Modern Medicine, Pharmacy and Psychological Health

PREDICTION OF COGNITIVE DYSFUNCTION IN PATIENTS WITH MULTIPLE SCLEROSIS

Dmytro Andreychenko — 2024-12-30

Multiple sclerosis (MS) is a chronic autoimmune disease characterized by myelin destruction, neurodegenerative changes, and cognitive impairments. One of the most common and insufficiently studied manifestations of MS is cognitive dysfunction (CD), which significantly affects patients' quality of life. Objective. To identify and analyze factors influencing the development of cognitive dysfunction in patients with multiple sclerosis. Methodology. Between 2021 and 2023, a study was conducted in the neurology department of the Dnipropetrovsk Regional Hospital named after I.I. Mechnikov. A total of 93 patients with a confirmed diagnosis of MS were included. Neuropsychological assessment methods (MoCA, MMSE, Schulte tests, Rybakov tests) and morphological indicators (brain atrophy indices) were used. Data were processed using non-parametric statistics. Logistic regression and ROC analysis were applied to predict CD. Scientific novelty. It was found that the key predictors of CD include age, disease duration, neurological deficit level (EDSS), and the subcortical atrophy index (BCR). The application of multiple logistic regression models improves the accuracy of CD prediction (AUC = 0.97). High efficiency of cognitive tests and instrumental diagnostic methods was established. Conclusions. Comprehensive assessment of cognitive functions, including testing and neuroimaging, allows for the early detection of CD. This facilitates the development of personalized rehabilitation programs and improves the quality of life for patients with MS. The use of brain atrophy indices and EDSS is recommended for regular monitoring of cognitive status.

STUDY OF THE EFFECT OF VACCINATION AGAINST COVID-19 ON THE CLINICAL COURSE OF CORONAVIRUS DISEASE IN PATIENTS WITH ACUTE CORONARY SYNDROME

Dmitro Bondaretc — 2024-12-30

In this article, the scientific problem is focused on establishing associative links between vaccination against COVID-19 and the clinical course and complications of acute coronary syndrome. A detailed review of foreign studies was conducted to study the available global experience of the impact of vaccination against COVID-19 on the course and complications of acute coronary syndrome. Aim. The purpose of the work is to determine the impact of vaccination against COVID-19 on the course and complications of acute coronary syndrome. Scientific novelty. For the first time, the impact of vaccination against COVID-19 on the course and complications of acute coronary syndrome was studied. Materials and methods: analysis of theoretical sources, comparison of formed groups of study participants: the main group (n=50), which included patients with acute coronary syndrome against the background of clinical manifestation of COVID-19, the presence of which was confirmed in a cardiac surgical hospital, and a comparison group (n= 50) – patients with acute coronary syndrome without signs of respiratory viral diseases, with a negative result of the polymerase chain reaction test for COVID-19; deduction of consequences from the hypothesis with clarification of its content; experimental verification of the consequences derived from the hypothesis. Conclusions. It was found that the number of people vaccinated against COVID-19 was significantly higher in the comparison group, with the study participants preferring the Pfizer and AstraZeneca vaccines and 72.9% of the sample patients having received the full vaccination course. Analysis of the clinical course showed that moderate COVID-19 was common in the vaccinated patients of the main group, and the severe course was significantly higher in the unvaccinated. It was found that the presence of complications was probably higher among unvaccinated patients of the main group, which increases the risk of developing complications. 30-day mortality was found to be significantly higher among patients in the main group, but was not associated with vaccination against COVID-19.

