Tumors of the head and neck account for a significant percentage of all oncopathology. Oral cancer is most often diagnosed. The location of the tumor and its invasion causes swallowing disorders in the preoperative period, which is exacerbated in the postoperative period due to bulky defects. Impaired swallowing leads to reduced nutritional status. Of interest is cognitive function against the background of nutritional deficiency. Metabolic disorders such as obesity are known to adversely affect cognitive function and may even lead to dementia. But it is still unknown how food deprivation affects the cognitive function of rats, as well as the ability of animals to cope with stressful situations, because hunger is one of the models of stressors. Objective – to assess the state of cognitive function and stress resistance against the background of partial food deprivation and its correction in the experiment. The work was performed on 60 adult male rats weighing 280±20 g (M±m) of the Wistar line. Prior to the experimental study, the animals were on partial food deprivation (PFD). After weight loss, rats were divided into 4 groups depending on the dietary adjustment schemes: 1 group - control animals, nutrition according to physiological needs; Group 2, partial food derivation (PFD), without compensatory nutrition; Group 3 – compensatory enteral nutrition with food mixture "Peptamen" (PFD+EX); Group 4 – enteral nutrition and the drug Glutargin (PFD+EX+Glutargin). Behavioral response and cognitive function were determined in the open field test and in the CRPA model (conditioned reflex of passive avoidance). Our results show that rats with partial food deprivation are more prone to stress and can not find a sure way out of this situation. Also, throughout the study period, they suffered from cognitive function, as evidenced by the CRPA test data. In the study of resistance to stress on the background of partial food derivation, rats that continued to receive a limited diet by indicators (ambulation, grooming, rearing. defecation) were not stress-resistant, compared with the control group on the background of compensatory nutrition (p<0.05). During all periods of the study of cognitive function there was a change in the rate of stay in the light chamber with a significant (p<0.05) improvement in group 1 – 20.5%, group 3 – 18.36% and group 4 – 19.53%.

Key words: cognitive function, stress, glutargine, supplementary nutrition, experiment, partial food deprivation

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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 

Kushta A.A. Experimental study of cognitive function against the background of partial food derivation and its correction. Medicni perspektivi. 2023;28(2):4-10. doi: https://doi.org/10.26641/2307-0404.2023.2.282990

Experimental study of cognitive function against the background of partial food derivation and its correction

The relevance of the study is related to the high frequency of blast-induced brain injury in both military and civilian populations, which is caused by the use of various types of explosives in military conflicts, including in Ukraine today.  Changes of biometals in the acute period of a mild blast-induced traumatic brain injury, including forebrain that participates in the implementation of various behavioral and cognitive processes, remain unexplained. The study was carried out on 54 sexually mature male Wistar rats, which were divided into 3 groups: experimental (influenced by a baroacoustic wave with an excess pressure of 26-36 kPa, previously anesthetized with halothane and softly fixed), sham (under the influence of halothane and fixation), intact. Behavior was studied in an elevated plus maze. Biometals in the forebrain were determined using energy dispersive X-ray fluorescence analysis. Standard deviation, Mann-Whitney U test (р<0.01, р<0.05), Spearman's correlation coef­ficient (r, р<0.01) were statistically calculated. According to the results of the study, behavioral changes in the elevated plus maze were found in the rats of the experimental group, which indicate the absence of fear on day 1 and 3 and the increase of anxiety on day 7 of the post-traumatic period. Spectral analysis of the forebrain showed significant (р<0.01) changes in the Cu/Fe, Cu/Zn and Zn/Fe ratios, which are the result of iron accumulation due to disruption of the blood-brain barrier. The obtained changes in the ratio of biometals lead to the development of anxiety, which is confirmed by correlation analysis. This indicates that the imbalance of biometals is an important secondary factor in the pathogenesis of blast-induced brain traumatic injury, which is important to consider for diagnosis, treatment and prevention of complications.

Key words: blast-induced trauma, iron, copper, zinc, forebrain, behavior, elevated plus maze

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Kozlova Yu.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/0000-0002-1364-1910

Kozlova Yu.V. Trace elements changes in the forebrain and their influence on the rats behavior in elevated plus maze in acute period of mild blast-induced traumatic brain injury. Medicni perspektivi. 2023;28(2):10-20. doi: https://doi.org/10.26641/2307-0404.2023.2.283151

Trace elements changes in the forebrain and their influence on the rats behavior in elevated plus maze in acute period of mild blast-induced traumatic brain injury

Continuing our research on compounds that affect urination, we have become interested in N-arylsulfonyl-2-aroylamino-1,4-quinone imines, which combine a quinone matrix with tolylsulfonamide and benzamide fragments with versatile biological activity in their structure, which has a promising value in preventing development of pathological processes in kidneys. Therefore, the search for low-toxic compounds with polyvector activity as a promising approach to the design of drug-like molecules has become an urgent aspect in this regard. The aim of this work was to investigate N-arylsulfonyl-2-aroylamino-1,4-quinone imines and their hydrogenated analogues as promising diuretic agents with antiradical and antibacterial activity using in silico, in vitro and in vivo methodologies. The virtual laboratory of the ProTox-II site is used to predict the toxicity of molecules. The study of compounds affecting the excretory function of the rat kidneys was carried out on 120 white Wistar rats according to the method of E.B. Berkhin under conditions of water stress and spontaneous urination. The interaction of the synthesised compounds with 2,2-diphenyl-1-picrylhydrazyl (DPPH) was used to study their antiradical activity in vitro. The antibacterial activity of the compounds was studied on test cultures of the bacteria Escherichia coli, Staphylococcus aureus, Mycobacterium luteum and the fungi Candida tenuis, Aspergillus niger by the method of serial dilutions in a liquid nutrient medium. Based on the results of the calculation, it was predicted that N-arylsulfonyl-2-aroylamino-1,4-quinone imines (2) and their hydrogenated analogues (3) have hepato-(immuno-, cyto-) toxicity, carcinogenicity (mutagenicity) similar to natural quinones and diuretics (toxicity class IV). This class of compounds has been shown to have both stimulatory and inhibitory effects on diuresis under condi­tions of water stress and spontaneous urination. At the same time, N-(5-methyl-6-oxo-3-(tosylimino)cyclohexa-1,4-dien-1-yl)benzamide (2.3) was revealed to increase daily diuresis by 67.1% compared with the control, exceeding the effect of «Furosemide» (22.2%). It was found that quinone imines (2.1-2.5) inhibited the formation of the DPPH radical by 25.99-40.09%, while their hydrogenated analogues (3.1 and 3.2) – by 61.56% and 68.28%, respectively, and are more effective acceptors of radicals. The microbiological screening revealed a number of promising compounds that inhibited the growth of S. aureus (compound 2.5, MIC 62.5 μg/ml, MBC 125.0 μg/ml), M. luteum (3.1 and 3.2, MIC 31.2 μg/ml, MBC 62.5 μg/ml) and A. niger (2.1, 2.4 and 3.2, MIC 31.2 μg/ml, MPC 62.5 μg/ml). According to the results of biological studies, among N-arylsulfonyl-2-aroylamino-1,4-quinone imines and their hydrogenated analogues, compound 2.3 has been iden­tified, which competes with «Furosemide» in potency and has high antibacterial activity against S. aureus. Other compounds show moderate antiradical activity, high antibacterial activity against M. luteum (2.1, 3.1) and antifungal activity against A. niger (2.1, 2.4, 3.2). The obtained results support the further research for diuretics with polyvector activity within this class of compounds.

Key words: N-arylsulfonyl-2-aroylamino-1,4-quinone imines, prediction of toxicitiy, influence on excretory function of kidneys, free-radical scavenging, antibacterial activity

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32. Nielubowicz GR, Mobley HL. Host-pathogen in­teractions in urinary tract infection (Review). Nature Reviews 2010;7(8):430-41. doi: https://doi.org/10.1038/nrurol.2010.101
33. Kosikowska P, Berlicki Ł. Urease inhibitors as potential drugs for gastric and urinary tract infections: a patent review. Expert Opinion on Therapeutic Patents. 2011;21(6):945-57. doi: https://doi.org/10.1517/13543776.2011.574615

Look through:

Sokolova K.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/0000-0001-5022-3227

Podpletnia O.A. Dnipro State Medical University, Dnipro, Ukraine,
https://orcid.org/0000-0003-4113-4665

Konovalova S.O. Donbas State Engineering Academy, Kramatorsk, Ukraine
http://orcid.org/0000-0003-3410-2550

Avdeenko A.P. Donbas State Engineering Academy, Kramatorsk, Ukraine
http://orcid.org/0000-0003-0549-2131

Komarovska-Porokhnyavets O.Z. Institute of Chemistry and Chemical Technologies, National University "Lviv Polytechnic", Lviv, Ukraine
https://orcid.org/0000-0003-2439-481X

Lubenets V.I. Institute of Chemistry and Chemical Technologies, National University "Lviv Polytechnic", Lviv, Ukraine
https://orcid.org/0000-0001-6189-0084

Kovalenko S.I. Research Institute of Chemistry and Geology, Oles Honchar Dnipro National University, Dnipro, Ukraine
https://orcid.org/0000-0001-8017-9108

Sokolova K.V., Podpletnia O.A., Konovalova S.O., Avdeenko A.P., Komarovska-Porokhnyavets O.Z., Lubenets V.I., Kovalenko S.I. N-arylsulfonyl-2-aroylamino-1,4-quinone imines and their hydrogenated analogues: prediction of toxicity and prospects for use as diuretics. Medicni perspektivi. 2023;28(2):20-28. doi: https://doi.org/10.26641/2307-0404.2023.2.283152

N-arylsulfonyl-2-aroylamino-1,4-quinone imines and their hydrogenated analogues: prediction of toxicity and prospects for use as diuretics

The article presents a review and analysis of scientific works on the problem of chronic relapsing inflammatory optic neuropathy, its diagnostic criteria and treatment methods. Chronic relapsing inflammatory optic neuropathy, first described in 2003, is an autoimmune inflammatory disease of the optic nerve of unknown etiology, accompanied by frequent painful episodes of optic neuritis, with a clear response to steroid therapy and relapses after its withdrawal. An analysis of foreign works published in the E-Library, CrossRef, PubMed, Web of Science, Scopus databases was carried out in order to systematize data on the etiology, pathogenesis, clinical manifestations, diagnostic criteria, differential diagnosis and treatment of this pathological condition. It has been established that chronic recurrent inflammatory optic neuropathy is a rare, recurrent, corticosteroid-dependent optic neuropathy in which there is no other neurological deficit, no etiological factor is identified and it is a diagnosis of exclusion. It is important to identify such patients because the appointment of appropriate immunosuppressive therapy causes remission of the disease.

Key words: chronic relapsing inflammatory optic neuropathy, relapsing idiopathic optic neuropathy, diagnosis, treatment, review

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2. Benoilid A, Tilikete C, Collongues N, Arndt C, Vighetto A, Vignal C, et al. Relapsing optic neuritis: A multicenter study of 62 patients. Mult Scler. 2014;20:848-53. doi: https://doi.org/10.1177/1352458513510223
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5. Dib El JalboutN, Rizk M, Khoueir Z, Sadaka Chronic relapsing inflammatory optic neuropathy: an underdiagnosed cause of recurrent vision loss. Can J Ophthalmol. 2022;57(2):e59-e61. doi: https://doi.org/10.1016/j.jcjo.2021.08.003
6. Molina-Carrión LE, Lira-Tecpa J, Jiménez-Arel­lano MP, Cruz-Domínguez MP, Medina Disease course of Chronic Relapsing Inflammatory Optic Neuropathy (CRION) in a single care center. Arq Neuropsiquiatr. 2022;80(5):510-5.
   doi: https://doi.org/10.1590/0004-282x-anp-2021-0157
7. Petzold A, Plant G. Chronic relapsing inflam­ma­tory optic neuropathy: a systematic review of 122 cases reported. J 2014;261:17-26. doi: https://doi.org/10.1007/s00415-013-6957-4
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11. Petzold A, Pittock S, Lennon V, Maggiore C, Weinshenker BG, Plant GT. Neuromyelitis optica-IgG (aquaporin-4) autoantibodies in immune-mediated optic neuritis. J Neurol Neurosurg Psychiatry. 2010;81:109-11. doi: https://doi.org/10.1136/jnnp.2008.146894
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13. Waschbisch A, Atiya M, Schaub C, Derfuss T, Schwab S, Lee DH, et al. Aquaporin-4 antibody negative recurrent isolated optic neuritis: clinical evidence for disease heterogeneity. J Neurol Sci. 2013;331:72-5. doi: https://doi.org/10.1016/j.jns.2013.05.012
14. Lee HJ, Kim B, Waters P, Woodhal M, Irani S, Ahn S, et al. Chronic relapsing inflammatory optic neuro­pathy (CRION): a manifestation of myelin oligoden­drocyte glycoprotein antibodies. J Neuroinflamm. 2018;15:302. doi: https://doi.org/10.1186/s12974-018-1335-x
15. Akaishi T, Sato DK, Takahashi T, Nakashima I. Clinical spectrum of inflammatory central nervous system demyelinating disorders associated with antibodies against myelin oligodendrocyte glycoprotein. Neurochem Int. 2019;130:104319. doi: https://doi.org/10.1016/j.neuint.2018.10.016
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18. Ramos-Fernández C, García-Oliva I, Reyes-Rod­ríguez MA, Francisco-Hernández F, Tandón-Cárdenes L, González-Hernández A. Neuropatía óptica inflamatoria recurrente crónica (CRION): a propósito de un caso. Arch Soc Canar Oftal. 2011;22:93-8.
19. Saini M, Khurana D. Chronic relapsing inflam­ma­tory optic neuropathy. Ann Indian Acad Neurol. 2010;13:61-3. doi: https://doi.org/10.4103/0972-2327.61280
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21. Frohman L, DellaTorre K, Turbin R, Bielory L. Clinical characteristics, diagnostic criteria and therapeutic outcomes in autoimmune optic neuropathy. Br J Ophthal­mol.2009;93:1660-6. doi: https://doi.org/10.1136/bjo.2009.159350
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Look through:

Nehrych T.I. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
https://orcid.org/0000-0003-0170-511X

Kopchak M.B. Lviv regional clinical perinatal center, Lviv, Ukraine
https://orcid.org/0000-0002-0035-2132

Kyryliuk S.Ya. Municupal non-profit enterprise of Lviv regional council «Lviv regional clinical hospital», Lviv, Ukraine
https://orcid.org/0000-0001-9547-314X

Nehrych T.I., Kopchak M.B., Kyryliuk S.Ya. Сhronic relapsing inflammatory optic neuropathy: diagnostic strategies and treatment (literature review). Medicni perspektivi. 2023;28(2):29-35.
doi: https://doi.org/10.26641/2307-0404.2023.2.283157

Сhronic relapsing inflammatory optic neuropathy: diagnostic strategies and treatment (literature review)

Higher level of functional incapacity and invalidity is noted in palliative patients, as a result of disease progression,  which is the reason for a significant decrease in the quality of life not only of these patients, but also of the family members who care for them. Physical therapy and occupational therapy are aimed at improving the patient's quality of life through rehabilitation measures to restore body function, ensure physical independence and activity, optimal physical condition and well-being, and patient adaptation in the environment. Aim: to review modern literary sources regarding the relevance of physical therapy and occupational therapy in palliative and hospice care. The search for literary sources was carried out in international scientometric databases: PubMed, Scopus, Web of Science, Google Scholar. The search depth is 13 years (from 2010 to 2022). The review indicates that physical therapy and occupational therapy in palliative and hospice medicine around the world are not used enough today. These two specialties of interdisciplinary treatment in palliative and hospice medicine play an important integral role, which is manifested in improving the quality of life of both patients and their family members who care for them through the use of a wide variety of methods. Hospice physical therapists not only help patients to support/keep functional abilities as long as possible, but also to reduce the burden on persons who care for terminally ill patients. Physical and occupational therapy have numerous benefits for patients with progressive life-threatening illnesses in palliative and hospice care. Physical therapy in palliative and hospice care can have a preventive, educational, and/or supportive function depending on the patient's situation. There is especially large deficiency in palliative physical therapy and occupational therapy among adolescents and young people, which requires wide implementation with high-quality training of relevant specialists. Physical therapy and occupational therapy play an important role in palliative and hospice care; all patients in palliative and hospice care, regardless of illness or severity, should have access to physical and occupational therapy based on individual needs.

