"Восточноукраинский медицинский журнал" - рецензированный журнал, в котором печатаются оригинальные статьи, охватывающие вопросы современной экспериментальной и клинической медицины.
CLINICAL MANAGEMENT AND REHABILITATION STRATEGY FOR WRESTLERS WITH PRE-EXISTING POST-TRAUMATIC GONARTHROSIS IN THE POST-ACUTE REHABILITATION PHASE AFTER RE-INJURY OR SURGICAL INTERVENTION
Introduction. Post-traumatic knee osteoarthritis in combat sports athletes is characterized by an aggressive clinical course due to constant axial and rotational overloads. Traditional rehabilitation approaches often neglect the specificity of the autonomic status and neuromuscular control in the post-acute period, leading to early disability. The study aimed to trace the dynamics of functional and structural changes in wrestlers with PTOA under the influence of the developed "Wrestle-Knee Rehab" clinical management strategy. Material and methods. A prospective study involved 32 wrestlers aged 22–35 with verified Stage I–II PTOA. The 8-week rehabilitation program was based on the International Classification of Functioning, Disability and Health (ICF) architecture and included four stages: immobilization, early and late post-immobilization, and pre-training. Assessment was performed using high-frequency ultrasonography, goniometry, the Lovett scale, and KOOS and WOMAC questionnaires. Statistical analysis was conducted using Wilcoxon and Spearman criteria (p<0.05). Results. The implementation of the strategy allowed for the elimination of active extension deficit (p < 0.01) and restoration of flexion range to 142.3°. Ultrasound monitoring showed regression of synovitis (reduction of effusion from 8.5 mm to<1.5 mm) and an increase in hyaline cartilage thickness from 1.8 mm to 2.2 mm. Muscle strength on the Lovett scale increased from 0.58 to 4.48. The most significant improvement on the KOOS scale was recorded in the “Sport and Recreation” subscale (from 22.4 to 79.8 points), indicating the restoration of the specific motor stereotype. Conclusions. It has been proven that the combination of structural damage and proprioceptive deficit necessitates active clinical management specifically during the post-acute period. The implementation of a four-stage rehabilitation program ensured the complete elimination of extension deficit and the attainment of physiological range of motion. A significant increase in muscle strength on the Lovett scale, alongside a decrease in the WOMAC index, confirmed the restoration of neuromuscular control. The most substantial improvement in KOOS scores within the «Sport and Recreation» domain verified the wrestlers’ readiness for a safe return to professional sports.
Copyright (c) 2026 Yuliia Tonkopei, Tetiana Buhaienko, Serhii Lazorenko, Iuliia Shevchuk, Tetiana Kozhemiako, Sofiia Torhach https://creativecommons.org/licenses/by/4.0
EFFECT OF DAYLIGHT EXPOSURE ON GLYCEMIC CONTROL IN ELDERLY PATIENTS WITH 2 TYPE DIABETES. LITERATURE REVIEW
Type 2 diabetes mellitus (T2DM) is highly prevalent among older adults, and optimal glycemic control remains essential for preventing complications. Increasing evidence highlights the role of circadian rhythms and environmental factors, particularly light exposure, in glucose metabolism. Natural daylight acts as a key regulator of circadian function, whereas disruption of the light–dark cycle, especially artificial light at night, contributes to insulin resistance and impaired glycemic control. Aim of the study: to analyze current scientific evidence on the impact of natural daylight exposure on glycemic control in elderly patients with type 2 diabetes mellitus and to identify potential mechanisms underlying this effect. Object of the study: metabolic and circadian mechanisms of glycemic regulation in elderly patients with type 2 diabetes mellitus under conditions of varying exposure to natural and artificial lighting. Results: This review summarizes current clinical, experimental, and epidemiological data on the impact of light exposure on metabolic regulation in elderly patients with T2DM. Adequate daytime exposure to natural light is associated with improved glycemic control, increased time in target range, and reduced glucose variability. In contrast, nocturnal light exposure disrupts circadian regulation, suppresses melatonin, and increases the risk of metabolic disturbances. Recent studies, including randomized and large-scale epidemiological analyses, confirm that light environment significantly influences glucose homeostasis. Conclusions Circadian rhythms and light exposure are important regulators of glucose metabolism. Adequate exposure to natural daylight contributes to improved glycemic control in patients with type 2 diabetes mellitus. Excessive artificial light exposure during nighttime disrupts circadian regulation and is associated with an increased risk of insulin resistance and diabetes development. Optimization of the light–dark cycle may be considered a promising non-pharmacological component of comprehensive T2DM management in elderly patients. Further clinical studies are required to determine the optimal duration and intensity of light exposure for improving metabolic outcomes.
Copyright (c) 2026 Anna Garnytska, Olga Orlyk, Maryna Kochuieva, Valentyna Psarova https://creativecommons.org/licenses/by/4.0
COVID-19, LIPID PROFILE DISORDERS, RENIN-ANGIOTENSIN-ALDOSTERON SYSTEM IMBALANCE: PECULIARITIES OF PATHOGENESIS AND TREATMENT (LITERATURE REVIEW)
Objective: The present study aimed to determine the peculiarities of pathogenesis and treatment of patients with lipid profile disorders, renin-angiotensin-aldosteron system imbalance and coexistent COVID-19. Materials and methods. Articles published in 2020-2025 in the PubMed, Scopus, and Google Scholar electronic databases were analyzed. The limitations of the review are narrative character of the work, different type and design of analyzed publications, parameters of the patients, the presence of conflicting results regarding to the effectiveness of individual therapeutic approaches. Results and discussion. The connection between severe acute respiratory syndrome coronavirus 2 and angiotensin-converting enzyme 2 leads to the inactivation of this enzyme, increased vasoconstriction and progression of arterial hypertension. The increased levels of serum amyloid A in patients with COVID-19 displace ApoA-I situated on high density lipoprotein, which leads to the impairment of reverse cholesterol transport, disorders of endothelium and promotion of oxidative stress. Prescription of rosuvastatin is considered for patients with COVID-19 if it is indicated because of antiinflammotory properties, protection of endothelial cells and further reduction the risk of hospitalization and mortality. Evidence suggests that prolongation of treatment with rosuvastatin is effective for people which have received it before because of lipid profile disorders, coexistent ischemic heart disease, heart failure or increased cardiovascular risk. The continuation of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ramipril, losartan, valsartan) prescribed previously for treatment of arterial hypertension, heart failure, coexistent lipid profile disorders during hospitalization in patients with COVID-19 as associated with decreased mortality. Not all clinical trials suggested the improvement of clinical outcomes and mortality rate after using statins and renin-angiotensin-aldosteron system inhibitors. Conclusions. Management with rosuvastatin, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers prescribed previously because of arterial hypertension, lipid profile disorders, heart failure, ischemic heart disease and increased cardiovascular risk may be beneficial to continua or initiation treatment with those drugs at first in patients with COVID-19 if contraindications are absent because these changes become more severe in the case of such comorbidity for achievement the goal ranges of blood pressure and low density lipoproteins, improvement of endothelial function, reduction the progression of oxidative stress, decrease mortality and prevention of cardiovascular complications.
Copyright (c) 2026 Olha Chernatska, Victoriіa Hula, Marina Lytvynets, Olexandra Kotkova https://creativecommons.org/licenses/by/4.0
ANTIMICROBIAL ENHANCEMENT OF GLASS IONOMER CEMENT WITH PHYTOMEDICINE
Background: Glass ionomer cement (GIC) is widely used in restorative dentistry because of its ability to release fluoride, its compatibility with biological tissues, and its chemical bonding with tooth structures. However, its inherently limited antimicrobial properties make restorations susceptible to bacterial growth and the development of secondary cavities. The integration of phytomedicines – bioactive compounds derived from plants – has been identified as a promising approach to boost the antimicrobial capabilities of GIC while maintaining its mechanical integrity. Aim: This review aims to explore and synthesize current evidence on the modification of Glass Ionomer Cement with phytomedicinal agents. Methods: Literature search was conducted using electronic databases including PubMed and Google Scholar, focusing on articles published in the English language between 2014 and 2024. Only in vitro studies evaluating antibacterial activity as a primary outcome were included, while mechanical properties were considered when reported alongside antimicrobial testing. This review collected evidence from in vitro studies evaluating GIC modified with herbal extracts such as Azadirachta indica (neem), Curcuma longa (turmeric), Thymus vulgaris (thyme), Triphala, propolis, Salvadora persica (miswak), and Acacia nilotica (babool). The antibacterial activity against cariogenic microorganisms, primarily Streptococcus mutans and Lactobacillus species, and compressive strength were assessed. Results: Most modified GIC formulations demonstrated enhanced antibacterial activity with surface antimicrobial characteristics compared with conventional GIC. Several studies also reported preserved or improved compressive strength at optimal extract concentrations. Conclusion: Phytomedicine-infused GIC shows promise as a biocompatible and cost-effective restorative material. However, further standardization and in vivo studies are required to validate clinical efficacy and safety.
