Donetsk National Medical University

The relevance of the study is to substantiate the significance and development directions of strategic pharmaceutical alliances in the context of a combination of biological sciences, digital technologies, and new geopolitical conditions, as well as the European integration processes of domestic pharmaceutical enterprises and the need for foreign investment. Aim. To study, analyze, and generalize the features of strategic pharmaceutical alliances and their use of digital technologies and relationship marketing as innovative tools for developing and improving the competitiveness of pharmaceutical companies. Materials and methods. Scientific literature data, information websites of online publications, and pharmaceutical companies were used. The methods applied included the content analysis, system-analytical, structural-logical, grouping, and generalization methods. Results and discussion. The importance of strategic relationships at the international level has been shown; the features, advantages, possible problems and risks, as well as methods for mitigating them, and the future development prospects of pharmaceutical alliances have been identified. Attention is focused on the fact that the main goals of international strategic relationships in pharmacy are to solve problems of drug shortages and stabilize supply chains through harmonized regulatory frameworks and investment attraction. The role of digitalization and partnership relationships between pharmaceutical companies and digital platforms in the drug development and market promotion has been demonstrated. The advantages and forms of relationship marketing with examples from the pharmaceutical sector have been generalized. Conclusions. Strategic pharmaceutical alliances are one of the most effective and widespread forms of partnership that aligns with current trends in international cooperation and offers a significant potential for national pharmaceutical enterprises.

Addressing the issue of significant prevalence of cervical dental lesions involves screening and prescribing preventive measures for individuals being at risk of their development. The aim of the study is to develop computer models for predicting risk of development of cervical dental lesions in young patients and evaluate their quality. Materials and methods. Sample included 272 patients (mean age 24.3 ± 6.9 years), in whom independent predictors for occurrence of wedgeshaped defect (WSD), cervical caries (CC) and enamel erosion (E) were identified that became input data for computer models. There was applied Extreme Gradient Boosting (XGBoost) tree-based machine learning method implemented in Python programming language with the use of scikit-learn and XGBoost librarie and SHAP. For WSD model, class imbalance was taken into account by introducing a class weight (scale_pos_weight), for CC model by a narrowed hyperparameter space and repeated stratified cross-validation, for enamel E model by Synthetic Minority Over-sampling Technique (SMOTE). The models were evaluated on out-of-sample (out-of-fold) predictions with calculation of Area under the curve-Receiver Operating Characteristic curve (AUC-ROC), sensitivity (recall), specificity, accuracy and NPV. Results. Priority was given to recall over indicators of accuracy and specificity that resulted in decreasing the number of missed cases for each pathology. The highest recall = 0.90 combined with moderate discrimination ability (AUC-ROC = 0.702) was consistent with CC prediction model. WSD prediction model also had a high recall = 0.833 and a slightly higher discrimination ability compared to CC (AUC-ROC = 0.714). This confirmed feasibility of using XGBoost algorithm to determine influence of predictors on development of dental lesions. Enamel E prediction model was developed under conditions of pronounced class imbalance (n = 15), therefore it is presented as a continuous evaluation of relative risk. Its discrimination ability (AUCROC = 0.638) confirmed presence of a useful prognostic signal when using SMOTE. Conclusions. Presented models can be used to identify individuals at increased risk of developing WSD, CC, and E of tooth enamel in order to reduce their prevalence and justify the prescribing therapeutic and preventive measures.

Summary. Organ failure typical clinical syndromes (OFTCS) are considered preliminary diagnoses. Determining their form, taking into account vegetative status and comorbidity, is the basis of a rehabilitation diagnosis. The aim of the study was to determine OFTCS as a preliminary diagnosis and to establish their pathogenetic forms based on vegetative status and mineral metabolism to optimize rehabilitation. Material and Methods. The study was conducted at the clinical departments of Donetsk National Medical University. The patterns of experimental myocardial infarction healing were established. Patients with OFTCS were divided into 2 groups according to the heart rate spectral analysis data. The form of comorbidity was determined by the calcium level in the hair using an atomic absorption spectrometer. Statistical processing was performed using "Statistica” StatSoft software. Results. Experimental models of myocardial infarction were developed. Variational pulsometry data (power of LF and HF spectra and their ratio) confirmed the significant role of vegetative status in OFTCS pathogenesis. A sympathovagal balance index >1.65 indicated sympathotonia dominance, while <1.55 reflected vagotonia. The intracellular calcium level allowed establishing the comorbidity form, which correlated with the sympathovagal balance index. The close relationship of OFTCS forms with vegetative status confirmed the "vegetative-homeokinetic theory of pathology". Conclusions. The conducted studies allowed to determine the patterns of myocardial infarction healing, identify informative indicators of the patient’s vegetative status, and establish OFTCS forms, which facilitates the individualization of treatment.

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.

Досліджено особливості клінічного перебігу та діагностики опортуністичних інфекцій у пацієнтів з різними формами імуносупресії, включно з ВІЛ-інфекцією та онкологічними захворюваннями. Розглянуто вплив нейтропенії, порушень клітинної та гуморальної ланок імунітету, тривалої терапії глюкокортикостероїдами, таргетними та біологічними препаратами на спектр збудників і характер клінічних проявів. Встановлено, що опортуністичні інфекції часто мають атиповий або малосимптомний перебіг, що ускладнює раннє розпізнавання та потребує застосування високочутливих методів діагностики, зокрема комп’ютерної томографії, молекулярних тестів, антигенних досліджень та інвазивного отримання матеріалу. Порівняно групи пацієнтів з ВІЛ-інфекцією та онкологічних хворих, визначено ключові відмінності у механізмах імуносупресії та спектрі опортуністичних інфекцій. Підкреслено важливість ризик-орієнтованого підходу, що враховує тип імунного дефекту, клінічний синдром та ймовірних збудників, для оптимізації діагностики та покращення клінічних результатів.