Experimental and Clinical Medicine

The relationship between serum galectin-3 levels and dysglycaemia in comorbid cardiometabolic pathology depending on heart failure phenotypes

2026-02-18T20:52:27+02:00

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Background. Chronic Heart Failure (CHF) is an unfavourable pathology, the prevalence of which is increasing in patients with cardiometabolic pathology (Coronary Artery Disease (CAD), Type 2 Diabetes Mellitus (T2DM) and obesity). One of the key profibrotic biomarkers in this pathology is galectin-3, but its role in the development of dysglycaemia in comorbidity remains insufficiently studied.

Aim. To study the relationship between serum galectin-3 levels and carbohydrate metabolism indicators in patients with comorbid cardiometabolic pathology depending on the phenotype of chronic heart failure.

Materials and Methods. We examined 225 patients with CHF in CAD, divided into four groups and subgroups according to CHF phenotypes (CHF with preserved Ejection Fraction (CHFpEF); CHF with moderately reduced Ejection Fraction (CHFmEF); HF with reduced Ejection Fraction (HFrEF)). Group 1 included 75 patients with CAD, T2DM and obesity. Group 2 included 50 patients with CAD and T2DM. Group 3 included 50 patients with CAD and obesity. Group 4 included 50 patients with CAD without metabolic pathology. The control group consisted of 30 healthy individuals. Serum glucose, insulin, and glycated haemoglobin (HbA1c) levels were determined, and the HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) index was calculated. The level of galectin-3 was determined by immunoenzymatic method. Statistical analysis was performed using Fisher's criterion and Spearman's coefficient (p=0.05). The work was performed as part of the author's dissertation research.

Research Ethics. The study was carried out in accordance with the norms of WMA Declaration of Helsinki (1964–2024) and approved by the Bioethics Committee of Kharkiv National Medical University. All involved patients signed an informed consent.

Results. In Groups 1 and 2, a progressive deterioration in carbohydrate metabolism and an increase in galectin-3 were found in parallel with a decrease in Left Ventricular (LV) Ejection Fraction (EF). In Group 2, the HOMA-IR index in HFpEF was 264.8% higher than in HFpEF, and galectin-3 was 95.4% higher. Strong correlations were found between galectin-3 and HOMA-IR (r=0.72; p<0.05) and glucose (r=0.64; p<0.05). In Group 3, with a decrease in LVEF, only insulin (by 98.6%) and HOMA-IR increased, while HbA1c and galectin-3 levels did not change significantly. The correlation of galectin-3 was significant only with insulin (r=0.73; p<0.05).

Conclusions. Insulin resistance progresses most sensitively with a decrease in ejection fraction in metabolic disorders. The activation of galectin-3 as a mediator of fibrosis and dysglycaemia is closely associated with type 2 diabetes mellitus. The absence of a reliable correlation between galectin-3 and heart failure phenotypes in patients without type 2 diabetes mellitus emphasises the critical role of comorbid metabolic pathology in the progression of heart failure.

Keywords: therapy, сhronic heart failure, coronary artery disease, type 2 diabetes mellitus, obesity, galectin-3.

Optimization of diagnostic and therapeutic tactics for bile extravasation after the formation of biliary-digestive anastomoses based on prognostic modeling

2026-03-11T21:47:41+02:00

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Background. Failure of biliary-digestive anastomoses with the development of bile extravasation remains a critical surgical complication associated with a high level of septic conditions and mortality. The lack of objective criteria for early differentiation of the severity of bile leakage necessitates the implementation of prognostic models to objectify surgical decision-making.

Aim. Development of a multifactorial mathematical model and clinical algorithm for early identification of the risk of progression of biliary extravasation in order to optimize the treatment strategy.

Materials and Methods. The results of treatment of 120 patients were analyzed by assessing diagnostic parameters, including the level of interleukin-6, the bilirubin gradient in the exudate, and the anatomical features of the biliary tree. Mathematical modeling and validation of the results were implemented using logistic regression analysis, construction of sigmoidal probability curves, and the bootstrap validation method with SPSS v.26.0 (IBM, USA). The work is a fragment of the research work of the Department of Surgery No.1 of the Kharkiv National Medical University "Development of diagnostic methods and open and minimally invasive technologies for the treatment of diseases and injuries of the thoracic and abdominal organs, vessels of the extremities in patients during wartime" (2024–2028), state registration number 0124U002908.

