarrhal gingivitis in the dynamics of orthodontic treatment]. Colloquium-journal. 2020;24:15-9. Ukrainian.
37. Jeong W, Kim YS, Roh TS, Kang EH, Jung BK, Yun IS. The effect of combination therapy on critical-size bone defects using platelet-rich plasma and adipose-derived stem cells. Childs Nerv Syst. 2020 Jan;36(1):145-51. doi: https://doi.org/10.1007/s00381-019-04109-z
38. Harrison TE, Bowler J, Levins TN, Reeves KD, Cheng AL. Platelet-rich plasma centrifugation changes leukocyte ratios. Cureus. 2021 Apr 13;13(4):e14470. doi: https://doi.org/10.7759/cureus.14470
39. Oudelaar BW, Peerbooms JC, Huis In 't Veld R, Vochteloo AJH. Concentrations of blood components in commercial platelet-rich plasma separation systems: A review of the literature. Am J Sports Med. 2019 Feb;47(2):479-87. doi: https://doi.org/10.1177/0363546517746112
40. Tey RV, Haldankar P, Joshi VR, Raj R, Maradi R. Variability in platelet-rich plasma preparations used in regenerative medicine: A comparative analysis. Stem Cells Int. 2022 Oct 20;2022:3852898. doi: https://doi.org/10.1155/2022/3852898
41. Samadi P, Sheykhhasan M, Khoshinani HM. The use of platelet-rich plasma in aesthetic and regenerative medicine: A comprehensive review. Aesthetic Plast Surg. 2019 Jun;43(3):803-14. doi: https://doi.org/10.1007/s00266-018-1293-9
42. Liebig BE, Kisiday JD, Bahney CS, Ehrhart NP, Goodrich LR. The platelet-rich plasma and mesenchymal stem cell milieu: A review of therapeutic effects on bone healing. J Orthop Res. 2020 Dec;38(12):2539-50. doi: https://doi.org/10.1002/jor.24786
43. Guida A, Cecoro G, Rullo R, Laino L, Del Fab­bro M, Annunziata M. A systematic critical appraisal of the methodological quality of systematic reviews on the effect of autologous platelet concentrates in the treatment of periodontal intraosseous defects. Materials (Basel). 2020 Sep 20;13(18):4180. doi: https://doi.org/10.3390/ma13184180
44. Tatsis D, Vasalou V, Kotidis E, Anestiadou E, Grivas I, Cheva A, et al. The combined use of platelet-rich plasma and adipose-derived mesenchymal stem cells promotes healing. A review of experimental models and future perspectives. Biomolecules. 2021 Sep 24;11(10):1403. doi: https://doi.org/0.3390/biom11101403
45. Mohan SP, Jaishangar N, DevyS, Narayanan A, Cherian D, Madhavan  Platelet-rich plasma and pla­telet-rich fibrin in periodontal regeneration: a review. J Pharm Bioallied Sci. 2019 May;11(Suppl 2):S126-30. doi: https://doi.org/10.4103/JPBS.JPBS_41_19
46. YamadaY, Ueda M, Hibi H, Baba  A novel approach to periodontal tissue regeneration with mesen­chymal stem cells and platelet-rich plasma using tissue engineering technology: A clinical case report. Int J Periodontics Restorative Dent. 2006;26(4):363-9.
47. YamadaY, Nakamura S, Ito K, Umemura E, Ha­ra K, Nagasaka T, et al. Injectable bone tissue engineering using expanded mesenchymal stem cells. Stem Cells. 2013 Mar;31(3):572-80. doi: https://doi.org/10.1002/stem.1300
48. TobitaM, Uysal CA, Guo X, Hyakusoku H, Mizu­no  Periodontal tissue regeneration by combined implantation of adipose tissue-derived stem cells and platelet-rich plasma in a canine model. Cytotherapy. 2013 Dec;15(12):1517-26. doi: https://doi.org/10.1016/j.jcyt.2013.05.007
49. TobitaM, Masubuchi Y, Ogata Y, Mitani A, Ki­kuchi T, Toriumi T, et al. Study protocol for periodontal tissue regeneration with a mixture of autologous adipose-derived stem cells and platelet rich plasma: A multicenter, randomized, open-label clinical trial. Regen Ther. 2022 Oct 12;21:436-41. doi: https://doi.org/10.1016/j.reth.2022.09.008
50. YamakawaJ, Hashimoto J, Takano M, Takagi  The Bone Regeneration Using Bone Marrow Stromal Cells with Moderate Concentration Platelet-Rich Plasma in Femo­ral Segmental Defect of Rats. Open Orthop J. 2017;11:1‐11. doi: https://doi.org/10.2174/1874325001711010001
51. NguyenATM, Tran HLB, Pham  In vitro evaluation of proliferation and migration behaviour of human bone marrow-derived mesenchymal stem cells in presence of platelet-rich plasma. Int J Dent. 2019 Apr 9;2019:9639820. doi: https://doi.org/10.1155/2019/9639820
52. Wang K, Li Z, Li J, Liao W, Qin Y, Zhang N, et al. Optimization of the platelet-rich plasma concentration for mesenchymal stem cell applications. Tissue Eng Part A. 2019 Mar;25(5-6):333-51. doi: https://doi.org/10.1089/ten.TEA.2018.0091

Look through:

Kopchak O.V. Kyiv Medical University, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-3244-2041

Kovach I.V. Dnipro State Medical University, Dnipro, Ukraine 
https://orcid.org/0000-0002-5887-4136

Litvinova Y.V. Kyiv Medical University, Kyiv, Ukraine
https://orcid.org/0000-0003-2673-9295

Yanishevsky K.A. Kyiv Medical University, Kyiv, Ukraine
https://orcid.org/0009-0000-6394-615X

Marchenko N.S. Kyiv Medical University, Kyiv, Ukraine
https://orcid.org/0000-0001-8885-5529

Kopchak O.V, Kovach I.V., Litvinova Y.V., Yanishevsky K.A., Marchenko N.S. Current regenerative approaches to the treatment of generalized periodontitis in young people (literature review). Medicni perspektivi. 2024;29(1):135-143.
DOI: https://doi.org/10.26641/2307-0404.2024.1.300786

The impact of biological and psychosocial factors on the formation of mental disorders in patients who have experienced COVID-19 and exposed to the stressors of the SARS-COV-2 pandemic

Gambling always carries risks for the player's mental health, as it can provoke the development of gaming addiction. A direct connection between the socio-psychological portrait of the player, his gaming behavior, and the risks of game addiction can be traced. The purpose of the work is to form a socio-psychological portrait of a "pathological" gambler. The work was performed based on the State Institution "Institute of Forensic Psychiatry of the Ministry of Health of Ukraine".  Methods used: CAWI (Computer Assisted Web Interviewing) questionnaires in online gambling establishments; CAPI (Computer Assisted Per­sonal Interviews - server event tracking method) in land-based casinos (more than 9,000 people were inter­viewed); statis­tical (for selection and analysis of materials). A questionnaire specially developed by the authors with a point evaluation of the results (from 71 to 90 points) allows us to conclude that the interviewee is a pathological gamb­ler. For the first time in Ukraine, the survey was conducted exclusively among gamblers at gambling establishments. The obtained results made it possible to form a statistically reliable р<0.05 socio-psychological portrait of a pathological gambler, mostly men (87.7%) aged 25-35 years (52.4%) with secondary special (43.4%) or higher education (37.7%). In this group, 94% of people declared their inability to resist the desire to play, and 83.0% thought about stealing money to continue. Of pathological gamblers, 85.0% consider gaming as a means of earning money. All interviewed pathological gamers have experienced continuous gaming for more than 5 hours; 79.2% play almost every day. Such players in 95.0% noticed that they lost more money or spent more time than they planned, 96.0% felt culpable for the game, and 95.0% started the day with a game. Based on this portrait, the authors derived quantitative criteria that the organizer of gambling games can use to prevent gambling addiction among players within the framework of the application of the principles of responsible gaming.

Key words: gambling disorder, hazard games, pathological gambler, prevention of gambling addiction

1. Harmful gambling: identification, assessment and management [Internet]. nice.org.uk. 2023 [cited 2023 Jul 05]. Available from: https://www.nice.org.uk/guidance/gid-ng10210/documents/draft-guidelin
2. Blank L, Baxter S, Woods HB, et al. Should scree­ning for risk of gambling-related harm be undertaken in health, care and support settings? A systematic review of the international evidence. Addict Sci Clin Pract. 2021;16:35. doi: https://doi.org/10.1186/s13722-021-00243-9
3. Deutscher K, Gutwinski S, Bermpohl F, et al. The Prevalence of Problem Gambling and Gambling Disorder Among Homeless People: A Systematic Re­view And Meta-Analysis. J Gambl Stud. 2023;39:467-82. doi: https://doi.org/10.1007/s10899-022-10140-8
4. Frisone F, Alibrandi A, Settineri S. Problem gam­bling during Covid-19 [Internet]. Mediterranean J of Clinical Psychology. 2020 [cited 2023 Jul 05];8(3). doi: https://doi.org/10.6092/2282-1619/mjcp-2457
5. Matheson FI, Dastoori P, Hahmann T, et al. Pre­valence of Problem Gambling Among Women Using Shelter and Drop-in Services. Int J Ment Health Addiction. 2022;20:2436-47.
   doi: https://doi.org/10.1007/s11469-021-00524-z
6. Cook S, Turner NE, Ballon B, Paglia-Boak A, Murray R, Adlaf EM, et al. Problem gambling among Ontario students: associations with substance abuse, mental health problems, suicide attempts, and delinquent Behaviours. J Gambl Stud. 2015;31(4):1121-34. doi: https://doi.org/10.1007/s10899-014-9483-0
7. Dowling N, Merkouris S, Lubman D, Thomas S, Bowden-Jones H, Cowlishaw S. Pharmacological inter­ventions for the treatment of disordered and problem gambling. Cochrane Database of Systematic Reviews. 2022;9:CD008936. doi: https://doi.org/10.1002/14651858.CD008936.pub2
8. Aimedov KV. [Igromania is a parallel world]. [Internet]. In: Scientific Research Institute of social and forensic psychiatry and narcology of the Ministry of Health of Ukraine. LAT & K; 2012 [cited 2023 Jul 05]. 244 р. Available from: https://www.onmedu.edu.ua/xmlui/bitstream/handle/123456789/3075/Aymedov2.pdf?sequence=1&isallowed=y 
9. Stefanchuk RO, Hetmantsev DO, Toporetska ZM. Models of public game business governance in the world. Journal of the National Academy of Legal Sciences of Ukraine [Internet]. 2022 [cited 2023 Jul 07];29(1):94-105. doi: https://doi.org/10.37635/jnalsu.29(1).2022.94–105
10. [On state regulation of activities related to the organization and conduct of gambling. Law of Ukraine No. 768-IX dated 2020 Jul 14]. [Internet]. 2020 [cited 2023 Jul 07]. Ukrainian. Available from: https://zakon.rada.gov.ua/rada/show/768–20#n1162 
11. Taniguchia T, Maruyamaa Y, Kuritaa D, Tana­kaa M. Analysis and classification of university students’ educational skills using a computer-assisted web-inter­vie­wing questionnaire. Procedia Computer Science [Internet]. 2018 [cited 2023 Jul 07];126;2021-9. doi: https://doi.org/10.1016/j.procs.2018.07.250
12. Sowa P, Pędziński B, Krzyżak M, Maślach D, Wójcik S, Szpak A. The Computer-Assisted Web Inter­view Method as Used in the National Study of ICT Use in Primary Healthcare in Poland – Reflections on a Case Study. Studies in logic, grammar and rhetoric [Internet]. 2015 [cited 2023 Jul 07];43 (56);137-46. doi: https://doi.org/10.1515/slgr-2015-0046
13. Squires JE, Hutchinson AM, Bostrom A-M, Deis K, Norton PG, Cummings GG, et al. A Data Quality Control Program for Computer-Assisted Personal Inter­views. Nursing Research and Practice [Internet]. 2012 [cited 2023 Jul 05];303816;1-8. doi: https://doi.org/10.1155/2012/303816
14. ICD-11 for Mortality and Morbidity Statistics (Version: 02/2022) [Internet]. 2022 [cited 2023 Jul 07]. Available from: https://icd.who.int/browse11/lm/en#/http%253a%252f%252fid.who.int%252ficd%252fentity%252f1448597234
15. Volberg RA, Abbott MW, Ronnberg S, Munck IME. Prevalence and risks of pathological  gam­bling in Sweden. Acta Psychiatr Scand. 2001;104:250-6. doi: https://doi.org/10.1034/j.1600-0447.2001.00336.x
16. Richard J, Fletcher É, Boutin S, Derevensky J, Temcheff C. Conduct problems and depressive symptoms in association with problem gambling and gaming: A systematic review. J Behav Addict. 2020;9(3):497-533. doi: https://doi.org/10.1556/2006.2020.00045
17. [On the approval of the Principles of Responsible Gaming. Decision of the Commission for the Regulation of Gambling and Lotteries No. 483 of 2021 Aug 11]. [Internet]. 2021 [cited 2023 Jul 07]. Ukrainian. Available from: https://gc.gov.ua/files/Richenya/2021/08/R-483.pdf

