Polski Merkuriusz Lekarski[JOURNAL]
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200 papers
Comparative effects of intravenous furosemide and torsemide on survival and length of hospital stay in acute heart failure.
Małek-Elikowska M, Szyszka A, Fedorowicz J … +3 more , Szymańska-Łyczkowska C, Dankowski R, Baszko A
Pol Merkur Lekarski · 2026 · PMID 42048496 · Publisher ↗
OBJECTIVE: Aim: To investigate the impact of the initial choice between intravenous furosemide and torsemide on mortality outcomes and duration of hospital stay. PATIENTS AND METHODS: Materials and Methods: The prospecti...
OBJECTIVE: Aim: To investigate the impact of the initial choice between intravenous furosemide and torsemide on mortality outcomes and duration of hospital stay. PATIENTS AND METHODS: Materials and Methods: The prospective, open-label, comparative study included 68 adult patients hospitalized with acute heart failure (AHF). Furosemide was administered to 35 patients (51.5%) and torsemide to 33 patients (48.5%) during the first 48 hours after admission. Diuretic dosing was titrated according to urinary sodium concentration. After the initial 48 hours, further diuretic therapy was administered at the discretion of the attending physician. The primary endpoint was all-cause mortality, and the secondary endpoints were length of hospital stay and in-hospital mortality. RESULTS: Results: All-cause mortality was 51.4% in patients treated with furosemide and 42.4% in those treated with torsemide (p=0.478). The median survival time was 633 days (95% CI 178-1,259) in the furosemide group and 1,093 days (95% CI 541-1,239) in the torsemide group, with no statistically significant difference in survival between the two treatment groups (p=0.44). No in-hospital deaths occurred in the torsemide group, whereas four in-hospital deaths (11.4%) were observed in the furosemide group (p=0.115). The mean length of hospital stay was 12±7 days in both groups (p=0.551). CONCLUSION: Conclusions: Both furosemide and torsemide showed no statistically significant differences in all-cause mortality, in-hospital mortality, and length of hospital stay.
Legal qualification of collaborationism in healthcare.
Shevchuk OM, Volodina OO, Povzyk YV … +1 more , Klimova VV
Pol Merkur Lekarski · 2026 · PMID 41746895 · Publisher ↗
OBJECTIVE: Aim: To investigate approaches to the criminal legal qualification of collaborationism in the field of healthcare, taking into account the norms of international humanitarian law. PATIENTS AND METHODS: Materia...
OBJECTIVE: Aim: To investigate approaches to the criminal legal qualification of collaborationism in the field of healthcare, taking into account the norms of international humanitarian law. PATIENTS AND METHODS: Materials and Methods: The research methodology involves an analysis of current legislative documents on the qualification of criminal liability for collaborative activities, as well as regulatory legal acts in the healthcare field, and documents of international humanitarian law. The data analysis was conducted using open sources, mainly for the period 2013-2025, with an emphasis on the period of the active phase of the war in Ukraine. The main search keywords were "human rights", "collaborationism", "criminal liability", "crimes against the foundations of national security", "medical immunity in international humanitarian law", and "healthcare". The initial database consisted of 70 sources, of which 34 were included in the final analysis. The materials of the publication form the basis for the systematization of criminal legislation on the problems of protecting the rights of persons accused of collaborative activities in the field of healthcare, the key ones being the Constitution of Ukraine, the Criminal Code of Ukraine, and the European Convention on Human Rights. CONCLUSION: Conclusions: The study emphasizes the need to improve the approach to the criminal legal qualification of collaborationism in the health sector, which covers both legal and organizational components, as well as mandatory compliance with the norms of international humanitarian law. The social danger of this phenomenon lies not only in the fact that it encroaches on the defense capability and foundations of national security, but also in the fact that it poses a threat to other objects of criminal law protection.
Case report of extramedullary plasmacytoma within the left palatine tonsil in a 31-year-old female patient.
Kubicka G, Sobocińska W, Sobociński M … +1 more , Kołodyński Ł
Pol Merkur Lekarski · 2026 · PMID 41746894 · Publisher ↗
Extramedullary plasmacytoma (EMP) is an uncommon variant (rare presentation) of plasma-cell neoplasia characterized by the proliferation of clonal plasma cells outside the bone marrow microenvironment. EMP most frequentl...
