Proceeding of the Shevchenko Scientific Society. Medical Sciences

SCIENCE IS THE WEAPON FOR THE FUTURE OF UKRAINE

2023-02-07T20:42:49+02:00

Dear Reader!

Today marked the 299th day of the war for the independence of Ukraine. Besides the Armed Forces of Ukraine, the frontline of our battle against the aggressor is being held by healthcare professionals whose selfless work saves lives and the health of patients and ensures the existence of Ukraine. From now on, along with experimental and clinical medicine, there is war medicine in Ukraine, and the entire world is fascinated by its results. NATO Parliamentary Assembly has recently recognized our enemy as a terrorist state and called for creating a specialized international tribunal to punish all criminals. However, the full-scale invasion of the enemy with air raid alerts, shelling, scheduled and emergency blackouts did not stop Ukrainians in their love for education, scientific and research work, and awareness-raising activities. The words once uttered by great Ukrainian Hryhoriy Skovoroda, whose 300th anniversary we are celebrating this year, “The one who thinks of science, loves it, and the one who loves it, will never stop learning, no matter how passive he might seem”, are now more levant than ever. After all, they represent Ukrainian healthcare professionals and scientists. Progressive colleagues from across the globe – people of all races, all ages, ethnicities and religious orientations stand in solidarity with them. Together, they use all available possibilities and talents to bring victory closer and strengthen the positive image of Ukraine in the world.

At this time the war situation is complex, with a labile standstill at the front in the east of Ukraine. Meanwhile is it an established fact that an independent Ukraine will continue to exist. Nevertheless, the loss of human lives and the destruction of society and infrastructure continues. Ukraine has shown an exceptional brave perseverance and strength. Now it is time to move forward with wise policies. Life must have to return to normal, without serious threats of war attacks. People have to build up Ukraine and healthcare professionals and scientists need to go back to their regular work finding improvements in daily living for the population.

Our journal has a dual mission: 1) to enshrine the confident and attractive image of the journal, which is read in 154 countries of the world, in Ukraine and on the scientific map of the world; and 2) to unite progressive medical communities to share experiences and help Ukraine in the time of war.

We would like to extend our sincere gratitude to members of the editorial board, who helped in the making of the journal in 2019-2020.

Proudly and confidently, we present our readers with a new issue of our journal. This issue saw the light of day thanks to the extraordinary efforts and incredible responsibility of our authors, reviewers, and editors. Review the detailed report on the 6th International Symposium SMARTLION 2022. Medicine and War, which gathered participating lecturers not just from Ukraine, but also the USA, Germany, France and the UK. View video collections in the annex to the publication to review the unique doctor’s experience under conditions of the terroristic russian-Ukrainian war [1].

We would like to express sincere gratitude to every volunteer for help, solidarity and partnership with Ukrainian doctors and scientists [2,3], as well as physicians who are on the medical frontline in this terroristic war [4]. The cover page of this Issue “The light will overcome the darkness” (author: Ivan Dzis, MD, PhD) reflects our hope for Victory for Ukraine in 2023.

We hope that the activities of our journal will serve as additional weapons for the future of Ukraine, and the editorial team will manage to continue developing the journal next year.

We wish everyone health and victory in 2023!

Glory to Ukraine! Glory to the Heroes!

6ᵗʰ INTERNATIONAL SYMPOSIUM “SMART LION”. MEDICINE AND WAR, OCTOBER 14, 2022

2023-02-06T23:20:32+02:00

On October 14, 2022, the 6ᵗʰ International Symposium “SMART LION” (Science Medicine Arts Research Translational Lviv International Opportunity Network) was held in Lviv with the support from Danylo Halytsky Lviv National Medical University, the Medical Commission of the Shevchenko Scientific Society, Lviv City Council and Lviv Conference Bureau. It was no coincidence that the time of the conference coincided with the Day of Defenders of Ukraine, which include military medical professionals and scientists who equip them with knowledge and skills enabling them to save lives on the battlefield.

The purpose of the symposium was to analyze the new experience of medical professionals and volunteers of Ukraine and its allies, which they acquired during russia's war against Ukraine, develop new methods in medical education, and establish close cooperation between military medical professionals, volunteers, and scientists.

The scientific event was held online via ZOOM. It was also streamed on the Facebook page of the journal “Proceedings of the Shevchenko Scientific Society. Medical Sciences”. The event featured more than 20 speeches by international and domestic scientists and highly qualified specialists. Subsequently, they will serve as a scientific and practical foundation for the development of both military and general medicine. Discussions during the conference clearly showed the need for systemic changes in medical education, supplementing educational programs taking into account the vast experience of military medical professionals, and improving teaching methods.

