https://ifnmujournal.com/acm/issue/feedArchive of Clinical Medicine2024-03-08T09:10:34+02:00Popadynets O.H.acm@ifnmu.edu.uaOpen Journal Systems<p>The Journal of Research and Practice “Archive of Clinical Medicine” is a journal covering innovative research and practice in medicine. It publishes the results of original clinical research, review papers, case reports and the results in sphere of medical education.</p> <div class="page" title="Page 2"> <div class="layoutArea"> <div class="column"> <p>The Journal is on the <a href="http://mon.gov.ua/activity/nauka/atestacziya-kadriv-vishhoyi-kvalifikacziyi/perelik-vidan/perelik-naukovix-faxovix-vidan.html" target="_blank" rel="noopener">List of Specialized Editions</a> in which the main results of theses are allowed to be published (The Order of Ministry of Education and Science of Ukraine of 16.05.2016, No 515) </p> </div> </div> </div> <p>p-ISSN <strong>2312-7007 (<span lang="EN-GB">Ukrainian ed. Print)</span></strong></p> <p>e-ISSN <strong><span lang="EN-US">2414-9853 (<strong><span lang="EN-GB">English ed. Online)</span></strong></span></strong></p>https://ifnmujournal.com/acm/article/view/acm202328Changes in Endogenous Intoxication and Antioxidant Defense System Markers in Patients with Tumor-Induced Acute Colonic Obstruction2024-03-08T09:10:33+02:00Dmytro Bachynskyibachinskiy28@gmail.comVasyl Skrypkoskrypko.vasyl@gmail.com<p>A comprehensive evaluation of clinical and biochemical markers defining the status of endotoxemia in patients diagnosed with acute colonic obstruction (ACO) was conducted. The findings revealed that advancing stages of ACO corresponded to an increase in serum levels of endogenous intoxication markers and a simultaneous decrease in antioxidant defense system (ADS) markers.</p> <p><strong>The aim of the study</strong> was to analyze changes in endogenous intoxication and ADS markers in patients with tumor-induced ACO throughout the disease progression and evaluate the outcomes.</p> <p><strong>Materials and Methods. </strong>The study is based on examining serum levels of endogenous intoxication markers, including middle weight molecules (MWM), products of lipid peroxidation (LPO) - conjugated dienes (CD), malonaldehyde (MA), protein oxidative modification (POM), and key ADS markers, specifically superoxide dismutase (SOD), catalase (CAT), and ceruloplasmin (CP), in 155 patients with ACO throughout the disease progression and 20 apparently healthy individuals.</p> <p><strong>Results.</strong> Upon patient admission to the hospital, the duration of ACO was found to correlate with an increase in endogenous intoxication markers and a decrease in antioxidant defense markers. Depending on ACO stage, MWM levels were 0.42 (0.38; 0.43) IU, 0.56 (0.51; 0.58) IU, and 0.72 (0.69; 0.73) IU, respectively (р<sub>1</sub><0.01, р<sub>2</sub><0.01, р<sub>3</sub><0.01), with a normal range of 0.23 (0.18; 0.25) IU. In the compensated stage of ACO, MA levels significantly increased compared to the control group, reaching 6.39 (6.25; 6.42) nmol/mL (р<sub>1</sub><0.001, р<sub>2</sub><0.01, р<sub>3</sub><0.05). Additionally, with the progression of the disease, a gradual increase in MA levels up to 6.39 (6.25; 6.42) nmol/mL, 7.88 (7.62; 7.92) nmol/mL, and 8.11 (8.05; 8.15) nmol/mL, respectively, was noted (р<sub>1</sub><0.001, р<sub>2</sub><0.01, р<sub>3</sub><0.05), with a normal range of 3.14 (2.58; 3.17) nmol/mL. Similar trend was observed in serum CD levels - 3.11 (3.02; 3.18) IU, 3.69 (3.52; 3.72) IU, and 4.69 (4.53; 4.82) IU, respectively, with a normal range of 1.41 (1.32; 1.46) IU (р<sub>1</sub><0.01, р<sub>2</sub><0.01, р<sub>3</sub><0.01). The study of LPO intensity via the optical density of aldehyde and ketone derivatives of neutral and basic dinitrophenylhydrazones (POM 356, POM 370, POM 430, POM 530) revealed an increase in POM product levels with the disease progression compared to the control group (р<sub>1</sub><0.001, р<sub>2</sub><0.01, р<sub>3</sub><0.01). The analysis of the ADS showed an opposite trend, characterized by a significant decrease in marker levels. In patients with different ACO stages, serum CAT levels were 8.08 (7.95; 8.12) Н2О2/mL, 6.32 (6.25;6.41) Н2О2/mL, and 5.67 (5.59; 5.75) Н2О2/mL, respectively, with a normal range of 12.36 (12.21; 12.55) Н2О2/ml (р<sub>1</sub><0.001, р<sub>2</sub><0.01, р<sub>3</sub><0.01), while SOD concentration decreased with the disease progression as well - 42.43 (31.75; 51.84) IU, 35.65 (24.72; 45.53) IU, and 32.18 (18.72; 41.15) IU, respectively, with a normal range of 63.60 (54.41; 74.56) IU (р<sub>1</sub><0.001, р<sub>2</sub><0.01, р<sub>3</sub><0.01). In the compensated stage of ACO, CP level exceeded the normal value - 39.21 (38.92; 39.41) IU, with a normal range of 28.9 (28.4; 29.1) IU, indicating a compensatory defensive response of the body to a dramatic increase in LPO products. CP reserves, however, were depleted with the disease progression and a consistent decrease in this marker was subsequently observed: 19.10 (18.91; 19.23) IU in the subcompensated stage and 16.12 (16.01; 16.15) IU in the decompensated stage (р<sub>1</sub><0.001, р<sub>2</sub><0.01, р<sub>3</sub><0.01).</p> <p><strong>Conclusions. </strong>As a systemic process that induces various metabolic homeostasis disorders, endogenous intoxication serves as the pathogenetic foundation for the development of multiple organ failure in ACO patients. With ACO progression, endogenous intoxication caused an increase in LPO and POM activity, resulting in elevation of highly toxic middle-molecular weight substances, concurrently accompanied by a decline in the AOS activity.