Extramedullary plasmacytoma (EMP) is an uncommon variant (rare presentation) of plasma-cell neoplasia characterized by the proliferation of clonal plasma cells outside the bone marrow microenvironment. EMP most frequently arises in the head and neck region, particularly within soft-tissue structures of the upper aerodigestive tract. Herein, we present a case report of a 31-year-old patient diagnosed with a localized extramedullary plasmacytoma (EMP) of the left palatine tonsil at the University Hospital in Krakow. We are also presenting a summary of the EMP of the tonsil case reports from the PubMed database. This article aims to present a clinical case of extramedullary plasmacytoma involving the palatine tonsil in a 31-year-old woman, with a detailed description of the diagnostic process and therapeutic management. In addition, the article reviews alternative diagnostic approaches and treatment modalities reported in the literature.
Myocardial work indices and cardiac magnetic resonance in the diagnosis and follow-up of Lyme carditis presenting with intermittent complete heart block.
Małek-Elikowska M, Elikowski W, Fedorowicz J … +4 more , Szymańska-Łyczkowska C, Rajewska-Tabor J, Klusek-Zielińska A, Baszko A
Pol Merkur Lekarski · 2026 · PMID 41746893 · Publisher ↗
This case report explores the spectrum and mechanisms of myocardial involvement in Lyme carditis, integrating clinical and imaging findings to better understand the disease course and its management implications. While c...
This case report explores the spectrum and mechanisms of myocardial involvement in Lyme carditis, integrating clinical and imaging findings to better understand the disease course and its management implications. While conduction abnormalities are the most well-recognized cardiac manifestation of Lyme carditis, our findings highlight the importance of myocardial work assessment by echocardiography in the early stage of the disease and by cardiac magnetic resonance in the late stage. These insights may guide clinicians in early recognition, targeted therapy, and prevention of adverse cardiac outcomes in Lyme carditis and other forms of myocarditis. We report the case of a 44-year-old male presenting with complete atrioventricular block. Myocardial work assessment by echocardiography was performed to investigate the underlying etiology, revealing findings suggestive of an inflammatory myopericardial syndrome as the cause of the conduction abnormality. The Suspicious Index in Lyme Carditis suspicious (SILC) score indicated an intermediate probability of Lyme infection, which was subsequently confirmed by laboratory testing. The patient was treated with intravenous ceftriaxone, resulting in resolution of the conduction disturbance and obviating the need for pacemaker implantation. During follow-up, myocardial work parameters were reassessed, and cardiac magnetic resonance imaging was performed, both supporting remission with residual changes and providing additional prognostic insights.
Acute pancreatitis as a severe complication of scoliosis surgery in pediatric patient: a case report and literature review.
Wędrychowicz A, Możdżeń K, Kaleta K … +4 more , Lis E, Błażejowski M, Oleksik ZS, Kowalska-Duplaga K
Pol Merkur Lekarski · 2026 · PMID 41746892 · Publisher ↗
Acute pancreatitis (AP) in children is a rare but severe inflammatory disease of the pancreas. Unlike in adults, where alcohol consumption and gallstones are the most common causes, pediatric AP results from various fact...
Acute pancreatitis (AP) in children is a rare but severe inflammatory disease of the pancreas. Unlike in adults, where alcohol consumption and gallstones are the most common causes, pediatric AP results from various factors such as abdominal trauma, infections, biliary tract disease, systemic disorders, genetic predisposition, and drug-induced injury, with many cases remaining idiopathic. Adolescent idiopathic scoliosis (AIS) is the most common form of pediatric scoliosis. Treatment options include physical therapy, bracing, and surgical correction in severe cases. A case of an adolescent patient with AIS who developed severe (AP) after scoliosis surgery was analyzed, alongside a review of the relevant literature. We report the case of a 14-year-old male with severe AIS and additional risk factors, including malnutrition and hypertension, who underwent transpedicular stabilization and spondylodesis from Th2 to L4. In the early postoperative period, he developed severe (AP) as a rare but serious complication. Conservative treatment involved withdrawal of oral feeding, initiation of parenteral nutrition, and subsequent transition to enteral feeding. Multidisciplinary management addressed associated liver abnormalities, gastrointestinal ulcerations, neurological findings, and persistent hypertension, leading to gradual clinical recovery.We present the case of an adolescent patient with (AIS) who developed severe (AP) as a complication of surgery. In addition, a review of the relevant literature is presented and discussed, demonstrating that multiple perioperative abnormalities associated with scoliosis surgery may represent significant risk factors for the development of AP and contribute to the occurrence of this complication.
Rare demyelinating diseases of the central nervous system: A diagnostic and therapeutic challenge - based on the case of a young woman with MOGAD.
