The aim of the study was to explore the most effective experimental models of obesity that have been used over many years to study this condition in animals, as well as the models that most closely resemble obesity in humans. The article analyzes the current scientific literature regarding the use of various models to study the most pressing and widespread medical issue of today – obesity. A literature review and analytical analysis were conducted, along with a synthesis of data from scientific literature, which allowed for the examination of various obesity models most commonly used in experimental research by scientists. With the increase in body mass index and the onset of morbid obesity, pathological modifications are observed in all organs and systems of the human body: non-alcoholic fatty liver disease, metabolic syndrome, type 2 diabetes, insulin resistance, dyslipidemia, cardiovascular pathologies, various types of cancer of internal organs, mental disorders, and others. Experimental models of obesity in research animals allow for a deeper understanding of the development and progression of this disorder, which can expand current knowledge about the mechanisms underlying its formation, establish key pathomorphological manifestations, potential complications, and optimize new approaches to the diagnosis and treatment of obesity. However, in contemporary scientific literature, the question of improved and adequate selection of obesity models in animal studies remains open, with results that can be extrapolated to humans. To date, no single animal model can fully represent the entire spectrum of diseases and metabolic disorders associated with obesity in humans. Fatty liver disease represents a spectrum of continuous conditions associated with obesity: type 2 diabetes, insulin resistance, and hyperlipidemia. A significant amount of contemporary scientific literature documents researchers' studies on the progression from simple steatosis to non-alcoholic steatohepatitis, as well as to fibrosis and ultimately to hepatocellular carcinoma. Over the past 5-10 years, researchers have described the most commonly used animal models of fatty liver disease: genetic, chemical, dietary, and others. However, the mechanisms underlying the pathogenesis of obesity and related diseases remain not fully understood, and currently there are few available effective therapeutic approaches in the scientific literature. A large number of different animal models of obesity have been developed and described by researchers to study the pathophysiology of non-alcoholic fatty liver disease. Scientific sources highlight their advantages and disadvantages, as well as provide recommendations for researchers in selecting appropriate animal models.

Key words: obesity, disease model, metabolic syndrome, non-alcoholic fatty live disease, rats, monosodium glutamate, diet

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Prymachenko V.I. Bogomolets National Medical University, Kyiv, Ukraine
e-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2783-8546

Prymachenko V.I. Methods of modelling obesity in an animal experiment (analytical literature review). Medicni perspektivi. 2025;30(2):4-12.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333079

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

Repeated blast-induced neurotrauma impairs the quality of life of military personnel and civilians who have suffered from repeated blast wave exposure. The aim was to study histopathological changes in the hippocampus and cerebellum of rats after repeated 3-fold blast wave exposure. The study was conducted on 40 male rats, randomly divided into control (n=5) and experimental groups (n=35). The experimental group of rats was divided into 5 animals for each observation period: 30 minutes, 1st, 3rd, 7th, 14th, 21st and 28th days, to track the dynamics of morphological changes. Animals of the experimental group were anesthetized with halothane and fixed on the abdomen so that the muzzle was at a distance of 5 cm from the device outlet. They were exposed to an excess pressure of 31.6±4.8 kPa. Then the animals were decapitated, the brain was removed, the hippocampus and cerebellum were separated, fixed and stained with hematoxylin-eosin according to the standard method. Light microscopy of the hippocampus demonstrated signs of karyopyknosis already 30 minutes after 3-fold exposure to the blast wave, as well as signs of perivascular and pericellular edema, and hypochromia of pyramidal cells. These signs intensified during all subsequent periods of observation. Light microscopy of the cerebellum demonstrated signs of pericellular edema in the Purkinje layer area 30 minutes after repeated exposure to the blast wave, which increased on the 1st and 3rd days, and then began to decrease. Hypochromia of Purkinje cells was observed throughout the entire period of observation of the experimental animals. On the 7th, 21st and 28th days, clearly visible signs of engorgement of the cerebellar blood vessels were observed. Thus, our morphological study showed that after 30 minutes, on the 1st, 3rd, 7th, 14th, 21st and 28th day after repeated exposure to a blast wave, primary and secondary brain changes were observed. In the hippocampus, signs of karyopyknosis and chromatolysis of pyramidal cells, as well as perivascular and pericellular edema were observed. In the cerebellum, hypochromia of Purkinje cells, pericellular edema in the Purkinje layer zone and hyperemia of blood vessels were detected. These changes can serve as biomarkers of traumatic disorders after 3-fold exposure to a blast wave.

Key words: hippocampus, cerebellum, histopathology, repeated blast-induced neurotrauma, blast wave, rats  

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Chaban V.O. Dnipro State Medical University, Dnipro, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-6002-5571

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

Chaban V.O., Kozlova Yu.V. Repeated blast-induced neurotrauma: histopathological changes in the hippocampus and cerebellum of rats. Medicni perspektivi. 2025;30(2):13-19.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333132

Analyses of electromagnetic effects as colors of the vision analyzer

Replacement of dentition defects using the dental implantation method is today one of the most common operations in the practice of a dentist-surgeon. The purpose of the study is to substantiate the choice of diagnostic methods for patients with type 2 diabetes mellitus, complicated by generalized periodontitis and diabetic osteopathy, who require dental implantation for total replacement of dentition defects. An electronic search was performed in PubMed and Google Scholar in the time interval 2003-2023. The study found 3728, selected 1170 and analyzed 24 sources, according to which the most optimal and expediently recommended research methods for the above group of patients were established. When processing information, the inclusion criteria were the study design, which included books and documents, clinical studies, meta-analysis, randomized controlled trial, review, systematic review, etc. The exclusion criteria were publications that did not meet the purpose of this review. The keywords used were “periodontitis”, “periodontal pathology”, “diabetes mel­litus”, “bone metabolism markers”, “dental implantation”, “bone metabolism”, “surgical dentistry”, “maxillofacial surgery”. In patients without general somatic pathology, the results of implant treatment are quite predictable, however, the treatment of patients with type 2 diabetes mellitus may be compromised by a large number of complications, especially if they have generalized periodontitis and diabetic osteopathy. There is no consensus in the literature among researchers regarding the nature of the combined effect of the above pathology and various variants of generalized periodontitis on the features of bone metabolism and the results of dental implantation, especially in those patients who require total rehabilitation, which in turn requires a more detailed study of their effect on the osseointegration of implants. This is of particular importance for the development of new approaches to preoperative diagnostics of personalized determination of indications and contraindications for dental implantation in this category of patients. In contrast to X-ray studies, cone-beam computed tomography and dual-energy X-ray absorptiometry have a more sensitive response to changes in the rate of balance between the processes of bone resorption and osteosynthesis, which makes their clinical use valuable for monitoring in the preoperative period and predicting osseointegration after dental implantation, as well as for assessing the response to the prescribed treatment. Diagnostics and planning of surgical interventions in patients with type 2 diabetes mellitus cannot be similar to those used in somatically healthy patients.

Key words: periodontitis, periodontal pathology, diabetes mellitus, bone metabolism markers, dental implantation, bone metabolism, surgical dentistry, maxillofacial surgery

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Gudarian O.O. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-5370-1570

Cherednyk D.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/0009-0007-0199-2784

Gudarian O.O., Cherednyk D.O. Methods for studying the state of bone metabolism in patients with diabetes who require comprehensive total rehabilitation of the oral cavity through dental implantation. Medicni perspektivi. 2025;30(2):20-27. 
DOI: https://doi.org/10.26641/2307-0404.2025.2.333358

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

This study aims to analyze in depth the mechanism of physical exercises in increasing the expression of PGC-1α (peroxisome proliferator-activated receptor gamma coactivator 1-alpha) as the most important part of mitochondrial biogenesis through a systematic review. Literature databases including PubMed, Web of Science, and Science Direct were searched for this systematic review study. The inclusion criteria for this study were articles published in the last five years. The articles discussed PGC-1α, exercises, and mitochondrial biogenesis. PubMed, Web of Science, and Science Direct databases were used to find 141 published articles. Finally, 13 articles that met the inclusion criteria were selected and analyzed for this systematic review. In this study, standard operating procedures were evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Exercises have been shown to increase PGC-1α expression, according to this systematic review. Increased biogenesis in mitochondria may be triggered by increased PGC-1α expression, which helps in the energy production process. On the other hand, it is not yet clear about the ideal intensity and type of physical activity to increase PGC-1α. This provides recommendations for further exploration in future experimental studies.

Key words: peroxisome proliferator-activated receptor gamma coactivator 1-alpha, physical exercises, mitochondrial, biogenesis

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39. Mozaffaritabar S, Koltai E, Zhou L, et al. PGC-1α activation boosts exercise-dependent cellular response in the skeletal muscle. J Physiol Biochem. 2024;80(2):329-35. doi: https://doi.org/10.1007/s13105-024-01006-1
40. Radak Z, Suzuki K, Posa A, Petrovszky Z, Kol­tai E, Boldogh I. The systemic role of SIRT1 in exercise mediated adaptation. Redox Biol. 2020;35(Feb):101467. doi: https://doi.org/10.1016/j.redox.2020.101467
41. Xu R, Luo X, Ye X, et al. SIRT1/PGC-1α/PPAR-γ correlate with hypoxia-induced chemoresistance in non-small cell lung cancer. Front Oncol. 2021;11(Jul):1-15. doi: https://doi.org/10.3389/fonc.2021.682762
42. Maissan P, Mooij EJ, Barberis M. Sirtuins-mediated system-level regulation of mammalian tissues at the interface between metabolism and cell cycle: A systematic review. Biology (Basel). 2021;10(3):1-78. doi: https://doi.org/10.3390/biology10030194
43. Juan CG, Matchett KB, Davison GW. A syste­matic review and meta-analysis of the SIRT1 response to exercise. Sci 2023;13(1):1-14. doi: https://doi.org/10.1038/s41598-023-38843-x
44. Zhou L, Pinho R, Gu Y, Radak Z. The role of SIRT3 in exercise and aging. cells. 2022;11(16):2596. doi: https://doi.org/10.3390/cells11162596
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46. Gao S, Yao W, Zhou R, Pei Z. Exercise training affects calcium ion transport by downregulating the CACNA2D1 protein to reduce hypertension-induced myocardial injury in mice. iScience. 2024;27(4):109351. doi: https://doi.org/10.1016/j.isci.2024.109351
47. Flück M, Sanchez C, Jacquemond V, et al. En­hanced capacity for CaMKII signaling mitigates calcium release related contractile fatigue with high intensity exercise. Biochim Biophys Acta – Mol Cell Res. 2024;1871(2):119610. doi: https://doi.org/10.1016/j.bbamcr.2023.119610
48. Bouviere J, Fortunato RS, Dupuy C, Werneck-De-castro JP, Carvalho DP, Louzada RA. Exercise-stimulated ros sensitive signaling pathways in skeletal muscle. Antioxidants. 2021;10(4):1-21. doi: https://doi.org/10.3390/antiox10040537
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50. You W, Knoops K, Berendschot TTJM, et al. PGC-1a mediated mitochondrial biogenesis promotes recovery and survival of neuronal cells from cellular degeneration. Cell Death Discov. 2024;10(1):1-15. doi: https://doi.org/10.1038/s41420-024-01953-0

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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

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

Callixte C. University of Rwanda, Kigali, Rwanda
https://orcid.org/0000-0002-9137-5515

Ayubi N., Wibawa J.C., Rizki A.Z., Afandi A., Callixte C. Physiological regulation of peroxisome proliferator-activated receptor-gamma coactivator 1 alpha in mitochondrial metabolism during physical exercises: a systematic review. Medicni perspektivi. 2025;30(2):27-37. 
DOI: https://doi.org/10.26641/2307-0404.2025.2.333361

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

Abscessing perifolliculitis of the scalp (Hoffmann's disease) is a rare but serious chronic purulent-inflammatory disease of the hair follicles, which leads to the formation of deep abscesses, cicatricial alopecia and a significant decrease in the quality of life of patients. Our observations of the increase in cases allow us to state the relevance of this problem today and the need for additional, more thorough study of the pathology of the immune system underlying this pathological process. In the skin, one of the leading places among the cells that maintain local immune homeostasis and initiate protective innate and adaptive immune responses is occupied by Langerhans cells or the so-called dendritic cells of the epithelium. The aim of the work is to investigate the number and location of skin dendritic cells (separately subpopulations of Langerhans cells and dermal dendritic cells) in subacute abscessing perifolliculitis of the head, with special attention to damage to the structures of the pilosebaceous unit of the skin. Biopsy material from patients diagnosed with abscessing perifolliculitis of the head (Hoffmann's disease) who underwent examination and treatment at the medical center of the private enterprise “Dzerkalo”, Dnipro, Ukraine, was studied. All patients were male military personnel, whose age ranged from 20 to 51 years, the average age was 35.5±11.54 years. IHC was performed according to the TermoScientific (TS) protocols with primary antibodies to dendritic cells (CD1a, RTU). The Lab Vision Quanto (TS, USA) imaging system was used with the determination of the reaction using the DAB Quanto Chromogen (TS, USA) chromogen. Studies of the number and distribution of CD1a (+) cells (epidermal Langerhans cells and dermal dendritic cells) revealed significant differences in their accumulation and branching for the comparison groups. The greatest difference was demonstrated by areas of hair follicles where Langerhans cells were absent in the control group, namely in the internal root epithelial sheath, as well as in the hair dermal papilla (all p<0.05). In comparison, in abscessing perifolliculitis of the head, CD1a (+) cells actively accumulated in these areas with spread to areas around the sebaceous glands and muscles that lift the hair, with significant infiltration of all structures of the pilosebaceous unit and the surrounding dermis or hypodermis stroma. The average number of Langerhans cells among keratinocytes in the study group significantly exceeded the control group's indicators (26.07±11.51 cells compared to 6.02±11.51 cells, respectively (p<0.05)), and also demonstrated a wide network of branched processes. The stratified squamous epithelium in abscessing perifolliculitis of the head was characterized by acanthosis, hyperplasia, and increased mitotic activity. Accumulation of CD1a (+) cells in the internal root epithelial sheath and hair dermal papilla was observed only in the study group and was absent in the control group, (p<0.05). In the outer root epithelial sheath of pilosebaceous units around the hair follicle bud roller, the number of CD1a (+) cells in the study group significantly exceeded the control group (31.44±8.86 cells compared to 4.84±1.12 cells, respectively (p<0.05)), due to which T-lymphocyte infiltration with prolonged inflammatory damage and alopecia is probably maintained in this area. A statistically significantly higher density of infiltration by CD1a (+) dendritic cells in the area of the excretory ducts of the secretory departments of the sebaceous glands in the study group compared to the control group (17.87±11.65 cells compared to 6.24±2.05 cells, respectively (p<0.05)) due to excessive antigenic stimulation may be the cause of sebaceous gland hyperplasia. The increased density of antigen-presenting cells such as CD1a (+) dendritic cells among the inflammatory infiltrate of the dermis in PCAS compared to the control group (52.50±16.77 cells compared to 6.87±3.13 cells, respectively (p<0.05)) indicates the active migration of these motile cells and the predominance of effector mechanisms of the immune response around the pilosebaceous units of the scalp.

Key words: Langerhans cells, dendritic cells, T-lymphocytes, abscessing perifolliculitis of the scalp, Hoffmann's disease, dissecting cellulitis of the scalp, abscessing and subluxing perifolliculitis of the scalp, cicatricial changes of the scalp, cicatricial alopecia, dermatology, trichology, hair diseases, skin pathomorphology, immunohistochemistry

1. Cuellar TA, Roh DS, Sampson CE. Dissecting cel­lulitis of the scalp: a review and case studies of surgical re­con­struction. Plast Reconstr Surg Glob Open. 2020;8(8):e3015. doi: https://doi.org/10.1097/GOX.0000000000003015
2. Melo DF, Lemes LR, Pirmez R, Duque-Estrada B. Trichoscopic stages of dissecting cellulitis: a potential complementary tool to clinical assessment. An Bras Dermatol.2020;95(4):514-17. doi: https://doi.org/10.1016/j.abd.2019.10.008 
3. Wu Q, Bu W, Zhang Q, Fang F. Therapeutic op­tions for perifolliculitis capitis abscedens et suffodens: A review. Dermatol 2022;35(10):e15763. doi: https://doi.org/10.1111/dth.15763
4. Abbas AK, Lichtman AH, Pillai S. Basic Immuno­logy. 7th Edition. Elsevier; 2023.
5. Ronchese F, Hilligan KL, Mayer JU. Dendritic cells and the skin environment. Current Opinion in Immunology. 2020;64:56-62. doi: https://doi.org/10.1016/j.coi.2020.03.006.
6. Mohamed A, Vella J, Turk MJ, Huang YH. Den­dritic cells instruct differentiation of tissue resident memory T cells in the skin to promote durable tumor immunity. J 2022;208(1):57.14. doi: https://doi.org/10.4049/jimmunol.208.Supp.57.14 
7. Dias de Oliveira NF, Santi CG, Maruta CW, Aoki V. Plasmacytoid dendritic cells in dermatology. An Bras 2021;96:76-81. doi: https://doi.org/10.1016/j.abd.2020.08.006
8. Scheib N, Tiemann J, Becker C, Probst HC, Ra­ker VK, Steinbrink K. The Dendritic Cell Dilemma in the Skin: Between Tolerance and Immunity. Front Immunol. 2022;13:929000. doi: https://doi.org/10.3389/fimmu.2022.929000
9. Sumpter TL, Balmert SC, Kaplan DH. Cutaneous immune responses mediated by dendritic cells and mast cells. JCI 2019;4(1):e123947. doi: https://doi.org/10.1172/jci.insight.123947 
10. Vareniuk IM, Dzerzhynskyi ME. [Methods of cyto-histological diagnosis]. Kyiv: Interservis; 2019. Ukrainian.
11. Nguyen T. Immunohistochemistry: A Technical Guide to Current Practices. Cambridge: Cambridge University Press; 2022.
12. Lombardo GP, Miller A, Aragona M, Messina E, Fumia A, Kuciel M, et al. Immunohistochemical Cha­rac­terization of Langerhans Cells in the Skin of Three Amphibian Species. Biology. 2024;13(4):210. doi: https://doi.org/10.3390/biology13040210
13. Strakhova OP, Androsov OI. [Statistical methods of processing the results of medical and biological re-search: educational and methodological manual]. Lviv: Vydavets Marchenko T.V.; 2021. Ukrainian.
14. Masson R, Jeong CY, Ma E, Crew AB, Fra­go­so NM, Shi VY, et al. Treatments for Dissecting Cellulitis of the Scalp: A Systematic Review and Treatment Algo­rithm. Dermatol Ther (Heidelb). 2023;13(11):2487-526. doi: https://doi.org/10.1007/s13555-023-01018-7
15. Poslavska OV, Statkevych OL, Sviatenko TV, Shponka IS. Pathomorphological analysis of the quali­tative composition of the inflammatory infiltrate around the pilosebaceous unit of the scalp in perifolliculitis capitis abscedens et suffodiens. Pathologia. 2025;22(1):33-40. doi: https://doi.org/10.14739/2310-1237.2025.1.314325

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Poslavska 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/0000-0002-3133-8413

Statkevych O.L. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-2324-998X

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

Chekan S.M. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-7702-8912

Poslavska O.V., Statkevych O.L., Sviatenko T.V., Chekan S.M. Distribution of dendritic cells in the pilosebaceous unit of the scalp in subversive abscessing perifolliculitis of the scalp: immunomorphological aspects. Medicni perspektivi. 2025;30(2):38-45. 
DOI: https://doi.org/10.26641/2307-0404.2025.2.333366

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

Cardiac amyloidosis was long considered a rare disease, primarily affecting the elderly. However, recent studies have demonstrated a higher prevalence, highlighting the need for further investigation, particularly in Ukraine, where data remain limited. The underdiagnosis of cardiac amyloidosis is primarily due to the low specificity of its clinical manifestations, which can mimic other cardiovascular diseases, particularly those presenting with a left ventricular hypertrophy phenotype. The aim of this study was to evaluate the prevalence and clinical characteristics of patients with cardiac amyloidosis among cardiomyopathies with the left ventricular hypertrophy phenotype, based on single-center data. This study was a retrospective analysis of medical records from the outpatient and inpatient departments of the SI “NSC “Strazhesko National Scientific Center of Cardiology and Regenerative Medicine of the NAMS of Ukraine” between 2020 and 2023. Data on subjective complaints, medical history, clinical examination findings, six-minute walk test results, and screening laboratory and instrumental evaluations were analyzed. Statistical analysis included confidence interval estimation, Pearson’s χ² test, one-way analysis of variance (ANOVA), and Tukey’s post hoc test. Data from 294 patients with left ventricular hypertrophy phenotypes were examined, including 177 cases (60.2%) of non-obstructive hypertrophic cardiomyopathy, 70 cases (23.8%) of hypertrophic cardiomyopathy with left ventricular outflow tract obstruction, and 47 cases (16%) of cardiac amyloidosis. The true prevalence of cardiac amyloidosis among cardiomyopathies with a left ventricular hypertrophy phenotype was estimated at 16% (CI 95%: 7.44-24.56%). Patients with cardiac amyloidosis were characterized by older age (56.8±11.7 years, F=6.85, p≤0.01), presence of congestive heart failure in the medical history (45 cases, χ2=65.54, p≤0.001), reduced distance covered in the 6-minute walk test (248.3±131.6 meters, F=10.77, p<0.001), signs of congestion in the systemic circulation (89%, 42 cases, χ2=64.56, p<0.001), and decreased left ventricular ejection fraction (54.5±15.1%, F=11.71, p≤0.05) compared to both groups of hypertrophic cardiomyopathy. Extracardiac manifestations of cardiac amyloidosis included proteinuria (83%, 39 cases), neuropathy (59.6%, 28 cases), hepatomegaly (55.3%, 26 cases), skin involvement and bruising (34%, 16 cases), carpal tunnel syndrome (23.4%, 11 cases), macroglossia (19.1%, 9 cases), digestive disturbances (12.8%, 6 cases), weight loss (19.1%, 9 cases), and thrombotic events at various sites (14.9%, 7 cases). Thus, cardiac amyloidosis is an underrecognized pathology, accounting for 16% of cardiomyopathies with a left ventricular hypertrophy phenotype. Compared to non-obstructive and obstructive hypertrophic cardiomyopathy, these patients are characterized by older age, more severe systemic conditions, decreased left ventricular systolic function, and systemic extracardiac manifestations. Multicenter studies are required to determine the true prevalence of cardiac amyloidosis in Ukraine.

