Introduction. Integrated medical care is a component of its quality and a priority direction of the current stage of development of healthcare systems. Patient perception of the integration of medical services is one of the indicators of achieving quality by healthcare institutions. Aim. To investigate whether medical care for patients is integrated according to the components of integration. Materials and methods. Answers to open questions (questionnaire); notes during the survey; scientific literature sources (19 units). Methods: semi-structured in-depth interview with 25 patients of the State Institution of Science «Center of innovative healthcare technologies» State Administrative Department, Kyiv, Ukraine; data analysis; generalization of results. Results. It was established that patients generally consider medical care to be person-oriented, the exchange of information with the doctor is satisfactory, information is available to the patient, the transfer of the patient under supervision between medical workers of the studied institution is coordinated, and the cooperation of medical workers is harmonious. At the same time, not all patients participate in the development of a treatment plan; training patients in self-control measures is not always carried out, and patient surveys regarding their satisfaction with the medical care received are not always conducted. Not all patients can afford treatment with original drugs due to their high cost. Discordance of medical care in the interaction of the State Institution of Science «Center of innovative healthcare technologies» State Administrative Department with other healthcare institutions was revealed, which is confirmed by the untimely transfer of information about the patient from them. Conclusions. Certain problems in the integration of medical care were identified in the studied healthcare institution, as well as at the network and industry levels, which require their solution.

Introduction. Supporting children and adolescents with mental illness in the Czech Republic is hampered by a fragmented care system, long waits and weak inter-institutional coordination. From the viewpoint of social work and social medicine, a guide is crucial for continuity of care, empowerment and active participation of families. Aim. To examine how the presence or absence of a guide shapes families’ ability to navigate services, stabilise their situation and access resources, and to propose a theory-based model underscoring the systemic importance of this role. The study was funded by the University of South Bohemia (GA JU 133/2024/S) and approved by the ZSF JCU Ethics Committee (No. 018/2023). Materials and methods. Qualitative grounded theory study drawing on 46 in-depth interviews with children aged 11–18 with mental disorders, their parents and social workers. Open, axial and selective coding identified key meanings and relationships informing an emergent model centred on the guide. Results. Without a guide, families reported heightened emotional distress, disorientation and stigma, exacerbated by systemic fragmentation and poor coordination. With a guide, orientation improved, parental competence strengthened, trust in services increased and continuity of care became more likely. A paradigmatic process model describes movement from crisis to stabilisation through guided support and inter-agency linkage. Conclusions. The guide is not an ancillary add-on but a pivotal mechanism that reduces isolation, restores trust and promotes mental well-being. Institutionalising and supporting this role—together with continuity and interdisciplinary coordination—should be a priority for child mental health policy and practice in the Czech Republic.

Introduction. Low back pain is one of the leading causes of disability worldwide and a significant burden on healthcare systems. Despite numerous studies, the mechanisms behind the relationship between clinical, structural, and psychoemotional factors influencing pain intensity and depressive symptoms remain poorly understood. Materials and methods. The study included 32 patients (17 men, 15 women) aged 22–72 years with pain lasting more than 3 months. All participants underwent clinical examinations, MRI to assess intervertebral herniation, and completed the Visual Analogue Pain Scale (VAS) and the PHQ-9 questionnaire to screen for depression. Patients were divided into groups with (n = 18) and without (n = 14) radicular syndrome. Multiple linear regression analysis was used to identify predictors of pain intensity and depression levels. Results. Multiple regression analysis showed that the level of depressive symptoms (β =- 1.71; p = 0.009) and the presence of radicular syndrome (β =-1.18; p = 0.036) were significantly associated with pain intensity. The presence of an intervertebral hernia showed a tendency to increase pain (β = 2.34; p = 0.055). Regarding depression, the presence of a hernia was the only significant factor associated with increased depressive symptoms (β = 10.64; p = 0.007). Comparing groups with and without radicular syndrome did not reveal statistically significant differences in the average pain level. Conclusions. The intensity of low back pain is influenced by a complex interplay of factors, including psychoemotional state and the presence of radicular syndrome, rather than only structural spine changes. These findings highlight the importance of a multidimensional and individualized approach to managing patients with chronic low back pain, considering both clinical and psychoemotional aspects.