ANXIETY AND DEPRESSIVE DISORDERS IN PATIENTS WITH CHRONIC MIGRAINE AND CHRONIC TENSION-TYPE HEADACHE

Yuliia Bukreieva — 2024-12-30

Chronic migraine and chronic tension headache are among the most common types of primary headache that have a negative impact on daily activities and quality of life. In addition to headache symptoms, chronic types of headache are usually associated with the presence of psychopathological disorders, usually depression and anxiety. Anxiety and depression act as prognostic factors that worsen the course of chronic headache and predict a more pronounced impact of headache on daily life and functioning. Aim: to investigate the prevalence and characteristics of depressive and anxiety symptoms in patients with chronic migraine and chronic tension headache. Methods: clinical, neurological and neuropsychological examination of 79 people was conducted, including: 31 patients with chronic tension headache, 30 patients with chronic migraine (16 patients had migraine without aura, 14 with aura), as well as 18 patients from the control group who had no more than two episodes of headache in the last year. To determine anxiety and depression, the hospital anxiety and depression scale was used. To determine the quantitative and qualitative characteristics of pain, the visual analog pain scale and the McGill pain questionnaire were used. Results: the structure of the severity of anxiety and depression symptoms in patients with chronic migraine differed statistically significantly (p<0.05) from that in patients with chronic tension headache and the control group. The vast majority of patients in the control group and the group with chronic tension headache demonstrated a minimal degree of severity of anxiety symptoms. In contrast, the majority of patients with chronic migraine had a clinical degree of anxiety. Half of the patients with chronic migraine had subclinical or clinical depression, which distinguished them from other groups. A strong correlation between the hospital anxiety and depression scale and the visual analog pain scale was determined among all patients in the study. The severity of anxiety and depression was positively correlated with the subscales of the McGill Pain Questionnaire, in particular the sensorydiscriminative and motivational-affective components. Conclusions: anxiety and depression are more common in individuals with primary headache compared to those without headache. The prevalence of symptoms of depression and anxiety disorders in chronic migraine is higher than in chronic tension headache. The presence of symptoms of anxiety and depression affects the qualitative and quantitative characteristics of pain. The presence of clinically pronounced anxiety and depression increases the intensity of headache. The presence of aura in chronic migraine does not affect the level of anxiety and depression.

COMPARATIVE CHARACTERISTICS OF PLACENTAL AND SPLEEN CRYOEXTRACT EFFECTS ON HEART MORPHOMETRIC PARAMETERS IN AN AUTOIMMUNE MYOCARDITIS MODEL ASSESSED BY CARDIAC ULTRASOUND

Fedir Hladkykh — 2024-12-30

Autoimmune diseases (AIDs) affect approximately 10% of the global population. As these conditions are often systemic, heart involvement is a frequent complication. In particular, myocarditis is closely linked to complex and abnormal autoimmune mechanisms. Despite its high mortality rate and potential for severe cardiac damage, treatment for myocarditis remains limited to symptomatic management. This prompted us to explore the effectiveness of biotechnological drugs, specifically cryoextracts – noncellular products developed using low-temperature processing and designed for long-term storage. The aim of the study is to characterize cardiac structure, with a focus on left ventricular morphology as assessed by ultrasound, when using placenta cryoextract and spleen cryoextract in a model of autoimmune myocarditis (AIM). Materials and methods. The effectiveness of CEP (cryoextract of placenta) and CES (cryoextract of spleen) in AIM was studied on 35 male rats weighing 200-220 g, randomized into 5 groups. Ultrasound examination of the heart was performed using the Sonomed 500 ultrasound echotomoscope (Poli-Spectrum, Ukraine) in B-mode and M-mode with a linear probe (7.5L38, 7.5 MHz) on the 28th day of the experiment. Results and Discussion. The study found that in rats with AIH, there was a statistically significant increase (p<0.001) in the left ventricular end-systolic diameter (LVD) by 47.0%, reaching 5.5±0.17 mm, indicating pronounced cardiac dilation. The thickness of the interventricular septum in diastole (IVST) increased by 30.0% compared to intact animals (p<0.001), indicating myocardial hypertrophy due to inflammation in AIH. There was also a 12.0% decrease in the relative wall thickness of the left ventricle (p=0.04), suggesting structural changes in the myocardium. Volumetric parameters, such as the end-diastolic volume and end-systolic volume (ESV), showed a tendency to increase (p>0.05), indicating left ventricular dilation in AIH without treatment. The introduction of CEP led to a decrease in the thickness of the interventricular septum (IVS) by 18.7% compared to the control (p=0.001), which indicates its effectiveness in restoring structural changes of the heart in AIM. When using CES, a decrease in the CSO by 31.7% (p=0.016) was observed, which indicates a significant improvement in left ventricular function. Conclusions. СEP administration reduced IVST by 18.7% (p=0.001), demonstrating its effectiveness in restoring structural changes in the heart in AIH, surpassing the effect of Cordarone (IVST reduction of 9.9%, p=0.01). СES also reduced IVST by 12.1% (p=0.006), confirming its potential as an alternative drug. СEP treatment decreased ESV by 62.0% (p<0.001), highlighting its cardioprotective effect. СES reduced ESV by 31.7% (p=0.016), confirming its therapeutic effect, although less pronounced than that of СEP.

