Donetsk National Medical University

OBJECTIVE:Aim: To summarize the biomarkers of cellular senescence in bone tissue and discuss their potential relevance for clinical risk stratification and outcomes related to bone remodeling and implant osseointegration. PATIENTS AND METHODS:Materials and Methods: A narrative literature review was performed using PubMed and Google Scholar searches focused on osteoblast, osteocyte and mesenchymal stem cell senescence, DNA damage response, senescence-associated secretory phenotype, oxidative stress, and epigenetic regulation in bone. Eligible peer-reviewed publications were screened for evidence on established and emerging senescence biomarkers, detection methods (histochemical, immunohistochemical, molecular, and secretory profiling), and mechanistic links to impaired osteogenesis and enhanced osteoclastogenesis. Findings were synthesized into practical biomarker categories (molecular, cellular/tissue, and functional) with emphasis on translational implications for dental implant planning and peri-implant bone stability. CONCLUSION:Conclusions: Bone cellular senescence is characterized by increased SA-β-gal activity, upregulation of cell-cycle inhibitors (p16INK4a, p21CIP1/WAF1, p53-related pathways), persistent DNA damage signaling, and a proinflammatory secretory phenotype that promotes osteoclast activation and suppresses osteogenesis. Tissue-level changes include reduced osteoblast function, osteocyte loss, and a shift toward resorptive remodeling reflected by an elevated RANKL/OPG ratio. Emerging signals (e.g., selected long non-coding RNAs and innate immune sensors such as TLR9) may complement classic markers in future panels. Integrating senescence-related biomarkers into clinical assessment may support individualized protocols for patients with biologically compromised bone and inform targeted preventive strategies.

Vitamin D is one of the key regulators of calcium and phosphorus homeostasis and plays an important role in bone tissue formation, as well as in the functioning of the immune, endocrine, and nervous systems. Under modern conditions, vitamin D deficiency has acquired a global character and is observed not only among individuals with chronic diseases but also among clinically healthy populations, particularly children and young adults. Limited insolation, lifestyle changes, dietary disorders, obesity, as well as diseases of the gastrointestinal tract contribute significantly to reduced vitamin D levels. Numerous scientific studies confirm the association between vitamin D deficiency and the development of rickets, osteoporosis, diabetes mellitus, cardiovascular, oncological, and neurodegenerative diseases, as well as an increased risk of infectious diseases, including COVID-19. Timely diagnosis and adequate prevention of vitamin D deficiency are essential components of public health preservation and reduction of disease incidence. Thus, studying the role of vitamin D and substantiating the need for its monitoring and correction remains a relevant direction of modern medicine.

Introduction. Martial law, the deterioration of the health of the Ukrainian population against the backdrop of four years of Russian aggression, and the consequences of the COVID-19 pandemic necessitate changes to the structure, forms, and scope of undergraduate, postgraduate dental education and continuous professional development of dentists to ensure qualified dental care for the population. Objective. To evaluate the current system of undergraduate, postgraduate dental education and continuing professional development of dentists in Ukraine and its relevance to current challenges, to identify measures for necessary changes. Materials and methods of research. An assessment of the existing regulatory framework and practical principles of undergraduate, postgraduate dental education and continuing professional development of dentists in Ukraine and the EU was carried out. Methods of a systematic approach and comparison were used. Results and discussion. The rapid development of digitalization in dental education and the introduction of interdisciplinary education, the latest information, simulation, and distance learning technologies, the use of artificial intelligence, and augmented reality techniques into the educational process must also be reflected in the new paradigm of continuing dental education in Ukraine in the current difficult circumstances. Undergraduate training for dentists will be provided in 2025 in Ukraine at 25 higher education institutions, including 14 higher education institutions of the Ministry of Health of Ukraine, 3 higher education institutions of the Ministry of Education and Science of Ukraine, and 8 privately owned institutions. It lasts 5 years, which generally corresponds to the standards of dental education in the EU. According to the Unified State Electronic Database on Education, as of October 2025, only 7,491 people are studying dentistry (in 2020 – 12,759), of which 595 (in 2020 – 502) are state-funded, mainly in higher education institutions of the Ministry of Health of Ukraine. The main characteristics of competency-based continuing dental education should be: modern content of educational programs developed in accordance with the needs of industry and society; student-centeredness; problem-oriented approach; rational use of teaching time with an emphasis on practice. Conclusions. Understanding the importance of dentists' competencies for the healthcare industry, the importance of their continuing education based on competence and proper medical practice, its integration with EU requirements, increasing the duration of internships, and introducing residencies will help improve the quality of dental education during wartime.