Copyright (c) 2026 Anwesha Mishra, Gunjan Kumar, Ipseeta Menon, Arpita Singh, Kabir Suman Dash, Asheerbad Swain https://creativecommons.org/licenses/by/4.0
THE IMPACT OF SYMMETRICAL VS. ASYMMETRICAL THERAPEUTIC EXERCISES ON POSTURAL ALIGNMENT AND TRUNK MUSCLE ENDURANCE IN CHILDREN WITH MILD SCOLIOSIS
Introduction. Scientific research has proven that therapeutic exercises provide an opportunity to achieve significant success in physical therapy for scoliosis in children. Both symmetrical and asymmetrical therapeutic exercises are used in rehabilitation interventions. In Ukraine, the rehabilitation package of the National Health Service of Ukraine (NHSU) provides physical therapy services for children with mild scoliosis (1-2 degree) for two weeks. However, the question of the impact of different types of therapeutic exercises in a two-week physical therapy programme remains open. Aim. This study aims to determine the effect of symmetrical and asymmetrical exercises on posture and strength of the abdominal muscles and back extensor strength in 10-12 year old children with mild scoliosis during a two-week physical therapy programme according to the NHS rehabilitation package. Materials and methods. The study included 25 patients aged 10-12 years, including 12 boys and 13 girls with diagnosed degenerative-dystrophic changes of the spine, namely S-shaped thoracolumbar scoliosis of the 2nd degree with different curvature angles (from 10 to 25° according to Cobb) or mild degree. All patients were divided into 2 groups, regardless of age and gender: a group of 11 people who participated in a physical therapy programme based on symmetrical therapeutic exercises, group training; a group of 14 people who participated in a physical therapy programme based on asymmetrical therapeutic exercises, individual training. At the beginning and at the end of the study, a survey was conducted, which included: New York Posture Rating Chart (NYPR) to assess posture in the frontal and sagittal planes, Adams test to assess posture in the horizontal plane, standardised functional tests to assess abdominal muscle strength and back extensor strength, height and weight measurements, and BMI calculation. An X-ray examination of the spine with the calculation of Cobb's angle and Risser's test score was performed only at the beginning of the study. The STATISTICA 6.0 software package was used for statistical processing of the study results. The probability level was taken as p < 0.05. Results. There is a decrease in postural asymmetry and an increase in functional endurance of the abdominal muscle strength and back extensor strength, regardless of gender and physical therapy programme, which confirms the success of different types and forms of therapeutic exercises to stabilise the muscular corset and reduce postural asymmetry. It should be noted that the SymG group showed more positive, but not significant, dynamics of functional indicators, but the only indicator, namely the NYPR posture score, was significantly improved in the AsymG. Conclusions. The use of an individual approach and asymmetrical exercises has a significantly better effect on postural symmetry, which indicates the feasibility of personalised development of physical therapy programmes for patients with more severe deformities of the posture and spine.
Copyright (c) 2026 Olha Yezhova, Viktoria Lohynova, Tetiana Baryshok https://creativecommons.org/licenses/by/4.0
CLINICAL CHARACTERISTICS OF BONE DEFECTS IN PERIPROSTHETIC INFECTION OF THE HIP JOINT
The purpose of this analysis was to describe and characterize bone defects that were detected in patients of the observation array to unify the diagnostic algorithm, which will allow comparing the effectiveness of two-stage tactics of treating periprosthetic infection in different groups of patients. Materials and methods: A prospective array was formed, which included 117 patients, who were divided into 2 groups. To the first experimental group, we assigned 53 patients with early (up to 4 weeks) onset of the infectious process after primary hip arthroplasty. To the second group, 42 cases of late manifestation of periprosthetic infection were assigned. Results: The absence of bone defect or type I was significantly more common among patients with early development of periprosthetic infection, which was detected in 66.0% of patients and in 35.7% of patients with late development of periprosthetic infection. All types of type II defects were more common in patients with late development of periprosthetic infection, which was found in 52.4% of cases, in contrast to patients with early manifestation of periprosthetic infection, where this type was found in 33.9% of cases. Both types of type III bone defects were found only among patients with late periprosthetic infection, which was found in 11.9% of cases and were not found among patients with early manifestation of infectious prosthesis. Absence or type I bone defect was observed in most patients with early periprosthetic infection, which was found in 84.9% of cases and in most patients with late periprosthetic infection in 73.8% of cases. The distribution of type II bone defects of the hip was uniform in the observation groups, which indicates the absence of the influence of time determinants in the development of this type of bone defect. In the early stages of periprosthetic infection development, there are no severe types of bone defects, however, in patients with late manifestation, these defects were detected in 11.9% of cases. Conclusions: Different types of bone defects are characteristic of different periods of periprosthetic infection. Early manifestations of periprosthetic infection are characterized by either the absence of bone defects or the first type of them. The distribution of type II bone defects of the thigh was uniform in the observation groups, which indicates the absence of the influence of time determinants in the development of this type of bone defect.
Copyright (c) 2026 Pavlo Tanasiienko, Gennadiy Kolov, Roman Kozak https://creativecommons.org/licenses/by/4.0
CLINICAL OUTCOMES AND AN ALGORITHM FOR SOFT-TISSUE COVERAGE AFTER ARTERIAL RECONSTRUCTION IN COMBAT-RELATED EXTREMITY VASCULAR INJURIES
Introduction. Extremity vascular injuries represent one of the most challenging forms of combat trauma due to the combination of acute limb ischemia, extensive soft-tissue destruction, and a high risk of infectious and hemorrhagic complications. Adequate soft-tissue coverage of the arterial reconstruction zone is therefore a critical factor in preventing postoperative complications. However, clear criteria for selecting the optimal reconstructive strategy remain insufficiently defined. Objective. To evaluate the clinical outcomes of different methods of soft-tissue defect closure in the area of arterial reconstruction after combat vascular trauma and to develop an algorithm for selecting the optimal coverage strategy based on defect size and the risk of postoperative complications. Methods. A retrospective analysis was performed on 85 servicemen with combat-related injuries to major extremity vessels treated at the Clinic of Vascular Surgery of the National Military Medical Clinical Center “Main Military Clinical Hospital” (Kyiv) in 2022. NPWT was used in 69 patients (81.2%) as a preparatory stage before definitive wound closure. Definitive closure techniques included primary closure, split-thickness skin grafting (STSG), flap coverage, or secondary healing. The incidence of erosive bleeding, reconstruction thrombosis, and secondary amputations was assessed, along with the timing of complications, defect size, and the number of NPWT sessions. Results. Primary closure was performed in 64 cases (75.3%), STSG in 14 (16.5%), flap coverage in 4 (4.7%), and secondary healing in 3 (3.5%). Erosive bleeding occurred in 9 patients (13.0%) with a median onset of 18 days (range 6–29 days). Two periods of increased risk were identified: days 7–10 (predominantly mechanical factors) and days 18–30 (infection-related tissue necrosis). Thrombosis of vascular reconstruction occurred in 6 patients (8.7%), all following primary closure. Secondary amputations were performed in 2 cases (2.9%). The mean defect size was approximately 15 × 20 cm in patients with erosive bleeding and 8 × 9 cm in those with thrombosis. The maximal linear dimension of the defect was used for stratification of surgical strategy. Among patients treated with NPWT, the number of sessions was higher in those who developed erosive bleeding (6–7 vs 2–3 in patients without bleeding). Conclusions. The size of the soft-tissue defect in the arterial reconstruction zone is a key determinant of postoperative complications and should guide the choice of definitive wound closure. Large defects (>15 cm) are associated with an increased risk of erosive bleeding, whereas primary closure in smaller defects may predispose to reconstruction thrombosis. Early stable vascularized soft-tissue coverage represents a pathogenetically justified preventive strategy in patients with extensive contaminated wounds. The proposed algorithm may assist in selecting the optimal reconstructive strategy in combat-related extremity vascular injuries
Copyright (c) 2026 Iurii Sivash, Kostyantyn Gumeniuk https://creativecommons.org/licenses/by/4.0
AGE-RELATED CLINICAL AND HEMODYNAMIC FEATURES OF THE EARLY POSTOPERATIVE PERIOD IN CHILDREN AFTER CONGENITAL HEART DEFECT REPAIR
Introduction. Congenital heart defects (CHDs) remain a major cause of pediatric cardiac surgery worldwide. Despite advances in surgical techniques and perioperative care, the early postoperative period remains variable and may depend on patient age, CHD characteristics, and postoperative adaptation. Objective. To evaluate age-related features of the early postoperative period in children after surgical correction of congenital heart defects and their association with CHD structure and postoperative adaptation. Materials and Methods. This retrospective single-center study included 206 children aged 0–14 years who underwent CHD repair between 2015 and 2024. Patients were divided into five age groups: neonates, infants, children aged 1–3 years, 3–7 years, and 7–14 years. Clinical, laboratory, and echocardiographic parameters were assessed during the early postoperative period. Statistical analysis included descriptive statistics, one-way ANOVA, and χ² testing. Results. Significant age-related differences were observed in hospitalization duration, heart rate, extracardiac comorbidity, and CHD structure. Neonates had the longest hospital stay, the highest prevalence of extracardiac comorbidity, and the greatest proportion of complex CHDs. Laboratory parameters were generally comparable between age groups and reflected a common postoperative inflammatory response. Echocardiography revealed more frequent right ventricular dilatation and pulmonary hypertension in younger patients. The distribution of CHD types differed significantly across age groups and appeared to influence postoperative adaptation. The observed differences were associated not only with age but also with CHD complexity, baseline clinical status, and perioperative factors. Conclusions. The early postoperative period after CHD repair demonstrates clinically relevant age-related characteristics. Neonates represent the most vulnerable patient group, whereas older children generally show a more stable postoperative course. These findings should be interpreted as reflecting the combined influence of age, CHD structure, extracardiac comorbidity, and postoperative adaptation rather than an independent effect of age alone.
