Mental health is a fundamental right of every person and an integral part of health. Its condition is influenced by socio-economic factors that need to be considered in comprehensive strategies for strengthening mental health, prevention of mental disorders, treatment and recovery using a whole-of-government approach. The purpose of our work was to study the dynamics of the term “mental health” use in publications available in electronic scientometric databases, in particular PubMed and Google Scholar, and to analyse such kind of works appearance after significant social events. To achieve the goal of the research we used key words “mental health”, “mental health natural disaster”, “mental health armed conflicts”, “mental health general practitioner” for scientific publications search in the scientometric medical database PubMed and key word “mental health” (in Ukrainian) in Google Scholar database. We analyzed the dynamics of publications from the moment of their first appearance until today in English and Ukrainian with search filters “systematic review” and “systematic review”. The package of statistical functions of Microsoft Excel for Microsoft 365 was used to analyse trends. For the term «mental health» in PubMed database we got more than five hundred thousand results, of which nineteen thousand publications were systematic reviews. Under the influence of natural disasters and military operations, the mental health of many people is deteriorating. In Ukraine due to military operations the entire population is at risk of mental health disorders which requires urgent responses of governmental and non-governmental organizations and creates additional challenges for public health. So, in the available scientific publications an annual increase in the number of publications by search query, “mental health” has been established. After significant social events (natural disasters, military conflicts), numerous publications highlighting the impact of the event on the mental health of the affected population appear.

Key words: mental health, public health, PubMed, systematic review

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Burak O.L. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, 
e-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-1332-2127

Fedorkiv N.B. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
https://orcid.org/0000-0002-0987-0286

Karpinets I.M. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
https://orcid.org/0000-0002-5030-1667

Kovalchuk R.Y. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
 https://orcid.org/0000-0001-9826-9312

Chaplynska N.V. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
https://orcid.org/0000-0002-5008-7453

Burak O.L., Fedorkiv N.B., Karpinets I.M., Kovalchuk R.Y., Chaplynska N.V. Mental health is an integral component of public health in the modern world: the dynamics of the term use in scientific publications. Medicni perspektivi. 2025;30(1):4-11.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325226

Influence of substituted quinones on the excretory function of the rat kidney and evaluation of the prospects of their use as potential diuretics

Multiple studies have focused on the genetic basis of stroke, in particular on single nucleotide polymorphisms. However, the contribution of single nucleotide polymorphism rs17216473 in the gene that encodes ALOX5AP to stroke has been researched too little. The purpose of the work is to study the association between the risk of ischemic stroke and the single nucleotide polymorphism rs17216473 of the gene that encodes ALOX5AP, in particular, the G/G and G/A genotypes and alleles A and G, within the Ukrainian population. DNA extracted from leukocytes of venous blood of healthy donors (control group) and patients (stroke group) was studied. The control group consisted of 110 people, including 60 men (54.5%) and 50 women (45.5%), the average age in the group was 58.8±6.2 years, mode (Mo) by group was equal to 64 years. The absence of cardiovascular pathology in the donors was confirmed by anamnesis, electrocardiography and pressure measurement. The stroke group included 109 patients, 58 men (53.2%) and 51 women (46.8%), suffering from an acute violation of cerebral blood circulation (acute ischemic stroke). The focus of brain infarction was localized in the basin of the left middle cerebral artery in 51 patients (46.8%), in the basin of the right middle cerebral artery in 39 (35.8%), in the vertebral-basilar basin in 18 (16.5%) and in the basin of the left anterior cerebral artery in 1 patient (0.9%). 21 of these patients also have a history of ischemic stroke, 15 (13.8%) of them in the same basin and 6 (5.5%) in another vascular basin. The average age of patients at the time of brain infarction was 70.3±10.0 years, mode (Mo) by group was equal to 60 years. In the context of the study of the role of single nucleotide polymorphisms in the occurrence of stroke, the contingent of patients by age and localization of the focus of brain infarction is considered as homogeneous. Healthy donors and stroke patients belonged to the older age group, they are residents of Kyiv, the percentage of men and women in the indicated groups was almost the same, therefore, according to socio-demographic indicators, the group of stroke patients and the control group can be considered homogeneous. Taking into consideration the average age and mode (Mo) in the groups (58.8±6.2 years, Mo was 64 years in the control group and 70.3±10.0 years, Mo was equal to 60 years in the stroke group), the groups are statistically comparable in age. All women in both groups are postmenopausal. Real-time polymerase chain reaction and the analysis to discriminate alleles were used. The statistical analysis was performed using χ2 criteria and by χ2 criteria with Yates correction. We identified two genotypes, G/G and G/A, of the single nucleotide polymorphism rs17216473 of the gene that encodes ALOX5AP. Humans that were homozygotes for the minor allele A (carrying the A/A genotype) were not found in our study. Genotype G/G was the most prevalent in both the control and stroke groups, without significant difference between these groups. The carries of the G/A genotype were not as significantly represented as those of the G/G genotype. Simultaneously, there was no significant difference in the quantity of G/A genotype carries between the control and stroke groups. The distribution of the G allele was not significantly different between the control and stroke groups. The same trend was observed for allele A; its number in the control group was almost identical to that in the stroke group, Neither the G/G nor G/A genotypes were significantly associated with ischemic stroke risk (p>0.05). Neither allele (dominant allele G or minor allele A) of single nucleotide polymorphism rs17216473 were significantly associated with ischemic stroke risk in the Ukrainian population (p>0.05). No contribution of single nucleotide polymorphism rs17216473 (SG13S377) in the gene encoding ALOX5AP to ischemic stroke onset was observed in a Ukrainian population.

Key words: single nucleotide polymorphism, genetics, ischemic stroke, ALOX5AP  

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24. Gretarsdottir S, Thorleifsson G, Reynisdottir ST, Manolescu A, Jonsdottir S, Jonsdottir T, et al. The gene encoding phosphodiesterase 4D confers risk of ischemic stroke. Nat 2003 Oct;35(2):131-8. doi: https://doi.org/10.1038/ng1245 
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Look through:

Pavlenko O.Yu. O.O. Bogomolets Institute of Physiology of the National Academy of Sciences of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0002-4253-1120

Strokina I.G. 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/0000-0002-3873-1111

Drevytska T.I. O.O. Bogomolets Institute of Physiology of the National Academy of Sciences of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0002-3192-4682

Karvatsky I.M. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-3117-309X

Sokurenko L.M. Bogomolets National Medical University, Kyiv, Ukraine; Laboratory of Engineering, Informatics and Imaging (ICube), Integrative multimodal imaging in healthcare (IMIS), CNRS, UMR 7357, University of Strasbourg, Strasbourg, France
https://orcid.org/0000-0002-4152-0032

Dosenko V.E. O.O. Bogomolets Institute of Physiology of the National Academy of Sciences of Ukraine, Kyiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-6919-7724

Pavlenko O.Yu., Strokina I.G., Drevytska T.I., Karvatsky I.M., Sokurenko L.M., Dosenko V.E. Association between risk of ischemic stroke and the rs17216473 single nucleotide polymorphism in the 5-lipoxygenase-activating protein gene locus. Medicni perspektivi. 2025;30(1):12-21.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325230

Analyses of electromagnetic effects as colors of the vision analyzer

Acute heat injury (AHI) occurs due to exposure to high environmental temperatures and is considered a dangerous condition that requires effective prevention and treatment. This underscores the importance of searching for and thoroughly studying thermoprotective agents. Previous studies on a rat model of AHI have shown that the highly selective cyclooxygenase-2 (COX-2) inhibitor celecoxib and the analgesic-antipyretic paracetamol effectively prevent hyperthermia, but celecoxib, unlike paracetamol, improves the functional state of the central nervous system during the recovery period. Since AHI induces blood coagulation disturbances, it is important to determine the effects of these thermoprotective agents on hemostasis. The aim of this study was to investigate the effects of paracetamol and celecoxib as effective thermoprotectors on coagulation parameters during the acute phase of heat trauma in rats. The AHI model was reproduced оn adult white male rats through a 30-minute exposure to +55°C. The animals were divided into four groups of 7-8 rats each: intact control, pathological control, celecoxib group (8.4 mg/kg intragastrically 50-60 minutes before heat exposure), and paracetamol group (125 mg/kg in the same regimen). Rectal temperature was monitored, and in rat plasma, fibrinogen, prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) were determined, while D-dimer was measured in serum. The results showed that during the acute phase of AHI in the pathological control group, when body temperature increased by an average of 4.33±0.33°C (p<0.01 compared to baseline), fibrinogen, PT, TT, and APTT levels remained unchanged, but the D-dimer level in serum increased by 2.2 times, indicating enhanced thrombogenesis. Both celecoxib and paracetamol exhibited a statistically significant thermoprotective effect (temperature rise of 3.16±0.40°C and 3.21±0.12°C, respectively, p<0.01 compared to untreated animals), had no effect on fibrinogen, PT, TT, or APTT levels, but normalized the D-dimer level, indicating an antithrombotic effect. The results justify the use of COX inhibitors, particularly celecoxib, in AHI.

Key words: acute heat injury, cyclooxygenase inhibitors, celecoxib, paracetamol, blood coagulation

1. Bauman J, Spano S, Storkan M. Heat-Related Illnesses. Emerg Med Clin North Am. 2024 Aug;42(3):485-92. doi: https://doi.org/10.1016/j.emc.2024.02.010
2. Stillman JH. Heat Waves, the New Normal: Summertime Temperature Extremes Will Impact Animals, Ecosystems, and Human Communities. Physiology (Bethesda).2019 Mar 1;34(2):86-100. doi: https://doi.org/10.1152/physiol.00040.2018
3. Périard JD, DeGroot D, Jay O. Exertional heat stroke in sport and the military: epidemiology and mitigation. Exp Physiol. 2022 Oct;107(10):1111-21. doi: https://doi.org/10.1113/EP090686
4. Zhao Q, Guo Y, Ye T, Gasparrini A, et al. Global, regional, and national burden of mortality associated with non-optimal ambient temperatures from 2000 to 2019: a three-stage modelling study. Lancet Planet Health. 2021 Jul;5(7):e415-e425. doi: https://doi.org/10.1016/S2542-5196(21)00081-4
5. Garcia CK, Renteria LI, Leite-Santos G, Leon LR, Laitano O. Exertional heat stroke: pathophysiology and risk factors. BMJ Med. 2022 Oct 11;1(1):e000239. doi: https://doi.org/10.1136/bmjmed-2022-000239
6. Knapik JJ, Epstein Y. Exertional Heat Stroke: Pathophysiology, Epidemiology, Diagnosis, Treatment, and Prevention. J Spec Oper Med. 2019;19(2):108-16. doi: https://doi.org/10.55460/5P2Q-1MBQ
7. Chuykova P, Shtrygol’ S, Taran A, Yudkevych T, Lebedinets I, Oklei D. Acute heat trauma model in rats, gender-dependent thermoresistance, and screening of potential thermoprotectors. ScienceRise: Pharmaceutical Science.2024 Apr;2 (48):4-11. doi: https://doi.org/10.15587/2519-4852.2024.301620
8. Chuikova P, Shtrygol’ S. Effect of celecoxib and paracetamol on the functional state of the central nervous system, pain sensitivity, and physical endurance of rats with acute heat injury. Med perspekt. 2024 Oct 16;29(3):11-9. doi: https://doi.org/10.26641/2307-0404.2024.3.313072
9. Bishara AJ, Li J, Conley C. Informal versus formal judgment of statistical models: The case of normality assumptions. Psychon Bull Rev. 2021 Aug;28(4):1164-82. doi: https://doi.org/10.3758/s13423-021-01879-z
10. Iba T, Helms J, Levi M, Levy JH. Inflammation, coagulation, and cellular injury in heat-induced shock. Inflamm 2023 Mar;72(3):463-73. doi: https://doi.org/10.1007/s00011-022-01687-8
11. Adelborg K, Larsen JB, Hvas AM. Disseminated intravascular coagulation: epidemiology, biomarkers, and management. Br J Haematol. 2021 Mar;192(5):803-18. doi: https://doi.org/10.1111/bjh.17172
12. Chung J, Afraz S, Germini F, Stevic I, Matino D, Chan AKC. Heterogeneity in the reported values and methodologies for detecting plasma D-Dimer in rat models: A systematic review. 2023 May;11:e100133. doi: https://doi.org/10.1016/j.tru.2023.100133
13. Di Nisio M, Squizzato A, Rutjes AWS, Buller HR, Zwinderman AH, Bossuyt PMM. Diagnostic accuracy of D-dimer test for exclusion of venous thromboembolism: a systematic review. J Thromb Haemost. 2007;5(2):296-304. doi: https://doi.org/10.1111/j.1538-7836.2007.02328.x
14. Iba T, Connors JM, Levi M, Levy JH. Heat­stroke-in­du­ced coagulopathy: Biomarkers, mechanistic insights, and patient management. eClinicalMedicine. 2022 Jan 22;44:101276. doi: https://doi.org/10.1016/j.eclinm.2022.101276
15. Kang DO, An H, Park GU, Yum Y, et al. Cardio­vascular and Bleeding Risks Associated With Nonsteroidal Anti-Inflammatory Drugs After Myocardial Infarction. J Am Coll Cardiol. 2020 Aug 4;76(5):518-29. doi: https://doi.org/10.1016/j.jacc.2020.06.017
16. Teerawattananon C, Tantayakom P, Suwana­wiboon B, Katchamart W. Risk of perioperative bleeding related to highly selective cyclooxygenase-2 inhibitors: A systematic review and meta-analysis. Semin Arthritis Rheum. 2017 Feb;46(4):520-8. doi: https://doi.org/10.1016/j.semarthrit.2016.07.008
17. Chung L, Chakravarty EF, Kearns P, Wang C, Bush TM. Bleeding complications in patients on celecoxib and warfarin. Journal of Clinical Pharmacy and Thera­peutics. 2005 Sep;30(5):471-7. doi: https://doi.org/10.1111/j.1365-2710.2005.00676.x
18. Chan AL. Celecoxib-induced deep-vein throm­bosis. Ann Pharmacother. 2005 Jun;39(6):1138. doi: https://doi.org/10.1345/aph.1E603
19. Goy J, Paikin J, Crowther M. Rofecoxib does not appear to increase the risk of venous thromboembolism: a systematic review of the literature. Thromb Res. 2014 Nov;134(5):997-1003. doi: https://doi.org/10.1016/j.thromres.2014.08.030
20. Leach T, Huang B, Kramer N, Challa S, Win­der RP. A Review of Platelet-Rich Plasma Use in Patients Taking Non-steroidal Anti-inflammatory Drugs for Guideline Development. Cureus. 2024;16(10):e71706. doi: https://doi.org/10.7759/cureus.71706
21. Martini AK, Rodriguez CM, Cap AP, Marti­ni WZ, Dubick MA. Acetaminophen and meloxicam inhibit platelet aggregation and coagulation in blood samples from humans. Blood Coagul Fibrinolysis. 2014 Dec;25(8):831-7. doi: https://doi.org/10.1097/MBC.0000000000000162
22. Groeneveld DJ, Poole LG, Bouck EG, Schulte A, et al. Robust coagulation activation and coagulopathy in mice with experimental acetaminophen-induced liver failure. J Thromb Haemost. 2023 Sep;21(9):2430-40. doi: https://doi.org/10.1016/j.jtha.2023.03.040

Look through:

Chuikova P.O. National University of Pharmacy, Kharkiv, Ukraine
https://orcid.org/0000-0002-9622-1566

Shtrygol’ S.Yu. National University of Pharmacy, Kharkiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-7257-9048

Lebedinets I.O. National University of Pharmacy, Kharkiv, Ukraine
https://orcid.org/0000-0001-6901-0045

Lytkin D.V. National University of Pharmacy, Kharkiv, Ukraine
https://orcid.org/0000-0002-4173-3046

Chuikova P.O., Shtrygol’ S.Yu., Lebedinets I.O., Lytkin D.V. Effect of paracetamol and celecoxib on the state of hemocoagulation in the most acute period of heat injury in rats. Medicni perspektivi. 2025;30(1):22-28. 
DOI: https://doi.org/10.26641/2307-0404.2025.1.325234

Characteristics of base materials and acrylates used in removable prosthetics in dental practice (review)

The study of prognostic biomarkers is crucial for personalising and enhancing the effectiveness of oropharyngeal cancer treatment, as they help identify patients with aggressive disease progression and determine the optimal patient management strategy. Purpose: Analysis of the effectiveness of the use of biomarkers in the context of human papillomavirus status for predicting oncological events, functional outcomes to optimise treatment approaches for patients with advanced oropharyngeal cancer. The study examined the results of examination and treatment of 120 patients aged 37 to 80 years, of both sexes diagnosed with stage III-IV oropharyngeal cancer (T_3-4N_0-3M_0-1). The clinical and morphological characteristics and the outcomes of histo­logical and immunohistochemical analyses of biopsy and surgical samples were assessed. Human papillomavirus (HPV) status was determined using immunohistochemistry for the p16 oncoprotein. Statistical analysis was performed using R Commander (https://www.r-project.org/) and MedCalc Statistical Software trial version 22.030 (https://www.medcalc.org/), applying descriptive and analytical statistics, rank correlation, logistic regression, and receiver operating characteristic (ROC) analysis. In late stages of oropharyngeal cancer, increased expression of Cyclin D1 and epidermal growth factor receptor (EGFR) was significantly more common in HPV-negative cases compared to HPV-positive ones (p<0.05). HPV-negative tumours were associated with homozygous deletion cyclin dependent kinase inhibitor 2a gene (CDKN2A). The identification of biomarkers as prognostic criteria for different HPV statuses confirms their role in choosing a treatment strategy. Biomarkers like Ki-67 and homozygous deletion of CDKN2A were prognostic for metastasis, while Ki-67 and Cyclin D1 were linked to recurrence. EGFR showed the highest prognostic accuracy for predicting masticatory muscle trismus. Increased expression of Cyclin D1 and Ki-67 in late stages of oropharyngeal neoplasms correlated with combined treatment, increasing the odds by 4.42 times and 25%, respectively (p<0.05). Evaluation of biomarkers such as p16, EGFR, Cyclin D1, and Ki-67 provides essential information into disease prognosis and response to treatment, enabling risk stratification, tailored treatment planning, and the development of personalized strategies for managing advanced oropharyngeal cancer.

