Polski Merkuriusz Lekarski最新文献

Objective: Aim: To determine the prevalence of traumatization, depression, stress, and anxiety during the war in the rear western region of Ukraine.

Patients and methods: Materials and Methods: For the study of the war's impact on the psychological state of medical students to be successful, it is essential to analyze various influencing factors and explore possible ways of supporting students in difficult situations duringmilitary conflict. The 1 to 6-year students of the Medical Faculty of I. Horbachevsky Ternopil National Medical University, who voluntarily completed the DASS-21 survey scale, participated in our research on students' mental health. The statistical sample was 716 students.

Results: Results: To compare the degree of the emotional state of depression, anxiety, and stress in medical students, we have used a survey conducted among the students (716 people). Horbachevsky Ternopil National Medical University in 2019 and 2024. In 2019, the degree of depression severity among the students was determined to be 50.9%, anxiety - 48.9%, and stress - 50.7%. After two years of the war, in 2024, this indicator is already 65.8%, 65.9 %, and 74.7%, respectively, which is 1.3 times higher than the degree of depression and anxiety severity and 1.5 times higher than the degree of stress severity in 2019. Withinan extensivesurvey of I. Horbachevsky Ternopil National Medical Universitystudents, 98% said they had been affected by the war in some way, 86% suffered from war-related nightmares, 49% experienced symptoms of insomnia, and 27% had symptoms of post-traumatic stress disorder. However, the mental health of young people who were close to the combat zone or directly participated in hostilities was significantly worse. At the same time, another study on the mental state of students in Ukraine revealed that symptoms of psychological disorder were observed in 52.7% of respondents, with anxiety being characteristic of the majority of participants - 54.1%. Almost half of the young respondents reported experiencing depression - 46.8%. The conducted studies established a connection between mental health disorders among young Ukrainians and factors such as gender, place of residence (urban or rural area), whether they lived in territory occupied by Russian forces, as well as the presence of their own family or elderly relatives.

Conclusion: Conclussions: As the trauma of war can persist for years after its end, there is a need to monitor the psychological state and well-being of students systematically. It is equally important to study the aspects of strengthening psychological health and the resources that may be needed for this. Maintaining students' mental health in martial law requires all types of resources (personal, physical, informational, and other), psychological competence, social support, cognitive training, and simulation modeling methods.

Objective: Aim: To analyze the significance of modern computer technologies within the value systems of teachers and students at medical universities. Through expert assessments, it explores the advantages and risks associated with artificial intelligence. Special attention is given to the impact of the ongoing war on the value orientations of future doctors and the organization of professional training under new conditions.

Patients and methods: Materials and Methods: The research employed modern methods of analysis, synthesis, generalization, and comparison, alongside expert assessments and creative essays. It also drew upon the experience of Ukrainian and Polish colleagues in creatively integrating AI into the educational process, particularly in training future doctors for effective patient communication during anamnesis-taking and for understanding the risks of iatrogenesis. To achieve the research goals, a digital information search was conducted using the scientometric database Scopus.

Conclusion: Conclusions: In the face of new challenges, there is an increasing need to examine the dynamics of professional self-development, motivation, and the value systems of future doctors. Given the innovative nature of AI, its potential applications in medicine, its significant benefits, and its possible risks, it is essential to study this issue in depth and systematically prepare medical students for the rational use of modern information technologies. The importance of international collaboration, comparative research, and the practical implementation of the Club of Rome's recommendations on integral thinking continues to grow.

Objective: Aim: To study the regenerative potential of calcium phosphate ceramics doped with germanium (CFCdGe; Ge amount 1-1,5%) compared to a deproteinized bovine material (DBM).

Patients and methods: Materials and Methods: The study was performed in vivo on 30 laboratory rabbits, which were formed with a bicortical bone defect in the mandibular angle area on both sides (diameter - 7 mm). There were 3 groups where defects were replaced by CFCdGe (group 1 [n= 10]) and DBM (group 2 [n= 10]) As a control (group 3 [n= 10]), a defect was healed under a blood clot. We studied microstructure of the CFCdGe, solubility, phase, chemical composition, and adsorption activity. The animals were euthanized on 21st, 42nd, and 90th day for taking histological samples to access trabecular width between and around granules.