Copyright (c) 2026 Mykhailo Kashtalian, Maryna Melnychenko, Volodymyr Buzovskyi, Yevhen Kvasnevskyi https://creativecommons.org/licenses/by/4.0
MORPHOLOGICAL VARIATION OF KNEE JOINTS IN DEGENERATIVE-DYSTROPHIC DISEASES
Introduction. Structural differences in knee joints associated with sex, height, body weight, individual characteristics and ethnic origin have been confirmed by numerous studies. However, the issue of segmenting a heterogeneous population of patients with degenerative-dystrophic knee joint diseases remains unresolved. Understanding the morphological variability of knee joints may contribute to improving orthopedic intervention techniques in line with the principles of personalized surgery and enhancing clinical outcomes in patients with degenerative-dystrophic knee conditions. Aim: To characterize the prevalence of morphological variants of the knee joint in patients with degenerative-dystrophic diseases, based on a modified Coronal Plane Alignment of the Knee (CPAK) classification and a custom clustering system. Materials and Methods. Radiographic examination of 100 cases of degenerative medial knee joint disease were analyzed. The average age was 63.56±8.10 years. The structural variants of the knee joint were assessed using a modified CPAK classification and a custom clustering system. Based on the clustering of morphometric indicators, morphotype I was identified in 21 patients (21.00 %), morphotype II in 38 patients (38.00 %), morphotype III in 29 patients (29.00 %), and morphotype IV in 12 patients (12.00 %). Statistical analysis was conducted using Statistica 13 software, with a significance level set at p≤0.05. Results. The mean value of the modified joint line orientation (mJLO) in the examined patients was 174.28±5.20°, and the mean arithmetic hip-knee-ankle angle (aHKA) was 0.19±4.74°, indicating a predominantly distal orientation of the joint line and neutral lower limb alignment in patients with degenerative-dystrophic knee diseases. A distal apex of the joint line was observed in 72 patients (72.00 %), a neutral position in 25 patients (25.00 %), and a proximal position in 3 individuals (3.00 %). aHKA values < -2° were recorded in 35 patients (35.00 %), values within ±2° in 41 patients (41.00 %), and values > 2° in 24 patients (24.00%). According to the modified CPAK classification, the most common knee joint types were type I (30.00 %), type II (28.00 %), and type III (14.00 %). Conclusion. The study confirmed the morphological variability of knee joints in degenerative-dystrophic diseases.
Copyright (c) 2026 Liubov Kylymniuk, Maksym Matsipura, Stanislav Iaremyn https://creativecommons.org/licenses/by/4.0
CONSERVATIVE VERSUS RADICAL TREATMENT OF ASCENDING AORTIC DILATION: COMPARATIVE ANALYSIS OF BASELINE CLINICAL DATA FOLLOWING WRAPPING, NO-TOUCH SURGICAL AORTIC VALVE REPLACEMENT, AND THE WHEAT PROCEDURE
Background: The optimal management of ascending aortic dilation in patients undergoing aortic valve replacement (AVR) remains debated. Although replacement of the ascending aorta is widely considered the standard, conservative strategies such as wrapping are still used in selected patients. Objective: This study aimed to analyze baseline characteristics and etiological patterns in patients treated with wrapping, supracoronary replacement (Wheat procedure), or isolated AVR without intervention on the ascending aorta. Methods: This retrospective, single-center analysis included 120 patients who underwent AVR in the presence of ascending aortic dilation (>40 mm) between 2016 and 2024. Patients with connective tissue disorders, prior aortic surgery, or acute aortic syndromes were excluded. After propensity score matching, 40 patients were assigned to each group: AVR with wrapping, Wheat procedure, and no-touch AVR. Demographic, clinical, and echocardiographic data were compared to identify factors associated with aortic dilation. Results: Patients in the No-touch group were significantly older (69.5 ± 5.2 years) compared with the Wheat (51.2 ± 13.7 years) and Wrapping (50.4 ± 13.3 years) groups (p < 0.001). Bicuspid valve morphology predominated in the Wheat (72.5%) and Wrapping (62.5%) groups, while tricuspid valves were most frequent in the No-touch group (80%; p < 0.001). Ascending aortic diameters were larger in the Wheat and Wrapping groups compared with No-touch (p < 0.001). The No-touch cohort showed more advanced ventricular remodeling, higher rates of left ventricular dilation, reduced ejection fraction, and increased pulmonary pressures. Neurological events and preoperative atrial fibrillation were also more common. Conclusion: Distinct etiological profiles exist among patients with ascending aortic dilation undergoing AVR. Wrapping and replacement were used mainly in younger patients with bicuspid valves and larger diameters, whereas the no-touch strategy was applied in older patients with tricuspid valves and ventricular dysfunction. These findings support individualized treatment based on valve phenotype, age, and etiology.
Copyright (c) 2026 Oleh Zelenchuk, Illia Nechai, Igor Mokryk, Ihor Stetsyuk, Vitaly Demyanchuk, Borys Todurov https://creativecommons.org/licenses/by/4.0
MECKEL’S DIVERTICULUM AS A CAUSE OF ACUTE STRANGULATED SMALL BOWEL OBSTRUCTION (A CASE REPORT)
Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract. One of its rare and potentially life-threatening complications is strangulated small bowel obstruction caused by a mesodiverticular band, which may lead to intestinal ischemia and necrosis. Objective. To present a clinical case of acute strangulated small bowel obstruction caused by a mesodiverticular band of Meckel’s diverticulum and to analyze diagnostic and surgical management features. Materials and Methods. A clinical case of a 26-year-old patient admitted with signs of acute mechanical bowel obstruction is described. Diagnosis was based on clinical findings, abdominal radiography, and intraoperative assessment. Results. During surgery, Meckel’s diverticulum connected to the mesentery of the small intestine by a fibrous mesodiverticular band was identified. The band caused torsion of the ileum with strangulated small bowel obstruction. No signs of bowel ischemia were detected. After division of the band, bowel passage was restored. Due to the small size of the diverticulum and absence of inflammatory changes, diverticular peritonization without bowel resection was performed. The postoperative period was uneventful. Conclusions. Strangulated small bowel obstruction caused by a mesodiverticular band of Meckel’s diverticulum is a rare condition with nonspecific clinical manifestations. Timely surgical intervention helps prevent bowel ischemia and allows organ-preserving treatment.
Copyright (c) 2026 Ihor Duzhyi, Serhii Metynskyi, Oleh Lamakh, Oleksandr Kurochkin, Vitalii Lohutov https://creativecommons.org/licenses/by/4.0
THE ROLE OF LIQUID BIOPSY IN THE DIAGNOSIS OF ENDOMETRIAL CANCER: A BIBLIOMETRIC ANALYSIS
Background. Liquid biopsy has emerged as one of the most promising approaches in modern oncological diagnostics, enabling the detection of tumor-derived components in biological fluids using minimally invasive methods. In recent years, this technique has attracted increasing attention in gynecologic oncology, particularly in the study of endometrial cancer. Aim. Perform a bibliometric analysis of scientific publications dedicated to the application of liquid biopsy in endometrial cancer research. Materials and methods. The analysis was conducted using the Scopus database and covered publications from 1956 to January 30, 2026. Results. In total, 736 relevant documents were identified and analyzed. Bibliometric visualization and network analysis were performed using the software VOSviewer. The results demonstrated a significant increase in publications after 2016, indicating growing scientific interest in the clinical potential of liquid biopsy for cancer diagnostics and monitoring. Geographic analysis revealed that the largest contributions to this field come from China and the United States, followed by several European countries. Subject-area analysis showed a strong interdisciplinary nature to the research, with medicine, biochemistry, chemistry, computer science, and chemical engineering being the most represented disciplines. Cluster analysis identified four major research directions: oncology, gynecologic oncology, molecular biology, and diagnostic technologies. Chronological analysis revealed a gradual shift in research focus from traditional clinical diagnostic approaches to molecular and integrative technologies involving circulating tumor DNA, microRNA, and exosomes. gies involving circulating tumor DNA, microRNA, and exosomes. Conclusions. The results confirm the growing scientific and clinical importance of liquid biopsy as a promising tool for early detection, monitoring, and personalized management of endometrial cancer.
Copyright (c) 2026 Nataliia Hyriavenko, Roman Moskalenko, Liudmyla Kiptenko https://creativecommons.org/licenses/by/4.0
COMORBIDITY OF DIABETIC RETINOPATHY AND METABOLICALLY ASSOCIATED STEATOTIC LIVER DISEASE
A personalized approach to the early diagnosis and prevention of diabetic retinopathy (DR) in patients with diabetes mellitus (DM) is currently a significant issue that requires investigation of comorbid effects, in particular in metabolic-associated steatotic liver disease (MASLD). This is due to the increase in the incidence of diabetes and complications, such as diabetic retinopathy, which significantly reduces the quality of life and often leads to blindness. Objective: to study the characteristics of the development and course of DR in patients with type 2 diabetes and MASLD. Materials and methods: The study included 62 patients with type 2 diabetes mellitus with DR. Patients were divided into two groups: I - patients with DR and MASLD and II - DR without liver pathology. In addition to general clinical and biochemical tests, all patients were determined by the NOMA index, BMI and liver fibrosis index. Anamnestic data on the occurrence and progression of DM, DR and MASLD were analyzed in detail. Elastography and optical coherence tomography were performed. Results. Nonproliferative diabetic retinopathy was more common than proliferative in both groups, but the degree of damage and the rate of its progression were higher (p<0.001) in patients in the first group. Proliferative diabetic retinopathy was detected with a higher frequency in patients with MASLD. Patients with proliferative DR in both groups had a worse level of diabetes compensation and a higher liver fibrosis index compared to patients with nonproliferative DR. A direct correlation was found between the rate of progression of DR and the level of liver fibrosis in patients with MASLD. Conclusions. The results of the study confirm the comorbidity of MASLD and DR in patients with type 2 diabetes. A direct correlation was found between the degree of liver fibrosis and the rate of progression of DR. Therefore, MASLD screening with determination of the level of fibrosis in patients with type 2 diabetes can be used as one of the markers of the development and progression of DR.
