OBJECTIVE:Aim: To analyze the development and implementation of the new framework for assessing the functional status of disability in Ukraine, and to evaluate the results of the first year of the new system's operation. PATIENTS AND METHODS:Materials and Methods: Sociological method was used. The Ministry of Health has published an analytical report on the results of the first year of work by the expert teams assessing a person's daily functioning from January 1, 2025. Before the reform, the system was based on 328 commissions and 1267 doctors. In contrast, after the reform, more than 7000 physicians were involved in all regions of Ukraine. More than 1,300 expert teams have been formed, making more than 554000 decisions in a yearStatistical analysis included descriptive statistics of indicators. Statistical processing and graphical visualisation of the data were performed using Microsoft Excel (Microsoft Excel for Microsoft 365 MSO, version 2603, build 16.0.19822.20086, 64-bit). RESULTS:Results: A new system focused on assessing functioning has been introduced into clinical practice. A comprehensive legal framework was developed, and the Center for Assessment of the Functional State of a Person was established in 2025. The system includes over 1300 expert teams and approximately 7000 doctors, operates nationwide, and is highly digitized via the Diia platform. Initial results show increased transparency, accessibility, and user satisfaction. CONCLUSION:Conclusions: The reform aligns with international standards and represents a systemic step toward rights-based disability assessment. However, further improvements are needed in regulatory support, institutional capacity, digital infrastructure, and consistent law enforcement.
The paper presents a clinical case of psoriasis that developed in a 23-year-old Ukrainian service member after a combat-related through-and-through gunshot wound to the lower leg sustained in 2022. The patient had no previous dermatological diseases or family history of psoriasis. Two weeks after the injury, irregular pink plaques appeared around the damaged skin areas and gradually spread to the lower limbs, trunk, and upper extremities, becoming generalised within two months. The disease subsequently progressed to severe plaque psoriasis, complicated by nail dystrophy and psoriatic arthritis. By 2026, skin lesions involved more than 50% of the body surface area (Psoriasis Area and Severity Index (PASI) 25,9) and were associated with a significant impairment in quality of life (Dermatology Life Quality Index (DLQI) 16). Persistent psycho-emotional stress related to military service, sleep disturbances, smoking, and poor adherence to therapy contributed to recurrent exacerbations. Screening revealed clinically significant anxiety, and the patient was referred for psychological evaluation and support. After referral to a mental health centre and implementation of comprehensive management that included psychological support and improved adherence to dermatological therapy, gradual improvement in skin condition and quality of life was observed.
OBJECTIVE:Aim: To evaluate the impact of postoperative hormonal disorders on dermatologic status and to determine the need for aesthetic rehabilitation in patients after surgical treatment of endocrine pathology. PATIENTS AND METHODS:Materials and Methods: A prospective cohort study included 128 patients aged 19-76 years after endocrine surgery. The sample comprised 54 patients after thyroidectomy, 61 after parathyroidectomy, 3 after adrenalectomy, and 10 after combined procedures. Dermatologic examination, scar assessment, hormonal profiling, and quality-of-life evaluation using SF-36 and DLQI were performed. Quantitative variables were summarized as mean ± standard deviation or median and interquartile range; qualitative variables as absolute and relative frequencies. Comparative analysis used the chi-square test, relative risk (RR) with 95% confidence interval (CI), and Pearson correlation (r). RESULTS:Results: Hormonal dysfunction was identified in 93 patients (72.7%). Dermatologic changes were found in 101 patients (78.9%), most commonly xerosis (50.0%), pathological scarring (40.6%), alopecia (28.9%), and pigmentation disorders (24.2%). Patients with hormonal imbalance had a significantly higher risk of dermatologic complications than those without endocrine dysfunction (88.2% vs 55.6%; RR = 1.59; 95% CI 1.21-2.08; p < 0.01). Aesthetic defects requiring correction were identified in 76 patients (59.4%). Scar severity correlated with impaired dermatology-specific quality of life (r = 0.61; p < 0.001). CONCLUSION:Conclusions: Hormonal disorders after endocrine surgery are significantly associated with dermatologic complications and reduced quality of life. Integration of dermatologic surveillance and aesthetic rehabilitation into postoperative care is clinically justified.
OBJECTIVE:Aim: To assess healthcare professionals' attitudes toward vaccination, evaluate vaccination coverage, and perform a SWOT analysis of immunoprophylaxis to identify strengths, weaknesses, opportunities, and threats. PATIENTS AND METHODS:Materials and Methods: A structured, anonymous 23-item questionnaire assessed knowledge and attitudes toward immunoprophylaxis among healthcare workers (HWs), covering demographics, vaccination awareness, infection prevention practices, attitudes, and professional motivation. The online survey (Google Forms) was conducted from May to December 2025 with ensured anonymity. Vaccination coverage was assessed using records of 1060 HWs from two public healthcare facilities, with comparative analysis across departments. A SWOT analysis was performed. For relative indicators, 95% confidence intervals (CIs) were calculated, accounting for sampling error associated with sample size (MedStat v.5.2). RESULTS:Results: The majority of study participants demonstrated a positive attitude towards immunoprophylaxis: 72.4% (CI: 63.8-81.0) rated it as absolutely positive. However, gaps were identified: correct understanding of current COVID-19 vaccination recommendations was 28% (CI: 19.4-36.6), while 74% (CI: 65.6-82.4) correctly assessed continuation of vaccination schedules. The SWOT analysis showed generally positive attitudes toward vaccination and potential for improving coverage through education and management interventions. CONCLUSION:Conclusions: Despite positive attitudes (72.4%) and satisfactory self-assessed knowledge, vaccination coverage among healthcare workers remains low (<30%): 29.7% for tetanus-diphtheria and 27.5% for hepatitis B. This reflects a clear gap between knowledge, motivation, and practice, indicating the need for integrated interventions, including education, communication skills development, and strengthened institutional vaccination policies.
OBJECTIVE:Aim: To evaluate the clinical significance of serum L-selectin (sCD62L) levels as a biomarker of retinal damage in patients with type 2 diabetes mellitus (T2DM) by correlating its concentration with the stages of diabetic retinopathy (DR) and clinical and morphological parameters of the retinal state. PATIENTS AND METHODS:Materials and Methods: A total of 124 patients (124 eyes) were examined: 95 patients with T2DM (ranging from mild non-proliferative to proliferative DR) and 29 age- and sex-matched controls. Diagnostic techniques included BCVA assessment, SD-OCT (Topcon 3D OCT-1000), and serum ELISA for L-selectin determination. RESULTS:Results: A significant 2.5-fold increase in serum L-selectin levels was identified in the T2DM cohort compared to controls ([mean ± standard error] 31.2 ± 8.6 ng/mL vs. 12.5 ± 3.5 ng/mL; p < 0.001). A progressive upward trend in marker concentration was observed relative to pathology severity: from (median [interquartile range]) 24.7 (20.4-29.0) ng/mL in mild non-proliferative DR (p < 0.001 vs. control group [12.5 (10.1-14.9)] ng/mL) to 39.5 (35.1-43.9) ng/mL in the proliferative stage (p < 0.001 vs. control group). Positive correlations were found between L-selectin levels and HbA1c (rs = 0.816, p < 0.001), as well as central retinal thickness (rs = 0.467, p = 0.002). CONCLUSION:Conclusions: CD62L is a significant biomarker of systemic inflammation and vascular dysfunction in T2DM, reflecting the severity of diabetic retinopathy and the risk of blood-retinal barrier disruption.
