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

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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

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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

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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.

The mental state of internally displaced persons during wartime: a study of depressive, anxiety, and post-traumatic symptoms

2026-02-11T10:13:08+02:00

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Background. War is one of the most powerful stress-inducing factors, capable of radically altering an individual's mental state and behavioral responses. According to existing research, prolonged armed conflicts not only increase levels of anxiety, depression, and Post-Traumatic Stress Disorder (PTSD), but also significantly affect adaptive capacity, cognitive risk appraisal, and the interpersonal domain of life in both civilian populations and military personnel.

Aim. To study and assess the course of depressive, anxiety, and post-traumatic symptoms among Internally Displaced Persons (IDPs) who have faced open military aggression.

Materials and Methods. Data from 2,100 IDPs collected during the period 2023–2025 via electronic questionnaires were analyzed. The assessment battery included: a specially designed anamnestic questionnaire, the Beck Depression Inventory (BDI), the Myers-Briggs Type Indicator (MBTI), the Spielberger-Hanin State-Trait Anxiety Inventory (STAI), the Impact of Event Scale (IES), and the Posttraumatic Stress Disorder Checklist (PCL). The study was a private initiative of the authors and received no grant funding.

Research Ethics. Participation of respondents was voluntary, based on informed consent. The study was conducted in accordance with the World Medical Association's Declaration of Helsinki (1964–2024). Ethical approval was obtained from the Bioethics Committee of Uzhhorod National University.

Results. The study sample was predominantly composed of women (77.0%), individuals with completed secondary or higher education (89.0%), and those with a sanguine temperament type (51.5%). According to the BDI results, mild depressive symptoms were identified in 56.0% of respondents. Assessment using the STAI revealed low anxiety levels in 53.0% of participants, moderate levels in 45.0%, and high levels in 2.0% (with moderate anxiety being more prevalent among women). Analysis using the IES demonstrated a predominance of elevated levels of intrusion (65.5%) and physiological hyperarousal (71.5%). Based on the PCL results, a high risk of developing PTSD was identified in 20.0% of IDPs, predominantly among women (95.2%), individuals without permanent housing (65.2%), and those with sanguine and choleric temperament types (85.2%).

Conclusions. A high prevalence of mild depressive and moderate anxiety symptoms, as well as a significant level of post-traumatic distress, was found among IDPs. Key risk factors for PTSD include female gender, lack of permanent housing, and certain temperament types. The results underscore the need for targeted psychoprophylactic and rehabilitation programs for this group.

Keywords: psychiatry, Beck Depression Inventory, Myers-Briggs Type Indicator, Spielberger-Hanin State-Trait Anxiety Inventory, Impact of Event Scale, Post-Traumatic Stress Disorder Checklist.

Features of treatment of patients with generalized periodontitis combined with herpesvirus infection

2026-02-25T13:29:02+02:00

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Background. In Ukraine, there is a tendency to increase the frequency of periodontal disease, which reaches 90 %. The lack of data on the features of the course of Generalized Periodontitis (GP) against the background of mixed HerpesVirus Infection (HVI) and scientifically substantiated approaches to its treatment became the reason for conducting scientific research in this direction.

Aim. To increase the effectiveness of the treatment of chronic GP in patients with HVI by using differentiated immunocorrective therapy taking into account the features of the immunopathogenesis of the dental disease.

Materials & Methods. A clinical and laboratory study, examination and treatment of 100 patients with chronic Herpes Simplex Virus-1 (HSV-1) combined with genital herpes was conducted: 40 patients with HSV-1 (Group 1); 30 patients with HSV-1 and chronic Epstein-Barr Virus Infection (EBVI) (Group 2); 30 patients with EBVI (Group 3). All patients divided into subgroups 1A and 1B, 2A and 2B, 3A and 3B depending on the prescribed immunotherapy. Patients in subgroups 1A, 2A, 3A were prescribed basic therapy, antiviral therapy and immunocorrective therapy in accordance with the type of herpesvirus infection. Patients in subgroups 1B, 2B and 3B received only basic therapy and antiviral therapy. The research results were processed using the method of variational and correlation statistics using the program Statistica 10.0 for Windows (StatSoft, USA).

Research Ethics. The study was carried out in compliance with the main provisions World Medical Association Declaration of Helsinki (1964–2024), the Council of Europe Convention on Human Rights and Biomedicine (Oviedo, 2007) and the recommendations of the Committee on Bioethics under the Presidium of the National Academy of Medical Sciences of Ukraine (2002).

Results. It was found that immunocorrective therapy increases the effectiveness of treatment of patients with GP combined with GVI. No patient who received immunocorrective therapy during the year had relapses of the disease. In contrast to the comparison subgroups, GP relapses were observed in subgroup 1A in 8.3 % of patients, in subgroup 2B – in 15.3 %, in subgroup 3B – in 16.6 % of patients.