Roszak M, Nosal E, Sadowski J … +3 more , Sierakowska A, Kandziora K, Łabuz-Roszak B
Pol Merkur Lekarski · 2026 · PMID 41746891 · Publisher ↗
Demyelinating diseases of the central nervous system constitute a heterogeneous group of diseases. The best known is multiple sclerosis, while neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte gly...
Demyelinating diseases of the central nervous system constitute a heterogeneous group of diseases. The best known is multiple sclerosis, while neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) are rare diseases. A 19-year-old female patient was admitted to the neurology department due to rapidly progressing memory and speech disorders. Mild mixed aphasia and right-sided pyramidal syndrome were diagnosed. Magnetic resonance imaging (MRI) of the brain revealed acute nodular demyelination in the left hemisphere. Intravenous methylprednisolone was administered. After approximately 2 months, the patient was readmitted due to several generalized epileptic seizures. At that time, the patient was transferred to a clinical center, where extensive diagnostics was performed. Among others, acute disseminated encephalitis, autoimmune encephalitis, tumefactive multiple sclerosis, and tumor were taken into consideration. MRI with spectroscopy and angiography revealed degenerative changes following acute demyelination. General examination of the cerebrospinal fluid was normal. No anti-neuronal antibodies were detected. However, positive anti-MOG antibodies were detected (and antibodies against aquaporin 4 were negative), which led to a suspicion of MOGAD. The patient was discharged home with a recommendation to use antiepileptic drugs and oral steroids. It is important to remember about rare demyelinating diseases, such as MOGAD, which require differentiation from multiple sclerosis. The prognosis for this condition is generally better, but the disease can lead to permanent neurological damage.
Protection of personal medical data in the context of GDPR implementation.
Berzina AB, Rozsokha SS, Makhmurova-Dyshliuk OP … +1 more , Pletenetska AO
Pol Merkur Lekarski · 2026 · PMID 41746890 · Publisher ↗
OBJECTIVE: Aim: To analyse the challenges of protecting personal medical data in European Union (EU) Member States and other European countries during the implementation of Regulation 2016/679 (General Data Protection Re...
OBJECTIVE: Aim: To analyse the challenges of protecting personal medical data in European Union (EU) Member States and other European countries during the implementation of Regulation 2016/679 (General Data Protection Regulation [GDPR]). PATIENTS AND METHODS: Materials and Methods: The study is based on an analysis of international and national legal frameworks governing personal medical data protection, focusing on the GDPR, the case law of the European Court of Human Rights (seven relevant judgments), and national data protection legislation. Statistical data from reports of national Data Protection Authorities were analyzed to identify dominant categories of infringements related to unlawful processing, storage, disclosure, and security breaches of medical data. The methodology included a comparative analysis of European Court of Human Rights judgments and an overview of enforcement activities of data protection authorities in 27 EU Member States. Dialectical, hermeneutic, comparative, analytical, and systemic analysis methods were applied. CONCLUSION: Conclusions: To comply with the GDPR, healthcare institutions must ensure lawful and secure processing of personal medical data: organize internal procedures, appoint a Data Protection Officer, implement technical and organizational measures, obtain informed consent from patients, and guarantee their rights to access and protect such sensitive information. The protection of personal medical data is ensured through a multi-level system that combines the GDPR, the European Court of Human Rights case law, and national institutions. It is essential to develop and implement clear data protection policies that define responsibilities, data handling procedures and incident response. Many countries still have low awareness among medical personnel regarding personal data protection.
Protection of the right to human dignity in medical relations in the practice of the European Court of Human Rights.
Shevchuk OM, Davydenko SV, Borodina IV … +1 more , Berezhnyi OI
Pol Merkur Lekarski · 2026 · PMID 41746889 · Publisher ↗
OBJECTIVE: Aim: To investigate the negative and positive obligations of the state in ensuring the right of an individual to respect for human dignity in medical and legal relations, taking into account the practice of th...
OBJECTIVE: Aim: To investigate the negative and positive obligations of the state in ensuring the right of an individual to respect for human dignity in medical and legal relations, taking into account the practice of the European Court of Human Rights, and to reveal the protection of this right among drug addicts. PATIENTS AND METHODS: Materials and Methods: The research methodology involves the analysis of national regulatory provisions, international treaties, legislative acts of Ukraine, and legal positions of the ECHR on the problems of implementing the right to respect for human dignity in medical and legal relations, as well as the case law of the European Court of Human Rights. Data analysis was conducted using open sources, mainly for the period 2010-2025. The main search keywords were "ECHR", "protection of rights", "health care", "legal regulation", "the right of an individual to respect for human dignity". The search criteria focused on modern scientific approaches and practical experience in ensuring the right of individuals to respect for human dignity in medical and legal relations. Sources that do not focus on medical-legal relations, that do not take into account the current practice of the ECHR, that do not comply with international human rights standards, legal acts or regulatory documents that contradict the practice of the ECHR were excluded from consideration. CONCLUSION: Conclusions: The study highlights cases of failure to fulfill negative obligations of a material nature of the studied right of individuals, among which the following are identified: improper performance by officials of their duties due to inaction (failure to provide medical services, which led to serious consequences); improper performance of official duties by officials of state bodies, as well as unlawful actions of law enforcement agencies of a deliberate nature (physical and psychological violence against persons in custody). An approach is proposed in which adherence to the principle of the supremacy of the law under study, taking into account the practice of the European Court of Human Rights, is the basis for respecting human rights and freedoms.
