Colorectal cancer, according to the International Agency for Research on Cancer, was and remains an urgent problem worldwide. In 2020, in Ukraine, morphological verification of new cases of colon and rectal cancer was carried out at a high level (83.2% and 89.5%, respectively), but despite this, specific treatment covered only 69.4% and 74.5% of eligible patients, that is why about a third of patients (30.8% of colon cancer patients and 25.0% of rectal cancer patients) did not live even a year from the moment of its detection in 2020. The aim of the study was to evaluate the prognostic significance of the expression of p53 and EGFR markers depending on the clinical, morphological characteristics and proliferative activity of colorectal carcinomas. The clinical and anatomical material of 37 patients (15 women and 22 men) was studied in the work. The age of the patients ranged from 27 to 82 years; the average age was 61.43±14.90 years. Antibodies to Ki-67, p53, EGFR and the UltraVision Quanto visualization system (LabVision) were used for immunohistochemical research. Digital morphometry was performed in the Fiji platform with the calculation of percentages of p53 and Ki-67-positive intranuclear reactions with the ImmunoRatio plugin. The distribution of p53 expression variants - wild type (0<p53 <10%) or "mutant" (overexpression ≥10% or completely negative samples) showed no significant difference in any group (all p>0.05), despite that among men, mutant expression of p53 was significantly higher than among women – 72.72% (16 out of 22) versus 53.33% (8 out of 15), and all patients under the age of 50 years had a mutant type of p53 expression 9 out of 9 (100%), while the number of such observations after 50 years already decreased to about half – 15 out of 28 (53.57%). The distribution of EGFR expression variants showed a significant difference in subgroups according to grade (p<0.05) and in subgroups with different proliferative potential according to Ki-67 (p<0.05).

Key words: colorectal carcinoma, digital morphometry, p53, EGFR, Ki-67

1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. Scientific 2020;71(3):209-49. doi: https://doi.org/10.3322/caac.21660 
2. Heather NM, Ward A, Jenab M, et al. Hetero­geneity of Colorectal Cancer Risk Factors by Anato­mical Subsite in 10 European Countries: A Multina­tional Cohort Study. Clinical Gastroenterology and Hepatology. 2019;17(7):1323-31.e6. doi: https://doi.org/10.1016/j.cgh.2018.07.030
3. Hofseth LJ, Hebert JR, Chanda A, et al. Early-onset colorectal cancer: initial clues and current views. Nature Reviews Gastroenterology & Hepatology. 2020;17:352-64. doi: https://doi.org/10.1038/s41575-019-0253-4
4. Graff RE, Möller S, Passarelli MN, et al. Familial Risk and Heritability of Colorectal Cancer in the Nordic Twin Study of Cancer. Clinical Gastroenterology and Hepatology. 2017;15(8):1256-64. doi: https://doi.org/10.1016/j.cgh.2016.12.041
5. Fedorenko ZP, Hulak LO, Mykhailovych YuY, et al. [Cancer in Ukraine, 2019-2020. Morbidity, mortality, performance indicators of the oncology service]. Bulletin of the National Chancery Register of Ukraine. [Internet]. 2021 [cited 2022 Nov 20];22. Ukrainian. Available from: http://www.ncru.inf.ua/publications/BULL_22/
6. Zhang Q, Wu J, Bai X, Liang T. Evaluation of Int­ra-Tumoral Vascularization in Hepatocellular Carcinomas. Front 2020;7:584250. doi: https://doi.org/10.3389/fmed.2020.584250
7. Melling N, Kowitz CM, Simon R, et al. High Ki67 expression is an independent good prognostic marker in colorectal cancer. J Clin Pathol. 2016;69:209-14. doi: https://doi:10.1136/jclinpath-2015-202985
8. Poslavska OV, Shponka IC, Hrytsenko PO. [Cha­racteristics of the colorectal phenotype of carcinomas of unknown primary localization]. Actual problems of pediatric medicine. 2018;18(3):111-5. Ukrainian.
9. Luo Z-W, Zhu M-G, Zhang Z-Q, et al. Increased expression of Ki-67 is a poor prognostic marker for colorectal cancer patients: a meta analysis. BMC Cancer. 2019;19(123):1-13. doi: https://doi.org/10.1186/s12885-019-5324-y
10. Nakayama M, Oshima M. Mutant p53 in colon cancer. Journal of Molecular Cell Biology. 2019;11(4):267-76. doi: https://doi.org/10.1093/jmcb/mjy075
11. Solé L, Lobo-Jarne T, Álvarez-Villanueva D, et al. p53 wild-type colorectal cancer cells that express a fetal gene signature are associated with metastasis and poor prognosis. Nat Commun. 2022;13(2866):1-15. doi: https://doi.org/10.1038/s41467-022-30382-9
12. Li X-L, Zhou J, Chen Z-R, Chng W-J. p53 muta­tions in colorectal cancer - molecular pathogenesis and pharmacological reactivation. World J Gastroenterol. 2015;21(1):84-93. doi: https://doi.org/10.3748/wjg.v21.i1.84
13. Lieb MC, Hofmann TG. The Role of p53 Signa­ling in Colorectal Cancer. Cancers (Basel). 2021;13(9):2125. doi: https://doi.org/10.3390/cancers13092125
14. Nigro CL, Ricci V, Vivenza D, et al. Prognostic and predictive biomarkers in metastatic colorectal cancer anti-EGFR therapy. World J Gastroenterol. 2016;22(30):6944-54. doi: https://doi.org/10.3748/wjg.v22.i30.6944
15. Martinelli E, Ciardiello D, Martini G. Imple­men­ting anti-epidermal growth factor receptor (EGFR) therapy in metastatic colorectal cancer: challenges and future perspectives. Annals of Oncology. 2020;31(1):30-40. doi: https://doi.org/10.1016/j.annonc.2019.10.007
16. Balakarthikeyan J, Mayakrishnan V, Kannap­pan P, et al. EGFR-Based Targeted Therapy for Colorectal Cancer – Promises and Challenges. Vaccines (Basel). 2022;10(4):499. doi: https://doi.org/10.3390/vaccines10040499
17. Li Q-H, Wang Y-Z, Tu J, et al. Anti-EGFR the­rapy in metastatic colorectal cancer: mechanisms and potential regimens of drug resistance. Gastroenterology Report.2020;8(3):179-91. doi: https://doi.org/10.1093/gastro/goaa026  
18. Vareniuk IM, Dzerzhynskyi ME. [Methods of cyto-histological diagnosis: study guide]. Kyiv; 2019. 256 p. Ukrainian.
19. Nguyen T. Immunohistochemistry: A Technical Guide to Current Practices. Cambridge: Cambridge Uni­versity Press; 2022. 272 p.
20. Poslavska OV. [The methodology of using soft­ware for the analysis of digital photomicrographs based on the course of pathomorphology in order to improve the professional level of students and scientists]. Morphologia. 2015;9(3):122-6. Ukrainian.
21. Poslavska OV. [Determining the linear dimensions and areas of individual morphological objects on photomicrographs using the ImageJ program]. Morpho­logia.2016;10(3):377-81.  doi: https://doi.org/10.26641/1997-9665.2016.3.377-381
22. Strahova OP, Androsov OI. [Statistical methods of processing the results of medical and biological research]. Lviv; 2021. 164 p. Ukrainian.

Look through:

Shponka I.S. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-7561-6489

Kharkhalis I.K. Uzhhorod National University, Uzhhorod, Ukraine
https://orcid.org/0000-0001-9487-4785

Poslavska O.V.  Dnipro State Medical University, Dnipro, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-3133-8413

Shponka I.S., Kharkhalis I.K., Poslavska O.V. Study of the expression of oncoprotein p53, EGFR in colorectal carcinomas with different proliferative activity. Medicni perspektivi. 2023;28(1):4-12. DOI: https://doi.org/10.26641/2307-0404.2023.1.275703 

Study of the expression of oncoprotein p53, EGFR in colorectal carcinomas with different proliferative activity

The problem of alimentary dystrophy, which develops due to various reasons, is an urgent problem, especially in patients with tumors of the head and neck. After removal of tumors, patients have large postoperative defects that interfere with proper nutrition. Therefore, to provide the body with the necessary nutrients, enteral nutrition is especially important. In addition, successful wound healing requires adequate blood supply and sufficient levels of nutrients, which depends on the general condition of the body and the patient's diet. However, the degree of reparative processes correlates not only with the number of substrates of anabolism, but also with the proper functioning of the liver. The aim of our study was to investigate the effect of the drug for enteral nutrition and glutargin on the reparative properties of rats’ wounds on the background of partial food deprivation. The study was performed on 60 adult male rats weighing 280±20 grams of the Wistar line, with a mean age of 15 weeks. Prior to the experimental study the regenerative properties of the animals were on partial food deprivation. On the 10th day, a wound with a diameter of 2.0 cm was inflicted. Then the rats were divided into 4 groups: 1 group (control) received food according to physiological needs; Group 2 (food derivation (FD)); Group 3 (FD+enteral nutrition); Group 4 (FD+enteral nutrition +glutargin). Against the background of alimentary dystrophy (20% weight loss) on the first day there was a significant difference in the edges of the wound due to loss of its elasticity. Wound contraction processes up to 14-15 days in all observation groups were quite active, regardless of the factors of malnutrition with cereals or additional therapeutic diet "Peptamen" or in combination with glutargin. Thus, every three days the area of wounds decreased by 30-40 mm² on an average. Only on the 15th-17th day the difference in the rate of wound contraction becomes visible and statistically significant. Thus, on the 15th day the largest wounds were in the second group on the background of partial food deprivation (p<0.05), at the same time in the first (control) and in the fourth groups the average area was almost equal (p>0.05). The smallest (p<0.05) area of wounds was observed in the first group (control) on the 15th day. On the 17th day wound healing was observed in the fourth group (FD+enteral nutrition+glutargin), despite the expansion of wounds on the first day. A pronounced therapeutic effect correcting alimentary dystrophy was obtained with enteral nutrition (Peptamen) and glutargin at a dose of 50 mg/kg, where the wounds healed simultaneously with those in the first (control) group, ie in animals with a normal diet, indicating a high effectiveness of the proposed method of correction of alimentary dystrophy. Enteral nutrition alone (Peptamen) was also effective, as evidenced by the small size of virtually epithelialized wounds on the 17th day.

Key words: wounds, regeneration, glutargine, supplementary nutrition, experiment, partial food deprivation

1. Gozhenko AI, Gryshko YuM, Gramatyuk SM. [The role of protein and lipid metabolism in energy supply of the body]. Clinical and experimental pathology. 2019;18(3):107-16. Ukrainian. doi: https://doi.org/10.24061/1727-4338.XVIII.3.69.2019.18
2. Klochkova IS, Astafieva LI, Kadashev BA, Sid­neva YuG, Kalinin PL. [Pathogenetic aspects of cachexia syndrome]. Obesity and metabolism. 2020;17(1):33-40. Russian. doi: https://doi.org/10.14341/omet10173
3. Koropetska NYu. [Changes in protein spectrum of rat organs under the influence of retabolil, LES-2222 * and testosterone propionate in food deprivation]. Bukovyna Medical Bulletin. 2015;19(3):73-7. Ukrainian. doi: https://doi.org/10.24061/2413-0737.XIX.3.75.2015.145
4. Lopatik DV, Kuvaeva ZI, Bondareva OM. [Syn­thesis and cardioprotective efficacy of arginite succinate]. Proceedings of the National Academy of Sciences of Belarus, Chemical series. 2020;56(2):181-6. Belarus. doi: https://doi.org/10.29235/1561-8331-2020-56-2-181-186
5. Mikhalyuk YeL, Brazhko OA. [Pharmacological correction of fatigue and recovery of sport performance: study guide]. Zaporizhzhia: ZSMU; 2017. 140 p. Ukrainian.
6. Rybolovlev YuR, Rybolovlev RS. [Dosing of sub­stances for mammals according to the constants of biological activity]. Moskva; 1979. p. 1513-6. Russian.
7. Fetisov VS. [STATISTICA statistical data ana­lysis package]. Nizhyn: NDU im. M. Gogolya; 2018. 114 p. Ukrainian.
8. Arends J, Bachmann P, Baracos V, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr. 2017;36(1):11-48. doi: https://doi.org/10.1016/j.clnu.2016.07.015
9. Grada A, Mervis J, Falanga V. Research Techni­ques Made Simple: Animal Models of Wound. J Invest Dermatol.2018;138(10):2095-105. doi: https://doi.org/10.1016/j.jid.2018.08.005
10. Horsley V, Watt F. Repeal and Replace: Adipo­cyte Regeneration in Wound Repair. Cell Stem Cell. 2017;20(4):424-6. doi: https://doi.org/10.1016/j.stem.2017.03.015
11. Mercuri E, Bönnemann CG, Muntoni F. Muscular dystrophies. The Lancet. 2019;394(10213):2025-38. doi: https://doi.org/10.1016/S0140-6736(19)32910-1
12. Kushta A, Shuvalov S, Shamray V, Misurko O. De­vеlopment and justification of alimentary experimental model in rats. Georgian med news. 2021;316-317(7-8):169-73.
13. Ginestal R, Pérez-Köhler B, Pérez-López P, Rod­ríguez M, Pascual G, Cebrián D, et al. Comparing the influence of two immunosuppressants (fingolimod, aza­thioprine) on wound healing in a rat model of primary and secondary intention wound closure. Wound Repair Regen. 2019;27(1):59-68. doi: https://doi.org/10.1111/wrr.12685

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Kushta A.A. National Pirogov Memorial Medical University, Vinnytsya, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0001-8994-2560

Shuvalov S.M. National Pirogov Memorial Medical University, Vinnytsya, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-5052-680X

Kushta A.A., Shuvalov S.M. Experimental evaluation of the effect of supplementary nutrition and glutargine on regenerative properties. Medicni perspektivi. 2023;28(1):13-21. DOI: https://doi.org/10.26641/2307-0404.2023.1.275706

Experimental evaluation of the effect of supplementary nutrition and glutargine on regenerative properties

The vasulature of the synovial membrane of the temporomandibular joint of 18 laboratory mature Vietnamese mini male pigs divided into 3 groups was morphologically studied. Group 1 – 6 control experimental animals, 2 – 6 pigs with a 30-day’s experimental hyperglycemia, 3 – 6 pigs with a 60-day’s hyperglycemia. Hyperglycemia was induced by a single intraperitoneal injection of streptozotocin at a dose of 50 mg/kg. Pigs were sacrificed by bloodletting under general thiopental sodium anesthesia 30 and 60 days after the start of the experiment. On the indicated days of the experiment, the concentration of glucose in the blood was determined. On the micropreparations of the synovial membrane of the temporomandibular joint in the small caliber arteries there was measured the diameter of the vessel, the diameter of the lumen, the thickness of the muscular, adventitious membranes, the Wogenworth and Kernogan indices; in the veins – the diameter of the vessel, its lumen, and the thickness of the vein. In arterial and venous vessels, morphometry of endothelial cells, their nuclei, the volume of their damage, and nuclear-cytoplasmic indices were determined. Arterial, metabolic and venous vessels of the hemomicrocirculatory bed were studied morphometrically, their number per 1 mm² of the synovial membrane was determined. Quantitative values were processed statistically. In conditions of experimental hyperglycemia, a thickening of the synovial membrane of the arteries of the tempo­romandibular joint, a narrowing of their lumen, a decrease in the Kernogan index, an increase in the Wogenvoort index, the volume of damaged endotheliocytes, a disorder of their nuclear-cytoplasmic indices were revealed, an increase in the outer and inner diameters of the veins, the volume of damaged endotheliocytes, disorders of their nuclear-cytoplasmic indexes, plethora was noted. Structural changes in the hemomicrocirculatory bed in experimental hyperglycemia were characterized by a decrease of the diameters of arterioles, precapillary arterioles, hemocapillaries, dilation of capillary venules and venules, marked decrease of microvascular density. The most pronounced degree of remodeling of the studied structures was found in the vessels of the hemomicrocirculatory bed of the synovial membrane of the temporomandibular joint in a 60-day’s experimental hyperglycemia.

Key words: hyperglycemia, temporomandibular joint, synovial membrane, vessels, morphometry

1. Kryzyna OV. [Trophic disorders of the tissues of the lower extremities in type 2 diabetes]. Klinichna endokrynolohiia ta endokrynna khirurhiia. 2018;1(6):15-24. Ukrainian.
   doi: https://doi.org/10.24026/1818-1384.1(61).2018.126901
2. Orlenko VL. [Hormonal characteristics of diabetes-associated osteoarthritis]. Visnyk problem biolohiyi ta medytsyny. 2020;2(159):138-43. Ukrainian. doi: https://doi.org/10.29254/2077-4214-2020-2-156-138-143
3. Ouanounou A, Goldberg M, Haas D. Pharma­cotherapy in temporomandibular disorders. J Can Dent Assos. 2017;83(7):1489-2159. doi: https://doi.org/10.1136/pgmj. 2017.146392rep
4. Tu M, Qiao F, Wong L. The pathogenic role con­nective tissue growth factor in ostheoarthritis. Biosci Rep. 2019;39(7):1374-1376. doi: https://doi.org/10.1042/bsr20191374
5. Punthakee Z, Goldenberg R, Katz P. Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Canadian Journal of Diabetes. 2018;42(1):10-5. doi: https://doi.org/10.1016/j.jcjd.2017.10.003
6. Inaba M. Musculoskeletal disease associated with diabetes mellitus. Springer Japan. 2016. 296 p. doi: https://doi.org/10.1007/978-4-431-55720-3
7. Hnatiuk MS, Rubas LV. Morphometric evaluation of features of remodeling of chondrocites of joint surfaces of temporomandibular joint of experimental animals in hyperglycemia. Journal of Education, Health and Sport. 2021;11(6):137-42. doi: https://doi.org/10.12775/jehs.2021.11.06.014
8. Stechyshyn I, Pavliuk B. The quercetin containing drugs in pharmacological conection of experimental diabetes with myocardial injury. Romanian Journal of Diabetes. 2020;26(4):393-9. doi: https://doi.org/10.2478/rjdnmd-2019-0042
9. Bahrii MM, Dibrova VA, Popadynets OH, Hry­shchuk MI. [Methods of morphological research]. Vin­nytsia: Nova knyha; 2016. 328 p. Ukrainian.
10. Hnatiuk MS, Hdanska NМ, Tatarchuk LV. [Pecu­liarities of remodeling of atrial arteries in conditions of post-resection portal hypertension]. Art of Medicinе. 2021;2(18):38-43. Ukrainian. doi: https://doi.org/10.21802/artm.2021.2.18.38
11. Hnatiuk MS, Nesteruk SO, Tatarchuk LV, Mona­sty­rska NYa. [Quantitative morphological evaluation of age remodeling of the venous bed of the prostate]. Visnyk medy­chnykh i biolohichnykh doslidzhen. 2021;4:27-30. Ukrainian.
    doi: https://doi.org/10.11603/bmbr.2706-6290.2021.4.12755
12. Holovanova IA, Byelikova IV, Liakhova NO. [Ba­sics of medical statistics]. Poltava: UMSA; 2017. Ukrainian.
13. Festing M, Nevalainen T. The design and statis­tical analysis of animal experiments introduction to this issue. Ilar J. 2014;55(3):379-2. doi: https://doi.org/10.1093/ilar/ilu046
14. Zaporozhyan VM, Aryaev ML. [Bioethics and biosafety]. Kyiv: Zdorov҆ia; 2013. 456 p. Ukrainian.
15. Popovych FA, Holovatskyi AS, Holovinska AK. [Morphofunctional characteristics of the hemomicro­circulatory bad of the cardiac and portal parts of the human stomach]. Naukovyy visnyk Uzhhorodsʹkoho universytetu, Ser. Medytsyna. 2015;2(52):24-9. Ukrainian.

