Background. High 24-hour mortality during martial law requires improved public health administration. Studying care defects is critical for reforming quality control and legal liability under emergency conditions. Purpose – to identify chronological patterns of 24-hour in-hospital mortality and systemic gaps in public healthcare administration through forensic medical examination data; to substantiate legal mechanisms for their elimination under martial law. Materials and Methods. Retrospective analysis of 51 early in-hospital death cases at a tertiary-level multidisciplinary hospital in Kyiv. Patients were stratified by six admission time intervals (4-hour periods), calendar quarters, ward profile, and admission source. Compliance with electrocardiography recording, intravenous access establishment, pharmacotherapy, and oxygen therapy was assessed; discrepancies between clinical and pathomorphological diagnoses were analysed. Statistical methods: Fisher exact test with Freeman–Halton extension, Holm–Bonferroni correction for 60 pairwise comparisons, Wilson 95% confidence intervals, Cramérʼs V coefficient, Spearman rank correlation coefficient, chi-square goodness-of-fit test. Results. A chronological paradox was identified: 66.7% of deaths occurred during daytime and evening hours (06:00–21:59). The maximum proportion was recorded in Interval II (10:00–13:59) – 27.45% (95% confidence interval: 17.1–40.9%); the minimum in Interval I (06:00–09:59) – 7.84% (95% confidence interval: 3.1–18.5%). No pairwise between-interval differences in medical care deficiency indicators were statistically significant after Holm–Bonferroni correction (p>0.05), confirming the systemic rather than chronologically determined nature of violations. The highest degree of variation was observed for absent intravenous access (Cramérʼs V=0.495). The uniform distribution of diagnostic discrepancies across all intervals (Cramérʼs V=0.159, p=0.936) confirms the structural nature of diagnostic errors. The only statistically significant finding: the proportion of cardiac ward patients in the 6–12-hour group (75.0%; 95% confidence interval: 50.5–89.8%) was significantly higher than in the 12–24-hour group (30.8%; 95% confidence interval: 12.7–57.6%), p=0.027. Conclusions. Systemic gaps in mandatory care standards persist regardless of the time of day. Under martial law, these gaps escalate from latent risks to survival threats, requiring regulatory consolidation of chronological quality monitoring, shift handover protocols, differentiated ward-specific quality management standards, and separate legal standards of medical liability for emergency conditions.
Background. Domestic violence, as a manifestation of physical aggression through neck compression, can lead both to health impairment of the victim and even to death. Insufficient attention has been paid to its consequences during the provision of medical care to the victim and in forensic medical examination. Purpose – to provide information on the increase in gender-based cases of domestic violence and to emphasize non-fatal neck compression, its impact on the victimʼs health, and the determination of the severity of such injuries according to forensic medical criteria. Materials and Methods. The analytical population consisted of adult women who were victims of domestic violence. A total of 52 literature sources from Scopus, PubMed, Google Scholar, and others were used based on keyword searches. In the English-language literature, sources using the terms «non-fatal strangulation» and «non-fatal asphyxia» were considered as types of mechanical asphyxia resulting from neck compression by hands or a ligature. Results. Human rights organizations and national institutions report an increase in domestic violence against women. Manifestations of non-fatal neck compression during domestic violence are accompanied by local injury, clinical symptoms of developing hypoxia or asphyxia, and possible psychological, cognitive, and behavioral disorders. Conclusions. Cases of gender-based domestic physical violence are characterized by an increase in their number both globally and in Ukraine. Its manifestations through neck compression by a ligature or hands require thorough screening, taking into account their clinical consequences both during the provision of medical care and in forensic medical assessment. In the forensic medical substantiation of injury severity in cases of non-fatal neck compression, it is necessary to consider complaints, the presence of bodily injuries, as well as health impairments caused by the development of hypoxia or asphyxia with consequences in the form of neurological, psychological, cognitive, and behavioral disorders.
Background. Oxidative stress plays a key role in the pathogenesis of autoimmune thyroiditis and benign thyroid tumors, but the impact of prolonged war-related stress on these processes remains insufficiently investigated. Рurpose – the aim of the study was to evaluate the impact of war-related chronic stress on glutathione peroxidase activity and selenium levels in blood and thyroid tissue in patients with autoimmune thyroiditis associated with benign thyroid tumors. Materials and Methods. 71 patients with autoimmune thyroiditis combined with benign thyroid tumors (group 1) and 22 healthy individuals (control, group 2) who were in military conditions for 4 years were examined. Situational anxiety according to the Spielberger scale, glutathione peroxidase activity in erythrocytes and thyroid tissue, selenium levels in plasma and thyroid tissue were determined. Results. In group 1, blood selenium and glutathione peroxidase levels were significantly reduced in both moderate and high levels of situational anxiety compared with the control group. It was found that in group 1, high levels of situational anxiety caused a significant decrease in glutathione peroxidase activity compared with patients with moderate levels of situational anxiety both in erythrocytes (from 41.50 ± 9.13 U/g Hb to 28.58 ± 4.08 U/g Hb, P = 0.0000) and in thyroid tissue (from 56.45 ± 4.92 to 43.61 ± 10.23 U/g protein P = 0.0002). High levels of situational anxiety compared to the average level in group 1 also led to a significant decrease in selenium levels both in plasma (from 1.28 ± 0.121 to 1.04 ± 0.10 μmol/L, р = 0.0000) and in thyroid tissue (from 1.00 ± 0.11 to 0.81 ± 0.06 μmol/L protein, р = 0.0000). Conclusions. Benign thyroid tumors on the background of autoimmune thyroiditis in combination with chronic psycho-emotional stress lead to depletion of the selenium-dependent antioxidant system.
