Ukrainian Journal of Translational Medicine (formerly Inter Collegas)

Clinical and instrumental characteristics of patients with ischemic stroke and stenotic and non-stenotic extracranial atherosclerosis

2026-06-01T21:54:52+03:00

In press

Background. Non-stenotic extracranial atherosclerosis is increasingly regarded as a clinically relevant source of ischemic stroke, particularly when plaque vulnerability is present despite the absence of severe luminal narrowing.

Aim. To compare computed tomography, computed tomographic angiography, magnetic resonance imaging, ultrasonographic and integrated clinical-instrumental characteristics in ischemic stroke patients with stenotic and non-stenotic extracranial atherosclerosis.

Materials and Methods. The clinical observational comparative study with a cross-sectional analytical framework and retrospective and prospective components included 100 patients with verified non-lacunar ischemic stroke and ipsilateral extracranial atherosclerosis: 50 with stenotic (≥50% luminal narrowing of the culprit ipsilateral extracranial artery) and 50 with non-stenotic disease (<50%). MRI variables (median [Q1; Q3] for quantitative, n (%) for categorical) were analyzed using Shapiro–Wilk (normality), Mann–Whitney U, chi-square or Fisher’s exact (group comparisons), and Spearman’s correlation. Statistical analysis was performed using Statistica 8.0 (StatSoft, USA). The study was conducted as an aspect of the author’s dissertation and research project "Anatomical-functional and neurohumoral features of neurological consequences of traumatic and vascular injuries of the nervous system in different age periods" (state registration number 0121U000035).

Research Ethics. The study complied with medical research ethics standards of the World Medical Association Declaration of Helsinki (1964–2024). Written informed consent for examination, treatment and use of anonymized clinical data for research purposes was obtained from all participants or their legal representatives.

Results. Stenotic atherosclerosis was associated with lower ASPECTS (Alberta Stroke Program Early CT Score) (8.0 [7.0; 8.8] versus 9.0 [8.0; 9.0]; p<0.001), larger infarct volume (47.9 [35.8; 55.8] ml versus 33.2 [23.6; 39.2] ml; p<0.001), greater culprit stenosis and higher ipsilateral internal carotid artery flow velocities. Non-stenotic disease showed more frequent vulnerability markers: lower plaque gray-scale median, higher vulnerability score and high vulnerability in 64.0% versus 20.0% of patients (p<0.001). Early neurological deterioration was also more frequent in the non-stenotic group (30.0% versus 8.0%; p=0.005).

Conclusions. Stenotic disease formed a hemodynamic and large-infarct phenotype, whereas non-stenotic disease formed a vulnerability-driven phenotype requiring plaque-oriented risk stratification.

Keywords: neurology, medical radiology, carotid plaque, Doppler ultrasonography, plaque vulnerability, vessel wall imaging.

Trends in asthma control test scores before and after the onset of martial law

2026-07-03T23:43:49+03:00

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Background. During the war in Ukraine, many patients experience an exacerbation of bronchial asthma due to treatment interruptions and limited access to diagnostic facilities, which necessitates a revision of approaches to patient care.

Aim. To determine the role of a remote "Asthma School" in the control of bronchial asthma in patients under martial law.

Materials and Methods. The study included 42 patients with Bronchial Asthma (BA), aged 20 to 60 years, with a disease duration of 5 to 15 years. There were 28 women (66.7%) and 14 men (33.3%). The patients were divided into three groups of 14: Group 1 – mild asthma, Group 2 – moderate asthma, and Group 3 – severe asthma. Four consecutive surveys were conducted using the Asthma Control Test (ACT) before and after the onset of martial law in 2022. Statistical analysis was performed using Excel 2016 (Microsoft, USA) and Statistica 10.0 (StatSoft, USA), with paired Student's t-test for comparisons. Results with normal distribution are presented as mean ± standard deviation (M±SD). The study was conducted as part of the master's thesis "The role of asthma schools in asthma management in a frontline city" (2024–2026).