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Shulgai A.H.  I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

Hnatiuk M.S.  I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Tatarchuk L.V.  I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

Monastyrska N.Ya.  I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine

Shulgai A.H., Hnatiuk M.S., Tatarchuk L.V., Monastyrska N.Ya. Quantitative morphological analysis of features of remodeling of the synovial membrane vasculature of the temporomandibular joint in hyperglycemia. Medicni perspektivi. 2023;28(1):22-27. DOI: https://doi.org/10.26641/2307-0404.2023.1.275709

Quantitative morphological analysis of features of remodeling of the synovial membrane vasculature of the temporomandibular joint in hyperglycemia

The possibility of usage of polymer nanocomposites is being intensively studied today with a purpose of their application in medicine, espessialy in oncology. At the experimental stage it is important to determine the mechanisms of the influence of such compounds on the body and their own possible undesirable effects. Aim – to study the effect of the treatment with maximal doses of the dextran-polyacrylamide polymers and their effect as carriers of silver and gold nanoparticles on the spleen and liver. Histological examination of micropreparations of the spleen and liver by the standard method with hematoxylin-eosin staining was made. As a result of the treatment with nonionic (D-g-PAA) and anionic (D-g-PAA (PE)) polymer matrices, changes which occurred in the spleen indicate an increase in the production of all blood cells. These phenomena were absent when silver and gold nanoparticles were included in the matrix. In the liver, treatment with D-g-PAA and D-g-PAA (PE) caused a disorder of hepatic circulation, focal infiltration by inflammatory cells and death of hepatocytes by necrosis. The addition of nanoparticles triggered other mechanisms of alteration, which manifested themselves in excessive accumulation of glycogen, fatty infiltration of hepatocytes, and cell death, mainly through apoptosis. However, along with this, signs of an incomplete regenerative response of the liver were revealed. Morphological changes caused by the treatment with maximal doses of the tested substances indicate their toxic effect, especially on the liver. Further researches are needed to establish the optimal doses and the frequency of their administration, which can be used for therapeutic purposes, including the interaction of studied polymers with blood cells.

Key words: dextran-polyacrylamide polymers, silver and gold nanoparticles, liver, spleen, toxicity

1. Wang H, Rempel GL. Introduction of polymer nanoparticles for drug delivery applications. J Nanotechnol Nanomed 2015;2:008. doi: https://doi.org/10.24966/NTMB-2044/100008 
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6. Kutsevol N, Naumenko A, Harahuts Yu, et al. New hybrid composites for photodynamic therapy: synthesis, characterization and biological study. Applied Nanoscience.2019;9:881-8. doi: https://doi.org/10.1007/s13204-018-0768-y
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9. Yuan YG, Zhang S, Ji-Yoon, Hwang JY, et al. Silver nanoparticles potentiates cytotoxicity and apoptotic potential of camptothecinin human cervical cancer cells. Oxidative Medicine and Cellular Longevity. 2018 Dec 12;2018:6121328. doi: https://doi.org/10.1155/2018/6121328
10. Yao Y, Zang Y, Qu J, et al. The toxicity of metallic nanoparticles on liver: the subcellular damages, mecha­nisms, and outcomes. International Journal of Nanome­dicine.2019;14:8787-804. doi: https://doi.org/10.2147/IJN.S212907
11. Huang Q, Zhang J, Zhang Y, et al. Adaptive chan­ges induced by noble-metal nanostructures in vitro and in vivo. Theranostics.2020;10(13):5649-70. doi: https://doi.org/0.7150/thno.42569
12. Kutsevol N, Bezugla T, Bezuglyi M, et al. Branched dextran-graft-polyacrylamide copolymers as perspective materials for nanotechnology. Macro­molecular Symposia.2012;317-318(1):82-90. doi: https://doi.org/10.1002/masy.201100087  
13. Bezuglyi M, Kutsevol N, Rawiso M, et al. Water-soluble branched copolymers dextran-polyacrylamide and their anionic derivates as matrices for metal nanoparticles in-situ synthesis. Chemik. 2012;8(66):865-7.
14. Chumachenko V, Kutsevol N, Rawiso M, et al. In situ formation of silver nanoparticles in linear and branched polyelectrolyte matrices using various reducing agents. Nanoscale Research Letters. 2014;9:164. doi: https://doi.org/10.1186/1556-276X-9-164
15. Chumachenko V, Naumenko A, Yeshchenko O, et al. Synthesis, morphology, and optical properties of Au/CdS hybrid nanocomposites stabilized by branched polymer matrices. Journal of Nanomaterials. 2016;2016:ID1439437. doi: https://doi.org/10.1155/2016/1439437
16. Gagliardi A, Giuliano E, Venkateswararao E, et al. Biodegradable polymeric nanoparticles for drug delivery to solid tumors. Front Pharmacol. 2021 Feb 3;12:601626. doi: https://doi.org/10.3389/fphar.2021.601626
17. Krishna M. Patterns of necrosis in liver disease. Clinical Liver Disease. 2017;10(2):53-6. doi: https://doi.org/10.1002/cld.653
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19. Yang L, Kuang H, Zhang W, et al. Comparisons of the biodistribution and toxicological examinations after repeated intravenous administration of silver and gold nanoparticles in mice. Scientific reports. 2017;7:3303. doi: https://doi.org/10.1038/s41598-017-03015-1
20. Colino CI, Lanao JM, Gutierrez-Millan C. Tar­geting of hepatic macrophages by therapeutic nano­particles. Frontiers in Immunology. 2020;11:1-17. doi: https://doi.org/10.3389/fimmu.2020.00218
21. Ibrahim KE, Al-Mutary MG, Bakhietand AO, et al. Histopathology of the liver, kidney, and spleen of mice exposed to gold nanoparticles. Molecules. 2018;23:1848. doi: https://doi.org/10.3390/molecules23081848

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Kaleinikova О.М. Bogomoletz Institute of Physiology, Kyiv, Ukraine
https://orcid.org/0000-0001-9812-6266

Kurovska V.О. Taras Shevchenko National University of Kyiv, Kyiv, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-7295-5549

Byelinska І.V. Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
https://orcid.org/0000-0003-3551-1161

Kutsevol N.V. Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
https://orcid.org/0000-0002-1468-4111

Blashkiv Т.V. Bogomoletz Institute of Physiology, Kyiv, Ukraine
https://orcid.org/0000-0003-1196-2929

Kaleinikova О.М., Kurovska V.О., Byelinska І.V., Kutsevol N.V., Blashkiv Т.V. Morphological changes of liver and spleen under the impact of dextran-polyacrylamide polymers and their effects as carriers of silver and gold nanoparticles. Medicni perspektivi. 2023;28(1):28-36. DOI: https://doi.org/10.26641/2307-0404.2023.1.275855

Morphological changes of liver and spleen under the impact of dextran-polyacrylamide polymers and their effects as carriers of silver and gold nanoparticles

Modern weapons cause severe damage, accompanied by high rates of complications and mortality. The investigation of such kinds of weapons is in high demand considering the ongoing active phase war against Ukraine since February 2022. In order to understand the pathological processes that occur in and outside the gunshot wound, we conducted an experimental study using mathematical simulation. The results presented in the article will help to choose the appropriate surgical management and improve the results of treatment. The aim of this study was to investigate and evaluate the damaging effect of a 5.45 mm 7N6M bullet and a 5.45 mm V-max expansive bullet using numerical modeling of wound canals in ballistic plasticine. The Ansys Explicit Dynamics engineering complex was used to simulate the dynamics of the bullet’s motion. The basic equations, solved by the explicit dynamic analysis, express the conservation of mass, momentum, and energy in Lagrange coordinates. Together with the material model and the set of initial and boundary conditions, they determine the complete solution to the problem. Taking into account that the initial velocity of the bullet is 1185 m/s at a mass of 3.9 g, we obtain energy 2740 J. All this energy acts at the area of the wound canal with a depth of 150 mm. Injury with a conventional 7N6M bullet is characterized by the fact that it passes through the block and loses only part of the kinetic energy. The simulation results showed that the velocity of the bullet at the outlet is 220 m/s. Taking into account the initial velocity of the bullet 918 m/s with a mass of 3.4 g, we obtain the kinetic energy acting on the walls of the wound canal with a depth of 200 mm of about 830 J. Mathematic analyses showed that the expansive bullet has a soft core that deforms and transfers all the kinetic energy to the tissues immediately after penetration into the tissues. The loss of kinetic energy of the bullet (ΔE, J) is defined as the difference between the kinetic energy at the time of injury (Ec, J) and the residual energy of the bullet when leaving the material (Er, J). Numerical modeling of wound ballistics in biological tissue simulators allows us to determine with high accuracy the features of wound canal formation and tissue response to damage of bullets having different kinetic energy, which contributes to the choice of adequate surgical management during surgery for gunshot wounds

Key words: gunshot wound, gushot injury, modelling of bullet injury, numerical modeling

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Tsymbaliuk V. National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0001-7544-6603

Lurin I. National Academy of Medical Sciences of Ukraine; SSI "Scientific and Practical Center of Preventive and Clinical Medicine" of the State Administration of Affairs, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6280-1725

Gumeniuk K. Ukrainian Military Medical Academy, Kyiv, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-8892-4061

Herasymenko O. Military Medical Clinical Center of the Southern Region;  Odessa National Medical University, Odesa, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-0039-5757

Furkalo S. National Aviation University, Kyiv, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-4797-6767

Oklei D.  V.N. Karazin Kharkiv National University, Kharkiv, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9509-3630

Negoduyko V. Kharkiv National Medical University, Kharkiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-4540-5207

Gorobeiko M. Institute of Biology and Medicine, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine 
https://orcid.org/0000-0003-1303-0076

Dinets A. Institute of Biology and Medicine, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9680-7519

Tsymbaliuk V., Lurin I., Gumeniuk K., Herasymenko O., Furkalo S., Oklei D., Negoduyko V., Gorobeiko M., Dinets A. Modeling of wound ballistics in biological tissues simulators. Medicni perspektivi. 2023;28(1):37-48. DOI: https://doi.org/10.26641/2307-0404.2023.1.275866

Modeling of wound ballistics in biological tissues simulators

The article reveals the features of coordinated rehabilitation – a process that leads to rehabilitating of people with neurological damage that limits their functionality. The purpose of the article is a literature review within the framework of GAJU 066/2022/S, funded by the grant agency of the South Bohemian University of Czech Budejovice, Czech Republic, examining the effectiveness of coordinated rehabilitation in patients recovering from strokes and the use of the standardized Functional Independence Measure (FIM) test to assess the patient’s condition. Data come from current Czech and foreign publications. The EDS multi-finder was used to search for literary sources. Document searches were from 2016-2022 in Czech and English. Search terms include post-stroke rehabilitation, FIM, rehabilitation after stroke, neurorehabilitation, and community based rehabilitation. The start of coordinated rehabilitation of stroke patients should be timely, long-term, comprehensive, and effective, involving a multidisciplinary approach and teamwork. It is essential to develop an individual approach and create a suitable individual plan that allows the use of the FIM test. This is the only way to establish long-term and mutually beneficial cooperation. As the cost of rehabilitation increases, the financial burden on the healthcare system also increases. Caring for a stroke patient also puts various burdens on the family. Successful rehabilitation can reduce the use of costly medicines and materials and decrease the need for nursing care and the term of hospital stay. The social costs of strokes are associated with long-term dependence and a low degree of resocialization. Considering the frequency of strokes and the associated disability, there is an increasing need for coordinated services within coordinated rehabilitation. Gaps in data on coordinated stroke rehabilitation should be filled by providing necessary information about long-term participation in community-based programs.

Key words: post-stroke rehabilitation, FIM, rehabilitation after stroke, neurorehabilitation, community based rehabilitation

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Shuranova L. University of South Bohemia, České Budějovice; Oblastní nemocnice Příbram, Příbram, Czech Republic,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-5611-0490

Vacková J. University of South Bohemia, České Budějovice, Czech Republic
https://orcid.org/0000-0002-0241-1052

Míková M. University of South Bohemia; Nemocnice České Budějovice, České Budějovice, Czech Republic
https://orcid.org/0000-0002-0637-5837

Shuranova L., Vacková J., Míková M. The benefits of coordinated rehabilitation in the treatment of stroke patients: A literature review. Medicni perspektivi. 2023;28(1):48-55. DOI: https://doi.org/10.26641/2307-0404.2023.1.275869

The benefits of coordinated rehabilitation in the treatment of stroke patients: A literature review

Thromboembolic diseases are of great clinical concern because of their high prevalence and consequences, which are often fatal. Despite significant progress in the prevention and treatment of thrombotic events, patients remain at risk of life-threatening bleeding episodes and other side effects arising from anticoagulant therapy, so the issue of personalizing prescriptions taking into account the genetic characteristics of patients has become urgent. The purpose of the study is to substantiate the need for patient genotype analysis in order to increase the effectiveness and safety of individual pharmacotherapy. The article has a conceptual nature, therefore the following research methods were chosen: systematization and generalization; analysis and specification; abstract and logical. For the search, we used PubMed, PubMedCentral, Google Scholar, dbSNP, Elsevier, Springer from September 2000 to November 2022. The review included studies written in English and Ukrainian. There were analyzed literature data on two main subclasses of oral antithrombotic agents, including oral anticoagulants and antiplatelet agents, namely warfarin, apixaban, rivaroxaban, and clopidogrel. Prognostically significant for evaluating the effectiveness and safety of anticoagulant use, as well as the most studied in this aspect, are CYP2C9 (rs1799853, rs1057910), CYP2C19 (rs4244285, rs4986893, rs12248560), VKORC1 (rs9923231, rs7294, rs9934438), MDR1 (rs4148738, rs2032582, rs1045642), FGB (rs1800787), PAI-1 (rs1799889) genes. The results of CYP2B6, CYP3A4/5 (rs776746), CYP4F2 (rs2108622) genes analysis indicate a certain influence on the anticoagulants metabolism and require further detailed study. Factors such as age, race, sex, smoking, diet, and other medications are known to influence the effectiveness of antithrombotic therapy, but the most influential factor is genetics, which accounts a significant percentage of interindividual variability. Future research should focus on the study of known and novel genetic variants that influence drug metabolism, as well as the molecular mechanisms that contribute to changes in plasma anticoagulant levels. The article provides a brief overview of action mechanisms, pharmacogenetics, and interactions between drugs and the genes responsible for their metabolism. The results indicate the need for studies of gene variants considered in this review before starting anticoagulant therapy, and attention should also be paid to the possibility of inhibitors and inductors influence on components of the metabolic pathway of anticoagulants and gene expression products that participate in their metabolism. The totality of these measures will ensure an increase in the efficiency and safety of individual pharmacotherapy and allow optimizing the choice and dosage of anticoagulants.

Key words: anticoagulants, thrombosis, warfarin, rivaroxaban, apixaban, clopidogrel, genes, inhibitors

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Bentsionova K.I. SI «Reference Center for Molecular Diagnostics of the Ministry of Health of Ukraine», Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-7446-5191

Rossokha Z.I. SI «Reference Center for Molecular Diagnostics of the Ministry of Health of Ukraine», Kyiv, Ukraine
https://orcid.org/0000-0002-4767-7364

Ievseienkova O.G. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9315-6108

Gorovenko N.G. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0003-4227-7166

Bentsionova K.I., Rossokha Z.I., Ievseienkova O.G., Gorovenko N.G. Pharmacogenetic substantiation of personalized prescription of oral anticoagulants in clinical practice. Medicni perspektivi. 2023;28(1):55-68. DOI: https://doi.org/10.26641/2307-0404.2023.1.275870

Pharmacogenetic substantiation of personalized prescription of oral anticoagulants in clinical practice

The purpose of the work was to analyze the experience of foreign specialists regarding movement and structural disorders of the proximal part of the femur in patients with the consequences of stroke and their impact on the effectiveness of rehabilitation programs for hip joint pathology. To fulfill the goal, an analysis of foreign literary sources was carried out in modern databases: Google Scholar, Web of Science, PubMed, Medline, Cochrane, Pedro. The search depth is 22 years (from January 2000 to October 2021). The analysis of literature sources indicated that limitation of motor activity and axial loads in patients after acute cerebrovascular accident, in particular limitation of mobility in the hip joint, impairment of muscle strength and tone due to hemiparesis can lead to the development of osteoporosis. Particularly important from the point of view of adverse consequences is a decrease in mineral density and fractures of the proximal part of the femur. On the other hand, disturbed biomechanics of movements in the hip joint in persons with the consequences of a cerebral stroke, under the condition of axial load on the limb, can lead to the development of osteoarthritis of the hip joint. Osteoarthritis results in limited mobility of the hip joint, which leads to secondary immobilization of the hip joint and, as a result, can also lead to further osteoporosis. Existing disorders of neuromuscular control, muscle tone and strength, limitation of mobility of the hip joint, including due to spasticity, problems with static and dynamic balance, and, as a result, an increased risk of falling in patients with the consequences of a stroke, can negatively affect the recovery of motor functions, activity limitation, and, as a result, reduce the effectiveness of rehabilitation of patients after hip joint replacement. Existing movement disorders, as a result of a stroke, require the development and justification of new rehabilitation programs, including the use of modern technical means and virtual reality.

Key words: rehabilitation, stroke, movement disorders, hip joint, osteoporosis, osteoarthritis, hip replacement

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Look through:

Shkurupіi О.І. Dnipro state medical university, Dnipro, Ukraine
https://orcid.org/0000-0001-8503-5509

Olexenko І.М. Dnipro state medical university, Dnipro, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-8926-6344

Smirnova О.L. Dnipro state medical university, Dnipro, Ukraine
https://orcid.org/0000-0003-2354-5380

Gryshunina N.Y. Dnipro state medical university, Dnipro, Ukraine
https://orcid.org/0000-0001-6159-1551

Yaroshenko K.O. Dnipro state medical university, Dnipro, Ukraine
https://orcid.org/0000-0002-0658-0486

Shkurupіi О.І., Olexenko І.М., Smirnova О.L., Gryshunina N.Y., Yaroshenko K.O. Problems of physical rehabilitation of movement disorders in the pathology of the hip joint in patients with the consequences of a cerebral stroke. Medicni perspektivi. 2023;28(1):69-76. DOI: https://doi.org/10.26641/2307-0404.2023.1.275872

Problems of physical rehabilitation of movement disorders in the pathology of the hip joint in patients with the consequences of a cerebral stroke

According to the recommendations of the European Society of Cardiology (ESC) 2021 for the management of patients with chronic heart failure (CHF), it is necessary to take into account the iron level in the diagnosis of all patients with firstly diagnosed heart failure (HF). Also the practical recommendations indicate that the assessment of iron deficiency is also carried out in patients with already confirmed CHF, especially if the symptoms of HF persist against the background of optimal treatment of the underlying disease, which necessitates knowledge of the diagnosis of anemia and iron deficiency in patients with CHF. The aim was review literature illustrating current data about diagnostics of iron deficiency and anemia in patients with CHF. In the work 28 sources from the Web of Science database and 7 sources from the PubMed database were analyzed. Anemia is diagnosed by hemoglobin levels. As criteria for iron deficiency, two parameters are used in clinical practice – ferritin level and transferrin saturation. The mean corpuscular volume of erythrocytes and the mean hemoglobin content in them were not reliable markers of iron deficiency and are not recommended for assessing iron deficiency in patients with HF. Depletion of iron stores in the bone marrow is a highly specific for iron deficiency, as it is not affected by inflammation and therefore the test for iron stores in the bone marrow is the gold standard for diagnosis, however its use in clinical practice is limited due to invasiveness and high cost. Diagnostic markers such as levels of hepsidin, dissolved transferrin receptor and ferritin index have low availability in laboratories. Since timely diagnosis followed by treatment of anemia and iron deficiency in patients with CHF impoves the quality of life of patients, therefore, increasing the diagnostic value of tests to identify iron deficiency remains a question for active research.

