Zaporizhzhia State Medical University Research Articles (Page 2)

To evaluate the eff ects of increased protein and L-carnitine supplementation in the feeding program of term infants withperinatal conditions on improving physical development outcomes, changes in body composition and hospital outcomes.The aim is to evaluate the eff ect of short-term increased protein intake in term infants and L-carnitine supplementation onbody composition and key indicators of physical development in children.Material and methods. To test the proposed hypothesis of neonatal nutrition, we studied the vital signs of 59 term infantsrandomized into two groups. The fi rst group (n = 30) received standard breastmilk (BM) or formula feeding, and the second group (n = 29) received a protein- fortifi ed (PF) formula and L-carnitine supplementation during the hospital stay. At the beginning and end of treatment, the children’s physical development and body composition were assessed using bioelectrical impedance.The study protocol was agreed and approved by the Regional Bioethics Committee of the Zaporizhzhia State Medical andPharmaceutical University. The study was conducted in accordance with the moral and ethical standards of the IGH/GCP, theDeclaration of Helsinki (1964 with amendments of 1975, 1983, 1989, 1996, 2000), the Convention of the Council of Europe onHuman Rights and Biomedicine, and the legislation of Ukraine. Written informed consent was obtained from the parents of the patients before the start of the study. All statistical analyses were performed using the software Statistica 13.0, TIBCO Software Inc (licence number JPZ804I382130ARCN10-J) and Microsoft Excel 2013 (licence number 00331-10000-00001-АА404). The probability of the diff erence in the absolute values of the means was determined using non-parametric methods of statistical analysis: the Mann-Whitney test (U) for unrelated groups and the Wilcoxon signed rank test (T) for related groups. Statistical signifi cance was defi ned as p < 0.05. The study was conducted within the framework of the research work of the Department of Anaesthesiology and Intensive Care Medicine of the Zaporizhzhia State Medical and Pharmaceutical University of the Ministry of Health of Ukraine – «Optimization of diagnosis and intensive care of multi etiological lesions of the brain, gastrointestinal tract, kidneys in newborns and older children», state registration number 0118U007142.Results. Infants in both groups had similar characteristics of weight, length and head circumference at baseline. Theproportions of infants of both sexes were within the 50 % percentile. In general, the proposed feeding strategy contributed to better indicators of infant physical development and a statistically signifi cant, faster recovery of body weight in the fortifi ed group. Thus, the generalised indicator of body weight of children in the GZ group was 3966.90 ± 439.08 g, compared to 3554.62 ± 452.28 g in the SC group, p = 0.0033. In general, the children who consumed more protein were transferred out of intensive care sooner – 10.00 (8.00, 12.00) days vs. 12.00 (11.00, 16.00) days, U = 235.00; p = 0.0024; discharged from hospital sooner – 21.00 (19.00, 27.00) days vs. 26.50 (22.00, 31.00) days, U = 267.00, p = 0.0109. This strategy proved to be safe, as evidenced by normal phenylalanine and urea levels at all stages of the children’s examination. Percentage analysis of body composition showed an increase in the formation of more dry mass in children on the standard diet, without protein fortifi cation and without carnitine supplementation. Thus, the percentage of FFM in the children on the standard diet was 84.71 (83.27; 85.47) % at the end of the study, compared with 83.09 (81.93; 83.96) % in the GZ group, U = 117.00; p = 0.0020. The total cohort indicator was infl uenced by the changes in body composition found in the women: in the GZ group, the percentage was 82.21 (81.55;83.10) % versus 84.71 (83.65;85.30) % in the SC group, U = 8.0; p = 0.0051. Thus, increased protein supplementation in term girls was associated with greater accumulation of fat mass, even with short-term supplementation.Conclusions. Consumption of more protein and carnitine supplementation in term neonates in the intensive care unitpromotes better growth against a background of body composition with higher fat content in females, a fact that limits the use of this strategy without further studies.

Abstract Introduction The marginal transitional zone of the joint is of fundamental importance in joint pathology. The normal marginal synovium takes part in articular cartilage repair (Adachi et al. 2012). The inflamed marginal synovium, in turn, promotes irreversible damage to the adjacent cartilage and bone (Hitchon & El-Gabalawy, 2011). Early erosive damage in rheumatoid arthritis and osteophyte formation in osteoarthritis occurs primarily here (Allard et al. 1990). Objectives The morphology of the marginal synovium from birth till the 90th day was studied using the hip joints of Wistar rats. Methods The collection of joints was carried out on the first, seventh, 14th, 30th, 45th, 60th and 90th day (six rats in each group, 42 in total). Joints were fixed, decalcified and dehydrated. Histologic paraffine sections were stained with Mallory's trichrome and Hart's elastin staining, analyzed at the acetabular labrum by light microscopy (χ100), morphometrical and statistical (P < 0.05) methods with extrapolation to humans (Sengupta, 2013). The obtained data were presented as percentages. Results In the marginal synovium, cells and components of the extracellular matrix, which are typical for fibrous connective tissue, could be seen. The synovial lining cells are embedded in the modified basement membrane which includes collagen and elastic fibers. They form a three-dimensional reticulum in it and adjacent synovial subintima. Vessels of the microcirculatory bed are also widely represented in the marginal synovium. The overall quantity of collagen fibers increased gradually, exceeding on the 90th day (approximately corresponds to 18–19 human years) that of newborns by one and a half times (48.92 ± 3.39 vs 72.17 ± 7.77; P = 0.023). The number of arranged collagen fibers increased gradually, exceeding on the 90th day that of newborns almost twofold (37.25 ± 3.21 vs 60.08 ± 5.99; P = 0.008). The area of distribution of disarranged collagen fibers in newborns was almost four and a half times less than the overall quantity of collagen fibers (11.67 ± 1.03 vs 48.92 ± 3.39; P < 0.001) and did not change substantially throughout the experiment. The number of elastic fibers increased till the 30th day (0.63 ± 0.11 vs 18.3 ± 1.25; P < 0.001) and did not undergo significant changes later. In newborns, the area of distribution of ground substance was not considerably higher than the ratio of disarranged collagen fibers (10.42 ± 1.8 vs 11.67 ± 1.03; P = 0.562) and did not undergo substantial changes later. The distribution density of vessels increased till the 30th-45th day (4.5 ± 0.67 vs 7.5 ± 0.82 and 7.7 ± 0.54; P < 0.001; approximately corresponds to the 9th and 14th human years respectively), followed by a gradual decrease from the 60th day (7.05 ± 0.72; roughly corresponds to the 16th human years). The maximum number of cells was in newborns. Subsequently, it gradually decreased and was almost three times less on the 90th day than that of newborns (38.01 ± 3.06 vs 12.58 ± 1.53; P < 0.001). Conclusion The morphogenesis of the marginal synovium during the postnatal period is accompanied by a gradual decrease in the number of cells, an increase in the area occupied by elastic and arranged collagen fibers with a relatively constant distribution density of disarranged collagen fibers and ground substance together with an undulatory pattern in the distribution of vessels. These peculiarities emphasize the morphological uniqueness of the marginal transitional zone, which forms the innate nonspecific barrier between the joint capsule and the articular cartilage, and thereby provides the necessary anatomical and physiological integrity of the joint as a whole organ. Knowledge about the patterns of morphogenesis of the marginal synovium will help in the future to analyze the modeled pathological or boundary states in it. Ethics The study was approved by the ethics committee of the Zaporizhzhia State Medical University.

