Polski Merkuriusz Lekarski[JOURNAL]
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Fibromuscular dysplasia as a rare cause of ischaemic stroke - a case report.
Kansik K, Sadowski J, Pawłowska J … +3 more , Otwinowska M, Roszak M, Łabuz-Roszak B
Pol Merkur Lekarski · 2026 · PMID 42048516 · Publisher ↗
Fibromuscular dysplasia (FMD) is a rare cause of ischemic stroke. It is an important element of differential diagnosis that should be considered, especially in patients who do not have common cardiovascular risk factors....
Fibromuscular dysplasia (FMD) is a rare cause of ischemic stroke. It is an important element of differential diagnosis that should be considered, especially in patients who do not have common cardiovascular risk factors. A 65-year-old man was admitted with transient left arm weakness and drooping of the mouth, asting about 3 minutes, followed by left-sided paresthesia. A similar episode had occurred a week earlier. On admission, the patient was alert and oriented. Neurological exam showed subtle flattening of the left nasolabial fold and a tendency to a positive ipsilateral Babinski sign, with no other abnormalities. Brain MRI revealed a subacute ischemic lesion in the anterior deep structures and a hyperacute focus at the right temporo-occipital border. CT angiography showed bilateral internal carotid artery changes suggestive of FMD, critical stenosis of the right MCA (M1), and aneurysmal dilation of the left ophthalmic artery origin. Digital subtraction angiography (DSA) confirmed a wide-neck saccular aneurysm of the left internal carotid artery (ICA). Rehabilitation and multidisciplinary consultations were undertaken. The patient was discharged in good condition without significant neurological deficits. Regular blood pressure control, atherosclerotic diet, physical activation and taking medications (antihypertensive drugs, acetylsalicylic acid and statin) regularly were recommended. Due to the diagnosis of a saccular aneurysm of the left ICA, a referral was issued to the neurosurgery department. The described case illustrates the need for a comprehensive and interdisciplinary approach to a patient with stroke in order to determine the etiology of the stroke and implement secondary prevention.
Effectiveness and safety of antiestrogens in the treatment of functional hypogonadism in men with obesity.
Rabijewski M, Wydra J, Kapuściński G … +1 more , Rabijewski M
Pol Merkur Lekarski · 2026 · PMID 42048515 · Publisher ↗
Functional hypogonadism in men is a syndrome characterized by low testosterone levels and clinical signs of hypogonadism without organic disease of the hypothalamus-pituitary-gonadal axis. It is most often caused by obes...
Functional hypogonadism in men is a syndrome characterized by low testosterone levels and clinical signs of hypogonadism without organic disease of the hypothalamus-pituitary-gonadal axis. It is most often caused by obesity, diabetes type 2, exogenous steroid abuse, excessive physical exercise, opioid use, co-occurring diseases, and is most prevalent among middle-aged and older men as so-called late-onset hypogonadism. It seems that the most important epidemiological factor causing functional hypogonadism is excess adipose tissue. Obesity is currently one of the most important public health problems and its prevalence is higher in men than in women. Complications of obesity include not only cardiovascular diseases or type 2 diabetes mellitus, but also lead to decreased testosterone levels, reduced libido and erectile dysfunctions, and impaired fertility in men. These disorders in men with obesity are associated with decreased gonadotropins and testosterone secretion due to hyperinsulinemia, hyperleptinemia, chronic inflammation and oxidative stress. Currently, it seems that an important complication of obesity is the deterioration of semen parameters (sperm concentration, motility, and morphology) and reduced fertility. Theoretically, obesity-related functional hypogonadism in men is reversible, so the basis of initial treatment is primarily lifestyle modification and effective treatment of chronic diseases but primarily reducing body fat mass (physical exercise and low-caloric diet). Unfortunately, lifestyle changes are often insufficient to significantly increase testosterone levels and resolve the clinical symptoms of hypogonadism. Because in men seeking fertility conventional testosterone replacement therapy is contraindicated, alternative pharmacological methods, such antiestrogens (selective estrogen receptor modulators and aromatase inhibitors) are often used.
Special education for individuals with severe mental disorders: definitions, discourses and contexts at the interface of pedagogy and psychiatry.
Pietras T, Stefanik A, Odziemczewski M … +4 more , Batko K, Król T, Witusik A, Sipowicz K
Pol Merkur Lekarski · 2026 · PMID 42048514 · Publisher ↗
OBJECTIVE: Aim: The aim of this paper is to define and discuss a new and emerging sub-discipline of special education, namely special education for individuals with mental disorders. PATIENTS AND METHODS: Materials and M...
OBJECTIVE: Aim: The aim of this paper is to define and discuss a new and emerging sub-discipline of special education, namely special education for individuals with mental disorders. PATIENTS AND METHODS: Materials and Methods: This paper is based on a narrative review and theoretical analysis of selected Polish and international literature from the fields of special education, psychiatry, and social sciences. The analysis included monographs and peer-reviewed articles addressing adult education, intellectual disability, autism spectrum disorders, and mental disorders, with particular emphasis on schizophrenia and affective disorders. A critical and comparative analysis of theoretical concepts and paradigmatic changes, especially the development of community-based models of care, was conducted. Mental disorders constitute an important cause of disability in adulthood and create a new area of interest for special education. The development of community psychiatry and community mental health centers opens opportunities for special educators to work with adults with mental disorders as community therapists, social skills trainers, or recovery assistants. However, the establishment of this professional role requires legal regulations and interdisciplinary cooperation. CONCLUSION: Conclusions: Special education pedagogy for people with mental disorders constitutes a new and essential subdiscipline of special education. The expansion of community psychiatry creates structural opportunities for the development of professional roles within this field. Whether community therapists evolve into formally recognized special educators for persons with mental disorders will depend on future legislative solutions, the engagement of universities in developing specialized training programs, and close cooperation between educators and psychiatrists.
