Medicni perspektivi

Analysis of the provision of dental care to children in a state-owned medical institution in wartime conditions

Mon, 29 Sep 2025 00:00:00 +0300

Aim of the study was to analyze the indicators of dental aid provided at the children's policlinic dental department in Poltava during the wartime in order to find ways of their optimization. Analytical and statistical methods of research are used. In 2024 there was a decrease in the number of working days of dentists by 6.17% and in the number of diagnostic visits by 23.02% (p<0.05); the number of applied fillings decreased by 13.85% (p<0.05); indicators of preventive, orthodontic and surgical work deteriorated, as well as the indicators of radiologic room. Also, some outpatient surgical procedures began to be performed in the children's hospital, as evidenced by a 1.39% increase in the number of hospitalizations and a 4.68% decrease in the proportion of patients undergoing surgery in the policlinic department (p<0.05). However, the number of preventive and primary visits increased, and the ratio of treated permanent teeth with uncomplicated to complicated caries increased from 17.1:1 in 2023 to 21.4:1 in 2024. In 2024, the number of visits per 1 remediation decreased by 16.67%, whereas the number of treatment courses for periodontal diseases doubled and the number of treatment courses for the diseases oral mucosa increased by 7.6%. In 2022-2024 years, an increase in the number of children examined during scheduled remediation is associated to the terms of the package of National service of health in Ukraine which includes mandatory checks-ups of children under 6 years of age. During wartime, the number of dental services provided by the department shifted due to the changes in the number of city residents, the decrease in the number of working days of dentists, and the transfer of some surgical services to the hospital. In order to optimize dental care for children in wartime, a state-owned medical institution has to promote its work on social media and television, focusing on preventive measures, and to introduce new diagnostic and treatment methods.

COVID-19 Pandemic: a novel theoretical approach to epidemics

Ugur Saglam — Mon, 29 Sep 2025 00:00:00 +0300

The coronavirus pan-demic 2019 (COVID-19) has completed numerous global spreading waves. Several models categorized as compart-mental, growth, and distributional have been derived and are intended to determine the spread dynamics of the pandemic and behavioral patterns. However, it seems that a more generalized theoretical approach to this phenomenon can be derived via distributional models, especially the Gaussian distribution. For this reason, we aim to approach the problem as a stochastic phenomenon, considering that the spread and the related outcomes of the epidemic occur randomly and exhibit stochastic behavior. In this way, we can predict the course of the pandemic by detecting the spreading wave patterns using stochastic instruments and methods. The purpose of our study is to present a phenomenological model that helps us understand the general outbreak behaviors that determine the characteristic parameters of the pandemic and behavioral patterns in spreading waves. To achieve the goal, we have developed a theoretical approach that obtains a stochastic differential equation or a master equation called the Fokker-Planck equation by starting with a stochastic difference equation or a random walk model. Thus, as a solution to this master equation, we get a time-dependent Gaussian distribution with a shifted center, which is a good instrument to determine the characteristic spreading parameters of COVID-19 and the general behavior patterns for all pandemic diseases. The model uncovers thoughts on preventative mechanisms and sheds light on most criticisms about the importance of individual isolation, recovery treatments, remedies, and vaccine development.

Nursing, midwifery and health psychology students' attitude towards health-promoting behaviours: a cross-sectional study

L. Xhakollari , J. Kraja, M. Marku , E. Fresku — Mon, 29 Sep 2025 00:00:00 +0300

The present study focuses on the assessment of health-promoting behaviors and the manner in which the curriculum of teaching programs affects students in the bachelor's degree programs in Nursing and Midwifery, as well as the professional master's degree program in Health Psychology. The study used a descriptive correlational design. The data were collected between 15th of February and 15th of March, 2024 from undergraduate students enrolled in nursing and midwifery programmes, as well as postgraduate students pursuing a professional master's degree in Health Psychology at the Faculty of Natural Sciences, University of Shkodra "Luigj Gurakuqi", Shkodër, Albania. The data were collected using an online questionnaire comprising three sections. The first section incorporated socio-demographic variables. The second section incorporated the Health-Promoting Lifestyle Profile II (HPLP II) questionnaire, developed by Walker et al., 1995, to assess health-promoting behaviours. The third section of the study focused on curricular formation and included three questions designed to assess students' perceptions of health promotion in their academic programmes. The mean overall Health-Promoting Lifestyle Profile II (HPLP II) score was 2.60±0.40, indicating that, on average, students follow health-promoting behaviours from "sometimes" to "often". Among the six subscales, spiritual growth (2.99±0.50) and interpersonal relations (2.89±0.47) had the highest mean scores, suggesting that students more frequently follow behaviours related to personal development and social support. The findings of the study indicated that students enrolled in both bachelor's degree programmes in Nursing and Midwifery and master's degree programmes in Health Psychology, despite being presumed to possess a substantial body of knowledge on health-promoting behaviours, do not consistently implement these practices in their daily lives. Given their role as role models for others, health personnel have a dual responsibility for the promotion of healthy behaviours. This finding suggests a deficiency in the incorporation of health-promoting behaviours as a core value within the curricula of bachelor's degree programmes in nursing and midwifery.

Electromyographic characteristics of muscles in children with malocclusion and disorders of the musculoskeletal system in the period of mixed bite

L.V. Smaglyuk, A.V. Liakhovska — Mon, 29 Sep 2025 00:00:00 +0300

The maxillofacial region, as a component of the stomatognathic system, is one of the links of a complex mechanism of postural control, and is closely related to other musculoskeletal and neural sensors, in particular the musculoskeletal system, under the control of the central nervous system. Electromyographic research is one of the leading diagnostic methods in dentistry, which allows to objectively assess muscle activity and, accordingly, the functional state of the maxillofacial region. The aim of the study was to determine the features of electromyographic activity of masticatory, mimic, sternocleidomastoid muscles in children with malocclusion and musculoskeletal disorders. The main group consisted of 26 children with malocclusion and musculoskeletal disorders. The average age was 9.5±1.8 years. There were 12 (46.2%) girls and 14 (53.8%) boys. The control group consisted of 20 children without malocclusion, musculoskeletal disorders and other somatic pathology, comparable in age and sex. The average age of the children was 9.2±1.6 years, there were 11 (55.0%) girls and 9 (45.5%) boys. All subjects of the main and control groups underwent surface electromyography of the temporal, masticatory, sternocleidomastoid, submental and orbicular muscle of mouth in the tests: maximum bilateral teeth clenching, swallowing, teeth clenching on the left side, teeth clenching on the right side. In children with malocclusion and musculoskeletal disorders, an imbalance of muscle work was established, both in tension tests (teeth clenching) and in swallowing functions. In the bilateral teeth clenching test, asymmetric, “cross” activity of the temporal, masticatory and sternocleidomastoid muscles on the left and right sides was diagnosed. In the test of the lateral teeth clenching in children of the main group, there was no significant difference between the electromyographic activity of the muscles of the working and balancing sides, which was observed in the control group and was accepted as physiologically normal activity in these tests. In the functional swallowing test of subjects of the main group, a significant increase in the electromyographic activity of the sternocleidomastoid, submental and orbicular muscle of the mouth was determined, which significantly exceeded the values of the control group (p>0.05). The electromyographic activity of the chewing muscles was low and asymmetric.