Biomarkers of cellular senescence in bone tissue.
Ostrianko VI, Yakubova II, Dosenko VY … +1 more , Andriiashyk RI
Pol Merkur Lekarski · 2026 · PMID 41746888 · Publisher ↗
OBJECTIVE: Aim: To summarize the biomarkers of cellular senescence in bone tissue and discuss their potential relevance for clinical risk stratification and outcomes related to bone remodeling and implant osseointegratio...
OBJECTIVE: Aim: To summarize the biomarkers of cellular senescence in bone tissue and discuss their potential relevance for clinical risk stratification and outcomes related to bone remodeling and implant osseointegration. PATIENTS AND METHODS: Materials and Methods: A narrative literature review was performed using PubMed and Google Scholar searches focused on osteoblast, osteocyte and mesenchymal stem cell senescence, DNA damage response, senescence-associated secretory phenotype, oxidative stress, and epigenetic regulation in bone. Eligible peer-reviewed publications were screened for evidence on established and emerging senescence biomarkers, detection methods (histochemical, immunohistochemical, molecular, and secretory profiling), and mechanistic links to impaired osteogenesis and enhanced osteoclastogenesis. Findings were synthesized into practical biomarker categories (molecular, cellular/tissue, and functional) with emphasis on translational implications for dental implant planning and peri-implant bone stability. CONCLUSION: Conclusions: Bone cellular senescence is characterized by increased SA-β-gal activity, upregulation of cell-cycle inhibitors (p16INK4a, p21CIP1/WAF1, p53-related pathways), persistent DNA damage signaling, and a proinflammatory secretory phenotype that promotes osteoclast activation and suppresses osteogenesis. Tissue-level changes include reduced osteoblast function, osteocyte loss, and a shift toward resorptive remodeling reflected by an elevated RANKL/OPG ratio. Emerging signals (e.g., selected long non-coding RNAs and innate immune sensors such as TLR9) may complement classic markers in future panels. Integrating senescence-related biomarkers into clinical assessment may support individualized protocols for patients with biologically compromised bone and inform targeted preventive strategies.
Cultural competence in healthcare: A systematic review of perceptions, assessment, and mental health interventions among professionals/students in Greece/Cyprus.
Piletska VC, Kotrotsiou E, Argyriadis A … +1 more , Charalampous G
Pol Merkur Lekarski · 2026 · PMID 41746887 · Publisher ↗
OBJECTIVE: Aim: This systematic review examined the cultural competence among healthcare professionals, focusing on: (I) the assessment of cultural competence among healthcare professionals; (II) the education and assess...
OBJECTIVE: Aim: This systematic review examined the cultural competence among healthcare professionals, focusing on: (I) the assessment of cultural competence among healthcare professionals; (II) the education and assessment of cultural competence among healthcare students; (III) healthcare professionals' perceptions and experiences regarding cultural competence; (IV) healthcare students' perceptions and experiences regarding cultural competence; and (V) educators' perspectives on teaching cultural competence. PATIENTS AND METHODS: Materials and Methods: A systematic review was conducted according to PRISMA 2020 guidelines. Databases searched included PubMed, Google Scholar, Elsevier, and ProQuest from 2017 to 2024. From 15, 053 studies identified initially, 31 studies met inclusion criteria after screening and were analyzed in depth. CONCLUSION: Conclusions: Healthcare professionals and students acknowledge the benefits of cultural competence training; however, undergraduate programs and curricula remain underdeveloped. Educators frequently rely on anecdotal methods rather than structured frameworks. Further systematic integration and evidence-based strategies are essential.
Academic performance and preclinical skills in the dental students of Ukrainian University.