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Toporetska Z.M. National Academy of the Security Service of Ukraine, Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2441-4852

Aymedov C.V. Medical Center «VitaSana Clinic», Odessa, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-2577-0151

Synitska T.V. SI «Institute of Forensic Psychiatry of the Ministry of Health of Ukraine», Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9575-2878

Oliinyk O.P. SI «Institute of Forensic Psychiatry of the Ministry of Health of Ukraine», Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-5376-0976

Toporetska Z.M., Aymedov C.V., Synitska T.V., Oliinyk O.P. A socio-psychological portrait of a pathological gambler as a prerequisite for preventing gambling addiction (gambling disorder). Medicni perspektivi. 2024;29(1):143-150. DOI: https://doi.org/10.26641/2307-0404.2024.1.301141

Sexual health preparedness among medical students

Schizophrenia is a severe mental disorder that leads to impaired social adaptation, interpersonal interaction, and disability. Negative symptoms are an integral part of schizophrenia. In the world psychiatric science and practice, there are still many questions about the typology of schizophrenia, the description of its clinical manifestations, first of all, the features of negative symptoms in schizophrenia. Psychiatrists of different countries draw attention to the fact that these descriptions do not always coincide. Socio-demographic factors can be considered as factors affecting the prognosis of the course and outcome of schizophrenia. In this regard, a comprehensive approach to the study of socio-demographic characteristics of patients with schizophrenia involves the study of the influence of social factors on the formation and course of schizophrenia and determines the relevance of this study. The purpose of the study was to determine the features of socio-demographic characteristics of patients with schizophrenia in order to improve diagnosis and create psycho-corrective measures. 252 patients with negative symptoms of schizophrenia and 79 patients with positive symptoms of schizophrenia were examined. During the research, a comprehensive approach was used, consisting  in the use of clinical-psychopathological, clinical-anamnestic and statistical research methods. Socio-demographic features of patients with negative symptoms in schizophrenia were established, consisting in the predominance of women; patients aged 20-29 years; persons with special secondary education; divorced and single persons; patients busy with physical labor; average level of material wealth; very poor and poor living conditions. Socio-demographic characteristics of patients with positive symptoms in schizophrenia were outlined by the predominance of men; patients aged 30-49 years; persons with incomplete higher education and with higher education; divorced and single persons; patients with disabilities; with extremely low and low levels of material well-being and a satisfactory level of living conditions. The conducted research made it possible to draw conclusions that socio-demographic features of patients with negative and positive symptoms have their own specificity, which should be taken into account when diagnosing patients with schizophrenia.

Key words: socio-demographic characteristics, patients with schizophrenia, negative symptoms, positive symptoms, clinical and anamnestic analysis

1. Jaeschke K. Global estimates of service coverage for severe mental disorders: findings from the WHO Mental Health Atlas 2017. Glob Ment Health. 2021;8:e27. doi: https://doi.org/10.1017/gmh.2021.19
2. Haigh SM, Coffman BA, Salisbury DF. Mismatch Negativity in First-Episode Schizophrenia: A Meta-Ana­lysis. Clinical EEG and neuroscience. 2017;48(1):3-10. doi: https://doi.org/10.1177/1550059416645980
3. Kushnir YuA. [Clinical and anamnestic characte­ristics of patients with negative symptoms in schi­zophrenia]. Ukrainskyi visnyk psykhonevrolohii. 2023;31:3(116):78-84. Ukrainian. doi: https://doi.org/10.36927/2079-0325-V31-is3-2023-13
4. Correll CU, Schooler NR. Negative Symptoms in Schizophrenia: A Review and Clinical Guide for Recog­nition, Assessment, and Treatment. Neuropsychiatr Dis Treat. 2020;16:519-34. doi: https://doi.org/10.2147/NDT.S225643
5. Galderisi S, Mucci A, Buchanan RW, Arango C. Negative symptoms of schizophrenia: new developments and unanswered research questions. Lancet Psychiatry. 2018;5:664-77.
   doi: https://doi.org/10.1016/S2215-0366(18)30050-6
6. Blanchard JJ, Bradshaw KR, Garcia CP, Nasral­lah HA, Harvey PD, et al. Examining the reliability and validity of the Clinical Assessment Interview for Negative Symptoms within the Management of Schizophrenia in Clinical Practice (MOSAIC) multisite national study. Schizophrenia research. 2017;185:137-43. doi: https://doi.org/10.1016/j.schres.2017.01.011
7. Shvets KN, Khamska IS. [Factors of social dis­adaptation of patients with schizophrenia and approaches to psychosocial therapy and rehabilitation (look back)]. Scientific results of biomedical research. 2019;5(2):72-85. doi: https://doi.org/10.18413/2658-6533-2019-5-2-0-8
8. Lee WH, Doucet GE, Leibu E, Frangou S. Res­ting-state network connectivity and metastability predict clinical symptoms in schizophrenia. Schizophrenia research. 2018;201:208-16. doi: https://doi.org/10.1016/j.schres.2018.04.029
9. Bucci P, Galderisi S. Categorizing and assessing negative symptoms. Current opinion in psychiatry. 2017;30(3):201-8. doi: https://doi.org/10.1097/YCO.0000000000000322
10. Galderisi S, Kaiser S, Bitter I, Nordentoft M, et al. EPA guidance on treatment of negative symptoms in schizophrenia. European psychiatry: the journal of the Association of European Psychiatrists. 2021;64(1):e21. doi: https://doi.org/10.1192/j.eurpsy.2021.13
11. Almulla AF, Al-Hakeim HK, Maes M. Schizo­phrenia phenomenology revisited: positive and negative symptoms are strongly related reflective manifestations of an underlying single trait indicating overall severity of schizophrenia. CNS spectrums. 2021;26(4):368-77. doi: https://doi.org/10.1017/S1092852920001182
12. Riehle M, Mehl S, Lincoln TM. The specific so­cial costs of expressive negative symptoms in schi­zophrenia: reduced smiling predicts interactional outcome. Acta psychiatrica Scandinavica. 2018;138(2):133-44. doi: https://doi.org/10.1111/acps.12892
13. Sabe M, Kirschner M, Kaiser S. Prodopaminergic Drugs for Treating the Negative Symptoms of Schizo­phrenia: Systematic Review and Meta-analysis of Ran­domized Controlled Trials. Journal of clinical psycho­pharmacology. 2019;39(6):658-64. doi: https://doi.org/10.1097/JCP.0000000000001124
14. [ICD 10 – International Classification of Diseases, 10th revision]. [Internet]. [cited 2023 Aug 20]. Russian. Available from: https://mkb-10.com/index.php?pid=4001
15. Skrypnikov AM, Zhyvotovska LV, Bodnar LA, Sonnyk HT. [Psychiatry and narcology: educational and methodological manual]. 2-e vydannia. 2021. 224 p. Ukrainian.
16. Walters SJ, Campbell MJ, Machin D. Medical Sta­tistics: A Textbook for the Health Sciences. 5th ed. Wiley-Blackwell; 2021. 448 p.
17. Altynbekov K, Raspopova N, Abetova A. Ana­lysis of social and demographic and clinical characteristics of patients with paranoid schizophrenia of the kazakh ethnic group in the republic of Kazakhstan. Georgian Med News. 2023 May;338:6-13. PMID: 37419463.
18. Vita A, Barlati S. Recovery from schizophrenia: is it possible? Curr Opin Psychiatry. 2018 May;31(3):246-55. doi: https://doi.org/10.1097/YCO.0000000000000407
19. Zhang CX, Ren XH, Yang XM, Fan RX, Wang Y, Li YL, et al. [Quality of Life and Its Influencing Factors Among Schizophrenia Patients Living in Urban and Rural Areas]. Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 May;54(3):608-13. Chinese. doi: https://doi.org/10.12182/20230560202
20. Coulibaly SDP, Ba B, Mounkoro PP, Diakite B, Kassogue Y, Maiga M, et al. Descriptive study of cases of schizophrenia in the Malian population. BMC Psychiatry. 2021 Aug 20;21(1):413. doi: https://doi.org/10.1186/s12888-021-03422-9

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Kushnir Yu.A. Communal non-commercial enterprise "Clinical Hospital "Psychiatry"",  Kyiv, Ukraine,
е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0002-7342-9636

Kushnir Yu.A. Socio-demographic characteristics of patients with negative and positive symptoms in schizophrenia. Medicni perspektivi. 2024;29(1):151-158. DOI: https://doi.org/10.26641/2307-0404.2024.1.301142

Peculiarities of identification of persons who died during martial law (literature review)

The COVID-19 pandemic has had a significant impact on the well-being, both mental and physical, of students worldwide. Medical students faced challenges in the educational process, including online education, uncertainty as for the terms of licensing exams, and limited practical experience. The present study aimed to compare the impact of the COVID-19 pandemic on the mental health of medical students from Ukraine, India, and African countries, focusing on the frequency of incidence of psychosomatic symptoms, anxiety/insomnia, social dysfunction, and depression. 230 students of the Academic and Research Medical Institute of Sumy State University were survey participants. The mental well-being of medical students was assessed using the General Health Questionnaire. The obtained data were analyzed using the statistical software PAST v4.03. It was found that 60 % of students had mental health disturbances during the COVID-19 pandemic. Symptoms of depression were detected in 15% of medical students, psychosomatic symptoms in 34%, anxiety and insomnia in 47%, and social dysfunction in 65% of respondents. The main psycho-emotional disorder in most students was social dysfunction, which was associated with limited social activity during quarantine. It was found that students from India and African countries had a higher incidence of depression than Ukrainian students. Obviously, being away from home during a pandemic has an additional negative impact on the mental health of international students. The frequency of anxiety and insomnia was higher among Ukrainians than among foreign students. Changes in learning environments and concerns about personal and family health have contributed to heightened anxiety levels among Ukrainian students. It should be noted that with the transition to online learning and communication, students had to spend more time in front of screens, which could contribute to digital fatigue, disrupt sleep patterns, and negatively affect mental well-being. The results of the study provided valuable insight into the mental health challenges faced by medical students during the COVID-19 pandemic with regard to their nationality, highlighting the need for targeted psychological support interventions for students to improve their mental health. 