Changes in the antioxidant defense system of the body in periodontitis of bacterial-immune genesis and against the background of using metal crowns

A.Ye. Demkovych , O.V. Marfiian — Mon, 29 Sep 2025 00:00:00 +0300

The purpose of this work was to study the effect of fixed prosthetics with metal crowns on the antioxidant defense system of the body in periodontitis of bacterial-immune genesis. The experimental animals were divided into four groups: I – control (n=10); II – animals with periodontitis on the 30^th day of the study (n=8); III – animals with periodontitis on the 30^th day of the study with stamped crowns (n=8); IV – animals with periodontitis on the 30^th day of the study with solid-cast crowns (n=8). Stamped crowns were manufactured by stamping standard sleeves, and cast crowns were manufactured by casting from cobalt-chromium alloy. Experimental bacterial-immune periodontitis was modeled by injecting a suspension of microorganisms (Staphylococcus aureus and Streptococcus haemolyticus) in egg white into the periodontal tissues. To enhance the immune response, rats were additionally administered Freund's complete adjuvant. This procedure was repeated on the 14^th day. On the 30^th day, blood serum was collected. The activity of antioxidant protection was assessed by the level of superoxide dismutase, catalase, ceruloplasmin and the glutathione system, which were determined by biochemical methods. On the 30^th day of periodontitis development, the level of superoxide dismutase decreased by 2.06 times (p<0.001), reduced glutathione by 3.39 times (p<0.001), and catalase and ceruloplasmin increased by 2.70 times compared to the control (p<0.001); by 1.25 times (p<0.01), respectively. After fixation of the stamped crowns, the level of catalase and ceruloplasmin was higher, and superoxide dismutase and reduced glutathione were lower compared to the control. The use of cast structures led to similar changes, but with less severity. Determination of catalase and ceruloplasmin activity in cast crowns showed its decrease by 1.06 times (p<0.05) compared to stamped ones, and the indicators of superoxide dismutase and reduced glutathione were higher by 1.61 times (p<0.01) and by 1.46 times (p<0.001), respectively when using cast structures. Cast crowns showed less negative impact on the antioxidant system compared to stamped ones, which may indicate better biocompatibility of this type of prosthesis.

Device-based methods in facial skin restoration during rehabilitation after plastic and reconstructive surgeries

Mon, 29 Sep 2025 00:00:00 +0300

An analysis of current scientific literature shows that device-based treatment methods play an important role in the comprehensive postoperative rehabilitation of patients after reconstructive and plastic surgery on the face. Despite the active introduction of radiofrequency, laser, ultrasound and light methods into clinical practice, the question of comparing their effectiveness remains open. This is particularly relevant in the treatment of the consequences of deep mechanical and thermal damage, which are accompanied by complex processes of skin restoration. Objective: to conduct an analysis, including a multidimensional comparative analysis, of device-based methods for facial skin restoration during rehabilitation after plastic and reconstructive surgery. The study involved 72 subjects (women and men, average age 40.5±8.1 years) who underwent plastic or reconstructive surgery on the face. Depending on the method of hardware exposure, patients were divided into four groups: radiofrequency, laser, ultrasound (HIFU) and light (LED/IPL) therapy. The control group (n=24) consisted of patients who received only traditional treatment without device-based methods. The Vancouver Scar Scale (VSS), biometric parameters (Cutometer^®, Corneometer^®), dermatoscopy and the visual analogue scale (VAS) were used to evaluate the results. A multidimensional comparative analysis was performed using the sum of squares method, which took into account five key characteristics: clinical effectiveness, duration of the procedure, number of sessions, interval between surgery and the start of therapy, and cost of treatment. LED light therapy received the highest rating (R=1), which was characterised by the shortest interval between surgery and the start of treatment (21 days), the lowest cost (6,000 UAH) and the shortest duration of the procedure (0.5 hours). Radiofrequency and non-ablative laser therapies received the same rating (R=2), indicating their high effectiveness but longer and more expensive therapy (1 hour and 9-15 thousand UAH, respectively). The ultrasound method ranked third (R=3) due to significant time (90 days) and financial (15,000 UAH) constraints, as well as the duration of the procedure (1.5 hours). The results of the study indicate the advisability of early inclusion of LED and radiofrequency therapy in standardised rehabilitation protocols to improve skin healing quality, reduce the risk of scarring and enhance the overall aesthetic effect after plastic and reconstructive surgery on the face.

Scientific rationale for the use of a mucogingival gel in the comprehensive treatment of generalized periodontitis in military personnel and veterans (literature review)

Mon, 29 Sep 2025 00:00:00 +0300

The current level of national defense security requires enhanced standards for the health and professional reliability of military personnel. In this context, oral health is considered a key factor influencing the performance of official duties, well-being, and quality of life. It can be asserted that optimizing the treatment of periodontal pathology in military personnel is not only an element of maintaining general health but also a part of the strategic orientation of any country. However, therapeutic approaches to generalized periodontitis often demonstrate low effectiveness, with only a temporary stabilizing effect on disease progression. The aim of this study is to evaluate the effectiveness of available local treatment options in controlling chronic periodontitis, with or without concurrent mechanical debridement by scaling. A total of 77 English- and Ukrainian-language scientific sources published between 2006 and 2025 were analyzed, selected based on relevance, presence of empirical data, and methodological quality. The literature search was conducted using the electronic catalog of the National Scientific Medical Library of Ukraine and databases such as Google Scholar, PubMed, and Scopus. The analysis focused on the effectiveness of various groups of local drug formulations, with special attention to gels exhibiting antibacterial, anti-inflammatory, antioxidant, and mucoadhesive properties. Mucogingival gels were found to ensure stable delivery of active components without systemic load, reduce periodontal pocket depth, bleeding, swelling, and promote tissue regeneration. The highest clinical efficacy was demonstrated by gels containing chlorhexidine, metronidazole, doxycycline, statins, and phytocomponents. Their use is recommended at all stages of treatment, including supportive therapy. The results of the literature review confirm the potential of mucogingival gel in the comprehensive treatment of generalized periodontitis, substantiating its application for military personnel and veterans.

Psychometric properties of the Albanian version of the effort-reward imbalance model in a sample of healthcare workers in Shkodra, Albania hospital

Emiljano Pjetri , Zamira Shabani , Irena Shala, Adem Bekteshi — Mon, 29 Sep 2025 00:00:00 +0300

The goal of this study was to test the reliability and validity of the Albanian version of the 23-item effort-rewardimbalance (ERI) questionnaire and to analyze its association with job dissatisfaction in a sample of Albanian healthcare professionals working in Regional Hospital in Shkodra.A cross-sectional study on a representative sample was carried out. Descriptive statistics was performed. Cronbach’s alpha coefficient was calculated to estimate the internal consistency reliability. Significant differences were calculated using ANOVA. A total of 270 study participants were involved in the study, and the response rate was 81% (219/270). Women and those with master degree predominated. The consistencies of the three scales: effort, reward, and overcommitment were obtained. Mean ratio effort-reward was all the time higher than 1 for all cases in the study. Results show a significant difference for effort and overcommitment based on gender and department in which a person is working.This study is the first one supporting psychometric properties of the Albanian version of the ERI model. Based on the results of this study the Albanian version of the ERI questionnaire is considered a reliable and valid instrument for measuring psychosocial stress at work. Our suggestion is that it is applicable to Albanians working in healthcare sector