Features of macrophage marker CD68 expression in the colonic mucosa of patients with symptomatic uncomplicated diverticular disease and acute uncomplicated diverticulitis.
Dorohavtseva HA, Dorofieiev AE, Dyadyk OO … +1 more , Myroshnychenko MS
Pol Merkur Lekarski · 2026 · PMID 42048513 · Publisher ↗
OBJECTIVE: Aim: The aim of the study was to determine the features of macrophage marker CD68 expression in the colonic mucosa of patients with symptomatic uncomplicated diverticular disease and acute uncomplicated divert...
OBJECTIVE: Aim: The aim of the study was to determine the features of macrophage marker CD68 expression in the colonic mucosa of patients with symptomatic uncomplicated diverticular disease and acute uncomplicated diverticulitis. PATIENTS AND METHODS: Materials and Methods: The study material comprised colonic mucosal biopsies obtained from 12 healthy individuals (group 1), biopsies of the colonic mucosa from the diverticular orifice region of 34 patients with symptomatic uncomplicated diverticular disease (group 2), and 26 patients with acute uncomplicated diverticulitis (group 3). Immunohistochemical study was performed using a monoclonal antibody to CD68. CD68 expression was assessed by counting the absolute number of immunopositive cells in the field of view of the microscope ×400. In immunopositive cells, the degree of expression of the monoclonal antibody to CD68 was assessed by determining the brightness coefficient. RESULTS: Results: Comparative analysis of the obtained results revealed an increased number of macrophages in the colonic mucosa of patients with symptomatic uncomplicated diverticular disease and acute uncomplicated diverticulitis, with the greatest increase observed in acute uncomplicated diverticulitis. The brightness coefficient decreased in patients with symptomatic uncomplicated diverticular disease and, more markedly, in acute uncomplicated diverticulitis, indicating increased expression of the studied monoclonal antibody by macrophages. In these patients, macrophages acquired elongated and irregular shapes and increased in size. CONCLUSION: Conclusions: The mucous membrane of the colon in patients with symptomatic uncomplicated diverticular disease and acute uncomplicated diverticulitis is characterized by a higher content of macrophages, mainly in the lamina propria, which are characterized by increased morphofunctional activity. The latter manifests itself in increased expression of the monoclonal antibody to CD68 by macrophages, an increase in the size of CD68+-cells, and their acquisition of an elongated or irregular shape. The quantitative and qualitative changes in macrophages in the colonic mucosa identified by the authors are more pronounced in patients with acute uncomplicated diverticulitis compared to patients with symptomatic uncomplicated diverticular disease.
Administrative-legal assurance of the reliability and ethics of medical decisions in wartime.
Rozsokha SS, Berzina AB, Makhmurova-Dyshliuk OP … +4 more , Felyk OV, Halunko OV, Rudenko MM, Pletenetska AO
Pol Merkur Lekarski · 2026 · PMID 42048512 · Publisher ↗
OBJECTIVE: Aim: This study aims to provide a comprehensive analysis of the administrative-legal assurance of the reliability and ethics of medical decision-making in wartime conditions, combining normative analysis with...
OBJECTIVE: Aim: This study aims to provide a comprehensive analysis of the administrative-legal assurance of the reliability and ethics of medical decision-making in wartime conditions, combining normative analysis with empirical data from a frontline Ukrainian hospital. PATIENTS AND METHODS: Materials and Methods: The normative framework includes international standards of the World Health Organization, the International Committee of the Red Cross, professional medical associations, the European Charter of Patients' Rights (2002), European Union legislation, and the national healthcare and wartime legislation of Ukraine. The empirical component comprised a cross-sectional anonymous survey conducted between May and September 2025 among 40 healthcare workers at a rural hospital located near the active frontline in the Dnipropetrovsk region. The questionnaire assessed decision-making complexity, perceived probability of errors, stress impact, resource availability, preparedness, and willingness to report incidents. RESULTS: Results: Wartime conditions significantly increase the perceived complexity of clinical decision-making, particularly in resource allocation, evacuation prioritization, and surgical interventions. Respondents reported elevated stress levels and increased risk of errors, primarily associated with limited resources, disrupted logistics, and administrative constraints. The reliability and ethical integrity of medical decisions were found to depend on the availability of updated clinical protocols, state monitoring mechanisms, organized evacuation systems, and guaranteed minimum healthcare services. CONCLUSION: Conclusions: Effective administrative-legal support is a prerequisite for ensuring both the reliability and ethical soundness of medical decisions in wartime. Strengthening institutional safeguards, resource allocation mechanisms, and clear regulatory guidance is essential to maintain medical standards under extreme conditions.
Resilience as a factor of psychological stability of modern police officers in crisis situations of their professional activities.