Conclusions. The inclusion of immunocorrectors in the complex therapy of patients with acute viral hepatitis enhances the effect of antiviral drugs, effectively restores the body's immunoreactivity, and alleviates the clinical course of the disease.

Keywords: dentistry, periodontal disease, immunocorrective therapy.

Perioperative changes in the health status of patients with acute bowel obstruction of tumor genesis

2026-03-03T01:37:17+02:00

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Backgrounds. Acute Intestinal Obstruction (AIO) is one of the most common complications of colon cancer, the frequency of which ranges from 40.00% to 60.00%.

Aim. To conduct a comparative analysis of perioperative changes in the health status of patients with acute intestinal obstruction of tumor genesis using the prognostic scale CR-POSSUM (ColoRectal Physiologic and Operative Severity Score for the enUmeration of Mortality).

Materials and methods. Data from 123 (100.00%) patients who underwent treatment for AIO of tumor genesis were analyzed. Patients were divided into two groups: a comparison group, in the treatment of which methods were used according to the existing standards for the treatment of AIO (Order of the Ministry of Health of Ukraine No.1422) and the main group, which underwent examination and treatment according to the developed strategy. At the stages of treatment, the patients' health status was assessed using the CR-POSSUM scale. Statistical processing was carried out using the computer programs Statistica 13.0 and Excel 2013 using non-parametric statistical methods. The study was carried out within the framework of the research work of the Department of General Surgery and Postgraduate Surgical Education of the Zaporizhia State Medical and Pharmaceutical University (No.0122U201230).

Research Ethics. All procedures that took place in the studies were carried out with the informed consent of the participants and met the ethical standards of the institutional research committee of the Zaporizhia State Medical and Pharmaceutical University, as well as the Declaration of Helsinki of the World Medical Association (1964–2024).

Results. The use of the developed strategy made it possible to prepare the patient and maximally compensate for changes in his general condition before performing the surgical intervention, as evidenced by a decrease in the score on the physiological subscale of the CR-POSSUM scale after treatment ([10.21±3.02] points) compared to the score at the stage of hospitalization ([11.8±3.67] points, p=0.0012). Preoperative comprehensive preparation of patients with intestinal obstruction for surgical intervention allowed patients to more stably endure the early postoperative period without worsening of the general condition: in the comparison group, perioperative changes in health status were estimated at [10.94±3.12] points before and [12.37±3.79] points after the intervention (p=0.0032), in the main group – [10.21±3.02] points and [10.62±3.11] points, respectively (p=0.6247 and p=0.0295).

Conclusions. The use of the developed treatment strategy for patients with AIO of tumor genesis allows preparing the patient and maximally compensating for changes in his general condition before performing surgical intervention, to more stably endure the early postoperative period without worsening of the general condition and to reduce postoperative mortality risks by almost 2.5 times compared to this indicator in the comparison group.

Keywords: surgery, oncology, cancer, colon, intestinal obstruction.

Effectiveness of a physical therapy program on the manifestations of asthenia and cancer-related fatigue in patients with the consequences of oncologic knee joint endoprosthetic replacement

2026-03-17T20:07:20+02:00

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Background. Oncologic joint endoprosthetic replacement imposes increased demands on rehabilitation, as patients, in addition to orthopedic sequelae, frequently experience asthenia and cancer-related fatigue encompassing physical, emotional, and cognitive components, which significantly reduces quality of life.

Aim. To evaluate the effectiveness of a developed physical therapy program in patients with the consequences of oncologic knee endoprosthetic replacement based on indicators of asthenia and parameters of cancer-related fatigue.

Materials and Methods. The study included 7 participants who underwent surgery for osteosarcoma of the distal femur. The physical therapy program was implemented for 12 weeks (strength exercises for extremities and trunk, gait training, correction of individual functional impairments). Outcomes were assessed using the six-minute walk test, handgrip and deadlift dynamometry, and the EORTC QLQ-FA12 questionnaire (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire cancer-related FAtigue (12 items)). Parametric statistical methods (the Student’s t-test) were applied for normally distributed variables, whereas the Wilcoxon signed-rank test was used for non-normally distributed data. The study constitutes a component of the research project «Improvement of Functional Status, Quality of Life, and Correction of Pathological Conditions of Various Origins by Means of Therapy and Rehabilitation», State Registration No.0123U01534, conducted at Vasyl Stefanyk Сarpathian National University (2023–2026).

Research Ethics. The study was conducted in accordance with the principles of the World Medical Association Declaration of Helsinki (1964–2024), with informed consent obtained from all participants. The study protocol was approved by the institutional bioethics committee.

Results. Following the physical therapy program, the distance covered in the six-minute walk test increased by 23.3% (p<0.001), while the median fatigue level according to the Borg scale decreased by 30.8% (p<0.05). Handgrip strength increased by 6.7 kg in males and by 6.3 kg in females (p<0.001). Deadlift strength increased by 19.6 kg in males (p<0.05) and by 8.2 kg in females (p<0.001). According to the QLQ-FA12 questionnaire, a reduction in symptoms was observed across all domains; the total score decreased from 81 to 59 (27.2%; p<0.05).