Survival Analysis in Stroke Patients with Cerebral Small Vessel Disease

Mon, 29 Sep 2025 00:00:00 +0300

Cerebral small vessel disease has been considered to worsen short-term stroke outcome in upcoming 90 days, whereas few research have evaluated the role of cerebral small vessel disease in long-term prognosis (for instance, beyond a year). The aim of the research is to investigate the association between cerebral small vessel disease burden and long-term post-stroke survival in patients with acute stroke. It was a prospective single-center cohort study. 294 consecutive patients with acute stroke were recruited. All participants underwent magnetic resonance imaging and computed tomography assessment for cerebral small vessel disease markers as well as clinical-neurological testing.. To determine the associations of small vessel disease with mortality in patients after stroke, we used multivariate survival analysis using Cox regression with Kaplan-Meier survival curves for 5 years of follow-up after discharge. In multivariable Cox regression proportional hazards model, cerebral small vessel disease presence was associated with long-term all-cause post-stroke mortality (hazard ratio =3.8; 95% confidence interval 1.9-7.9, p<0.001). In the same model, cerebral small vessel disease severity grade 1 (hazard ratio =2.4; 95% confidence interval 1.1-5.4, p=0.033), cerebral small vessel disease severity grade 2 (hazard ratio =6.9; 95% confidence interval 3.2-15.0, p<0.001) were associated with poor survival. We also found significant association between presence of lacunes and mortality: (adjusted hazard ratio =6.2; 95% confidence interval 3.3-11.5, p<0.001); as well as severe white matter hyperintensity and mortality: (adjusted hazard ratio =2.1; 95% confidence interval 1.1-4.1, p=0.019). Cerebral vessel disease is significantly associated with mortality in patients after stroke during 5 years of follow-up. It may be useful in determining patient prognosis and future patient selection for preventive strategies.

Changes in some indicators of hemostasis and inflammatory markers in patients with COVID-19

Mon, 29 Sep 2025 00:00:00 +0300

The COVID-19 pandemic has become one of the most serious challenges for the global healthcare system, causing high mortality and a significant burden on medical institutions. Despite the development of medicine in many countries, none of them was fully prepared for the pandemic. Comorbid conditions that complicate the course of coronavirus disease and affect the effectiveness of treatment have become one of the key risk factors for severe disease and death. Identification of the most important laboratory markers and their correlation with the clinical course of COVID-19 will allow us to improve the prediction of disease outcomes and develop more effective treatment strategies. The article examines the impact of COVID-19 on the overall mortality structure in Ukraine, the features of its course, and prognostic markers of disease severity in patients with comorbid conditions. The aim of our work was to study specific changes in hemostasis indicators as markers of disease severity and prognosis for health status in patients with COVID-19 and comorbid conditions. A retrospective analysis of 399 hospitalizations and 296 deaths in the Chernivtsi Regional Clinical Hospital in 2021 was conducted. The changes we identified showed that a severe course of COVID-19 was significantly more common (p<0.05) in older patients and mainly in men, which may indicate that age and gender are one of the causes of the severity of COVID-19. This pattern is explained by the fact that with age (>65 years), patients are more likely to suffer from cardiovascular diseases and metabolic diseases (diabetes mellitus (DM)), which significantly reduces immunological resistance to SARS-CoV-2 infection. Laboratory indicators that can serve as prognostic markers of a severe course of the disease were analyzed: thrombocytopenia, increased levels of D-dimer, procalcitonin, C-reactive protein, and IL-6. Low body temperature at admission and decreased saturation levels were found to be predictors of poor prognosis. The results may improve monitoring and treatment strategies for COVID-19.

Oxidative stress in skin diseases and the role of antioxidants in their treatment

Mon, 29 Sep 2025 00:00:00 +0300

More and more preclinical and clinical studies indicate the crucial role of oxidative stress in the pathogenesis of skin diseases. This became the basis for the analysis of current literature data on oxidative stress and antioxidant protection in the skin in the norm and dermatological diseases, as well as on the antioxidants use to manage this pathology.The aim of the study was to review the current literature on oxidative stress and antioxidant protection in the skin and to analyze the possibilities of using antioxidants in skin diseases. The search for literature sources for 2005-2025 was carried out in the biometric search engine PubMed using the terms: “oxidative stress”, “antioxidant”, “skin”, “skin disease”, “topical treatment”, “α-tocopherol”, “ascorbic acid”, “polyphenol”, “quercetin”, “coenzyme Q10”, “resveratrol”, “N-acetylcysteine”, as well as word combinations based on them. The inclusion criteria were: a document in English; publication in the period 2005-2025; compliance with search queries; availability of the article full text. The exclusion criteria were: a case from practice; conference proceedings; a publication that does not meet the purpose of the review; lack of full text, reflection of skin manifestations of a systemic disease or infection. The maximum number of literature sources was found for the query “oxidative stress – antioxidant – skin” (n=3076). After systematizing the selected documents using bibliographic and analytical methods, 115 of the most relevant sources remained. It was shown that the suppliers of reactive oxygen species (ROS) in the skin are processes that occur in keratinocytes, fibroblasts, and hematogenous cells. Many antioxidants eliminate ROS in the skin, they act together with superoxide dismutase, catalase, glutathione peroxidase and non-enzymatic antioxidants. Disruption of the balance between ROS and the power of antioxidant protection, i.e. oxidative stress, accompanies contact dermatitis, urticaria, atopic dermatitis, psoriasis, malignant skin tumors, photoaging, and vitiligo. The contribution of key natural antioxidants (ascorbic acid, α-tocopherol, retinoids, coenzyme Q10, resveratrol, selenium, and polyphenols) to skin care has been described, but there was only a small number of evidence-based studies that would justify the dosage and indications for their use in dermatology. Synthetic antioxidants are represented by almost one N-acetylcysteine in the treatment of toxic epidermal necrolysis, drug hypersensitivity syndrome, ichthyosis, contact and atopic dermatitis and some other diseases. The topical use of antioxidants is complicated by the search for an adequate dosage form, in which the stabilization of a substance with antioxidant properties is crucial, as well as its absorption, the ability to reach the target tissue in an active form and remain there for a long enough time, which is solved by the use of new methods of drug delivery, in particular based on nanotechnology. Thus, changes in the redox balance are widely represented in dermatoses, and the use of antioxidants can be of great importance if they are prescribed rationally. Obviously, it is advisable to combine antioxidants with each other and to introduce synthetic antioxidants more widely into practice.