Key words: cardiac amyloidosis, cardiomyopathy, myocardial hypertrophy, AL amyloidosis, heart failure, diagnostics, epidemiology

1. Maurer MS, Elliott P, Comenzo R, Semigran M, Rapezzi C. Addressing common questions encountered in the diagnosis and management of cardiac amyloidosis. Circulation.2017;135:1357-77. doi https://doi.org/10.1161/CIRCULATIONAHA.116.024438
2. Westin O, Butt JH, Gustafsson F, Schou M, Salo­mo M, Køber L, et al. Two Decades of Cardiac Amy­loidosis: A Danish Nationwide Study. JACC CardioOncol. 2021;3(4):522-33. doi: https://doi.org/10.1016/j.jaccao.2021.05.004
3. Gilstrap LG, Dominici F, Wang Y, El-Sady MS, Singh A, Di Carli MF, et al. Epidemiology of Cardiac Amyloidosis-Associated Heart Failure Hospitalizations Among Fee-for-Service Medicare Beneficiaries in the United States. Circ Heart Fail. 2019;12(6):e005407. doi: https://doi.org/10.1161/CIRCHEARTFAILURE.118.005407 
4. Quock TP, Yan T, Chang E, Guthrie S, Bro­der MS. Epidemiology of AL amyloidosis: a real-world study using US claims data. Blood Adv. 2018;2:1046-53. doi: https://doi.org/10.1182/bloodadvances.2018016402
5. Ney S, Ihle P, Ruhnke T, Günster C, Michels G, Seuthe K, et al. Epidemiology of cardiac amyloidosis in Germany: a retrospective analysis from 2009 to 2018. Clin Res 2023;112(3):401-8. doi: https://doi.org/10.1007/s00392-022-02114-y 
6. Kyle RA, Linos A, Beard CM, et al. Incidence and natural history of primary systemic amyloidosis in Olmsted County, Minnesota, 1950 through 1989. Blood. 1992;79(7):1817-22. doi: https://doi.org/10.1182/blood.V79.7.1817.1817
7. Ruberg FL. Cardiac Amyloidosis: A Zebra Hiding in Plain Sight? Circ Cardiovasc Imaging. 2017;10(3):e006186. doi: https://doi.org/10.1161/CIRCIMAGING.117.006186
8. Kieninger B, Eriksson M, Kandolf R, Schna­bel PA, Schönland S, Kristen AV, et al. Amyloid in endo­myocardial biopsies. Virchows Arch. 2010;456(5):523-32.
   doi: https://doi.org/10.1007/s00428-010-0909-5
9. Bonderman D, Pölzl G, Ablasser K, Agis H, Aschauer S, Auer-Grumbach M, et al. Diagnosis and treatment of cardiac amyloidosis: an interdisciplinary con­sensus statement. Wien Klin Wochenschr.
   2020;132(23-24):742-61.
   doi: https://doi.org/10.1007/s00508-020-01781-z
10. Erdogdua T, Uysala OK, Icena YK, Alicia G, Koca M, Ibrahim Halil Kurta IH. Increased EHRA score predicts atrial fibrillation recurrence in paroxysmal atrial fibrillation patients undergoing cryoablation. Ann Med Res.2024;31(2):94-100. doi: https://doi.org/10.5455/annalsmedres.2023.11.299
11. Garcia-Pavia P, Rapezzi C, Adler Y, Arad M, Basso C, Brucato A, et al. Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases. EurHeart  2021;42(16):1554-68. doi: https://doi.org/10.1093/eurheartj/ehab072 
12. Mishra P, Singh U, Pandey CM, Mishra P, Pan­dey G. Application of student's t-test, analysis of variance, and covariance. Ann Card Anaesth. 2019;22(4):407-11. doi: https://doi.org/10.4103/aca.ACA_94_19
13. Germain DP, Altarescu G, Barriales-Villa R, Mig­nani R, Pawlaczyk K, Pieruzzi F, et al. An expert con­sensus on practical clinical recommendations and guidance for patients with classic Fabry disease. Mol Genet Metab. 2022 Sep-Oct;137(1-2):49-61. doi: https://doi.org/10.1016/j.ymgme.2022.07.010
14. Castaño A, Narotsky DL, Hamid N, Khalique OK, Morgenstern R, DeLuca A, et al. Unveiling transthyretin cardiac amyloidosis and its predictors among elderly patients with severe aortic stenosis undergoing trans­catheter aortic valve replacement. Eur Heart J. 2017;38(38):2879-87. doi: https://doi.org/10.1093/eurheartj/ehx350
15. Porcari A, Bussani R, Merlo M, Varrà GG, Pa­gura L, Rozze D, et al. Incidence and Characterization of Concealed Cardiac Amyloidosis Among Unselected El­derly Patients Undergoing Post-mortem Examination. FrontCardiovasc  2021;8:749523. doi: https://doi.org/10.3389/fcvm.2021.749523
16. Maurizi N, Rella V, Fumagalli C, Salerno S, Cas­telletti S, Dagradi F, et al. Prevalence of cardiac amy­loidosis among adult patients referred to tertiary centres with an initial diagnosis of hypertrophic cardiomyopathy. IntJ  2020;300:191-5. doi: https://doi.org/10.1016/j.ijcard.2019.07.051 
17. Rubin J, Maurer MS. Cardiac Amyloidosis: Over­looked, Underappreciated, and Treatable. Annu Rev Med. 2020;71:203-19.
    doi: https://doi.org/10.1146/annurev-med-052918-020140
18. Arbelo E, Protonotarios A, Gimeno JR, Arbus­tini E, Barriales-Villa R, Basso C, et al. ESC Scientific Document Group. 2023 ESC Guidelines for the mana­gement of cardiomyopathies. Eur Heart J. 2023;44(37):3503-626. doi: https://doi.org/10.1093/eurheartj/ehad194
19. Mostbauer HV. [Cardiac amyloidosis]. Zdorovia Ukrainy. 2023;88(3):24-7. Ukrainian.
20. Muchtar E, Dispenzieri A, Magen H, Grogan M, Mauermann M, McPhail ED, et al. Systemic amyloidosis from A (AA) to T (ATTR): a review. J Intern Med. 2021;289(3):268-92. doi: https://doi.org/10.1111/joim.13169
21. Fend F, Dogan A, Cook JR. Plasma cell neo­plasms and related entities-evolution in diagnosis and classification. Virchows Arch. 2023;482(1):163-77. doi: https://doi.org/10.1007/s00428-022-03431-3
22. Imperlini E, Gnecchi M, Rognoni P, Sabidò E, Ciuffreda MC, Palladini G, et al. Proteotoxicity in cardiac amyloidosis: amyloidogenic light chains affect the levels of intracellular proteins in human heart cells. Sci Rep. 2017;7(1):15661.
    doi: https://doi.org/10.1038/s41598-017-15424-3
23. Papathanasiou M, Schlender LS, Johnson VL, Wakili R. [Arrhythmias and amyloidosis]. Herzschrit­tmacherther Elektrophysiol. 2024;35(3):199-204. German. doi: https://doi.org/10.1007/s00399-024-01016-y
24. Chompoopong P, Mauermann ML, Siddiqi H, Pel­tier A. Amyloid Neuropathy: From Pathophysiology to Treatment in Light-Chain Amyloidosis and Hereditary Transthyretin Amyloidosis. Ann Neurol. 2024;96(3):423-40. doi: https://doi.org/10.1002/ana.26965

Look through:

Kozliuk A.S. SI “NSC “Strazhesko National Scientific Center of Cardiology and Regenerative Medicine of the NAMS of Ukraine”, Kyiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-3832-4134

Kozliuk A.S. Cardiomyopathies with left ventricular hypertrophy phenotype: prevalence of cardiac amyloidosis and clinical characteristics of patients. Medicni perspektivi. 2025;30(2):46-53.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333369

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

Post-covid syndrome is a multisystem disease. The totality of disorders of organs and systems, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes significant damage to human health for a long time, especially if the patient has comorbid pathology. Taking into account the concern about the impact of COVID-19 on the cardiovascular system, several mechanisms of the direct impact of SARS-CoV-2 on the specified system are considered. It should be noted that there is a limited number of studies on the observation of patients with post-covid syndrome. Today, the priority direction is the study of predictors of the adverse course of cardiovascular diseases, especially after COVID-19. Transforming growth factor β1 can be considered one of the potential markers of cardiovascular complications. The aim of our study was to evaluate the level of transforming growth factor β1 in patients with hypertension who had COVID-19. The cross-sectional study included 27 patients with hypertension after COVID-19. 16 patients with controlled hypertension (blood pressure 140/90 mm Hg) formed the first group. The second group was formed by 11 patients with uncontrolled hypertension (blood pressure ≥140/90 mm Hg). We determined the increased level of transforming growth factor β1 and its relationship with the glucose (r=0.38, p=0.049). The level of blood pressure control was associated with increasing age of patients, lower glomerular filtration rate (p<0.01), and worse glucose control (p<0.05). Thus, the data indicate that transforming growth factor β1 may be a possible factor inducing the development of cardiometabolic disorders in patients with hypertension after COVID-19.

Key words: post-COVID syndrome, arterial hypertension, transforming growth factor β1

1. Bielecka E, Sielatycki P, Pietraszko P, et al. Ele­vated arterial blood pressure as a delayed complication following COVID-19 – A narrative review. Int J Mol Sci. 2024;25(3):1837. doi: https://doi.org/10.3390/ijms25031837
2. National Institute for Health and Care Research. NIHR themed review: living with COVID-19 [Internet]. 2020 [cited 2024 Dec 23]. Available from: https://evidence.nihr.ac.uk/themedreview/living-with-covid19/
3. World Health Organization. A clinical case definition of post COVID-19 condition by a Delphi consensus [Internet]. 2021 [cited 2024 Dec 23]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1
4. World Health Organization. Post COVID-19 Condition (Long COVID) [Internet]. 2022 [cited 2024 Dec 23]. Available from: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition
5. Kuriata O, Mytrokhina O, Kushnir Yu, et al. [Post-COVID syndrome: status of carbohydrate metabolism in patients with hypertension and stable ischemic heart disease]. Mizhnar endokrynol zhurn [Internet]. 2024;20(1):31-8.Ukrainian. doi: https://doi.org/10.22141/2224-0721.20.1.2024.1354
6. Cinar A, Gedikli O, Uyanik M, Terzi O. Eva­luation of Coronary Artery Calcium Score (CACS) in Dipper and Non-Dipper Hypertensive Patients with Moderate and High Cardiovascular Disease Risks. Medicina.2024;60(12):1999. doi: https://doi.org/10.3390/medicina60121999
7. Gemelli Against COVID-19 Post-Acute Care Study Group. Post-COVID-19 global health strategies: the need for an interdisciplinary approach. Aging Clin Exp Res. 2020;32:1613-20. doi: https://doi.org/10.1007/s40520-020-01616-x
8. Strilchuk L. [Post- COVID syndrome: a new mul­tidisciplinary challenge]. Zdorovia Ukrainy. 2021;498(5):3.
9. Quinn KL, Lam GY, Walsh JF, et al. Cardio­vascular Considerations in the Management of People With Suspected Long COVID. Can J Cardiol. 2023;39(6):741-53. doi: https://doi.org/10.1016/j.cjca.2023.04.003
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18. Li B, Khanna A, Sharma V, et al. TGF-β1 DNA Polymorphisms, Protein Levels, and Blood Pressure. Hypertension.1999;33(1):271-5. doi: https://doi.org/10.1161/01.HYP.33.1.271
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22. Carod-Artal F. Post-COVID-19 syndrome: epide­miology, diagnostic criteria and pathogenic mechanisms involved. Rev 2021;72(11):384-96. doi: https://doi.org/10.33588/rn.7211.2021230
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24. Dubrov SO, Kovalenko VM, Vakaliuk IP, et al. [State Expert Center of the Ministry of Health of Ukraine. Clinical guideline based on evidence «Arterial hyper­tension» [Internet]. 2024 [cited 2024 Nov15]. Ukrainian. Available from: https://www.dec.gov.ua/mtd/arterialna-gipertenziya-2/
25. Hallek M, Adorjan K, Behrends U, et al. Post-COVID Syndrome. DTSCH Arztebl Int. 2023;120(4):48-55. doi: https://doi.org/10.3238/arztebl.m2022.0409
26. Yong SJ. Long COVID or post-COVID-19 synd­rome: putative pathophysiology, risk factors, and treat­ments. Infect 2021;53(10):737-54. doi: https://doi.org/10.1080/23744235.2021.1924397
27. Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney 2024;105(4S):117-314. doi: https://doi.org/10.1016/j.kint.2023.10.018
28. Makhanets L, Vinnychuk O, Hryhorkiv M. [Sta­tistics: Laboratory Workshop in STATISTICA 12: Tu­torial. Chernivtsi]. Chernivets nats un-t im. Yu. Fed­kovycha; 2023. 161 р. Ukrainian.
29. Scherer PE, Kirwan JP, Rosen CJ. Post-acute sequelae of COVID-19: a metabolic perspective. eLife. 2022;11:e78200. doi: https://doi.org/10.7554/eLife.78200
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31. Kheirollahi V, Khadim A, Kiliaris G, et al. Trans­criptional Profiling of Insulin-like Growth Factor Signa­ling Components in Embryonic Lung Development and Idiopathic Pulmonary Fibrosis. Cells. 2022;11(12):1973. doi: https://doi.org/10.3390/cells11121973
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Look through:

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

Mytrokhina O.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/0000-0001-6485-4329

Stadnyk O.I. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-8253-5524

Kuryata O.V., Mytrokhina O.S., Stadnyk O.I. Transforming growth factor beta-1 in patients with hypertension who had COVID-19. Medicni perspektivi. 2025;30(2):53-60.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333373

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

Postnasal drip syndrome (PNDS) is one of the most common clinical conditions in the practice of otolaryngologists and family physicians, characterized by the drainage of mucous or mucopurulent secretions along the posterior wall of the pharynx and accompanied by rhinorrhea, nasal congestion, cough, and a feeling of irritation in the throat. Epidemiological studies show that approximately 20% of the adult population and 15% of children regularly suffer from manifestations of postnasal drip. The pathogenetic mechanisms of the development of PNDS are mucus hypersecretion, impaired rheological properties, dysfunction of mucociliary clearance, and local inflammation. The aim of our study was to clinically evaluate the efficacy and safety of different dosage regimens of the drug "Respx® Spray" (ambroxol) for postnasal drip on the background of common respiratory diseases. A large-scale prospective observational multicenter study was conducted, which included 1867 patients aged 12 to 65 years from 15 regions of Ukraine. The study lasted from September 2023 to March 2024. Patients had various respiratory diseases accompanied by postnasal drip: rhinopharyngitis (47.3%), acute rhinosinusitis (34.0%), vasomotor rhinitis (7.4%), tonsillopharyngitis (4.6%), acute tracheobronchitis (3.8%) and laryngitis/laryn­gotracheitis (2.9%). The effectiveness of the use was assessed by the dynamics of the intensity of postnasal drip on a 5-point scale at the beginning and on the 5-7th day of treatment. The safety of the drug was monitored by registering and analyzing adverse reactions. The results of the study showed a statistically significant decrease in the intensity of postnasal drip from 4.28±0.03 to 0.91±0.03 points on the 5th day of therapy (p<0.001). The highest efficiency was recorded with the dosage regimens of 4 sprays 4 times a day (decrease to 0.38±0.10 points) and 3 sprays 2 times a day (decrease to 0.60±0.15 points). Subjective assessment of the dynamics of symptoms by patients showed a rapid development of the therapeutic effect – already on the 2nd day of treatment, patients noted a moderate improvement (1.55±1.19 points), and on the 5th day a significant improvement was observed (4.66±0.99 points). The highest subjective improvement rates were recorded in patients with hypertrophic rhinitis (4.56±0.08 points) and tracheitis/acute bronchitis/acute tracheobronchitis (4.52±0.15 points). Overall satisfaction with the treatment was extremely high – 76.4% of patients rated it at 9-10 points on a 10-point scale, another 20.3% – at 7-8 points. Multivariate regression analysis revealed that the effectiveness of the treatment was significantly influenced by factors such as the dosage regimen (p<0.01), the initial intensity of the symptom (p<0.001) and the underlying disease (p<0.05). Non-serious adverse reactions were observed in only 1.2% of patients, which is a fairly low rate and indicates a good safety profile of the drug. The obtained data indicate that ambroxol in the form of a high-dose oromucosal spray is an effective and safe means for alleviating the manifestations of postnasal drip, ensuring high compliance and patient satisfaction. The choice of dosage regimen should be made taking into account the nature of the underlying disease and the initial intensity of postnasal drip syndrome. The safety of the preparation was monitored through registration and analysis of adverse reactions. The results of the study established a statistically significant reduction in the intensity of postnasal dripping from 4.28±0.03 to 0.91±0.03 points on the 5th day of therapy (p<0.001). The highest clinical efficacy was observed with dosing regimens of 4 jets 4 times a day (reduction to 0.38±0.10 points) and 3 jets 2 times a day (reduction to 0.60±0.15 points). Patients' subjective assessment of symptom dynamics indicated a rapid development of therapeutic effect – by the 2nd day of treatment, patients noted moderate improvement (1.55±1.19 points), and by the 5th day, significant improvement in condition was observed (4.66±0.99 points). The highest indicators of subjective improvement were recorded in patients with hypertrophic rhinitis (4.56±0.08 points) and tracheitis/acute bronchitis/acute tracheobronchitis (4.52±0.15 points). Overall treatment satisfaction was exceptionally high – 76.4% of patients rated it at 9-10 points on a 10-point scale, while another 20.3% gave it 7-8 points. Multivariate regression analysis revealed that treatment efficacy was significantly influenced by factors such as dosing regimen (p<0.01), baseline symptom intensity (p<0.001), and underlying disease (p<0.05). The obtained data indicate that ambroxol in the form of oromucosal spray is an effective and safe remedy for the treatment of postnasal syndrome of various etiologies, providing high compliance and patient satisfaction. The selection of dosing regimen should be tailored according to the nature of the underlying disease and the baseline intensity of the postnasal syndrome.