ANALYSIS OF TREATMENT OUTCOMES IN PATIENTS WITH RADIAL HEAD FRACTURES

Andrii Domansky — 2024-12-30

Radial head fractures are the most common and account for 2.8% of all fractures of the entire skeleton, ulnar and radial neck fractures occur in 1% of cases. The aim of our work was to determine the optimal model of surgical treatment of patients with radial head fractures. Materials and methods. Our study involved 73 patients with radial head fractures who were treated at the Regional Clinical hospital named after II Mechnikov, Dnipro, from 2020 to 2023. The first group included 17 patients with radial head fractures who underwent head removal. The second group included 38 patients who underwent open reduction and osteosynthesis of the radial head. The third group included 18 patients who underwent radial head arthroplasty. Results. Among the patients of the general array, Mason-Hotchkiss type II fractures were most common and were detected in 42.5% of cases. In 31.5% of the patients of the general array, type III damage to the radial head was detected. Type I damage was the least common, which was detected in 26.0%. An excellent result of treatment according to the MEPS scale was most often detected among the patients of the third group. This result was observed in 38.9% of the patients of this group. Good results according to the MEPS scale were most often observed in the second group. Such a result of treatment of fractures of the radial head was registered in 47.4% of the patients of the second group. The assessment of the treatment result as “satisfactory” was detected in 47.1% of the patients of the first group. Patients with an unsatisfactory result according to the MEPS scale were most often detected in the first group, where they were registered in 23.5% of cases. Conclusions. According to our study, radial head arthroplasty in patients with isolated radial head fractures showed better clinical outcomes and patient satisfaction. Therefore, radial head arthroplasty may be a better treatment option for patients with such injuries, especially in cases of Mason.

ANALYSIS OF LEFT VENTRICULAR EJECTION FRACTION AS A PREDICTOR OF DEVELOPMENT OF HEART FAILURE AND RISK STRATIFICATION OF CORONARY BYPASS

Oleg Zhurba — 2024-12-30

In this article, the scientific problem is confined to the study of the values of the left ventricular ejection fraction in patients of different age groups in order to establish the effectiveness of surgical treatment and prevent the progression of heart failure. A detailed review of modern scientific research was carried out to study the available world experience of the influence of the preserved contractile capacity of the myocardium on the development of chronic heart failure. Aim. The purpose of the work is to study the values of the left ventricular ejection fraction in the dynamics of the perioperative period of coronary artery bypass grafting in patients of different age groups with coronary heart disease. Scientific novelty. For the first time, the values of the left ventricular ejection fraction were studied on a large sample of patients with coronary heart disease of different age groups in the dynamics of surgical treatment. Materials and methods. The study included patients with coronary heart disease of different ages (n=3672), the average age of the study participants was 60.6±0.8 years. All patients of this sample underwent coronary bypass surgery on a working heart, and risk stratification was determined for the timeliness of its implementation. Conclusions. Studying the values of the left ventricular ejection fraction in the dynamics of recovery after coronary artery bypass grafting in patients with coronary heart disease of different age groups is important, as it allows to objectively assess the effectiveness of surgical treatment and directly affects life expectancy. It was found that in all age groups, the left ventricular ejection fraction had an increase after coronary artery bypass grafting, which averaged 3.63% and was the highest in middle-aged patients (group #2). It was determined that the left ventricular ejection fraction in the dynamics from hospitalization to the 30-day period after coronary artery bypass grafting was significantly higher in the largest study group – middle-aged patients (р=0.052, χ2=3.77), which directly indicates the timeliness and the effectiveness of its implementation.