Current understanding of the pathogenetic relationships between chronic obstructive pulmonary disease and type 2 diabetes mellitus: an integrative review

N.A. Sanina , D.O. Sutyrin, T.S. Turlyun — Mon, 29 Sep 2025 00:00:00 +0300

Currently, chronic obstructive pulmonary disease (COPD) is considered a systemic disease with multiple extrapulmonary effects, which is caused by systemic manifestations of the inflammatory process. On the other hand, obesity, oxidative stress, chronic hyperglycemia, and insulin resistance, inherent in type 2 diabetes mellitus (DM), are key factors for enhancing the body's inflammatory response. Our study aimed to review the existing scientific literature to determine the patterns, relationships, and pathogenetic relationships between type 2 diabetes mellitus and chronic obstructive pulmonary disease. The empirical research method of modern English-language medical literature was used in depth from 2003 to 2024, using search engines on the PubMed and Google Scholar platforms and the Scopus and Web of Science abstract scientific literature databases, and the Cochrane scientific library. Based on the search results, 59 information sources were selected and processed.The analysis used system-structural, formal-logical, bibliographic, and informal (traditional) methods. The authors designed their own figures to visually present information using the infographic methods based on the Miro web resource (miro.com). It has been shown that patients with type 2 diabetes mellitus have an increased risk of developing COPD due to active systemic inflammation, obesity, insulin resistance, and oxidative stress. In addition, hyperglycemia contributes to decreased lung functional parameters and airway remodeling. Adipose tissue plays a vital role in the pathogenesis of COPD and type 2 diabetes mellitus by producing adipokines, such as leptin, resistin, adiponectin, and omentin. An imbalance between pro- and anti-inflammatory adipokines contributes to chronic inflammation, leading to lung function deterioration. Oxidative stress caused by chronic hyperglycemia is an essential factor in the pathogenesis of COPD. Reactive oxygen species (ROS) activate signaling pathways that lead to chronic inflammation and damage to lung tissue. Chronic hyperglycemia affects the function of bronchial smooth muscles, causing its hyperreactivity and excessive proliferation, which can worsen the course of COPD. Thus, COPD and type 2 diabetes are closely interconnected at the level of pathogenetic mechanisms, and the presence of one of these diseases may contribute to the development and progression of the other. Further studies of these relationships may contribute to developing more effective approaches to diagnosing, treating, and prevention of given pathologies.

Clinical and instrumental criteria for the prognosis of the course of hereditary motor-sensory neuropathy type 1A

I.O. Govbakh , O.Ya. Grechanina , L.M. Tsogoeva , L.V. Molodan — Mon, 29 Sep 2025 00:00:00 +0300

Hereditary motor-sensory neuropathies (HMSN) are a large group of genetically heterogeneous diseases of the peripheral nerves, characterized by symptoms of progressive polyneuropathy with a predominant lesion of the muscles of the distal parts of extremities. The progressive course of the disease and the lack of effective etiological therapy lead to early disability of patients and significantly reduce the level of their quality of life due to significant limitations in gait and self-care. The study of the relationship between neurophysiological indicators, anamnestic data and clinical and neurological characteristics of patients with HMSN type 1A is important for understanding the pathophysiology of clinical polymorphism, as well as factors affecting the severity and rate of progression of the disease. The aim of the work was to determine clinical and instrumental criteria for predicting the severity of HMSN type 1A. The study included 153 patients with HMSN type 1A. During the study, a comprehensive approach was applied using clinical and anamnestic, clinical and neurological, clinical and genealogical, and electroneuromyographic methods. Conducting a comprehensive assessment of testing data using the following diagnostic scales and questionnaire: "Neuropathy Impairment Score (NIS)", "Neuropathy Disability Score (NDS)", "Medical Research Council Weakness Scale Sum Score (MRC-SS)", "Overall Disability Sum Score (ODSS)", "Bartel's Daily Activity Scale (Bartel Index)", and the "Functional Walking Categories" test allowed us to objectify the criteria for determining the severity of HMSN type 1A and improve the quality of diagnosis of functional disorders due to this pathology. The majority of the examined patients, namely 41.2%, were aged from 36 to 60 years at the time of examination. Early clinical debut of the disease (up to 20 years) in the examined was observed in 65.4% of cases; the average age of clinical debut of the disease was 19.3 years. In the vast majority of patients, namely 43.8%, the duration of the period of clinical manifestation of the disease was more than 10 years. The electroneurophysiological pattern in the vast majority of the examined patients was characteristic of diffuse demyelination and axonal loss of varying degrees; a gross decrease in the SPI was determined in the motor nerves, mainly of the lower extremities. According to the Spearman rank correlation coefficient, a correlation between the amplitude of the M-response and the age of the disease debut, as well as between the amplitude of the M-response and the age at the time of examination; and was absent a high degree of negative correlation between the amplitude of the M-response and the duration of the period of clinical manifestation of the disease was determined. Analysis of the obtained research results allowed us to determine the following clinical, anamnestic and instrumental criteria for the prognosis of the course of HMSN type 1A: 1) low M-response amplitudes from the beginning of clinical debut are a prognostic criterion for an unfavorable prognosis with a severe clinical course and a rapid rate of progression; 2) late clinical debut (after 20 years) is a prognostic criterion for a rapid rate of disease progression; 3) a decrease in M-response amplitudes is a prognostic criterion for the progression of the pathological process and indicates an aggravation of the severity of the disease before the appearance of clinical signs.

Evolution of professional identity: the Dnipro School of Dermatovenereology in the XX-XXI centuries

Mon, 29 Sep 2025 00:00:00 +0300

The purpose of the study is a historical analysis of the Dnipro School of Dermatovenereology through the prism of the philosophy of science, identification of key periods of its formation and development, main achievements, and the role of leaders in the formation of the scientific school for further improvement of teaching methodology and scientific research. Materials and methods of the study – general scientific, special and interdisciplinary methods based on the principles of historicism, scientificity and objectivity in the coverage of events which formed the methodological basis of the study. General scientific methods such as synthesis, analysis, induction and deduction were used to define the object and subject, the purpose, and conclusions were formulated. Descriptive statistics allowed us to process the data to ensure accuracy and relevance to the problem under study. The article highlights the “life path” of the Department of Skin and Venereal Diseases of Dnipro State Medical University from the moment of creation and formation of the scientific school to the “modern life of the department”. The authors try to strictly adhere to the principle of historicism, events and facts are considered in chronological order, taking into account the peculiarities of the circumstances and the flow of historical time for the development of education and science. The methodological basis of the study is based on the following: scientific and objective approach to the sequence of historical events and their impact on the present, using a set of general scientific methods with an interdisciplinary approach. The authors draw attention to the formation of medical science as a complex process and the importance of the discipline “History of Medicine” in covering the events of this process, the impact on medical students and the transformation in the field of medical research. In the historical development of the department, four periods were identified, which were compared with the areas of art, given that the word “Medicine” (Latin medicina) comes from the phrase “ars medicina” – the art of treatment, healing: The period of “medical ‘abstractionism’; The period of ‘medical modernism’; The period of ‘medical revival’; The period of ‘medical constructivism’. It was found that the historical development of the department follows the philosophical laws of the development of science by T. Kuhn and I. Lakatos. For the first time, the department was defined in terms of philosophy and its driving force in both formal and informal terms. The criteria and conditions for the creation of scientific schools are proved, and it is also proved that the life cycle of a department is longer than that of scientific schools. The importance of a leader in the life of a department and a scientific school is emphasized. It is emphasized that the main components of a leader are: charisma, strategic thinking, the desire for self-development, active scientific activity, and that these components contribute to the formation of medical science, improvement of methodological work in the educational activities of scientists and, as a result, the formation of the scientific and medical elite of the state.

