The aim. To substantiate the necessity of implementing a systemic approach to occupational health and safety for healthcare workers during wartime based on the ISO 45001 standard and to develop practical tools for mitigating occupational risks in extreme environments. Materials and methods. Statistical data from the Ministry of Health of Ukraine, KSE Institute reports on infrastructure damage, and research findings on injuries and burnout among medical personnel were analyzed. Methods of SWOT analysis, systems analysis, and adaptation of international safety standards to martial law conditions were applied. Results. A critical increase in «hidden» injuries and specific threats was identified: biological contamination stress, ergonomic disorders when working in shelters, and secondary traumatization. It was established that the level of teamwork in hospitals dropped from 82% to 60%. A «hygienic minimum» algorithm was developed for resource-scarce conditions, prioritizing the use of alcohol-based antiseptics and autonomous lighting. A «Healthcare Worker Safety and Hygiene Checklist» was created, adapted to ISO 45001:2018 standards, which allows for automated safety control in stressful situations and formalizes psychological support. Conclusions. Implementing a risk-oriented approach according to the ISO 45001 standard transforms formal labor protection into a living protection system. The use of adapted checklists minimizes the cognitive load on personnel, promotes the prevention of professional burnout, and ensures sustainable professionalism in the medical sector as an element of national security.
The Aim. Comparative Analysis of current protocols and standards for glaucoma treatment in Ukraine and the World Health Organization’s Package of Eye Care Interventions for early diagnosis and complication prevention. Materials and methods. Comparison of the Glaucoma Medical Care Standard, the Evidence-based Clinical Guideline for Glaucoma, and the Order of the Ministry of Health No. 959 of 05/26/2023 and the World Health Organization's Package of Eye Care Interventions of 2022. Literature search. Results. Interventions for the screening, diagnosing and treatment of glaucoma indicated in the Evidence-Based Clinical Guideline for Glaucoma correspond to the list of examinations of the Package of Eye Care Interventions. However, unlike the recommendations of the World Health Organization, the Clinical Guideline does not indicate at which levels of medical care the appropriate measurements should be provided. Regarding the rehabilitation of patients with glaucoma, the recommendations of the World Health Organization indicate groups of rehabilitation interventions necessary to improve the quality of life of patients with irreversible significant decrease in visual acuity. The current standards for the diagnosis and treatment of glaucoma in Ukraine do not contain clearly structured rehabilitation and preventive interventions for such groups of patients. Conclusions. In terms of the diagnosing and treatment of primary open-angle glaucoma, the Standards of Medical Care for Glaucoma, the Evidence-Based Clinical Guideline for Glaucoma and the Order of the Ministry of Health No. 959 dated May 26, 2023 generally comply with the Package of Eye Care Interventions (PECI) of the World Health Organization. However, the Ukrainian standards lack algorithms and interventions for the rehabilitation of patients with visual impairment due to advanced stages of glaucoma, which is an important link in the treatment of this disease.
Introduction. Rehabilitation treatment is one of the key stages of health care delivery, aimed at restoring or improving physical, cognitive, and functional abilities after injury, illness, or surgical interventions. International clinical guidelines clearly regulate the need for nutritional screening of all hospitalized patients, followed by risk assessment and dietary correction in accordance with the patient’s clinical condition. Assessment of satisfaction with the organization of nutrition is an important indicator of the quality of nutritional support, as it makes it possible to identify discrepancies between regulatory requirements and actual food practices. The relevance of this study is обусловлена the need to improve food quality and to adapt menus to the actual needs of military personnel undergoing inpatient rehabilitation. Purpose. To assess the level of satisfaction of military personnel with the organization of food during rehabilitation treatment and to determine the factors affecting eating habits, the feeling of satiety, and the overall assessment of diet quality. Materials and methods. The study was conducted within the framework of a planned research project of the Ukrainian Military Medical Academy using an anonymous survey of servicemen undergoing rehabilitation at a military medical rehabilitation center. The questionnaire included items on satisfaction with food organization, quality and variety of dishes, and suggestions for menu improvement. Percentage distributions, Student’s t-test, and Spearman’s correlation coefficient (p < 0.05) were used for statistical analysis. A total of 92 male servicemen aged 19–62 years participated in the study. Results. More than 80.0% of the surveyed military personnel positively assessed the sanitary condition of dining facilities, timeliness of service, portion sizes, and freshness of food products, whereas only 48.9% of respondents positively assessed the variety of dishes. At the same time, the majority of respondents (72.0%) skipped one or more main meals, most often breakfast. In addition, 46.7% did not consume all served meals, and 80.4% additionally consumed food purchased at their own expense between main meals. The main suggestions for improving the diet concerned increasing the amount of fruits, vegetables, berries, fish products, and juices. Correlation analysis revealed statistically significant associations between skipping breakfast and assortment score (rₛ = 0.29; p < 0.01), between meal frequency and the desire to change portion sizes (rₛ = 0.31; p < 0.006), and between assortment score and the desire to review menus (rₛ = 0.56; p < 0.001). Associations were also found between feelings of heaviness/abdominal pain and the desire to reduce portion sizes (rₛ = 0.34; p < 0.002). Conclusions. The obtained results indicate the need to improve food provision for servicemen undergoing rehabilitation by expanding the range of dishes, updating menus, optimizing portion sizes, and adapting meals to individual needs while taking into account the energy expenditure of military personnel.