</p>2024-03-07T12:13:23+02:00Copyright (c) 2024 Dmytro Bachynskyi, Vasyl Skrypkohttps://ifnmujournal.com/acm/article/view/acm2023211Features of the Dermatoglyphic Foot Pattern in Suicider Males2024-03-08T09:10:33+02:00Valeriia Chadiukvchadiuk@ifnmu.edu.uaNataliia Kozannmkozan@gmail.com<p>Since suicide is one of the most common types of violent death among people of working age (including military personnel) and children, it is necessary to conduct in-depth studies of the structure of skin patterns in a group of people with completed suicide in order to develop methods of active suicide prevention. In order to determine the propensity to commit suicide, the dermatoglyphs of the distal phalanges and metacarpal pads of the toes of 138 male subjects aged 18 to 59 years who committed suicide and 100 control subjects aged 18 to 59 years were studied. The type of pattern (arc, tibial or fibular loop, curl, complex pattern), delta and comb counts were determined. It was found that the suicide group differs from the control group mainly in a higher number of interruptions (ending X) of the main plantar lines A, B and C; an increase in the frequency of arc patterns on most toes of both feet with a degree of reliability; a decrease in the frequency of curls on the third toe of the left foot to 44.5±11.2 (p<0.001) and an increase in the frequency of this pattern on the second toes of both feet; an increase in the value of the comb count in the area of the tibial edge of the foot, with a decrease in the values near the fibular edge of the foot.</p>2024-03-07T12:16:30+02:00Copyright (c) 2024 Valeriia Chadiuk, Nataliia Kozanhttps://ifnmujournal.com/acm/article/view/acm2023212Dermatoglyphic Phenotype in Patients with Cardiovascular Disease2024-03-08T09:10:33+02:00Serhii Fedorovsfedorov@ifnmu.edu.uaNataliia Voronych-Semchenkonvoronych@ifnmu.edu.uaVasyl Ivanochkovivanochko@ifnmu.edu.uaAndrii Hrechynahrechyn@ifnmu.edu.uaI. Kozannmkozan@gmail.comV. Liampelnmkozan@gmail.com<p><strong>Introduction. </strong>Since the predisposition to develop cardiovascular disease is genetically determined, it can be assumed that there are phenotypic features (in particular, dermatoglyphic) that allow predicting the predisposition to develop acute myocardial infarction (MI).</p> <p><strong>The aim of the study</strong> was to determine the dermatoglyphic phenotype in patients with myocardial infarction.</p> <p><strong>Materials and methods</strong>. The object of the study was dermatoglyphs of distal phalanges of the fingers obtained from 60 male subjects (30 patients with myocardial infarction and 30 healthy men without cardiovascular pathology as a control group). The dermatoglyphic method and the method of statistical analysis were used.</p> <p><strong>Results</strong><strong>. </strong>It was found that patients with MI had a higher frequency of curl patterns, but a lower frequency of ulnar and radial loops and arc patterns compared to the control group. The value of the comb count in patients with MI was lower than in the control group (p>0.05). The total comb count of the palmar fields a-b, c-d was higher, and the fields b-c were lower in patients with MI than in the control group. The mean value of the angle Аtd on both hands was higher in patients with MI than in the control group. Palm patterns and folds showed no significant differences between the groups.</p> <p><strong>Conclusions</strong></p> <p>The results of this study can be used to standardize the dermatoglyphic pattern of the Ukrainian population and identify individuals prone to MI.</p>2024-03-07T12:17:48+02:00Copyright (c) 2024 Serhii Fedorov, Nataliia Voronych-Semchenko, Vasyl Ivanochko, Andrii Hrechyn, I. Kozan, V. Liampelhttps://ifnmujournal.com/acm/article/view/acm202324Indicators of Mineral Metabolism in the Oral Fluid in Patients with Gastroesophageal Reflux Disease2024-03-08T09:10:33+02:00Oksana Kerziukoksanakerzyuk@gmail.comMykola Rozhkomrozhko@ifnmu.edu.ua<p>Disruption of the digestive system in the gastrointestinal tract, namely in gastroesophageal reflux disease, leads to the development of pathological processes in the oral cavity, changing the homeostasis of the viscoelastic gel layer of the esophageal mucosa. Thus, it has been proven that there are reflex connections between the receptor apparatus of the esophageal mucosa and the efferent nerve fibers of the salivary glands, which can be disrupted in GERD. Therefore, saliva is involved in providing effective protection of the esophagus. As a result, the content of mineral components changes significantly: in particular, the level of calcium and enzyme composition.</p> <p>Aim to study the indicators of mineral metabolism: the content of calcium, alkaline, and acid phosphatases in mixed saliva in patients with gastroesophageal reflux disease.</p> <p>Methods 60 patients of various ages who underwent inpatient treatment at the IFNMU University Clinic were examined, where pH-metry was performed to determine acidity. The main group consisted of patients diagnosed with GERD, with decreased and increased acidity. The content of indicators of mineral metabolism in saliva was determined as follows: calcium (Ca) - photometric method with arsenase -111; acid phosphatase (AC) was determined by the Hillman method, alkaline phosphatase (AL) by hydrolysis of p-nitrophenyl phosphate at pH -10.4, release of p-nitrophenol and phosphate. The norm of indicators of mineral metabolism was established on 30 practically healthy volunteers. Statistical processing of data was carried out using the Microsoft Excel program by calculating the arithmetic mean.</p> <p>Conclusions thus, the results obtained indicate that in GERD there is a violation of mineral metabolism in the oral fluid. The oral fluid is the first to come into contact with the reflux agent. This leads to a violation of saliva neutralization, so the study of saliva mineral composition can be considered as an early diagnostic marker for gastroesophageal reflux disease.</p>2024-03-07T12:19:41+02:00Copyright (c) 2024 Oksana Kerzyuk, Mykola Rozhkohttps://ifnmujournal.com/acm/article/view/acm2023210Dermatoglyphic Phenotype of a Person As One of the Criteria For Its Identification2024-03-08T09:10:33+02:00Yulya Kotsyubynskakotsyubynskayz@gmail.comVolodymyr Voloshynovychvvoloshynovych@ifnmu.edu.uaValery Gunasigor.v.gunas@gmail.comMarta Garazdiukkotsyubynskayz@gmail.comV. Fentsykkotsyubynskayz@gmail.comV. Liampelkotsyubynskayz@gmail.com<p><strong>Introduction.