Abstract Introduction The marginal transitional zone is of fundamental importance in joint pathology. It includes the marginal cartilage and marginal synovium. The normal marginal synovium takes part in articular cartilage repair (Adachi et al. 2012). The inflamed marginal synovium, in turn, promotes irreversible damage to the adjacent cartilage and bone (Hitchon & El-Gabalawy, 2011). Objectives The morphology of the normal marginal synovium from birth till the 90th day was studied using the hip joints of Wistar rats. Methods The collection of joints was carried out on the first, seventh, 14th, 30th, 45th, 60th and 90th day (six rats in each group, 42 in total). Joints were fixed, decalcified and dehydrated. Histologic paraffine sections were stained with Mallory's trichrome and Hart's elastin staining, analyzed at the acetabular labrum by light microscopy (χ100), morphometrical and statistical (P < 0.05) methods with extrapolation to humans (Sengupta, 2013). The obtained data were presented as percentages. Results In the marginal synovium, cells and components of the extracellular matrix, which are typical for fibrous connective tissue, could be distinguished. The synovial lining cells are embedded in the modified basement membrane which is a meshwork of collagen and elastic fibers. They form a three-dimensional reticulum in it and adjacent synovial subintima. Vessels of the microcirculatory bed are also widely represented in the marginal synovium. The overall quantity of collagen fibers increased gradually, exceeding on the 90th day (∼18–19 human years) that of newborns by one and a half times (48.92 ± 3.39 vs 72.17 ± 7.77; P = 0.023). The number of arranged collagen fibers increased gradually, exceeding on the 90th day that of newborns almost twofold (37.25 ± 3.21 vs 60.08 ± 5.99; P = 0.008). The area of distribution of disarranged collagen fibers in newborns was almost four and a half times less than the overall quantity of collagen fibers (11.67 ± 1.03 vs 48.92 ± 3.39; P < 0.001) and did not change substantially throughout the experiment. The number of elastic fibers increased till the 30th day (0.63 ± 0.11 vs 18.3 ± 1.25; P < 0.001) and did not undergo significant changes later. In newborns, the area of distribution of ground substance was not considerably higher than the ratio of disarranged collagen fibers (10.42 ± 1.8 vs 11.67 ± 1.03; P = 0.562) and did not undergo substantial changes later. The distribution density of vessels increased till the 30th-45th day (4.5 ± 0.67 vs 7.5 ± 0.82 and 7.7 ± 0.54; P < 0.001; ∼9-14th human years), followed by a gradual decrease from the 60th day (7.05 ± 0.72; ∼16 human years). The maximum number of cells was in newborns. Subsequently, it gradually decreased and was almost three times less on the 90th day than that of newborns (38.01 ± 3.06 vs 12.58 ± 1.53; P < 0.001). Conclusion The morphogenesis of the marginal synovium during the postnatal period is accompanied by a gradual decrease in the number of cells, an increase in the area occupied by elastic and arranged collagen fibers with a relatively constant distribution density of disarranged collagen fibers and ground substance together with an undulatory pattern in the distribution of vessels. These peculiarities emphasize the morphological uniqueness of the marginal transitional zone, which forms the innate nonspecific barrier between the joint capsule and the articular cartilage, and thereby provides the necessary anatomical and physiological integrity of the joint as a whole organ. Knowledge about the patterns of morphogenesis of the normal marginal synovium will help to understand joint pathology. Ethics The study was approved by the ethics committee of the Zaporizhzhia State Medical University.