Key words: oncology, oropharyngeal cancer, squamous cell carcinoma, human papillomavirus status, immunohistochemical study, biomarkers, epidermal growth factor receptor, Cyclin D1, Ki-67, cyclin dependent kinase inhibitor 2a gene, prognosis, treatment

1. Zumsteg ZS, Luu M, Rosenberg PS, Elrod JK, Bray F, Vaccarella S, et al. Global epidemiologic patterns of oropharyngeal cancer incidence trends. J Natl Cancer Inst.2023 Dec 6;115(12):1544-54. doi: https://doi.org/10.1093/jnci/djad169
2. Barsouk A, Aluru JS, Rawla P, Saginala K, Bar­souk A. Epidemiology, Risk Factors, and Prevention of Head and Neck Squamous Cell Carcinoma. Med Sci (Basel).2023 Jun 13;11(2):42. doi: https://doi.org/10.3390/medsci11020042
3. Bray F, Laversanne M, Sung H, Ferlay J, Sie­gel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin.2024 May-Jun;74(3):229-63. doi: https://doi.org/10.3322/caac.21834
4. Huang J, Chan SC, Ko S, Lok V, Zhang L, Lin X, et al. Disease burden, risk factors, and trends of lip, oral cavity, pharyngeal cancers: A global analysis. Cancer Med. 2023 Sep;12(17):18153-64. doi: https://doi.org/10.1002/cam4.6391
5. Fonsêca TC, Jural LA, Marañón-Vásquez GA, Mag­no MB, Roza ALOC, Ferreira DMTP, et al. Global pre­valence of human papillomavirus-related oral and oro­pharyngeal squamous cell carcinomas: a systematic review and meta-analysis. Clin Oral Investig. 2023;28(1):62. doi: https://doi.org/10.1007/s00784-023-05425-0
6. Lingen MW, Abt E, Agrawal N, Chaturvedi AK, Cohen E, D'Souza G, et al. Evidence-based clinical prac­tice guideline for the evaluation of potentially malignant disorders in the oral cavity: A report of the American Dental Association. J Am Dent Assoc. 2017 Oct;148(10):712-727.e10. doi: https://doi.org/10.1016/j.adaj.2017.07.032
7. Fedorenko ZP, Goulak LO, Gorokh YL, Ry­zhov AY, Soumkina OV. Cancer in Ukraine 2022-2023: Incidence, mortality, prevalence and other relevant statistics. Bull Nat Cancer Reg Ukr [Internet]. 2024 [cited 2024 Oct 17];25:62.Available from: http://ncru.inf.ua/publications/BULL_25/PDF_E/Bull_Eng_25.pdf
8. Massa ST, Chidambaram S, Luong P, Gra­boyes EM, Mazul AL. Quantifying Total and Out-of-Pocket Costs Associated With Head and Neck Cancer Survivorship. JAMA Otolaryngol Head Neck Surg. 2022 Dec 1;148(12):1111-9. doi: https://doi.org/10.1001/jamaoto.2022.3269
9. Awawdeh MA, Sasikumar R, Aboalela AA, Sid­deeqh S, Gopinathan PA, Sawair F, et al. Evaluation of Prognostic Significance of the Expression of p53, Сyclin D1, EGFR in Advanced Oral Squamous Cell Carcinoma after Chemoradiation – A Systematic Review. Applied Sciences. 2023;13(9):5292. doi: https://doi.org/10.3390/app13095292
10. Rakhmanov VV, Shponka IS. [Features of the ex­pression of Сyclin D1 and oncoprotein p27 in oropha­ryngeal squamous cell carcinomas with different proli­ferative potential]. Morphologia. 2023;17(2):52-60. Ukrainian.
    doi: https://doi.org/10.26641/1997-9665.2023.2.52-60
11. Shponka IS, Bondarenko OO, Kovtunenko OV, Rakhmanov VV. Deletion of Сyclin dependent kinase inhibitor 2a gene as a marker of oropharyngeal carcinomas non-associated with human papillomavirus and its prognostic value. Medicni perspektivi. 2024;29(2):56-61. doi: https://doi.org/10.26641/2307-0404.2024.2.307479
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15. Tariq N, Mirza T, Ansari M, Nazir S. Role of Hu­man Papilloma Virus 16/18 In Laryngeal Carcinoma with Correlation to the Expression of Сyclin D1, p53, p16 and EGFR. Pak J Med Sci. 2023 Nov-Dec;39(6):1768-73. doi: https://doi.org/10.12669/pjms.39.6.8220
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17. Pekarek L, Garrido-Gil MJ, Sánchez-Cendra A, Cassinello J, Pekarek T, Fraile-Martinez O, et al. Emer­ging histological and serological biomarkers in oral squamous cell carcinoma: Applications in diagnosis, prog­nosis evaluation and personalized therapeutics (Review). Oncol Rep. 2023 Dec;50(6):213. doi: https://doi.org/10.3892/or.2023.8650

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Rakhmanov V.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/0000-0003-3200-6039

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

Rakhmanov V.V., Shponka I.S. Prognostic biomarkers and their impact on treatment strategy selection for patients with advanced stages of oropharyngeal cancer. Medicni perspektivi. 2025;30(1):29-38.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325236 

Deletion of cyclin dependent kinase inhibitor 2a gene as a marker of oropharyngeal carcinomas non-associated with human papillomavirus and its prognostic value

The main risk factors for the development of heart failure, in addition to the main disease, are old age, male sex, comorbidity, insufficient self-care and self-control at home. The aim of the study is to evaluate the impact of the "Heart Failure Symptoms Monitoring Diary" on self-care behavior in patients with diagnosed hypertensive heart disease with heart failure in an outpatient setting. We examined 110 patients with signs of heart failure. All respondents were divided equally into control and experimental groups, aged 60-96 years. The self-care index was determined using the Self-Care of Heart Failure Index scale proposed by Dr. Barbara Riegel, 2019 version 7.2. Referring to the cut-off score of less than 70 in this study control group participants exhibited inadequate self-care (58.77±4.23 points), with a tendency to repeated (early) hospitalization (less than 75 points). In the control group, the results of the study showed a low level of behavior in terms of the average total number of points (41.90±4.26) in all three areas of self-care had 87.2% of patients, 41.69±4.88; 43.42±3.60; 40.63±4.31 for self-care support, symptom perception and self-care management, respectively. Patients in the experimental group reported improvements in all domains of self-care from baseline after 30 days of keeping a Heart Failure Symptom Monitoring Diary and following all recommendations. The main group demonstrated adequate self-care (70.05±3.49 points) in all three areas of self-care. Medium and high level of behavior was demonstrated by 82.7% of patients with a total average score of 91.08±4.93 in all areas of self-care and in each area (54.54% of patients – in the area of self-care support scored 88.53±5.09 points; 52.62% of patients – in the area of symptom perception – 90.72±5.37 points; 50.91% of patients – in the area of self-care management – 94.00±4.33 points), which is a good prognostic indicator. In order to prolong the quality of life of patients with heart failure, limit the frequency of repeated visits to the polyclinic cardiologist's office, it is necessary to implement "Monitoring diaries of symptoms of heart failure" to assess the level of self-care behavior in outpatient settings.

Key words: heart failure, self-care index, self-monitoring, continuous nursing care

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10. Pulignano G, Del Sindaco D, Minardi G, Taranti­ni L, Cioffi G, et al. Translation and validation of the Ita­lian version of the European Heart Failure Self-care Beha­viour Scale. J Cardiovasc Med (Hagerstown). 2010;11:493-8. doi: https://doi.org/10.2459/JCM.0b013e328335fbf5
11. Köberich S, Glattacker M, Jaarsma T, Lohr­mann C, Dassen T. Validity and reliability of the German version of the 9-item European Heart Failure Self-care Behaviour Scale. Eur J Cardiovasc Nurs. 2013;12(2):150-8. doi: https://doi.org/10.1177/1474515112438639
12. González B, Lupón J, Parajón T, Urrutia A, Her­reros J, Valle V. [Use of the European Heart Failure Self-care Behaviour Scale (EHFScBS) in a heart failure unit in Spain]. Rev Esp Cardiol. 2006;59(2):166-70. Spanish. doi: https://doi.org/10.1016/S1885/5857(06)60126-6
13. Uchmanowicz I, Wleklik M. Polish adaptation and reliability testing of the nine-item European Heart Failure Self-care Behaviour Scale (9-EHFScBS). Kardiol Pol. 2016;74(7):691-6. doi: https://doi.org/10.5603/KP.a2015.0239
14. Aamodt IT, Lycholip E, Celutkiene J, von Lue­der T, Atar D, Falk RS, et al. Self-Care Monitoring of Heart Failure Symptoms and Lung Impedance at Home Following Hospital Discharge: Longitudinal Study. J Med Internet Res. 2020;22(1):15445. doi: https://doi.org/10.2196/15445
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17. Kirtoka DV, Baryshok TV. [Restoring Movement Skills of Patients with Spinal Injury by Physical Therapy]. Fi­zychna kultura, sport ta zdorovya natsiyi. 2019;8(27):266-71. Ukrainian.
    doi: https://doi.org/10.31652/2071-5285-2019-5(24)-266-271
18. Riegel B, Barbaranelli C, Carlson B, Sethares KA, Daus M, Moser DK, et al. Psychometric Testing of the Revised Self-Care of Heart Failure Index. J Cardiovasc Nurs. 2019;34(2):183-92. doi: https://doi.org/10.1097/JCN.0000000000000543
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Hryhorets D.K. Bukovinian State Medical University, Chernivtsi, 58002, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0008-0495-1037

Plesh I.A. Bukovinian State Medical University, Chernivtsi, 58002, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-0283-7571

Hryhorets D.K., Plesh I.A. Evaluation of the effectiveness of heart failure symptoms monitoring diary in outpatient settings. Medicni perspektivi. 2025;30(1):39-46.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325241

Pathomorphology of severe Grade 3-4 hepatic encephalopathy in decompensated cirrhosis patients with acute-on-chronic liver failure

Different dental restoration methods probably influence the resulting pattern of periodontal microbiocenosis. The purpose of this study was to compare the periodontal microbiota composition ac­cording to the examination of the gingival fluid in the dental restorations with different materials, taking into account the state of the periodontal tissues. All participants were divided into two research groups: persons with healthy periodontium and dental caries (n=30) and patients with generalized periodontitis, I-II degree, chronic course and dental caries (n=30); and healthy control (n=10). In the participants of the research groups, partial crown defects of the II class by Black were treated with paired restorations: on the one side – with direct composite, on the other one – indirect zirconium. Gingival fluid samples were taken before treatment and 12 weeks after. It was established that the microbial load of periodontal biofilms in carious decay against the background of periodontitis was characterized by a significant number of pathogens with a deficiency of commensals and an overgrowth of obligate anaerobes. Dental biota associated with the development of periodontitis contained such patterns as Streptococcus anginosus, Porphyromonas gingivalis, Candida albicans, Fusobacterium nucleatum, Tannerella forsythia, Aggregatibacter actinomycetemcomitans. In parodontitis, it was co-aggregation of Porphyromonas spp. with Fusobacterium spp. (p<0.05) and/or Porphyromonas spp. with A. acti­nomycetemcomitans (p<0.05). The cariogenic pattern was distinguished by the multiplicity of the genus Streptococcus with the predominance of Streptococcus mutans, Enterococcus faecalis, C. albicans, Peptostreptococcus spp., Entero­bacterales and the absence of S. anginosus, P. gingivalis, T. forsythia and A. actinomycetemcomitans. The results of the comparative microbiological study of gingival fluid after dental restorative treatment showed that zirconium restorations had the most favorable effect on periodontal microbiocenosis, in particular, it contributed to the protection against the colonization by Porphyromonas spp., Fusobacterium spp., T. forsythia, A. actinomycetemcomitans, as well as the accumulation of commensals Streptococcus salivarius and Aerococcus viridans. So, in comparison with direct composite restorations, it was more expressed approximation of the microbial spectrum, both in the persons with healthy periodontium and in the patients with general periodontitis, to the complete healthy cohort of research participants (p<0.05), which means to eubiosis. The obtained results should be taken into account when choosing a method of restorative treatment of carious decay in patients with periodontal diseases.

Key words: periodontitis, caries, restoration, composite, zirconia, gingival fluid, microbiocenosis

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6. Carroll CK, Pfaller AM. Manual of Clinical Microbiology. ASM Books; 2023. 3456 p.
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9. Abdulkareem AA, Al-Taweel FB, et al. Current con­cepts in the pathogenesis of periodontitis: from symbiosis to dysbiosis. JOral  2023;15(1):2197779. doi: https://doi.org/10.1080/20002297.2023.2197779
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14. Avetisyan A, Markaryan M, Rokaya D, et al. Cha­racteristics of periodontal tissues in prosthetic treatment with fixed dental prostheses. Molecules. 2021;26(5):1331. doi: https://doi.org/10.3390/molecules26051331

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Fastovets O.O. Dnipro State Medical University, Dnipro, Ukraine, 
e-mail: e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2769-3244

Shram S.S. Dnipro State Medical University, Dnipro, Ukraine 
https://orcid.org/0009-0009-8566-6541

Kobylyak S.S. Dnipro State Medical University, Dnipro, Ukraine 
https://orcid.org/0000-0001-9117-0723

Ishchenko O.V. Dnipro State Medical University, Dnipro, Ukraine 
https://orcid.org/0000-0001-7677-5062

Fastovets O.O., Shram S .S., Kobylyak S.S., Ishchenko O.V. The results of the comparative microbiological study of gingival fluid in restoration of partial defects of tooth crowns with different materials considering the state of periodontal tissues. Medicni perspektivi. 2025;30(1):46-55.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325243 

Conections between platelets amino acids profile and known cardiometabolic risk factors in patients with coronary artery disease and atrial fibrillation

The purpose of this work was to study the effect of acrylic and nylon bases of removable dentures on the content of immunoglobulins and circulating immune complexes in the blood serum of rats with bacterial-immune periodontitis. The experimental animals were divided into 4 groups: I – control (n=10); II – animals with periodontitis on the 30th day of research (n=8); III – animals with periodontitis on the 30th day of research with acrylic bases (n=8); IV – animals with periodontitis on the 30th day of research with nylon bases (n=8). Acrylic bases were made by thermal polymerization of polymethacrylate material, and nylon bases were made from thermoplastic material by the method of pressing under pressure. Experimental bacterial-immune periodontitis was caused by injection of a mixture of microorganisms suspended in egg protein into the periodontal tissue. To enhance the immune response, rats were simultaneously administered Freund's complete adjuvant. This procedure was repeated on the 14th day. On the 30th day, blood serum was collected. The concentration of immunoglobulins A, M, G was determined by immunoturbidimetric method, circulating immune complexes – by pre­cipitation method using photometry. The results were analyzed using non-parametric statistical methods. On the 30th day of periodontitis development, the level of IgA, M and G increased compared to the control by 2.70 times (p<0.001); 1.25 times (p<0.01) and 1.28 times (p<0.01), respectively. After fixation of acrylic bases, the content of IgA, M and G also increased by 2.48 times (p<0.001); 1.19 times (p<0.001) and 1.13 times (p<0.01), respectively. The use of acrylic bases led to a decrease in immunoglobulins compared to results without dentures. The use of nylon plastic contributed to an increase in the level of all classes of immunoglobulins, but they were lower compared to the data without prosthetics. Determination of IgA and M with nylon prosthetics showed their decrease compared to acrylic bases. The indicators of circulating immune complexes under prosthetics were higher when using acrylic bases than with nylon dentures. During the development of inflammation in the periodontium, a response of the innate link of the cellular immune system to prosthetics with acrylic and nylon structures was observed, which affects the nature of the development, course and completion of the inflammation.