Yevdokimova OO, Boichuk SS, Ponomarenko YS … +4 more , Shylina AA, Pavlovska-Kravchuk VA, Mokhorieva OM, Okhrimenko IM
Pol Merkur Lekarski · 2026 · PMID 42048511 · Publisher ↗
OBJECTIVE: Aim: To investigate the psychological characteristics of resilience among modern police officers in wartime crises. PATIENTS AND METHODS: Materials and Methods: The research, which lasted from 2023 to 2025, in...
OBJECTIVE: Aim: To investigate the psychological characteristics of resilience among modern police officers in wartime crises. PATIENTS AND METHODS: Materials and Methods: The research, which lasted from 2023 to 2025, involved 120 employees of the National Police of Ukraine: experimental group (EG, n=60) - police officers performing their duties in combat conditions; control group (CG, n=60) - police officers whose activities took place in relatively safe conditions. The resilience of police officers was assessed using three methods: the Connor-Davidson Resilience Scale, the Wagnild and Young Resilience Scale, and the Posttraumatic Growth Inventory. RESULTS: Results: It has been established that resilience in police officers not only provides a basic ability to cope with the negative consequences of traumatic experiences, but also acts as a mechanism that helps transform these experiences into a source of development. It has been determined that police officers' resilience in combat conditions serves a protective function, helping maintain stability and minimize the destructive effects of stress. Overcoming extreme situations in such an environment contributes to rethinking life values, the formation of new meanings, and spiritual growth, thereby enhancing the ability to adapt. CONCLUSION: Conclusions: It has been shown that, under relatively safe conditions, resilience contributes to the internal restructuring of a police officer's personality and promotes personal growth. However, in combat situations, it tends to become a resourcee for preservation, minimizing the impact of traumatic events but not stimulating development through posttraumatic growth. This underscores the need for a comprehensive approach to developing resilience among police officers, whose work involves high levels of danger and psychological stress.
Research management skills in medical PHD education: A cross-sectional study from Ukraine.
Lymar LV, Drapey IM
Pol Merkur Lekarski · 2026 · PMID 42048510 · Publisher ↗
OBJECTIVE: Aim: To characterise Ukrainian PhD students' research management skills, the difficulties experienced in Ukrainian medical PhD education, and to provide insights into potential directions for improving medical...
OBJECTIVE: Aim: To characterise Ukrainian PhD students' research management skills, the difficulties experienced in Ukrainian medical PhD education, and to provide insights into potential directions for improving medical education. PATIENTS AND METHODS: Materials and Methods: The authors conducted a cross-sectional study using a convenience sample. In 2025, the authors surveyed 118 medical PhD students of Bogomolets National Medical University to evaluate their research management competence and attitudes towards it. The authors offered a 17-item questionnaire on research management. To process the data, the authors used descriptive and thematic analysis. RESULTS: Results: This study shows that medical PhD students at Bogomolets National Medical University generally recognise the importance of research management skills for successful doctoral training. However, attitudes towards these skills remain fragmented, and recognition of their value does not translate into confidence or effective practice. The findings reveal significant gaps in strategic planning, adaptability to change, bureaucratic communication, self-discipline, and the ethical use of digital tools such as artificial intelligence. Research management effectiveness relies mainly on external control and personal self-regulation rather than structured curricular support. CONCLUSION: Conclusions: The research management skills of Ukrainian medical PhD students should be conceptualised not as their individual psychological capacity but as a competence shaped by educational design, mentoring structures, ethical training, and career support. The results support the need for curricular integration of research management as a structured competence area, including training in planning, adaptability, communication, academic integrity, and the responsible use of digital tools.
Comparative effectiveness of atorvastatin monotherapy vs. atorvastatin plus bempedoic acid combination in patients with coronary artery disease: a multicenter observational study.
Rhabneh L, Ababneh R, Alnaser I … +4 more , Aloqaily M, Alfarrajin I, Albadawi I, Amawi A
Pol Merkur Lekarski · 2026 · PMID 42048509 · Publisher ↗
OBJECTIVE: Aim: To evaluate the impact of adding bempedoic acid to atorvastatin therapy on cardiovascular outcomes, including major adverse cardiovascular events (MACE), cardiac arrest, all-cause hospitalization, and myo...
OBJECTIVE: Aim: To evaluate the impact of adding bempedoic acid to atorvastatin therapy on cardiovascular outcomes, including major adverse cardiovascular events (MACE), cardiac arrest, all-cause hospitalization, and myopathy, in patients with established coronary artery disease. PATIENTS AND METHODS: Materials and methods: We conducted a retrospective cohort study using the TriNetX global health research network. Patients with established CAD were categorized based on their antilipemic therapy into two cohorts: atorvastatin monotherapy and atorvastatin plus bempedoic acid. Propensity score matching was employed to balance baseline characteristics between the cohorts. The primary outcome was the occurrence of MACE, while secondary outcomes included cardiac arrest events, all-cause hospitalization, and incidence of myopathy. RESULTS: Results: After matching, 6,549 patients were included in each cohort. MACE occurred more frequently in the atorvastatin group (5.7%) compared to the combination therapy group (3.2%), with a hazard ratio of 1.606 (95% CI: 1.302-1.980, P<0.001). Cardiac arrest and all-cause hospitalizations were also higher in the atorvastatin group, with hazard ratios of 1.628 (95% CI: 1.041-2.544, P<0.001) and 1.418 (95% CI: 1.177-1.710, P<0.001), respectively. No significant difference in myopathy was observed (HR 0.915, 95% CI: 0.741-1.129). CONCLUSION: Conclusions: Adding bempedoic acid to atorvastatin therapy appears to confer a protective effect in CAD patients by significantly reducing MACE, cardiac arrest, and hospitalizations without increasing myopathy risk. Prospective studies are warranted to confirm these findings.
