Видання іноземною мовою. Кафедра загальної, дитячої та військової хірургії з курсом урології та офтальмології

Arnold-chiari syndrome in ophthalmology (clinical cases)

2026-05-05T06:06:26Z

Arnold-chiari syndrome in ophthalmology (clinical cases) Konovalova, N. V.; Zborovska, O. V.; Bushueva, N. M.; Guzun, O. V.; Kovtun, O. V. Arnold-Chiari syndrome is a pathology manifested by displacement of the cerebellum and cerebrum through the foramen of the spinal canal, inherited from the inconsistency of the dimensions of the posterior cranial fossa and placement brain structures. Purpose – to evaluate the results of a comprehensive approach to the differential diagnosis of Arnold-Chiari malformation in ophthalmology using two patients as an example. Materials and methods 2 patients (4 eyes) were examined for Arnold-Chiari malformation by generally accepted methods, and optical coherence tomography (OCT). Results There is no pathognomonic symptom or group of symptoms that allow for the clinical diagnosis of Arnold Chiari syndrome, and only neuroimaging diagnostics are possible. Whenever there is inflammation, congestive disc, or optic nerve atrophy, the first action of the ophthalmologist is to refer the patient for magnetic resonance imaging (MRI) or computed tomography (CT) imaging. Identification of relevant ophthalmological disorders at an early stage allows for timely suspicion and detection of this anomaly. Neuroimaging diagnostics justifies the doctor's alertness to this pathology. Conclusion Current diagnostic and treatment advances bring together specialists from various fields – ophthalmologists, radiologists, and neurologists – and present new challenges for physicians. The presented series of clinical cases demonstrated possible manifestations of Arnold-Chiari syndrome, including strabismus and congestion in the optic nerve, which was confirmed by MRI.

Proteolisis status in the oral mucosa of rats after “mild” stress

2026-05-04T06:22:50Z

Proteolisis status in the oral mucosa of rats after “mild” stress Pavlenko, K. V. Aim. To investigate the effect of “mild” stress on the state of proteolysis in the oral mucosa (OM). Methods. Rats were subjected to “mild” stress by holding them at −20 °C for 5 minutes. In the OM, in blood serum, liver, kidneys and pancreas, proteolysis activity was determined by the rate of hydrolysis of two substrates: casein and BAEE (benzoyl-arginine ethyl ether). Results. It has been established that OM has a high proteolytic activity, which begins to decrease already 5 hours after stress. In blood serum, on the contrary, the activity of proteolysis (substrate casein) increases after stress. The activity of BAEE-esterase does not change significantly after stress. Conclusion. The level of proteolysis in OM is several times higher than the corresponding indicator for blood serum and rat liver. "Mild" stress causes an increase in the level of proteolysis in the blood serum as early as 5 hours after stress, while the level of proteolysis in the OM after stress tends to decrease. Activation of proteolysis in the blood after stress requires antiprotease actions using protease inhibitors.

Antielastasic activity of antistressants in bone tissue of rats after stress

2026-04-28T09:48:45Z

Antielastasic activity of antistressants in bone tissue of rats after stress Pavlenko, К. V. Stress causes the development of post-stress pathological reactions, which culminate in dysmetabolic disorders, against the background of which most diseases of humans and animals develop. Bone tissue has been found to be one of the most sensitive organs and tissues to the effects of dysmetabolic syndrome. Aim. Study of the effect of stress on the activity of the proteolytic enzyme elastase in bone tissue and determination of the possibility of preventing elastase activation using antistress agents. Methods. Stress was induced in rats by holding the animals at −20 °C for 30 minutes and elastase activity was investigated on the 4th day after stress. Antioxidant preparations EkSoVit, Quercetin and ascorbic acid were used as anti-stressors, which were administered into the oral cavity 3 days before stress and 3 days after stress in the form of an oral gel in doses (mg/kg): EkSoVit 0.43 and 1.07, Quercetin 0.128 and 0.257 and ascorbic acid 0.257. Results. In rats without stress, the elastase activity in the femur was (μk-kat/kg) 6.66; in rats after stress 9.61; in rats with stress that received EkSoVit, 8.16 and 6.90; in rats with stress that received quercetin, 7.20 and 5.60; in rats with stress that received ascorbic acid, 7.20. The antielastase activity in vivo was: EkSoVit – 49.15 and 126.05; quercetin – 112.10 and 135.93 and ascorbic acid – 81.63. The antielastase efficacy of antistressants was after conversion of antielastase activity to a dose of 1 g/kg: for EkSoVit 114.3 and 117.8; for quercetin 875.8 and 528.9; for ascorbic acid 317.8. Conclusion. After stress, the activity of the proteolytic enzyme elastase increases in bone tissue. The use of anti-stress agents with antioxidant action significantly prevents the activation of elastase. The most effective anti-elastase drug was quercetin (vitamin P).