Copyright (c) 2026 Rimma Skrypnyk, Bogdan Kozak https://creativecommons.org/licenses/by/4.0
ROSACEA AND CHRONIC VENOUS DISEASE: COMORBIDITY PATTERNS AND HEREDITARY RISK
Introduction. The pathophysiology of rosacea is driven by complex interactions involving dysregulation of the immune system, neurogenic inflammation, and vascular hyperreactivity. Parallel to this, the hallmark of chronic venous disease (CVD) pathophysiology likely remains in inflammation, possibly triggered by sustained venous hypertension and valvular incompetence. No reliable epidemiological data on comorbidity rosacea with CVD were found in the literature. The aim was to study the comorbidity of rosacea with chronic venous disease and to determine the impact of positive rosacea and chronic venous disease family anamnesis as risk factors for rosacea using the logistic regression model with the goals of sustainable development, namely, ensuring good health and well-being. Materials and Methods. A total of 245 individuals were enrolled in the study and allocated between two groups. Rosacea Group included 141 patients who were eligible diagnostic criteria for rosacea [5]. Control Group included 104 participants who have been consulting by a GPs about a healthy lifestyle and had no clinical signs of the Rosacea disease. The mean age of patients in the Control Group was 45.84 ± 14.47 years, in the Rosacea Group it was 44.46 ± 11.26 years. No statistically significant difference was found between the groups (Welch t = 0.806; df = 188; p = 0.421). These findings indicate that age distribution was comparable in both cohorts. To proof the evidence of comorbidity Rosacea with Chronic Venous Disease we assess potential risk factors for the development of rosacea, the presence of Chronic Venous Disease (CVD), rosacea family history (positive family history of rosacea), and CVD family history (positive family history of CVD) were analyzed. Statistical data analysis was performed using the free software JASP (Version XX, University of Amsterdam, Netherlands). Descriptive statistics were used to assess the age characteristics of the sample; the Bayesian Binomial Test was used to assess the frequency of clinical signs and anamnestic factors; and the Binary Logistic Regression method was used to calculate the association between risk factors and the probability of developing rosacea. Results and Discussion. It was found that CVD was detected in 40.8% of patients (n=100), a positive family history of rosacea was identified in 26.9% of patients (n=66), and a positive family history of CVD in 23.3% (n=57) of respondents. Regression analysis demonstrated statistically significant associations between rosacea and all investigated predictors. The presence of CVD was associated with substantially increased odds of rosacea development (OR = 3.570; 95% CI: 1.987–6.417; p < 0.001). Family history of rosacea showed the strongest relationship with disease occurrence (OR = 4.399; 95% CI: 2.172–8.909; p < 0.001). This observation indicates a pronounced hereditary component in rosacea susceptibility. A positive family history of Chronic Venous Disease was also independently associated with rosacea (OR = 2.342; 95% CI: 1.189–4.615; p = 0.014). Numerous scientific researches on the comorbidity of rosacea emphasise the significance of this disease and do not limit rosacea only to skin manifestations, considering it within the framework of the exposome theory. Our data confirm the influence of genetic and epigenetic factors (family health history, positive with rosacea or CVD, concomitant rosacea with CVD) on the incidence of rosacea, which can be used in clinical practice for making prognosis and prescribing appropriate treatment with the goals of sustainable development, namely, ensuring good health and well-being.
Copyright (c) 2026 Sultan Zuhair Ali Asiri, Oksana Melekhovets, Mariia Lobatiuk, Iurii Melekhovets https://creativecommons.org/licenses/by/4.0
MORPHOMETRIC CHARACTERISTICS OF THE VASTUS LATERALIS MUSCLE OF THE QUADRICEPS GROUP OF THE THIGH ACCORDING TO ULTRASOUND RESEARCH
The structure and distribution of muscles play a central role in determining athletic performance, especially in sports involving speed and strength. Objective: To determine the volume of the vastus lateralis muscle (part of the quadriceps femoris) in relation to sports orientation and selection for professional football. Materials and Methods: A total of 48 young men were studied, including 16 players from the Ukrainian professional football team “Universytet” (Chernivtsi), 16 first- and second-year students of the Faculty of Physical Culture, Sports and Rehabilitation at Yuriy Fedkovych Chernivtsi National University, and 16 first- and second-year medical students of Bukovinian State Medical University. All participants underwent morphometric assessment using ultrasound imaging of the vastus lateralis muscle of the quadriceps femoris. Measurements included length, width, and depth. Results: In the upper third of the muscle, the volume in professional football players was 14.3% greater than in students attending football training and 39.3% greater than in control group students. In the middle third, the muscle volume in professional football players was 17.0% greater than in students attending football training and 36.1% greater than in control group students. In the lower third, the volume of the vastus lateralis in professional football players was 19.2% greater than in students attending football training and 44.5% greater than in control group students. Conclusion: Ultrasound examination of the vastus lateralis muscle to determine its volume in the upper, middle, and lower thirds has practical significance for identifying sports orientation and selecting candidates for professional football.
Copyright (c) 2026 Svitlana Karatieieva, Halyna Honchar, Serhii Karasievych, Sergiy Ilchenko, Mykola Maievskyi https://creativecommons.org/licenses/by/4.0
FREQUENCY OF COMPLICATIONS AND LESIONS OF ORGANS/SYSTEMS IN PULMONARY TUBERCULOSIS AMONG HIV-PATIENTS
Objective: To study the frequency of complications and organ/system involvement in pulmonary tuberculosis in the context of HIV/AIDS infection. Materials and Methods. We analyzed medical data from 103 patients with pulmonary tuberculosis that developed in the setting of HIV/AIDS infection. The patients were divided into groups: drug-sensitive pulmonary tuberculosis (DS-PTB) – 42 patients who excreted Mycobacterium tuberculosis (MBT) strains sensitive to anti-mycobacterial drugs (AMD); and drug-resistant pulmonary tuberculosis (DR-PTB) – 61 patients with resistant MBT strains. Data from the period 2020–2024 were analyzed. To study the frequency of complications and organ/system involvement, the results of laboratory tests, abdominal ultrasound, computed tomography of the chest and abdominal organs, and consultations with specialized physicians were taken into account. Microbiological detection of MBT included molecular genetic testing, microscopy and culture methods, and drug susceptibility testing of MBT strains to anti-mycobacterial drugs. HIV/AIDS infection was diagnosed using rapid tests, and viral load was determined by polymerase chain reaction. Microsoft Excel software was used for statistical analysis of the results. Results and Discussion. In both study groups, men predominated by 1.5 times, aged over 30 to 50 years. A severe condition at admission was noted in 23.8% of patients with DS-PTB and 9.8% with DR-PTB. The average hospital stay for DS-PTB was (23.1 ± 2.1) bed-days, and for DR-PTB – (61.7 ± 4.5). In DR-PTB/HIV, miliary tuberculosis predominated 1.7 times more often, and infiltrative pulmonary tuberculosis – 2.0 times more often. In DS-PTB/HIV, an increased frequency of disseminated pulmonary tuberculosis was observed. Patients with DR-PTB reported pronounced intoxication and cachexia twice as often compared to those with DS-PTB. In both groups, sepsis, pericarditis, and spontaneous pneumothorax were diagnosed with nearly equal frequency. Respiratory failure was detected 1.5 times more often in DR-PTB, while chronic obstructive bronchitis was 1.7 times more frequent in DS-PTB. In both groups, chronic hepatitis, liver cirrhosis, ascites, and toxic liver damage were noted. In DR-PTB, chronic hepatitis B, nervous system involvement, and eye disorders were observed twice as often as in DS-PTB. Conclusions. Drug-resistant pulmonary tuberculosis in the context of HIV/AIDS infection had a significantly more severe course due to the development of multiple organ failure. These changes in the combined TB/HIV/AIDS condition contributed to disability in 24.4% (10) of patients with drug-sensitive TB/HIV and in 55.7% (34) of patients with drug-resistant TB/HIV.