Key words: postnasal drip syndrome, ambroxol, oromucosal spray, postnasal dripping, rhinosinusitis, rhinopharyngitis, efficacy, safety, multicenter study

1. Babchenko NV, Dieieva YuV, Konovalov SE, Motailo OV. [Expression indicators of mucopoly­sac­charides MUC 5AC and MUC 1 in the nasal mucosa in patients with postnasal drip syndrome and nasal septum curvature]. Klinichna ta profilaktychna medytsyna. 2024;(2):43-8. doi: https://doi.org/10.31612/2616-4868.2.2024.06
2. Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: A practice parameter update. J Allergy Clin Immunol.2020;146:721-67. doi: https://doi.org/10.1016/j.jaci.2020.07.007
3. Sanu A, Eccles R. Postnasal drip syndrome. Two hundred years of controversy between UK and USA. Rhinology. 2008;46(2):86-91.
4. Krajewska J, Zub K, Słowikowski A, Zatoński T. Chronic rhinosinusitis in cystic fibrosis: a review of therapeutic options. Eur Arch Otorhinolaryngol. 2022:1-24. doi: https://doi.org/10.1007/s00405-021-06875-6
5. Kumar A, Sharma S, Singh P, et al. Comparison of different formulations of mucolytics in post-nasal drip: a network meta-analysis. Eur Respir J. 2024;63:2302544. doi: https://doi.org/10.1183/13993003.02544-2023
6. Trykhlib V, Zadorozhna V, Tkachuk S, Palatna L, Operchuk N. The Incidence of Acute Upper Respiratory Infections of Multiple or Uncertain Localization in Ukrainian Children. Actual Infectology. 2016;(3.12):83-92. doi: https://doi.org/10.22141/2312-413x.3.12.2016.81720
7. Naumenko OM, Zabolotnyi DI, Dieieva YuV, Za­bo­lotna DD. [Features of the clinical course of acute rhi­nosinusitis in COVID-19]. Pohlyad otorynolarynholoha. II Scientific and Practical Conference; 2021. Ukrainian. Availablefrom: http://ir.librarynmu.com/bitstream/123456789/8230/1/Особливості%20клінічного.pdf
8. Scaglione F, Petrini O. Mucoactive Agents in the Therapy of Upper Respiratory Airways Infections: Fair to Describe Them Just as Mucoactive? Clin Med Insights Ear Nose 2019;12. doi: https://doi.org/10.1177/1179550618821930
9. Paleari D, Rossi GA, Nicolini G, Olivieri D. Ambroxol: a multifaceted molecule with additional therapeutic potentials in respiratory disorders of childhood. Expert Opin Drug Discov. 2011;6(11):1203-14. doi: https://doi.org/10.1517/17460441.2011.629646
10. Weiser T. Ambroxol: a CNS drug? CNS Neurosci Ther.2008;14(1):17-24. doi: https://doi.org/10.1111/j.1527-3458.2007.00032.x
11. Malerba M, Ragnoli B. Ambroxol in the 21st century: pharmacological and clinical update. Expert Opin DrugMetab  2019;12:1-10. doi: https://doi.org/10.1080/17425255.2019.1670168
12. Beeh KM, Beier J, Esperester A, Paul LD. Antiin­flammatory properties of ambroxol. Eur J Med Res. 2008;13:557-62.
13. Zhang ZQ, Wu QQ, Huang XM, Lu H. Prevention of respiratory distress syndrome in preterm infants by antenatal ambroxol: a meta-analysis of randomized controlled trials. Am J Perinatol. 2023;30:529-36. doi: https://doi.org/10.1055/s-0032-1329188
14. Kantar A, Klimek L, Cazan D, Sperl A, Sent U, Mesquita M. An overview of efficacy and safety of am­broxol for the treatment of acute and chronic respiratory diseases with a special regard to children. Multidiscip Respir 2020;15(1):511. doi: https://doi.org/10.4081/mrm.2020.511
15. Cheng X, Xie Q, Sun Y. Advances in nano­ma­terial-based targeted drug delivery systems. Front Bioeng Biotechnol.2023;11:1177151. doi: https://doi.org/10.3389/fbioe.2023.1177151
16. Collins JC, Moles RJ. Management of respiratory disorders and the pharmacist's role: Cough, colds, and sore throats and allergies (including eyes). Encyclopedia of pharmacy practice and clinical pharmacy. 2019:282. doi: https://doi.org/10.1016/B978-0-12-812735-3.00510-0
17. de Mey C, Patel J, Lakha DR, Richter E, Koelsch S. Efficacy and Safety of an Oral Ambroxol Spray in the Treatment of Acute Uncomplicated Sore Throat. DrugRes (Stuttg). 2015;65(12):658-67. doi: https://doi.org/10.1055/s-0035-1547229
18. Chenot JF, Weber P, Friede T. Efficacy of Am­broxol lozenges for pharyngitis: a meta-analysis. BMC Fam 2014;15:45.
    doi: https://doi.org/10.1186/1471-2296-15-45
19. Brahmeshwar Mishra, Juhi Singh. Novel drug deli­very systems and significance in respiratory diseases. In: Tar­geting Chronic Inflammatory Lung Diseases Using Advanced Drug Delivery Systems. Academic Press; 2020. p. 57-95. doi: https://doi.org/10.1016/B978-0-12-820658-4.00004-2
20. Doulaptsi M, Prokopakis E, Seys S, Pugin B, Steelant B, Hellings P. Visual analogue scale for sino-nasal symptoms severity correlates with sino-nasal outcome test 22: paving the way for a simple outcome tool of CRS burden. Clin Transl Allergy. 2018;8:32. doi: https://doi.org/10.1186/s13601-018-0219-6
21. Butcher NJ, Monsour A, Mew EJ, et al. Guidelines for Reporting Outcomes in Trial Reports: The CONSORT-Outcomes 2022 Extension. JAMA. 2022;328(22):2252-2264. doi: https://doi.org/10.1001/jama.2022.21022
22. Walther C, Döring K, Schmidtke M. Comparative in vitro analysis of inhibition of rhinovirus and influenza virus replication by mucoactive secretolytic agents and plant extracts. BMC Complement Med Ther. 2020;20:380. doi: https://doi.org/10.1186/s12906-020-03173-2
23. Cheng L, Liu M, Wang R, Cao S, Li R, Su B, et al. Ambroxol hydrochloride spray (Luo Runchang®) in the treatment of acute respiratory infectious diseases: a pro­spective, multicenter, open label, randomized controlled study.Front  2024;12:1380189. doi: https://doi.org/10.3389/fped.2024.1380189
24. Alkotaji M. Azithromycin and ambroxol as po­tential pharmacotherapy for SARS-CoV-2. Int J Antimicrob 2020;56:106192. doi: https://doi.org/10.1016/j.ijantimicag.2020.106192
25. Nakahari T, Suzuki C, Kawaguchi K, Hosogi S, Tanaka S, Asano S, et al. Ambroxol-Enhanced Frequency and Amplitude of Beating Cilia Controlled by a Voltage-Gated Ca2+ Channel, Cav1.2, via pHi Increase and [Cl−]i Decrease in the Lung Airway Epithelial Cells of Mice. Int J Mol Sci. 2023;24:16976. doi: https://doi.org/10.3390/ijms242316976

Look through:

Deeva Yu.V. Bogomolets National Medical University, Kyiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-0552-1254

Fomin S.F. Poltava region, Ukraine
https://orcid.org/0009-0004-8109-1289

Kuznetsova O.V. Poltava region, Ukraine
https://orcid.org/0009-0009-8251-9933

Tsyba L.L. Sumy region, Ukraine
https://orcid.org/0009-0006-8000-0642

Lavrova N.P. Mykolaev, Ukraine
https://orcid.org/0009-0005-9792-2873

Deeva Yu.V., co-authors (42). Clinical efficacy and safety of high-dose ambroxol in the form of oromucosal spray in postnasal drip syndrome: results of a multicenter study in Ukraine. Medicni perspektivi. 2025;30(2):61-77.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333376

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

Coronary artery disease (CAD) is one of the most prevalent and life-threatening complications in individuals with type 2 diabetes mellitus (T2DM). The aim of this study was to develop a mathematical model for predicting the risk of CAD in patients with T2DM. A total of 242 patients with T2DM, aged 30-80 years, were examined. The following parameters were analyzed: patient age, age at T2DM onset, disease duration, fasting glucose levels, glycated hemoglobin levels, lipid profile parameters, blood pressure, presence of diabetic complications, lifestyle factors, family history, and parental exposure to famine in 1932-1933. The predictive mathematical model for CAD development in T2DM patients was constructed using receiver operating characteristic (ROC) analysis and multiple logistic regression. ROC analysis identified the prognostic value of each of the eight key independent variables, which do not depend on the patient's current health status and can be considered independent at the time of CAD diagnosis. In the second phase of the study, a formula for calculating CAD probability was developed, incorporating the most informative variables with predictive significance. These included the patient’s age, T2DM duration, presence of chronic kidney disease, paternal history of T2DM, maternal famine exposure during pregnancy, rural residence, and patient sex. The developed formula was used to predict CAD risk, and its sensitivity, specificity, and diagnostic performance were evaluated. The model demonstrated high predictive accuracy (AUC=0.792 [0.734–0.842], chi-square =65.1; p<0.001). The probability of CAD development was determined with an accuracy of 72.3%, and the model’s predictive efficiency was 73.6%. The obtained results allowed us to establish statistically significant associations between the studied risk factors and CAD development in T2DM patients. Based on these findings, we have developed a mathematical model for predicting CAD risk in T2DM patients, which can be implemented in clinical practice.

Key words: type 2 diabetes mellitus, coronary artery disease, mathematical model

1. Seo DH, Kim M, Suh YJ, Cho Y, Ahn SH, Hong S, et al. Association between age at diagnosis of type 2 diabetes and cardiovascular morbidity and mortality risks: A nationwide population-based study. Diabetes Res Clin 2024;208:111098. doi: https://doi.org/10.1016/j.diabres.2024.111098
2. Huang L, Wu P, Zhang Y, Lin Y, Shen X, Zhao F, et Relationship between onset age of type 2 diabetes mellitus and vascular complications based on propensity score matching analysis. J Diabetes Investig. 2022;13(6):1062-72. doi: https://doi.org/10.1111/jdi.13763
3. Kim SM, Lee G, Choi S, Kim K, Jeong SM, Son JS, et Association of early-onset diabetes, pre­diabetes, and early glycaemic recovery with the risk of all-cause and cardiovascular mortality. Diabetologia. 2020;63(11):2305-14. doi: https://doi.org/10.1007/s00125-020-05252-y
4. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension.J  2013;31(7):1281-9. doi: https://doi.org/10.1097/01.hjh.0000431740.32696.cc
5. Goodarzi MO, Rotter JI. Genetics insights in the relationship between type 2 diab etes and coronary heart disease.Circ  2020;126(11):1326-40. doi: https://doi.org/10.1161/CIRCRESAHA.120.317103
6. Ye Y, Han J, Jiang W, Natarajan P, Zhao H. Interac­tions between enhanced polygenic risk scores and lifestyle for cardiovascular disease, diabetes, and lipid levels. Circulation: Genomic and Precision Medicine. 2021;14(1):e003128. doi: https://doi.org/10.1161/CIRCGEN.120.003128
7. Polemiti E, Baudry J, Kuxhaus O, Jäger S, Berg­mann MM, Weikert C, et BMI and BMI change fol­lowing incident type 2 diabetes and risk of microvascular and macrovascular complications: the EPIC-Potsdam study. Diabetologia. 2021;64(5):1084-96. doi: https://doi.org/10.1007/s00125-021-05367-x
8. Nanayakkara N, Curtis AJ, Heritier S, Ga­dows­ki AM, Pavkov ME, Kenealy T, et al. Impact of age at type 2 diabetes mellitus diagnosis on mortality and vascular complications: systematic review and meta-analyses. Diabetologia.2021;64(2):275-87. doi: https://doi.org/10.1007/s00125-020-05319-w
9. Sattar N, Rawshani A, Franzén S, Rawshani A, Svensson AM, Rosengren A, et al. Age at diagnosis of type 2 diabetes mellitus and associations with cardiovascular and mortality risks. Circulation. 2019 May 7;139(19):2228-37. doi https://doi.org/10.1161/CIRCULATIONAHA.118.037885
10. de Jong M, Woodward M, Peters SAE. Duration of diabetes and the risk of major cardiovascular events in women and men: a prospective cohort study of UK biobank participants. Diabetes Res Clin Pract. 2022;188:109899. doi: https://doi.org/10.1016/j.diabres.2022.109899
11. Huang JX, Liao YF, Li YM. Clinical features and microvascular complications risk factors of early-onset type 2 diabetes mellitus. Curr Med Sci. 2019;39(5):754-8. doi: https://doi.org/10.1007/s11596-019-2102-7
12. Endothelial Dysfunction and Diabetic Cardio­myopathy. Front Endocrinol. 2022;13:851941. doi: https://doi.org/10.3389/fendo.2022.851941
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17. Ye Y, Chen X, Han J, Jiang W, Natarajan P, Zhao H. Interactions Between Enhanced Polygenic Risk Scores and Lifestyle for Cardiovascular Disease, Diabetes, and Lipid Levels. Circulation: Genomic and Precision Medicine.2021;14(1):e003128. doi: https://doi.org/10.1161/CIRCGEN.120.003128
18. Vaiserman AM, Khalangot ND, Pisaruk AV, Me­khova LV, Kolyada AK, Kutsenko KY, et al. Predis­posi­tion to type II diabetes among those residents of Ukraine whose prenatal development coincided with the famine of 1932-1933.Adv  2011;1:362-6. doi: https://doi.org/10.1134/S2079057011040163
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Look through:

Saienko Y.A. D.F. Chebotarev Institute of Gerontology of the National Academy of Medical 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/0000-0003-1953-1066

Koshel N.M. D.F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0003-1429-2326

Pysaruk A.V. D.F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0001-5522-0172

Mankovsky B.M. D.F. Chebotarev Institute of Gerontology of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0001-8289-3604

Saienko Y.A., Koshel N.M., Pysaruk A.V., Mankovsky B.M. Prediction of coronary artery disease risk in patients with type 2 diabetes mellitus: a mathematical model. Medicni perspektivi. 2025;30(2):78-90.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333436

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

This article explores changes in pulmonary function in patients who underwent lung decortication as a method of treating complications caused by post-pneumonic pleurisy. It is emphasized that complications such as post-pneumonic pleurisy may lead to the formation of pulmonary fibrosis, which results in a progressive decrease in the effectiveness of external respiratory function. The objective of this research was to assess the clinical effectiveness of surgical lung decortication in individuals with complicated post-pneumonic pleurisy during the early postoperative period based on comparative analysis of spirometric indicators measured both before and after the surgical procedure. A total of 36 patients who suffered from post-pneumonic pleurisy and underwent decortication were included in this study. The primary diagnostic tool used was spirometry. Pulmonary function tests were performed in full compliance with the guidelines of the European Respiratory Society, ensuring accuracy and consistency of results. Statistical analysis using the Wilcoxon test for dependent samples confirmed that decortication led to a statistically significant improvement (p<0.05) in ventilation performance. The procedure was especially effective for addressing restrictive ventilatory impairments caused by fibrotic changes in the pleura, which develop due to the complicated course of pleurisy. Indications for decortication included severe impairment of lung ventilation, radiological signs of fibrin adhesions, and failure of less invasive interventions such as pleural puncture. The operation enables to noticeably improve the quality of life of patients, achieved through the restoration of respiratory function and decrease of restrictive disorders already in early postoperative period: a 16% increase in forced vital capacity and a 13% improvement in forced expiratory volume in the first second. These outcomes correspond with those documented in international clinical studies, confirming the value and effectiveness of the procedure.

Key words: decortication, pleurisy, pleural effusion, functions of external respiration

1. Koshak YuF. [Analysis of results of surgical treatment of patients with tuberculous pleural empyema]. Achievements of clinical and experimental medicine. 2020;1:106-12. Ukrainian. doi: https://doi.org/10.11603/1811-2471.2020.v.i1.11077
2. Madhi S, Boudaya MS, Attig YB, Rammeh M, Souissi F, Dhou AB, et al. Video-assisted thoracoscopic surgery for pleural decortication in empyema. European Respiratory Journal. 2024;64(Suppl 68):PA3159. doi: https://doi.org/10.1183/13993003.congress-2024.PA3159
3. Dokhan AL, Ibrahim IM, Hagag M. Video-assis­ted thoracoscopic surgery versus open decortication in chronic pleural empyema. The Egyptian cardiothoracic surgeon. 2022;4(4):68-72. doi: https://doi.org/10.35810/ects.v4i4.222
4. Makarov VV, Tsivenko ОІ. [Early complications by patients with decortications of lung in empyema pleural: causes, methods of prevention]. World Science. 2020;4(56):24-8. doi: https://doi.org/10.31435/rsglobal_ws/30042020/7020
5. Kondov G, Colanceski R, Kondova Topuzovska I, Spirovski Z, Caeva Jovkovska B, Kokareva A, et al. Analysis of lung function test in patients with pleural empyema treated with thoracotomy and decortication. Prilozi. 2011;12:259-71.
6. Özer КВ, Tükel M, Özdemir A, Cesur EE, De­mirhan R. The Effects of Pleural Decortication on Respiratory Functions of the Patients with Pleural Em­pyema. South Clin Ist Euras. 2018;29(2):99-104. doi: https://doi.org/10.14744/scie.2018.85866
7. Elsheikh A, Bhatnagar M, Rahman NM. Diagno­sis and management of pleural infection. Breathe. 2023;19(4):230146. doi: https://doi.org/10.1183/20734735.0146-2023
8. Cheikhrouhou T, Dhaou MB, Elleuch A, Hbaieb M, Zouari M, et al. The thoracoscopic approach in the mana­gement of parapneumonic pleural effusion in children. J Pulmonol Respir Res. 2022;6:025-9. doi: https://doi.org/10.29328/journal.jprr.1001041
9. Duzhyi ID. [Features of the diagnosis of pleural diseases: monograph]. 2 ed. Sumy: Sumy State University; 2021. 716 p. Ukrainian.
10. Roberts ME, Rahman NM, Maskell NA, Bibby AC, Blyth KG, Corcoran P, et al. British Thoracic Society Gui­deline for pleural disease. Thorax. 2023;78(Suppl 3);s1-s42. doi: https://doi.org/10.1136/thorax-2022-219784
11. Savenkov YuF. [Rational phthisiosurgery]. Dnip­ro: Dmitrieva G.V.; 2022. 115 p. Russian.
12. Gokce M, Okur E, Baysungur V, Ergene G, Sevil­gen G, Halezeroglu S. Lung decortication for chronic empyaema: effects on pulmonary function and thoracic asymmetry in the late period. Eur J Cardiothorac Surg. 2009;36:754-8. doi: https://doi.org/10.1016/j.ejcts.2009.04.043
13. Abraham SV, Chikkahonnaiah P. Change in pul­monary function following decortication for chronic pleural empyema. Turk Thorac J. 2020;21(1):27-31. doi: https://doi.org/10.5152/TurkThoracJ.2019.180146
14. Rai SP, Kaul SK, Tripathi RK, Bhattacharya D, Kashyap M. Decortication in chronic pleural empyema. Lung 2006;23:100-2. doi: https://doi.org/10.4103/0970-2113.44399
15. Ryzhov OA, Penkin YuM. [Statistical methods of processing the results of medical and biological research]. Magnolia; 2022. 160 p. Ukrainian.
16. Bhatnagar M, Najib NC, Rahman NM, Stan­ton AE. Front-door thoracic ultrasound in patients with community-acquired pneumonia to diagnose and predict pleural infection – a prospective study. ERJ Open Research. 2024;10(4):00662-2023. doi: https://doi.org/10.1183/23120541.00662-2023

Look through:

Duka R.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-3962-8746

Bilov 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/0000-0001-8076-6871

Duka M.V. MNE “City Clinical Hospital No. 16” of the Dnipro City Council, Dnipro, Ukraine
 https://orcid.org/0009-0006-5004-5161

Duka R.V., Bilov O.V., Duka M.V. Changes in the function of external breathing in patients who underwent lung decortication after post-pneumonic pleurisy. Medicni perspektivi. 2025;30(2):91-97.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333439

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

This article explores changes in pulmonary function in patients who underwent lung decortication as a method of treating complications caused by post-pneumonic pleurisy. It is emphasized that complications such as post-pneumonic pleurisy may lead to the formation of pulmonary fibrosis, which results in a progressive decrease in the effectiveness of external respiratory function. The objective of this research was to assess the clinical effectiveness of surgical lung decortication in individuals with complicated post-pneumonic pleurisy during the early postoperative period based on comparative analysis of spirometric indicators measured both before and after the surgical procedure. A total of 36 patients who suffered from post-pneumonic pleurisy and underwent decortication were included in this study. The primary diagnostic tool used was spirometry. Pulmonary function tests were performed in full compliance with the guidelines of the European Respiratory Society, ensuring accuracy and consistency of results. Statistical analysis using the Wilcoxon test for dependent samples confirmed that decortication led to a statistically significant improvement (p<0.05) in ventilation performance. The procedure was especially effective for addressing restrictive ventilatory impairments caused by fibrotic changes in the pleura, which develop due to the complicated course of pleurisy. Indications for decortication included severe impairment of lung ventilation, radiological signs of fibrin adhesions, and failure of less invasive interventions such as pleural puncture. The operation enables to noticeably improve the quality of life of patients, achieved through the restoration of respiratory function and decrease of restrictive disorders already in early postoperative period: a 16% increase in forced vital capacity and a 13% improvement in forced expiratory volume in the first second. These outcomes correspond with those documented in international clinical studies, confirming the value and effectiveness of the procedure.