Background. Insufficient control of acute pain necessitates the improvement of opioid-sparing analgesic strategies. One of the promising approaches is the combined use of nonsteroidal anti-inflammatory drugs with centrally acting adjuvant analgesics, which makes it possible to target different pathways of nociceptive transmission and potentially enhance the analgesic effect. Purpose – of the study was to investigate and comparatively evaluate the analgesic efficacy of combinations of ketoprofen with gabapentin, amitriptyline, and ketamine in an experimental model of inflammatory pain. Materials and Methods. The study was performed on 42 outbred male rats weighing 180–220 g, divided into six groups: control, morphine, ketoprofen, ketoprofen + gabapentin, ketoprofen + amitriptyline, and ketoprofen + ketamine. The nociceptive response was induced by subcutaneous injection of 0.1 mL of a 5.0% formalin solution into the plantar surface of the hind paw. Phase I of the formalin test was assessed based on the latency of the pain response, duration of Phase I, and the number of behavioral flinch-patterns. Results. In the control group, the latency of the pain response was 1.7 ± 0.28 min, the duration of Phase I was 5.6 [5.5; 6.3] min, and the number of flinch patterns was 70.7 ± 5.8. Morphine, used as the reference drug, significantly reduced the duration of Phase I to 4.8 [4.5; 5.0] min and decreased the number of flinch patterns to 12.1 ± 1.5. Ketoprofen monotherapy reduced the number of pain reactions to 49.3 ± 2.1, confirming its antinociceptive activity; however, its effect was less pronounced compared with morphine. The combination of ketoprofen with gabapentin reduced the number of flinch patterns to 34.4 ± 2.1, while the combination with amitriptyline reduced it to 38.5 ± 2.8. The most pronounced potentiation of the analgesic effect of ketoprofen was observed in combination with ketamine: the duration of Phase I decreased to 4.3 [3.4; 4.6] min, and the number of flinch patterns decreased to 25.7 ± 1.6. At the same time, changes in the latency of the pain response in the combination therapy groups did not reach statistical significance. Conclusions. Centrally acting adjuvant analgesics potentiate the antinociceptive activity of ketoprofen in Phase I of the formalin test, primarily by reducing the duration and intensity of the behavioral pain response. Among the studied combinations, the ketoprofen + ketamine regimen demonstrated the highest efficacy, supporting the rationale for further preclinical investigation of multimodal analgesic strategies.
Background. Treatment of prostate cancer involves androgen deprivation therapy with triptorelin. Despite oncological efficacy, the therapy causes adverse effects. Systemic complications of the therapy are well known, whereas changes in the upper respiratory tract, in particular the nasal mucosa, remain poorly studied by clinicians. This discrepancy between the widespread use of the drug and the lack of understanding of its impact on the respiratory epithelium dictates the need to search for safe correction. Purpose – is a systematic analysis of morphological and pathogenetic mechanisms of changes in the nasal mucosa under the conditions of testosterone-suppressing action of triptorelin and substantiation of the use of quercetin as a corrective agent. Materials and methods. Data from English-language literature obtained from scientometric databases Scopus Web of Science MEDLINE PubMed Google Scholar were studied and analyzed. The study covers mainly the last 5 years 2020-2025. A search by keywords systematic and comparative analysis of selected articles study of full-text articles for compliance with inclusion criteria in the reference list and relevance of the studies was conducted. Results. The nasal mucosa functions as an active hormone-dependent organ. Testosterone critically regulates mucociliary clearance by stimulating nitric oxide synthase expression providing vasodilation and antimicrobial protection. Chronic administration of triptorelin leads to receptor desensitization and reduction of testosterone concentration to castration level. Androgen deficiency transforms the mucosa reduction of nitric oxide correlates with dryness and congestion. Type 2 innate lymphoid cells physiologically suppressed by testosterone become activated secreting excess proinflammatory interleukins. This potentiates allergic inflammation, promoting the formation of a secretory aging epithelial phenotype. Tissue remodeling and the development of hormonal rhinitis require therapy. The bioflavonoid quercetin, due to its ability to mitigate oxidative stress and modulate inflammatory pathways without stimulating tumor growth, is considered an effective pathogenetic agent for the protection of the respiratory epithelium. Conclusions. The nasal mucosa is a hormone-sensitive target. Pharmacological castration with triptorelin disrupts nasal cavity homeostasis, causing inflammation and suppression of mucociliary clearance. The use of quercetin may represent a justified strategy for correcting nasal symptoms in oncological patients.