Key words: mental health, medical students, General Health Questionnaire, depression, anxiety, COVID-19 pandemic

1. Fedotova Z, Abdrjahimova C, Kleban K. [The mental health of medical students during the COVID-19 pandemic: a literature review]. Psychosomatic Medicine and General Practice. 2023;8(1):e0801415. Ukrainian. doi: https://doi.org/10.26766/pmgp.v8i1.415
2. Penninx BWJH, Benros ME, Klein RS, Vin­kers CH. How COVID-19 shaped mental health: from infection to pandemic effects. Nature Medicine. 2022;28(10):2027-37. doi: https://doi.org/10.1038/s41591-022-02028-2
3. Catling JC, Bayley A, Begum Z, Wardzinski C, Wood A. Effects of the COVID-19 lockdown on mental health in a UK student sample. BMC Psychology. 2022;10:118-24.
   doi: https://doi.org/10.1186/s40359-022-00732-9
4. Elharake JA, Akbar F, Malik AA, Gilliam W, Omer SB. Mental Health Impact of COVID-19 among Children and College Students: A Systematic Review. Child Psychiatry Hum Dev. 2023;54(3):913-25. doi: https://doi.org/10.1007/s10578-021-01297-1
5. Al-Balas M, Al-Balas HI, Jaber HM, Obeidat K, Al-Balas H, Aborajooh EA, et al. Distance learning in clinical medical education amid COVID-19 pandemic in Jordan: current situation, challenges, and perspectives. BMCMed  2020;20:341-7. doi: https://doi.org/10.1186/s12909-020-02257-4
6. Sipeki I, Vissi T, Túri I. The effect of the Covid-19 pandemic on the mental health of students and teaching staff. Heliyon.2022;8(4):e09185. doi: https://doi.org/10.1016/j.heliyon.2022.e09185
7. Goldberg DP, Hillier VF. A scaled version of the General Health Questionnaire. Psychol Med. 1979;9(1):139-45. doi: https://doi.org/10.1017/s0033291700021644
8. Rezaei F, Karimi K, Omidpanah N. Mental Well-being of the First and Final-Year Medical and Dental Students of Kermanshah University of Medical Sciences. OpenDent  2019;13(1):177-82. doi: https://doi:10.2174/1874210601913010177
9. Jackson CA. The General Health Questionnaire. Occup Medicine. 2007;57:79. doi: https://doi:10.1093/occmed/kql169
10. de la Revilla Ahumada L, de los Rios Alva­rez AM, Luna del Castillo JD. Use of the Goldberg General Health Questionnaire (GHQ-28) to Detect Psychosocial Problems in the Family Physician's Office. Aten 2004;33(8):417-22. doi: https://doi.org/10.1016/s0212-6567(04)79426-3
11. Hammer O, Harper D, Ryan P. PAST: Paleontolo­gical Statistics Software Package for Education and Data Analysis. Palaeontol 2001;4(1):1-9. doi: http://palaeo-electronica.org/2001_1/past/issue1_01.htm
12. Chaturvedi K, Vishwakarma DK, Singh N. COVID-19 and its impact on education, social life and mental health of students: A survey. Child Youth Serv Rev. 2021;121:105866. doi: https://doi.org/10.1016/j.childyouth.2020.105866

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Inshyna N.M. Sumy State University, Sumy, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-8204-8547

Chorna I.V. Sumy State University, Sumy, Ukraine
https://orcid.org/0000-0002-3094-4518

Inshyna N.M., Chorna I.V. Medical students’ mental health in the COVID-19 pandemic. Medicni perspektivi. 2024;29(1):158-163.
DOI: https://doi.org/10.26641/2307-0404.2024.1.301146

Long-term postoperative regional analgesia of the lower third of the face in patients with tumors of the oral cavity

The article represents the results of a study aimed on predicting the risks and odds of rehospitalization among patients with eating disorders in anxiety-depressive disorders. In total, 147 patients with anxiety and depressive disorders were examined. Patients were divided into a main group of 82 and a comparison group of 65 patients. The main group consisted of 21 (26%) men with a mean age of 38.33 (SD 11.53) and 61 (74%) women with a mean age of 43.15 (SD 11.44). The comparison group consisted of 19 (29%) men, mean age 37.53 (SD 9.75) and 46 (71%) women, mean age 45.22 (SD 12.17). At the time of the initial examination in the main group, 35 (43%) patients were hospitalized for the first time, 47 (57%) – rehospitalized; in the comparison group, 23 (35%) patients – for the first time hospitalized, and 42 (65%) – rehospitalized. It was found that 27  patients were rehospitalized within the next year after the intervention and treatment. Clinical-anamnestic, clinical-psychopathological and psychodiagnostic study supplemented by psychometric scales (PHQ-9 health questionnaire, Dutch Eating Behaviour Questionnaire (DEBQ), State-Trait Anxiety Inventory (STAI; C.D. Spielberger), Methodology for assessing the integrative Quality of Life Index (QLI; J.E. Mezzich)) was conducted. As a result of the study, it was found that patients in the main group had a 3.6 times lower risk of rehospitalization over the next year than patients in the comparison group. When constructing a unipolar regression model, the best predictive power and discriminative ability was demonstrated by the number of previous hospitalizations (p<0.01, AUC 0.75 (0.67-0.82)) and the intervention in the main group, which reduced the odds of rehospitalization over the next year by 4.8 times. The highest discriminative ability was demonstrated by the multiple logistic regression model (AUC 0.83 (0.76-0.88)), according to which intervention in the main group reduced the odds of rehospitalization in the next year by 5.9 times. The results of the study became the basis for the development of differentiated treatment and correctional measures for eating disorders in patients with anxiety-depressive disorders to improve the quality of care, prevent psychosocial maladjustment and improve the quality of life of this population.

Key words: anxiety, depression, anxiety-depressive disorders, eating behavior, eating behavior disorders, prediction

1. Qian J, Wu Y, Liu F, Zhu Y, Jin H, Zhang H, et al. An update on the prevalence of eating disorders in the general population: a systematic review and meta-analysis. Eat Weight Disord. 2022 Mar;27(2):415-28. doi: https://doi.org/10.1007/s40519-021-01162-z
2. Silén Y, Keski-Rahkonen A. Worldwide preva­lence of DSM-5 eating disorders among young people. Curr Opin Psychiatry. 2022 Nov 1;35(6):362-71. doi: https://doi.org/10.1097/YCO.0000000000000818
3. van Eeden AE, van Hoeken D, Hoek HW. Inci­dence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021 Nov 1;34(6):515-24. doi: https://doi.org/10.1097/YCO.0000000000000739
4. van Hoeken D, Hoek HW. Review of the burden of eating disorders: mortality, disability, costs, quality of life, and family burden. Curr Opin Psychiatry. 2020 Nov;33(6):521-7. doi: https://doi.org/10.1097/YCO.0000000000000641
5. van Eeden AE, van Hoeken D, Hoek HW. Inci­dence, prevalence and mortality of anorexia nervosa and bulimia nervosa. Curr Opin Psychiatry. 2021 Nov 1;34(6):515-24. doi: https://doi.org/10.1097/YCO.0000000000000739
6. The Universal Declaration on Bioethics and Human Rights. International Social Science Journal [Internet]. 2005 Dec [cited 2021 Oct 29];57(186):745-53. doi: https://doi.org/10.1111/j.1468-2451.2005.00592
7. World Medical Association Declaration of Helsinki. JAMA [Internet]. 2013 Nov 27 [cited 2021 Oct 29];310(20):2191. doi: https://doi.org/10.1001/jama.2013.281053
8. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: https://doi.org/10.1046/j.1525-1497.2001.016009606.x
9. Strien T van, Frijters JER, Bergers GPA, Defa­res PB. The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International Journal of Eating Disorders. 1986 Feb;5(2):295-315.
   doi: https://doi.org/10.1002/1098-108X(198602)5:2<295::AID-EAT2260050209>3.0.CO;2-T
10. Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1983.
11. MarutaNO, Panko TV, Yavdak IO. [Quality of life criterion in psychiatric practice]. Kharkiv: RVF Arsis, LTD; 2004. Russian.
12. Torres D, Normando D. Biostatistics: essential concepts for the clinician. Dental Press J Orthod. 2021 Mar 10;26(1):e21spe1. doi: https://doi.org/10.1590/2177-6709.26.1.E21SPE1
13. Ying GS, Maguire MG, Glynn RJ, Rosner B. Tu­torial on Biostatistics: Receiver-Operating Characteristic (ROC) Analysis for Correlated Eye Data. Ophthalmic Epidemiol. 2022 Apr;29(2):117-27. doi: https://doi.org/10.1080/09286586.2021.1921226
14. Wiechert M, Holzapfel C. Nutrition Concepts for the Treatment of Obesity in Adults. Nutrients. 2021 Dec 30;14(1):169. doi: https://doi.org/10.3390/nu14010169
15. Kahn M, Brunstein-Klomek A, Hadas A, Snir A, Fennig S. Early changes in depression predict outcomes of inpatient adolescent anorexia nervosa. Eat Weight Disord. 2020 Jun;25(3):777-85. doi: https://doi.org/10.1007/s40519-019-00686-9
16. Lipsitz O, McIntyre RS, Rodrigues NB, Lee Y, Gill H, Subramaniapillai M, et al. Does body mass index predict response to intravenous ketamine treatment in adults with major depressive and bipolar disorder? Results from the Canadian Rapid Treatment Center of Excellence. CNS Spectr. 2022 Jun;27(3):322-30. doi: https://doi.org/10.1017/S1092852920002102
17. Daley A, Scobie B, Shorey J, Breece J, Oxley S. Predicting 30-Day Readmissions: Evidence From a Small Rural Psychiatric Hospital. J Psychiatr Pract. 2021 Sep 16;27(5):346-60. doi: https://doi.org/10.1097/PRA.0000000000000574
18. Zhao Y, Hoenig JM, Protacio A, Lim S, Nor­man CC. Identification of risk factors for early psychiatric rehospitalization. Psychiatry Res. 2020 Jan 21;285:112803. doi: https://doi.org/10.1016/j.psychres.2020.112803