Aim. To summarize the data from scientific literature and determine the attitude of physicians of the State Institution of Science «Center of innovative healthcare technologies» State Administrative Department (SIS «CHIT» SAD) towards self-management of cardiovascular diseases risk factors. Materials and methods. At the first stage of the study, an analysis and generalization of scientific publications on the prevalence of cardiovascular disease risk factors among healthcare workers, in particular, physicians, were conducted. At the second stage, using a specially developed questionnaire, a survey of the 20 physicians of a therapeutic profile of SIS «CIHT» SAD was conducted. The age of the surveyed physicians was 36-69 years (average 53.5 ± 9.1 years). The results of a survey of 59 physicians conducted at the institution in 2014 served as a comparison group. The age of the surveyed physicians was 31-65 years (average 49.4 ± 10.1 years). Methods used: system analysis, bibliosemantic analysis, questionnaire survey, statistical analysis. Results. The analysis of scientific publications showed that a significant part of physicians in different countries of the world do not follow the recommendations for monitoring and correction of cardiovascular diseases risk factors, which has an impact on their health and the implementation of preventive measures among patients. According to the results of a questionnaire survey of the therapeutic profile physicians of the SIS «CHIT» SAD, conducted in 2025, it was determined that 95,7% of them know their total cholesterol level, which is significantly higher compared to the results of the 2014 survey – 53.8% (p < 0.05). The level of total cholesterol < 5 mmol/l among the surveyed physicians was observed in 47.8%, compared to 12.5% in 2014 (p < 0.05). All physicians had a blood pressure level < 140/90 mm Hg and none were current smokers. However, only 34.8% had a body mass index within the recommended range, while 17.4% were obese and 47.8% were overweight. Conclusions. The problem of self-management of cardiovascular disease risk factors is relevant for physicians worldwide. Positive dynamics of self-management of most risk factors by physicians of a therapeutic profile of SIS «CHIT» SAD in 2025 compared to 2014 were identified. The issue of self-management of physicians’ body weight and achievement of the target cholesterol level requires attention.

Introduction. Lymphangiomas are neoplasms that arise from lymphatic vessels and are mainly found at a young age. These tumors can have different localizations and sometimes reach significant sizes. This case is of clinical interest due to the rare localization of the neoplasm. Aim. To present our clinical observation of a huge retroperitoneal cavernous lymphangioma and the features of its diagnosis and surgical treatment. Materials and methods. The article presents a clinical case of a huge retroperitoneal cavernous lymphangioma. A 44-year-old female patient sought medical care with complaints of increased abdominal volume, a feeling of heaviness in the epigastrium, constant dull pain in the right hypochondrium and epigastrium, and periodic nausea and vomiting. She had been ill for about seven years. Clinical examination and instrumental diagnostic methods confirmed the presence of a huge tumor in the area of the lesser sac. The patient underwent a planned surgical procedure; an upper midline laparotomy was performed. The large size of the tumor and its close association with the stomach, duodenum, transverse colon, liver, pancreas, and blood vessels significantly complicated tumor mobilization; however, with the use of modern surgical techniques and intraoperative monitoring, complete tumor removal was achieved without damage to adjacent organs, major vessels, or blood loss. Results. The patient successfully underwent surgery, and postoperative rehabilitation was carried out according to the ERAS protocol. The postoperative course was without complications, and the patient was discharged on the 3rd postoperative day. Pathohistological examination revealed a cavernous lymphangioma. At follow-up examinations performed 1, 3, 6, 12, and 36 months after surgery, the patient was in good condition, had no complaints, and no signs of disease recurrence were detected. Conclusions. Retroperitoneal cavernous lymphangioma is a benign tumor that is extremely rare, grows gradually over a long period of time, and can reach enormous sizes. Surgical treatment of retroperitoneal tumors is a complex task that requires a tailored approach, a highly qualified operating team, and the use of modern technologies.

