Medicni perspektivi

Improvement of the chemotherapy and pharmaceutical service management system by monitoring drug prescription errors in oncology patients

Ye.V. Zalyhina — 2025-03-28

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

Access to healthcare for foreigners in the Czech Republic: challenges, opportunities, and pathways to integration

L. Shuranova — 2025-03-28

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

Impact of combined fixed-dose formulations in Helicobacter pylori eradication on incidence rate of gastric cancer in Ukraine from 2014 to 2021

Y.O. Protas — 2025-03-28

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

Prognostic biomarkers and their impact on treatment strategy selection for patients with advanced stages of oropharyngeal cancer

V.V. Rakhmanov — 2025-03-28

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

Evaluation of the effectiveness of heart failure symptoms monitoring diary in outpatient settings

D.K. Hryhorets — 2025-03-28

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

The results of the comparative microbiological study of gingival fluid in restoration of partial defects of tooth crowns with different materials considering the state of periodontal tissues

O.O. Fastovets — 2025-03-28

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

Changes in immunological reactivity in bacterial-immune inflammation of the periodontium under the condition of using different types of removable dentures

Yu.I. Poliukhovych — 2025-03-28

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

Comparison of opioid-limiting anesthesia methods in patients undergoing total abdominal hysterectomy

V.V. Osadcha — 2025-03-28

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

Prediction of obstetric complications in women with hypertensive disorders of pregnancy

O.V. Vaskiv — 2025-03-28

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

Non-interventional study of the epidemiological and clinical aspects of war-related spinal cord injuries among military personnel

V.O. Artemenko — 2025-03-28

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

Diagnostic significance of bone turnover markers for predicting the risk of osteopenic syndrome in children with juvenile idiopathic arthritis

O.A. Makoviichuk — 2025-03-28

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

Neuropsychological indicators of postoperative cognitive dysfunctions after off-pump coronary artery bypass grafting

V.V. Antonenko — 2025-03-28

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

Clinical and psychological features of combined trauma in servicemen of the Armed Forces of Ukraine in the Russian-Ukrainian war

K.S. Hutchenko — 2025-03-28

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

Disability due to ophthalmic pathology in Ukraine and Dnipro region (2018-2022). Modern approaches to determining the status of “person with disability”

I.S. Borysova — 2025-03-28

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

Limited impact of roselle flower extract on protein carbonyl levels after physical exercise in healthy men

N. Ayubi — 2025-03-28

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

The effectiveness of compensatory strategies in the rehabilitation of patients with visuospatial neglect during the post-acute period of stroke rehabilitation

A.V. Totska — 2025-03-28

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

Translation, cross-cultural adaptation and content validation of the Canadian Occupational Performance Measure (COPM) in the Ukrainian language

O.O. Mangusheva — 2025-03-28

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

A case of late syphilis of the nervous system with a fatal outcome

V.V. Rodionova — 2025-03-28

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

A case report of a hemorrhagic stroke with right hemiparesis

Franklin Baltodano Ardón — 2025-03-28

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

Active policies to promote active aging and address demographic challenges in Bulgaria

T. Vazova — 2025-03-28

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

Biomonitoring of toxic and potentially toxic trace elements in the urine of residents of an industrial region

N.M. Onul — 2025-03-28

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

The impact of varying intensities of magnetically treated water on renal and testicular tissue

Sura Fouad Alsaffar — 2025-03-28

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

Mental health is an integral component of public health in the modern world: the dynamics of the term use in scientific publications

O.L. Burak — 2025-03-28

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

Association between risk of ischemic stroke and the rs17216473 single nucleotide polymorphism in the 5-lipoxygenase-activating protein gene locus

O.Yu. Pavlenko — 2025-03-28

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

Effect of paracetamol and celecoxib on the state of hemocoagulation in the most acute period of heat injury in rats

P.O. Chuykova — 2025-03-28

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