Introduction. Distance learning during the COVID-19 outbreak in 2020-2021, and the Russian war actions whichstarted in 2022, which we refer to as "training under and after attacks," has had a significant impact on medicalundergraduate and postgraduate training in Ukraine. Despite the challenges posed by these events, the implementationof distance learning for medical PhD students proved to be beneficial for their academic performance, and regarded it asadvantageous.The aim of the research is to explore the peculiarities of distance learning for medical PhD medical students, includingits organization, main advantages, disadvantages, and challenges. The research focused on the experience of distancelearning of medical PhD students, particularly at Bogomolets National Medical University in Ukraine, and some others.Material and methods. To determine the effectiveness of distance learning for future medical PhDs, we analyzed theperformance in the course "Academic and Medical English for Medical PhD Students" of 247 medical PhD students, aged21 to 59, who were enrolled in the course at Kyiv Medical University, Bukovinian State Medical University, ZaporizhzhiaState Medical University, Kharkiv Medical Academy of Postgraduate Education, during 2021-2022, and BogomoletsNational Medical University, during 2018-2023, as well as the subjective perception of distance learning by medicalPhDs. The scope of the multi-center research was chosen to neutralize factors that may hinder objective research. Theparticipation was voluntary, upon oral consent of the respondents. The results were treated by the Statistica 19.0., and thesignificance was determined using the Wilcoxon and Student's t-tests.The study was conducted within the doctoral research framework of L. Lymar, “Developing English academic competenceof Healthcare PhD students through distance communication”, approved by the Scientific Council of Bogomolets NationalMedical University on 25.11.2021, protocol № 4.Results. The English language communicative competence characteristics of the medical PhD students were analyzed,and it was statistically determined that after distance learning, the overall level of the competence improved by 0.3-0.5points on a 5-point scale. Additionally, medical PhD students expressed positive attitude towards distance learning.The advantages of distance learning of the medical PhD students, based on a 4-year experience, include: time savingsin commuting, absence of classroom space issues, transparency in the implementation of electronic assessment, andincreased opportunities for creativity and collaboration. Under the realities of Ukraine, distance learning limited possibilityof COVID19 infection, and since 2022, mitigated military threats, with the opportunity to study in safe locations, suchas bomb shelters, in a flexible mode. Disadvantages of distance learning for Ukrainian medical PhD students includedependence on the internet connection and electricity supply, and the psychological stress factor, which is not directlyrelated to distance learning, but rather to "learning under and after fire" in Ukraine.Conclusion. Despite the stressful component of distance learning for medical PhDs, its organization using LMS andonline classes has contributed to improved performance indicators and competences, and positive attitude of PhDs todistance learning. The advantages of distance learning include time saving, the absence of classroom space issues, andbroader possibilities offered by educational systems. The disadvantages of distance learning are its dependence on internetand power supply, as well as the psychological unpreparedness of some learners and instructors for distance learning.

Seborrheic keratosis (SK) remains the leader among benign skin pathologies. In the classical sense, extragenital foci of this dermatosis look like light or dark brown papules with dense hyperkeratotic or verrucous layers. Such a clinical picture is characteristic of the typical form of foci of skin lesions. The etiopathogenetic mechanisms of SK appearance are not sufficiently studied, because a large number of trigger factors are reported. Given the benign profile of these lesions, practitional doctors very often do not pay much attention to these foci. While for patients, their appearance and increase in size can cause the emergence of obsessive or anxiety states both due to the development of cancer-phobic states due to significant aesthetic discomfort.The objective: to determine the peculiarities of the course of seborrheic keratosis in women, taking into account anamnestic data on the effect of insolation on the skin and phenotypic criteria represented by the skin phototype, as well as to analyze the dermatological quality of life indicator in patients with keratosis depending on the location of neoplasms.Materials and methods. Based on the Educational and Scientific Medical Center «University Clinic» of Zaporizhzhia State Medical and Pharmaceutical University, 50 patients with foci of seborrheic keratosis, whose ages ranged from 27 to 80 years old, were examined. To verify the diagnosis, the following parameters were carried out: a clinical examination of neoplasms with an assessment of the phenotypic criterion – skin phototype according to Fitzpatrick, dermatoscopic and pathomorphological examination. The assessment of the impact of keratosis on the quality of life of patients was based on the calculation of the results of the DLQI (Dermatology Life Quality Index) questionnaire.Results. The studied sample is represented by the majority of representatives of the II phototype – 44 persons and a small number of the III phototype – 6 patients, which amounted to 88% and 12%, respectively. The most frequent localization of keratosis was the head – 18 (36%), torso – 11 (22%), extremities – 13 (26%), and neck – 8 (16%). This location on open areas of the body can be an additional confirmation of the effect of ultraviolet radiation on the occurrence of keratosis. According to the results of the questionnaire with the study of anamnestic data, more than half of the examined patients (58%) had skin burns after a long stay in the open sun. In addition, an insufficient level of use of photoprotective agents was determined. All these factors can be as triggers for the appearance of keratosis foci and negatively affect the self-esteem and aesthetic appeal of patients. Indeed, when efflorescences are located in visual areas of the body, the dominant factor is a decrease in the quality of life.Conclusions. Predominance of patients with II skin phototype (88%) and lack of photoprotection skills (48% never use sunscreen, 32% sometimes) are the most influential factors in determining insolation as one of the leading triggers of seborrheic keratoma formation. Localization of keratosis foci on open areas of the body to a greater extent negatively affects the quality of life of women, demonstrating higher DLQI index values – 7 points – versus 5 points in the women with the keratomas on the torso. Therefore, increasing the level of awareness among patients about sun exposure, the use of photoprotection and regular examination is a priority task for doctors of all levels.

Aim: to demonstrate the features of detection and diagnosis of latent tuberculosis infection and pulmonary tuberculosis in children from household contacts based on own clinical observation. Materials and methods. A clinical case of own observation of pulmonary tuberculosis and latent tuberculosis infection in children from household contacts who were treated in the paediatric department of the clinical base of the Phthysiatry and Pulmonology Department of Zaporizhzhia State Medical and Pharmaceutical University on Public Non-Profit Enterprise of the “Zaporizhzhia Regional Clinical and Diagnostic Center of Phthysiatry and Pulmonology” of Zaporizhzhia Regional Council. Results. Children from household contacts were examined at ages: 8 months, 2, 3, 5 and 7 years, after their mother was diagnosed with tuberculosis (TB). All children showed an increase in tuberculin skin test, at the X-ray of the thoracic cavity organs (TCO) no changes were detected in any child. Taking into account the age of the children and their constant residence with the index patient, a decision was made to conduct an additional examination using CT scan of the TCO. Thus, three children were diagnosed with pulmonary tuberculosis – primary tuberculosis complex, and two were infected. After receiving the results of the culture test in the gastric lavage, the youngest child was found MBT, which was resistant to first-line drugs, namely isoniazid and rifampicin, which required a treatment regimen adjustment. It should be noted that the youngest girl, who was not vaccinated, had the most widespread process in the lungs compared to other children. Conclusions. Monitoring and screening of children who have been in contact with the index patient within the household maximises the detection of additional cases of latent tuberculosis infection and pulmonary TB. The most at-risk groups are those who not vaccinated with BCG vaccine and children under 5 years of age. Early detection and timely prescription of anti-TB therapy is the key not only to effective treatment, but also to preventing the transmission of TB infection.