At the end of the symposium, organizers expressed confidence that most of the deliverables and ideas highlighted during the conference will be successfully implemented. We sincerely thank all defenders and allies of Ukraine, volunteers and medical professionals who save people's lives, sometimes pulling them out of the death grip. With hope for and belief in a bright future, with faith in an upcoming victory and plans to meet again live in Lviv at SMART LION 2023.

SENSORY GATING: BALANCE BETWEEN SLEEP AND LIFE

2023-02-06T23:25:19+02:00

Sleep is a state of the brain characterized by a low level of vigilance and diminished consciousness. The reaction to external stimuli and the processing of stimuli are attenuated in sleep. During sleep, the reticular thalamic nucleus inhibits at the thalamus the flow of sensory activity from the senses to the cerebral cortex. After arrival at the afferent layer of the primary cortex, the reduced sensory flow is analyzed and personalized by layers of the cortical area and transferred by the corticofugal system back to appropriate subdivisions of the thalamus. Thalamic subdivisions target the information of the senses to related areas of the cerebral cortex, where the messages can be (sub)consciously perceived. When necessary, the sleeper can be awakened by a wake-up call, either by stimuli indicating danger or by personally meaningful stimuli. Evidently, sensory gating in sleep has two main features. First, it is favorable for sleep, by reducing the cerebral brain activity through the reticular thalamic nucleus, and second, it is necessary for the sleepers' safety and well-being, by analyzing the preserved activity on essential or dangerous external elements by the corticofugal system. These two features are analyzed in detail in non-REM sleep as well as in REM sleep. In the latter type of sleep, the process of sensory gating is almost similar to non-REM sleep, despite the enigmatic reconstruction of external stimuli into the dream. With the extended corticofugal system, sleep phenomena as the first-night effect, the occurrence of local sleep and wake states, as well as the unihemispheric sleep are comprehensible.

MENINGOCOCCAL INFECTION: A BRIEF REVIEW AND PERSONAL OBSERVATIONS OF THE GENERALIZED FORM OF THE DISEASE IN THREE-MONTH-OLD TWINS

2023-02-06T23:26:59+02:00

Meningococcal infection in the form of sporadic cases or minor group outbreaks, mostly among children, is registered in all countries of the world. The disease has a wide range of clinical manifestations – from an asymptomatic bacterial carriage and acute nasopharyngitis to the rapid development of meningococcemia, acute meningococcal sepsis and meningitis. The article highlights and summarizes literature data related to the incidence of meningococcal infection, ways of infection, features of the clinical course of the disease in the newborn period, and modern views on the problem. A rare clinical case of the development of severe generalized forms of meningococcal infection in 3-month-old twins with a fatal outcome in one child is described. The decisive role in the development of the disease of twins is determined by the way and duration of children’s contact with their father, who has a bacteriologically confirmed (Neisseria meningitidis, biovar C) meningococcal nasopharyngitis. Early diagnosis and treatment of all forms of meningococcal infections are important to prevent the development of GMI. The key method of MI prevention is vaccination.

THE PROFILE OF ANTIBIOTIC PRESCRIPTIONS IN PEDIATRIC OUTPATIENTS: A RETROSPECTIVE OBSERVATIONAL STUDY

2023-02-06T23:31:01+02:00

Background. Antimicrobial therapy is a common practice in pediatrics.

Aim. The main objective was to determine and characterize the profile of antibiotic prescriptions in pediatric outpatients.

Methods. This was a retrospective observational study performed in two pharmacies in Lviv (October 2021). 113 written doctor’s prescriptions for outpatient children were collected.

Results. Antibiotics were administered for 44.2% (95%CI 34.9%–53.9%) of patients. The main reasons for antibiotic prescriptions were acute tonsillitis (30.0%) and acute upper respiratory tract infections (26.0%). Macrolides, cephalosporins, penicillins, and sulfonamides with trimethoprim presented 40.0%, 36.0%, 20.0%, and 4.0% of antibiotic prescriptions, respectively. Antimicrobials from the Access group accounted for 26.0% of antibiotic prescriptions (instead of at least 60.0%, WHO) and antibiotics from the Watch group constituted 74.0% (instead of a maximum of 40.0%, WHO). Antibiotics were prescribed to 61.9% of outpatients with acute upper respiratory tract infections, 93.7% of patients with acute tonsillitis, and 45.5% – with otitis media instead of recommended 0-20% (ESAC-Net). The first-line antibiotics were used in 23.1% of cases of acute upper respiratory infections, 26.7% of cases of acute tonsillitis, and 40.0% of otitis media, which is below the acceptable range (80–100%, ESAC-Net). In total, 22 antibiotic-associated drug-related problems (DRPs) were found in 34.0% of written doctor’s prescriptions with antimicrobials. The most common were: (1) excessive length of therapy (36.4%) and (2) potential drug-drug interactions (31.8%).