Kaskova L, Yanko NV, Vashchenko I … +3 more , Sadovski M, Novikova S, Morhun N
Pol Merkur Lekarski · 2026 · PMID 41746886 · Publisher ↗
OBJECTIVE: Aim: To identify the relation between academic performance and preclinical skills in pediatric dentistry, and which skills need to be refined. PATIENTS AND METHODS: Materials and Methods: This is a cross-secti...
OBJECTIVE: Aim: To identify the relation between academic performance and preclinical skills in pediatric dentistry, and which skills need to be refined. PATIENTS AND METHODS: Materials and Methods: This is a cross-sectional study conducted among the second year students of Poltava state medical university (PSMU) in the 2023/2024 academic year. Oral questions used for knowledge assessment, and academic performance was calculated as average score of grades for all classes. Preclinical skills were estimated with developed assessment at two stations during objective structural phantom exam (OSFE). The χ2 test for proportions and Spearman`s rank correlation coefficient were calculated. RESULTS: Results: The assessment of practical skills found that the students with excellent level of skills showed same academic performance (P<0,05). The students with weak satisfactory skills prevailed among the students with same academic performance (P<0,05). Spearman`s rank correlation coefficient (p=0,7) showed moderate relation between preclinical and academic performance (P<0,01). At the station «Fissure sealing», the worst skill was plaque removal and saliva isolation (P<0,05). At this station «Finishing and polishing of composite restoration», the worst skill was the second using of occlusal paper and filling finishing with a bur (P<0,05). The average grade for station «Fissure sealing» 4,22±0,05 was higher than the grade for «Finishing and polishing of composite restoration» 3,76±0,07 (P<0,0001). CONCLUSION: Conclusions: A moderate association was found between academic performance and preclinical skills in prevention of dental diseases with propaedeutic of pediatric dentistry. During classes, students` skills in finishing of composite restorations need to be improved, also students need more practice and feedback from the teacher at fissure sealing.
Dynamics of psychosomatic health indicators in future law enforcement officers under the influence of high-intensity loads.
Babchuk OG, Pasko OM, Matiienko TV … +4 more , Isaienko MM, Serednytska IA, Zhuk NT, Okhrimenko IM
Pol Merkur Lekarski · 2026 · PMID 41746885 · Publisher ↗
OBJECTIVE: Aim: To investigate the impact of high-intensity interval training (HIIT) on cadets' somatic and mental health indicators during their academic training under martial law. PATIENTS AND METHODS: Materials and M...
OBJECTIVE: Aim: To investigate the impact of high-intensity interval training (HIIT) on cadets' somatic and mental health indicators during their academic training under martial law. PATIENTS AND METHODS: Materials and Methods: The research involved 98 male cadets, who were divided into three groups: group No. 1 (n=21), whose cadets engaged in HIIT; Group No. 2 (n=53), whose cadets were involved in other sports; Group No. 3 (n=24), whose cadets did not engage in additional sports. Research methods: theoretical analysis and generalization of literature, biomedical methods, psychological methods, statistical methods. RESULTS: Results: In most tests, cadets in Group No. 1 had significantly better somatic and mental health indicators during their senior training years than those in Group No. 3, indicating a more pronounced effect of HIIT on the morphofunctional and psycho-emotional state of cadets during their academic training. At the same time, no significant difference was found between the indicators of cadets in Group No. 1 and Group No. 2, which indicates the effectiveness of additional motor activity and sports training sessions in improving the psychosomatic health of cadets. CONCLUSION: Conclusions: The positive effect of HIIT on indicators of psychosomatic health among future law enforcement officers has been demonstrated. This underscores the advisability of the broader implementation of HIIT in the physical training of future law enforcement officers during their academic training at higher educational institutions with a specific learning environment, to improve their psychosomatic health and, accordingly, increase the effectiveness of their future service activities.
Health service accessibility and psychological distress among displaced populations during the armed conflict: A cross-sectional survey.
Chervynskyy II, Kondratiuk NY
Pol Merkur Lekarski · 2026 · PMID 41746884 · Publisher ↗
OBJECTIVE: Aim: To quantify barriers to access to essential health services and describe patterns of psychological distress and help-seeking among displaced populations during the armed conflict in Ukraine. PATIENTS AND...
