Shupyk National Healthcare University of Ukraine

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.

Analysis of gene variants, oxidative and nitrosative stress markers, and their interrelationships may facilitate the development of personalized approaches to the prevention and treatment of coronavirus disease 2019 (COVID-19) and other infectious diseases, particularly in regions affected by environmental pollution. The present study was conducted to evaluate the influence of MTHFR (rs1801133, rs1801131) and VDR (rs731236) gene variants, as well as oxidative and nitrosative stress markers, on the course of COVID-19 in children residing in the Poltava region, with consideration of nitrate and fluoride pollution. Methods. The study included 40 children diagnosed with COVID-19 and 17 age-matched children in the comparison group. The following parameters were assessed: variants of the MTHFR and VDR genes; urinary concentrations of nitrates, nitrites, malondialdehyde (MDA), and sialic acids; and residence in territories with elevated fluoride and nitrate pollution. Results. In children with COVID-19, a significantly higher frequency of the AA genotype of the rs1801131 variant was observed. Elevated urinary levels of nitrites, MDA, and sialic acids were identified as significant pathogenic factors associated with the disease. Among children living in fluoride- and nitrate-polluted areas, correlations were found between MTHFR gene variants and serum concentrations of bilirubin, creatinine, and MDA. Betaine-arginine supplementation was identified as a potential strategy for personalized prevention and treatment in pediatric COVID-19. Conclusion. Associations were established between MTHFR gene variants and increased susceptibility to COVID-19. The influence of fluoride- and nitrate-polluted environments was confirmed, key pathogenic factors (nitrite, MDA, and sialic acid levels) were delineated, and betaine-arginine supplementation was proposed as a potential preventive and therapeutic intervention.

The large-scale war of the Russian Federation against Ukraine has resulted not only in physical disabilities among both military personnel and civilians (injuries, burns, poisoning, etc.), but also in the development or exacerbation of mental health disorders such as panic attacks, neuroses, and hysteria. These conditions arise under severe stress and manifest through functional disturbances of mental health and pain syndromes. We examined a cohort of 145 patients aged 30–58 years who developed mental health disorders in the context of massive stress. Twenty-five of them had pre-existing neurotic manifestations that had been compensated by medication; however, stress associated with hostilities reactivated these disturbances and significantly aggravated their condition. Clinical examinations were performed by dentists, neurologists, cardiologists, and otolaryngologists (when required). Additional diagnostic procedures included CT, MRI, ultrasound, ECG, and dental radiography. Laboratory investigations comprised blood glucose, cholesterol and lipoprotein levels, biochemical blood tests, and coagulation profiles. These examinations allowed us to exclude organic lesions of the brain and internal organs and to confirm mental health disturbances. Furthermore, inpatient assessments using international diagnostic scales were conducted to validate the diagnoses. Mental health disorders may present as anxiety, panic attacks, depression, delirium, psychosis, neurasthenia, hysteria, obsessive-compulsive disorder, and other conditions, which can be acute or chronic. Such disorders may occur in association with neurological and somatic diseases (cardiovascular, cerebrovascular, or internal organ pathology). Therefore, the task of internists, family physicians, neurologists, cardiologists, and dentists is to collect a thorough medical, life, and allergy history, review previous treatment methods, and develop a comprehensive management plan at both pre-hospital and hospital stages.

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.

Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Despite major advances in therapy, the treatment of ALL remains a significant challenge. Therapeutic protocols are based on the use of combinations of chemotherapeutic drugs. While such combinations increase treatment efficacy, they also complicate the assessment of toxicity. It should be noted that the variability in the occurrence of toxic responses to ALL therapy in children may be determined by the presence of gene variants that influence both the pharmacokinetics and pharmacodynamics of chemotherapeutic drugs. This review summarized and analyzed the most significant and well-studied pharmacogenetic markers to date associated with the toxicity and response to chemotherapeutic agents used in the treatment of pediatric ALL. In particular, pharmacogenetic markers for the following drugs were analyzed: anthracyclines (doxorubicin, daunorubicin), vincristine, glucocorticoids (prednisone, dexamethasone), L-asparaginase, methotrexate, alkylating agents (cyclophosphamide, ifosfamide), 6-mercaptopurine, cytarabine, and etoposide. At present, only a few genes, TPMT and NUDT15, have well-established clinical utility, whereas the clinical relevance of pharmacogenetic markers for other drugs used in pediatric ALL therapy remains under investigation. The review also highlights the main knowledge gaps in current research and outlines promising directions for future studies aimed at integrating pharmacogenetic testing into clinical practice for personalized treatment of ALL.

The objective: to evaluate the feasibility of using the synbiotic Active Flora Duo Plus in the treatment of patients with irritable bowel syndrome with diarrhea (IBS-D) and small intestinal bacterial overgrowth (SIBO). Materials and methods. The study involved 69 patients with SIBO against the background of IBS-D: men – 43.5%, women – 56.5% aged 23 to 72 years (mean age 43.6 ± 12.1 years). After excluding inflammatory bowel diseases and infections as causes of diarrhea syndrome, the diagnosis of IBS-D was established according to the Rome IV criteria, and SIBO – according to the results of a hydrogen breath test with lactulose loading. In the I stage of the study all patients were treated with SIBO (14 days of rifaximin at a dose of 550 mg 3 times a day). In the II stage the patients were randomized to the main group (MG, n = 32) and additionally were prescribed a 20-day course of treatment with the synbiotic Active Flora Duo Plus at a dose of 1 capsule twice daily (recommendation dose). The results of the treatment’s effect on intestinal symptoms in the study group of patients were compared after 20 days with the control group (CG, n = 37), who continued standard treatment and observation without the use of synbiotics. During the study, all patients were assessed for quality of life related to IBS-D, bloating, abdominal pain, and well-being after defecation using 10-point questionnaire scales. Data analysis and randomization (using the built-in random number generator) were performed in Microsoft Excel spreadsheets, with the IBM SPSS Statistics 23.0 statistical software package additionally used for statistical analysis. Results. At the I stage of treatment with SIBO, there was a tendency toward improvement in the condition of patients in both groups for all analyzed parameters (bloating, abdominal pain, satisfaction with defecation, quality of life associated with IBS-D). The results of the II stage of treatment showed a further statistically significant improvement in the condition of patients in the MG who took Active Flora Duo Plus compared to the CG on all scales analyzed (p &lt; 0.001; one-sided). Conclusions. The inclusion of the synbiotic Active Flora Duo Plus in the complex treatment of patients with IBS-D is advi­sable for improving all major intestinal symptoms and overall quality of life.