Key words: decortication, pleurisy, pleural effusion, functions of external respiration

1. Babych MS. [Personal and academic stress in students receiving higher education in a different specialty]. Kyiv: Natsionalnyi linhvistychnyi universytet; 2023. 74 p. Ukrainian.
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7. Akanpaadgi Е, Binpimbu F, Naalu Kuuyelleh E. The impact of stress on students’ academic performance. J Educational 2023;2(1):60-7. doi: https://doi.org/10.56773/ejer.v2i1.17
8. Solis AC, Lotufo-Neto F. Predictors of quality of life in Brazilian medical students: a systematic review and meta-analysis. Braz J Psychiatry. 2019 Nov-Dec;41(6):556-67.
   doi: https://doi.org/10.1590/1516-4446-2018-0116
9. Ramón-Arbués E, Echániz-Serrano E, Martínez-Abadía B, Antón-Solanas I, Cobos-Rincón A, Santolalla-Arnedo I, et al. Predictors of the Quality of Life of University Students: A Cross-Sectional Study. Int JEnviron Res Public Health. 2022;19(19):12043. doi: https://doi.org/10.3390/ijerph191912043
10. Omodaka Y, Sato T. The Quality of Life of Students With Difficulties Accessing Support. Inquiry. 2023;60:469580231159728. doi: https://doi.org/10.1177/00469580231159728
11. Kordunova N, Mudrak I, Dmytriiuk N. [Features of vitality and adaptability of students in crisis situations]. Psychological Prospects Journal. 2021;38:96-109. Ukrainian. doi: https://doi.org/10.29038/2227-1376-2021-38-96-109
12. Noreen A, Iqbal N, Hassan B, Ali SA. Rela­tionship between psychological distress, quality of life and resilience among medical and non-medical students. J Pak Med 2021;71(9):2181-5. doi: https://doi.org/10.47391/JPMA.04-611
13. Fechenko YuI, Mostovoy YuM, Babiychuk YuV. [The procedure of adaptation of international quality of life questionnaire MOS SF-36 in Ukraine. The experience of administration in asthma patient]. Ukrainskiy pulmono­logichniy Journal. 2002;3:9-11. Ukrainian.
14. Zlivko VL, Lukomska CO, Fedan OV. [Psycho­diagnostics of personality in life crisis situations]. Kyiv: Pedagogichna dumka; 2016. 219 р. Ukrainian.
15. Kolesnichenko OS. [Applied psychodiagnostics in the National Guard of Ukraine]. Kharkiv: NANGU; 2020. 338 р. Ukrainian.
16. Kireeva ZO, Odnostalko OS, Biron BV. [Psycho­metric analysis of the adapted version of the resilience scale]. 2020;14:110-6. Ukrainian. doi: https://doi.org/10.32843/2663- 5208.2020.14.17 
17. Panok VG, Rybalka VV, Shandruk SK, et al. [Me­thods of psychological support of participants in the educational process in wartime conditions: practical manual]. Kyiv: UNMC of practical psychology and social work; 2023. 212 р. Ukrainian.
18. Moskalenko VF, Gulchiy OP, Golubchikov MV. [Biostatistics]. Kyiv: Knyga Plus; 2009. 217 р. Ukrainian.
19. Korda M, Shulhai A, Shevchuk O, Shulhai O, Shulhai A-M. Psychological well-being and academic performance of Ukrainian medical students under the burder of war: a cross-sectional study. Front Public Health. 2025 Jan 6;12:1457026. doi: https://doi.org/10.3389/fpubh.2024.1457026
20. Dzeruzhynska N, Gindych A. [Research on the mental health of students affected by war: comorbidity, quality of life and effective therapeutic approaches]. Psychosomatic medicine and general practice [Internet]. 2025[cited 2024 Dec 17];10(1).  doi: https://doi.org/10.26766/pmgp.v10i1.596
21. Chachko SL, Travinina EI. [Experience of pro­longed traumatic stress of war by higher education stu­dents]. Scien­tific notes of the Tavria National University named V.I. Ver­nandsky. Psychology. 2024;35(74)(3):67-75. Ukrainian.
    doi: https://doi.org/10.32782/2709-3093/2024.3/10
22. Sholubka T. [Content-organizational aspects of building a program for the formation of psychological resilience of students in war conditions]. Bulletin of Lviv University. Psychological Sciences. 2023;Issue 17:73-82. doi: https://doi.org/10.30970/PS.2023.19.9
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Look through:

Khanyukov O.O. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-4146-0110

Krotova V.Yu. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-2517-435X

Panina S.S. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-1080-7185

Khramtsova V.V. State institution "Ukrainian State Institute of Medical and Social Problems of Disability Ministry of Public Health of Ukraine", Dnipro, Ukraine
https://orcid.org/0000-0001-7007-249711

Yegorov K.Yu. Dnipro State Medical University, Dnipro, Ukraine
 https://orcid.org/0000-0002-4524-1014

Shchukina O.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/0000-0002-9543-1545

Khanyukov O.O., Krotova V.Yu., Panina S.S., Khramtsova V.V., Yegorov K.Yu., Shchukina O.S. Experience of using psychological support for 6th year medical university students in conditions of high stress levels and reduced quality of life indicators. Medicni perspektivi. 2025;30(2):97-107.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333441

Side effects and hypersensitivity reactions to corticosteroids

This article presents the findings of a study on the causes, impact of war and coping strategies for burnout and depression among medical interns. The study aimed to identify the factors contributing to burnout and depression in interns, the effects of war on these conditions, and respondents’ suggested strategies for managing them, to develop preventive and psychoeducational measures. The study involved 63 medical interns from the Dnipro State Medical University, undergoing training at the Department of Psychiatry, Narcology and Medical Psychology, and the Department of Pediatrics 3 and Neonatology. The interns were divided into two groups based on their specialty: "Psychiatry" (Group 1) – 31 individuals, and "Pediatrics" (Group 2) – 32 individuals. A psychodiagnostic method was employed, utilizing a custom-designed questionnaire inspired by a Med­scape survey. The questionnaire focused on burnout and depression in medical interns during wartime and consisted of 21 questions structured into five clusters. The study revealed a high prevalence of symptoms of depression and burnout syndrome. Specifically, 51,6% of Group 1 and 56,3% of Group 2 reported such symptoms. War significantly impacted the psychological state of respondents, as reported by 67,7% of Group 1 and 96,9% of Group 2. Key factors included information overload, air raid alarms, and working with war-affected individuals. Female respondents were more likely to report a significant impact of war, while male respondents noted reduced attentiveness and irritability in workplace relationships. Approximately 22% of participants considered changing their profession due to burnout, with higher rates observed in Group 2 (34,4% versus 9,7%). The main coping strategies were communication with loved ones (68,3%) and creating a comfortable work environment (84,1%). However, some respondents, particularly from Group 1, resorted to isolation or psychoactive substance use (25,8%). Despite the prevalence of these issues, only 25,4% sought psychological help, with some avoiding disclosure due to stigma. The findings highlight the urgent need to develop targeted psychoeducational and preventive programs to address professional burnout and depression, particularly during wartime and in the post-war period.

Key words: burnout, depression, intern doctor, war, coping

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   doi: https://doi.org/10.1186/s13063-019-3401-9
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20. Sanfilippo F, Palumbo GJ, Noto A, Pennisi S, Mi­neri M, Vasile F, et al. Prevalence of burnout among intensive care physicians: a systematic review. Rev Bras Ter 2020 Jul-Sep;32(3):458-67. doi: https://doi.org/10.5935/0103-507X.20200076
21. Al-Youbi RA, Jan MM. Burnout syndrome in pe­diatric practice. Oman Med J. 2013 Jul;28(4):252-4. doi: https://doi.org/10.5001/omj.2013.71
22. Rivas-García A, Míguez-Navarro MC, Ferrero-García-Loygorri C, Marañón R, Vázquez-López P; en rep­resentación del Grupo para el estudio del Burnout de la Red de Investigación de la Sociedad española de Urgencias Pediátricas (RISeuP-SPERG). Burnout syndrome in paediatricians working in paediatric emergency care set­tings. Prevalence and associated factors: a multilevel analysis. An Pediatr (Engl Ed). 2023 Feb;98(2):119-28. doi: https://doi.org/10.1016/j.anpede.2023.01.004
23. Jagannath G. Burnout syndrome in healthcare pro­fessionals. Telangana J Psychiatry. 2020;6(2):105-9. doi: https://doi.org/10.18231/j.tjp.2020.023

Look through:

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

Mavropulo T.K. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-9351-3080

Borysova I.S. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-4703-6046

Shusterman T.Y. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-5422-1624

Nikolenko A.Ye. 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/0000-0001-5523-8858

Plekhanova T.M. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-9243-5399

Ogorenko V.V., Mavropulo T.K., Borysova I.S., Shusterman T.Y., Nikolenko A.Ye., Plekhanova T.M. Burnout and depression in medical interns: causes, impact of war and coping strategies. Medicni perspektivi. 2025;30(2):108-119.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333442

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

Human papillomavirus (HPV) is a common sexually transmitted infection with potentially serious health con­sequences, including anogenital and oropharyngeal cancers and genital warts. In 2022, Albania implemented an HPV vaccination program for girls aged 13-20 years, offering a single dose of the bivalent or quadrivalent vaccine. This study aims to evaluate the status of HPV vaccination in the Shkodra region after its first year of implementation and explore reasons for non-vaccination. This retrospective study collected data from official vaccination registers at health centers in the Shkodra region for the period 2022-2023. Additionally, face-to-face interviews were conducted with nurses res­ponsible for administering vaccinations (vaccinators) and with parents present at the centers. Quantitative data were obtained and validated by the Chief Vaccination Office in the Epidemiology Sector at the Local Health Care Unit in Shkodra. A simple descriptive and comparative method was employed. Data for this study were gathered from two main sources: official vaccination records and interviews conducted with nurses and parents. Quantitative data were processed and analyzed using Microsoft Office Excel 2010. The vaccination coverage plan aimed to vaccinate 812 girls, with 67% (n=546) from urban areas and 33% (n=266) from rural areas. Overall, vaccination coverage was 51% (n=412 girls). Coverage was higher in rural areas (72.6%, n=193 girls) than in urban areas (40%, n=219 girls). This study highlights the challenges and successes of the HPV vaccination program in the Shkodra region during its first year of implementation. Vaccination coverage was higher in rural areas (72.6%) compared to urban areas (40%). Key barriers to vaccine uptake included parental refusal, lack of information, and fear of side effects.

Key words: human papillomavirus, HPV, vaccine, vaccination, immunization, public health, healthcare

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2. Smith JS, Gilbert PA, Melendy A, Rana RK, Pi­menta JM. Age-Specific Prevalence of Human Papillo­mavirus Infection in Males: A Global Review. Journal of Adolescent 2011 Jun;48(6):540-52. doi: https://doi.org/10.1016/j.jadohealth.2011.03.010
3. Winer RL, Feng Q, Hughes JP, O’Reilly S, Ki­viat NB, Koutsky LA. Risk of Female Human Papilloma­virus Acquisition Associated with First Male Sex Partner. JInfect  2008 Jan 15;197(2):279-82. doi: https://doi.org/10.1086/524875
4. Baandrup L, Blomberg M, Dehlendorff C, Sand C, Andersen KK, Kjaer SK. Significant Decrease in the Inci­dence of Genital Warts in Young Danish Women After Implementation of a National Human Papillomavirus Vac­cination Program. Sex Transm Dis. 2013 Feb;40(2):130-5. doi: https://doi.org/10.1097/OLQ.0b013e31827bd66b
5. Chaturvedi AK. Beyond Cervical Cancer: Burden of Other HPV-Related Cancers Among Men and Women. Journal of Adolescent Health. 2010 Apr;46(4):S20-6. doi: https://doi.org/10.1016/j.jadohealth.2010.01.016
6. Giuliano AR, Anic G, Nyitray AG. Epidemiology and pathology of HPV disease in males. Gynecol Oncol. 2010 May;117(2):S15-9. doi: https://doi.org/10.1016/j.ygyno.2010.01.026
7. Giuliano AR, Palefsky JM, Goldstone S, Mo­rei­ra ED, Penny ME, Aranda C, et al. Efficacy of Quadri­valent HPV Vaccine against HPV Infection and Disease in Males. New England Journal of Medicine. 2011 Feb 3;364(5):401-11. doi: https://doi.org/10.1056/NEJMoa0909537
8. Hariri S, Markowitz LE, Dunne EF, Unger ER. Po­pulation Impact of HPV Vaccines: Summary of Early Evidence. Journal of Adolescent Health. 2013 Dec;53(6):679-82. doi: https://doi.org/10.1016/j.jadohealth.2013.09.018
9. Parkin DM, Bray F. Chapter 2: The burden of HPV-related cancers. Vaccine. 2006 Aug;24:S11-25. doi: https://doi.org/10.1016/j.vaccine.2006.05.111
10. Forhan SE, Gottlieb SL, Sternberg MR, Xu F, Dat­ta SD, McQuillan GM, et al. Prevalence of Sexually Trans­mitted Infections Among Female Adolescents Aged 14 to 19 in the United States. Pediatrics. 2009 Dec 1;124(6):1505-12. doi: https://doi.org/10.1542/peds.2009-0674
11. Giuliano AR, Lu B, Nielson CM, Flores R, Pa­penfuss MR, Lee J, et al. Age‐Specific Prevalence, Inci­dence, and Duration of Human Papillomavirus Infections in a Cohort of 290 US Men. J Infect Dis. 2008 Sep 15;198(6):827-35. doi: https://doi.org/10.1086/591095
12. Etter DJ, Zimet GD, Rickert VI. Human papil­lomavirus vaccine in adolescent women. Curr Opin Obstet Gynecol.2012 Oct;24(5):305-10. doi: https://doi.org/10.1097/GCO.0b013e3283567005
13. Fisher WA. Understanding Human Papilloma­virus Vaccine Uptake. Vaccine. 2012 Nov;30:F149-56. doi: https://doi.org/10.1016/j.vaccine.2012.04.107
14. Stupiansky NW, Alexander AB, Zimet GD. Hu­man papillomavirus vaccine and men. Curr Opin Infect Dis.2012 Feb;25(1):86-91. doi: https://doi.org/10.1097/QCO.0b013e32834ed5be
15. Markowitz LE. dvisory Committee on Immu­nization Practices (ACIP). Quadrivalent Human Papil­lomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2007;2(56):1-24. doi: https://doi.org/10.1037/e601292007-001
16. Dunne EF; MLE; CHCCRSMGJUER. Recom­mendations on the Use of Quadrivalent Human Papillo­mavirus Vaccine in Males – Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morb Mortal Wkly Rep. 2011 Dec 23;60(50):1705-8. PMID: 22189893
17. Curtis CR YDJJDCSSMJHS. National and State Vaccination Coverage Among Adolescents Aged 13-17 years – United States, 2012. MMWR Morb Mortal Wkly Rep. 2013 Aug 30;62(34):685-93. PMID: 23985496.
18. Nolan KM, Seaton B, Antonello J, Zhang Y, Cook L, Delfino K, et al. Development and Validation of Two Optimized Multiplexed Serologic Assays for the 9-Valent Human Papillomavirus Vaccine Types. mSphere. 2023 Apr 20;8(2):e0096221. doi: https://doi.org/10.1128/msphere.00962-21
19. Borah P, Kim S, Xiao X, Lee DKL. Correcting misinformation using theory-driven messages: HPV vaccine misperceptions, information seeking, and the moderating role of reflection. Atl J Commun. 2022 May 27;30(3):316-31. doi: https://doi.org/10.1080/15456870.2021.1912046
20. Adekanmbi V, Sokale I, Guo F, Ngo J, Hoang TN, Hsu CD, et al. Human Papillomavirus Vaccination and Human Papillomavirus–Related Cancer Rates. JAMA Netw Open.2024 Sep 5;7(9):e2431807. doi: https://doi.org/10.1001/jamanetworkopen.2024.31807
21. Dorji T, Nopsopon T, Tamang ST, Pongpirul K. Human papillomavirus vaccination uptake in low-and middle-income countries: a meta-analysis. Ecli­nicalMe­dicine.2021 Apr;34:100836. doi: https://doi.org/10.1016/j.eclinm.2021.100836
22. Dykens JA, Peterson CE, Holt HK, Harper DM. Gender neutral HPV vaccination programs: Reconsidering policies to expand cancer prevention globally. Front Public Health.2023 Feb 21;11:1067299. doi: https://doi.org/10.3389/fpubh.2023.1067299
23. Athanasiou A, Bowden S, Paraskevaidi M, Foto­poulou C, Martin-Hirsch P, Paraskevaidis E, et al. HPV vaccination and cancer prevention. Best Pract Res Clin Obstet 2020 May;65:109-24. doi: https://doi.org/10.1016/j.bpobgyn.2020.02.009
24. Pojani E, Bozo S, Capparelli E, Hoxha B. Cer­vical Cancer and HPV vaccination: Insights into know­ledge, attitudes, and practices among Albanian women. Vaccine 2025 Jan;22:100594. doi: https://doi.org/10.1016/j.jvacx.2024.100594
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26. Bakiri F, Abazi E, Lika M. Albanian Male Stu­dents Perception and Knowledge of Human Papilloma­virus (HPV). Journal of Biological Studies. 2023 Dec 31;6(4):273-81. doi: https://doi.org/10.62400/jbs.v6i4.8727
27. Shin MB, Sloan KE, Martinez B, Soto C, Baez­conde-Garbanati L, Unger JB, et al. Examining multilevel influences on parental HPV vaccine hesitancy among multiethnic communities in Los Angeles: a qualitative analysis. BMC Public Health. 2023 Mar 22;23(1):545. doi: https://doi.org/10.1186/s12889-023-15318-2
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32. Beavis AL, Krishnamoorthi MS, Adler S, Fles­zar LG, Moran MB, Rositch AF. Contemporary provider perspectives on how to address HPV vaccine hesitancy in the US: A qualitative study. Vaccine X. 2024 Oct;20:100533. doi: https://doi.org/10.1016/j.jvacx.2024.100533

Look through:

Shabani Zamira University of Shkodra “Luigj Gurakuqi” Faculty of Natural Sciences, Shkoder, Albania
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-8021-5391

Haxhija Edona University of Shkodra “Luigj Gurakuqi” Faculty of Natural Sciences, Shkoder, Albania
https://orcid.org/0000-0002-9454-8485

Pjetri Emiljano University of Shkodra “Luigj Gurakuqi” Faculty of Natural Sciences, Shkoder, Albania
https://orcid.org/0009-0004-7299-0346

Shala Irena University of Shkodra “Luigj Gurakuqi” Faculty of Natural Sciences, Shkoder, Albania
https://orcid.org/0000-0002-3726-6115

Bushati Nevila University of Shkodra “Luigj Gurakuqi” Faculty of Natural Sciences, Shkoder, Albania
https://orcid.org/0000-0001-7913-9088

Malevija Amela University of Shkodra “Luigj Gurakuqi” Faculty of Natural Sciences, Shkoder, Albania
https://orcid.org/0009-0005-6314-0355

Shabani Zamira, Haxhija Edona, Pjetri Emiljano, Shala Irena, Bushati Nevila, Malevija Amela. The situation with vaccination in Shkodra region after the first year of implementation of human papillomavirus vaccine. Medicni perspektivi. 2025;30(2):120-127.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333445

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

Coronavirus disease 2019 (COVID-19) and preeclampsia (PE) have shared clinical and pathological manifestations, creating a diagnostic challenge. The aim of the study was to identify pathomorphological changes in the placenta that are diagnostically significant for COVID-19 and preeclampsia. We studied the placenta in full-term pregnancies with maternal COVID-19 (Group I, n=80; Subgroup I.1 – COVID-19 at 19–34 weeks of gestation, n=48; Subgroup I.2 – COVID-19 at 35–40 weeks, n=32), the placenta in cases of preeclampsia (PE, n=30) – Group II (Subgroup II.1 – with mild PE; Subgroup II.2 – with moderate and severe PE), and the placenta in the comparison group, n=40. Macroscopic, microscopic, immunohistochemical, morphometric, and statistical methods were used. Placentae in the main groups were characterized by circulatory disorders. Placentitis was present exclusively in Group I. Arteriolosclerosis with vascular lumen obliteration was predominantly detected in Group II and was associated with arteriolar wall hyalinosis: Subgroup II.1 – 75% (95% CI: 49.5%–93.5%), Subgroup II.2 – 100% (95% CI: 87.3%–100%) compared to 25% (95% CI: 13.6%–38.4%) in Subgroup I.1, where it was caused by the proliferation of smooth muscle cells in the arteriolar wall followed by fibrosis, and was not observed in Subgroup I.2. A reduction in the number of terminal chorionic villi was observed in Subgroup I.1 and Subgroup II.2: 16.6 [10; 25] and 12.8 [12; 14], respectively. This was attributed to delayed villous maturation caused by vascular damage in the stem villi. The placenta in Subgroup I.2 was characterized by stromal edema of terminal villi, which led to external compression of the vessels, resulting in a reduced percentage of vessels within the villi – 26.9% [20.9%; 35.6%]. The reduction in vessel percentage in Group II.2 – 29.0% [25.6%; 34.2%] was associated with fibrosis of the chorionic villous stroma. These indicators significantly differed (p<0.0001) from Group I.1 and II.1: 45.2% [40.9%; 48.3%] and 57.6% [50.2%; 64.1%], respectively, and from the comparison group: 67.8% [58.78%; 73.7%]. Compensatory changes, such as an increase in syncytial knots, were observed in Subgroup I.2 and Subgroup II.1, with densities of 12.8 [11; 14] and 9.1 [8; 10], respectively, compared to 5.7 [5; 7] in the comparison group. A reduction in the percentage of the intervillous space was observed in Subgroup I.2 and Subgroup II.1: 26.0% [20.7%; 33.8%] and 29.2% [18.9%; 42.2%], respectively, versus 44.9% [40.5%; 49.6%] in the comparison group; p<0.0001. Placentitis is the main pathomorphological difference in placental changes in COVID-19 compared to preeclampsia. Pathomorphological changes in the placenta during the acute phase of COVID-19 and in mild preeclampsia, despite differences in disease pathogenesis, shared common features: microcirculatory disturbances and an increased number of syncytial knots as a compensatory response to reduced intervillous space (caused by villous stromal edema in COVID-19 and angiomatous changes in terminal villi in preeclampsia). Placental changes in moderate and severe preeclampsia, characterized by infarctions, arteriolosclerosis, and delayed villous maturation (distal villous hypoplasia), were similar to changes observed in COVID-19 in the second trimester of pregnancy. 