Key words: removable denture, base materials, acrylic denture, nylon denture, immunoglobulins, circulating immune complexes, periodontitis

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7. Hasiuk P, Kindiy D, Vorobets A, Kindiy V, Dem­kovych A, Odzhubeiska O. Analysis of the advisability of using different types of base plastics by studying the needs of the population in removable prosthesis. Wiad Lek. 2022;75(12):3055-9. doi: https://doi.org/10.36740/WLek202212128
8. Yeroshenko GA, Shevchenko KV, Krama­ren­ko DR, Yachmin AI, Tymoshenko YuV, Lisachenko OD. Impact of methacrylate on the morphofunctional state of the oral cavity organs. Bulletin of problems biology and medicine. 2019;4:23-6.
   doi: https://doi.org/10.29254/2077-4214-2019-4-1-153-23-26
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11. Demkovych A, Bondarenko Y, Shcherba V, Lu­chynskyi V, Vitkovskyy V, Machogan V. Quercetin ef­fects on adaptive immune response in experimental perio­dontitis of bacterial-immune genesis. Pharmacia. 2021;68(4):877-82. doi: https://doi.org/10.3897/pharmacia.68.e70883
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13. Ramage G, O’Donnell L, Sherry L, Culshaw S, Bagg J, Czesnikiewicz-Guzik M, et al. [Impact of fre­quency of denture cleaning on microbial and clinical para­meters – a bench to chairside approach]. Actual Dentistry. 2020;5:53-68. Ukrainian.
14. Kostić M, Igić M, Gligorijević N, Nikolić V, Stošić N, Nikolić L. The use of acrylate polymers in dentistry. Polymers (Basel). 2022 Oct 25;14(21):4511. doi: https://doi.org/10.3390/polym14214511
15. Le Bars P, Bandiaky ON, Le Guéhennec L, Clouet R, Kouadio AA. Different polymers for the base of removable dentures? Part I: A narrative review of me­chanical and physical properties. Polymers (Basel). 2023 Aug 22;15(17):3495. doi: https://doi.org/10.3390/polym15173495
16. Demkovych A. Endogenous intoxication in deve­lopment of experimental periodontitis of bacterial-immune genesis. Folia Med (Plovdiv). 2023 Feb 28;65(1):149-54. doi: https://doi.org/10.3897/folmed.65.e71970
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18. Kudo C, Naruishi K, Maeda H, Abiko Y, Hino T, Iwata M, et al. Assessment of the plasma/serum IgG test to screen for periodontitis. J Dent Res. 2012 Dec;91(12):1190-5. doi: https://doi.org/10.1177/0022034512461796
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20. Zhu X. Sample size calculation for Mann-Whitney U test with five methods. Int J Clin Trials. 2021 Aug;8(3):184-95. doi: https://doi.org/10.18203/2349-3259.ijct20212840
21. Zubeidat K, Jaber Y, Saba Y, Barel O, Naam­neh R, Netanely Y, et al. Microbiota-dependent and -independent postnatal development of salivary immunity. Cell Rep. 2023 Jan 31;42(1):111981. doi: https://doi.org/10.1016/j.celrep.2022.111981
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23. Cruz AR, Bentlage AEH, Blonk R, de Haas CJC, Aerts PC, Scheepmaker LM, et al. Toward understanding how Staphylococcal protein A inhibits IgG-mediated phagocytosis. J Immunol. 2022 Sep 15;209(6):1146-55. doi: https://doi.org/10.4049/jimmunol.2200080
24. Вaida ML, Solvar ZL. [Characteristics of indivi­dual components of the humoral and cellular links of im­munity in the blood of guinea pigs with experimental periodontitis]. Odesa Medical Journal. 2023;4(185):18-20. Ukrainian. doi: https://doi.org/10.32782/2226-2008-2023-4-3
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Poliukhovych Yu.I. I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
https://orcid.org/0009-0007-4726-9372

Demkovych A.Ye. I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9823-4283

Poliukhovych Yu.I., Demkovych A.Ye. Changes in immunological reactivity in bacterial-immune inflammation of the periodontium under the condition of using different types of removable dentures. Medicni perspektivi. 2025;30(1):56-63.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325349

Association between glycosylated hemoglobin and newly diagnosed hypertension in a non-diabetic kosovar population: a cross-sectional analysis

The article reviews the comparison of opioid-limiting anesthesia methods in patients undergoing total abdominal hysterectomy. The aim of the study was to improve the method of anesthesia in the early postoperative period by reducing the dose of opioids, using 100 μg of morphine intrathecally. The quality of the perioperative period was analyzed in terms of inflammation, analgesia and comfort of women. Patients were randomly divided into 4 groups with different anesthesia methods: group I: endotracheal anesthesia – 25 women; group II: endotracheal ane­sthesia + epidural analgesia – 28 women; group III: endotracheal anesthesia + intrathecal morphine – 19 women; group IV: endotracheal ane­sthesia + intrathecal morphine + epidural anesthesia – 19 women. The following results were obtained: Leukocytes after surgery: (17.32 [14.48; 20.11]), (13.65 [11.27; 15.72]), (15.4 [13.4; 18.47]), (15.36 [13.47; 18.4]), which is significantly lower in group II, p_I-IV =0.037. The next day: a statistically significant difference is observed between groups I and II-IV, p_I-IV =0.047; after 3 days – no significant difference between the groups was detected, p_I-IV >0.05. Patients of the first group required intramuscular morphine in 56% of cases, while patients of the second group – 21.4%, patients of the third group – 15.7%, and in the fourth group 0% – a significant difference (p_I-IV =0.004). The pain index (M±m) on the visual analog scale after awakening (3.9±0.2); (1.4±0.3), (3.2±0.2); (0.7±0.1) – lower in the second and, especially, the fourth group p_I-IV =0.001; after 3 hours – lower in the second and fourth groups, p_I-IV =0.01; after 6 – lower in the third and fourth groups, p_I-IV = 0.029; further, a sta­tistical difference is observed in the decrease in the scores on the visual analog scale in the third and fourth groups. The time of the first need for analgesia (M±m) in group I was 1.8±0.2 hours, while in group II it was 2.8±0.2 hours, in group 3 it was 2.0±0.2 hours, while in group 4 it was 5.7±0.3 hours, which significantly prolongs the time of the first need for analgesia for group IV, p=0.0001. Therefore, after analyzing the data, we can conclude that the combination of intrathecal morphine and epidural analgesia is optimal for providing effective anesthesia.

Key words: hysterectomy, intrathecal opioids, epidural analgesia, pain, analgesia

1. Cliby WA. Total abdominal hysterectomy. Curr Opin Obstet Gynecol. 1997;9(4):295-300. doi: https://doi.org/10.1016/S0950-3552(97)80051-X
2. Chale GJ, Salim RM, Leshabari KM. Clinical indications for total abdominal hysterectomy among women seen in Dar es Salaam regional referral hospitals, Tanzania: a prospective, observational hospital-based study. PanAfr Med  2021;38:10. doi: https://doi.org/10.11604/pamj.2021.38.10.17695
3. Aarts JWMA, Nieboer TE, Johnson N, Taven­der E, Garry R, Mol BWJ, et al. Surgical approach to hysterectomy for benign gynaecological disease. Cochrane Database Syst Rev. 2015 Aug 12;8:CD003677. doi: https://doi.org/10.1002/14651858.CD003677.pub5
4. Han Y, Han L, Dong M, Sun Q, Ding K, Zhang Z, et al. Comparison of a loading dose of dexmedetomidine combined with propofol or sevoflurane for hemodynamic changes during anesthesia maintenance: a prospective, randomized, double-blind, controlled clinical trial. BMC Anesthesiol.2018;18(1):12. doi: https://doi.org/10.1186/s12871-018-0468-x
5. Niu Z, Gao X, Shi Z, Liu T, Wang M, Guo L, Qi D. Effect of total intravenous anesthesia or inhalation anesthesia on postoperative quality of recovery in patients undergoing total laparoscopic hysterectomy: A randomized controlled trial. JClin  2021;68:110374. doi: https://doi.org/10.1016/j.jclinane.2021.110374
6. Kehlet H, Werner MU. Intrathecal hydrophilic opi­oids for abdominal surgery: a meta-analysis, meta-regression, and trial sequential analysis. Anesth Analg. 2020;125(3):358-372. doi: https://doi.org/10.1016/j.bja.2020.05.061
7. Kunst AM, Wulf H, Stegemann B, Fiehn A. Intra­operative guidance of anesthesia: Analgesia Nociception Index (ANI) vs. standard care for hysterectomy under anesthesia with sevoflurane: A randomized controlled simple blinded study on intraoperative opioid con­sumption, postoperative pain and patient satisfaction. Die Anaesthesiologie.2023;72(7):477-87. doi: https://doi.org/10.1007/s00101-023-01288-y
8. Shen C, Panda S, Vogelstein JT. The Chi-Square Test of Distance Correlation. Journal of Computational and Graphical Statistics. 2021;31(1):254-62. doi: https://doi.org/10.1080/10618600.2021.1938585
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10. Kim TK. T-test as a parametric statistic. Korean J Anesthesiol. 2015;68(6):540-6. doi: https://doi.org/10.4097/kjae.2015.68.6.540
11. Paudel R, Dogra P, Montgomery-Yates AA, Coz Yataco A. Procalcitonin: A promising tool or just another overhyped test? Int J Med Sci. 2020;17(3):332-7. doi: https://doi.org/10.7150/ijms.39367
12. Moutachakkir M, Hanchi AL, Baraou A, Bou­khira A, Chellak S. Immunoanalytical characteristics of C-reactive protein and high sensitivity C-reactive protein. AnnBiol Clin (Paris). 2017;75(2):225-9. doi: https://doi.org/10.1684/abc.2017.1232
13. Dexter F. Wilcoxon-Mann-Whitney test used for data that are not normally distributed. Anesth Analg. 2013;117(3):537-8. doi: https://doi.org/10.1213/ANE.0b013e31829ed28f
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15. Wan X, Wang W, Liu J, et al. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol.2014;14:135. doi: https://doi.org/10.1186/1471-2288-14-135
16. Meylan N, et al. Benefit and risk of intrathecal morphine without local anaesthetic in patients undergoing major surgery: meta-analysis of randomized trials. British Journal of Anaesthesia. 2009;102(2):156-67. doi: https://doi.org/10.1093/bja/aen368
17. O'Neill A, Lirk P. Multimodal Analgesia. Ane­sthesiology Clinics. 2022;40(Iss 3):455-68. doi: https://doi.org/10.1016/j.anclin.2022.04.002
18. Fallon F, Moorthy A, Skerritt C, Crowe GG, Bug­gy DJ. Latest Advances in Regional Anaesthesia. Medicina (Kaunas). 2024 Apr 28;60(5):735. doi: https://doi.org/10.3390/medicina60050735

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Osadcha V.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/0009-0002-7647-8732

Kobeliatsky Yu.Yu. 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/0000-0002-8504-6125

Osadcha V.V., Kobeliatsky Yu.Yu. Comparison of opioid-limiting anesthesia methods in patients undergoing total abdominal hysterectomy. Medicni perspektivi. 2025;30(1):64-71. DOI: https://doi.org/10.26641/2307-0404.2025.1.325350

Predicting the dynamics of heart rate variability in patients with type 1 diabetes against improving glycemic control

In the structure of maternal mortality causes, hypertensive disorders of pregnant women rank third. Hypertensive disorders of pregnant women can cause abortion and premature birth, fetal growth retardation, fetal hypotrophy, fetal hypoxia, premature detachment of a normally located placenta, and even fetal death. The aim of the study is to develop a mathematical model for predicting the risk of obstetric complications in women with gestational hypertensive disorders. Determination of independent predictors of obstetric complications of pregnancy and creation of a mathematical model for predicting the risk of obstetric complications in women with hypertensive disorders of pregnancy was performed using multiple stepwise linear regression analysis. Statistical analysis of the data was carried out according to standard methods using the «STATISTICA 5.5». In order to develop a mathematical model for predicting obstetric complications of pregnancy from the point of view of the influence of hypertensive disorders of pregnancy, data from a retrospective analysis of 60 women with hypertensive disorders of pregnancy were included in the multivariate statistical analysis. Women who had adverse obstetric outcomes of pregnancy (n=15) formed the main group (1-М). The group of women without complications of pregnancy and childbirth consisted of 45 people and was defined as a control group (1-C). The most significant independent predictors of obstetric complications of gestation in pregnant women with hypertensive disorders were identified, namely: systolic blood pressure, risk of preterm birth, primary manifestation of hypertensive abnormalities at 31-32 weeks of pregnancy, endothelin-1 concept in blood plasma and umbilical cord artery pulsatility index. It was found that the value of the multiple regression equation of the proposed model ≥503.38 points makes it possible to predict adverse obstetric outcomes of pregnancy in women with gestational hypertensive disorders in this pregnancy with a sensitivity of 73.3% and a specificity of 68.9%. Thus, the prognostic model developed by us with a fairly high sensitivity and specificity allows predicting obstetric outcomes of pregnancy in women with hypertensive disorders of pregnancy. 

Key words: gestational hypertensive disorders, gestational hypertension, preeclampsia, prognostic model, obstetric complications

1. Bulavenko OV, Vaskiv OV. [Risk assessment of perinatal pathology in gestational hypertension]. Visnyk Vinnytskoho natsionalnoho medychnoho universytetu. 2017;1:277-80. Ukrainian.
2. Vaskiv OV. [Prediction of development and opti­mization of diagnosis of perinatal pathology in pregnant women with gestational hypertension]. [dissertation]. Ternopil: Ternopilskyi derzhavnyi medychnyi universytet im. IYa Horbachevskoho; 2022. 204 р. Ukrainian.
3. Magee LA, Nicolaides KH, von Dadelszen P. Preeclampsia. N Engl J Med. 2022;386(19):1817-32. doi: https://doi.org/10.1056/NEJMra2109523
4. Horbatiuk O, Hryhorenko A, Shatkovska A, Bin­kovska A, Vaskiv O. Using pentoxifylline, arginine hyd­rochloride, levocarnitine and rheosorbilact solutions for correction of fetoplacental dysfunction in pregnant women with preeclampsia. Reports of Vinnytsia National Medical University. 2021;25(1):88-93. doi: https://doi.org/10.1016/j.ajog.2024.03.012
5. Jena MK, Sharma NR, Petitt M, Maulik D, Na­yak NR. Pathogenesis of Preeclampsia and Therapeutic Ap­proaches Targeting the Placenta. Biomolecules. 2020;10(6):1-28. doi: https://doi.org/10.3390/biom10060953
6. Brownfoot F, Rolnik DL. Prevention of preeclam­psia. Best Pract Res Clin Obstet Gynaecol. 2024;93:102481. doi: https://doi.org/10.1016/j.bpobgyn.2024.102481
7. Liu YH, Zhang YS, Chen JY, Wang ZJ, Liu YX, Li JQ, et al. Comparative effectiveness of prophylactic strategies for preeclampsia: a network meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2023;228(5):535-46. doi: https://doi.org/10.1016/j.ajog.2022.10.014
8. Poon LC, Kametas NA, Chelemen T, Leal A, Nico­laides KH. Maternal risk factors for hypertensive disorders in pregnancy: a multivariate approach. J Hum Hypertens.2010;24(2):104-10. doi: https://doi.org/10.1038/jhh.2009.45
9. Tan L, Kluivers ACM, Cruz-López EO, Broekhui­zen M, Chen Z, Neuman RI, et al. Statins Prevent the Deleterious Consequences of Placental Chemerin Upre­gulation in Preeclampsia. Hypertension. 2024;81:861-75. doi: https://doi.org/10.1161/HYPERTENSIONAHA.123.22457
10. Griffin M, Heazell AEP, Chappell LC, Zhao J, Lawlor DA. The ability of late pregnancy maternal tests to predict adverse pregnancy outcomes associated with placental dysfunction (specifically fetal growth restriction and pre-eclampsia): a protocol for a systematic review and meta-analysis of prognostic accuracy studies. Systematic Reviews.2020;9:78.
    doi: https://doi.org/10.1186/s13643-020-01334-5
11. Magee LA, Wright D, Syngelaki A, von Da­delszen P, Akolekar R, Wright A, et al. Preeclampsia pre­vention by timed birth at term. 2023 May;80(5):969-78. doi: https://doi.org/10.1161/HYPERTENSIONAHA.122.20565
12. Rolnik DL, Nicolaides KH, Poon LC. Prevention of preeclampsia with aspirin. Am J Obstet Gynecol. 2022;226(2S):1108-19. doi: https://doi.org/10.1016/j.ajog.2020.08.045
13. Coffey CG. Issues in the interpretation of serum endothelin levels in preeclampsia. Medical Hypotheses. 2019;133:109400. doi: https://doi.org/10.1016/j.mehy.2019.109400
14. Cruz-Lemini M, Vazquez JC, Ullmo J, Llurba E. Low-molecular-weight heparin for prevention of preeclampsia and other placenta-mediated complications: a systematic review and meta-analysis. Am J Obstet Gynecol. 2022;226:1126-44. doi: https://doi.org/10.1016/j.ajog.2020.11.006
15. Vatansever D, Vatansever P, Giray B, Erte­kin AA, Bilsel S. Do N-Terminal Pro-C-Type Natriuretic Peptide Levels Relate to Severity of Preeclampsia? International Jour­nalof  2020;2020:2693534. doi: https://doi.org/10.1155/2020/2693534
16. Westerberg AC, Langeland Degnes M-H, Andre­sen IJ, Paasche Roland MC, Michelsen TM. Angiogenic and vasoactive proteins in the maternal-fetal interface in healthy pregnancies and preeclampsia. American Journal of Obstetrics and Gynecology. 2024 Nov;231(5):550.e1-550.e22. doi: https://doi.org/10.1016/j.ajog.2024.03.012
17. Prydannykova YЕ. Statistical Methods for Stu­dying the Causality between Economic Growth and Material Welfare of Populations. 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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Vaskiv O.V. National Pirogov Memorial Medical University, Vinnytsia, Khmelnytskyi, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6310-5692

Horbatiuk O.H. National Pirogov Memorial Medical University, Vinnytsia, Khmelnytskyi, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-0123-367X

Hryhorenko A.P. National Pirogov Memorial Medical University, Vinnytsia, Khmelnytskyi, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-3184-5359

Zhylko O.L. National Pirogov Memorial Medical University, Vinnytsia, Khmelnytskyi, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9475-349X

Harbuziuk V.V. National Pirogov Memorial Medical University, Vinnytsia, Khmelnytskyi, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-6104-7879

Perebendiuk T.V. Khmelnytskyi Basic Medical Professional College, Khmelnytskyi, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0007-7537-4954

Vaskiv O.V., Horbatiuk O.H., Hryhorenko A.P., Zhylko O.L., Harbuziuk V.V., Perebendiuk T.V. Prediction of obstetric complications in women with hypertensive disorders of pregnancy. Medicni perspektivi. 2025;30(1):71-78.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325354

Side effects and hypersensitivity reactions to corticosteroids

With the beginning of active hostilities in Ukraine the amount of victims with gunshot, mine-explosive and shrapnel injuries of the musculoskeletal system among  military personnel increased sharply. Therefore, the problems of treatment and rehabilitation of victims of hostilities have become especially acute in the last year. The purpose of the study was to characterize combat spinal cord injuries in military personnel based on the analyzed literature and clinical observations based on medical institutions. Primary literature search was conducted using Medline, Excerpta Medica dataBASE, and PsycINFO databases published from 2014 to 2024. After STROBE screening of articles, reviewers abstracted relevant data for analysis and statistical processing using Microsoft Excel Atte Stat 2010. In total, 263 publications were analyzed, of which 25 articles met the inclusion and exclusion criteria, and only 7 articles altogether created a homogeneous sample in terms of age, gender, time since the injury was sustained. Data from the neurological status of the patients’ medical histories, including the Spinal Cord Independence Scale, were used to construct recovery profiles for the first year after injury. For analysis, 50 case histories were randomly selected from the paraplegic cohort, and 50 from the tetraplegic cohort. Both groups were homogeneous according to all criteria. The total number of analyzed medical histories was n=100. To create recovery profiles, data on the neurological status of the patients, including the spinal cord independence scale, were taken. The gunshot traumas of the musculoskeletal system are accompanied by plenty of complications and unsatisfactory by the anatomic and functional results of treatment. Such injuries are characterized by a traumatic disease that develops in response to combat trauma and has a long and complicated course, high rates of mortality and severe disability. Damage to the spine and spinal cord is characterized by high mortality (19.1-52.9%) and permanent disability. The most common mechanisms of spinal cord injuries (SCI) were gunshot (from 9.4 to 93.3%), explosive (from 2.7% to 81.8%). Gunshot SCI most often affected the cervical (from 25 to 88% according to various studies) and thoracic part of spinal cord (24-63%). Blast SCI more often affected the lower parts of spine: lumbar – from 21 to 72%, sacral – from 27 to 89%. The share of complete injuries (18.2-90%) was greater than the share of incomplete SCI (10-81.8%). Level and severity of SCI matter in neurological recovery, with the least favorable prognosis among patients with tetraplegia with complete SCI (type A) and the most favorable prognosis – among patients with paraplegia with type D. Only 30.2% of patients with type A SCI progressed to type B (17.3%), type C (5.8%) or type D (7.2%) within a year after trauma, while 76.7% of patients with type B or type C SCI improved their clinical grade and only 8.5% patients with type D were switched to type E. In the context of the genesis of combat SCI, the largest share is occupied by explosive and mine-explosive injuries, which most often affect the sacral and lumbar spine according to the mechanism of injury, as well as gunshot wounds, which more often affect the cervical and thoracic regions, and determines the ranking of the clinical picture among patients. Differences in the level and severity of injury have obvious consequences in terms of neurological and functional recovery in the whole spectrum, with the least favorable prognosis among patients with tetraplegia with complete injury (type A) and the most favorable prognosis among patients with paraplegia with type D injury, according to the international standard for neurological classification of spinal cord injury.