</strong> One of the methods used to track the pattern of heredity and variability of human psychophenotypic traits is dermatoglyphic. It is used to study the hereditary patterns that form skin lines on the fingertips, palms, and soles of a person.</p> <p><strong>The aim of the study</strong> to develop expert criteria for the informativeness of dermatoglyphic fingerprints in the system of forensic medical identification of a person.</p> <p><strong>Materials and methods</strong>. The object of the study was fingerprint cards obtained from 460 people (200 women and 260 men) aged 18-59 years living in Ukraine. The dermatoglyphic method and the method of statistical analysis were used.</p> <p><strong>Results</strong><strong>. </strong>It has been established that dermatoglyphic features can be congenitally unchanged (pattern type and its orientation, comb and delta count, rudiments and dysplasias);</p> <p>congenital variables (altitude-latitude index, delta-interphalangeal fold distance, line density); acquired variables (white lines and scars).All these features have not only individual but also group variability.</p> <p><strong>Conclusion.</strong> The proposed forensic classification of dermatoglyphic features does not include individual features of the structure of patterns (minutiae), the appearance of which is largely due to the action of random factors and therefore is valuable for forensic science (fingerprinting).</p>2024-03-07T12:22:15+02:00Copyright (c) 2024 Yulya Kotsyubynska, Volodymyr Voloshynovych, Valery Gunas, Marta Garazdiuk, V. Fentsyk, V. Liampelhttps://ifnmujournal.com/acm/article/view/acm202322Attitudes of Gynecologists on Oral Health Care During the Pregnancy in the Republic of North Macedonia 2024-03-08T09:10:33+02:00Tina Krmzovavesna.ambarkova@gmail.comVesna Ambarkovavesna.ambarkova@gmail.comLidia Gaviclgavic@mefst.hrGoran Dimitrovgorandimi@gmail.comKiro Ivanovskivesna.ambarkova@gmail.com<p><strong>Objective:</strong> The aim of the study was to determine the attitudes and the knowledge of gynecologists in the Republic of North Macedonia on oral health care during the pregnancy.</p> <p><strong>Materials and methods:</strong> The specialists and residents of obstetrics and gynecology in Republic of North Macedonia were involved in this cross-sectional study. The survey was conducted by a questionnaire which consisted the questions on general demographic data and issues related to the attitudes of gynecologists to oral health care of pregnant women. The data were collected from January to May 2022 using Google Form, a link to which questionnaire was send via available social media platforms.</p> <p><strong>Results:</strong> Out of the total number of 120 respondents, 86 (71.64%) were specialists and 34(28.33%) residents of obstetrics and gynecology. As many as 116 (96.67%) gynecologists answered that they advise their patients to visit the dentist for an examination. However, of these 116 gynecologists, 16 (13.33%) responded by advising their patients to postpone a visit to the dentist until the end of the pregnancy. 79 (65.83%) gynecologists answered that their patients complained of gingival bleeding during pregnancy. 48 (40.33%) gynecologists answered that their patients complained about tooth mobility during pregnancy. When respondents were asked where they get information about the connection between oral health and pregnancy, only 27 respondents answered correctly that they receive information from all the above sources. Only 7 (5.83%) respondents, 5 specialists and 2 residents of obstetrics and gynecology know that breastfeeding a child can cause dental caries.</p> <p><strong>Conclusion:</strong> Additional collaboration between gynecologists and doctors of dental medicine is essential in order for every pregnant woman to receive a satisfactory level of dental care and proper education on the preservation of oral health.</p>2024-03-07T12:24:58+02:00Copyright (c) 2024 Tina Krmzova, Vesna Ambarkova, Lidia Gavic, Goran Dimitrov, Kiro Ivanovskihttps://ifnmujournal.com/acm/article/view/acm2023219Peculiarities of the Clinical Picture of Hirschsprung’s Disease in Children of the First Year of Life Taking Into Account the Extent of Aganglionosis2024-03-08T09:10:33+02:00Oleh Kurtashokurtash@ifnmu.edu.uaVasyl Prytulaokurtash@ifnmu.edu.uaVasyl Rybalchenkookurtash@ifnmu.edu.uaHussaini Syed Faizullahokurtash@ifnmu.edu.ua<p><strong>The aim of the work.</strong> To investigate the peculiarities of the clinical course of Hirschsprung’s disease in children of the first year of life and to determine the significance of symptoms in the verification of the disease.</p> <p><strong>Research materials and methods.</strong> Since 1980 up to 2021, at the pediatric surgery clinic of the National Medical University named after O.O. Bohomolets on the basis of the National Children’s Specialized Hospital “OKHMATDYT” and in the pediatric surgery clinic of the Ivano-Frankivsk National Medical University on the basis of the Ivano-Frankivsk Regional Children’s Clinical Hospital, there were examined and treated 483 children of the first year of life suffering from Hirschsprung’s disease.</p> <p><strong>Results of the study.