Learning is a complex creative process based on the use of modern technologies and taking into account the psycho-physiological properties of an individual. The martial law introduced significant changes in the operation mode of higher education institutions in Ukraine. Therefore, the problem of organization and implementation training in higher education institutions is very relevant in current conditions. The purpose is the study and application of those modern forms and methods of education that would provide a sufficient level of knowledge in martial law, as well as the study of the peculiarities of student’s motivation in martial law. Methodology. We conducted a comprehensive analysis of sources about various teaching methods and generalization own experience of teaching Medical Biology in online format at Zaporizhzhia State Medical University. Results. It was implemented the interaction concept of higher education students with the teaching staff and educational activity was monitored, Zaporizhzhia State Medical University introduced a remote form of education using MS Teams and the edX platform. Based on Teams, the work was carried out to create and fill in online platforms with an educational material, a content visualization with a large amount of illustrative materials, video materials, packages of test tasks in MS Forms, along with educational methods adaptation, including interactive ones, to a distance form. Interactive distance learning means are very diverse. They include synchronous tools such as video conferencing and virtual classroom discussions, as well as asynchronous tools such as online forums and chats. Interactive distance learning means are crucial for several reasons: increasing contact, improving communication and collaboration, and contributing to a more dynamic and collaborative learning environment. While our teachers in real-time use synchronous interactive methods, asynchronous methods provide great flexibility for students regarding when and where they can participate in classes, that is especially important for students in complex real-world settings of martial law. Conclusions: Distance learning in modern higher education has become a forced alternative to traditional forms despite the difficulties ensuring the educational process under challenging conditions. Interactive means are becoming increasingly important in distance learning, as they help boost student’s communication and interaction, improve collaboration, and provide greater flexibility and convenience in the distance learning process for students and teachers. Modern technologies and means will be appropriate if we take into account the students’ psycho-physiological state and the degree of their motivation.

Gastroesophageal reflux disease (GERD) is one of the most common gastroenterological diseases. Therefore, the issues of diagnosis and the most effective treatment of GERD are extremely relevant. Achieving a stable positive result of treatment is impossible without taking into account the pathogenetic mechanisms of the development of GERD. Particularly relevant are the little-studied issues of the influence of humoral factors on the development of GERD in the course of treatment. One of the interesting biologically active substances is prostaglandin E2, the possible involvement of which in the mechanisms of the development of GERD is insufficiently reported. The aim of the study is to evaluate the effect of antireflux surgery on the level of prostaglandin E2 in blood serum and to verify that its changes after surgical treatment are associated with the decrease of gastroesophageal reflux and esophageal inflammation. Materials and methods. 35 patients were examined with GERD who underwent laparoscopic total antireflux fundoplication. There were 26 women (74.3 %) and 9 men (25.7 %). Their age is 55.3 ± 11.3. The control group consisted of 20 practically healthy people (women – 14 (70.0 %), men – 6 (30.0 %), average age – 56.7 ± 10.6). Immunoenzymatic analysis of prostaglandin E2 was performed in blood plasma, which was obtained according to a stan­dard method. Determination of prostaglandin E2 (Prostaglandin E2 ELISA, KGE004B, RnD Systems) was carried out by the immunoenzymatic method based on the use of the “sandwich“ variant of the solid-phase immunoenzymatic analysis. The procedure was carried out on the immunoenzyme complex ImmunoChem-2100 (USA) at the Department of Clinical Laboratory Diagnostics in Zaporizhzhia State Medical University. Research on the level of prostaglandin E2 in the main group was carried out before surgical treatment and 2–3 months after surgery by taking venous blood and using the above test systems. Statistical evaluation of the research results was performed using the Statistica for Windows 13 software package (StatSoft Inc., No. JPZ804I382130ARCN10-J). Results. The level of prostaglandin E2 in the blood of practically healthy people was 16.7 ± 6.1 pg/ml. In the main group, the values of prostaglandin E2 before surgical treatment were 25.8 ± 5.7 pg/ml, after surgical treatment, they decreased to 13.5 ± 5.3 pg/ml. The detailed analysis of patients in the main group showed that the level of prostaglandin E2 did not differ statistically in different erosive forms of esophagitis, or CLE and NERD. But it is statistically different from the level of prostaglandin E2 in practically healthy individuals of the control group. The conducted correlation analysis indicated that the level of prostaglandin E2 did not depend on the duration of acid exposure in the esophagus, as well as on the severity of esophagitis or the presence of CLE. Conclusions. With effective surgical treatment of gastroesophageal reflux disease, a decrease in the level of prostaglandin E2 after surgery is determined compared to preoperative data to the level obtained in a group of practically healthy patients. The obtained dynamics of the level of prostaglandin E2 indicates the possibility of this hormone influencing the tone of the lower esophageal sphincter and active participation in the pathogenesis of GERD, which confirms the possibility of its use as an additional diagnostic marker of inflammation in the esophagus and a marker of the effectiveness of surgical treatment.

Aim. To analyze the effectiveness and safety of a modified short-term regimen (mSTR) of antimycobacterial therapy (AMBT) for rifampicin-resistant tuberculosis (RR-TB) in a 71-year-old patient with type 2 diabetes mellitus (T2DM) on the clinical case example of own observation. Materials and methods. A clinical case from own observation of the patient who was treated at the clinical base of the Department of Phthisiology and Pulmonology of Zaporizhzhia State Medical University – Pulmonary Tuberculosis Department No. 2 of the Communal Non-profit Organization “Zaporizhzhia Regional Phthisio-Pulmonology Clinical Treatment and Diagnostic Center” is presented. Results. The presented case demonstrates the high safety and efficacy of all oral mSTR, including Lfx-Bdq-Lzd-Cfz-Cs, in the elderly person with RR-TB and concomitant decompensated T2DM who was smear-negative after 4 months as a result of treatment with 9-month mSTR AMBT (Lfx, Bdq, Lzd, Cfz, Сs). Positive radiological dynamics were observed all the time and residual changes in the lungs after tuberculosis were diagnosed at the end of the treatment course. These results complement indications for the use of mSTR, including Lfx-Bdq-Lzd-Cfz-Cs, in RR-TB patients. Conclusions. mSTR AMBT (Lfx, Bdq, Lzd, Cfz, Сs) is effective and safe in elderly patients with RR-TB and concomitant decompensated type 2 diabetes mellitus when adequate treatment of diabetes and timely correction of antimycobacterial drug side effects are undertaken.

