Wiadomosci lekarskie最新文献

Objective: Aim: To discuss the indications for elective thyroid surgery and peri-surgical clinical strategy in patients with thyroid diseases.

Patients and methods: Materials and Methods: A comprehensive literature review was conducted from October 2024 to April 2025, analyzing relevant publications published between June 2005 and January 2024, sourced from PubMed, Scopus, Web of Science, and the Cochrane Library. Thyroid disorders encompass various conditions, including Graves' disease, hyperthyroidism, and thyrotoxicosis. Hypothyroidism manifests as subclinical or overt. Surgical indications for thyroidectomy include symptomatic nodules, indeterminate/Bethesda III-V cytology, malignancy (Bethesda VI), or compressive symptoms. Ultrasound-guided Fine-Needle Aspiration (FNA), based on nodule size and EU-TIRADS risk stratification, is pivotal for evaluation. Advanced aids in risk assessment. Surgical complications (hemorrhage, hypoparathyroidism, recurrence laryngeal nerve injury) require prompt management. Molecular testing refines indeterminate cytology diagnoses. Thyroidectomy is contraindicated in anaplastic cancer and/or high surgical risk cases. Postoperative monitoring for hypocalcemia, voice changes, and bleeding is essential.

Conclusion: Conclusions: Resource constraints hinder widespread adoption of advanced thyroid diagnostics, creating challenges in optimal nodule management.

Objective: Aim: This work uses a male Wistar Albino rat model of experimentally induced renal ischemia-reperfusion injury (IRI) to examine the nephroprotective potential of Urolithin A.

Patients and methods: Materials and Methods: Twenty-eight rats (N=7) were randomly assigned to four groups: DMSO pre-injection as a vehicle, bilateral renal IRI for 30 minutes followed by two hours of reperfusion as a control, sham (laparotomy without IRI), and treatment (Urolithin A pre-injection for three days). ELISA and histological analysis were used to assess biomarkers of kidney injury, oxidative stress, inflammation, and apoptosis.

Results: Results: While GSH levels were enhanced, Urolithin A therapy primarily decreased TNF-α, IL-1β, MDA, Caspase-3, and KIM-1 levels. Furthermore, the group treated with Urolithin A showed a substantial downregulation of FOXO3 expression. Histopathological results verified that the therapy group had less kidney damage.

Conclusion: Conclusions: These findings suggest that Urolithin A produces nephroprotective effects against IRI via modulating oxidative stress, inflammation, and apoptosis, particularly through the control of FOXO3. This study suggests that Urolithin A is a good treatment candidate for renal IRI control.

Objective: Aim: The relationship between diabetes mellitus (DM) and lifestyle quality become important in diabetes research in last year. The present study aims to study the influence of metformin response in sleep in diabetes mellitus patients type 2.

Patients and methods: Materials and Methods: A cross sectional study was designed to achieve study goal, glycemic parameters included fasting blood glucose (FBG), glycated protein (HbA1c%), insulin (IN), insulin resistance (HOMA-IR) and insulin sensitivity (IS). PCR sequencing was used to detect SLC47A2 intronic variants and its related with glycemic control and sleep status.

Results: Results: Among the study population, about 26.3% achieved well glycemic control, 30% were moderately controlled, and 43.8% were poorly controlled. Sleep quality assessment showed that the majority of participants in all glycemic groups experienced intermediate sleep. The prevalence of insomnia increased with worsening glycemic control, from 4.8% in the well-controlled group to 17.1% in poorly controlled participants, in non- statistically significant (p = 0.722). Biochemical parameters confirmed significant differences in fasting blood glucose and HbA1c across the three glycemic categories (p < 0.001), insulin, HOMA-IR, and insulin sensitivity did not differ significantly. Multiple regression analyses indicated that none of the biochemical predictors significantly explained sleep in any group (p > 0.05), in poorly controlled patients, non-significant opposing trends were observed for insulin and insulin resistance, sociodemographic factors included supplement use, education level, and employment were associated with better sleep among poorly controlled patients. Genetic analysis of two intronic variants in the SLC47A2 gene (g.19716681G>C and rs1597652185) revealed no significant associations with glycemic control or sleep, though both showed similar distribution patterns across groups. Statistical analysis didn't find significant association between either variant and glycemic or sleep status (p > 0.05).

Conclusion: Conclusions: Poor glycemic control was common and associated with higher insomnia prevalence. While demographic and clinical factors showed no clear links with glycemic control or sleep, supplement use emerged as a protective factor. FBG and HbA1c strongly differentiated control groups, but other biomarkers and SLC47A2 variants were not predictive. Findings suggest that combining metabolic management with supportive measures like supplementation may improve sleep and outcomes in type 2 diabetes..

Objective: Aim: To evaluate the effectiveness of determining the fertile window in women with idiopathic infertility based on the results of crystallization of saliva samples obtained using the Ovul portable device with a mobile application by comparing them with the results of urine test strips and folliculometry data.