Conclusions. The rate of antibiotic prescriptions for children is high and associated with different DRPs. The majority of antibiotic prescription quality indicators are outside the recommended ranges. Thus, effective interventions and campaigns to improve antibiotic therapy in children are needed.

PROLONGED STORAGE OF THAWED RED BLOOD CELLS

2023-02-06T23:36:14+02:00

Introduction. In modern transfusion practice, both in peacetime and in military conditions, red blood cells (RBCs) are widely used as the main component of donor blood. Cryopreserved red blood cells are considered the most safe and high-quality RBC-containing environment. However, the storage period of thawed RBCs after cryopreservation is limited to 24 hours, and significantly complicates their use. Therefore, extending the storage period of thawed RBCs is relevant for the blood service. Research objective: study the RBCs morphological state and functional completeness that were cryopreserved at -40ºС and stored for 7 days at a temperature of +2ºС - +4ºС after thawing.

Materials and methods. The object of the study were RBCs that were cryopreserved at -40ºС and stored for 7 days at a temperature of +2ºС - +4ºС after thawing. Deglycerolization of the thawed red blood cells, cryopreserved at -40ºС, required three time washing by using reverse cytoagglomeration. Thawed RBCs were re-suspended in lactate-sucrose-phosphate solution. After RBC thawing and storage for 7 days (186 doses) in the suspension the following indicators were studied: free hemoglobin, extracellular potassium, adenosine triphosphoric acid (ATP), 2,3-diphosphoglycerate (2,3-DPG), hematocrit, degree of hemoglobin affinity to oxygen (P₅₀,), viscosity coefficient, osmotic stability, electrophoretic mobility of erythrocytes. as well as the total number of cells lost and recovered.

Results. After storage for 7 days of suspension of thawed RBCs at a temperature of +2ºС - +4ºС indicators of free hemoglobin (0,62±0,02 g/l), extracellular potassium (2,7±0,3 mmol/l), hematocrit (0,4±0,02 l/l) were within normal limits. Osmotic resistance (0,46±0,02%), electrophoretic mobility (0,94±0,04 µm·cm·V^-1·s^-1) of RBCs, suspension viscosity factor (5,5±0,20mPa·С) did not exhibit changes in comparison with normal values. High levels of ATP indicators (3,0±0,2 µmol/gHb) and 2,3-DPG (10,5±1,3 µmol/gHb) were established. Indicator Р₅₀ (24,1±1,3 hPa) corresponded to low hemoglobine affinity for oxygen. After 7-day storage at +2ºС - +4ºС total cell loss was insignificant and amounted to 5,6±0,4%. High percentage of viable thawed RBCs 94,4±0,5% was shown.

Conclusions. Deglycerolization of thawed red blood cells, cryopreserved at -40ºС, by reverse cytoagglomeration, as well as use of lactate-sucrose-phosphate solution for washed RBCs resuspending promote prolongation of thawed RBCs storage period up to 7 days at +2ºС - +4ºС in viable condition.

RELATIONSHIP OF APOPTOSIS AND SECONDARY NECROSIS OF LEUCOCYTES WITH ACTIVITY OF DISEASE AND CLINICAL MANIFESTATION IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2022-12-29T20:35:20+02:00

The presence of several different autoantibodies (auto-AT) at the same time is a specific peculiarity of the “autoantibody profile” of SLE (systemic lupus erythematosus). It is known that the induction of auto-AT formation involves both nonspecific and antigen-specific immunoregulatory disorders. In apoptosis, the primary changes in the cell membrane composition or/and the excretion of intracellular compounds into the intercellular milieu lead to an inflammatory reaction.