Sitagliptin-induced hyperthyroidism: a case report

Feras M. Almarshad, Yusuf Jamal , Dushad Ram, Jamal Arif , Kauser Usman — Mon, 29 Sep 2025 00:00:00 +0300

Sitagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, is commonly used to manage type 2 diabetes mellitus (T2DM). Although generally considered safe, recent studies suggest a potential role of DPP-4 inhibitors in modulating immune responses, potentially leading to autoimmune conditions, including thyroid dysfunction. This case report aims to investigate the potential association between sitagliptin use and hyperthyroidism, emphasizing the significance of regular thyroid function monitoring in patients treated with DPP-4 inhibitors. A 54-year-old man with a history of hypertension and a family history of diabetes and hypothyroidism was initiated on sitagliptin and metformin for diabetes (HbA1c=8.1%) with normal thyroid function. Three months after initiating treatment, the patient noted weight loss and other initial symptoms of hyperthyroidism; however, nine months later, the patient developed full symptoms of hyperthyroidism, including significant weight loss, palpitations, tremors, and fatigue. Laboratory findings confirmed elevated total T3 (260 ng/dL) and total T4 (20 µg/dL) levels, suppressed TSH (<0.05 µIU/mL) levels, and increased anti-thyroid peroxidase (anti-TPO) antibodies (548 IU/mL). Although thyroid-stimulating hormone receptor antibody (TRAb) testing, ultrasonography, and scintigraphy were not performed, the temporal relationship between sitagliptin initiation and symptom onset, followed by resolution upon drug discontinuation, strongly suggests a probable association. Sitagliptin was discontinued, and Carbimazole was initiated, resulting in clinical and biochemical improvement. The patient’s thyroid function normalized within six months, further supporting the association between sitagliptin and hyperthyroidism. Carbimazole was continued for 15-months resulting in Hb1Ac (6.6%), total T3 (140 ng/dL), total T4 (8.85 µg/dL), and TSH (1.81 µIU/mL) levels. Five months after discontinuation of Carbimazole, laboratory investigations revealed HbA1c (6.6%), fasting blood glucose (112.33 mg/dL), vitamin D (29.7 ng/mL), vitamin B12 (231 pg/mL), total T3 (151 ng/dL), total T4 (9.84 µg/dL), and TSH (1.18 µIU/mL) levels. In conclusion, this case suggests a potential association between sitagliptin and hyperthyroidism, possibly via immunomodulation. While routine thyroid function monitoring in patients on DPP-4 inhibitors may be considered, larger studies are needed to confirm this association.

Anaphylaxis during anesthesia: a clinical case

A.G. Tutunnyk , N.V. Mynka , Yu.Yu. Kobelyatskyy — Mon, 29 Sep 2025 00:00:00 +0300

Adverse events associated with the use of various diagnostic and therapeutic agents are becoming an increasingly urgent and social problem. Anaphylaxis during anesthesia is a rare but life-threatening complication. The incidence of anaphylaxis to cephalosporins according to US researchers was 8 cases per 487,630 cases of parenteral administration of drugs, while cefazolin was the most common cause of perioperative anaphylaxis. Antibiotic prophylaxis is widely used before surgery, but can lead to severe anaphylactic reactions, including anaphylactic shock. The aim of this article was to present a clinical case of anaphylaxis during anesthesia with a description of the symptoms, differential diagnosis and algorithm for providing emergency care, which will allow to deepen the awareness of practicing anesthesiologists about this rare but potentially fatal complication. We present a clinical case of a 32-year-old patient who was scheduled for arthroscopic knee surgery under spinal anesthesia. Upon admission to the operating room, the patient's condition was assessed as satisfactory. Antibiotic prophylaxis with 2 g of cefazolin was performed. After preloading with isotonic NaCl solution, the patient underwent unilateral spinal anesthesia, which was subsequently assessed as inadequate. As a result, it was necessary to supplement the anesthesia plan with an additional femoral nerve blockade. 5 minutes after the femoral nerve blockade, the patient developed a clinical picture of shock. Intensive therapy included the use of vasopressors (adrenaline) and infusion therapy. As a result of the therapy, the patient's condition was stabilized and he was discharged from the hospital after 24 hours of observation in the intensive care unit. During the case analysis, it was found that the patient had concealed an episode of a mild anaphylactic reaction to cefazolin in the past. Preventive measures should include the availability of detailed medical documentation of drug allergies, including anaphylaxis. Thus, anesthesiologists should be familiar with the epidemiology, mechanisms of development, clinical cases and treatment of patients with anaphylaxis during anesthesia. The result of the study is a recommendation to practicing anesthesiologists to carefully approach the collection of allergic history, including the possible use of preoperative questionnaires for patients for this purpose, which contributes to a significant reduction in the risks of adverse events during anesthesia care.

Psychiatric and behavioral disorders in patients undergoing opioid agonist maintenance therapy

N.R. Halytska-Pasichnyk — Mon, 29 Sep 2025 00:00:00 +0300

The aim of this study was to analyze anxiety, depression, aggression, cognitive impairments, and quality of life in patients receiving methadone maintenance therapy. The study was conducted in 2024 at one of the methadone maintenance therapy sites of the Municipal Enterprise «Dnipropetrovsk multidisciplinary clinical hospital for the provision of psychiatric care» Dnipropetrovsk Regional Council». A total of 150 patients aged 26 to 64 years participated in the study, including 117 (78.0%) men and 33 (22.0%) women. The participants were divided into the main group (101 individuals) and the comparison group (49 individuals). The study employed clinical-anamnestic, clinical-psychopathological, and psychodiagnostic methods, including the Symptom Checklist-90-Revised (SCL-90-R), the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Buss-Durkee Hostility Inventory, the Montreal Cognitive Assessment (MoCA), and the World Health Organization Quality of Life Brief Questionnaire (WHOQOL-BREF). The results indicated that the median levels of depression 13,0 [7,0; 19,0] and anxiety 15,0 [8,0; 22,0] in the total sample and both groups corresponded to a mild severity. Most patients exhibited mild anxiety (60,7%). Depression assessment revealed that the majority of patients either had no depression (28,7%) or presented with mild symptoms (24,0%). The majority of participants had no cognitive impairment (45,3%) or only mild deficits (54,7%). Patients demonstrated normal levels of aggression 19,0 [16,0; 24,0] but exhibited an increased level of hostility 10,0 [8,0; 12,0]. At baseline, mild anxiety and depressive symptoms predominated among patients receiving methadone therapy. Elevated hostility was observed, whereas overall aggression remained within the normative range. Cognitive impairment was absent or mild. These baseline findings may inform the development of differentiated treatment strategies for this cohort.