Key words: gunshot wounds, mine-blast trauma, battle trauma, spinal cord, military personnel

1. Furlan JC, Gulasingam S, Craven BC. Epidemio­logy of War-Related Spinal Cord Injury Among Com­batants: A Systematic Review. Global Spine Journal. 2019;9(5):545-58. doi: https://doi.org/10.1177/2192568218776914
2. Fathe MA, Farhat F, Karim SK, Moalla W. Spinal Cord Injuries in Iraq: A Teleassessment Survey of the Survivors from 2017 to 2018 Islamic State of Iraq and Syria War. Telemedicine Journal and E-health. 2024;30(7):2059-71. doi: https://doi.org/10.1089/tmj.2024.0037
3. Schoenfeld AJ, Dunn JC, Belmont PJ. Pelvic, spi­nal and extremity wounds among combat-specific per­sonnel serving in Iraq and Afghanistan (2003-2011): A new paradigm in military musculoskeletal medicine. Injury. 2013;44(12):1866-70. doi: https://doi.org/10.1016/j.injury.2013.08.001
4. Rahimi-Movaghar V, Sayyah MK, Akbari H, Khor­ramirouz R, Rasouli MR, Moradi-Lakeh M, et al. Epidemiology of traumatic spinal cord injury in developing countries: a systematic review. Neuroepidemiology. 2013;41(2):65-85. doi: https://doi.org/10.1159/000350710
5. Adebusoye FT, Wireko AA, Wellington J, Deb­rah AF, Tenkorang PO, AbdulRahman T, et al. Manage­ment gaps of traumatic spinal cord injuries in war-torn low and middle-income nations: why has this massive problem garnered little attention? Editorial. International Journal of Surgery. 2023;109(3):239-41. doi: https://doi.org/10.1097/JS9.0000000000000218
6. Khomenko IP, Korol SO, Khalik SV, Shapo­va­lov VY, Yenin RV, Gerasimenko OS, et al. Clinical and epidemiological analysis of the structure of combat sur­gical trauma during the anti-terrorist operation/operation of the United Forces in the east of Ukraine. UJMM. 2020;2(2):5-13. doi: https://doi.org/10.46847/ujmm.2021.2(2)-005
7. Shvets AV, Horishna OV, Deputat YM, Rychka OV, Zhaldak AY, Kikh AY. Prognostic assessment of the need for medical rehabilitation among military officers of the Armed Forces of Ukraine based on the structure of their combat trauma. Ukrainian Journal of Military Medicine. 2022;3(3):110-7. doi: https://doi.org/10.46847/ujmm.2022.3(3)106-110
8. Reginald AА. Surgery of experimental lesion of spinal cord equivalent to crush injury of fracture dislocation of spinal column: a preliminary report. JAMA. 1911;57(11):878-80. doi: https://doi.org/10.1001/jama.1911.04260090100008
9. Alizadeh A, Dyck SM, Karimi-Abdolrezaee S. Traumatic Spinal Cord Injury: An Overview of Patho­physiology, Models and Acute Injury Mechanisms. Front Neurol.2019;10(282):1-25. doi: https://doi.org/10.3389/fneur.2019.00282
10. Fehlings МА, Boakye M, Rossignol S, Di­tun­no JF, Anthony S. Burns Essentials of Spinal Cord Injury Basic Research to Clinical Practice. Acta Neuro­chirurgica. 2013;155(5):949-50. doi: https://doi.org/10.1007/s00701-013-1654-8
11. Shafqat A, Albalkhi I, Magableh HM, Saleh T, Alkattan K, Yaqinuddin A. Tackling the glial scar in spinal cord regeneration: new discoveries and future directions. Frontiers in Cellular Neuroscience. 2023;17(2):1-24. doi: https://doi.org/10.3389/fncel.2023.1180825
12. Nekhlopochyn OS, Verbov VV, Tsymbaliuk IV, Cheshuk IV, Vorodi MV. Contusion Spinе Injury in the Thoracolumbar Junction Region. Terra orthopaedica. 2023;2(117):32-9.
    doi: https://doi.org/10.37647/2786-7595-2023-117-2-32-39
13. Denysiuk MV, Dubrov CO, Chernyaev SV, Sere­da SO, Zaikin YM. The structure of traumatic injuries and the experience of treating the wounded as a result of hostilities in the first days of Russia's attack on Ukraine. Pain, anaesthesia and intensive care. 2022;1(98):7-12. doi: https://doi.org/10.25284/2519-2078.1(98).2022.256092
14. Agarwal P, Mishra AN, Sudesh W, Prachir M, Dhananjaya S. Priorities of desired functional recovery in Indian spinal cord injury patients. Journal of Clinical Orthopaedics and Trauma. 2020;11(5):896-9. doi: https://doi.org/10.1016/j.jcot.2019.08.001
15. Mishra P, Pandey CM, Singh U, Keshri A, Saba­retnam M. Selection of appropriate statistical methods for data analysis. Annals of Cardiac Anaesthesia. 2019;22(3):297-301. doi: https://doi.org/10.4103/aca.ACA_248_18

Look through:

Artemenko V.O.  National Pirogov Memorial Medical University, Vinnytsya, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0006-7434-4473

Matsipura M.M. National Pirogov Memorial Medical University, Vinnytsya, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-5631-8056

Sazonova S.O. National Pirogov Memorial Medical University, Vinnytsya, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0000-5253-6892

Artemenko V.O., Matsipura M.M., Sazonova S.O. Non-interventional study of the epidemiological and clinical aspects of war-related spinal cord injuries among military personnel. Medicni perspektivi. 2025;30(1):78-89.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325361

Microbiological profile and antimicrobial susceptibility of bacteria associated with urinary tract infections in Ukrainian adults

Juvenile idiopathic arthritis (JIA) in children remains one of the world's serious medical and social problems. One of the complications of the disease is the development of osteopenic syndrome (OS) with possible formation of osteoporosis in the future. Routine methods of laboratory diagnostics of OS in children with JIA remain within normal values for a long time and therefore are unsuitable for early diagnosis of OS when there are no clinical manifestations of bone metabolism disorders. Modern instrumental methods for assessing bone mineral density (BMD) also do not characterize the speed and nature of bone metabolism. Therefore, an important addition to the methods of early diagnosis of OS in children with JIA is the assessment of biochemical markers of bone turnover (BTMs). The aim of the study was to determine the diagnostic value of bone metabolism markers for predicting the risk of osteopenic syndrome in children with JIA. 50 children with JIA aged 5 to 18 years were examined. Among the laboratory methods of investigation, in addition to general clinical ones, the deter­mination of the content of the active metabolite of vitamin D – 25 hydroxyvitamin D (25(OH)D), osteocalcin and the marker of osteoresorption β-Cross Laps (b-ctx) in the blood serum by enzyme-linked immunosorbent assay was used. Instrumental methods of research included the assessment of BMD using an ultrasonic densitometer Sunlight Omnisense 9000. It was established that in 42% of cases, children with JIA were diagnosed with OS of varying degrees of severity. The study of serum 25(OH)D level, as an important diagnostic criterion for OS, showed that in children with OS it was significantly lower than in children without OS and amounted to 17.5 [15.7; 23.6] vs. 34.1 [22.8; 39.2] ng/ml; (p<0.05). The level of osteocalcin in children with OS was significantly lower than in children without OS (6.7 [3.9; 11.5] vs. 14.9 [9.2; 20.9] ng/mL, (p<0.05), while the level of the osteoresorption marker β-Cross Laps in children with OS was significantly higher than in children without OS (1.83 [1.48; 2.27] vs. 0.95 [0.78; 1.52] ng/mL (p<0.05). The correlation analysis revealed a positive correlation of osteocalcin level with Z-score according to densitometry (r=0.44, p<0.05) and 25(OH)D level (r=0.60, p<0.05), a negative correlation with disease activity (r= -0.88, p<0.05) and the number of active joints (r= -0.29, p<0.05). The level of the osteoresorption marker β-Cross Laps also correlated with the Z-score according to densitometry (r= -0.42, p<0.05) and 25(OH)D level (r= -0.40, p<0.05). The optimal threshold value of the levels of osteosynthesis and osteoresorption markers for the development of OS in children with JIA was determined by ROC analysis. Increased in the serum level of β-Cross Laps above 1.7 ng/ml (sensitivity – 61.9%, specificity – 89.7%, diagnostic efficiency of the test – 78.0%) and decreased in the level of osteocalcin below 8.7 ng/ml (sensitivity – 66.7%, specificity – 75.9%, diagnostic efficiency of the test – 72.0%) in the blood can be used for early diagnosis of the risk of developing OS in pediatric practice.

Key words: juvenile idiopathic arthritis, osteopenic syndrome, osteoporosis, bone turnover markers, children

1. Antypkin YuG, Marushko YuV, Omelchenko LI, et al. [Calcium homeostasis and certain aspects of its disturbances in juvenile idiopathic arthritis]. Child`s Health. 2022;17(8):5-11. Ukrainian. doi: https://doi.org/10.22141/2224-0551.17.8.2022.1542
2. Marushko YuV, Marushko TV, Kurilina TV, Kho­dakivska SP, Onufreiv OIe, editors. [Juvenile arthritis in the practice of a pediatrician and a general practitioner-family medicine doctor]. Kyiv: Individual entrepreneur: Storozhuk O.V.; 2024. 64 р. Ukrainian.
3. Shevchenko NS, Bogmat LF, Khadzhinova YuV. [Bone condition in children with juvenile idiopathic arthritis]. Modern Pediatrics. Ukraine. 2021;1(113):45-52. Ukrainian. doi: https://doi.org/10.15574/SP.2021.113.45
4. Marushko TV, Holubovska YuYe. [Is it possible to predict the development of osteopenia in patients with juvenile idiopathic arthritis?] Child`s Health. 2019;14(7):397-402. Ukrainian.
   doi: https://doi.org/10.22141/2224-0551.14.7.2019.184618
5. Marushko TV, Holubovska YuYe. [Vitamin D status and bone mineral density in patients with juvenile rheumatoid arthritis]. Child`s Health. 2019;14(1):13-8. Ukrainian.
   doi: https://doi.org/10.22141/2224-0551.14.1.2019.157873
6. Chong KH, Poh BK, Jamil NA, Kamaruddin NA, Deurenberg P. Radial quantitative ultrasound and dual energy x-ray absorptiometry: intermethod agreement for bone status assessment in children. Biomed Res Int. 2015;2015:232876. doi: https://doi.org/10.1155/2015/232876
7. Marushko YuV, Volokha TI, Asonov SA. [Ultra­sound densitometry (axial dimension) in the diagnosis of osteopenia syndrome in children with various somatic pathology]. Modern pediatrics. 2016;1(73):54-8. Ukrainian.
8. Abrahamovych U, Abrahamovych O, Tsyha­nyk L, Synenkyi O, Guta S. [Сomparative Evaluation of Bone Mineral Density Based upon the Results of Ultrasound Osteodensitometry, X-ray Osteodensitometry, and Dual-Energy X-ray Absorptiometry Tests in Pre­menopausal Women with Systemic Lupus Erythematosus]. Lviv Clinical Bulletin. 2017;1(17):32-7. Ukrainian. doi: https://doi.org/10.25040/lkv2017.01.032
9. Cerar S, Paro-Panjan D, Soltirovska-Šalamon A. The role of quantitative ultrasound in diagnosing severe bone metabolic diseases in newborns. Front Pediatr. 2023 Apr 11;11:1109553. doi: https://doi.org/10.3389/fped.2023.1109553
10. Swinton PA, Elliott-Sale KJ, Sale C. Comparative analysis of bone outcomes between quantitative ultrasound and dual-energy x-ray absorptiometry from the UK Biobank cohort. Arch Osteoporos. 2023 May 30;18(1):77. doi: https://doi.org/10.1007/s11657-023-01287-x
11. Răduț RM, Crăciun AN, Silaghi C. Bone Markers in Arthropathies. Acta clinica Croatica. 2019;58(4):716-25. doi: https://doi.org/10.20471/acc.2019.58.04.19
12. Zhang Y, Huang X, Li C, Zhang J, Yu X, Li Y, et al. Broad application prospects of bone turnover markers in pediatrics. J Clin Lab Anal. 2022 Sep;36(9):e24656. doi: https://doi.org/10.1002/jcla.24656
13. Peichl P, Griesmacherb A, Marteau R, Hejc S, Kumpan W, Müller MM, et al. Serum crosslaps in com­parison to serum osteocalcin and urinary bone resorption markers. Clin Biochem. 2001 Mar;34(2):131-9. doi: https://doi.org/10.1016/s0009-9120(01)00193-x
14. Greenblatt MB, Tsai JN, Wein MN. Bone Tur­nover Markers in the Diagnosis and Monitoring of Metabolic Bone Disease. Clin Chem. 2017 Feb;63(2):464-74. doi: https://doi.org/10.1373/clinchem.2016.259085
15. Pagano M, Gauvreau K, Mattie H. Principles of Biostatistics. CRC Press; 2022. 735 p.
16. Babienko VV, Mokiienko AV, Levkovska VIu. [Bio­statistics]. Odesa; 2022. 178 p. Ukrainian.
17. Lorentzon M, Branco J, Brandi ML, et al. Algo­rithm for the Use of Biochemical Markers of Bone Turnover in the Diagnosis, Assessment and Follow-Up of Treatment for Osteoporosis. Adv Ther. 2019 Oct;36(10):2811-24. doi: https://doi.org/10.1007/s12325-019-01063-9
18. Deng L, Yao F, Tian F, Luo X, Yu S, Wen Z. Influence of Iguratimod on Bone Metabolism in Patients with Rheumatoid Arthritis: A Meta-analysis. Int J Clin Pract. 2022 Jul 21;2022:5684293. doi: https://doi.org/10.1155/2022/5684293
19. Simeonova T, Stefanova K, Yordanova-Laleva P, Ruseva B, Dimitrova A. Bone resorption marker Beta-CrossLaps for early monitoring of osteoporosis treatment with Denosumab. J of IMAB. 2022 Oct-Dec;28(4):4731-4. doi: https://doi.org/10.5272/jimab.2022284.4731

Look through:

Makoviichuk O.A. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-4641-8838

Ilchenko S.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/0000-0003-2181-1833

Fialkovska A.O. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-6004-8418

Makoviichuk O.A., Ilchenko S.I., Fialkovska A.O. Diagnostic significance of bone turnover markers for predicting the risk of osteopenic syndrome in children with juvenile idiopathic arthritis. Medicni perspektivi. 2025;30(1):90-95.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325364

Results of surgical treatment of patients with acute destructive diverticulitis of the colon using minimally invasive technologies

The problem of postoperative cognitive dysfunctions (POCD) becomes more significant with the increase in frequency and expansion of operations in cardiac surgery practice. It’s one of the common clinical complications following anesthesiologic support in cardiac surgery, which can change in a long-term period. POCD is a decrease of cognitive functions after surgery and general anesthesia from the baseline preoperative level. It’s characterized by impairment of attention, concentration, memory, learning and processing of information, verbal, visual and visuospatial deficits. The attention of anesthesiologists and specialists in related specialties is attracted by the medical and social consequences of cognitive disorders, which have a negative impact on the duration of hospitalization, its cost, and the quality of life of patients in the remote postoperative period with an increase in the frequency and duration of incapacity for work, the need for rehabilitation, the financial burden on the patient and his family The aim of our study was to identify neuropsychological indicators of cognitive functions in the short-term and long-term postoperative period in patients with coronary heart disease who underwent off-pump coronary bypass grafting. There were examined 257 patients of 44-78 years old with coronary artery disease, all of them underwent off-pump coronary bypass grafting during period of 2019-2021 years and were hospitalized in the department of Cardiac Surgery at the National scientific center of surgery and transplantation named after O.O. Shalimov, Kyiv, Ukraine. Trail Making Test (TMT) and Mini Mental State Examination (MMSE) were used for cognitive function assessment. This study showed that 47.08% of patients had cognitive dysfunctions after cardiac surgery, which improved in postoperative period after 6 months in 19.01% (n=23) of patients with POCD. Worsening of cognitive performance was observed mainly in older population (65 and older). Geriatric patients had lower cognitive performance and are vulnerable to neuro­physiological changes after cardiac surgery, that may be a higher risk of POCD. The results of testing using MMSE and TMT in patients with coronary heart disease who underwent off pump coronary artery bypass grafting revealed that the frequency of POCD with a maximum decrease of cognitive functions was on the 3rd day after surgery with gradual recovery of cognitive functions on 6-8 day. However, in 80.99% of patients with POCD the level of cognitive functions is not recovered in full preoperative score.

