Inter Collegas

Assessment of GAS6 in various clinical variants of coronary artery disease in patients with chronic heart failure and concomitant metabolic pathology

K. Borovyk — 2025-12-31

In press

Background. Chronic Heart Failure (CHF) of ischemic origin is a significant medical problem, aggravated by concomitant Type 2 Diabetes Mellitus (T2DM) and obesity. Growth Arrest-Specific protein 6 (GAS6), a ligand for TAM (Tyro3, Axl, Mer) receptors family, is involved in apoptosis and myocardial fibrosis, making it a potential diagnostic marker.

Aim. To assess circulating GAS6 levels and establish correlations with various clinical variants of coronary artery disease in patients with chronic heart failure and concomitant type 2 diabetes mellitus and obesity.

Materials and Methods. The study involved 225 patients with ischemic heart failure, divided into groups according to metabolic disorders: Group 1 – 75 patients with Coronary Artery Disease (CAD), СHF, T2DM and obesity; Group 2 – 50 patients with CAD, CHF and T2DM; Group 3 – 50 patients with CAD, CHF and obesity; Group 4 – 50 patients with CAD and CHF without metabolic disorders. A Control Group included 30 healthy individuals. The patients were sub-divided in accordance with CAD form: stable angina, diffuse cardiosclerosis, and Post-Infarction CardioSclerosis (PICS). GAS6 levels were determined by Enzyme-Linked ImmunoSorbent Assay (ELISA). The data were analyzed using parametric and non-parametric methods via Statistica 14.0 (TIBCO Software Inc., USA). Group comparisons were performed using the Kruskal-Wallis H-test with post-hoc Mann-Whitney U-test with Bonferroni correction. The work was carried out within the framework of the author's dissertation.

Research Ethics. The study was approved by the Bioethics Commission of Kharkiv National Medical University and conducted in accordance with the principles of the World Medical Association Declaration of Helsinki (1964–2024). All patients provided written informed consent to participate.

Results. The most pronounced and significant increase in circulating GAS6 levels was observed in patients of Groups 1 and 3 compared to the controls. The highest GAS6 level ([38.18±2.15] ng/ml) was found in Group 1 patients with PICS, significantly exceeding values in the diffuse cardiosclerosis subgroup (p<0.008). In Groups 2 and 4, GAS6 levels did not differ significantly from the Control Group (p>0.008). Correlation analysis revealed a strong positive correlation between GAS6 and obesity (r=0.77; p<0.05). A moderate significant positive correlation with PICS (r=0.63; p<0.05) and T2DM (r=0.61; p<0.05) was found. The correlation with stable angina was weak and insignificant (r=0.26; p>0.05).

Conclusions. Obesity is a key factor in GAS6 activation, reflecting systemic inflammation and profibrotic processes. Elevated GAS6 levels are reliably associated with post-infarction cardiosclerosis specifically in the presence of obesity, indicating its role in myocardial remodeling and fibrogenesis.

Keywords: therapy, cardiovascular diseases, ischemic heart disease, type 2 diabetes mellitus, obesity, post-infarction cardiosclerosis.

Features of left ventricular remodeling in trained individuals depending on the orientation of the training process

V.R. Burdina — 2025-12-31

In press

Background. The study of left ventricular remodeling features in athletes depending on the orientation of the training process is relevant for optimizing training loads and preventing cardiovascular system disorders.

Aim. To identify the features of left ventricular remodeling in trained individuals depending on the orientation of the training process based on the analysis of morphometric parameters.

Materials and Methods. The study included 149 athletes aged 18 to 34 years specializing in various athletics disciplines. Depending on the training orientation, they were divided into three groups: speed-oriented (n=62), speed-strength oriented (n=49), and endurance-oriented (n=38). Echocardiography was performed with measurement of cardiac dimensions and left ventricular mass by Devereux formula. Statistical analysis was performed using SPSS 29.0 (IBM, USA). One-way ANOVA with Tukey HSD post-hoc test was used for intergroup comparisons. Two-way ANOVA was applied to assess the effects of training orientation and sex. The investigation was conducted as a private initiative of the authors, without grant funding.