Variants of the structure of the urinary system organs in human fetuses.
Vladychenko KA, Skoreiko PM, Andrushchak LA … +2 more , Petryshen OI, Tsyhykalo OV
Pol Merkur Lekarski · 2026 · PMID 42048508 · Publisher ↗
OBJECTIVE: Aim: To find out the features of individual anatomical variability of the urinary system organs in the fetal period of human ontogenesis. PATIENTS AND METHODS: Materials and Methods: 102 human fetuses with a p...
OBJECTIVE: Aim: To find out the features of individual anatomical variability of the urinary system organs in the fetal period of human ontogenesis. PATIENTS AND METHODS: Materials and Methods: 102 human fetuses with a parieto-calcaneal length (PCL) of 160.0-480.0 mm (4-10 months of gestation) were studied. A complex of morphological research methods was applied, which included anthropometry, morphometry, injection of blood vessels with dyes for visualization of blood vessels of macrospecimens, preparation of macrospecimens, and statistical analysis. RESULTS: Results: Our material revealed a number of variants of the shape and structure of the ureters, in particular, doubling of the renal pelvis and ureters - 4 observations. The reasons for this may be impaired morphogenesis of the metanephros at the end of the 6th - beginning of the 7th week of intrauterine development. Bends of the proximal part of the ureter, megaureter were observed in 2 cases, polymegacolix, megacolix - in 2 cases. Aberrant renal vessels were detected in 8 specimens. The reasons for their occurrence may be impaired angiogenesis at the end of the 6th week of prenatal development. CONCLUSION: Conclusions: 1. Variants of the structure and topography, as well as malformations of the upper urinary tract, were detected in 15.7% of 102 studied fetal specimens. 2. The ratio of detected variants and anomalies of the structure and topography in female fetuses prevailed over those in male fetuses in the ratio of 5:3. 3. Extreme forms of anatomical variability of the structure of renal vessels and their syntopy with the renal pelvis and ureter in all observations were a potential danger of vasorenal conflicts, which would subsequently lead to hydronephrotic transformation of the kidney.
Enhancing cognitive engagement in medical students through problem-based histology instruction: implications for competency-oriented physician training.
Dymar NM, Reva TD, Drapei IM … +1 more , Yaremenko LM
Pol Merkur Lekarski · 2026 · PMID 42048507 · Publisher ↗
OBJECTIVE: Aim: This study aimed to verify experimentally the effectiveness of a problem-search approach for teaching Histology in enhancing the level of cognitive engagement among first-year medical students enrolled in...
OBJECTIVE: Aim: This study aimed to verify experimentally the effectiveness of a problem-search approach for teaching Histology in enhancing the level of cognitive engagement among first-year medical students enrolled in specialty I2 "Medicine," as well as to substantiate the feasibility of its implementation in the educational process of future physician training. PATIENTS AND METHODS: Materials and Methods: The study was conducted during the 2024-2025 academic year and consisted of three stages (summative, formative, and final) using a pedagogical quasi-experimental design. A total of 756 undergraduate students enrolled in specialty I2 "Medicine" participated and were divided into a control group (n=352) and an experimental group (n=354). The level of cognitive engagement was assessed before and after the formative stage using B. K. Pashnev's questionnaire. The experimental group was taught using a combination of problem-based learning, the case method, heuristic dialogue, smallgroup work, project-based learning, and digital interactive technologies. RESULTS: Results: At the summative stage, no statistically significant differences between the groups were identified. After the implementation of the problem-inquiry teaching methodology, the experimental group demonstrated a significant increase in the proportion of medical students with an advanced level of cognitive engagement (from 32.5% to 70.1%) compared with the control group (χ2=38.369; p<0.05). CONCLUSION: Conclusions: The proposed methodology for teaching Histology to future physicians, grounded in a problem-search approach, is an effective means of enhancing medical students' cognitive engagement and may be recommended for implementation in higher medical education practice.
Impact of sarcoidosis on clinical outcomes in patients with dilated cardiomyopathy: A propensity-matched analysis from the TriNetX network.
Rhabneh L, Ababneh R, Alfarrajin I … +4 more , Aloqaily M, Alwardat AR, Hazaimeh K, Al Khodari K
Pol Merkur Lekarski · 2026 · PMID 42048506 · Publisher ↗
OBJECTIVE: Aim: Our study aims to compare the outcomes in patients with dilated cardiomyopathy (DCM) who have sarcoidosis and who do not have sarcoidosis. PATIENTS AND METHODS: Materials and Methods: We used data from th...