ASSESSMENT OF THE MENTAL HEALTH OF STUDENTS OF NATIONAL PIROGOV MEMORIAL MEDICAL UNIVERSITY BY SELFSURVEY METHOD

Svitlana Malyk — 2024-12-30

Given the frequent stressful situations that have become almost familiar companions of modern Ukrainians today, especially in war conditions, the load on the psycho-emotional state of the population has increased significantly. Accordingly, various neurological disorders are growing and intensifying, in particular neurodegenerative ones, leading to irreversible death of neurons and disability of people exposed to constant stress factors. It is important to conduct timely diagnostics and treatment of this pathology in the early stages, while there is an opportunity to prevent serious complications and consequences The purpose of the study: to assess the psycho-emotional state of medical students of the M.I. Pirogov VNMU using methods that are easily accessible and financially unburdensome. Methodology: 79 4th-year students of the M.I. Pirogov VNMU, aged 18 to 23, took part in a longitudinal prospective study. To obtain information about the psycho-emotional state of young doctors, their questionnaire was conducted. Situational anxiety was assessed using the Spielberg-Hanin test, depression was assessed using the Beck Depression Inventory, sleep quality scale (SQS) was used to assess sleep disturbance, and primary headache was assessed using the MIDAS questionnaire. Statistical analysis of the study results was performed using the SPSS20 program (© SPSS Inc.). Scientific novelty: the average level of anxiety prevailed among the subjects, with a low level being more typical for men, a medium level for women, and a high level being equally typical for both subjects. According to the data obtained from the Beck Depression Inventory, the general emotional state of the subjects was good, and depressive tendencies were not observed. 21-yearold students had moderate sleep quality, unlike 23-year-olds, who described their sleep as «good». According to the MIDAS test, it was found that girls had a 3-fold higher frequency of headaches compared to boys. Conclusions. To ensure the greatest coverage of the population with the diagnosis of disorders at early stages, it is necessary to choose methods that are easily accessible and financially unburdensome for the population, such as self-questionnaires for assessing anxiety, depression, sleep quality and headache. The self-questionnaires we used make it possible to prevent and suspect autonomic dysfunctions at early stages.

CHARACTERISTICS OF MORPHOMETRIC INDEXES IN OFFSPRING KIDNEYS WITH PRENATAL INFLUENCE OF EXPERIMENTAL MATERNAL CHRONIC GENITOURINARY SYSTEM INFLAMMATORY PROCESS CAUSED BY UROISOLATE OF STREPTOCOCCUS PYOGENES

Yurii Mishyn — 2024-12-30

Introduction. The article is devoted to the urgent problem such as a development of nephropathology in offspring born from mothers with exacerbation of chronic genitourinary system inflammatory process during pregnancy, which provided the basis for conducting an experimental research to study the morphometric indexes of offspring kidneys at different times after birth. The aim of the study is to characterize the influence of experimental maternal chronic genitourinary system inflammatory process caused by uroisolate of Streptococcus pyogenes on the dynamics of changes in morphometric indexes of offspring kidneys. Material and methods. The material for morphological research was the kidneys of rats from the control and experimental groups. The morphometric method was used to objectify the results of the study. The width of nephrogenic zone of cortical layer in newborn rats, the width of cortical layer and the numerical density of glomeruli in all age categories were determined in kidney preparations stained with hematoxylin and eosin by videomicroscopic morphometry using the Olympus DP-Soft program (Version 3:1) and Microsoft Excel. Research results and their discussion. In 7-day-old rats of the experimental group, the kidneys had a thin fibrous capsule, under which the cortical and medulla layers were visualized, the border between them was unclear. In the cortical layer, a wide neurogenic zone was detected in the subcapsular area, which included immature glomeruli and tubules, diffusely located poorly differentiated cells, immune cells and fibroblasts, collagen fibers, and undifferentiated vessels. The average width of the nephrogenic zone was 169.2±4.04 μm. In 1-month-old rats, the fibrous capsule of the kidneys was thickened. The thickness of the cortical layer increased compared to the previous period, mainly due to the tubular apparatus. The average width of the cortical layer was 589.20±12.83 μm. The density of the glomeruli was lower, and their sizes were larger compared to the kidneys of 7-day-old rats of the experimental group. In 2-month-old rats of the experimental group, microscopically in the kidneys the width of the cortical layer increased due to the growth of mainly tubules. The average value of the width of the cortical layer was 960.798±25.35 μm. In most fields of view, the glomeruli were evenly located, agglomerular areas were rarely found. Conclusions. Chronic genitourinary system inflammatory process of maternal rats, caused by Streptococcus pyogenes, causes a complex of pathological changes in all components of the renal tissue in the offspring. In all age groups, a significant decrease in the width of the cortical layer as a whole, an increase in the numerical density of glomeruli in the field of view is observed, and in 7-day-old rats, a significantly greater width of the nephrogenic zone is noted compared to the corresponding indexes in control group, which shows severe inhibition of nephrogenesis. The pathological changes in the glomerular, tubular apparatus and stromal component of the kidneys appear similar, but the degree of severity of alterative, dyscirculatory, inflammatory-proliferative changes decreases with increasing age of the animals, but fibrous changes in the stromal component become more widespread.