OBJECTIVE: Aim: To quantify barriers to access to essential health services and describe patterns of psychological distress and help-seeking among displaced populations during the armed conflict in Ukraine. PATIENTS AND METHODS: Materials and Methods: A cross-sectional questionnaire captured displacement status, linkage to primary care (declaration), perceived accessibility, barriers in the previous 6 months, awareness of reimbursement medicines, unmet service needs, and psychological symptoms within the last 2 weeks. The dataset (n=450) comprises anonymized real-world responses collected in this study. RESULTS: Results: The 48,4% of respondents were classified as currently displaced, and 75,8% reported a primary care declaration. Primary care was rated fully accessible by 20,9%, whereas 42,7% reported difficult/very difficult access. Appointment unavailability (61,6%), lack of medicines (49,8%), and high service costs (40,0%) were common barriers. Sleep disturbance (37,6%) and anxiety/panic (36,2%) were frequent; 18,7% reported seeking any support for mental health needs. CONCLUSION: Conclusions: In this cross-sectional survey, access constraints clustered around appointment availability, medicine supply, and affordability, while psychological symptoms were frequent and support-seeking remained limited. Interventions should combine primary care navigation and capacity measures with integrated, stigma-sensitive mental health pathways.
Resveratrol improves cognitive function and quality of life in postmenopausal women.
Myhal V, Kazakov Y, Shut S … +4 more , Tribrat T, Petrov Y, Ivanytska T, Chekalina N
Pol Merkur Lekarski · 2026 · PMID 41746883 · Publisher ↗
OBJECTIVE: Aim: To evaluate the effect of trans-resveratrol on cognitive function and quality of life in postmenopausal women. PATIENTS AND METHODS: Materials and Methods: A prospective controlled clinical study involved...
OBJECTIVE: Aim: To evaluate the effect of trans-resveratrol on cognitive function and quality of life in postmenopausal women. PATIENTS AND METHODS: Materials and Methods: A prospective controlled clinical study involved 88 women aged 52.1±2.5 years, postmenopausal for 2.3±1.2 years, who were randomized into two groups: study (n=55) and comparison (n=33). All patients underwent laboratory and psychometric examinations. RESULTS: Results: Compared with the control group, resveratrol intake was associated with an increase in serum magnesium levels (p 0.05). Resveratrol administration in the study group resulted in positive changes in cognitive function (P<0.001), unlike in the control group, where no significant changes were observed (P>0.05). Improvements in quality of life according to the EQ-5D-3L scale occurred in both groups, but with an advantage in the study group (p 0.05). CONCLUSION: Conclusions: The results of the study indicate a significant positive effect of resveratrol on cognitive functioning, as confirmed by an increase in MoCA scores, as well as an improvement in quality-of-life parameters according to the EQ-5D-3L and MENQOL questionnaires. The data obtained provide grounds for asserting that resveratrol can help slow age-related cognitive decline in postmenopausal women.
Scientific rationale for the use of calcium pectate in foods for special medical purposes under conditions of lead exposure.
Kurdil NV, Kalashnikov AA, Shchutska TO … +4 more , Khudaikulova OO, Kudryavtseva AG, Petrashenko HI, Kostyuchenko TP
Pol Merkur Lekarski · 2026 · PMID 41746882 · Publisher ↗
OBJECTIVE: Aim: To study the complexing ability of pectins of different origins towards calcium ions (Ca2⁺) and lead ions (Pb2⁺), in order to justify the introduction of calcium pectate into product formulations for spec...
OBJECTIVE: Aim: To study the complexing ability of pectins of different origins towards calcium ions (Ca2⁺) and lead ions (Pb2⁺), in order to justify the introduction of calcium pectate into product formulations for special medical purposes and the subsequent medical use of such products for therapeutic and prophylactic purposes under conditions of lead exposure. PATIENTS AND METHODS: Materials and Methods: The complexation ability of six different fruit and vegetable pectins with calcium (Ca2⁺) and lead (Pb2⁺) ions was investigated using the atomic emission method. RESULTS: Results: It was found that the highest complexing ability towards Ca2⁺ ions was observed in sugar beet pectin: 5,02±0,04 mmol Me/g pectin; the complexing ability of quince, citrus, apple, carrot, and pumpkin pectins ranged from 3,07±0,02 to 3,91±0,03 mmol Me/g pectin. The complexing ability of sugar beet pectin towards Pb2⁺ ions was 1,40±0,01 mmol Me/g pectin, while other pectins exhibited complexing abilities from 1,00±0,01 to 1,31±0,01 mmol Me/g pectin. The study of pectins' complexing ability in an aqueous medium in vitro, in the simultaneous presence of Ca2⁺ and Pb2⁺ ions, did not reveal a statistically significant change in complexing ability towards Pb2⁺ ions in sugar beet pectin (p=0,052), citrus pectin (p=0,054), carrot pectin (p=0,072), or pumpkin pectin (p=0,061); however, a decrease in complexing ability with Pb2⁺ ions was observed in quince pectin (p=0,036) and apple pectin (p=0,048). CONCLUSION: Conclusions: Calcium pectates of fruit and vegetable origin can be added to dietary products for special medical purposes to reduce lead exposure.