Research Ethics. The study was conducted in accordance with the Declaration of Helsinki of the World Medical Association (1964–2024). Patients provided informed consent.

Results. At the first and second assessments, all groups showed good asthma control with a trend toward slight improvement. The third assessment (during martial law) revealed a significant decrease in ACT scores in all groups: Group 1 – to [14.2±1.8], Group 2 – to [16.3±1.4], and Group 3 – to [19.4±1.1] (p<0.05). The fourth assessment (after implementation of the remote "Asthma School") showed increases: Group 1 to [17.3±1.5], Group 2 to [19.2±1.2], and Group 3 to [20.3±1.2]. A trend toward restoration of asthma control was observed in Groups 2 and 3 (p>0.05), while statistically significant residual decompensation persisted in Group 1 (p<0.05).

Conclusions. During martial law, a significant decline in asthma symptom control was observed in all groups. The greatest decrease was noted in patients with mild asthma, while patients with severe asthma demonstrated the highest resilience to the negative impact of the war. The introduction of the remote "Asthma School" contributed to a significant improvement in ACT scores.

Keywords: respiratory diseases, patient education, war, monitoring.

Anatomical formation, spatial orientation, and dynamics of morphological changes of the human atrioventricular valve apparatus during prenatal development

2026-10-09T19:29:59+03:00

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Background. The increasing incidence of Сongenital Heart Defects (CHDs) drives interest in the study of cardiogenesis. Despite the successes of morphological research on the human heart, controversial issues remain. Understanding the precise chronology and dynamics of morphofunctional changes in the human atrioventricular heart valves provides a foundation for the development of prenatal diagnostics and pediatric cardiac surgery.

Aim. To investigate the initiation and formation of atrioventricular valve apparatuses in the human heart.

Materials and Methods. The hearts of 17 embryos, 24 prefetuses, and 40 fetuses were examined. Macroscopic, microscopic, histochemical methods, and 3D reconstruction were utilized. The study was qualitative and descriptive; no statistical analysis was performed. This study is a part of the planned research project of the Department of Histology, Cytology, and Embryology at BSMU "Patterns of Morphogenesis, Structural-Functional Organization and Anatomical Variability of Organs and Structures in Various Body Regions and Systems of Humans and Experimental Animals" (implementation period: 01.2026–12.2030), state registration number 0126U003125.

Research Ethics. The Biomedical Ethics Committee of BSMU (Protocol No.5 of February 19, 2026) found no violations of moral or legal standards during the course of this research work.

Results. It was revealed that the initiation of endocardial cushions, from which the atrioventricular valves are formed, begins at the end of the 4^th week of intrauterine development. During the fetal period, the valve leaflets remain immature: they are covered with endothelium and contain interstitial cells. The matrix is represented by an amorphous substance and immature fibers. Chordae tendineae begin to form at the 15^th week. The primary chordae tendineae are muscular. Subsequently, they differentiate into mature chordae, dominated by dense, regular connective tissue. Thus, chordae tendineae are classified into two types: muscular and fibro-muscular.

Conclusions. 1. Endocardial cushions are identified at the 4^th week of embryogenesis and give rise to the atrioventricular valves. 2. In fetuses, the valve leaflets are covered with endothelium and contain interstitial cells and an extracellular matrix with an amorphous substance and immature fibers. 3. Primary chordae tendineae appear at the 15^th week in the form of muscular bands. 4. They undergo remodeling and exhibit dense, regular connective tissue. The cords are classified into muscular and fibro-muscular types.

Keywords: theoretical medicine, endocardial cushions, chordae tendineae, papillary muscles, intrauterine ontogenesis.

Biochemical evaluation of anti-inflammatory action of a pharmaceutical composition of nimesulide with caffeine in a formalin pain model in rats

2026-10-23T22:20:36+03:00

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Background. Nonsteroidal anti-inflammatory drugs are widely used to treat pain and inflammation, while combination formulations may modify treatment effects through complementary mechanisms.

