Experimental and Clinical Medicine

The impact of a physical therapy algorithm on the subjective assessment of functional asymmetries in pole sports acrobats: a pilot study

2025-11-28T15:34:31+02:00

In press

Background. The asymmetrical nature of the loads in pole acrobatics leads to the
formation of persistent muscle imbalances and postural deviations, which are risk factors for overuse injuries. This creates a need for the development and evaluation of targeted physical therapy programs to correct these dysfunctions in healthy female athletes.

Aim. To conduct a pilot evaluation of a developed 8-week complex of corrective exercises and to assess its impact on the subjective indicators of functional status in female athletes practicing pole acrobatics.

Materials and Methods. A single-group quasi-experimental pilot study with assessment of indicators before and after the intervention was conducted with 20 experienced female athletes (age 23–40 years, experience >18 months). The intervention consisted of integrating the developed complex of corrective exercises into their training process over eight weeks. To quantify the changes, a validated 50-item questionnaire was used, which was specially developed and validated by comparing its results with instrumental methods in previous research stages. Statistical analysis of the changes in scores was performed using the non-parametric Wilcoxon signed-rank test. The study was carried out within the framework of the topic "Restoration of functional capabilities, activities and participation of persons of different nosologic, professional and age groups" (state registration number 0121U107926).

Research Ethics. All participants in the study signed an informed consent. The study was conducted in compliance with the requirements of the Helsinki Declaration of the World Medical Association (1964–2024).

Results. After the 8-week program's completion, a significant positive trend was recorded in the athletes' subjective assessment of their functional status, and a statistically significant improvement (p<0.05) was found in 33 out of 50 (66 %) responses of female athletes. The most pronounced changes were observed in indicators of shoulder girdle stability and muscle control: the number of participants reporting "sinking" in one arm (when one arm reacts slower during strength movements) decreased from 70 % to 15 %. However, indicators related to the performance of complex elements on the non-dominant side showed no significant changes (p>0.05).

Conclusions. The developed complex of corrective exercises demonstrated its potential
effectiveness as a tool for correcting functional asymmetries and improving the subjective condition of female pole athletes. The program helps restore muscle balance, improve proprioception, and enhance trunk stabilization, which justifies the need for its further investigation in larger-scale controlled studies.

Keywords: muscle imbalance, proprioception, corrective exercises, sports rehabilitation, injury prevention.

Regional disparities in staffing and the qualification index of gynecologic oncologists in Ukraine: statistical portrait and human resource development scenarios (2015–2020, 2022–2024)

2025-12-12T00:16:51+02:00

In press

Background. Cervical cancer remains a leading cause of mortality among women of reproductive age in Ukraine. The effectiveness of its prevention depends on the availability and qualifications of gynecologic oncologists. A comprehensive analysis of the staffing of Ukraine's gynecologic oncology service had not been previously conducted.

Aim. To analyze regional disparities and the qualification structure of oncogynecologists in Ukraine for the periods 2015–2020 and 2022–2024, as well as to develop composite statistical indicators for identifying staffing imbalances and forecasting human resources for the cervical cancer prevention system.

Materials and Methods. A retrospective study was conducted based on official aggregated data from the Ministry of Health and the State Statistics Service for 2015–2020 and 2022–2024. For each region, the following indicators were calculated: staffing ratio (Kz), Qualification Index (QI), Proportion of Highest-category specialists (PH), Integral Staffing index (IS_integr), and Personnel Shift Rate (PSR). Statistical analysis included descriptive statistics, correlation, and factor analysis using Excel, SPSS, and RStudio packages.

Research Ethics. The study was based solely on aggregated open statistical data containing no personal information. In accordance with the standards of the WMA Declaration of Helsinki, additional ethical approval was not required.

Results. The average annual number of gynecologic oncologists was 264. A high level of regional disparity was revealed: the coefficient of variation for Kz was 43.6%. The average QI was 0.93, which is below the normative level (≥1.20). Analysis of IS_integr showed that over a third of regions have critically low staffing potential (e.g., Luhansk and Zakarpattia regions). In some regions, staff turnover exceeded 15%. A statistically significant positive correlation was found between IS_integr and the rate of early cervical cancer detection (r=0.68; p<0.01). Regions were classified into three types: potentially stable, vulnerable, and destabilized.

Conclusions. Ukraine's gynecologic oncology service is characterized by insufficient staffing and significant regional disparities. More than one-third of regions have a critically low level of human resource potential. The established direct link between the integral staffing index and the effectiveness of early diagnosis underscores the key role of staff quality and stability. The proposed composite indicators, particularly IS_integr, can serve as an effective tool for evidence-based management planning for cervical cancer prevention for 2025–2030.

Keywords: oncogynecology, health care management, regional disproportions, cervical cancer, integral index of availability, medical statistics.

Features and prognostic significance of infiltration by immunocompetent cells in secondary edematous breast cancers

2025-12-15T23:40:45+02:00

In press

Background. Secondary edematous breast cancers (SEBC) are characterized by an aggressive clinical course and require in-depth study of their molecular and biological features, among which the tumor immune microenvironment plays a key role. Analysis of infiltration by immunocompetent cells can reveal new prognostic markers and therapeutic targets.