Key words: placenta, COVID-19, SARS-CoV-2, preeclampsia, pregnancy, chorionic villi

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2. Naeh A, Berezowsky A, Yudin MH, Dhalla IA, Berger H. Preeclampsia-Like Syndrome in a Pregnant Patient With Coronavirus Disease 2019 (COVID-19). 2022 Feb 1;44(2):193-5. doi: https://doi.org/10.1016/j.jogc.2021.09.015
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4. Sankar KD, Bhanu PS, Kiran S, Ramakrishna BA, Shanthi V. Vasculosyncytial membrane in relation to syn­cytial knots complicates the placenta in preeclampsia: a histo­morphometrical study. Anat Cell Biol. 2012 Jun;45(2):86-91. doi: https://doi.org/10.5115/acb.2012.45.2.86
5. Shaw LJ, Patel K, Lala-Trindade A, Feltovich H, Vieira L, Kontorovich A, et al. Pathophysiology of Pree­clampsia-Induced Vascular Dysfunction and Implications for Subclinical Myocardial Damage and Heart Failure. JACC: 2024 Jun;3(6):100980. doi: https://doi.org/10.1016/j.jacadv.2024.100980
6. Serrano B, Bonacina E, Garcia-Ruiz I, Men­do­za M, Garcia-Manau P, Garcia-Aguilar P, et al. Confirma­tion of preeclampsia-like syndrome induced by severe COVID-19: an observational study. American Journal of Obstetrics & Gynecology MFM. 2023 Jan;5(1):100760. doi: https://doi.org/10.1016/j.ajogmf.2022.100760
7. Mendoza M, Garcia‐Ruiz I, Maiz N, Rodo C, Gar­cia‐Manau P, Serrano B, et al. Pre‐eclampsia‐like synd­rome induced by severe COVID‐19: a prospective obser­vational study. BJOG: An International Journal of Obstetrics & Gynaecology. 2020 Jun 21;127(11):1374-80. doi: https://doi.org/10.1111/1471-0528.16339
8. Turpin CA, Sakyi SA, Owiredu WK, Eph­raim RKD, Anto EO. Association between adverse preg­nancy outcome and imbalance in angiogenic regulators and oxidative stress biomarkers in gestational hypertension and preeclampsia. BMC Pregnancy and Childbirth. 2015 Aug 25;15(1):189. doi: https://doi.org/10.1186/s12884-015-0624-y
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10. Gheblawi M, Wang K, Viveiros A, Nguyen Q, Zhong JC, et al. Angiotensin Converting En­zyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System. Circulation Research. 2020 May 8;126(10):1456-74. doi: https://doi.org/10.1161/CIRCRESAHA.120.317015
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12. Gychka SG, Brelidze TI, Kuchyn IL, Sav­chuk TV, Nikolaienko SI, Zhezhera VM, et al. Placental vascular remodeling in pregnant women with COVID-19. PLOS 2022 Jul 29;17(7):e0268591. doi: https://doi.org/10.1371/journal.pone.0268591
13. Savchuk T, Malysheva T, Vaslovych V, Chernen­ko O, Leshchenko I, Gychka S. Pathomorphological chan­ges of the placenta in the acute period of coronavirus disease 2019 (COVID-19) at 37–41 weeks of gestation. Proc Shevchenko Sci Soc Med Sci [Internet]. 2024 Dec 24 [cited2025 Jan 8];76(2). doi: https://doi.org/10.25040/ntsh2024.02.12
14. Nunes PR, Mattioli SV, Sandrim VC. NLRP3 Acti­vation and Its Relationship to Endothelial Dysfunction and Oxidative Stress: Implications for Preeclampsia and Phar­macological Interventions. Cells. 2021 Nov 1;10(11):2828. doi: https://doi.org/10.3390/cells10112828
15. Savchuck TV, Gychka SG, Leshchenko IV. Pa­tho­morphological changes of the placenta in coronavirus disease (COVID 19). Patologìâ. 2021 Aug 20;18(2):128-35.doi: https://doi.org/10.14739/2310-1237.2021.2.231461
16. Sara S, Peter L, Ajlana L, Matts O, Francisco ON, Jan W, et al. OP003. Placental perfusion in normal pregnancy and in early and late preeclampsia: A magnetic resonance imaging study. Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health. 2013 Apr;3(2):63. doi: https://doi.org/10.1016/j.preghy.2013.04.019
17. Savchuk T. Pathomorphological changes of the placenta in coronavirus disease (COVID-19) in pregnant women at 19-32 weeks of gestation. Proceeding of the Shevchenko Scientific Society. Medical Sciences [Internet]. 2024 Jun 28 [cited 2024 Jun 30];73(1). doi: https://doi.org/10.25040/ntsh2024.01
18. Savchuk T. Pathomorphological changes of the placenta in the acute period of COVID-19 in pregnant women. Eastern Ukrainian Medical Journal [Internet]. 2024 Jun 24 [cited 2024 Jun 30];12(2):323-34. doi: https://doi.org/10.21272/eumj.2024;12(2):323-334
19. Savchuk TV. Pathomorphological changes of the placenta in coronavirus disease (COVID-19) in pregnant women in the second and third trimesters of pregnancy. Medicni perspektivi. 2024;29(4):84-94. doi: https://doi.org/10.26641/2307-0404.2024.4.319224
20. Aeffner F, Zarella MD, Buchbinder N, Bui MM, Goodman MR, Hartman DJ, et al. Introduction to Digital Image Analysis in Whole-slide Imaging: A White Paper from the Digital Pathology Association. Journal of patho­logy informatics [Internet]. 2019;10(1):9. doi: https://doi.org/10.4103/jpi.jpi_82_18
21. Savchuk TV, Leshchenko IV, inventors; Bogo­molets National medical university (UA), assignee. [Method for quantitative determination of delayed placental maturation]. Patent Ukraine u202400917. 2024 Dec 18. Ukrainian.
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23. Kruskal WH, Wallis WA. Use of Ranks in One-Criterion Variance Analysis. Journal of the American Sta­tistical Association. 1952;47(260):583-621. doi: https://doi.org/10.1080/01621459.1952.10483441
24. Sharps MC, Hayes DJL, Lee S, Zou Z, Brady CA, Almoghrabi Y, et al. A structured review of placental morphology and histopathological lesions associated with SARS-CoV-2 infection. Placenta. 2020 Nov;101:13-29. doi: https://doi.org/10.1016/j.placenta.2020.08.018
25. Turyanytsya SМ, Korchins’ka OO, Sabova АV, Baloga OА, Petrov VO. Influence of SARS-CoV-2 acute respiratory viral disease on pregnancy and childbirth. Reproductive health of woman. 2021 Apr 1;2:15-8. doi: https://doi.org/10.30841/2708-8731.2.2021.232515
26. Yamada S, Asakura H. Coagulopathy and Fibri­nolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination. International Journal of Molecular Sciences. 2022 Mar 19;23(6):3338. doi: https://doi.org/10.3390/ijms23063338
27. Garg R, Agarwal R, Yadav D, Singh S, Kumar H, Bhardwaj R. Histopathological Changes in Placenta of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2) Infection and Maternal and Perinatal Outcome in COVID-19. J Obstet Gynaecol India. 2023 Feb;73(1):44-50. doi: https://doi.org/10.1007/s13224-022-01666-3
28. Bodnarchuk ОV. [Тhe metabolic aspects of pree­clampsia development]. Collection of scientific papers of the Association of Obstetricians and Gynecologists of Ukraine. 2022 Sep 21;1(49):5-15. Ukrainian.
    doi: https://doi.org/10.35278/2664-0767.1(49).2022.266320
29. Burton GJ. The Fine Structure of the Human Placental Villus as Revealed by Scanning Electron Micro­scopy. Scanning Microscopy. 1987;1(4):29

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Savchuk T.V. Bogomolets National medical university, Kyiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-7218-0253

Leshchenko I.V. Bogomolets National medical university, Kyiv, Ukraine
https://orcid.org/0000-0001-8239-256X

Savchuk T.V., Leshchenko I.V. Coronavirus disease 2019 (COVID-19) or preeclampsia: pathomorphological differential diagnosis of placental changes. Medicni perspektivi. 2025;30(2):128-139.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333460

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

Acute myeloid leukemias (AML) are a heterogeneous group of neoplasms of hematopoietic tissue, to determine the subtypes of which cytomorphological and cytochemical methods, immunophenotyping, cytogenetic and molecular genetic studies are carried out. Numerous genetic studies have identified criteria for diagnosis and prognosis of the course of the disease, which play a decisive role in the algorithms for stratifying clinical risk groups, which in turn contributes to the choice of optimal treatment tactics. However, the effectiveness of chemotherapy may lose its importance due to the lack of response to therapy and the development of relapses. The aim of the work was to establish ways to form resistance to therapy by comparing the features of quantitative and structural chromosome abnormalities at the time of diagnosis and in relapse of AML. Karyotyping was performed on bone marrow cells of 14 patients at the time of diagnosis of AML, sex ratio 1.0:1.0, mean age 44.0±3.6 years and 9 patients in relapsed disease: sex ratio 1.0:0.8, mean age 31.0±5.9 years. The analysis of the results included a comparison of the features of karyotype formation by clone structure, assessment of clones in relation to ploidy, balanced and unbalanced structural rearrangements and the frequency of chromosome involvement in such rearrangements. Subsequently, the formation of the stages of clonal chromosome abnormalities evolution was reconstructed and the frequencies of the cytogenetic prognosis groups were compared. As a result of the studies, the heterogeneity of quantitative (monosomies, trisomies) and structural balanced (translocations, inversions, insertions) and unbalanced chromosome abnormalities (deletions, isochromosomes, additional material of unknown origin, marker chromosomes) were determined, both in diagnosis and in relapse of AML. Mosaic karyotypes were almost three times more likely to occur in relapses than at the time of diagnosis (100% vs. 35.7%). At the time of diagnosis, an increased percentage of hyperdiploid clones (28.6%) was registered due to trisomies of chromosomes 2, 8×2, 13, 19, 20 and complex karyotypes (21.4%); chromosome 17 (20.8%) was more often involved in structural rearrangements, the group of intermediate cytogenetic prognosis dominated (57.1%). In relapses, chromosomes 8 and 9 were more often involved in structural rearrangements (17.6% each) and the group of unfavorable cytogenetic prognosis dominated (55.6%).

Key words: chromosomal abnormalities, acute myeloid leukemias, diagnosis making, relapse

1. Khoury JD, Solary E, Abla O, et al. The 5th edition of the World Health Organization Classification of haematolymphoid tumors: myeloid and histiocytic/den­dritic neoplasms. Leukemia. 2022 June;36(7):1703-19. doi: http://doi.org/10.1038/s41375-022-01613-1
2. Mrozek K, Heerema NA, Bloomfield CD. Cytoge­netics in acute leukemia. Blood Rev. 2004 Jun;18(2):115-36. doi: http://doi.org/10.1016/S0268-960X(03)00040-7
3. Desai RH, Zandvakili N, Bohlander S. Dissecting the genetic and non-genetic heterogeneity of acute myeloid leukemia using next-generation sequencing and in vivo models.Cancer (Basel). 2022 Apr;14(9):2182. doi: http://doi.org/10.3390/cancers14092182
4. Acute myeloid leukemia. NCCN Clinical Practice Guidelines in Oncology. NCCN Evidence Blocks. Ver­sion 3. 2024 [Internet]. 2024 [cited 2025 Mar 16]. Availablefrom: http://www.nccn.org/professionals/physician_gls/pdf/  
5. Thol F, Ganser A. Treatment of relapsed acute mye­loid leukemia. Curr Treat Options Oncol. 2020 Jun;21(8):66. doi: http://doi.org/10.1007/s11864-020-00765-5
6. Hackl H, Astanina K, Wieser R. Molecular and genetic alterations associated with therapy resistance and relapse of acute myeloid leukemia. Journal of hematology & 2017 Feb;10(1):51. doi: http://doi.org/10.1186/s13045-017-0416-0
7. [Acute myeloid leukemia. Evidence-based clinical guidelines. Ministry of Health of Ukraine]. [Internet]. 2023 [cited 2025 Mar 16]. Ukrainian. Available from: https://www.dec.gov.ua/wp-content/uploads/2023/10/2023_kn-gml.pdf
8. SilvaM, Leeuw N, Mann K, et al. European guidelines for constitutional cytogenomic analysis. Euro­pean Journal of Human Genetics. 2018 Jan;27(1):16. doi: http://doi.org/10.1038/s41431-018-0244-x
9. McGowan-Jordan J, Hastings RJ, Moore S. An International System for Human Cytogenomic Nomen­clature: Karger AG, Basel; 2020. 163 p.
10. Arber DA, Orazi A, Hasserjian R, et al. Inter­national Consensus Classification of Myeloid Neoplasms and Acute Leukemias: integrating morphologic, clinical, and genomic data. Blood. 2022 Sep;140(11):1200-28. doi: https://doi.org/10.1182/blood.2022015850
11. Kurzer JH, Weinberg OK. Updates in molecular genetics of acute myeloid leukemia. Seminars in diagnostic pathology.2023 May;40(3):140-51. doi: https://doi.org/10.1053/j.semdp.2023.04.002
12. Anelli L, Pasciolla C, Zagaria A, et al. Monosomal karyotype in myeloid neoplasias a literature review. Onco Targets 2017 Apr;10:2163-71. doi: http://doi.org/10.2147/OTT.S133937
13. Dwivedi AK. How to write statistical analysis section in medical research. J Investig Med. 2022 Dec;70(8):1759-70. doi: https://doi.org/10.1136/jim-2022-002479
14. White NM, Balasubramaniam T, Nayak R, Bar­nett AG. An observational analysis of the trope "A p-value of< 0.05 was considered statistically significant" and other cut-and-paste statistical methods. PLo SOne. 2022;17(3):e0264360. doi: https://doi.org/10.1371/journal.pone.0264360
15. Mrozek K, Eisfeld A, Kohlschmidt J, et al. Com­plex karyotype in de novo acute myeluod leukemia: typical and atypical subtypes differ molecularly and clinically. Leukemia.2019 Jul;33(7):1620-34. doi: http://doi.org/10.1038/s41375-019-0390-3
16. Ansar Z, Alam H, Shariq M, et al. Acute myeloid leukemia with hyperdiopoidy. AMP case report. CAP TODAY [Inretnet]. 2024 Mar [cited 2025 Mar 16]:1-3. Availablefrom: https://www.amp.org/AMP/assets/File/clinical-practice/0324_26-27_AMPcase-Ansar-reprint_HiRes.pdf?pass=98
17. Yeh W, Tirado C. Hypodiploidy in AML. J Assoc Genet Technol. 2021;47(3):122-6. PMID: 34491230

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Andreieva S.V. SI “National Research Center for radiation medicine, hematology and oncology of the national academy of medical science of Ukraine”, Kyiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-3029-4444

Korets K.V. SI “National Research Center for radiation medicine, hematology and oncology of the national academy of medical science of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0001-6519-8626

Skorokhod I.M. Limited Liability Company «Institute of medical molecular diagnostics», Kyiv, Ukraine
https://orcid.org/0000-0002-2219-5713

Hartovska I.R. Municipal Non-Profit Enterprise of the Kyiv Regional Council "Kyiv Regional Oncology Dispensary", Kyiv, Ukraine
https://orcid.org/0000-0002-8283-429X

Melnyk U.I. Municipal Non-Profit Enterprise "Kyiv City Clinical Hospital No. 9", Kyiv, Ukraine
https://orcid.org/0009-0006-7026-7669

Andreieva S.V., Korets K.V., Skorokhod I.M., Hartovska I.R., Melnyk U.I. Comparative characteristics of quantitative and structural chromosome abnormalities at the time of diagnosis and in relapses of acute myeloid leukemias. Medicni perspektivi. 2025;30(2):140-148.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333463

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

This study addresses the significant gap in existing literature regarding the long-term effects of emollients and emulsifiers on skin health to systematically evaluate the impact of these substances on Trans-Epidermal Water Loss (TEWL) and skin barrier functions across various skin conditions. The main aim of this research is to evaluate the effects of commonly used emollients and emulsifiers on skin barrier function across different skin conditions to provide insights that will contribute to the development of optimized skincare formulations for individuals with compromised skin barriers. A literature search was conducted across multiple databases, including PubMed, Scopus, Web of Science, and Google Scholar, using targeted search strings to gather relevant studies published over the last 20 years. The inclusion criteria focused on peer-reviewed studies that provided empirical data on the effects of emollients and emulsifiers on TEWL and skin barrier functions, specifically in human subjects. A total of 88 articles were initially identified, with 41 meeting the strict inclusion criteria after quality assessment using Joanna Briggs Institute checklists. The review revealed varied effects of emollients and emulsifiers on skin health. Natural oils were found to enhance skin barrier functions and reduce TEWL, whereas synthetic emollients raised concerns about their occlusive properties and potential to worsen skin conditions over time. Emulsifiers showed dual effects; some exacerbated TEWL in normal skin but reduced it in damaged skin, highlighting the complexity of their interaction with skin barrier components. The findings emphasize the need for standardized research methodologies and long-term studies to better understand the mechanisms by which emollients and emulsifiers influence skin health, particularly regarding TEWL measurement techniques while products do exhibit dual behavior and scientific evidence should guide the selection of emulsifiers and emollients in skincare products to ensure both efficacy and long-term safety as well  as the special assessment of the safer alternative what support both human health and environmental sustainability.