Prognostic model of integral renal risk in infants after correction of congenital heart defects

2026-04-27T07:54:46Z

Prognostic model of integral renal risk in infants after correction of congenital heart defects Melnychenko, M. H.; Buzovskyi, V. P.; Elii, L. B.; Мельниченко, М. Г.; Бузовський, В. П.; Елій, Л. Б. Renal complications and subclinical renal stress are frequent components of the early postoperative period in infants after cardiac surgical correction of congenital heart defects and require early risk stratification. Objective – to develop a prognostic scoring index for assessing the integral renal risk index in infants after cor rection of congenital heart defects in the early postoperative period. Materials and methods. A retrospective single-center descriptive-analytical study was conducted (n = 101; age 1 – 12 months). The dependent variable was the integral renal risk index (a continuous scale of integral renal risk or stress) formed within the analysis of the early postoperative period. The following predictors were consid ered: disease severity, physical development as a proxy for nutritional status, class or complexity of the surgical intervention, syndromic or genetic features, creatinine level, and left ventricular ejection fraction. Multiple linear regression was constructed with diagnostics of assumptions (normality of residuals, linearity, homoscedasticity, multicollinearity assessed by the variance inflation factor, and influential observations). Results. The model was statistically significant (F(6, 94) = 9.82; p < 0.001) and explained 38.5 % of the variance in risk (adjusted R2 = 0.346). The largest independent contribution was made by the operation class (surgical complexity) (b = 0.578; p < 0.001), whereas ejection fraction demonstrated an inverse association with risk (b = –0.0167; p = 0.016). Conclusions. A scoring index, X, defined by a formula and within-cohort thresholds (X > 1 – high risk; X > 1.5 – very high risk), is proposed. This index integrates perioperative burden and perfusion reserve and may be used for early nephroprotective management.; Ренальні ускладнення та субклінічний ренальний стрес є частими компонентами раннього післяопера ційного періоду в немовлят після кардіохірургічної корекції вроджених вад серця та потребують ранньої стратифікації ризику. Мета — розробити прогностичний скоринговий індекс для оцінки інтегрального показника ренального ризику (risk) у немовлят після корекції вроджених вад серця в ранній післяопераційний період. Матеріали та методи. Проведено ретроспективне одноцентрове описово-аналітичне дослідження (n = 101; 1 — 12 міс). Залежною змінною був інтегральний показник risk (безперервна шкала інтегрально го ренального ризику або стресу), сформований у межах аналізу раннього післяопераційного періоду. Як предиктори розглядали: тяжкість стану, фізичний розвиток як проксі нутритивного статусу, клас або складність оперативного втручання, синдромальні або генетичні стигми, креатинін і фракцію викиду лівого шлуночка. Побудовано множинну лінійну регресію з діагностикою припущень (нормальність залишків, лінійність, гомоскедастичність, мультиколінеарність за VIF (the variance inflation factor), впли вові спостереження). Результати. Модель була статистично значущою (F (6, 94) = 9,82; p < 0,001) і пояснювала 38,5 % варіації risk (Adjusted R2 = 0,346). Найбільший незалежний внесок мав operation_class (b = 0,578; p < 0,001), тоді як фракція викиду демонструвала негативний зв’язок із risk (b = –0,0167; p = 0,016). Висновки. Запропоновано скоринговий індекс X із формулою та внутрішньокогортними порогами (X > 1 — високий, X > 1,5 — дуже високий ризик), який інтегрує періопераційне навантаження та перфу зійний резерв і може застосовуватися для раннього нефропротективного ведення.

