2026-02-10
O. M. Sulima, V. M. Chornyi, O. Ye. Yuryk, V. V. Chornyi, Ye. M. Kudiienko, I. O. Bakumenko
Aim. To evaluate the impact of complex regional pain syndrome (CRPS) on outcomes following primary and revision total knee arthroplasty (TKA). The study assesses the incidence, clinical manifestations, and functional consequences of CRPS, while evaluating current diagnostic and treatment approaches and the need for standardization. Materials and methods. A systematic scientific review was conducted, covering literature from PubMed, Scopus, and Web of Science published between 2015 and 2025. Inclusion criteria focused on studies of adult patients undergoing TKA who developed CRPS diagnosed by IASP or Budapest criteria. The analysis targeted incidence, clinical manifestations, risk factors, diagnostic approaches, treatment efficacy, and impact on rehabilitation outcomes. Results. CRPS remains a significant complication of TKA, with a reported incidence of approximately 0.2–2.0 % after primary procedures and 2–5 % following revision surgery. Clinical presentation is characterized by refractory pain, vasomotor dysfunction, and restricted range of motion, leading to significantly lower WOMAC and SF-36 scores and prolonged rehabilitation compared to uncomplicated TKA. Diagnosis remains challenging due to the lack of standardized early-detection protocols and symptom overlap with other complications, and underutilization of international diagnostic criteria. While multimodal management (pharmacotherapy, physiotherapy, and interventional techniques) is effective, its success is highly dependent on early initiation. High-quality evidence regarding CRPS in the specific context of revision TKA remains limited. Conclusions. CRPS adversely affects functional outcomes after TKA, with higher prevalence observed in revision cases. The absence of standardized preventive measures and optimized therapeutic regimens highlights an urgent need for personalized rehabilitation strategies and the implementation of international diagnostic criteria in routine clinical practice. Further research is needed to establish precise diagnostic criteria, effective prevention strategies, and personalized therapeutic and rehabilitation approaches.
2026-02-10
Yu. V. Myronchuk, O. O. Pushnova, L. V. Taran, L. I. Chernyshova, O. V. Dvizov
Aim: to demonstrate, based on an original clinical observation, the features of diagnosis, clinical management, and outcomes of rifampicin-resistant tuberculous meningitis in a child. Materials and methods. A clinical case of rifampicin-resistant tuberculous meningitis in a child treated in the Pediatric Unit at the clinical base of the Department of Phthisiology and Pulmonology of Zaporizhzhia State Medical and Pharmaceutical University, located at the Public Non-Profit Enterprise “Zaporizhzhia Regional Clinical and Diagnostic Center of Phthisiology and Pulmonology” of the Zaporizhzhia Regional Council. Results. A child was admitted to the Pediatric Unit from the pediatric intensive care unit (ICU) with a diagnosis of acute tuberculous meningitis. The diagnosis was confirmed by cerebrospinal fluid analysis using the Xpert MTB/RIF Ultra assay, which detected Mycobacterium tuberculosis resistant to the first-line antituberculous medication rifampicin. At the time of transfer, chest radiography revealed no pulmonary abnormalities. Brain magnetic resonance imaging showed no focal pathology. During further evaluation, the child’s mother was diagnosed with chemoresistant tuberculosis. The child received antituberculous and symptomatic therapy prescribed by a neurologist in the ICU for more than four months. During follow-up, chest computed tomography revealed disseminated pulmonary involvement. Following completion of treatment, the child was cured; however, epileptic syndrome developed, requiring lifelong therapy. Conclusions. Delayed diagnosis of tuberculous meningitis in children is a major risk factor for disability. The clinical presentation is nonspecific, with manifestations typically occurring at later stages of the disease. Management requires combined antituberculous, hormonal, and symptomatic therapy and close cooperation among physicians of various specialties. Rapid and timely diagnosis, screening of at-risk groups, and effective treatment significantly improve prognosis and reduce mortality and disability.