OBJECTIVE: Aim: Our study aims to compare the outcomes in patients with dilated cardiomyopathy (DCM) who have sarcoidosis and who do not have sarcoidosis. PATIENTS AND METHODS: Materials and Methods: We used data from the TriNetX US collaborative network database, including DCM patients with and without sarcoidosis between Aug 1, 2015 and Aug 1, 2025. Propensity score matching was done to minimize differences in baseline characteristics. A total of 4,514 patients in each cohort (sarcoidosis vs. non-sarcoidosis) were studied after propensity score matching. The primary outcome was ventricular assist device (VAD) placement, and the secondary outcomes were ventricular arrhythmia, hospitalization or ED visits, acute kidney injury, and stroke. RESULTS: Results: The incidence of VAD insertion was more frequent in the sarcoidosis group (2.2% vs. 1.3%; OR: 1.676, 95% CI: 1.210-2.321; P<0.001). Secondary outcomes also showed significant differences, with higher rates of ventricular arrhythmia (OR: 2.082, 95% CI: 1.833-2.364; P<0.001), acute kidney injury (OR: 1.305, 95% CI: 1.157-1.473; P<0.001), and hospitalization/ED visits (OR: 1.159, 95% CI: 1.003-1.340; P<0.001) in the sarcoidosis cohort. Other arrhythmia events were more frequent (OR: 2.517, 95% CI: 2.425-2.613; P<0.001). The risk of composite stroke did not differ significantly between groups (OR: 1.132, 95% CI: 0.957-1.339; P=0.146). CONCLUSION: Conclusions: Sarcoidosis in DCM was associated with higher risk of VAD insertion and most secondary outcomes, except stroke, indicating worse prognosis and need for closer monitoring and targeted management.
Adaptive swimming as a means of physical and sports rehabilitation for people with musculoskeletal disorders.
Prontenko KV, Bondarenko VV, Chernikov AM … +4 more , Tomenko OA, Kondratska HD, Bashtova OH, Gavryliuk VO
Pol Merkur Lekarski · 2026 · PMID 42048505 · Publisher ↗
OBJECTIVE: Aim: To investigate the impact of adaptive swimming training sessions on the psycho-emotional and functional state of individuals with musculoskeletal disorders. PATIENTS AND METHODS: Materials and Methods: Th...
OBJECTIVE: Aim: To investigate the impact of adaptive swimming training sessions on the psycho-emotional and functional state of individuals with musculoskeletal disorders. PATIENTS AND METHODS: Materials and Methods: The research was conducted in 2025, with 32 male service members aged 26-58 who underwent rehabilitation for musculoskeletal injuries over 6 weeks. The research used a combination of theoretical, empirical, and mathematical statistical methods. The psycho-emotional state was assessed using the Wessman-Ricks technique, and the functional state was assessed using a 100 m swimming test and the duration of heart rate recovery after exercise. RESULTS: Results: Data analysis showed that adaptive swimming training sessions have a pronounced rehabilitative effect: they normalize the psycho-emotional state, reduce stress levels, and increase the body's adaptive capabilities. The integral indicator of emotional state after 6 weeks of training increased by 1.15 points (p≤0.001) and reached a good level, reflecting the restoration of emotional balance. Functional indicators also improved: the time to cover a distance of 100 meters was reduced by 51 seconds (p≤0.001); the duration of heart rate recovery was reduced by 3.65 beats per minute (p≤0.001). CONCLUSION: Conclusions: It has been established that adaptive swimming training sessions contribute to improving the psycho-emotional state and functional capabilities of individuals with musculoskeletal disorders. A significant improvement in the integral indicators of the cardiovascular system's emotional and functional states has been observed.
Effective interventions used by preschool teachers to develop executive functions in preschoolers with attention difficulties.
Kyriakou T, Vasileiou I, Katsarou DV
Pol Merkur Lekarski · 2026 · PMID 42048504 · Publisher ↗
OBJECTIVE: Aim: This study explores the interventions used by preschool teachers to develop executive functions in preschoolers with attention difficulties. It aims to provide a comprehensive understanding of effective i...
OBJECTIVE: Aim: This study explores the interventions used by preschool teachers to develop executive functions in preschoolers with attention difficulties. It aims to provide a comprehensive understanding of effective interventions for fostering executive function development, as viewed from the perspectives of preschool teachers. PATIENTS AND METHODS: Materials and Methods: A qualitative study was conducted through semi-structured interviews with thirty preschool teachers. Thematic analysis was employed to examine the interventions proposed by teachers for enhancing executive functions in preschoolers with concentration difficulties. The results were subsequently discussed in relation to the existing literature. RESULTS: Results: The results indicate that motor games and interest-driven activities are the most effective in developing executive functions in children with attention difficulties. Teachers suggested that successful interventions often incorporate rhythm and movement, aligning with children's interests. CONCLUSION: Conclusions: Early and effective interventions aimed at developing executive functions in preschoolers at risk of ADHD can delay the onset of symptoms and enhance academic success. Teachers emphasise that motor games and activities based on children's interests are key strategies for improving concentration and self-regulation; however, further research is required to validate these findings.
Enterosorption therapy of chronic obstructive pulmonary disease against the background of endogenous intoxication.
Fedoniuk LY, Kucher SV, Lototska OV
Pol Merkur Lekarski · 2026 · PMID 42048503 · Publisher ↗
OBJECTIVE: Aim: improve the effectiveness of treatment for patients with COPD in the acute phase with clinical and laboratory manifestations of endogenous intoxication by including carbon or organosilicon sorbents in com...