Key words: physical therapy, occupational therapy, palliative care, hospice care

1. Putt K, Faville KA, Lewis D, McAllister K, Piet­ro M, Radwan A. Role of Physical Therapy Intervention in Patients With Life-Threatening Illnesses. Am J Hosp Palliat Care. 2017 Mar;34(2):186-96. doi: https://doi.org/10.1177/1049909115623246
2. Eva G, Morgan D. Mapping the scope of occu­pational therapy practice in palliative care: A European Association for Palliative Care cross-sectional survey. Palliat Med. 2018 May;32(5):960-8. doi: https://doi.org/10.1177/0269216318758928
3. Morrow BM, Barnard C, Luhlaza Z, Naidoo K, Pitt S. Knowledge, attitudes, beliefs and experience of palliative care amongst South African physiotherapists. S Afr J Physiother. 2017 Jul 31;73(1):384. doi: https://doi.org/10.4102/sajp.v73i1.384
4. Kumar SP, Jim A. Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian J Palliat Care. 2010 Sep;16(3):138-46. doi: https://doi.org/10.4103/0973-1075.73670
5. Høgdal N, Eidemak I, Sjøgren P, Larsen H, Sø­rensen J, Christensen J. Occupational therapy and phy­siotherapy interventions in palliative care: a cross-sectional study of patient-reported needs. BMJ Support Palliat Care. 2020 Aug 11:bmjspcare-2020-002337. doi: https://doi.org/10.1136/bmjspcare-2020-002337
6. Wilson CM, Stiller CH, Doherty DJ, Thomp­son KA, Smith AB, Turczynski KL. Physical therapists in integrated palliative care: a qualitative study. BMJ Support Palliat Care. 2022 May;12(e1):e59-e67. doi: https://doi.org/10.1136/bmjspcare-2019-002161
7. Tlhoiwea DD, Tlhoiwea T, Phokontsia L, Muyaa CK, Mudawarimaa T, Silumesii L, et al. A Syste­matic Review of the Role of Physiotherapy Interventions in Palliative Care. Preprints. Not peer-reviewed. 2020:1-20. doi: https://doi.org/10.20944/preprints202004.0519.v1
8. Saher T, Kalra S, Yadav J, Thariwal S, Yadav K, Tanwar P. Role and importance of Physiotherapy during Palliative Care in India: A Review. WJRR. 2018;7(4):01-08. Available from: https://www.wjrr.org/download_data/WJRR0704003.pdf
9. Anna Elisabeth P, Gschnell M, Maul J, Volberg C. Physio- und Ergotherapie in der deutschen Palliativ­medizin – wo stehen wir? [Physical therapy and occupational therapy in German palliative care: Where do we stand?]. Z Evid Fortbild Qual Gesundhwes. 2022 Nov 16:S1865-9217(22)00181-7. German. doi: https://doi.org/10.1016/j.zefq.2022.10.002
10. Olsson Möller U, Stigmar K, Beck I, Mal­mström M, Rasmussen BH. Bridging gaps in everyday life – a free-listing approach to explore the variety of activities performed by physiotherapists in specialized palliative care. BMC Palliat Care. 2018 Jan 29;17(1):20. doi: https://doi.org/10.1186/s12904-018-0272-x
11. Cullum S. Rehabilitative Palliative Care – a Challenge on the Hospice Inpatient Unit? Physiotherapy. 2019;105:e167-e168. doi: https://doi.org/10.1016/j.physio.2018.11.172
12. Kaur D, Kumar G, Billore N, Singh A. Defining the Role of Physiotherapy in Palliative Care in Multiple Sclerosis. Indian Journal of Palliative Care. 2016;22(2):176. doi: https://doi.org/10.4103/0973-1075.179599
13. Bernabeu-Wittel M, Moreno-Gaviño L, Nieto-Martín D, Lanseros-Tenllado J, Sáenz-Santamaría A, Mar­tínez-Pérez O, et al. Physiotherapy in palliative medicine: patient and caregiver wellness. BMJ Support Palliat Care. 2021 Feb 12:bmjspcare-2020-002826. doi: https://doi.org/10.1136/bmjspcare-2020-002826
14. Wilson CM, Stiller CH, Doherty DJ, Thomp­son KA. The Role of Physical Therapists Within Hospice and Palliative Care in the United States and Canada. Am J Hosp Palliat Care. 2017 Feb;34(1):34-41. doi: https://doi.org/10.1177/1049909115604668
15. McLeod KE, Norman KE. "I've found it's very meaningful work": Perspectives of physiotherapists providing palliative care in Ontario. Physiother Res Int. 2020 Jan;25(1):e1802. doi: https://doi.org/10.1002/pri.1802
16. Engel JM. Physio- und Ergotherapie sind unver­zichtbar. Konkretes Rezeptieren von Heilmitteln - ohne Regress [Physiotherapy and ergotherapy are indispensable. Concrete prescription of remedies – without recourse]. Z Rheumatol. 2012 Jul;71(5):369-80. German. doi: https://doi.org/10.1007/s00393-011-0865-8
17. Cobbe S, Nugent K, Real S, Slattery S, Lynch M. A profile of hospice-at-home physiotherapy for com­munity-dwelling palliative care patients. Int J Palliat Nurs. 2013 Jan;19(1):39-45. doi: https://doi.org/10.12968/ijpn.2013.19.1.39
18. Cobbe S, Kennedy N. Physical function in hospice patients and physiotherapy interventions: a profile of hospice physiotherapy. J Palliat Med. 2012 Jul;15(7):760-7. doi: https://doi.org/10.1089/jpm.2011.0480
19. Soukkio P, Suikkanen S, Kääriä S, Kautiainen H, Sipilä S, Kukkonen-Harjula K, et al. Effects of 12-month home-based physiotherapy on duration of living at home and functional capacity among older persons with signs of frailty or with a recent hip fracture – protocol of a randomized controlled trial (HIPFRA study). BMC Geriatr. 2018 Oct 1;18(1):232. doi: https://doi.org/10.1186/s12877-018-0916-y
20. Ramdharry G, Buscemi V, Boaz A, Dawes H, Jaki T, Jones F, et al. Proposing a Core Outcome Set for Physical Activity and Exercise Interventions in People With Rare Neurological Conditions. Front Rehabil Sci. 2021 Oct 21;2:705474. doi: https://doi.org/10.3389/fresc.2021.705474
21. Ortiz-Campoy S, Lirio-Romero C, Romay-Bar­rero H, Álvarez DM, López-Muñoz P, Palomo-Carrión R. The Role of Physiotherapy in Pediatric Palliative Care: A Systematic Review. Children (Basel). 2021 Nov 12;8(11):1043. doi: https://doi.org/10.3390/children8111043
22. Jeyaraman S, Kathiresan G, Gopalsamy K. Hos­pice: rehabilitation in reverse. Indian J Palliat Care. 2010 Sep;16(3):111-6.
    doi: https://doi.org/10.4103/0973-1075.73640
23. Turner F, Seiger C, Devine N. Impact of patient and caregiver transfer training provided by a physical therapist in the hospice setting: a case study. Am J Hosp Palliat Care. 2013 Mar;30(2):204-9. doi: https://doi.org/10.1177/1049909112444716
24. Ćwirlej-Sozańska A, Wójcicka A, Kluska E, Sta­choń A, Żmuda A. Assessment of the effects of a multi-component, individualized physiotherapy program in patients receiving hospice services in the home. BMC Palliat Care. 2020 Jul 9;19(1):101. doi: https://doi.org/10.1186/s12904-020-00600-6
25. Essential Yeh HH, McColl MA. A model for occupation-based palliative care. Occup Ther Health Care. 2019 Jan;33(1):108-23. doi: https://doi.org/10.1080/07380577.2018.1544428
26. Talbot-Coulombe C, Bravo G, Carrier A. Occupa­tional Therapy Practice in Palliative and End-of-Life Care in Québec. Can J Occup Ther. 2022 Jun;89(2):201-11. doi: https://doi.org/10.1177/00084174221084466
27. Tavemark S, Hermansson LN, Blomberg K. Enabling activity in palliative care: focus groups among occupational therapists. BMC Palliat Care. 2019 Feb 7;18(1):17.
    doi: https://doi.org/10.1186/s12904-019-0394-9
28. Hammill K, Bye R, Cook C. Occupational enga­gement of people living with a life-limiting illness: Occupational therapists' perceptions. Aust Occup Ther J. 2019 Apr;66(2):145-53.
    doi: https://doi.org/10.1111/1440-1630.12557
29. Ellison N, Keesing S, Harris C. Understanding occupational engagement for individuals with bariatric needs: The perspectives of Australian Occupational The­rapists. Aust Occup Ther J. 2020 Oct;67(5):417-26. doi: https://doi.org/10.1111/1440-1630.12657
30. Apostol C, Cranwell K, Hitch D. Evaluating a multidimensional strategy to improve the professional self-care of occupational therapists working with people with life limiting illness. BMC Palliat Care. 2021 Jan 4;20(1):2. doi: https://doi.org/10.1186/s12904-020-00695-x
31. Scanlan JN, Hazelton T. Relationships between job satisfaction, burnout, professional identity and meaningfulness of work activities for occupational the­rapists working in mental health. Aust Occup Ther J. 2019 Oct;66(5):581-90.
    doi: https://doi.org/10.1111/1440-1630.12596
32. Goh NCK, Hancock N, Honey A, Scanlan JN. Thriving in an expanding service landscape: Experiences of occupational therapists working in generic mental health roles within non-government organisations in Australia. Aust Occup Ther J. 2019 Dec;66(6):753-62. doi: https://doi.org/10.1111/1440-1630.12616
33. Treggalles K, Lowrie D. An exploration of the lived experience of professional grief among occupational therapists working in palliative care settings. Aust Occup Ther J. 2018 Aug;65(4):329-37. doi: https://doi.org/10.1111/1440-1630.12477
34. Mueller E, Arthur P, Ivy M, Pryor L, Armstead A, Li CY. Addressing the Gap: Occupational Therapy in Hos­pice Care. Occup Ther Health Care. 2021 Apr;35(2):125-37. doi: https://doi.org/10.1080/07380577.2021
35. Morgan DD, Willis E, Sweet K, Roe P, Rabaçal J, Currow DC. The Complexities of Prescribing Assistive Equipment at the End of Life-Patient and Caregivers' Perspectives. Healthcare (Basel). 2022 May 29;10(6):1005. doi: https://doi.org/10.3390/healthcare10061005
36. Wallis A, Meredith P, Stanley M. Occupational therapy in oncology palliative care for adolescents and young adults: Perspectives of Australian occupational therapists. Aust Occup Ther J. 2022 Apr;69(2):165-76. doi: https://doi.org/10.1111/1440-1630.12780 

Look through:

Raznatovska О.М. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-2252-9063

Kanygina S.M. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
https://orcid.org/0000-0002-8919-300X

Yasinskyi R.M. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
https://orcid.org/0000-0003-4132-731X

Fedorec A.V. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
https://orcid.org/0000-0003-0994-5265

Svitlytska O.A. Zaporizhzhia State Medical and Pharmaceutical University, Zaporizhzhia, Ukraine
https://orcid.org/0000-0003-4987-8458

Raznatovska О.М., Kanygina S.M., Yasinskyi R.M., Fedorec A.V., Svitlytska O.A. The importance of physical therapy and occupational therapy in palliative and hospice medicine (review). Medicni perspektivi. 2023;28(2):35-41. doi: https://doi.org/10.26641/2307-0404.2023.2.283161

The importance of physical therapy and occupational therapy in palliative and hospice medicine (review)

Vaccination against COVID-19 is the main global preventive measure in the fight against SARS-CoV-2. As the COVID-19 vaccine will be administered to billions of individuals worldwide during the pandemic, there exists a reasonable fear of severe adverse reactions requiring constant vigilance and careful treatment, particularly in individuals with a history of severe allergy. The aim of our study was to develop and implement an algorithm for the safe vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions. From January to June 2022, after signing the informed consent, 126 adult patients with relevant diseases in remission were included in a prospective single-center study. Complaints and case histories were collected from all patients, including comorbidity and medications received, anthropometric data were studied, a standard clinical examination was performed, tryptase in venous blood was measured, the level of control was additionally assessed in patients with asthma using the asthma control test and spirography. According to the results of the study, it was proven that vaccination against COVID-19 in patients with pathology associated with hypersensitivity reactions is safe, on condition of prior consultation with an allergist and performing vaccination in a medical institution. The algorithm developed for preparing for vaccination in the mentioned above persons consists of a careful collection of case history; assessment and, in case of absence – achieving control of the underlying disease; analysis and correction of therapy with temporary replacement of medications that are potential cofactors of anaphylaxis; determination of blood tryptase level. For safe vaccination in patients with severe allergic anamnesis, administration of 20 mg of desloratadine before each dose of the vaccine with observation after vaccination within 30 minutes is suggested.

Key words: COVID-19, vaccination, anaphylaxis, hypersensitivity, anphylactogenic substances, tryptase, immunoglobulin E, bronchial asthma, urticaria, allergic rhinitis, hay fever, mastocytosis, atopic dermatitis, comorbidity

1. Barbaud A, Garvey LH, Arcolaci A, Brockow K, Mori F, Mayorga C, et al. Allergies and COVID-19 vac­cines: An ENDA/EAACI Position paper. Allergy. 2022 Aug;77(8):2292-312. doi: https://doi.org/10.1111/all.15241
2. Bousquet J, Agache I, Blain H, Jutel M, Ven­tura MT, Worm M, et al. Management of anaphylaxis due to COVID-19 vaccines in the elderly. Allergy. 2021 Oct;76(10):2952-64. doi: https://doi.org/10.1111/all.14838
3. Banerji A, Wickner PG, Saff R, et al. mRNA vac­cines to prevent COVID‐19 disease and reported allergic reactions: current evidence and approach. J Allergy Clin Immunol Pract. 2021;9(4):1423-37. doi: https://doi.org/10.1016/j.jaip.2020.12.047
4. Klimek L, Jutel M, Akdis CA, et al. ARIA‐EAACI statement on severe allergic reactions to COVID‐19 vaccines – an EAACI‐ARIA position paper. Allergy. 2021;76(6):1624‐8. doi: https://doi.org/10.1111/all.14726
5. Shimabukuro T. COVID‐19 vaccine safety update. Advisory Committee on Immunization Practices (ACIP) January 27, 2021. National Center for Immunization and respiratory diseases CDC [Internet]. 2021 [cited 2022 Dec 10]. Available from: https://wwwcdcgov/vaccines/acip/meetings/downloads/slides‐2021‐01/06‐COVID‐Shimabukuropdf
6. Shimabukuro T, Nair N. Allergic reactions inclu­ding anaphylaxis after receipt of the first dose of Pfizer‐BioNTech COVID‐19 vaccine. JAMA 2021;325(8):780. doi: https://doi.org/10.1001/jama.2021.0600
7. Klimek L, Novak N, Cabanillas B, Jutel M, Bous­quet J, Akdis CA. Allergenic components of the mRNA‐1273 vaccine for COVID‐19: Possible involvement of polyethlene glycol and IgG‐mediated complement activation. Allergy. 2021 Nov;76(11):3307-13. doi: https://doi.org/10.22541/au.160952242.21038379/v1
8. Caminati M, Guarnieri G, Senna G. Who Is Really at Risk for Anaphylaxis Due to COVID-19 Vaccine? Vaccines.2021;9:38. doi: https://doi.org/10.3390/vaccines9010038
9. Francuzik W, Dölle-Bierke S, Knop M, Scherer Hofmeier K, Cichocka-Jarosz E, García BE, et al. Ref­ractory Anaphylaxis: Data From the European Anaphy­laxis Registry. Front Immunol. 2019 Oct 18;10:2482. doi: https://doi.org/10.3389/fimmu.2019.02482
10. Cabanillas B, Akdis C, Novak N. Allergic reactions to the first COVID‐19 vaccine: a potential role of Polyethylene glycol? Allergy. 2021;76(6):1617‐8. doi: https://doi.org/10.1111/all.14711
11. Worm M, Ring J, Klimek L, Jakob T, Lange L, Treudler R, et al. Anaphylaxie-Risiko bei der COVID-19-Impfung: Empfehlungen für das praktische Management [Covid-19 vaccination and risk of anaphylaxis – Recom­mendations for practical management]. MMW Fortschr Med. 2021 Jan;163(1):48-51. doi: https://doi.org/10.1007/s15006-021-9530-6
12. Gashynova K, Suska K, Dmytrychenko V. Micro­biome landscape and disease duration role in allergy in adult patients with bronchiectasis. Eur Respir J. 2019;54(63):PA2763. doi: https://doi.org/10.1183/13993003.congress-2019.PA2763
13. Dytyatkovska E, Gashynova K, Panov V. Patterns of molecular sensitization in adults in Dnipro region (Ukraine). Allergy. 2019;74:831-2. doi: https://doi.org/10.37219/2528-8253-2020-6-42
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15. [On the approval and implementation of medical and technological documents on the standardization of medical care for bronchial asthma. Order of the Ministry of Health of Ukraine dated October 8, 2013 No. 868]. [Internet]. 2013 [cited 2022 Aug 26]. Available from: https://zakon.rada.gov.ua/rada/show/v0868282-13#Text
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Dytiatkovska Ye.M. Dnipro state medical university; Municipal Non-Profit Enterprise «Clinical Hospital of Emergency Medical Care» DCC, Dnipro, Ukraine
https://orcid.org/0000-0001-9007-8634

Gashynova K.Yu. 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/0000-0003-2955-9687

Korietskaia Ye.V. Dnipro state medical university; Municipal Non-Profit Enterprise «Clinical Hospital of Emergency Medical Care» DCC, Dnipro, Ukraine
https://orcid.org/0000-0003-3891-8813

Yevtushenko M.A. Municipal Non-Profit Enterprise «Clinical Hospital of Emergency Medical Care» DCC, Dnipro, Ukraine
https://orcid.org/0000-0002-8088-5608

Dytiatkovska Ye.M., Gashynova K.Yu., Korietskaia Ye.V., Yevtushenko M.A. Vaccination against COVID-19 in patients with allergy: experience of the allergological center in Dnipro. Medicni perspektivi. 2023;28(2):42-49. doi: https://doi.org/10.26641/2307-0404.2023.2.283163

Vaccination against COVID-19 in patients with allergy: experience of the allergological center in Dnipro

It's known that pathological changes in structural and functional condition of the heart, which are caused by arterial hypertension, trigger development of chronic heart failure and disablement of population. Nowadays, it proven that candidate genes, expression products of which participate in regulating vascular tone, have considerable influence upon development of arterial hypertension, however their role in pathogenesis of arterial hypertension has not been fully clarified, and results of the respective researches significantly vary among different populations. To determine the structural and functional state of the heart in patients with hypertension depending on the polymorphism of the A1116C gene of the angiotensin II receptor type I and the T786C promoter of the endothelial NO-synthase gene we examined 86 patients, aged from 45 to 76 years. 30 people without signs of hypertension were in the control group. The structural and functional state of the heart was assessed by cardiac ultrasound according to standard methods. Studies of the A1166C allelic polymorphism of the angiotensin II receptor gene type 1 and the T786C promoter of the eNOS gene were performed by polymerase chain reaction with electrophoretic detection of results. Analysis of cardiac ultrasound showed, that in the patients – carriers of C-allele of both studied genes (AС+СС and TC+CC) left ventricular ejection fraction tended to decrease. We found a bigger thickness of the posterior wall of the left ventricle in patients with CC genotype compared to carriers of AA genotype A1166C – (1.3±0.07) cm vs. (1.1±0.05) cm (p<0.005). The mass of the left ventricular myocardium index in the group of patients with the genotype AC and CC was (157.5±7.3) g/m² and (161.5±7.1)) g/m², respectively, being by 16.7% and 19.6% more than in carriers of AA genotype of the AGTR1 gene. In the groups of patients-carriers of C-allele (TC+CC) of the eNOS gene the mass of the left ventricular myocardium index values were (155.2±11.4)) g/m² and (158.4±7.9)) g/m², respectively, which is by 5.4% and 7.5% more than in carriers of TT genotype. The mean size of the left atrium was significantly higher in patients who had AC and CC genotype of the AGTR1 gene, as well as TC and CC genotype of the eNOS gene compared with the control group. Carriers of C-allele (AC+CC genotype) of AGTR1 gene polymorphism had clearly bigger sizes of the left atrium, as compared to homozygotes by A-allele. The severity of diastolic dysfunction was higher in carriers of the CC genotype of the AGTR1 gene and the eNOS gene than in heterozygotes of the studied genes by 4.3% and 3.3%, respectively. The research shows that inheritance of CC genotype for A1166C polymorphism of the the angiotensin II type 1 receptor gene and of CC T786C polymorphism in the promoter of eNOS gene is associated with more noticeable changes in structural and functional heart condition among patients with arterial hypertension.

Key words: arterial hypertension, gene polymorphism

1. Williams B, Mancia G, Spiering W, Agabiti Ro­sei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018 Sep 1;39(33):3021-104. Erratum in: Eur Heart J. 2019 Feb 1;40(5):475. doi: https://doi.org/10.1093/eurheartj/ehy686
2. Tseluyko VI. [Reality of arterial hypertension treatment in Ukraine: the results of «SYSTEMA 2» cohort study]. Ukrainskyi kardiolohichnyi zhurnal. 2018;25(1):13-20.
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4. Paini A, Tarozzi L, Bertacchini F, Aggiusti C, Rosei CA, De Ciuceis C, et al. Cardiovascular prognosis in patients admitted to an emergency department with hypertensive emergencies and urgencies. Journal of hypertension.2021;39(12):2514-20. doi: https://doi.org/10.1097/HJH.0000000000002961
5. Nesukay EG, Giresh II. [Left heart geometry changes in patients with essential hypertension and different heart rate]. Ukrainskyi kardiolohichnyi zhurnal. 2017;1:64-9. Ukrainian.
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7. Sakovych OO, et al. [Polymorphism of the second type angiotensin II receptor’s gene in women with essential hypertension and the corresponding features of structural and functional parameters of myocardium]. Pathologia. 2018;15(2):169-75. doi: https://doi.org/10.14739/2310-1237.2018.2.141398
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9. Rani B, Kumar A, Bahl A, Sharma R, Prasad R, Khullar M. Renin-angiotensin system gene polymo­r­phisms as potential modifiers of hypertrophic and dilated cardiomyopathy phenotypes. Mol Cell Biochem. 2017 Mar;427(1-2):1-11.
   doi: https://doi.org/10.1007/s11010-016-2891-y
10. Marwick TH, Gillebert TC, Aurigemma G, Chi­rinos J, Derumeaux G, Galderisi M, et al. Recommen­dations on the use of echocardiography in adult hyper­tension: a report from the European Associa-tion of Car­diovascular Imaging (EACVI) and the American Society of Echocardiography (ASE). Systemic 2017;14(2):6-28.
    doi: https://doi.org/10.26442/2075- 082x_14.2.6-28
11. Perrone-Filardi P, Coca A, Galderisi M, Paolil­lo S, Alpendurada F, de Simone G, et al. Non-invasive cardiovascular imaging for evaluating subclinical target organ damage in hypertensive patients: A consensus paper from the European Association of Cardiovascular Imaging (EACVI), the European Society of Cardiology Council on Hypertension, and the European Society of Hypertension (ESH). Eur Heart J Cardiovasc Imaging. 2017 Sep 1;18(9):945-60. doi: https://doi.org/10.1093/ehjci/jex094
12. Antomonov MYu. [Mathematical processing and analysis of biomedical data]. Kyiv: Medinform; 2018. р. 579. Russian.
13. Ma D, Mandour AS, Yoshida T, Matsuura K, Shi­mada K, Kitpipatkun P, et al. Intraventricular pressure gradients change during the development of left ventricular hypertrophy: Effect of salvianolic acid B and beta-blocker. Ultrasound.2021 Nov;29(4):229-40. doi: https://doi.org/10.1177/1742271X20987584
14. Shalimova A. Heart and vascular remodeling in essential hypertension and type 2 diabetes is dependent on genetic polymorphisms. Vessel Plus. 2017;1: 84-90. doi: https://doi.org/10.20517/2574-1209.2016.08
15. Mahmoodi K, Soltanpour MS, Kamali K. Asses­sment of the role of plasma nitric oxide levels, T-786C genetic polymorphism, and gene expression levels of endothelial nitric oxide synthase in the development of coronary artery disease. J Res Med Sci. 2017 Mar 15;22:34. doi: https://doi.org/10.4103/1735-1995.202144

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Hnizdiukh R.V. 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.
https://orcid.org/0000-0003-2833-0661 

Shmanko V.V. I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
https://orcid.org/0000-0003-1128-200X

Hnizdiukh R.V., Shmanko V.V. Structural and functional condition of the heart in patients with arterial hypertension depending on A1166C-gene polymorphism of angiotensin II type 1 and T786C-promoter of endothelial NO-synthase gene. Medicni perspektivi. 2023;28(2):50-55. doi: https://doi.org/10.26641/2307-0404.2023.2.283252

Structural and functional condition of the heart in patients with arterial hypertension depending on A1166C-gene polymorphism of angiotensin II type 1 and T786C-promoter of endothelial NO-synthase gene

It is a well-known factor that the implementation of cardiopulmonary rehabilitation leads to a decrease in the number of deaths and morbidity, however, this method is not widely used in Albania. One of the possible factors of low demand is the ignorance of patients regarding the benefits and effectiveness of this method. The purpose of this study is to find out the level of awareness of patients with cardiopulmonary diseases. During the study, a cross-sectional survey method was used among patients with this disease. Interest in and use of this rehabilitation was assessed using questionnaires that were given to 690 patients who underwent a course of treatment in university clinics and research hospitals that provide cardiopulmonary resuscitation services. The results of the study show that a third of patients learned information about cardiopulmonary rehabilitation (CPR) from medical personnel, and the other part received it from doctors. Despite the fact that almost half of the patients knew that they should perform certain physical activities and exercises to maintain their positive dynamics in relation to cardiopulmonary disease, only one third of the patients understood that such everyday activities as climbing stairs and a brisk walk down the street do not constitute threats to their heart and lungs, respectively. It was also found that a significant part of the patients regularly played sports. Certain types of exercises were offered to one half of the patients, at that time, the rest of them performed various exercises. 69% of all patients who were given detailed information about CPR were ready to participate in this program. Despite the fact, that numerous people were ready to undergo this method of rehabilitation, not all of them were sufficiently knowledgeable and did not fully understand the essence of this technique. Also, an important factor in the positive dynamics of the patient's recovery is his relationship with the doctor and medical personnel involved in the treatment of patients with cardiopulmonary diseases.

