Wiadomosci lekarskie最新文献

Objective: Aim: To assess the awareness and training needs of healthcare professionals regarding the multidisciplinary rehabilitation of patients with pain syndromes and comorbid conditions resulting from war trauma.

Patients and methods: Materials and Methods: The structured online survey of 120 people, including doctors, nurses, medical assistants, paramedics and senior students of medical universities in Kyiv and Zaporizhzhya (Ukraine). Before that, a targeted review of international (WHO, NICE, EULAR) and national guidelines on multidisciplinary rehabilitation was conducted. Based on this regulatory framework, the authors developed the «Multidisciplinary Rehabilitation Attitude and Readiness Questionnaire».

Results: Results: Although 89% of respondents were familiar with the concept of multidisciplinary rehabilitation, only 17% demonstrated a comprehensive understanding. Most respondents (54%) reported only partial awareness and emphasized the need to improve teamwork skills and learn modern rehabilitation methods. Psychological support was recognized as essential by 58%, while 42% showed uncertainty or held misconceptions. Core rehabilitation components identified included pharmacological stabilization (65%), interdisciplinary collaboration (50%), and patient education (45%). However, elements such as empathy, active listening (25%), and social reintegration (15%) were undervalued. Only 23% of participants rated their competence in teamwork as sufficient, and nearly half (48%) assessed their preparedness as low. Priority areas for further education included trauma-informed care, psychological first aid, prevention of professional burnout, and the use of non-pharmacological methods such as electrotherapy and acupuncture.

Conclusion: Conclusions: Despite formal awareness of multidisciplinary rehabilitation, significant gaps exist in practical competencies. Expanding interdisciplinary training and emphasizing psychosocial components are critical to improving care for war-affected patients.

Objective: Aim: To analyze the changes in the psycho-emotional state of participants in the educational process in Ukraine under wartime conditions and to identify effective educational technologies for overcoming psycho-emotional barriers.

Patients and methods: Materials and Methods: The research applies both quantitative and qualitative analyses of data collected through surveys of 269 students and 100 faculty members at higher education institutions (totally, 369 respondents). The study is grounded in an interdisciplinary approach that combines psychological, pedagogical and sociological methods.

Results: Results: The most common issues were anxiety, fear, and emotional exhaustion (222 individuals [60,2 %]). Problems with stress resilience were noted by 96 respondents (26,0 %), and traumatic wartime experiences were a challenge for 60 respondents (16,3 %). Feelings of physical danger were noted by 58 people (15,7 %). Misinformation and the information war were mentioned by 50 respondents (13,5 %). A total of 27 respondents (7,3 %) were forced to change their place of study, 12 (3,3 %) reported experiencing bullying, and 9 (2,4 %) reported discrimination based on origin or views. It has been found that the use of educational technologies such as trauma-informed approaches, coaching, mentoring, and mediation contributes to reducing stress levels and supporting psychological well-being.

Conclusion: Conclusions: In times of crisis, the educational process should focus not only on achieving academic outcomes but also on maintaining the psycho-emotional health of all participants. An integrated approach to learning, including adaptive educational technologies aimed at overcoming psycho-emotional barriers of higher education students, ensures the sustainability of the educational environment.

Objective: Aim: This paper explores the relationship between obesity and oral diseases. Early detection and prevention of risk factors are essential for indispensable for promoting long-term health and elevating the quality of life in affected patients.

Patients and methods: Materials and Methods: A search of PubMed and Google Scholar on November 10, 2024, retrieving 48 articles from 2016-2024. After screening criteria, 45 articles were included. All authors verified the final content.

Conclusion: Conclusions: Evidence suggests a notable association between obesity and oral health issues, including periodontitis, peri-implantitis, and other gum diseases. Certain research point to the possibility that patients who undergo bariatric surgery could also experience worsening dental health. Inadequate oral hygiene and excessive sugar consumption, along with obesity, contribute to the worsening of dental problems in both children and adults. Further studies are required to better elucidate the underlying mechanisms of this association, which remains insufficiently explained in literature.

Objective: Aim: To investigate the relationships of kidney function with clinical and laboratory parameters in multiple myeloma (MM) patients.

Patients and methods: Materials and Methods: A cross-sectional study involved 105 MM patients. Data included clinical manifestations and standard laboratory parameters. Kidney function was assessed via estimated glomerular filtration rate (eGFR), serum creatinine, urea, uric acid (UA), calcium (Ca), and albumin-to-creatinine ratio (ACR). The markers of MM activity and burden included M-protein, beta-2 microglobulin (β2m), albumin, hemoglobin (Hb), lactate dehydrogenase (LDH) and platelets (PLT). Rank biserial correlation assessed associations between symptoms and laboratory parameters. Rank-based canonical correlation analysis (RCCA) explored the multivariate relationship between six kidney function indicators and six MM-related markers.