Research Ethics. The study was conducted in accordance with the ethical standards of the World Medical Association's Declaration of Helsinki (1964–2024) with informed consent of all participants.

Results. Endurance athletes showed increased left ventricular end-diastolic dimension (p<0.05) and left ventricular myocardial mass (p<0.01) with proportional wall thickening (eccentric hypertrophy). Speed athletes had only systolic posterior wall thickening (p<0.05). Speed-strength athletes showed increased aortic diameter and left atrium size; two-way ANOVA confirmed independent training orientation effect after controlling for sex (p<[0.05–0.01]). Left ventricular mass strongly correlated with anthropometric parameters (height r=0.72, weight r=0.74, body surface area r=0.76) and left ventricular dimensions (end-diastolic dimension r=0.74, end-systolic dimension r=0.81). All parameters remained within physiological norms (wall thickness <12 mm, left ventricular end-diastolic dimension <60 mm).

Conclusions. The orientation of the training process is a determining factor in the formation of a specific "athlete's heart" phenotype. The obtained data justify the need for mandatory indexing of left ventricular myocardial mass to body surface area for correct intergroup and intersex comparative assessment.

Keywords: physical therapy and rehabilitation, athlete's heart, echocardiography, exercise-induced cardiomegaly, morphometric parameters, speckle tracking echocardiography.

Pathophysiological mechanisms of mucociliary clearance function in patients with respiratory and olfactory disorders of functional-mechanical and viral origin

Ya.D. Bondarenko — 2025-12-31

In press

Background. MucoCiliary Clearance (MCC) is the primary protective mechanism of the upper respiratory tract. Differentiating between extracellular (functional-mechanical) and intracellular (viral cytopathic) mechanisms of MCC impairment has been studied insufficiently but critical for selecting adequate therapeutic strategies.

Aim. To investigate the pathophysiological mechanisms of MCC in patients with respiratory and olfactory disorders depending on the duration and degree of nasal obstruction, and in patients post-Coronavirus Disease 2019.

Materials and Methods. A prospective observational study included 196 patients (mean age [37.4±13.1] years) with nasal obstruction and impaired respiratory/olfactory functions (disease duration from 1 month to 5 years). Patients were divided into four groups: Group 1 (n=53) – pronounced chronic nasal obstruction ([3–5] years); Group 2 (n=48) – partial obstruction (up to 6 months); Group 3 (n=44) – pronounced obstruction (up to 1 month); Group 4 (n=51) – acute post-viral rhinosinusitis after Severe Acute Respiratory Syndrome Coronavirus 2. Two pathogenetic profiles were evaluated: functional-mechanical (groups 1–3) and viral cytopathic (Group 4). Assessment included rhinomanometry, Saccharin Transit Time (STT), olfactometry (Sniffin’ Sticks), and high-speed video microscopy of ciliary epithelium (×100, 120 frames/s) analyzed in ImageJ/ciliaFA. Statistical processing of the data was performed using one-way analysis of variance (ANOVA) with post hoc Student’s test and Bonferroni correction and Pearson correlation with Excel 2022 (Microsoft, USA). The article is a part of scientific research with state registration number 0125U001264.

Research Ethics. The study complied with the World Medical Association Declaration of Helsinki (1964–2024) and relevant Ministry of Health of Ukraine orders. All participants provided written informed consent.

Results. In Group 1, aerodynamic resistance was [3.1±0.4] kPa·s/L, STT was [24.5±3.1] min, and ciliary beat frequency (CBF) was [7.3±1.4] Hz; metachronal wave was absent in 100% of cases, with hyposmia in 100% ([4.1±1.3] points). In Group 2, STT was [18.0±2.4] min, CBF was [7.6±3.1] Hz; in Group 3, STT was [34.7±3.3] min, CBF was [6.8±2.2] Hz. In Group 4, resistance was [1.9±0.4] kPa·s/L, STT was [17.0±1.9] min, and CBF was [8.1±1.4] Hz. Here, anosmia was present in 31.6% ([0.9±0.5] points) and hyposmia in 68.4% ([4.1±0.9] points).