Aim. To evaluate the anti-inflammatory activity of a pharmaceutical composition containing nimesulide and caffeine based on serum ceruloplasmin levels and to assess its antioxidant activity based on serum conjugated triene levels in rats with formalin-induced paw edema.

Materials and Methods. The study included 36 male Wistar Albino Glaxo rats allocated to six groups: intact control, formalin-induced paw edema, nimesulide (15 mg/kg), caffeine (0.6 mg/kg), nimesulide with caffeine (15 mg/kg and 0.6 mg/kg), and diclofenac sodium (8 mg/kg). Paw edema was induced by 2% formalin. Serum ceruloplasmin was measured by enzyme-linked immunosorbent assay (Cusabio, China), and conjugated trienes spectrophotometrically. Statistical analysis used one-way analysis of variance with Tukey's post hoc test or the Kruskal–Wallis test with Dunn's post hoc test; p<0.05 indicated significance. The study was performed within the research project "Chemical and Pharmaceutical Substantiation for the Development of Biologically Active Compositions with Anti-Inflammatory and Analgesic Activities" (2024–2026), state registration No.0124U002495.

Research Ethics. Procedures complied with the European Convention on experimental vertebrate animals and ARRIVE 2.0; the protocol was approved by the Bioethics Committee of Kharkiv National Medical University.

Results. Formalin increased serum ceruloplasmin and conjugated triene levels. The nimesulide-caffeine combination reduced ceruloplasmin to [139.83±18.42] mg/L and conjugated trienes to [0.124±0.012] arb. units/mL. These values were lower than with nimesulide or caffeine alone. Ceruloplasmin was also lower than with diclofenac sodium, while conjugated trienes did not differ significantly from the diclofenac sodium group or intact control.

Conclusions. Under the experimental conditions, the nimesulide-caffeine combination produced the largest reductions in the inflammatory and lipid-peroxidation biomarkers studied among the treatment groups. The findings support further investigation of this combination.

Keywords: experimental medicine, biomarkers of inflammation, antioxidant activity, ceruloplasmin, conjugated trienes, lipid peroxidation.

Low triiodothyronine in metabolic and inflammatory stress: A context-dependent model of thyroid adaptation

2026-05-06T00:29:25+03:00

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Background. Low triiodothyronine status has been described in a wide range of physiological and pathological conditions, including energy restriction, critical illness, and systemic inflammation. In the literature, these alterations are commonly referred to as the low T₃ state. Traditionally, they have been interpreted within the framework of the Non-Thyroidal Illness Syndrome (NTIS). However, accumulating experimental and clinical evidence suggests that a similar biochemical phenotype may arise in different systemic contexts through distinct regulatory mechanisms. Thus, low triiodothyronine status may be considered a context-dependent phenotype of systemic adaptation that develops under diverse metabolic and immune conditions.

Aim. To summarize current pathophysiological concepts of low triiodothyronine status in systemic inflammatory and metabolic stress, to analyze their limitations, and to propose an integrative context-dependent model of thyroid adaptation.

Materials and Methods. The study is a literature review. A bibliographic analysis of scientific literature published between 2015 and 2025 was conducted using the PubMed, Scopus, ScienceDirect, Google Scholar, and MEDLINE databases. The following keywords were used: adaptive physiological processes, deiodinases, thyroid hormones, energy metabolism, cytokines, and allostatic load. Clinical, experimental, and review studies meeting contemporary evidence-based medicine standards were included in the analysis. The study was conducted as a private initiative of the authors, without grant support and state registration of the topic.

Research Ethics. This review was conducted using previously published studies performed in accordance with current bioethical standards.

