https://inter.knmu.edu.ua/ <p>Founder, editorial board and publisher: <a href="https://ror.org/01sks0025"><strong>Kharkiv National Medical University</strong></a></p> <p>Online ISSN: 2409-9988.</p> <p>DOI: 10.35339/ic</p> <p>The journal is assigned to the scientific professional publications of Ukraine in the field of medical sciences by the Ministry of Education and Science of Ukraine (September 24, 2020) <strong>"Б" category</strong> for specialties <strong>221</strong> - dentistry, <strong>222</strong> - medicine, <strong>223</strong> - nursing, <strong>225</strong> - medical psychology, <strong>227</strong> - therapy and rehabilitation, <strong>228</strong> - pediatrics.</p> <p><strong>Editorial and publisher address:</strong>&nbsp;<br>61022, Kharkov, Nauky Ave., 4<br>Tel.: +38 063 069 9000 <span class="VIiyi" lang="en"><span class="JLqJ4b ChMk0b" data-language-for-alternatives="en" data-language-to-translate-into="uk" data-phrase-index="0" data-number-of-phrases="1">(Monday to Friday 9:00-17:00 Ukrainian time, except holidays)</span></span>&nbsp;<br>E-mail: ic.journal@knmu.edu.ua</p> Kharkiv National Medical Unviersity en-US Inter Collegas 2409-9988 <p><span class="HwtZe" lang="en"><span class="jCAhz ChMk0b"><span class="ryNqvb">"Inter Collegas" is an open access journal: all articles are published in open access without an embargo period, under the terms of the CC BY-NC-SA (Creative Commons Attribution ‒ Noncommercial ‒ Share Alike) license;</span></span> <span class="jCAhz ChMk0b"><span class="ryNqvb">the content is available to all readers without registration from the moment of its publication.</span></span> <span class="jCAhz ChMk0b"><span class="ryNqvb">Electronic copies of the archive of journals are placed in the repositories of the KhNMU and </span></span>V.I. Vernadsky National Library of Ukraine.<br></span></p> <p><span class="HwtZe" lang="en">Copyright Agreement<br>1. This Agreement on the transfer of rights to use the work from the Co-authors to the publisher (hereinafter the Agreement) is concluded between all the Co-authors of the work, represented by the Corresponding Author, and Kharkiv National Medical University (hereinafter the University), represented by an authorized representative of the Editorial Board of scientific journals (hereinafter the Editorial Board).<br>2. This Agreement is an accession agreement within the meaning of clause 1 of Article 634 of the Civil Code of Ukraine: that is, a contract, "the terms of which are established by one of the parties in forms or other standard forms, which can be concluded only by joining the other party to the proposed contract as a whole. The other party cannot offer its terms of the contract." The party that established the terms of this contract is the University.<br>3. 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The University undertakes not to violate the integrity of the Work, to agree with the Corresponding Author on all changes made to the Work during processing and editing.<br>19. In case of violation of their obligations under this Agreement, its parties bear the responsibility defined by this Agreement and the current legislation of Ukraine. All disputes under the Agreement are resolved through negotiations, and if the negotiations do not resolve the dispute – in the courts of the city of Kharkiv.<br>20. The parties are not responsible for the violation of their obligations under this Agreement, if it occurred through no fault of theirs. The party is considered innocent if it proves that it has taken all measures dependent on it for the proper fulfillment of the obligation.<br>21. The Co-authors are responsible for the truthfulness of the facts, quotes, references to legislative and regulatory acts, other official documentation, the scientific validity of the Work, all types of responsibility to third parties who have claimed their rights to the Work. The co-authors reimburse the University for all costs caused by claims of third parties for infringement of copyright and other rights to the Work, as well as additional material costs related to the elimination of identified defects. </span></p> https://inter.knmu.edu.ua/article/view/10.35339.ic.2025.12.4.bok <p><strong>In press</strong></p> <p><strong>Background.</strong> 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.</p> <p><strong>Aim</strong>. 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.</p> <p><strong>Materials and Methods.</strong> 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.</p> <p><strong>Research Ethics.</strong> 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.</p> <p><strong>Results.