Introduction. Post-acne scars are a frequent long-term consequence of acne vulgaris and may significantly affect facial aesthetics, psychosocial well-being, and overall quality of life. Despite the availability of multiple therapeutic options, managing post-acne scarring remains challenging due to variable treatment efficacy, prolonged therapeutic courses, and inconsistent patient satisfaction. Laser technologies have become widely used in scar correction; however, comparative evidence on optimized laser-based approaches — particularly regarding clinically meaningful outcomes and quality-of-life improvement — remains limited. Aim. To optimize treatment strategies for post-acne scars and to evaluate their impact on patients’ quality of life. Materials and methods. This prospective randomized comparative study included 30 patients aged 18–40 years (26 women and 4 men) with clinically confirmed post-acne scars in stable remission. The diagnosis and baseline severity of post-acne scarring were confirmed by clinical visual assessment in accordance with the qualitative principles of the Goodman and Baron global acne scarring classification. Participants were allocated into two groups: Nd:YAG (1064 nm) laser monotherapy (n = 15) or combined Er:YAG (2940 nm) and Nd:YAG (1064 nm) laser therapy (n = 15). Treatment was administered over a 24-week follow-up period, with 12 sessions performed at 2-week intervals. Assessments were conducted at baseline and at weeks 8, 16, and 24. Quality of life was measured using the Dermatology Life Quality Index (DLQI). Safety was evaluated by documenting all treatment-related adverse events. Results. Baseline demographic and clinical characteristics were comparable between groups. Both protocols resulted in gradual improvement in DLQI scores; however, patients receiving combined Er:YAG + Nd:YAG therapy demonstrated faster and more pronounced reductions, with significantly greater DLQI improvement from week 8 onward (weeks 8, 16, and 24; p < 0.05). Clinical examination revealed more notable enhancement of scar texture and skin surface uniformity in the combined-therapy group. Both treatments were well tolerated, with only mild and transient adverse events. Conclusions. Both laser protocols improved clinical outcomes and patient quality of life. The combined Er:YAG + Nd:YAG approach provided more substantial and rapid improvement compared with Nd:YAG monotherapy, supporting its value as an effective and safe strategy for routine clinical practice.

Introduction. Chronic pain is a frequent and disabling consequence of combat-related extremity injuries. However, data on modifiable and non-modifiable risk factors for pain chronification in military trauma populations remain limited. Aim. To identify risk factors associated with the development of chronic pain after combat-related extremity injuries and to assess the impact of injury characteristics and early treatment strategies on pain outcomes. Materials and methods. This multicenter observational cohort study included 322 patients with combat-related extremity injuries treated at three tertiary care centers. Demographic, injury-related, and treatment-related variables were prospectively collected. Chronic pain persisting for ≥ 3 months after injury was the primary outcome. Univariate analyses were followed by multivariable logistic regression to identify independent predictors of chronic pain development. Results. Chronic pain developed in 98 patients (30.4%). In multivariable analysis, peripheral nerve injury (OR 2.78, 95% CI 1.68–4.60), infectious complications (OR 2.14, 95% CI 1.29–3.55), number of surgical procedures (OR 1.29 per procedure, 95% CI 1.14–1.47), and delayed initiation of analgesia (> 6 hours) (OR 1.71, 95% CI 1.05–2.78) were independently associated with chronic pain. Use of regional anesthesia during the acute phase was associated with a reduced risk of chronic pain (OR 0.66, 95% CI 0.43–0.99). Conclusions. Approximately one-third of patients developed chronic pain following combat-related extremity injuries. Both injury severity and early treatment-related factors contribute to pain chronification. Optimization of early analgesia, prevention of infectious complications, and broader use of regional anesthesia may reduce the long-term burden of chronic pain in military trauma survivors.

