Bogomolets National Medical University

ICD-11 presents updated descriptions for single episode and recurrent depressive disorder. A depressive episode (DE) is integral to these disorders and contrasting descriptions of the structure of DE symptoms are presented in ICD-11 and the Clinical Descriptions and Diagnostic Requirements for ICD-11 (CDDR). The former presents symptoms as unidimensional while the latter suggests symptoms are multidimensional reflecting affective, cognitive-behavioural, and vegetative clusters. This study examined if the latent structure of the DE symptoms is better represented by a one- or three-factor model. Data were collected from general population samples from the United Kingdom (UK: N=975) and Ukraine (N=2050). DE symptoms were measured using the International Depression Questionnaire, and the latent structure of the DE symptoms was assessed using confirmatory factor analysis. The three-factor model of DE symptoms outlined in the CDDR performed substantially better than the one-factor model and was a close fit to the UK and Ukrainian data. This model was invariant for sex in each nation. Prevalence estimates based on a three-factor model were similar to those based on the ICD-11 requirements, and similarly sized sex differences were observed. The multidimensional description of the DE symptoms outlined in the CDDR better represented data from two culturally distinct samples. Discrepancies in how DE symptoms are described in ICD-11 and the CDDR should be resolved to facilitate future research efforts.

Insoluble fibre (IF) may reduce the risk factors of type 2 diabetes development, but evidence on its short-term effects is limited. The influence of IF on oxidative stress markers, including reduced glutathione (GSH) and antioxidant enzymes, as well as on leukocyte telomere length (LTL), remains poorly studied. Coronavirus disease (COVID-19) occurring before or during IF interventions may influence study outcomes. The study included 29 adults with impaired fasting glucose (IFG) who received 15 g/day of IF for 3 months. Seven participants had a recent history of COVID-19, defined as PCR-confirmed infection within 6 months before the intervention or COVID-19-like symptoms during the study. Fasting plasma glucose, 2-h plasma glucose (2hPG) during a WHO oral glucose tolerance test, glycated haemoglobin (HbA1c) and GSH were assessed at baseline and after 3 months. Fat mass (FM), blood pressure (BP), LTL, superoxide dismutase and catalase (CAT) were also measured. In participants without COVID-19 (n = 22), IF intake was associated with reductions in 2hPG, HbA1c, FM and GSH, along with an increase in systolic BP. In the COVID-19 group (n = 7), HbA1c decreased, while both systolic and diastolic BP increased. No significant changes in LTL, superoxide dismutase or CAT levels were observed in either group. Short-term IF supplementation in individuals with IFG improved selected glycaemic parameters but was accompanied by unexpected reductions in GSH and increases in blood pressure. These findings indicate complex physiological responses to IF that warrant further investigation. ClinicalTrials.gov identifier: NCT04283201.

Chronic anal fissure is a common proctological condition characterized by severe pain and a substantial reduction in quality of life. Despite the availability of various treatment modalities, rates of incomplete healing and recurrence remain high, underscoring the multifactorial nature of the disease and the necessity to identify determinants of treatment effectiveness. Objective. To identify factors associated with complete healing of chronic anal fissures at week 4 of treatment. The study was conducted in accordance with ethical standards and principles governing medical research involving human subjects. The work was performed under the departmental research project “Development and improvement of methods for diagnosis, surgical treatment, and rehabilitation of patients with pathologies of the digestive tract and perineum,” implementation period 2024–2026, state registration number 0123U1051738. Materials and methods. This prospective single-center study analyzed 155 patients with chronic anal fissures treated between 2022 and 2024. Univariate and multivariate analyses, including odds ratio regression, were performed to identify factors influencing complete defect healing at week 4. Patients were stratified into two subgroups according to treatment strategy: personalized management algorithm (n = 83) and standardized therapy (n = 72). The study was conducted in accordance with the principles of the Helsinki Declaration. All patients provided informed consent to participate in the study. The study protocol was approved by the Bioethics Committee of the Bogomolets National Medical University (protocol No. 2 dated October 17, 2022). Statistical processing was performed using IBM SPSS Statistics Base v.22, R-Statistics v.3.2.0, and Medstat software. Standard methods of variational statistics were applied. The work was performed as part of the departmental research project entitled “Development and improvement of methods for diagnosis, surgical treatment, and rehabilitation of patients with pathologies of the digestive tract and perineum”, implementation period 2024–2026, state registration number 0123U1051738. The work was performed under the departmental research project “Development and improvement of methods for diagnosis, surgical treatment, and rehabilitation of patients with pathologies of the digestive tract and perineum,” implementation period 2024–2026, state registration number 0123U1051738. Results. Complete healing was achieved in 128 (82.6%) patients. The personalized target-to-treat algorithm significantly increased the likelihood of healing compared with standardized therapy (92.1% vs 71.8%; p < 0.001). In multivariate analysis, independent predictors of complete healing were treatment type (OR = 4.31; 95% CI 1.63–11.41; p = 0.003) and disease duration (OR = 0.73; 95% CI 0.61–0.87; p = 0.001). Age, gender, fissure location, pain intensity, and presence of concomitant pathology had no independent effect on treatment outcome. The predictive performance of the model was excellent (AUC = 0.97). Conclusions. The principal factors influencing complete healing of chronic anal fissures at week 4 of treatment are the treatment strategy and disease duration. Implementation of a personalized target-to-treat algorithm reliably improves treatment efficacy and can be recommended for clinical practice.