Background. Listeriosis belongs to infectious disease common to humans and animals, caused by Listeria monocytogenes. The medical and social significance of listeriosis is determined by its high mortality rate in affected people, including pregnant women and newborns, the elderly, and persons with immunodeficiencies. Controlling listeriosis in veterinary medicine leads to significant economic costs for implementing additional food chain safety measures. Purpose – the aim of the work is to highlight the current state of the listeriosis problem in the context of the «One Health» concept with regard to risk assessment for human infection and food safety. Materials and methods. A literature search was conducted in the scient metric databases Scopus, Web of Science, MEDLINE/PubMed, Google Scholar (1995–2025) using the terms: «L. monocytogenes», «human listeriosis», «listeriosis ecosystem», «Listeria in the food chain», «Listeria in livestock», «One Health concept». National and international regulatory documents on listeriosis were analyzed. Analytical methods were used to determine the medical and veterinary significance of listeriosis, as well as programs and strategies to reduce the disease burden. Results. There is a growing trend in the prevalence of listeriosis, and expansion in the range of animal- and plant-derived agents of pathogen transmission to humans, requiring strengthened control over raw materials and food products. Intensification of international trade and inconsistency of food safety regulations among countries increase the risk of epidemics caused by L. monocytogenes. The absence of a human vaccine limits the prevention of listeriosis. The key factors influencing the listeriosis epidemic process are food security and minimizing human infection risks. Cross-sectoral collaboration requires standardization at national and international levels, improvement of regulatory documents for risk on assessment for transboundary spread, and implementation of outbreak investigations and response mechanisms. Conclusions. Optimization of food safety control and reduction of the listeriosis burden from positions of the «One Health» concept require harmonization of national and international regulation documents and vaccine development.
Background. Children in Ukraine are exposed to war-related stress, and a proportion of them live in regions that include territories radioactively contaminated as a result of the Chornobyl disaster. However, evidence on trait anxiety levels and their independent predictors under these conditions remains limited, highlighting the need for quantitative assessment. Purpose – to assess the level of trait anxiety in school-aged children exposed to war-related events and to identify independent psychological and contextual factors associated with the level of trait anxiety. Materials and Methods. A cross-sectional study included 231 school-age children from three regions of Ukraine, including settlements located in radioactively contaminated territories. Trait anxiety, perceived stress, depressive symptoms, self-efficacy, and sleep quality were assessed using standardized questionnaires; warrelated exposure was recorded (occupation/displacement/evacuation, parental military service). Internal 137Cs activity was measured. Analyses included descriptive statistics and multivariable linear regression to identify independent predictors of anxiety. Results. Nearly half of the children (44%) had high anxiety. Girls showed higher anxiety scores than boys, and the highest levels were observed among children with occupation experience and children of military personnel. In the multivariable model (R² = 0.60), anxiety was independently associated with war-related exposure, higher perceived stress and depressive symptom scores, and lower self-efficacy. Internal 137Cs activity ranged from 37 to 7807 Bq and was not associated with anxiety. Conclusions. High levels of trait anxiety were observed among the examined children. In the multivariable linear regression model, independent predictors of anxiety included war-related exposure, higher perceived stress and depressive symptoms, and lower self-efficacy. No independent contribution of the radiation context was observed.
Background. Transforaminal endoscopic discectomy of L5–S1 disc herniation may be difficult due to the anatomical features of the lumbosacral segment and ilium, which have not been sufficiently studied. Purpose – of this study was to analyze the radiographic features of the lower lumbar segments and pelvis in patients with L5–S1 disc herniations who underwent transforaminal endoscopic discectomy, based on a retrospective analysis of preoperative instrumental imaging data. Materials and methods. Protocols of clinical and radiological examination of 35 patients with L5–S1 disc herniation, who underwent transforaminal endoscopic discectomy with partial facetectomy of the superior articular process of the S1 vertebra. Methods: 1) clinical; 2) radiological; 3) statistical. Results. The results of transforaminal endoscopic discectomy of L5–S1 disc herniations were favorable in all patients. The patients were divided into: group A (n=32; 91%) by transforaminal endoscopic discectomy and group B (n=4; 9%) with cases of conversion of endoscopic discectomy to open microdiscectomy (n=3) and intraoperative discography (n=1). It was found that lumbar lordosis LL, sacral slope SS, the size of the transverse and articular processes of the lower lumbar vertebrae, the orientation of the articular facets on both sides, degeneration stages according to Pfirrmann (IV–V) and Modic (type 3) in the L5–S1 segment in both groups were almost identical. The groups differed in: a) the height of the iliac crest: in group Apredominantly below the horizontal line through the middle of the L5 pedicle (81%; (p<0.001); b) the distance between the articular facet and the vertebral body at the L5–S1 level on the ipsilateral ((0.8±0.56) cm in group A and (2.0±0.82) cm in group B) and contralateral side of the disc herniation ((0.6±0.41) cm and (1.12±0.71) cm, respectively). Conclusions. When selecting patients with L5–S1 disc herniation for transforaminal endoscopic discectomy, morphometric parameters of the lumbosacral segment and the height of the iliac crest play a significant role.