Ways to reduce complications during open adenomectomy in patients with BPH using modified removable sutures

B. Botalaev, A. Usupbaev, M. Abdykalykov , T. Zhumagaziev , M. Mailubashev — Mon, 29 Sep 2025 00:00:00 +0300

The study was aimed at evaluating the effectiveness of using a modified removable purse-string suture with polyurethane tubing to reduce complications after transvesical adenomectomy in patients with benign prostatic hyperplasia. A total of 60 patients participated in the study. They were distributed into two groups: 30 patients in the main group, where the improved method using a polyurethane tube was used, and 30 patients in the control group, where the standard technique without removable suture was used. The comparison showed that in the main group, the average volume of blood loss in the first 48 hours was 240 [200-280] ml, which was significantly less than in the control group, where it reached 385 [320-450] ml (p<0.05). Furthermore, in patients of the main group, the haemoglobin level on the first day after surgery was higher – 112.3 [103.9-120.7] g/l compared to 104.5 [96.9-112.1] g/l in the control group (p<0.05). This indicated better control of blood loss. The incidence of complications such as bleeding and inflammation was lower in the main group, 6% versus 20% in the control group (p<0.05). Additionally, the level of C-reactive protein on the third day after surgery in the main group was 12.3 [10.1-14.5] mg/l, while in the control group, it was significantly higher – 17.6 [14.1-21.1] mg/l (p<0.05). Thus, the use of removable purse-string suture with polyurethane tube demonstrated its effectiveness in reducing blood loss and complication rate, providing better recovery after surgery in patients with benign prostatic hyperplasia. The findings demonstrate that the use of a modified removable purse-string suture with polyurethane tubing effectively reduces blood loss, enhances haemostasis, and lowers the incidence of postoperative complications in patients undergoing transvesical adenomectomy for benign prostatic hyperplasia. Additionally, this technique contributes to a shorter recovery period and improved haemoglobin levels, indicating better overall postoperative outcomes.

Circadian blood pressure profile in patients with chronic obstructive pulmonary disease and arterial hypertension on baseline therapy

L.I. Konopkina, Ya.O. Dziublyk , A.A. Babets , O.O. Shchudro — Mon, 29 Sep 2025 00:00:00 +0300

The aim of the study was to analyse the effect of a long-acting muscarinic antagonist and an inhaled corticosteroid on the circadian profile, blood pressure (BP) variability, and circadian rhythm disturbances in patients with chronic obstructive pulmonary disease (COPD) and concomitant arterial hypertension, based on ambulatory blood pressure monitoring (ABPM) data during long-term use of these therapies. A total of 86 patients with COPD of GOLD stage II and III (Global Initiative for Chronic Obstructive Lung Disease) and stage II hypertension (men – 67 (77.9%), women – 19 (22.1%), mean age – 62 (56; 74) years) in a stable phase of the disease were examined. All patients received continuous combined antihypertensive therapy, which remained unchanged for at least 6 months. Depending on the degree of bronchial obstruction and the type of inhalation therapy, patients were divided into three subgroups: subgroup 1 included 34 patients with GOLD stage II airflow limitation who received only a bronchodilator (tiotropium bromide 18 μg per day); subgroup 2 included 23 patients with GOLD stage III airflow limitation who received both a bronchodilator (tiotropium bromide 18 μg/day) and an inhaled corticosteroid (ICS) (beclometasone dipropionate 250 μg twice daily); subgroup 3 included 29 patients with GOLD stage III airflow limitation who received only a bronchodilator (tiotropium bromide 18 μg/day), despite indications for combined therapy. All patients achieved target office blood pressure levels (<140/90 mmHg); however, ABPM revealed elevated mean daily blood pressure (>130/80 mmHg) in 60 out of 86 patients (69.8%), predominantly in subgroup 2 (p<0.05). At night, mean diastolic blood pressure in subgroup 2 was 67 (57; 79) mmHg, higher than in subgroup 1 (60 (51; 69) mmHg; p<0.05). Blood pressure variability also increased with severe bronchial obstruction: in subgroup 3, night-time systolic BP variability reached 14 (13; 17) mmHg (p<0.05 vs. other groups). A normal circadian profile (“dipper”) was observed in 25 patients (41.7%), whereas pathological types were recorded in 35 patients (58.3%) – “non-dipper” and “night-peaker” in 33 cases (94.3%) and “over-dipper” in 2 cases (5.7%). Disturbances in nocturnal blood pressure reduction were most frequent in subgroup 2 (p<0.05). Thus, patients with COPD and clinically stable (medically compensated) concomitant hypertension generally exhibit normal office blood pressure values. However, nearly 70% of such patients show elevated night-time blood pressure according to ABPM. Patients receiving ICS for COPD therapy predominantly demonstrate pathological circadian BP patterns (“non-dipper” and “night-peaker”), whereas a normal circadian BP pattern (“dipper”) is more frequent in patients treated with a long-acting muscarinic antagonist as baseline COPD therapy (p<0.05). In patients with COPD and concomitant hypertension, blood pressure should be monitored not only by office measurements but also using ABPM; in cases of ABPM abnormalities, patients require dynamic follow-up by a cardiologist.

Prospects for off-label use of propranolol for the treatment of infantile hemangioma in children

Mon, 29 Sep 2025 00:00:00 +0300

Infantile hemangiomas are the most common benign vascular tumors in infants, with a detection rate of 2-5% in newborns, while among premature infants their incidence reaches 23%. These tumors can vary greatly in size and location, sometimes causing serious complications such as visual, respiratory or bleeding disorders, which significantly impair the quality of life of patients and can lead to long-term consequences. Propranolol in the form of an oral solution has been approved as a first-line treatment for infantile hemangiomas, it has vasoconstrictor and antiangiogenic effects and promotes the induction of apoptosis of tumor endothelial cells, resulting in a significant reduction in hemangioma size and improvement in patient condition. Despite the high incidence of the disease, there are no standardized propranolol medicines for pediatric patients in Ukraine, which greatly complicates treatment and forces doctors to use off-label drugs. This creates risks associated with improper dosage, variability in the concentration of the active ingredient, and possible side effects. The purpose of the study is to analyze the scientific literature on the efficacy and safety of propranolol in the treatment of infantile hemangiomas, as well as to justify the need to develop new dosage forms for pediatrics. To achieve this goal, we analyzed scientific articles, clinical trial data, and the legislative framework, including international guidelines and treatment protocols. The study used methods of analysis, information systematization and genera¬lization.The results of the study show that propranolol is highly effective in the treatment of hemangiomas. Its therapeutic effect is explained by vasoconstrictor, antiangiogenic effects and induction of apoptosis of tumor endothelial cells. According to clinical trials, the standard treatment regimen involves the use of propranolol at a dose of 2-3 mg/kg of body weight per day for six months, which helps to reduce tumor size, low the possibility of complications and improve the quality of life of patients. The development of new, standardized pharmaceutical products for children with propranolol will increase the effectiveness of treatment and minimize side effects, making this issue relevant for both clinical practice and the pharmaceutical industry.

5-Arylidene derivatives of 3-(benzo[d]thiazol-2-ylamino)-2-thioxothiazolidin-4-one as potential antineoplastic agents – in silico evaluation