The treatment and prevention of hair loss have been a serious aesthetic problem for the population for a long time due to the widespread occurrence of the condition and its undesirable medical and social consequences. The pharmacotherapeutic options for trichological practice are very limited, and the effectiveness of many of these drugs is small or questionable. The peripheral vasodilator minoxidil is one of the few medicinal substances that has been proven to stimulate hair growth. However, the number of minoxidil preparations allowed by the Ministry of Health for use in Ukraine is minimal and mainly represented by rare dosage forms for external use. Considering the above, the employees of the Department of Medicines Technology at Zaporizhzhia State Medical University have proposed rational formulations and technologies for two new soft dosage forms of minoxidil – a 2 % cream for external use based on an emulsion, and a shampoo in gel form – based on complex physical-chemical, pharmaco-technological, rheological, and biopharmaceutical research. These formulations are intended to stabilize hair growth and restore hair coverage in men and women suffering from androgenic alopecia. The aim of this research is to study the specific activity of the proposed topical dosage forms of minoxidil. Materials and methods. Experimental cream with 2 % minoxidil on an emulsion carrier and a gel-like shampoo containing 1 % minoxidil combined with phytoextracts of hops and burdock, as well as corresponding placebo compositions, were used as objects of preclinical studies. The compositions of the topical minoxidil pharmacotherapeutic agents are scientifically based, ensuring their optimal pharmacotechnological, biopharmaceutical, and consistent consumer properties. The study of the specific activity of soft medicinal forms of minoxidil for external use was carried out by evaluating their growth-stimulating and follicle-protective activity. “Pilfood Bosnalek” spray for external use (Bosnalijek, Bosnia and Herzegovina), containing 2 % minoxidil, was used as a reference drug when studying the growth-stimulating effect of 2 % cream for external use with minoxidil. The reference drug in the study of the similar activity of the gel-like shampoo “Trichlomine” was the shampoo against hair loss “Dove” (Unilever, Germany). Results. It has been found that a 2 % minoxidil cream for topical use, when used together with the reference drug “Pilfood Bosnalek” (Bosnalijek, Bosnia and Herzegovina), has a significant hair growth-stimulating effect, which statistically significantly increases hair growth in experimental animals from as early as 3–4 days of use. The shampoo “Trichlomine” also has a significant effect on hair growth in experimental animals, with results observed from 3–4 days of use. Furthermore, the strength of the hair growth-stimulating effect observed from the use of “Trichlomine” shampoo significantly exceeds that of the reference “Dove” shampoo (Unilever, Germany). These results demonstrate the presence of significant follicle-stimulating activity in the tested minoxidil preparations for treating experimental alopecia and their positive effects on the weight and structure of laboratory animal fur. The follicle-protective activity of experimental minoxidil dosage forms (2 % cream and gel-like shampoo) was also experimentally confirmed, due to the regulation of various metabolic pathways in the dermis. The use of 2 % minoxidil cream and comparison preparations (“Dove” shampoo and “Pilfood Bosnalek” spray) did not result in the normalization of the investigated indicators of dermal energy metabolism. However, a positive effect of “Trichlomine” shampoo was found, which is associated with the presence of a plant antioxidant complex in the pharmacotherapeutic agent and its potentiating effect with minoxidil. Conclusions. It was found that the application of soft dosage forms of minoxidil (2 % emulsion-based cream and 1 % gel-based shampoo) exhibited pronounced growth-stimulating and follicle-protective activity in the model of experimental alopecia in white rats. At the same time, it was established that the cream with minoxidil 2 % for external use and the reference spray for external use “Pilfood Bosnalek” (Bosnalijek, Bosnia and Herzegovina) have a significant statistically comparable growth-stimulating effect. The strength of the growth-stimulating effect recorded from the use of the “Trichlomine” shampoo significantly exceeded the effect of the reference shampoo “Dove” (Unilever, Germany). It was found that both experimental medicinal forms of minoxidil (2 % cream and gel-like shampoo) had a follicle-protective effect by normalizing various links of dermis metabolism. The most pronounced effect in this regard was recorded in the shampoo “Trichlomine”, which contained not only minoxidil but also plant-antioxidant complexes. Application of 2 % cream with minoxidil, as well as reference drugs (spray “Pilfood Bosnalek” and shampoo “Dove”), did not have a reliable effect on the indicators of energy exchange of the dermis studied.

Aim. To analyze the nature of Bedaquiline (Bdq) resistance in Mycobacterium tuberculosis (MBT) during antimycobacterial therapy (AMBT) in patients with multidrug-resistant tuberculosis (MDR-TB), its impact on clinical outcomes and to detect risk factors for the Bdq drug resistance development on the example of own observed clinical cases. Materials and methods. 2 clinical cases of own observations of the Bdq resistance development in MBT during AMBT in patients with MDR-TB who were treated at the clinical base of the Department of Phthisiology and Pulmonology of Zaporizhzhia State Medical University – Pulmonary Tuberculosis Department No. 2 of the Communal Non-profit Organization “Zaporizhzhia Regional Phthisio-Pulmonology Clinical Treatment and Diagnostic Center” are presented. Results. The presented clinical cases confirm the literature data that the treatment effectiveness in patients with Rifampicin-resistant TB (RR-TB) and MDR-TB is associated with Bdq drug resistance. Regarding the reasons for the development of acquired Bdq drug resistance, the second clinical case, like the examples of other authors, demonstrates low adherence to treatment. There is no data in the literature about the lack of controlled treatment at the outpatient stage as a risk factor for Bdq drug resistance and negative clinical outcomes in patients with MDR-TB, which would complement the scientific experience in this problem. Conclusions. In both clinical cases, Bdq drug resistance was acquired (secondary), and had an impact on the clinical outcomes of tuberculosis treatment. The risk factors for Bdq drug resistance and negative clinical outcomes were lack of controlled treatment at the outpatient stage in the first case and low adherence to treatment in the second one.