The Aim. to investigate the opinion of health care organizers on the possibility of providing medical, diagnostic and preventive care to patients with glaucoma at the present time in Ukraine. Materials and methods. Evaluation of the results of a questionnaire of 290 health care organizers of private and public institutions of Ukraine. The work used bibliographic and analytical methods. Results. When asked about the quality and accessibility of ophthalmological care in health care institutions (HCPs) of Ukraine, more than 90% of respondents defined it as average and higher. 73% of respondents answered that the level of care for patients with glaucoma in Ukraine is lower than the world average. More than 85% of respondents answered that they use National and European clinical protocols in their practice. Less than 60% of respondents confirmed that there is surgical treatment of glaucoma used in their health care centers. The main factors influencing the high incidence of glaucoma were named by respondents as: insufficient attention of the population to their health (90.4%), insufficient awareness of the dangers of glaucoma and its consequences (81.9%), insufficient awareness of risk factors for glaucoma (78.3%); on the other hand, low accessibility of ophthalmological care was noted by only 15.7%. According to respondents, to improve glaucoma prevention, it is necessary to: strengthen preventive measures (87.6%), strengthen the work of family doctors on glaucoma (78.7%), increase public awareness of the dangers of glaucoma and its consequences (70.8%). At the same time, measures that will improve the quality and accessibility of medical care for glaucoma are considered: optimization of resource provision of health care facilities (73%), governmental control (60.7%), implementation of treatment standards (58.4%), improvement of technologies of preventive, diagnostic and treatment processes (42.7%). Conclusions. The study showed that the vast majority of respondents noted an insufficient level of care for patients with glaucoma in the institutions where they work, compared to the global one. The vast majority of respondents confirmed the use of approved clinical protocols and guidelines in their practice. Respondents considered the main shortcomings of organizing medical care for patients with glaucoma to be low awareness of the population and a preventive focus in providing care, insufficient material and technical base of health care facilities, and insufficient involvement in the processes of early detection of glaucoma in the primary care setting.
Purpose. To provide a comparative hygienic assessment of the quality and safety of groundwater from pump room and water supply wells fed from the same aquifers, under the conditions of their different purposes and operating conditions, in order to substantiate simplified ecological and hygienic requirements for the design and construction of pump room complexes in settlements. Materials and methods. The current regulatory documents and construction projects for groundwater wells of pump rooms complexes were analyzed. A comparative hygienic assessment of retrospective and modern data on the chemical analysis of the composition (12 indicators) of groundwater from pump rooms and water supply wells fed by the same aquifers (Cenomanian and Jurassic) in the Kyiv was conducted. The research covered 22 pump rooms at specific addresses located in different districts of the city, and water supply wells from five city water intakes. The current situation regarding the placement of pump rooms and the size of their water protection zone (first belt) in the settlement (Kyiv) was analyzed. The work used sanitary-chemical, bibliometric, analytical and mathematical methods. Results. Analysis of regulatory documents in the field of water supply has shown that there are still no standards in the country for the design and construction of groundwater wells for pump rooms, which are identified with water supply wells, being different from them in purpose and operating mode. Monitoring of groundwater quality from pump rooms showed that the chemical composition of pump room water, as well as from centralized water supply wells, generally meets sanitary requirements for drinking water and only in some samples are abnormally recorded levels for odor, turbidity, total iron, manganese. These individual non-toxic indicators do not pose a direct threat to the health of water consumers. It is also shown that the quality of pump room water does not change significantly during long-term operation of wells (over 25 years) and does not depend on the size of the first belt of the water protection zone (30 m, 15 m, 7-10 m). For pump room wells, this belt of the water protection zone is nominal (formal) in nature, in which the legal regime of its proper maintenance is not maintained. For pump room wells, this factor is not a key factor in influencing the quality of groundwater extracted from deep-water horizons. Conclusion. The established differences between groundwater wells of pump room complexes and water supply wells became the basis for the development of simplified ecological and hygienic requirements for the design and construction of groundwater wells of pump room complexes. They require regulatory regulation by amending the current DBN V.2.5-74:2013 «Water Supply. External networks and facilities. Main provisions» and DSanPiN 2.2.4-171-10 «Hygiene Requirements for Drinking Water Intended for Human Consumption».