Key words: aetiology, physical activity, heart disease, awareness, personal habits

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12. Cuthbet JJ, Pellicori P, Clack AL. Optimal mana­gement of heart failure and chronic obstructive pulmonary disease: Clinical challenges. International Journal of General Medicine. 2022;15:7961-75. doi: https://doi.org/10.2147/IJGM.S295467
13. Stafinski T, Nagase FI, Avdagovska M, Stick­land MK, Menon D. Effectiveness of home-based pulmo­nary rehabilitation programs for patients with chronic obstructive pulmonary disease (COPD): Systematic review. BMC Health Services Research. 2022;22:1-14. doi: https://doi.org/10.1186/s12913-022-07779-9
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15. Nolan MC, Rochester CL. Exercise Training Mo­dalities for People with Chronic Obstructive Pulmonary Disease. COPD: Journal of Chronic Obstructive Pulmo­nary Disease. 2019;16(5-6):378-89. doi: https://doi.org/10.1080/15412555.2019.1637834
16. Nolan CM, Kaliaraju D, Jones SE, Patel S, Barker R, Walsh JA, et al. 2019. Home versus outpatient pulmonary rehabilitation in COPD: A propensity-matched cohort study. Thorax.2019;74:996-8. doi: https://doi.org/10.1136/thoraxjnl-2018-212765
17. Mendes Xavier D, Lanza Galvão E, Aliane Fon­seca A, de Souza GM, Pereira Lima V. Effects of home-based pulmonary rehabilitation on dyspnea, exercise capacity, quality of life and impact of the disease in COPD patients: A systematic review. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2021;19(1):18-46. doi: https://doi.org/10.1080/15412555.2021.2020234
18. Aboumatar H, Naqibuddin M, Chung S. Effect of a Hospital-Initiated program combining transitional care and long-term self-management support on outcomes of patients hospitalized with chronic obstructive pulmonary disease: a randomized clinical trial. Journal of the Ame­rican Medical Association. 2020;322(14):1371-80. doi: https://doi.org/10.1001/jama.2019.11982
19. Burge AT, Holland AE, McDonald CF. Home-based pulmonary rehabilitation for COPD using minimal resources: an economic analysis. Respirology. 2020;25(2):183-90. doi: https://doi.org/10.1111/resp.13667
20. Moazeni SS, Ghaljeh M, Navidian A. The effect of pulmonary rehabilitation on fatigue and quality of life in patients with Chronic Obstructive Pulmonary Disease: A quasi-experimental study. Medical-Surgical Nursing Journal. 2020;9(1):e103899. doi: https://doi.org/10.5812/msnj.103899
21. Chacin-Suarez A, Grace ShL, Anchique-Santos C, Supervia M, Turk-Adawi K, Britto RR, et al. Cardiac reha­bilitation availability and characteristics in Latin America and the Caribbean: A global comparison. American Heart Journal.2021;240:16-27. doi: https://doi.org/10.1016/j.ahj.2021.05.010
22. Louvaris Z, Vogiatzis I. Physiological basis of cardiopulmonary rehabilitation in patients with lung or heart disease. Breathe.2020;11(2):120-7. doi: https://doi.org/10.1183/20734735.021114
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Ledi Necaj. Medical University of Tirana, Albania, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-3190-0015

Ledi Necaj. Cardiopulmonary rehabilitation among patients with heart and chronic obstructive pulmonary disease in a hospital in Tirana. Medicni perspektivi. 2023;28(2):55-63. doi: https://doi.org/10.26641/2307-0404.2023.2.283253

Cardiopulmonary rehabilitation among patients with heart and chronic obstructive pulmonary disease in a hospital in Tirana

Cur   rently, the search for additional organ-sparing methods of intravesical therapy for non-muscular-invasive bladder cancer (NMIBC) is actively continuing, which could become an effective alternative to standard treatment using the Bacillus Calmette-Guérin (BCG) vaccine. The aim of this work was to analyze the safety profile and long-term results of treatment of patients with the high-risk non-muscular-invasive bladder cancer who received adjuvant intravesical chemotherapy using the Combat BRS HIVEC^® device for local hyperthermia (HIVEC^® therapy group; n=53) in comparison with patients who received adjuvant therapy after transurethral resection of bladder performed with the Bacillus Calmette-Guérin vaccine (BCG therapy group; n=54). As a result, the median follow-up was 30 months (range 7-36). According to Common Terminology Criteria for Adverse Events (CTCAE) v 5.0, the most relevant side effects in HIVEC®/BCG therapy groups were adverse events grade 1-2: fever – 1%/8%; dysuria – 9%/13%; bladder spasms – 7%/12%; hematuria – 3%/4% and urinary tract infection – 3%/10%. Tumor recurrence was reported in 23 patients receiving intravesical BCG therapy and in 10 patients receiving intravesical hyperthermic chemotherapy (42.6% versus 18.9%, p=0.008). Tumor progression was recorded in 11 patients receiving intravesical BCG therapy and in 4 patients receiving intravesical hyperthermic chemotherapy (20.4% versus 7.5%, p=0.046). The study allows us to conclude that the method of hyperthermic intravesical chemotherapy has a better safety profile compared to intravesical Bacillus Calmette–Guérin vaccine therapy, while such indicators of oncological efficacy as 3-year recurrence-free survival and the incidence of progression were better in the HIVEC^® therapy group.

Key words: non-muscle invasive bladder cancer, hyperthermic intravesical chemotherapy

1. Vozianov SA, Shamrayev SN, Stus VN, Kras­nov VN, Vasylieva VD, Polion NYu, Shamrayeva DN. [Radical cystectomy: a comparative evaluation of perio­perative outcomes in patients with a complicated and uncomplicated postoperative period]. Zdorov'e muzh­chiny. 2017;2:100-4. doi: https://doi.org/10.30841/2307-5090.2(61).2017.116643
2. Sharashova EE, Kholmatova KK, Gorbatova MA, Grjibovski AM. [The application of multiple logistic regression analysis in health sciences using SPSS software]. Nauka i zdravookhranenie. Russian. 2017;3:5-31. doi: https://doi.org/10.34689/SH.2020.19.4.001
3. Babjuk M, Burger M, Compérat EM, Gontero P, Mostafid AH, Palou J, et al. European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (TaT1 and Carcinoma In Situ) – 2019 Update. Eur Urol.2019 Nov;76(5):639-57. doi: https://doi.org/10.1016/j.eururo.2019.08.016
4. Brausi M, Oddens J, Sylvester R, Bono A, van de Beek C, van Andel G, et al. Side effects of Bacillus Calmette-Guérin (BCG) in the treatment of intermediate- and high-risk Ta, T1 papillary carcinoma of the bladder: results of the EORTC genito-urinary cancers group randomised phase 3 study comparing one-third dose with full dose and 1 year with 3 years of maintenance BCG. Eur Urol.2014 Jan;65(1):69-76. doi: https://doi.org/10.1016/j.eururo.2013.07.021
5. Kramer MW, Altieri V, Hurle R, Lusuardi L, Mer­seburger AS, Rassweiler J, et al. Current Evidence of Transurethral En-bloc Resection of Nonmuscle Invasive Bladder Cancer. Eur Urol Focus. 2017 Dec;3(6):567-76. doi: https://doi.org/10.1016/j.euf.2016.12.004
6. Larsen ES, Nordholm AC, Lillebaek T, Hol­den IK, Johansen IS. The epidemiology of bacille Calmette-Guérin infections after bladder instillation from 2002 through 2017: a nationwide retrospective cohort study. BJU 2019 Dec;124(6):910-6. doi: https://doi.org/10.1111/bju.14793
7. Parker WP, Smelser W, Lee EK, Habermann EB, Thapa P, Zaid HB, et al. Utilization and Outcomes of Radical Cystectomy for High-grade Non-muscle-invasive Bladder Cancer in Elderly Patients. Clin Genitourin Cancer. 2017 Aug 1:S1558-7673(17)30208-2. doi: https://doi.org/10.1016/j.clgc.2017.07.011
8. Plata A, Guerrero-Ramos F, Garcia C, González-Díaz A, Gonzalez-Valcárcel I, de la Morena JM, et al. Long-Term Experience with Hyperthermic Chemotherapy (HIVEC) Using Mitomycin-C in Patients with Non-Muscle Invasive Bladder Cancer in Spain. J Clin Med. 2021Oct 30;10(21):5105. doi: https://doi.org/10.3390/jcm10215105
9. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021 Feb 4;71(3):209-49. doi: https://doi.org/10.3322/caac.21660
10. Tan WS, Panchal A, Buckley L, Devall AJ, Lou­bière LS, Pope AM, et al. Radiofrequency-induced Ther­mo-chemotherapy Effect Versus a Second Course of Bacillus Calmette-Guérin or Institutional Standard in Patients with Recurrence of Non-muscle-invasive Bladder Cancer Following Induction or Maintenance Bacillus Calmette-Guérin Therapy (HYMN): A Phase III, Open-label, Randomised Controlled Trial. Eur Urol. 2019 Jan;75(1):63-71. doi: https://doi.org/10.1016/j.eururo.2018.09.005 

Look through:

Chystiakov R.S. Odessa National Medical University, Odessa, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
http://orcid.org/0000-0002-7049-7628

Kostyev F.I. Odessa National Medical University, Odessa, Ukraine
http://orcid.org/0000-0001-6480-564X

Bondar O.V. Odessa National Medical University, Odessa, Ukraine
http://orcid.org/0000-0001-8746-1878

Lysenko V.V. Odessa National Medical University, Odessa, Ukraine
http://orcid.org/0000-0002-7200-4954

Varbanets V.O. Odessa National Medical University, Odessa, Ukraine
https://orcid.org/0000-0001-7216-7203

Chystiakov R.S., Kostyev F.I., Bondar O.V., Lysenko V.V., Varbanets V.O. 3-year experience of hyperthermic intravesical chemotherapy use in patients with high risk non-muscular-invasive bladder cancer. Medicni perspektivi. 2023;28(2):64-70. doi: https://doi.org/10.26641/2307-0404.2023.2.283254

3-year experience of hyperthermic intravesical chemotherapy use in patients with high risk non-muscular-invasive bladder cancer

The treatment of herpetic stomatitis should be etiotropic, pathogenetic, symptomatic, and local. The research determined the effectiveness of inosine pranobex (1000 mg 4 times a day) in herpetic stomatitis treatment. Addition of inosine pranobex to the pharmacotherapy of herpetic stomatitis reduced hospital stay and duration of treatment. The drug suppresses the synthesis of the virus due to the structure of inosinic acid in the polyribosomes of the cell affected by the virus, and also helps to eliminate the deficiency or dysfunction of immunity that occurred in the case of herpetic stomatitis, it affects the activity of T-cytotoxic lymphocytes and natural killers, enhances the action of neutrophil granulocytes, chemotaxis and phagocytosis of monocytes and macrophages, increases the synthesis of interleukins IL-1 and IL-2, affects the number of Ig G immunoglobulins. Applying inosine pranobex also significantly decreased pain syndrome manifestations from the start of the treatment. It contributed to body temperature normalization 2 days earlier which shortened the treatment period at the in-patient department. Applying inosine pranobex in the combination therapy of herpetic stomatitis has shown a potent clinical efficacy and can be an alternatіve to acyclic nucleosides in patients with herpetic stomatitis of the oral mucosa.

Key words: herpes simplex virus, herpetic stomatitis, inosine pranobex, combination therapy, immunological parameters

1. Bida AV, Romanova YuH. [Indicators of immu­nological markers of blood serum and the level of mineral metabolism of oral fluid in patients with chronic herpes infection in the evaluation of the treatment and prevention complex during dental implantation]. Actual problems of modern medicine: Herald of the Ukrainian Medical Stomatological Academy. 2018;18(1):217-21. Ukrainian.
2. Bondarenko HM, Shcherbakova YuV, Chyr­va VB, Teslenko SV. [Ultrashort treatment regimen for recurrence of genital herpes using pathogenetic agents].Dermatolohiia ta venerolohiia. 2019;4:12-4. Ukrainian. doi: https://doi.org/10.33743/2308-1066-2019-4-12-17
3. Horai MA, Kurdysh LF, Popova OI, Kotel­mach OI. [Efficient improvements of herpex simplex la­bialis treatment using diode laser and “tebodont” gel]. Ukrainskyi stomatolohichnyi almanakh. 2018;1:21-3. Ukrainian. doi: https://doi.org/10.31718/2409-0255.1.2018.05
4. Hryshakova AM, Chaban TV, Skyba VYa. [Clini­cal effectiveness of treatment of acute herpetic stomatitis in children]. Journal of dentistry. 2017;3:49-52. Ukrainian.
5. Dronyk I. [Current issues of treatment of herpetic infection at a doctor's office]. The scientific heritage. 2020;47:7-8. Ukrainian.
6. Kravchun PH, Babadzhan VD, Miasoiedov VV, editors. [Methodology of scientific research in medicine]. Kharkiv: KhSMU; 2020. p. 260. Ukrainian.
7. Kramarov SO, Yevtushenko VV. [Modern appro­aches to the treatment of herpetic infection in children]. Aktualna infektolohiia. 2021;7:144-9. Ukrainian. doi: https://doi.org/10.22141/2312-413x.7.3.2019.170993
8. Nikolyshyna YeV, Bublii TD. [Prospects of improving treatment of HSV infected at the dentist’s]. Ukrainskyi stomatolohichnyi almanakh. 2018;2:30-2. Ukrainian.
9. Khodak LA, Ohiienko VI, Khodak AS. [Difficul­ties with the diagnosis of pain syndrome in a 16-year-old patient with herpes zoster (clinical case)]. Aktualna infektolohiia.2021;7(3):172-4.  doi: https://doi.org/10.22141/2312-413x.7.3.2019.170999
10. Abaturov A, Nikulina A, Tokareva N. Effect of treatment with inosine pranobex in acute respiratory viral infections in children. Child`s health. 2021;13(5):490-4. doi: https://doi.org/10.22141/2224-0551.13.5.2018.141565
11. Avetikov DS, Bukhanchenko OP, Ivanytskyi IO, Aipert VV, Steblovskyi DV. Perspectives for applying the additional study methods for diagnostics optimization of postoperative hypertrophic scars of the head and neck. Wiadomosci lekarskie. 2018;71(3):470-3.
12. Cole S. Herpes simplex virus: epidemiology, diagnosis, and treatment. Nursing Clinics of North America. 2020;3(55):337-45. doi: https://doi.org/10.1016/j.cnur.2020.05.004
13. Edgar NR, Saleh D, Miller RA. Recurrent aphthous stomatitis: a review. J Clin Aesthet Dermatol. 2017;10(3):26-36.
14. Horbal N. Peculiarities of immunological para­meters in patients with recurrent herpes simplex virus infection. Proceedings of the Shevchenko Scientific Society. Medical Sciences. 2019;2(57):128-32. doi: https://doi.org/10.25040/ntsh2019.02.13
15. Kłysik K, Pietraszek A, Karewicz A, Nowa­kowska M. Acyclovir in the Treatment of Herpes Viruses - A Review. Curr Med Chem. 2020;27(24):4118-37. doi: https://doi.org/10.2174/0929867325666180309105519
16. PettiS, Lodi The controversial natural history of oral herpes simplex virus type 1 infection. Oral Dis. 2019;25(8):1850-65. doi: https://doi.org/10.1111/odi.13234
17. Petrushanko T, Chereda V, Loban G. The rela­tionship between colonization resistance of the oral cavity and individual-typological characteristics of personality: dental aspects. Wiadomosci lekarskie. 2017;70(4):754-7.
18. Zhu S, Viejo-Borbolla A. Pathogenesis and viru­lence of herpes simplex virus. Virulence. 2021;1(12):2670-702. doi: https://doi.org/10.1080/21505594.2021.1982373

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Lutsenko R.V. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0003-0277-0458

Moisieieva N.V. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-5511-2988

Sydorenko A.H. Poltava state medical university, Poltava, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-9853-5892

Ostrovska H.Yu. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-3132-3537

Kapustianska A.A. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0001-9150-8472

Lutsenko R.V., Moisieieva N.V., Sydorenko A.H., Ostrovska H.Yu., Kapustianska A.A. Ways to promote the efficiency of herpetic stomatitis treatment. Medicni perspektivi. 2023;28(2):71-76. doi: https://doi.org/10.26641/2307-0404.2023.2.283255

Ways to promote the efficiency of herpetic stomatitis treatment

Pain remains an important problem after radical prostatectomy, leading to discomfort and sometimes prolonged hospital stays. Despite the fact that laparoscopic procedures are less invasive surgical interventions, they can still be challenging in terms of postoperative pain, as both somatic and visceral pain pathways are involved. To alleviate pain and optimize improved recovery after laparoscopic prostatectomy, regional anesthesia techniques have been used to avoid or reduce the need for opioids. The aim of our study was to investigate the postoperative recovery of patients after laparoscopic robotic-assisted radical prostatectomy, depending on the method of postoperative analgesia and in the context of the peculiarities of anesthesia in robotic surgery. To achieve this goal, the “Medical Plaza” Medical Center examined 49 patients who underwent radical prostatectomy using a robotic system. Patients were divided into 2 groups. Group 1 (n=25) – combined intraoperative anesthesia with epidural analgesia with 0.125% bupivacaine. Patients in group 2 (n=24) underwent TAP-block with 15 ml of 0.25% bupivacaine immediately after the last suture was placed on the skin both sides of the abdomen. Patients in the groups did not differ in age, height, body weight and physiological status (р>0.05) according to the American Society of Anesthesiologists (ASA) scale. When analyzing the statistical data it was found that the volume of the prostate did not differ in the study groups, as well as the duration of the operation and the amount of blood loss (р>0.05). Blood pressure and heart rate fluctuations were similar between the groups. The amount of muscle relaxants used had no statistical difference in the study groups (р>0.05). The amount of opiates used during anesthesia did not differ (р>0.05). Mobilization of patients in both groups occurred in 8 hours without statistical difference (p=0.094). A direct medium strength significant correlation was found between the method of analgesia and weakness in one of the lower limbs at the time of mobilization (r=0.69; p=0.039), a direct medium strength significant correlation was found between the size of the prostate and the time to tracheal extubation (r=0.39; p=0.041). So, the level of intraoperative blood loss did not depend on the variants of perioperative analgesia. Haemodynamics and heart rate did not decrease with the addition of intraoperative epidural analgesia. Intraoperative initiation of epidural analgesia with a low concentration of local anesthetic does not affect the rate of postoperative mobilization. Pain after robotic radical prostatectomy is moderate, but requires multimodal treatment for faster mobilization of the patient, adaptation to the existing urinary catheter. Both epidural analgesia and TAP block have shown sufficient safety profile and efficacy in postoperative pain management. After radical prostatectomy, the TAP-block is an effective method of analgesia, while not interfering with the timely full mobilization of the patient. Epidural analgesia has a high analgesic profile, but is associated with certain risks of catheter migration and interference with full mobilization of the patient.