DETECTION OF ANTIMICROBIAL EFFECT OF NEW COMPOSITIONS WITH DIINDOLILMETHANE ON FORMED MICROBIAL BIOFILMS

Maryna Mishyna — 2024-12-30

Introdction. Antimicrobial resistance is a global threat to public health, which permeates all domains of modern medicine, the use of drug combinations to re-sensitize resistant strains has emerged as a promising means to bypass the stagnant drug discovery pipeline. The aim of the study was to determine the antimicrobial effect of compositions based on 3,3’-diindolylmethane (DIM) with antimicrobial drugs in vitro on daily biofilms of reference and clinical, multi-resistant strains of microorganisms. Materials and methods. Identification of microorganisms was carried out using the «MIKROLATEST®» kits. The sensitivity of clinical strains to antimicrobial drugs was studied using a microtest system with semi-quantitative registration of results «MIKROLATEST SensiLaTest MIC» (ERBA, Lahema). Analysis of the results was provided using an automatic analyzer «Multiskan EX» (type 355). Research results and their discussion. It was found that the experimental compositions based on DIM with ofloxacin or dioxidine were effective against reference and clinical strains. The introduction of these experimental compositions into bacterial biofilms led to damage of its integrity and formation of morphological differences from the control daily biofilms. Visualization of biofilms in 24 hours after the addition of ofloxacin or dioxidine showed the formation of a biofilm almost similar to the control one, but partial destruction of its integrity was recorded. Thus, when using the experimental composition «ofloxacin + DIM + soluble base» the proportion of cells with a damaged membrane was 69.4%, and when adding the experimental sample «dioxidin + DIM + soluble base» the proportion of cells with a damaged membrane was 61.8%. Adding samples containing «DIM + soluble base» and only «soluble base» without antimicrobial drugs caused partial destruction of the daily biofilm. Conclusions. Investigating the effect of DIM in new compositions with antimicrobials, which are most often used in the treatment of purulent-inflammatory diseases, on dense biofilms formed by resistant strains, which are the cause of lethal consequences, it was found that compositions with DIM are able to affect the biofilms formed by microorganisms by destroying them. Thus, DIM has properties that inhibit the process of biofilm formation and destroy already formed dense biofilms.