Conclusions. Two fundamentally different pathophysiological profiles of MCC dysfunction were identified: functional-mechanical origin(groups 1–3) and viral cytopathic origin (Group 4), requiring diametrically opposite therapeutic strategies.

Keywords: otorhinolaryngology, ciliary epithelium, nasal obstruction, olfactory dysfunction, COVID-19, rhinomanometry.

The interplay between diabetes compensation status and mental health in displaced Ukrainians with type 2 diabetes during the ongoing russian-Ukrainian war

L.S. Kiro — 2025-12-31

In press

Background. Diabetes cases in Ukraine rose from 490,000 in 2022 to 731,000 in 2025, with high rates of anxiety (40%) and depression (35%) among patients, worsening prognosis and quality of life.

Aim. To investigate the levels of anxiety and depressive disorders in displaced Ukrainians with Type 2 Diabetes Mellitus (T2DM), comparing the differences between compensated and subcompensated patients.

Materials and Methods. Sixty-four displaced Ukrainians with T2DM were examined. Group 1 consisted of 54 patients with T2DM of moderate severity and subcompensation stage with neurological symptoms. The average HbA1c was [7.3±2.1] %, and the duration of T2DM was [9.89±0.56] years. The control group included 10 patients with T2DM of mild severity in the compensation stage, without neurological complaints. The average HbA1c was [6.5±2.1] %, and the duration of the disease was [7.89±0.26] years. Anxiety and depression levels were assessed using the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI). Statistical processing of the data was carried out using the statistical software package SPSS 10.0 (IBM, USA). Comparison of variables was performed using nonparametric statistical methods: the Mann-Whitney U-test for two independent samples and the Pearson χ²criterion for dependent samples. The results were considered reliable at p<0.05. The research was conducted as a private initiative of the authors, did not receive funding from grant programs, and the research topic was not officially registered in the state register of research topics.

Research Ethics. This study was conducted in accordance with the fundamental bioethical principles outlined in the Helsinki Declaration of the World Medical Association Declaration of Helsinki (1964–2024), as well as subsequent updates and additions, including the General Declaration on Bioethics and Human Rights (2005) and the Council of Europe Convention on Human Rights and Biomedicine (1997).

Results. In group 1, the level of anxiety was 2.8 times higher than in the control group (13.0 [7.0; 17.0] vs. 4.5 [4.0; 6.0], p<0.001); the level of depression was 4 times higher than in the control group (12.0 [5.0; 16.0] vs. 3.0 [2.0; 4.0], p<0.001). According to both scales (HADS, BDI), patients in the control group did not have a depressive state, while in patients in group 1, mild (subclinical) depression was detected in 24.1%, moderate depression in 33.3%, and very severe depression in 1 patient.

Conclusions. The absence of subclinical/clinical depression in patients in the control group may indicate that anxiety disorders precede the development of depression and require timely correction by clinicians to prevent their further transformation into depression.

Keywords: therapy, diabetes mellitus, depression, anxiety disorders, phobic disorders.

Threat of miscarriage at 10–13 weeks of gestation: Consequences and possible risks

О.V. Kravchenko — 2025-12-31

In press

Background. Problems during the fetal period attract our particular attention, as they prevent the second wave of cytotrophoblast invasion into the myometrial segments of the spiral arteries and contribute to the development of placental dysfunction.

Aim. To study the state of extraembryonic structures in case of miscarriage, at the fetal stage of intrauterine development of the child, at the end of the first trimester of gestation and their influence on the development of placental dysfunction.