Copyright (c) 2026 Manana Sakhelashvili, Zoriana Piskur, Olga Sakhelashvili-Bil https://creativecommons.org/licenses/by/4.0
PROSPECTS OF USING INFRARED THERMOGRAPHY IN THE DIFFERENTIAL DIAGNOSIS OF BRONCHOPULMONARY PATHOLOGICAL CONDITIONS
Introduction. The search for new non-invasive diagnostic methods for detecting pathological changes in the bronchopulmonary system is a pressing issue in modern medical diagnostics, gaining even greater significance during the COVID-19 pandemic. Existing clinical and morphological diagnostic methods for the differential diagnosis of viral and viral-bacterial pneumonia often require significant time for data acquisition and processing. There is substantial scientific and practical interest in developing a differential diagnostic method using remote infrared thermography to identify patients with viral and viral-bacterial pneumonia and to study the characteristics of thermographic visualization of the pulmonary system under various pathological conditions. This method allows for a rapid and non-invasive identification of the nature of the pathology. Purpose of the study. To obtain thermal images of the posterior projection of the lungs in individuals with a history of bronchopulmonary pathology; to analyze the obtained thermographic images and oscillographic temperature distributions in the areas of interest; and, based on this information, to develop a method for the differential diagnosis of pathological states of the bronchopulmonary system. Materials and methods. The study utilized a domestically developed thermograph with a temperature sensitivity of 0.07 °C developed by the V.E. Lashkaryov Institute of Semiconductor Physics of the NAS of Ukraine, featuring a cooled focal plane array and the ThermoVisio base test software, as well as a FLIR SYSTEM ThermaCAM E300 thermograph. Observations and control of thermal fields were conducted in the 3 ÷ 5 µm and 8 ÷ 14 µm ranges. Results. Thermographic images and oscillographic temperature profiles of the posterior lung projection were obtained for various bronchopulmonary diseases. The analysis and processing of these images and distributions revealed significant differences in thermographic visualizations and oscillograms depending on the pathogenic agent. It was demonstrated that infrared thermography enables differential diagnosis of respiratory tract lesions. In conjunction with other clinical and laboratory methods, thermography simplifies the diagnostic search and treatment strategy. Conclusions. A method for the differential diagnosis of bronchopulmonary pathological states using remote infrared thermography has been developed. The implementation of this thermal imaging method allows for the investigation of temperature pattern distributions in the posterior lung projection. It was found that thermographic visualization of the lung projection in patients with COVID-19-associated pneumonia lacks the clear inflammatory focus areas characteristic of viral-bacterial pneumonias of other etiologies. Infrared thermography is a promising method for detecting bronchopulmonary diseases caused by various pathogens.
Copyright (c) 2026 Dmytro I. Zabolotnyi, Liudmyla V. Zabrodska, Vadym I. Dunaievskyi, Vitaliy Y. Kotovskyi, Volodymyr I. Tymofieiev, Svitlana S. Nazarchuk https://creativecommons.org/licenses/by/4.0
PARENTS' KNOWLEDGE AND ATTITUDE TOWARD CHICKENPOX AND ITS PREVENTION
Introduction: Chickenpox is a highly contagious condition, often leading to severe illness in adults and immunocompromised conditions, attributed to the varicella-zoster virus. Therefore, these facts describe the importance and severity of chickenpox that makes prioritizing protection through vaccination a point of need. However, confirmation and utilization depend on the knowledge and attitude of parents. This study was done to assess the knowledge and attitude of parents toward chickenpox and vaccination for its prevention. Methods: This cross-sectional study enrolled 261 parents of children visiting the primary healthcare centres. It used a pretested questionnaire requesting information regarding demographic characteristics along with an assessment of knowledge and attitudes toward chickenpox and the chickenpox vaccine. Appropriate statistics in the descriptive form and in proper tests, including chi-square and Fisher exact tests, were drawn for proper data analysis. Results: 64.4% of the participants were willing to accept chickenpox vaccination for their children. Predictors of willingness to vaccinate were: living in a family with fewer rooms (p=0.028) and being married (p=0.026). In all, 98.2% of those willing to be vaccinated were knowledgeable about chickenpox, compared to 86.0% of those unwilling (p<0.001). There was also a significant correlation between perceived risk of reinfection and attitude towards vaccination (p=0.002). This is an indicative study that shows that educational intervention for parents is necessary to clear myths and misconceptions associated with chickenpox and its prevention. Conclusion: Increasing parents' knowledge regarding vaccine safety and efficacy and measures taken to ensure the safety of the vaccine and promoting it in the community can help in the acceptance of the vaccine and may further reduce the incidence of chickenpox.
Copyright (c) 2026 Islam Tariq, Farah Ramzi, Hala F. Kasim, Salah Yousif, Suhir M. Rashid, Luma M. Al-Obaidy https://creativecommons.org/licenses/by/4.0
RECREATIONAL USE OF PREGABALIN IN UKRAINE: AVAILABILITY, PATTERNS OF USE, AND APPLICATION IN CHEMSEX
Introduction: Substance use disorders lead to public health and social problems. Reports about the addictive potential of pregabalin appeared immediately after the drug's launch in 2005. Subsequently, the prevalence of pregabalin abuse in countries around the world began to increase. Methods: The inclusion criterion for the study was recreational use of pregabalin at the time of the study or a history of such use. The sample was formed by the snowball sampling method, data collection was conducted through semi-structured interviews, and analysis was performed using the phenomenological method. The Drugs Wheel model was used to classify psychoactive substances. Results: Substance users are not aware of the risks of recreational use of pregabalin. Pregabalin is available for recreational use in Ukraine through over-the-counter pharmacies. Patterns of recreational use of pregabalin in Ukraine are dangerous in terms of mental and physical health disorders and negative socioeconomic consequences. Pregabalin is used as a tool for chemsex, and users neglect harm reduction measures for risky sexual behavior during such contacts. The difficulty of quitting recreational pregabalin use has been documented, and adherence to the existing mental health care system is low. Discussion: Low awareness of the risks of recreational use of pregabalin among substance users creates a need for educational activities among target groups. Given the commitment of doctors to prescribing pregabalin and the lack of warnings about the negative consequences, it is imperative to educate healthcare professionals about the risks of such prescriptions. Since pregabalin is used as a tool for chemsex, and users neglect harm reduction measures for such contacts, it is advisable to provide them with access to harm reduction measures for risky sexual behavior. Given the difficulty of quitting recreational pregabalin use and the low adherence of substance users to the existing mental health care system, it is recommended to improve this system and introduce harm reduction programs.
Copyright (c) 2026 Mykyta Lapin, Maryna Shevchenko https://creativecommons.org/licenses/by/4.0
ANTI-MÜLLERIAN HORMONE AND HOMA-IR LEVELS IN PCOS PHENOTYPES
Introduction: Polycystic ovary syndrome (PCOS) is a common endocrinopathy affecting women, with variable prevalence (8–13%) and clinical manifestations, and it comprises four main clinical phenotypes. Elevated anti-Müllerian hormone (AMH) levels and insulin resistance are associated with ovarian dysfunction and metabolic disturbances in PCOS. The present study sought to describe the distribution of patients among PCOS phenotypes, evaluate AMH and HOMA-IR levels, and determine any correlation between them. Methods: This was a prospective cross-sectional study of infertile women attending the outpatient infertility clinic in Mosul city. The ages of the included patients, who were enrolled between July 2023 and 2024, ranged from 18 to 39 years. PCOS was diagnosed according to the Rotterdam criteria, and patients were grouped into four phenotypes. On cycle days 2–5 (of a spontaneous or induced menstrual cycle), transvaginal ultrasound was performed to evaluate polycystic ovaries and follicle number; the ultrasound was repeated on cycle day 14 to assess the presence or absence of ovulation. Additionally, on cycle days 2–5, an early-morning blood sample was collected after 8 hours of fasting. Results: The 132 infertile women with PCOS enrolled in the study demonstrated distinct phenotype prevalence: types A and D were more prevalent (57.57% and 30.31%, respectively) than types B and C. The duration of infertility was an important factor in differentiating between types, with the shortest duration (2.5 years) observed in type B patients compared to other types (4.37–4.45 years). AMH levels showed clear differences across groups, with Types A and C having the highest levels and Type B the lowest. LH levels were highest in Types C and D and lowest in Type B. FSH levels were higher in Type A compared to Types B, C, and D. The LH:FSH ratio was highest in Types C and D, while Type B had the lowest ratio. The highest insulin resistance (HOMA-IR and fasting insulin levels) was observed in Type A patients. Type A also demonstrated a high miscarriage rate (26.3%), whereas Type B showed no history of miscarriage. Types C and D revealed a high rate of ovarian cysts (37.5%). A positive correlation was found between insulin resistance and BMI, as well as between AMH levels and ovarian follicle count. Conclusion: The majority of patients fell into Types A and D, with high AMH and HOMA-IR values. A positive correlation existed between AMH and ovarian follicle number, as well as between HOMA-IR and BMI; therefore, both should be evaluated in all PCOS phenotypes. The study underscores the interconnected nature of metabolic and reproductive dysfunction in PCOS.