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Ogorenko V.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-0549-4292

Kokashynskyi V.O. Dnipro State Medical University, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0002-6191-3757

Ogorenko V.V., Kokashynskyi V.O. Prediction of risks and odds of rehospitalization of patients with eating disorders in anxiety-depressive disorders. Medicni perspektivi. 2024;29(1):163-169. DOI: https://doi.org/10.26641/2307-0404.2024.1.301148

Correction of insulin resistance in patients with chronic obstructive pulmonary disease under the influence of recovery treatment

Acute cerebrovascular accident remains an important medical and social problem. An important area of intensification of rehabilitation care for patients after cerebral ischemic stroke is the using of a patient-centered approach, which is often associated with increased patient satisfaction and adherence to rehabilitation. The aim of the study was to balance the restoration of physical and functional capabilities of patients after cerebral ischemic stroke in the post-acute rehabilitation period using a patient-centered approach. A program of physical therapy for patients after cerebral ischemic stroke in the post-acute rehabilitation period was implemented from the standpoint of a patient-centered approach in accordance with the defined goals of rehabilitation intervention. The study included 37 patients, 22 men and 15 women with post-stroke muscle spasticity who were under a nine-month follow-up during the second stage of rehabilitation in the post-acute rehabilitation period. The average age of men was 52.1±8 years, the average age of women was 50±13 years. A comparative evaluation of the effectiveness of the physical therapy program was conducted, based on examination methods in accordance with the International Classification of Functioning, Disability and Health. At the end of the experimental study, the following changes in patients after cerebral ischemic stroke were found: decrease in the intensity of pain in the muscles of spastic limbs according to the visual analog pain scale by 12.9±1.02 points (p<0.05); decrease in the severity of motor deficit by an average of 1.7±1.0 points (p<0.05) according to the Motor Deficit Scale (Medical Research Council); the index of muscle tone of the adductor muscles of the shoulder decreased by 0.9±0.4 points (p<0.05), the muscles of the forearm flexors by 0.4±0.2 (p<0.05) points on the Ashworth Scale (Modified Ashworth Scale); assessment of motor function of the affected limb showed an increase in motor activity by 15±0.4 points (p<0.05), before physical therapy the index was 29±0.2 points (p<0.05), and after it – 44.3±0.8 points (p<0.05) on the Action Research Arm Test scale; statistical impro­vement in self-care and functionality in patients by 1.2±0.1 points (p<0.05) on the Modified Rankin Scale; the average walking and mobility score in patients increased by 3.7±0.1 points (p<0.05) on the Rivermead mobility index. The results of the experimental study confirmed that the algorithm and content of the physical therapy program from the standpoint of a patient-centered approach were effective for patients who had suffered a cerebral ischemic stroke; this indicates the possibility and feasibility of their further using for post-stroke patients in the post-acute rehabilitation period.

Key words: ischemic stroke, рhysical therapy, patient-centeredness, therapeutic exercises, functionality

1. Public Health Center of the Ministry of Health of Ukraine [Internet]. 2024 [cited 2024 Jan 14]. Ukrainian. Available: http://medstat.gov.ua/ukr/statdanMMXIX.html
2. Zozulia IS, Volosovets AO, Zozulia AI, Parkho­menko BL. [Peculiarities of rehabilitation of patients with ischemic stroke against the background of cardiac and cerebral pathology]. Ukrainskyi medychnyi chasopys. 2022;4(150):1-3. Ukrainian.
3. Lee J, Yu J, Hong J, Lee D, Kim J, Kim S. The Effect of Augmented Reality-Based Proprioceptive Trai­ning Program on Balance, Positioning Sensation and Flexibility in Healthy Young Adults: A Randomized Controlled Trial. Healthcare. 2022;10:1202. doi: https://doi.org/10.3390/healthcare10071202
4. Bannikova R, Kerestei V. [Modern approaches to the construction of a physical rehabilitation program for persons with the consequences of acute disorders of cerebral blood circulation in the late recovery period]. Teoriia i metodyka fizychnoho vykhovannia i sportu. 2018;3:29-37. Ukrainian.
5. Maalouf E, Hallit S, Salameh P, Hosseini H. Eating Behaviors, Lifestyle, and Ischemic Stroke: A Lebanese Case-Control Study. Int J Environ Res Public Health. 2023;20:1487. doi: https://doi.org/10.3390/ijerph20021487
6. Diachuk DD, Moroz HZ, Hidzynska IM, Krav­chenko AM. [Introducing a patient-oriented approach and improving the organization of medical care at the current stage (literature review)]. Klinichna ta profilaktychna medytsyna. 2023;1(23):67-77. Ukrainian.
7. Yun D, Choi J. Person-centered rehabilitation care and outcomes: A systematic literature review. Int J Nurs Stud.2019;93:74-83. doi: https://doi.org/10.1016/j.ijnurstu.2019.02.012
8. Von Korff M, DeBar LL, Krebs EE, et al. Graded chronic pain scale revised: mild, bothersome, and high-impact chronic pain. Pain. 2020;161(3):651-61. doi: https://doi.org/10.1097/j.pain.0000000000001758
9. Skivington K, Matthews L, Simpson SA, et al. A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. 2021;374:2061. doi: https://doi.org/10.1136/bmj.n2061
10. Wilson N, Howel D, Bosomworth H, Shaw L, Rodgers H. Analysing the Action Research Arm Test (ARAT): a cautionary tale from the RATULS trial. Int J Rehabil 2021;44(2):166-9. doi: https://doi.org/10.1097/MRR.0000000000000466
11. Vidmar T, Goljar Kregar N, Puh U. Reliability of the Modified Ashworth Scale After Stroke for 13 Muscle Groups. Arch Phys Med Rehabil. 2023;104(10):1606-11. doi: https://doi.org/10.1016/j.apmr.2023.04.008
12. Tsang RC, Chau RM, Cheuk TH, et al. The measurement properties of modified Rivermead mobility index and modified functional ambulation classification as outcome measures for Chinese stroke patients. Physiother Theory 2014;30(5):353-9. doi: https://doi.org/10.3109/09593985.2013.876563
13. Pożarowszczyk N, Kurkowska-Jastrzębska I, Sar­zyńska-Długosz I, Nowak M, Karliński M. Reliability of the modified Rankin Scale in clinical practice of stroke units and rehabilitation wards. Front Neurol. 2023;14:1064642. doi: https://doi.org/10.3389/fneur.2023.1064642
14. Xiong F, Liao X, Xiao J, Bai X, Huang J, et Emerging Limb Rehabilitation Therapy After Post-stroke Motor Recovery. Front Aging Neurosci. 2022;14:863379. doi: https://doi.org/10.3389/fnagi.2022.863379
15. [On rehabilitation in the field of health care. The Law of Ukraine dated 2020 Dec 3. No. 1053-IX. Infor­mation of the Verkhovna Rada, 2021, No. 8, Article 59]. [Internet]. 2021 [cited 2024 Jan 14]. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/1053-20#Text
16. Andriichuk O, Ulianytska N, Hreida N, Stru­bitska N. [Patient-centeredness of physical therapy during sports and rehabilitation meetings]. Fizychne vykhovannia, sport i kultura zdorovia u suchasnomu suspilstvi. 2021;2(54):112-9. doi: https://doi.org/10.29038/2220-7481-2021-02-112-119
17. Sybiriakin A, Balazh M. [Modern views on the use of physical therapy measures in people with stroke]. Teoriia i metodyka fizychnoho vykhovannia i sportu. 2020;1:93-8. Ukrainian. doi: https://doi.org/10.32652/tmfvs.2020.1.93-98

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Malyarova Y.M. Sumy State A.S. Makarenko Pedagogical University, Sumy, Ukraine
https://orcid.org/0000-0003-3073-8973

Rudenko A.M. Sumy State A.S. Makarenko Pedagogical University, Sumy, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-5428-6305

Zviriaka O.M. Sumy State A.S. Makarenko Pedagogical University, Sumy, Ukraine
https://orcid.org/0000-0001-8618-9665

Kuksa N.V. Sumy State A.S. Makarenko Pedagogical University, Sumy, Ukraine
https://orcid.org/0000-0001-5650-1873

Malyarova Y.M., Rudenko A.M., Zviriaka O.M., Kuksa N.V. Physical therapy of patients after cerebral ischemic stroke from the standpoint of a patient-centered approach. Medicni perspektivi. 2024;29(1):170-179. DOI: https://doi.org/10.26641/2307-0404.2024.1.301153

Dynamics of movement amplitude indicators in joints of patients with rheumatoid arthritis

In order to address safety concerns related to the acquisition and utilization of TiO₂ and TiO₂@Ag nanomaterials, as well as to investigate their disinfectant and biological effects, the structural-morphological, morpho­metry, toxicological, cytotoxic, and virucidal properties of these specified nanomaterials have been studied through experiments conducted on laboratory animals and in vitro. It has been demonstrated that the TiO₂@Ag nanocomposite exhibited distinct physicochemical characteristics: it consisted of TiO₂ nanoparticles ranging in size from 13 nm to 20 nm and Ag nanoparticles ranging from 35 nm to 40 nm with 4.0 wt% of silver localized on the surface of titanium dioxide. The purity of the modification of synthesized nano-TiO₂ and nano-TiO₂@Ag has been confirmed. Acute intraperitoneal administration of nanopowders revealed LD₅₀ values of 4783.30 mg/kg for nano-TiO₂ and 724.44 mg/kg for nano-TiO₂@Ag. A slight accumulation was observed upon repeated (28-fold) intragastric administration of nano-TiO₂. The cumulative dose administered, which equated to 15.9 multiples of the LD₅₀ (76040 mg/kg), did not result in animal mortality but led to retardation in body weight gain. TiO₂ and TiO₂@Ag nanopowders do not irritate the skin, induce mild conjunctival irritation, and may exhibit a weak sensitizing effect. Nano-TiO₂ and nano-TiO₂@Ag powders accumulate in the tissues of internal organs and cause damage to the liver, kidneys, and lungs of laboratory animals upon intraperitoneal administration. The most characteristic morphological signs of the toxic effect of nano-TiO₂ on liver tissue were observed at a level of 67.7% (cytoplasmic vacuolization in hepatocytes), while in the case of nano-TiO₂@Ag initial necrotic changes were at a level of 70.0% (hepatocytes with pyknotic nuclei). Immunoassay analysis has demonstrated that TiO₂@Ag and TiO₂ nanomaterials at concentrations of 30 µg/ml can enhance the functional activity of peripheral blood mononuclear cells in vitro by increasing the production of cytokines IL-1, IL-6, TNF-α, and IL-4 in donors (p<0.05). This indicates the potential for chronic inflammation and allergic reactions among synthesis operators. In the study of the impact of nanomaterials on murine germ cells, it has been established that they affect the activity of mitochondrial enzymes and exert a damaging effect on mitochondrial membranes and overall cell integrity. Estimated approximate safe exposure levels in the workplace air are 0.3 mg/m³ for nano-TiO₂ and 0.2 mg/m³ for nano-TiO₂@Ag. Nano-TiO₂@Ag and nano-TiO₂ at a concentration of 100 µg/ml exhibit pronounced extracellular virucidal activity against human adenovirus serotype 2. The TiO₂@Ag nanocomposite has a less damaging effect on Нер-2 cells compared to nano-TiO₂.