Key words: anemia, iron deficiency, chronic heart failure, diagnostics

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Look through:

Khanyukov O.O. Dnipro State Medical University, Dnipro, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

https://orcid.org/0000-0003-4146-0110

Pesotskaya L.A. Dnipro State Medical University, Dnipro, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-0784-1465

Sapozhnychenko L.V. Dnipro State Medical University, Dnipro, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-6472-2235

Pampukha O.O. Dnipro State Medical University, Dnipro, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

https://orcid.org/0000-0002-7721-4109

Khanyukov O.O., Pesotskaya L.A., Sapozhnychenko L.V., Pampukha O.O. Diagnostics of anemia and iron deficiency in patients with chronic heart failure. Medicni perspektivi. 2023;28(1):77-82. DOI: https://doi.org/10.26641/2307-0404.2023.1.276007

Diagnostics of anemia and iron deficiency in patients with chronic heart failure

Chronic systemic inflammation is a key component of the pathogenesis of both type 2 diabetes mellitus (T2DM) and coronary artery disease (CAD). Soluble vascular cell adhesion molecule‑1 (sVCAM‑1) is considered as the indicator of vascular inflammation and endothelial activation. The aim of our study was to investigate sVCAM‑1 levels in patients with CAD with T2DM and to determine their dependence on a previous history of myocardial infarction (MI). The study included 52 patients with stable CAD with T2DM, 20 CAD patients without diabetes and 14 control group persons. sVCAM-1 levels were measured in serum by the enzyme-linked immunosorbent assay. sVCAM‑1 levels in patients with CAD with T2DM and patients with CAD without diabetes were higher than in the control group (p<0,001 and p<0,001, respectively). The difference in sVCAM‑1 levels between CAD patients with T2DM and without diabetes was not significant (p=0,355). There were no significant correlations of sVCAM‑1 levels with glucometabolic indices in any group. Only in patients with CAD with T2DM sVCAM‑1 level negatively correlated with high-density lipoprotein cholesterol. CAD patients with and without T2DM with a history of myocardial infarction (MI) had higher sVCAM‑1 levels than patients without previous MI (p=0,038, р=0,043, respectively). Only in diabetic CAD patients sVCAM‑1 levels were increased in those without a history of MI (р=0,036, in comparison with the controls). There were no correlations between sVCAM‑1 levels and left ventricular remodeling indices in patients either with or without MI. Conclusions. In patients with CAD with T2DM and patients with CAD without T2DM, sVCAM‑1 levels increased in comparison with the controls. However, in patients without diabetes sVCAM‑1 level was increased only in those with previous MI. In patients with T2DM, sVCAM‑1 level increased in the absence of previous MI and there was the further significant increase of its level in postinfarction cardiosclerosis.

Key words: coronary artery disease, type 2 diabetes mellitus, vascular cell adhesion molecule‑1

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14. Storti F, Pulley J, Kuner P, Abt M, Luhmann U. Circulating Biomarkers of Inflammation and Endothelial Activation in Diabetic Retinopathy. Translational Vision Science &amp; Technology. 2021;10(12):8. doi: https://doi.org/10.1167/tvst.10.12.8
15. Hayek A, Paccalet A, Mechtouff L, Da Silva C, Ivanes F, Falque H, et al. Kinetics and prognostic value of soluble VCAM‐1 in ST‐segment elevation myocardial infarction patients. Immunity, Inflammation and Disease. 2021;9(2):493-501. doi: https://doi.org/10.1002/iid3.409
16. Palella E, Cimino R, Pullano S, Fiorillo A, Gul­letta E, et al. Laboratory Parameters of Hemo­stasis, Adhesion Molecules, and Inflammation in Type 2 Diabetes Mellitus: Correlation with Glycemic Control. International J of Environmental Research and Public Health. 2020;17(1):300. doi: https://doi.org/10.3390/ijerph17010300
17. Antuna-Puente B, Disse E, Rabasa-Lhoret R, La­ville M, Capeau J, Bastard J. How can we measure insulin sensitivity/resistance?. Diabetes &amp; Metabolism. 2011;37(3):179-88. doi: https://doi.org/10.1016/j.diabet.2011.01.002
18. Mach F, Baigent C, Catapano A, Koskinas K, Casu­la M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. European Heart J. 2019;41(1):111-88. doi: https://doi.org/10.1093/eurheartj/ehz455
19. Lang R, Badano L, Mor-Avi V, Afilalo J, Arm­strong A, Ernande L, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocar­diography and the European Association of Cardiovascular Imaging. J of the American Society of Echocardiography. 2015;28(1):1-39.e14. doi: https://doi.org/10.1016/j.echo.2014.10.003
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21. Hegazy G, Awan Z, Hashem E, Al-Ama N, Abu­naji A. Levels of soluble cell adhesion molecules in type 2 diabetes mellitus patients with macrovascular complications. J of International Medical Research. 2019;48(4):030006051989385. doi: https://doi.org/10.1177/0300060519893858
22. Fadel M, Abdel Ghaffar F, Zwain S, Ibrahim H, Badr E. Serum netrin and VCAM-1 as biomarker for Egyptian patients with type IΙ diabetes mellitus. Bio­chemistry and Biophysics Reports. 2021;27:101045. doi: https://doi.org/10.1016/j.bbrep.2021.101045
23. Hocaoglu-Emre F, Saribal D, Yenmis G, Guvenen G. Vascular Cell Adhesion Molecule 1, Intercellular Adhesion Molecule 1, and Cluster of Differentiation 146 Levels in Patients with Type 2 Diabetes with Complications. Endocri­nologyand  2017;32(1):99. doi: https://doi.org/10.3803/EnM.2017.32.1.99
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27. Hulok A, Ściborski K, Marczak J, Bańkowski T, Po­ręba R, Negrusz-Kawecka M. Soluble Cell Adhesion Mole­cules – Does Estimating sVCAM-1 and sICAM-1 Concen­tration Provide Additional Information About Car­diovascular Risk in Patients with Coronary Artery Disease? Advances in Clinical and Experimental Medicine. 2014;23(5):735-41. doi: https://doi.org/10.17219/acem/37232 

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Serik S.A. SI «L.T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine», Kharkiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6257-3566

Mavrycheva N.R. SI «L.T. Malaya Therapy National Institute of the National Academy of Medical Sciences of Ukraine», Kharkiv, Ukraine
https://orcid.org/0000‑0001‑7967‑4179

Serik S.A., Mavrycheva N.R. Vascular cell adhesion molecule‑1 levels in patients with coronary artery disease with type 2 diabetes mellitus. Medicni perspektivi. 2023;28(1):82-89. DOI: https://doi.org/10.26641/2307-0404.2023.1.276010

Vascular cell adhesion molecule‑1 levels in patients with coronary artery disease with type 2 diabetes mellitus

Carpal tunnel syndrome is the most common of compression neuropathies and in the structure of upper limb tunnel syndromes. Surgical treatments are diverse and clarifications of the indications for the implementation of each of them will allow to individualize the behavior of the intervention. Purpose of work – clarify the determining factors for classical and advanced minimally invasive intervention in carpal tunnel syndrome; evaluate the effectiveness of such an approach. We observed 52 patients with carpal tunnel syndrome with unsuccessful conservative treatment; electroneuromyographic and ultrasound signs of gross changes in the structures of the carpal canal. There were 19 men and 33 women (36.5% and 63.5%, respectively). In 28 patients (group 1), surgical intervention was performed according to the classical technique from an incision of 5.0-5.5 cm. Surgical treatment in 24 patients was carried out from an access of up to 2.5 cm (minimally invasive intervention). They made up the 2nd group. The dynamics of the indicators of the Boston BCTQ questionnaire and the visual analogue scale indicated a greater severity of symptoms, functional and pain disorders of the hand after 4 weeks in the extended access group compared with the minimally invasive access group with similar indicators before the intervention. However, by 3 and 6 months, the results converge and practically do not differ. Similar good results indicate the correctness of the chosen tactics and the validity of an individual approach in determining the nature and scope of the intervention. 

Key words: carpal tunnel syndrome, evaluation of surgical treatment

1. Feng B, Chen K, Zhu X, Ip WY, Andersen LL, Page P, et al. Prevalence and risk factors of self-reported wrist and hand symptoms and clinically confirmed carpal tunnel syndrome among office workers in China: a cross-sectional study. BMC Public Health. 2021 Jan 6;21(1):57-63. doi: https://doi.org/10.1186/s12889-020-10137-1
2. Gilveg A, Parfenov V, Evzikov G. Median nerve decompression in carpal tunnel syndrome: Short- and long-term results. Neurology, Neuropsychiatry, Psycho­somatics. 2018;10:79-85. doi: https://doi.org/10.14412/2074-2711-2018-3-79-85
3. Turgut MC, Saglam G, Toy S. Efficacy of extra­corporeal shock wave therapy for pillar pain after open carpal tunnel release: a double-blind, randomized, sham-controlled study. Korean J Pain. 2021;34:315-21. doi: https://doi.org/10.3344/kjp.2021.34.3.315
4. Schwarz AM, Lipnik G, Hohenberger GM, Krauss A, Plecko M. Mini-open carpal tunnel release: technique, feasibility and clinical outcome compared to the conventional procedure in a long-term follow-up. Scientific reports. 2022;12(1):9122. doi: https://doi.org/10.1038/s41598-022-11649-z
5. Saglam G, Turgut MC, Semis HS, Toy S. Ultra­sonographic Measurement of Median Nerve Cross-Sectional Area in Evaluating Carpal Tunnel Release Outcomes. The Journal of hand surgery. 2022;00162:9. doi: https://doi.org/10.1016/j.jhsa.2022.03.007
6. Goru P, Butaliu GC, Verma GG, et al. Effecti­veness of ultrasound-guided local steroid injection to the wrist for the treatment of carpal tunnel syndrome: Is it worth it? Egypt Rheumatol Rehabil. 2022;49:21. doi: https://doi.org/10.1186/s43166-022-00121-5
7. Razavipour M, Ghaffari S, Ghadiri A. Clinical Outcomes of Median Nerve Release in Carpal Tunnel Syndrome with and without Cervical Radiculopathy. Trauma Monthly. 2021;26(6):322-9. doi: https://doi.org/10.30491/TM.2021.294747.1331
8. Multanen J, Uimonen MM, Repo JP, et al. Use of conservative therapy before and after surgery for carpal tunnel syndrome. BMC Musculoskelet Disord. 2021;22:484. doi: https://doi.org/10.1186/s12891-021-04378-3
9. com. [Internet]. Excel-Based Tools for Educators. [cited 10 Dec 2022]. Available from: http://www.ezanalyze.com/
10. Segal KR, Debasitis A, Koehler SM. Optimization of Carpal Tunnel Syndrome Using WALANT Method. J Clin Med. 2022;11(13):3854. doi: https://doi.org/10.3390/jcm11133854
11. Braga DM, Rocha AD, Amaral I, Diniz DS, Gui­marães VD. Epidemiology and approach in Carpal Tunnel Syndrom: An analysis of the impact on return on labor. Interação. 2021;21(3):24-42. doi: https://doi.org/10.53660/inter-81-s210
12. Utomo P, Surya WA, Hadinoto SA, Sumarwoto T. Current Concept Management of Carpal Tunnel Synd­rome: A Case Report. Indones J Med. 2020;05(01):70-86. doi: https://doi.org/10.26911/theijmed.2020.05.01.11
13. Phan A, Hammert W. Evaluation of PROMIS Outcomes for Surgical Treatment of Cubital Tunnel Syndrome With and Without Carpal Tunnel Syndrome. Hand (NY). 2021;Jul 3:15589447211028921. doi: https://doi.org/10.1177/15589447211028921
14. Kamel SI, Freid B, Pomeranz C, Halpern EJ, Nazarian LN. Minimally Invasive Ultrasound-Guided Car­pal Tunnel Release Improves Long-Term Clinical Out­comes in Carpal Tunnel Syndrome. Am J Roentgenol. 2021;217(2):460-8.
    doi: https://doi.org/10.2214/AJR.20. 24383
15. Chen Z, Liu J, Yuan T, Cai D, Wang X, Qin J. Comparison of clinical outcomes between open and modified endoscopic release for carpal tunnel syndrome. Experimental and Therapeutic Medicine. 2021;22:861. doi: https://doi.org/10.3892/etm.2021.10293 

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Rushay A.K. National Medical University О.О. Bogomolets, Kyiv, Ukraine, е-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-9530-2321

Lisaychuk Yu.S. National Medical University О.О. Bogomolets, Kyiv, Ukraine
https://orcid.org/0000-0002-2231-193X

Voyennyy I.V. National Medical University О.О. Bogomolets, Kyiv, Ukraine
https://orcid.org/0000-0002-3366-1126

Rushay A.K., Lisaychuk Yu.S., Voyennyy I.V. Algorithm of surgical tactics for the treatment of carpal tunnel syndrome. Medicni perspektivi. 2023;28(1):90-94. DOI: https://doi.org/10.26641/2307-0404.2023.1.276012

Algorithm of surgical tactics for the treatment of carpal tunnel syndrome

The development of modern diagnostic medicine, the important task of which is the use of non-invasive methods for detecting a disease without impact of radiation exposure, has led to the spread of the method of infrared thermography, which allows to quickly and informatively identify pathological conditions of a person within a single examination. The main complaints characteristic of Raynaud's phenomenon are associated with cold, hyperemia, edema, and a feeling of paresthesia in the limbs. A significant number of scientific works have been devoted to the study of the Raynaud's phenomenon, where basically, examples of manifestations of Raynaud's phenomenon are given in the form of a violation of the microcirculation of the distal parts of limbs. Comprehensive studies of the combination of Raynaud's phenomenon with concomitant diseases, according to the authors, are insufficiently covered. The application of sophisticated modern laboratory diagnostic methods to detect this disease is nonspecific and burdensome for the patient. Thermographic diagnostics within one examination reveals both the presence of signs of Raynaud's phenomenon and concomitant somatic diseases. This paper presents the results of many years’ thermographic research, demonstrating the variety of manifestations of the Raynaud's phenomenon. For the first time, it has been shown that patients with signs of Raynaud's phenomenon, as a rule, have concomitant somatic diseases, which should be the subject of research of specialists in different medical fields to determine the relationship of Raynaud's phenomenon with the identified diseases. The results of visualization of thermoasymmetries of the skin of various pathological conditions during a complex thermographic examination were obtained, which greatly simplify the diagnostic search and understanding the complexity and danger of Raynaud's phenomenon. Of particular importance are the results of work for the differential diagnosis of complications of diabetes mellitus – diabetic foot syndrome. The paper presents some results of thermographic examinations of patients with signs of Raynaud's phenomenon and identified pathological changes in the body.

Key words: Raynaud's phenomenon, thermography, temperature gradient, concomitant diseases, diabetes mellitus

1. Golovach IYu, Chipko TM, Korbut NN. [Ray­naud’s phenomenon and digitalulcers in systemic scle­rosis:pathophysiology questionsand management at the present stage]. Ukrainian journal of rheumatology. 2017;4(70):15-23. Ukrainian. Available from: https://www.rheumatology.kiev.ua/wp/wp-content/uploads/2018/01/1063.pdf?upload=
2. Dunaevskyi VI, Kyslyi VP, Bogdan TV. [Medico-biological aspects of the manifestation of Raynaud`s phenomenon in children. In: Science and education: a collection of works of the XVI international scientific conference; 2022 Jan 4-11]. Hajdúszoboszló (Hungary); 2022. р. 143-8. Ukrainian. Available from: http://lib.khmnu.edu.ua/konfer_HNU/2022/Konf_22.pdf
3. Goundry B, Bell L, Langtree M, Moorthy A. Diagnosis and management of Raynaud`s phenomenon. BMJ.2012;344:e289. doi: https://doi.org/10.1136/bmj.e289
4. Flavahan NA. A vascular mechanistic approach to understanding Raynaud phenomenon. Nat Rev Rheumatol. 2015;11:146-58. doi: https://doi.org/10.1038/nrrheum.2014.195
5. Linnemann B, Erbe M. Raynaud`s phenomenon-assessment and differential diagnoses. Vasa. 2015;44:166-77. doi: https://doi.org/10.1024/0301-1526/a000426
6. Marushko TV. [Raynaud’s syndrome in children]. Dytiachyi likar. 2018;1(58):27-34. Ukrainian. Available from:
   https://d-l.com.ua/ua/archive/2018/1%2858%29/pages-27-34/sindrom-reyno-u-ditey
7. Herrik AL. Management of Raynaud`s pheno­menon and digital ischemia. Curr Rheumatol Rep. 2013;15(1):303.
   doi: https://doi.org/10.1007/s11926-012-0303-1
8. Herrik AL. Recent advances in the pathogenesis and management of Raynaud`s phenomenon and digital ulcers. Curr Opin Rheumatol. 2016;28(6):577-85. doi: https://doi.org/10.1136/bmj.e289
9. Gulchiy MV, Nazarchuk SS, Dunaevskiy VI, Ko­tovskiy VY, Timofeev VI. [Monitoring the status of the blood circulation in the lower limbs in patients with diabetes mellitus.]. International journal of endocrinology. 2018;14(8):769-75. doi: https://doi.org/10.22141/2224-0721.14.8.2018.154858
10. Dunaievsky V., Kotovskyi V, Nazarchuk S, Kys­lyi V. Expanding the modern approaches of diagnostics of the state of a biological object by introducing infrared thermography. National Health as Determinant of Sustainable Development of Society. Bratislava: St. Filip; 2021. р. 35-55. Available from: https://dspace.uzhnu.edu.ua/jspui/bitstream/lib/37505/3/Mono_VSEMvsMED2021.pdf
11. Hughes M, Herrick AL. Digital ulcers in systemic sclerosis. Rheumatology (Oxford). 2017;56(1):14-25. doi: https://doi.org/10.1039/rheumatology/kew047
12. Marushko TV. [Raynaud`s phenomenon in child­ren: a modern view of the problem]. Health-ru.com. Cardiology. Rheumatology. Сardiac surgery. 2015;21(1). Ukrainian.
13. Ostafiychuk DI, Shaiko-Shaikovsky OG, Be­lov ME, Chibotaru KI. [Thermography, application in medicine]. Clinical and experimental pathology. 2019;18:1(67):126-31. doi: https://doi.org/10.24061/1727-4338.XVIII.1.67.2019.218
14. Guk MT, Andreychyn MA, Shkilna MI, Zapo­rozhan SY. [Thermographic study of migrating erythema]. Scientific Bulletin of Uzhhorod University. Series "Medicine". 2021;1(63):43-48. Ukrainian. Available from: https://med-visnyk.uzhnu.uz.ua/index.php/med/article/view/167
15. Adam M, Ng E, Tan J, Heng M, Tong J, Acha­rya U. Computer aided diagnosis of diabetic foot using infrared thermography: A review. Computers in Biology and Medicine. 2017;91:326-36. doi: https://doi.org/10.1016/j.compbiomed.2017.10.030
16. Rusak OB. [Peculiarities of pathogenetic mecha­nisms of regional blood flow disorders in diabetic foot syndrome (literature review)]. International Endo­crinology Journal.2015;6(70):91-5.  doi: https://doi.org/10.22141/2224-0721.6.70.2015.72646
17. Kotovskyi VY, Dzhezheria YI. [Non-invasive technologies in biomedical research]. NTUU "KPI": Kyiv; 2014. 204 p. ISBN 978-966-432-157-7. Ukrainian. http://194.44.11.130/cgi-bin/irbis_nbuv/cgiirbis_64.exe?C21COM=S&I21DBN=EC&P21DBN=&S21FMT=JwU_B&S21ALL=%28%3C.%3EU%3D%D0%A0343.39%3C.%3E%29&Z21ID=&S21SRW=AVHEAD&S21SRD=&S21STN=1&S21REF=10&S21CNR=20

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Zabolotnyi D.I. SI "O.S. Kolomiychenko Institute of Otolaryngology of National Academy of Medical Science of Ukraine", Kyiv, Ukraine
http://orcid.org/0000-0001-9429-4414

Loboda T.V. Kyiv city clinical hospital No. 12, Kyiv, Ukraine
http://orcid.org/0000-0002-1868-1698

Dunaievskyi V.I. Institute of Semiconductor Physics V.Ye. Lashkaryova National Academy of Sciences of Ukraine, Kyiv, Ukraine
http://orcid.org/0000-0002-2106-9520

Kotovskyi V.Y. National Technical University of Ukraine "Igor Sikorsky Kyiv Polytechnic Institute", Kyiv, Ukraine
http://orcid.org/0000-0003-3372-7815

Timofeiev V.I. National Technical University of Ukraine "Igor Sikorsky Kyiv Polytechnic Institute", Kyiv, Ukraine
http://orcid.org/0000-0003-0515-1580

Nazarchuk S.S. National Technical University of Ukraine "Igor Sikorsky Kyiv Polytechnic Institute", Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
http://orcid.org/0000-0002-3794-609X

Zabolotnyi D.I., Loboda T.V., Dunaievskyi V.I., Kotovskyi V.Y., Timofeiev V.I., Nazarchuk S.S. Application of the infrared thermography method in diagnosis of Raynaud`s phenomenon. Medicni perspektivi. 2023;28(1):95-103. DOI: https://doi.org/10.26641/2307-0404.2023.1.276014

Application of the infrared thermography method in diagnosis of Raynaud`s phenomenon

To date, there are no effective treatment for placental dysfunction in pregnant women with gestational hypertension. Therefore, the purpose of our study was to investigate the clinical efficacy of proposed method of infusion therapy for pregnant women with gestational hypertension, which included a complex of drugs: pentoxifylline, arginine hydrochloride with levocarnitine and rheosorbilact. We observed 73 pregnant women with single fetation, starting from 28 weeks of gestation, who were observed before and during childbirth, and in the postpartum period by the time of discharge from the hospital. All examined women were divided into 3 groups. The first group included 30 pregnant women with gestational hypertension, who received (along with the basic therapy of methyldopa drugs) a complex of infusion solutions: pentoxifylline 0.05% – 100 ml; solution containing arginine hydrochloride 4.2% and levocarnitine 2.0% – 100 ml; reosorbilact preparation – 100 ml. The infusion was carried out once a day in the specified sequence for 10 days. The second group included 20 patients with gestational hypertension on basic therapy with methuldopa only. The control group included 23 women with physiological pregnancy. The data of our study show that in patients receiving the proposed infusion therapy there was a significant decrease in the development of placental dysfunction by 38.3%, the threat of premature birth – by 18.3% and fetal distress – by 30.0%, premature rupture of the membranes – by 35.0%, weakness of labor – by 28.3%, a decrease in the risk of perinatal central nervous system damage – by 33.3% and the frequency of cephalohematomas – by 30.0% compared with women who received only antihypertensive therapy.