Copyright (c) 2026 Asmaa Abdulrazaq Al-Sanjary https://creativecommons.org/licenses/by/4.0
INSTITUTIONAL EXPERIENCE WITH LAPAROSCOPIC ANTERIOR VAGINOCERVICOPEXY USING A MESH IMPLANT IN PATIENTS WITH ANTERIOR COMPARTMENT DEFECT AND APICAL PROLAPSE OF VARYING SEVERITY
Introduction. In reconstructive pelvic floor surgery using synthetic implants, several laparoscopic techniques have evolved as alternatives to sacrocolpopexy. Laparoscopic vaginocervicopexy is intended to correct apical descent together with anterior compartment failure. Since its first publication, the technique has been repeatedly modified, emphasizing the need to evaluate outcomes of different technical refinements across clinical scenarios. The aim of this study was to report a single-center experience with a modified laparoscopic vaginocervicopexy technique and to assess its effectiveness in relation to defect location and severity. Methods. Outcomes of 137 women with apical and combined prolapse (apical defect with cystocele), including women with a preserved uterus and women after hysterectomy, operated on in 2018–2024 were analyzed. The modification included intraoperative individualization of mesh dimensions based on measured dissection length and width, followed by bilateral fixation to the aponeurosis of the anterior abdominal wall. The assessment included intraoperative and postoperative complications, recurrences, repeat surgeries, operative time, length of hospital stay, and patient-reported satisfaction measured with a standardized satisfaction questionnaire using a five-point response scale. Mean follow-up was 12.8 months. Results. Mean age at surgery was 61.56 ± 9.59 years. The complication rate was 1.46 %, and the recurrence rate was 3.65 %. Mean operative time was 90.36 ± 14.33 minutes, and mean hospitalization duration was 52.20 ± 6.27 hours. Intraoperative blood loss did not exceed 150 mL. Patient-reported satisfaction was high, with a mean score of 4.54 ± 0.41 points, without meaningful differences across clinical groups. Discussion. The modified laparoscopic vaginocervicopexy with individualized mesh sizing and bilateral fixation to the anterior abdominal wall aponeurosis demonstrated favorable mid-term outcomes, combining high effectiveness with low complication and recurrence rates in women with apical prolapse and cystocele.
Copyright (c) 2026 Yurii O. Chekhanov, Oleksandr Yu. Chekhanov , Igor Z. Gladchuk https://creativecommons.org/licenses/by/4.0
MENTAL HEALTH OF MEDICAL STUDENTS DURING WARTIME
Introduction. Preserving the mental health of Ukrainians during wartime remains one of the most urgent challenges for the national healthcare system. Continuous monitoring of psychological well-being is essential for developing effective recovery strategies and fostering resilience, particularly among young people in medical education who are expected to provide care to others in the future. Objective. This study aimed to assess the impact of the war in Ukraine on the mental health of medical students at Sumy State University. Materials and Methods. The mental health status of the students was evaluated using the Goldberg General Health Questionnaire (GHQ-28), which measures four domains: somatic symptoms, anxiety and insomnia, social dysfunction, and depression. A total of 105 students (72 females and 33 males) aged 18–22 years participated in the anonymous survey conducted from May 2024 to January 2025. The study was conducted in accordance with the Declaration of Helsinki (World Medical Association, “Ethical Principles for Medical Research Involving Human Subjects,” 2013 revision). Statistical analysis was carried out using descriptive statistics with the Microsoft Open Value Subscription program. Results. The findings revealed that 85% of the respondents experienced a deterioration in mental health related to wartime stress. The most prevalent psychological disturbances were anxiety and insomnia (80%), followed by social dysfunction (65%) and somatic symptoms (60%). Depressive manifestations were observed in 11% of the participants. Female students demonstrated a higher vulnerability to stress and emotional distress than their male peers. Conclusions. Wartime conditions significantly affect the psychological well-being of medical students, compromising their academic performance and professional preparedness. To sustain effective learning and adaptation, it is crucial to provide targeted psychological support, implement mental health monitoring, and develop training programs focused on self-regulation and stress resilience in crisis environments.
Copyright (c) 2026 Nataliia Inshyna, Inna Chorna https://creativecommons.org/licenses/by/4.0
PROSPECTS OF APPLICATION OF ARTIFICIAL INTELLIGENCE IN THE TRAINING AND CONTINUOUS PROFESSIONAL DEVELOPMENT OF PEDIATRICIANS
Introduction. The need to actively integrate AI tools into the daily practice of pediatricians and family physicians has become a pressing priority, with the aim of improving the quality of medical care provided to children. Objective: Based on an analysis of the literature, to summarize the latest achievements regarding the implementation of AI in continuing pediatric education and to identify promising areas for its application. Materials and Methods. A bibliosemantic method was used. Information retrieval and analysis of scientific sources were conducted using the scientometric databases of PubMed (https://pubmed.ncbi.nlm.nih.gov/) for the past 10 years. Results and Discussion. Our analysis of scientific publications about the application of AI in pediatric education for the period from 2015 to 2025 demonstrates a progressive increase in their number, reflecting the current transformation of the educational paradigm in pediatrics. The use of such widely adopted AI tools as DeepSeek and ChatGPT has now become an integral part of modern medical education due to their ability to rapidly process and structure large datasets and information. To enhance pediatricians’ knowledge regarding the use of artificial intelligence models in the diagnosis and treatment of childhood diseases, existing educational programs must be improved to account for the specificities of applying artificial intelligence tools in pediatric practice, as well as the associated challenges and ethical issues. A phased approach to teaching medical students and pediatricians the fundamentals of artificial intelligence throughout their educational and professional careers is recommended. At all stages, artificial intelligence tools should be used only as a supplement to existing educational programs. Conclusions. Artificial intelligence currently serves as a powerful driver of change in the training and professional development of pediatricians, offering tools that make pediatric education more clinically oriented and personalized.
Copyright (c) 2026 Oleksandr Volosovets, Oleksandr Naumenko, Inna Kucherenko, Ruslan Tsymbalyuk, Oksana Vygovska, Sergii Kryvopustov, Sergii Kramariov, Ievgeniia Burlaka, Viktoria Khomenko, Oleksii Kuznetsov https://creativecommons.org/licenses/by/4.0
FEATURES OF NEUROCOGNITIVE AND AUTONOMIC DISORDERS AND PAIN IN PATIENTS IN THE ACUTE PHASE OF COVID-19
Introduction. The WHO emphasizes that the COVID-19 pandemic has a negative impact on mental health, with approximately 20% of patients who have had COVID-19 experiencing mental disorders. Research objective was to investigate gender and age characteristics of psychopathological symptoms in patients in the acute phase of SARS-CoV-2 respiratory infection. Materials and methods. A total of 66 patients aged 8 to 92 years with COVID-19 undergoing inpatient treatment with confirmed lung damage were examined. Clinical, clinical-psychopathological, psychometric, and statistical data processing methods were used to assess the mental status of patients. Results. A high frequency of autonomic symptoms was found among the examined patients. The presence of autonomic dysfunction syndrome correlates with female gender, age, the presence of depression, anxiety, and the presence of concomitant diseases. The data obtained indicate greater autonomic reactivity in women, especially young women. Patients in the acute phase of COVID-19 showed cognitive impairment according to the MMSE results. Among women, disturbances in time orientation, writing, and reading were more pronounced. The presence and deepening of cognitive impairment correlates with age, the presence of concomitant diseases, and the presence of depression. Analysis of pain sensations using the Paindetect questionnaire revealed the presence of neuropathic pain in 25.8% of respondents: 87.5% of women and 58.3% of men. Neuropathic pain in Covid-19 patients correlates with female gender, age over 50, lack of a partner, depression, anxiety, and autonomic dysfunction syndrome. Women mostly complained of headaches, pain in the arms, neck, and back; men were more bothered by pain in the legs, lumbar region, and joints. At the same time, widespread pain was more common in men. The highest intensity of neuropathic pain was found in the 46–60 age group. Discussion and conclusions. COVID-19 affects the autonomic nervous system, neurocognitive processes, and pain sensitivity. The data obtained will be useful in developing personalized approaches to the diagnosis and support of patients with COVID-19.
Copyright (c) 2026 Iryna Mudrenko, Oleksandra Kotkova, Dmytro Sotnikov, Oleksandr Potapov, Anna Kobyletskaya, Vitaliy Mudrenko, Valeriia Hetmanska https://creativecommons.org/licenses/by/4.0
CHANGES IN THE PHAGOCYTIC ACTIVITY OF LEUKOCYTES AND THE LEVEL OF C-REACTIVE PROTEIN AS PATHOGENIC FACTORS OF THE INFLAMMATORY PROCESS IN PERIODONTIUM SECONDARY TO THE USE OF METAL CROWNS
The aim of the study: The aim of this work was to investigate changes in the phagocytic activity of leukocytes and the level of C-reactive protein in experimental periodontitis of bacterial-immune genesis under the condition of using different types of metal crowns. Materials and methods. The study was conducted on clinically healthy male white rats weighing 150–200 g, which were kept in a vivarium in compliance with sanitary and hygienic standards and requirements of good laboratory practice (GLP). The experimental animals were divided into four groups: Group I – intact animals (n = 10); Group II – animals with periodontitis (30th day of the experiment, n = 8); Group III – animals with periodontitis, which were installed with stamped crowns for periodontitis (30th day of the experiment, n = 8); Group IV – animals with periodontitis, which were installed with cast crowns for periodontitis (30th day of the experiment, n = 8). Bacterial-immune periodontitis was modeled by injecting a mixture of Staphylococcus aureus and Streptococcus hemolyticus microorganisms suspended in egg white into periodontal tissues. To produce permanent structures, impressions were taken from the central incisors of the lower jaw of experimental animals using Speedex silicone impression material and crowns were fabricated using standard techniques. To study the phagocytes activity of leukocytes, it was determined by counting the number of neutrophils in smears and expressed as phagocytic number. The level of C-reactive protein (CRP) in serum was determined by enzyme-linked immunosorbent assay. Data processing was carried out using non-parametric statistical methods in STATISTICA 10.0 software (StatSoft, USA). Results. Analysis of the dynamics of the phagocytic number of blood granulocytes in animals with periodontitis under the conditions of using cast crowns showed that on the 30th day of the experiment this indicator was significantly higher – by 1,48 times, p<0,001, compared to the intact group. It was also found that the phagocytic number slightly exceeded the value in animals with an inflammatory process without prosthetics by 1.07 times, p<0.05. At the same time, this indicator was lower by 1,07 times, p<0,01, compared to similar data obtained in rats with stamped crowns. The content of C-reactive protein, on the 30th day of the experiment, in the blood serum of experimental animals with periodontitis of bacterial-immune genesis, exceeded by 1,40 times, p<0.001, the indicators that were in the animals of the intact group. In experimental animals after prosthetics with stamped crowns, the content of CRP was significantly increased compared to the data of the intact and the groups with periodontitis of bacterial-immune genesis – by 1.83 times and by 1.30 times, respectively, p<0,001. A similar trend was observed in the blood serum of animals with cast structures: the CRP content significantly increased – by 2,14 times, p<0,001, compared to intact animals; by 1,53 times, p<0.001, compared to the group with simulated periodontitis on the 30th day without crowns and by 1,17 times, p<0,01, in animals with fixed stamped structures. Conclusion. Thus, as a result of the study, it was found that on the 30th day of periodontitis of bacterial-immune genesis, activation of the immune response was observed with a significant increase in phagocytic activity in the experimental groups using fixed dentures, which indicates an increase in the inflammatory reaction, probably due to mechanical irritation or microbial colonization around the dentures. The course of experimental periodontitis was also accompanied by an increase in the level of C-reactive protein in the blood serum, which indicates the presence of an inflammatory process, and the indicators obtained under the conditions of using fixed structures indicate a more adverse effect of integral prosthetics on this link in the development of the inflammatory process in the periodontal complex.