Background. The study of sclerostin is of particular clinical interest in patients with chronic kidney disease stage V and diabetes mellitus, because today it is an insufficiently studied biomarker of bone metabolism disorders, potentially associated with vascular calcification in hyperazotemia conditions. Purpose – to determine the clinical significance of serum sclerostin in patients with chronic kidney disease VD stage and diabetes mellitus by analyzing its relationships with key clinical and laboratory parameters. Materials and methods. A single-center cross-sectional cohort study was conducted in which 134 patients with chronic kidney disease stage VD were examined. All patients were determined by the level of vitamin D (25(OH)D), C-reactive protein, lipid profile, urea, creatinine, total protein and albumin, ferritin, intact parathyroid hormone, calcium, phosphorus, alkaline phosphataseactivity. The level of circulating sclerostin was determined using an automated enzyme-linked immunosorbent assay – ELISA SOST for humans (ab221836). Result. In patients with chronic kidney disease stage VD and diabetes mellitus, lower levels of intact parathyroid hormone were found, which were associated with higher levels of serum sclerostin; a higher frequency of heart valvular apparatus calcification, which was accompanied by an increase in the frequency of vertebral and non-vertebral fractures against the background of vitamin D(25(OH)D) severe deficiency. Lipid metabolism disorders in the form of hypercholesterolemia and hypertriglyceridemia, combined with a higher level of serum ferritin were detected in the group with diabetes mellitus. A positive correlation was found between body mass index and sclerostin (r = 0.448; p = 0.008), urea level and sclerostin (r = 0.364; p = 0.034). There was a negative correlation between intact parathyroid hormone level and sclerostin (r = -0.371; p = 0.031); alkaline phosphatase and sclerostin (r = -0.401; p = 0.025); total plasma protein level and sclerostin (r = -0.368; p = 0.032). Conclusion. Chronic kidney disease stage V on dialysis and diabetes mellitus have profound disorders of mineral and lipid metabolism. The results indicate significance of sclerostin as a modern biomarker in the diagnosis of mineral and bone disorders in patients with chronic kidney disease stage V on dialysis.
Background. Ulcerative colitis is an inflammatory recurrent disease of the intestinal mucosa. Given its prevalence, colitis is a global problem in modern society. One of the factors of the development and progression of ulcerative colitis is the disruption of immune processes that protect the intestine from damage. Рurpose – is to study morphological indicators of colon mucosal proliferation against the background of determining pro- and anti-inflammatory cytokines and neutrophils in the blood of rats with induced ulcerative colitis caused by dinitrobenzenesulfonic acid. Materials and methods. The experiment involved 42 adult rats of both sexes. The animals were divided into three groups of fourteen animals each, and intestinal inflammation was induced by rectal administration of 2.4-dinitrobenzenesulfonic acid over a period of 14 days. Results. The obtained results of the immunohistochemical study showed that rectal administration of 50% ethanol solution causes an increase in the proliferative activity of the epithelium of the colon. The expression of Ki-67 correlates with the levels of interleukins in the blood in the model of experimental colitis. The content of pro-inflammatory and anti-inflammatory interleukins in the blood plasma were increased both in the second control group with the introduction of 50% ethanol solution and in the experimental group of animals with DNBS administration. Conclusions. The obtained results indicate that ethanol provokes inflammation of the mucous membrane and can increase the permeability of the intestinal membrane, and the administration of DNBS can enhance the harmful effect on the intestine.