Results. Analysis of the literature indicates that most current concepts interpret low T₃ either as an energy-saving adaptive response or as a marker of disease severity. At the same time, the role of the immune system as an active regulatory component of thyroid homeostasis remains insufficiently addressed. The present review proposes a context-dependent model of thyroid adaptation, according to which an identical biochemical phenotype of low T₃ may develop under different systemic conditions – energy deficit or systemic inflammation – through distinct regulatory mechanisms. Particular attention is given to the integration of neuroendocrine, metabolic, and immune signals, including the roles of cytokines, deiodinases, and the potential involvement of iodine-dependent mechanisms of innate immunity. A central element of the proposed model may be the functional interaction between the thyroid axis and phagocytic activity.

Conclusions. Low triiodothyronine status should be considered a context-dependent phenotype of systemic adaptation that emerges from interactions between metabolic, immune, and neuroendocrine regulatory processes. The proposed model expands current understanding of the mechanisms underlying low T₃ and provides a conceptual framework for future mechanistic and clinical studies.

Keywords: endocrinology, literature review, deiodinases, thyroid hormones, energy metabolism, cytokines.

Diet and the microbiome: Interaction pathways in chronic intestinal diseases (literature review)

2026-06-06T17:51:55+03:00

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Background. Nutrition is the science of food, nutrients, their effects, interactions, and balance in the context of human health and disease. Nutraceuticals provide the body with energy substrates, which are converted in the body’s cells into important metabolites used in physiological and biochemical processes. Diet plays an important role in shaping the qualitative and quantitative composition of the human gut microbiome.

Aim. To analyze the interaction between diet and the gut microbiome, and to investigate the role of specific nutrients in the development and progression of chronic intestinal diseases.

Materials and Methods. The study was carried out using the bibliosemantic method and system analysis. For analysis, the sources of 2012–2026 were selected. from scientometric databases PubMed, Scopus, ScienceDirect, EMBASE, Medline, Cochrane Library and Google Scholar. The study was carried out as a private initiative of the authors without grant support and state registration of the topic.

Research Ethics. For the analysis, only those sources were selected, the authors of which adhered to modern bioethical norms when performing their research.

Results. Fermentation of dietary fiber by the colonic gut microbiota produces short-chain fatty acids, which provide [60–70]% of the energy needs of colonocytes, maintain intestinal barrier integrity, and modulate cell proliferation. Polysaccharide deficiency leads to destruction of the mucus layer, erosions, and "leaky gut" syndrome. High consumption of fruit, vegetables, legumes and potatoes reduces the risk of Crohn's disease (adjusted Hazard Ratio (aHR) = 0.44) but does not affect ulcerative colitis; excessive potato consumption increases the risk of ulcerative colitis (aHR=1.51). Insoluble dietary fiber may provoke abdominal pain, diarrhea and flatulence, whereas soluble fiber stimulates Lactobacillus sp. and Bifidobacteria sp. Legumes, in particular Phaseolus vulgaris Navy bean, due to their content of lysine, iron, phosphatidylserine, apigenin and coumaric acid, reduce oxidative stress, inflammation and the risk of colorectal adenoma recurrence.

Conclusions. The interaction between diet and the microbiome through fermentation of dietary fiber is a key mechanism for maintaining intestinal homeostasis. Different dietary components have a differentiated effect on the risk and course of Crohn's disease and ulcerative colitis. Unbalanced nutrition causes dysbiosis, increased intestinal barrier permeability and chronic inflammation, which justifies the need for personalized dietary approaches.

Keywords: nutrition, dietary fiber, inflammatory intestinal diseases.

Chrononutrition as a factor in the regulation of metabolism and human health (literature review)

2026-07-02T19:18:03+03:00

In press

Background. The global epidemic of obesity and metabolic disorders necessitates a reassessment of traditional dietary approaches. Chrononutrition, which investigates the impact of meal timing on health, is emerging as a novel paradigm, as the misalignment ("chronodisruption") of internal biological clocks is an independent risk factor for the development of type 2 diabetes mellitus and cardiovascular diseases.