The aim. To substantiate and systematize an integrated model for the prevention of hyperprolactinemia in women with metabolic syndrome. Materials and methods. The study involved 203 women of reproductive age from 20 to 49 years, who were verified to have metabolic syndrome. All patients underwent laboratory and clinical examination with determination of prolactin, total cholesterol, glucose, Noma index, leptin. The hardware examination was performed using magnetic resonance tomography. The analysis of the study results was performed using IBM SPSS Statistics version 26 software. Results. A comprehensive prevention system is proposed, including lifestyle modification, psychoemotional stabilization, correction of metabolic disorders, pharmacological and educational interventions. Conclusions. An integrated approach allows you to influence all pathogenetic links in the formation of metabolic syndrome. The most effective is a combination of non-drug and pharmacological measures. Psycho-emotional correction is a necessary component of prevention.
The aim of the study is to determine the participation of homocysteine (Hcy) in the regulation of calcium-phosphorus metabolism in children living near the Chornobyl Exclusion Zone (ChEZ). Materials and methods. Using the statistical processing program IBM SPSS Statistics 22 (USA), the results of laboratory, instrumental and genetic examination of 956 children aged 12-18 years who permanently reside near the ChEZ were assessed. The parameters reflecting the specific activity of 137Cs radionuclides in the body, the content of Hcy, calcium (Ca), inorganic phosphorus (P), ionized calcium (Ca2+), and parathyroid hormone (PTH) in the blood were analyzed. To determine the degree of physical development of adolescents, the Rohrer mass-height index (IR) was calculated - the quotient of dividing body weight in kilograms by body length in meters cubed. Results. 137Cs was registered in the body of all examined children, in the group of boys its values were from 0.78 to 95.11 Bq/kg, in the group of girls - from 1.06 to 26.96 Bq/kg. In the analyzed groups of children, an inverse correlation was established between the specific activity of 137Cs radionuclides in the body and the content of Ca in the blood, as well as the IR values, reflecting the ratio of body weight to its length. Hyperhomocysteinemia was registered in most genetic subgroups of the folate cycle. The highest statistically significant proportion of hyperhomocysteinemia cases was found in subgroups with the main genotypes G/G MTR:2756 and T/TMTHFR:677. Based on a comprehensive study of the results of the correlation analysis of the parameters under study, the mechanism of participation of Hcy, folate cycle genes and environmental factors in the regulation of Ca-P metabolism in children is presented. Conclusions. Incorporation of 137Cs into the body of people living in areas affected by the Chornobyl accident causes energy deficiency in the cells of vital organs, leading to a decrease in the intensity of anabolic processes, impaired methylation of Hcy and changes in Ca-P metabolism. Impaired physical development of the examined children is directly related to the content of Ca in their blood, as evidenced by the direct correlation between Ca and IR. Energy deficiency associated with the incorporation of 137Cs into the body, as well as mutations of the FC genes, are the causes of hyperhomocysteinemia - an increased content of the sulfur-containing amino acid Hcy in the blood of children living in settlements located near the ChEZ. Hcy, by affecting the skeletal system, compensates for the deficiency of Ca in the blood induced by 137Cs. An increase in the Ca content in the blood with hyperhomocysteinemia has a negative effect on the processes of PTH formation and, therefore, creates conditions for the disruption of P excretion from the body through the kidneys. However, in most genetic subgroups, a direct correlation between P and PTH was recorded, illustrating the ability of the child's body to stimulate the excretion of P with urine when its concentration in the blood increases. Thus, transient hyperhomocysteinemia is an element of the body's adaptation system to environmental radiation exposure. In subgroups of children with risk alleles of genetic polymorphisms MTHFR:C677T and MTR:A2756G in the genome, there was no direct correlation between P and PTH, which indicates the possibility of formation of calcium-phosphorus complexes in the blood and their deposition in soft tissues and vessel walls.