Key words: nanomaterials, electron microscopy, toxicology, cytokines, oxidative enzymes, hygiene regulation, cytotoxicity, adenovirus

1. Zahornyi M, Sokolsky G. Nanosized Titania Com­posites for Reinforcement of Photocatalysis and Photo­electrocatalysis: manuscript. Newcastle upon Tyne, UK: Academic Cambridge Scholars Publishing; 2022. 275 p.
2. Sescu AM, Favier L, Lutic D, Soto-Donoso N, Ciobanu G, Harja M. TiO2 Doped with Noble Metals as an Efficient Solution for the Photodegradation of Hazardous Organic Water Pollutants at Ambient Conditions. Water. 2021;13(1):19. doi: https://doi.org/10.3390/w13010019
3. Zahornyi MM, Yavorovsky OP, Riabovol VM, et al. [Morphological, spectral and toxicological features of new composite material of titanium nanodioxide with nanosilver for use in medicine and biology]. Medicni perspektivi. 2022;27(1):152-9. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2022.1.254381
4. Leonenko OB, Demetska OV, Leonenko NS. [Na­nomaterials in the workplace: current issues of occupational safety]. Kyiv: VD "Avicena"; 2018. 144 p. Ukrainian.
5. OECD Guidelines for Testing of Chemicals Test Guideline No. 405 Acute Eye Irritation/Corrosion. 2022. 12 p.
6. OECD Guidelines for Testing of Chemicals Test Guideline No. 402 Acute Dermal Toxicity. 2017. 13 p.
7. OECD Guidelines for Testing of Chemicals Test Guideline No. 406 Skin Sensitization. 2022. 12 p.
8. Lim RK, Rink KG, Glass HG, Soaje-Echague EA. A method for the evaluation of cumulation and tolerance by the determination of acute and subchronic median effective doses. Arch Intern Pharm Ther. 1961;130:336-52.
9. Green M, Loewenstein PM. Human adenoviruses: propagation, purification, quantification, and storage. Curr Protoc Microbiol. 2006;00:14C.1.1-14C.1.19. doi: https://doi.org/10.1002/9780471729259.mc14c01s00
10. Andrighetti-Fröhner RV, Creczynski-Pasa TB, Barardi CRM, Simões CMO. Cytotoxicity and Potential Antiviral Evaluation of Violacein Produced by Chro­mobacterium violaceum CR. Mem Inst Oswaldo Cruz. 2003;98(6):843-8.
    doi: https://doi.org/10.1590/S0074-02762003000600023
11. Shcherbinska AM, Dyachenko NS, Rybalko SL, et al. [Study of the antiviral effect of potential medi­cines]. In: Stefanova K, editor. [Preclinical re­search of medicines: me­thodical recommendations]. Kyiv; 2001. р. 371-95. Ukrainian.
12. Antomonov MYu. [Mathematical processing and analysis of medical and biological data]. Кyiv: MYCz "Medynform"; 2018. р. 579.
13. Sukitpong J, Chiarakorn S. Degradation of acetal­dehyde by Ag/TiO2 photocatalyst coated on polyester air filter. IOP Conf Series: Earth and Environmental Science. 2019;373:012020.
    doi: https://doi.org/10.1088/1755-1315/373/1/012020
14. [On the approval of hygienic regulations on the permissible content of chemical and biological substances in the air of the working area. Order ministry of health protection of Ukraine No. 1596 of 2020 Jul 14]. [Internet]. 2020 [cited 2023 Jul 15]. Ukrainian. Available from: https://zakononline.com.ua/documents/show/487693___761836
15. Yavorovsky O, Zazuliak T, Ostapiv D, Riabo­vol V, Demetska O. [Comparative assessment of the effect of tita­nium dioxide – based nanoparticles on boar germ cells in vitro]. Medicni perspektivi. 2022;27(4):13-9. Ukrainian.
    doi: https://doi.org/10.26641/2307-0404.2022.4.271117
16. Kundiev YI, Trachtenberg IM, Yavorovskyi OP, et al. [Hygienic regulation and control of nanomaterials in the production environment. Guidelines]. Kyiv; 2016. 21 p. Ukrainian.
17. Povnitsa OYu, Zahorodnia SD, Artiukh LO, et al. Photodynamic treatment of titanium dioxide nanoparticles is a convenient method of antiviral inactivation. Micro­biological journal. 2023;85(3):61-9. doi: https://doi.org/10.15407/microbiolj85.03.061
18. Yavorovsky OP, Riabovol VM, Zinchenko TO, et al. The impact of silver nanoparticle modification on the structure, photoactive, toxicological, and virucidal properties of anatase for use in biology and medicine. World of Medicine and Biology. 2023;86(4):181-6. doi: https://doi.org/10.26724/2079-8334-2023-4-86-181-186
19. Yavorovskiy O, Omelchuk S, Sokurenko L, et al. Environmental and occupational hazards of metal nano­compounds production and application: hygienic, clinical and toxicological aspects. Wiad Lek. 2019;72(8):1504-11. doi: https://doi.org/10.36740/WLek201908117
20. Demetska O, Beliuha O, Movchan V, et al. Scree­ning Assessment of the Potential ‎Hazard of Nanomaterials using a Bull ‎Sperm. International Journal of Nanoscience and Nanotechnology. 2023;19(2):77-84. doi: https://doi.org/10.22034/ijnn.2023.557252.2236

Look through:

Yavorovsky O.P. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-4573-8039

Riabovol V.M. Bogomolets National Medical University, Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-1582-7188

Zinchenko T.O. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-6652-2800

Zahornyi M.M. Frantsevich Institute for Problems of Materials Science NASU, Kyiv, Ukraine
https://orcid.org/0000-0003-2443-8050

Ragulya A.V. Frantsevich Institute for Problems of Materials Science NASU; Nanotechcenter, Kyiv, Ukraine
https://orcid.org/0000-0002-0859-0004

Tyschenko N.I. Frantsevich Institute for Problems of Materials Science NASU, Kyiv, Ukraine
https://orcid.org/0000-0001-6714-121X

Povnitsa O.Yu. D.K. Zabolotny Institute of Microbiology and Virology, NAS of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0003-0349-7174

Artiukh L.O. D.K. Zabolotny Institute of Microbiology and Virology, NAS of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0003-3163-2492

Zahorodnia S.D. D.K. Zabolotny Institute of Microbiology and Virology, NAS of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0002-0892-772X

Ostapiv D.D. Institute of animal biology NAAS, Lviv, Ukraine
https://orcid.org/0000-0001-8112-5398

Yavorovsky O.P., Riabovol V.M., Zinchenko T.O., Zahornyi M.M., Ragulya A.V., Tyschenko N.I., Povnitsa O.Yu., Artiukh L.O., Zahorodnia S.D., Ostapiv D.D. Comparative toxicological-hygienic assessment, structural-morphological, physicochemical characteristics, and virucidal properties of new nanopowder materials TiO₂ and TiO₂@Ag. Medicni perspektivi. 2024;29(1):180-192. DOI: https://doi.org/10.26641/2307-0404.2024.1.301212

Risk assessment when consuming drinking water treated with chlorine dioxide and risk management in EU countries and Ukraine to protect public health

Modern agriculture extensively uses pesticide formulations at various stages of crop growth. Sunflower cultivation accounts for 31% of the global production. Assessing the occupational risk associated with pesticide application in sunflower farming is of paramount importance. Improper handling and application of pesticide formulations can have immediate adverse effects on workers, leading to acute poisoning, long-term health consequences, and the potential for chronic illnesses, including neurotoxic effects. The aim of this study was to conduct a hygienic assessment of the professional risk faced by workers during pre- and post-emergence herbicide applications in sunflower cultivation. This assessment was carried out to establish the regulations for their safe usage. Research samples after the application of the herbicides AGAT, GARPUN, KORVUS, and PARUS (patches from overalls, gloves, skin swabs from exposed areas (face-neck, hands), air samples (atmospheric air, working zone and drift zone). The assessment of professional risk was conducted in accordance with the methodological recommendations provided by experts from the L.I. Medved's Research Center of Preventive Toxicology, Food and Chemical Safety, Ministry of Health, Ukraine (State Enterprise). Statistical analysis of the results was carried out using the licensed statistical software packages MedStat v.5.2 (Copyright^© 2003-2019) and Microsoft^® Excel^® for Microsoft 365 MSO (Version 2305, Build 16.0.16501.20074). It has been determined that under real conditions, during pre- and post-emergence herbicide applications in sunflower cultivation using AGAT, GARPUN, KORVUS, PARUS preparations, while adhering to recommended agrotechnical and hygiene safety regulations, the inhalation, dermal, complex, and combined (AGAT and PARUS) risks for applicators are 0.0409±0.0179, 0.0429±0.0193, 0.0838±0.0224, and 0.1557±0.1322 a.u., respectively, and for tractor operators – 0.0818±0.0358, 0.0425±0.0192, 0.1243±0.0356, and 0.2347±0.1567 a.u., respectively. There is no observed increase in hygiene standards in the workplace atmosphere and in the air of the potential drift zone. It has been proven that the professional risk of their use does not exceed permissible limits (<1). It has been determined that during the performance of techno­logical operations, the mentioned risks in applicators and tractor operators did not differ significantly (p>0.05). However, a significant difference was found in the proportion of percutaneous risk (42.7±17.4% in applicators compared to 34.8±17.0% in tractor operators; p=0.034). The regulations for the safe use of the investigated pesticide formulations have been substantiated. Statistical analysis of the obtained results revealed that the values of inhalation, dermal, and combined risks during the application of these pesticides did not significantly differ during the various technological operations (applicators and tractor operators) (p>0.05). The values of the combined comprehensive risk associated with the use of the studied preparations also did not show significant differences (p>0.05). The proportion of dermal risk was significantly higher in applicators compared to this parameter determined in tractor operators (p=0.034).