Key words: robotic surgery, radical prostatectomy, TAP-block, epidural analgesia

1. Sun T, Wang Y, Liu Y, Wang Z. Perioperative outcomes of robotic versus laparoscopic distal gastrectomy for gastric cancer: a meta-analysis of propensity score-matched studies and randomized controlled trials. BMC Surg.2022;22(1):427. doi: https://doi.org/10.1186/s12893-022-01881-9
2. Wang D, Dong T, Shao Y, et al. Laparoscopy versus open appendectomy for elderly patients, a meta-analysis and systematic review. BMC Surg. 2019;19:54. doi: https://doi.org/10.1186/s12893-019-0515-7
3. Kowalewski KF, Wieland VLS, Kriegmair MC, et al. Robotic-assisted Versus Laparoscopic Versus Open Radical Cystectomy-A Systematic Review and Network Meta-analysis of Randomized Controlled Trials. Eur Urol Focus. 2022;16:S2405-4569(22)00285-1. doi: https://doi.org/10.1016/j.euf.2022.12.001
4. Singh P, Gupta SK, Kumar M. A comparative study of open cholecystectomy and laparoscopic cholecys­tectomy in patients with cholelithiasis. International Surgery 2018;5(1):253-6. doi: https://doi.org/10.18203/2349-2902.isj20175905
5. Corrado G, Vizza E, Cela V, et al. Laparoscopic ver­sus robotic hysterectomy in obese and extremely obese pa­tients with endometrial cancer: A multi-institutional analysis. European Journal of Surgical Oncology. 2018;44(12):1935-41. doi: https://doi.org/10.1016/j.ejso.2018.08.021
6. Herling SF, Dreijer B, Wrist Lam G, Thomsen T, Møller AM. Total intravenous anaesthesia versus inhala­tional anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic surgery. Cochrane Database of Systematic Reviews. 2017;4:CD011387. doi: https://doi.org/10.1002/14651858.CD011387.pub2
7. Pathirana S, Kam P. Anaesthetic issues in robotic-assisted minimally invasive surgery. Anaesth Intensive Care.2018;46(1):25-35. doi: https://doi.org/10.1177/0310057X1804600105
8. Bae J, Kim HC, Hong DM. Intrathecal morphine for postoperative pain control following robot-assisted prostatectomy: a prospective randomized trial. J Anesth. 2017;31:565-71. doi: https://doi.org/10.1177/0300060515595650
9. Cacciamani GE, Menestrina N, Pirozzi M, Tafuri A, Corsi P, De Marchi D, et al. Impact of com­bination of local anesthetic wounds infiltration and ultra­sound transversus abdominal plane block in patients undergoing robot-assisted radical prostatectomy: periope­rative results of a double-blind randomized controlled trial. J 2019;33:295-301. doi: https://doi.org/10.1089/end.2018.0761
10. Shahait M, Lee DI. Application of TAP block in laparoscopic urological surgery: current status and future directions. CurrUrol  2019;20:20. doi: https://doi.org/10.1007/s11934-019-0883-7
11. Taha T, Sionov BV, Rosenberg P, Stein A, Tsi­vian M, Sidi A, et al. Pain control after laparoscopic radical prostatectomy: comparison between unilateral transversus abdominis plane block and wound infiltration. Urol Int. 2019;103:19-24. doi: https://doi.org/10.1159/000500744
12. Lemoine A, Witdouck A, Beloeil H, Bonnet F. On behalf of the Prospect Working Group of The European Society of Regional Anaesthesia and Pain Therapy (ESRA). PROSPECT guidelines update for evidence-based pain management after prostatectomy for cancer. Anaesthesia Critical Care & Pain Medicine. 2021;40(4):100922. doi: https://doi.org/10.1016/j.accpm.2021.100922
13. Cruff J. Robotic surgical training at home: a low-fidelity simulation method. J Surg Educ. 2020;78(2):379-81. doi: https://doi.org/10.1016/j.jsurg.2020.07.021
14. Lee JH, Kim CS, Kim H, et al. Preemptive visceral analgesic effect of thoracic paravertebral block on postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy: a prospective, randomized, assessor-blind study. Korean J Anesthesiol. 2022;21. doi: https://doi.org/10.4097/kja.22481
15. Fayezizadeh M, Majumder A, Neupane R, et al. Efficacy of transversus abdominis plane block with liposomal bupivacaine during open abdominal wall recon­struction. AmJ  2016;212(3):399-405. doi: https://doi.org/10.1016/j.amjsurg.2015.12.026
16. Maloney C, Kallis M, El-Shafy IA, et al. Ultra­sound-guided bilateral rectus sheath block vs. conventional local analgesia in single port laparoscopic appendectomy for children with nonperforated appendicitis. J Pediatr Surg.2018;53(3):431-36. doi: https://doi.org/10.1016/j.jpedsurg.2017.05.027
17. Liu R, Qin H, Wang M, et al. Transversus abdominis plane block with general anesthesia blunts the perioperative stress response in patients undergoing radical gastrectomy. BMC Anesthesiol. 2019;19(1):205. doi: https://doi.org/10.1186/s12871-019-0861-0
18. Xu YJ, Sun X, Jiang H, et al. Randomized clinical trial of continuous transversus abdominis plane block, epidural or patient-controlled analgesia for patients undergoing laparoscopic colorectal cancer surgery. Br J Surg.2020;107(2):e133-41. doi: https://doi.org/10.1002/bjs.11403
19. Sammons G, Ritchey W. Use of transversus abdominis plane (TAP) blocks for pain management in elderly surgical patients. AORN J. 2015;102(5):493-97. doi: https://doi.org/10.1016/j.aorn.2015.09.003
20. Thakre AB, Ramteke KA, Zanwar YN, Shro­tey VR. Comparison of non-invasive (EsCCO) and invasive (Pac-CCO) method of cardiac output assessment in patients undergoing elective coronary artery bypass grafting surgery. International Journal of Scientific Research. 2018;7(2):4-6.
21. Malik MB, Goyal A. Cardiac Exam. In: StatPearls [Internet]. 2021 [cited 2022 Aug 01]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553078/
22. Peacock JL, Peacock PL. Oxford Hadbook of Medical Statistics. 2nd ed. Oxford University Press, UK; 2020. 640 p. doi: https://doi.org/10.1093/med/9780198743583.001.0001
23. Pawlik MT, Prasser C, Zeman F, et al. Pro­noun­ced haemodynamic changes during and after robotic-assisted laparoscopic prostatectomy: a prospective observational study. BMJ Open. 2020;10:e038045. doi: https://doi.org/10.1136/bmjopen-2020-038045
24. Ono N, Nakahira J, Nakano S, Sawai T, Mi­nami T. Changes in cardiac function and hemodynamics during robot-assisted laparoscopic prostatectomy with steep head-down tilt: a prospective observational study. BMCRes  2017;10(1):341. doi: https://doi.org/10.1186/s13104-017-2672-z
25. Luciani LG, Mattevi D, Mantovani W, et al. Ret­ropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: A Comparative Analysis of the Surgical Outcomes in a Single Regional Center. Curr Urol. 2017;11:36-41. doi: https://doi.org/10.1159/000447192
26. Sharma G, Parsad S, Sharma A, et al. Anaesthesia concerns of steep Trendelenburg position in robotic pelvic surgeries: a critical review. Indian J Clinical Anaesthesia. 2021;8(1):7-10. doi: https://doi.org/10.18231/j.ijca.2021.003
27. Тan M, Law LSC, Gan TJ. Optimizing pain mana­gement to facilitate Enhanced Recovery After Surgery pathways. CanJ  2015;62:203-18. doi: https://doi.org/10.1007/s12630-014-0275-x
28. Joshi GP, Schug SA, Kehlet H. Procedure-specific pain management and outcome strategies. Best Practice & Research Clinical Anaesthesiology. 2014;28(2):191-201. doi: https://doi.org/10.1016/j.bpa.2014.03.005
29. Coughlin GD, Yaxley JW, Chambers SK, et al. Ro­bot-assisted laparoscopic prostatectomy versus open radical retropubic prostatectomy: 24-month outcomes from a ran­domised controlled study. Lancet Oncol. 2018;19(8):1051-60. doi: https://doi.org/10.1016/S1470-2045(18)30357-7
30. Woldu SL, Weinberg AC, Bergman A, et al. Pain and Analgesic Use After Robot-Assisted Radical Pro­statectomy. Journal of Endourology. 2014;28(5):544-8. doi: https://doi.org/10.1089/end.2013.0783

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Volkov O.O. Dnipro State Medical University, Ukraine
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-3097-3319

Lutsenko V.V. Medical Center “Medical Plaza”, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Plis M.O. Medical Center “Medical Plaza”, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Pavlenko M.V. Medical Center “Medical Plaza”, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Krishtafor D.A. Dnipro State Medical University, 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

Volkov O.O., Lutsenko V.V., Plis M.O., Pavlenko M.V., Krishtafor D.A. Comparison of TAP block and epidural analgesia for postoperative analgesia after robotic-assisted radical prostatectomy. Medicni perspektivi. 2023;28(2):76-84. doi: https://doi.org/10.26641/2307-0404.2023.2.283258

Comparison of TAP block and epidural analgesia for postoperative analgesia after robotic-assisted radical prostatectomy

Peculiarities of operative interventions for malignant neoplasms of the larynx, their traumatic nature, and side effects of opioid use require the search for optimization of anesthesia and perioperative analgesia aimed at reducing surgically and anesthetically induced immunosuppression and related negative consequences.Aim: to investigate the immune status of laryngeal cancer patients with different options of anesthetic support for total laryngectomy and to evaluate the relationship between perioperative im­munosuppression and the use of various adjuvant components of analgesia (dexmedetomidine and lidocaine).100 patients with T3-4N0-3M0 laryngeal cancer who underwent total laryngectomy were included in the study. Patients were evenly and comparably divided into 4 research groups (n=25) based on the main clinical and age-sex characteristics (p>0.05) depending on the use of adjuvant components of multimodal anesthesia: in the group 1 they were not used, only opioid analgesics, in group II – lidocaine was used, in group III – dexmedetomidine, and in group IV – both lidocaine and dexmedetomidine. Studies of markers of the immune state (leucoformula, IL-2 and TNF-α) were carried out on the 1st, 2nd, 5th and 7th days after surgery. Statistical analysis was carried out using STATISTICA v.6.1 (Statsoft Inc., USA, license number AGAR909E415822FA), it included parametric and non-parametric, and analytical statistics, parametric and non-parametric variance analysis descriptive of ANOVA, repeated measurements with an assessment of the degree of influence of an independent factor on the studied characteristic. A relatively stable state of cellular immunity and a certain suppression of humoral immunity after total laryngectomy was determined. Immunosuppression was most evident on the 2nd day after surgery in the  group 1 with standard opioid anesthesia. The best indicators of the immune state were determined in group IV of the study. The method of anesthesia had the greatest influence on the state of immunosuppression (according to TNF-ɑ) on the 2nd day after surgery – K=30.9% (p<0.001) and was observed within a week after surgery. Lidocaine and dexmedetomidine, as adjuvant components of multimodal anesthesia for total laryngectomy, when used together led to less immunosuppression, contributed to better rates of recovery of the immune status of laryngeal cancer patients compared  to the standard approach with the use of opioids.

Key words: anesthetic technique, anesthetic agent, immunosuppression, total laryngectomy

1. Chow LQM. Head and Neck Cancer. N Engl J Med. 2020 Jan 2;382(1):60-72. doi: https://doi.org/10.1056/NEJMra1715715
2. Hinther A, Nakoneshny SC, Chandarana SP, Mat­thews TW, Hart R, Schrag C, et al. Efficacy of Multimodal Analgesia for Postoperative Pain Mana­gement in Head and Neck Cancer Patients. Cancers (Basel).2021 Mar 12;13(6):1266. doi: https://doi.org/10.3390/cancers13061266
3. Go BC, Go CC, Chorath K, Moreira A, Rajase­karan K. Nonopioid perioperative analgesia in head and neck cancer surgery: A systematic review. World J Otorhinolaryngol Head Neck Surg. 2022 May 9;8(2):107-17. doi: https://doi.org/10.1002/wjo2.62
4. O'Neill A, Lirk P. Multimodal Analgesia. Ane­sthesiol Clin. 2022 Sep;40(3):455-68. doi: https://doi.org/10.1016/j.anclin.2022.04.002
5. Luan T, Li Y, Sun L, Xu S, Wang H, Wang J, Li C. Systemic immune effects of anesthetics and their intracellular targets in tumors. Front Med (Lausanne). 2022 Jul 28;9:810189. doi: https://doi.org/10.3389/fmed.2022.810189
6. Zhang XY, Liang YX, Yan Y, Dai Z, Chu HC. Morphine: double-faced roles in the regulation of tumor development. Clin Transl Oncol. 2018 Jul;20(7):808-14. doi: https://doi.org/10.1007/s12094-017-1796-x
7. Kim R. Effects of surgery and anesthetic choice on immunosuppression and cancer recurrence. J Transl Med. 2018 Jan 18;16(1):8.
   doi: https://doi.org/10.1186/s12967-018-1389-7
8. Lee IW, Schraag S. The Use of Intravenous Lidocaine in Perioperative Medicine: Anaesthetic, Analgesic and Immune-Modulatory Aspects. J Clin Med. 2022 Jun 20;11(12):3543. doi: https://doi.org/10.3390/jcm11123543
9. Chalmers A. 22 – Anesthesia and Airway Mana­gement for Oral Cancer and Microvascular Surgery. In: Maxillofacial Surgery. Brennan РА, Schliephake Н, Gha­li GE, Cascarini L, Livingstone C, editors. Third Edition. 2017. p. 355-73.
   doi: https://doi.org/10.1016/B978-0-7020-6056-4.00023-X
10. Park E, Cho M, Ki CS. Correct use of repeated measures analysis of variance. Korean J Lab Med. 2009 Feb;29(1):1-9. doi: https://doi.org/10.3343/kjlm.2009.29.1.1
11. Huang L, Qin C, Wang L, Zhang T, Li J. Effects of dexmedetomidine on immune response in patients undergoing radical and reconstructive surgery for oral cancer. Oncol 2021 Feb;21(2):106. doi: https://doi.org/10.3892/ol.2020.12367
12. Mynka NV, Kobeliatskyi JuJu. [The experience of using dexmedetomidine as an adjuvant of anesthesia in ophthalmic surgery]. Medicni perspektivi. 2021;26(1):128-35. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2021.1.227950

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Kobelyatskyi Yu.Yu. Dnipro State Medical University, Dnipro, Ukraine 
https://orcid.org/0000-0002-8504-6125

Shkitak I.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/0000-0002-2019-6173

Kobelyatskyi Yu.Yu., Shkitak I.O. Study of the immune state in different variants of anesthetic support  for total laryngectomy. Medicni perspektivi. 2023;28(2):85-92. doi: https://doi.org/10.26641/2307-0404.2023.2.283264

Study of the immune state in different variants of anesthetic support  for total laryngectomy

The objective of the work was to study the effectiveness of the use of purified bacterial lysates of the most therapy-resistant strains of microorganisms, the causative agents of pustular skin infections, by comparing clinical data and the skin microbiome in patients with acne. The results of the study are based on the data of a comprehensive examination of 35 patients with acne of 2-3 degrees before and after treatment, as well as data of the examination of 15 patients of the control group. Examination methods: clinical examination of the skin, determination of the quantitative composition and microbiological identification of the skin microbiome (bacteria of the genera Staphylococcus, Streptococcus, Propionibacterium Corynebacterium, Micrococcus, Sarcina, Aerococcus, Acinetobacter, Brevibacterium, Citrobacter, Serratia, Lactobacillus; yeast-like fungi of the genera Malassesia and Candida, mold fungi ). In the studied patients with acne, the representative microorganisms of the skin microbiome were Propionibacterium acnes, S. epidermidis, and C. lipophilicum. In patients with acne, the stability of the skin microbiome was carried out due to the redistribution between S. epidermidis and C. lipophilicum. In patients receiving "Acnevac"^® (Bioveta, a. s.), a component of a complex treatment, along with earlier periods of clinical improvement, there was noted an earlier normalization of the skin microbiome in comparison with patients receiving standard therapy. Approaches to the treatment of acne with antibiotics and chemotherapy require a revision. The state of the skin microbiome broadens knowledge on the pathogenesis of acne and the search for other means for the individual treatment of patients. Positive changes in the skin microbiome under the influence of treatment with purified bacterial lysates of the most therapy-resistant strains of microorganisms, the causative agents of pustular skin infections, make it possible to recommend its use for a longer term – up to 6 months.