DEVELOPMENT OF REHABILITATION SYSTEM IN UKRAINE UNDER CURRENT CONDITIONS: CHALLENGES AND PROSPECTS

Yaryna Nahurna — 2024-12-30

The military aggression provoked by Russia leads to the destruction of infrastructure and results in casualties and mass injuries among both military personnel and civilians. Consequently, the number of individuals requiring rehabilitation increases daily. Over two years of full-scale war, the number of people with disabilities in Ukraine has risen by 10%. Rehabilitation of the victims and their reintegration into society are priority areas in healthcare. Objective. To optimize the organization of the rehabilitation system for the population of Ukraine under martial law based on a SWOT analysis. Materials and Methods. A search and analysis of public and scientific sources of relevant information regarding the current state, scope of needs, and existing issues in the rehabilitation process in Ukraine under martial law were conducted. The study utilized bibliosemantic and structural-logical analysis methods. The obtained information was analyzed following the principles of system analysis, a system approach, as well as SWOT analysis. Results and Discussion. Expanding the Program of Medical Guarantees with new packages 53 and 54 on Rehabilitation has significantly increased the accessibility of rehabilitation services for the population of Ukraine. Under the Program of Medical Guarantees, rehabilitation services are fully covered by the National Health Service of Ukraine. Medical rehabilitation care, whether outpatient or inpatient, is available to patients of any age, gender, or social status, free of charge and at the hospital of their choice. Rehabilitation services can be provided during the acute, post-acute, and long-term periods. The optimal time to begin rehabilitation is immediately after stabilizing the patient’s vital functions. Rehabilitation care is delivered by multidisciplinary rehabilitation teams or individual rehabilitation specialists, adhering to the fundamental principles of rehabilitation. As the number of injured individuals grows, so does the need for assistive rehabilitation devices, which are integral to creating a barrier-free environment. In matters of rehabilitation for wounded military personnel, 25 partner countries assist Ukraine, with leading support from Germany, Poland, Spain, the Netherlands, France, Bulgaria, and the Baltic States. SWOT analysis was utilized to analyze key characteristics and trends in developing rehabilitation in Ukraine. Conclusions. Rehabilitation is one of the priority areas of activity for the Ministry of Health in cooperation with other ministries and agencies. Training of rehabilitation specialists and formation of multidisciplinary rehabilitation teams, along with equipping healthcare facilities with technical rehabilitation tools, ensure timely and evidence-based rehabilitation care. According to the results of the SWOT analysis, rehabilitation in Ukraine is at the stage of formation and development. Considering opportunities, strengths, weaknesses, and threats, the rehabilitation process can be significantly expanded and improved, thereby contributing to the restoration of human capital, i.e. the reintegration of the victims into active social life and employment.

MENTAL HEALTH OF VOLUNTEERS DURING WARTIME: COMPREHENSIVE ASSESSMENT USING A STANDARDIZED EVALUATION QUESTIONNAIRE AND DEVELOPMENT OF A PROGRAM FOR THE PREVENTION AND CORRECTION OF NEUROTIC AND STRESS-RELATED MENTAL DISORDERS

Bohdan SUMARIUK — 2024-12-30

The article addresses pressing issues related to the mental health of individuals on the front lines of response during the russian- Ukrainian war. These individuals are directly involved in providing aid in shelling zones, interacting with affected populations, and coordinating humanitarian operations. Their activities are characterized by a high risk of primary and secondary traumatization due to constant contact with people who have experienced loss, destruction, and grief. This group also includes volunteers actively engaged in providing psychosocial and humanitarian assistance. Volunteer initiatives have played a crucial role in mitigating the socio-economic challenges Ukraine faced during the initial stages of the war. However, as the workload of volunteers increases, there is a notable rise in stress levels and emotional exhaustion, adversely affecting their productivity and efficiency. This underscores the need to study factors contributing to the development of mental disorders among volunteers and to determine the prevalence of these conditions. Notably, it is essential to create an effective program for psychosocial support, prevention, and management of neurotic and stress-related mental disorders, tailored for implementation at the outpatient level. The aim. To examine the prevalence and analyze the factors contributing to the development of neurotic and stress-related disorders among individuals engaged in volunteer activities during the war. The study results will serve as the basis for developing a comprehensive personalized program for psychosocial support, prevention, and management at the outpatient level in mental health centers. The goal is to reduce psycho-emotional stress and improve the quality of life for volunteers. Methodology. A standardized assessment questionnaire was developed for the study, including socio-demographic data, a social problems survey, and psychopathological test methods. The research was conducted in two stages and included both quantitative and qualitative data analysis. Scientific novelty. For the first time, the mental health of volunteers has been studied in the context of the russian-Ukrainian war, as this group is at high risk of exposure to psychotraumatic factors. The results of the study formed the basis for the implementation of a comprehensive program for psychosocial support, prevention, and management of neurotic and stress-related disorders among volunteers. Conclusions. The findings indicate an increased vulnerability of volunteers to stress-related mental disorders, driven by the nature of their work and the constant impact of stress factors. This aligns with previous research, which highlights significant levels of stress and a high risk of emotional burnout among humanitarian workers in crisis situations. A critical issue is the lack of psychological support for volunteers, which complicates their adaptation process and increases the risk of developing neurotic and stress-related disorders.

