Aim. To demonstrate the clinical heterogeneity of post-inflammatory interventricular septal injury and highlight the role of cardiac magnetic resonance (CMR) imaging in diagnosis and risk stratification. Materials and methods. A comparative analysis of myocardial changes was conducted in two young male servicemembers who developed significant cardiac manifestations following presumed inflammatory triggers (infection and trauma). Clinical evaluation included ECG, ambulatory rhythm monitoring, serum biomarkers, and CMR. Results. Both patients demonstrated preserved or only minimally elevated biomarkers, underscoring the limitations of laboratory screening alone. Case 1: a 40-year-old patient developed presyncope after pneumonia and blast-related trauma. Monitoring revealed high-grade atrioventricular block (Mobitz Type II). CMR identified focal intramural late gadolinium enhancement within the basal IVS, necessitating permanent pacemaker implantation. Case 2: a 39-year-old patient presented with acute dyspnea and fatigue after a viral infection. Despite a normal ECG, CMR revealed segmental fibrosis of the IVS with a moderately reduced left ventricular ejection fraction (45 %) without conduction disturbances. Conclusions. Post-inflammatory septal injury in young military personnel manifests across a broad clinical spectrum, ranging from malignant conduction failure to early-onset heart failure. These cases underscore the pivotal diagnostic value of CMR in detecting structural changes that remain occult on echocardiography. Early comprehensive evaluation and risk stratification are essential to prevent sudden cardiac death and preserve operational readiness.
Aim. To evaluate the effectiveness of surgical treatment for elderly and senile patients with acute malignant colonic obstruction using a differentiated approach to the choice of tactics based on the data of additional instrumental methods of examination. Materials and methods. The surgical treatment results of 122 patients aged 65–89 years with acute malignant colonic obstruction treated at the Surgical Department of the Municipal Non-Profit Enterprise “City Hospital No. 9” of the Zaporizhzhia City Council between 2022 and 2024 were analyzed. The diagnostic protocol included contrast-enhanced computed tomography, colonoscopy, plain abdominal radiography, abdominal ultrasonography, and intra-abdominal pressure measurement. Results. Computed tomography was performed as the gold standard of diagnosis and enabled precise identification of tumor location, degree of obstruction, lymph node involvement, and signs of intestinal ischemia (wall thickening, lack of contrast) as well as potential complications (perforation, abscess, peritonitis) in all patients examined. Colonoscopy confirmed tumor topography and provided histological verification of the diagnosis. Measurement of intra-abdominal pressure complemented the examination complex, correlating with abdominal hypertension severity. The use of minimally invasive methods (endoscopic stenting and laparoscopy) showed favorable treatment results, allowing effective elimination of the obstruction and, after stabilization of the condition, radical resection with primary anastomosis. Conclusions. Early multimodal diagnosis combined with an individualized surgical approach improves the effectiveness of treatment for older patients with acute malignant colonic obstruction. The use of minimally invasive techniques (stenting and laparoscopy) enables resection with primary anastomosis in a substantial proportion of patients, reduces stoma formation rates, and increases the quality of patients’ life.
Aim. To determine the expression patterns of p53 and annexin A5 in the cells of the basal magnocellular nucleus (BMN) of the rat brain following early neuroprotective intervention with citicoline, thiocetam, and recombinant HSF-1 in a rat model of colchicine-induced neurodegeneration. Materials and methods. The study involved 50 male Wistar rats divided into five groups (n = 10 each). Group 1 (control) received an intracerebroventricular (ICV) injection of 0.9 % NaCl solution. Animals in groups 2–5 received ICV colchicine. Group 2 served as the positive control (untreated pathology model). Groups 3–5 received citicoline, thiocetam, and HSF-1, respectively, for 14 consecutive days beginning the day after surgery. Subsequently, all rats were euthanized under thiopental sodium anesthesia, and the brains were harvested for histochemical and immunofluorescent analyses. Results. ICV colchicine caused loss of the neuronal component and an increase in glial cell number in the BMN. A two-week course of neuroprotective correction prevented these changes. Colchicine-induced neurodegeneration was also associated with an elevated number of p53- and Annexin A5-immunopositive cells in the BMN. Notably, administration of citicoline and HSF-1 resulted in a further pronounced increase in p53-positive neurons (by 60–70 % relative to the pathology group), whereas thiocetam caused a significantly increased number of annexin A5-immunopositive cells. Concurrently, all types of pathogenetic correction normalized the Corrected Total Cell Fluorescence (CTCF) of annexin A5+ cells to control levels. Conclusions. In the BMN of experimental animals on day 14 post-ICV colchicine injection, a decrease in neuronal density and an increase in glial density were observed compared to sham-operated rats. In contrast, in the groups receiving early administration of citicoline, thiocetam, or recombinant HSF-1, neuronal and glial density parameters remained at levels comparable to control animals. The highest CTCF values for annexin A5-positive cells were recorded in the colchicine group compared to both sham-operated and correction groups, with no statistically significant differences among the latter. At the same time, p53 CTCF values in the BMN across all experimental groups showed no statistically significant differences compared to the control or each other. While the total counts of p53- and annexin A5-positive cells in the colchicine group significantly exceeded those in sham-operated animals, this parameter in the correction groups varied according to the specific pharmacological agent used.