Introduction. Given the emerging challenges associated with the ongoing conflict, the implementation of innovative rehabilitation approaches is imperative to preserve military personnel's combat morale and facilitate their successful reintegration into civilian society. Aim. To review and synthesize scientific research on innovative rehabilitation methods for military personnel, including state-of-the-art prosthetic technologies, and assess their impact on physical and psychological recovery. Materials and methods. This study presents a comprehensive analysis and generalization of current scientific literature, guidelines, and expert recommendations related to the justification and implementation of medical and social rehabilitation strategies for military personnel who have undergone limb amputation due to combat-related injuries during the war in Ukraine. Results. The full-scale war in Ukraine, which began in 2022, has served as a powerful catalyst for the development and integration of innovative technologies in medical rehabilitation, particularly in the field of prosthetics. The widespread occurrence of traumatic injuries among military personnel, especially limb amputations, has created an urgent demand for high-tech solutions aimed at restoring lost functionality. In response to these challenges, domestic and international scientific and engineering communities have intensified efforts to develop advanced prosthetic systems based on bioengineering, robotics, neurotechnology, and additive manufacturing achievements. Particular attention has been given to the development of bionic prostheses capable of not only morphologically replicating lost limbs but also restoring their functional capabilities through the use of sensory systems, neural interfaces, and machine learning algorithms. The integration of cutting-edge technologies into prosthetics is regarded as a promising direction in rehabilitation medicine, contributing to improved quality of life and full social reintegration of affected individuals. Conclusions. Innovative approaches to the rehabilitation of military personnel after limb amputation and prosthetics occupy a key position in modern medical practice. The effectiveness of the rehabilitation process is ensured through a comprehensive approach that includes physical therapy, psychological support, social integration measures, and the application of high-tech solutions.

Introduction. The problem of viral hepatitis C requires increased attention to studying the dynamics of morbidity in Ukraine, and comparison with global indicators contributes to identifying domestic epidemiological specifics and determining epidemiological factors of disease transmission, as well as developing and implementing preventive measures. Aim. Comprehensive epidemiological analysis of viral hepatitis C incidence in Ukraine for the period 2013–2023 compared with corresponding global indicators. Materials and methods. According to official statistical reports from the Public Health Center of the Ministry of Health of Ukraine and an analytical report by the Robert Koch Institute, the incidence of viral hepatitis C in Ukraine was analyzed for the period 2013-2023. A comparative analysis of viral hepatitis C incidence rates in Ukraine was conducted by comparing global data published by the WHO and the European Centre for Disease Prevention and Control. Results. An analysis of global viral hepatitis C prevalence rates has shown that the disease is prevalent in all WHO regions. The highest HCV prevalence rates are observed in the Eastern Mediterranean Region, where 12 million people are chronically infected. WHO analytical data on primary and chronic viral hepatitis incidence worldwide show a negative trend since 2019. During 2013-2022, there was a gradual decline in the total number of HCV cases: the number of acute forms of infection decreased by almost half, from 698 cases in 2013 to 397 in 2022; the number of chronic cases decreased from 6,144 in 2013 to 3,575 cases registered in 2022. In 2023, the epidemiological situation regarding HCV incidence significantly worsened: there was an increase in the total number of registered cases of both acute and chronic forms of the disease. The reason for the deterioration of the epidemiological situation is related to the full-scale Russian aggression in 2022, when the risk of infection with parenteral viral hepatitis increased significantly due to: injuries; contact with blood that had not undergone appropriate testing; injuries and sexual violence; deterioration of access to medical care due to the destruction of health care facilities; displacement of a significant number of people from the eastern and southern regions of Ukraine. According to global analytical forecasts, by 2030, preventive programs and measures against viral hepatitis C will lead to a significant reduction in both primary morbidity and mortality from the infection. Conclusions. Full-scale Russian aggression has negatively affected the incidence of viral hepatitis C in Ukraine. Improvements in the epidemiological situation regarding viral hepatitis C are possible due to increased effectiveness of non-specific prevention, implementation of the basic principles of the National Strategy for Combating HIV/AIDS, Tuberculosis, and Viral Hepatitis.