Key words: fetoplacental dysfunction, gestational hypertension, treatment

1. Avakov VE, Sayipov RM, Davydov DV, Begma­tov S, Bazarov A. [Detoxifying Properties of Reosorbilact and Its Effects on Hemostasis]. Emergency medicine. 2014;2(57):47-51. doi: https://doi.org/10.22141/2224-0586.2.57.2014.83096
2. Avramenko TV, Kolomiichenko TV, Yaniuta Saar M. [The use of Tivortin in the complex treatment of pregnant women with chronic arterial hypertension]. Health of woman. 2012;4(70):76-80. Ukrainian.
3. Ventskivskyi BM, Bila VV, Strashko IV, Zaho­rodnia ОS. [Clinical efficacy of pentoxifylline in the treatment of pregnant women with preterm premature rupture of membranes]. Actual Problems of Pediatrics, Obstetrics and Gynecology. 2017;1:42-6. doi: https://doi.org/10.11603/24116-4944.2017.1.7356
4. Lapovets LYe, et al. [Clinical laboratory diag­nostics]. Кyiv: Меdytsyna; 2019. 472 p. Ukrainian.
5. Меrts E. [Ultrasound diagnostics in obstetrics and gynecology. Vol. 1. Obstetrics]. МЕDрRеss-inform; 2016. 720 p. Russian.
6. Rebrova OYu. [Statistical analysis of medical data. Application of Statistica applications]. MediaSfera; 2018. 312 p. Russian.
7. Horbatiuk OH, Shatkovska AS, Hryhorenko AP, inventors; Vinnyts. nats. med. іn-t im. M.I. Pyrohova, assignee. [The method of restoring the function of the placenta in pregnant women with fetoplacental dysfunction against the background of pre-eclampsia]. Ukraine patent u201809586. 2019 Feb 25. Ukrainian.
8. Acharya S, Yasmin E, Balen AH. The use of a combination of pentoxifylline and tocopherol in women with a thin endometrium undergoing assisted conception therapies – a report of 20 cases. Hum Fertil (Camb). 2019;12:198-203. doi: https://doi.org/10.3109/14647270903377178
9. Azimi A, Ziaee SM, Farhadi P, Sagheb MM. Hypothesis: Pentoxifylline explores new horizons in treatment of preeclampsia. Med Hypotheses. 2015;85:468-74. doi: https://doi.org/10.1016/j.mehy.2015.06.031
10. Dorniak-Wall T, Grivell RM, Dekker GA, et al. The role of L-arginine in the prevention and treatment of pre-eclampsia: a systematic review of randomised trials. Journal of Human Hypertension. 2014;28:230-5. doi: https://doi.org/10.1038/jhh.2013.100
11. Griffin M, Heazell AE, Chappell LC, Zhao J, Lawlor DA. The ability of late pregnancy maternal tests to predict adverse pregnancy outcomes associated with placental dysfunction (specifically fetal growth restriction and pre-eclampsia): a protocol for a systematic review and meta-analysis of prognostic accuracy studies. Systematic Reviews.2020;9(1):78. doi: https://doi.org/10.1186/s13643-020-01334-5
12. Safarova S, Aliyeva E, Abbasova F, Mirzoyeva K. [The Experience of L-Arginine Using in Placental Insuf­ficiency]. Infusion & Chemotherapy. 2020;3.1:67-8. Rus­sian. doi: https://doi.org/10.32902/2663-0338-2020-3.1-56
13. Schoots MH, Gordijn SJ, Scherjon SA, van Goor H, Hillebrands JL. Oxidative stress in placental pathology. 2018;69:153-61. doi: https://doi.org/10.1016/j.placenta.2018.03.003
14. Tomimatsu T, Mimura K, Endo M, Kumasawa K, Kimura T. Pathophysiology of preeclampsia: an angio­genic imbalance and long-lasting systemic vascular dysfunction. Hypertension Research. 2017;40(4):305-10. doi: https://doi.org/10.1038/hr.2016.152
15. Tomimatsu T, Mimura K, Matsuzaki S, Endo M, Kumasawa K, Kimura T. Preeclampsia: Ma­ternal Syste­mic Vascular Disorder Caused by Generalized Endothelial Dysfunction Due to Placental Antiangiogenic Factors. International Journal of Molecular Science. 2019;20(17):42-6. doi: https://doi.org/10.3390/ijms20174246

Look through:

Vaskiv O.V. Vinnytsia National Pirogov Memorial Medical University, Khmelnytskyi, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6310-5692

Grigorenko A.P. Vinnytsia National Pirogov Memorial Medical University, Khmelnytskyi, Ukraine
https://orcid.org/0000-0003-3184-5359

Gorbatyuk O.G. Vinnytsia National Pirogov Memorial Medical University, Khmelnytskyi, Ukraine
https://orcid.org/0000-0002-0123-367X

Shatkovska A.S. Vinnytsia National Pirogov Memorial Medical University, Khmelnytskyi, Ukraine
https://orcid.org/0000-0002-3638-8882

Binkovska A.M. Vinnytsia National Pirogov Memorial Medical University, Khmelnytskyi, Ukraine
https://orcid.org/0000-0002-6718-4882

Priymak I.A. Vinnytsia National Pirogov Memorial Medical University, Khmelnytskyi, Ukraine
https://orcid.org/0000-0001-9933-3371

Vaskiv O.V., Grigorenko A.P., Gorbatyuk O.G., Shatkovska A.S., Binkovska A.M., Priymak I.A. Modern approach to infusion therapy of pregnant women with gestational hypertension. Medicni perspektivi. 2023;28(1):104-110. DOI: https://doi.org/10.26641/2307-0404.2023.1.276021

Modern approach to infusion therapy of pregnant women with gestational hypertension

The goal of this study was to determine the association between the level of 25-(OH) vitamin D and excessive body weight in women on preconceptional period and during gestation. There were studied 117 women. The first group included 68 overweight women (body mass index (BMI) 25.0-29.9 kg/m²), the second – 49 with normal body weight (BMI 18.5-24.9 kg/m²) before prepregnancy. Anthropometry was performed, BMI (kg/m²) by Quetelet formula. The 25-(OH) vitamin D blood serum level was studied by immunoenzymatic method. Fasting blood serum levels of glucose, insulin were determined by the immunoenzymatic method, insulin resistance index was calculated, serum concentrations of triglycerides, total cholesterol, high, low and very low density lipoproteins were determined. The results were statistically analyzed using Statistica 10 (Serial Number: STA999K347150-W) and MEDCALC^®. It was found an inverse correlation between the level of vitamin D and BMI (r= – 0.71, p<0.001). Excessive body weight on precon­ceptional period reduces the chances of an adequate level of vitamin D (0.02; 0.00-0.10; p<0.001) and increases the chances of its deficiency (13.11; 4.89-35.30; p<0.001) during early gestational period. It was diagnosed that during pregnancy, the chances of vitamin D deficiency increase in women with normal body weight (3.16; 1.11-9.02; p=0.04), but remain significantly higher in the overweight (6.30; 2.80-14.18; p<0.001). It was shown that insufficiency/deficiency of vitamin D during pregnancy was accompanied by insulin resistance, hyper/dyslipidemia, which are the metabolic basis of gestational complications. The assessment of an inverse relationship between the level of 25-(OH) vitamin D and excessive body weight in women on preconceptional period and the increase of deficiency during pregnancy should be taken into account for the purpose of laboratory determination of the vitamin at the stage of pregnancy planning for the appointment of therapeutic correction.

Key words: pregnancy, overweight, 25-(OH) vitamin D, preconceptional care

1. Arkhypkina TL, Lyubymova LP, Bonda­ren­ko VO, Yerʹomenko RF. [The relationship between vita­min D and excess body weight and blood lipid spectrum in women with polycystic ovary syndrome]. Problemy endokrynnoi patolohii. 2020;4:7-14. Ukrainian. doi: https://doi.org/10.21856/j-PEP.2020.4.01
2. Hurianov VH, Lyakh YuYe, Parii VD, Korot­kyi OV, Chalyi OV, Chalyi KO, Tsekhmister YA. [Hand­book of biostatistics. Analysis of the results of medical research in the EZR (R-statistics) package. Educational manual]. Kyiv: Vistka. 2018. 208 p. Ukrainian.
3. Lapovets LY, Lebed HB, Yastremska OO. [Clini­cal laboratory diagnostics]. 2-d ed. Kyiv: Medytsyna. 2021. 472 p. Ukrainian.
4. Lyasota TI. [Monitoring of physical condition]. Manual. Chernivtsi: Chernivetskyi nats. universitet. 2018. 136 p.
5. Tatarchuk TF, Bulavenko OV, Kapshuk IM, Tar­nopolska VO. [Vitamin D deficiency in the genesis of reproductive health disorders]. Ukrayinskyi medychnyi chasopys. 2015;5(109):56-61. Ukrainian. Available from: http://nbuv.gov.ua/UJRN/UMCh_2015_5_18
6. Tkachenko VI, Berezovska LO. [The effect of vitamin D on the onset and progression of type 2 diabetes]. Zdorove natsii. 2019:8(5);179-85. Ukrainian. doi: https://doi.org/10.22141/2306-2436.8.5.2019.198387
7. Bettencourt A, Boleixa D, ReisJ. Serum 25-hydro­xyvitamin D levels in a healthy population from the North of Portugal. J Steroid Biochem Mol Biol. 2018;175:97-101. doi: https://doi.org/10.1016/j.jsbmb.2016.11.005
8. Carrelli A, Bucovsky M, Horst R. Vitamin D sto­rage in adipose tissue of obese and normal weight women. J Bone Miner Res. 2017;32:237-42. doi: https://doi.org/10.1002/jbmr.2979
9. Chen C, Xu X, Yan Y. Estimated global over­weight and obesity burden in pregnant women based on panel data model. Plos One. 2018;13(8):e0202183. doi: https://doi.org/10.1371/journal.pone.0202183
10. Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D: metabolism, molecular mecha­nism of action, and pleiotropic effects. Physiol Rev. 2016;96:365-408. doi: https://doi.org/10.1152/physrev.00014.2015
11. De Pergola G, Martino T, Zupo R. 25 Hydro­xyvitamin D levels are negatively and independently associated with fat mass in a cohort of healthy overweight and obese subjects. Endocr Metab Immune Disord Drug Targets. 2019;19(6):838-44. doi: https://doi.org/10.2174/1871530319666190122094039
12. FoxA, Feng W, Asal What is driving global obesity trends? Globalization or "modernization"? Global Health. 2019;15(1):32. doi: https://doi.org/10.1186/s12992-019-0457-y
13. Grieger JA, Hutchesson MJ, Cooray SD, Kho­mami MB, Zaman S, Segan L, Teede H, Moran LJ. A review of maternal overweight and obesity and its impact on cardiometabolic outcomes during pregnancy and postpartum. Ther Adv Reprod Health. 2021;15:1-16. doi: https://doi.org/10.1177/2633494120986544
14. Hajar Sharami S, Abbasi Ranjbar Z, Alizadeh F, Kazemnejad E. The relationship of hyperlipidemia with maternal and neonatal outcomes in pregnancy: A cross-sectional study. Int J Reprod Biomed. 2019;17(10):739-48. doi: https://doi.org/10.18502/ijrm.v17i10.5294
15. Jiang X, Peng M, Chen S, Wu S, Zhang W. Vita­min D deficiency is associated. 2019;35(6):1059-63. doi: https://doi.org/10.1080/03007995.2018.1552849
16. Mansoor KMKh, Iqbal S, Nowshada N, Abdel­mannanb D. Interplay between Vitamin D, obesity, and other metabolic factors in a multiethnic adult cohort. Dubai DiabetesEndocrinol  2020;26:152-7.  doi: https://doi.org/10.1159/000511687
17. Ostafiichuk SO. Genetic aspects of metabolic disorders in pregnant women with pathological gestational weight gain. Regulatory Mechanisms in Biosystems. 2019;10(3):271-5. doi: https://doi.org/10.15421/021941
18. Rafiq S, Jeppesen PB. Is hypovitaminosis d related to incidence of type 2 diabetes and high fasting glucose level in healthy subjects: A systematic review and meta-analysis of observational studies. Nutrients. 2018;10(1):59-77. doi: https://doi.org/10.3390/nu10010059
19. Ruiz-Ojeda FJ, Anguita-Ruiz A, Leis R, Agui­lera CM. Genetic factors and molecular mechanisms of vitamin D and obesity relationship. Ann Nutr Metab. 2018;73:89-99. doi: https://doi.org/10.1159/000490669
20. Sadat-Ali M, AITabash K, AL-Turki, ALMousa S, ALSayed H. Time out: should vitamin D dosing be based on patient's body mass index (BMI): a prospective controlled study. J Nutrit Scien. 2021;10:E106. doi: https://doi.org/10.1017/jns.2021.100
21. Yang K, Liu J, Fu S, Tang X, Ma L, Sun W, Niu Y, Jing G, Niu Q. Vitamin D status and correlation with glucose and lipid metabolism in Gansu province, China. Diabetes Metabc Syndr Obes. 2020;13:1555-63. doi: https://doi.org/10.2147/DMSO

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Maksymenko L.R. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0002-0919-0838

Perkhulyn O.M. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
https://orcid.org/0000-0002-0033-5156

Drohomyretska N.V. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
https://orcid.org/0000-0002-7371-2450

Henyk N.I. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
https://orcid.org/0000-0001-5755-7537

Maksymenko L.R., Perkhulyn O.M., Drohomyretska N.V., Henyk N.I. The significance of assessment the relationship between the level of 25-(OH) vitamin D and excessive body weight in women on preconceptional period and during pregnancy. Medicni perspektivi. 2023;28(1):110-118. DOI: https://doi.org/10.26641/2307-0404.2023.1.276031

The significance of assessment the relationship between the level of 25-(OH) vitamin D and excessive body weight in women on preconceptional period and during pregnancy

Bacterial vaginosis and aerobic vaginitis are the most common problems among gynecological pathology in women of reproductive age. The share oh nonspecific vaginitis is affected by stress, which affects the state of a woman’s hormonal system. However, the relationship between hormonal changes, exposure to chronic stress and nonspecific vaginitis has not been fully estab­lished, which is up-to-date task. Aim of study is to study changes in the levels of gonadotropic and sex hormones, as well as cortisol in women of reproductive age with aerobic vaginitis and bacterial vaginosis. 160 women (100%), divided into 2 clinical groups with subgroups were examined: the main group – 94 (58.8 %) patients with nonspecific vaginitis, who received treatment according to developed clinical diagnostic algorithms and schemes. The comparison group included 66 (41.2%) patients with nonspecific vaginitis, who received treatment according to known protocols. In the process of examining groups, the following research methods were used: general (collection of complaints and anamnesis, gyneco­logical examination, assessment of microscopy of vaginal smears according to the Amsel, Nugent and Donders criteria), laboratory (method of determining the level of follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, cor­tisol), statistical. According to the study results it was found that women of reproductive age with nonspecific vaginitis are likely to have elevated levels of follicle-stimulating, luteinizing hormones, prolactin, cortisol and significantly reduced estradiol levels compared to healthy individuals. In conclusion, the results indicate changes in gonadotropic and sex hor­mones in women with nonspecific vaginitis towards the increased levels of follicle-stimulating, luteinizing hormones, prolac­tin, cortisol and decreased levels of estradiol. Such hormonal changes indicate depletion of the hypothalamic-pituitary-genital system, which occurs under the influence of chronic stress on the body of women of reproductive age with nonspecific vaginitis.