Results: Results: The size of CFCdGe (Ge 1%) participles was smaller, but the porosity was larger, therefore the working concentration of Ge was chosen as 1%. At 90th day, the trabecular width around granules in group 1 (98,9±27,2 μm) was 92,78% greater than in group 2 (51,3±20,8 μm) and 22,70% greater than width of new bone trabeculae in the control group (80,6±34,2 μm) (groups 1 vs. 2: p<0,01). The trabecular width between granules in group 1 (121,0±21,0 μm) was 68,05% greater than in group 2 (72,0±13,1 μm) (p<0,01). The CFCdGe granules were surrounded by formed bone tissue with overwhelming amount of mature lamellar bone.

Conclusion: Conclusions: The CFCdGe (Ge 1%) in the experimental study on laboratory rabbits demonstrated a significantly better result than the DBM.

Objective: Aim: To determine the effectiveness of a multidisciplinary rehabilitation program (MRP), integrating mesenchymal stem cells (MSCs) therapy, acupuncture, physiotherapy and physical exercises, in improving the functional recovery in patients with combat-related injuries and chronic critical lower limb ischemia (CCLLI).

Patients and methods: Materials and Methods: A six-month comparative clinical trial was conducted involving 40 male patients (mean age [mean ± standard error] 62,5±2,3 years) diagnosed with CCLLI, including 10 individuals with combat-related injuries, being randomized into 2 groups: the MSCs group (main group [MG]) (n=20) received MRP, including autologous MSCs therapy; the control group (CG) (n=20) received standard therapy only. Five patients with gunshot wounds were randomly assigned to each group.

Results: Results: MG patients presented with significant increase in ankle-brachial index and VAS pain score decrease, being more pronounced as opposed to CG. Walking distance improvement was achieved in 75% of MG patients vs. 40% in CG (p<0,01). Trophic ulcers healed in 100% of MG patients (vs 25% in CG [p<0,01]). After treatment, only 1 (5%) patient in the MG remained at risk of lower limb amputation, as compared to 8 (40%) patients in the CG (p<0,05) (RR 0,13 [95% CI 0,02-0,91]; p<0,05).

Conclusion: Conclusions: The implementation of MRP, integrating MSCs therapy, led to significant improvements in pain relief, tissue regeneration and overall functional recovery in patients with CCLLI, particularly those with military-related injuries, favouring the reduction of the risk of lower limb amputation.

Objective: Aim: The aim of the present study is to analyse and summarize the experience of the Department of Reconstructive and Plastic Microsurgery of the National Scientific Center of Surgery named after A.N. Syzganov in the field of treatment of hand injuries..

Patients and methods: Materials and Methods: The study sample included 295 patients who applied to the Department of Reconstructive and Plastic Microsurgery of the National Scientific Center of Surgery named after A.N. Syzganov from the beginning of 2021 to the end of 2022, in relation to which general clinical methods of research, including the method of dynamic observation and innovative microsurgical techniques, were applied. Innovative minimally invasive surgical techniques were developed and successfully applied to the flexor tendons of the fingers, ensuring precise juxtaposition of tendon ends, reducing tissue trauma, and facilitating smooth passage of the repaired tendons in bone-fibrous canals.

Results: Results: The application of the developed methods demonstrated high clinical efficacy, as evidenced by the high percentage of good and satisfactory treatment results - 98.8% in one group and 93.7% in the other. Nevertheless, in 3.4% of cases, the development of flexion contractures of fingers of different severity was observed, which was associated with insufficient intensity of rehabilitation, lack of proper dynamic control and indiscipline of some patients.

Conclusion: Conclusions: The result of the work was a comprehensive analysis of the experience of microsurgery of the hand obtained in the Republic of Kazakhstan during the study period.