</strong> The clinical manifestation and course of aganglionosis varied in length at the time of hospitalization and depended on the time after birth. During the first month of life, 97 (20.08%) patients were hospitalized; of them 39 (8.07%) patients had an atypical clinical picture due to: colonic atresia in 15 (3.10%), colonic atresia + gastroschisis in 3 ( 0.62%), ileal atresia in 9 (1.86%), esophageal atresia in 3 (0.62%), cleft of the hard and soft palate in 9 (1.86%) patients. Depending on the age, there were 280 (57.97%) patients under 6 months, and 203 (42.03%) patients between 6 months and 1 year. The classic typical clinical picture was in 444 (91.93%) patients, which was characterized by the absence of meconium excretion, abdominal distension in 444 (91.93%) patients, delayed physiological weight gain against the background of nutritional insufficiency with the development of hypotrophy in 327 (67.70%) patients, vomiting of stagnant gastric and intestinal contents in 417 (86.34%) patients. On the other hand, there occurred enterocolitis in 315 (65.22%) patients, toxic megacolon in 16 (3.31%) patients, and anemia of various degrees in 241 (49.89%) patients, among the complications that arose during the examination of patients with Hirschsprung’s disease. According to the results of a comprehensive examination, the following extent of aganglionosis was determined: rectal form in 100 (20.70%) patients, rectosigmoid form – in 192 (39.75%), subtotal – in 150 (31.06%) and total in 41 (8.49%) patients. Concomitant malformations were found in 98 (20.29%) patients: renal malformations were diagnosed in 7 (1.45%) patients, concomitant heart malformations in 18 (3.73%) patients. Associated intraoperative findings were: Meckel’s diverticulum in 5 (1.03%) patients, and congenital cyst of the right ovary in 1 (0.21%) patient. The clinical course was affected by the concomitant malformations: incomplete bowel rotation in 10 (2.07%) patients and internal abdominal hernia in 2 (0.42%) patients.</p> <p><strong>Conclusions.</strong> Clinical manifestations and course of HD primarily depend on the presence of accompanying developmental defects, which may prevail during the examination due to vital disorders. In the clinical course of Hirschsprung’s disease, it is necessary to distinguish between typical and atypical forms. Typical clinical symptoms were in 444 (91.93%), and atypical in 39 (8.07%) patients.</p>2024-03-07T12:25:57+02:00Copyright (c) 2024 Oleh Kurtash, Vasyl Prytula, Vasyl Rybalchenko, Hussaini Syed Faizullahhttps://ifnmujournal.com/acm/article/view/acm202323Perinatal Consequences in Pregnant Women Suffering from Metabolic Syndrome2024-03-08T09:10:33+02:00Iryna Adoninaadonina@mail.comValeria Maricheredavalmar@i.ua<p>The aim of the study was to evaluate perinatal outcomes in pregnant women suffering from metabolic syndrome</p> <p>Material and methods. The study was carried out on the basis of Maternity House No. 7" (Odesa) in 2014-2021. 57 women with metabolic syndrome were examined. Anthropometric parameters, basic metabolism, leptin content and lipid profile, frequency of complications of pregnancy and childbirth were evaluated. Statistical processing was carried out by methods of dispersion and correlation analysis using Statistica 13.0 software (TIBCO, USA).</p> <p>Research results.</p> <p>The average age of the examined women was 27.4±1.1 years. Of them, 16 (28.1%) pregnant women were primiparous, and 41 (71.9%) pregnant women gave birth again. BMI in all women was above 25 kg/m2 (on average 29.2±0.6 kg/m2) with a fat content of 47.3±2.4%. During pregnancy, leptin level was on average 39.3±1.6 ng/ml, LDL content was 1.8±0.1 mmol/l. The presence of metabolic syndrome significantly increased the frequency of obstetric and perinatal complications. The possible relationship between the identified disorders and qualitative changes in the intestinal microbiome is discussed.</p> <p>Conclusions:</p> <ol> <li class="show">In women with manifested metabolic syndrome, the course of pregnancy was complicated by preeclampsia in 24.6% of cases, placental dysfunction in 29.8% of cases. The threat of premature birth occurred in 40.4%, gestational diabetes – in 31.6% of women.</li> <li class="show">With metabolic syndrome, the frequency of operative delivery increases to 35.1%. The main indications for a cesarean section were a clinically narrow pelvis, a severe form of preeclampsia, and weakness of labor that cannot be corrected with medication.</li> <li class="show">During childbirth, women in labor with metabolic syndrome often experience such complications as weakness of labor (19.3%), premature discharge of amniotic fluid (24.6%). The main complication of the postpartum period was subinvolution of the uterus (15.8%).</li> <li class="show">Most of the children born had signs of macrosomia, which closely depended on leptin concentration (r=-0.31).</li> <li class="show">The proven existence of a strong correlation between the level of leptin production and LDL (rs=0.76).</li> </ol>2024-03-07T12:26:52+02:00Copyright (c) 2024 Iryna Adonina, Valeria Maricheredahttps://ifnmujournal.com/acm/article/view/acm202326Optimization of Diagnostics and Treatment of Nasopharyngeal Cysts2024-03-08T09:10:33+02:00Diana Orishchakdiana-lor@i.ua Nataliia Vasyliuknvasyliuk@ifnmu.edu.uaOstap Orishchakorishchak@ifnmu.edu.uaNatalia Aleksandruk naleksandruk@ifnmu.edu.ua<p>Nasopharyngeal cysts are typically benign, congenital lesions filled with fluid and encapsulated from surrounding tissues. Both children and adults may present with clinical signs.</p> <p><strong>The aim of the study</strong> was to improve the efficiency of diagnostics and treatment of nasopharyngeal cysts in adults based on the differential diagnosis.</p> <p><strong>Materials</strong> <strong>and</strong> <strong>Methods. </strong>The study was carried out at the Department of Otolaryngology with the Course of Head and Neck Surgery, Ivano-Frankivsk National Medical University, Ukraine, and encompassed both outpatient and inpatient-to-outpatient observations. Fifteen (9 females, 6 males) patients with nasopharyngeal cysts at the age of 28 to 51 years were examined. All patients underwent a comprehensive assessment, including a thorough evaluation of their medical history, a standard examination of the ears, nose, and throat (ENT) using conventional and optical techniques, alongside computed tomography (CT) of the nasopharynx and paranasal sinuses, complemented by a general physical examination.