Research Ethics. The study was conducted in accordance with the main provisions of the Declaration of Helsinki of the World Medical Association (1964–2024). All patients signed a written informed consent for participation and processing of personal data.

Results. Key predictors of bile leak risk were identified, namely: anastomotic re-reconstruction, high strictures, hyperbilirubinemia > 100 μmol/l and hypoalbuminemia. The developed model demonstrated high predictive ability (AUC 0.94; sensitivity 89.3%; specificity 85.7%). The implementation of a three-stage algorithm allowed us to clearly distinguish treatment tactics between conservative management, minimally invasive decompression at an average risk level and urgent relaparotomy with the formation of a "guided fistula" at a high risk level.

Conclusions. The implementation of a three-level risk stratification system provided an objective choice between conservative tactics, minimally invasive interventions and relaparotomy. The use of interventional radiological techniques allowed us to avoid repeated operations and significantly improve treatment outcomes.

Keywords: surgery, biliodigestive anastomosis, bile leak, prognosis, minimally invasive interventions.

Prospects for the use of plant extracts for the treatment of wounds infected with poly-resistant pathogens

2026-03-18T13:50:51+02:00

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Background. The global spread of multi-drug resistant microorganisms has significantly complicated the treatment of bacterial infectious diseases in general and traumatic injuries in particular. Multi-drug resistant bacteria of the ESKAPE group pose a particular threat, which necessitates the search for alternative antimicrobial agents of natural origin.

Aim. Study the possibility of using alcoholic extracts of pomegranate peels and comfrey roots for the treatment of wounds infected with multi-drug resistant microorganisms of the ESKAPE group.

Materials and Methods. The antimicrobial activity of alcoholic extracts of pomegranate peels and comfrey root against multi-drug resistant microorganisms was studied using the agar diffusion spot method. The cytotoxicity of plant extracts was studied on human dermal fibroblast and osteosarcoma cell cultures in the resazurin assay. The overall toxicity of the extracts was determined on the in ovo model. Quail eggs (29 pieces) were divided into four groups: two – treated with pomegranate and comfrey extracts, one – with saline, and one – non-treated. Statistical analysis was performed using one-way ANOVA in GraphPad Prism 8.0 software, with significance set at p≤0.05. The study was carried out at the expense of grant support of the Ministry of Education and Science of Ukraine (state registration number 0124U000540).

Research Ethics. The studies were conducted in accordance with the "General Ethical Principles of Animal Experiments" (Kyiv, 2001), the World Medical Association Declaration of Helsinki (1964–2024) and with Sumy State University bioethics commission’s approval (Protocol No.1/02 of 02/18/2025).

Results. The alcoholic extract of pomegranate demonstrated effectiveness against all studied microorganisms and was non-toxic to cell cultures on the 1st day of observation at a dilution of 1:8. The alcoholic extract of comfrey demonstrated the absence of toxicity during 1, 3 and 5 days of observation and a moderate stimulating effect on cell culture at a dilution of 1:32. The general safety of pomegranate extract and the stimulating effect of comfrey extract were demonstrated in the in ovo model.

Conclusions. Alcoholic extracts of pomegranate peel and comfrey root are promising for complex therapy of ESKAPE-infected wounds: pomegranate extract exhibits antimicrobial activity, while comfrey extract stimulates MG63 and HDF cell proliferation without general toxicity, justifying their further evaluation.

Keywords: experimental medicine, antimicrobials, antibiotic-resistant microorganisms.

Dynamics of the manifestations of stress-associated disorders and their clinical correction in individuals who engaged in volunteer activities during the war

2026-03-18T14:59:29+02:00

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Background. Russia’s full-scale invasion of Ukraine has led to a significant increase in the psycho-emotional burden on the population, particularly on volunteers who experience prolonged stress and regularly encounter traumatic events. This significantly increases the risk of developing stress-associated mental disorders.

Aim. To evaluate the clinical effectiveness of a therapeutic and psychosocial program in reducing the severity of symptoms of stress-associated disorders among volunteers involved in wartime activities.