Objective: Aim: To find out new objective criteria for laser histological differential diagnosis of thyroid pathology based on the use of a digital method of layer-by-layer polarization-interference mapping of polarization ellipticity maps of microscopic images of native histological sections of thyroid biopsy.

Patients and methods: Materials and Methods: Four groups of patients were studied: control group 1 - healthy donors (51 patients); study group 2 - patients with nodular goiter (51 patients); study group 3 - patients with autoimmune thyroiditis (51 patients); study group 4 - patients with papillary cancer (51 patients). Methods used: polarization-interference, statistical.

Results: Results: A brief theory and model concepts of the formation of structural optical anisotropy of polycrystalline networks of native histological sections of thyroid biopsy are considered. The structural and logical scheme of the method of polarization-interference layer-by-layer mapping of microscopic images of thyroid biopsies is presented. The statistical analysis of algorithmically reproduced maps of polarization ellipticity of experimental samples of biopsies of donors and patients with nodular goiter, autoimmune thyroiditis and papillary cancer was performed. Statistical objective markers for the differential diagnosis of thyroid pathology have been determined.

Conclusion: Conclusions: An excellent level (~93%-95%) of the balanced accuracy of differentiation of pathological conditions by the method of polarization-interference layer mapping was demonstrated.

Objective: Aim: The aim of this work is to analyze the provision of medical care to military personnel on the example of the activities of the Poltava Military Hospital (Poltava, Ukraine) for the period 2021-2023.

Patients and methods: Materials and Methods: The design of our study was descriptive. During the research, the reporting and accounting documentation of the Poltava Military Hospital for the relevant years was used. Descriptive statistics methods were used to analyze the main indicators of the hospital's activity: growth rates and growth rates were calculated to describe changes in the main indicators.

Results: Results: The average number of staffed beds in the hospital as a whole is growing. Thus, compared to 2021, in 2023, this figure increased by 200% (100% growth increment rate). The bed utilization, we can note that in 2022, the utilization of both staffed beds (67.29%) and actually deployed beds (47.93%) was inefficient, and during the war it reached a sufficient level - 89.27% and 63.84.8%, respectively, bed occupancy rates in all hospital departments were 7.7-7.3.

Conclusion: Conclusions: The ultimate impact of the ongoing war in Ukraine on the organization of medical care for injured servicemen and women remains uncertain, and we plan to explore this issue in our next work.

The aim of the paper is to reflect on the importance of the teacher of the medical profession in graduate and postgraduate education. The objective of the analysis was a narrative reflection on the profession of a teacher of medical professionals based on the principles of medical education and specialization programs applicable in Poland. The core curriculum for teaching in the field of medicine was analysed in detail, including also the insufficiently developed principles of selection and education of academic and vocational teachers. It has been demonstrated that there is no uniform concept of teaching competences for teachers of the medical profession in Poland. Academic teachers are usually recruited by medical universities based on their education and declaration of scientific work. Much less attention is paid to the development of their teaching competences. The current medical study programs are increasingly focused on practical skills. However, the limitation of theoretical subjects sometimes fails to provide sufficient knowledge to ensure the proper and in-depth education of medical students. Teaching future doctors requires reasonable care and reflection on the structure of the curricula, specialization programs, as well as on appropriate preparation of the teachers.

Air pollution currently plays a vital role in the increase in the number of deaths in the world. The problem of air pollution is now a very important public health problem. The effects of this pollution on the cardiovascular system have long been known. This impact is known in the field of PM2.5 and PM10 particulate matter. There are fewer reports on this impact in the field of heavy metals. The authors of this study present a brief description of acute ischemia of the lower limb and the possible effect of heavy metals from polluted air on the formation of thrombus in the arteries of the lower limbs and thus on acute ischemia of the lower limbs. The authors present an outline of the possible impact of polluted air elements on the formation of thrombus. This process can be combined with coagulation inside the peripheral arteries. The above problem requires research in the future. The authors plan such studies. This issue requires further research, and the authors plan to conduct such studies in the future.