Background. Proximal femur fractures are among the most common injuries in elderly patients and are associated with high rates of disability, mortality, and loss of independence. More than 1.5–1.7 million cases are reported worldwide annually, and this number is expected to increase nearly fourfold by 2050 due to population aging. Most fractures occur after low-energy trauma, particularly falls from standing height, in patients with osteoporosis and frailty. Despite advances in surgical techniques, the optimal management strategy remains controversial. Purpose – to systematize current literature data on the epidemiology, classification, and surgical management of proximal femoral fractures in elderly patients. Materials and Methods. A literature review was conducted using PubMed, Scopus, Web of Science, MEDLINE, and Google Scholar databases for the period 2015–2025. Search terms related to proximal femur fractures, osteosynthesis, arthroplasty, orthogeriatric care, and rehabilitation were used. Clinical studies, systematic reviews, and meta-analyses were included. Results. Proximal femur fractures remain one of the leading causes of hospitalization and disability among older adults. Treatment strategies include osteosynthesis and arthroplasty, with the choice depending on fracture type, patient age, bone quality, functional status, and comorbidities. Modern evidence supports the use of cephalomedullary fixation for unstable intertrochanteric fractures and arthroplasty for displaced femoral neck fractures in elderly patients. Multidisciplinary orthogeriatric care, early surgery, and accelerated rehabilitation protocols significantly improve clinical outcomes and reduce postoperative complications and mortality. Conclusions. Proximal femur fractures represent a major medical and social challenge in aging populations. Contemporary multidisciplinary approaches, including individualized surgical management and early rehabilitation, improve functional recovery and quality of life. Further research should focus on personalized treatment strategies and optimization of perioperative care.
Background. Urinary tract infections are among the most common bacterial pathologies in children: up to 8% of girls and 2% of boys experience at least one episode of the disease by the age of 7 years. An important risk factor for recurrence is vesicoureteral reflux – a common congenital anomaly detected in 0.5–3% of children in the general population and in 20–50% of patients with urinary tract infections. Purpose – to systematize current data on the clinical course of urinary tract infections in children with vesicoureteral reflux, taking into account age-related and regional characteristics; to analyze the impact of reflux grade on recurrence rates and the risk of renal parenchymal damage; and to compare international and Ukrainian indicators. Materials and methods. Within the scope of the conducted study, an analysis of 200 relevant scientific publications was performed. Of these, 56 were selected from leading medical information platforms, including Scopus, PubMed, MEDLINE, and Google Scholar, covering the period from 2016 to 2026, using the following keywords: «infection», «urinary tract», «children», «congenital malformations», «vesicoureteral reflux», «antibiotic therapy», and «diagnosis». Results. Vesicoureteral reflux is detected in 25–45% of children with urinary tract infections most frequently in those under 3 years of age (up to 40–45%). The recurrence rate depends on the grade of reflux: 15–25% in grades I–II and 50–60% in grades III–V. The leading pathogen remains E. coli (70–80%). Ukrainian data generally correspond to European findings; however, the absence of national registries limits the accuracy of assessment. Conclusions. Urinary tract infections in children with vesicoureteral reflux are characterized by a high risk of recurrence and the development of reflux nephropathy, particularly in early childhood. Higher grades of reflux are associated with a greater frequency of infections and renal tissue damage. Early diagnosis, risk stratification, and standardized management approaches are essential for the prevention of complications and improvement of prognosis.
Background. Post-COVID syndrome in children is characterized by a multisystem course and may be accompanied by persistent cardiovascular involvement. Alterations in markers of endothelial activation, coagulation, and cardiac stress, particularly NT-proBNP and D-dimer, may reflect subclinical cardiovascular damage following SARS-CoV-2 infection. However, the relationship between these markers and humoral immune response in pediatric patients remains insufficiently studied. Purpose – to assess the association between IgG levels to SARS-CoV-2 and D-dimer and NT-proBNP concentrations as laboratory markers of cardiovascular involvement in children with post-COVID syndrome. Materials and Methods. A single-center open prospective cohort study included 110 children aged 5–12 years. The main group consisted of 80 patients with clinically verified post-COVID syndrome, while 30 children without a history of SARS-CoV-2 infection formed the control group. Serum levels of IgG to SARS-CoV-2, NT-proBNP, and D-dimer were measured using enzyme-linked immunosorbent assay. Statistical analysis included intergroup comparisons and correlation analysis (SPSS v.26, Statistica v.13). Results. Children with post-COVID syndrome demonstrated significantly higher levels of D-dimer and NT-proBNP compared with controls (median ≈ 91 vs 1.24 ng/mL and 4.95 vs 0.45 ng/mL, respectively). A moderate positive correlation was found between IgG and D-dimer (r = 0.55; p < 0.001), while no significant association was observed between IgG and NT-proBNP. A very strong positive correlation was identified between NT-proBNP and D-dimer (r = 0.88; p < 0.001). No sex-related differences were detected for any of the studied markers. Conclusions. The combined elevation of D-dimer and NT-proBNP and their strong association reflect a unified pathophysiological cascade of endothelial dysfunction and subclinical cardiac stress in children with post-COVID syndrome, whereas IgG levels are primarily associated with coagulation abnormalities.