</p> <p><strong>Results. </strong>Fifteen patients with nasopharyngeal cysts were examined and treated. In nine (60%) cases, the cyst appeared as a round mass with a dense wall, partially or completely obstructed by the excretory duct and containing dense content, localized in the central region of the nasopharynx. In four (26.6%) cases, the cyst ruptured. Cysts were localized laterally, originating from the fossa of Rosenmüller in three (20%) cases. All patients underwent minimally invasive surgery.</p> <p><strong>Conclusions</strong><strong>.</strong> Endoscopic examination, CT, and magnetic resonance imaging are the most informative diagnostic methods for nasopharyngeal cysts. A definitive diagnosis can be made based on pathomorphological examination. The treatment of choice for nasopharyngeal cysts is endoscopic endonasal surgery with a microdebrider and laser coagulation.</p>2024-03-07T12:28:07+02:00Copyright (c) 2024 Diana Orishchak, Nataliia Vasyliuk, Ostap Orishchak, Natalia Aleksandruk https://ifnmujournal.com/acm/article/view/acm2023213Changes in Lipid and Protein Peroxidation in Blood Serum and Respiratory Lungs Homogenate in Experimental Iodine Deficiency, Insulin Resistance and Their Combination2024-03-08T09:10:33+02:00Sofіia Petruniakspetrunyak@ifnmu.edu.ua<p>The relevance of the study is the prevalence of diet-induced metabolic disorders, in particular, iodine deficiency and insulin resistance. The aim of the study was to find out the features of lipids and proteins peroxidation in blood serum and lung tissue in rats with iodine deficiency, insulin resistance and their combination. Thyroid profile indicators, carbohydrate metabolism markers, proteins and lipids peroxidation were determined in animals kept on a standard diet (1st, control group), iodine-deficient diet (2nd group), under high-fructose feeding conditions (3rd group) and combination of iodine deprivation and the high-fructose diet (4th group). Indicators lipids and proteins free radical oxidation were determined in serum and homogenate of the pulmonary respiratory part. Iodine insufficient diet caused hypothyroid dysfunction, as evidenced by a decrease level of thyroid hormones and increase TSH in the blood serum of rats (2nd and 4th experimental groups). Increase in serum insulin and HOMA-IR index reflects the insulin resistance (3rd and 4th groups). Long-term iodine deprivation and a high-carbohydrate diet (three months) caused a violation of thyroid homeostasis and the development of insulin resistance, which are potentiated in their combination. Under such conditions oxidative stress develops, reflecting elevation of lipid and protein peroxidation products in blood serum (by 16,40-83,10 %, р<0,05) and homogenate of the respiratory pulmonary section (by 39,61 % - 2,55 times, р<0,05) according to the control. Increase the intensity of peroxidation in a combination of iodine-deficient and high-carbohydrate diets suggests a synergism of comorbid pathology and an increase in bronchopulmonary risks.</p>2024-03-07T12:30:54+02:00Copyright (c) 2024 Sofіia Petruniakhttps://ifnmujournal.com/acm/article/view/acm2023214Features of Inflammatory Syndrome in Patients with COVID-19-Associated Pneumonia and Concomitant Chronic Coronary Syndrome2024-03-08T09:10:33+02:00Ihor Tomynihor.tomyn@gmail.comSerhii Fedorovamidna73@gmail.com<p><strong>Introduction.</strong> The COVID-19 coronavirus disease caused by the SARS-CoV-2 virus has become an unprecedented challenge for the healthcare system and has taken a leading position among infectious diseases due to its rapid spread and development of complications in various body systems. COVID-19 has been shown to increase the long-term risk of both ischemic and nonischemic cardiovascular diseases. This underscores the need for primary prevention through measures such as vaccination and a deeper understanding of the pathophysiology linking COVID-19 to endothelial dysfunction and systemic inflammation. Patients hospitalized for coronavirus disease often have concomitant cardiometabolic disease. Cardiovascular complications are common in these patients, emphasizing the need for ongoing research to better understand these effects. The role of integral inflammatory indices in patients with coronavirus disease in the setting of chronic coronary syndromes (CCS) is unexplored.</p> <p><strong>Aim.</strong> To identify the features of the course of chronic coronary syndromes in patients with pneumonia caused by coronavirus infection COVID-19, as well as to assess the relationship between the level of inflammatory indices and the severity of the disease.</p> <p><strong>Materials and methods.</strong> 124 patients with COVID-19 were enrolled upon admission to the cardiology department of the Central City Clinical Hospital in Ivano-Frankivsk, the therapeutic department of the Kolomyia Central District Hospital and the therapeutic department of the Verkhovyna Hospital, 124 patients with COVID-19-associated pneumonia were selected, including 92 patients with a history of chronic coronary syndromes (CCS), including 49 patients with a history of acute myocardial infarction, 43 patients with stable angina pectoris and 32 patients without a history of CCS.</p> <p><strong>Results of the study.</strong> The mean age of the examined patients was (66,2±7,8) years in the CCS group and (59,9±8,9) years in the non-CCS group.Among the patients with severe course, there were 36 patients (39,1%) in the CCS group and 10 patients (31,2%) in the non-CCS group. In the CCS group, 4 patients (4,3%) died, and in the non-CCS group, 2 patients (6,2%) died. The BMI in patients with CCS was (28,3 [26,2; 30,9]) kg/m<sup>2</sup>, in the group without CCS (26,66±3,59) kg/m<sup>2</sup> and was higher in the CCS group (p=0,03). The mean number of days from the onset of symptoms to hospitalization in the CCS group was (7 [5;7] days, in the non-CCS group (7 [5;7] days). There was significant difference in the levels of inflammatory indices in the study groups after treatment, lower levels of SIRI 1,12 [0,58; 1,98] vs. 1,71 [0,74; 3,98] (p=0,04), NLR 4,22 [2,79; 5,40] vs. 5,3 [3,8; 9,56] (p=0,03), SII 936,75 [571,30; 1263,16] vs. 1198,75 [784,0; 2627,78] (p=0,008), PLR 154,75 [115,27; 208,09] vs. [124,23; 307,83] (p=0,04), AISI 253,61 [96,18; 437,47] vs.345,28 [229,48; 1040,13] (p=0,01). In the CCS group, a significant increase in the level of the LMR index (p=0,01) and a decrease in the level of CRP/L (p<0,0001) were observed after treatment. According to the results of the ROC analysis, there is a significant prognostic value of the CRP/L marker for mortality in patients with COVID-19 pneumonia and concomitant CVD (AUC = 0,901; 95% CI 0,820 – 0,953; p<0,0001) during hospitalization. The markers NMR, SIRI, NLR, SII, PLR, AISI, dNLR, CRP/L had a significant prognostic value for mortality when observed in the dynamics.