Patients and methods: Materials and Methods: The menstrual cycles of 42 women with idiopathic infertility were analyzed: Group I - 21 women who took drugs to induce ovulation, Group II - 21 women with natural menstrual and ovarian cycles. Ovulation was confirmed or excluded based on the results of the Ovul device, urine test strips, and folliculometry.

Results: Results: Although ovulation detection using the Ovul device and urine test strips has 100% specificity, the sensitivity of the device is 97.4%and the accuracy is 97.6% (if the positive result is ovulation or the fertile window), while for urine test strips the sensitivity is 94.9% and the accuracy is 95.2% if we consider a positive result not only to be the same as the day of ovulation according to folliculometry, but also a positive result within the next 72 hours (mainly 12-24).

Conclusion: Conclusions: Ovulation detection using the Ovul device is a highly accurate, 100% specific and highly sensitive method that can be used at home, will optimize diagnostics, make it more convenient and cheaper for patients who want to get pregnant or, on the contrary, who are trying to avoid pregnancy.

Objective: Aim: This study investigates the association of the TLR4 Thr399Ile (rs4986791) polymorphism with T2DM in Iraqi patients and its influence on clinical parameters.

Patients and methods: Materials and Methods: A case-control study was conducted on 200 participants (100 T2DM cases and 100 healthy controls). Phenotypic analyses included fasting blood glucose, HbA1c, lipid profiles, and insulin sensitivity indices. Genotyping of the TLR4 Thr399Ile polymorphism was performed using PCR-RFLP. Statistical analyses were conducted using SPSS.

Results: Results: The CT and TT genotypes were significantly more frequent in T2DM patients, associated with higher odds ratios (OR=2.40, p=0.003; OR=5.33, p=0.04, respectively). HDL levels were significantly lower in variant genotypes (p = 0.01). Other clinical parameters showed no significant genotype-specific differences.

Conclusion: Conclusions: The TLR4 Thr399Ile polymorphism is significantly associated with increased T2DM risk and altered HDL levels in Iraqi patients, highlighting its potential as a genetic marker for early risk assessment.

Objective: Aim: Highlighting the main problems of forming a healthy lifestyle among the youth of Ukraine and determining the role of the family doctor in solving them.

Patients and methods: Materials and Methods: The study used bibliosemantic, statistical, analytical methods and descriptive modeling. Data processing was performed using the Microsoft ® Excel ® software package (trial version); statistical processing of results was performed using the statistical analysis software package Statsoft ®Statistica ® ver. 10 (STA999K347156-W) and IBM ® SPSS 25.0 (trial version).

Results: Results: According to the results of the study, numerous health problems associated with an unhealthy lifestyle are observed in Ukraine: physical inactivity, bad habits (use of alcoholic beverages and psychoactive substances, smoking), excessive communication on social networks, lack of safe sexual behavior skills. To increase the level of awareness of young people about a healthy lifestyle, we modeled the administration of services for the formation of a healthy lifestyle in the field of primary health care by a family doctor.

Conclusion: Conclusions: One of the main links in the formation of a healthy lifestyle is the professional approach of this family doctor in the framework of performing his direct functions of eliminating habits and behavior that pose a risk to health and forming healthy lifestyle skills. Public administration should ensure the effectiveness of the family doctor in providing services for the formation of a healthy lifestyle through the process of collective adoption and implementation of strategic decisions.

Objective: Aim: The aim of this study was to evaluate the microbial contamination of dental unit waterlines (DUWLs) and characterize the microbial communities of biofilms in dental chair units (DCUs) from different specialties in Ukrainian dental clinics.

Patients and methods: Materials and Methods: A multicentre study was performed between January 1, 2020, to December 31, 2022. Dental water samples and biofilm samples were obtained from 191 DCUs at eighteen dental clinics from seven regions of Ukraine. The genomic DNA of the biofilm samples was extracted, then 16S rDNA were amplified and sequenced.

Results: Results: A total of 1,146 dental water samples were collected, of which 57,4% samples did not meet microbiological parameters of Ukrainian National Standard on drinking water. Sequencing results showed significant differences in bacterial community structure between dental specialties. The largest specific weight of biofilm samples with high bacterial concentrations were detected from orthodontics (54.2%), prosthodontic (47.5%), and oral surgery (44,3%). The 16S rDNA gene sequencing showed high diversity of bacteria (311 genera) were detected in the biofilm samples. Amount of potential human pathogens were detected in the biofilm samples, including Pseudomonas aeruginosa (33.7%), Escherichia coli (27.3%), Enterococcus faecalis (17.4%), Enterococcus faecium (9.5%), Serratia marcescens (6.8%), Stenotrophomonas maltophilia (5.9%), Staphylococcus aureus (5.1%), Burkholderia cepacia (4.3%), Acinetobacter lwoffii (4.8%), Enterobacter cloacae (4.6%), Klebsiella oxytoca (4.2%), Streptococcus pneumoniae (3.9%), Streptococcus pyogenes (2.6%), and Streptococcus sp, (1.9%).