Background. The production of biologically active cell-free therapeutic products based on tissue cryoextracts requires the optimization of cell lysis technologies and control of cryogenic membrane injury, as these processes determine the preservation of endogenous regulatory molecules and the reproducibility of their biological effects. The growing interest in cell-free approaches in regenerative medicine highlights the need to systematize modern strategies of cell disruption and to analyze their influence on the quality of therapeutic extracts. Purpose – to summarize and critically analyze current biotechnological strategies of cell lysis and the mechanisms of cryogenic membrane injury based on literature data, to evaluate their impact on the release and preservation of endogenous regulatory molecules, to identify optimal conditions for obtaining high-quality tissue cryoextracts, to characterize their molecular and functional stability, and to substantiate the prospects for standardizing cell-free biological products for use in regenerative medicine. Materials and Methods. The literature search was performed in PubMed, Clinical Key Elsevier, Cochrane Library, eBook Business Collection, and Google Scholar. The search was conducted using relevant keywords, followed by screening of article abstracts and full-text evaluation. Publications were included if they contained up-to-date data on methods of cell lysis, cryogenic membrane injury, and the production of tissue extracts, and if they adhered to the principles of evidence-based medicine. Results. It was established that mechanical, physical, chemical, and enzymatic methods of cell lysis differ markedly in the intensity of their impact on cellular structures, in their ability to preserve proteins, peptides, lipids, and low-molecular-weight components, as well as in the purity of the resulting extract. Cryogenic lysis ensures minimal degradation of sensitive molecules, suppression of endogenous enzymatic activity, and enhanced stability of the native structure of bioactive substances, making it the most suitable approach for producing standardized therapeutic products. Other methods demonstrate higher membrane-disrupting efficiency but are associated with risks of thermomechanical or chemical damage, contaminant formation, and variability in extract composition. The significance of cryogenic mechanisms including lipid phase transitions, osmotic shifts, and intracellular ice formation was analyzed, as they determine the release of intracellular regulatory molecules and shape the bioactive profile of cryoextracts. Conclusions. Cryogenic lysis represents the most balanced approach for obtaining high-quality tissue cryoextracts, as it combines effective cell disruption with maximal preservation of biological activity. The standardization of lysis methods is a key prerequisite for improving the efficacy and safety of cell-free regenerative technologies.
Background. The study of structural and functional changes of the myocardium in patients with chronic coronary syndrome and type 2 diabetes mellitus makes it possible to identify early processes of cardiac remodeling, diastolic dysfunction, to assess the degree of coronary involvement. Purpose – is to investigate the relationship between the state of systolic and diastolic myocardial functions and the level of N-terminal pro–B-type natriuretic peptide in patients with chronic coronary syndrome with concomitant type 2 diabetes mellitus taking into account the degree of coronary artery involvement according to coronary angiography. Materials and Methods. The object of the study was 95 patients with exertional angina who underwent coronary angiography. The main group consisted of 60 individuals (63.2%) with exertional angina in combination with type 2 diabetes mellitus. The comparison group included 35 patients with a verified analogous cardiological diagnosis without concomitant type 2 diabetes mellitus. Results. In patients with exertional angina and type 2 diabetes mellitus, coronary angiography more frequently revealed multivessel coronary artery disease. These patients showed a significant increase in left atrial size, left ventricular end-diastolic and end-systolic volumes. Left ventricular ejection fraction decreased with increasing severity of coronary artery involvement and was significantly lower in patients with type 2 diabetes mellitus. In the examined patients with combined pathology, the ratio of transmitral flow velocities was significantly lower, especially in those with multivessel coronary artery disease, indicating pronounced myocardial relaxation impairment. In both patient groups, a reduction in global longitudinal myocardial strain was observed, particularly in individuals with multivessel coronary artery involvement against the background of concomitant pathology. In patients with chronic coronary syndrome and multivessel coronary artery disease, a significant increase in the level of N-terminal pro–B-type natriuretic was noted. Conclusions. In patients with chronic coronary syndrome combined with type 2 diabetes mellitus the progression of chronic heart failure increases with the rise in the number of affected coronary arteries. The changes manifest as dilation of the left ventricular cavity and its hypertrophy, diastolic dysfunction, a decrease in left ventricular ejection fraction and the index of global longitudinal myocardial strain of the left ventricle, an increase in the level of N-terminal pro–B-type natriuretic peptide.