OBJECTIVE: Aim: improve the effectiveness of treatment for patients with COPD in the acute phase with clinical and laboratory manifestations of endogenous intoxication by including carbon or organosilicon sorbents in complex therapy. PATIENTS AND METHODS: Materials and Methods: To evaluate the effectiveness of enterosorption therapy in the complex treatment of patients with COPD in the acute phase with clinical and laboratory manifestations of endogenous intoxication, patients were divided into three groups according to severity. The first group consisted of 34 patients (21.9%) with mild bronchial obstruction (GOLD 1), the second group included 64 patients (41.3%) with moderate bronchial obstruction (GOLD 2), and the third group included 57 patients (36.8%) with severe bronchial obstruction (GOLD 3). The control group consisted of 20 healthy people aged 40 to 78 years. The following exclusion criteria were used: the presence of diabetes mellitus, acute coronary syndrome, previous myocardial infarction, rheumatological pathology, oncological and infectious diseases, acute inflammatory processes of any localization in patients. RESULTS: Results: COPD in the exacerbation phase is accompanied by clinical and laboratory manifestations of endotoxicosis, more pronounced in patients with severe broncho-obstruction. This is manifested by an increase in the content of endogenous intoxication indicators in blood serum (molecules of medium weight by 84% and 126% (p<0.001) and erythrocyte intoxication index by 86% (p<0.001)). There is a direct correlation of mean strength between the severity of the disease and the level of MSM254 and MSM280 (r=0.496 and r=0.557, p<0.01) and weak strength - with an erythrocyte index of intoxication (r=0.253, p<0.01). COPD in the exacerbation phase is accompanied by the activation of free radical processes, most pronounced in patients with severe broncho-obstruction, manifested by a probable increase in malondialdehyde - by 116% (p<0.001) and a decrease in the activity of superoxide dismutase - by 59% (p<0.01) compared to the control. There is a direct mean strength correlation between severity and malondialdehyde levels (r=0.486, p<0.01) and inverse with serum superoxide dismutase (r=-0.500, p<0.01). MDA content in blood serum increases, SOD activity decreases with increasing age of patients. CONCLUSION: Conclusions: COPD exacerbation accompanied by clinical and laboratory manifestations of endogenous intoxication, namely increasing concentrations of malondialdehyde and superoxide dismutase activity decrease depending on the severity and age of bronchial patients. With the progression of the disease also increases the content of interleukin 1β and 10, tumor necrosis factor α, circulating immune complexes, immunoglobulin E and reduced lysozyme activity in serum, in proportion to the increase in the severity of the disease. The use in treatment of 10-day course enterosorbtsiynoyi therapy using carbon (karbolaynu) or silicone (enterosgel) enterosorbent in treatment of patients with COPD exacerbation is accompanied by a decrease in clinical and laboratory manifestations of endotoxemia, such as cough, shortness of breath, discharge of phlegm, weakness and significant reduction of the average molecular weight and erythrocyte intoxication index, malondialdehyde, interleukins, immunoglobulin E and circulating immune complexes and increased activity of SOD and content of lysozyme in serum.
Evaluation of correlation of GDF11 and atherogenic factors in patients with diabetic dyslipidemia.
Ghafil NY, Ali SHIA
Pol Merkur Lekarski · 2026 · PMID 42048502 · Publisher ↗
OBJECTIVE: Aim: To explore link between circulating Growth Differentiation Factor 11 (GDF11) levels and atherogenic lipid parameters in individuals with diabetic dyslipidemia, and to evaluate whether GDF11 may serve as a...
OBJECTIVE: Aim: To explore link between circulating Growth Differentiation Factor 11 (GDF11) levels and atherogenic lipid parameters in individuals with diabetic dyslipidemia, and to evaluate whether GDF11 may serve as a potential biomarker to minimize atherosclerosis in this population. PATIENTS AND METHODS: Materials and methods: A cross-sectional study was conducted at AL-Hassn Metabolism, Endocrine, and Diabetes Center in Kerbala, Iraq, February-April, 2025. A 172 participants with either type 1 or type 2 diabetes mellitus. Diabetic patients with dyslipidemia (n=90, 52 male and 38 female), with 4 having type 1 diabetes, 86 having type 2 diabetes, and without dyslipidemia (n=86: 36 male and 46 female), with 28 having type 1 diabetes and 54 having type 2 diabetes. Ages 20-70 years, serum level of GDF11 was determined using ELISA method. Atherogenic marker measures include midkine, NLRP3 inflammasome, PPARy and oxidative stress. Additional data obtained included age, BMI, duration of diabetes, fasting glucose, and liver enzyme (ALT). Link between GDF11 and atherogenic markers was assessed using Spearman's correlation analysis to assess independent connections, multivariate regression analysis was performed, with adjustments for age, BMI, and glycemic control. RESULTS: Results: diabetic individuals with dyslipidemia had considerably greater levels of all biomarkers tested (GDF11, SOD, NLRP3, MIDKINE, and PPARy) than with diabetes alone. Diabetes and dyslipidemia are linked to increased oxidative stress (SOD), heightened inflammation (NLRP3, Midkine), and altered metabolic regulation (GDF11, ppary). CONCLUSION: Conclusions: Diabetes with dyslipidemia linked to elevated levels of GDF11, SOD, NLRP3, midkine and PPARy, indicating increased oxidative stress, inflammation, and metabolic dysregulation.