Key words: pesticides, working conditions, complex and combined professional risk

1. Anfarovych YH, Popov DO. [Ways of inten­sifying agricultural production]. Bulletin of the Student Scientific Society. 2019;2:242-3. Ukrainian.
2. Bubalo NN, Balan GM. [Metabolic disorders, dehydrogenic effects and imbalance of adipose tissue hormones in patients undergoing acute and chronic into­xication with pesticides]. Modern problems of toxicology, radiation and chemical safety. 2018;2-3:51-70. Ukrainian. doi: https://doi.org/10.33273/2663-4570-2018-82-83-2-3-51-70
3. Ilkiv L. [Economic aspects of sunflower produc­tion]. Young Scientist. 2019;10(74):661-5. Ukrainian. doi: https://doi.org/10.32839/2304-5809/2019-10-74-139
4. Tkachenko IV, Antonenko AM, Borysenko AA, Korshun OM, Lipavska AO. [Hygienic assessment of occu­pational risk when using pesticide formulations based on spiroxamine and abamectin for agricultural workers]. Ukrainian Journal of Occupational Health. 2021;17(4):253-60. 
   doi: https://doi.org/10.33573/ujoh2021.04.253
5. Vavrinevych OP, Antonenko AM, Omelchuk ST. [The results of monitoring studies to assess occupational risk in the application of pesticide formulations in the agro-industrial sector of Ukraine]. Ukrainian Journal of Occupational Health. 2018;1(54):24-31. Ukrainian. doi: https://doi.org/10.33573/ujoh2018.01.024
6. [Study, assessment and reduction of the risk of inhalation and percutaneous exposure of pesticides to persons who work with them or may be exposed during and after chemical protection of plants and other objects. Methodological recommendations. Order of the Ministry of Health I'm from Ukraine 2009 May 13 No. 324]. [Internet]. 2009 [cited 2023 Aug 01]. Ukrainian. Available from: https://ips.ligazakon.net/document/MOZ9481
7. US Environmental Protection Agency Office of Pesticide Programs. Occupational Pesticide Handler Unit Exposure Surrogate Reference Table [Internet]. 2021 [cited 2023 Aug 01]. Available from: https://www.epa.gov/sites/default/files/2021-05/documents/occupational-pesticide-handler-unit-exposure-surrogate-reference-table-may-2021.pdf
8. World Health Organization. WHO Generic Risk Assessment Models for Vector Control Products. [Internet]. [cited 2023 Aug 01]. Available from:https://extranet.who.int/pqweb/vector-control-products/who-generic-risk-assessment-models-vector-control-products
9. Guidance on the assessment of exposure of operators, workers, residents and bystanders in risk assessment of plant protection products [Internet]. EFSA Journal. 2022 [cited 2023 Aug 01];20(1). Available from: https://efsa.onlinelibrary.wiley.com/doi/epdf/10.2903/j.efsa.2022.7032 doi: https://doi.org/10.2903/j.efsa.2022.7032
10. Mandic-Rajcevic S, Rubino FM, Ariano E, Cot­tica D, Negri S, Colosio C. Exposure duration and absor­bed dose assessment in pesticide-exposed agricultural workers: Implications for risk assessment and modeling. Int J Hyg Environ Health. 2019;222(3):494-502. doi: https://doi.org/10.1016/j.ijheh.2019.01.006
11. Kongtip P, Tingsa T, Yoosook W, Chantanakul S. Health risk assessment and biomarkers of chlorpyrifos in rice farmers. J Health Res. 2009;23(1):23-9.
12. Kour G, Kothari R, Dhar S, Pathania D. Nanoma­terials and heavy metals: environmental risk assessment and remediation strategies for wastewater. In: Legacy and Emerging Contaminants in Water and Wastewater: Moni­toring, Risk Assessment and Remediation Techniques. Cham: Springer International Publishing; 2022. p. 21-46. doi: https://doi.org/10.1007/978-3-030-95443-7_2
13. Guryanov VG, Lyakh YuYe, Pariy VD, Korot­ky OV, Chaliy OV, Chaliy KO, et al. [Analysis of Medical Research Results using the EZR Package (R-statistics). Handbook of Biostatistics]. Kyiv: Vistka; 2018. 208 p. Ukrainian.
14. Diez DC, Getinkaya-Rundel M, Barr CD. Open­Intro Statistics. Fourth Edition. OpenIntro; 2019. 408 p.
15. EFSA (European Food Safety Authority). Con­clusion on the peer review of the pesticide risk assessment of the active substance imazamox. EFSA Journal. 2016;14(4):4432. doi: https://doi.org/10.2903/j.efsa.2016.4432
16. Syracuse Environmental Research Associates. Hu­man Health and Ecological Risk Assessment. Final report. Syracuse Environmental Research Associates, Inc.; 2011. 203 p.
17. Environmental Protection Authority. Science me­mo for application to import or manufacture Boxer Gold for release (APP203736). Environmental Protection Authority. SCIENCE MEMO; 2020. 255 р.
18. European Food Safety Authority. Conclusion on the peer review of the pesticide risk assessment of the active substance propisochlor. EFSA Journal. 2010;8(9):1769. doi: https://doi.org/10.2903/j.efsa.2010.1769
19. Cheminova Agro France S.A.S. DPX-LDY15 28.6SG (ALLIE MAX SX). Registration report. Part A. Risk Management. National assessment France (renewal of authorisation and label extension). National Assessment – Country – FRANCE; 2019. 40 р.
20. European Food Safety Authority. Conclusion on the peer review of the pesticide risk assessment of the active substance terbuthylazine. EFSA Journal. 2011;9(1):1969. doi: https://doi.org/10.2903/j.efsa.2011.1969

Look through:

Novokhatska O.O. Bogomolets National Medical University, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0003-1834-79532

Kondratiuk M.V. Bogomolets National Medical University, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0001-5500-6352

Grynzovskyi A.M. Bogomolets National Medical University, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-8391-5294

Pelo I.M. Bogomolets National Medical University, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-4764-102X

Babiienko V.V. Odesa National Medical University, Odessa, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-4597-9908

Novokhatska O.O., Kondratiuk M.V., Grynzovskyi A.M., Pelo I.M., Babiienko V.V. Hygienic assessment of occupational risk for workers during pre- and post-emergence herbicide treatments of sunflower crops. Medicni perspektivi. 2024;29(1):193-200. DOI: https://doi.org/10.26641/2307-0404.2024.1.301252

HET-CAM test in evaluation of irritating action of adhesives used in shoe making industry

The level of development of the country's health care system can be assessed in different ways, in particular by the level of pharmaceutical aid provision to the population. The quality of pharmaceutical aid for the population depends on many factors, including physical accessibility and the number of pharmacies located in a certain area. The aim of the work was to study the dynamics of changes in the physical accessibility of pharmaceutical aid provision for the population and changes in the number of pharmacies in Ukraine during 2017–2022. Annual reports of the State Service of Ukraine for medicinal products and drug control, regarding licensees in the field of economic activity in the production of medicines, wholesale and retail trade of medicinal products, circulation of drugs have been used for the analysis of dynamics. It was established that the pandemic of the coronavirus disease, which was caused by the SARS-CoV-2 (COVID-19) coronavirus, and the full-scale invasion of the Russian Federation had a significant impact on the development of the pharmaceutical market in Ukraine according to the results of the study. There is a general tendency to decrease the number of economic entities conducting their activities in the retail trade of medicines, while simultaneous increasing the places of activity, which may indicate the globalization of the pharmaceutical market. However, it can also cause a reduction in the quality of the competitive environment and limit the choice of pharmaceutical aid providers by patients. Thus, in the studied period, the number of economic entities decreased by more than 1,400. The number of pharmaceutical establishments engaged in the compounding of medicinal products also decreased significantly, by 23.5%. The total number of economic entities engaged in activities related to the circulation of narcotic drugs, psychotropic substances and precursors also decreased significantly, which definitely worsened the physical availability of this group of drugs.

Key words: pharmaceutical aid, physical accessibility, pharmacies, medicines compounding, pandemic, martial law

1. Tharumia JC, Wirtz VJ. Geographical accessi­bility of medicines: a systematic literature review of pharmacy mapping. J Pharm Policy Pract [Internet]. 2021 [cited 2023 Jun 06];14(1):28. doi: https://doi.org/10.1186/s40545-020-00291-7
2. Oliinyk RV, Chukhray IL, Oliinyk SR. [Pharma­ceutical provision of the population under martial law: analysis and prospects]. Farmatsevtychnyi chasopys. 2023;3:1-7.
   doi: https://doi.org/10.11603/2312-0967.2022.3.13468 
3. Svitovyi O. [Some aspects of the functioning of the pharmaceutical market of Ukraine]. Ekonomika ta sus­pilstvo [Internet]. 2023 [cited 2023 Jun 06];47. Ukrainian. doi: https://doi.org/10.32782/2524-0072/2023-47-80
4. Sallami Z, Kassim Y, Selvaraj J, Parry E, Win­ter G. Impact of the armed conflict of 2015-2016 in Aden on health services and the availability of medicines. Health[Internet]. 2017 [cited 2023 Jun 01];09(04):685-96. doi: https://doi.org/10.4236/health.2017.94049
5. Khanyk N, Hromovyk B, Levytska O, Agh T, Wet­termark B, Kardas P. The impact of the war on maintenance of long-term therapies in Ukraine. Front Pharmacol.2022 Nov 24;13:1024046. doi: https://doi.org/10.3389/fphar.2022.1024046
6. Disruption of access to medicines and medical de­vices in Ukraine: February–June 2022. World Health Organi­zation [Internet]. 2022[cited 2023 May 16]. Available from: https://www.who.int/europe/publications/i/item/WHO-EURO-2022-6873-46639-67795
7. Bellamy K, Ostini R, Martini N, Kairuz T. Access to medication and pharmacy services for resettled refugees: a systematic review. Aust J Prim Health [Internet]. 2015 [cited 2023 Jun 26];21(3):273. doi: https://doi.org/10.1071/PY14121
8. El Arnaout N, Rutherford S, Zreik T, Nabulsi D, Yassin N, Saleh S. Assessment of the health needs of Sy­rian refugees in Lebanon and Syria’s neighboring coun­tries. Confl 2019;13(1):31. doi: https://doi.org/10.1186/s13031-019-0211-3
9. Steenkamp C, Wazaify M. The impact of violent conflict on pharmacy practice in the Middle East. Popul Med.2023;5(Suppl):А1683. doi: https://doi.org/10.18332/popmed/165364
10. Alhamad H, Abu‐Farha RK, Albahar F, Jaber D. Pu­blic perceptions about pharmacists’ role in prescribing, pro­viding education and delivering medications during COVID‐19 pandemic era. Int J Clin Pract. 2021 Apr;75(4):e13890. doi: https://doi.org/10.1111/ijcp.13890
11. Farrell B, Tsuyuki RT. Pharmacists step up to the challenge of COVID-19. Can Pharm J Rev Pharm Can [Internet]. 2020 [cited 2023 Jun 05];153(4):185. doi: https://doi.org/10.1177/1715163520930705
12. Parkhurst C, Singh Purewal G, Donyai P. Com­munity pharmacy and COVID-19-the unsung heroes on our high streets. J Patient Exp [Internet]. 2020 [cited 2023 May 31];7(3):282-4. doi: https://doi.org/10.1177/2374373520927638
13. [Report on the results of the State Service of Ukraine for medicinal products and drug control in 2022]. [Internet]. 2023 [cited 2023 May 08]. Ukrainian. Available from: https://www.dls.gov.ua/wp-content/uploads/2023/02/%D0%9F%D1%83%D0%B1%D0%BB%D1%96%D1%87%D0%BD%D0%B8%D0%B9-%D0%B7%D0%B2%D1%96%D1%82-%D0%93%D0%BE%D0%BB%D0%BE%D0%B2%D0%B8-%D0%B7%D0%B0-2022.pdf
14. [Report on the results of the activities of the State Service of Ukraine for medicinal products and drug control in 2021]. [Internet]. 2022 [cited 2023 May 02]. Ukrainian. Available from: https://www.dls.gov.ua/wp-content/uploads/2023/02/%D0%9F%D1%83%D0%B1%D0%BB%D1%96%D1%87%D0%BD%D0%B8%D0%B9-%D0%B7%D0%B2%D1%96%D1%82-%D0%93%D0%BE%D0%BB%D0%BE%D0%B2%D0%B8-%D0%94%D0%B5%D1%80%D0%B6%D0%BB%D1%96%D0%BA%D1%81%D0%BB%D1%83%D0%B6%D0%B1%D0%B8-%D0%B7%D0%B0-2021.pdf
15. [Report on the results of the activities of the State Service of Ukraine for medicinal products and drug control in 2020]. [Internet]. 2021 [cited 2023 May 14]. Ukrainian. Available from: https://www.dls.gov.ua/for_subject/%D0%B7%D0%B2%D1%96%D1%82-%D0%BF%D1%80%D0%BE-%D0%BF%D1%96%D0%B4%D1%81%D1%83%D0%BC%D0%BA%D0%B8-%D0%B4%D1%96%D1%8F%D0%BB%D1%8C%D0%BD%D0%BE%D1%81%D1%82%D1%96-%D1%83-2020-%D1%80%D0%BE%D1%86%D1%96/
16. [Report on the results of the activities of the State Service of Ukraine for medicinal products and drug control in 2019]. [Internet]. 2020 [cited 2023 May 07]. Ukrainian. Available from: https://www.dls.gov.ua/wp-content/uploads/2020/02/%D0%97%D0%B2%D1%96%D1%82-%D0%B7%D0%B0-2019-%D1%84%D1%96%D0%BD%D0%B0%D0%BB-6.pdf
17. [Report on the results of the activities of the State Service of Ukraine for medicinal products and drug control in 2018]. [Internet]. 2019 [cited 2023 May 12]. Ukrainian. Available from: https://www.dls.gov.ua/activity_results/%D0%B7%D0%B2%D1%96%D1%82-%D0%BF%D1%80%D0%BE-%D0%BF%D1%96%D0%B4%D1%81%D1%83%D0%BC%D0%BA%D0%B8-%D0%B4%D1%96%D1%8F%D0%BB%D1%8C%D0%BD%D0%BE%D1%81%D1%82%D1%96-%D0%B4%D0%B5%D1%80%D0%B6%D0%B0%D0%B2%D0%BD/
18. [Report on the results of the activities of the State Service of Ukraine for medicinal products and drug control in 2017]. [Internet]. 2018 [cited 2023 May 12]. Ukrainian. Available from: https://www.dls.gov.ua/wp-content/uploads/2018/10/%D0%97%D0%B2%D1%96%D1%82.pdf
19. Hovorukha VB, Tkachova OK. [Mathematical methods and forecasting models in the field of foreign economic activity]. Pytannia prykladnoi matematyky i matematychnoho modeliuvannia [Internet]. 2017 [cited  2023 Jun 11];17:54-61. Ukrainian. Available from: https://pm-mm.dp.ua/index.php/pmmm/article/view/196
20. Nemchenko AS, Tsarova KO, Khomenko VM. [Analysis of the current state and problems of phar­maceutical drug manufacturing in Ukraine]. Farma­tsev­tychnyi chasopys [Internet]. 2020 [cited 2023 Jun 01];75(3):29-38. Ukrainian. Available from: https://pharmj.org.ua/index.php/journal/article/view/880
21. Compounding Pharmacies Industry in the US – Market Research Report [Internet]. 2022 [cited 2023 Jun 06]. Available from: https://www.ibisworld.com/united-states/market-research-reports/compounding-pharmacies-industry
22. Schwaabe S. The European pharmacy market: the density and its influencing factors. Eur J Public Health [In­ternet]. 2022 [cited 2023 Jun 04];32(Suppl 3): ckac131.027. doi: https://doi.org/10.1093/eurpub/ckac131.027