Background. Chemotherapy-induced peripheral neuropathy is a common complication of anticancer therapy with taxane- and platinum-based agents and is accompanied by persistent motor impairments that significantly limit the body’s functional capacity and reduce patients’ quality of life. Despite the clinical significance of motor deficits, their temporal dynamics and severity under concurrent administration of paclitaxel and cisplatin remain insufficiently studied. Purpose – to compare the temporal dynamics and severity of motor impairments in rats with chemotherapy-induced peripheral neuropathy following administration of paclitaxel, cisplatin, and their concurrent use over a 120-day observation period. Materials and Methods. The study was conducted on adult male inbred white rats, divided into four groups: intact control, paclitaxel (cumulative dose 8 mg/kg, intraperitoneally), cisplatin (cumulative dose 16 mg/kg, intraperitoneally), and a combination group. In the combination group, animals received cisplatin at 2 mg/kg and paclitaxel at 5 mg/kg once weekly for six weeks, providing a cumulative dose of 12 mg/kg for cisplatin and 30 mg/kg for paclitaxel. This regimen corresponded to standard clinical protocols of paclitaxel (175 mg/m²) and cisplatin (75 mg/m²) when adjusted for body surface area. Motor activity and coordination were assessed on days 1, 7, 14, 28, 60, 90, and 120 using the Open Field and Rotarod tests with a patented device for evaluating coordination and muscle endurance. Results. Chemotherapy-treated animals demonstrated persistent reductions in overall motor activity and coordination compared to the intact control group. Motor deficits developed from day 7 with paclitaxel, whereas cisplatin-induced impairments appeared as early as day 1. The most pronounced and long-lasting changes were observed under concurrent administration of paclitaxel and cisplatin, persisting throughout the 120-day observation period. Conclusions. Paclitaxel and cisplatin induce long-term motor deficits in an experimental model of chemotherapy-induced peripheral neuropathy, with combined administration resulting in the most severe impairments of coordination and activity. Behavioral tests such as Open Field and Rotarod provide informative tools for assessing the temporal dynamics and severity of motor dysfunction in neurotoxicity models.
Background. Local allergic rhinitis is a distinct nosological entity whose immunopathogenetic mechanisms and phenotypic heterogeneity are currently being actively studied. It is believed that disturbances of the microbiota associated with changes in the immune response of the nasal mucosa, including those related to lower levels of secretory immunoglobulin A in local allergic rhinitis, may help explain an individualʼs predisposition to allergen sensitization and the development of allergic inflammation. Purpose – to investigate the characteristics of the nasopharyngeal microbiome and the levels of secretory immunoglobulin A in primary school–aged children with suspected local allergic rhinitis. Materials and Methods. A total of 72 children with suspected local allergic rhinitis were examined; the mean age was 8.6 ± 1.7 years; 54.2% were boys and 45.8% were girls. The comprehensive examination included analysis of anamnestic data, clinical examination, general clinical laboratory tests, and allergological assessment. Rhinitis was diagnosed according to the ARIA 2024–2025 criteria, and severity was assessed using a visual analog scale. Identification of microorganisms from nasopharyngeal cultures was performed based on colony morphology, microscopy, and biochemical tests. Levels of secretory immunoglobulin A in nasal lavage were determined using the ELISA method. Results. An intermittent course of rhinitis was observed in 43.1% of children, while a persistent course was noted in 41 (56.9%). Manifestations of allergic rhinitis were mild in 59.7% of children (visual analog scale: 17.7 ± 6.65 mm), moderate in 38.4% (visual analog scale: 46.1 ± 10.1 mm), and severe in 2.6% (visual analog scale: 72.0 ± 1.00 mm). Microbial colonization of the nasopharynx was detected in 90.3% of examined children: representatives of the genus Staphylococcus (40.3%), Streptococcus spp. (25.0%), Moraxella catarrhalis (30.5%), and Haemophilus influenzae (15.3%). The mean sIgA level was 38.6 ± 14.9 μg/mL; decreased levels were found in 61.1% of children and were associated with a persistent moderate course of rhinitis. They were also lower in the presence of microbial associations compared with children with monoflora (p = 0.018). Conclusions. Reduced levels of secretory immunoglobulin A in the presence of microbial associations of S. aureus, coagulase-negative staphylococci, and Moraxella catarrhalis may play an important role in initiating local allergic inflammatory processes upon contact with allergens, with the subsequent development of local allergic rhinitis.
Background. Nasal vestibular furunculosis is an acute purulent-inflammatory condition with a risk of recurrence, driven by persistent bacterial colonization and impaired local immune regulation. Interleukin-33, as a mediator of barrier tissue injury, may reflect the intensity of the systemic inflammatory response even in cases of localized lesions. Purpose – to evaluate the role of interleukin-33 in the pathogenesis of nasal cavity furunculosis by comparing its serum levels in episodic and recurrent courses. Materials and Methods. A total of 67 individuals were examined: 37 patients with nasal cavity furunculosis, including 15 with a recurrent course, and 15 healthy volunteers. Serum samples were stored at −80°C. Interleukin-33 concentrations were determined using an enzyme-linked immunosorbent assay (ELISA). Results. In the furunculosis group, the mean interleukin-33 concentration was 79.12 ± 16.4 pg/mL, exceeding the control level 5.3-fold (14.91 ± 5.2 pg/mL; p < 0.001). In the recurrent course group, the value reached 108.77 ± 21.3 pg/mL, which was 7.3 times higher than in controls (p < 0.001). Comparison between the two clinical groups revealed a tendency toward higher values in recurrent cases (1.4-fold increase); however, the difference was not statistically significant (p > 0.05). Cluster analysis demonstrated that in the episodic course, values of 61.0–90.9 pg/mL predominated, whereas in recurrent cases, low values (1.0–30.9 pg/mL) were absent and the proportion of high levels (91.0–120.9 pg/mL) increased. Conclusions. Serum interleukin-33 levels are significantly elevated in nasal cavity furunculosis regardless of the disease course and may reflect systemic immune reactivity. The recurrent course is characterized by a shift in distribution toward higher concentrations, supporting further investigation of the prognostic value of this biomarker.