Conclusions. A functionally oriented physical therapy program is effective in reducing cancer-related fatigue and asthenia in patients after oncologic knee endoprosthetic replacement, improving exercise tolerance and muscle strength while decreasing the impact of fatigue on daily life.

Keywords: physical therapy and rehabilitation, orthopedics and traumatology, malignant tumor, muscle weakness, lower limb, gait impairment.

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

2026-02-06T02:37:04+02:00

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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.

Rethinking the prevention of preeclampsia in the context of contemporary concepts of pathogenesis (literature review)

2026-01-15T17:55:30+02:00

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Background. Preeclampsia of varying severity accompanies every tenth pregnancy and is the cause of almost 15% of maternal deaths. Despite the availability of evidence-based recommendations, the issue of optimal selection and combination of preventive strategies remains the subject of active scientific discussions, which determines the expediency of generalizing current data in the context of the pathogenesis of preeclampsia.

Aim. To systematize and critically analyze current scientific literature on the pathogenetic mechanisms of preeclampsia development and the evidence base for the use of pharmacological and nutritional approaches for its prevention.

Materials and Methods. The study was conducted using systematic analysis and bibliosemantic method, within the framework of the study with the state registration number 0124U001136. The search for sources was performed in PubMed and Google Scholar databases for the period 1985–2025.

Research Ethics. The review was conducted in accordance with the ethical principles of scientific research. Only publicly available and published scientific literature data were used, without involving patients, biological samples, or any personalized information.

Results. The analysis of literary sources demonstrates that preeclampsia is a multifactorial placenta-mediated syndrome, for which there is currently no universal preventive approach. The most convincing evidence base comes from studies on the use of acetylsalicylic acid. The effectiveness of using this drug depends on the dose and early initiation of application. Calcium supplementation reliably reduces the risk of preeclampsia, especially in women with low baseline calcium consumption. L-arginine demonstrated pathogenic rationale and the ability to reduce the frequency of preeclampsia and its severe forms in high-risk groups. Data on metformin, statins, and low-molecular-weight heparin are promising but remain heterogeneous. The effects of their application require further study, particularly from the standpoint of safety for pregnant women and the fetus. Vitamin monotherapy and dietary interventions do not have convincing evidence of effectiveness, while combined approaches demonstrate more encouraging results.

Conclusions. The conducted literature review indicates that, despite progress in understanding the pathogenesis of preeclampsia, a universally effective strategy for its prevention currently does not exist. The heterogeneity of clinical forms and disease development mechanisms determines the limited efficacy of monotherapy and necessitates an individualized approach. Modern preventive strategies are oriented toward key pathogenetic pathways, which explains the growing interest in combined and targeted interventions.

Keywords: obstetrics, placenta-associated complications, pathogenesis, aspirin, calcium, L-arginine.

The accuracy of Vytruve 3D modeling as a guarantee of patient safety and comfort (literature review)

2026-02-02T17:40:38+02:00

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Background. The implementation of innovative solutions is critically important for minimizing the impact of the human factor during the acquisition of anthropometric data and for improving the overall quality of life of patients with lower limb amputations. This is because traditional techniques demonstrate significant limitations in the form of excessive production cycle duration, subjectivity of manual measurements, and high hygiene risks associated with the use of plaster compounds.

Aim. A comparative analysis of the classical plaster method for stump modeling in prosthesis fabrication and the novel digital Vytruve ecosystem, with a focus on technological and sanitary-hygienic aspects.

Materials and Methods. The study was conducted using systematic analysis, bibliosemantic, and comparative methods. A literature search was performed in Google, Google Scholar, and PubMed. The practical application of structured-light 3D scanning and specialized CAD modeling is described. The use of thermoplastic polymers and composites was analyzed for compliance with international ISO standards. The research was carried out as a private initiative of the authors, without additional funding or state registration of the scientific topic.

Research Ethics. For this review, literature sources were selected that indicated adherence to ethical requirements in the described studies.

Results. The results obtained during the work convincingly confirm that the Vytruve method provides an accuracy of reproduction of anatomical parameters within a deviation of [0.1–0.5] mm, which is an unattainable level for traditional methods. This enables precise digital modeling of the loading and unloading zones, thereby optimizing biomechanical pressure distribution within the sleeve. Digitalization reduces the total time required to manufacture the prosthesis and enables remote monitoring of the stump condition.

Conclusions. The main conclusions of the study indicate that integrated digital prosthetics using the Vytruve method is the most effective and safe alternative and complement to classical approaches in modern rehabilitation. The implementation of such standards into prosthetics and orthotics practice is a strategically necessary step for realizing a truly patient-centered approach, ensuring high result reproducibility, and enhancing the global competitiveness of domestic specialists.

Keywords: orthopedics and traumatology, precision, prosthetics-orthotics safety, hygiene.

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