Key words: cognitive dysfunctions, off-pump coronary artery bypass, neurocognitive testing, general anesthesia

1. Bryson GL, Wyand A, Wozny D, Rees L, Ta­ljaard M, Nathan H. A prospective cohort study evaluating associations among delirium, postoperative cognitive dysfunction, and apolipoprotein E genotype following open aortic repair. Can J Anaesth. 2011;58(3):246-55. doi: https://doi.org/10.1007/s12630-010-9446-6
2. Yuan SM, Lin H. Postoperative Cognitive Dysfun­ction after Coronary Artery Bypass Grafting. Braz J Cardiovasc Surg. 2019 Jan-Feb;34(1):76-84. doi: https://doi.org/10.21470/1678-9741-2018-0165
3. Newman MF, Kirchner JL, Phillips-Bute B, Ga­ver V, Grocott H, Jones RH, et al. Neurological Outcome Research Group and the Cardiothoracic Anesthesiology Research Endeavors Investigators Longitudinal asses­sment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med. 2001;344(6):395-402. doi: https://doi.org/10.1056/NEJM200102083440601
4. Rundshagen I. Postoperative cognitive dysfunc­tion. Dtsch Arztebl Int. 2014;111(8):119-25. doi: https://doi.org/10.3238/arztebl.2014.0119
5. Habib S, Khan Au, Afridi MI, Saeed A, Jan AF, Amjad N. Frequency and predictors of cognitive decline in patients undergoing coronary artery bypass graft surgery. J Coll Physicians Surg Pak. 2014;24(8):543-8.
6. Laalou FZ, Carre AC, Forestier C, Sellal F, Lan­geron O, Pain L. Pathophysiology of post-operative cogni­tive dysfunction: current hypotheses. J Chir (Paris). 2008;145(4):323-30.
   doi: https://doi.org/10.1016/S0021-7697(08)74310-2
7. Youngblom E, DePalma G, Sands L, et al. The temporal relationship between early postoperative delirium and postoperative cognitive dysfunction in older patients: a prospective cohort study. Can J Anaesth. 2014;61:1084-92. doi: https://doi.org/10.1007/s12630-014-0242-6
8. Silbert BS, Evered LA, Scott DA. Incidence of postoperative cognitive dysfunction after general or spinal anaesthesia for extracorporeal shock wave lithotripsy. Br J Anaesth.2014;113:784-91. doi: https://doi.org/10.1093/bja/aeu163
9. Polunina AG, Golukhova EZ, Guekht AB, Lefte­rova NP, Bokeria LA. Cognitive dysfunction after on-pump operations: neuropsychological characteristics and optimal core battery of tests. Stroke Res Treat. 2014;2014:302824. doi: https://doi.org/10.1155/2014/302824
10. Van Harten AE, Scheeren TW, Absalom AR. A review of postoperative cognitive dysfunction and neuroinflammation associated with cardiac surgery and anaesthesia. Anaesthesia. 2012;67(3):280-93. doi: https://doi.org/10.1111/j.1365-2044.2011.07008.x
11. Zhang X, Dong H, Li N, Zhang S, Sun J, Zhang S, et al. Activated brain mast cells contribute to postoperative cognitive dysfunction by evoking microglia activation and neuronal apoptosis. J Neuroinflammation. 2016;13(1):127. doi: https://doi.org/10.1186/s12974-016-0592-9
12. Ge Y, Ma Z, Shi H, Zhao Y, Gu X, Wei H. Inci­dence and risk factors of postoperative cognitive dysfunc­tion in patients underwent coronary artery bypass grafting surgery. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2014;39(10):1049-55. doi: https://doi.org/10.11817/j.issn.1672-7347.2014.10.011  
13. Krenk L, Kehlet H, Bæk Hansenetal T. Cognitive dysfunction after fast-track hip and knee replacement. Anesth  2014;118:1034-40. doi: https://doi.org/10.1213/ANE.0000000000000194
14. Pan LF, Wang DX, Li J. [Effects of different methods of anesthesia and analgesia on early postoperative cognitive dysfunction after non-cardiac surgery in the elderly]. Journal of Peking University. Health Sciences. 2006;38(5):510-4. Chinese.
15. Lamy A, Devereaux PJ, Prabhakaran D, et al. Effects of off-pump and on-pump coronary-artery bypass grafting at 1 year. N Engl J Med. 2013;368:1179-88. doi: https://doi.org/10.1056/NEJMoa1301228
16. Patel N, Minhas JS, Chung EM. Intraoperative embolization and cognitive decline after cardiac surgery: A systematic review. Semin Cardiothorac Vasc Anesth. 2016;20:225-31. doi: https://doi.org/10.1177/1089253215626728
17. Selnes OA, Gottesman RF, Grega MA, Baum­gartner WA, Zeger SL, McKhann GM. Cognitive and neurologic outcomes after coronary-artery bypass surgery. N Engl J Med. 2012;366(3):250-7. doi: https://doi.org/10.1056/NEJMra1100109
18. Kok WF, Koerts J, Tucha O, et al. Neuronal damage biomarkers in the identification of patients at risk of long-term postoperative cognitive dysfunction after cardiac surgery. Anaesthesia. 2017;72:359-69. doi: https://doi.org/10.1111/anae.13712
19. Prokopenko SV, Mozheyko EY, Petrova MM, et al. Correc – tion of post-stroke cognitive impairments using computer programs. J Neurological Sciences. Elsevier BV. 2013;325(1-2):148-53. doi: https://doi.org/10.1016/j.jns.2012.12.024
20. Qiao Y, Feng H, Zhao T, et al. Postoperative cognitive dysfunction after inhalational anesthesia in elderly patients undergoing major surgery: the influence of anesthetic technique, cerebral injury and systemic inflammation. BMC Anesthesiol. 2015;15:154. doi: https://doi.org/10.1186/s12871-015-0130-9
21. Helkala EL, Kivipelto M, Hallikainen M, Alhai­nen K, Heinonen H, Tuomilehto J, et al. Usefulness of repeated presentation of Mini-Mental State Examination as a diagnostic procedure: a population-based study. Acta Neurol 2002;106(6):341-6. doi: https://doi.org/10.1034/j.1600-0404.2002.01315.x
22. Saraçli Ö, Akca AS, Atasoy N, Önder Ö, Senor­manci Ö, Kaygisiz I, et al. The relationship between quality of life and cognitive functions, anxiety and depression among hospitalized elderly patients. Clin Psychopharmacol 2015;13(2):194-200. doi: https://doi.org/10.9758/cpn.2015.13.2.194
23. Jildenstål PK, Hallén JL, Rawal N, Berggren L. Does depth of anesthesia influence postoperative cognitive dysfunction or inflammatory response following major ENT surgery? J Anesth Clin Res. 2012;3(6):220. doi: https://doi.org/10.4172/2155-6148.1000220
24. Bittner EA, Yue X, Xie F. Brief review: anesdys­function and Alzheimer’s disease. Can J Anaesth. 2010;50(2):216-33.
    doi: https://doi.org/10.1007/s12630-010-9418-x
25. Kok WF, Koerts J, Tucha O, et al. Neuronal damage biomarkers in the identification of patients at risk of long-term postoperative cognitive dysfunction after cardiac surgery. Anaesthesia. 2017;72:359-69. doi: https://doi.org/10.1111/anae.13712
26. Brown EN, Purdon PL. The aging brain and anesthesia. Curr Opin Anaesthesiol. 2013;26:414-9. doi: https://doi.org/10.1097/ACO.0b013e328362d183
27. Neupane I, Arora RC, Rudolph JL. Cardiac surgery as a stressor and the response of the vulnerable older adult. Exp Gerontol. 2017;87(Pt B):168-74. doi: https://doi.org/10.1016/j.exger.2016.04.019
28. Evered LA, Silbert BS, Scott DA, Maruff P, Ames D. Prevalence of dementia 7.5 years after coronary artery bypass graft surgery. Anesthesiology. 2016;125:6271. doi: https://doi.org/10.1097/ALN.0000000000001143
29. Vega Alonso T, Miralles Espí M, Mangas Rei­na JM, Castrillejo Pérez D, Rivas Pérez AI, Gil Costa M, et al. Prevalence of cognitive impairment in Spain: the Gómez de Caso study in health sentinel networks. Neurologia. 2018 Oct;33(8):491-8. doi: https://doi.org/10.1016/j.nrl.2016.10.002

Look through:

Antonenko V.V. SI “National scientific center of surgery and transplantation named after O.O. Shalimov to National Academy of Medical Sciences of Ukraine”; 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/0000-0003-2395-4563

Dubrov S.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/0000-0002-2471-3377

Antonenko V.V., Dubrov S.O. Neuropsychological indicators of postoperative cognitive dysfunctions after off-pump coronary artery bypass grafting. Medicni perspektivi. 2025;30(1):96-101.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325365

Altruistic values among students of Nursing, Midwifery, Physiotherapy, and Health Psychology: a cross-sectional study

The analysis of literature shows that servicemen who participated in armed conflicts occupy a special place in the group of people with an increased risk of developing psychogenic disorders. However, this issue remains virtually unexplored in servicemen of the Armed Forces of Ukraine who participated in the Russian-Ukrainian war. Objective – to identify the clinical and psychological features of combined trauma in servicemen of the Armed Forces of Ukraine who are participants in the Russian-Ukrainian war. The paper presents the results of a clinical and psychological examination of 63 male servicemen of the Armed Forces of Ukraine who are combatants and sustained injuries in the period from 2022 to 2023. The average age of the patients was 41.0 ±2.36 years.  The comparison group consisted of 48 men aged 42.08±4.02 years who had participated in combat operations until 2022, did not complain of impaired memory and attention, had no history of traumatic brain injury, and at the time of the study (acute and chronic (acute) diseases. Patients were divided into 3 subgroups: 18 people with shrapnel wounds as a result of mine-blast injuries, 12 with contusions and 33 with other types of injuries. All patients were found to be prone to anxiety disorders and depression. In accordance with the criteria of the International Classification of Diseases (ICD-10), reactions to severe stress and adaptation disorders (F43) were diagnosed, followed by other anxiety disorders (F41), and comorbid variants (F06) to a lesser extent. As a result of the distribution of the examined servicemen of the Armed Forces of Ukraine who are participants in the Russian-Ukrainian war and were injured while performing their duties during 2022-2023, depending on the level of intensity of combat experience, it was found that the level of intensity of combat experience was reduced in 9.5% of cases, moderate – in 52.4%, and increased – in 38.1%.The obtained results allowed us to include 27 (42.8%) people in the risk group of developing long-term consequences of the stress reaction already at a moderate level of intensity of combat experience. The main clinical and psychological features of combined traumas in military personnel of the Armed Forces of Ukraine who participated in combat operations in the period from 2022 to 2023 are the predominant development of reactions to severe stress and adaptation disorders (F43), anxiety and depressive disorders, and the presence of mild cognitive impairment. The identified clinical and psychological features of trauma in the Armed Forces of Ukraine of the Russian-Ukrainian war participants should be taken into account when improving the rehabilitation system for the Armed Forces of Ukraine.

Key words: participants of the Russian-Ukrainian war, combined trauma, psychological trauma, servicemen the Armed Forces of Ukraine, combatants; war, rehabilitation, post-traumatic stress disorder

1. Kazmirchuk A, Yarmoliuk Y, Lurin I, Gybalo R, Burianov O, Derkach S. Ukraine’s Experience with Mana­gement of Combat Casualties Using NATO’s Four-Tier “Changing as Needed” Healthcare System. World J Surg. 2022 Dec;46(12):2858-62. doi: https://doi.org/10.1007/s00268-022-06718-3
2. Peterson A. General Perspective on the U.S. Military Conflicts in Iraq and Afghanistan after 20 years. Mil 2022;187(9-10):248-51. doi: https://doi.org/10.1093/milmed/usab496
3. Reid M, Cooper D, Lu L, Iverson G, Kennedy J. Adversity and Resilience Are Associated with Outcome after Mild Traumatic Brain Injury in Military Service Members. J 2018;35(10):1146-55. doi: https://doi.org/10.1089/neu.2017.5424
4. Elliott T, Hsiao Y, Kimbrel N, DeBeer B, Gul­liver S, Kwok O, et al. Resilience facilitates adjustment through greater psychological flexibility among Iraq/Af­ghanistan war veterans with and without mild traumatic brain injury. Rehabilitation Psychology. 2019;64(4):383-97. doi: https://doi.org/10.1037/rep0000282
5. McCarron K, Dasgupta M, Campbell C, Hull A, Namazi S, Adams A. Social rehabilitation for military veterans with traumatic brain injury, psychological trauma, and chronic neuropsychiatric symptoms: Intervention development and initial outcomes. Psychiatric Re­habilitation 2019;42(3):296-304. doi: https://doi.org/10.1037/prj0000361
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15. Saumur T, Gregor S, Xiong Y, Unger J. Quan­ti­fying the amount of physical rehabilitation received by individuals living with neurological conditions in the community: a scoping review. BMC Health Serv Res. 2022 Mar 16;22(1):349. doi: https://doi.org/10.1186/s12913-022-07754-4

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Hutchenko K.S. Central Research Institute of the Armed Forces of Ukraine, Kyiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0008-6377-7745

Kozachuk V.L. Central Research Institute of the Armed Forces of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0002-0207-7461

Hutchenko O.A. Central Research Institute of the Armed Forces of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0001-5918-1545

Shemchuk O.M. Ukrainian Military Medical Academy, Kyiv, Ukraine
https://orcid.org/0000-0002-0641-0313

Tymkiv O.A. Central Research Institute of the Armed Forces of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0002-2248-382X

Hrom V.A. Central Research Institute of the Armed Forces of Ukraine, Kyiv, Ukraine
https://orcid.org/0009-0009-5415-9758

Hutchenko K.S., Kozachuk V.L., Hutchenko O.A., Shemchuk O.M., Tymkiv O.A., Hrom V.A. Clinical and psychological features of combined trauma in servicemen of the Armed Forces of Ukraine in the Russian-Ukrainian war. Medicni perspektivi. 2025;30(1):102-108.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325366

Assessment of adolescent physical development using body mass index and body self-perception

Taking into account the social significance of the problem of ophthalmic diseases and their consequences, the aim of the study was to study the dynamics and structure of indicators of primary disability due to ophthalmic pathology in the Dnipropetrovsk region and Ukraine and to investigate current world scientific trends in determining the status of “person with disability” from the standpoint of the International Classification of Functioning. The methods of parametric and nonparametric statistics were used. It has been determined that the state of primary disability indicators in the Dnipro region and in Ukraine reflects the prevalence of certain ophthalmic pathologies in the country and in the world. The main causes of newly recognized persons with disabilities due to ophthalmic pathology during the study period of 2018-2022 in the Dnipro region and in Ukraine were: glaucoma; fundus pathology; consequences of trauma; degenerative (complicated) myopia and optic nerve atrophy. The epidemiological indicators are also similar in the Dnipropetrovsk region and in Ukraine, in particular, it was found that the vast majority of people were men (up to 56%); urban residents (about 60%); people of working age (about 80%), among whom only 25% continued to work. Today, in Ukraine, as in other countries, there is no unified degree assessment systems of disability for people with visual impairments. In this regard, further scientific work is needed to develop standardized approaches to classification approaches to impairments in the daily functioning of persons with ophthalmic diseases that lead to disability. For the first time in Ukraine, the study proposes new methodological approaches to determining the correspondence of medical signs of disability to certain social signs, in particular, the domains of the International Classification of Functioning, Disability and Health. Additional application of the ICF, as a new national classifier, in medical practice and the work of social and pedagogical workers will allow for a more detailed description of the problems faced by persons with visual impairment in everyday life and a detailed definition of their impairment in daily functioning.

Key words: disability, rehabilitation, vision, ophthalmic pathology, health expertise, disturbance of vital activity, examination; International Classification of Functioning, Disability and Health

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10. [On approval of the national classifier NK 030:2022. Order of the Ministry of Economy of Ukraine No. 810-22 dated 2022 Apr 09]. [Internet]. 2022 [cited 2023 Jul 06]. Ukrainian.
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12. Kyrychenko A, Moroz OM, et al. [Basic indicators of disability and activity of medical and social expert commissions of Ukraine for 2022: analytical-informational guide]. Dnipro: Aktsent PP; 2023. 186 p. Ukrainian.
13. [Medical and social examination and rehabi­litation in pathology of the organ of vision. Study guide]. Dnipro: Lira; 2019. 184 p. Ukrainian.
14. [International classification of functioning, limitations of vital activity and health (ICF)]. Kyiv; 2018. 259 p. Ukrainian.
15. ICF [Internet]. [cited 2023 May 20]. Available from: https://apps.who.int/classifications/icfbrowser/
16. Lundeen EA, Flaxman AD, Wittenborn JS, et al. County-level differences in the prevalence of visual acuity loss or blindness in the United States. JAMA Ophthal­mology.2022 Aug 1;140(8):831-2. doi: https://doi.org/10.1001/jamaophthalmol.2022.2405
17. Li C, Zhu B, Zhang J, Guan P, Zhang G, Yu H, et al. Epidemiology, health policy and public health im­plications of visual impairment and age-related eye diseases in mainland China. Front Public Health. 2022 Nov 9;10:966006. doi: https://doi.org/10.3389/fpubh.2022.966006
18. Serdiuk VM, Isaiev OA. [Prevalence and epide­miology of primary open-angle glaucoma]. Ukrainian journal Ophthalmology [Internet]. 2021 [cited 2023 Aug 12];14(3). Ukrainian. Available from:
    https://oculist.in.ua/number14/388-3-14-55-57-abstract-ua.html
19. World Health Organization. World report on vision. 2019. [Internet]. 2019 [cited 2023 Aug 12]. Available from: https://www.who.int/publications/i/item/9789241516570
20. Fraser S, Beeman I, Southall K, Wittich W. Ste­reotyping as a barrier to the social participation of older adults with low vision: a qualitative focus group study. BMJ 2019 Sep 3;9(9):e029940. doi: https://doi.org/10.1136/bmjopen-2019-029940
21. Borysova IS. [Disability is at diabetic reti­no­pathy from positions of biopsychosocial model of ICF]. Pers­pektyvy ta innovatsii nauky. 2023;16:775-85. Ukrainian. doi: https://doi.org/10.52058/2786-4952-2023-16(34)-775-785

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Borysova I.S. 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/0000-0003-4703-6046

Borysova I.S. Disability due to ophthalmic pathology in Ukraine and Dnipro region (2018-2022). Modern approaches to determining the status of “person with disability”. Medicni perspektivi. 2025;30(1):108-116.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325367

Health and school difficulties of children in foster care in the experience of their foster parents

Exercise-induced oxidative stress can lead to muscle damage, with protein carbonyls serving as a key biomarker of oxidative modification in proteins. Roselle flower extract contains polyphenols with potential antioxidant properties that may reduce oxidative damage after physical exercise. This study investigated whether post-exercise supplementation of roselle flower extract reduces protein carbonyl levels. A randomized controlled trial with a parallel group pre-test/post-test design was con­ducted, comparing a placebo group with a treatment group receiving 500 mg of roselle flower extract. The extract did not result in a statistically significant reduction in protein carbonyl levels (p>0.05). However, a non-significant decreasing trend was observed, suggesting that future studies should explore larger sample sizes and longer intervention periods to assess potential cumulative effects. Further studies should explore the effects of higher doses of roselle flower extract (e.g., >500 mg/day) and chronic supplementation over several weeks to determine its long-term impact on markers of oxidative stress. 