Copyright (c) 2026 Oleh V. Marfiian, Andrii Ye. Demkovych, Orysia O. Bandrivska, Oleksandr A. Bedenyuk https://creativecommons.org/licenses/by/4.0
ASSESSMENT OF THE DENTAL STATUS OF INTERNALLY DISPLACED CHILDREN DUE TO THE ARMED CONFLICT IN UKRAINE
Introduction. Modern epidemiological studies show that the child population is highly vulnerable to the effects of social, environmental and economic factors, which is particularly relevant in the context of forced displacement due to military conflict. Internally displaced children are a group at increased risk of developing dental pathologies due to a number of adverse factors, including psycho-emotional stress, limited access to medical and preventive dental care, changes in diet and deterioration of hygiene skills. The aim of the study: to study the characteristics of the dental status of children internally displaced as a result of the armed conflict in Ukraine. Materials and methods. The study was conducted at the Department of Paediatric Dentistry of the I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine and included a comprehensive assessment of the dental status of internally displaced children affected by the armed conflict in Ukraine. International standards for the diagnosis of dental caries were used to assess the dental status of the study participants. In particular, the prevalence of caries was determined as a percentage and its intensity was assessed using the DMFT index (DMFT+dft, dft). The condition of the periodontal tissues was analysed using the modified PMA index (C. Parma, 1960), which allows the degree of inflammatory changes in the gingival tissues to be assessed. The oral hygiene status was determined using the OHI-S index (Green, Vermillion, 1964), which is a generally accepted standard for assessing the level of oral hygiene. Results. The prevalence of caries in temporary teeth in internally displaced children aged 6–7 years was 86,27±4,82 %, in permanent teeth – 23,53±5,94 %, and increased to 89,34±2,79 % in adolescents aged 14–16 years. The intensity of caries (DMFT index) of temporary teeth in children aged 6 years was high (6,01±0,231), that of permanent teeth in children aged 12 years was average (3,52±0,122) and that of adolescents aged 15 years was high (4,91±0,242). In the structure of the DMFT index, the “D” component was predominant in all age groups, ranging from 57,67 % to 87,10 %. The level of oral hygiene (OHI-S index) was described as unsatisfactory, ranging from 1,86±0,020 to 2,08±0.025, and the PMA index values corresponded on average to moderate gingivitis. Conclusions. Thus, the dental and oral hygiene status of internally displaced children is significantly worse than that of their peers from the general population of children and adolescents in Ukraine.
Copyright (c) 2026 Yurii Bandrivsky, Andrii Bambuliak, Khrystyna Pohoretska, Vitalii Myhailiuk, Iryna Dankevych-Kharchyshyn https://creativecommons.org/licenses/by/4.0
COMPUTER SIMULATION OF TRAUMATIC MANDIBULAR FRACTURES IN CHILDREN OF DIFFERENT AGES
Introduction. The study of the mechanisms of traumatic bone destruction using computer-aided technologies is a pressing problem in modern medicine, particularly in maxillofacial surgery. It has not only diagnostic meaning, but also plays a major role in planning treatment measures. Materials and methods. The study was aimed at assessing the mechanisms of bone destruction in different age periods. A feature of the applied approach was the reconstruction of simulated lower jaw models based on multispiral computed tomography data of 4 patients aged 2, 6, 9, and 17 years, corresponding to different dentition periods. Results. When applying force to the chin area, the displacement of the model nodes was greater than when applying force to the body area. They were mainly caused by bending deformation in the area of both condylar processes and reached 3.7 mm for the 17-year-old lower jaw model. When reproducing a traumatic effect on the body of the lower jaw, the maximum displacement was also found in the model of a 17-year-old child and amounted to 2.4 mm, while the smallest displacement was recorded in the 9-year-old lower jaw model, which amounted to 0.8 mm. Conclusions. When studying the stress-strain state of the lower jaw of pediatric patients under the influence of external traumatic loads, it was found that in all studied age periods, when force is applied to the symphysis area, the stress-strain state of the bone is characterized by the formation of maximum stress concentration in the cortical layer of the bone in the area of the condylar processes. Calculations of external force extreme values for the studied lower jaw models with a strength limit of 100 MPa indicated that LJ fractures can occur under the impact applied to the chin with an amplitude from 247 N to 266 N for a 2-year-old and 9-year-old jaw models, respectively, and from 145 N – for a 6-year-old jaw model.
Copyright (c) 2026 Rostyslav Yehorov, Andrii Kopchak, Oleksandr Kaniura, Mykola Kryshchuk https://creativecommons.org/licenses/by/4.0
CHARACTERISTICS OF THE ORAL MICROBIOTA IN CHILDREN WITH CONGENITAL CLEFT PALATE WITH CLEFT LIP
Introduction. The oral cavity microbiota plays a crucial role in maintaining oral health. However, its composition may change under the influence of exogenous factors or due to disruptions in the anatomical and consequently, functional features of various biotopes within the oral cavity. Under such conditions, the development of dysbiosis can lead to a chronic, persistent inflammatory process. These pathologies require further investigation to develop recommendations for correcting the identified imbalances. Objective: To study the microbiota of oral cavity biotopes in children with cleft hard and soft palate with cleft lip. Materials and Methods: In children with bilateral (n = 46) and unilateral (n = 44) cleft hard and soft palate with cleft lip was examined through dental assessment and microbiological analysis of cultured biological samples (smears from inflammatory sites), using differential diagnostic nutrient media. These media were used to cultivate conditionally pathogenic microbiota. For cultivating anaerobic microbiota, Shedler agar supplemented with 5% sheep blood ("Himedia", India) was used. Anaerobic conditions were created using an anaerostat with the AnaeroGen System ("Oxoid", United Kingdom). Results: It was found that in children with unilateral and bilateral cleft hard and soft palate with cleft lip, the lowest values ​​of the digital data of the hygiene indices was assessed as poor, the qualitative and quantitative composition of the oral microbiota was characterized by a predominance of conditionally pathogenic, aerobic, and facultative anaerobic microorganisms. The oral microbiota in these patients was classified as dysbiotic, with a dominance of facultative conditionally pathogenic microorganisms, which include opportunistic infection pathogens. A comparison of the oral microbiota in children with cleft hard and soft palate and cleft lip - both unilateral and bilateral - showed that the number of facultative microbiota representatives was higher in children with bilateral clefts. At the same time, the species composition of the dominant microbiota representatives showed little variation. Conclusions:The oral microbiota in children with cleft hard and soft palate with unilateral and bilateral cleft lip was dominated by 2–5 associative complexes composed of gram-positive and gram-negative bacteria, microscopic fungi of the genus Candida, and periodontal pathogenic microorganisms, primarily from Socransky’s orange complex. In cases of bilateral clefts of the hard and soft palate with cleft lip, the titer of facultative microbiota was higher. The structure of the microbial community included obligate anaerobes associated with periodontal pathogens. In the microbial coenosis of children with bilateral clefts of the lip and palate, anaerobic bacteria such as Prevotella, Peptococcus, Peptostreptococcus, and Fusobacterium were present against a background of high concentrations of conditionally pathogenic microorganisms.