OBJECTIVE:War is a significant factor affecting human health, including sleep and quality of life, however, the characteristics of these differences among university students remain insufficiently studied. This study aimed to comprehensively assess sleep quality, chronotype, and quality of life indicators among students under wartime conditions, to analyze their inter-relationships, and to identify clusters based on their combined patterns. METHODS:A cross-sectional study included 130 students aged 18-25 years. The Pittsburgh Sleep Quality Index (PSQI), the Morningness-Eveningness Questionnaire (MEQ), and the Short Form-36 Health Survey (SF-36) were used to assess sleep quality, chronotype, and quality of life. RESULTS:Poor sleep quality was identified in 67.7% of participants (PSQI: 5.92 ± 2.96). Students with poor sleep quality were more likely to live separately from family members (p < .05) and to consume alcohol (p < .05). According to chronotype, participants were classified as intermediate (74.6%), morning (9.2%), or evening (16.1%). The evening chronotype was associated with lower vitality scores (p < .05) and more frequent alcohol consumption (p < .05). Poor sleep quality was associated with lower scores in the physical and mental health components; the mental component of quality of life emerged as an independent predictor of poor sleep quality (OR = 0.41; 95% CI: 0.20-0.86). Cluster analysis identified four distinct profiles of sleep quality, chronotype, and quality of life, ranging from optimal to less favorable. CONCLUSIONS:The findings indicate that, under wartime conditions, the interaction between sleep quality, chronotype, and quality of life among students forms four distinct profiles, reflecting the multidimensional nature of the impact of the war context on sleep and related aspects of students' quality of life.

Obesity can complicate radical prostatectomy (RPЕ) and affect intra- and postoperative outcomes, but data on different surgical approaches remain inconsistent. The objective: to evaluate the relationship between the degree of obesity and the perioperative outcomes of RPЕ depending on the type of intervention and stage of prostate cancer. Materials and methods. A retrospective analysis was performed of 420 patients with prostate cancer who underwent RPЕ: endoscopic extraperitoneal (EERPE, n = 236), laparoscopic (LRPE, n = 88) and retropubic open (RRPE, n = 96). The stage of the tumor process was determined according to the T category: localized process – T1–T2 and locally advanced – T3–T4. The degree of obesity was determined by body mass index: 0 (< 30 kg/m2), I (30.0–34.9 kg/m2), II (35.0–39.9 kg/m2), III (≥ 40.0 kg/m2). The duration of surgery, blood loss, postoperative complications according to Clavien–Dindo, and the duration of postoperative hospitalization were assessed. The relationship between the indicators was determined using Spearman’s correlation coefficient (ρ). Results. For RRPE, a statistically significant positive relationship was found between the degree of obesity and the duration of surgery for both T1–T2 (ρ = 0.331; p = 0.007) and T3–T4 (ρ = 0.461; p = 0.006). For EERPE and LRPE, the relationship between obesity and the duration of the intervention was weak and unreliable (p > 0.05). The effect of obesity on blood loss was limited: a significant association was obtained only for EERPE at T1–T2 (ρ = 0.206; p = 0.004). Correlations between obesity and the severity of complications according to Clavien–Dindo, as well as the duration of postoperative hospitalization, did not reach statistical significance in any subgroup (all p > 0.05). Conclusions. Obesity exerted its influence mainly through parameters of technical complexity (increased duration of surgery for RRPE), while blood loss, severity of complications according to Clavien–Dindo, and length of hospitalization did not show a stable dependence on obesity in most stratifications.