Look through:

Koval V.M. National Pirogov Memorial Medical University, Vinnytsia, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9324-209X

Kryvoviaz O.V. National Pirogov Memorial Medical University, Vinnytsia, Ukraine
https://orcid.org/0000-0001-5441-1903

Koval V.M., Kryvoviaz O.V. The analysis of dynamics of physical accessibility of pharmaceutical aid in Ukraine. Medicni perspektivi. 2024;29(1):201-206.
DOI: https://doi.org/10.26641/2307-0404.2024.1.301254

The Ukrainian war and the pandemic: the impact on public health and the need for new health digital tools and the next level of intelligence

Dirofilariasis is a helminthiasis that occurs in carnivorous animals (dogs, cats, foxes, wolves, etc.) and less often in humans, although according to some authors it is believed that the number of infected animals approximately corresponds to the number of infected people. Dirofilariasis of the maxillofacial area is not a widespread condition, its cases are described in short series, therefore, the aim of this work is to share our own experience of managing patients with this rare condition.The work presents our own experience in the management of 14 dirofilariasis patients with lesions of the maxillofacial area, of them there are 3 men and 11 women aged 29 to 54. Most patients sought help in the late autumn, winter and spring periods and only 2 people in the summer period. All patients were examined by a dentist, and an ultrasound examination of the area with a formation was performed. According to the clinical manifestations, the disease began acutely in nine patients and had a picture of inflamed atheroma (2 – in the zygomatic area, 1 – in the parotid, 2 – in the infraorbital area, 2 – in the temporal area, and 2 – in the area of the nasal bridge). All patients were operated on and tumor-like formations in dense membranes were removed, inside which one live nematode 11-18 cm long was found. In 3 observations, fragments of dead, partially lysed nematodes were removed from the oral cavity, the capsules of which imitated a migrating granuloma. According to the location – 5 capsules with dirofilaria were located in the subcutaneous fatty tissue, 3 – in the submucosal layer of the gums fused to the periosteum of the upper jaw, 1 – in the submucous layer of the lower jaw, 2 – in the fibers of the temporalis muscle and 1 – in the fibers of the buccal muscle. In each case, the localization of the nematode was close to the places of accumulation of adipose tissue or large blood vessels. In the postoperative period complex therapy was prescribed, including symptomatic anti-inflammatory and desensitizing agents, and consultation with infectionist was recommended. Thus, according to our observations, dirofilariasis most often affects areas of the face in which there are large vessels and accumulation of fatty tissue. In connection with the prevalence of dirofilariosis in humans and the predominant localization of parasitic infection in the face area, dentists, ophthalmologists and otolaryngologists need to be familiar with this pathology and show definite vigilance. Treatment dirofilariosis patients should be carried out comprehensively, together with parasitologists, with surgical excision of the lesion and appropriate drug therapy.

Key words: dirofilariasis, maxillofacial, helminthiasis, nematode

1. Bondarenko AV, Torianyk II, Pokhil SI, et al. Se­roprevalence of babesiosis in immunocompetent and immunocompromised individuals. Pol Merkur Lekarski. 2021;49(291):193-7.
2. Polyvianna Y, Chumachenko D, Chumachenko T. Computer aided system of time series analysis methods for forecasting the epidemics outbreaks. In: 2019 15th Inter­national Conference on the Experience of Designing and Application of CAD Systems, CADSM; Polyana (Sva­lyava); Feb 26 – Mar 2, 2019. Lviv; 2019. р. 1-4. doi: https://doi.org/10.1109/CADSM.2019.8779344
3. Riebenbauer K, Weber PB, Walochnik J, et al. Human dirofilariosis in Austria: the past, the present, the future.Parasit  2021;14(1):227. doi: https://doi.org/10.1186/s13071-021-04696-4
4. Miterpáková M, Antolová D, Ondriska F, Gál V. Human Dirofilariarepens infections diagnosed in Slovakia in the last 10 years (2007-2017). Wien Klin Wochenschr. 2017;129(17-18):634-41. doi: https://doi.org/10.1007/s00508-017-1233-8
5. Jyotsna AS, Vinayan KP, Biswas L, et al. Eosi­nophilic Meningitis and Intraocular Infection Caused by Dirofilaria sp. Genotype Hongkong. Emerg Infect Dis. 2021;27(5):1532-4. doi: https://doi.org/10.3201/eid2705.203599
6. Chaudhry K, Khatana S, Dutt N, Mittal Y, Shai­lja Sharma, Elhence P. Systematic Review of Lesser Known Parasitoses: Maxillofacial Dirofilariasis. J Maxil­lofacOral  2019;18(2):180-9. doi: https://doi.org/10.1007/s12663-018-1139-7
7. Ondriska F, Boldiš V, Stanislavová M, et al. Ocu­lar Dirofilariasis after Clinically Manifested Subcutaneous Migration of the Parasite: A Case Report. Iran J Parasitol. 2020;15(1):147-52. doi: https://doi.org/10.18502/ijpa.v15i1.2539
8. To KK, Wong SS, Poon RW, et al. A novel Diro­filaria species causing human and canine infections in Hong Kong. J Clin Microbiol. 2012;50(11):3534-41. doi: https://doi.org/10.1128/JCM.01590-12
9. Mistry MA, Hoejvig J, Helleberg M, et al. Human subcutaneous dirofilariasis: the 'migrating' skin tumor. Case Reports Plast Surg Hand Surg. 2021;8(1):181-5. doi: https://doi.org/10.1080/23320885.2021.2002154
10. Gargin V, Radutny R, Titova G, Bibik D, Kiri­chenko A, Bazhenov O. Application of the computer vi­sion system for evaluation of pathomorphological images. In: 2020 IEEE 40th International Conference on Elec­tronics and Nanotechnology, ELNANO 2020 – Pro­ceedings; 2020 Apr 22-24; Kyiv, Ukraine. IEEE; 2020. р. 469-73. doi: https://doi.org/10.1109/ELNANO50318.2020.9088898
11. Fesenko D, Glazunov O, Nakonechna O, et al.Consequences of microsequences of microcirculatory distrurbances of oral mucosa in modeling of rheumatoid arthritis. Georgian Med News. 2019;(295):137-40.
12. Denga O, Pyndus T, Gargin V, Schneider S. In­fluen­ce of metabolic syndrome on condition of micro­circulatory bed of oral cavity. Georgian Med News. 2017;(273):99-104.
13. Nechyporenko AS, Alekseeva VV, Sychova LV, et al. Anatomical prerequisites for the development of rhinosinusitis. Lek Obz. 2020;6(10):334-38.
14. Alekseeva V, Nechyporenko A, Frohme M, et al. Intelligent Decision Support System for Differential Diagnosis of Chronic Odontogenic Rhinosinusitis Based on U-Net Segmentation. Electronics. 2023;12(5):1202. doi: https://doi.org/10.3390/electronics12051202
15. Tilakaratne WM, Pitakotuwage TN. Intra-oral Dirofilariarepens infection: report of seven cases. J Oral Pathol 2003;32(8):502-5. doi: https://doi.org/10.1034/j.1600-0714.2003.00183.x
16. Nazaryan R, Kryvenko L, Zakut Y, et Applica­tion of estimated oral health indices in adolescents with tobacco addiction. Pol Merkur Lekarski. 2020;48(287):327-30.
17. Nechyporenko AS, Nazaryan RS, Semko GO, Lu­pyr AV, Yurevych NО, Fomenko YV, et al. Application of spiral computed tomography for determination of the minimal bone density variability of the maxillary sinus walls in chronic odontogenic and rhinogenic sinusitis. UkrJ Radiol  2021;29(4):65-75. doi: https://doi.org/10.46879/ukroj.4.2021.65-75
18. Nechyporenko AS, Radutny R, Alekseeva VV, et al. Complex Automatic Determination of Morphological Parameters for Bone Tissue in Human Paranasal Sinuses. OpenBioinformatics  2021;14(1):130-7. doi: https://doi.org/10.2174/18750362021140100130
19. Romaniuk A, Sikora V, Lуndіna Yu, et al. Effect of heavy metals on the readaptive processes in the urinary bladder. Bangladesh Journal of Medical Science. 2019;18(1):100-6. doi: https://doi.org/10.3329/bjms.v18i1.39558
20. Kon K, Rai M. Antibiotic Resistance: Mechanisms and New Antimicrobial Approaches. Academic Press is an imprint of Elsevier; 2016. 413 р.
21. Sikora V, Lуndіn M, Hyriavenko N, et al. Mor­pho­logical peculiarities of parasitic (Trichosomo­ides­cras­sicauda) infection in rat urinary bladder. MacVet Rev. 2021;44(2):159-67. doi: https://doi:10.2478/macvetrev-2021-0019
22. Morgese MG, Bove M, Di Cesare Mannelli L, et al. Precision Medicine in Alzheimer's Disease: Inves­tigating Comorbid Common Biological Substrates in the Rat Model of Amyloid Beta-Induced Toxicity. Front Pharmacol.2022 Jan 3;12:799561. doi: https://doi:10.3389/fphar.2021.799561 
23. Tucci P, Bove M, Sikora V, et al. Glucoraphanin Triggers Rapid Antidepressant Responses in a Rat Model of Beta Amyloid-Induced Depressive-like Behaviour. Pharmaceuticals (Basel). 2022 Aug 26;15(9):1054. doi: https://doi:10.3390/ph15091054
24. Bove M, Schiavone S, Tucci P, et al. Ketamine ad­ministration in early postnatal life as a tool for mimicking Autism Spectrum Disorders core symptoms. Prog Neuro­psychopharmacol Biol Psychiatry. 2022 Jul 13;117:110560. doi: https://doi:10.1016/j.pnpbp.2022.110560
25. Bove M, Tucci P, Dimonte S, et al. Postnatal Anti­oxidant and Anti-inflammatory Treatments Prevent Early Ketamine-Induced Cortical Dysfunctions in Adult Mice. Front 2020 Nov 4;14:590088. doi: https://doi:10.3389/fnins.2020.590088
26. Sałamatin RV, Pavlikovska TM, Sagach OS, et al. Human dirofilariasis due to Dirofilariarepens in Ukraine, an emergent zoonosis: epidemiological report of 1465 cases.Acta  2013 Dec;58(4):592-8. doi: https://doi:10.2478/s11686-013-0187-x  
27. Shepherd L, Borges Á, Ledergerber B, et al. In­fection-related and -unrelated malignancies, HIV and the aging population. HIV Med. 2016 Sep;17(8):590-600. doi: https://doi:10.1111/hiv.12359
28. European Society of Diroflariosis and Angio­strongylosis (ESDA). Guidelines for clinical management of canine heartworm disease [Internet]. EV/ESDA; 2017 [cited 2023 Mar 19]. Available from: https://www.esda.vet/wp-  content/uploads/2017/11/GUIDELINES-FOR-CLINICAL-MANAGEMENT-OF-CANINE-HEARTWORM-DISEASE.pdf  