The goal of this study was to determine the bactericidal effectiveness of a portable UV-LED water treatment system, developed by the authors, using the sanitary indicator microorganism E. coli. The authors' portable UV water purification system model, which uses UV-LED lights with a wavelength of 279 nm, was used for this study. Microbiological research was conducted on the sanitary indicator microorganism E. coli (strain UKM B-906) from the collection of the D.K. Zabolotny Institute of Microbiology and Virology. The results of the study showed that the developed model meets the necessary criteria: it is portable and energy-efficient (powered by a standard power bank or solar battery). At a 10-minute exposure, it completely inactivates E. coli at the highest concentration. For lower concentrations, even a 5-minute exposure is effective. When testing the absorption of UV radiation in the A, B, and C zones by a quartz tube, which is supposed to allow UV radiation to pass through with minimal energy loss, it was found that the absorption was lowest (less than 5%) at a distance of 20 cm. Therefore, the method of disinfection using UV-LEDs with a wavelength of 279 nm is effective for improving the epidemiological safety of drinking water. Portable systems based on this technology could be a promising solution for obtaining safe drinking water during emergencies.
The aim. The purpose of the study is to assess the risk of exposure to electric and magnetic fields for the health of the population of. Zaporizhzhia, which lives within the sanitary protection zone of high-voltage power lines of industrial frequency with a capacity of 150-330 kW. Materials and methods. The work was carried out taking into account the requirements and recommendations of the International Commission for Protection against Non-ionizing Radiation. 832 measurements of electromagnetic radiation were carried out using the PZ-50 industrial frequency field strength meter, which was calibrated. Measurements were carried out on the basis of Standard operating procedure «Methodology for measuring the level of electromagnetic radiation in the territory of residential buildings, in the premises of residential, public and industrial buildings». Research results. 27 monitoring points were identified, where the indicators of the electric field strength did not exceed the maximum permissible limits and the potential risk for the population was assessed as acceptable. However, at 4 points, the indicators of the electric field were registered at the limit of normal and the level of potential risk was estimated as permissible, and at one point, in which the excess of the maximum permissible level was determined, the potential risk for the population was estimated as extremely high (dangerous). Conclusions. 1. The results of the study made it possible to assess the potential risk of health of the population of. Zaporizhzhia from the influence of electromagnetic fields of high-voltage power lines of industrial frequency with a capacity of 150-330 kW. 2. As a result of the study, a monitoring point was identified, where an excess of the maximum permissible level and, accordingly, a high (dangerous) level of potential risk were observed. 3. Information about the results of the work was sent to the authorities and network owners for their further management decisions.
The principle of Open Science provides for general access to scientific results, data and research methods, and also promotes transparency and collaboration in the scientific process. This, in turn, provides for open access to publications and data, open analysis, open materials, pre-registration and open collaboration. The creation of an electronic repository of scientific data of a research institution and its subsequent integration into national-level electronic archives is an important component of the development of a single scientific space in Ukraine. Purpose: to highlight the results of the creation of a pilot project of an open archive of scientific publications of the State Institution «O.M. Marzieiev Institute of Public Health of the National Academy of Medical Sciences of Ukraine». Methods: computer search methods (keyword search, semantic search) and computer modeling were used. Results. It was found that a National Repository of Academic Texts has been created in Ukraine, which closely cooperates with such well-known scientific institutions as the Taras Shevchenko National University of Kyiv, NTU «Igor Sikorsky Kyiv Polytechnic Institute», the National Academy of Pedagogical Sciences of Ukraine, the O.O. Bogomolets National Medical University. In order to constantly inform the target audience, useful materials are published on various issues, from administrative decisions adopted by the government and central authorities, discussions of draft documents, scientific events, to analytical materials of international organizations, best practices of open science and research data management, the use of AI technologies, academic integrity, and the popularization of scientific achievements. At the same time, the National Repository of Academic Texts does not represent such participants as the National Academy of Medical Sciences of Ukraine and its departmental research institutions, in particular the State Institution «O.M. Marzieiev Institute of Public Health of the National Academy of Medical Sciences of Ukraine». Conclusions. It has been proven that the presence of scientific publications on the official website of a research institution is not a sufficient condition for increasing their citation index. The necessary creation at the level of a research institution of an open archive of scientific publications of its scientists, and its integration into nationwide distributed electronic databases in which academic texts are accumulated, stored and systematized, will contribute both to increasing the authority of the institution in scientific circles and to the development of educational, scientific, scientific-technical and innovative activities of our state as a whole.