Key words: roselle flower extract, oxidative stress, protein carbonyl, antioxidants, exercise-induced muscle damage

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47. Jomova K, Alomar SY, Alwasel SH, Nepovimo­va E, Kuca K, Valko M. Several lines of antioxidant defense against oxidative stress : antioxidant enzymes , nanomaterials with multiple enzyme – mimicking acti­vities , and low – molecular – weight antioxidants. Arch Toxicol.2024 May;98(5):1323-67. doi: https://doi.org/10.1007/s00204-024-03696-4
48. Anwar S, Alrumaihi F, Sarwar T, Babiker AY, Khan AA, Prabhu SV, et al. Exploring Therapeutic Po­tential of Catalase : Strategies in Disease Prevention and Management. 2024 Jun 14;14(6):697. doi: https://doi.org/10.3390/biom14060697
49. Wibawa JC, et al. Increased activity of the catalase enzyme after physical exercise as a signal for reducing hydrogen peroxide (H₂O₂): a systematic review. Fizjo­terapia 2024;5:232-8. doi: https://doi.org/10.56984/8ZG020C7GDL
50. Bloomer RJ, Davis PG, Consitt LA, Wideman L. Plasma protein carbonyl response to increasing exercise duration in aerobically trained men and women. Int J Sports Med. 2007 Jan;28(1):21-5. doi: https://doi.org/10.1055/s-2006-924140
51. Poblete Aro CE, Russell Guzmán JA, Soto Mu­ñoz ME, Villegas González BE. Effects of high intensity interval training versus moderate intensity continuous training on the reduction of oxidative stress in type 2 diabetic adult patients: CAT. Medwave.2015 Aug 13;15(7):e6212. doi: https://doi.org/10.5867/medwave.2015.07.6212
52. Quan H, Koltai E, Suzuki K, Aguiar AS Jr, Pin­ho R, Boldogh I, et al. Exercise, redox system and neurodegenerative diseases. Biochim Biophys Acta - Mol Basis Dis. 2020 Oct 1;1866(10):165778. doi: https://doi.org/10.1016/j.bbadis.2020.165778

Look through:

Ayubi N. Universitas Negeri Surabaya, Surabaya, Jawa Timur, Indonesia
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-5196-6636

Rusdiawan A. Universitas Negeri Surabaya, Surabaya, Jawa Timur, Indonesia
https://orcid.org/0000-0001-5388-7061

Hartoto S. Universitas Negeri Surabaya, Surabaya, Jawa Timur, Indonesia
https://orcid.org/0000-0003-1310-3570

Wibawa J.C. STKIP PGRI Trenggalek, Trenggalek, Jawa Timur, Indonesia

Rizki A.Z. Universitas Negeri Surabaya, Surabaya, Jawa Timur, Indonesia
https://orcid.org/0009-0006-7025-7209

Afandi A. Universitas Negeri Surabaya, Surabaya, Jawa Timur, Indonesia
https://orcid.org/0009-0009-7161-3852

Wardani A.P.S. Universitas Negeri Surabaya, Surabaya, Jawa Timur, Indonesia
https://orcid.org/0009-0009-2829-4075

Halip M.F. Universitas Negeri Surabaya, Surabaya, Jawa Timur, Indonesia
https://orcid.org/0000-0002-7208-6048

Jr P.B.D. Mariano Marcos State University, Batac, Ilocos Norte, Philippines
https://orcid.org/0000-0002-4249-6126

Ayubi N., Rusdiawan A., Hartoto S., Wibawa J.C., Rizki A.Z., Afandi A., Wardani A.P.S., Halip M.F., Jr P.B.D. Limited impact of roselle flower extract on protein carbonyl levels after physical exercise in healthy men. Medicni perspektivi. 2025;30(1):117-126. DOI: https://doi.org/10.26641/2307-0404.2025.1.325371

Diagnostic value of the gingival cytogram in school-age children suffering from chronic gastritis and duodenitis

Despite significant advances in the rehabilitation of patients with acute stroke, there is no convincing evidence on the effectiveness of individual interventions to improve function in the presence of visuospatial neglect (VSN). The aim of this study was to evaluate the impact of compensatory strategies on fine motor skills, gross motor functions of the upper limb, cognitive functions and disability in patients with acute stroke and visuospatial neglect during the post-acute rehabilitation period. In the study 86 patients were included, the mean age was 61.9±13.5 years. All patients were assessed for cognitive function, motor and sensory impairments, activity limitations, visual impairments, and visuospatial perception at the beginning and the end of rehabilitation. Patients were divided into two groups: the main group (n=18) with signs of VSN and the control group (n=68) without signs of VSN. All patients received 3 hours of rehabilitation interventions per day for 14 days. The occupational therapy program consists of compensatory techniques for patients in the main group. The use of the rehabilitation program improved the cognitive level of patients with acute stroke by an average of 3.2±3.0 points according to the Montreal Cognitive Test (p<0.05). At the same time it wasn’t established statistically significant difference between the groups at the end of the rehabilitation program (p>0.05). During the course of therapy an improvement in the gross motor functions of the upper limb on the opposite side to the area of damage to the cerebral hemisphere was determined according to the results of the “Box and Blocks” test (p<0.05). However, in the presence of VSN the dynamics was 4.2 times worse than in patients in the control group (p<0.05). When studying fine motor skills of the upper limb, the average time to complete the “9 pegs” test in the group with VSN was 14.5 seconds longer at the beginning of the study and 21.3 seconds longer at the end of the study (p<0.05). The effect of the standard therapy program led to significantly lower dynamics in the level of the Barthel Index in the group with VSN, which resulted in a lower level of the Barthel Index in this group at the end of the study (p<0.05). Thus, the use of approaches focused mainly on compensatory strategies is insufficient to restore fine motor and gross motor functions of the upper limb, which is an important base for a negative impact on the ability of patients to perform basic activities of daily living. Therefore, there is an urgent need to continue research to find therapeutic interventions aimed at restoring the functions of the affected limbs, starting from the earliest stages of rehabilitation.

Key words: stroke, visuospatial neglect, rehabilitation, occupational therapy, compensatory strategies, cognitive function, functioning, disability

1. Hillis AE. Neurobiology of unilateral spatial neglect. Neuroscientist. 2006 Apr;12(2):153-63. doi: https://doi.org/10.1177/1073858405284257
2. Esposito E, Shekhtman G, Chen P. Prevalence of spatial neglect poststroke: a systematic review. Ann Phys Rehabil Med. 2021;64:101459. doi: https://doi.org/10.1016/j.rehab.2020.10.010
3. Overman MJ, Binns E, Milosevich ET, De­meyere N. Recovery of Visuospatial Neglect With Standard Treatment: A Systematic Review and Meta-Analysis. Stroke.2024 Sep;55(9):2325-39. doi: https://doi.org/10.1161/STROKEAHA.124.046760
4. Chen P, Hreha K, Kong Y, Barrett AM. Impact of spatial neglect on stroke rehabilitation: evidence from the setting of an inpatient rehabilitation facility. Arch Phys Med Rehabil. 2015;96:1458-66. doi: https://doi.org/10.1016/j.apmr.2015.03.019
5. Moore MJ, Vancleef K, Riddoch MJ, Gille­bert CR, Demeyere N. Recovery of visuospatial neglect subtypes and relationship to functional outcome six months after stroke. Neurorehabil Neural Repair. 2021;35:82-35. doi: https://doi.org/10.1177/15459683211032977
6. Nijboer T, van de Port I, Schepers V, Post M, Vis­ser-Meily A. Predicting functional outcome after stroke: the influence of neglect on basic activities in daily living. FrontHum  2013 May 9;7:182. doi: https://doi.org/10.3389/fnhum.2013.00182 
7. Bosma MS, Nijboer TCW, Caljouw MAA, Ach­terberg WP. Impact of visuospatial neglect post-stroke on daily activities, participation and informal caregiver burden: a systematic review. Ann Phys Rehabil Med. 2020;63:344-58. doi: https://doi.org/10.1016/j.rehab.2019.05.006
8. Moore MJ, Driscoll R, Colwell M, Hewitt O, De­meyere N. Aligning formal and functional assessments of visuospatial neglect: a mixed-methods study. Neuro­psychol 2022;32:2560-79. doi: https://doi.org/10.1080/09602011.2021.1967172
9. National clinical guideline for stroke. Fifth Edition. UK: Royal college of Physycians; 2016. 151 p.
10. Kwakkel G, Kollen BJ. Predicting activities after stro­ke: what is clinically relevant? Int J Stroke. 2013;8(1):25-32. doi: https://doi.org/10.1111/j.1747-4949.2012.00967.x
11. Gibson E, Koh CL, Eames S, Bennett S, Scott AM, Hoffmann TC. Occupational therapy for cognitive impairment in stroke patients. Cochrane Database Syst Rev. 2022 Mar 29;3(3):CD006430. doi: https://doi.org/10.1002/14651858.CD006430.pub3
12. Nekhanevych O, Griban G, Sekretnyi V, Bakuri­dze-Manina V, Kaniuka Ye, Kovalenko T, et al. Predicting the Effectiveness of Physical Therapy in Hockey Players after Cerebral Concussion. International Journal of Human Movement and Sports Sciences. 2023;11(2):316-25. doi: https://doi.org/10.13189/saj.2023.110208
13. [Standard of medical care for ischemic stroke. Order of the Ministry of Health of Ukraine 20.06.2024 N 1070]. [Internet]. 2024 [cited 2024 Dec 17]. Ukrainian. Available from: https://moz.gov.ua/storage/uploads/a1795243-5238-47bc-a60c-241adf749ce7/dn_1070_20062024_dod.pdf
14. Vratsistas-Curto A, Downie A, McCluskey A, Sher­rington C. Trajectories of arm recovery early after stroke: an exploratory study using latent class growth analysis. Ann 2023 Dec;55(1):253-65. doi: https://doi.org/10.1080/07853890.2022.2159062
15. Hassanin AM, Aly MG, Atef H, Marques-Sule E, Ahmed GM. Task-oriented training for upper limb functions in patients with multiple sclerosis: Systematic review and meta-analysis. Mult Scler Relat Disord. 2023 May;73:104625. doi: https://doi.org/10.1016/j.msard.2023.104625
16. Huang YD, Li W, Chou YL, Hung ES, Kang JH. Pendulum test in chronic hemiplegic stroke population: additional ambulatory information beyond spasticity. Sci Rep.2021;11(1):14769. doi: https://doi.org/10.1038/s41598-021-94108-5
17. Hulyaeva МV, Piontkovsky MІ, Piontkovska МІ. [Scales in Neurorehabilitation]. Kyiv: Publisher D.V. Hulyaev; 2014. 68 p. Ukrainian.
18. Stroke rehabilitation in adults. NICE guideline [Internet]. 2023 Oct 18 [cited 2024 Dec 17];18. Available from: https://www.nice.org.uk/guidance/ng236
19. Pirogkov SІ, Ryazantsev VV, Motorin RМ. [Sta­tistic: textbook]. Kyiv: Kyiv National Trade University; 2020. 328 p. doi: http://doi.org/10.31617/p.knute.2020-164
20. Buxbaum LJ, Ferraro MK, Veramonti T, Farne A, Why­te J, et al. Hemispatial neglect: Subtypes, neuroanatomy, and disability. Neurology. 2004 Mar 9;62(5):749-56. doi: https://doi.org/10.1212/01.wnl.0000113730.73031.f4
21. Mead GE, Sposato LA, Sampaio Silva G, Yper­zeele L, Wu S, Kutlubaev M, et al. A systematic review and synthesis of global stroke guidelines on behalf of the World Stroke Organization. Int J Stroke. 2023 Jun;18(5):499-531. doi: https://doi.org/10.1177/17474930231156753
22. Demeyere N, Gillebert CR. Ego- and allocentric visuospatial neglect: dissociations, prevalence, and late­rality in acute stroke. Neuropsychology. 2019;33:490-8. doi: https://doi.org/10.1037/neu0000527
23. Cumming TB, Plummer-D’Amato P, Linden T, Bernardt J. Hemispatial neglect and rehabilitationin acute stroke. Archives of Physical Medicine and Rehabilitation. 2009;90:1931-6. doi: https://doi.org/10.1016/j.apmr.2009.04.022

Look through:

Totska A.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0009-0001-7169-3022

Nekhanevych O.B. 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/0000-0003-0307-784X

Korota Yu.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0009-0000-7536-7673

Mokhna V.S. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-6009-6110

Kharchenko V.O. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0009-0000-2034-1927

Totska A.V. Nekhanevych O.B., Korota Yu.V., Mokhna V.S., Kharchenko V.O. The effectiveness of compensatory strategies in the rehabilitation of patients with visuospatial neglect during the post-acute period of stroke rehabilitation. Medicni perspektivi. 2025;30(1):127-134. DOI: https://doi.org/10.26641/2307-0404.2025.1.325373

Results of biochemical and histological studies after restoration of bone defects using cellular technologies in dental patients

The study aimed at generating an evidence-informed, culturally adapted and valid translation of the Canadian Occupational Performance Measure (COPM) into the Ukrainian language. Due to increased need for rehabilitation of military personnel during the ongoing war, the secondary purpose of the study was to investigate the feasibility of using the COPM with military servicemen and veterans. The translation procedure followed established guidelines for cross-cultural adaptation of outcome measures with an addition of a Committee Approach to ensure alignment of the translation with the emerging professional terminology in Ukrainian. During pre-testing and field testing, the newly translated Ukrainian version of the COPM was used with 84 occupational therapy clients, 51% of whom were military servicemen and 49% representing general population. Content validity was assessed using Content Validity Index (CVI) with feedback from 20 occupational therapists and 84 clients from six regions of Ukraine through anonymous surveys developed in adherence with the COSMIN methodology for evaluating the content validity of patient-reported outcome measures. As a result, the CVI calculated from anonymous responses of clients of occupational therapy ranged from 0.89 to 0.99 on items associated with relevance, comprehensiveness and comprehensibility of the outcome measure. CVI calculated from responses of occupational therapists was 1.0 for all categories, indicating outstanding content validity. Both occupational therapists and clients of occupational therapy reported the perceived positive impact of the COPM on client-centeredness and occupational focus of occupational therapy services. The new Ukrainian translation of the COPM demonstrated sufficient cultural equivalence, and content validity, making it a valid tool for client-centered and occupation focused occupational therapy practice with both the civilian population and military servicemen. The study describes the first translation and validation of an occupational therapy outcome measure in Ukrainian, contributs to the development of rehabilitation and occupational therapy terminology and the development of occupational therapy in Ukraine. Future studies are necessary for continued psychometric testing of the Ukrainian translation of the COPM with military personnel as well as the general population.