Materials and Methods. Within the overall study, 288 volunteers aged [18–60] years were examined. Among them, a clinical sample of individuals with neurotic and stress-associated mental disorders was formed (n=82). This article presents the results of the analysis of a subgroup of respondents with disorders of the F43 category. The analytical sample included 25 individuals. Depending on the type of intervention, they were divided into an experimental group (n=12), which received a comprehensive therapeutic and psychosocial program, and a control group (n=13), which received pharmacotherapy. Diagnostics were performed using the clinical-psychopathological method and psychodiagnostic tools: the Primary Care Post-Traumatic Stress Disorder (PTSD) Screen, PTSD Checklist (PCL) for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Impact of Event Scale – Revised (IES-R) The treatment program combined pharmacotherapy and a low-intensity psychological intervention "Problem Management+". Treatment effectiveness was assessed by the dynamics of psychometric indicators. The study was conducted within the framework of research projects with state registration numbers 0120U101503 and 0125U001434.

Research Ethics. The study was approved by the Commission on Biomedical Ethics of Bukovinian State Medical University (Protocol No.1 of September 15, 2022). All participants signed voluntary informed consent.

Results. In the experimental group, a statistically significant reduction in the severity of post-traumatic stress disorder symptoms was found across all scales, which persisted for three months after the completion of the intervention. In the control group, which received only pharmacotherapy, improvement was also observed, however it was less pronounced and less stable.

Conclusions. The comprehensive therapeutic-psychosocial program demonstrated high clinical effectiveness and can be recommended for integration into the system of assistance to volunteers. Its implementation contributes to increased psychological resilience and reduction of the risk of exacerbation of psychopathological symptoms.

Keywords: psychiatry, volunteers, psychosocial support, anxiety, post-traumatic stress disorder, stress.

Medico-social substantiation of a model for early detection and prevention of burnout syndrome in healthcare workers

2026-03-23T17:09:34+02:00

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Background. Emotional Burnout Syndrome (EBS) among healthcare workers is a pressing public health issue that affects professional performance, patient safety, and healthcare system sustainability. Despite growing recognition, standardized early detection and prevention models remain underdeveloped in Ukraine.

Aim. To conduct medical and social research and develop a model for early detection and prevention of burnout syndrome among healthcare workers.

Materials & Methods. The study employed structural-functional modeling, synthesized from a literature review and empirical research conducted in 2021–2023. The study population comprised 483 healthcare professionals (study group, n=294; control group, n=189). An index-based approach was applied using integral indicators: Emotional Burnout Index (EBI), Stress Load Index (SLI), Support Index (SI), Access to Help Index (AHI), Learning Readiness Index (LRI), and Work Ability Index (WAI). Risk prediction was performed using Wald’s Sequential Probability Ratio Test. The model was validated via expert elicitation (12 experts) on a 10-point scale.

Research Ethics. The study was conducted in accordance with the World Medical Association Declaration of Helsinki (1964–2024). Ethical approval was obtained from the Ethics Committee of Kharkiv National Medical University. All participants provided written informed consent.

Results. Structural changes in burnout prevalence were observed: the proportion of individuals with EBI <40% decreased from 354.7‰ to 314.7‰, while those with EBI >70% increased from 191.9‰ to 231.9‰. Thirty risk factors were identified, with organizational-managerial determinants showing the strongest effect. Work ability among healthcare workers with burnout symptoms was low (mean WAI, [42.23±0.91]%). Access to help was limited (mean AHI, 59.18%), with the presence of specialized services significantly increasing the odds of high access (odds ratio, OR=43.56; p<0.001). A functional-structural model integrating screening, risk stratification, forecasting, and routing to assistance was developed and validated (mean overall score, [8.7±0.6] points).

Conclusions. The proposed model ensures standardized index-based screening, risk stratification, forecasting, formalized access to psychotherapeutic assistance, and monitoring of effectiveness, including work ability assessment. Implementation of the model corresponds to contemporary international approaches to mental health governance in the workplace.

Keywords: social medicine, emotional burnout syndrome, prevention, work ability.

Anxiolitic effect of cryopreserved placentar blood serum in a model of mild blast train injury

2026-04-29T01:25:06+03:00

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Background. The significant prevalence of traumatic brain injury during armed conflicts and the insufficient effectiveness of existing treatment programs for victims necessitates the development of new therapeutic approaches.

Aim. To investigate the effect of cryopreserved human placental blood serum on the level of anxiety in mice with a model of mild blast-induced traumatic brain injury.