Accurate detection of botulinum neurotoxin (BoNT) requires assessing both its proteolytic SNARE-cleaving activity and its ability to inhibit synaptic transmission. While the mouse bioassay remains the traditional diagnostic standard, its prolonged turnaround time, limited reproducibility, and ethical constraints underscore the urgent need for advanced in vitro methodologies. Recent advances in analytical chemistry, stem-cell-derived neuronal platforms, and multi-omics profiling enable the development of sensitive systems that replicate BoNT’s molecular and functional mechanisms with greater precision than conventional in vivo models. Aim. To evaluate current methodologies for the diagnosis and functional analysis of botulinum neurotoxin and, synthesizing these findings, to propose a conceptual algorithmic model for comprehensive neurotoxin detection independent of in vivo methods. Materials and methods. A literature review was conducted utilizing the PubMed, Scopus, and Web of Science databases. Studies detailing molecular, cellular, multi-omics, and computational approaches to BoNT detection were included. The extracted data were synthesized across molecular, cellular, and systems-level domains to construct an integrated diagnostic model. Results. Modern diagnostic strategies increasingly surpass the mouse bioassay in terms of sensitivity, specificity, and mechanistic insight. SNARE-specific proteolytic profiling, notably Endopep-MS, enables precise detection of BoNT serotypes and their functional states by quantifying cleavage kinetics across a diverse array of substrates. Complementary human iPSC-derived neuronal platforms allow for direct functional assessment, revealing electrophysiological suppression, altered calcium signaling, and reporter-confirmed SNARE cleavage within living cells. Multi-omics analyses, including single-cell transcriptomics, epigenomics, and metabolomics, capture early stress signatures, serotype-specific responses, and determinants of neuronal susceptibility. Additional resolution is provided by receptor-binding kinetics and intracellular trafficking studies, which elucidate how serotype-dependent variations dictate overall toxicity. The integration of these molecular, cellular, and systems-level insights establishes the foundation for the ULTIMA-BoNT framework, a unified platform designed for high-precision BoNT detection. Conclusions. The convergence of proteolytic assays, physiologically relevant neuronal models, and multi-omics analytics presents a robust, reproducible, and ethically sustainable alternative to the mouse bioassay. This integrative approach not only provides profound mechanistic insights but also supports the predictive analysis of emerging BoNT variants.
The issue of mental health among students whose families are involved in military events, especially those whose close relatives are directly engaged in combat operations or reside in an area of active armed conflict, is becoming particularly relevant. The constant anticipation of danger to the lives of loved ones, emotional involvement, and empathetic experience of another person’s trauma creates conditions for the development of secondary traumatic stress (STS), which in its clinical manifestations is comparable to post-traumatic stress disorder. Aim. To investigate the characteristics of STS and chronic fatigue syndrome (CFS) in higher education students who reported having at least one close relative with a status related to participation in military operations or presence in a combat zone; to assess the intensity of emotional, cognitive, and somatic symptoms, as well as to analyze the relationship between indicators of secondary traumatization and the level of chronic fatigue. Materials and methods. Empirical data were collected via standardized questionnaires assessing STS and CFS (Fukuda criteria), administered to 75 higher education students in Ukraine (years 1–5). Analysis of the respondents’ academic profiles allowed classification into five primary fields of study. The majority of participants were enrolled in medical and pharmaceutical programs (53.2 %), with substantial representation from psychological and humanities disciplines (18.6 %) and rehabilitation-related programs (15.8 %). Students from the natural sciences and pedagogical fields accounted for 5.2 %, while the remaining 7.2 % were distributed across other specialties with lower individual representation. At the time of data collection, all participants (100 %) were residing within Ukraine. The survey was conducted via Google Forms web-based application. Statistical processing included Pearson’s correlation analysis with interpretation on the Chaddock scale and significance testing via Student’s t-test. The study conducted a systematic review of 13 national and international publications indexed in the Scopus and PubMed databases (search period: 2020–2025). Results. Of the 75 students surveyed, 68.0 % reported having close relatives involved in military operations or residing in the combat zone. These findings underscore the extensive familial exposure to the war among study participants and suggest an elevated vulnerability to STS, as well as to its associated psychophysiological sequelae. Regular obsessive thoughts about the possible suffering of relatives were reported by almost 70.0 % of respondents (options “sometimes” and “often” combined). Conclusions. A strong direct correlation was established between STS indicators and CFS (r = 0.70, p < 0.001), indicating the formation of a unified psychosomatic complex in students whose relatives are in the combat zone. These findings confirm the need for comprehensive rehabilitation programs that simultaneously address both psychological and physiological components of distress.