Key words: nonspecific vaginitis, hormonal status, bacterial vaginosis, aerobic vaginitis, women of reproductive age

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2. Jones A. Bacterial Vaginosis: A Review of Treat­ment, Recurrence, and Disparities. The Journal for Nurse Practitioners. 2019;15:420-3. doi: http://doi.org/10.1016/j.nurpra.2019.03.010
3. Ma X, Wu M, Wang C, et al. The pathogenesis of prevalent aerobic bacteria in aerobic vaginitis and adverse pregnancy outcomes: a narrative review. Reprod Health. 2022;19:21.
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4. Donders GG, Bellen G, Grinceviciene S, Ru­ban K, Vieira-Baptista P. Aerobic vaginitis: no longer a stranger. Research in Microbiology. 2017;168(9-10):845-58. doi: http://doi.org/10.1016/j.resmic.2017.04.004
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6. Wang C, Fan A, Li H, Yan Y, Qi W, Wang Y, et al. Vaginal bacterial profiles of aerobic vaginitis: a case-control study. Diagnostic microbiology and infectious disease. 2020;96:1-11. doi: https://doi.org/10.1016/j.diagmicrobio.2019.114981
7. Chen X, Lu Y, Chen T, Li R. The Female Vaginal Microbiome in Health and Bacterial Vaginosis. Frontiers in cellular and infection microbiology. 2021;11:631972. doi: https://doi.org/10.3389/fcimb.2021.631972
8. Kaambo E, Africa C, Chambuso R, Passmore JS. Vaginal Microbiomes Associated With Aerobic Vaginitis and Bacterial Vaginosis. Frontiers in Public Health. 2018;6:1-6. doi: http://doi.org/10.3389/fpubh.2018.00078
9. Burka OA, Tutchenko TM. [Laboratory asses­sment on the etiology of pathological vaginal discharges]. Zdorovia 2019;4:64-8. Ukrainian. doi: https://doi.org/10.15574/HW.2019.140.64
10. Novikova L. [Stressful situations in Ukrainian’s lives]. [Internet]. 2019. [cited 2022 Dec 20]. Ukrainian. Available from: https://www.kiis.com.ua/?lang=eng&cat=reports&id=910&page=1
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12. Coffman JA. Chronic stress, physiological adap­tation and developmental programming of the neuro­endo­crine stress system. Future Neurology. 2020;15(1):FNL39. doi: https://doi.org/10.2217/fnl-2019-0014
13. Edward N, Simone P. Influences of the stress endocrine system on the reproductive endocrine axis in sheep (Ovis aries). Italian Journal of Animal Science. 2017;16(4):640-51. doi: http://doi.org/10.1080/1828051X.2017.1321972
14. Amabebe E, Anumba DOC. Psychosocial Stress, Cortisol Levels, and Maintenance of Vaginal Health. Frontiers in Endocrinology. 2018;568(9):1-11. doi: http://doi.org/10.3389/fendo.2018.00568
15. Gruzevskiy АА. [Indicators of the hormonal regulation system in colonization resistance of vaginals]. Aktualni problemy transportnoi medycyny. 2019;4:84-90. Ukrainian. doi: http://dx.doi.org/10.5281/zenodo.1239467
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19. Pletzer B, Poppelaars ES, Klackl J, Jonas E. The gonadal response to social stress and its relationship to cortisol. Stress. 2021;1-10. doi: http://doi.org/10.1080/10253890.2021.1891220 
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21. Levine S, Muneyyirci-Delale O. Stress-Induced Hyperprolactinemia: Pathophysiology and Clinical Ap­proach. Obstetrics and gynecology international. 2018;1-6. doi: http://doi.org/10.1155/2018/9253083
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Ryazanova O.D. SI "Zaporizhia Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine", Zaporizhzhia, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2717-4890

Ryazanova O.D. Hormonal status in women of reproductive age with nonspecific vaginitis. Medicni perspektivi. 2023;28(1):119-124. DOI: https://doi.org/10.26641/2307-0404.2023.1.276040

Hormonal status in women of reproductive age with nonspecific vaginitis

Resilience in veterans with brain trauma in remote period has received considerable attention over the past years. Cognitive functioning is described among factors that may influence resilience and included in the modern theoretical models of this positive psychology phenomenon. However, the characteristics of relationship between resilience and cognitive functioning in veterans with traumatic brain injury (TBI) in remote period was not studied empirically. Therefore, the purpose of this study was to gain better understanding of the possible association between resilience and cognitive functioning in Ukrainian war veterans with traumatic brain injury in remote period. This study included 146 veterans who were admitted to two clinical hospitals for war veterans. The Connor-Davidson Resilience Scale and Montreal Cognitive Assessment Scale were used. The present study shows that lower cognitive functioning in total and in several domains is associated with less effective resilience regardless of TBI clinical type (whether it is concussion or mild cerebral contusion). Moreover, such correlation was still present after excluding the effect of age, education and TBI characteristics like number of traumas and time since last TBI.  Overall, we found empirical evidence that good cognitive functioning (especially executive functions, memory, attention, abstract thinking, and orientation) is essential for effective resilience in veterans with mild TBI even years after trauma and has more effect on ability to adapt than age, education, and trauma characteristics. Educating veterans to use their cognitive potential and to compensate the restrictions after mild TBI possibly may lead to better overcoming adversities and counteracting the risks of des­adaptation and traumatic events. Therefore, psychological interventions for improving the ability to readapt and recover possibly should consider this relationship and include the component of educating veterans to use their cognitive reserve and compensate limitations to better adapt and thrive. Studies related to such interventions appear to be promising.

Key words: traumatic brain injury, cognitive functions, resilience, veterans

1. McCarron K, Dasgupta M, Campbell C, Hull A, Namazi S, Adams A, et al. Social rehabilitation for military veterans with traumatic brain injury, psycho­logical trauma, and chronic neuropsychiatric symptoms: Intervention development and initial outcomes. Psychiatric Rehabilitation J. 2019;42(3):296-304. doi: https://doi.org/10.1037/prj0000361
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3. Neils-Strunjas J, Paul D, Clark A, Mudar R, Duff M, Waldron-Perrine B, et al. Role of resilience in the rehabilitation of adults with acquired brain injury. Brain Injury. 2017;31(2):131-9. doi: https://doi.org/10.1080/02699052.2016.1229032
4. Assonov D, Khaustova O. Development of resi­lience concept in scientific literature of recent years. Psychosomatic Medicine and General Practice. 2019;4(4):e0404219. doi: https://doi.org/10.26766/pmgp.v4i3-4.219
5. Reid M, Cooper D, Lu L, Iverson G, Kennedy J. Adversity and Resilience Are Associated with Outcome after Mild Traumatic Brain Injury in Military Service Members. J Neurotrauma. 2018;35(10):1146-55. doi: https://doi.org/10.1089/neu.2017.5424
6. Elliott T, Hsiao Y, Kimbrel N, Meyer E, DeBeer B, Gulliver S, et al. Resilience and Traumatic Brain Injury Among Iraq/Afghanistan War Veterans: Differential Patterns of Adjustment and Quality of Life. J Clinical Psychology. 2016;73(9):1160-78. doi: https://doi.org/10.1002/jclp.22414
7. Elliott T, Hsiao Y, Kimbrel N, DeBeer B, Gul­liver S, Kwok O, et al. Resilience facilitates adjustment through greater psychological flexibility among Iraq/Af­ghanistan war veterans with and without mild traumatic brain injury. Rehabilitation Psychology. 2019;64(4):383-97. doi: https://doi.org/10.1037/rep0000282
8. Skandsen T, Stenberg J, Follestad T, Karaliute M, Saksvik S, Einarsen C, et al. Personal Factors Associated With Postconcussion Symptoms 3 Months After Mild Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation. 2021;102(6):1102-12. doi: https://doi.org/10.1016/j.apmr.2020.10.106
9. Stainton A, Chisholm K, Kaiser N, Rosen M, Up­thegrove R, Ruhrmann S, et al. Resilience as a multimodal dynamic process. Early Intervention in Psychiatry. 2018;13(4):725-32. doi: https://doi.org/10.1111/eip.12726
10. Nalder E, Hartman L, Hunt A, King G. Traumatic brain injury resiliency model: a conceptual model to guide rehabilitation research and practice. Disability and Rehabilitation. 2018;41(22):2708-17. doi: https://doi.org/10.1080/09638288.2018.1474495
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17. Flora K, Georgiadou T, Megari K, Grigoro­poulos I, Chasiotis V. Resilience, fear of COVID-19 and their relationship with cognitive functioning and mood: a study on the administrative staff of the University of Western Mace­donia, Greece. J Ideas in Health. 2021;4(Special3):458-565. doi: https://doi.org/10.47108/jidhealth.Vol4.IssSpecial3.157
18. Deng M, Pan Y, Zhou L, Chen X, Liu C, Huang X, et al. Resilience and Cognitive Function in Patients With Schizophrenia and Bipolar Disorder, and Healthy Controls. Frontiersin  2018;9. doi: https://doi.org/10.3389/fpsyt.2018.00279
19. Jung S, Lee G, Nishimi K, Chibnik L, Koenen K, Kim H. Association between psychological resilience and cognitive function in older adults: effect modification by inflammatory status. Geroscience. 2021;43(6):2749-60. doi: https://doi.org/10.1007/s11357-021-00406-1
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21. Assonov D. Two-Step Resilience-Oriented Inter­vention for Veterans with Traumatic Brain Injury: A Pilot Randomized Controlled Trial. Clinical Neuropsychiatry. 2021;18(5):247-59. doi: https://doi.org/10.36131/cnfioritieditore20210503
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23. Kaplan G, Leite-Morris K, Wang L, et al. Patho­physiological Bases of Comorbidity: Traumatic Brain Injury and Post-Traumatic Stress Disorder. J Neurotrauma. 2018;35(2):210-25. doi: https://doi.org/10.1089/neu.2016.4953
24. Ben-Zion Z, Fine N, Keynan N, et al. Cognitive Flexibility Predicts PTSD Symptoms: Observational and Interventional Studies. Frontiers in Psychiatry. 2018;9:477. doi: https://doi.org/10.3389/fpsyt.2018.00477

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Assonov D.O. Bogomolets National Medical University, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

https://orcid.org/0000-0002-6803-6961

Assonov D.O. Correlation between resilience and cognitive functioning in veterans with traumatic brain injury. Medicni perspektivi. 2023;28(1):124-131. DOI: https://doi.org/10.26641/2307-0404.2023.1.276041

Correlation between resilience and cognitive functioning in veterans with traumatic brain injury

One of the most common mental illnesses is schizophrenia and schizotypal disorders. According to the literature data, mortality among patients with schizophrenia is 1.5-2 times higher than among the general population. Patients with schizophrenia have a higher prevalence of cardiovascular disease, obesity, diabetes, osteoporosis in comparison with the general population. Such comorbid somatic diseases in the case of schizophrenia have a more acute course, a significant impact on the course of the underlying disease, the development of complications, decrease in quality of life and social functioning. The aim of the study was to study the presence and features of comorbidity, its impact on the quality of life and social functioning of patients with schizophrenia and schizotypal disorders. 100 patients were included in the study. They were divided into two groups: experimental (Group I) with schizophrenia and comparison (Group II), with other schizophrenic diseases, such as schizoaffective and schizotypal disorder. All patients were scaled according to the following methods: The Cumulative Illness Rating Scale (CIRS), Clinical Global Impression – Severity Scale (CGI-S), The Personal Social Performance Scale (PSP), CGI-S, and a short form of the questionnaire Medical Outcomes Study 36-Item Short-Form Health Status (SF-36). Charlson Index was also calculated for all patients included in the study. Due to CIRS, we detected undiagnosed comorbidity that aggravated the course of the underlying disease: 38% in Group I and 26% in Group II. The most common components in the structure of comorbidity in the patients with schizophrenia were diabetes mellitus, musculoskeletal diseases, cardiovascular diseases, non-alcoholic fatty liver disease (NAFLD). Patients with schizotypal disorders were more often diagnosed with peripheral vascular diseases, chronic lung diseases, chronic kidney diseases, and upper gastrointestinal tract disorders. A com­pre­hensive approach to be important in the treatment of such patients. The nature and extent of comorbidity should be definitely taken into account. This will promote the compliance and improve the indicators in the examined category of patients.

Key words: schizophrenia, schizotypal disorders, comorbid profile, quality of life, social functioning

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7. Mathers CD. History of global burden of disease assessment at the World Health Organization. Archives of Public Health. 2020;78. doi: https://doi.org/10.1186/s13690-020-00458-3
8. Charlson FJ, Ferrari AJ, Santomauro DF, Dimi­nic S, Stockings E, Scott JG, et al. Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016. Schizophrenia Bulletin. 2018;44:1195-203. doi: https://doi.org/10.1093/schbul/sby058
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10. Li Y, Yan LL, Ronsmans C, Wen H, Xu J, Wang D, et al. Excess mortality among patients with severe mental disorders and effects of community-based mental healthcare: a community-based prospective study in Sichuan, China. Bjpsych Open. 2021;7. doi: https://doi.org/10.1192/bjo.2021.46
11. Fisher K, Griffith LE, Gruneir A, Kanters D, Markle-Reid M, Ploeg J. Functional limitations in people with multimorbidity and the association with mental health conditions: Baseline data from the Canadian Longitudinal Study on Aging (CLSA). PLOS ONE 2021;16:e0255907. doi: https://doi.org/10.1371/journal.pone.0255907
12. Romash IR, Vynnyk MI. [Dynamics of indicators of social functioning in case of metabolic syndrome in patients with paranoid schizophrenia on the background of atypical neuroleptic agents application and improvement comor­bidity.] Art of medicine. 2019;4(12):102-9. Ukrainian. doi: https://doi.org/10.36927/2079-0325-V27-is4-2019-11
13. Romash IR, Vynnyk MI. [Dynamics of Quality of Life Indices in Case of Metabolic Syndrome in Patients with Paranoid Schizophrenia on the Background of Aty­pical Neuroleptic Agents Application and Improvement of Comorbidity]. Ukrainskyi visnyk psykhonevrolohii. 2020;27,4(101):62-7. Ukrainian. doi: https://doi.org/10.36927/2079-0325-V27-is4-2019-11
14. Chang WC, Ng CM, Chan KN, et al. Psychiatric comorbidity in individuals at-risk for psychosis: Rela­tionships with symptoms, cognition and psychosocial functioning. Early Interv Psychiatry. 2021;15(3):616-23. doi: https://doi.org/10.1111/eip.12992
15. Sharma MP. Comorbidity of mental and physical disorders. Indian J Med Res. 2016 Nov;144(5):786-7. doi: https://doi.org/10.4103/0971-5916.203466
16. Smashna OYe. [Syndromogenesis of paranoid form of schizophrenia, comorbid with somatic pathology.] Ukrainskyi visnyk psykhonevrolohii. 2010;18(62):62-6. Ukrainian.
17. Pati S, Mahapatra P, Dwivedi R, et al. Multimor­bidity and Its Outcomes Among Patients Attending Psy­chiatric Care Settings: An Observational Study From Odisha, India. Front Public Health. 2021;8:616480. doi: https://doi.org/10.3389/fpubh.2020.616480
18. Ishigooka J, Nakagome K, Ohmori T, Iwata N, Inada K, Iga J, et al. Discontinuation and remission rates and social functioning in patients with schizophrenia re­ceiving second‐generation antipsychotics: 52‐week eva­luation of JUMPs, a randomized, open‐label study. Psychiatry and Clinical Neurosciences. 2022;76:22-31. doi: https://doi.org/10.1111/pcn.13304
19. Hudon C, Fortin M, Soubhi H. Abbreviated guide­lines for scoring the cumulative illness rating scale (CIRS) in family practice. J Clin Epidemiol. 2007;60:212.e1-4. doi: https://doi.org/10.1016/j.jclinepi.2005.12.021
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Romash I.R. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-6591-6613

Romash I.R. Assessment of comorbid profile, quality of life and social functioning in patients with schizophrenia and schizotypal disorders. Medicni perspektivi. 2023;28(1):131-141. DOI: https://doi.org/10.26641/2307-0404.2023.1.276043

Assessment of comorbid profile, quality of life and social functioning in patients with schizophrenia and schizotypal disorders

The aim of this work is the rationale for using radiological method of examination in diagnosing and monitoring the mandibular osteomyelitis treatment. A total of 60 patients with traumatic (first group) and odontogenic (second group) mandibular osteomyelitis were examined. Among them, there were 24 (40%) males and 36 (60%) females aged between 20 and 45 years. The patients received intravenous injection of Technefor (^99MTc) with the radiation activity of 300-400 megabecquerel 3-4 hours before scintigraphy. The mandible radiopharmaceutical uptake was measured using a computerized gamma camera. The level of ^99MTc accumulation in the bone tissue was quantified by gamma-radiation. A patient was examined on the day of hospital admission and on day 14 after surgical treatment of osteomyelitis of the mandible. Our studies have shown that all forms of traumatic and odontogenic osteomyelitis are accompanied by significant changes in ^99MTc uptake in the mandible, however, both ^99MTc uptake and its decrease after surgical treatment were most obvious in odontogenic osteomyelitis. The increase in ^99MTc uptake in traumatic mandibular osteomyelitis was 38,1% (up to 1669,9 gamma-radiation pulses), 140,9% (up to 2913,7 gamma-radiation pulses) and 129% (up to 2772,7 gamma-radiation pulses) in the acute, subacute and chronic stages of the disease, respectively. The increase in ^99MTc uptake in odontogenic mandibular osteomyelitis was 160,0% (up to 3144,1 gamma-radiation pulses), 218,1% (up to 3846,6 gamma-radiation pulses) and 275,2% (up to 4537,6 gamma-radiation pulses) in the acute, subacute and chronic stages of the disease, respectively. The increase in ^99MTc uptake was due to blood flow enhancement, metabolic disorders, activation of osteoblast and osteoclasts in the bone tissue. The decrease in ^99MTc uptake after the treatment indicated the positive response to treatment. Scintigraphic examination was more sensitive and specific in comparison to X-ray diagnostics of mandibular ostemyelitis. The sensitivity of scintigraphic findings ranged from 60.0% to 100%, and the specificity was 100% at different stages of ostemyelitis.

Key words: osteomyelitis, mandible fracture, scintigraphy, diagnostics, reparative osteogenesis, bone remodelling

1. Arıcan P, Okudan B, Şefizade R, Naldöken S. Diagnostic Value of Bone SPECT/CT in Patients with Suspected Osteomyelitis . Mol Imaging Radionucl Ther. 2019;28:89-95. doi: https://doi.org/10.4274/mirt.galenos.2019.20053
2. Ayati N, Norouzi M, Sadeghi R, Erfani M, Ghare­daghi M, Aryana K. Diagnostic value of 99mTc-ubi­quicidin scintigraphy in differentiation between osteo­myelitis and bone tumors. Nucl Med Commun. 2017;11:885-90. doi: https://doi.org/10.1097/MNM.0000000000000744
3. Connolly CM, Donohoe KJ. Nuclear medicine imaging of infection. Semin Roentgenol. 2017;2:114-9. doi: https://doi.org/10.1053/j.ro.2016.07.001
4. Govaert GA, Ijpma FF, McNally M, McNally E, Reininga IH, Glaudemans AW. Accuracy of diagnostic imaging modalities for peripheral post-traumatic osteo­myelitis - a systematic review of the recent literature. Eur J Nucl Med Mol Imaging. 2017;8:1393-407. doi: https://doi.org/10.1007/s00259-017-3683-7
5. Gudmundsson T, Torkov P, Thygesen TH. Diag­nosis and Treatment of Osteomyelitis of the Jaw – A Systematic Review (2002-2015) of the Literature. J Dent Oral Disord. 2017;3:1066. doi: https://doi.org/10.26420/jdentoraldisord.2017.1066
6. Heuker M, Gomes A, van Dijl JM, van Dam GM, Friedrich AW, Sinha B, et al. Preclinical studies and pros­pective clinical applications for bacteria-targeted imaging: the future is bright. Clin Transl Imaging. 2016;4:253-64. doi: https://doi.org/10.1007/s40336-016-0190-y
7. Kim C, Lee SJ, Kim JY, Hwang KT, Choi YY. Comparative Analysis of 99mTc-MDP Three-Phase Bone Scan with SPECT/CT and 99mTc-HMPAO-Labeled WBC SPECT/CT in the Differential Diagnosis of Clinically Suspicious Post-traumatic Osteomyelitis. Nucl Med Mol Imaging. 2017;51(1):40-8. doi: https://doi.org/10.1007/s13139-016-0441-x
8. Kitajima K, Noguchi K, Moridera K, Kishi­moto H, Tsuchitani T, Takahashi Y, et al. Usefulness of Quantitative Bone SPECT/CT for Evaluating Treatment Response in a Patient with Mandibular Osteomyelitis. Case Rep Oncol. 2021;14:820-5. doi: https://doi.org/10.1159/000516761
9. Lee SJ, Won KS, Choi HJ, Choi YY. Early-Phase SPECT/CT for Diagnosing Osteomyelitis: A Retrospective Pilot Study. Korean J Radiol. 2021;4:604-11. doi: https://doi.org/10.3348/kjr.2019.0746
10. Llewellyn A, Jones-Diette J, Kraft J, Holton C, Harden M, Simmonds M. Imaging tests for the detection of osteomyelitis: a systematic review. Health Technol Assess. 2019;6:1-128. doi: https://doi.org/10.3310/hta23610
11. Malina-Altzinger J, Klaeser B, Suter VG, Schri­ber M, Vollnberg B, Schaller B. Comparative evaluation of SPECT/CT and CBCT in patients with mandibular osteomyelitis and osteonecrosis. Clin Oral Investig. 2019;23:4213-22.
    doi: https://doi.org/10.1007/s00784-019-02862-8
12. Mills B, Bradley M, Dhaliwal K. Optical imaging of bacterial infections. Clin Transl Imaging. 2016;4:163-74. doi: https://doi.org/10.1007/s40336-016-0180-0
13. Muñoz-Mahamud E, Fernández-Valencia JÁ, Combalia A, Morata L, Soriano Á. Fluorescent tetra­cycline bone labeling as an intraoperative tool to debride necrotic bone during septic hip revision: a preliminary case series. J Bone Jt Infect. 2021;6(4):85-90. doi: https://doi.org/10.5194/jbji-6-85-2021
14. Ogura I, Kobayashi E, Nakahara K, Igarashi K, Ha­ga-Tsujimura M, Toshima H. Quantitative SPECT/CT ima­ging for medication-related osteonecrosis of the jaw: a pre­liminary study using volume-based parameters, com­pa­rison with chronic osteomyelitis. Ann Nucl Med. 2019;33:776-82.
    doi: https://doi.org/10.1007/s12149-019-01390-5
15. Antomonov MYu. [Mathematical processing  and  analysis of medical and biological data]. Кyiv: Medinform. 2018. Russian.
16. Shreenivasamurthy P, Shastry SL. Nuclear medi­cine in orofacial diagnosis: A review. J Med Radiol Pathol Surg. 2016;4:12-6. doi: https://doi.org/10.15713/ins.jmrps.63
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Look through:

Komskyi M.P. Dniprovskyi Medical Institute of Traditional and Non-Traditional Medicine, Dnipro, Ukraine
https://orcid.org/0000-0002-5717-9473

Romanenko Ye.G. Dnipro State Medical University, Dnipro, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9524-4187

Lisova I.G. Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine
https://orcid.org/0000-0002-1846-1054

Titov G.I. Dniprovskyi Medical Institute of Traditional and Non-Traditional Medicine, Dnipro, Ukraine
https://orcid.org/0000-0002-5460-0728

Trushenko O.S. Dniprovskyi Medical Institute of Traditional and Non-Traditional Medicine, Dnipro, Ukraine
https://orcid.org/0000-0002-1719-1451

Lavreniuk Ya.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-6293-9203

Komskyi M.P., Romanenko Ye.G., Lisova I.G., Titov G.I., Trushenko O. S., Lavreniuk Ya.V. Radioisotopic evaluation of reparative osteogenesis in various forms of osteomyelitis of the mandible. Medicni perspektivi. 2023;28(1):141-147. DOI: https://doi.org/10.26641/2307-0404.2023.1.276044

Radioisotopic evaluation of reparative osteogenesis in various forms of osteomyelitis of the mandible

Rheumatoid arthritis is a chronic systemic disease of connective tissue of immune genesis and unknown etiology. In the developed countries of the world, about 1 in 100 people suffer from rheumatoid arthritis, while in Ukraine the occurrence of the disease is 340 cases per 100,000 adult population. Chronic pain syndrome and limitation of joint functions significantly reduce the life quality of patients. At this stage, along with drug therapy, physical rehabilitation / therapy plays an important role in the restorative treatment of patients with rheumatoid arthritis. The purpose of the study is a comprehensive assessment of the main indicators of pain syndrome and morning stiffness of joints in patients with rheumatoid arthritis. 216 patients with rheumatoid arthritis were examined: 178 (82%) of them were women, 38 (18%) were men. The age of the patients is from 25 to 59 (average age is 46±0,24). The diagnosis was established on the basis of the ACR/EULAR 2010 criteria and in accordance with the Order of the Ministry of Health of Ukraine No. 263 dated November 04, 2014. A comprehensive analysis of the pain syndrome in patients with rheumatoid arthritis was carried out. Pain and severity of morning stiffness in the joints were determined using Huskisson’s visual analog scale (VAS, 100 mm). Statistical analysis was performed on the basis of the statistical analysis Statistica 10 (Serial Number: STA999K347150-W) and MEDCALC^®. It was found that pain of low intensity was observed in 62 (28,7%), pain of medium intensity – in 120 (55,6%), and maximum intensity pain was experienced by 34 (15,7%) patients. It was found that in women with rheumatoid arthritis of radiological stage I, the average morning stiffness index according to VAS (100 mm) is 46,1±7,3, in men – 45,3±4,8; in women of radiological stage II, the average indicator is 52,6±7,9, in men – 50,3±6,1; in women of radiological stage III, the average indicator is 66,8±5,9, in men – 63,6±1,7. The analysis of the indicators showed that the severity of morning stiffness is more pronounced in women of all radiological stages than in men. All the above determines an urgent need to develop and implement in practice the concept of physical therapy for patients with rheumatoid arthritis in order to reduce the pain syndrome, severity of rheumatoid arthritis, eliminate morning stiffness, improve the functional condition and restore the motor functions of the joints, improve the health and quality of life of patients.

Key words: rheumatoid arthritis, pain syndrome, morning stiffness, visual analog scale 

1. Vizir VA, Buriak VV, Sholokh SH, Zaika IV, Shko­lovyi VV. [Basics of diagnosis, treatment and prevention of diseases of the musculoskeletal system and  connective tis­sue]. Zaporizhzhia: ZDMU; 2021. Ukrainian. Available from: http://dspace.zsmu.edu.ua/handle/123456789/9603
2. Kononenko NM, Chikitkina VV. [Basic Methods of Physical Rehabilitation of Patients with Rheumatoid Arthritis]. Ukrainskyi zhurnal medytsyny, biolohii ta sportu. 2022;7,4(38):19-24. Ukrainian. doi: https://doi.org/10.26693/jmbs07.04.019
3. Kuriata OV, Sirenko OIu, Lysunets TK. [Joint pain in rheumatology patients: the role of anxiety-depressive disorders]. Ukrainian Journal of Rheumatology. 2017;2(68):52-7. Ukrainian. Available from: https://www.rheumatology.kiev.ua/article/10099/bil-u-suglobax-u-xvorix-revmatologichnogo-profilyu-rol-kontrolyu-trivozhno-depresivnix-rozladiv
4. [World Health Organization. International clas­sification of functioning, limitations of vital activity and health]. Kyiv; 2018. 1048 p. Ukrainian.
5. [Rheumatoid arthritis adapted evidence-based clinical guideline. Order of the Ministry of Health of Ukraine No. 263 of 11 April 2014].
6. Nogas AO. Karpinskyi AIu. [Motor activity in physical rehabilitation of patients with rheumatoid arthritis. Youth scientific bulletin of Lesya Ukrainka East European National University]. Fizychne vykhovannia i sport. 2017;1(37):130-5. Ukrainian.
7. Nogas A, Grygus I, Prymachok L. Application physiotherapy in rehabilitation rheumatoid arthritis. Journal of Education, Health and Sport. 2016;6(11):184-94. doi: https://doi.org/10.5281/zenodo.166045
8. Ponyk RM, Korytko ZI. [Disease and peculiarities of rehabilitation of patients with rheumatoid arthritis in the present time]. Zdobutky klinichnoi i eksperymentalnoi medytsyny. 2019;3:183-7. Ukrainian. doi: https://doi.org/10.11603/1811-2471.2019.v.i3.10504
9. Grygus I, Nogas A. [Recourses use modern as­pects of physical rehabilitation of patients with rheu­matoid arthritis. In: Pop T, editor. Research in rehabi­li­tation]. Rzeszów: Wydawnictwo Uniwersytetu Rzeszow­skiego; 2014. р. 80-87. Polish.
10. Grygus I, Nogas A. Improvement of Life Quality of the Patients with Rheumatoid Arthritis with Help of Physical Activity. Journal of Health Sciences. 2013;3(1):97-104.
11. Boers M. Patient global assessment to define remis­sion in rheumatoid arthritis: quo vadis? Ann Rheum Dis. 2021;80:277-9.
    doi: https://doi.org/10.1136/annrheumdis-2020-218802
12. Hawker GA, Mian S, Kendzerska T, French M. Measures of Adult Pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care & Research. 2011;63(Suppl 11):S240-52. doi: https://doi.org/10.1002/acr.20543
13. Fraenkel L, Bathon JM, England BR, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2021;73:1108-23. doi: https://doi.org/10.1002/acr.24596
14. Smolen JS, Landewe RB, Bijlsma JW, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheu­matic drugs: 2019 update. Ann Rheum Dis. 2020;79:685-99. doi: https://doi.org/10.1136/annrheumdis-2019-216655
15. Studenic P, Aletaha D, de Wit M, Stamm TA, Alas­ti F, Lacaille D, et al. American College of Rheumato­logy/EULAR Remission Criteria for Rheumatoid Arthritis: 2022 Revision. Arthritis & Rheumatology. 2022;2022:1-8. doi: https://doi.org/10.1002/art.42347

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Grygus I.M. National university of water and environmental engineering, Rivne, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-2856-8514

Nogas A.O. National university of water and environmental engineering, Rivne, Ukraine
https://orcid.org/0000-0003-1287-9828

Grygus I.M., Nogas A.O. Comprehensive analysis of pain syndrome in patients with rheumatoid arthritis. Medicni perspektivi. 2023;28(1):148-152. DOI: https://doi.org/10.26641/2307-0404.2023.1.276049

Comprehensive analysis of pain syndrome in patients with rheumatoid arthritis

The purpose of the study is a comprehensive hygienic assessment of the relationship between medico-social conditions of educational activities, quality of life and adaptive capabilities of students. During the research conducted on the basis of 5 modern educational institutions of different types: university, college, specialized school, lyceum and school, the significant deviations of indicators of hygienic assessment of daily regimen of pupils and students from generally accepted normative values (p<0.05-0.001)were revealed, which, first of all, concerned the excess of the maximum allowable duration of their daily stay in educational institutions, the length of time required to complete homework, low levels of physical activity, etc. It was found that the highest levels of quality of life among boys and girls are recorded according to the scales of Physical Functioning (PF), Bodily Pain (BP) and Role-Physical (RP), the lowest ones were Mental Health (MH), Vitality (VT) and Social Functioning (SF). The relationships between the values that indicate the characteristics of quality of life and features of the psychophysiological adaptation of pupils and students were revealed. Moreover, the largest number of relationships (r=0.36-0.77; p<0.05-0.001) which characterize quality of life indicators belong to boys according to the scales of Physical Functioning (PF), Mental Health (MH), Vitality (VT) , Bodily Pain (BP); to girls – Bodily Pain (BP), Vitality (VT), Mental Health (MH), General Health (GH), Role-Emotional (RE). When determining the features of intersystem relationships between components of quality of life and indicators of psychophysiological functions, it was found that the closest relationship (r=0.37-0.99; p<0.05-0.001) is observed between the characteristics of the speed of visual-motor reactions, mobility and balance of nervous processes, coordination of movements and indicators of quality of life according to the scales of General Health (GH), Physical Functioning (PF), Social Functioning (SF) and Mental Health (MH).

Key words: pupils and students, educational activity, medico-social conditions, quality of life, psychophysiological adaptation, hygienic assessment

1. Antomonov MYu. [Mathematical processing and analysis of medical and biological data]. 2nd ed. Кyiv: Medynform; 2018. 579 p. Russian.
2. Amirdzhanova VN, Goryachev DV, Korshu­nov NI, et al. [Population indicators of quality of life according to the SF-36 questionnaire. Results of a multicenter study of the quality of life MIRA]. Nauchno-prakticheskaya revmatologiya. 2008;1:36-48. Russian.
3. Moroz VM, Makarov SYu, Serebrennikova OA, Serheta IV. [Educational stress and psychophysiological criteria for assessing the adaptation capabilities of the body of students of higher medical education institutions]. Vinnytsia: TOV “TVORY”; 2020. 184 p. Ukrainian.
4. Moroz VM, Serebrennikova OA, Cerheta IV, Stoian NV. [Psychophysiological and psychohygienic ba­ses of effective use of health-preserving technologies in institutions of higher education]. Vinnytsia: TOV “TVORY”; 2021. 208 p. Ukrainian.
5. Serheta IV, Bardov VH, Drezhenkova IL, Pan­chuk OIu. [Hygienic norms of motor activity of students of higher medical education institutions and ways of its optimi­zation]. Vinnytsia: TOV “TVORY”; 2020. 184 p. Ukrainian.
6. Serheta IV, Panchuk OIu, Yavorovskyi OP. [Hy­gie­nic diagnosis of the professional suitability of students of me­dical education institutions (on the example of dental spe­cial­ties)]. Vinnytsia: TOV “TVORY”; 2020. 348 p. Ukrainian.
7. Tymoshchuk OV, Polka NS, Serheta IV. [Scien­tific basis of a complex hygienic assessment of the quality of life and adaptation possibilities of modern pupils and students]. Vinnytsia: TOV “TVORY”; 2020. 272 p. Ukrainian.
8. Afsar ST. Impact of the Quality of Work-Life on Organizational Commitment: A Comparative Study on Academicians Working for State and Foundation. Isg J Ind RelatHum  2015;17;45-75. doi: https://doi.org/10.4026/1303-2860.2015.0278.x
9. Khairunneezam MN, Siti Suriani O, Nurul Na­dirah AH. Work-Life Balance Satisfaction among Aca­demics in Public Higher Educational Sector. Int J Acad Res BusSoc  2017;7:5-19. doi: https://doi.org/10.6007/IJARBSS/v7-i13/3181
10. Cheung YB, Yeo KK, Chong KJ, Khoo EY, Wee HL. Measurement equivalence of the English, Chi­nese and Malay versions of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaires. Health Qual.Life  2019;17;67. doi: https://doi.org/10.1186/s12955-019-1130-0
11. Omorou AY, Langlois J, Lecomte E, Briançon S, Vuillemin А. Cumulative and bidirectional association of physical activity and sedentary behaviour with health-related quality of life in adolescents. Quality of Life Research.2016;25(5):1169-78. doi: https://doi.org/10.1007/s11136-015-1172-7
12. Ramon-Arbues E, Gea-Caballero V, Granada-Lo­pez JM, Juarez-Vela R, Pellicer-Garcia B, Anton-So­lanas I. The prevalence of depression, anxiety and stress and their associated factors in college students. Int J EnvironRes Public  2020;17:7001. doi: https://doi.org/10.3390/ijerph17197001
13. Sanchez HM, Sanchez EG, Barbosa MA, Guima­raes EC, Porto CC. Impact of health on quality of life and quality of working life of university teachers from different areas of knowledge. Cien Saude Colet. 2019;24:4111-23. doi: https://doi.org/10.1590/1413-812320182411.28712017
14. Singh OP, Singh SK. Quality of Work Life of Teachers Working in Higher Educational Institutions: A Strategic Approach towards Teacher’s Excellence. Int J Adv Res Comput Sci Manag Stud. 2015;3:180-6.
15. Sjøgaard JR. Christensen JB, Justesen JB, et al. Exercise is more than medicine: the working age population’s well-being and productivity. J of Sport and Health Science. 2016;5(2):159-65. doi: https://doi.org/10.1016/j.jshs.2016.04.004

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Tymoshchuk O.V. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9179-9951

Serheta I.V. National Pirogov Memorial Medical University, Vinnytsya, Vinnytsia, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-4439-3833

Malyshevska O.S. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-0180-2112

Melnyk V.I. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2641-9673

Motriuk V.B. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-8664-8614

Tymoshchuk O.V., Serheta I.V., Malyshevska O.S., Melnyk V.I., Motriuk V.B. Medico-social conditions of educational activity, quality of life and aspects of psychophysiological adaptation of modern pupils and students: features of interrelation and their hygienic assessment. Medicni perspektivi. 2023;28(1):153-161. DOI: https://doi.org/10.26641/2307-0404.2023.1.276203

Medico-social conditions of educational activity, quality of life and aspects of psychophysiological adaptation of modern pupils and students: features of interrelation and their hygienic assessment

The purpose of the publication was to assess the strength and direction of correlation relationships between mortality rates from non-communicable diseases of the population of Zhytomyr region of Ukraine and sanitary-chemical indicators of safety and quality of drinking water. The need for this study was determined by the necessity to adjust existing and develop new strategic approaches to the prevention of non-communicable diseases that depend on the level of chemical contamination of drinking water. The study was conducted in 2016-2020. Standardized indicators of mortality from non-communicable diseases (per 100,000 population) were analyzed. 25375 water samples were studied, among them 8339 belonged to centralized and 17036 – to decentralized water supply. The strength and direction of correlation relationships between population mortality rates from non-communicable diseases and the average values of sanitary-chemical indicators of drinking water were determined by Pearson's linear correlation coefficients and the Chaddock scale. The statistical significance of the correlation coefficients was determined by Student's t-test. In the process of research work such methods as: bibliographic, medical and sociological, retrospective, epidemiological, statistical, system analysis and generalization were used. Statistically significant (p˂0.05) strong direct correlations were found between mortality rates of the urban population of Zhytomyr region from diseases of the circulatory system (I00-I99) (including myocardial infarction) (I21-I22), coronary heart disease (I20-I25), of digestive organs (K00-K93) and average total iron and total hardness values; between nervous system diseases (G00-G99) and average values of manganese in drinking water of centralized water supply, as well as between mortality rates of rural population from diseases of the circulatory system (I00-I99) and average values of total hardness, total iron and nitrates in drinking water of decentralized water supply. The urgent need to develop new strategic approaches to improve the quality of drinking water in the region as one of the factors in the prevention of non-communicable diseases has been proved.