Materials and Methods. Human placental blood was obtained from the umbilical vein of postpartum placenta weeks of gestation with a physiological course of pregnancy. Experiments were conducted on 6-month-old mice. Human placental blood was obtained from the umbilical vein of postpartum placenta 38–40 weeks of gestation with a physiological course of pregnancy. Experiments were conducted on 6-month-old mice. Statistical analysis of the obtained experimental data was performed by analysis of variance using the software package "StatGraphics Plus 2.1" (Statgraphics Technologies, Inc., USA). The study was carried out within the framework of the scientific project "Cryotechnologies in overcoming the consequences of combat blast-induced brain injury", state registration number 0125U000872.

Research Ethics. Human placental blood was obtained with informed consent of parturient women in compliance with the principles of the World Medical Association Declaration of Helsinki (1964–2024). All manipulations with animals were carried out in accordance with the "General Principles of Animal Experiments" adopted by the First National Congress on Bioethics (Kyiv, 2001) and consistent with the provisions of the "Convention of the Council of Europe for the Protection of Laboratory Animals" (ETS 123, 1986).

Results. Analysis of the obtained data proves that mild blast-induced craniocerebral trauma leads to increased anxiety in mice. Conducting a 5-day course of injections of cryopreserved or cryosublimated cord blood serum in the first days after the injury reduces pathological anxiety of experimental animals, which demonstrated a lower percentage of the total time spent in the closed arms of the maze, lower coefficients of preference for visiting and staying in the closed arms of the maze, a longer average duration of one episode of staying on the platform between the arms of the maze and higher exploratory activity. Cryosublimated cord blood serum was not inferior in activity to cryopreserved

Conclusions. The revealed anxiolytic effect of the use of cryopreserved, cryosublimated placental blood serum allows us to consider it as a promising means of overcoming increased anxiety – a pathological consequence of mild blast-induced craniocerebral trauma.

Keywords: neurology, placental blood serum, cryopreservation, mild traumatic brain injury, anxiety, elevated plus maze test, anxiolytic activity.

Adaptive role of the thyroid system in low triiodothyronine syndrome: immunometabolic mechanisms, clinical significance and rehabilitation perspectives (literature review, part 2)

2026-04-12T23:19:26+03:00

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Background. Low triiodothyronine syndrome (LT₃S) is a common manifestation of severe non-thyroidal conditions (trauma, infections, ischemic and oncological processes) associated with a systemic inflammatory response dominated by innate immune mechanisms, particularly phagocytosis. Traditionally regarded as an energy-conserving mechanism, it is now understood to reflect adaptive changes in thyroid metabolism related to immune regulation, prompting a reassessment of its clinical significance.

Aim. To systematize current knowledge on the pathophysiological mechanisms of adaptive changes in the thyroid system in non-thyroidal conditions with systemic inflammation and their clinical significance.

Materials and Methods. The study employed systematic analysis and bibliosemantic synthesis of scientific sources. The review is based on publications from 2015–2025 indexed in PubMed, Scopus, ScienceDirect, EMBASE, MEDLINE, the Cochrane Library, and Google Scholar. Peer-reviewed review, clinical, and experimental studies in Ukrainian and English were included. The study was conducted as a private initiative of the authors, without grant support and state registration of the scientific topic.

Research Ethics. Only publications meeting current bioethical standards were included.

Results. Alterations in thyroid metabolism in non-thyroidal conditions with systemic inflammation should be interpreted not only as an energy-conserving response but as an immune-mediated adaptive remodeling. These changes redistribute energy and micronutrients toward innate immune cells, particularly phagocytes, and clinically manifest as LT₃S. From a systems perspective, they correspond to the concept of a functional dominant. However, there is no unified clinical consensus regarding their therapeutic correction.

Conclusions. LT₃S should be considered a clinical and laboratory manifestation of adaptive changes in thyroid metabolism in non-thyroidal conditions with systemic inflammation. These changes are immune-mediated and aimed at supporting the functional activity of innate immune cells. The lack of consistent correction strategies underscores the need for further research and integration of these concepts into a unified pathophysiological model.

Keywords: rehabilitation medicine, non-thyroidal illness, thyroid hormones, thyroxine, cytokines, phagocytosis.