The purpose of the study was to highlight the connection between apoptosis and secondary necrosis of granulocytes and mononuclear (lymphocytes and monocytes) with inflammation activity in patients with SLE to improve diagnosis and basic therapy efficacy. In patients with SLE, secondary necrosis of granulocytes was 3.4 times higher compared to healthy control. Moreover, the level of apoptotic monocytes was 1.87 times higher, and secondary necrosis of monocytes was 5.58 times higher than healthy control. The secondary necrosis of lymphocytes was higher 9.0 times than in the case of healthy control. The usage of Apolect technology in patients with SLE allows differentiating various cell types of immunological inflammation with the analysis of the degree of apoptosis and secondary necrosis of immunocompetent cells (granulocytes, monocytes, lymphocytes) to determine the aggressiveness of cytostatic therapy and predict the development of complications of this disease.

PREDICTIVE NOMOGRAM OF THE RISK OF PERITONEAL RELAPSE FOLLOWING RADICAL GASTRIC CANCER SURGERY

2022-12-29T20:35:27+02:00

Background and objectives. Peritoneal relapse (PR) is the most common pattern of gastric cancer (GC) recurrence after radical treatment. Currently, a variety of adjuvant intraperitoneal chemotherapy methods are being tested for their efficacy in reducing the level of PR.

Methods. The radical treatment results of 226 patients with localized and locally-advanced GC have been analyzed. In order to select a group of patients with indications for adjuvant intraperitoneal therapy, a study of independent predictive factors and the development of a predictive PR nomogram for gastric cancer was completed.

Results. As a result of the analysis of about three dozen potential factors in mono- and multivariate analysis, the impact on PR risk was confirmed by 4 independent predictive factors, namely: serosal invasion and its size (HR 9.36, p <0.001), morphological type according to Lauren (HR 5.3, p <0.001), index of regional lymph node involvement (HR 2.23, p = 0.015) and localization of the tumor in the stomach (HR 3.98, p <0,001).

Conclusions. A predictive PR risk nomogram of gastric cancer after radical surgical treatment has been developed based on the identified independent factors, and it is of great clinical importance as a tool for segregating patients who require adjuvant intraperitoneal chemotherapy.

COVID-19 PULMONARY PATHOLOGY: A MULTI-INSTITUTIONAL AUTOPSY COHORT FROM LVIV AND LVIV REGION

2022-12-29T20:35:33+02:00

Introduction. In Ukraine 2,2 million coronavirus disease-19 (COVID-19) cases are reported now with 51,8 thousand deaths.

Methods. A retrospective analysis of 1036 consecutive autopsies at COVID-19 in 2020 was conducted on the basis of the Lviv Regional Office for Autopsy and Lviv Railway Clinical Hospital. The diagnosis of COVID-19 was confirmed by clinical signs of viral pneumonia, nasopharyngeal smear analysis, and radiological changes. Statistical study was performed with IBM SPSS Statistics 24.0.

Results. The majority (72.4%) were elderly (after 60 y.o., fig.2) males (54.1%) and females (45.9%), with age range from 19 to 93 years (mean age 66.9 ± 0.4 years). All examined patients had pneumonia, which was detected during a clinical examination with CT diagnosis and confirmed at autopsy. Acute phase of pneumonia was diagnosed in 18.5% of cases, proliferative phase – in 18.6%, fibrotic phase – in 5.9%. And in 53.5% of cases prevailed signs of progressive fibrosis associated with exudative lesions. COVID-19 was single original cause of death in 88.7% cases. In the lungs were identified: the typical virus-induced changes in epithelial cells of the trachea, bronchi, bronchioles and alveoli (100%, n=1036); different phases of diffuse alveolar damage in majority of cases (96.5%); manifestations of innate/adaptive immunity were described; pathological changes in microvasculature (large vessel thrombi were detected in 37.9%).

Conclusion. Our study results prove the importance of pathological examination of tissues during autopsies to determine the pathophysiological mechanisms and underlying causes of death of patients with COVID-19.

DETECTION OF SPECIFIC ANTIBODIES USING MPT83-MPT63 FUSION PROTEIN IN PATIENTS WITH DESTRUCTIVE PULMONARY TUBERCULOSIS

2022-12-29T20:35:40+02:00

Introduction. The development of effective test systems for tuberculosis (TB) diagnosis and the study of factors influencing their sensitivity and specificity constitute urgent tasks given the unstable epidemiological situation with TB in Ukraine and the world.

The study aimed to determine the clinical and laboratory features of pulmonary TB that may affect the sensitivity of IgG TB antibody detection in human serum by the immuno-enzyme test system “IB-Chem Anti-Mycobacterium tuberculosis”, which was developed at the Palladin Institute of Biochemistry of the NAS of Ukraine and uses recombinant fusion protein MPT83-MPT63 as an antigen.