DIFFERENTIAL DIAGNOSTICS OF MASKED DEPRESSIONS IN THE CLINICAL PICTURE OF PSYCHOSOMATIC DISEASES

Oleg Chernyshov — 2024-12-30

The article is devoted to the study of the problems of masked depressions in the clinic of psychosomatic diseases. The problem of depressive disorders is one of the most topical in medicine today. Unlike other types of mental disorders, depressive states in 40% of cases remain undiagnosed in time, especially in the case of masked depressions. The aim of this study is to analyze and systematize data on the problem of masked depression in the clinical picture of psychosomatic diseases at the present stage. Materials and methods. The materials of the study were international and national concepts and strategies, regulatory documents, clinical guidelines, information from scientific databases such as Scopus, Web of Science, Cochrane Library, PubMed. The methods of comparative analysis, systematization and generalization of information on the problem of masked depression at the current stage of development of medicine and society were used. Results and discussion. Masked depression is a group of affective disorders, in the clinical picture of which somatic and vegetative symptoms and symptoms of atypical “algic syndrome” prevail, while true affective depressive symptoms are relegated at the background or absent. The similarity of symptoms of somatic pathology and depression determines the course of depression under different “masks”: “masks” in the form of psychopathological disorders; “masks” in the form of biological rhythm disturbances; “masks” in the form of vegetative, somatic and endocrine disorders; “masks” in the form of algia; “masks” in the form of pathocharacterological disorders. Due to the significant polymorphism of symptoms of masked depression, diagnosis of this condition is often complicated, patients get help not from psychiatrists, but from general practitioners, do not receive timely adequate treatment, this makes the course of the disease worse and contributes to the chronicity of the process. Conclusions. The necessity of a more significant study of the problem of masked depression in the clinical picture of psychosomatic diseases, its etiology, pathogenesis, clinical manifestations, diagnostics and timely specialized treatment has been substantiated.

COMPARATIVE LITHOLYTIC ACTIVITY OF SOME EDIBLE AND MEDICINAL PLANTS

Anna Megalinska — 2024-12-30

The aim of the presented study was to investigate the litholytic activity of three groups of plant material that is most commonly encountered in daily life. These include medicinal plants: dyer’s madder (Rubia tinctórum L.), couch grass (Elymus repens L.); spice-aromatic plants: black pepper (Piper nigrum L.), peppermint (Mentha piperita L.), ginger (Zingiber officinale Rosc.); and fruit plants: rowan (Sorbus aucuparia L.), wild strawberry (Fragaria vesca L.), sea buckthorn (Hippophaё rhamnoides L.), and pear (Pyrus communis L.). Methodology. The composition of stones removed endoscopically at O.F. Vozianov Institute of Urology was invstigated using infrared spectroscopy. The dissolution rate of calculi was analyzed applying Yachi L. and Benis S. Method – by exposing calculi to lectin-containing plant extracts in vitro and monitoring changes in their mass. Scientific novelty. The dynamics of phosphate, urate, and oxalate dissolution in lectin-containing extracts of some representatives of three plant groups were studied in vitro for the first time. Conclusions. The conducted research suggests that the use of dyer’s madder, against a diet rich in black pepper and peppermint, may serve as a preventive measure in cases of oxalaturia. In uraturia, the use of tea made from dyer’s madder combined with a diet including peppermint, sea buckthorn, and wild strawberry fruits appears to be justified. The mechanism of the effect of plant extracts on reducing calculus mass may be associated with the formation of chelate compounds with calcium. Polyphenolic compounds are likely to exhibit chelating properties. In cases of phosphaturia, it is advisable to use tea made from dyer’s madder and dietary supplements such as ginger, sea buckthorn, and wild strawberry.