Key words: occupational therapy, outcome measures, disability and health, cross-cultural adaptation, content validation, military servicemen

1. Carswell A, McColl MA, Baptiste S, Law M, Polatajko H, et al. The Canadian occupational performance measure: a research and clinical literature review. Can J Occup 2004;71(4):210-22. doi: https://doi.org/10.1177/000841740407100406 
2. Law M, Baptiste S, Carswell A, McColl M, Pola­tajko H, Pollock N. Canadian occupational performance measure. Altona, Canada: COPM, Inc; 2019. 58 p. doi: https://doi.org/10.1037/t71986-000
3. Ohno K, Tomori K, Sawada T, Seike Y, Yagu­chi A, Kobayashi R. Measurement properties of the Cana­dian occupational performance measure: a systematic review. Am J Occup Ther. 2021;75(6):7506205100. doi: https://doi.org/10.5014/ajot.2021.041699
4. Mangusheva OO, Lazarieva OB, Enemark Lar­sen A. Exploring the use of the Canadian occupational performance measure (COPM) in Ukraine: determining the need. Rehabil 2024;18(3):32-40. doi: https://doi.org/10.32782/2522-1795.2024.18.3.3
5. Cruchinho P, López-Franco MD, Capelas ML, Al­meida S, Bennett PM, Miranda da Silva M, et al. Trans­lation, cross-cultural adaptation, and validation of measurement instruments: a practical guideline for novice researchers. J Multidiscip Healthc. 2024;17:2701-28. doi: https://doi.org/10.2147/jmdh.s419714
6. Praveen S, Parmar J, Chandio N, Arora A. A Sys­tematic Review of Cross-Cultural Adaptation and Psy­chometric Properties of Oral Health Literacy Tools. Int J Environ Res Public Health. 2021;18(19):10422. doi: https://doi.org/10.3390/ijerph181910422
7. Herdman M, Fox-Rushby J, Badia X. A model of equivalence in the cultural adaptation of HRQoL instru­ments: the universalist approach. Qual Life Res. 1998;7(4):323-35. doi: https://doi.org/10.1023/A:1008846618880
8. Arafat S, Chowdhury H, Qusar M, Hafez M. Cross cultural adaptation and psychometric validation of research instruments: a methodological review. J Behav Health. 2016;5(3):129. doi: https://doi.org/10.5455/jbh.20160615121755
9. Terwee CB, Prinsen CA, Chiarotto A, Wester­man MJ, Patrick DL, Alonso J, et al. COSMIN methodo­logy for evaluating the content validity of patient-reported outcome measures: a Delphi study. Qual Life Res. Mar 2018;27(5):1159-70. doi: https://doi.org/10.1007/s11136-018-1829-0
10. Bull C, Crilly J, Latimer S, Gillespie BM. Estab­lishing the content validity of a new emergency department patient-reported experience measure (ED PREM): a Delphi   study. BMC Emerg Med. 2022;22(1):65. doi: https://doi.org/10.1186/s12873-022-00617-5
11. Lövestad S, Sjöström K, Björk J, Örmon K. The questions on violence (FOV) tool for interpersonal vio­lence inquiry in Swedish healthcare settings – evaluation of content validity, face validity and test-retest reliability. BMCHealth Serv  2024;24(1):1240. doi: https://doi.org/10.1186/s12913-024-11708-3
12. Adamit T, Shames J, Rand D. Effectiveness of the functional and cognitive occupational therapy (facot) inter­vention for improving daily functioning and participation of individuals with mild stroke: a randomized controlled trial. Int J Environ Res Public Health. 2021;18(15):7988. doi: https://doi.org/10.3390/ijerph18157988
13. Duncan Millar J, Van Wijck F, Pollock A, Ali M. International consensus recommendations for outcome measurement in post-stroke arm rehabilitation trials. Eur J Phys Rehabil Med.2021 Feb;57(1):61-8. doi: https://doi.org/10.23736/S1973-9087.20.06575-2
14. Budgett J, Sommerlad A, Kupeli N, Zabihi S, Ol­sen A, Cooper C. Setting individualised goals for people living with dementia and their family carers: A systematic review of goal-setting outcome measures and their psychometric properties. Dementia. Dementia (London). 2024 Feb;23(2):312-40. doi: https://doi.org/10.1177/14713012231222309
15. Mc Kittrick A, Jones A, Lam H, Biggin E. A feasibility study of the Canadian Occupational Perfor­mance Measure (COPM) in the burn cohort in an acute tertiary facility. Burns.2021;(48):1183-9. doi: https://doi.org/10.1016/j.burns.2021.09.005
16. Beit Yosef A, Refaeli N, Jacobs JM, Shames J, Gilboa Y. Exploring the Multidimensional Participation of Adults Living in the Community in the Chronic Phase following Acquired Brain Injury. Int J Environ Res Public Health. 2022;19(18):11408. doi: https://doi.org/10.3390/ijerph191811408
17. de Waal MW, Haaksma ML, Doornebosch AJ, Meijs R, Achterberg WP. Systematic review of measu­rement properties of the Canadian Occupational Perfor­mance Measure in geriatric rehabilitation. Eur Geriatr Med.2022 Aug 23;13(6):1281-98. doi: https://doi.org/10.1007/s41999-022-00692-8
18. Torpil B, Ekici Çağlar G, Bumin G, Pekçetin S. Validity and Reliability of the Turkish Canadian occupa­tional performance measure (COPM-TR) for people with multiple sclerosis. Occup Ther Health Care. 2021;35(3):306-17. doi: https://doi.org/10.1080/07380577.2021.1933673
19. Bianchini E, Della Gatta F, Virgilio M, Al­borghetti M, Salvetti M, Giubilei F, et al. Validation of the canadian occupational performance measure in Italian parkinson’s disease clients. Phys Amp Occup Ther Geriatr. 2021:40(1):26-37. doi: https://doi.org/10.1080/02703181.2021.1942392
20. Vyslysel G, Barker D, Hubbard IJ. The Canadian Occupational Performance Measure (COPM) as Routine Practice in Community-Based Rehabilitation: A Retro­spective Chart Review. Arch Rehabil Res Clin Transl. 2021 May 24;3(3):100134. doi: https://doi.org/10.1016/j.arrct.2021.100134
21. Mouchaers I, Verbeek H, van Haaster S, van Haastregt JC, Vlaeyen E, Goderis G, et al. What matters to you? A mixed-method evaluation of goal setting and attainment within reablement from a client perspective. ScandJ Occup  2024 May;31(1):2356548. doi: https://doi.org/10.1080/11038128.2024.2356548
22. Yusoff MS. ABC of Content Validation and Content Validity Index Calculation. Educ Med J. 2019;11(2):49-54. doi: https://doi.org/10.21315/eimj2019.11.2.6
23. Larsen AE, Morville AL, Hansen T. Translating the Canadian occupational performance measure to danish, addressing face and content validity. Scand J Occup Ther. 2017;26(1):33-45. doi: https://doi.org/10.1080/11038128.2017.1388441
24. Enemark Larsen A, Jessen Winge C, Christen­sen JR. Clinical utility of the danish version of the Canadian occupational performance measure. Scand J Occup 2019 Jul;28(3):239-50. doi: https://doi.org/10.1080/11038128.2019.1634150
25. Enemark Larsen A, Wehberg S, Christensen JR. Looking into the content of the Canadian occupational performance measure (COPM): a danish cross-sectional study. OccupTher  2020:1-11. doi: https://doi.org/10.1155/2020/9573950
26. Tuntland H, Aaslund M, Langeland E, Espe­haug B, Kjeken I. Psychometric properties of the Canadian occupational performance measure in home-dwelling older adults. JMultidiscip  2016;9:411-23. doi: https://doi.org/10.2147/jmdh.s113727  
27. Parker DM. An exploration of client-centered practice in occupational therapy: perspectives and impact [dissertation]. Birmingham: University of Birmingham; 2013. 318 p.
28. Enemark Larsen A, Rasmussen B, Christensen JR. Enhancing a client-centred practice with the Canadian occupational performance measure. Occup Ther Int. 2018;2018:1-11. doi: https://doi.org/10.1155/2018/5956301
29. Sawada T, Tomori K, Ohno K, Takahashi K, Saito Y, Levack W. Information bias in the Canadian occupational performance measure: a qualitative study.   BrJ Occup Ther. 2022;85(9):030802262210792. doi: https://doi.org/10.1177/03080226221079234
30. Colquhoun H, Letts L, Law M, MacDermid J, Ed­wards M. Routine administration of the Canadian occupational performance measure: effect on functional outcome. Aust Occup Ther J. 2010;57(2):111-7. doi: https://doi.org/10.1111/j.1440-1630.2009.00784.x
31. Dedding C, Cardol M, Eyssen IC, Beelen A. Validity of the Canadian occupational performance measure: a client-centred outcome measurement. Clin Rehabil.2004;18(6):660-7. doi: https://doi.org/10.1191/0269215504cr746oa  
32. Karstensen JK, Kristensen HK. Client-centred practice in Scandinavian contexts: A critical discourse analysis. Scand J Occup Ther. 2020 Jun 4;28(1):46-62. doi: https://doi.org/10.1080/11038128.2020.1769183
33. Moyers PA. Patient Consumerism and Its Influence on the Future of Occupational Therapy. Am J Occup Ther. 2023 Sep;77(5):7705090010. doi: https://doi.org/10.5014/ajot.2023.050384
34. Cahill S, Richardson H. Shared Decision Making and Reducing the Use of Low-Value Occupational Therapy Interventions. Am J Occup Ther. 2022;76(3):7603090010. doi: https://doi.org/10.5014/ajot.2022.050065
35. Walder K, Bissett M, Molineux M, Whiteford G. Understanding professional identity in occupational therapy: A scoping review. Scand J Occup Ther. 2021;29(3):175-97. doi: https://doi.org/10.1080/11038128.2021.1974548
36. Kerr NC, Ashby S, Gerardi SM, Lane SJ. Occu­pational therapy for military personnel and military veterans experiencing post‐traumatic stress disorder: A scoping review. Aust Occup Ther J. 2020;67(5):479-97. doi: https://doi.org/10.1111/1440-1630.12684

Look through:

Mangusheva O.O. University of Indianapolis, College of Health Sciences, School of Occupational Therapy, Indianapolis, Indiana, USA; National University of Ukraine on Physical Education and Sport, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-7528-2597

Lazarieva O.B. National University of Ukraine on Physical Education and Sport, Kyiv, Ukraine
https://orcid.org/0000-0002-7435-2127

Larsen A. Enemark University College Copenhagen, Faculty of Health, Institute of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Department of Occupational Therapy, Copenhagen N, Denmark
https://orcid.org/0000-0003-1395-4156

Mangusheva O.O., Lazarieva O.B., Larsen A. Enemark Translation, cross-cultural adaptation and content validation of the Canadian Occupational Performance Measure (COPM) in the Ukrainian language. Medicni perspektivi. 2025;30(1):135-149.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325375

Indicative features of tissue and microbial sensitization in the pathogenesis of generalized parodontitis associated with rheumatoid arthritis

The article explores the concept of active aging in Bulgaria, emphasizing the economic, social, and health benefits of implementing policies aimed at older adults. In light of the rapid population aging, Bulgaria faces significant demographic challenges impacting its economic, social, and health systems. The primary objective of the research is to analyze the strategic framework and active aging policies at both national and regional levels, focusing on their effects on the quality of life, health status, and social integration of the elderly. This study uses a mixed methods approach integrating both quantitative and qualitative analysis to assess the economic and social impact of active aging policies in Bulgaria. This approach combines quantitative data that provide objective measurements of current status with qualitative analyzes that provide an in-depth understanding of the context and impact of existing programs. Through this approach, the research aims to provide a basis for formulating specific and effective recommendations to improve policies and programs in the field of active aging and healthy living of the elderly. This multi-layered approach will provide a basis for future research and policies aimed at improving the quality of life of older people, emphasizing the importance of active aging and healthy lifestyles in the context of dynamically changing social and economic conditions in Bulgaria. Active aging is linked to numerous benefits, such as improved health outcomes, increased social engagement, reduced poverty, and enhanced economic productivity. By fostering an active lifestyle and improving access to health and social services, the pressure on Bulgaria's healthcare system is alleviated. However, challenges persist, notably insufficient coordination among institutions and a lack of integrated policies. The article concludes with specific recommendations for enhancing existing programs, including the establishment of a central coordinating body for active aging policies, ensuring sustainable funding for health and social services, and implementing innovative strategies such as digital learning for promoting healthy lifestyles and chronic disease prevention. These measures aim to enhance the socio-economic and health conditions of the elderly in Bulgaria while supporting overall economic growth.

Key words: aging, active aging, healthcare, social integration, economic growth, demographic changes, healthcare management

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Vazova T. Plovdiv University Paisii Hilendarski, Plovdiv, Bulgaria,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-0768-9720

Stasiuk Y. Oles Honchar Dnipro National University, Dnipro, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6644-8658 

Vazova T., Stasiuk Y. Active policies to promote active aging and address demographic challenges in Bulgaria. Medicni perspektivi. 2025;30(1):150-165.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325454

On the issue of creating an algorithm for assessing safety culture in modern healthcare institutions

The problem of the influence of environmental heavy metals on the human body is extremely relevant. At the same time, the study of trace element status under the influence of environment and during various pathological processes in the body using modern biomonitoring methods is increasingly used as a tool for risk assessment, risk communication and decision-making on public health risk management. The purpose of the work was to determine the concentration and gender-age characteristics of the content of toxic and potentially toxic trace elements from the group of heavy metals in the urine of clinically healthy residents of the industrial region and patients with pyelonephritis. To achieve the goal, the content of toxic and potentially toxic trace elements – aluminum, lead, barium, cadmium and strontium - was determined in the urine of 108 residents of the Dnipropetrovsk region - clinically healthy individuals and patients with pyelonephritis during 2022-2024. It was established that the content of toxic and potentially toxic metals in the urine of conditionally "healthy" residents of the industrial region fluctuates in a wide range, cadmium concentration in the urine of the inhabitants of the region corresponds to the reference values, however it exceeds them in terms of aluminum, barium, lead and strontium content. The content of such xenobiotics as lead, cadmium and barium is 1.4-14.2 times higher than the data of studies conducted in the territory of the ecological-geochemical optimum according to the maximum and average indicators, which indicates their technogenic origin. Concentrations of barium, cadmium, lead, and strontium in urine of men is higher than in women, with lower levels of aluminum. The development of diseases of the urinary system is accompanied and may be aggravated by microelement imbalance, which is manifested by a significant increase in the concentration of aluminum and cadmium by 1.4-1.7 times with a decrease in the content of barium. During kidney diseases development adaptation of the organism was defined as a stage of tension and was related to the duration of the disease. The obtained results are an important basis for the further development of the national base of reference values for microelements content in the biosubstrates during biomonitoring for the timely diagnosis of microelement dyshomeostasis and the implementation of a set of measures to improve public health.

Key words: heavy metals, trace elements, biosubstrates, urine, biomonitoring, industrial region, imbalance

1. Zhang Z, Guo S, Hua L, et al. Urinary levels of 14 metal elements in general population: a region-based ex­ploratory study in china. Toxics. 2023;11(6):488. doi: https://doi.org/10.3390/toxics11060488
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Onul N.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/0000-0002-4968-3469

Yuntunen H.M. CE "Dnipropetrovsk Regional Blood Transfusion Station", Dnipro, Ukraine
https://orcid.org/0009-0004-5918-6898

Rodionova V.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-0221-5625

Biletska E.M. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-0256-2002

Polion M.Iu. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-9307-1411

Turenko O.A. CNCE "City Clinical Hospital No.4" Dnipro City Council, Dnipro, Ukraine
https://orcid.org/0000-0002-8830-6674

Onul N.M., Yuntunen H.M., Rodionova V.V., Biletska E.M., Polion M.Iu., Turenko O.A. Biomonitoring of toxic and potentially toxic trace elements in the urine of residents of an industrial region. Medicni perspektivi. 2025;30(1):166-173.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325456

On the issue of creating an algorithm for assessing safety culture in modern healthcare institutions

This study aimed to investigate the effect of water treated with a magnetic field with different induction on the histological structure of the kidney and testicular tissue of albino rats. For this purpose, fifty albino rats were divided into five equal groups, the first of which was used as a control group, drank clean tap water for four weeks, the other groups were given daily water treated with a magnetic field with an induction of 500, 1000, 1500 and 2000 gauss. Then the animals were sacrificed and histological changes in the kidneys and testicles were examined. Histopathological examination of the kidneys of animals that were given water treated with a magnetic field with an induction of 500, 1000 and 1500 gauss revealed normal renal tubules and glomeruli. Histopathological examination of the kidneys of rats that consumed water treated with a magnetic field with an induction of 2000 gauss showed numerous focal hemorrhages and vacuolar degeneration of the epithelium lining the tubules. Histological sections at magnification revealed vacuolar degeneration of the epithelium of the tubules, mainly the collecting tubules, the formation of tubular casts and tubular necrosis. Examination of the testicular tissue of rats exposed to water treated with a magnetic field with an induction of 500 and 1000 gauss showed normal seminiferous structure and cytoarchitecture of the germinal epithelium areas, as well as normal interstitial tissue. In contrast, rats given water treated with a magnetic field with an induction of 1500 gauss showed marked narrowing of the seminiferous tubules, moderate vacuolar degeneration of the germinal epithelium, necrosis of a number of spermatogonia cells, and thickening of the testicular interstitium. Histopathological examination of the testes of rats exposed to water treated with a magnetic field with an induction of 2000 gauss showed significant vacuolar degeneration, necrosis of a number of spermatogonia cells, and thickening of the testicular interstitium, as well as significant damage to the seminiferous tubules and germinal epithelium. Thus, water treated with a magnetic field with an induction of 2000 gauss negatively affected both the kidneys and testicles, while water treated with a magnetic field with strength of 1000 gauss improved the function of the kidney and testicular tissue of rats and did not affect their structure.

Key words: magnetic water, kidney, testes, rats

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4. Attia YA, Abd-Elhamid AEE, Mustafa M, Al-Harthi MA, Muhammad M. Response of slow-growing chickens to feed restriction and effects on growth per­formance, blood constituents and immune markers. Rev MexCienc  2017 Apr 1;8(2):175-84. doi: https://doi.org/10.22319/rmcp
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21. Alimi F. Influence of Magnetic Field on Calcium Carbonate Precipitation: A Critical Review. Magneto­chemistry.2024;10(11):83. doi: https://doi.org/10.3390/magnetochemistry10110083
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Sura Fouad Alsaffar University of Baghdad, College of Science, Department of Biology, Aljaderiah campus, Baghdad, Iraq
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-4657-9404

Lamyaa Abdulridha Fadhil University of Baghdad, College of Science, Department of Biology, Aljaderiah campus, Baghdad, Iraq

Ishraq Mohammed Baker University of Baghdad, College of Science, Department of Biology, Aljaderiah campus, Baghdad, Iraq

Sura Fouad Alsaffar, Lamyaa Abdulridha Fadhil, Ishraq Mohammed Baker The impact of varying intensities of magnetically treated water on renal and testicular tissue. Medicni perspektivi. 2025;30(1):173-186.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325457

On the issue of creating an algorithm for assessing safety culture in modern healthcare institutions

In hospital conditions the prevalence of errors in prescribing drugs is 2-94%. The prevalence of errors in prescribing chemotherapeutic drugs is 1-3% of adults. An important area of improvement of the chemotherapy and pharmaceutical service management system is the introduction of innovative technologies aimed at automating quality control processes. The purpose of the work is to compare the level of errors while using drugs in oncology patients and patients of the surgical department and to form principles for improving the management system of chemotherapy and pharmaceutical services by automating processes. During the research, an analysis of scientific publications and a retrospective analysis (examination of internal documents) were carried out, followed by generalization and comparison of data. Statistical processing of the results was carried out using the method of interval dynamic series analysis. Error rates were presented using median and quartiles (Me [Q1; Q3]), comparisons were made using the Mann-Whitney test (p<0.05). The level of errors in appointment lists in the surgical hospital for the analyzed period was 27.2 [19.3; 45.9], at the same time in the oncology department this indicator was 249.2 [220.8; 390.6]. That is, the rate of errors in the oncology department is on average 8.9 (5.6-18.3) times higher (p<0.001) than in the surgical hospital. The level of errors in appointment lists in the oncology department significantly (p<0.05) decreased from 379.17 in the first half of the analyzed period (03.01.23-09.30.23) to 212.67 in the next similar period (10.01.23-04.01.24), which is explained by the introduction of an automated decision-making algo­rithm in the information system. Therefore, it can be concluded that the level of errors in the appointment lists in the onco­logy department is on average by 8.9 (5.6-18.3) times higher (p<0.001) than in the surgical hospital, as well as the level of errors in the appointment lists of the oncology department significantly (p<0.05) decreased from 379.17 to 212.67 in the first half of the analyzed period in the next similar period due to timely detection and analysis of deviations, implementation of an automated decision-making algorithm in the information system of the medical center, improvement of individual work with by health care specialists and revision of professional roles, as well as to change the structure of providing medical care.