</p> <p><strong>Conclusions.</strong> Increased levels of inflammatory indices showed a significant value in predicting hospital mortality from COVID-19 with concomitant CCS in the dynamics but had no prognostic value during hospitalization. Patients who were discharged with recovery or improvement had lower levels of inflammatory indices in the presence of concomitant CCS in the anamnesis.</p>2024-03-07T12:32:38+02:00Copyright (c) 2024 Ihor Tomyn, Serhii Fedorovhttps://ifnmujournal.com/acm/article/view/acm2023215Distribution of Zinc in Muscle, Adipose Tissue and Blood Serum of Rats Under Conditions of Zinc-Deficient, Iodine-Deficient, High-Carbohydrate and High-Fat Diets2024-03-08T09:10:33+02:00Iryna Vasylyshynvasylyshyn_ir@ifnmu.edu.uaNataliia Voronych-Semchenkonvoronych@ifnmu.edu.ua<p>The relevance of the study is due to the prevalence of hypothyroid dysfunction, type II diabetes mellitus, and metabolic syndrome. The study was carried out on sexually mature male rats that were on a standard vivarium diet (control group), zinc-deficient, iodine-deficient, high-carbohydrate and high-fat diets. Under the experimental conditions, the distribution of zinc in blood serum, adipose (visceral fat) and muscle (femoral and tibial muscles) tissues was studied. The study showed a decrease in serum zinc content by 13.79-30.89 % (p<0.05) compared to the control group, regardless of diet. The concentration of the trace element in adipose tissue was significantly reduced relative to the control under conditions of zinc deprivation (by 18.37 %, p<0.05), and especially high-fat feeding (by 74.74 %, p<0.001). The increase in the content of the trace element in muscles under conditions of zinc deficiency (by 36.84 %, p<0.001) compared to the same indicator in animals fed a standard diet) is noteworthy. Taking into account the role of the bioelement in the maintenance of thyroid homeostasis, carbohydrate metabolism, and antioxidant potential, the detected changes involving zinc may act as a trigger for changes in the hormonal profile, metabolic and oxidative disorders.</p>2024-03-07T12:35:12+02:00Copyright (c) 2024 Iryna Vasylyshyn, Nataliia Voronych-Semchenkohttps://ifnmujournal.com/acm/article/view/acm2023216Results of Primary Arteriovenous Fistulas Formation with Different Types of Anastomoses in the Early Postoperative Period in Patients on Programmed Hemodialysis 2024-03-08T09:10:33+02:00Vitalii Voronychvoronych_vi@ifnmu.edu.uaOleh Popadiukopopadyuk@ifnmu.edu.ua<p>The study includes the analysis of the results of using the different types of arteriovenous anastomoses in the formation of arteriovenous fistulas and their impact on fistula maturation in the early postoperative period. One of the main aspects of the work is to determine the optimal type of anastomosis to ensure the proper functioning of arteriovenous fistula that is an important element of vascular access in patients on renal replacement therapy. It is important to consider such factors as the diameter of formed arteriovenous fistula, the blood flow velocity through it, the incidence of complications and the duration of its functioning. The study also takes into account the impact of patients’ characteristics, such as age, condition of arteries and veins, as well as general health indicators on the results of surgery. Taking these factors into account allows to identify the groups of patients who can benefit most from a particular type of anastomosis.</p> <p>During the sample period, 384 patients with terminal stage of renal failure aged 20 to 84 years undergoing programmed hemodialysis, the native arteriovenous fistula was formed. It was found that 94.01 % of arteriovenous fistulas were successful in the early postoperative period. The average age of these patients was 44.2 years, while unsuccessful cases developed in people with an average age of 66.8 years. It was also found that within an hour after surgery for the formation of an arteriovenous fistula with the type end-to-side anastomosis, its diameter increases from 2.08±0.42 mm to 2.96±1.68 mm, and the blood flow velocity increases from 21.4±7.6 ml/min to 212.4±74.6 ml/min. The risk factor for effective fistula formation, in addition to age, is the diameter of vessels, anatomical features of the venous system, the presence of concomitant pathology (primarily diabetes mellitus).</p> <p>The obtained results can serve as a basis for the developing of recommendations for the optimal choice of anastomosis type for certain categories of patients who will undergo renal replacement therapy. The study is aimed at improving the results of surgical treatment and increasing the quality of life of patients with chronic renal failure.