The aim. Based on the examination of people with metabolic syndrome, determine the necessary regimen, nutritional principles, and range of foods to prevent the development of complications from the gastrointestinal tract. Mаterials and methods. A narrative review of publications related to changes in risk factors, dietary principles, and the effectiveness of prevention of metabolic syndrome was conducted. The analysis included WHO sources, materials from open databases, and author's data. Results. One of the best ways to prevent metabolic syndrome is a balanced and rational diet. It is clear that in wartime it is difficult to adhere to the principles of healthy eating, especially since there may be a complete or partial lack of food, but we must remember that nutrition affects the psycho-emotional state, the development of new diseases, the exacerbation of existing ones, the reduction of life expectancy and the deterioration of its quality. Conclusions. Metabolic syndrome is a complex clinical and biochemical disease with a high risk of complications. Its prevention in war and emergency situations requires a multilevel, systemic approach, taking into account pathogenesis, comorbidities, psycho-emotional stress, and limited access to resources. But to support the body, it will be enough to follow the principles of nutrition and consume simple foods to prevent the development of metabolic syndrome, as well as its complications. KEYWORDS: metabolic syndrome, prevention, nutrition, nutritional principles
Introduction. Nearly 40 years after the Chernobyl Catastrophe, its health effects remain significant for health of the population of Ukraine. Most affected groups include clean-up workers, evacuees, and residents of the radioactively contaminated territories. The aim. To systematize current data on cancer and non-cancer morbidity, mortality, disability, and dose-related factors in the main exposed cohorts; and to define health priorities ahead of the 40th anniversary of the accident. Materials and Methods. Sources include data from the State Registry of Chornobyl victims, long-term epidemiological studies, radiation and hygiene monitoring and dosimetric passportization of settlements. Main indicators: standardized incidence ratios (SIR), excess relative risk (ERR/Gy), mortality structure, and multimorbidity prevalence. Results. Clean-up workers have been found to have an increased cancer incidence (SIR>1), in particular thyroid cancer and leukemia (ERR/Gr>0). The dominance of non-oncological pathology of the cardiovascular, cerebrovascular, endocrine, and respiratory systems has been determined. Increased mortality of victims since the late 1990s and an increase in multimorbidity have been recorded. Current exposure is formed mainly due to the internal accumulation of 137Cs. The full-scale war of 2022 has complicated access to medical care. Conclusions. The high level of cancer morbidity and mortality among victims remains, the main causes of mortality remain cardiovascular and cerebrovascular diseases, and comorbidity plays an important role. Radiation and non-radiation factors of the Chernobyl disaster have a persistent negative impact on health. It is necessary to restore dosimetric control, registry surveillance and international cooperation for effective monitoring and prevention of radiological and medical consequences. KEYWORDS: Chornobyl, radiation exposure, dosimetric monitoring, cancer morbidity, multimorbidity, clean-up workers, 137Cs
As a result of full-scale armed aggression against Ukraine, there has been a significant reformatting of the infectious epidemiological landscape, accompanied by an increase in the prevalence of parasitic and zoonotic infections, especially among vulnerable population groups. The aim of the study was to identify the characteristics of the formation and dynamics of infectious epidemiology in wartime, to outline the key risk factors for the growth of parasitic infestations and zoonoses, and to assess their impact on the public health system. Methods included analysis of current epidemiological, clinical, and parasitological studies conducted in Ukraine and the EU between 2021 and 2025: observations among refugee children, surveys of internally displaced persons, clinical data on military personnel, and meta-analysis of publications in SCOPUS, PubMed, and other peer-reviewed sources. The results showed that the war contributed to an increase in cases of parasitic and zoonotic diseases due to deteriorating sanitary conditions, mass migration, ecosystem disruption, and increased human contact with reservoirs of infection. According to the annual report on the state of public health, in 2022, the incidence of ascariasis was 36.85 per 100,000 population, and in 2023, it increased to 40.56 (+8.94%). The highest incidence was recorded in relatively safe regions, while in combat zones the figures were underestimated due to population migration and limited medical supervision. For military personnel, prolonged exposure to conditions of clean water shortages, lack of sanitation and food safety, as well as stress and weakened immunity, increase the risk of infection. Conclusions. The development of a national strategy for controlling parasitic infestations–with protocols for mass treatment, health education programs, and enhanced veterinary and epidemiological surveillance—is a key condition for restoring epidemic stability in Ukraine in the postwar period. Keywords: infectious epidemiology, parasitic infections, war in Ukraine, internally displaced persons, zoonoses, Blastocystis spp., echinococcosis, Bartonella quintana