Assessment of renal function in newborns is extremely important and at the same time challenging due to the unique body structure, increased vulnerability and rapid growth of the latter. However, for the early detection of acute kidney injury (АКI), rational dosing of drugs and safe drug therapy, the identification of early markers of renal dysfunction is essential.The objective is to evaluate the prognostic value of serum biomarkers for the early diagnosis of АКI in newborns with hypoxic-ischemic encephalopathy against the background of therapeutic hypothermia and preventive use of methylxanthines.Materials and Methods. A single-center, prospective, randomized trial involving 44 neonates with АКI requiring therapeutic hypothermia and prophylactically receiving caffeine citrate or theophylline to prevent АКI progression was conducted in from 2019 to 2022 on the basis of the NICU of Zaporizhzhia Regional Clinical Children's Hospital.Laboratory analysis of blood serum samples was performed on day 1, day 3 and 5 from birth, creatinine (Cr) and cystatin C (CysC) levels and their associations with the development of АКI were determined according to the neonatal criteria of the 2012 KDIGO guideline.Statistical analysis was performed using Statistica 13.0 program, TIBCO Software Inc. (license number JPZ804I382130ARCN10-J) and Microsoft Excel 2013 (license number 00331-10000-00001-АА404). The probability of the difference in absolute values of mean values was determined using non-parametric methods of statistical analysis: the Mann-Whitney U-Test for unrelated groups and the Wilcoxon signed-rank t test for related groups. Statistical significance was defined as p < 0.0500.The study was performed in accordance with the moral and ethical standards established by the IGH / GCP guidelines, the World Medical Association Helsinki Declaration, adopted in 1964 and amended in 1975, 1983, 1989, 1996 and 2000, The European Convention of Human Rights and Biomedicine and the legislation of Ukraine. The protocol was approved by the Medical Ethics Commission at Zaporizhzhia State Medical University. The study was performed as part of the research project "Optimization of diagnostics and intensive care of polyetiologic lesions of the brain, gastrointestinal tract, and kidneys in newborns and older children" (State registration number O118U007142) of the Pediatric Surgery and Anesthesiology Department of the State Institution "Zaporizhzhia State Medical University of the Ministry of Health of Ukraine."Results and their discussion. In general, AKI according to KDIGO developed in 5.00 (11.36 %) neonates out of 44.00 (100.00 %), stage 0 was found in 39.00 (88.64 %). 4.00 (9.09%) newborns had stage I, and 1 (2.27%) developed stage II; the data obtained were similar: p = 0.7872; U = 230.00. None of the patients progressed to stage III.In the newborns with preserved renal function during the study there was a decrease in Cr and a predictable, by this marker, increase in GFR. A statistically significant increase in Cr level and decrease in GFR was found in the newborns with renal dysfunction on days 3 and 5 of the study. Cr level progressed from baseline 1.07 (0.87; 1.10) mg/dl to 1.13 (0.86; 1.25) mg/dl on day 3 and to 1.40 (1.15; 1.82) mg/dl on day 5, while GFR decreased from 19.76 (19.07; 22.90) ml/min/1.73m2 to 17.97 (13.84; 24.42) ml/min/1.73m2 on day 3 and was 12.38 (11.12; 17.54) ml/min/1.73m2 on day 5, with p < 0.0500.CysC progressively decreased in the neonates without AKI from 2.50 (2.20; 2.60) ng/ml to 2.25 (2.08; 2.49) ng/ml, p = 0.0095; while in the neonates with AKI the level of this marker did not change and was 2.56 (2.41; 2.70) ng/ml on day 1 and 2.42 (1.89; 2.45) ng/ml on day 5, p = 0.2963. As this marker changed, eGFR (CysC) increased progressively in the cohort of patients without kidney damage but did not change in the other group.The diuresis rates in the newborns of both groups did not differ, being ≥ 1.5 ml/kg/h, which is probably due to methylxanthine therapies, p ≥ 0.0500.Conclusions. CysC assessment did not provide additional information on the development of acute kidney injury in neonates (nAKI) in the first 5 days of life, which would have allowed a quick decision to change the intensive care program. Further studies involving newborns who did not receive prophylactic therapy are needed.

The aim: The paper is aimed to find correlations between English language communicative academic and medical competence components (theoretical, practical, and individual by certain methods), to improve design of the course "Academic English for PhDs in Medicine", its methods and strategy. Materials and methods: The study sample includes postgraduate groups studying for PhD in Healthcare, aged 21-59 years, in Bukovinian State Medical University (39 respondents), Zaporizhzhia State Medical University (32 respondents), Kharkiv Medical Academy of Postgraduate Education (33 respondents), and Bogomolets National Medical University (318 respondents). The study was held in 2019-2023. We assessed theoretical and practical components using our tests, individual component - psychological methods. The values of three components were transformed into general English communicative academic and medical competence level. The data were treated with SPSS Statistica 18.0, using Spearman correlation significance. Results: We found positive correlation between English communicative competence and communicative tolerance, general communicative skills level, and high or medium communicative control level. Also, positive correlation characterizes interaction as a conflict-resolving strategy and communicative competence. Highly manifested intolerance in communication, predominance of negative mindsets, intolerance to stress negatively affect the level of English communicative academic and professional competence of PhD students. Conclusions: Analysis of the English speaking competence, and its components, showed positive correlation between interaction as a conflict-resolving strategy and English communicative competence of respondents. Regarding the results, the curriculum of the "Academic English for Medical PhDs" should be modified, including interactive methods, case studies, problem solving, and other methods for individual component training.

This article presents the study results of the hypoglycemic properties among 1,2,4-triazole derivatives synthesized at the Department of Physical and Colloidal Chemistry of the Zaporizhzhia State Medical University. Today, many people have a sedentary way

The purpose of this work is to analyze the chronology and state of development of chromatographic methods at the Zaporizhzhia State Medical University (ZSMU). A historical overview of the use of chromatographic methods at ZSMU is provided. First of all, emphasis is placed on the introduction of high-performance liquid chromatography and gas-liquid chromatography. The main scientific laboratories and groups that worked and are working at the Zaporizhzhia State Medical University in the field of instrumental chromatography are shown. There were groups at the Department of Biological Chemistry, the Department of Faculty Pediatrics, the Department of Physical and Colloidal Chemistry. Currently, the Department of Physical Colloid Chemistry is actively working on a new laboratory of liquid chromato-mass spectrometry of the Department of Experimental Pharmaceutical Research of the training medical-laboratory center. The laboratory performs research for many departments of ZSMU, including the Faculty of Pharmacy, the Faculty of Postgraduate Education, the Faculty of Medicine. The laboratory develops, validates and uses methods to establish the purity and confirm the molecular weight and structure of new biologically active substances synthesized to search for new drugs, research of impurities in drug substances, determination of biologically active substances in extracts of medicinal plant raw materials, determination of residual amounts drugs in poultry meat and eggs, and other livestock and poultry products, determination of concentrations of disease markers, determination of distribution, metabolism and excretion of drugs.