</p>2024-03-07T12:36:41+02:00Copyright (c) 2024 Vitalii Voronych, Oleh Popadiukhttps://ifnmujournal.com/acm/article/view/acm202321Historical Landmarks of Congresses of All-Ukrainian Public Organization “Scientific Society of Anatomists, Histologists, Embryologists and Topographic Anatomists of Ukraine”2024-03-08T09:10:34+02:00Olena Appelhanst.raskaley@gmail.comVolodymyr Raskalieit.raskaley@gmail.comLiliya Yaremenkot.raskaley@gmail.comVolodymyr Pivtorakt.raskaley@gmail.comOksana Popadynetsopopadynets@ifnmu.edu.uaVolodymyr Shepitkot.raskaley@gmail.comTetiana Raskalieit.raskaley@gmail.comOmelian Yurakhyuomelian@ifnmu.edu.uaHalyna YurakhhYurakh@ifnmu.edu.uaTaras Kotyktkotyk@ifnmu.edu.uaRomania Barchukrbarchuk@ifnmu.edu.uaLiliya Sobollsobol@ifnmu.edu.uaNadiya Tokarukntokaruk@ifnmu.edu.uaLarisa FedoniukFedonyuk22Larisa@gmail.comNataliia Dubynanata.dubina.74@gmail.com<p>The Scientific Society of Anatomists, Histologists, Embryologists and Topographic Anatomists of Ukraine - is a public organization whose activity is aimed at the formation of conditions for revealing the scientific and creative potential of morphologists in Ukraine; at the development of the research work; at the development of innovative activity; and at the creation of a society website. This article aims to highlight the historical aspects of the formation and development of the society since Ukraine gained independence and up to nowadays, to focus attention on the famous Ukrainian scientists having managed the society and made significant efforts to develop morphology in Ukraine and in the whole world.</p>2024-03-07T12:00:27+02:00Copyright (c) 2024 Olena Appelhans, Volodymyr Raskaliei, Liliya Yaremenko, Volodymyr Pivtorak, Oksana Popadynets, Volodymyr Shepitko, Tetiana Raskaliei, Omelian Yurakh, Halyna Yurakh, Taras Kotyk, Romania Barchuk, Liliya Sobol, Nadiya Tokaruk, Larisa Fedoniuk, Nataliia Dubynahttps://ifnmujournal.com/acm/article/view/acm202329Diagnosis and Treatment of Chronic Urticaria: The Importance of Autoimmune Aspects and Comorbidity2024-03-08T09:10:33+02:00Nataliia Cherniuknvchernjuk@gmail.comIrena Popadynetsiresja88@gmail.comIvan Stoikaistoika@ifnmu.edu.uaMarianna Derkachiresja88@gmail.comHalyna Smachyloiresja88@gmail.com<p>The study <strong>aimed</strong> to conduct a comprehensive systematic review of the literature on the autoimmune mechanisms associated with chronic spontaneous urticaria (CSU) in adults, explore the association between chronic urticaria (CU) and autoimmune disorders, analyze two case reports, and develop a diagnostic algorithm considering the autoimmune pathogenesis.</p> <p><strong>Materials</strong> <strong>and</strong> <strong>Methods</strong><strong>. </strong>The literature review was conducted to study the mechanisms underlying autoimmune CU. Two case reports were analyzed and a diagnostic algorithm for patients suspected of autoimmune urticaria was formulated.</p> <p><strong>Results</strong><strong>.</strong> CU significantly impairs patients’ quality of life, posing problems in daily activities and is often associated with concomitant autoimmune diseases. Though the pathogenesis of CSU remains incompletely understood, in recent years, there has been significant progress in understanding the pathophysiology of this condition, prompting researchers to explore new agents, especially biological ones, in cases with severe refractory urticaria. We have developed a diagnostic algorithm aimed at improving the management tactics for CSU and autoimmune pathology, that involves a thorough collection of complaints, medical history, performing a series of basic laboratory tests for specific markers of autoimmune disorders, and expanding their spectrum with detailed differential diagnostics.</p> <p><strong>Conclusions. </strong>CU is an important medical and social issue that requires an interdisciplinary personalized approach to patients. The diagnosis of the condition involves a comprehensive approach, considering potential concomitant autoimmune disorders and detailed laboratory investigations, especially in cases refractory to standard second-generation antihistamine therapy. The treatment of CU, specifically the stepwise therapy protocol based on symptom severity and response to treatment and aimed at reducing symptoms, improving patients’ quality of life, and achieving CU remission, is outlined in various national and international guidelines, and is carried out gradually, involving three lines of therapy.</p>2024-03-07T12:06:16+02:00Copyright (c) 2024 Nataliia Cherniuk, Irena Popadynets, Ivan Stoika, Marianna Derkach, Halyna Smachylohttps://ifnmujournal.com/acm/article/view/acm202325Study of Morphofunctional Relationships Between Adrenal Pathology and Hypothyroidism and Iodine Deficiency (Review)2024-03-08T09:10:33+02:00Oleksandra Harhaunloshak.oleksandra@gmail.com<p>Hormones that produce the adrenal glands affect most of the functional and metabolic processes in the human body, and also ensure its stability under stress. Since the adrenal glands are a stress-sensitive organ in the endocrine regulation system of all body functions, the development of adaptation mechanisms under the conditions of stress factor action can be characterized by their morphological state. However, thyroid diseases associated with a persistent lack of hormones are the cause of impaired homeostasis, metabolism and oxygen exchange. Since the adrenal glands belong to the vital target organs of the thyroid gland, of particular interest is the study of their functional relationships in normal and pathological conditions.</p>2024-03-07T12:07:41+02:00Copyright (c) 2024 Oleksandra Harhaunhttps://ifnmujournal.com/acm/article/view/acm2023218Incidence of Skin Melanoma in the Precarpathian Region. Overview of Trends of the Last Decade and Demonstration of Clinical Cases2024-03-08T09:10:33+02:00Marian Voloshynovychmvoloshynovych@gmail.comIryna Blahaiblaha@ifnmu.edu.uaGalyna Girnykggirnyk@ifnmu.edu.uaNataliia Kozaknkozak@ifnmu.edu.uaNataliia Matkovskanmatkovska@ifnmu.edu.uaVolodymyr Holotiukvholotiuk@ifnmu.edu.ua<p><strong>Introduction.</strong> Melanoma is a malignant tumour that develops from melanocytes and in most cases affects the skin. Although melanomas are usually highly pigmented, they can also be amelanotic. In the structure of mortality from skin cancers, melanoma takes the leading place with a rate of 90%.</p> <p>Even small tumours can metastasise. Under such conditions, early diagnosis is of paramount importance, as its main task is to detect and eliminate the primary lesion before it becomes deeply invasive.