Objective: To analyze scientific data on the prevalence of tobacco and nicotine product consumption among the population of Ukraine and the world. Materials and Methods: An analytical review of scientific publications was conducted using bibliographic databases of the National Scientific Medical Library of Ukraine, WHO’s Medical Information Network, the National Library of Medicine (USA), the National Institutes of Health (USA), Directory of Open Access Journals, BioMed Central, FREE MEDICAL JOURNALS, ScienceDirect, The BMJ, among others. Scientometric, logical, and systematic analysis methods were employed. Overview: Currently, there are over 1.25 billion adult tobacco consumers worldwide. It is known that 84.0% of current smokers reside in developing countries, notably in Eastern Europe, Asia, Latin America, North Africa, and some island nations of Oceania. In several countries, such as the USA, Canada, Brazil, Australia, the United Kingdom, Norway, and Italy, the smoking rate among men is at its lowest due to strict regulatory measures. Ukraine ranks first in Europe for the number of male smokers, with every second adult Ukrainian smoking, totaling 15.5 million smokers in the country. Smoking among adolescents remains a serious issue in many regions worldwide, especially in countries with weak anti-smoking policies. Recent WHO-initiated surveys indicate a decrease in the prevalence of traditional smoking methods among Ukrainian adolescents; however, the use of alternative smoking products, such as e-cigarettes, hookah, and heated tobacco devices, poses a new public health challenge in Ukraine. Conclusions: The analysis of scientific literature indicates that smoking is a serious public health issue globally. Amid decreasing levels of traditional tobacco smoking prevalence among the child population of Ukraine, there is an observed increase in the prevalence of alternative nicotine products, aligning with global trends. It was noted that the military aggression against Ukraine may have contributed to an increase in smoking prevalence among the population. KEYWORDS: adult population, child population, smoking prevalence, alternative smoking products, scientific literature
Background. Primary health care (PHC) is a cornerstone of the national health care system and a key determinant of the country’s socio-economic development. The resilience of the health care system in emergency conditions directly depends on the functioning of PHC. Objective. To assess the resilience of Ukraine’s health care system and the population’s access to medical services at the PHC level under prolonged military aggression. Materials and Methods. The study involved an analysis of reports from the World Health Organization (WHO) and the National Health Service of Ukraine (NHSU), scientific literature, and the authors’ previous research findings. Results. Due to active hostilities, approximately 10% of primary health care centers located in government-controlled areas of Ukraine were partially or completely destroyed. Reduced access to PHC manifested in a decline in the proportion of the population with signed declarations with PHC physicians. In the most affected regions, the coverage rate dropped to 34.7%. A general decline in PHC service utilization was also observed, with the number of patient visits in the most affected regions decreasing nearly threefold. The full-scale invasion also triggered a temporary critical decline in the availability of medications. The number of electronic prescriptions issued in March 2022 dropped by 27% compared to February, and in the most affected regions, this indicator decreased more than fourfold. However, positive developments were also noted in addressing medical service accessibility in regions close to combat zones, based on effective cooperation between Ukraine and international organizations. Conclusions. The critical situation in the most affected regions may indicate a systemic crisis in access to medical services in areas close to active hostilities. Developing effective strategies to strengthen the health care system under current challenges is of utmost importance. KEYWORDS: primary health care, patient safety, health system resilience, emergency, military aggression
Purpose of the work. To analyze the requirements in the field of circulation of dietary supplements (hereinafter referred to as DD) in Europe and Ukraine and assess the changes that await DD market operators after the adoption of the new Law No. 4122-IX "On Amendments to Certain Laws of Ukraine on Improving the Regulation of the Production and Circulation of Dietary Supplements, and on Regulating Other Issues in the Sphere of Healthcare" (hereinafter referred to as the Law). Materials and methods. Analysis of current European legislation in the field of circulation of dietary supplements and new provisions of Law No. 4122-IX "On Amendments to Certain Laws of Ukraine on Improving the Regulation of the Production and Circulation of Dietary Supplements, and on Regulating Other Issues in the Sphere of Health Care". The analysis was carried out using bibliographical, system-structural methods and the method of traditional analysis. Research results. In the EU Member States, the circulation of food (dietary) supplements is classified as a subject of legal regulation of the legislation on the circulation and safety of food products. In order to regulate the DD market in order to establish proper control over such products and implement EU standards provided for by Directive 2002/46/EC, Ukraine adopted a Law aimed at improving control over the DD market and harmonizing