Background. Obesity is one of the leading pathogenetic links in the development of type 2 diabetes mellitus (T2DM) and is accompanied by impaired energy homeostasis, formation of insulin resistance and activation of chronic low-grade inflammation. These processes lead to the progression of metabolic disorders and increase the risk of cardiovascular complications. An important role in the regulation of metabolic processes is played by the irisin myokine, which has an anti-inflammatory, cytoprotective and stabilizing effect on glucose homeostasis and lipid metabolism. At the same time, the results of modern studies on changes in its circulating levels in obesity and T2DM remain controversial and depend on clinical and metho­dological approaches. The probable pathophysiological relationship between irisin levels, vitamin D status, skeletal muscle condition, and the nature of metabolic disorders makes further comprehensive studies on their role in the formation of obesity and the development of T2DM relevant. The purpose of the study was to determine the level of irisin in individuals with and without T2DM with different body weights, as well as to investigate the relationships between irisin, body composition, sarcopenia indicators, and vitamin D levels. Materials and methods. One hundred individuals were examined. Serum concentrations of irisin and 25(OH)D were determined by enzyme-linked immunosorbent assay. Body composition was assessed using bioimpedance analysis. Results are presented as mean ± standard deviation. Methods of variation and descriptive statistics were used. Student’s t-test was applied to assess the significance of differences between mean values. Correlation analysis was performed using Pearson’s coefficient, as well as multivariate regression analysis. Results. In obese patients, elevated irisin levels were associated with no high risk of sarcopenia, suggesting preserved or compensatory activation of muscular-endocrine function. In contrast, in patients with T2DM, decreased irisin levels, vitamin D deficiency, and adverse changes in body composition were associated with high risk of sarcopenia and impaired metabolic adaptation. Conclusions. Irisin can be considered a promising biomarker of meta­bolic status, predicting the course of the disease, and individuali­zing the management of patients with metabolic disorders.

ABSTRACT. The article provides a systematic review of lung damage associated with the use of electronic cigarettes or vaping products (EVALI – E-cigarette and Vaping use-Associated Lung Injury). Diagnostic and therapeutic algorithms for these patients are proposed. Attention is focused on the problem of timely detection of EVALI, in particular the difficulties of differential diagnosis with viral infections and other diseases. The pathophysiological mechanisms and histopathological manifestations of EVALI are discussed, and the characteristics of clinical manifestations are analysed. Current EVALI treatment protocols are reviewed and areas for further research needed to improve the management of patients with EVALI are identified.

This article systematizes current concepts of drug safety in dentistry. It reviews the most common adverse reactions, the main groups of drugs, risk factors for their occurrence, clinical examples, and statistical data from international and national sources. The experience of Ukraine in the field of dental pharmacovigilance is highlighted. Practical recommendations are proposed to help dentists minimize the risk of adverse reactions and improve the safety of pharmacotherapy. Purpose: to summarize contemporary scientific data on drug safety in dentistry, identify the main risk factors for adverse reactions, outline the principles of pharmacovigilance, and formulate practical recommendations for dental practitioners. Materials and methods: scientific literature (PubMed, Scopus, Google Scholar), statistics from EudraVigilance, VigiBase, and the State Expert Center of the Ministry of Health of Ukraine were analyzed. Practical recommendations were developed to reduce the risk of adverse reactions.