Background. Acute myocardial infarction remains a leading cause of mortality worldwide despite significant advances in reperfusion therapy. In most patients, the post-infarction period is characterized by myocardial remodeling, which determines long-term prognosis and the development of chronic heart failure. Increasing attention is being paid to metabolic and structural cardiac changes depending on infarct localization and the influence of modern cardioprotective therapies. Sodium-glucose cotransporter type 2 inhibitors have demonstrated the ability to reduce the risk of cardiovascular complications; however, their effect on the course of acute myocardial infarction with different infarct localizations during the early phase of the disease remains insufficiently studied. Purpose – to evaluate the effect of early administration of dapagliflozin on the dynamics of epicardial adipose tissue thickness and the level of N-terminal pro–B-type natriuretic peptide during 30 days in patients with acute myocardial infarction of anterior and inferior localization. Materials and methods. The study included 78 patients with acute myocardial infarction who were stratified according to infarct localization: anterior (n = 50) and inferior (n = 28). Myocardial infarction with and without Q-wave formation was determined according to electrocardiographic criteria. Within each subgroup, patients who received dapagliflozin from the first day of hospitalization (10 mg per day) were compared with a control group without therapy with sodium-glucose cotransporter type 2 inhibitors. The dynamics of epicardial adipose tissue thickness and the level of N-terminal pro–B-type natriuretic peptide were assessed during a 30-day follow-up period. Statistical analysis included parametric and non-parametric methods depending on data distribution. Results. The most pronounced and statistically significant changes were observed in patients with Q-wave myocardial infarction. In patients with anterior Q-wave myocardial infarction treated with dapagliflozin, a significant reduction in epicardial adipose tissue thickness and the level of N-terminal pro–B-type natriuretic peptide was observed compared with the control group. Similar trends were found in patients with inferior myocardial infarction. In patients without Q-wave formation, the reduction of the studied parameters was less pronounced and did not always reach statistical significance. Conclusions. Within 30 days after acute myocardial infarction, changes in epicardial adipose tissue thickness and the level of N-terminal pro–B-type natriuretic peptide were associated with infarct localization and the presence of a pathological Q wave. Early administration of dapagliflozin was associated with a more pronounced reduction of these parameters, suggesting a potential role of sodium-glucose cotransporter type 2 inhibitors in the modification of post-infarction remodeling.
Background. Post-COVID-19 syndrome is associated with long-term disturbances of cardiovascular regulation, including alterations in the circadian blood pressure profile, which may worsen the course of ischemic heart disease and increase the risk of complications. The role of smoking in the development of these abnormalities remains insufficiently studied. Purpose – to assess the characteristics of the ambulatory blood pressure profile in patients with unstable angina depending on the presence of post-COVID-19 syndrome and smoking status. Materials and Methods. A total of 147 patients with unstable angina were examined and divided into groups with and without post-COVID-19 syndrome, as well as into subgroups of smokers and non-smokers. All patients underwent 24-hour ambulatory blood pressure monitoring with analysis of the main parameters. Results. Patients with post-COVID syndrome demonstrated higher 24-hour and nighttime systolic and diastolic blood pressure levels, higher pulse pressure values and blood pressure load indices, as well as a significantly higher prevalence of abnormal circadian blood pressure patterns, particularly the «night-peaker» type. Smokers had significantly higher blood pressure levels and worse ambulatory blood pressure profile parameters compared with non-smokers. The highest frequency of exceeding target blood pressure levels and blood pressure load indices was observed in smokers with post-COVID syndrome. The most unfavorable parameters were found in patients with post-COVID syndrome who smoked. Conclusions. Post-COVID-19 syndrome is associated with more pronounced pathological changes in the circadian blood pressure rhythm in patients with unstable angina, including higher mean blood pressure levels and a higher prevalence of unfavorable circadian phenotypes («non-dipper», «night-peaker»). Post-COVID syndrome and smoking independently worsen ambulatory blood pressure parameters; however, their combination has a synergistic negative effect on the blood pressure profile and increases cardiovascular risk in patients with unstable angina.