Immunohistochemical analysis and distribution of lymphocytes and Kupffer cells in the liver of rats with long-term experimental use of hemp seed oil.
Shevchuk MM, Volos LI, Kovalska OR
Pol Merkur Lekarski · 2026 · PMID 42048501 · Publisher ↗
OBJECTIVE: Aim: To conduct histological and immunohistochemical analysis and distribution of lymphocytes and Kupffer cells in the liver of rats with long-term experimental use of hemp seed oil (HSO). PATIENTS AND METHODS...
OBJECTIVE: Aim: To conduct histological and immunohistochemical analysis and distribution of lymphocytes and Kupffer cells in the liver of rats with long-term experimental use of hemp seed oil (HSO). PATIENTS AND METHODS: Materials and Methods: 26 sexually mature male rats (180-230 g, 5-7 months old) were divided into three groups: experimental (n=14, 0.5 ml/kg/day HSO orally for 10 weeks), control (n=6, 0.1 ml/kg/day HSO orally for 10 weeks), and intact (n=6). Histological and immunohistochemical (CD3, CD20, CD56, CD68) studies, alongside quantitative analysis of lymphocyte and macrophage distribution in hepatic lobules, were performed. Statistical significance was assessed using Mann-Whitney and Pearson tests, with p<0.05 considered significant. RESULTS: Results: After 10 weeks of 0.5 ml/kg/day HSO, 71.43% of experimental rats developed mild fatty liver disease (Kleiner grade S1 steatosis), a significant difference from the control group (p<0.0001). No histological inflammation or necrotic changes in hepatocytes were observed. Small numbers of CD3 lymphocytes were present in portal tracts, without extending into or damaging the adjacent parenchyma. CD20 and NK resident lymphocytes were sparse. Aggregates of CD68-positive Kupffer cells were most common near liver lobule triads. The average number of Kupffer cells (5.79±0.06 per 0.01 mm2) in the experimental group significantly (p<0.001) exceeded the control by 1.49 times, suggesting hyperplasia of specialized macrophages and their increased role in liver immune function. CONCLUSION: Conclusions: Ten weeks of experimental use indicates that hemp seed oil is safe to consume at a dose of 0.5 ml/kg/day.
Stress, resilience and job satisfaction among emergency department healthcare workers in Greece.
Karimali Z, Karimali E, Mitsopoulou E … +1 more , Charalambous G
Pol Merkur Lekarski · 2026 · PMID 42048500 · Publisher ↗
OBJECTIVE: Aim: This study aimed to assess levels of perceived stress, psychological resilience and job satisfaction among Emergency Department (ED) healthcare professionals in Attica, Greece, and examine the correlation...
OBJECTIVE: Aim: This study aimed to assess levels of perceived stress, psychological resilience and job satisfaction among Emergency Department (ED) healthcare professionals in Attica, Greece, and examine the correlations among them. PATIENTS AND METHODS: Materials and Methods: A cross-sectional study was conducted in 12 public hospitals in Attica, Greece, using self-administered questionnaires: Perceived Stress Scale (PSS-10), Connor-Davidson Resilience Scale (CD-RISC-10), and Job Satisfaction Survey (JSS). Descriptive statistics, Pearson correlations, and multiple linear regression analyses were performed using SPSS v30. RESULTS: Results: Participants reported moderate levels of perceived stress (M=17.72, SD=6.30) and psychological resilience (M=27.18, SD=6.01), while job satisfaction appeared variable, with an overall mean score indicating low to moderate satisfaction (M=113.10, SD=23.41). A significant negative correlation was found between perceived stress and job satisfaction (r=-0.36, p < .001), as well as between stress and resilience (r=-0.53, p < .001). A positive but weaker correlation was observed between resilience and job satisfaction (r=0.14, p < .001). CONCLUSION: Conclusions: Psychological resilience plays a critical protective role against stress and positively influences job satisfaction among ED healthcare professionals. Resilience-enhancing interventions may reduce stress and improve satisfaction among ED staff.
Histological changes in the structural organization of rat kidneys 3 days after administration of Leiurus macroctenus scorpion venom.
Matkivska RM, Samborska IA, Maievskyi OY
Pol Merkur Lekarski · 2026 · PMID 42048499 · Publisher ↗
OBJECTIVE: Aim: To investigate histological changes in the structural organization of rat kidneys 3 days after administration of Leiurus macroctenus scorpion venom. PATIENTS AND METHODS: Materials and Methods: The venom...
OBJECTIVE: Aim: To investigate histological changes in the structural organization of rat kidneys 3 days after administration of Leiurus macroctenus scorpion venom. PATIENTS AND METHODS: Materials and Methods: The venom of Leiurus macroctenus, was administered to rats (0.5 ml of venom solution; 28.8 μg/ml; LD50=0.08 mg/kg). The study used 20 white male laboratory rats weighing 200 g (±10 g). The rats were divided into two groups: control group - 10 rats; experimental group - 10 rats. For microscopic examination, kidney samples from animals of all groups were taken. Histological samples of rat kidneys were stained with hematoxylin and eosin. RESULTS: Results: Microscopically, on the 3rd day of the experiment after the introduction of Leiurus macroctenus scorpion venom, significant destructive-degenerative changes in all structural components of the kidney were detected. Most renal corpuscles are large with well-defined vascular glomeruli. The endothelium of the capillaries is thinned, destructively changed. Heterogeneity of changes in proximal and distal tubules is manifested. CONCLUSION: Conclusions: The indirect effect of the Leiurus macroctenus scorpion venom led to the formation of voluminous inflammatory loci of leukocyte infiltrates in the interstitium and directly in the tubules and renal corpuscles on the 3rd day of the experiment. Significant alterative changes in the renal corpuscles were manifested by their deformation, atrophy, hyperemia and multiple hemorrhages. In the tubular system, pronounced hydropic and protein dystrophy were detected, and in their lumens, voluminous accumulations of cellular detritus were detected.