Results: Results: Common laboratory abnormalities included elevated β2m (90,5 %) and anemia (indicated by low Hb in 52,4 % of patients). Frequent symptoms included bone pain (71,4 %) and weakness (68,6 %). Symptoms like weakness/breathlessness correlated significantly with (β2m, M-protein) and renal impairment (creatinine, ACR, eGFR). RCCA identified one significant canonical correlation (R1=0,497; p=0,013), linking impaired renal function (characterized by low eGFR, high ACR, creatinine and urea) with a myeloma profile indicative of disease activity and burden (high β2m, low Hb, low albumin, and high M-protein).

Conclusion: Conclusions: The study confirms a significant multivariate association between a profile of impaired renal function and markers reflecting MM activity, hematopoietic suppression and systemic burden. These findings underscore the multifactorial nature of MM-related kidney injury and highlight the clinical utility of monitoring key laboratory markers (including eGFR, ACR, creatinine, β2m, Hb and albumin) alongside clinical evaluation for comprehensive assessment and management of MM patients.

Objective: Aim: To investigate the features of professional medical communication in wartime through the prism of gender characteristics based on the analysis of authentic dialogues from clinical conversations.

Patients and methods: Materials and Methods: Bibliosemantic, content, psychosemantic, and comparative analysis; empirical methods: observing the living language of doctors and patients, creating and typologising the collection of authentic doctor-patient dialogues. The authentic audio and video recordings of 232 doctor-patient dialogues were collected. After conducting an initial typology of the dialogues, four samples were created: «male» and «female doctors», «male» and «female patients». The dialogues were transcribed and subjected to content analysis using the «Textanz» software (v. 2.3).

Results: Results: The psycholinguistic features of professional medical communication in each of the four studied samples were established. For example, male doctors have higher speech activity within their professional role (181 words vs. 138 for female doctors). Their speech is characterised by a predominance of verbs and rational structuring. In contrast, female doctors use nominative constructions with a predominance of nouns, pronouns, and adverbs more often, which indicates the objectification of symptoms and an empathic orientation. Female patients show higher speech activity, ask questions more often, and use more emotionally coloured vocabulary and modal words, which indicates increased anxiety.

Conclusion: Conclusions: The study confirms the presence of gender-based models of medical communication, which are exacerbated in wartime. The results of the study can be used in training on the development of communication skills of medical workers, in writing clinical protocols, as well as in psychological support for wounded and displaced persons.

Objective: Aim: To assess the level of patient satisfaction and their opinions about the services provided by community pharmacists and their changes depending on the socio-demographic characteristics that influence the level of satisfaction and expectations of patients served in the city of Al-Najaf Al-Ashraf city of Iraq.

Patients and methods: Materials and Methods: A structured questionnaire was allocated among patients who were staying pharmacies regarding aspects like accessibility, communication, and quality of services. A descriptive cross-sectional survey was executed utilizing a questionnaire that encompassed various dimensions of pharmaceutical services. The sample population comprised 449 patients who frequented a range of pharmacies with varying regularity within the province.

Results: Results: A significant majority of individuals exhibit a favorable perception regarding community pharmacists in Al-Najaf Al-Ashraf, with patients articulating substantial satisfaction, recognition, and esteem for the contributions that pharmacists make within the healthcare team.

Conclusion: Conclusions: Pharmacists play a vital role in providing pharmaceutical care, and patients generally express satisfaction with their services. However, there is a significant need for additional initiatives to enhance the clinical skills of community pharmacists, identify factors affecting patient satisfaction, and conduct comparative research on pharmacy services in different regions of Iraq.

Objective: Aim: The aim is to determine the causes and consequences of combat stress in armed conflict participants.

Patients and methods: Materials and Methods: The research involved 109 service members (under 30) who participated in the russian-Ukrainian war in 2022-2024 on a rotational basis for different durations (from 4 to 18 months). Research methods included theoretical analysis and generalization of literary sources, interviews, questionnaires, and statistical methods.