Look through:

Buniatian Kh.A. Dnipro State Medical University, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-7957-9067

Khotimska Yu.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-0161-1191

Kovach I.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-5887-4136

Yaroslavska Yu.Yu. Kharkiv National Medical University, Kharkiv, Ukraine
https://orcid.org/0000-0002-9710-2331

Bondarenko O.V. Kharkiv International Medical University, Kharkiv, Ukraine
https://orcid.org/0000-0003-1755-925X

Nazaryan R.S. Kharkiv National Medical University, Kharkiv, Ukraine
https://orcid.org/0000-0002-0005-8777

Buniatian Kh.A., Khotimska Yu.V., Kovach I.V., Yaroslavska Yu.Yu., Bondarenko O.V., Nazaryan R.S. Peculiarities of the clinical picture and diagnosis of dirofilariasis in the maxillofacial area: a series of cases from practice. Medicni perspektivi. 2024;29(1):207-213. DOI: https://doi.org/10.26641/2307-0404.2024.1.301274

Lymphoadenopathies caused by Bartonella henselae

The article presents a clinical case of the abscessing perifolliculitis of the head. Nowadays due to socio-economic circumstances, there is an increase in the number of patients with abscessing perifolliculitis of the head. Among the triggering factors are emergency conditions associated with chronic stress, poor hygiene, and the need to use special clothing and head protection in military personnel, which cause initial occlusion in the scalp area. Treatment is usually difficult and often unsuccessful, with regular relapses after treatment is stopped. However, the issues of diagnosing abscessing perifolliculitis of the head remain relevant and extremely difficult in the clinical practice of dermatologists and related specialists, and a single treatment protocol with clear recommendations has not yet been developed. All of the above determines the need to study the specifics of clinical and morphological manifestations in patients suffering from abscessing perifolliculitis of the head with the further aim of pathogenetic substantiation and development of complex therapy. The article aimed to improve the diagnosis and treatment of the abscessing perifolliculitis of the head by studying the clinical and anamnestic features and the course of the disease on the example of a clinical case with further implementation of recommendations in clinical practice.

Key words: perifolliculitis capitis, dissecting cellulitis of the scalp, Hoffman’s disease, perifolliculitis capitis abscedens et suffodiens, cicatricial changes of the scalp

1. Wu Q, Bu W, Zhang Q, Fang F. Therapeutic options for perifolliculitis capitis abscedens et suffodens: A review. Dermatol Ther. 2022;35(10):e15763. doi: https://doi.org/10.1111/dth.15763
2. Su Y, Xu Q, Zhang C, Zhang C. Photodynamic the­rapy pre-treated by fire needle combined with isotre­tinoin in the treatment of refractory perifolliculitis capitis abscedens et suffodiens: Case report. Photodiagnosis Photodyn 2021;33:102103. doi: https://10.1016/j.pdpdt.2020.102103
3. Rallis E, Verros C, Katoulis A. Perifolliculitis Ca­pitis Abscedens et Suffodiens Treated with Systemic Isotretinoin Monotherapy: Case Report and Review of Current Therapeutic Options. Acta Dermatovenerologica Croatica. 2022;30(4):256-60.
4. Thomas J, Aguh C. Approach to treatment of ref­ractory dissecting cellulitis of the scalp: a systematic review. J Dermatolog. Treat. 2021:32(2):144-9. doi: https://10.1080/09546634.2019.1642441
5. Karpouzis A, Giatromanolaki A, Sivridis E, et al. Perifolliculitis capitis abscedens et suffodiens successfully controlled with topical isotretinoin. Eur J Dermatol. 2003;13(2):192-5. doi: https://10.1001/archdermatol.2010.16
6. Díaz-Pérez LM, Escobar-Ramírez K, Sánchez-Dueñas LE. A new familial presentation of dis­secting cellulitis: The genetic implications on scarring alopecias. JAAD Case Rep. 2020;1;6(8):705-7. doi: https://10.1016/j.jdcr.2020.05.027
7. Guo W, Zhu C, Stevens G, et al. Analyzing the Efficacy of Isotretinoin in Treating Dissecting Cellulitis: A Literature Review and Meta-Analysis. Drugs R D. 2021;21(1):29-37. doi: https://10.1007/s40268-020-00335-y
8. von Laffert M, Helmbold P, Wohlrab J, et al. Hid­radenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis. Exp 2010;19:533-7. doi: https://doi.org/10.1111/j.1600-0625.2009.00915.x
9. Werth von der JM, Jemec GB. Morbidity in pa­tients with hidradenitis suppurativa. Br J Dermatol. 2001;144:809-13. doi: https://doi.org/10.10 46/j.1365-2133.2001.0 4137.x
10. Cuellar TA, Roh DS, Sampson CE. Dissecting Cellulitis of the Scalp: A Review and Case Studies of Surgical Reconstruction. Plast Reconstr Surg Glob Open. 2020;18;8(8):e3015. doi: https://doi.org/10.1097/GOX.0000000000003015
11. Jemec GBE. The concept of ‘smoker’s boils’ is suggestive of a new hypothesis on the pathogenesis of hidradenitis suppurativa. Dermatology. 2011;222:196-7. doi: https://doi.org/10.1159/000327928
12. Tammaro A, Caro G, Parisella FR, et al. Acne ke­loidalis nuchae in a Caucasian young man. G Ital Dermatol Venereol.2019;154(3):360-1. doi: https://10.23736/S0392-0488.17.05734-0
13. von Laffert M, Helmbold P, Wohlrab J, et al. Hidradenitis suppurativa (acne inversa): early inflam­matory events at terminal follicles and at interfollicular epidermis. Exp  2010;19:533-7. doi: https://10.1111/j.1600-0625.2009.00915.x
14. Constantinou A, Kanti V, Polak-Witka K, et al. The Potential Relevance of the Microbiome to Hair Phy­siology and Regeneration: The Emerging Role of Meta­genomics. Biomedicines. 2021;9:236. doi: https://doi.org/10.3390/biomedicines9030236
15. Polishchuk DS, Polishchuk SY, Bondar SA. [Op­timization of the complex treatment of patients with abscessing undermining folliculitis and Hoffman's peri­folliculitis]. Ukrainskyi zhurnal dermatolohii, venerolohii, kosmetolohii. 2010;4(39):63-6. Ukrainian.
16. Fanti PA, Baraldi C, Misciali C, et al.  Cicatricial alopecia. Giornale Italiano di Dermatologia e Venereolo­gia: Organo Ufficiale, Societa Italiana di Dermatologia e Sifilografia. 2018;153(2):230-42. doi: https://10.23736/S0392-0488.18.05889-3
17. Sjerobabski Masnec I, Franceschi N. Perifol­liculitis capitis abscedens et suffodiens treated with anti-tumor necrosis factor-alpha–Possible new treatment option. Acta Dermatovenerologica Croatica. 2018;26(3):255-88.
18. Takahashi T, Yamasaki K, Terui H, et al. Perifol­liculitis capitis abscedens et suffodiens treatment with tumor necrosis factor inhibitors: a case report and review of published cases. The Journal of Dermatology. 2019;46(9):802-7. doi: https://10.1111/1346-8138.14998
19. Ring HC, Emtestam L. The Microbiology of Hid­radenitis Suppurativa. Dermatol Clin. 2016 Jan;34(1):29-35. doi: https://10.1016/j.det.2015.08.010

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Statkevych O.L. Medical center of the private enterprise "Dzerkalo"; Dnipro State Medical University, Dnipro, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2324-998X

Svyatenko T.V. Medical center of the private enterprise "Dzerkalo"; Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-4303-2937

Statkevych O.L., Svyatenko T.V. Perifolliculitis capitis abscedens et suffodiens: features of diagnostics and approaches to treatment. Medicni perspektivi. 2024;29(1):213-222.
DOI: https://doi.org/10.26641/2307-0404.2024.1.301275

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