2026-02-10
Kh. Ya. Abrahamovych, O. V. Bevz, A. B. Haiduk, R. S. Ivasivka, A. B. Novosad, A. Ya. Bazylevych
Aim. To assess physical activity, sleep quality, and the mental health status of students during wartime, to explore their interrelationships, and to examine the mediating role of sleep quality. Materials and methods. A cross-sectional study was conducted among 245 first- to third-year students of State Non-Profit Enterprise “Danylo Halytsky Lviv National Medical University”aged 18–24 years (mean age 19.15 ± 0.95 years; 25 % males, 75 % females). Validated Ukrainian versions of standardized instruments were used: Perceived Stress Scale-14 (PSS-14, stress), Hospital Anxiety and Depression Scale (HADS, anxiety and depressive symptoms), Pittsburgh Sleep Quality Index (PSQI, sleep quality), and International Physical Activity Questionnaire – Long Form (IPAQ-LF, physical activity). Statistical analysis included descriptive statistics, Student’s t-test, one-way ANOVA, χ 2 test, Pearson’s correlation, and mediation analysis (Hayes’ PROCESS Macro, model 4, with 5000 bootstrap resamples). Results. Most students reported moderate stress scores (74.3 %). Elevated anxiety levels (HADS) were found in 38.8 % of participants, while increased depressive symptoms were observed in 7.3 %. Sleep disturbances (PSQI >5) were found in 64.1 % of students, with the most affected components being daytime dysfunction, sleep latency, and dissatisfaction with sleep quality. A high level of physical activity was observed in 73.9 % of students. Sleep quality showed a strong correlation with depressive symptoms (r = 0.473, p < 0.001), a moderate correlation with anxiety (r = 0.373, p < 0.001), and a weak correlation with stress scores (r = 0.230, p < 0.001). Physical activity was not directly associated with stress or anxiety but was significantly correlated with better sleep quality (r = -0.253, p < 0.001). Mediation analysis demonstrated that the effect of physical activity on depressive symptoms (β = -0.120; 95 % CI: -0.177 to -0.062) and anxiety (β = -0.097; 95 % CI: -0.147 to -0.050) was fully mediated by sleep quality, whereas for stress only partial mediation was observed (β = -0.059; 95 % CI: -0.106 to -0.020). Conclusions. Students during wartime exhibited a high prevalence of mental health issues combined with frequent sleep disturbances. Despite a generally high level of physical activity, sleep quality emerged as the key predictor and mediator of stress, anxiety, and depressive symptoms. These findings highlight the need for integrated programs that address both physical activity and sleep hygiene to safeguard students’ mental health in wartime conditions.
2026-02-10
A. I. Babiachok, I. R. Fedun, M. P. Ilchyshyn, I. V. Kendra, M. A. Pasichnyk, I. I. Horban, H. Z. Borys
Aim: to determine the relationship between hepatobiliary system (HBS) pathology and oral health status based on a synthesis of professional literature. Materials and methods. A bibliosemantic analysis was performed on research results from Ukrainian and international professional literature indexed in PubMed, Scopus, Web of Science, and Google Scholar. The search utilized keywords: hepatobiliary system, liver diseases, biliary tract diseases, dental caries, periodontitis, and oral mucosal diseases. Results. The study indicates that pathological changes in the hepatobiliary complex disrupt numerous vital systemic processes. Existing research has explored the development of hepatorenal, hepatoencephalic, hepatopulmonary, dermatological, and cardiovascular syndromes associated with HBS pathology. The authors have identified a significant influence of hepatobiliary diseases on the development of oral conditions, specifically affecting the periodontium, oral mucosa, salivary glands, and dental hard tissues. Furthermore, periodontitis is increasingly recognized as a risk factor that may contribute to the progression of hepatobiliary pathology. Evidence confirms a bidirectional correlation between HBS disorders and oral tissue health. Conclusions. Impairment of hepatic metabolic functions, including protein synthesis, accumulation, and distribution, as well as hormone and vitamin regulation and the activation of pro-inflammatory processes, negatively impacts various organ systems. It has been established that microbiome alterations observed in periodontitis play a significant role in the pathogenesis of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. Hepatobiliary pathology impairs the regeneration of both connective tissue and bone structures within the oral cavity. Clinical and experimental data also confirm that viral hepatitis is frequently accompanied by pathological changes in the salivary glands.
2026-02-10
I. V. Yanishen, R. V. Kuznietsov, N. V. Krychka, I. L. Diudina, V. H. Tomilin
In pathological attrition, teeth change the anatomical shape of the crown part of the teeth and the character of the mastication pressure distribution on the cutting and chewing surfaces. Dentition defects accompany this process and need the use of adhesive dental bridge (ADB), which is more suited to modern biotechnological requirements. Aim. To statistically analyze the dimensions of the oral surfaces of the anterior teeth in patients with a compensated form of pathological attrition, and to evaluate the potential applicability of these teeth as abutment elements for ADB. Materials and methods. We selected 30 patients (18 men and 12 women) aged 35–55 years with first-degree (attrition up to 1/3 of crown height) or second-degree (attrition up to 2/3 of crown height). From these, we formed two groups of 15 patients each. A third control group comprised 15 patients with intact dentition and physiological occlusion. We used a mathematical model from prior work for rational planning of ADB abutments in specific patients. Results. The examination results of 45 patients (270 teeth) conducted on models allowed us to determine the oral surface area of the anterior teeth, depending on the degree of pathological attrition. Conclusions. The mean occlusal surface areas of upper and lower jaw teeth have been identified. Based on clinical and laboratory experiments, this made it possible to plan the supporting elements of ADB for patients with a horizontal form of pathological dental attrition.