Metabolically associated steatotic liver disease (MASLD) is a prevalent and serious global health concern, affecting 20–40% of the population. Early detection and accurate quantification of liver steatosis (LS) are crucial for preventing disease progression[1]. Current imaging methods, including ultrasound (US), and magnetic resonance imaging (MRI), play key roles in noninvasive diagnosis. Among these, MRI-proton density fat fraction (MRI-PDFF) serves as the reference standard for quantitative assessment; however, its cost and limited availability restrict widespread use. This study evaluated the diagnostic performance of attenuation coefficient measurements (ACM) for detecting and quantifying LS in MASLD using MRI-PDFF as the reference standard. This prospective study included 168 patients aged 18–64 years. Demographic, anthropometric, and laboratory data were collected. US evaluation included right and left liver lobe thickness, hepatorenal index (HRI), shear wave elastography (SWE), and ACM quantification. MRI-PDFF was performed on a 1.5-T system. Statistical analysis included the Kruskal–Wallis test, correlation analysis, and receiver operating characteristic (ROC) curve assessment. A strong correlation was found between ACM and MRI-PDFF (r = 0.83, p < 0.0001), confirming high diagnostic reliability. ACM demonstrated high diagnostic accuracy for identifying hepatic steatosis (AUC = 0.94, 95% CI: 0.88–0.96), with specificity and sensitivity of 89.8% and 82.2%, respectively. Compared with other ultrasound techniques, ACM outperformed HRI (AUC = 0.89) and SWE (AUC = 0.72). The established ACM cut-off values for LS stages were 2.29 dB/cm (S0–S3), 2.24 dB/cm (S1), 2.51 dB/cm (S2), and 2.88 dB/cm (S3). ACM demonstrates high diagnostic accuracy for detecting and quantifying LS and shows strong agreement with MRI-PDFF. Given its noninvasive nature, accessibility, and reliability, ACM has strong potential as a primary screening and monitoring tool for MASLD. Further validation in larger cohorts is recommended to support widespread clinical implementation.

This study presents the results of smoke simulations from wildfires that occurred in September 2024 in northern Ukraine. The case study focuses on peatland fires near Loshakova Huta (Chernihiv region), specifically during 19–23 September, when smoke was transported toward the capital city of Kyiv under northerly wind direction. Burnt areas were identified using multiple data sources, including Sentinel-2 and Planet satellite imagery (false-colour analysis), EFFIS (European Forest Fire Information System) polygons, land surface temperature anomalies obtained from MODIS and VIIRS satellite instruments (NASA FIRMS (Fire Information for Resource Management System) platform) and EUMETSAT LSA SAF (Land Surface Analysis Satellite Application Facility), and Sentinel-3 fire radiative power data. Emissions of major air pollutants were estimated using the Fuel Fire Tools application, which integrates the FCCS (Fuel Characteristic Classification System), the CONSUME fuel consumption model, and FEPS (Fire Emission Prediction Simulator). The FCCS module provided fire behaviour parameters and fuel loading for the identified burnt areas based on a 30-m fuel map developed for Ukraine, which had previously been modified by introducing peat fuel classes using available soil data. Total emissions and their temporal dynamics were then calculated. Smoke transport and dispersion were simulated by means of the CALPUFF Lagrangian puff model and HYSPLIT (Hybrid Single-Particle Lagrangian Integrated Trajectory Model) at 1 km spatial resolution. Both models were applied to simulate the transport of carbon monoxide and particulate matter (PM2.5 and PM10) using meteorological fields simulated by the WRF (Weather Research &amp; Forecasting) model driven by ERA5 reanalysis. Model performance was evaluated by comparing background-corrected modelled pollutant concentrations with measurements from eight air-quality monitoring stations in Kyiv, using several statistical metrics. Data from seven stations were provided by the Department of Environmental Protection and Climate Change Adaptation of the Kyiv City State Administration, and data from one station were provided by the SI “Marzieiev Institute for Public Health of the National Academy of Medical Sciences of Ukraine”. The results showed acceptable accuracy for both models, despite the relatively large distance from the active fires (~60-70 km) and uncertainties related to other emission sources and surrounding conditions near the monitoring sites. Periods of substantial concentration increases were also well reproduced by the models.Peatland wildfires pose a significant public health hazard due to their enormous emissions of air pollutants, particularly the PM2.5 fraction. This case study is valuable due to the availability of qualitive satellite-based information, on-site documentation, and reliable air-quality measurements in Kyiv. The results indicate that the CALPUFF and HYSPLIT models can adequately reproduce smoke plume transport and dispersion when peat-fire source terms are properly parameterized, especially with respect to emission rates, and when accurate meteorological input is used.

Three-dimensional (3D) reconstruction of nasal structures based on computed tomography (CT) data plays an increasingly important role in the preoperative planning of otolaryngological procedures. This literature review analyzes the current state of knowledge on the integration of 3D technologies — particularly the Blender and Unreal Engine 5 software — with CT imaging in the context of the anatomical assessment of the nasal septum as well as the cartilaginous and bony structures of the nose. The review includes reports comparing various visualization tools such as Osirix, Horus, Blender, and UE5 in terms of anatomical accuracy and clinical applicability. Models created in advanced graphic environments enable not only more precise representation of curvatures and simulation of tissue movements but also prediction of airflow and biomechanical stresses. In light of the analyzed studies, combining CT with modern spatial modeling represents a promising approach to improving diagnostics, planning, and safety in nasal reconstructive surgery.