</p> <p>However, naked eye examination is limited to a sensitivity of about 75%, and is more effective when the tumour size is more than 5 mm. Among the additional examination methods, dermoscopy has become widespread. The technique has been introduced into the world dermatological practice for a long time and is actively used in Ukraine, demonstrating high efficiency at a relatively low cost of equipment.</p> <p><strong>Materials and methods.</strong> Statistical data on 901 cases of newly diagnosed skin melanoma in the Ivano-Frankivsk region were obtained from the bulletins of the National Cancer Registry of Ukraine for the period 2012-2022.</p> <p><strong>Results and discussion. </strong>There has been a gradual decline in the number of undetermined melanoma cases according to the TNM classification. The indicator has changed by more than 50 percentage points, with the lowest values at the turn of 2017-2018, and a subsequent increase of 10 percentage points until 2022.</p> <p>The number of reported cases of skin melanoma where the primary tumour distribution corresponds to the TI-TII category has increased, with a peak value of 92.7% as of 2017. However, in the period 2019-2022, the trend changed dramatically. Since 2019, cases of skin melanoma diagnosed in the state of spread, which corresponds to category TIII, have prevailed – 51.1%, while cases of TI-TII accounted for 32.2%</p> <p>The global COVID pandemic that began in 2019 led to negative trends, contributed to the isolation of patients, and complicated their access to specialists. russia’s full-scale invasion of Ukraine in 2022 exacerbated this impact, which was reflected in the indicators of 2019-2022.</p> <p>The clinical cases from our practice in 2018 and 2021 were presented in the article.</p> <p><strong>Conclusions. </strong>Melanoma is a malignant tumour with a high metastatic potential, with a better prognosis for recovery if diagnosed early. The increase in the number of registered cases of skin melanoma with primary tumour distribution in category TI-TII in 2013-2017 may indicate the effectiveness of measures aimed at promoting self-examination and timely treatment of patients for specialised care. The global COVID-19 pandemic and the full-scale russian invasion of Ukraine led to an increase in the proportion of melanomas diagnosed at the stage when the prevalence of the primary tumour corresponds to category TIII. It is necessary to resume measures that have had a positive impact on the health of residents of the Precarpathian region.</p>2024-03-07T12:10:44+02:00Copyright (c) 2024 Marian Voloshynovych, Iryna Blaha, Galyna Girnyk, Nataliia Kozak, Nataliia Matkovska, Volodymyr Holotiukhttps://ifnmujournal.com/acm/article/view/acm2023217Traumatic Brain Injury: Current Trends Towards the Increase of the Number of Cases and Its Diagnosis2024-03-08T09:10:33+02:00Nataliia Kozannmkozan@gmail.comOleksandr Dunaievov.dunaiev@knmu.edu.ua<p><strong>Introduction</strong> The global medical community calls traumatic brain injury (TBI) a "silent epidemic" because the latter causes a significant increase in mortality and disability more than any other mechanical injury. Although today's world achievements demonstrate powerful technical capabilities for accurate diagnosis of the time of occurrence and mechanism of TBI, however, the commission examination departments of the forensic medical examination bureau are considering more and more cases of diagnostic errors made by forensic medical experts during autopsies , which later caused protracted legal proceedings.</p> <p><strong>Aim</strong><strong>.</strong> In this study, we aimed to evaluate the modern diagnostic possibilities of methods for verifying the diagnosis and the time formation of TBI.</p> <p><strong>Methods.</strong> Literary data on the prevalence and methods of diagnosing TBI at the present time were analyzed.</p> <p><strong>Results</strong><strong>. </strong>The degree and severity of TBI, as well as its course, after the initial mechanical injury depends on many factors. In the last decade, there has been an intensification of research on protein biomarkers based on biofluids (blood, cerebrospinal fluid) for intravitality diagnosis. However, not all markers provide reliable information that would correlate with the presence of TBI. Until now, the "gold standard" of diagnosis is an autopsy, next to which radiological studies are effectively used.</p> <p><strong>Conclusion</strong><strong>.</strong></p> <p>Taking into account the global statistical data, postmortem diagnosis of TBI is an important issue of forensic traumatology, which requires a careful approach.</p> <p> </p>2024-03-07T12:09:22+02:00Copyright (c) 2024 Nataliia Kozan, Oleksandr Dunaievhttps://ifnmujournal.com/acm/article/view/acm202327Tuberous Sclerosis: A Case of Delayed Retrospective Diagnosis2024-03-08T09:10:33+02:00Maya Bondarenkomayaabondarenko@gmail.comVolodymyr Kozovyikozovyi_vo@ifnmu.edu.uaAnastasiia Dutchakanastasiiadutchakk@gmail.comRuslan Kozovyiruslan_kozovyi@ukr.net<p>Tuberous sclerosis is a rare genetic disorder, often diagnosed based on clinical manifestations. We report a case of a 39-year-old woman retrospectively diagnosed with tuberous sclerosis after giving birth to a child with cardiac rhabdomyomas. This case highlights the awareness of clinical manifestations of orphan diseases among physicians and the need for a broader approach to managing patients, extending beyond the limited perspective of medical professionals specializing in a particular area of health and facilitated through multidisciplinary consultations, highlighting the significance of educational initiatives among specialists and the general population for early detection and implementation of corrective measures in rare genetic disorders.</p>2024-03-07T12:39:22+02:00Copyright (c) 2024 Maya Bondarenko, Volodymyr Kozovyi, Anastasiia Dutchak, Ruslan Kozovyi