Methods. Sera of 62 patients with chemoresistant pulmonary TB were tested for TB antibodies using an indirect enzyme-linked immunosorbent assay. Dependence of the obtained results on clinical symptoms and signs of pulmonary TB, the frequency of different types of antibiotic resistance, cellular and biochemical parameters of blood were analysed.

Results. The sensitivity of the immuno-enzyme test system “IB-Chem Anti-Mycobacterium tuberculosis” for detecting human IgG TB antibodies using recombinant fusion protein MPT83-MPT63 was found to constitute 71.0%; it reached 81.3% in patients with destructive pulmonary TB.

Conclusion. The developed test system should primarily be used for the TB diagnosis in patients with destructive changes in the lungs where the diagnostic efficiency of this test system reaches high indicators.

MEDICAL AND SOCIAL SUBSTANTIATION OF THE PROBLEM OF QUALITY OF LIFE OF PATIENTS WITH PROSTATE CANCER

2023-02-07T18:43:50+02:00

Introduction. Prostate cancer (PC) is one of the most common cancers among men over 50. Nowadays in Ukraine, the number of new cases of PC tends to increase according to statistics.

Objectives. The aim of the study is to identify the main problems in the life quality of patients with PC (C61) to optimize medical care for them.

Methods. The main aspects of the quality of life of PC patients are studied by means of EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires.

Results. In Ukraine, as of the pre-war period (November 2021 – February 2022), the quality of life of patients with PC amounted to 52.31 on a 100-point scale. The worst indicators within the functional scale QLQ-C30 belonged to the subscale “Role functioning” (65.44). According to the QLQ-C30 symptoms scale, the highest score among the complaints of Ukrainian patients is fatigue (48.58). Given the results of our research on the QLQ-PR25 symptom scale, patients with PC were the most worried about “Urinary symptoms”, with a score of 38.54 out of 100. According to the functional scale QLQ-PR25, the worst indicators were for “Sexual activity”, which is equal to 32.22 points on a 100-point scale.

Conclusions. It is important to create socio-psychological support for patients with PC and their families, which will include the development and implementation of standardized psychological care at all stages of diagnosis, treatment and rehabilitation.

STATE OF THE GUT MICROBIOTA IN PATIENTS WITH METABOLIC-ASSOCIATED FATTY LIVER DISEASE WITH TYPE 2 DIABETES MELLITUS

2023-02-07T19:20:41+02:00

Introduction. One of the frequent complications of the type 2 diabetes mellitus (T2DM) is a metabolic-associated fatty liver disease (MAFLD). Aim. To study the composition of gut microbiota in patients with a combination of T2DM and MAFLD and to compare it with the microbiota in isolated T2DM and MAFLD.

Methods. 111 patients were studied. The main group consisted of 56 patients with a combination of MAFLD and T2DM; the 1st group included 28 patients with MAFLD and the 2nd - 27 patients with T2DM. The control group consisted of 30 practically healthy people. Diagnosis was made by steatometry, shear wave elastography, lactulose H2 breath test, qPCR of feces using primers targeting the 16S rRNA gene, and stool culture.

Results. In the the main group SIBO was found in 48.2%, in 1st – 35.7%, in 2nd – 33.3%, compared to 10% in the control group. When compared with healthy people, the number of "other" microorganisms significantly increased in the group with isolated T2DM and Clostridium, Proteus and Candida were cultured; in the case of isolated MAFLD, a decrease in Bacteroidetes and an increase in the Firmicutes/Bacteroidetes ratio, as well as an increase in Klebsiella and Clostridium. In the main group, an increase in Actinobacteria, "other" microorganisms, a ratio of Firmicutes/Bacteroidetes and a decrease in Bacteroidetes were found, when cultured - an increase in Clostridium, Klebsiella and Candida.

Conclusions. Only the group of MAFLD with T2DM was characterized by increased Actinobacteria; decreased absolute number of Bifidobacterium and Lactobacillus and increased Escherichia, including with altered enzymatic properties in the stool culture.

BIOMETRIC AND BIOCHEMICAL INDICATORS AS FACTORS OF METABOLIC RISK AMONG FOOTWEAR INDUSTRY WORKERS: THE RELATIONSHIP WITH WORK CONDITIONS

2023-02-07T19:27:13+02:00

Introduction. The presence of a connection of metabolic syndrome (MetS) with working conditions in various professional groups dictates the necessity to use diagnostics of its presymptomatic phase in the practice of occupational medicine.

The aim was to analyze the indices of anthropometric screening and blood lipid spectre among footwear industry workers with the aim of detecting early metabolic disorders..