Key words: acne vulgaris, skin microbiome, purified bacterial lysates, Acnevac

1. Bienova M, Kucherovi R. [Evaluation of the effec­tiveness of vaccine therapy ("Acnevac®") in the treatment of acne papulopustulosa]. Ukrainskyi zhurnal dermatolohii, venerolohii, kosmetolohii. 2019;1(72):75-8. Ukrainian.
2. Diudiun AD, Polion NN, Reznichenko NYu, Svi­rid SG, Gorbuntsov VV. ["AEvit" in the complex treat­ment of patients with acne]. Ukrainskyi zhurnal derma­tolohii, venerolohii, kosmetolohii. 2018;2:48-55. Ukrai­nian. doi: https://doi.org/10.30978/UJDVK2018-2-48
3. Kutasevich YaF, Joraeva SL, Mangusheva VYu. [Study of the composition of the skin microbiota, analysis of its antibiotic resistance in patients with allergic dermatoses]. Eksperimental'naya i klinicheskaya meditsina. 2018;1(78):101-7. Ukrainian.
4. [About the consolidation of approximate pro­visions in the bacteriological services of the system of the Ministry of Health of Ukraine. Order of the Ministry of Health of Ukraine No. 500 dated 28 Dec 2002]. [Internet]. 2002 [cited 2022 Oct 12]. Ukrainian. Available from: https://zakon.rada.gov.ua/rada/show/v0500282-02#Text
5. [Protocol on the provision of medical assistance we are sick in the vulgar. Order of the Ministry of Health of Ukraine No. 312 on 05 Aug 2009. About the hardened clinical protocols for medical aid, we are ill at der­matovenerological ailments]. [Internet]. 2009 [cited 2022 Oct 12]. Ukrainian. Available from: https://zakon.rada.gov.ua/rada/show/v0312282-09#Text9
6. Acne vulgaris: management. NICE guideline. NICE; 2021. 53 p. Available from: www.nice.org.uk/guidance/ng198
7. Antwi-Boasiako C. Statistics and Research Methods for Medical Scientists. Mabel Ntiamoah; 2020. 246 р.
8. Dreno B, Araviiskaia E, Berardesca E, et Microbiome in healthy skin, update for dermatologists. J Eur Acad Dermatol Venereol. 2016;30(12):2038-47. doi: https://doi.org/10.1111/jdv.13965
9. Dréno B, Dagnelie MA, Khammari A, Corvec S. The Skin Microbiome: A New Actor in Inflammatory Acne. Am J Clin Dermatol. 2020;Sep 21(Suppl 1):18-24. doi: https://doi.org/10.1007/s40257-020-00531-1
10. Karadag AS, Aslan KM, Wu CY, Chen W, Pa­rish LC. Antibiotic resistance in acne: changes, con­sequences and concerns. J Eur Acad Dermatol Venereol. 2021;35(1):73-8. doi: https://doi.org/10.1111/jdv.16686
11. Parvin Z, Kowsar M, Jafar A, Jafar S, Ali A. A Therapeutic Oral Vaccine Candidate against Propioni­bacterium acnes: Preparation and Immunological Eva­luation of Nanoparticles Encapsulated Sialidase-CAMP Fusion Protein. Brazilian Archives of Biology and Technology.2020;63(1):e20190427. doi: https://dx.doi.org/10.1590/1678-4324-202019042
12. Ramasamy S, Barnard E, Dawson TL, Li H. The role of the skin microbiota in acne pathophysiology. Br J Dermatol.2019;181(4):691-9. doi: https://doi.org/10.1111/bjd.18230
13. Segall Richard S, Niu Gao. Open Source Software for Statistical Analysis of Big Data: Emerging Research and Opportunities. Engineering Science Reference. 2020. 256 p.
14. Xu S, Zhu Y, Hu H, Liu X, Li L, Yang B, et al. The analysis of acne increasing suicide risk. Medicine (Baltimore).2021;100(24):e26035. doi: https://doi.org/10.1097/MD.0000000000026035
15. Zaenglein AL, Pathy AL, Schlosser BJ, Ali­khan A, Baldwin HE, Berson DS, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945-73.e33. doi: https://doi.org/10.1016/j.jaad.2015.12.037

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Zakharov S.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/0000-0002-2278-5692

Zakharov V.K. Dnipro State Medical University, Dnipro, Ukraine  
https://orcid.org/0000-0001-5140-4417

Gorbuntsov V.V. Dnipro State Medical University, Dnipro, Ukraine  
https://orcid.org/0000-0001-7752-0993

Zakharov S.V., Zakharov V.K., Gorbuntsov V.V. The effectiveness of the use of purified bacterial lysates of the most therapy-resistant strains of microorganisms – the causative agents of pustular skin infections in the treatment of acne vulgaris (acne vulgaris). Medicni perspektivi. 2023;28(2):93-98. doi: https://doi.org/10.26641/2307-0404.2023.2.283344

The effectiveness of the use of purified bacterial lysates of the most therapy-resistant strains of microorganisms – the causative agents of pustular skin infections in the treatment of acne vulgaris (acne vulgaris)

The goal of the study was to elucidate the impact of the single nucleotide variants rs11466749 of the thymic stromal lymphopoietin gene, rs_7216389 of the orsomucoid-1-like protein 3 gene, and rs10052957 of the human nuclear glucocorticoid receptor subfamily 3, group C, member 1 gene on the development of the mono-organic phenotype “atopic eczema” or the poly-organic “atopic eczema + allergic rhinitis/allergic rhino-conjunctivitis”. We recruited 101 patients into the main and 105 into control groups aged from 3 to 18 years old. Patients of the main group suffered from atopic eczema (58 children) and atopic eczema + allergic rhinitis/allergic rhino-conjunctivitis (43 children). Patients of the control group  suffered from the digestive tract pathology. Main group patients were genotyped for the A/A, A/G, G/G of rs11466749, C/T, C/C and T/T of rs_7216389 and A/A, A/G and G/G of rs10052957; patients of the control group were genotyped for the A/A, A/G, G/G of rs11466749, C/T, C/C and T/T of rs_7216389 by polymerase chain reaction in real time with restricted fragment length polymorphism. Results: no significant differences in rs11466749 among the main and control groups, the most common variant is A/A – 55.2% (mono-organic) and 55.8% (poly-organic); T/T rs_7216389 is significantly the most common in poly-organic phenotype – 39.5%; rs10052957: A/G variant is significantly most common in mono-organic phenotype – 51.7% and G/G – in the poly-organic phenotype – 62.8%. The G/G rs11466749 variant has a trending to significance direct 0.173 association and increased odds ratio = 5.85 (0.63-54.31) for the poly-organic phenotype and protective impact onto the mono-organic phenotype -0.173 (0.17 (0.02-1.59); T/T rs7216389 variant increases the risk of poly-organic phenotype: 0.227, odds ratio = 2,79 (1.14-6.85) and decreases the risk of mono-organic” phenotype: -0.227, 0.36 (0.15-0.88); A/G rs_10052957 variant significantly increases the risk the mono-organic phenotype: 0.215, odds ratio = 2.5 (1.08-5.56)) and decreases risk of poly-organic phenotype: 0.215, odds ratio = 0.4 (0.18-0.93); G/G rs_10052957 variant significantly increases the risk of the poly-organic phenotype: 0.263, odds ratio = 2.97 (1.31-6.74)) and decreases for the mono-organic phenotype: -0.263, odds ratio = 0.34 (0.15-0.76)). Genotype variant T/T rs_7216389 of the orsomucoid-1-like protein 3 gene significantly increases the risk of developing the poly-organic atopic phenotype by 2.79 times and protects against the mono-organic atopic phenotype by 0.34 times. G/G genotype variant of rs10052957 of the human glucocorticoid receptor subfamily, group C, member 1 gene significantly increases the risk of developing the poly-organic phenotype by 2.97 times, protecting against mono-organic atopic phenotype by 0.34 times.

Key words: atopic disorders, children, mono-organic phenotypes, poly-organic phenotypes, single nucleotide variants

1. Keller W, Vogel M, Prenzel F, Genuneit J, Jur­kutat A, Hilbert C, et al. Atopic diseases in children and adolescents are associated with behavioural difficulties. BMC 2021;21(1):197. doi: http://dx.doi.org/10.1186/s12887-021-02663-7 
2. Hill DA, Spergel JM. The atopic march. Ann Allergy Asthma Immunol. 2018;120(2):131-7. doi: http://dx.doi.org/10.1016/j.anai.2017.10.037
3. Torres T, Ferreira EO, Gonçalo M, Mendes-Bas­tosP, Selores M, Filipe P. Update on Atopic Dermatitis. Acta Med  2019;32(9):606-13. doi: http://dx.doi.org/10.20344/amp.11963  
4. Løset M, Brown SJ, Saunes M, Hveem K. Gene­tics of atopic dermatitis: From DNA sequence to clinical relevance. 2019;235(5):355-64. doi: http://dx.doi.org/10.1159/000500402  
5. Sroka-Tomaszewska J, Trzeciak M. Molecular me­chanisms of atopic dermatitis pathogenesis. Int J Mol Sci.2021;22(8):4130. doi: http://dx.doi.org/10.3390/ijms22084130
6. Čepelak I, Dodig S, Pavić I. Filaggrin and atopic march. Biochem Med (Zagreb). 2019;29(2):214-27. doi: http://dx.doi.org/10.11613/bm.2019.020501
7. Dytiatkovsky VO, Abaturov OE, Naumenko NV, Pinayeva NL, Alifirenko OO. Associations of genotype variants of single nucleotide polymorphism of gene orosomucoid-1-like-protein 3 and atopic diseases at children. Medicni perspektivi. 2019;24(3):67-73. doi: http://dx.doi.org/10.26641/2307-0404.2019.3.181882
8. Al-Shami HM, Al-Awadi SJ, Khaleel KhJ. Asso­ciation of Glucocorticoid Receptor Gene NR3C1 (Tth111I, Bcli) Polymorphisms with Asthma Children in Iraq. Annals of RSCB. 2021 May 4:1405562. Available from: https://www.annalsofrscb.ro/index.php/journal/article/view/4553
9. Birben E, Sahiner UM, Karaaslan C, Yavuz TS, Cosgun E, Kalayci O, et al. The genetic variants of thymic stromal lymphopoietin protein in children with asthma and allergic rhinitis. Int Arch Allergy Immunol. 2014;163(3):185-92. doi: http://dx.doi.org/10.1159/000358488
10. Heo WI, Park KY, Lee M-K, Moon NJ, Seo SJ. TSLP polymorphisms in atopic dermatitis and atopic march in Koreans. Ann Dermatol. 2018;30(5):529. doi: http://dx.doi.org/10.5021/ad.2018.30.5.529
11. Dytiatkovskyi VO. Role of single nucleotide va­riants of thymic stromal lymphopoietin in the mono- and polyorganic lesions within atopic disorders in children.Modern pediatrics Ukraine. 2021;8(120):23-9. doi: http://dx.doi.org/10.15574/sp.2021.120.23
12. Antomonov MY. [Mathematical processing and analysis of medical and biologic data]. Kyiv: IIC «Med­inform»; 2018. 579 p. Russian.
13. Lou C, Mitra N, Wubbenhorst B, D’Andrea K, Hof­fstad O, Kim BS, et al. Association between fine mapping thymic stromal lymphopoietin and atopic dermatitis onset and persistence. Ann Allergy Asthma Immunol.2019;123(6):595-601.e1. doi: http://dx.doi.org/10.1016/j.anai.2019.08.018
14. Dytiatkovskyi V, Drevytska T, Lapikova-Bryhins­ka T, Dosenko V, Abaturov O. Genotype associations with the different phenotypes of atopic dermatitis in children. Acta Medica (Hradec Kralove). 2021;64(2):96-100. doi: http://dx.doi.org/10.14712/18059694.2021.17
15. Panek M, Jonakowski M, Zioło J, Wieteska Ł, Małachowska B, Pietras T, et al. A novel approach to understanding the role of polymorphic forms of the NR3C1 and TGF-β1 genes in the modulation of the expression of IL-5 and IL-15 mRNA in asthmatic inflammation. Mol Med Rep. 2016;13(6):4879-87. doi: http://dx.doi.org/10.3892/mmr.2016.5104

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Dytiatkovskyi V.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/0000-0002-8508-5562

Dytiatkovskyi V.O. Personalized genotype markers of the atopic disorders phenotypes in children. Medicni perspektivi. 2023;28(2):99-105. doi: https://doi.org/10.26641/2307-0404.2023.2.283346

Personalized genotype markers of the atopic disorders phenotypes in children

Multiple sclerosis is a chronic progressive inflammatory autoimmune disease of the central nervous system. This disease mainly affects young females and leads to disability of the patient, which causes a significant socio-economic burden which this disease causes. Clinically, multiple sclerosis is characterized by a wide variety of neurological and neuropsychological manifestations: movement disorders, sensory disturbances and cognitive dysfunction. One of the most typical psycho-emotional disorders that occur in patients with multiple sclerosis are anxiety and depression. The article is devoted to the study of the features of these disorders in patients with multiple sclerosis. The purpose of the study is to evaluate and characterize psycho-emotional disorders in patients with relapsing-remitting multiple sclerosis. The study included 105 patients with relapsing-remitting multiple sclerosis who underwent inpatient treatment in the Department of Neurology No. 1 Municipal Institution “Dnipropetrovsk Regional Clinic Hospital named after I.I. Mechnykov" Dnipropetrovsk Regional Council". Among the patients included in the study, there were 74 women (70.5%) and 31 men (29.5%). The largest proportion of those surveyed falls on the age group from 25 to 40 years – 80 (76.2%). All participants were assessed according to the generally accepted scale for multiple sclerosis patients assessment – Expanded Disability Status Scale (EDSS). All study participants were divided into two groups – group 1 and group 2 – according to the degree of disability according to EDSS. Considering that the degree of disability according to EDSS≤3.5 is defined as mild, and most patients had just this level, they were assigned into group 1, patients with a score of 3.5<EDSS≤6.5 points were assigned to group 2 with a moderate degree of disability. The number of participants in group 1 was 73 patients (69.5%), group 2 – 32 (30.5%). The psychoemotional sphere was assessed using validated psychodiagnostic tests: Beck Depression Inventory and the State-Trait Anxiety Inventory. The average level of depression, determined by Beck Depression Inventory, was 16.0 (13.0; 18.0) points among all examined, in patients of the 1st group – 14.0 (11.0; 16.0) points, while in patients of the 2nd group it was significantly higher (p<0.001) and amounted to 19.0 (19.0; 24.5) points. Assessment of the level of anxiety according to State-Trait Anxiety Inventory showed that in the majority of patients (84.8%) the level of reactive anxiety was moderate (31-44 points) and made up 36.0 (34.0; 39.0) points. Indicators of personal anxiety in most cases (69.5%) were low (up to 30 points) and averaged 27.0 (24.0; 31.0) points. It should be noted that the level of reactive anxiety exceeded the level of personal anxiety in the study groups and in general among all examined (p<0.001 for all comparisons). Anxiety and depression are very common psychoemotional disorders in patients with relapsing-remitting multiple sclerosis. The relationship between the degree of depression, as well as personal and reactive anxiety and the degree of disability according to the EDSS, has been revealed, but the origin of these disorders is still not clear. Given the significant influence of psycho-emotional disorders on the quality of life of patients and the course of the disease, timely diagnosis and treatment should be the priority areas of management of patients with multiple sclerosis.

Key words: multiple sclerosis, depression, anxiety, Beck Depression Inventory, State-Trait Anxiety Inventory, expanded disability status scale

1. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen 1961 Jun;4:561-71. doi: https://doi.org/10.1001/archpsyc.1961.01710120031004
2. Boeschoten RE, Braamse AMJ, Beekman ATF, Cuijpers P, van Oppen P, Dekker J, et al. Prevalence of depression and anxiety in Multiple Sclerosis: A systematic review and meta-analysis. J Neurol Sci. 2017 Jan 15;372:331-41. doi: https://doi.org/10.1016/j.jns.2016.11.067
3. Dobson R, Giovannoni G. Multiple sclerosis – a review. Eur J Neurol. 2019 Jan;26(1):27-40. doi: https://doi.org/10.1111/ene.13819
4. Karimi S, Andayeshgar B, Khatony A. Prevalence of anxiety, depression, and stress in patients with multiple sclerosis in Kermanshah-Iran: a cross-sectional study. BMC 2020 Apr 15;20(1):166. doi: https://doi.org/10.1186/s12888-020-02579-z
5. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology.1983 Nov;33(11):1444-52. doi: https://doi.org/10.1212/WNL.33.11.1444
6. Masuccio FG, Gamberini G, Calabrese M, So­laro C. Imaging and depression in multiple sclerosis: a historical perspective. Neurol Sci. 2021 Mar;42(3):835-45. doi: https://doi.org/10.1007/s10072-020-04951-z
7. Mustač F, Pašić H, Medić F, Bjedov B, Vujević L, Alfirević M, et al. Anxiety and Depression as Comor­bidities of Multiple Sclerosis. Psychiatr Danub. 2021 Spring-Summer;33(Suppl4):480-5. PMID: 34718269.
8. Ohlmeier C, Gothe H, Haas J, Osowski U, Wein­hold C, Blauwitz S, et al. Epidemiology, characteristics and treatment of patients with relapsing remitting multiple sclerosis and incidence of high disease activity: Real world evidence based on German claims data. PLoS One. 2020 May 1;15(5):e0231846. doi: https://doi.org/10.1371/journal.pone.0231846
9. Peres DS, Rodrigues P, Viero FT, Frare JM, Kudsi SQ, Meira GM, et al. Prevalence of depression and anxiety in the different clinical forms of multiple sclerosis and associations with disability: A systematic review and meta-analysis. Brain Behav Immun Health. 2022 Jul 6;24:100484. doi: https://doi.org/10.1016/j.bbih.2022.100484
10. Petrie A, Sabin C. Medical Statistics at a Glance. 4th edition. Wiley-Blackwell; 2019. p. 208.
11. Solaro C, Gamberini G, Masuccio FG. Depression in Multiple Sclerosis: Epidemiology, Aetiology, Diagnosis and Treatment. CNS Drugs. 2018 Feb;32(2):117-33. doi: https://doi.org/10.1007/s40263-018-0489-5
12. Spielberger CD, Vagg PR, Barker LR, Don­ham GW, Westberry LG. The factor structure of the state-trait anxiety inventory. Stress and anxiety. 1980;7:95-109.
13. Tauil CB, Grippe TC, Dias RM, Dias-Car­neiro RP, Carneiro NM, Aguilar ACR, et al. Suicidal ideation, anxiety, and depression in patients with multiple sclerosis. Arq Neuropsiquiatr. 2018 May;76(5):296-301. doi: https://doi.org/10.1590/0004-282x20180036
14. Thompson AJ, Baranzini SE, Geurts J, Hem­mer B, Ciccarelli O. Multiple sclerosis. Lancet. 2018 Apr 21;391(10130):1622-36. doi: https://doi.org/10.1016/S0140-6736(18)30481-1
15. Wallis O, Bol Y, Köhler S, van Heugten C. An­xiety in multiple sclerosis is related to depressive symp­toms and cognitive complaints. Acta Neurol Scand. 2020 Mar;141(3):212-8. doi: https://doi.org/10.1111/ane.13191

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Somilo O.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-4429-8884

Makarov S.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/0000-0002-3106-9727

Kalbus O.I. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-0796-4825

Sorokin A.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0003-0995-2035

Somilo O.V., Makarov S.O., Kalbus O.I., Sorokin A.V. Anxiety and depression in patients with multiple sclerosis. Medicni perspektivi. 2023;28(2):106-111. doi: https://doi.org/10.26641/2307-0404.2023.2.283349

Anxiety and depression in patients with multiple sclerosis

Recently, a number of delinquencies with children and adolescents increases. Currently, numerous sociopsychological factors of deviant behavior have been  identified. At the same time, modern research of delinquency is also focused on the study of medical prerequisites for the deviant behavior development, such as the presence of mental diseases that cause low intelligence, a tendency to auto-aggression and extra-aggression, emotional insensitivity and asociality. Until now, medical aspects of delinquency have been mainly focused on psychosocial factors and psychiatric nosologies. However, such an important factor as the general somatic health of the child is often not taken into account. Despite the high frequency of somatic morbidity in children with autism spectrum disorders (such as: gastrointestinal functional disorders, allergic diseases, metabolic disorders), the role of psychosomatic factors and comorbid conditions and their association with delinquency is still undetermined. The aim is to determine the structure of delinquency and the importance of psychosomatic factors in the formation of externalizing disorders in children and adolescents with neurodevelopmental disorders, which was conducted with the participation of 32 children aged 2 to 11 (7.3±0.5) years. It was established that changes in the cog­nitive (56.2±7.0%) and emotional (62.5±8.6%) spheres prevail in the structure of psycho-behavioral disorders of children with neurodevelopmental disorders. A significant role in the formation of externalizing disorders is played by concomitant somatic pathology, which is characterized by a tendency to process chronification, disturbs the quality of life, and negatively affects emotional and volitional indicators. An integrated assessment of social, psychological, pedagogical and medical factors of delinquency is the key to effective correction and prevention of behavior disorders in children.

Key words: behavior, delinquency, children, adolescents, somatic morbidity, neurodevelopmental disorders

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Bratkova L.B. Odesa 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/0000-0003-3548-559X

Kryvda G.F. Odesa National Medical University, Odesa, Ukraine
https://orcid.org/0000-0002-4487-184X

Stoieva M.I. Odesa National Medical University, Odesa, Ukraine
https://orcid.org/0000-0002-2109-6000

Kryvda R.G. Odesa National Medical University, Odesa, Ukraine
https://orcid.org/0000-0003-0923-9512

Fedin M.V. Odesa National Medical University, Odesa, Ukraine
https://orcid.org/0000-0001-8856-393X

Godlevska T.L. Odesa National Medical University, Odesa, Ukraine
https://orcid.org/0000-0002-9723-1424

Bratkova L.B., Kryvda G.F., Stoieva M.I., Kryvda R.G., Fedin M.V., Godlevska T.L. Medical and social factors of delinquency in children with pervasive neurodevelopmental disorders. Medicni perspektivi. 2023;28(2):112-119. doi: https://doi.org/10.26641/2307-0404.2023.2.283354

Medical and social factors of delinquency in children with pervasive neurodevelopmental disorders

The growing requirements for the quality of dental care necessitates expert evaluation of dental prostheses. Therefore, on the way to improve the structure and process of providing dental care, it is important to analyze the primary data of its results in quantitative and qualitative terms. The purpose of this work is to clarify the content and results of consulting care by analyzing clinically important indicators of the quality of fixed dentures that determine their applicability for further use. Among the 410 patients aged 35-81 examined for damage to abutment teeth and periodontal tissues, unsatisfactory condition of crowns and bridges, the 1st subgroup included 76 (18.5%) persons who sought counseling on their own initiative and the 2nd subgroup – 334 (81.5%) persons with referrals from other medical institutions. Quality indicators of 759 artificial crowns and 803 bridges were determined (K08.5 – unsatisfactory restoration of teeth) in the early (up to 24 months) and remote (more than 24 months of use) periods of observation using a modified index of clinical and technological quality. In patients of both groups in the early observation period 67 crowns and 101 bridges (all signs – 253), and in the remote period – 692 crowns and 702 bridges (3804 signs) of low quality were revealed. Quality index of these structures in the early and remote periods of observation was 0,71 versus 0,36 (p<0.05) and 0.64 versus 0.37 respectively (p<0.05). In 71 (93.4%) patients of the 1st group grounds for replacement of 292 out of 327 (89.3%), and in 238 (71.3%) patients of the 2nd group – 827 (67.0%) out of 1235 fixed partial dentures were found. Thus, expert assessment of the quality of dental care is an integral part of ensuring the predicted results of prosthetic treatment. The proposed method of assessing the clinical and technological quality of fixed dentures makes it possible to determine their suitability or unsuitability for further use.

