https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19053 2026-08-11T18:55:47Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20203 Порівняльний аналіз результатів персоніфікованого лікування хворих на розповсюджений рак яєчників Рибін, А. І.; Кузнецова, О. В.; Максимовський, В. Є.; Замишляк, В. І.; Rybin, A.; Kuznetsova, O.; Maksimovsky, V.; Zamyshlyak, V. Авторами проведений аналіз результатів лікування хворих на розповсюджений рак яєчників в залежності від виконаного хірургічного доступу та результатів використання НІРЕС. Дослідження проводилось на базі Університетської клініки Одеського національного медичного університету. Порівняно дані 104 пацієнтів з РЯ, яким оперативне втручання було виконано лапароскопічним хірургічним доступом (L-CRS) (54 хворих) та хворих, яким було виконано операцію з лапаротомним доступом (O-CRS) (50 хворих). Показано, що лапароскопічний доступ дозволив зменшити частоту післяопераційних ускладнень II–ІV ступеня за Clavien-Dindo з 56,4 % до 27,8 % (χ2=14,56; р < 0,001), тривалість стаціонарного лікування (в середньому (5,4 ± 1,2) дні проти (10,1 ± 2,3) дні (t = 14,58; p < 0,001) та термін до початку ад'ювантної хіміотерапії (4,1 ± 1,2) тижні і (7,2 ± 1,5) тижні відповідно (t = 14,29; p < 0,001) без істотної різниці у післяопераційній смертності. Техніка HIPEC продемонструвала свою клінічну безпеку при лікуванні перитонеального канцероматозу різних первинних локалізацій.; The authors analysed the results of treatment of patients with advanced ovarian cancer depending on the surgical approach used and the results of NIRES application. The study was conducted at the University Clinic of Odessa National Medical University. The data of 104 patients with OC who underwent laparoscopic surgical access (L-CRS) (54 patients) and patients who underwent laparotomy access (O-CRS) (50 patients) were compared. It was shown that laparoscopic accessreduced the incidence of postoperative complications of II–IV degrees according to Clavien-Dindo from 56.4% to 27.8% (χ2=14.56; p < 0.001), the duration of hospitalisation (on average (5.4 ± 1.2) days versus (10.1 ± 2.3) days (t = 14.58; p < 0.001) and the time to the start of adjuvant chemotherapy (4.1 ± 1.2) weeks and (7.2 ± 1.5) weeks, respectively (t = 14.29; p < 0.001) without a significant difference in postoperative mortality. The HIPEC technique has demonstrated its clinical safety in the treatment of peritoneal carcinomatosis of various primary localisations. 2025-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/20149 ARM-ICG in the prevention of lymphedema after surgical treatment of breast cancer Dumanskyi, Yu. V.; Bondar, A. V.; Patskov, A. A.; Stolyarchuk, Ye. A. Objective: To evaluate the effectiveness of Axillary Reverse Mapping (ARM) using indocyanine green (ICG) during axillary lymph node dissection (ALND) in breast cancer (BC) patients, aimed at preventing postoperative upper limb lymphedema. Materials and Methods: A prospective study included 128 female patients with invasive breast cancer who underwent surgical treatment at the University Hospital of Odesa National Medical University. The control groups underwent sentinel lymph node biopsy (SLNB) or standard ALND, whereas the study group underwent ARM-ICG with intraoperative visualization of upper limb lymphatic pathways. Lymphedema was assessed at 1, 3, 6, and 12 months postoperatively. Results: ARM-ICG provided clear visualization of lymphatic collectors in 94% of cases and reduced the rate of postoperative lymphedema to 5%, which was significantly lower than after conventional ALND (42.9%, p < 0.001). In the SLNB-only group, lymphedema occurred in 9.4% of patients. The use of ARM-ICG did not compromise oncologic radicality or increase the risk of residual disease. Conclusions: The application of ARM-ICG in surgical management of breast cancer effectively decreases the risk of postoperative lymphedema by preserving upper extremity lymphatic drainage without loss of oncologic control. The technique demonstrates high clinical relevance and may be recommended for routine inclusion in the comprehensive treatment of breast cancer patients. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19805 Visualization of combat injuries: temporal structure and demographic determinants Herasymenko, O. S.; Sokolov, V. M.; Dorofeeva, T. K.; Dolhushin, O. O.; Sokolov, D. V.; Герасименко, О. С.; Соколов, В. М.; Дорофеєва, Т. К.; Долгушин, О. О.; Соколов, Д. В. Modern warfare with widespread use of body armour has shifted the spectrum of combat injuries. The study aims to describe the pattern of combat-related injuries from computed tomography (CT) imaging during the full-scale invasion of Ukraine and to assess the predictive value of age alone employing machine learning methods. Materials and methods. Opportunistic retrospective cohort study of 606 consecutively evacuated adult males who underwent CT at a second-level medical centre from April 2022 to September 2025. Multiclass automated machine learning (H2O AutoML) was trained using age as the sole predictor of CT-diagnosed injury category. Results and discussion. No acute pathology was found in 50.3 % of scans. The most common findings were metallic foreign bodies in soft tissues (25.5 %) and extremity fractures. Penetrating torso and severe traumatic brain injuries were rare (< 0.3 %). The age patterns strongly influenced injury pattern: soft-tissue shrapnel wounds predominated in patients < 40 years, whereas fractures and degenerative changes prevailed in older combatants. Over four years, the proportion of chronic and combined injuries increased 2–3-fold. The bestperforming generalised linear model achieved R² = 0.9996, but log-loss remained high (5.04) in middle-aged groups, confirming limited predictive power of age alone. Conclusion. CT remains a gold standard in stratifying combat injuries. Machine-learning models using demographic variables are promising as clinical decision-support tools in resource-constrained wartime settings.; Одеський національний медичний університет, Одеса, Україна Ретроспективне дослідження комп’ютерної томографії 606 поранених військових за 04.2022 – 09.2025: 50,3 % пацієнтів без гострої патології. Домінували металеві сторонні тіла в м’яких тканинах (25,5 %) та переломи кінцівок; тяжкі торакальні / черепно-мозкова травма – < 0,3 % через ефект бронезахисту. Визначено віковий профіль: < 40 років – уламкові контузії м’яких тканин; > 40 років – переломи, гемартрози, дегенеративні зміни опорно-рухового апарату. Лінійна модель лише за віком досягла R² = 0,9996, але log-loss 5,04 вказує на потребу додаткових предикторів. Комп’ютерна томографія залишається золотим стандартом стратифікації бойових ушкоджень. Машинне навчання на демографічних даних має потенціал як інструмент підтримки рішень в умовах війни. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19474 Historical aspects of endometrial cancer staging: the transition to molecular classification (a literature review) Rybin, A. I.; Kuznetsova, O. V.; Zamyshlyak, V. I. Determining the stage of a tumour is a crucial step in the management of patients with malignant diseases; it is directly linked to prognosis and the choice of specialised treatment, whilst facilitating the exchange of information between healthcare professionals. A staging system must possess three key characteristics: it must be effective, reliable and practical. The current staging (classification) system for endometrial cancer, developed in 2009, is highly reproducible and does not require excessive diagnostic investigations. However, the classification contains numerous ‘grey areas’ that hinder the evidence-based selection of appropriate treatment for patients falling within them. The most striking example is the need for lymph node dissection in clinical stage I endometrial cancer, where, in cases of intermediate risk, the decision to proceed is left to the discretion of the treating physician. To address this issue, and in an effort to individualise treatment and stratify the risk of recurrence, molecular classification has become widely adopted in recent years. Furthermore, in 2023, the International Federation of Gynaecologists proposed a new staging system for endometrial cancer. This review focuses on the historical aspects of the evolution of the concept of systematic assessment of endometrial cancer and provides a better understanding of recent advances in the biology of endometrial tumours. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19464 Patients’ attitudes towards cancer screening: a literature review Rybin, A. I.; Zamyshlyak, V. I. The aim of this review is to summarise the findings of studies on patients’ attitudes towards cancer screening. The review examined the full texts of 63 publications on four common cancers: breast cancer, cervical cancer, colorectal cancer and lung cancer. For each disease, specific features of patients’ attitudes towards screening programmes were identified, as reflected in their willingness to undergo screening, their awareness of the disease and screening for it, and the motivators and barriers to participating in cancer screening. For all these diseases, widespread support for screening programmes was found among various population groups, but the awareness of this support is called into question. The review concludes with recommendations for conducting research into patients’ attitudes towards cancer screening in Ukraine. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19397 Molecular characteristics of endometrial cancer: entering the era of precision medicine Rybin, A. I.; Kuznetsova, O. V.; Zamyshlyak, V. I. Endometrial cancer ranks third among cancers affecting women in Ukraine, with a tendency to incidence rate increase every year. The disease is extremely rare in women under 40, and uncommon between 40 and 50, but thereafter, as age increases, the incidence curve rises sharply, peaking at around 63 years of age. As a rule, the disease is diagnosed at an early stage, with an overall 5-year survival rate exceeding 95%. However, this rate drops significantly in cases of regional or distant spread, standing at 68% and 17% respectively. Historically, endometrial carcinoma was classified into two main clinical-pathological types. The first type comprised endometrioid adenocarcinomas, whilst the second included nonendometrioid tumours (serous, clear cell, undifferentiated carcinomas and carcinosarcomas). However, the work carried out in compiling The Cancer Genome Atlas (TCGA) has transformed our understanding of the molecular landscape of endometrial cancer, identifying not two but four molecular subtypes: tumours with mutations in the POLE gene, microsatellite-unstable carcinomas, tumours with mutations in the TP53 gene, and carcinomas of an unspecified molecular subtype. The integration of molecular classification into clinical practice has altered the stratification of patients into risk groups, which, in turn, has influenced the choice of adjuvant therapy. The rehabilitation of patients and ensuring a high quality of life is a very complex task, and to address it, an appropriate balance is required between reducing the risk of recurrence and preventing side effects associated with unjustified escalation of treatment. This review presents information on the molecular subtypes of endometrial cancer, surrogate markers for each molecular subtype, and methods for their determination. The prognostic significance of molecular classification is discussed, as well as the prospects for its use in the design of future studies. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19169 Modern look on resistance to platinum in patients with the serous ovarian cancer Rybin, A. I.; Kuznetsova, O. V. The study was aimed to determine the platinum-resistance biomarkers in patients with ovarian cancer. 29 platinum-resistant patients with verified serous ovarian cancer of IIIA–IIIC stages were examined, who received 6 courses of adjuvant chemotherapy with platinum preparations (cisplatin 75–100 mg/m2 intravenously with hydration and forced diuresis every 3 weeks) in the postoperative period. As control, 26 patients with non-recurrence of the disease performed for 6 months post-treatment observation (platinum-susceptible tumors) were observed. The expression of ABCA1 is higher in platinum-resistant cases of ovarian cancer. The most pronounced relationship exists between the values of survivin expression, local activity of nitric oxide, the expression of glutathione dependent enzymes, the content of catecholamines in erythrocytes, and the expression of ABCA1 transporter. 2025-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/19102 Зміна сучасного стилю навчання здобувачів вищої медичної освіти завдяки циклу Колба Рибін, А. І.; Кузнецов, О. В.; Rybin, A.; Kuznetsova, O. Освіта має вирішальне значення для благополуччя та соціального розвитку, її не можна призупинити, не ризикуючи майбутнім цілого покоління. Цикл Колба — це нова практична модель удосконалення та модернізації сучасного стилю навчання, яка допомагає навчатися ефективніше. Щоб навчання за циклом Колба справді приносило результат, важливо дотримуватися балансу всіх етапів, давати студентам час на рефлексію, адаптовувати тести та клінічні задачі під їхній досвід і забезпечувати якісний зворотний зв’язок.; Education is crucial to well-being and social development, and cannot be suspended without risking the future of an entire generation. The Kolb Cycle is a new practical model for improving and modernizing the modern learning style, helping to learn more effectively. For Kolb's cycle to truly be effective, it is important to maintain a balance between all stages, give students time to reflect, adapt tests and clinical tasks to their experience, and provide quality feedback. 2026-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/18955 When endometrioma becomes malignant: a clinical case and conclusions for oncogynecological practice Rybin, A.; Liskovskyi, S. Objective. To evaluate the clinical and morphological features of malignant transformation of ovarian endometrioma and to emphasise the importance of oncological vigilance in the management of patients with endometriosis.Materials and methods.A clinical case of early endometrioid carcinoma of the ovary against the background of endometrioma in a woman of reproductive age is presented. An analysis of current literature data and ESGO, ESHRE, and JSGO recommendations for the diagnosis and treatment of such patients wasperformed.Results.Morphological and radiological signs of increased oncological risk were identified, which became the basis for timely surgical intervention. Endometrioid carcinoma G1, FIGO IA was histologically verified. Fertility-preserving staging surgery was performed. No recurrence was detected during 24 months of follow-up.Conclusions.Ovarian endometrioma can be a source of early gynaecological cancer processes even in young patients. Vigilance, high-quality imaging and adequate surgical tacticsare key factors for successful treatment. 2025-01-01T00:00:00Z https://repo.odmu.edu.ua:443/xmlui/handle/123456789/18933 Epidemiology of papillomavirus infection in Ukraine Rybin, A.; Liskovskyi, S. The aim of this study was to assess the prevalence of HPV infection among women in different regions of Ukraine.Materials and methods. An analysis of data from the Quintip Recordati database, containing 195 records, was performed using frequency analysis methods. The distribution of different HPV strains among the women surveyed, who live in different regions, was determined. An analysis of the frequency of seropositive results depending on the degree of urbanisation was performed. The main ways of preventing HPVinfection were identified.Results. It was found that the number of positive tests accounted for 38.5% of the total sample. When comparing the frequency of detection of high-oncogenic strains, it was found that they are more often registered in cities with larger populations. Conclusions:1. The prevalence of HPV in the women examined is twice the European average.2. The frequency of detection of highly oncogenic HPV strains is higher in urbanised regions.3. Widespread implementation of HPV screening methods in Ukraine could significantly reduce the incidence of cervical cancer. 2025-01-01T00:00:00Z