Methods. It was conducted a cross-sectional study of 200 footwear industry workers: 119 male (59.5%) and 81 female (40.5%) aged 25 to 62. All workers were divided into groups according to their professional working experience: under 5 years, 6-14 years, 15-21 years.Anthropometric profile indexes were determined: body height (BH), body weight (BW), waist circumference (WC) and hip circumference (HC), body mass index (BMI), waist-to-hip ratio (WHR). Biochemical indicators of the lipid body balance were assessed by total cholesterol (TCH), triglycerides (TG), high density lipoprotein cholesterol (HDL CH), low density lipoprotein cholesterol (LDL CH), atherogenic coefficient (AC).

Results: Visceral obesity was detected among 60.56% of female workers and 30.91% male workers. It has been found that the increasing tendency of WHR was associated with the increase of working experience. The share of workers with normal body weight according to BMI accounts for 39.7-41.18%.

Lipid metabolism indices among workers with working experience under 5 years do not differ from referent norm and are characterized as dyslipidemia in the experience group of 15-21 years. The signs of MetS development were detected in 5.0-5.26% (experience group under 5 years), 10.7-11.1% (6-14 years), and 23.5-31.8% (15-21 years) of footwear industry workers. It was higher in male workers (18.3%), than female (11.7%).

Conclusions. Professional factors in footwear industry increase the risk of developing MetS components. Inclusion of anthropometric and lipid statuses assessments into the monitoring of health state will help to detect individuals with early dysmetabolic disturbances and to develop preventive instruments directed at saving metabolic health of workers in the branch.

ASSESSMENT OF RISK FACTORS FOR DEVELOPMENT OF BIRTH DEFECTS AMONG NEWBORNS IN LVIV REGION IN 2002-2020 (PART 1)

2023-02-07T19:47:35+02:00

Introduction. The frequency of children with birth defects (BD) according to the WHO reaches 4-6% of the total number of newborns.

Objectives. The purpose of this work was to determine the probable risk factors for “model” BDs in newborns.

Methods. Analysis of clinical-epidemiological and medical-statistic data from the primary documentation on newborns in 2002-2020 with BDs by the “case-control” method filling out registration cards in maternity hospitals of Lviv region was conducted.

Results. There were filled 1204 healthy newborns’ cards and 1211 cards of newborns with BDs. In the structure of “model” BD, the deformations of the musculoskeletal system composed 272 (22.5%) cases, clefts of the lip and palate accounted for 193 (15.9%) cases, chromosomal abnormalities comprised 174 (14.4%) cases. We observed statistically significant risk (р<0.05) of BDs for newborns with increased numbers of pregnancies in mothers. There was a statistically significant difference [OR=3.97; 95%CI: 1.97; 7.99] in the medical history relative to stillbirths (3.2%) in mothers with BD newborns as compared to women in the control group (0.8%). The prevalence of pathological structure of the placenta in women of the study group (32.8%) was higher [OR=3.71; 95%CI:3.01; 4.56] than in those of the control group (16.8%).

Mothers of both groups showed no statistically significant difference in anemia, preeclampsia, the interval between pregnancies, and the number of abortions and miscarriages (p> 0.05).

Conclusions. Further research in this area should be directed to determine the contributions of genetic factors in BD occurrence, considering the genealogical history of each family.

AN EXPLORATORY STUDY OF PHYSIOLOGICAL AND BIOCHEMICAL PARAMETERS TO IDENTIFY SIMPLE, ROBUST AND RELEVANT BIOMARKERS FOR THERAPEUTIC INTERVENTIONS FOR PTSD: STUDY RATIONALE, KEY ELEMENTS OF DESIGN AND A CONTEXT OF WAR IN UKRAINE

2023-02-07T19:38:51+02:00

Introduction. The incidence of post-traumatic stress disorder (PTSD) is increasing due to war in Ukraine is of growing importance as this disorder is a serious risk factor for alcohol/drug abuse, depression, suicide and functional dysregulation of internal organs, in particular cardiovascular, endocrine, immune systems. PTSD can also lead to social inadaptation in family and at work. This makes PTSD a very important social problem in Ukraine that causes significant economic damage, since most of the PTSD patients are young and in working age.

Objectives. The purpose of this paper is to describe the rationale, key elements of design, methodology and future prospects of the ongoing project “Exploratory study of health related physiological and biochemical parameters to identify simple, robust and relevant biomarkers for therapeutic interventions for PTSD patients”.