Materials and Methods. The study included 20 patients (Group 1) with a verified threat of pregnancy termination without bleeding at the fetal stage of gestation ([10–13] weeks), 22 women with verified RetroChorial Hematoma (RСH) at the same time (Group 2) and 20 women (Control Group) with a physiological course of the first trimester of gestation. During the transvaginal ultrasound examination, the chorionic volume was calculated using a special three-dimensional program VOCAL (Virtual Organ Computer-aided AnaLysis), and its vascular system was assessed. The data are presented as Me [Q₁; Q₃]; the comparison of three groups was performed by the Kruskal–Wallis test with Dunn's post-hoc test and Bonferroni correction.

Research Ethics. The study was conducted in accordance with the principles of the World Medical Association Declaration of Helsinki (1964–2024) and approved by the Biomedical Ethics Committee of Bukovinian State Medical University (Protocol No.7 of April 17, 2025). The examination was performed only after obtaining the patient's informed consent.

Results. In the Control Group, the median chorionic volume (Vx) was 164.0 [162.5; 165.2] cm³, the Vascularization Index (VI) was 19.4 [18.3; 20.7], and the blood Flow Index (FI) was 49.2 [48.5; 50.1]. In Group 1 (threat of miscarriage without bleeding), Vx decreased to 152.1 [146.2; 156.8] cm³ (by 7.4%), VI to 13.4 [12.5; 14.3] (by 30.9%), and FI to 41.3 [39.0; 43.7] (by 16.1%). In Group 2 (threat of retrochorial hematoma), Vx decreased to 131.5 [127.1; 135.9] cm³ (by 20.1%), VI to 9.6 [8.9; 10.4] (by 50.5%), and FI to 34.1 [31.8; 36.3] (by 30.7%). All differences were statistically significant (Kruskal–Wallis test with Dunn’s post-hoc and Bonferroni correction, adjusted p<0.01 for Group 1 vs. Control Group, and p<0.001 for Group 2 vs. Control Group as well as p<0.01 for Group 1 vs. Group 2).

Conclusions. Retrochorionic hematomas formed at the risk of miscarriage at [10–13] weeks of gestation are a direct cause of chorionic hypoplasia and impaired chorionic maturation. A decrease in the index of vascularization and blood flow in the chorion creates a high risk of placental dysfunction, which in turn worsens the prognosis of further pregnancy.

Keywords: obstetrics, placenta, angiogenesis, ultrasonography, obstetric hemorrhage, trophoblast.

Significance of the educational component "Science of Nutrition" in medical education: a survey of Kharkiv National Medical University students

І.V. Zavgorodnii — 2025-12-31

In press

Background. Non-communicable diseases account for over 90% of mortality in Ukraine, establishing preventive medicine as a strategic priority. Nutrition is one of the leading modifiable risk factors; however, nutrition-related training among healthcare professionals remains insufficient. Integrating nutritional topics into the medical curriculum is therefore strategically important for developing the professional competencies of future physicians.

Aim. To assess the awareness and attitudes of medical students toward the elective educational component "Nutritional Science" and to determine its significance for future professional practice.

Materials and Methods. A cross-sectional anonymous online survey was conducted among students of Kharkiv National Medical University who had completed the elective component "Nutritional Science" (n = 68), representing the specialties of Medicine, Pediatrics, Dentistry, and Therapy and Rehabilitation. Descriptive statistical analysis was performed using IBM SPSS Statistics v.26.0; results are presented as absolute frequencies (n) and percentages (%).

Research Ethics. The study complied with the World Medical Association Declaration of Helsinki (1964–2024), the Council of Europe Convention on Human Rights and Biomedicine, Good Clinical Practice (1996–2025), Good Laboratory Practice (1981–2002), and the Statute of the Ukrainian Association for Bioethics.

Results. Half of the respondents actively maintain a healthy lifestyle; 35.3% aspire to do so but cite limited knowledge or time. Personal interest in nutrition was the primary enrollment motivation (61.8%), while 32.4% sought to strengthen professional knowledge. Overall, 86.8% reported the course fully met their expectations. The most valued sections were "Nutritional Characteristics of Food Products," "Principles of Rational Nutrition," and "Nutritional Status Disorders and Their Correction". Most respondents (58.8%) consider the course essential for clinical practice, and 39.7% value it for forming a broader medical outlook. The strongest professional orientation was observed among Therapy and Rehabilitation students. A total of 69.1% expressed high willingness to recommend the course to peers.