L.M. Mosula , I.O. Zhmura, V.S. Mosula — Mon, 29 Sep 2025 00:00:00 +0300

Computer modeling and in silico prediction of molecular properties are rational approaches in early Drug Development, facilitating the targeted synthesis. One of the promising scaffold for the Drug Design is the rhodanine cycle due to the possibility of introducing substituents in positions 3 and 5. The aim of the work is to study the spectrum of biological activity of a series of 5-arylidene derivatives of 3-(benzo[d]thiazol-2-ylamino)-2-thioxothiazolidin-4-one, predict the affinity for therapeutic targets and establish their possible affiliation to certain codes according to the Anatomical Therapeutic Chemical Classification System of drugs, and predict possible toxicity of hit compounds via the online services. The investigated series of compounds consists of 21 derivatives. In silico prediction was carried out with the use of the web resources SuperPred 3.0, ProTox 3.0. A wide spectrum of biological activity of the derivatives of the series with a predominant antitumour effect is demonstrated. The group structural similarity of compounds to antineoplastic and immunomodulating agents was established. A high probability of group-level efficacy is predicted for the antitumor therapy targets: Krüppel-like factor 5, Nuclear factor erythroid 2-related factor 2, and DNA-(apurinic/apyrimidinic site) lyase. Compounds 3 ((ethyl (E)-4-(2-(2-((3-(benzo[d]thiazol-2-ylamino)-4-oxo-2-thioxothiazolidin-5-ylidene)methyl)-4-chlorophenoxy)acetamido)benzoate)), 4 ((E)-2-(2-((3-(benzo[d]thiazol-2-ylamino)-4-oxo-2-thioxothiazolidin-5-ylidene)methyl)-4-chlorophenoxy)-N-(4-sulfamoylphenyl)acetamide) and 9 ((E)-2-(2-((3-(benzo[d]thiazol-2-ylamino)-4-oxo-2-thioxothiazolidin-5-ylidene)methyl)-4,6-dimethylphenoxy)acetamide) can be considered as hit compounds. With high predictive model accuracy, their potential impact on the specified targets is 99.43%, 95.88%, and 96.92%, respectively. Compound 3 is a potential multi-hitter. The obtained results confirmed the viability of further in vitro, in vivo research.

Global experience with medical cannabis use: indications and safety profile (literature review)

S.P. Kaidash , V.Yu. Sliesarchuk , K.V. Sokolova, T.M. Potapova — Mon, 29 Sep 2025 00:00:00 +0300

Over the past decades, medical cannabis has received official recognition in more than 40 countries around the world, including Germany, Canada, Italy, and Israel. Medical cannabis is considered a potentially effective remedy for incurable conditions accompanied by pain, spasms, or nausea. Despite its relative safety compared to opioids, the issue of side effects remains relevant. The aim of the study was to systematize information on the main pharmacological properties of medical cannabis and its bioactive components, available dosage forms and medically approved cannabis-based drugs, as well as analyze the evidence base for assessing the effectiveness of medical cannabis in various pathological conditions, taking into account potential risks and safety of use in clinical practice. To achieve the aim of the study, a search for scientific publications was carried out using the queries: medical marijuana, cannabis, cannabinoids, names of medical cannabis drugs, names of cannabinoids in the PubMed, Scopus and Google Scholar databases (2005-2025). 8254 results were obtained for the query. The exclusion criteria were: publications that did not meet the purpose of the review; language of publications (except Ukrainian, English); annotations that did not contain complete information about the results of the studies; publications with closed access. 44 publications were selected for analysis. The article analyzed clinical conditions in which the use of cannabis may be potentially beneficial (mental disorders (post-traumatic stress disorder, anxiety, depression), pain, drug addiction, diseases of the central nervous system and gastrointestinal tract). The safety of medical cannabis is highlighted: risks of addiction, neuro- and cardiotoxicity, psychotic reactions, side effects and features of using by vulnerable groups. Despite the growth of therapeutic use, the evidence base for clinical benefit remains incomplete, and undesirable effects limit its use. The choice of form and route of administration should be adapted to the individual needs of the patient. Thus, the analysis of the literature confirms the significant potential of medical cannabis in the treatment of various diseases, but the safety of its use requires further research.

Impact of digoxin and sodium valproate on the mechanisms of neuroinflammation and neuroapoptosis under experimental epileptogenesis

V.V. Tsyvunin , S.Yu. Shtrygol’, D.V. Lytkin, D.V. Shtrygol’ — Mon, 29 Sep 2025 00:00:00 +0300

Cardiac glycoside digoxin may be an effective adjuvant to classical antiepileptic drugs (AEDs) in the drug-resistant epilepsy treatment. However, the mechanisms of digoxin’s anticonvulsant effect, in particular ability of digoxin itself and its combination with classical AED sodium valproate to influence neuroinflammation as well as counteracting neuronal damage, remains unexplored. Thus, the aim of the study is to elucidate the role of individual markers of neuroinflammation and neuronal apoptosis, in particular interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), interleukin-4 (IL-4), Fas ligand (FasL), heat shock protein 70 (HSP₇₀), 5-lipoxygenase (5-LOX) and nitric oxide synthase (NOS) in the realization of the anticonvulsant potential of digoxin and sodium valproate under experimental epileptogenesis. The model of chronic epileptogenesis, kindling induced pentylenetetrazole (PTZ) in mice, has been used. 40 animals were divided into 5 groups of 8 mice each: vehicle control (receiving solvent – water), positive control (receiving only PTZ), sodium valproate (150 mg/kg intragastrically), digoxin (0.8 mg/kg subcutaneously), and valproate+digoxin combination. Medicines – both per se and in combination – were administered 30 min before PTZ (30 mg/kg intraperitoneally). After 16 days, IL-6, TNF-α, IL-4, FasL, HSP₇₀, 5-LOX and NOS have been identified in the whole brain. It was confirmed that the combination of digoxin with sodium valproate more effectively prevents the development of seizures than monotherapy. It was proven that sodium valproate and digoxin exhibit pronounced anti-inflammatory properties, restoring the content of TNF-α (but not IL-6) and increasing the expression of IL-4, and in combination they also normalize the level of 5-LOX in the brain. Also, digoxin more clearly than sodium valproate counteracts neuroapoptosis and neurodegeneration by affecting FasL and HSP₇₀. Cerebral NOS, however, is not involved in the development of experimental seizures, nor in the anticonvulsant effect of sodium valproate and digoxin. The obtained results expand the understanding of the mechanisms of anticonvulsant action of digoxin and sodium valproate and may be important in the development of new strategies for drug-resistant epilepsy treatment.

A modern view of the lipid hypothesis and the effect of statins on the physiological systems on the human body (literature review)

T.V. Popova , O.G. Rodynskyi , L.D. Skubytska, M.O. Rolduhina, O.V. Mozgunov — Mon, 29 Sep 2025 00:00:00 +0300

The main objective was to determine whether it is always appropriate, according to the lipid hypothesis, to reduce low-density lipoprotein fractions in primary prevention, particularly through the use of statins. Another aim was to update information on the mechanisms of the adverse effects of statins on various physiological systems of the human body. The study analyzed current scientific evidence on the causal relationships between hypercholesterolemia and the risk of cardiovascular diseases (including their impact on patients’ lifespan and quality of life), as well as the consequences of using the most common treatment for this condition – statins. Statins are a group of hypolipidemic drugs whose mechanism of action involves inhibition of the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase), which catalyzes the initial and intermediate stages of cholesterol biosynthesis in the liver. These cholesterol-lowering agents, widely known as statins, are heavily promoted not only for secondary but also for primary prevention of cardiovascular disease (CVD), despite their proven side effects, and in some cases, the risks of their use may outweigh the benefits. The analysis showed that the widespread belief that “elevated cholesterol is the primary cause of cardiovascular disease” is limited, while low cholesterol levels may sometimes pose even greater risks to the body. It is known that statins cause mitochondrial dysfunction and act as mevalonate blockers, promote coronary artery calcification, and inhibit the synthesis of vitamin K2. Statins also interfere with the cardioprotective effects of omega-3 fatty acids and contribute to the development of insulin resistance, while their adverse effects can negatively impact various physiological systems. In conclusion, our findings suggest that in certain patient groups (especially those with low or moderate risk), statin prescription remains debatable. Therefore, we believe that the lipid hypothesis has limitations and requires reconsideration, particularly in the context of primary prevention.