Methods. Short time ECG records (5 minutes in supine position and 6 minutes in orthostatic test) recorded by “CARDIOLAB” (Kharkiv, Ukraine) digital ECG device with software to analyze HRV was used to calculate time-domain and frequency-domain parameters of HRV.

Results. The pattern of HRV changes indicates suppression of parasympathetic activity, low overall spectral power and dominance of sympathetic branch of autonomic nervous system in participants with PTSD.

Conclusions. PTSD has no effective treatment so far and the best clinical practices rarely reach efficacy of 50%. The realization of the exploratory clinical study described in this paper will provide insights in the mechanisms underlying systemic consequences of PTSD and will build the evidence enabling clinical trial(s) for studying treatment intervention for patients with PTSD.

TREATMENT OF COMBAT SURGICAL TRAUMA OF THE LIMBS IN THE CONDITIONS OF MODERN WAR

2023-02-07T19:51:17+02:00

Among the total number of wounded who entered the Military Medical Clinical Center of the Western Region from February to September 2022, combat injury to the limbs was in 63.3%. Bullet wounds caused combat injury to the limbs in 10.4%, shrapnel and mine-explosive – in 68.1%, explosive injury – in 21.5%. At the second role of medical care, emergency surgical interventions were performed on the wounded, immobilization of bone fractures with an external fixation and anti-shock therapy. At the third and fourth roles – the treatment of the wounded consisted in the use of a multidisciplinary approach with the involvement of doctors of various specialties, first of all, general surgeons, traumatologists, vascular, plastic surgeons and anesthesiologists. The most frequent surgical intervention was repeatened and secondary debridment of gunshot wounds, which was required by 93% of the wounded. The main pathogens that vegetated in wounds were Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter aerogenes, Proteus vulgaris, Enterococcus faecalis with high levels of microbial contamination – 10⁴-10⁸/g in tissues., Various types of plastics were used to close soft tissue defects, according to the rule of the reconstruction ladder. After healing a soft tissue wound to determine the timing of replacing the method of fixing fractures with internal osteosynthesis, were analyzed clinical and laboratory parameters and assessed the risks of complications. The main causes of amputations of the limbs were common defects in soft tissue and bones, which were not subject to reconstruction with no prognosis for bone fusion and progression of the infectious-necrotic process.

UNIVERSITY MEDICAL CENTER SCHLESWIG-HOLSTEIN – CONTRIBUTION IN DEVELOPMENT OF UKRAINIAN MEDICINE AND SUPPORT IN THE WAR TIME

2023-02-07T19:55:34+02:00

The key areas of scientific and practical cooperation between the University of Lübeck, the University Clinic of Schleswig-Holstein (Germany), Danylo Halytsky Lviv National Medical University and hospitals of Ukraine are presented. The active position of the University Clinic Schleswig-Holstein (UKSH) made it possible to organize the transfer of significant humanitarian aid to Ukraine during the full-scale invasion of Russia.

THE WORK OF AN ALLERGIST AND SCIENTIST DURING THE FULL-SCALE WAR IN UKRAINE

2023-02-07T20:03:34+02:00

The article provides a brief description of the heroic work of Ukrainian physicians- volunteers, including allergists, during Russia's brutal war against Ukraine. Examples of the evacuation of Ukrainian residents, including patients with bronchial asthma, respiratory allergies, COVID-19 and other diseases that worsened under the influence of stress, are given. It is briefly described about the destroyed hospitals throughout the territory of Ukraine. In such a critical situation, Ukrainian doctors continue to provide assistance to patients, improve their scientific level, each in his place does everything to Victory. The light will defeat the darkness!

DISTANCE LEARNING EXPERIENCE FOR MEDICAL STUDENTS DURING A PANDEMIC AND MARTIAL LAW

2023-02-07T20:13:17+02:00

Being unable to use the usual form of education focused mainly on the teacher, higher education institutions are forced to introduce rules and instructions that would be focused on education seekers and help facilitate the perception of educational material. The consequence of the current situation is the growth of the general interest in distance learning during the pandemic, which later continued during the Russian aggression. In the case of clinical disciplines, certain features determine the use of methods and elements of simulation and individualized training for students of medical faculties, interns and students of the faculty of postgraduate education. Objective. To study the peculiarities of distance learning during the pandemic of acute respiratory disease COVID-19, caused by SARS-CoV-2, and martial law, the identification of the main determinants for the successful arrangement of the online education process. The logical method was used to create instructions for optimizing the conditions and means of learning and teaching. The article reflects the peculiarities of distance learning, introduced during the pandemic and continued under circumstances of martial law caused by the armed aggression of the Russian Federation. Positive aspects of an adequate visual presentation of information during clinical lectures are determined. The results of the survey conducted to determine the attitude of education seekers and scientific and teaching staff to distance learning are presented to identify the shortcomings of this form of education and the development and implementation of Internet resources based on methods and tools that can be used in training to increase the level of student success. Based on its results, the most important features that have the biggest effect on the quality of education were identified.