Key words: chemotherapy and pharmaceutical service management, error management, management decision algorithm, deviations in appointment lists 

1. Assiri GA, Shebl NA, Mahmoud MA, Aloudah N, Grant E, Aljadhey H, et al. What is the epidemiology of medication errors, error-related adverse events and risk factors for errors in adults managed in community care contexts? A systematic review of the international litera­ture.BMJ  2018 May 5;8(5):e019101. doi: https://doi.org/10.1136/bmjopen-2017-019101
2. Suclupe S, Martinez-Zapata MJ, Mancebo J, Font-Vaquer A, Castillo-Masa AM, Viñolas I, et al. Medication errors in prescription and administration in critically ill J Adv Nurs. 2020 May;76(5):1192-200. doi: https://doi.org/10.1111/jan.14322
3. Rodziewicz TL, Houseman B, Hipskind JE. Medi­cal Error Reduction and Prevention. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan [cited 2024 Apr 12]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499956/
4. Moon JY, Lee Y, Han JM, Lee MH, Yee J, Song MK, et al. Effects of pharmacist interventions on reducing prescribing errors of investigational drugs in oncology clinical trials. J Oncol Pharm Pract. 2020 Jan;26(1):29-35. doi: https://doi.org/10.1177/1078155219834723
5. Valencia Quintero AF, Amariles P, Rojas He­nao N, Granados J. [Medication errors in pediatrics]. Andes Pediatr. 2021 Apr;92(2):288-97. Spanish. doi: https://doi.org/10.32641/andespediatr.v92i2.1357
6. Adil MS, Sultana R, Khulood D. PRIME study: Prescription review to impede medication errors. Int J Risk Saf 2020;31(2):67-79. doi: https://doi.org/10.3233/JRS-191025
7. Weingart SN, Zhang L, Sweeney M, Hassett M. Chemotherapy medication Lancet Oncol. 2018 Apr;19(4):e191-e199. doi: https://doi.org/10.1016/S1470-2045(18)30094-9
8. Tariq RA, Vashisht R, Sinha A, Scherbak Y. Me­dication Dispensing Errors And Prevention. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan [cited 2024 Apr 12]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519065/
9. Atif M, Azeem M, Rehan Sarwar M, Malik I, Ah­mad W, Hassan F, et al. Evaluation of prescription errors and prescribing indicators in the private practices in Bahawalpur, Pakistan. J Chin Med Assoc. 2018 May;81(5):444-9. doi: https://doi.org/10.1016/j.jcma.2017.12.002
10. Samuseva AA, Zotov OS. [Antitumor chemo­the­rapy: possible risks, mistakes during the implementation and ways of their prevention]. Likariu, shcho praktykuie. Praktychna onkolohiia. 2019;2(1):26-9. Ukrainian. doi: https://doi.org/10.22141/oncology.2.1.2019.165450
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    https://www.mif-ua.com/archive/article/51604
12. Skrynnikova KO. [Qualification of medicinal (me­dical) errors]. Naukovyi visnyk Uzhhorodskoho Na­tsionalnoho Universytetu. Ser.: Pravo. 2023;80(1):246-52.
    doi: https://doi.org/10.24144/2307-3322.2023.80.1.35
13. 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.
14. Kassem AB, Saeed H, Bassiouny NA, Kamal M. Assessment and analysis of outpatient medication errors related to pediatric prescriptions. Saudi Pharm J. 2021 Oct;29(10):1090-5. doi: https://doi.org/10.1016/j.jsps.2021.08.009
15. Bohórquez Moreno C, Suárez Rivera M, Moli­nares Avila A, Arroyo Gonzalez S, Madero Zambrano K. [Pre­scription errors and drug interactions in adults hos­pitalized in an intensive care unit in Barranquilla (Colom­bia)]. Rev Esp Salud Publica. 2023 Apr 21;97:e202304031. PMID: 37083193; PMCID: PMC10541242.
16. Ashokkumar R, Srinivasamurthy S, Kelly JJ, Ho­ward SC, Parasuraman C, Uppugunduri RS. Frequency of Chemotherapy Medication Errors: A Systematic Review. Journal of Pharmacology and Pharmacotherapeutics. 2018;9(2):86. doi: https://doi.org/10.4103/jpp.JPP_61_18

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Zalyhina Ye.V. Dnipro State Medical University; LLC "Endotechnomed", surgical clinic "Garvis", Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
http://orcid.org/0000-0002-0478-5664

Bereznytskyi Ya.S. Dnipro State Medical University; LLC "Endotechnomed", surgical clinic "Garvis", Dnipro, Ukraine
http://orcid.org/0000-0003-2968-7443

Zalyhina Ye.V., Bereznytskyi Ya.S. Improvement of the chemotherapy and pharmaceutical service management system by monitoring drug prescription errors in oncology patients. Medicni perspektivi. 2025;30(1):187-195.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325460

On the issue of creating an algorithm for assessing safety culture in modern healthcare institutions

In the Czech Republic, foreig­ners constitute approximately one-tenth of the population: as of the end of 2022, over 1,065,740 foreigners were living in the country, a fourteenfold increase since 1993. The war in Ukraine has significantly increased the number of Ukrainian migrants, who now make up more than half of all foreigners in the country. This demographic shift has presented new challenges to the healthcare system, which must adapt to these changing realities. This article aims to identify the specific healthcare and social support needs of foreigners in the Czech Republic and to assess the strengths and weaknesses of their integration process. Materials and This research was conducted as part of the GAJU project 101/2022/S, funded by the University of South Bohemia in České Budějovice. Data collection occurred from January to October 2023 through a survey of 1,010 migrants residing in the Czech Republic, of whom 885 were Ukrainians. The questionnaire, developed based on a literature review, included questions on body mass index (BMI), subjective per­ception of health, socio-economic conditions, and access to medical and social services. The data were processed using SASD 1.5.8, and statistical associations were tested using Pearson's chi-square test (p<0.05). The study show that 61.9% of migrants had a normal BMI and reported the most positive health perceptions. In contrast, 30% of migrants faced barriers to accessing healthcare services, such as language difficulties and lack of health insurance. Additionally, 45% of migrants in stable employment reported good health, compared to only 25% of those in unstable employment. Furthermore, 15% of respondents reported having chronic illnesses, negatively affecting their health and integration process. These findings emphasize the need for a comprehensive healthcare policy that addresses the socio-economic and medical needs of migrants. Improving healthcare access and promoting stable employment are critical for enhancing migrants' well-being and ensuring their successful integration into Czech society. Involving migrants in decision-making processes is essential to achieve equitable access to medical services and support their integration.

Key words: migrants, healthcare, integration, health-related data, socio-economic factors

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14. Wickramage K, Simpson PJ, Abbasi K. Improving the health of migrants. BMJ. 2019 Sep 16;366:15324. doi: https://doi.org/10.1136/bmj.l5324
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16. Acquadro-Pacera G, Valente M, Facci G, Molla Kiros B, Della Corte F, Barone-Adesi F, et al. Exploring differences in the utilization of the emergency department between migrant and non-migrant populations: a sys­tematic review. BMC Public Health. 2024;24(1):963. doi: https://doi.org/10.1186/s12889-024-18472-3
17. Ledoux C, Pilot E, Diaz E, Krafft T. Migrants' access to healthcare services within the European Union: a content analysis of policy documents in Ire­land, Portugal, and Spain. Glob Health. 2018;14(1):57. doi: https://doi.org/10.1186/s12992-018-0373-6
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21. Hamel-Smith Grassby M, Wiedmeyer ML, La­vergne MR, Goldenberg SM. Qualitative evaluation of a mandatory health insurance 'wait period' in a publicly funded health system: understanding health inequities for newcomer im/migrant women. BMJ Open. 2021;11(8):e047597. doi: https://doi.org/10.1136/bmjopen-2020-047597
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26. Savas ST, Knipper M, Duclos D, Sharma E, Ugar­te-Gurrutxaga MI, et al. Migrant-sensitive healthcare in Europe: advancing health equity through accessibility, acceptability, quality, and trust. Lancet Reg Health Eur. 2024;41:100805. doi: https://doi.org/10.1016/j.lanepe.2023.100805

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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

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

Němečková K. University of South Bohemia, České Budějovice, Czech Republic
https://orcid.org/0009-0006-0714-6493

Shuranova L., Vacková J., Švestková R., Prokešová R., Němečková K. Access to healthcare for foreigners in the Czech Republic: challenges, opportunities, and pathways to integration. Medicni perspektivi. 2025;30(1):195-201.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325465

Optimization and standardization of the work of a health care facility during a chemical accident

A worldwide decrease in the incidence of gastric cancer and its most common form, adenocarcinoma, has long been observed. Helicobacter pylori (H. pylori) is a causative carcinogen for gastric adenocarcinoma. Triple and quadruple regimens for H. pylori eradication have been well identified and established. Aims of the research: this article aims to evaluate trends in the administration of combined drug therapy for H. pylori eradication and how this can impact gastric cancer rates in Ukraine.Defined daily doses (DDD) of the combined drugs for H. pylori eradication (years 2014-2020), gastric cancer, and gastric adenocarcinoma incidence rates in Ukraine from 2014 to 2021 were calculated and analyzed annually per 100,000 of inhabitants. The number of DDDs of the combined drugs used in H. pylori eradication increased by 27.28% (p<0.0001). The incidence of gastric cancer decreased by 26.56% (p<0.0001) from 2014 to 2021. Gastric adeno­carcinoma was the most common form of gastric cancer comprising 94.56% (93.04–96.56%, 95% CI) of all cases. In Ukraine, the consumption of combined drugs for H. pylori eradication increased from 2014 to 2020, while the incidence of gastric cancer and gastric adenocarcinoma decreased from 2014 to 2021. Gastric adenocarcinoma is the most common form of gastric cancer in Ukraine. Use of these drugs might contribute to the decrease in gastric cancer incidence rate. These trends reflect global patterns.

Key words: Helicobacter pylori, eradication, gastric cancer, Ukraine

1. Waldum H, Fossmark R. Gastritis, Gastric Polyps and Gastric Cancer. International Journal of Molecular Sciences. 2021 Jun 18;22(12):6548. doi: https://doi.org/10.3390/ijms22126548
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8. Hollingworth S, Kairuz T. Measuring Medicine Use: Applying ATC/DDD Methodology to Real-World Data. 2021 Mar 17;9(1):60. doi: https://doi.org/10.3390/pharmacy9010060
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14. Weltermann T, Schulz C, Macke L. Effect of frequently prescribed drugs on gastric cancer risk. Best Practice & Research Clinical Gastroenterology. 2021 Mar;50-51:101741. doi: https://doi.org/10.1016/j.bpg.2021.101741
15. Baig MA, Bazarbashi MS, AlDakhil H, Baig SM. The Journey of Clinical Registries Through Various Phases of the Digital Age: A Technical Perspective. Studies in Health Technology and Informatics. 2022 Jan 14;289:345-8. doi: https://doi.org/10.3233/SHTI210930 

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Protas Y.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/0009-0001-8662-7554

Makarenko O.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/0000-0001-8730-1081

Duka R.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/0000-0003-3962-8746

Protas Y.O., Makarenko O.V., Duka R.V. Impact of combined fixed-dose formulations in Helicobacter pylori eradication on incidence rate of gastric cancer in Ukraine from 2014 to 2021. Medicni perspektivi. 2025;30(1):202-205.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325466

Optimization and standardization of the work of a health care facility during a chemical accident

The article presents literature data on etiopathogenesis, classification, clinical features and diagnostics of neurosyphilis. The relevance of the problem is due to the social significance of the pathology, the complexity of establishing a diagnosis against the background of changes in symptoms and the course of syphilitic infection, and the relatively rare cases of late neurosyphilis. The purpose of the work is to present our own clinical observation of a case of neurosyphilis that ended in death. Upon urgent admission to the hospital, the patient showed clinical signs of general cerebral and focal syndromes (suppression of consciousness to the point of muffledness (Glasgow Coma Scale – 13 points), neuro-cognitive syndrome (MoCA – 21 points), sensory and sensitive disorders, left-sided reflex pyramidal insufficiency, oculomotor disorders – absence of miotic reaction to light, both direct and coordinated, with preservation of miotic reaction to the nearest stimulus (accommodation - convergence), pronounced vestibulo-atactic syndrome, mild amyostatic syndrome). The data of the patient's initial computed tomography examination did not confirm the diagnosis of acute cerebral circulation disorder. However, according to the results of magnetic resonance imaging of the brain (performed in T1, T2, FLAIR modes. SAG., AX., COR. projections) a picture of multifocal changes in the cerebellum, pons with edema of brain tissue, manifestations of encephalitis was obtained, which required lumbar puncture and additional examination. Total antibodies to Treponema pallidum were detected in the patient's blood. Despite the atypical clinical manifestations of syphilitic infection, based on the exa­mination data, a diagnosis of neurosyphilis was established, treatment was started, but the patient's condition worsened due to the rapid progression of circulatory disorders, psychoorganic syndrome, which led to the patient's death. Thus, with an atypical clinical picture, special vigilance should be exercised regarding the possible neurological manifestation of syphilitic infection; timely early diagnosis should be based on a comprehensive assessment of clinical and laboratory data and the involvement of a multidisciplinary team of doctors in making the diagnosis.

Key words: late neurosyphilis, laboratory diagnostics, magnetic resonance imaging, multidisciplinary team, clinical case, fatal outcome

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Rodionova V.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/0000-0002-0221-5625

Svyatenko T.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-4303-2937

Zakharov V.K. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-5140-4417

Gushcha I.S. Communal non-commercial enterprise “City Clinical Hospital No. 4” of Dnipro City Council”, Dnipro, Ukraine
https://orcid.org/0009-0007-0372-1961

Sydorenko D.V. Communal non-commercial enterprise “City Clinical Hospital No. 4” of Dnipro City Council”, Dnipro, Ukraine
https://orcid.org/0009-0001-7748-1530

Trokhymenko Yu.R. Communal non-commercial enterprise “City Clinical Hospital No. 4” of Dnipro City Council”, Dnipro, Ukraine
https://orcid.org/0009-0008-5337-7545

Rodionova V.V., Svyatenko T.V., Zakharov V.K., Gushcha I.S., Sydorenko D.V., Trokhymenko Yu.R. A case of late syphilis of the nervous system with a fatal outcome. Medicni perspektivi. 2025;30(1):206-213.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325469

Сlinical case of funicular myelosis in combination with a concomitant genetic predisposition to folate cycle disorder

Cardiovascular diseases and dyslipidemia lead to complications such as cerebrovascular accidents and severe sequelae such as neurological deficits in different presentations depending on the affected area. The objective is to describe the clinical case of a patient with hemorrhagic cerebrovascular disease, presenting with right-sided hemiparesis and ataxia, as well as the therapeutic options employed in their rehabilitation process to improve their quality of life. The present investigation deals with a case report that provides relevant information before the implementation of a personalized interdisciplinary treatment, corresponding to a 53-year-old male patient with a history of hypertension and dyslipidemia. Outcome – the case reflects a patient with a neurological condition presenting challenges in communication and mobility, requiring a comprehensive approach to treatment and follow-up to address both acute symptoms and possible underlying impairments. The emergent approach in patients with stroke is determinant to reduce possible sequelae, a personalized comprehensive care involving an interdisciplinary team is essential to improve the prognosis on the patient's quality of life and functionality.

Key words: hemiparesis, ataxia, neurology, neuromuscular

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Franklin Baltodano Ardón National University of Chimborazo, Faculty of Health Sciences, Riobamba, Ecuador
https://orcid.org/0000-0001-7393-7353

Indira Pineda Grillo Higher Polytechnic School of Chimborazo (ESPOCH), Faculty of Public Health, Riobamba, Ecuador
https://orcid.org/0000-0002-9107-654X

Shirley Mireya Ortiz Pérez National University of Chimborazo, Faculty of Health Sciences, Riobamba, Ecuador
https://orcid.org/0000-0003-0648-2381

David Marcelo Guevara Hernández National University of Chimborazo, Faculty of Health Sciences, Riobamba, Ecuador
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-5063-0519

Franklin Baltodano Ardón, Indira Pineda Grillo, Shirley Mireya Ortiz Pérez, David Marcelo Guevara Hernández A case report of a hemorrhagic stroke with right hemiparesis. Medicni perspektivi. 2025;30(1):214-217.
DOI: https://doi.org/10.26641/2307-0404.2025.1.325477

Orthodontic and orthopedic rehabilitation of adult patients with congenital cleft lip and palate (clinical case)