Key words: artificial crowns, bridge-like dentures, index of quality

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Malanyak B.R. Private higher education institution «Lviv medical university», Lviv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-6955-0508

Kordiyak A.Y. Lviv Danylo Halytskyi National Medical University, Lviv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-4394-5795

Malanyak B.R., Kordiyak A.Y. Clinical signs of the quality level of fixed dentures in the process of use and rationale for feasibility of their replacement. Medicni perspektivi. 2023;28(2):120-127. doi: https://doi.org/10.26641/2307-0404.2023.2.283359

Clinical signs of the quality level of fixed dentures in the process of use and rationale for feasibility of their replacement

A high level of chronic emotional stress affects the occurrence and increases the severity of diseases of the oral mucosa and internal pathology. The aim of the work is to increase the effectiveness of the treatment of prosthetic stomatitis in patients with diabetes mellitus against the background of psycho-emotional stress by correcting it. To objectify the state of psycho-emotional stress, in 2005-2015 and in 2022 psychological testing was carried out by the D. Taylor method on 230 people aged 19-70 years, among whom 85 patients were diagnosed with diabetes mellitus – the main group; 145 people were without internal diseases – two control groups. General examination and treatment of patients of the main group – 46 women and 39 men aged 19-70 years was carried out by endocrinologists according to the relevant protocols. Dental examination and treatment of prosthetic stomatitis was carried out in 12 patients with diabetes mellitus who had a high level of general anxiety according to the D. Taylor method. Own method of treatment: after the correction of the prosthesis, sanitation of the oral cavity, applications of thiotriazoline 2% ointment, a course of 7-10 days on the areas of the prosthetic bed, most often subject to trauma were prescribed. For general therapy, an additional stress-protective drug which corrects psycho-emotional stress in patients with diabetes mellitus was prescribed, thiotriazoline, orally, for 30 days. In patients of the main group, a high level of general personal anxiety was recorded in 21.63% of respondents and an average level with a tendency to high – in 54.29%. In many cases, the dentist should know the level of the patient's psycho-emotional stress in order to justify an individual approach to therapeutic measures and maintenance therapy in the choice of drugs and methods. The proposed method of treatment of prosthetic stomatitis has an individual approach, includes the stress-protective drug thiotriazoline, which corrects psycho-emotional stress, allowing to achieve a stable remission of the disease.

Key words: prosthetic stomatitis, diabetes mellitus, psychological testing, thiotriazoline

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12. Dvornik VM, Devʼiatkina TO, Marchenko AV, Teslenko OI, Yeris LB, Nikolishin IA, et al. [Method of maintenance therapy of prosthetic stomatitis against the background of diabetes]. Certificate of copyright regis­tration for the work No. 102771 Ukraine. 2021. Ukrainian.
13. Chulak LD, Yakymenko DO, Yefremenkova LN, Bondar VM, Sydorenko IO, inventor. [Method of treat­ment of prosthetic stomatitis against the background of metabolic syndrome]. Patent Ukrainy No. u200708731. 2007 Jul 30. Ukrainian.
14. Chulak LD, Mohylevskyi VV, Mohylevska NV, inventor. [A method of complex prevention and treatment of pathological changes in the tissues of the prosthetic bed during prosthetics with removable lamellar dentures]. Patent Ukrainy No. u200600004. 2006 Jan 03. Ukrainian.
15. Rozhko MM, Leibiuk LV, inventor. [The method of correction of complications during the orthopedic treatment of adentia with complete removable lamellar prostheses in patients with type 2 diabetes]. Patent Ukrainy No. u202003786.  2020 Jun 23. Ukrainian.

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Dvornyk V.M. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-9154-9351

Lytovchenko I.Yu. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-3505-1057

Popovych I.Yu. Poltava state medical university, Poltava, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-1720-095X

Holovanova I.A. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-8114-8319

Dvornyk I.L. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-3809-8272

Muravlova O.V. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-5319-7092

Yerus L.B. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0001-5912-919X

Teslenko O.I. Poltava state medical university, Poltava, Ukraine
https://orcid.org/0000-0002-5023-7204

Dvornyk V.M., Lytovchenko I.Yu., Popovych I.Yu., Holovanova I.A., Dvornyk I.L., Muravlova O.V., Yerus L.B., Teslenko O.I. Prosthetic stomatitis in patients with diabetes mellitus: correction of psycho-emotional stress. Medicni perspektivi. 2023;28(2):143-149. doi: https://doi.org/10.26641/2307-0404.2023.2.283362

Prosthetic stomatitis in patients with diabetes mellitus: correction of psycho-emotional stress

The purpose of the study was to increase the effectiveness of osseointegration of implants in dental implantation in patients with rapidly progressing generalized periodontitis combined with diabetic osteopathy by restoring normal remodeling of bone tissue and intensifying its density. The study included 84 patients aged 30 to 50 years (average 41.9±2.36 years) with type 2 diabetes mellitus associated with generalized periodontitis, among them 56 women and 28 men and 19 volunteer donors without periodontal and detected somatic pathology, identical by gender and age. Surgical intervention for the installation of dental implants was performed in 3 groups of patients identical by gender and age: I, II and III groups. Groups I and II included 52 patients (26 patients in each) with rapidly progressing generalized periodontitis, with type 2 diabetes, complicated by systemic osteoporosis, who differed only in the prescribed treatment complex. Group III was formed by patients with a similar pathology of periodontal tissues, but without background diabetic osteopathy (32 patients), who received an identical treatment complex with patients in Group II. During the surgical intervention, 282 dental implants were installed: 92 implants in group I patients, 89 implants in group II, and 101 dental implants in group III. At the same time, we strove to ensure that the percentage of the performed operations was approximately the same. The analysis of the obtained data of laboratory studies showed that in patients with diabetic osteopathy with rapidly progressing periodontitis and rapidly progressing generalized periodontitis without background pathology, a deeper imbalance of the processes of bone remodeling with high level of both – bone resorption and osteogenesis is observed, which causes acceleration of the destruction of periodontal bone tissue and their loss. At the same time, it was found that with a complex and correct selection of antiresorptive therapy, the level of markers of bone metabolism approaches the norm, which is positively reflected in the dynamics and frequency of osseointegration of dental implants. Our research and received data from laboratory studies showed that in patients with rapidly progressing generalized periodontitis with and without diabetic osteopathy, there is an inhomogeneity and imbalance in the functioning of bone remodeling, which negatively affects the process of osseointegration of dental implants and requires a complex approach in the selection of antiresorptive therapy. Inclusion in the protocol of dental implantation of recombinant morphogenetic protein in patients with diabetes with osteopathology leads to completion of osseointegration of dental implants in the term up to 3 months, and monotherapy with  ossein-hydroxyapatite complex in patients with rapidly progressing generalized periodontitis has a similar effect on the osseointegration process – it accelerates the recovery of bone tissue around dental implants.

Key words: periodontitis, periodontal pathology, rapidly progressive generalized periodontitis, diabetes, markers of bone metabolism, dental implantation, recombinant morphogenetic protein BMP-2, ossein-hydroxyapatite complex

1. Gudaryan OO, Kucherenko TO. [The state of bone metabolism in patients with various variants of the course of generalized periodontitis]. Visnyk problem biolohii i medytsyny. 2020;3:314-8. Ukrainian.
2. Gudaryan OO, Mashchenko IS, Kucherenko TO. [Treatment of aggressive (rapidly progressing) generalized periodontitis with the use of systemic enzyme therapy in combination with osteoinductive means]. Medicni perspektivi.2020;25(3):144-52.  doi: https://doi.org/10.26641/2307-0404.2020.3.214852
3. Alghamdi HS, Jansen JA. The development and future of dental implants. Dent Mater J. 2020;39(2):167-72. doi: https://doi.org/10.4012/dmj.2019-140
4. Prots H, Rozhko M, Pjuryk V, Nychyporchuk H, Pa­velko N. Efficiency of dental implantation in prosthetic reha­bilitation of patients with generalized periodontitis. Georgian Med News. 2021 May;(314):77-82. PMID: 34248031.
5. Do TA, Le HS, Shen YW, Huang HL, Fuh LJ. Risk Factors related to Late Failure of Dental Implant-A Systematic Review of Recent Studies. Int J Environ Res Public Health. 2020 Jun 2;17(11):3931. doi: https://doi.org/10.3390/ijerph17113931
6. Camps-Font O, Martín-Fatás P, Clé-Ovejero A, Fi­gueiredo R, Gay-Escoda C, Valmaseda-Castellón E. Post­operative infections after dental implant placement: Variables associated with increased risk of failure. J Periodontol.2018 Oct;89(10):1165-73. doi: https://doi.org/10.1002/JPER.18-0024
7. Liaw K, Delfini RH, Abrahams JJ. Dental Im­plant Complications. Semin Ultrasound CT MR. 2015 Oct;36(5):427-33. doi: https://doi.org/10.1053/j.sult.2015.09.007
8. Aghaloo T, Pi-Anfruns J, Moshaverinia A, Sim D, Grogan T, Hadaya D. The Effects of Systemic Diseases and Medications on Implant Osseointegration: A Systematic Review. Int J Oral Maxillofac Implants. 2019 Suppl;34:s35-s49. doi: https://doi.org/10.11607/jomi.19suppl.g3
9. Mashchenko IS, Kucherenko TO. [Clinical, im­munological and metabolic features of acute and rapidly progressing variants of generalized periodontitis]. Su­chasna stomatolohiia. 2020;4:26-32. Ukrainian. doi:https://doi.org/10.33295/1992-576X-2020-4-26
10. Germanchuk SM. [Morphobiochemical changes in periodontal tissues in experimental diabetes]. Ukrainskyi zhurnal medytsyny, biolohii ta sportu. 2018;3(4):13-9. Ukrainian. doi:https://doi.org/10.26693/jmbs03.04.013
11. Jiang X, Zhu Y, Liu Z, Tian Z, Zhu S. Association between diabetes and dental implant complications: a systematic review and meta-analysis. Acta Odontol Scand. 2021 Jan;79(1):9-18. doi: https://doi.org/10.1080/00016357.2020.1761031
12. Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Periodontitis, implant loss and peri-implantitis. A meta-analysis. Clin Oral Implants Res. 2015 Apr;26(4):e8-e16. doi: https://doi.org/10.1111/clr.12319
13. Monje A, Alcoforado G, Padial-Molina M, Sua­rez F, Lin GH, Wang HL. Generalized aggressive perio­dontitis as a risk factor for dental implant failure: a systematic review and meta-analysis. J Periodontol. 2014 Oct;85(10):1398-407. doi: https://doi.org/10.1902/jop.2014.140135
14. Patel RM. Dental Implants for Patients with Periodontitis. Prim Dent J. 2020 Jan 29;8(4):54-61. doi: https://doi.org/10.1308/205016820828463898
15. LeBoff MS, Greenspan SL, Insogna KL, Le­wiecki EM, Saag KG, Singer AJ, et al. The clinician's gui­de to prevention and treatment of osteoporosis. Osteoporos Int. 2022 Oct;33(10):2049-102. Epub 2022 Apr 28. Erra­tum in: Osteoporos Int. 2022 Jul 28. PMID: 35478046. PMCID: PMC9546973. doi: https://doi.org/10.1007/s00198-021-05900-y
16. Chiodini I, Bolland MJ. Calcium supplementation in osteoporosis: useful or harmful? Eur J Endocrinol. 2018 Apr;178(4):D13-D25. doi: https://doi.org/10.1530/EJE-18-0113
17. Mohsin S, Baniyas MM, AlDarmaki RS, Tekes K, Kalász H, Adeghate EA. An update on therapies for the treatment of diabetes-induced osteoporosis. Expert Opin Biol 2019 Sep;19(9):937-48. doi: https://doi.org/10.1080/14712598.2019.1618266
18. Castelo-Branco C, Dávila Guardia J. Use of os­sein-hydroxyapatite complex in the prevention of bone loss: a review. Climacteric. 2015 Feb;18(1):29-37. doi: https://doi.org/10.3109/13697137.2014.929107
19. Johnson TB, Siderits B, Nye S, Jeong YH, Han SH, Rhyu IC, et al. Effect of guided bone regeneration on bone quality surrounding dental implants. J Biomech. 2018 Oct 26;80:166-70. doi:https://doi.org/10.1016/j.jbiomech.2018.08.011
20. James AW, LaChaud G, Shen J, Asatrian G, Nguyen V, Zhang X, et al. A Review of the Clinical Side Effects of Bone Morphogenetic Protein-2. Tissue Eng Part B Rev. 2016 Aug;22(4):284-97. doi: https://doi.org/10.1089/ten.teb.2015.0357
21. Mitra S. Multiple Data Analyses and Statistical Approaches for Analyzing Data from Metagenomic Stu­dies and Clinical Trials. Methods Mol Biol. 2019;1910:605-34. doi: https://doi.org/10.1007/978-1-4939-9074-0_20

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Gudarian O.O. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-5370-1570

Cherednyk D.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/0009-0007-0199-2784

Gudarian O.O., Cherednyk D.O. Increasing the efficiency of osseointegration in dental implantation in patients with diabetic osteopathy by remodeling bone tissue and intensifying its density. Medicni perspektivi. 2023;28(2):136-142. doi: https://doi.org/10.26641/2307-0404.2023.2.283365

Increasing the efficiency of osseointegration in dental implantation in patients with diabetic osteopathy by remodeling bone tissue and intensifying its density

Mine-explosive wounds at the level of the lower leg are accompanied by significant functional disorders, leading to long-term disability, and in some cases – to disability. The introduction at the state level of the document of the International Classification of Functioning, Disabilities and Health (ICF) in the treatment and rehabilitation process of medical institutions, necessitates its detailed study and application for making a rehabilitation diagnosis of patients. The aim of this study is to improve the process of rehabilitation diagnosis of patients with mine-explosive wounds of the lower leg based on the International Classification of Functioning, Disability and Health. The study involved 54 people, the average age of the subjects was 37±4.2 years, 80% of them were men, 20% were women. In the course of the clinical and instrumental methods of examination of patients with mine-explosive wounds at the level of the lower leg, the assessment of categories according to the ICF revealed disorders at the level of structure: functions: s 75010 bones of lower leg, s 75012 muscles of lower leg, s 75013 ligaments and fasciae of lower leg, s 8104 skin of lower extremity; b 28015 pain in the lower limb, b 4550 general physical endurance, b 7101 mobility of several joints, b 7351 muscle tone of one limb, b 770 function of the stereotype of walking, b 7800 sensation of muscular stiffness, b 810 protective function of skin; activities: d 4104 standing position, d 4106 moving the center of gravity of the body, d 4501 walking long distances, d 465 moving using technical means, d 5100 washing body parts, d 5102 wiping and drying, d 5402 putting on footwear, d 5403 taking off footwear, d 5702 self-health support, d 850 well-paid work, d 920 recreation and leisure, e 1151 assistive products and technologies for personal everyday use, e 310 close relatives, e 355 professional health care workers. Mine-blast injuries of the shin cause impairments at the structural level, but the majority of impairments in patients were found at the level of function, activity, and participation, which significantly affected their quality of life.

Key words: rehabilitation diagnosis, mine-explosive injuries, ICF, physical therapy

1. Tsymbaliuk VI. [Gunshot wounds of soft tissues (Experience of anti-terrorist operations / Joint forces operations)]. Kharkiv: Kolehium; 2020. Ukrainian.
2. Pustovoit BA. [Medical and physical therapy for combat injuries at the stages of restorative treatment]. Kharkiv: Planeta-Print; 2019. Ukrainian.
3. Pasenko MV, Hlyniana OO, Somich YuV. [Reha­bilitation diagnosis of patients after osteosynthesis of the acetabulum based on the international classification of functioning, limitations of life and health]. Fizychne vykhovannia, sport i kultura zdorovia u suchasnomu suspilstvi. 2022;1(57):52-9. Ukrainian. doi: https://doi.org/10.29038/2220-7481-2022-01-52-58
4. [Pursuant to the Order of the Cabinet of Ministers of Ukraine dated December 27, 2017 No. 1008]. Ukrain­skyi visnyk medyko-sotsialnoi ekspertyzy. 2018;3-4(29-30):66-71. Ukrainian.
5. Prodinger B, Stucki G, Coenen M, Tennant A. The measurement of functioning using the International Clas­sification of Functioning, Disability and Health: comparing qualifier ratings with existing health status instruments. Disabil 2019;41(5):541-8. doi: https://doi.org/10.1080/09638288.2017.1381186
6. [International classification of functioning, limi­tations of vital activity and health: ICF]. [Internet]. Zheneva, Shveitsariia: Vsesvitnia orhanizatsiia okhorony zdorovia; 2001 [cited 2022 Oct 06]. Ukrainian. Available from: http://moz.gov.ua/mkf
7. Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, et al. Neck pain: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. Journal of Orthopaedic & Sports Physical Therapy. 2017 Jul;47(7):A1-83. doi: https://doi.org/10.2519/jospt.2017.0302
8. Bezpalova OO, Rybalko PF, Sitovskyi AM, Tsiu­pak TYe. [Rehabilitation diagnosis of patients with osteoarthritis based on the International Classification of Functioning, Limitation of Vital Activities and Health (ICF)]. Art of medicine. 2021;3(19):6-15. Ukrainian. doi: http://doi.org/10.21802/artm.2021.3.19.6
9. Abedi M, Gane E, Aplin T, Zerguine H, John­ston V. Barriers and facilitators associated with return to work following minor to serious road traffic musculo­skeletal injuries: a systematic review. J Occup Rehabil. 2022;32(1):13-26.
   doi: https://doi.org/10.1007/s10926-021-09994-3
10. Mitra S, Shakespeare T. Remodeling the ICF. Disabil Health J. 2019;12:337-9. doi: https://doi.org/10.1016/j.dhjo.2019.01.008
11. Leonardi M, Lee H, Kostanjsek N, Fornari A, Rag­gi A, Martinuzzi A, et al. 20 Years of ICF – In­ternational Classification of Functioning, Disability and Health: Uses and Applications around the World. Int J Environ Res Public Health. 2022;19:11321. doi: https://doi.org/10.3390/ijerph191811321
12. Strahova OP, Androsov OI. [Statistical methods of processing the results of medical and biological research]. Lviv; 2021. 164 p. Ukrainian.
13. Duong HP, Garcia A, Hilfiker R, Leger B, Lu­thi F. Systematic review of biopsychosocial prognostic factors for return to work after acute orthopedic trauma: a 2020 update. Front Rehabil Sci. 2022;2:791351. doi: https://doi.org/10.3389/fresc.2021.791351
14. Negrini S, Kiekens C, Zampolini M, et al. Metho­dology of «Physical and rehabilitation medicine practice, evidence based position papers: the European position» produced by the UEMS-PRM section. Eur J Phys Reha-bil Med. 2016;52:1:134-41.