Key words: emollients, skin diseases, homeostasis, lipids, humans

1. Schrader A, Siefken W, Kueper T, Breitenbach U, Gatermann C, Sperling G, et al. Effects of glyceryl glucoside on AQP3 expression, barrier function and hydration of human skin. Skin Pharmacology and Physiology.2012;25(4):192-9. doi: https://doi.org/10.1159/000338190 
2. Basson R, Baguneid M, Foden P, Al Kredly R, Bayat A. Functional testing of a skin topical formulation in vivo: Objective and quantitative evaluation in human skin scarring using a double-blind volunteer study with Sequential Punch Biopsies. Advances in Wound Care. 2019 May;8(5):208-19. doi: https://doi.org/10.1089/wound.2018.0864
3. Draelos ZD. A clinical evaluation of the com­parable efficacy of hyaluronic acid-based foam and ceramide-containing emulsion cream in the treatment of mild-to-moderate atopic dermatitis. Journal of Cosmetic Dermatology. 2011 Sept;10(3):185-8. doi: https://doi.org/10.1111/j.1473-2165.2011.00568.x
4. van Smeden J, Janssens M, Kaye EC, Caspers PJ, Lavrijsen AP, Vreeken RJ, et al. The importance of free fatty acid chain length for the skin barrier function in atopic eczema patients. Experimental Dermatology. 2013 Dec 30;23(1):45-52. doi: https://doi.org/10.1111/exd.12293
5. Green M, Feschuk AM, Kashetsky N, Mai­bach HI. “Normal” tewl‐how can it be defined? A systematic review. Experimental Dermatology. 2022 Jul 31;31(10):1618-31. doi: https://doi.org/10.1111/exd.14635
6. Glatz M, Jo J-H, Kennedy EA, Polley EC, Seg­re JA, Simpson EL, et al. Emollient use alters skin barrier and microbes in infants at risk for developing atopic dermatitis. PLOS ONE. 2018 Feb 28;13(2):e0192443. doi: https://doi.org/10.1371/journal.pone.0192443
7. Lee H-J, Kim M. Skin barrier function and the microbiome. International Journal of Molecular Sciences. 2022 Oct 28;23(21):13071. doi: https://doi.org/10.3390/ijms232113071
8. Danby SG, Chalmers J, Brown K, Williams HC, Cork MJ. A functional mechanistic study of the effect of emollients on the structure and function of the Skin Barrier. British Journal of Dermatology. 2016 Aug 23;175(5):1011-9. doi: https://doi.org/10.1111/bjd.14684
9. Vaillant L, Georgescou G, Rivollier C, Delarue A. Combined effects of glycerol and petrolatum in an emollient cream: A randomized, double‐blind, crossover study in healthy volunteers with Dry Skin. Journal of Cosmetic Dermatology. 2019 Sept 18;19(6):1399-403. doi: https://doi.org/10.1111/jocd.13163
10. Chuberre B, Araviiskaia E, Bieber T, Barbaud A. Mi­neral oils and waxes in cosmetics: An overview mainly based on the current European regulations and the safety profile of these compounds. Journal of the European Aca­de­my of Dermatology and Venereology. 2019 ;33(S7):5-14. doi: https://doi.org/10.1111/jdv.15946
11. Ogorzałek M, Klimaszewska E, Mirowski M, Ku­lawik-Pióro A, Margula K, Tomasiuk R. Natural or syn­thetic emollients? Physicochemical properties of body oils in relation to selected parameters of epidermal barrier function. Appl 2024;14(7):2783. doi: https://doi.org/10.3390/app14072783  
12. Monteiro R, Nikam V, Dandakeri S, Bhat R. Tran­sepidermal water loss in psoriasis: A case-control study. Indian Dermatology Online Journal. 2019;10(3):267. doi: https://doi.org/10.4103/idoj.idoj_180_18
13. Pereira G, Fernandes C, Dhawan V, Dixit V. Pre­paration and development of nanoemulsion for skin moisturizing. In: Nanotechnology for the Preparation of Cosmetics Using Plant-Based Extracts. 2022. р. 27-47. doi: https://doi.org/10.1016/b978-0-12-822967-5.00008-4
14. Mawazi SM, Ann J, Othman N, Khan J, Alo­layan SO, Al thagfan SS, et al. A review of moisturizers; history, preparation, characterization and applications. Cosmetics. 2022 Jun 9;9(3):61. doi: https://doi.org/10.3390/cosmetics9030061
15. Armstrong J, Rosinski NK, Fial A, Ansah S, Hag­lund K. Emollients to prevent eczema in high-risk infants. MCN: The American Journal of Maternal/Child Nursing. 2022 May;47(3):122-9. doi: https://doi.org/10.1097/nmc.0000000000000809
16. Blanks KJ, Musaba MW, Ren L, Burgoine K, Mukunya D, Clarke A, et al. Neonatal emollient therapy and massage practices in Africa: A scoping review. International Health. 2023 Jul 22;16(2):152-64. doi: https://doi.org/10.1093/inthealth/ihad052
17. Techasatian L, Kiatchoosakun P. Effects of an emollient application on newborn skin from birth for prevention of atopic dermatitis: A randomized controlled study in Thai neonates. Journal of the European Academy of Dermatology and Venereology. 2021;36(1):76-83. doi: https://doi.org/10.1111/jdv.17675
18. Mehling A, Haake H‐M, Poly W. Differential deposition of emollients from tripartite formulation sys­tems. International Journal of Cosmetic Science. 2010 Mar 3;32(2):117-26. doi: https://doi.org/10.1111/j.1468-2494.2009.00546.x
19. Schoenfelder H, Liu Y, Lunter DJ. Systematic in­vestigation of factors, such as the impact of emulsifiers, which influence the measurement of skin barrier integrity by in-vitro trans-epidermal water loss (TEWL). Interna­tional Journal of Pharmaceutics. 2023 May;638:122930. doi: https://doi.org/10.1016/j.ijpharm.2023.122930
20. Leoty-Okombi S, Gillaizeau F, Leuillet S, Douil­lard B, Le Fresne-Languille S, Carton T, et al. Effect of sodium lauryl sulfate (SLS) applied as a patch on human skin physiology and its microbiota. Cosmetics. 2021 Jan 6;8(1):6. doi: https://doi.org/10.3390/cosmetics8010006
21. Ruiz PS, Serafini MR, Alves IA, Novoa DM. Re­cent progress in self-emulsifying drug delivery systems: A systematic patent review (2011-2020). Critical Re­views^TM in Therapeutic Drug Carrier Systems. 2022;39(2):1-77. doi: https://doi.org/10.1615/critrevtherdrugcarriersyst.2021038490
22. Schoenfelder H, Wiedemann Y, Lunter DJ. Deve­lopment and characterization of topical formulation for maintenance therapy containing Sorbitan monostearate with and without peg‐100‐stearate. Int J Cosmet Sci. 2025 Apr;47(2):223-33. doi: https://doi.org/10.1111/ics.13023
23. Sherif G, Naguib Y, Mady F, Khaled K. Po­lyethylene Glycol: Properties, applications, and chal­lenges. Journal of advanced Biomedical and Pharma­ceutical Sciences. 2023 Dec 21;0(0):26-36. doi: https://doi.org/10.21608/jabps.2023.241685.1205
24. Fu J, Wu E, Li G, Wang B, Zhan C. Anti-PEG antibodies: Current situation and countermeasures. Nano Today. 2024 Apr;55:102163. doi: https://doi.org/10.1016/j.nantod.2024.102163
25. Liu L, Zeng L, Gao L, Zeng J, Lu J. Ozone therapy for skin diseases: Cellular and Molecular Mechanisms. International Wound Journal. 2022 Dec 16;20(6):2376-85. doi: https://doi.org/10.1111/iwj.14060
26. Pham Le Khanh H, Nemes D, Rusznyák Á, Ujhelyi Z, Fehér P, Fenyvesi F, et al. Comparative in­vestigation of cellular effects of polyethylene glycol (PEG) derivatives. Polymers. 2022 Jan 11;14(2):279. doi: https://doi.org/10.3390/polym14020279
27. Hirano A, Goto M, Mitsui T, Hashimoto-Ha­chiya A, Tsuji G, Furue M. Antioxidant artemisia princeps extract enhances the expression of filaggrin and loricrin via the ahr/OVOL1 pathway. International Journal of Molecular Sciences. 2017 Sept 11;18(9):1948. doi: https://doi.org/10.3390/ijms18091948
28. Maroto-Morales D, Montero-Vilchez T, Arias-Santiago S. Study of skin barrier function in psoriasis: The impact of Emollients. Life. 2021 Jul 4;11(7):651. doi: https://doi.org/10.3390/life11070651
29. Ryczaj K, Dumycz K, Spiewak R, Feleszko W. Contact allergens in moisturizers in preventative emollient therapy – A systematic review. Clinical and Translational Allergy. 2022 Jun 5;12(6):e12150. doi: https://doi.org/10.1002/clt2.12150
30. Akdeniz M, Gabriel S, Lichterfeld-Kottner A, Blu­me-Peytavi U, Kottner J. Transepidermal water loss in healthy adults: A systematic review and meta-analysis update. British Journal of Dermatology. 2018 Sept 9;179(5):1049-55. doi: https://doi.org/10.1111/bjd.17025
31. Kang S-Y, Um J-Y, Chung B-Y, Lee S-Y, Park J-S, Kim J-C, et al. Moisturizer in patients with inflam­matory skin diseases. Medicina. 2022 Jul 1;58(7):888. doi: https://doi.org/10.3390/medicina58070888
32. Roso A, Kern C, Cambos S, Garcia C. Diversity Challenge in skin care: Adaptations of a simple emulsion for efficient moisturization across multiple geographies. Applied Sciences. 2023 Dec 12;13(24):13175. doi: https://doi.org/10.3390/app132413175
33. Rajkumar J, Chandan N, Lio P, Shi V. The skin barrier and moisturization: Function, disruption, and mechanisms of repair. Skin Pharmacology and Physiology. 2023;36(4):174-85. doi: https://doi.org/10.1159/000534136
34. Jung Y-O, Jeong H, Cho Y, Lee E-O, Jang H-W, Kim J, et al. Lysates of a probiotic, lactobacillus rham­nosus, can improve skin barrier function in a reconstructed human epidermis model. International Journal of Mole­cular Sciences. 2019 Sept 2;20(17):4289. doi: https://doi.org/10.3390/ijms20174289
35. Kouassi M-C, Grisel M, Gore E. Multifunctional active ingredient-based delivery systems for skincare formulations: A Review. Colloids and Surfaces B Biointerfaces. 2022 Sept;217:112676. doi: https://doi.org/10.1016/j.colsurfb.2022.112676
36. Jung S-W, Park GH, Kim E, Yoo KM, Kim HW, Lee JS, et al. Rosmarinic acid, as an NHE1 activator, decreases skin surface ph and improves the skin barrier function. International Journal of Molecular Sciences. 2022 Mar 31;23(7):3910. doi: https://doi.org/10.3390/ijms23073910
37. Sounouvou HT, Lechanteur A, Piel G, Evrard B. Silicones in dermatological topical drug formulation: Overview and advances. International Journal of Pharmaceutics. 2022 Sept;625:122111. doi: https://doi.org/10.1016/j.ijpharm.2022.122111
38. Eskens O, Amin S. Challenges and effective routes for formulating and delivery of epidermal growth factors in skin care. International Journal of Cosmetic Science. 2021 Jan 15;43(2):123-30. doi: https://doi.org/10.1111/ics.12685
39. Stefanov SR, Andonova VY. Lipid Nanoparti­culate Drug Delivery Systems: Recent advances in the treatment of skin disorders. Pharmaceuticals. 2021 Oct 26;14(11):1083. doi: https://doi.org/10.3390/ph14111083
40. Kouassi M-C, Grisel M, Gore E. Multifunctional active ingredient-based delivery systems for skincare formulations: A Review. Colloids and Surfaces B Biointerfaces. 2022 Sept;217:112676. doi: https://doi.org/10.1016/j.colsurfb.2022.112676
41. Barradas TN, de Holanda e Silva KG. Nanoemul­sions of essential oils to improve solubility, stability and permeability: A Review. Environmental Chemistry Letters. 2020 Nov 23;19(2):1153-71. doi: https://doi.org/10.1007/s10311-020-01142-2

Look through:

Brunina L. Turība University, Riga, Latvia
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0002-0051-1030

Brunina L. Bridging the gap: evaluating emollients and emulsifiers in dermatology for long-term skin health and barrier recovery. Medicni perspektivi. 2025;30(2):149-155.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333650

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

The aim of this study was to determine the structure and characteristics of traumatic injuries in patients with mine-blast and gunshot wounds, serving as a basis for developing a comprehensive approach to medical care. The study included 127 individuals with combat-related injuries who received treatment at a healthcare facility between February 24, 2022, and October 30, 2023. Medical records, including case histories and reporting forms, were analyzed. The structure and localization of injuries, types of trauma, and the frequency of combined and multiple injuries were assessed. Statistical analysis was performed using MS Office Excel (2010) and STATISTICA v.6.1 (Statsoft Inc., USA). In this study, the nature of traumatic injuries in hos­pitalized patients with mine-blast and gunshot wounds was analyzed. Results: 45.7% of patients sustained combined or multiple injuries, while 54.3% had injuries limited to a single anatomical region. The most common injury traumas of were the chest (18.9%), head and neck (16.5%), and abdomen (14.2%). Penetrating wounds to the chest and head were often associated with more severe consequences, such as pneumohemothorax and traumatic brain injuries. In mine-blast injuries, non-penetrating trauma predominated, in particular injuries of the extremities and pelvic bones, observed in 80 patients. A significant proportion of patients also experienced bleeding, exceeding 750 ml, which led to hemorrhagic shock in 63.6% of cases. The overall mortality rate was 13.4%, with most deaths occurring in the early stages of treatment, primarily due to the severity of injuries and the development of purulent-septic complications. Combat trauma is predominantly associated with mine-explosive mechanisms, characterized by a high frequency of multiple and combined injuries, significantly complicating the provision of medical care and necessitating a multidisciplinary approach.

Key words: mine-explosive trauma, gunshot trauma, traumatic injuries, bleeding

1. Tin D, Barten DG, Granholm F, Kovtonyuk P, Burkle FM, Ciottone GR. Hybrid warfare and counter-terrorism medicine. European Journal of Trauma and Emergency Surgery. 2023;2:583-93. doi: https://doi.org/10.1007/s00068-023-02230-y
2. Jarrassier A, Py N, de Rocquigny G, Raux M, Lasocki S, Dubost C, et al. Lessons learned from the war in Ukraine for the anesthesiologist and intensivist: A scoping review. Anaesthesia Critical Care & Pain Medicine. 2024 Jul 30;43(5):101409. doi: https://doi.org/10.1016/j.accpm.2024.101409
3. Spagnolello O, Gatti S, Shahir MAA, Afzali MF, Portella G, Baiardo Redaelli M. Civilian war victims in Afghanistan: five-year report from the Kabul EMERGENCY NGO hospital. European Journal of Trauma and Emergency Surgery. 2022 Nov 30;49(3):1401-5. doi: https://doi.org/10.1007/s00068-022-02137-0
4. Kuchyn I, Horoshko V. Chronic pain in patients with gunshot wounds. BMC Anesthesiol. 2023;23(1):47. doi: https://doi.org/10.1186/s12871-023-02005-3
5. Wightman JM, Springer BL, Pickett JR. Blast injury management for operators and tactical emergency medical support providers. The Tactical Edge [In­ternet]. 2018 [cited 2025 Mar 07];(Fall):74-8. Available from: https://www.researchgate.net/publication/361594434_Blast_injury_management_for_operators_and_TEMS_providers
6. Kobayashi L, Coimbra R, Goes AMO Jr, et al. American Association for the Surgery of Trauma-World Society of Emergency Surgery guidelines on diagnosis and management of peripheral vascular injuries. J Trauma Acute Care Surg. 2020;89(6):1183-96. doi: https://doi.org/10.1097/TA.0000000000002967
7. Alarhayem AQ, Cohn SM, Cantu-Nunez O, Eas­tridge BJ, Rasmussen TE. Impact of time to repair on outcomes in patients with lower extremity arterial injuries. J Vasc Surg. 2019;69(5):1519-23. doi: https://doi.org/10.1016/j.jvs.2018.07.075
8. [On approval of the procedures for providing first aid to persons in emergency conditions. Order of the Ministry of Health of Ukraine dated 2022 Mar 9  441]. [Internet]. 2022 [cited 2025 Mar 07]. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/z0356-22#Text
9. Owens BD, Kragh JF Jr, Wenke JC, Macaitis J, Wade CE, Holcomb JB. Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. J Trauma. 2008;64(2):295-9. doi: https://doi.org/10.1097/TA.0b013e318163b875
10. Khomenko IP, Korol SO, Khalik SV, Shapo­va­lov VY, Yenin RV, Нerasimenko OS, Tertyshnyі SV. Cli­nical and Epidemiological analysis of the structure of combat surgical injury during Antiterrorist operation “Clinical and Epidemiological Analysis of the Structure of Combat Surgical Injury During Antiterrorist Operation. Joint Forces Operation. Ukrainian Journal of Military Medicine. 2021;2(2):5-13. doi: https://doi.org/10.46847/ujmm.2021.2(2)-005
11. Trentzsch H, Goossen K, Prediger B, Schwei­gkofler U, Hilbert-Carius P, Hanken H, et al. Stop the bleed “ – Prehospital bleeding control in patients with mul­tiple and/or severe injuries – A systematic review and clinical practice guideline – A systematic review and clinical practice guideline. European Journal of Trauma  and Emergency Surgery. 2025 Feb 5;51(1):92. doi: https://doi.org/10.1007/s00068-024-02726-1
12. O'Banion LA, Dirks R, Saldana-Ruiz N, et al. Contemporary outcomes of traumatic popliteal artery injury repair from the popliteal scoring assessment for vascular extremity injury in trauma study. J Vasc Surg. 2021;74(5):1573-80.e2. doi: https://doi.org/10.1016/j.jvs.2021.04.064
13. Patel JA, White JM, White PW, Rich NM, Ras­mussen TE. A contemporary, 7-year analysis of vascular injury from the war in Afghanistan. J Vasc Surg. 2018;68(6):1872-9. doi: https://doi.org/10.1016/j.jvs.2018.04.038
14. Danford JR, Reyes F, Gurney JM, Smith JP, Stin­ner DJ. Optimizing Advanced Trauma Life Support (ATLS®) to Maximize Readiness. Mil Med. 2024 Aug 30;189(9-10):e2206-10. doi: https://doi.org/10.1093/milmed/usae073
15. Pape HC, Lefering R, Butcher N, et al. The defi­nition of polytrauma revisited: An international consensus process and proposal of the new 'Berlin definition. J Trauma Acute Care Surg. 2014;77(5):780-6. doi: https://doi.org/10.1097/TA.0000000000000453
16. Chen Y, Liu Z, Zhang P, Huang W. [Consistency of injury severity scores in patients with severe trauma]. Medical and health technology. 2024;56(1):157-60. Chinese. doi: https://doi.org/10.19723/j.issn.1671-167X.2024.01.024
17. Hardy BM, Varghese A, Adams MJ, Ennin­ghorst N, Balogh ZJ. The outcomes of the most severe polytrauma patients: a systematic review of the use of high ISS cutoffs for performance measurement. Eur J Trauma Emerg Surg. 2024;50(4):1305-12. doi: https://doi.org/10.1007/s00068-023-02409-3 

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Denysiuk M.V. Bogomolets National Medical University, Kyiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-2811-8046

Dubrov S.O. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-2471-3377

Poniatovska H.B. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0001-7224-4213 

Lianskorunskyi V.M. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-1288-0688

Denysiuk M.V., Dubrov S.O., Poniatovska H.B., Lianskorunskyi V.M. Analysis of the structure and features of traumatic injuries in victims with combat trauma. Medicni perspektivi. 2025;30(2):156-163. DOI: https://doi.org/10.26641/2307-0404.2025.2.333655

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

A well-founded choice of means of medical support for patients after total hip arthroplasty and rational use of financial resources for this purpose allow to achieve the maximum possible socio-economic effect in the future. Its methodological basis is made up of clinical and economic concepts based on the concepts of cost (price, expenses) and clinical effectiveness of the intervention (treatment results).The aim of the study was to determine the financial component of medical support in the postoperative period of total hip arthroplasty using ABC/VEN analysis (Vital Essential Non-essential). In the current study, the ranking of medical products when conducting both ABC/VEN analysis was carried out by the number of prescriptions. The number of prescriptions is a more indicative approach, as it demonstrates the real frequency of drug use in practice, the relevance and demand for specific medications in real-world conditions, allowing for a more accurate determination of priority drugs for clinical use and, accordingly, providing a more relevant and practical assessment of drug needs. The number of observations (n), minimum and maximum values (min – max) were used to describe the variables, quantitative data were presented as the arithmetic mean and standard deviation. Qualitative data - in the format n (%). Results – analysis of prescriptions from medical records of patients with dysplastic coxarthrosis revealed that 6548 prescriptions were made for 367 people during the study period. The results of the integrated ABC/VEN analysis showed that in the context of the most costly group “A”, the main financial resources were spent on providing long-term antithrombotic therapy to prevent pulmonary embolism and lower limb vein thrombosis, the total amount for 2754 prescriptions (42.1% of all prescriptions) was 1,745,478.90 UAH. Less costly (group “B”, 2351 prescriptions) were drugs prescribed for antibiotic prophylaxis of infectious complications. In general, the costs of drugs in group “B” (35.9% of all prescriptions) amounted to 552,820.30 UAH, which corresponded to 21.6% of the financial costs for medical support of patients after TEP. The least expensive group "C" consisted mostly of secondary category N means, which accounted for 17.9% (1173 out of 6548) of the total number of prescriptions and accounted for 6.7% (171,986.75 out of 2,559,353.23 UAH) of the total amount of expenses. «Vital» category V means in this analysis group accounted for 4.1% (270 out of 6548) of all prescriptions, and the expenses for them were 3.5% (89,067.28 out of 2,559,353.23 UAH). The share of financial expenses for these means amounted to half (52.8%) of the total budget for medical support of patients after total hip arthroplasty, which in monetary equivalent was 1,350,380.53 UAH. The leading positions in terms of costs were occupied by vital category V drugs – the synthetic selective inhibitor of activated factor X fondaparinux (“Arixtra”) and the competitive reversible direct thrombin inhibitor dabigatran etexilate (“Pradaxa”), the share of prescriptions of which was 89.4% and 82.3%, respectively.