Ukrainian legislation with European ones. The Law introduces a DD notification procedure and strengthens responsibility for the production and sale of dietary supplements that do not meet the requirements of current legislation, in particular, it introduces significant fines for unscrupulous entrepreneurs. According to the Law, DD that met the requirements of the legislation in force before the entry into force of the specified Law, but do not meet the updated requirements, may be imported into the territory of Ukraine, manufactured and/or put into circulation within a year after the law enters into force. Such dietary supplements may be in circulation until the minimum shelf life or the “use by…” date, but not longer than three years from the date of entry into force of this Law. According to the requirements of the Law, market operators are obliged, within six months from the date of entry into force of the Law, to submit to the State Service for Food Safety and Consumer Protection a notification of the intention to first place a dietary supplement in circulation, which was in circulation on the territory of Ukraine before the entry into force of this Law and is planned to be put into circulation after the entry into force of this Law. Conclusions. It has been established that in Europe the main supervisory authority is the European Food Safety Authority, and the circulation of dietary supplements takes place in accordance with the requirements of Directive 2002/46/EC. In addition, each country has its own legislation in the field of circulation of the specified products, which supplements the requirements of the Directive. With the entry into force of the Law No. 4122-IX "On Amendments to Certain Laws of Ukraine on Improving the Regulation of the Production and Circulation of Dietary Supplements, and on Regulating Other Issues in the Sphere of Health Care", notification of dietary supplements is being introduced in Ukraine. However, for the effective implementation of the law, it is necessary to introduce a mechanism for examining documents prior to the notification of the introduction of dietary supplements into circulation (to make a decision on compliance/non-compliance). In addition, in order to confirm the safety of dietary supplements, it is necessary to provide for laboratory tests. An operating system of registers of permitted/unpermitted substances with nutritional and physiological properties and plant substances and their maximum quantities should also be created, and mechanisms for the functioning and updating of registers should be developed. KEYWORDS: dietary supplements (DS), Directive 2002/46/EC, Law No. 4122-IX, regulation of the production and circulation of dietary supplements, notification of dietary supplements
The Aim. To investigate the need among future doctors of various specialties (students of medical universities) to study the fundamentals of diagnosis, treatment, and prevention of glaucoma. Materials and Methods. The research tool was a self-developed questionnaire. The study materials consisted of data obtained from a survey of senior students at three medical universities in Ukraine. Bibliographic, statistical, and analytical methods were used. Results. Overall, 80% of medical students believe that knowledge of the discipline Ophthalmology is necessary for future doctors of all specialties. Seventy-five percent of respondents rated the volume and quality of ophthalmology knowledge obtained during their undergraduate training at 3–5 points on a 5-point scale. One-third of students rated their knowledge of the organization of ophthalmic care and the prevention of ophthalmic diseases at 3 points. More than 80% highly valued the importance of understanding modern approaches to organizing glaucoma prevention and the factors influencing its development for doctors of all specialties. While most future doctors recognize the need to know the modern algorithm of actions in cases of suspected glaucoma or pseudoexfoliative syndrome, not all consider in-depth knowledge of modern glaucoma treatment approaches to be necessary. Although 75% of students plan to apply knowledge of glaucoma prevention in their future practice, they do not plan to engage in specific preventive activities aimed at preventing its development. Conclusions. In general, 70–80% of surveyed medical students recognize the importance of knowledge in ophthalmology. However, their evaluation of the volume and quality of the knowledge they acquired was not sufficiently high. Future doctors are aware of the importance of understanding risk factors for glaucoma and its prevention, while assessments of the need for in-depth knowledge of modern treatment approaches and the organization of glaucoma prevention were more reserved. Sixth-year medical students and interns feel uncertain about their theoretical and practical ophthalmology knowledge. Ophthalmology educators should clearly demonstrate the importance of ophthalmological knowledge for various specialists, especially family physicians. KEYWORDS: ophthalmology, glaucoma, education, medical students, specialties, awareness, risk factors, early diagnosis, prevention