</strong> 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&lt;0.008). In Groups 2 and 4, GAS6 levels did not differ significantly from the Control Group (p&gt;0.008). Correlation analysis revealed a strong positive correlation between GAS6 and obesity (r=0.77; p&lt;0.05). A moderate significant positive correlation with PICS (r=0.63; p&lt;0.05) and T2DM (r=0.61; p&lt;0.05) was found. The correlation with stable angina was weak and insignificant (r=0.26; p&gt;0.05).</p> <p><strong>Conclusions.</strong> 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.</p> <p><em><strong>Keywords:</strong> therapy, cardiovascular diseases, ischemic heart disease, type 2 diabetes mellitus, obesity, post-infarction cardiosclerosis.</em></p> K. Borovyk Copyright (c) 2025 Borovyk K. https://creativecommons.org/licenses/by-nc-sa/4.0/ 2025-12-31 2025-12-31 12 4 10.35339/ic.2025.12.4.bok https://inter.knmu.edu.ua/article/view/10.35339.ic.2025.12.4.bdg <p><strong>In press</strong></p> <p><strong>Background.</strong> 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.</p> <p><strong>Aim. </strong>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.</p> <p><strong>Materials and Methods.</strong> 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. &nbsp;The investigation was conducted as a private initiative of the authors, without grant funding.</p> <p><strong>Research Ethics.</strong> 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.</p> <p><strong>Results.</strong> Endurance athletes showed increased left ventricular end-diastolic dimension (p&lt;0.05) and left ventricular myocardial mass (p&lt;0.01) with proportional wall thickening (eccentric hypertrophy). Speed athletes had only systolic posterior wall thickening (p&lt;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&lt;[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 &lt;12 mm, left ventricular end-diastolic dimension &lt;60 mm).</p> <p><strong>Conclusions.</strong> 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.</p> <p><strong><em>Keywords:</em></strong><em> physical therapy and rehabilitation, athlete's heart, echocardiography, exercise-induced</em> <em>cardiomegaly</em><em>, </em><em>morphometric parameters, speckle tracking echocardiography.</em></p> V.R. Burdina S.I. Danylchenko I.V. Golovchenko D.V. Morozenko A.S. Shevchenko N.V. Cherkova L.N. Dushik Copyright (c) 2025 Burdina V.R., Danylchenko S.I., Golovchenko I.V., Morozenko D.V., Shevchenko A.S., Cherkova N.V., Dushik L.N. https://creativecommons.org/licenses/by-nc-sa/4.0/ 2025-12-31 2025-12-31 12 4 10.35339/ic.2025.12.4.bdg https://inter.knmu.edu.ua/article/view/10.35339.ic.2025.12.4.bsk <p><strong>In press</strong></p> <p><strong>Background.</strong> 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.</p> <p><strong>Aim.</strong> 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.</p> <p><strong>Materials and Methods.</strong> 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.</p> <p><strong>Research Ethics.</strong> 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.</p> <p><strong>Results.</strong> 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).</p> <p><strong>Conclusions.</strong> 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.</p> <p><strong><em>Keywords: </em></strong><em>otorhinolaryngology, ciliary epithelium, nasal obstruction, olfactory dysfunction, COVID-19, rhinomanometry.</em></p> Ya.D. Bondarenko N.O. Shushliapina Yu.M. Kalashnyk-Vakulenko M.I. Yashchenko Copyright (c) 2025 Bondarenko Ya.D., Shushliapina N.O., Kalashnyk-Vakulenko Yu.M., Yashchenko M.I. https://creativecommons.org/licenses/by-nc-sa/4.0/ 2025-12-31 2025-12-31 12 4 10.35339/ic.2025.12.4.bsk https://inter.knmu.edu.ua/article/view/10.35339.ic.2025.12.4.kzm <p><strong>In press</strong></p> <p><strong>Background.</strong> 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.</p> <p><strong>Aim.</strong> 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.</p> <p><strong>Materials and Methods.</strong> 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&lt;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.</p> <p><strong>Research Ethics.</strong> 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).</p> <p><strong>Results</strong><strong>.</strong> 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&lt;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&lt;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.</p> <p><strong>Conclusions.</strong> 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.</p> <p><strong><em>Keywords: </em></strong><em>therapy, </em><em>diabetes mellitus, depression, anxiety disorders, phobic disorders</em><em>.</em></p> L.S. Kiro M.Y. Zak O.M. Maksymenko I.B. Zhukova A.I. Ovechko Copyright (c) 2025 Kiro L.S., Zak M.Y., Maksymenko O.M., Zhukova I.B., Ovechko A.I. https://creativecommons.org/licenses/by-nc-sa/4.0/ 2025-12-31 2025-12-31 12 4 10.35339/ic.2025.12.4.kzm https://inter.knmu.edu.ua/article/view/590 Copyright (c) 2025 Shevchenko A.S., Danylchenko S.I., KhNMU https://creativecommons.org/licenses/by-nc-sa/4.0/ 2025-12-31 2025-12-31 12 4