Histomorphological changes in gunshot wounds using the developed method of surgical debridement of soft tissue defects in amputation stumps after gunshot traumatic amputations of lower extremities.
Shaprynskyi YV, Lypkan VM, Karyi YV … +2 more , Makhovskyi OL, Tomashevskyi AV
Pol Merkur Lekarski · 2026 · PMID 41746881 · Publisher ↗
OBJECTIVE: Aim: To study histomorphological changes in gunshot wounds when applying the developed technique of surgical debridement of soft tissue defects in amputation stumps following gunshot traumatic amputations of t...
OBJECTIVE: Aim: To study histomorphological changes in gunshot wounds when applying the developed technique of surgical debridement of soft tissue defects in amputation stumps following gunshot traumatic amputations of the lower extremities. PATIENTS AND METHODS: Materials and Methods: A histomorphological study of soft tissue defects in amputation stumps was carried out in 40 patients, including 20 patients in the main group who were treated according to the developed surgical debridement technique involving pulse lavage, ultrasonic cavitation, proposed dermatotension sutures, and early plastic closure. Tissue samples were obtained during hospitalization - on day 1; during the second debridement - on day 4; and during the fourth one - on day 12. RESULTS: Results: On day 1, histomorphological changes were similar in the patients of both groups, presenting as deep defects, an extensive damage region with necrosis in the centre, diffuse polymorphonuclear inflammatory infiltration, and signs of oedema with marked perifocal inflammatory changes. On day 4, a decreased volume of necrotic tissue was noted in the patients of the main group as compared to the control group; the infiltrate contained segmented neutrophils in low quantities, and there was significant development of granulation tissue. On day 12, the patients of the main group showed complete resolution of the inflammatory process with healing of soft tissue defects and formation of a fully epithelialised connective tissue scar. CONCLUSION: Conclusions: The histomorphological study of soft tissue defects in amputation stumps in patients treated by the developed surgical debridement technique demonstrated rapid elimination of necrotic tissue, a decrease in signs of inflammation, early development of mature granulation tissue, and wound healing.
Functionality and protection of personal data when using Ukrainian-language mHealth apps.
Pishta VI, Boldizhar SO, Popovych TP … +3 more , Holovatskiy NT, Potapchuk AM, Hechko MM
Pol Merkur Lekarski · 2025 · PMID 41554083 · Publisher ↗
OBJECTIVE: Aim: to assess the functionality of mHealth apps with a Ukrainian interface and their compliance with personal data processing requirements. PATIENTS AND METHODS: Matherials and Methods: we employed methods su...
OBJECTIVE: Aim: to assess the functionality of mHealth apps with a Ukrainian interface and their compliance with personal data processing requirements. PATIENTS AND METHODS: Matherials and Methods: we employed methods such as Overview, Data Retrieval and Analysis. The study is also based on overviewing and analyzing data of 40 mHealth apps. RESULTS: Results: a study of 40 Ukrainian-language mHealth apps was conducted: 27.5% work only on Android, 72.5% on Android and iOS. There were identified 24 functions, among which the most common are arranging an appointment with a doctor (in 17 apps), online doctor consultation (in 12 apps), searching and reserving medicines (in 12 apps). Only 20 apps have a privacy policy, but most do not provide sufficient details on data processing. Only 9 apps have requirements for user data deletion, and 12 have mechanisms for withdrawing consent to data processing. CONCLUSION: Conclusions: as a result of the study, there were detected risks for users of mHealth apps due to insufficient transparency of privacy policies, the lack of precise mechanisms for transferring personal data to third parties, withdrawal of personal data processing consent, and data deletion requirements.
Artificial intelligence in the value system of future doctors.
Khrystenko OM, Vykhrushch AV, Novitska OI … +3 more , Fedoniuk LY, Drach ID, Rudenko MI
Pol Merkur Lekarski · 2025 · PMID 41554082 · Publisher ↗
OBJECTIVE: Aim: To analyze the significance of modern computer technologies within the value systems of teachers and students at medical universities. Through expert assessments, it explores the advantages and risks asso...