The aim of this study was to examine the relationship between homocysteine (Hcy) and cortisol (Cortisol), depending on the state of genetic polymorphisms of the folate cycle, in children living near the Chernobyl Exclusion Zone (ChEZ) 30 or more years after the Chernobyl accident. Research methods. Immunochemical, mathematical and statistical. Results. A correlation analysis was conducted between the studied indicators in a group of 158 children (78 boys and 80 girls), aged 12-18 years, permanently residing in populated areas of the Polessky district of the Kyiv region. The participation of Hcy and genetic polymorphisms of folate cycle (FC) in the regulation of the content of the stress hormone Cortisol in the blood was revealed. In the group of girls, a connection was established between Hcy, Cortisol, and the GMTR:2756 allele, which significantly affects the process of Hcy methylation. In the blood of girls carriers of the GMTR:2756 allele, which negatively affects the activity of B12 dependent methionine synthase, the content of Cortisol in the blood is increased, in comparison with girls without this allele in the genome. The concentration of Cortisol in the blood of girls in the subgroups with the genetic alleles GMTR:2756, AMTHFR:1298, CMTHFR:677, GMTRR:66 and the general group, with the level of Hcy > 10.0 μmol/l, was statistically higher than with the level of Hcy ≤ 10.0 μmol/l. At the same time, the proportion of cases with the allele GMTR:2756 was more. A direct correlation between the values of Hcy and Cortisol in the blood was noted in the subgroups with the genetic alleles GMTR:2756, AMTHFR:1298 and in the general group of girls, whereas among boys this relationship was recorded only in the subgroup with the TMTHFR:677 allele. Conclusions. Radiation exposure induces metabolic stress in the bodies of children living near the ChEZ, which, like mutations in the FC genes, causes an increase in the Hcy content in the blood. With moderate hyperhomocysteinemia, the antioxidant system is activated, one of the elements of which is Cortisol. In this regard, Hcy should be considered as a factor in stabilizing metabolic processes when exposed to incorporated 137Cs. KEYWORDS: homocysteine, Cortisol, stress response, folate cycle genes, children, Chernobyl Еxclusion Zone
The purpose of this study is to investigate subjective audiometry parameters in individuals who have recovered from COVID-19. Materials and methods. Fifty-four patients who had recovered from COVID-19 and reported hearing-related complaints were examined. Audiometric testing was conducted in a soundproof booth, using a clinical AC-40 audiometer (Interacoustics, Denmark). Results and discussion. Patients who had recovered from COVID-19 reported auditory complaints, including hearing loss, impaired speech discrimination, subjective tinnitus, and a sensation of ear fullness. Pure-tone audiometry revealed sensorineural hearing loss with a descending audiometric curve. The mean hearing thresholds for pure tones in post-COVID-19 patients were significantly (P < 0,05) elevated compared to controls in the conventional frequency range, starting from 1 kHz. The most pronounced increase was observed in the 4–8 kHz range: the thresholds were 28,29 ± 5,61 dB at 4 kHz, 35,45 ± 3,62 dB at 6 kHz, and 41,45 ± 3,93 dB at 8 kHz. The thresholds for extended high-frequency tones were as follows: 9 kHz – 56,78 ± 3,39 dB; 10 kHz – 45,22 ± 4,35 dB; 11 kHz – 50,68 ± 5,89 dB; 12 kHz – 66,95 ± 7,75 dB; 14 kHz – 68,72 ± 6,46 dB; 16 kHz – 70,18 ± 5,59 dB. The mean speech discrimination thresholds tests were slightly elevated in the post-COVID-19 patient group, however, were not statistically significant. Differential thresholds measured using the Lüscher’s method were within the normal range at 0,5 and 1 kHz, at 4 kHz, were slightly reduced (0,78 ± 0,12 dB), which may indicate receptor-level dysfunction of the auditory system in post-COVID-19 patients. Conclusions: 1. According to subjective audiometry data, patients with COVID-19 exhibited sensorineural hearing impairments characterized by a gently descending form of pure-tone audiometric curves. 2. The most significant and statistically reliable (P < 0,01) elevation of hearing thresholds in post-COVID-19 individuals was observed for tones in the high-frequency range 4–8 and 10–16 kHz. 3. The results of subjective audiometry indicate the importance of assessing auditory function in patients with COVID-19, particularly using high-frequency audiometry, which enables timely detection of auditory analyzer impairment in such patients. KEYWORDS: subjective audiometry, sensorineural hearing loss, COVID-19
Introduction. The research method is: to analyze the role and significance of ensuring the sanitary and epidemiological well-being of military personnel in the process of transforming the Armed Forces of Ukraine in accordance with NATO standards, programming key areas of development of military hygiene as a factor in increasing the combat capability of the army and its integration into the Euro-Atlantic security space. Materials and Methods. This study employs systemic, comparative, and logical-legal methods to analyze national and international public health regulations. Review and discussion. Ukraine’s Armed Forces must quickly adopt NATO hygiene standards to maintain combat readiness during war. Key areas include sanitary monitoring, infection control, nutrition, living conditions, and psychological support. These measures will enhance combat capability and align with Euro-Atlantic standards. Conclusions. Ukraine’s Armed Forces are being modernized following NATO standards, including advanced technologies and logistics. Effective hygiene monitoring, prevention, and rapid response systems are essential to protect personnel and boost combat readiness. Hygiene policies must also focus on service conditions, nutrition, and mental health, all critical for combat effectiveness and Euro-Atlantic integration. Keywords: Armed Forces of Ukraine, army transformation, military hygiene, Euro-Atlantic integration, NATO standards.