In modern neurology, the main component of successful treatment of cerebrovascular pathology is pharmacotherapy. At the same time, the arsenal of effective medicines of evidence-based medicine in this area is quite limited. Vinpocetine (Cavinton) is one of the drugs that effectively selectively corrects cerebral perfusion. The use of alternative ways of absorption of vinpocetine (rectal and nasal) in certain soft application dosage forms will allow to significantly increase the bioavailability of the medicinal substance, reduce the level of adverse reactions from its use and expand the pharmacotherapeutic arsenal of domestic effective neuroprotective drugs. Taking into account the above, the employees of the Department of Medicines Technology of Zaporizhzhia State Medical University, on the basis of complex physical-chemical, pharmacotechnological, rheological and biopharmaceutical research, proposed rational formulations and technologies of two new soft application dosage forms of vinpocetine – rectal suppositories on a lipophilic basis and nasal cream on an emulsion basis for the therapy of arterial hypertension of II–III stages with cerebrovascular complications, reduction of the manifestation of neurological and/or mental symptoms in various forms of cerebral blood circulation insufficiency, consequences of a stroke, transient ischemic attack, etc. The aim of the work is to study the specific activity of the proposed innovative application dosage forms of vinpocetine. Materials and methods. Nasal ointment containing 0.5 % vinpocetine on an emulsion basis and rectal suppositories with vinpocetine 0.01 g on a lipophilic carrier were used as the object of preclinical studies, which ensure optimal release of the active pharmaceutical ingredient. The study of the specific activity of the developed medicinal forms of vinpocetine was carried out on a model of acute cerebrovascular accident of the type of ischemic stroke. Vinpocetin tablets (Astrapharm, Ukraine), which are used in neurological practice quite effectively and over a long period of time, were used as a comparison drug. Results. The comparative results showed that the appointment of all studied drugs led to an increase in motor activity. In addition, the administration of medicinal forms of vinpocetine reduced the development of cognitive and cognitive disorders after acute disorders of cerebral blood circulation. It was found that the highest result was shown by the group of animals that received a course of vinpocetine intranasally. In the groups of animals that received vinpocetine for 4 days, markers of oxidative stress – aldehyde phenylhydrazones and ketone phenylhydrazones – were significantly reduced. The highest activity was demonstrated by the pharmaceutical form of vinpocetin, which was used intranasally for 4 days. The introduction of dosage forms of vinpocetine exerted an energizing effect, which was expressed in an increase in the level of macroergic phosphates. Evidently, vinpocetine has a direct positive effect on the three-carbon sections of the Krebs cycle and increases the production of adenosine triphosphate (ATP). At the same time, the vinpocetine nasal cream applied intranasally for 4 days demonstrated the greatest energizing activity. Conclusions. Preclinical studies of the developed application soft medicines with vinpocetine on the model of acute cerebrovascular accident type ischemic stroke experimentally confirmed the expressed neuroprotective activity of rectal suppositories and nasal cream with vinpocetine and it was found that the effectiveness of therapy with these application medicinal forms is demonstrably higher than that in comparison with oral tablet means.

Aim. To analyze the features of the simultaneous course of pulmonary aspergillosis and multidrug-resistant pulmonary tuberculosis (MDR-TB) on the background of type 1 diabetes mellitus, on the example of a clinical case of our practice. Materials and methods. Clinical case of our practice of simultaneous pulmonary aspergillosis and MDR-TB on the background of type 1 diabetes mellitus in a patient, who was treated in Pulmonary tuberculosis department No. 2 of clinical base of Phthisiatry and Pulmonology Department of Zaporizhzhia State Medical University at Communal Non-Commercial Enterprise of the “Zaporizhzhia Regional Clinical and Diagnostic Center of Phthisiatry and Pulmonology” of Zaporizhzhia Regional Council. Results. In the presented clinical case, the patient had been suffering from diabetes mellitus for 8 years and had been receiving insulin therapy for all these years. One year before the TB disease, he had contact with an index patient, but he categorically refused a course of preventive chemotherapy. Also, the patient did not make a comparison X-ray TCO after 6 months, as a contact person. MDR-TB and aspergilloma of the left lung of the patient were diagnosed simultaneously on the background of severe condition with decompensated form of type 1 diabetes mellitus, severe intoxication syndrome and inflammatory process, massive hemoptysis. Aspergilloma of the left lung was diagnosed using X-ray TCO and cultural examination of bronchial aspirate for Aspergillus, which was not difficult to diagnose. Diagnosis of MDR-TB was also not difficult, because the patient had MBT, which contributed to the timely and correct appointment of antimycobacterial therapy. Surgery for aspergilloma of the left lung was contraindicated, as the type 1 diabetes was in decompensation. Persistent hyperglycemia remained, despite the fact of antifungal therapy and constant correction of insulin therapy prescribed for the patient. Endocarditis quickly developed in the patient, which was the reason of patient’s death. Conclusions. The decompensated form of type 1 diabetes mellitus caused persistent hyperglycemia, which was the reason of immune disorders and this made the patient’s body susceptible to bacterial (MDR-TB) and fungal (aspergillosis) infections, which led to the development of the complication of endocarditis and death. A big mistake in his case, was a categorical refusal by the patient to receive a course of preventive chemotherapy, as a contact person with an index patient. In view of this, in the presence of type 1 diabetes, the patient should have not neglected it. And as a result, the patient had a MDR-TB, one year after. At the same time, the patient did not make a comparison X-ray TCO, after 6 months, as a contact person, which was a possible reason for the missing of early diagnosis of pulmonary aspergilloma. That’s why, a correct treatment of type 1 diabetes mellitus and timely preventive radiological examination of the thoracic cavity organs are especially important, as the diabetes mellitus is the most common premorbid background for TB and aspergillosis.