The effect of physical exercise in increasing hypoxia-inducible factor-1 alpha: a systematic review

A. Yulfadinata , N. Ayubi , J.C. Wibawa , A.Z. Rizki, A. Afandi, P.B.D. Jr — Mon, 29 Sep 2025 00:00:00 +0300

The human body during physical exercise triggers various molecular reactions, one of which is the activation of hypoxia-inducible factor-1 alpha (HIF-1α), a transcription factor that plays a role in cellular responses to hypoxic conditions. Hypoxia is a condition in which the body experiences a lack of oxygen. Although it is known that physical exercise can increase HIF-1α expression, until now there is still inconsistency in the results of studies related to the impact of physical exercise on HIF-1α expression.In addition, the underlying mechanism of increased HIF-1α during physical exercise is not fully understood. The lack of a deep understanding of the causal relationship between physical exercise and HIF-1α expression is a challenge in efforts to unravel the underlying mechanisms. Therefore, more systematic studies are needed to evaluate the specific effects of physical exercise on HIF-1α regulation and its impact on physiological adaptation. The aim of this study was to investigate and measure the mechanism of physical exercise on increasing the expression of hypoxia-inducible factor 1-alpha (HIF-1α). Several journal databases, including Embase, Pubmed, Web of Science, and Scopus, were searched for this study. The study considered several criteria, including studies published in the last five years and those related to erythropoietin, physical activity, and HIF-1α. The only papers excluded from inclusion in this analysis were those published in non-reputable journals.Using databases from Embase, Web of Science, Pubmed, and Scopus, a total of 1578 publications were identified. Ten carefully screened and peer-reviewed papers addressed what is needed for this systemic change. The current standard operating procedure for investigations was established using Systematic and Meta-Analysis Preferred Reporting Items (PRISMA). The results of this systemic analysis show that physical exercise has been shown to increase HIF-1α expression. Increased HIF-1α causes the hormone erythropoietin to be secreted and an increase in erythrocytes count which then affects hemoglobin and VO₂max and ultimately increases the athlete's physical performance.

Effectiveness of device for using interactive and cognitive therapy in the rehabilitation of patients with visuospatial neglect due to cerebral stroke during the post-acute rehabilitation period

A.V. Totska , O.B. Nekhanevych , Yu.V. Korota , V.S. Mokhna , V.V. Logvynenko — Mon, 29 Sep 2025 00:00:00 +0300

Despite the successes of modern rehabilitation in acute stroke, the effectiveness of existing methods remains limited in patients with visuospatial neglect (VSN). This encourages the search for new methods of occupational therapy interventions, in particular, taking into account the available interactive devices. The aim of this study was to evaluate the impact of the interactive and cognitive rehabilitation device Myro on the state of cognitive functions, visuospatial perception, fine motor skills, gross upper limb functions and limitations of daily activity in patients with neglect due to stroke during the post-acute rehabilitation period. In the study 46 patients were included, 12 women and 34 men, aged 32 to 86 years (mean age was 62.8(12.8) years). All patients were assessed for their visuospatial perception, cognitive function, motor and sensory functions, and activity limitations at the beginning and the end of rehabilitation. In the first stage, during 2023-2024, 18 patients were included in the control group, who were assigned a standardized rehabilitation program. In the second stage, during 2024-2025, 28 patients participated in the main group, who were assigned an author's occupational therapy program using the Myro interactive and cognitive rehabilitation device. All patients received 3 hours of rehabilitation interventions per day for 14 days. The use of the program with an interactive device showed greater effectiveness in restoring gross motor functions of the upper limb, in particular 2.1 times better according to the results of the “Box and Blocks” test (p<0.05), to significantly greater dynamics according to the Barthel Index level (3.3 times, p<0.05). In addition, in the main group, signs of VSN were 27.1% less common at the end of therapy (p<0.05). However, after completing the rehabilitation course there weren’t the advantages of the author's program in terms of the effectiveness of improving cognitive function according to the Montreal Cognitive Test, functioning of the upper limb according to the Fugl-Meyer scale, as well as in terms of restoring fine motor skills of the upper limb according to the “9 pegs” test (p>0.05). Thus, the use of the interactive and cognitive rehabilitation device Myro has shown its effectiveness for the treatment of symptoms of VSN, recovery of gross motor functions and limitations of daily functioning in patients with the consequences of cerebral stroke. However, there is no convincing data on the superior effectiveness of this technique in patients with impaired fine motor skills of the upper limb and cognitive impairment compared to the standard program.

Effectiveness of immunosuppressive therapy in children with autoimmune hepatitis and autoimmune sclerosing cholangitis

M.B. Dyba, V.S. Berezenko, O.M. Tkalyk , Kh.Z. Dmytrenko — Mon, 29 Sep 2025 00:00:00 +0300

Autoimmune liver diseases in children, particularly autoimmune hepatitis and autoimmune sclerosing cholangitis, represent a challenging clinical issue due to their variable clinical course, diagnostic complexity, and suboptimal therapeutic efficacy. Despite common pathogenetic mechanisms, including impaired immune regulation, association with class II major histocompatibility complex molecules, chronic inflammation, and fibrosis, these conditions differ significantly in clinical presentation, treatment response, and prognosis. The incidence of autoimmune hepatitis in children is 3-6 cases per 100,000, whereas autoimmune sclerosing cholangitis is rarer, diagnosed in 0.2-1.5 cases per 100,000 children. The primary therapeutic goal is achieving biochemical remission and preventing fibrosis progression. A lack of biochemical improvement within the first 6–12 months of treatment is associated with poorer outcomes; however, clear algorithms for intensifying therapy have not yet been established. Standardizing biochemical markers for assessing treatment effectiveness remains a relevant issue. The aim of this study was to perform a comparative analysis of immunosuppressive therapy effectiveness in children with autoimmune hepatitis and autoimmune sclerosing cholangitis based on the evaluation of biochemical response rates. We conducted a retrospective analysis of immunosuppressive therapy effectiveness during the first 12 months in children and adolescents with autoimmune liver diseases treated in the pediatric hepatology department for 2016 to 2024. Two groups were formed: group 1 – autoimmune hepatitis (n=84), and group 2 – autoimmune sclerosing cholangitis (n=38). At disease onset, children in group 2 exhibited higher gamma-glutamyltransferase levels (p=0.003) and more frequently had inflammatory bowel disease (68% vs. 9.5%, p<0.0001). Early biochemical response was achieved in 4 weeks of therapy in 86% of group 1 and 82% of group 2, respectively (p>0.05). In 6 months, complete biochemical response was observed in 50% of group 1 and 32% of group 2 (p=0.07). In 12 months, complete response rates were 73% and 47%, respectively (p=0.007). Elastography indicated a significant decrease in liver stiffness in both groups (p<0.0001 and p=0.002, respectively). Thus, children with autoimmune sclerosing cholangitis demonstrate significantly lower efficacy of immunosuppressive therapy within the first 12 months compared to autoimmune hepatitis. Liver stiffness measurement by elastography may serve as an additional objective criterion for evaluating treatment effectiveness.