Copyright (c) 2026 Tetiana Timokhina, Marina Kryvtsova, Nina Proshchenko, Mykola Spivak https://creativecommons.org/licenses/by/4.0
BIOMINERALIZATION OF MICROSTRUCTURAL VARIATIONS OF DENTINAL TUBULES AFTER ROOT CANAL OBTURATION USING MTA-BASED CEMENT WITH SUBSEQUENT SEM ANALYSIS
Introduction. The quality of endodontic treatment of teeth with intra-root resorption process directly depends on careful instrumental, medicinal treatment and root canal filling. The use of Mineral Trioxide Aggregate (MTA) cement aggregates during root canal obturation is of concern due to its bioactive interactions with dentinal tubule phosphoapatite. Methods. We prepared 50 curved root canals of human maxillary molars extracted according to indications and prepared them instrumentally for obturation. The intratubular biomineralization at the dentin-filling material interface was carefully analysed by scanning electron microscopy (SEM). Results.We prepared 50 curved root canals of human maxillary molars extracted according to indications and prepared them instrumentally for obturation. The intratubular biomineralization at the dentin-filling material interface was carefully analysed by scanning electron microscopy (SEM). In the case of root canal obturation with GP and MTA sealer, increased biomineralization of dentinal tubules outside the penetrating sealant mark was confirmed by SEM observation (p<0.05). Mineralised structures of phosphoapatite (calcium/phosphorus ratio 1.45-1.89) were detected on the path of MTA penetration through dentinal tubules at a distance of 350-400 µm from the tubule mouth. The beginnings of crystallisation were observed along the intra- and/or intertubular dentin collagen. The depth of intratubular biomineralization was significantly increased in all pretreated dentinal tubules (p<0.05). Conclusions. MTA cement and its derivatives can be used as a promising bioactive root canal filling agent to enhance biomineralization of dentinal tubules in a controlled environment.
Copyright (c) 2026 Dmytro Dobrovolskyi, Natallia Gevkaliuk https://creativecommons.org/licenses/by/4.0
ANTIMICROBIAL RESISTANCE OF OPPORTUNISTIC ORAL ISOLATES: A COMPARATIVE MONITORING STUDY (2021 AND 2025)
Introduction. The rational use of antibiotics in dentistry is a key factor that improves the quality of medical care. Monitoring studies of bacterial sensitivity to antibiotics in a time retrospective, the development of local antibiotic therapy protocols, the use of personalized approaches to the use of antibiotics are effective mechanisms for containing antibiotic resistance and achieving a rapid and effective therapeutic effect. Standardization of the interpretation of results ensures effective treatment of oral diseases of microbial etiology. The aim of this study was to conduct a comparative study of the sensitivity of opportunistic representatives of the oral microbiota isolated from patients with periodontitis to antibiotics in a 5-year retrospective (compare isolates isolated in 2021 and 2025). Materials and methods. The studies were conducted during 2021-2025 at the clinical and clinical-laboratory bases of the departments of the Faculty of Dentistry of the State Higher Educational Institution "Uzhgorod National University". In order to assess the antibiotic resistance of bacteria in a time retrospective manner, we conducted a comparative study of the sensitivity of bacteria belonging to opportunistic microorganisms. In 2021, 452 bacterial isolates were isolated from 252 patients with periodontitis. In 2025, 249 patients with periodontitis were examined and 430 isolates of microorganisms were isolated, which were subjected to antibiotic sensitivity testing. The stage of periodontitis was determined according to the new classification of periodontal diseases and peri-implant conditions (2017). The study selected biological material from patients of both sexes aged 35-65 years with stage II-III periodontitis (II - moderate, III - severe with potential tooth loss). The material for the study was taken from periodontal pockets by inserting a sterile aluminum pin with a sterile cotton swab into them. Then the pin was placed in a sterile Amies transport medium (Italy) and delivered to the laboratory. The material was sown on nutrient media by the Gold sector culture method on Himedia differential diagnostic media: blood agar (MPA + 5% blood) for the isolation of bacteria of the genus Streptococcus; Endo Agar - bacteria of the Enterobacteriaceae family, Mannitolsalt Agar - bacteria of the genus Staphylococcus, Biel esculent Agar - bacteria of the genus Enterococcus. Bacteria were identified by morphological, tinctorial and biochemical signs using systems for identification of the company Sani-Med (Ukraine). For the cultivation of anaerobic representatives of the microbiota, the nutrient medium Schedler agar + 5% sheep blood («Himedia», India) was used. To create anaerobic conditions, an anaerostat with a system for creating anaerobic conditions (AnaeroGen System – «Oxoid», Great Britain) was used. Identification of isolated pure anaerobic bacterial cultures was carried out using MALDI-TOF (matrix-activated laser desorption/ionization and time-of-flight mass spectrometry). Antibiotic susceptibility was determined by the disk diffusion method according to the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). When studying the sensitivity of microorganisms, standard disks with antibiotics manufactured by "Pharmaktiv" (Ukraine) were used. Results. Comparative analysis of antibiotic sensitivity of bacteria of the genera Porphyromonas, Staphylococcus, Streptococcus, Enterobacteralis, Enterococccus showed that the change in the sensitivity of microorganisms to antibiotics is clearly demonstrated in the decrease in the activity of amoxicillin/clavulanate, imipenem and meropenem. A significant decrease in sensitivity to cephalosporins was noted. At the same time, it should be noted that the sensitivity to cefuroxime did not change significantly. Susceptibility to macrolides was low. The revealed variability in antibiotic susceptibility in time retrospectively (the general trend of change in antibiotic susceptibility) indicates the feasibility of a patient-oriented approach and conducting an antibiotic regimen in each individual case. Conclusions: The analysis of changes in the sensitivity of bacterial isolates in 2021 and 2025 showed significant changes in the spectrum of effectiveness of various antibacterial drugs. The data obtained indicate a decrease in the sensitivity of pathogens to a number of widely used antibiotics, which reduces the effectiveness of empirical therapy and emphasizes the need for an individualized approach. It was found that both anaerobic, aerobic and facultative anaerobic representatives of the oral microbiota show a general tendency to decrease in sensitivity to combined beta-lactam antibiotics, carbapenems and macrolides. A significant decrease in the sensitivity of bacteria of the genus Porphyromons to metronidazole was found. Only a tendency for the formation of resistance of the isolated isolates to fluoroquinolones was detected. No significant decrease in the proportion of fluoroquinolone fourth-generation–susceptible strains was detected. In view of the obtained results, a patient-centered approach involving antimicrobial susceptibility testing prior to treatment initiation should become standard practice. This strategy would optimize antimicrobial selection, reduce the risk of resistance development, and improve the effectiveness of infectious disease management. The findings also indicate the necessity of developing antimicrobial prescribing guidelines based on annual surveillance of microbial susceptibility patterns, particularly for urgent clinical situations or when susceptibility testing cannot be performed.
Copyright (c) 2026 Maryna Kryvtsova, Yevgen Kostenko, Oleksandr Bida, Vjacheslav Burlik, Roman Mandula, Oleksij Bida, Volodymyr Klymchak https://creativecommons.org/licenses/by/4.0
FEATURES OF CLINICAL PRESENTATION, DIAGNOSIS, AND PREVENTION OF HIV INFECTION AMONG THE GENERAL POPULATION AND MILITARY PERSONNEL UNDER WAR CONDITIONS
Relevance. Timely detection of HIV infection remains a key factor in reducing incidence and preventing transmission. In the military context, this means combining screening at mobilization, periodic testing for individuals at increased risk, and testing in case of characteristic symptoms or after high-risk exposures. Since the beginning of the full-scale Russian invasion of Ukraine, the displacement of large numbers of people has caused problems with treatment and prevention, which may have led to the spread of infection to new regions. Military personnel and veterans may face increased risks of infection due to combat injuries, specific features of medical support in field conditions, and challenges in ensuring confidentiality and continuity of antiretroviral therapy (ART) during rotations and combat operations. Objective. To summarize current clinical, epidemiological, and diagnostic features of HIV infection and existing and prospective prevention measures among the general population and military personnel under wartime conditions, as well as to identify key directions for improving diagnosis, treatment, and prevention. Materials and Methods. A systematic analysis of scientific publications, official reports, and recommendations from international organizations (EUCALB, CDC, ECDC) from 2013 to 2025 was conducted. Both original studies and systematic reviews and meta-analyses were analyzed. Results. Practical recommendations for military medical services should include HIV testing within routine examinations using “opt-out” algorithms to reduce stigma. Rapid linkage to care for positive cases should be ensured - initiation of etiotropic therapy and virological assessment (CD4 count and viral load) immediately after confirmation. The expansion of rapid test (RDT) use in standard protocols during mobilization and in field medicine is justified. Implementation of self-testing algorithms, use of dried blood spot (DBS) methods, and point-of-care (POC) platforms for rapid diagnostics directly at the patient is recommended, which is critically important in areas with disrupted infrastructure. This approach reduces decision-making time and ensures patient routing in case of a positive result. Conclusions. It has been demonstrated that adapting HIV response systems to wartime conditions requires decentralization of diagnostics through the implementation of the “opt-out” model, use of rapid tests, and deployment of POC platforms in field conditions. The expansion of access to biomedical prevention post-exposure prophylaxis(PEP)/pre-exposure prophylaxis (PrEP), with priority for long-acting injectable forms, is justified. Implementation of the proposed organizational and technological solutions will ensure confidentiality, continuity of treatment, and preservation of operational readiness of personnel during prolonged martial law.
Copyright (c) 2026 Nataliya Klymenko, Valeriia Borshchenko, Vladyslav Svitailo, Oksana Chemych, Olexandr Saienko, Mykola Chemych https://creativecommons.org/licenses/by/4.0