Key words: mortality, non-communicable diseases, sanitary-chemical indicators of safety and quality of drinking water, correlation relationships, population of Zhytomyr region of Ukraine

1. Antomonov MYu. [Mathematical processing and analysis of medical and biological data]. 2nd ed. Kyiv: MYCz "Medynform"; 2018. 579 p. Russian.
2. [State sanitary norms and rules. Hygienic require­ments to drinking water intended for human consumption. (SSanRaN 2.2.4-171-10). The order of the Ministry of Health of Ukraine N 400 from 12 May 2010]. (2010). Ukrainian. Available from: http://zakon4.rada.gov.ua/laws/show/z0452-10
3. Lypovetska OB. [The influence of the mineral com­position of drinking water on diseases of the digestive organs of the adult population (on the example of the city of Kher­son)]. Hihiiena naselenykh mists. 2015;65:73-9. Ukrainian.
4. Prokopov VO. [Drinking water of Ukraine: medi­cal, ecological, sanitary and hygienic aspects]. Kyiv: A-USPH “Medicine”; 2016. 400 p. Ukrainian.
5. Fallahzadeh RA, Ghaneian MT, Miri M, Das­hti MM. Spatial analysis and health risk assessment of heavy metals concentration in drinking water resources. Environ Sci Pollut Res Int. 2017;24(32):24790-802. doi: https://doi.org/10.1007/s11356-017-0102-3
6. Fuller R, Rahona E, Fisher S, Caravanos J, Webb D, Kass D, et al. Pollution and non-communicable disease: time to end the neglect. The Lancet Glob Health. 2018 Mar;2(3):96-8.
   doi: https://doi.org/10.1016/S2542-5196(18)30020-2
7. Ghosh GC, Khan MJ, Chakraborty TK, Zaman S, Kabir AE, Tanaka H. Human health risk assessment of elevated and variable iron and manganese intake with arsenic-safe groundwater in Jashore, Bangladesh. Sci Rep. 2020;10:1-9. doi: https://doi.org/10.1038/s41598-020-62187-5
8. Jones RR, Weyer PJ, DellaValle CT, Inoue-Choi M, Anderson KE, Cantor KP, et al. Nitrate from drin­king water and diet and bladder cancer among postmenopausal women in Iowa. Environ. Health Perspect. 2016;124:1751-8. doi: https://doi.org/10.1289/EHP191
9. Kousa A, Moltchanova E, Viik-Kajander M, Ryt­könen M, Tuomilehto J, Tarvainen T, et al. Geochemistry of ground water and the incidence of acute myocardial infarction in Finland. J Epidemiol Community Health. 2014;58(2):136-9. doi: https://doi.org/10.1136/jech.58.2.136
10. Kozisek F. Regulations for calcium, magnesium or hardness in drinking water in the European Union member states. Regul Toxicol Pharm. [Internet]. 2020 April [cited 2022 Dec 02];112:104589. doi: https://doi.org/10.1016/j.yrtph.2020.104589
11. Landrigan PJ, Fuller R, Acosta NJ, et al. The Lancet Commission on pollution and health. Lancet Comm.2018;391:462-512. doi: https://doi.org/10.1016/S0140-6736(17)32345-0
12. Sarfraz M, Sultana N, Tariq MI. Hazardous pol­lutants in potable groundwater sources of public schools, Southern Punjab (Pakistan). Rev Int Contam. 2019;35(4):797-805. doi: https://doi.org/10.20937/RICA.2019.35.04.02 
13. Shlezinger M, Amitai Y, Goldenberg I, Shech­ter M. Desalinated seawater supply and all-cause mortality in hospitalized acute myocardial infarction patients from the Acute Coronary Syndrome Israeli Survey 2002-2013. Int J Card. 2016 Oct;220(1):544-50. doi: https://doi.org/10.1016/j.ijcard.2016.06.241
14. Ward MH, Jones RR, Brender JD, Kok ThMDe, Weyer PJ, Nolan BT, et al. Drinking Water Nitrate and Hu­man Health: An Updated Review. Int J Environ Res Pub­lic Health. [Internet]. 2018 [cited 2022 Dec 06];15(7):1557. doi: https://doi.org/10.3390/ijerph15071557

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Zablotska O.S. Zhytomyr Medical Institute attached to Zhytomyr Regional Council, Zhytomyr, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0002-0850-5754

Kyrychuk I.M. Zhytomyr Medical Institute attached to Zhytomyr Regional Council, Zhytomyr, Ukraine

Shcherba N.S. Zhytomyr Ivan Franko State University, Zhytomyr, Ukraine
https://orcid.org/0000-0002-5467-4292

Nikolaieva I.M. Zhytomyr Medical Institute attached to Zhytomyr Regional Council, Zhytomyr, Ukraine
https://orcid.org/0000-0002-6866-7587

Zablotska O.S., Kyrychuk I.M., Shcherba N.S., Nikolaieva I.M. Assessment of correlation relationships between the level of mortality of the population of Zhytomyr region of Ukraine from non-infectious diseases and sanitary-chemical indicators of safety and quality of drinking water. Medicni perspektivi. 2023;28(1):161-167. DOI: https://doi.org/10.26641/2307-0404.2023.1.276204

Assessment of correlation relationships between the level of mortality of the population of Zhytomyr region of Ukraine from non-infectious diseases and sanitary-chemical indicators of safety and quality of drinking water

Chemical plant protection pro­ducts account for at least 3 % of all biosphere pollutants and are the most studied pollutants on our planet. A very significant potential risk to public health is the consumption of foodstuffs contaminated with residual quantities of pesticide compounds. The aim of the work was to assess the potential hazard to humans when eating apples and grapes treated with an insecticide based on spiromesifen. A stepwise study was used: the content of spiromesifen in apples and grapes was calculated; the risk to humans was assessed (comparing the values of the permissible daily intake of the compound with food products with the maximum possible daily intake); the integral hazard index of pesticide-contaminated products consumption was calculated and assessed. The results obtained for the determination of residual amounts of spiromesifen in apples and grapes made it possible to substantiate the value of its maximum allowable value – 0.02 mg/kg; apple and grape juices – 0.01 mg/kg. It was found that the actual intake of spiromesifen with apples and grapes can be 0.0065 mg, and this does not exceed 0.5% of the permissible daily intake, or 0.7% of the estimated permissible amount of spiromesifen that can be consumed with food. According to the value of the integral index of hazard in contaminated food consumption (6 points) spiromesifen belongs to class 3 – moderately dangerous to humans. It has been established that substantiated standards for spiromesifen make it possible to ensure the safety of consumption of grapes and apples grown with the Oberon Rapid 240 SC application, as well as the use of other pesticide formulations based on this substance on other crops.

Key words: spiromesifen, maximum residue levels, apples, grapes, consumption safety

1. Antonenko AM, Vavrinevych OP, Omelchuk ST, Korshun MM. [Hygienic substantiation of the model for predicting the danger to humans when using agricultural products contaminated with pesticides (on the example of fungicides of the pyrazolecarboxamide class)]. The unity of science. Venna, Avstriia; 2018 Aug:46-8. Ukrainian.
2. Antonenko AM. [Peculiarities of toxicodynamics and hazard assessment of a new insecticide spiromesifen]. Yednist nauky. Venna, Avstriia. 2019:57-8. Ukrainian.
3. [The importance of regulated use of pesticides to ensure the safety of finished products]. Syngenta [Internet]. 2019 Feb [cited 23 Sept 2021]. Ukrainian. Available from: https://www.syngenta.ua/news/novini-kompaniyi/vazhlivist-reglamentovanogo-zastosuvannya-pesticidiv-dlya-garantuvannya
4. [StateSatndard 8.8.1.002-98. State sanitary norms and rules. Hygienic classification of pesticides by degree of danger. Approved by the Ministry of Health of Uk­raine 28 Aug 1998]. Kyiv; 1998. 20 p. Ukrainian.
5. [Guidelines for the determination of spiromesifen in apples and apple juice by high performance liquid chromatography No. 1560-2018. Approved Ministry of Ecology and Natural Resources of Ukraine. Order No. 246 dated 06 Jul 2018 and agreed with the State Service of Ukraine for Food Safety and Consumer Protection (No. 7/1173-18 dated 22 May 2018 and No. 87/2594-18 dated 13 Apr 2018)]. (2018). Ukrainian.
6. [Guidelines for the determination of spiromesifen in grapes and grape juice by high performance liquid chromatography No. 1561-2018. Approved Ministry of Ecology and Natural Resources of Ukraine. Order No. 246 dated 06 Jul 2018 and agreed with the State Service of Ukraine for Food Safety and Consumer Protection (No. 7/1173-18 dated 22 May 2018 and No. 87/2594-18 dated 13 Apr 2018)]. (2018). Ukrainian.
7. [Guidelines on hygienic assessment of new pesti­cides. МU No. 4263-87]. Кyiv; 1988. 210 p. Russian.
8. [Unified Rules for Sampling Agricultural Pro­ducts, Food Products and Environmental Objects to Deter­mine Micro Amounts of Pesticides. Guidelines. Approved Ministry of Health of the USSR 21 Aug 1997 (1979), No. 2051-79]. (1997). Russian.
9. Shenashen MA, Ayman ES, Emran YM, et al. Progress in sensory devices of pesticides, pathogens, coronavirus, and chemical additives and hazards in food assessment: Food safety concerns. Progress in Materials Science. 2021:100866. doi: https://doi.org/10.1016/j.pmatsci.2021.100866
10. Eliseev YY, Spirin VF, Chechomov SY, Eli­seeva JuV. Potential health risk associated with con­sumption of local food containing pesticide residues for the rural population. Gigiena i Sanitariia. 2021;100(5):482-8. doi: https://doi.org/10.47470/0016-9900-2021-100-5-482-488
11. PPDB: Pesticide Properties DataBase. Spiro­mesi­fen. [Internet]. 2002 [cited 23 Sept 2021]. Available from: http://sitem.herts.ac.uk/aeru/ppdb/en/Reports/598.htm
12. EU Pesticides database. [Internet]. [cited 2021 Sep 23]. Available from: https://ec.europa.eu/food/plant/pesticides/eu-pesticides-database/active-substances/index.cfm?event=as.details
13. The use of pesticides in developing countries and their impact on health and the right to food. Policy Department for External Relations Directorate General for External Policies of the Union PE 653.622; 2021. 56 p.
14. Vavrinevych OP, Antonenko AM, Omelchuk ST. Hygiene assessment of fungycides on human health influence risk after consumption of agricultural products grown in their application. Dovkillia i zdorovia. 2018;1(85):58-63. doi: https://doi.org/10.32402/dovkil2018.01.058

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Tkachenko I.V. Bogomolets National Medical University, Kyiv, Ukraine, 
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2148-0934

Antonenko A.M. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0001-9665-0646

Bardov V.G. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-9846-318X

Omelchuk S.T. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0003-3678-4241

Tkachenko I.V., Antonenko A.M., Bardov V.G., Omelchuk S.T. Assessment of potential hazard for humans when eating apples and grapes treated with insecticide based on spiromesifen. Medicni perspektivi. 2023;28(1):168-172. DOI: https://doi.org/10.26641/2307-0404.2023.1.276209

Assessment of potential hazard for humans when eating apples and grapes treated with insecticide based on spiromesifen

In Ukraine and worldwide more attention is paid to the study and application of titanium dioxide nanoparticles (TiO₂ NPs). These nanoparticles find use in many industrics (medicine, cosmetology, materials science, environmental protection, etc.). The aim of the study was to study the features of the distribution of TiO₂ nanoparticles, a composite of titanium nanodioxide with nanosilver (TiO₂/Ag NPs) in the internal organs of laboratory animals (mice, rats) after acute intraperitoneal administration of TiO₂ NPs and TiO₂/Ag NPs. The objects of toxicological studies were TiO₂ NPs (crystalline form - anatase, 21-28 nm in size) and TiO₂/Ag NPs (17-22 nm in size, 4 wt% Ag) synthesized at the Frantsevich Institute for Problems of Materials Science NASU. Nanopowder suspensions were introduced in high doses (from 1,000 to 13,000 mg/kg) during a 14 days observation period. The content of che­mical elements Ti and Ag in organs (liver, kidneys, spleen, heart, lungs, adrenal glands, thymus, brain) was determined using the method of optical emission spectroscopy with inductively coupled plasma. It was found accumulation of metals in the internal organs on the 14th observation day after a single intraperitoneal injection. It was revealed that the kidneys and liver in rats are the most sensitive to the accumulation of TiO₂ and TiO₂/Ag NPs; accumulation in the thymus and adrenal glands is also shown. In an experiment on mice, it was found that the kidneys, liver and spleen accumulate titanium and silver after exposure at a dose of 4, 7 and 10 thousand mg/kg of NPs of TiO₂ and TiO₂/Ag.

Key words: nanoparticles of titanium dioxide, nanocomposite of titanium dioxide with silver, distribution, nanotoxicology

1. Andrusyshyna IM, Lampeka OG, Golub IO, Lu­byanova IP, Kharchenko TD. [Evaluation of the des­truction of mineral exchange in professional contingents by the method of atomic emission spectrometry with induc­tively coupled plasma. Methodical recommendations (111)72.14/133.14]. Kyiv: Avicena; 2014. 60 p. Ukrainian.
2. Antomonov MYu. [Mathematical processing and analysis of medical and biological data]. Кyiv: MYCz "Medynform"; 2018. 579 p. Russian.
3. Andrusyshyna IM. [Elemental homeostasis in wistar rats as a manifestation of adaptation in an ex­periment with metal loading in the form of micro- and nanoparticles]. Medical science of Ukraine. 2021;17(2):27-32. doi: https://doi.org/10.32345/2664-4738.2.2021.04
4. Demetska OV, Andrusyshyna IM, Tka­chen­ko TYu, Lukіanenko AO, Polukarov YuO. [Nanosize fractions of the welding aerosol hard component that emit during welding operations using coated electrodes with reduced chromium (VI) content]. Technical sciences and technologies. 2021;1(7):79-86. Ukrainian.
5. Dontsova TA, Nahirniak SV, Astrelin IM. Meta­loxide Nanomaterials and Nanocomposites of Ecological Purpose. J of Nanomaterials. 2019;2019(4):1-31. doi: https://doi.org/10.1155/2019/5942194
6. Andrusyshуna IN. [Features of exposure silver and aluminium oxides nanoparticles on the rats thyroid gland]. Ukrainian journal of modern problems of toxicology. 2016;76(4):49-55. Russian.
7. Yavorovsky OP, Solokha NV, Veremiy MI, et al. [Hy­gienic assessment of the production factors as a basis for risk management in the operators’ work for the manufacture of titanium nitride, chromium disilicide, and zirconium dio­xi­de nanopowders]. Environment & Health. 2016;4:63-8. doi: https://doi.org/10.32402/dovkil2016.04.063
8. Aliofkhazraei M, Macdonald DD, Matykina E, Parfenov EV, Egorkinet VS, et al. Review of plasma electrolytic oxidation of titanium substrates: mechanism, properties, applications and limitation. Applied Surface Science Advances. 2021;5:1-67. doi: https://doi.org/10.1016/j.apsadv.2021.100121
9. Baranowska-Wójcik E, Szwajgier D, Patryk Oles­zczuk P, Winiarska-Mieczan A. Effects of Titanium Dioxide Nanoparticles Exposure on Human Health — a Review. Biological Trace Element Research. 2020;193:118-29. doi: https://doi.org/10.1007/s12011-019-01706-6
10. Lu Z, Xie X, Zhou Y, et al. Gestational exposure to titanium dioxide nanoparticles impairs the placentation through dysregulation of vascularization, proliferation and apoptosis in mice. Int J Nanomedicine. 2018;13:777-89. doi: https://doi.org/10.2147/IJN.S152400
11. Hong F, Yu X, Wu N, Zhang Y. Progress of in vivo studies on the systemic toxicities induced by titanium dioxide nanoparticles. Toxicol Res. 2017;6:115-33. doi: https://doi.org/10.1039/c6tx00338a
12. Besha AT, Liu Y, Bekele DN, Dong Z, Naidu R, Gebremariam GN. Sustainability and environmental ethics for the application of engineered nanoparticles. Environ Sci 2020;103:85-98. doi: https://doi.org/10.1016/j.envsci.2019.10.013
13. Rashid MM, Tavcer PF, Tomšic B. Influence of Titanium dioxide nanoparticles on human health and the environment. Nanomaterials.2021;11(9):2354. doi: https://doi.org/10.3390/nano11092354
14. Bello D, Warheit DB. Biokinetics of engineered na­no-TiO2 in rats administered by different exposure routes: im­plications for human health. Nanotoxicology. 2017;11:431-3. doi: https://doi.org/10.1080/17435390.2017.1330436
15. Riabovol VM, Kozar TI. [Investigation of acute toxic effects of nanopowders of titanium dioxide and its composites with nanosilver in laboratory mice]. Ecological and hygienic problems of the sphere of human life. In: Collection of materials of the scientific-practical con­ference with international participation. Kyiv; 2022. p. 160-2. Ukrainian.
16. Zahornyi MM, Yavorovsky OP, Riabovol VM, Tyschenko NI, Lobunets TF, Tomila TV, et al. [Morpho­logical, spectral and toxicological features of new composite material of titanium nanodioxide with nano­silver for use in medicine and biology]. Medicni perspektivi. 2022;27(1):152-9. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2022.1.254381

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Yavorovsky O.P. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-4573-8039

Andrusyshyna I.М. SI "Yu. Kundiiev Institute for Occupational Health of the NAMS of Ukraine", Kyiv, Ukraine 
https://orcid.org/0000-0001-5827-3384

Riabovol V.M. Bogomolets National Medical University, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-1582-7188

Yavorovsky O.P., Andrusyshyna I.М., Riabovol V.M. Features of distribution of titanium and silver in the internal organs of laboratory rats and mice exposed to high doses of titanium dioxide nanoparticles and its composite with nanosilver. Medicni perspektivi. 2023;28(1):173-178. DOI: https://doi.org/10.26641/2307-0404.2023.1.276213

Features of distribution of titanium and silver in the internal organs of laboratory rats and mice exposed to high doses of titanium dioxide nanoparticles and its composite with nanosilver

The paper considers the application of the theoretical model of epidemiological development of COVID-19 disease among the regional population based on the statistical data in Chernivtsi region of Ukraine for the period from March 2020 to June 2021. Using these data, a mathematical assessment of the values of the main parameters of the compartmental model (SIR) β and γ was performed and the analysis of the relationship between the values of β and γ and antiepidemiological measures was carried out for the region. Determining the parameters β and γ based on available statistics allows us to predict the duration of precautionary measures such as quarantine, lockdown, border closure and predict the effectiveness of their implementation as well. The analysis of statistical data showed the moderate effectiveness of quarantine and lockdown in changing the daily rates of infected and recovered people, while the dynamics of the epidemic development during these periods changed from negative to positive. The introduction of vaccination has shown the significant reduction in the daily rate of infected people and the substantial increase in the daily rate of the recovered people.

Key words: compartmental model (SIR), COVID-19, computer simulation, Chernivtsi region

1. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91(1):157-60. doi: https://doi:10.23750/abm.v91i1.9397
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11. Kyrychko YN, Blyuss KB, Brovchenko I. Mathe­matical modelling of the dynamics and containment of COVID-19 in Ukraine. Sci Rep. 2020;10:19662. doi: https://doi.org/10.1038/s41598-020-76710-1
12. Cano C. Louisiana Tech University: Louisiana Tech Digital Commons Repository [Internet]. 2020 [cited 15 Jun 2021]. Available from: http://network.bepress.com/physical-sciences-and-mathematics/mathematics/dynamical-systems
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15. Singh R, Lal R, Kotti R. Time-discrete SIR model for COVID-19 in Fiji. Epidemiology and Infection. 2022;150:E75. doi: https://doi.org/10.1017/S0950268822000590

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Nahirniak V.M. Bukovinian State Medical University, Chernivtsi, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9802-397X

Nahirniak V.M. Evaluation of the main parameters of the compartmental model of the epidemic development based on the example of the spread of the COVID-19 pandemic in Chernivtsi region. Medicni perspektivi. 2023;28(1):179-187. DOI: https://doi.org/10.26641/2307-0404.2023.1.276215

Evaluation of the main parameters of the compartmental model of the epidemic development based on the example of the spread of the COVID-19 pandemic in Chernivtsi region

The quality of life of patients is one of the indicators of the medical care effectiveness for cancer patients. In order to study the main aspects of the quality of life of patients with breast cancer, a survey of 400 patients at the stage of their inpatient treatment in oncological institutions in nine regions of Ukraine (Chernihiv, Zaporizhia, Dnipropetrovsk, Kyiv, Poltava, Khmelnytsky, Ivano-Frankivsk, Zakarpattia and Lviv) using the EORTC QLQ-C30 and EORTC QLQ-BR45 questionnaires was carried out. In Ukraine, as of the pre-war period (November 2021 – February 2022), the quality of life of breast cancer patients equaled 53.22 on a 100-point scale. The most pronounced impact of breast cancer on the quality of life of the patient was observed in the psycho-emotional sphere (71.26), role functioning (70.48), views on future prospects (30.95). Patients complained of financial difficulties (44.19), fatigue (35.16), sleep disturbances (33.00), hair loss (43.41), as well as decreased sexual function (16.06) and pleasure (18.16 points). Given the low quality of life of breast cancer patients, they need psychological support, which should be aimed at adapting to the manifestations of the disease and future prospects, and the quality of life of patients should be one of the indicators in the course of treatment and providing psychological support. Since patients who have received social and psychological support from their doctors and friends/family have higher quality of life, we consider it necessary to focus on developing a comprehensive program to support breast cancer patients in collaboration with society, family and workplace.