Congenital heart defects in children: the current state of the problem and challenges for the healthcare system

2026-03-26T13:19:18Z

Congenital heart defects in children: the current state of the problem and challenges for the healthcare system Melnychenko, M. H.; Buzovskyi, V. P.; Yurchenko, I. V.; Мельниченко, М. Г.; Бузовський, В. П.; Юрченко, І. В. Congenital heart defects (CHDs) are among the most common congenital anomalies worldwide. They adversely affect human health, lead to disability, and remain a leading cause of infant mortality. Objective. To summarize the global prevalence of CHDs among live-born children and worldwide trends in improving diagnosis and treatment. The term “trends” refers to temporal changes in the reported prevalence of CHDs and mortality rates, which depend on healthcare system factors, including screening organization, case registration, and access to treatment. Results. The global prevalence of CHDs ranges from 8 to 12 ‰. Structurally, the most common defects are VSD (40%), ASD (14%), PDA (10%), PS (7.6%), TOF (5.5%), CoA (4.7%), TGA (3.7%), HLHS (2.6%). With timely surgical intervention, up to 95% of affected children survive. In Ukraine, approximately 4.500 children with CHDs are born annually, of whom about 30–40% require surgical treatment during the first year of life.; Однією з найчастіших вроджених аномалій у світі є вроджені вади серця (ВВС), які завдають шкоди здоров’ю людини, призводять до інвалідизації і є основною причиною летальності немовлят. Мета – узагальнення глобальної поширеності ВВС серед живонароджених дітей та тенденцій щодо поліпшення діагностики та лікування у світі. Під «тенденціями» розуміли часові зміни зареєстрованої частоти ВВС та показників смертності, які залежать від системи – організації скринінгу, реєстрації випадків і доступності лікування. Результат. Частота ВВС у світі коливається в межах 8–12‰. За структурою найпоширенішими дефектами є: VSD (40%), ASD (14%), PDA (10%), PS (7,6%), TOF (5,5%), CoA (4,7%), TGA (3,7%), HLHS (2,6%). За умови своєчасної хірургічної допомоги 95% дітей виживають. В Україні щороку народжується близько 4500 дітей із ВВС, з яких приблизно 30–40% потребують хірургічного втручання у перший рік життя.

Clinical monitoring of refractory interstitial cystitis during pharmacotherapy in women

2026-03-26T11:29:44Z

Clinical monitoring of refractory interstitial cystitis during pharmacotherapy in women Vydrin, K. Ye.; Poliakov, V. O.; Kostev, F. I.; Dekhtiar, Yu. M.; Shostak, M. V.; Видрін, К. Є.; Поляков, В. О.; Костєв, Ф. І.; Дехтяр, Ю. М.; Шостак, М. В. Refractory interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition marked by resistance to standard treatments and persistent symptoms such as pelvic pain, urgency, frequency, and reduced bladder capacity. Objective – to improve treatment outcomes in women with refractory IC/BPS by using a personalized multimodal approach combining intravesical botulinum toxin type A (BTA), gabapentin, and hydroxychloroquine. Materials and methods. A prospective study included 67 women diagnosed with refractory IC/BPS. Patients were assigned to two groups: the control group (n=32) received intravesical BTA alone, while the main group (n=35) received the combination therapy. Treatment lasted 6 months, with follow-up for 12 months. Efficacy was evaluated using O’Leary-Sant questionnaires, VAS for pain, urinary diaries, and cystoscopy. Results. Combination therapy showed superior efficacy over BTA monotherapy. In 6 months, 80% of patients in the main group reported good/satisfactory outcomes vs. 53.1% in the control group. At 12 months, Hunner’s ulcers were observed in 22.85% of the main group vs. 59.37% of the control group (p < 0.001); glomerulations occurred in 40% vs. 87.5% (p < 0.001). Functional bladder capacity improved by 99.05%. Pain (VAS) decreased by 68.3%, urinary frequency by 54.6%, urgency by 76.1%, nocturia by 69.7%, and ICSI/ICPI scores by 70% and 65.9%, respectively (p < 0.05). Conclusion. The combination therapy offers better symptom control, improved urothelial healing, and sustained results compared to BTA monotherapy.; Рефрактерний інтерстиціальний цистит/больовий синдром сечового міхура (РІЦ/БССМ) – це хронічне захворювання, стійке до стандартної терапії. Мета дослідження – підвищити ефективність лікування жінок з РІЦ/БССМ шляхом застосування персоналізованої комбінованої терапії: внутрішньоміхурового введення ботулінічного токсину типу А (БТА), габапентину та гідроксихлорохіну. Комбіноване лікування показало переваги над монотерапією БТА: після 6 місяців покращення відзначалося у 80% пацієнток проти 53,12%, зниження частоти виразок Гуннера та гломеруляцій – до 22,85% і 40% відповідно. Комбінація препаратів забезпечує кращий контроль симптомів та тривале поліпшення.