Aim. To synthesize and analyze current scientific data on the impact of meal timing on metabolic processes and key human health metrics, with a particular focus on the clinical application of the Time-Restricted Eating (TRE) strategy and personalized approaches.

Materials and Methods. A search of publications was conducted in the PubMed, Cochrane Library, and Google Scholar bibliographic databases using the keywords chrononutrition, circadian rhythm, meal timing, and time-restricted eating. The analysis included reviews, meta-analyses, and randomized controlled trials involving human subjects published from 2015 to 2025. The research was carried out as a private initiative of the authors, without grant support and state registration of the topic.

Research Ethics. This work is a literature review; no original research was conducted. Only those publications whose authors confirmed adherence to international ethical standards, particularly the provisions of the World Medical Association Declaration of Helsinki (1964–2024), and had obtained approval from ethics committees were selected for analysis.

Results. The body's metabolic efficiency, including insulin sensitivity and the diet-induced thermogenesis, peaks in the morning and declines in the evening. The TRE strategy demonstrates clinical efficacy in improving cardiometabolic outcomes, including body weight and blood pressure. Early TRE (eTRE) has been found to be significantly more effective for improving insulin sensitivity than late TRE (lTRE), and these benefits may be independent of weight loss. The effectiveness of these approaches depends on individual chronotype and requires adaptation for specific groups (e.g., shift workers, the elderly). The underlying mechanisms of chrononutrition effects include the modulation of gut microbiome diurnal rhythms and epigenetic regulation.

Conclusions. Meal timing represents a powerful, independent determinant of metabolic health. The integration of chrononutrition principles, particularly shifting caloric intake to the first half of the day and implementing eTRE, is a scientifically substantiated strategy for the prevention and management of metabolic disorders, opening a new era in dietetics.

Keywords: endocrinology, circadian rhythms, time-restricted eating, insulin resistance, chronotype.

Prospects on the implementation of the training course "Psychophysiology of conscious communication in crisis conditions" for international medical students

2026-06-16T14:39:29+03:00

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Background. Prolonged crisis conditions, including the coronavirus disease 2019 pandemic and the full-scale war in Ukraine, have significantly affected higher medical education. International medical students are particularly vulnerable due to stress, intercultural adaptation challenges, language barriers, and difficulties in academic communication. Under these circumstances, the development of conscious communication skills and emotional self-regulation becomes an important component of professional training.

Aim. To substantiate the development and implementation of the course "Psychophysiology of Conscious Communication in Crisis Conditions" for international medical students, considering psychophysiological aspects of communication under stress and contemporary educational approaches.

Materials and Methods. The study was based on the analysis of contemporary scientific literature on communication competence, neurophysiological mechanisms of communication, emotional regulation, and communication training in medical education during crisis conditions. Educational materials developed within the Ukrainian-Swiss Project "Medical Education Development" were adapted. Based on this framework, the authors developed the course "Psychophysiology of Conscious Communication in Crisis Conditions", integrating a neurophysiological component developed at the Department of Physiology of Kharkiv National Medical University. The conceptual structure of the course was developed by the authors, while ChatGPT (GPT-5.5, OpenAI) was used solely for visualization of the course framework.

Research Ethics. The article describes the development of an educational course and does not involve human participants or biomedical experimentation. Therefore, ethical approval was not required.

Results. Chronic stress affects communication, emotional regulation, and adaptation processes. Analysis of educational practices revealed limited integration of psychophysiological approaches into communication training. A course concept (1.5 European Credit Transfer and Accumulation System credits) is proposed, combining psychophysiological knowledge, conscious communication skills, and practice-oriented learning in blended and online formats.

Conclusions. The proposed course may enhance communicative resilience, emotional self-regulation, and adaptive capacity among international students, contributing to a psychologically safe educational environment in crisis conditions.

Keywords: soft skills, communicative resilience, neurophysiological component, emotional self-regulation, educational environment.

Requirements for the design of manuscripts of scientific articles of journals of the Kharkiv National Medical University

2026-06-02T02:10:02+03:00