Key words: quality of life, breast cancer, psychological support

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7. Finck C, Barradas S, Zenger M, Hinz A. Quality of life in breast cancer patients: Associations with opti­mism and social support. Int J Clin Health Psychol. 2018;18(1):27-34. doi: https://doi.org/10.1016/j.ijchp.2017.11.002
8. Park JH, Jung YS, Kim JY, Bae SH. Determinants of quality of life in women immediately following the completion of primary treatment of breast cancer: A cross-sectional study. PLOS ONE. 2021;16(10):e0258447. doi: https://doi.org/10.1371/journal.pone.0258447
9. Sharma N, Purkayastha A. Impact of Radiotherapy on Psychological, Financial, and Sexual Aspects in Post­mastectomy Carcinoma Breast Patients: A Prospective Study and Management. Asia Pac J Oncol Nurs. 2017;4(1):69-76. doi: https://doi.org/10.4103/2347-5625.199075
10. Villar RR, Fernández SP, Garea CC, Pillado MT, Barreiro VB, Martín CG. Quality of life and anxiety in women with breast cancer before and after treatment. Rev LatAm  2017;25:e2958. doi: https://doi.org/10.1590/1518-8345.2258.2958
11. Konieczny M, Cipora E, Sygit K, Fal A. Quality of Life of Women with Breast Cancer and Socio-Demographic Factors. Asian Pac J Cancer Prev. 2020;21(1):185-93. doi: https://doi.org/10.31557/APJCP.2020.21.1.185
12. Al Zahrani AM, Alalawi Y, Yagoub U, Saud N, Siddig K. Quality of life of women with breast cancer undergoing treatment and follow-up at King Salman Armed Forces Hospital in Tabuk, Saudi Arabia. Breast Cancer (Dove Med Press). 2019;11:199-208. doi: https://doi.org/10.2147/BCTT.S200605

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Zub V.O. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9823-4216

Zub V.O. Medico-social substantiation of the issue of quality of life in patients with breast cancer and finding ways to improve it. Medicni perspektivi. 2023;28(1):188-193. DOI: https://doi.org/10.26641/2307-0404.2023.1.276216

Medico-social substantiation of the issue of quality of life in patients with breast cancer and finding ways to improve it

Suicide prevention efforts require conscious coordination and close collaboration between health agencies. They should be based on an understanding of the true picture of the prevalence of this phenomenon in a particular area, the characteristics of the dynamics of changes in the frequency of suicides, and high-risk factors, namely age, gender, climatic and social components. The purpose of this study was an attempt to create for each region of Ukraine a statistical model of the dynamics of the frequency of completed suicides depending on the time component (months of the year) and to build on its basis a forecast of the dynamics of the indicator of the number of deaths due to intentional self-harm. For this, the autocorrelation of absolute indicators was carried out and correlograms of time series of indicators of the deaths' number due to intentional self-harm were constructed. The obtained correlograms had sufficiently pronounced features, which made it possible to structure them into 4 separate groups. For further analysis, we used the time series of the areas that made up the first two groups, characterized by a trend and seasonality. For further analysis, only models of exponential smoothing of the time series of areas were used, whose indicators of Ljung-Box Q-statistics, coefficient of determination, mean modulus of error, and smoothing of the mean were in an acceptable range. Based on the created time series model, it is possible to assume that the period from August 2021 to September 2022, will increase in the absolute indicator of the number of deaths due to intentional self-harm in the spring months and, for most regions, in January. For the autumn period, on the contrary, a decrease in the number of completed suicides is characteristic. the characteristics of the time series models for a whole group of regions did not allow us to use them to build a forecast. These regions are represented by two different geographical groups – a group of regions of Western Ukraine and three Black Sea regions. Created for each region of Ukraine, a statistical model of the frequency dynamics of the completed suicides depending on the time component (months of the year) made it possible to build an annual forecast for the number of deaths dynamics due to intentional self-harm. Longer-term forecasts are possible by analyzing more data.

Key words: self-injurious behavior, suicide, completed/prevention & control, suicide, completed/statistics & numerical data, seasonality, mortality, predictive model

1. World Health Organization (WHO). Suicide. [Internet]. [cited 2022 Jan 11]. Available from: https://www.who.int/news-room/fact-sheets/detail/suicide
2. Loban IA, Shilovich OS. [Suicide in the Republic of Belarus is a problem the importance of which is underestimated]. Problemy nauki. 2016;3(4):48-9. Russian.
3. Khaustova O, Pinchuk I, Suhoviy O, Romaniv O. Su­icidal Activity in Ukraine. European Psychiatry. 2015;30:307.
   doi: https://doi.org/10.1016/S0924-9338(15)30248-0
4. Vorsina OP. [Prevalence of teenage suicides in the Irkutsk region (1991–2018)]. Sib. Bulletin of Psychiatry and 2019;4(105):60-6. Russian. doi: https://doi.org/10.26617/1810-3111-2019-4(105)-60-66
5. Zotov PB, Lobov EB, Shidin VA. [Suicide: chro­nobiologic issues]. J Chronomed. (Tyumen Medical Journal). 2020;22(1):49-55. Russian. doi: https://doi.org/10.36361/2307-4698-2020-22-1-49-55
6. Budonnyi P. [Comparative Analysis Of Seaso­nally-Monthly And Weekly Fluctuations of Suicidal Activity Of People Living In The Depressed Industrial Region Of Lisichansk In The 2006–2013 and 2014–2016 Periods]. Psychiatry, Neurology and Medical Psychology. 2017;4,1(7):10-7. Ukrainian. Available from: https://periodicals.karazin.ua/pnmp/article/view/9299
7. Yu J, Yang D, Kim Y, Hashizume M, Gaspar­rini A, Armstrong B, et al. Seasonality of suicide: a multi-country multi-community observational study. Epide­miology and Psychiatric Sciences. 2020;29:e163. doi: https://doi.org/10.1017/S2045796020000748
8. Akkaya-Kalayci T, Vyssoki B, Winkler D, Wil­leit M, Kapusta ND, Dorffner G, et al. The effect of seasonal changes and climatic factors on suicide attempts of young people. BMC Psychiatry. 2017;17(1):365. doi: https://doi.org/10.1186/s12888-017-1532-7
9. Veisani Y, Delpisheh A, Sayehmiri K, Moradi G, Hassanzadeh J. Seasonality in Violent and Nonviolent Me­thods of Suicide Attempts: A Cross-Sectional Study on Systematic Registry Data. Acta Med Iran. 2017;55(8):507-13. PMID: 29034647.
10. Yang CT, Yip PS, Cha ES, Zhang Y. Seasonal changes in suicide in South Korea, 1991 to 2015. PLoS One. 2019;14(6):e0219048. doi: https://doi.org/10.1371/journal.pone.0219048
11. Rozanov VA, Grigoriev PE. [Environmental fac­tors and suicide behavior in human being]. Suicidology. 2018;9(2):30-49. Russian.
12. Boo J, Matsubayashi T, Ueda M. Diurnal variation in suicide timing by age and gender: Evidence from Japan across 41 years. Journal of Affective Disorders. 2019;243:366-74. doi: https://doi.org/10.1016/j.jad.2018.09.030
13. Khaustova OO. [Suicide and household mortality in Ukraine: results of 2012]. Ukrains'kyi visnyk psykho­nevrolohii. 2013;21(4):12-8. Ukrainian.
14. Romaniv AP, Khaustova ОО. [Suicide: Modern Approaches to Prevention]. Medicine of Ukraine. 2013;(1):89-94. Ukrainian.
15. Chapter XX. External causes of morbidity and mortality (V01-Y98). ICD-10, Version: 2019. [Internet]. [cited 2022 Jan 11]. Available from: https://icd.who.int/browse10/2019/en#/XX
16. [Рopulation of Ukraine. State Statistics Service of Ukraine, Lomonosov Institute of Demography and Social Research Birds of the National Academy of Sciences of Uk­raine] [Internet] [cited 2022 Jan 11]. Ukr. Available from: http://database.ukrcensus.gov.ua/MULT/Dialog/statfile_c.asp
17. Andrusenko YuО. [Analysis of the basic models for forecasting time series]. Scientific Works of Kharkiv National Air Force University. 2020;3(65):91-6. Ukrai­nian. doi: https://doi.org/10.30748/zhups.2020.65.14
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Chaban O.S. Bogomolets National Medical University, Kyiv, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9702-7629

Khaustova O.O. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-8262-5252

Omelyanovich V.O. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0001-8587-1312

Sukhoviy O.O. SI "Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of the Ministry of Health of Ukraine", Kyiv, Ukraine

Chaban O.S., Khaustova O.O., Omelyanovich V.O., Sukhoviy O.O. Statistical model of seasonal forecasting the completed suicides number in the regions of Ukraine. Medicni perspektivi. 2023;28(1):194-201. DOI: https://doi.org/10.26641/2307-0404.2023.1.276217

Statistical model of seasonal forecasting the completed suicides number in the regions of Ukraine

A clinical case of a severe course of coronavirus infection (COVID-19) in an adolescent is described. A 15-year-old patient was admitted to the surgical department with suspicion of acute appendicitis. According to the results of the ultrasound examination of the abdomen it was decided to perform diagnostic laparoscopy, which excluded the presence of acute surgical pathology. The increase of intoxication symptoms and the data of epidemiological anamnesis, concerning the contact with patients with the catarrhal symptoms 3-4 weeks before the disease onset, were the reason for the examination for SARS-CoV-2. On the basis of a positive  polymerase chain reaction for SARS-CoV-2 and existing pneumonia according to X-ray examination of the chest, the patient was transferred to an infectious disease hospital. Further examination revealed polyserositis (ascites, pleurisy); acute kidney damage (high levels of urea, creatinine, oliguria); cytolytic syndrome (increased level of aspartate aminotransferase in 1,7 times); high level of C-reactive protein and increased level of procalcitonin, which corresponded to the local infection. After the administration of the first dose of intravenous immunoglobulin the patient's condition has improved significantly. The set of symptoms of multiple organ damage in this clinical case provides grounds for differential diagnosis between coronavirus disease and multisystem inflammatory syndrome in children on the background of the coronavirus infection COVID-19. Based on the diagnostic criteria for multisystem inflammatory syndrome in children presented by the World Health Organization, the Centers for Disease Control and Prevention, the British Medical Journal, the American Academy of Pediatrics, this clinical case can be considered as multisystem inflammatory syndrome.

Key words: coronavirus infection (COVID-19), multisystem inflammatory syndrome (MIS-C), children, intravenous immunoglobulin

1. Beth FM, Friedman K. COVID-19: Multisystem inflammatory syndrome in children (MIS-C) clinical features, evaluation, and diagnosis. UpToDate [Internet]. 2022 Oct 27 [cited 27 Dec 2022]. Available from: https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-clinical-features-evaluation-and-diagnosis
2. Health Department-Reported Cases of Multi­system Inflammatory Syndrome in Children (MIS-C) in the United States [Internet]. [cited 27 Dec 2022]. Available from: https://www.cdc.gov/mis-c/cases/index.html
3. Multisystem inflammatory syndrome (MIS-C) [Internet]. [cited 27 Dec 2022]. Available from: https://www.cdc.gov/mis-c
4. Radia T, Williams N, Agrawal P, Harman K, Weale J, Cook J, et al. Multi-system inflammatory synd­rome in children & adolescents (MIS-C): A systematic review of clinical features and presentation. Pediatr Respir Rev. 2021 Jun;38:51-7. doi: https://doi.org/10.1016/j.prrv.2020.08.001
5. Payne AB, Gilani Z, Godfred-Cato S, Belay ED, Feldstein LR, Patel MM, et al. Incidence of multisystem inflammatory syndrome in children among US persons infected with SARS-CoV-2. JAMA Netw Open. 2021;4(6):e2116420. doi: https://doi.org/10.1001/jamanetworkopen.2021.16420
6. Infographic: MIS-C: Multi-System Inflammatory Syndrome in U.S. Children. [Internet]. [cited 27 Dec 2022]. Available from: https://covid.cdc.gov/covid-data-tracker/#mis-national-surveillance
7. Paediatric inflammatory multisystem syndrome and SARS-CoV-2 infection in children. European Centre for Disease Prevention and Control [Internet]. Stockholm; 2020 [cited 27 Dec 2022]. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-risk-assessment-paediatric-inflammatory-multisystem-syndrome-15-May 2020.pdf
8. Nijman RG, De Guchtenaere A, Koletzko B, Ross Russell R, Copley S, et al. Pediatric Inflam­matory Multi­system Syndrome: Statement by the Pediatric Section of the European Society for Emergency Medicine and European Academy of Pediatrics. Front Pediatr. 2020 Aug 28;8:490. doi: https://doi.org/10.3389/fped.2020.00490
9. Rubens JH, Akindele NP, Tschudy MM, Sick-Sa­muels AC. Acute COVID-19 and multisystem inflam­matory syndrome in children. BMJ. 2021;372:n385. doi: https://doi.org/10.1136/bmj.n385
10. Multisystem Inflammatory Syndrome in Children (MIS-C) Interim Guidance: [Internet]. [cited 27 Dec 2022]. Available from: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/multisystem-inflammatory-syndrome-in-children-mis-c-interim-guidance/
11. Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19. Scien­tific Brief. [Internet]. Geneva: World Health Organization; 15 May 2020 [cited 27 Dec 2022]. Available from:  https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19

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Mateiko H.B. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-4512-4552

Matvisiv M.V. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6745-1461

Pylyuk I.I. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, e-mail:  This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-8196-444X

Nesterova T.V. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6260-4860

Glushko U.A. Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-4044-766X

Mateiko H.B., Matvisiv M.V., Pylyuk I.I., Nesterova T.V., Glushko U.A. Clinical case severe course of coronavirus infection (COVID-19) in a child. Medicni perspektivi. 2023;28(1):202-207. DOI: https://doi.org/10.26641/2307-0404.2023.1.276219

Clinical case severe course of coronavirus infection (COVID-19) in a child

The diagnosed gout is a signal to search for unrecognized concomitant conditions and their underlying causes and mechanisms of development. Due to the fact that gout is a common metabolic disorder with symptoms of localized inflammation caused by chronic and/or episodic deposition of monosodium urate crystals (MSU) in joints and soft tissues, the understanding of the inflammation interaction in metabolic disorders has changed. In cases of severe visceral complications of gout, the most common sites of tophl are kidneys, liver, spleen, lungs, pericardium, subcutaneous tissue and other soft tissues. The aim of this study was to outline the features of severe visceral complications with atypical localization in a patient with gout (identification of MSU crystals with polarization microscopy) and to determine the role of videothoracoscopy in this case. Patient N., 55 years old, complained of moderate chest pain, shortness of breath during exercise, general weakness and occasional cough. The patient was hospitalized in a multidisciplinary clinical institution. Examinations were performed, including polarization microscopy, spiral computed tomography (polytopic foci, formations), videothoracoscopy. Endoscopic resection of SVII of the lower lobe of the left lung with a biopsy of the lungs formations and mediastinal lymph nodes was performed. Results of histologic examination: amorphous masses are presented in combination with the organized chronic giant cell granulomatous structure (tophus), which contains clusters of crystals of MSU. Cytological examination of pleural cavity fluid revealed the presence of crystals of MSU. The presence of crystals of MSU was confirmed by polarization microscopy. From the anamnesis of the disease it became known that at the age of 38 the patient consulted a rheumatologist for moderate joint syndrome. On the basis of anamnesis, laboratory and instrumental data (X-ray, ultrasound examination) the diagnosis of gout, chronic gouty arthritis was established. Urate lowering therapy was prescribed. The patient took the drugs periodically without re-consultation with the doctor. The presented case of untreated gout has led to significant structural disorders in organs such as lungs, pleura. Endoscopic resection of the lower lobe of the left lung and revision of the thoracic cavity revealed atelectasis, hemorrhage, inflammatory infiltration, fibrous changes in tissues, amorphous masses with organized chronic giant cell granulomatous structure, presented by crystals of MSU. During the surgery, a powdery substance was found on the pleura surfaces. A video thoracoscopy in this case was a means to present a visceral damage in gout. The search for diagnostic tools to diagnose a severe visceral complications with atypical localization in gout still remains unsolved. Undoubtedly, the central role in the development of gout is played by the deposition of numerous crystals of MSU. In the patient under observation, crystals of MSU were found in pleural fluid and sputum consisting of sodium urate, like the known facts of their appearance in the joint fluid and urine. Uric acid salt crystals were also detected in the areas of pulmonary fibrosis formation according to the results of radiological examination, as well as endoscopic intervention in the lower lobe of the left lung.

Key words: gout, blood uric acid, monosodium urate crystals

1. Aiguo M, Jingyan W, Zhang Н, Dayong Wu. Analysis of Serum Ferritin and High Sensitive C Reactive Protein in Patients with Gout. FASEB J. 2017;31(1):lb414. doi: https://doi.org/10.1096/fasebj.31.1_supplement.lb414
2. Chen-Xu M, Yokose C, Rai SK, Pillinger MH, Choi HK. Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol. 2019;71(6):991-9. doi: https://doi.org/10.1002/art.40807
3. Fatima T, McKinney C, Major TJ, et al. The rela­tionship between ferritin and urate levels and risk of gout. ArthritisRes  2018;20:179. doi: https://doi.org/10.1186/s13075-018-1668-y
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5. Kondratjuk VJe, Tarasenko OM. [A modern look at the pathogenetic aspects of gout (literature review)]. Ukrainskyi revmatologichnyi zhurnal. 2018;74(4):32-7. Ukrainian.
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Kuzmina G.P. Dnipro State Medical University, Dnipro, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-4556-4013

Markova O.Ya. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-7061-4241

Lazarenko O.M. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-7806-2661

Kuzmina G.P., Markova O.Ya., Lazarenko O.M. Clinical case of severe visceral complications with atypical localization in a patient with gout. Medicni perspektivi. 2023;28(1):208-216. DOI: https://doi.org/10.26641/2307-0404.2023.1.276221

Clinical case of severe visceral complications with atypical localization in a patient with gout

Pelvic fracture is a serious injury that carries a significant risk of mortality. The cause of death in these victims is the formation of a retroperitoneal hematoma and massive bleeding. The article presents a clinical case of a pelvic fracture with a massive retroperitoneal hematoma in a 30-year-old man who was brought to the regional hospital in hemorrhagic shock 5 hours after falling from the 5th floor. Upon admission, computed tomography (CT) showed a rupture of the pubic joint, a multifragmentary fracture of the sacrum, and the presence of a hematoma in the right parts of the pelvic cavity. Despite immobilization of the fracture and massive transfusion, it was not possible to stabilize the patient's hemodynamics and improve the parameters of the patient's general blood analysis. Due to the clinic of active bleeding, the patient repeatedly underwent control ultrasound examinations of the abdominal cavity and pleural sinuses, but the presence of free fluid in the abdominal cavity could be confirmed only after 12 hours of treatment. At the emergency laparotomy, a hematoma was found, which spread through the retroperitoneal space to the level of the diaphragmatic crura and the root of the small-bowel mesentery in a relatively thin layer, which explained the impossibility of its visualization by ultrasound or CT. Despite the intensive care measures, over the next few days the patient's condition gradually worsened, multiple organ failure developed. On the 3rd day after the operation, the patient died due to progressive multiple organ failure. The described case demonstrates the severity of the condition of victims with a traumatic retroperitoneal hematoma and the difficulty of diagnosis and effective treatment using conservative methods.

Key words: multiple trauma, massive bleeding, retroperitoneal hematoma, pelvic fracture

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Look through:

Krishtafor D.A. Dnipro State Medical University; MI "Dnipropetrovsk Oblast Clinical Hospital named after I.I. Mechnikov", Dnipro, Ukraine,  e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-0942-4099

Krishtafor A.A. Dnipro State Medical University; MI "Dnipropetrovsk Oblast Clinical Hospital named after I.I. Mechnikov", Dnipro, Ukraine
https://orcid.org/0000-0002-1717-4889

Tsarev A.V. Dnipro State Medical University; MI "Dnipropetrovsk Oblast Clinical Hospital named after I.I. Mechnikov", Dnipro, Ukraine
https://orcid.org/0000-0002-2611-604X

Balyk D.V. Dnipro State Medical University; MI "Dnipropetrovsk Oblast Clinical Hospital named after I.I. Mechnikov", Dnipro, Ukraine
https://orcid.org/0000-0002-7848-3415

Halushchak A.Y. MI "Dnipropetrovsk Oblast Clinical Hospital named after I.I. Mechnikov", Dnipro, Ukraine

Pelekh V.A. MI "Dnipropetrovsk Oblast Clinical Hospital named after I.I. Mechnikov", Dnipro, Ukraine

Krishtafor D.A., Krishtafor A.A., Tsarev A.V., Balyk D.V., Halushchak A.Y., Pelekh V.A. Clinical case of a pelvic fracture with massive retroperitoneal hematoma. Medicni perspektivi. 2023;28(1):216-222. DOI: https://doi.org/10.26641/2307-0404.2023.1.276259 

Clinical case of a pelvic fracture with massive retroperitoneal hematoma