Method for determining in vivo antielastasy activity and effectiveness of treatmental and prophylaxis drugs

2026-04-01T10:55:49Z

Method for determining in vivo antielastasy activity and effectiveness of treatmental and prophylaxis drugs Levitsky, A. P.; Malinovskii, V. O.; Pavlenko, K. V.; Yuzkiv, Ya. S.; Selivanska, I. О.; Lapinska, A. P. Aim. A method for determining in vivo antielastase activity in rat bone tissue after stress has been proposed. Methods. Stress was reproduced in rats by exposing the animals to −20 °C for 30 minutes. The dietary supplement “EkSoVit” (containing soy extract with proteolysis inhibitors), quercetin and ascorbic acid were used as anti-stressors. Anti-stressors were administered orally 3 days before stress and 3 days after stress. Animals were euthanized on day 4. Results. An increase in elastase activity in the femur of rats after stress was established. All 3 anti-stressors reduce elastase activity: "EkSoVit" by 49 %, quercetin by 136 % and ascorbic acid by 91 %. In terms of anti-elastase efficacy, Quercetin exceeded "EkSoVit" by almost 5 times, and ascorbic acid by three times. Conclusion. Stress causes activation of elastase activity in bone tissue. The main reason for the increase in elastase activity may be the translocation of the enzyme from leukocytes and the intestine. The most active anti-elastase agent was the flavonoid quercetin, which does not have a direct inhibitory effect on the elastase enzyme.

Reducing the risk of age-related macular degeneration progression - fiveyear follow-up study in Ukraine and Moldova

2026-04-15T08:17:23Z

Reducing the risk of age-related macular degeneration progression - fiveyear follow-up study in Ukraine and Moldova Guzun, O. V.; Zadorozhnyy, O. S.; Konovalova, N. V.; Bezdetko, P. A.; Korol, A. R.; Dumbrăveanu, L. G.; Cușnir, V. N.; Cușnir, V. V. This open prospective study aimed to evaluate the dynamics of progression of early and intermediate age-related macular degeneration (AMD) against the background of continuous use of the nutraceutical formula AREDS2, which includes omega-3 polyunsaturated fatty acids (PUFAs), vitamin D, resveratrol, and photobiomodulation (PBM), over a 5-year follow-up in patients from Ukraine and Moldova. Examining 126,400 patients, 163 patients (304 eyes) with early and intermediate stages of AMD were treated (5-year follow-up). Patients were divided into two groups. Patients in the 1st group (149 eyes) were prescribed a nutraceutical formula based on AREDS2 with omega-3 PUFAs, vitamin D, and resveratrol (Nutrof®Forte 1 capsule once a day continuously). The second group (155 eyes) included patients who irregularly took various vitamin-antioxidant complexes. All patients underwent PBM every 6 months. The five-year prevalence of early and intermediate AMD was estimated using data from leading ophthalmological centers in Ukraine (Odesa - 7.1%, Kharkiv - 6.6%) and Moldova (6.3%). AMD progression in the multivariate Cox regression model over five years showed a 3.24-fold reduction in relative risk (95% CI: 2.15-4.79, p=0.000) for patients with early and intermediate AMD who regularly took the recommended nutraceutical (compared to those who irregularly took various vitamin-antioxidant complexes). Patients with early and intermediate AMD are recommended to undergo courses of PBM every six months. Additionally, it is crucial to address cardiovascular issues and consistently use the AREDS2 nutraceutical formula. Adherence to these recommendations can reduce the likelihood of disease progression by at least 3.24 times over the next 5 years.