VOLODYMYR NICOLAS BANDERA (11.12.1932 – 23.10.2022)

2022-12-30T23:42:11+02:00

Лікарська комісія Наукового товариства Шевченка (НТШ) сьогодні в жалобі: прощаємося з Дійсним членом НТШ (1972) професором Володимиром Бандерою. Відомий вчений, освітянин і меценат, життєве перконання якого: «Патріотизм – це віддана праця» прекрасно відтворює зміст його життя. Володимир Бандера – великий УКРАЇНЕЦЬ, щедро ділився знаннями та радів кожному поступу, навіть маленькому кроку до незалежності України. Увесь вік професор Бандера невтомно та жертовно працював для своєї Батьківщини – розбудови України, повернення її в коло цивілізованих країн.

Володимир Бандера народився в Стрию (тепер Україна) в сім’ї Йосифа та Марії Бандери. Через події Другої світової війни продовжив навчання в таборі для переміщених осіб у Міттенвальді (Німеччина), а згодом в США, де з відзнакою закінчив Університет Коннектикуту. Завжди відмінник у навчанні, талановитий скрипаль, щедро обдарований Богом іншими талантами, Володимир Бандера у 1960 році отримав ступінь доктора філософії з міжнародної економіки та фінансів у Каліфорнійському університеті Берклі. Професор Бандера був директором Інституту бізнесу Університету Темпл. Згодом працював професором у Бостоні, Філадельфії (Університет Темпл). Тричі стипендіат фонду Фулбрайт, був запрошеним професором у Канаді, Шотландії, Італії та Японії. Його науковий доробок отримав широке визнання у світі, він також автор і редактор статей у «Encyclopedia of Ukraine». Володимир Бандера був активним членом численних наукових і громадських товариств, включно з НТШ США з 1970 року. Від 1986-1988, 1998-2002, 2005-2007 – член Контрольної комісії НТШ США.

З перших днів української незалежності професор В. Бандера як стипендіат програми Фулбрайт (1992) став запрошеним професором Львівського національного університету імені Івана Франка (1994-2005). Невимушений і водночас чіткий стиль спілкування зі студентами був особливою «родзинкою» його викладацької майстерності, а численні проєкти – літня школа міжнародної економіки, наукові семінари – набули популярності. Товариськість та бажання допомогти добрим ділом чи порадою – важливі риси характеру Володимира Бандери, а своєму життєвому кредо: «Працювати для України» – вірно служив все життя.

Розуміючи важливість освіти для майбутньої України і як керівник освітньої програми Української Федерації Америки, Володимир Бандера започаткував численні навчальні та видавничі проєкти новітньої літератури не лише з економіки, а також медицини й екології, яких не було в Україні. Серед великої кількості науково-практичних видань, які побачили світ за його ініціативи та допомоги, – перші україномовні переклади всесвітньовідомих підручників, які використовують для освіти майбутніх лікарів, видання сучасної медико-біологічної літератури найвищого наукового рівня, підручник з анатомії та фізіології «Людина» (DK Publishing (Dorling Kindersley)), 20-те видання підручника професора Каліфорнійського університету Вільяма Френсіса Ґанонґа «Фізіологія людини» (Lange Medical Books/McGraw-Hill) та багато інших. Найпомітнішими відмінностями цих книг стали досконалість викладу, репрезентативність ілюстрацій, гармонійна інтеграція фундаментальних і клінічних наук. Саме на них сфорувалось покоління українських лікарів, які зараз разом з Українськими збройними силами, що боронять Вітчизну від лютого ворога, тримають медичний фронт вже дев’ятий місяць.

Великий життєлюб Володимир Бандера був щасливим у родинному житті, разом з дружиною Софією Ніною (з дому Заячківська) виховали трьох дітей, яких захопили любов’ю до України та навчили цінувати культуру, музику, науку.

Патріотизм, наснага, високий фаховий та організаційний професіоналізм і доброчинність Володимира Бандери назавжди залишаться в нашій пам’яті!

Вічна пам’ять!

Оксана Заячківська

Дійсний член Наукового товариства імені Шевченка, професор, доктор медичних наук