Key words: clinical-economic analysis, ABC-analysis, postoperative period, hip joint, endoprosthetics, financial costs

1. Jerrhag D, Englund M, Karlsson MK, Rosen­gren BE. Epidemiology and time trends of distal forearm fractures in adults – a study of 11.2 million person-years in Sweden. BMC Musculoskelet Disord. 2017;18(1):240. doi: https://doi.org/10.1186/s12891-017-1596-z
2. Loskutov OYe, Oliinyk OE, Loskutov OO, Syne­hubov DA. [Development of national joint endoprosthesis (results of 30-year research)]. Transplantatsiia ta shtuchni organy. 2021;2:37-50. Ukrainian. doi: https://doi.org/10.30702/transpaorg/10_21.2710/0437-50/451.30(477)
3. Turchin VM, Loskutov OYe, Savynska OYu. [On the optimal choice of hip joint implant]. Issues of applied mathematics and mathematical modeling. 2020;20:163-74. Ukrainian. doi: https://doi.org/10.15421/322016
4. Dudko S, Kusz D, Kopeć K, Wojciechowski P, Kwiatkowska K, Niemiec D. Pseudotumor as a Com­plication of Total Hip Replacement. Ortop Traumatol Rehabil.2022 Aug 31;24(4):273-80. doi: https://doi.org/10.5604/01.3001.0015.9991
5. Yakovlieva LV, Bezditko NV, Herasymova OO, Mishchenko OYa, Karbusheva IV, Tkachova OV, et al. [Pharmacoeconomics: a textbook for university students]. Vinnytsia: NOVA KNYHA; 2009. 208 р. Ukrainian.
6. Ubohov SH, Trokhymchuk VV, Todorova VI, Za­horiy VA. Process model of the pharmaceutical inte­grated management systems. Wiadomości Lekarskie. 2019;72(2):201-8. doi: https://doi.org/10.36740/WLek201902112
7. Hruzieva TS, Lekhan VM, Ohniev VA, Ha­liien­ko LI, Kriachkova LV, Palamar BI, et al. [Biostatistics]. 2020. 384 p. Ukrainian.
8. Goodman SM, Springer BD, Chen AF, Davis M, Fernandez DR, Figgie M, et al. 2022 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline for the Perioperative Management of Antirheumatic Medication in Patients With Rheumatic Di­seases Undergoing Elective Total Hip or Total Knee Arthro­plasty. Arthritis Care Res (Hoboken). 2022 Sep;74(9):1399-408. doi: https://doi.org/10.1002/acr.24893
9. Khalid T, Ben-Shlomo Y, Bertram W, Culli­ford L, Henderson EJ, Jepson M, et al. Prehabilitation for frail patients undergoing hip and knee replacement in the UK: Joint PREP feasibility study for a randomised controlled trial. BMJ Open. 2024 Sep 17;14(9):e084678. doi: https://doi.org/10.1136/bmjopen-2024-084678

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Brodska E.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0009-0004-7141-6625

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

Dronov S.M. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-7495-2835

Brodska E.V., Makarenko O.V., Dronov S.M. Clinical and economic analysis of the prescription of drugs for postoperative support of total hip arthroplasty. Medicni perspektivi. 2025;30(2):164-170. DOI: https://doi.org/10.26641/2307-0404.2025.2.333657

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

Signi­ficant achievements in modern dental materials science, improvements in all-ceramic technologies, microprosthetics, and inert removable prosthetics have not eliminated the relevance of assessing the biocompatibility of dental construction materials with the tissues of the prosthetic bed. Currently, almost 47% of the global population suffers from food, drugs, various materials, and chemical compounds intolerances. Aim of the study – to present a clinical case of intolerance to structural materials, and to demonstrate the prediction and prevention of their adverse effects on the whole organism through biocompatibility testing with the tissues of the prosthetic bed. A 62-years-old male patient sought prosthodontic care with complaints of pain, bleeding, redness, and swelling at the sites where metal-ceramic crowns contacted the oral mucosa, along with itching, burning sensations, and halitosis. Approximately two weeks after fixing the bridge prostheses, skin rashes appeared on the neck, accompanied by itching and tingling sensations. Given that the patient associated symptom onset with the fixation of full-cast metal-ceramic bridges, and based on the clinical picture in the oral cavity and results of epicutaneous patch testing, a diagnosis was established: “Intolerance to dental materials. Localized periodontitis complicated by Kennedy Class II, Subclass 2 maxillary and Class I, Subclass 1 mandibular edentulous areas. Masticatory efficiency loss according to Agapov – 84%.” Due to positive patch test results and clinical findings, removal of the metal-ceramic constructions from the oral cavity was deemed necessary. After extraction of all mobile teeth and their destroyed roots, it was planned to restore the edentulous spaces with zirconia bridge prostheses and fabricate clasp dentures based on polyamide for both jaws.

Key words: biocompatibility, individual sensitivity, material intolerance, tests

1. Schmalz G, Watts DC, Darvell BW. Dental ma­terials science: research, testing and standards. Dent Mater. 2021;37(3):379-81. doi: https://doi.org/10.1016/j.dental.2021.01.027
2. Arakelyan M, Spagnuolo G, Iaculli F, Diko­pova N, Antoshin A, Timashev P, et al. Minimization of adverse effects associated with dental alloys. Materials (Basel). 2022;15(21):7476. doi: https://doi.org/10.3390/ma15217476
3. Bousquet J, Pfaar O, Agache I, Bedbrook A, Ak­dis CA, Canonica GW, et al. ARIA‐EAACI care pathways for allergen immunotherapy in respiratory allergy. Clinical and Translational Allergy. 2021;11(4):e12014. doi: http://dx.doi.org/10.1002/clt2.12014
4. Domic I, Budmir J, Novak I, Mravak-Stipetic M, Lugovic-Mihic L. Assessment of allergies to food and addi­tives in patients with angioedema, burning mouth syndrome, cheilitis, gingivostomatitis, oral lichenoid reac­tions, and perioral dermatitis. Acta Clin Croat. 2021;60(2):276-81. doi: https://doi.org/10.20471/acc.2021.60.02.14
5. Schmalz G, Jakubovics N, Schwendicke F. Nor­mative approaches for oral health: standards, specifi­cations, and guidelines. J Dent Res. 2022;101(5):489-94. doi: https://doi.org/10.1177/00220345211049695
6. Budimir J, Mravak-Stipetic M, Bulat V, Fercek I, Japundzic I, Lugovic-Mihic L. Allergic reactions in oral and perioral diseases-what do allergy skin test results show? Oral Surg Oral Med Oral Pathol Oral Radiol. 2019;127(1):40-8. doi: https://doi.org/10.1016/j.oooo.2018.08.001
7. Itoh E, Furumura M, Furue M. Rate of actual metal allergy prior to dental treatment in subjects complaining of possible metal allergy. Asian Pac J Allergy Immunol. 2020;38(3):186-9. doi: https://doi.org/10.12932/ap-241018-0425
8. Gryzodub DV, Gryzodub VI, Gryzodub YeV, vy­nakhidnyky; Kharkivska medychna akademiia pisliadyp­lomnoi osvity MOZ Ukrainy, patentovlasnyk. [Method for determining individual sensitivity to dental materials]. Patent Ukrainy No. 91624. 2014.04.10. Ukrainian.
9. Fletcher R, Harrison W, Crighton A. Dental mate­rial allergies and oral soft tissue reactions. Br Dent J. 2022;232(9):620-25.
   doi: https://doi.org/10.1038/s41415-022-4195-9
10. Sokolovska V, Tsvetkova N, Davydenko V, Pysa­renko O, Tarashevska Y. Dental rehabilitation of a patient with a decrease in bite height due to pathological abrasion of hard tooth tissues (clinical case). Medicni Perspektivi. 2024;(29):245-53.
    doi: https://doi.org/10.26641/2307-0404.2024.2.307778
11. Sokolovska V, Tsvetkova N. [Displays of un­bea­rab­leness of stomatological materials are in cavity of mouth (clinical case)]. Ukr Dent Alm. 2022;4:48-52. Ukrainian.
    doi: https://doi.org/10.31718/2409-0255.4.2022.08
12. Alarcon-Sanchez MA, Heboyan A, Fernan­des GVO, Castro-Alarcon N, Romero-Castro NS. Poten­tial impact of prosthetic biomaterials on the periodontium: a comprehensive review. Molecules. 2023;28(3):1075. doi: https://doi.org/10.3390/molecules28031075
13. Forkel S, Schubert S, Corvin L, Heine G, Lang CCV, Oppel E, et al. Contact allergies to dental ma­terials in patients. Br J Dermatol. 2024;190(6):895-903. doi: https://doi.org/10.1093/bjd/ljad525
14. Müller-Heupt LK, Schiegnitz E, Kaya S, Jacobi-Gresser E, Kämmerer PW, Al-Nawas B. Diagnostic tests for titanium hypersensitivity in implant dentistry: a sys­tematic review of the literature. Int J Implant Dent. 2022;8(1):29. doi: https://doi.org/10.1186/s40729-022-00428-0
15. Sousa‐Pinto B, Sa‐Sousa A, Vieira RJ, Amaral R, Klimek L, Czarlewski W, et al. Behavioural patterns in allergic rhinitis medication in Europe: A study using MASK‐air® real‐world data. Allergy. 2022;77(9):2699-711. doi: http://dx.doi.org/10.1111/all.15275
16. Can A, Karabacak DE, Yalcin BK, Demir S, Buyukozturk S, Colakoglu B, et al. How important is patch testing with dental materials in real-life clinical practice? AllergyAsthma  2023;44(2):136-44. doi: https://doi.org/10.2500/aap.2023.44.220074
17. Lugovic-Mihic L, Ilic I, Budimir J, Pondeljak N, Mravak Stipetic M. Common allergies and allergens in oral and perioral diseases. Acta Clin Croat. 2020;59(2):318-28. doi: https://doi.org/10.20471/acc.2020.59.02.16
18. Forkel S, Schubert S, Corvin L, Heine G, Lang CCV, Oppel E, et al. Contact allergies to dental materials in patients. Br J Dermatol. 2024;190(6):895-903. doi: https://doi.org/10.1093/bjd/ljad525
19. Bacchi A, Cesar PF. Advances in ceramics for dental applications. Dent Clin North Am. 2022 Oct;66(4):591-602. doi: https://doi.org/10.1016/j.cden.2022.05.007
20. Muntian LM, Kulyhin OB. [Dynamics of bio­physical and biochemical changes in oral fluid parameters during orthopedic treatment of patients with fixed dentures and their prognostic significance]. Novyny stomatolohii. 2010;1:47-51. Ukrainian.
21. Zemelka-Wiacek M. Metal Allergy: State-of-the-art mechanisms, biomarkers, hypersensitivity to implants. JClin  2022;11(23):6971. doi: https://doi.org/10.3390/jcm11236971
22. Kilic K, Koc AN, Tekinsen FF, Yildiz P, Kilic D, Zararsiz G, et al. Assessment of Candida species colo­nization and denture-related stomatitis in barand locator-retained overdentures. J Oral Implantol. 2014;40(5):549-56. doi: https://doi.org/10.1563/AAID-JOI-D-12-00048
23. Brown A, Mandelberg NJ, Munoz-Mendoza D, Palys V, Schalock PC, Mogilner A, et al. Allergy consi­derations in implanted neuromodulation devices. Neuro­modulation. 2021;24(8):1307-16. doi: https://doi.org/10.1111/ner.13332
24. Grizodub DV. [Analysis of the frequency of soma­tic complications in patients with intolerance to con­structional dental materials and with fixed bridge pro­stheses]. Problemy bezperervnoi medychnoi osvity ta nauky. 2019;(1):64-7. Ukrainian.

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Davydenko V.Yu. Poltava state medical university, Poltava, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-4231-7343

Davydenko H.M. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0001-6219-2376

Sokolovska V.M. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-8944-5828

Khilinich Ye.S. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0001-7970-944X

Tarashevska Yu.Ye. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0003-2983-1708

Davydenko V.Yu., Davydenko H.M., Sokolovska V.M., Khilinich Ye.S., Tarashevska Yu.Ye. Rehabilitation of a patient with manifistations of intolerance to dental materials in the oral cavity (clinical case). Medicni perspektivi. 2025;30(2):171-179.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333658

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

This study investigated the physiological adaptations and functional conse­quences of a 12-week specialized training program in youth soccer players, focusing on musculoskeletal development, cardiorespiratory responses, and neuromuscular adaptations during the critical growth period of 11-14 years. Sixty male youth soccer players (mean age: 12.5±1.2 years; height: 156.3±8.7 cm; weight: 45.8±7.2 kg) underwent comprehensive medical screening before randomization to experimental (n=30) or control (n=30) groups. Initial screening included growth plate assessment and cardiovascular fitness testing. The intervention included continuous monitoring of phy­siological parameters including heart rate variability, oxygen consumption, blood lactate levels, and musculoskeletal development markers. Weekly medical monitoring assessed recovery markers and growth indicators to ensure safe adaptation to training loads. The experimental group showed significant physiological adaptations (p<0.001): resting heart rate decreased by 8.4% (95% CI: 6.2-10.6%), peak oxygen consumption increased by 12.3% (95% CI: 9.8-14.8%), bone density improved by 6.2%, muscle mass increased by 8.5%, neuromuscular coordination improved by 24.3% (95% CI: 20.1-28.5%), and recovery time between high-intensity efforts improved by 42%. Growth plate safety markers remained within normal ranges throughout the intervention. The 12-week program produced significant positive physiological adaptations in youth athletes without compromising growth patterns. The study establishes evidence-based guidelines for safe training prescription during crucial developmental periods, emphasizing the importance of medical monitoring in youth sports. These findings contribute to sports medicine protocols for youth athlete development, demonstrating that properly structured training can enhance physiological development while maintaining growth safety parameters.

Key words: youth sports medicine, physiological adaptation, growth and development, cardiovascular response, musculoskeletal development, neuromuscular adaptation, training safety

1. LloydRS, Faigenbaum AD, Stone MH, Meyer GD, Gregory D, Myer GD, et al. Position statement on youth resistance training: the 2014 International Consensus. Br J Sports Med. 2014;48(7):498-505. doi: https://doi.org/10.1136/bjsports-2013-093614
2. GranacherU, Lesinski M, Büsch D, Muehl­bauer T, Prieske O, Puta C, et al. Effects of resistance trai­ning in youth athletes on muscular fitness and athletic performance: a conceptual model for long-term athlete development. Front  2016;7:164. doi: https://doi.org/10.3389/fphys.2016.00164
3. BehmDG, Young JD, Whitten JHD, Reid JC, Quigley PJ, Low J, et al. Effectiveness of traditional strength vs. power training on muscle strength, power and speed with youth: a systematic review and meta-analysis. Front  2017;8:423. doi: https://doi.org/10.3389/fphys.2017.00423
4. Ford P, De Ste Croix M, Lloyd R, Meyers R, Moosavi M, Oliver J, et al. The long-term athlete develop­ment model: physiological evidence and application. J Sports 2011;29(4):389-402. doi: https://doi.org/10.1080/02640414.2010.536849
5. Malina RM, Rogol AD, Cumming SP, Coelho e Silva MJ, Figueiredo AJ. Biological maturation of youth athletes: assessment and implications. Br J Sports Med. 2015;49(13):852-9.
   doi: https://doi.org/10.1136/bjsports-2015-094623
6. Myer GD, Faigenbaum AD, Ford KR, Best TM, Bergeron MF, Hewett TE. When to initiate integrative neuromuscular training to reduce sports-related injuries and enhance health in youth? Curr Sports Med Rep. 2011;10(3):155-66. doi: https://doi.org/10.1249/JSR.0b013e31821b1442
7. Fort-Vanmeerhaeghe A, Romero-Rodriguez D, Lloyd RS, Kushner A, Myer GD. Integrative neuromus­cu­lar training in youth athletes. Part II: Strategies to prevent injuries and improve performance. Strength Cond J. 2016;38(4):9-27. doi: https://doi.org/10.1519/SSC.0000000000000229
8. Lesinski M, Prieske O, Granacher U. Effects and dose-response relationships of resistance training on phy­sical performance in youth athletes: a systematic review and meta-analysis. Br J Sports Med. 2016;50(13):781-95. doi: https://doi.org/10.1136/bjsports-2015-095497
9. Faigenbaum AD, Lloyd RS, MacDonald J, Myer GD. Citius, Altius, Fortius: beneficial effects of resistance training for young athletes. Br J Sports Med. 2016;50(1):3-7.
   doi: https://doi.org/10.1136/bjsports-2015-094621
10. Bergeron MF, Mountjoy M, ArmstrongN, Chia M, Côté J, Emery CA, et al. International Olympic Committee consensus statement on youth athletic development. Br J Sports Med. 2015;49(13):843-51. doi: https://doi.org/10.1136/bjsports-2015-094962
11. Moran J, Sandercock GR, Ramírez-Campillo R, Meylan C, Collison J, Parry DA. A meta-analysis of maturation-related variation in adolescent boy athletes' adaptations to short-term resistance training. J Sports Sci. 2017;35(11):1041-51. doi: https://doi.org/10.1080/02640414.2016.1209306
12. Lubans DR, Morgan PJ, Cliff DP, Barnett LM, Okely AD. Fundamental movement skills in children and adolescents: review of associated health benefits. Sports Med.2010;40(12):1019-35. doi: https://doi.org/10.2165/11536850-000000000-00000
13. Brownlee TE, O'Boyle A, Morgans R, Morton JP, Erskine RM, Drust B. Training duration may not be a predisposing factor in potential maladaptations in talent development programmes. Int J Sports Sci Coach. 2018;13(5):674-8. doi: https://doi.org/10.1177/1747954118758744
14. Haugen TA, Tønnessen E, Seiler S. Speed and countermovement-jump characteristics of elite female soccer players, 1995-2010. Int J Sports Physiol Perform. 2014;9(5):906-13.
    doi: https://doi.org/10.1123/ijspp.2013-0096
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Look through:

Grygus I. National University of Water and Environmental Engineering, Rivne, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-2856-8514

Grynova M. Poltava V. G. Korolenko National Pedagogical University, Poltava, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-3912-9023

Gamma T. National University of Water and Environmental Engineering, Rivne, Ukraine
https://orcid.org/0000-0001-9295-3375

Hodlevskyi P. National University of Water and Environmental Engineering, Rivne, Ukraine
https://orcid.org/0000-0001-8655-4546

Zukow W. Nicolaus Copernicus University, Torun, Poland
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-7675-6117

Grygus I., Grynova M., Gamma T., Hodlevskyi P., Zukow W. Physiological adaptations and functional changes in young soccer players' organisms aged 11-14 years following a 12-week specialized training program: a sports medicine perspective. Medicni perspektivi. 2025;30(2):180-189.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333676

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

The issue of specialized multicomponent studies of defining the functional state of the organism under the influence of personalized factors of external influence in sport is not sufficiently studied in the scientific and methodological literature. It needs to be expanded and supplemented. The aim of the study was to determine the resilience of an individual's health and the components of the endogenous response to the determinants of athlets's motor activity. The study involved 15 experienced football players, whose average age was 25.47±4.66 years.To achieve this goal, based on the analysis of scientific and methodological literature and the questionnaire, we identified the factors of exogenous influence and the main determinants of motor activity of athletes. An additional specialized questionnaire was conducted to assess the per­sonalized general state of health. According to the previous diagnostic data and on the basis of empirical components, a programme for the development of certain motor qualities (general, power endurance) as a specialized training was developed, which was coordinated with the training process of athletes. Before the beginning of the formed programme the testing of the background assessment of development of aerobic functional capabilities was carried out. In the context of the research the programme with the use of certain determinants of motor activity was implemented. We repeatedly tested the development of aerobic capabilities, determined the resilience of an individual's health and the impact of the research block of exogenous agents on the state of the cardiovascular and muscular systems. We also used a repeated questionnaire to assess the general state of health and health resilience of the individual. We determined the conditions for the implementation and effectiveness of the use of determinants of motor activity as exogenous factors of influence on the health resilience of an individual. Specialized questionnaires and protocols have been created to determine the priority personalized factors of exogenous influence and the operational state of the organism. Based on the data obtained, a programme for the development of motor skills was developed and scientifically and methodically regulated. A systematic assessment of the functional state of athlets on the basis of test models and statistical processing unit was carried out. Defining determinants of motor activity of athletes, resilience of health of an individual and specialized methods of assessment of influence of exogenous factors requires statistically confirmed efficiency of the offered methods in the structure of experimental and research check of their use. The methodology for applying an individual programme for the development of functional capabilities of the motor systems of the body of athletes has been established and substantiated. The effectiveness of the influence of exogenous means on the state of functional systems of the organism in the direction of general and power endurance is statistically substantiated. The positive influence on the general state of health (according to the questionnaire, monitoring of heart rate and intensity of movement, analysis of graphic images built on the obtained indicators) is established.

Key words: health resilience, endogenous response, motor activity of athletes

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2. Nikitina LP. [Biological and medical aspects of a healthy lifestyle]. Zaporizhzhia: ZDMU; 2021. p. 50-65. Ukrainian.
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6. Kohl HW, Murray TD. Foundations of Physical Ac­tivity and Public Health. Human Kinetics; 2021. р. 50-65.
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    doi: https://doi.org/10.26641/2307-0404.2023.2.283388
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Look through:

Sirenko P.O. Rīga Stradiņš University, Rīga, Latvia
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2787-6497

Storozhenko I.P. State Biotechnological University, Kharkiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-7344-242X

Sirenko R.R. Private higher education institution "Lviv medical university", Lviv, Ukraine
e-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9100-4709

Yuzyk O.P. Rivne State University of the Humanities, Rivne, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9586-6015

Kindrat V.K. Rivne State University of the Humanities, Rivne, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
htths://orcid.org/0000-0002-7475-3385

Lietuviete D. Clinic Aiwa, Riga, Latvia
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0000-2821-3559

Kolesnyk T.V. Shupyk National University of Health Care, Kyiv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-4849-5615

Sirenko P.O., Storozhenko I.P., Sirenko R.R., Yuzyk O.P., Kindrat V.K., Lietuviete D., Kolesnyk T.V. Resilience of individual health and endogenous response to determinants of motor activity of athletes. Medicni perspektivi. 2025;30(2):190-203.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333679

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

The most common group of drugs today are non-steroidal anti-inflammatory drugs, among which diclofenac sodium is one of the most widely used. It has a pronounced anti-inflammatory, analgesic and moderate antipyretic effect by inhibiting the synthesis of prostaglandins. This active pharmaceutical ingredient belongs to the second class of the Biopharmaceutical classification system, which has a high degree of permeability through biological membranes, which leads to the possibility of absorption of diclofenac sodium already in the stomach, thereby causing unwanted side and negative effects. Considering the large volumes of production and possible serious side effects of this active pharmaceutical ingredient, it is advisable to control the level of this substance in atmospheric air. The purpose of this work was to scientifically substantiate the hygienic regulation of diclofenac sodium in the atmospheric air of populated areas based on studies of the toxicological properties of this active pharmaceutical ingredient. Experimental animals (102 non-linear white mice, 136 non-linear white rats of both sexes, 60 short-haired mice) were divided into experimental and control groups of 6 individuals each. Based on the obtained indicators of lethality of experimental animals, using the method of probit analysis, the indicators of toxicity during acute exposure of the substance were determined – semi-lethal dose with a single intragastric administration of DL₅₀ for female rats (54.83 mg/kg), DL₅₀ for mice (550 mg/kg), DL₅₀ for rats-females (104.4 mg/kg), and CL₅₀ for male rats (243.11 mg/m³), CL₅₀ for mice (71.61 mg/m³). According to sub­chro­nic exposure, it was established that diclofenac sodium has supercumulative activity, since the cumulative coefficients for subacute administration to mice and rats are <1 (0.94 and 0.96, respectively). It was determined that this substance does not have a pronounced irritating effect on the mucous membrane of the eyes and does not exhibit allergenic properties. Does not cause sensitization of the body. It is shown that the possibility of developing acute poisoning from a single inhalation exposure to diclofenac sodium is unlikely, which is confirmed by the coefficient of the possibility of inhalation poisoning (CPIP=0.000032). In turn, the low value of the Lim_ch indicator (1.18 mg/m³) indicates the real danger of developing chronic inhalation poisoning with diclofenac sodium. Z_biol is 60.7, which indicates a significant sign of the ability to accumulate in the body. Expressed cumulative properties of this substance increase the risk of chronic poiso­ning. The maximum one-time maximum permissible concentration (MPC) in the atmospheric air of populated areas at the level of 0.03 mg/m³ was determined and substantiated. Thus, it is expedient to control and monitor the air environment during the production of medicinal products in order to prevent diclofenac sodium from entering the sanitary protection zones.