Application of perineural administration of fibroblasts and PRP in tourniquet syndrome: a surgeon’s perspective

2026-04-15T11:19:03Z

Application of perineural administration of fibroblasts and PRP in tourniquet syndrome: a surgeon’s perspective Samarskyi, I. M.; Kashtalian, M. A.; Tsepkolenko, V. O.; Davydov, D. M.; Самарський, І. М.; Каштальян, М. А.; Цепколенко, В. О.; Давидов, Д. М. Tourniquet syndrome causes compression-ischemic neuropathy and remains a significant challenge in combat-related limb injuries. Regenerative therapies using platelet-rich plasma (PRP) and fibroblasts may enhance neural recovery through trophic, angiogenic, and anti-inflammatory mechanisms. Objective. To evaluate the clinical efficacy of perineural administration of PRP and autologous dermal fibroblasts in patients with tourniquet-induced neuropathy. Materials and methods. A prospective study was conducted at the Military Medical Clinical Center of the Southern Region (Odesa, 2023–2024). Thirty-two patients with lower-limb injuries complicated by tourniquet application were examined. Group I (n = 17) received multimodal pharmacotherapy plus perineural PRP injections (3 sessions of 4 mL under ultrasound guidance) followed two weeks later by autologous fibroblast transplantation (30 million cells). Group II (n = 15) received pharmacotherapy only. Outcomes included pain intensity (VAS), motor and sensory function recovery, hospital stay duration, and complications. Results. Group I demonstrated significantly faster reduction of neuropathic pain (VAS decreased from 8.9 to 3.6 at one month vs. 9.1 to 4.9 in controls, p < 0.05), earlier return of active distal motor function (10–14 days vs. > 4 weeks), and quicker recovery of tactile and pain sensitivity (7–10 days vs. approximately 4 weeks). Length of hospital stay was reduced by 10–17 days (35.8 ± 4.2 vs. 57.3 ± 5.1 days). Analgesic demand decreased by 50% after 2 weeks and by 75% at one month. No infectious complications occurred; local pain and transient edema were the most common mild adverse effects. No amputations were required. Conclusions. Perineural PRP and fibroblast therapy accelerates functional recovery, decreases analgesic load, and shortens rehabilitation period in tourniquet neuropathy. The approach appears safe and feasible in military hospital practice but requires multicenter randomized trials to standardize dosing, timing, and protocols.; У статті представлено клінічне дослідження ефективності периневрального введення збагаченої тромбоцитами плазми (PRP) та фібробластів у лікуванні компресійно-ішемічної нейропатії, спричиненої тривалим накладанням турнікета. PRP-терапія, яка використовує аутологічний концентрат тромбоцитів, показала здатність активізувати регенеративні процеси, зменшувати запалення та стимулювати ангіогенез і ремієлінізацію. Отримані результати засвідчили значно швидше зниження больового синдрому, поліпшення моторної функції, відновлення чутливості та скорочення тривалості перебування в стаціонарі у пацієнтів першої групи. Також спостерігалося зменшення потреби в анальгетиках. Автори підкреслюють необхідність подальших багатоцентрових досліджень для стандартизації протоколів застосування PRP у нейрореабілітації.

Enzymatic method for determining in vivo the mineralizing efficiency of osteoprotective drugs

2026-01-13T11:07:20Z

Enzymatic method for determining in vivo the mineralizing efficiency of osteoprotective drugs Levitsky, A. P.; Pavlenko, K. V.; Selivanska, I. О.; Lapinska, A. P. For screening osteoprotectors, it is proposed to investigate the mineralizing activity of rat bone tissue (femur, jaws, teeth) in which experimental osteoporosis was reproduced (stress, inadequate nutrition, dysmetabolic syndrome). It is proposed to determine the mineralizing activity by the ratio of alkaline (ALP) and acid (AP) phosphatase activity in bone tissue. It is proposed to determine in vivo the mineralizing efficiency of the drug by the percentage increase in mineralizing activity per dose of the drug in mg/kg of live weight. Of the three osteoprotectors studied (EkSoVit, quercetin and ascorbic acid), quercetin was the most effective, and ascorbic acid was the least effective.