Results: Results: The causes of combat stress in service members participating in military operations have been identified. It has been established that during the first rotation, service members most often suffer from being in conditions of constant threats (71.6 %), experience fear of death and injury (70.6 %), fear of killing a person (67.9 %), loud sounds (63.3 %) and lack of sleep (52.3 %). With the acquisition of combat experience, the frequency of these factors decreases. The research revealed the consequences of combat stress, which worsen depending on the duration of stay in a combat situation: increased aggressiveness (71.1 %), anxiety, fear (68.4 %), sleep problems (31.6 %), cognitive impairment (28.9 %), and psychosomatic disorders (26.3 %).

Conclusion: Conclusions: Ensuring military personnel's access to qualified psychological assistance, creating a support and rehabilitation program, and raising public awareness of the problems faced by service members participating in combat operations will reduce the negative effects of combat stress and help improve the quality of life of military personnel and their families.

Objective: Aim: The article is devoted to the study of the right to life as a key aspect of legal theory. The purpose of the study is to examine the theoretical aspects of the right to life, to analyze its essence, place and significance in the system of general human rights; to outline the main principles and concepts related to the right to life, to consider their evolution in different legal systems and to discuss important ethical aspects related to this topic.

Patients and methods: Materials and Methods: The article examines the right to life, defines its place in the modern world, highlights the issues of correlation between this right and the right to abortion and euthanasia, and assesses the prospects for their realization. The empirical basis of the study is grounded on articles by scholars and assessments by leading experts in the field. The authors used general scientific methods, including system analysis, system modeling, and the dialectical method. To demonstrate the relationship between the right to life of an unborn child and a woman's right to abortion, a social survey was conducted among different population groups.

Conclusion: Conclusions: Analyzing the right to life in the context of its interrelationship with other human rights, such as the right to liberty, the right to health and the right to a fair trial, helps to affirm the principles of the rule of law and ensure equality before the law for all. In the modern world, the concept of the right to life has become an important element of international law, which covers not only physical existence, but also the provision of a decent and quality life, health, education and social protection. Cultural and religious aspects play a significant role in shaping the understanding of the right to life. Different religious and cultural traditions have their own interpretations of the beginning and end of life, influencing attitudes to aspects related to medical interventions, abortion, euthanasia and other issues.

Objective: Aim: The purpose of this study is to analyze the correlations of pro-inflammatory cytokines and β2-microglobulin with indicators of changes in the functional state of kidneys in patients with diabetic nephropathy, to determine different degrees of chronic renal failure.

Patients and methods: Materials and Methods: 80 patients with type 1 and type 2 diabetes, complicated by diabetic nephropathy, at different levels of the functional state of the kidneys were examined.

Results: Results: It has been shown that the level of tumor necrosis factor α (TNFα) in the blood of patients with diabetic nephropathy (DN) is increased already with sufficient kidney function, decreases with chronic renal failure (CRF) of the I degree and reaches maximum values with CRF of the II and III degrees. Which indicates the degree of progression of fibroplastic and sclerotic processes in the kidneys with DN. The level of interleukin-1α (IL-1α) in the blood of patients with DN begins to decrease with sufficient kidney function, increases with CRF of the II degree, but remains below the values of the control group and is minimal in patients with CRF of the III degree, which reflects a decrease in the intensity of the acute-phase inflammatory process in the development of CRF.

Conclusion: Conclusions: The development and progression of CRF is accompanied by an increase in the excretion of β2-microglobulin in the urine in parallel with changes in the cytokine profile in the blood.

Objective: Aim: To assess the impact of surgical treatment on quality of life in patients with chronic slow transit constipation according to the PAC-QOL scale one year after surgery.

Patients and methods: Materials and Methods: PAC-QOL scores were studied in 107 patients with chronic slow-transit constipation (main group) before and one year after total colectomy (57), subtotal colectomy (29) and colectomy with low rectal resection (21). 70 patients were included into the reference group. Open surgery was performed in 70 (65.4%) patients, while laparoscopic access - in 37 (34.6%) patients.

Results: Results: Despite the long-term conservative treatment PAC-QOL scores for all subscales significantly exceeded the reference values in all patients before surgery (all p<0,05). After surgery PAC-QOL scores decreased to reference values and were statistically lower than preoperative values (all p<0.01): physical component - from 2.78±0.52 to 1.01±0.32; psychological component - from 1.90±0.48 to 0.83±0.41; warries and concerns - from 1.99±0.31 to 0.72±0.34; the satisfaction component - from 2.35±0.60 to 0.84±0.47; total PAC-QOL score - from 2.14±0.23 to 0.82±0.35.

Conclusion: Conclusions: Surgical treatment - total or subtotal colectomy in patients with chronic slow-transit constipation resistant to conservative treatment provides a significant reduction of all PAC-QOL scores to reference values and provides full social and functional adaptation.