Key words: diclofenac sodium, nonsteroidal anti-inflammatory drugs, toxicological studies, regulation, atmospheric air

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Nikolaieva Ya.Yu. State Institution "Marzieiev Institute for Public Health of the National Academy of Medical 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/0000-0003-4031-9967

Nikolaieva Ya.Yu. Regulation of the non-steroid anti-inflammatory drug «Diclofenac sodium» in the air environment of populated places. Medicni perspektivi. 2025;30(2):204-212.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333685

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

The combined use of cellular, extracellular research methods for studying the toxic effect of shoe glues is an additional tool for screening and assessing the potential risks of their use. The aim of the work was to investigate the mechanisms of the toxic effect of shoe glues at the cellular, molecular and biochemical levels. Rubber, polychloroprene and polyurethane shoe glues were used. Three experimental approaches were applied: measurement of survival of mam­malian cells, a spectroscopic study of conformational changes of albumin, and a free radical measurement. Cytotoxicity testing was performed on murine fibroblasts Balb/c-3T3 line, human embryonic kidney cells HEK-293 and human keratinocytes of the HaCaT line treated for 24 and 72 hours with glues samples. A survival of treated cells was monitored using MTT-test. Changes in the spectral characteristics of albumin were monitored during exposure for 24 hours and 21 days with "fresh" and "dried" samples of glues. Content of free radicals was evaluated in the reaction with DPPH reagent. The cytotoxicity was increased with increasing exposure time, and depended on both the type of glue and the type of treated cells. The polyurethane glue demonstrated the most pronounced cytotoxic effect. Balb/c-3T3 fibroblasts were the most sensitive to the action of all types of glues, a reliable maximum increase in cell death was manifested in 72 hours exposure (28.9-19.1% of living cells).While cells of HEK-293 and НаСаТ lines were more resistant. At 24 hours contact, their viability was 99.12-79.22% and 99.0-56.9%, respectively. Increased exposure up to 72 hours reliably caused a decrease in the survival of these cell lines – 96.24-68.1% and 82.2-51.7%. The loss of the solvent didn’t affect the cytotoxic effect of the studied glues. Conformation changes in albumin were manifested during its long-term contact with both "fresh" and "dried" glues. Manifestations of the toxic effect of glues on biomolecules were increased in the sequence: rubber > polyurethane > polychloroprene. Shoe glues demonstrated an ability to generate free radicals in the sequence: rubber > polychloroprene > polyurethane. These manifestations were increased in a time period of 4 hours – 24 hours. That may create risks when they are used. The results can be used to determine the targets and mechanisms of the toxic effect of shoe glues and to obtain new knowledge in the field of research of industrial toxicants.

Key words: shoe glues, in vitro method, cytotoxicity, conformational changes of albumin, radicals activity

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Lototska-Dudyk U.B. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-7587-8457

Kuzminov B.P. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
https://orcid.org/0000-0002-8693-1046

Lototska L.B. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
https://orcid.org/0000-0002-2690-1793

Klyuchivska O.Yu. Institute of cell biology of the NAS of Ukraine, Lviv, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-8657-5945

Stoika R.S. Institute of cell biology of the NAS of Ukraine, Lviv, Ukraine
https://orcid.org/0000-0001-5719-2187

Lototska-Dudyk U.B., Kuzminov B.P., Lototska L.B., Klyuchivska O.Yu., Stoika R.S. Search for biological mechanisms of toxic action of shoe glues: cell viability in vitro, albumin damage and free radical generation. Medicni perspektivi. 2025;30(2):212-221.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333689

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

Timeliness, purposefulness, patient centeredness, consistency, and continuity are the general principles of rehabilitation and the defining tasks of developed countries, especially in the context of ensuring the realization of the rights and opportunities of people with disabilities. The purpose of the study was to identify the features of medical rehabilitation systems for persons with disabilities in the leading EU and NATO countries that have experience in rehabilitating combatants and to substantiate proposals for improving the current system of medical rehabilitation in Ukraine. The study is based on the analysis of the conceptual principles of building rehabilitation systems in eight countries with developed democratic institutions, experience of military operations and belonging to classical models of social protection: Canada, France, Germany, Italy, Poland, Spain, the United Kingdom, the United States. The methods of comparative analysis, structural analysis, objectivity and consistency were used. The main results of the study are the identification of weaknesses of the Ukrainian medical rehabilitation system, such as fragmentation of service provision, lack of unified management coordination, insufficient information and uneven location of institutions. The advantages of foreign systems are analyzed: targeting medical rehabilitation, use of outsourcing, involvement of the community and volunteers, creation of competition between medical institutions, emphasis on mental rehabilitation, and use of sanatorium and resort facilities. It is proposed to create a single state body for coordinating medical services, develop a national roadmap for rehabilitation measures, encourage volunteers and expand the range of rehabilitation professions. The experience of the leading EU and NATO countries demonstrates the need for a systemic restructuring of medical rehabilitation in Ukraine through the introduction of modern approaches and methods aimed at improving the quality and accessibility of services. Successful implementation of foreign experience will create an effective national system capable of meeting the current challenges and needs of people with disabilities.

Key words: medical rehabilitation system, persons with disabilities, EU countries, NATO countries, war, peacekeeping operations

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Ozerniuk H.V. Odesa Politechnic National University, Odesa, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-5030-6356

Balan O.S. Odesa Politechnic National University, Odesa, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Prokopenko O. Estonian Entrepreneurship University of Applied Sciences, Tallinn, Estonia
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-1362-478X

Stasiuk Yu.M. 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

Krupskyi O.P. 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/0000-0002-1086-9274

Ozerniuk H.V., Balan O.S., Prokopenko O., Stasiuk Yu.M., Krupskyi O.P. The system of medical rehabilitation of the disabled people: experience of the leading EU and NATO countries. Medicni perspektivi. 2025;30(2):222-234.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333692

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

The digital transformation of the healthcare system is a key factor in improving the efficiency of medical services and sector management. One of the critical aspects of this transformation is the development of digital workforce potential, which includes the formation and enhancement of digital competencies among healthcare professionals. The aim of the study was to provide a medical and social justification and develop a conceptual model for the development of the digital potential of healthcare personnel to improve the sector's operational efficiency. A comprehensive approach was applied in the research, including a sociological survey of 162 healthcare professionals (practicing physicians, managers, and researchers), an analysis of strategic documents, the conceptual modeling method, and statistical analysis using standard tests conducted via Jupyter Notebook (https://jupyter.org). The findings indicate that the overall self-assessed level of digital competencies among healthcare professionals is moderate – 2.63 (95% CI 2.53-2.74) on a 5-point scale – suggesting potential for further growth. The highest competency level was recorded in general digital literacy, while the lowest was in digital tools and applications. Statistically significant differences were identified (p<0.001), as well as a positive correlation between the level of digital skills and the awareness of their importance for professional activities. The study identified the key stages in the cycle of forming, developing, and consolidating digital competencies among healthcare personnel while building digital human resource potential in healthcare. The most important stakeholder groups were also highlighted, with the top three, as identified by respondents, being: the Ministry of Health, higher medical education institutions, and healthcare institutions. Other key stakeholders include healthcare professionals and patients. Among the measures for developing digital competencies in healthcare personnel, respondents rated infrastructure development as the most significant at the systemic and organizational levels (over 40% of top ratings). A conceptual model for the digital potential of healthcare personnel in the healthcare system has been proposed. This model could serve as a foundation for developing further strategies in this area and contribute to achieving the primary goal of the sector – improving public health.

Key words: efficiency of the health care system, digitalization, management, health workforce, competencies, conceptual model

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Kriachkova L.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/0000-0001-7635-2609

Simon K.I. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-4155-5873

Kriachkova L.V., Simon K.I. Medico-social rationale for the development of digital personnel potential in healthcare. Medicni perspektivi. 2025;30(2):234-246.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333698

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

Increasing the availability and affordability of medical and pharma­ceutical care to the population is the most important task of all levels of government. The purpose of the work is to study the affordability of glucose-lowering drugs for the treatment of type 2 diabetes in Ukraine. Research materials are: State Register of Medicinal Products and price of glucose-lowering drugs. Marketing, analytical, graphic and pharma­coeconomic analysis were used. On the pharmaceutical market of Ukraine 161 glucose-lowering drugs are registered, which contain 16 international non-proprietary names and 8 international non-proprietary names combinations. It was established that the cost of Defined Daily Dose for mono glucose-lowering drugs varies from UAH 1,1 for glibenclamide up to UAH 90,7 for liraglutide. Most of the Ukrainian-made and foreign drugs are highly affordable, but foreign pre­parations of modern groups are moderately affordable, only one foreign drug, Liraglutide, is unaffordable ratio. But the analysis of affovailability for pensioners only metformin (Ukrainian production), glibenclamide, gliclazide, and glimepiride are highly affordable, three of which are already subject to reimbursement. Modern glucose-lowering drugs, both of foreign and Ukrainian production, is scarcely affordable, which makes it practically impossible to use them in the majority of retirees with diabetes. Thus, the analysis showed that in order to implement modern treatment schemes for type 2 diabetes, which according to the current legislation can be used in Ukraine, it is necessary to expand the list of glucose-lowering drugs included in the reimbursement program. This will improve treatment results, which in turn will reduce the development of diabetes complications and improve the quality of life of patients.

Key words: affordability, diabetes melitus, glucose-lowering drugs, reimbursement, solvency adequacy ratio, pharmacoeconomic research

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12. [Analysis of the treatment system and calculation of economic losses from diabetes in Ukraine]. Kyiv; 2020. 30 p. Ukrainian.
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16. American Diabetes Association. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes. Diabetes 2022;45(1):125-43. doi: https://doi.org/10.2337/dc22-S009
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Vlasenko I.O. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-5530-4189

Gladyshev V.V. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0001-5935-4856

Zaliska О.M. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-1845-7909

Davtian L.L. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0001-7827-2418

Vlasenko I.O., Gladyshev V.V., Zaliska О.M., Davtian L.L. Study of affordability of pharmaceutical provision for type 2 diabetes therapy in Ukraine. Medicni perspektivi. 2025;30(2):247-254.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333711

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

During the coronavirus pandemic, health care systems worldwide encountered serious challenges. Many patients were hospitalized, and hospital sectors in numerous countries struggled to handle the crisis. The pandemic caused disruptions in health care delivery and heavily impacted hospital financing. The financial sustainability of hospitals differed among countries, depending on reliance on outpatient and elective services and other features. These gaps drove health organizations to develop new crisis management plans. This review analyzed changes in hospital financing during the pandemic in Poland, Bulgaria, the Czech Republic, Slovakia, Estonia, Latvia, Lithuania, and Georgia. We selected typical post-socialist nations in Central Europe that share similar geopolitical contexts and membership in the European Union, transitioning from centrally planned to market economies with distinct health financing models, as well as Georgia, which aims to become a member of the European Union. The aim of the present study is a comprehensive analysis of international practices of hospital sector financing under the conditions of the COVID-19 pandemic, based on a comparative analysis of crisis response mechanisms in eight countries, with an emphasis on identifying effective remediation strategies and systemic healthcare improvements in the context of financial sustainability, digitalization, and integration into the public health system. Comparing these countries reveals how they adapted to pandemic pressures, employed financial regulations, and addressed challenges, offering insights for similar health systems worldwide. The analysis indicates that the strength and structure of a country’s health financing, especially having an established diagnosis-related group system and comprehensive public health insurance, were crucial for managing the pandemic. Countries with robust systems, such as the Czech Republic, Poland, and Estonia, had better capacity to mobilize resources, adjust funding mechanisms, and support hospitals and staff. In contrast, countries with less well-funded structures, including Bulgaria, Latvia, and Georgia, experienced greater obstacles in their pandemic responses. Remediation of the public health sector within socio-ecological and socio-economic frameworks is essential. It covers a wide spectrum of pressing issues, proposing integrated solutions that safeguard health and improve social and environmental living conditions.

Key words: COVID-19 pandemic, health financing system, financial sustainability, public health sector, remediation, health development strategy

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Sharashenidze A. Georgian Technical University, Tbilisi, Georgia
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
http://orcid.org/0009-0008-8289-1850

Cherniavskyi B. University of Applied Science in Konin, Konin, Poland
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
http://orcid.org/0000-0001-9174-6139

Buleishvili M. European University, Tbilisi, Georgia
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0004-2657-8473

Sanikidze T. Tbilisi State Medical University, Tbilisi, Georgia
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
http://orcid.org/0000-0003-1618-5276

Krasnikova N. 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/0000-0002-6484-2050

Sharashenidze A., Cherniavskyi B., Buleishvili M., Sanikidze T., Krasnikova N. Remediation strategies and systemic improvements in health care after COVID-19: an analysis of international practices in hospital financing. Medicni perspektivi. 2025;30(2):255-271.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333807

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

The purpose of the work is to publicize a complex clinical case of the disease – pseudoaneurysm of the thoracic aorta, based on the results of the patient's examination and treatment. Analysis of surgical treatment tactics, description of applied surgical techniques during radical surgery, the results of a clinical study of a patient with a thoracic aortic pseudoaneurysm are presented. For this purpose, echocardioscopy, coronary angiography, contrast-enhanced computed tomography, general clinical laboratory tests, and microbiological examination of biological fluids and tissues were used. Based on the diagnostic data, the primary clinical diagnosis was established: Ischemic heart disease. Stable angina pectoris, functional class III, post-infarction cardiosclerosis with hypokinesis of the posterior wall of the middle and basal segments of the left ventricle. Polytopic supraventricular extrasystole of the type of bigeminia and trigeminia. Hypertensive disease of the 2nd stage, 3rd stage. Thoracic aortic aneurysm. CHF IIa stage. A clinical case of surgical treatment of thoracic aortic pseudoaneurysm is described: the course of primary surgical treatment of thoracic aortic aneurysm (Supracoronary prosthesis of the ascending aorta, aortic valve revision. CABG (Ao-PDA) in conditions of artificial blood circulation), postoperative observation, as well as the prerequisites for the occurrence of thoracic aortic pseudoaneurysm. The course of this complication is directly described, with a description of the course of surgical treatment: Resternotomy. Elimination of prosthetic pseudoaneurysm of the ascending aorta. Plastic surgery of the distal anastomosis and plastic surgery of a linear rupture of the right ventricle in conditions of complete circulatory arrest (18°C, 38 min.), as well as the features of the postoperative period after it. Conclusions have been made that may help prevent the occurrence of thoracic aortic pseudoaneurysm and treat it more effectively. In particular, its infection was established as a factor in the cause of the defect of the distal anastomosis of the prosthesis. The described surgical technical method of peripheral cannulation with artificial blood circulation, with heart drainage, with cold arrest up to 18°C, within 38 minutes allowed to quickly localize the pseudoaneurysm of the thoracic aorta, bleeding from the defect of the distal anastomosis of the prosthesis, which occurred during resternotomy; to perform the main stage of surgical intervention – elimination of prosthetic pseudoaneurysm of the ascending aorta, plastic surgery of the distal anastomosis and plastic surgery of the linear rupture of the right ventricle.

Key words: pseudoaneurysm of the thoracic aorta, surgical treatment, surgical technique

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Romaniuk T.V. Municipalnon-profitenterprise «Ternopil Regional Clinical Hospital» Ternopil City Council; 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/0000-0001-9279-3711

Moroz V.S. Municipalnon-profitenterprise «Ternopil Regional Clinical Hospital» Ternopil City Council, Ternopil, Ukraine
https://orcid.org/0009-0002-5925-2694

Lekan R.Io. Municipalnon-profitenterprise «Ternopil Regional Clinical Hospital» Ternopil City Council, Ternopil, Ukraine
https://orcid.org/0000-0002-5969-9886

Romaniuk T.V., Moroz V.S. Lekan R.Io. Pseudoaneurysm of the thoracic aorta (clinical case). Medicni perspektivi. 2025;30(2):272-277.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333827

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

Systemic lupus erythematosus (SLE) is a prognostically unfavorable systemic connective tissue disease with heterogeneous clinical manifestations, development of complications, and an unpredictable wave-like course, which complicates the diagnosis of this pathology. The relevance of this clinical case is determined by a number of features: the debut of SLE with isolated kidney damage, an 11-year delay in the date of diagnosis, and the occurrence of an extremely rare complication – lupus crisis (LC), which became fatal for the patient. The aim of the work: to analyze a clinical case as unique in terms of the features of the debut and clinical course of systemic lupus erythe­ma­tosus, which has become a multidisciplinary problem, to highlight the reasons for the delay in diagnosis verification, to assess, in dynamics, the effectiveness of the prescribed treatment and to report on the development of a multiorgan lupus crisis. The article analyzes data from the medical documents of a 31-year-old inpatient. An illustrative clinical case of SLE, which debuted with glomerulonephritis at the age of 16, 11 years before the appearance of specific clinical symptoms that met the criteria of the American College of Rheumatology and the European League Against Rheumatism 2019, is presented. The level of im­munological indicators specific for SLE – antinuclear antibodies to double-stranded deoxyribonucleic acid increased in the pa­tient in 2023, i.e. 4 years later. The patient’s refusal of nephro biopsy, starting from the debut of the disease and from patho­genetic therapy at the stage of diagnosis and during the next 4 years. led to increased SLE activity, frequent relapses with the development of polymorbid pathology and, incompatible with life, multiorgan lupus crisis. The article describes in detail the dynamics of clinical manifestations of SLE and LC. The stages of diagnostic search, features of differential diagnosis and treat­ment of SLE and LC are discussed on the example of a clinical case. Based on the results of a review of the medical literature, analysis of articles, databases PubMed, SCOPUS, Web of Science, MedScape, the current state of the problem is highlighted, literature data on the incidence, features of the clinical course, diagnosis and treatment of SLE, its complications are sum­marized. The description of the clinical case, analysis of the literature is an addition to modern information about the pos­sible clinical manifestations and consequences of SLE with the development of a severe, extremely rare complication – lupus crisis.

Key words: systemic lupus erythematosus, lupus crisis, lupus nephritis, renal failure

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Talash V.V. Poltava State Medical University, Poltava, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-5700-557X

Katerenchuk I.P. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0003-3765-4895

Kostrikova Yu.A. Poltava State Medical University, Poltava, Ukraine
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https://orcid.org/0000-0002-8675-8896

Yarmola T.I. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0002-7428-0223

Hutsalenko O.O. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0001-8313-3201

Pustovoyt H.L. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0001-6879-8088

Tkachenko L.A. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0001-9356-6385

Mokhnachev O.V. Poltava State Medical University, Poltava, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-4247-6926

Rustamіan S.T. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0003-4348-6365

Talash V.V. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0001-7758-767X

Sarychev L.P. Poltava State Medical University, Poltava, Ukraine
https://orcid.org/0000-0003-3257-4845

Savchenko R.B. Poltava State Medical University, Poltava, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9790-8821

Talash V.V., Katerenchuk I.P., Kostrikova Yu.A., Yarmola T.I., Нutsalenko O.O., Pustovoyt Н.L., Tkachenko L.A., Mokhnachev O.V., Rustamіan S.T., Talash V.V., Sarychev L.P., Savchenko R.B. Systemic lupus erythematosus as a multidisciplinary problem (clinical case). Medicni perspektivi. 2025;30(2):278-292.
DOI: https://doi.org/10.26641/2307-0404.2025.2.333835

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