CD38 genotype-dependent regulation of CD44 and TP53 links genetic variation to aggressive phenotype in chronic lymphocytic leukemia.
Hussain MA, Amer ME, El-Ashwah S … +4 more , ElKosairy M, El-Sherbini YM, Mabed M, Abdraboh ME
Pol Merkur Lekarski · 2026 · PMID 42048498 · Publisher ↗
OBJECTIVE: Aim: To estimate role of CD38 rs6449182 polymorphism in CLL risk and its effect on the expression of critical tumor suppressor TP53, the promoter of cell adhesion and migration, CD44, and the immune checkpoint...
OBJECTIVE: Aim: To estimate role of CD38 rs6449182 polymorphism in CLL risk and its effect on the expression of critical tumor suppressor TP53, the promoter of cell adhesion and migration, CD44, and the immune checkpoint molecule PD-L1. PATIENTS AND METHODS: Materials and Methods: This case-control study included 50 CLL patients and 50 healthy individuals, age- and sex-matched. CLL diagnosed by flow cytometry (CD5+/CD19+/CD23+) based on WHO criteria. Genotyping of the CD38 rs6449182 polymorphism was detected through TaqMan SNP Assay. mRNA expression levels of TP53, CD44, and PD-L1 were quantified using real-time RT-PCR . RESULTS: Results: Mutant G-allele was more frequent in CLL patients than in controls (19.0% vs. 10.0%), although this difference was only marginally significant P=0.075. No statistically significant association was observed between specific CD38 genotypes and the regulatory status (upregulation/downregulation) of the target genes P>0.05, while individuals with GG genotype exhibited higher median fold changes for TP53 (FC=2.97) and CD44 (FC=2.00) than the wild-type, the presence of significant inter-individual variance and broad confidence intervals indicates that these genetic variants do not serve as definitive independent predictors of gene expression in this cohort. CONCLUSION: Conclusions: results suggest that the CD38 rs6449182 polymorphism may, at least in part, be involved in CLL risk but that it does not lead to a significant genotype-specific regulatory effect on the fold change of CD44, TP53, or PD-L1 expression. Although CD38 remains an important prognostic biomarker, the absence of a genetic-phenotypic relationship found in this study illustrates the complexity of molecular regulation by CLL. Larger studies are needed to confirm these findings.
Urinary tract infections in pregnant women from the Russian--Ukrainian military conflict regions: A multicenter study (2022-2025).
Salmanov AG, Senchuk A, Dzheneti B … +13 more , Suslikova LV, Savchenko SЕ, Rud VO, Strakhovetskyi VS, Korniyenko SM, Kovalyshyn OA, Vdovychenko SY, Prishchepa AP, Talko OV, Voloshyn OA, Chubatyy AI, Paliga I, Artyomenko VV
Pol Merkur Lekarski · 2026 · PMID 42048497 · Publisher ↗
OBJECTIVE: Aim: To estimates of the prevalence rate of urinary tract infections (UTIs) in pregnant women from the Ukrainian-Russian military conflict regions and antimicrobial resistance of causing pathogens. PATIENTS AN...
OBJECTIVE: Aim: To estimates of the prevalence rate of urinary tract infections (UTIs) in pregnant women from the Ukrainian-Russian military conflict regions and antimicrobial resistance of causing pathogens. PATIENTS AND METHODS: Materials and Methods: Retrospective multicenter cohort study was conducted from April, 2022 to May, 2025.The study population consisted of 2,576 pregnant women from the Ukrainian-Russian military conflict regions. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST guidelines. RESULTS: Results: Among 2,576 pregnant women, 1,002 (38.9%) UTIs were observed. The most frequently reported UTI types were cystitis (48.4%) and asymptomatic bacteriuria (39%). Of all UTI cases, 14.6% were defined as acute pyelonephritis. The most common causative agents of UTIs were Escherichia coli (27.6%), Klebsiella pneumoniae (13.9%), Proteus mirabilis (11.2%), Coagulase-negative staphylococci (8.7%), Enterococcus faecalis (8.5%), Enterobacter spp. (7.2%), and Pseudomonas aeruginosa (6.6%). Methicillin-resistance S. aureus (MRSA), vancomycin resistance enterococci (VRE), and extended spectrum beta-lactamases (ESBL) production among Enterobacteriales was found observed in 11.3%, 9.1%, and 29.4% isolates, respectively. Carbapenem resistance was identified in 13.7% of P. aeruginosa strains. CONCLUSION: Conclusions: This study findings demonstrate the high rate of UTIs in pregnant women from the Ukrainian-Russian military conflict regions and many cases are caused by pathogens that are resistant to antibiotics. Strategies for deterrence include optimal hygiene practices to minimize the risk of bacterial colonization and ascending infection.
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