Aim. To investigate the features of infiltration by CD4+, CD8+, CD20+ lymphocytes and CD68+ macrophages in secondary edematous breast cancers compared to non-edematous forms (NEBC) and to evaluate their association with clinical and pathological parameters and metastatic potential.

Materials and Methods. A comprehensive pathomorphological and immunohistochemical study of 45 cases of breast cancer was conducted: 30 cases of SEBC (main group) and 15 cases of locally advanced NEBC (comparison group). Quantitative assessment of infiltration by the specified cell types and analysis of their correlation with molecular subtype, presence of lymphogenous metastases, and other characteristics were performed.

Research Ethics. The study was conducted in accordance with the ethical standards of the World Medical Association's Declaration of Helsinki (1964–2024), European Community Directive 86/609 on the participation of humans in biomedical research, and Order No.690 of the Ministry of Health of Ukraine dated September 23, 2009. Informed consent was obtained from all participants.

Results. It was found that SEBC is characterized by a significantly higher level of CD68+ macrophage infiltration compared to NEBC (p<0.05). The highest macrophage density was found in the triple-negative SEBC subgroup, which correlated with a more aggressive course (p<0.001). A CD4/CD8 ratio ≥1.5 was significantly more frequent in SEBC (46.6% vs. 13.3% in NEBC, p<0.05) and was associated with the presence of metastases in regional lymph nodes (p<0.03). Absolute counts of CD4+, CD8+, and CD20+ cells did not show significant differences between groups or clear prognostic value.

Conclusions. The obtained results indicate a pathogenetically important role of macrophage infiltration in the development of aggressive forms of SEBC, especially the triple-negative subtype. The CD4/CD8 ratio is defined as a promising prognostic indicator of lymphogenous metastasis in SEBC. These findings justify the feasibility of further study of the immune microenvironment for risk stratification and development of personalized immunotherapeutic strategies for patients with secondary edematous breast cancers.

Keywords: oncology, lymphocytic infiltration, CD68+ macrophages, CD4/CD8, triple-negative breast cancer, tumor microenvironment.

Adaptive role of the thyroid system and iodine in low triiodothyronine syndrome: clinical significance and rehabilitation strategies (literature review, part 1)

2025-12-22T14:57:40+02:00

In press

Background. The thyroid system is a crucial regulator of homeostasis, influencing energy metabolism, immune responses, and adaptation processes. In clinical practice, the low triiodothyronine (T3) syndrome in non-thyroidal illnesses is often viewed as an adaptive response aimed at reducing energy expenditure. However, a one-sided interpretation of this phenomenon limits the understanding of its sanogenetic role in the immune response, as well as the rationale for using iodine and hormone replacement therapy when adaptive potential is depleted. Recent studies demonstrate that iodine performs not only a structural function in the synthesis of thyroid hormones but also exhibits independent antioxidant and immunomodulatory properties.

Aim. Based on source analysis, to substantiate the sanogenetic significance of the low T3 state during fasting and low T3 syndrome in non-thyroidal illnesses, and to evaluate the prospects for using iodine preparations and T3 replacement therapy as part of comprehensive rehabilitation medicine.

Materials and Methods. The methods of systematic analysis and a bibliosemantic approach were used. Publications from 2015–2025 indexed in PubMed, Scopus, ScienceDirect, EMBASE, Medline, Cochrane Library, and Google Scholar were analyzed. Selection was performed using the following keywords: rehabilitation medicine, non-thyroidal illnesses, thyroid hormones, thyroxine, cytokines, phagocytosis. Reviews, clinical and experimental studies in Ukrainian and English were included in the analysis.

Research Ethics. Preference was given to works adhering to bioethical principles and clinical standards, with a clear design and correct interpretation of results.

Results. Historically, iodine was used for the prevention of endemic goiter, and later in surgery and dermatology due to its antiseptic properties. Modern data confirm its antioxidant and immunomodulatory effects. Two variants of low T3 status have been described in patients: one with normal and one with elevated T3 clearance. The former is associated with fasting and liver damage, the latter with severe conditions such as trauma, infections, ischemia, and cancer pathology. Immune cells are capable of locally regulating thyroid hormone metabolism and iodine transport, which determines their role in adaptation mechanisms.

Conclusions. The low T3 syndrome can have both adaptive and maladaptive significance in non-thyroidal illnesses. Iodine is considered not only a component of thyroid hormones but also an immunomodulatory agent. This provides a basis for further research to determine the optimal strategy for iodine provision and thyroid hormone replacement therapy within modern rehabilitation medicine.

Keywords: rehabilitation medicine, nonthyroidal illnesses, thyroid hormones, thyroxine, cytokines, phagocytosis.

Requirements for the design of manuscripts of scientific articles of journals of the Kharkiv National Medical University (in force from 2 July 2025)

2025-12-11T00:37:40+02:00