PREDICTION OF ORAL DRUG BIOAVAILABILITY BASED ON CHEMICAL STRUCTURE

Yaroslava PUSHKAROVA — 2024-12-30

Prediction of bioavailability is a crucial aspect of drug development and formulation design. Aim. To investigate the possibility of predicting the bioavailability of oral drug compounds based on molecular descriptors by means of feedforward neural network. Materials and methods. Software ChemOffice 2020 was used for calculation molecular descriptors from the drug structures. Software Matlab R2022b was used for building the multivariate regression between molecular descriptors and bioavailability as well as feedforward neural network. For each of the 145 drug molecules 16 molecular descriptors were calculated. Of the 145 compounds, 10 were randomly selected for use as a test subset, 5 compounds – as a validation subset. The remaining 130 compounds were used to train feedforward neural network. Results and discussion. It is established that there are 7 the most informativeness molecular descriptors for oral drug bioavailability prediction: molecular weight, hydrogen bond acceptors, hydrogen bond donors, partition coefficient, Balaban index, molecular topological index, Wiener index (multiple coefficient of determination is equal to 0,3701). Optimal number of hidden neurons for effective realization feedforward neural network was found by experimental way and its equal to 16. Trained feedforward neural network with 16 hidden neurons was used for predicting bioavailability values for test and validation subsets. Conclusions. Feedforward neural network is the effective tool for prediction of oral drug bioavailability based on chemical structure. This is evidenced by high values of determination coefficient between predicted bioavailability values and experimental bioavailability values for test and validation subsets (0,7084 and 0,8432, correspondingly). Obtained results can be useful at the stage of experiment planning or drug design.

GENETIC AND ENVIRONMENTAL RISK FACTORS FOR PERIODONTAL DISEASES (LITERATURE REVIEW)

Olexandr Bilynskyi — 2024-12-30

Introduction. Periodontal tissue diseases are multifactorial in nature and depend not only on local etiological factors, but can also be a consequence of somatic pathology. Identification of risk factors helps to adjust the treatment and prevention among patients by stopping impact of such factors or by modifying intensity of their influence. Objective. To assess the significance of the available evidence regarding the issue of periodontal disease occurrence and to identify the leading influencing factors. Methods. In order to form the primary cohort of publications, a search for such publications was conducted using the Google Scholar (https://scholar.google.com/), PubMed (https://pubmed.ncbi.nlm.nih.gov/), ResearchGate (https://www.researchgate. net/) services and the following set of keywords: “risk factors”, “periodontitis”, “genetic factors”. Results. The paper analyzes the literature on the causes of periodontal diseases, including the most common factors, such as poor oral hygiene, indicators of balanced nutrition, social factors, and also, taking into account the genetic component, including a set of genes responsible for the occurrence and progression of the inflammatory process within periodontal tissues. Conclusions. During the literature review, it was found that microbial and environmental factors play a significant role regarding the onset and progression of inflammatory processes within periodontal tissues, however, the severity of inflammation can be partially mediated by the influence of genetically associated factors, some of which are modifiable risk factors and are subject for full or partial correction.

THE ELIMINATION OF SPEECH DEFECT IN CHILDREN WITH DENTOFACIAL ANOMALIES

Nataliia Rashchenko — 2024-12-30

The article highlights the problem of speech function disorders in children due to existing dentofacial anomalies and their corrections. Data from the Ukrainian scientific and practical community indicate an increasing number of patients with anomalies and deformations of the dentofacial apparatus who require orthodontic correction. Speech disorders development hasn’t the single cause and can be caused by a lot of etiological factors. However, the leading one remains a shortened tongue frenulum. Despite today's significant progress in performing tongue frenotomy, it is not always possible to achieve the desired result in improving the sound pronunciation of patients. Therefore, improving the methodological approach to the correction of sound pronunciation does not lose its relevance. The aim. The elimination of speech defect methods development by performing frenotomy in children with dentofacial anomalies and evaluating treatment effectiveness. Materials and Methods. A prospective controlled study conducted by us included 28 children (7 to 11 years old) with limited tongue mobility of 50–80%, who were randomly divided into 2 groups (experimental and control). All patients underwent frenotomy, in addition to which (and postoperative rehabilitation) patients in the experimental group were offered several myofunctional exercises. Results. According to the research results in the current research, corrective treatment results, 81.25% of patients showed a significant improvement in sound pronunciation in the experimental group (vs 25% in the control). An insignificant result was recorded in 18.75% of patients in the experimental group vs 33.33% of patients in the control. In 41.67% of the control patients, no improvement in sound pronunciation was found. Conclusion. The combined use of frenotomy (according to indications) and myofunctional exercises complex allows for significant improvement in the result of orthodontic correction.