The external treatment of seborrheic dermatitis of the scalp depends on the withdrawal of clinical symptoms and the complaints the patient made to the doctor. At present Ukrainian dermatology has several dozen pharmacotherapeutic products in this direction, with dominating medicines of ketoconazole, zinc pyrition, and their combinations. They are characterized by the short-term or weak effect, associated with the pathogenic microorganisms’ resistance against the background of long-term use of biologically active substances which are their active parts. One way to solve the problem is using the drugs with new highly active pharmaceutical ingredients. Employees of the Department of Technology of Medications of the Zaporizhzhia State Medical University proposed the composition of a new applicate semisolid dosage form of pirocton olamine based on complex physical-chemical, pharmacotechnological, biopharmaceutical, and rheological investigations – topical ointment on the hydrophilic base in combination with resin-free naphthalene for external use in the complex etiotropic treatment of seborrheic dermatitis of the scalp. The aim of this work is to study the specific activity of the combined ointment with pirocton olamine and resin-free naphthalene on a hydrophilic vehicle. Materials and methods. As the object of preclinical studies used experimental ointment containing 1 % piroctone olamine and 5 % resin-free naphthalene on the base of sodium carboxymethylcellulose glycerogel, providing optimum release of active pharmaceutical ingredients from the vehicle, and appropriate placebo semisolid dosage form. The study of the specific activity of the developed ointment under the conditional name “Oktonaf” was carried out by evaluating its antimicrobial, anti-inflammatory, and antioxidant effects given the foreseeable therapeutic focus and the literature on the spectrum of biological activity of active substances. The anti-inflammatory and antioxidant action of the proposed composition was evaluated by the allergic contact dermatitis model. As a reference drug cream “Psoricap” (KMP, Ukraine), which has long been applied in dermatological practice was used. Results of comparative microbiological studies proved that composite anti-seborrheic ointment with piroctone olamine and resin-free naphthalene by the antibacterial effect in relation to the size of the growth delay zones for Staphylococcus aureus and Escherichia coli (gram-positive and gram-negative microorganisms) slightly exceeds the effective dermatological medication reference cream “Psoricap”. At the same time, the antimycotic activity of experimental ointment in relation to Candida albicans practically does not differ from the same reference drug. A study of antioxidant and anti-inflammatory activity of the developed piroctone olamine ointment on a hydrophilic basis using the model of allergic contact dermatitis revealed that its level reliably was exceed the efficacy of topical reference medication “Psoricap”. Conclusions. Obtained data of a spectrum of specific activity of a combined ointment with piroctone olamine and resin-free naphthalene can predict the high clinical value of the proposed drug for practical domestic dermatology.

In providing the population with high-quality food products, a special place is given to poultry meat production. The purpose of this study was to investigate the effect of triazoline compounds on the productivity and haematological parameters of broiler chickens. The study was conducted in 2021–2022 at the Odesa State Agrarian University in vivarium and analytical laboratories. 1,2,4-triazole derivatives synthesised at the Zaporizhzhia State Medical University were used for the study: GKPF-109 – Morpholin-4-ium-2-((4-amino-5-(3-methyl-pyrazol-5-yl) -1,2,4-triazol-3-yl)thio)acetate; ASP-34 – sodium 2-((4-amino-5-(thiophen-2-ylmethyl)-4H-1,2,4-triazol-3-yl)thio)acetate. The dynamics of poultry growth was determined by individual weighing, followed by determination of absolute and average daily live weight gains. Poultry feeding was carried out according to species and age periods per the existing norms. Haematological, immunological, and biochemical studies were performed according to the following methods.Tasting evaluation of meat and broth was carried out according to a 5-point system. Broths were evaluated according to 4 indicators – taste, smell, colour, transparency, each of them according to a 5-point system. The analysis of total weight data in the groups indicates the highest gross gain in live weight in the group of 36-day-old chickens that received GKPF-109 from 10 days of age, which is 14,966 g in 26 days of the experiment. The preservation of broiler chickens during the experimental period was 96% in the experimental groups, and 94% in the control group. Analysing the above, it can be concluded that adding research compounds of the triazoline series to drinking water increases haematopoiesis, has anti-inflammatory and hepatoprotective effects. Evaluation of the quality of meat of broiler chickens and broth at the end of the experiment does not allow claiming a decrease in their aroma and taste qualities, which indicates the absence of a negative effect of the research compounds of the triazoline series and the methods of their application on the organoleptic parameters of the meat.

The aim of the study was to determine the patterns of changes in the concentration of mold spores of the genus Alternaria in the air of Zaporizhzhia city. Materials and methods. The object of the study was the dynamics of Alternaria spore concentration in the atmospheric air of Zaporizhzhia city. The study was carried out at the Department of Medical Biology, Parasitology and Genetics of Zaporizhzhia State Medical University. Samples were taken annually from March 1 to October 31 by volumetric method using a Hirst-type trap. The device is yearly certified by the state metrological service with certificates. The samples were analyzed using a light microscope at ×400 magnification using the method of vertical transects. The results of the research were processed by applying the Statistica® for Windows 13.0 licensed software package. Results. The seasonal dynamics of fungal spores of the genus Alternaria in the atmospheric air of Zaporizhzhia was analyzed over several years: from 2015 to 2020. The beginning, end and duration of sporulation, maximum values were determined. Conclusions. Analyzing the average daily (for six years) indicators of the spore number in the air of Zaporizhzhia city, it can be concluded that their distribution is normal throughout the year, which corresponds to the intensity of spore formation, depending on changes in meteorological conditions, that is, an almost equally symmetric range from the optimum, which falls on the beginning of June and is associated with an increase in precipitation in this region. Thus, an average of 17 256 spores/m3 were determined over six years. The maximum number of spores was 680 spores/m3 (6.07). The average day fell on July 25, σ = 37.1. In general, sporulation lasted 119 days. Peak concentrations were recorded in summer and autumn.