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Dorofieieva O.E. 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/0000-0002-2028-6064

Yarymbash K.S. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0003-4694-291X

Glinyana O.A. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0003-4118-0856

Syomych Yu.V. Kyiv Regional Clinical Hospital, Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-8563-0639

Skrypchenko I.T. Dnipropetrovsk State University of Internal Affairs, Dnipro, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
http://orcid.org/0000-0001-5895-3099

Dorofieieva O.E., Yarymbash K.S., Glinyana O.A., Syomych Yu.V., Skrypchenko I.T. Rehabilitation diagnosis of patients with mine-explosive wounds of the lower leg based on the international classification of functioning, disability and health. Medicni perspektivi. 2023;28(2): 143-149. doi: https://doi.org/10.26641/2307-0404.2023.2.283384

Rehabilitation diagnosis of patients with mine-explosive wounds of the lower leg based on the international classification of functioning, disability and health

The purpose of the study was to increase the efficiency of diagnostics of the strength indicators of the lower extremity muscles by determining the optimal conditions for the mutual location of segments of kinematic links for the best implementation of contractile capabilities during functional testing. The main focus of the work was to determine the positions for the maximum overlaying of myofilaments in the sarcomeres of the investigated contractile areas of the movable segments of the lower extremities during power loads. 20 experienced football players, whose average age was 26.8±6.2 years, took part in the study. In order to fulfill the set goal, interference electromyography was performed on all athletes. The function of a separate group of muscles was considered in accordance with the endogenous ability to overcome external resistance in a given direction. Dependence of contractile manifestations was coordinated in accordance with the approach or distance of areas of attachment of muscles. The positions of the muscles were regulated by the ventral and sagittal planes, as well as by the average amplitude of rotation. On the basis of the ratio of maximum, average amplitudes and frequency, data regarding the maximum overlaying of myofilaments in sarcomeres (maximum bioelectric activity), in accordance with the position angle of the movable segment of the lower extremity were obtained. It was established that for conducting functional testing, the location of the trunk and lower extremities in the same plane of movement and axis were the optimal positions for the diarticular muscles of the thigh and lower leg; for monoarticular extensors of the lower leg - a position at a right angle between the lower leg and thigh; for rotators of the lower leg and foot - location of these segments in a plane parallel to the sagittal one. On the basis of the obtained data, the optimal conditions for the mutual location of the segments of the kinematic links for the realization of the contractile capabilities of the muscles of the lower extremities have been determined, a protocol for functional testing of the muscles of the lower extremities has been developed, it is presented in graphic form with the possibility of entering data from both limbs, while test points of rotator muscles of the thigh and lower leg have been added.

Key words: kinematic link, functional testing, lower extremities

1. Pontaga I, Zidens J. Fatigue resistance of thigh muscles in sport games players. In: Kalina RM, editor. Proceedings of the 1st World Congress on Health and Martial Arts in Interdisciplinary Approach, HMA; 2015 Sep;17-19; Czestochowa, Poland. Warsaw: Archives of Budo; 2015. p. 165-9.
2. Mishchenko O, Smyrnova T, Tkachenko T, Pota­moshnieva O, Yuzyk O, Berezhnyi Yu. Conditions For Activating The Cognitive Independence Of Higher Education Seekers. International Journal of Computer Science and Network Security. 2021;21(10):245-50. doi: https://doi.org/10.33022/IJCS.V10I2.446
3. Yuzyk O, Yuzyk M, Bilanych L, Honcharuk V, Bilanych H, Fabian M. Distance Learning in Higher Education Institutions in Conditions of Quarantine and Military Conflicts. IJCSNS International Journal of Computer Science and Network Security. 2022;22(4):741-9. doi: https://doi.org/10.22937/IJCSNS.2022.22.4.87
4. Garrett J, Graham SR, Eston RG, Burgess DJ, Garrett LJ, Jakeman J, et al. A Novel Method of Asses­sment for Monitoring Neuromuscular Fatigue in Australian Rules Football Players. International Journal of Sports Physiology and Performance. 2019;14(5):598-605. doi: https://doi.org/10.1123/ijspp.2018-0253
5. Bergstrom HC, Dinyer TK, Succi PJ, Voskuil CC, Housh TJ. Applications of the Critical Power Model to Dynamic Constant External Resistance Exercise: A Brief Review of the Critical Load Test. Sports. 2021;9(2):15. doi: https://doi.org/10.3390/sports9020015
6. Sirenko PO. [Innovative technologies in physical tra­ining of skilled football players]. [dis.]. Lviv; 2015. Ukranian.
7. Sirenko PO, Istomin AH, Sirenko RR, Khorka­vyi BV, Rybchych IE. Special and preventive exercises for hamstring muscles in the training process of experienced football players. Pedagogy of Physical Culture and Sports. 2022;26(5):344-52. doi: https://doi.org/10.15561/26649837.2022.0509
8. Garrett J, Graham SR, Eston RG, Burgess DJ, Garrett LJ, Jakeman J, et al. A Novel Method of Asses­sment for Monitoring Neuromuscular Fatigue in Australian Rules Football Players. International Journal of Sports Physiology and Performance. 2019;14(5):598-605. doi: https://doi.org/10.1123/ijspp.2018-0253
9. Herold JL, Sommer A. A model-based estimation of critical torques reduces the experimental effort com­pared to conventional testing. European Journal of Applied Physiology. 2020;120(6):1263-76. doi: https://doi.org/10.1007/s00421-020-04358-w
10. Häkkinen K, Newton RU, Walker S, Häkkinen A, Krapi S, Rekola R, et al. Effects of Upper Body Eccentric versus Concentric Strength Training and Detraining on Maximal Force, Muscle Activation, Hypertrophy and Serum Hormones in Women. Journal of Sports Science & Medicine. 2022;21(2):200-13. doi: https://doi.org/10.52082/jssm.2022.200
11. Kendall FP, McCreary EK, Provance PG. Muscle Testing and Function. 4th Edition, Lippincott. Philadel­phia: Williams and Wilkins; 1993. p. 451.

Look through:

Sirenko P.O. Latvian Academy of Sport Education, Latvia,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-2787-6497

Storozhenko I.P. State Biotechnological University, Kharkiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-7344-242X

Žīdens J. Latvian Academy of Sport Education, Latvia
https://orcid.org/0000-0002-8244-4451

Zuša A. Latvian Academy of Sport Education, Latvia
https://orcid.org/0000-0001-8801-9141

Yuzyk O.P. Rivne State University for the Humanities, Rivne, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9586-6015

Lietuviete D. Clinic Aiwa, Riga,  Latvia, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0009-0000-2821-3559

Kolesnyk T.V. Kyiv Medical University, Kyiv, Ukraine
https://orcid.org/0000-0003-4849-5615

Sirenko P.O., Storozhenko I.P., Žīdens J., Zuša A., Yuzyk O.P., Lietuviete D., Kolesnyk T.V. Functional testing of the lower extremity muscles. Medicni perspektivi. 2023;28(2):150-163. doi: https://doi.org/10.26641/2307-0404.2023.2.283388

Functional testing of the lower extremity muscles

The effects of tobacco smoke and nicotine on the health of adults and children remain one of the most burning problem in our days. In 2019 the prevalence of active smoking in Ukraine reached 42.0 among men and 14.4% among women. The negative effects of second-hand tobacco smoke exposure are most significant in children under 5 years of life, especially in families with smoking mothers. The goal of the study was to assess the current smoking prevalence in families with children, including the use of modern electronic nicotine delivery devices. A self-reported survey of 414 families living in Odessa and Odessa region (Ukraine) was conducted. All questionnaires were divided into two groups depending on the presence of tobacco smoke exposure. To asses the factor's relevance the odds ratio (OR) and its 95% confidence interval (CI) were used. The prevalence of smoking in families was associated with the age of the father up to 30 years (16.13 [95% CI 11.54–22.09]%; OR 2.73 [1.42–5.25]), mother’s and father’s low education lever (OR 2.73 [1.42–5.25] and 2.70 [1.64–4.44]), as well as with the residence of the family in the city (OR 4.30). The prevalence of smoking exposure was not associated with the income level or number of household members. The prevalence of smoking in women before pregnancy was more than 20%, and during pregnancy – 10%. After delivery women smoked in 23.91 (95% CI 20.06-28.25)% of cases. Proportion of families where smoked someone other than the mother reached 42.75 (95% CI 38.08–47.56)%. Other family members smoking negatively affected mothers’ tobacco consumption, both before and after childbirth. After pregnancy, women used both smoked tobacco and noncombustible forms of nicotine (51.52 vs 48.48%) with the same frequency. Other family members consumed smoking tobacco more often than e-cigarettes. All smokers who used electronic nicotine delivery devices more likely smoked at home (OR 5.33 [95% CI 0.53–54.04]).

Key words: children, second-hand smoke, tobacco product, nicotine vaping, smoking, prevalence

1. Antomonov MYu. [Mathematical Processing and Analysis of Medico-biological Data]. 2-e ed. Kyiv: Med­inform; 2018. Russian.
2. Global Adults Tobacco Survey 2017 (Ukraine). [Internet]. [cited 2021 Sep 24]. Ukrainian. Available from: https://kiis.com.ua/materials/pr/20180214_GATS/Full%20Report%20GATS%20Ukraine%202017%20UKR.pdf 
3. Bao W, Liu B, Du Y, et al. Electronic Cigarette Use Among Young, Middle-aged, and Older Adults in the United States in 2017 and 2018. JAMA Intern Med. 2020;180:313. doi: https://doi.org/10.1001/jamainternmed.2019.4957
4. Core Questionnaire with Optional Questions. [Internet]. [cited 2021 Sep 24]. Available from: https://cdn.who.int/media/docs/default-source/ncds/ncd-surveillance/gats/gats-corequestionnairewithoptionalques­tions_0525f659-106d-435a-93f7-ea0adb63c218.pdf?sfvrsn=3b5ca226_6
5. Cornelius ME, Wang TW, Jamal A, et al. Tobacco Product Use Among Adults – United States, 2019. MMWR Morb Mortal Wkly Rep. 2020;69:1736-42. doi: http://dx.doi.org/10.15585/mmwr.mm6946a4
6. Dai H, Leventhal AM. Prevalence of e-Cigarette Use Among Adults in the United States, 2014-2018. JAMA.2019;322:1824. doi: https://doi.org/10.1001/jama.2019.15331
7. Drake P, Driscoll AK, Mathews TJ. Cigarette smoking during pregnancy: United States, 2016. NCHS Data Brief. 2018 Feb;(305):1-8.
8. Kasza KA, Ambrose BK, Conway KP, et al. To­bacco-Product Use by Adults and Youths in the United States in 2013 and 2014. N Engl J Med. 2017;376:342. doi: https://doi.org/10.1056/NEJMsa1607538
9. Large S, Probst C, Rehm J, et al. National, regio­nal, and global prevalence of smoking during pregnancy in the general population: a systematic review and meta-analysis. The 2018 July;6(7);769-76. doi: https://doi.org/10.1016/S2214-109X(18)30223-7 
10. Levine MD, Cheng Y, Marcus MD, et al. Preven­ting Postpartum Smoking Relapse: A Randomized Clinical Trial. JAMA Intern Med. 2016 Apr;176(4):443-52. doi: https://doi.org/10.1001/jamainternmed.2016.0248
11. National Health Interview Survey; 2019. [Internet]. [cited 2021 Sep 24]. Available from: https://www.cdc.gov/nchs/nhis/tobacco/tobacco_statistics.htm
12. Oldereid NB, Wennerholm UB, Pinborg A, et al. The effect of paternal factors on perinatal and paediatric outcomes: a systematic review and meta-analysis. Hum Reprod Update. 2018 May 1;24(3):320-89. doi: https://doi.org/10.1093/humupd/dmy005
13. GBD 2019 Tobacco Collaborators. Spatial, tem­poral, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet. 2021 Jun 19;397(10292):2337-60. doi: https://doi.org/10.1016/S0140-6736(21)01169-7 

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Starets O.O. Odessa National Medical University, Odessa, Ukraine
https://orcid.org/0000-0003-4918-5870

Kovalenko D.A. Odessa National Medical University, Odessa, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-9673-2131

Starets O.O., Kovalenko D.A. Smoking prevalence among adults in households with children: parental survey. Medicni perspektivi. 2023;28(2):164-169. doi: https://doi.org/10.26641/2307-0404.2023.2.283396

Smoking prevalence among adults in households with children: parental survey

The aim of this work was to assess the risk of carcinogenic substances with a proven danger to humans at the level of current maximum permissible concentrations (MPC). The results were obtained on the basis of the collection and analysis of data on chemical carcinogenic compounds that are included in the national regulatory base of permissible content in the atmospheric air of populated areas, as well as the base of Directives of EU countries and the International Agency for the Study of Cancer using bibliosemantic, bibliographic and hygienic research methods. At the same time, the chemical substances classified by experts from International Agency for Research on Cancer in terms of carcinogenicity to humans were taken into consideration: definitely carcinogenic (group 1), probably (group 2A) and possibly carcinogenic to humans (group 2B). As a result, 52 compounds were identified in the list of carcinogenic substances normalized in atmospheric air, of which 12 substances are assigned to group 1, 13 to group 2A, and 27 to group 2B. In this work, only substances of the first group were subject to in-depth analysis. To assess the danger of substances’ concentrations at the level of maximum permissible concentrations, risk indicators according to the recommended methodical documents were determined. Calculations of the carcinogenic risk caused by the concentrations of these substances at the level of hygienic regulations for the atmospheric air of populated areas proved that only for two compounds (benzo/a/pyrene and formaldehyde) the risk is acceptable and meets the international standards recommended by EU and WHO. For other substances of this group, the carcinogenic risk of exposure is excessive. A conclusion was made regarding the need to review the existing hygienic standards from the standpoint of risk and consider them in the future as annual averages. In order to solve this issue, the criterion scale "concentration - carcinogenic risk" was highlighted in the work, with the help of which it was proposed to determine the maximum permissible concentrations according to the indicators of risk acceptable for the conditions of Ukraine.

Key words: carcinogenic substances, hygienic standards, atmospheric air, carcinogenic risk, reference concentrations

1. Yanysheva NYa, Antomonov YuA, Albert RE, Altschuler B, Friedman L. Approaches to the Formulation of Standards for Carcinogenic Substances in the Environ­ment. Environmental Health Perspectives. 1979;30:81-5. doi: https://doi.org/10.1289/ehp.793081
2. On the protection of workers from the risks related to exposure to carcinogens or mutagens at work. Directive 2019/130 of the European Parliament and of the Council Official. Journal of the European Union. 2019;31(1):112.
3. Braakhuis HM, Slob W, Olthof ED, et al. Is Cur­rent Risk Assessment of Non-Genotoxic Carcinogens Pro­tective? Crit Rev Toxicol. 2018;48:500-11. doi: https://doi.org/10.1080/10408444.2018.1458818
4. Fukushima S, Gi M, Fujioka M, et al. Quantitative Approaches to Assess Key Carcinogenic Events of Geno­toxic Carcinogens. Toxicol Res. 2018;34(4):291-6. doi: https://doi.org/10.5487/TR.2018.34.4.291
5. Wollin KM, Apel P, Chovolou Y, et al. Concept for the Evaluation of Carcinogenic Substances in Popu­lation-Based Human Biomonitoring. Int J Environ Res Public Health. 2022;19(12):7235. doi: https://doi.org/10.3390/ijerph19127235
6. Hartwig A, Arand M, Epe B, et al. Mode of action-based risk assessment of genotoxic carcinogens. Arch Toxicol. 2020;94(6):1777-87. doi: https://doi.org/10.1007/s00204-020-02733-2
7. [Hygienic regulations. Maximum permissible con­centrations of chemical and biological substances in the atmospheric air of populated areas. Order of the Ministry of Health of Ukraine No. 52, 2020 Jan 14]. [Internet]. 2020. [cited 2023 Feb 09]. Ukrainian. Available from: https://zakon.rada.gov/ua
8. [Methodological recommendations 2.2.12 – 142-2007. Assessment of the risk to public health from atmospheric air pollution]. Kyiv; 2007. 39 p. Ukrainian.
9. Minimal Risk Levels (MRLs) for Hazardous Sub­stances. Agency for Toxic Substances and Disease Re­gistry. [Internet]. 2018. [cited 2023 Feb 09]. Available from: https://www.atsdr.cdc.gov/mrls/index.html
10. Chernychenko IO, Lytvychenko OM, Babii VF, Harkavyi SI, Balenko NV, Kondratenko OIe, et al. [Regar­ding the revision of the regulatory framework of chemical carcinogens in the air environment according to the risk criterion]. Dovkillia ta zdorovia. 2022;2:42-8. Ukrainian. doi: https://doi.org/10.32402/dovkil2022.02.042
11. Air quality and health: fact sheet on Sustainable Development Goals (‎SDGs)‎: health targets. World Health Organization [Internet]. [cited 2023 Feb 09]. Available from:https://apps.who.int/iris/bitstream/handle/10665/340799/WHO-EURO-2018-2376-42131-58026-eng.pdf?sequence=3&isAllowed=y
12. Air quality Standards. European Commission, 2019. [Internet]. 2019 [cited 2023 Feb 09]. Available from: https://www.euro.who.int/_data/assets/pdf_file/0005/78638/E90038.pdf
13. A Review of the Reference Dose and Reference Concentration Processes. Reference Dose / Reference Concentration (RfD/RfC) Technical Panel. [Internet]. Washington, DC: Risk Assessment Forum. US EPA; 2002. [cited 2023 Feb 09]. 192 p. Available from: https://www.epa.gov/sites/default/files/2014-12/documents/rfd-final.pdf

Look through:

Chernychenko I.O. SI “O.M. Marzeiev Institute for Public Health, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0002-4784-4628

Lytvychenko O.M. SI “O.M. Marzeiev Institute for Public Health, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0003-2039-3318

Babii V.F. SI “O.M. Marzeiev Institute for Public Health, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0003-2519-1440

Kondratenko O.Ie. SI “O.M. Marzeiev Institute for Public Health, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0003-2166-882X

Rudnytska O.P. SI “O.M. Marzeiev Institute for Public Health, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0002-5065-3152

Hlavachek D.O. SI “O.M. Marzeiev Institute for Public Health, National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-0512-6927

Chernychenko I.O., Lytvychenko O.M., Babii V.F., Kondratenko O.Ie., Rudnytska O.P., Hlavachek D.O. Assessment of the safety of priority carcinogenic substances at the level of hygienic regulations in atmospheric air. Medicni perspektivi. 2023;28(2):170-175. doi: https://doi.org/10.26641/2307-0404.2023.2.283402

Assessment of the safety of priority carcinogenic substances at the level of hygienic regulations in atmospheric air

The formation of human health takes place under conditions of both positive and negative influence of the external environment. There is an undoubted connection between human health and the degree of its intervention in the natural environment, which, in turn, is determined by the level of environmental awareness of society. The purpose of this study was to determine the relationship between the levels of awareness, instructions and activities at different levels of environmental consciousness of modern youth. Used methods: bibliographic; questionnaire method (to collect data on the environmental awareness of young people); statistical (for selection and analysis of obtained data); mathematical (for constructing formulas and calculating levels of ecological consciousness and its components). A questionnaire was developed to survey students and high school students in different cities of Ukraine. 285 respondents aged 15 to 24 took part in the survey. In order to compare the level of environmental awareness of young people with  people of other age groups, 53 respondents over the age of 24 were involved in the survey, which was 15,7% of the total number of respondents. The questionnaire was conventionally divided into semantic modules for the possibility of determining the levels of environmental knowledge, instructions and behavior. To achieve the goal of the work, the level of environmental awareness and its components, taking into account gender and age, was assessed. Quantitative values of the levels of the components of environmental consciousness were calculated according to the integral evaluation formulas. For the convenience of assessing the level of the components of environmental consciousness, the quantitative values were ranked in three classes: "weak", "medium" and "high" severity. It was found that young people of both sexes almost do not differ in the high level of guidance. However, the share of girls with a high level of awareness is slightly higher than the share of boys and is significantly higher by a high level of activity. Awareness of the social and individual value of nature increases significantly with age, but readiness for active nature conservation activities does not change with age. The dependence of eco-awareness on the place of residence has been established: in small towns, the eco-awareness of residents is higher than in those who live in large cities. Also, eco-awareness depends on the field of study: students of humanitarian specialties have a significantly higher level of eco-awareness than students of technical universities. The analysis of the obtained results will contribute to the development of ways of forming the ecological consciousness of pupils and students, which is one of the main tasks of ecological and hygienic education and education of young people.