Conclusion: Conclusions: The most water quality of the DUWLs tested failed to reach the Ukrainian drinking water standard. Furthermore, most DCUs contained pathogens which poses a risk of infection for patients.

Objective: Aim: To investigate the peculiarities of psycho-emotional and neurovegetative disorders in women exposed to war-related stress and to assess the possibilities of their correction by cognitive behavioural therapy (CBT) and Transcendental Meditation (TM).

Patients and methods: Materials and Methods: The study involved 72 women, 35 of whom had experienced high-intensity stress and 37 of whom were in the control group. The psychoemotional state was assessed by the DASS-21 test and a screening test for post-traumatic stress disorder. The neurovegetative state was assessed by mathematical analysis of heart rate variability (HRV). The main group was divided into subgroups that received correction using CBT or TM.

Results: Results: In the main group exposed to the stressors of war, a higher level of anxiety, depression, PTSD score, and neurovegetative imbalance (decreased total adaptation reserve [SDNN], decreased parasympathetic regulation activity [RMSSD], increased vegetative balance index [LF/HF], indicating a shift towards sympathicotonia) was found. After the correction, both subgroups (CBT and TM) showed a decrease in anxiety, depression and stress. TM showed a more pronounced corrective effect on neurovegetative regulation and some indicators of psycho-emotional state (anxiety) compared to CBT.

Conclusion: Conclusions: A war significantly affects the psycho-emotional and neurovegetative state of women. Both of the applied non-medicated methods (CBT and TM) showed a significant corrective effect. The results of the study confirm the positive effects of TM and indicate the feasibility of its use for psychological support of persons exposed to the stress factors of war.

Objective: Aim: Conduct an analysis and provide a pathophysiological justification for the case of the formation of an ulcer of the duodenal bulb in a 27-year-old soldier of the Armed Forces of Ukraine.

Patients and methods: Materials and Methods: After collecting the anamnesis, the patient underwent a comprehensive examination, which included step-by-step pH-metry, esophagogastroduodenoscopy, testing for Helicobacter pylori infection (HP) (urease test and microscopic examination of stained smears-prints) in 4 topographic zones of the stomach, and histological examination of the gastric mucosa in the same zones.

Results: Results: When collecting a family history, it was found that relatives on one male line - father and grandfather - suffered from ulcer disease. It was established that on the eve of an exacerbation, which lasted 3 weeks, the soldier helped load a car, repeatedly lifting boxes with ammunition up to 20 kg to a height of 1.5 m. During pH-metry it was found that the acidity level of gastric juice corresponded to the basal normacidity of total. During esophagogastroduodenoscopy the following diagnosis was made: "Ulcer of the duodenal bulb in the active stage (in the middle third, along the back wall, 1.5 x 0.8 cm, the ulcer defect is covered with gray fibrin). Erythematous duodenogastropathy. Indirect signs of pancreatopathy." The presence of chronic gastritis in the active stage in the patient was confirmed by the results of histological examination of the gastric mucosa. The type of gastritis (non-atrophic) was confirmed by testing for HP infection, which revealed a high concentration of the active form of bacteria - (+++) in all 4 topographic zones of the stomach.

Conclusion: Conclusions: Stress associated with participation in military operations led to the active reproduction of Helicobacter pylori infection and, accordingly, an increase in "residual" ammonia in the stomach cavity. Heavy physical exertion, which was accompanied by a sharp contraction of the muscles of the anterior abdominal wall, created a "bellows" effect, which concentrated the "residual" ammonia in the cavity of the duodenal bulb and led to the formation of an ulcer.

Objective: Aim: to analyze the possibilities to implement dispensing of medicines via vending machines.

Patients and methods: Materials and Methods: A systematic literature review was conducted using PubMed, Scopus, and Google Scholar databases. A SWOT analysis of dispensing medicines through vending machines was performed. Ukrainian legal framework and content analysis were used to assess feasibility, with an anonymous survey of 106 respondents aged 20 to 70 gathering opinions on installing vending machines for over-the-counter medications in public places.

Results: Results: The study showed the following: 1) strengths were: convenience, access to medicines in remote areas; 2) weaknesses: limited number of medicines, lack of possibility to consult with a pharmacist, cost of vending machines; 3) opportunities: possibilities to use for prescribed medicines or for chronic diseases medication; 4) threats: exclusion of pharmaceutical professionals from the process of ensuring access to medicinal products, self-medication and danger of side effects. The 58 % of respondents supported vending machines, citing convenience, availability, and shorter pharmacy queues.

Conclusion: Сonclusions: Dispensing medicines via vending machines presents a viable alternative to traditional methods. The main advantage is patient convenience, but attention must be given to mitigating risks from self-medication. Licensing terms should be established for business entities involved in vending machine operations, ideally those holding a retail license for medicinal products.