OBJECTIVE: Aim: To analyze the significance of modern computer technologies within the value systems of teachers and students at medical universities. Through expert assessments, it explores the advantages and risks associated with artificial intelligence. Special attention is given to the impact of the ongoing war on the value orientations of future doctors and the organization of professional training under new conditions. PATIENTS AND METHODS: Materials and Methods: The research employed modern methods of analysis, synthesis, generalization, and comparison, alongside expert assessments and creative essays. It also drew upon the experience of Ukrainian and Polish colleagues in creatively integrating AI into the educational process, particularly in training future doctors for effective patient communication during anamnesis-taking and for understanding the risks of iatrogenesis. To achieve the research goals, a digital information search was conducted using the scientometric database Scopus. CONCLUSION: Conclusions: In the face of new challenges, there is an increasing need to examine the dynamics of professional self-development, motivation, and the value systems of future doctors. Given the innovative nature of AI, its potential applications in medicine, its significant benefits, and its possible risks, it is essential to study this issue in depth and systematically prepare medical students for the rational use of modern information technologies. The importance of international collaboration, comparative research, and the practical implementation of the Club of Rome's recommendations on integral thinking continues to grow.
Application of the medicine GPT model in diagnosing rare diseases in the emergency department.
Obeid EH, Ulrych J, Krupa J … +7 more , Malinowski M, Krasowski M, Kalinowska A, Pietras W, Kozieł A, Kurek Z, Jentkiewicz A
Pol Merkur Lekarski · 2025 · PMID 41554081 · Publisher ↗
OBJECTIVE: Aim: Evaluataion of the diagnostic accuracy and clinical utility of the Medicine GPT model in identifying and managing rare diseases in the emergency department. PATIENTS AND METHODS: Materials and methods: A...
OBJECTIVE: Aim: Evaluataion of the diagnostic accuracy and clinical utility of the Medicine GPT model in identifying and managing rare diseases in the emergency department. PATIENTS AND METHODS: Materials and methods: A retrospective study was conducted using 100 published rare case reports retrieved from PubMed. Cases were selected based on three common complaints: chest pain (n = 50), abdominal pain (n = 30), and shortness of breath (n = 20). Each case's clinical presentation was input into Medicine GPT, which then generated a leading diagnosis. The primary outcome was the proportion of correct diagnoses. Cohen's Kappa (κ) was calculated to determine inter-rater reliability. Diagnostic accuracy varied by symptom category: chest pain (92%, κ = 0.84), abdominal pain (87%, κ = 0.81), and shortness of breath (90%, κ = 0.875). Based on full clinical presentations, overall diagnostic agreement reached 90% (κ = 0.84), indicating substantial to almost perfect consistency. CONCLUSION: Conclusions: Medicine GPT demonstrated substantial diagnostic accuracy for rare emergency department presentations, indicating potential to enhance clinical decision-making. It may serve as a foundation for refining future AI models in real-world settings, but always should remain only as an assistive tool for professional clinical judgment.
Language-dependent performance of large language models in medical diagnostics: A comparative study of ChatGPT-4o and Claude 3.5 Sonnet.
El Mahdaoui EH, Mykhalko YO
Pol Merkur Lekarski · 2025 · PMID 41554080 · Publisher ↗
OBJECTIVE: Aim: The aim for this study was to evaluate the efficacy of ChatGPT-4o and Claude 3.5 Sonnet in diagnosing diseases from clinical case descriptions presented in various languages. PATIENTS AND METHODS: Materia...
OBJECTIVE: Aim: The aim for this study was to evaluate the efficacy of ChatGPT-4o and Claude 3.5 Sonnet in diagnosing diseases from clinical case descriptions presented in various languages. PATIENTS AND METHODS: Materials and Methods: The study used 50 clinical case descriptions provided by both LLMs in three languages - English, Arabic and Ukrainian. Diagnostic results were assessed by a panel of clinicians according to standard criteria, and statistical methods were employed to determine the significance of the difference between the obtained indicators. RESULTS: Results: The overall diagnostic accuracy for ChatGPT-4o was 62.00%±15.62%, with performance significantly differing by language: 72.00%±10.00% in English, 44.00%±12.00% in Arabic, and 70.00%±9.00% in Ukrainian. A similar pattern was observed in Claude 3.5 Sonnet, which had a mean accuracy of 60.67%±14.50%. Both models performed significantly worse in Arabic compared to English and Ukrainian (p<0.05). Both models showed reduced, but significant, accuracy for cases published in 2024-2025 vs. 2023 (p>0.05). CONCLUSION: Conclusions: No significant differences in diagnostic accuracy were found between the LLMs; rather, the discrepancies were primarily related to the languages used. In multilingual healthcare settings, such as those involving Arabic, various underlying factors-particularly language complexity, cultural context, and the type of clinical cases-affect their performance. Further research is essential to improve the capabilities of LLMs, ensuring equitable healthcare access for diverse linguistically representative populations.
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