Key words: youth, environmental consciousness, environmental awareness, environmental acceptance, environmental activity

1. Tkalenko NV, Mykhailovska OV, Tatarchuk MS. [Eco consciousness of the population as a strategic goal of environmental activity in modern Ukraine]. Derzhava ta rehiony. Ser.: Derzhavne upravlinnia. 2019;1(65):159-65. Ukrainian.
2. Berdnyk OV, Polka NS, Dobryanska OV, Rud­nytska OP, Skochko TP. [Child population through the prism of public health]. Kyiv: Medinform; 2020. 200 p.
3. Kwiatek A, Skiba M. [Environmental conscious­ness of young people]. Scientific Journals of the Częstochowa University of Technology Management. 2017;28(2):127-36. Polish. doi: https://doi.org/10.17512/znpcz.2017.4.2.10
4. Machnev VY, Grudtsina LY, Pashentsev DA, Zin­natullina AN, Pavlenko EM, et al. Socio-psychological aspects of preschoolers’ formation of ecological installation for environmental protection. Eurasian Journal of Biosciences. 2018;12:175-80.
5. Nagla BK. Ecology, Culture and Development. In: Environment, Development and Sustainability in India: Perspectives, Issues and Alternatives. Springer; 2021. р. 23-40. doi: https://doi.org/10.1007/978-981-33-6248-2_2
6. Jzhanzakova Sh, Bazargaliev G, Shapieva M, Kai­darova A. Formation of ecological culture of students – the basis of a healthy lifestyle. Pedagogy and Psychology. 2020;45:23-9. doi: https://doi.org/10.51889/2020-4.2077-6861.03
7. Yungho W, Kuang-Chung H, Liu BJ. Increasing worldwide environmental consciousness and environ­mental policy adjustment. The Quarterly Review of Economics and Finance. 2019;71:205-10. doi: https://doi.org/10.1016/j.qref.2018.08.003
8. Kichuk AV. [The latest approaches to the develop­ment of environmental awareness among students]. Ukraine – EU. Innovations in Education, Technology, Business and Law: collection of international scientific papers. Chernihiv: CNUT; 2018. р. 358-60. Ukrainian.
9. Voloshok О. [Ecological consciousness and ways of its formation in student youth]. Visnyk of the Lviv University. : Psychological Science. 2020;6;32-7. Ukrainian. doi: https://doi.org/10.30970/2522-1876-2020-6-5
10. Robison Millennials worry about the environ­ment - should your company? [Internet]. Workplace. 2019 May 29. [cited 2023 Jan 10]. Available from: https://www.gallup.com/workplace/257786/millennials-worry-environment-company.aspx
11. Antomonov MJ, Korobeinikov GV, Hmelny­tska IV, Harkovliuk-Balakina NV. [Mathematical methods of processing and modeling the results of experimental research: a study guide]. Kyiv: Olimpiiska literatura; 2021. 216 p. Ukrainian.
12. [Attitude of the population to environmental is­sues. Ecology – Law – Man] [Internet]. Lviv; 2015 Sep 21. [cited 2023 Jan 10]. Ukrainian. Available from: http://epl.org.ua/announces/stavlennya-naselennya-do-py­tan-ekolohiyi
13. Ningrum Z, Herdiansyah H. Environmental awa­reness and behavior of college students in regards to the environment in urban area. E3S Web Conf. 2018;74:10004. doi: https://doi.org/10.1051/e3sconf/20187410004
14. Sousa S, Correia E, Leite J, Viseu  C. Environ­mental knowledge, attitudes and behavior of higher education students: a case study in Portugal. International Research in Geographical and Environmental Education. 2021;30(4):348-65. doi: https://doi.org/10.1080/10382046.2020.1838122
15. Simiyu G, Kariuki V, Ombaba M, Otuya R. Does Environmental Knowledge Matter? Social Influence and Pro-Environmental Behavior in University Students: An Indirect Effect Model. Seisense Journal of Management. 2022;5(1):1-16. doi: https://doi.org/10.33215/sjom.v5i1.724
16. Ganatsa M, Tsakaldimi M, Ganatsas P. Factors af­fecting Attitudes and Behavior of Greek Secondary School Students on Current Environmental Issues. Review of Inter­national Geographical Education Online. 2021;11(3):600-20. doi: https://doi.org/10.33403/rigeo.860160

Look through:

Аntomonov М.Yu. SI “O.M. Marzeiev Institute for Public Health of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0003-3939-6156

Pashynska S.L. SI “O.M. Marzeiev Institute for Public Health of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0003-1625-3136

Sokolova M.P. SI “O.M. Marzeiev Institute for Public Health of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0001-9590-1407

Skochko T.P. SI “O.M. Marzeiev Institute for Public Health of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0002-7849-0244

Rudnytska О.P. SI “O.M. Marzeiev Institute for Public Health of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
https://orcid.org/0000-0002-5065-3152

Аntomonov М.Yu., Pashynska S.L., Sokolova M.P., Skochko T.P., Rudnytska О.P. Awareness, attitude and activities as components of the environmental consciousness of youth. Medicni perspektivi. 2023;28(2):176-182. doi: https://doi.org/10.26641/2307-0404.2023.2.283407

Awareness, attitude and activities as components of the environmental consciousness of youth

The study of individual characteristics of the patient safety culture was conducted in various Ukrainian health care facilities using the questionnaire of the Agency for Healthcare Research and Quality's (AHRQ). The characteristics of the patient safety culture were analyzed by taking into account the length of service, membership of respondent to medical or nursing staff, and the profile of therapeutic or surgical activity. The essential professional qualities of patient safety specialists and the categories of persons who are the most suitable candidates for the training of patient safety specialists were defined. It was noted that training specialists to ensure patients safety, taking into account professionally essential qualities, becomes especially relevant in connection with the transition from the culture of blaming individuals for mistakes to the practice of a fair culture, in which mistakes are not considered as a personal oversight, but as an opportunity to improve the system and prevent future harm. It was found that the nursing staff rated patient safety on wards lower than in hospital. A greater risk of adverse event reporting was found for surgical workers and a reduced risk of adverse event reporting for workers with 21 years of experience or more compared to workers with five years of experience or less. Based on the conducted research, it was concluded that the most suitable candidates for training patient safety specialists would be surgeons with 5 years of experience, who are critical as for patient safety in their units and prone to disclose adverse events.

Key words: health care, safety culture, patient safety, health care facilities

1. Antomonov MYu. [Mathematical processing and analysis of medical and biological data]. Kyiv: MIC "Medinform"; 2018. 579 р. Russian.
2. Yavorovskуi ОР, Ryhan MM, Naumenko OM, Ska­letskyi YuM, Hychka SH, Ivanko OV, et al. [Patient safety culture in health care facilities in Ukraine (message 1)]. Medicni Perspektivi. 2021;26(3):179-87. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2021.3.242257
3. Yavorovskyi AP, Rygan MM, Naumenko AN, Ska­letskyi YuN, Gichka SG, Ivanko AV, et al. [A com­parative analysis on safety culture in domestic and foreign health care facilities and enterprises of other activities (message 2). Medicni Perspektivi. 2021;26(4):153-60. Ukrainian. doi: https://doi.org/10.26641/2307-0404.2021.4.248210
4. Gur'yanov VG, Liakh YuIe, Parii VD, Korot­kyi OV, Chalyi OV, Chalyi KO, et al. [Handbook of bio­statistics. Analysis of the results of medical research in the EZR package (R-statistics)]. Kyiv: Vistka; 2018. 208 р. Ukrainian.
5. Sorra J, Gray L, Streagle S, et al. AHRQ Hos­pital Survey on Patient Safety Culture: User’s Guide [Internet]. Westat, Rockville. 2018 [cited 2022 Mar 08]. 45 р. Available from: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patientsafetyculture/hospital/userguide/hospitalusersguide.pdf/
6. Donaldson L, Ricciardi W, Sheridan S, Tartag­lia R. Textbook of Patient Safety and Clinical Risk Ma­nagement. Springer; 2021. Available from: https://link.springer.com/book/10.1007/978-3-030-59403-9
7. Identifying patient safety specialists. NHS Eng­land and NHS Improvement [Internet]. 2020 Aug. [cited 2022 Mar 08]. Available from: https://www.england.nhs.uk/wp-content/uploads/2020/­08/identifying-patient-safetyspecialists-v2.pdf
8. Job Profile: Healthcare Risk. Management Ma­na­ger. Best College [Internet]. 2022 Jul. [cited 2022 Mar 17]. Available from: https://www.bestcolleges.com/healthcare/healthcare-risk-management-m anager-job/
9. Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow 2013;48:452-8. doi: https://doi.org/10.1038/bmt.2012.244 
10. Patient Safety Incident Reporting and Learning Systems Technical report and guidance. WHO; 2020. 72 p. Available from: 9789240010338-eng.pdf.
11. NRLS national patient safety incident reports: com­mentary. NHS England and NHS Improvement; 2020. 21 р. Available from: NaPSIR 2021 (england.nhs.uk).

Look through:

Rygan M.M. National University of Ukraine on Physical Education and Sport, Kyiv, Ukraine
https://orcid.org/0000-0003-1244-9801

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

Bruкhno R.P. 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/0000-0002-6666-397X

Skaletskyi Y.M. SI "O.M. Marzeіev Institute for Public Health of the NAMS of Ukraine", Kyiv, Ukraine
https://orcid.org/0000-0001-7527-6827

Badyuk M.I. Ukrainian Military Medical Academy, Kyiv, Ukraine
https://orcid.org/0000-0002-2995-0910

Zinchenko T.O. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0002-6666-397X

Anisimov E.M. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0001-6822-5212

Kozak N.D. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0001-9407-9634

Ustiak N.V. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0003-1454-567X

Kudiievskyi Y.V. Bogomolets National Medical University, Kyiv, Ukraine
https://orcid.org/0000-0003-0282-0005

Rygan M.M., Yavorovskyi O.P., Bruкhno R.P., Skaletskyi Y.M., Badyuk M.I., Zinchenko T.O., Anisimov E.M., Kozak N.D., Ustiak N.V., Kudiievskyi Y.V. Important professional qualities of patient safety specialists. Medicni perspektivi. 2023;28(2):183-190. doi: https://doi.org/10.26641/2307-0404.2023.2.283413

Important professional qualities of patient safety specialists

Acute pancreatitis is a disease that is accompanied by systemic inflammatory response syndrome and polysystemic dysfunction. Often acute pancreatitis leads to damage to various organs, including: pleura, mediastinum, cardiovascular structures. These complications cause difficulties in diagnosing and treating patients. In this review, we discuss the complications of acute pancreatitis, focusing on the diagnosis and treatment of pancreatopleural fistulas. Pancreatopleural fistula is a rather rare complication observed in patients with both acute and chronic pancreatitis due to traumatic or iatrogenic damage to the pancreatic duct. Conservative treatment with ocreatid combined with stenting of the pancreatic duct currently makes it possible to achieve closure of the fistula in 31-45% of cases, surgical intervention – in 80-90% of cases. The clinical case presented in this article demonstrates the successful treatment of this difficult complication of acute pancreatitis. The authors emphasized the need for timely diagnosis of this condition, as delaying adequate treatment can worsen the prognosis of recovery of patients with pancreatopleural fistulae.

Key words: acute pancreatitis, thoracoabdominal complications of acute pancreatitis, pancreatopleural fistula

1. Peery AF, Crockett SD, Murphy CC, Jennifer LL, Evan SD, et al. Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2018. Gastroenterology. 2019;156:254. doi: https://doi.org/10.1053/j.gastro.2018.08.063
2. Michael AM, Howard AR, Mark DG. Acute Pancreatitis. JAMA. 2021;325(4):382-90. doi: https://doi.org/10.1001/jama.2020.20317
3. Colvin SD, Smith EN, Morgan DE, Porter KK. Acute pancreatitis: an update on the revised Atlanta classification. Abdom Radiol (NY). 2020 May;45(5):1222-31. doi: https://doi.org/10.1007/s00261-019-02214-w
4. Ortiz Morales CM, Girela Baena EL, Olalla Muñoz JR, Parlorio de Andrés E, López Corbalán JA. Radiology of acute pancreatitis today: the Atlanta clas­sification and the current role of imaging in its diagnosis and treatment. Radiologia (Engl Ed). 2019 Nov-Dec;61(6):453-66. English, Spanish. doi: https://doi.org/10.1016/j.rx.2019.04.001
5. Luiken I, Eisenmann S, Garbe J, Sternby H, Verdonk RC, Dimova A, et al. Pleuropulmonary pa­thologies in the early phase of acute pancreatitis correlate with disease severity. PLoS One. 2022 Feb 7;17(2):e0263739. doi: https://doi.org/10.1371/journal.pone.0263739
6. Iyer H, Elhence A, Mittal S, Madan K, Garg PK. Pulmonary complications of acute pancreatitis. Expert Rev Respir Med. 2020 Feb;14(2):209-17. doi: https://doi.org/10.1080/17476348.2020.1698951
7. Katageri B, Rana SS, Bhatia A, Sharma RK, Gup­ta R. Serial lung ultrasound in the assessment of volume status and disease severity in acute pancreatitis. Gastro­enterology. 2018;154:S-103.51. doi: https://doi.org/10.1016/S0016-5085(18)30782-0
8. Tan JH, Chin W, Shaikh AL, Zheng S. Pancreatic pseudocyst: Dilemma of its recent management. Exp Ther Med. 2021 Feb;21(2):159. doi: https://doi.org/10.3892/etm.2020.9590
9. Silverman MB, Oliver JJ, Belcher CN, Wray J, Bridwell RE. Pancreaticopleural fistula, a rare mediastinal emergency. Am J Emerg Med. 2021 Jun;44:477.e1-477.e3. doi: https://doi.org/10.1016/j.ajem.2020.10.032
10. Chen Y, Jiang Y, Qian W, Yu Q, Dong Y, Zhu H, et al. Endoscopic transpapillary drainage in disconnected pancreatic duct syndrome after acute pancreatitis and trauma: long-term outcomes in 31 patients. BMC Gastro­enterol. 2019 Apr 16;19(1):54. doi: https://doi.org/10.1186/s12876-019-0977-1

Look through:

Desyateryk V.I. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0001-7097-8141

Kotov O.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-1409-3020

Mikhno S.P. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-8793-8493

Okhotnik Ye.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/0000-0003-2101-2919

Krasnov M.P. Shyrokivska Central Hospital, Shyroke, Dnipropetrovsk Region, Ukraine
https://orcid.org/0000-0003-4540-9216

Desyateryk V.I., Kotov O.V., Mikhno S.P., Okhotnik Ye.O., Krasnov M.P. Pancreatopleural fistula as a complication of necrotizing pancreatitis (clinical case). Medicni perspektivi. 2023;28(2):191-196. doi: https://doi.org/10.26641/2307-0404.2023.2.283421

Pancreatopleural fistula as a complication of necrotizing pancreatitis (clinical case)

Rapid rehabilitation and restoration of the function of damaged anatomical areas in the military is the main goal of military medicine. In the case of gunshot wounds of the knee joint with defects of soft tissues, one of the optional methods of reconstructive and plastic "closure" is the usage of a propeller flap. The clinical case represents a mine-explosive wound of the lower extremities with a defect of the soft tissues of the lateral aspect of the right knee joint in a serviceman of the Ukrainian Armed Forces as a result of artillery shelling in the east of Ukraine in November 2022. There was an isolated shrapnel tangential non-penetrating wound on the lateral aspect of the right knee joint with a soft tissue defect measuring 7.2x3.2-1.0 cm. The aim of the work was to study the thermographic and sonographic features of soft tissue perfusion after gunshot injuries of the lower extremities and on the basis of the temperature dynamics data from the wound surface in combination with the sonographic examination of the vessels to determine the rationality and relevance in the reconstruction of defects of the lower extremities by propeller tactics. Reconstruction with flap with a perforating vessel as the "key" of LSGA (lateral superior genicular artery) and a dynamic multimodal concept (DMT) with the use of audio doppler in the pre-, intra- and postoperative period) with closure of the defect due to a rotary perforating flap with supplying was carried out. During the entire period of treatment, of the injured the temperature background from the surface of the flap was followed up using FLIR C2, and sonographic changes in blood flow were monitored in the projection of the LSGA location. We came to the conclusion that applying the technique of flaps on perforating vessels, several goals are tactically achieved: restoration of the completeness and function of the damaged area, reduction of complications in the recipient and donor areas. Thus, the propeller flap can be classified as a primary option for "replacemen t" of tissues among the restorative tactics of the damaged area of the lower extremities caused by a gunshot origin.

Key words: perforator flap, gunshot defects of the lower extremities, reconstruction

1. Korol SO, Khomenko IP, Matviichuk BV, Ustino­va LA. [Surgical tactics of treatment of the wounded with gunshot wounds of the thigh at all levels of medical support]. Klinichna khirurhiia. 2019;5(86):22-6. Ukrai­nian. doi: https://doi.org/10.26779/2522-1396.2019.05.22
2. Khomenko IP. [Instruction on medical support of the Armed Forces of Ukraine for a special period]. Kyiv: «Vydavnytstvo Liudmyla»; 2019. 192 р. Ukrainian.
3. Kosutic D. Hybrid perforator flaps: Introducing a new concept in perforator flap surgery. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2020;73:764-9. doi: https://doi.org/10.1016/j.bjps.2019.11.007
4. Tenekeci G. Perforator Flaps: Principles and Techniques. [Internet]. 2017 [cited 2022 Oct 09]. doi: https://doi.org/10.5772/intechopen.71270
5. Koshima I. Perforator flaps concept, history and evolution of the use of anterolateral thigh flap (ALT). Reconstructive and plastic surgery issues. 2020;73(2):5-12.
6. Hallock GG. The propeller flap version of the adductor muscle perforator flap for coverage of ischial or trochanteric pressure sores. Ann Plast Surg. 2006; 56:540-2. doi: https://doi.org/10.1097/01.sap.0000210512.81988.2b
7. O-Wern Low, Tian Fu Loh, Hanjing Lee, Yan Lin Yap, Jane Lim, Thiam Chye Lim, et The superior lateral genicular artery flap for reconstruction of knee and proximal leg defects. Arch Plast Surg. 2022;49(01):108-14. doi: https://doi.org/10.5999/aps.2021.01123
8. Yadav P, Thakur S, Agarwal P, Sharma D, Kukre­le R. Perforator-based propeller flap for coverage of lower leg: Single centre experience. Tropical Doctor. 2021;51(3):331-8. doi: https://doi.org/10.1177/0049475520988225
9. Sapino G, Gonvers S, Cherubino M, di Sum­ma PG. The "Sombrero-Shape" Super-Thin Pedicled ALT Flap for Complete Scrotal Reconstruction Following Fournier's Gangrene. Arch Plast Surg. 2022 May 27;49(3):453-6. doi: https://doi.org/10.1055/s-0042-1748663
10. Kishk TF, Elbarah AM, Elsheikh YM, et al. The assessment of the clinical applications of propeller flaps of the lower leg. Menoufia Med J. 2016;29:580-6. doi: https://doi.org/10.4103/1110-2098.198717
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Look through:

Lurin I.A. National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0001-6280-1725

Khomenko I.P. National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
https://orcid.org/0000-0002-8199-5083

Khoroshun E.M. Military Medical Clinical Center of the Northern Region, Ministry of Defense, Kharkiv, Ukraine,
e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0003-1258-1319

Nehoduiko V.V. Military Medical Clinical Center of the Northern Region, Ministry of Defense; Kharkiv National Medical University, 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

Tertyshnyi S.V. Military Medical Clinical Center of the Southern Region; Odessa National Medical University, Odessa, Ukraine, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.
https://orcid.org/0000-0002-4949-5409

Kosynskyi O.V. Dnipro State Medical University, Dnipro, Ukraine
https://orcid.org/0000-0002-2759-2726

Buzmakov D.L. 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/0000-0001-8719-5696

Weiss B.  Care Medicine at Charité, Berlin, Germany, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. 
https://orcid.org/0000-0003-3139-595X

Lurin I.A., Khomenko I.P., Khoroshun E.M., Nehoduiko V.V., Tertyshnyi S.V., Kosynskyi O.V., Buzmakov D.L., Weiss B. A clinical case of using the concept of monitoring in the treatment of a gunshot defect of the soft tissues of the knee joint. Medicni perspektivi. 2023;28(2):197-207. doi: https://doi.org/10.26641/2307-0404.2023.2.283427

A clinical case of using the concept of monitoring in the treatment of a gunshot defect of the soft tissues of the knee joint