Conclusions. The educational component "Nutritional Science" received high appraisal from Kharkiv National Medical University students, confirming its practical relevance. Further adaptation of the course to the specific requirements of individual medical specialties will support the preparation of physicians equipped to implement preventive strategies and apply nutritional knowledge in clinical practice.

Keywords: public health, prevention, non-communicable diseases, healthy lifestyle.

The impact of physical activity on quality-of-life indicators in patients with chronic heart failure

K.P. Meleha — 2025-12-31

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Background. Heart failure is one of the most common complications of cardiovascular diseases. In this regard, physical rehabilitation programs aimed at improving the psychophysical state of patients are becoming increasingly relevant.

Aim. The aim of the study is to assess the impact of systematic physical exercise within a multidisciplinary outpatient cardiac rehabilitation program on the quality-of-life and psychological adaptation of patients with heart failure.

Materials and Methods. The study involved 100 patients (50 men and 50 women) with diagnosed heart failure. To assess the effectiveness of rehabilitation, the Quality-of-Life scale (QoL) and the Acceptance of Illness Scale (AIS) were used. Statistical analysis was performed using Excel 365 (Microsoft, USA) and Statistica 10 (StatSoft, USA), with the Mann–Whitney U test for pairwise comparisons and the Kruskal–Wallis test with post hoc analysis for multiple group comparisons. The study was carried out as a private initiative of the authors, without additional funding and state registration of the scientific topic.

Research Ethics. The study was conducted in compliance with the basic principles of bioethics, respect for the person, confidentiality, voluntary participation, and patient safety. The participants in the experiment were informed about the details of participation in the rehabilitation program and provided written consent to participate. The results were used only for scientific purposes, with participants’ anonymity ensured.

Results. This study presents the dynamics of the quality-of-life of patients with heart failure under the influence of physical rehabilitation. A comparison of the physical (FIZ) and psycho-emotional (MENT) aspects of quality-of-life, the general quality-of-life index (QoL) and the acceptance of illness scale (AIS) between men and women was conducted. The results showed that patients who participated in the physical rehabilitation program demonstrated a significant improvement in physical performance, tolerance to stress and emotional state. According to the AIS scale, statistically significant gender differences were found (p=0.002): women reported higher rates of disease acceptance (M=[25.8±5.3]) than men (M=[22.7±6.1]), indicating better psychological adaptation of women to a chronic disease.

Conclusions. The results confirmed that it has a significant positive impact on the general condition of patients. In the control group, a less pronounced improvement in the studied indicators was observed. The study findings emphasize the importance of systematic physical activity as an integral element of heart failure treatment and is the key to successful long-term rehabilitation.

Keywords: physical therapy and rehabilitation, sports medicine, organization of health care, psychological adaptation, multidisciplinary approach, cardiac rehabilitation.

Perspectives on studying the biophysical values of oral fluid in patients with different conditions of the cervical area of the teeth

I.I. Zabolotna — 2025-12-31

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Background. The properties of Oral Fluid (OF) directly affect dental pathology development, but their role has not been fully studied yet.

Aim. Identification and analysis of biophysical values of oral fluid in patients with different conditions of the cervical area of teeth.

Materials and Methods. The study enrolled 272 patients aged 18–44 years who underwent a comprehensive examination and were divided into groups based on the condition of the Cervical Area (CA) of the teeth. Biophysical values of the OF were identified. The Odds Ratio (OR) with 95% Confidence Interval (CI) was used to analyze the strength of correlation between factors and the outcome. Risk Factors (RF) were identified using logistic regression analysis. Statistical analysis was performed using Statistica 8.0 (Statsoft, USA). The study was conducted within the framework of the dissertation research "Clinical and pathogenetic substantiation of a differentiated approach to the diagnosis, treatment, and prevention of cervical lesions of hard dental tissues" (2021–2024).

Research Ethics. The research was carried out in accordance with the principles of World Medical Association Declaration of Helsinki (1964–2024), Order of the Ministry of Health of Ukraine No. 690 dated September 23, 2009, conclusion of the Bioethics Commission of Donetsk National Medical University No. 43 dated January 21, 2021. All patients provided written informed consent to participate in the study.

Results. Saliva of patients with cervical lesions of teeth (Wedge-Shaped Defect (WSD) and Cervical Caries (CC)) corresponded to significantly lower mean values of electrical impedance (Z) and Coefficient Of Dispersion (COD) compared to patients with intact CA of teeth (p<0.01). The liquid crystal phase of OF in patients with WSD and CC of teeth was unstable, with low micellarity and weakened mineralizing function. More significant changes were typical for saliva of patients with WSD of the teeth. Salivary Flow Rate (SFR) less than 0.5 ml/min increased OR of developing WSD and CC: in univariate analysis, 2.12 and 2.26 times, respectively; in multivariate analysis, 1.23 and 2.17 times, respectively. Values of buffer capacity less than 6.5 increased OR of developing CC: in univariate analysis, 2.34 times, in multivariate analysis, 1.30 times. The pH values less than 6.9 increased OR of developing WSD and enamel E: in univariate analysis, 1.50 and 2.90 times, respectively; in multivariate analysis – 1.48 and 1.22 times, respectively, and they were also an independent factor of the active course of enamel E. However, in the case of enamel E, wide CIs for the variable, determined in univariate analysis, indicate instability of the assessment.

Conclusions. Values of SFR, buffer capacity, and pH can be considered as RF of developing WSD and CC. The pH values as predictors of development and active course of enamel Е require further research. An alternative to the mineralizing potential of saliva is proposed – identification of Z and COD.

Keywords: dentistry, erosion, caries, risk factors.

Use of electronic courses on the Moodle platform in the educational process at Kharkiv National Medical University during martial law

Ya.V. Zhuravel — 2025-12-31

In press

Background. The paper examines the organization of the educational process for students at Kharkiv National Medical University (KhNMU) under martial law, with a focus on the use of electronic courses. It highlights key challenges of online learning: hazardous conditions, power and internet disruptions, and the need to balance studies with work or volunteering.

Aim. To assess the attitudes of students at KhNMU toward the use of electronic courses in the learning process, as well as the effectiveness of the Moodle platform's resource base offered by the academic staff of the departments, to improve and optimize the structure of electronic courses.

Materials and Methods. The study was carried out as a private initiative of the authors, without additional funding and state registration of the scientific topic, using bibliosemantic, sociological, and systems analysis methods. The survey involved 124 students: 67 first‑year, 45 third‑year, and 12 fourth‑year students. The study evaluated the advantages and disadvantages of learning through electronic courses, challenges encountered in using the Moodle distance learning system, and the level of knowledge acquisition during distance learning supported by the electronic courses. Statistical analysis was performed using descriptive statistics (frequency distribution analysis) with Excel 2016 (Microsoft, USA).

Research Ethics. The study was conducted in accordance with the principles of the Declaration of Helsinki of the World Medical Association (1964–2024). All respondents signed an informed consent to participate in the study.

Results. Among 124 respondents, 87.9% were in Ukraine (66.1% in eastern regions, close to the combat zone), 67.7% could join online classes, and 32.2% experienced power/internet disruptions. Most (66.1%) had experience with electronic courses, 52.4% reported no difficulties with Moodle, and 44.0% encountered no significant learning challenges. Students valued self‑paced study and combining education with work or military service.

Conclusions. Electronic courses enable students to continue studying during martial law, even in frontline areas, supporting flexible, individualized learning. Given frequent power and internet disruptions, they are often the only means of maintaining educational continuity.

Keywords: distance learning, online platforms, educational trends.

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

2025-12-31