The human toll and humanitarian crisis of the Russia-Ukraine war: the first 162 days.

BACKGROUND: We examined the human toll and subsequent humanitarian crisis resulting from the Russian invasion of Ukraine, which began on 24 February 2022. METHOD: We extracted and analysed data resulting from Russian military attacks on Ukrainians between 24 February and 4 August 2022. The data tracked direct deaths and injuries, damage to healthcare infrastructure and the impact on health, the destruction of residences, infrastructure, communication systems, and utility services - all of which disrupted the lives of Ukrainians. RESULTS: As of 4 August 2022, 5552 civilians were killed outright and 8513 injured in Ukraine as a result of Russian attacks. Local officials estimate as many as 24 328 people were also killed in mass atrocities, with Mariupol being the largest (n=22 000) such example. Aside from wide swaths of homes, schools, roads, and bridges destroyed, hospitals and health facilities from 21 cities across Ukraine came under attack. The disruption to water, gas, electricity, and internet services also extended to affect supplies of medications and other supplies owing to destroyed facilities or production that ceased due to the war. The data also show that Ukraine saw an increase in cases of HIV/AIDS, tuberculosis, and Coronavirus (COVID-19). CONCLUSIONS: The 2022 Russia-Ukraine War not only resulted in deaths and injuries but also impacted the lives and safety of Ukrainians through destruction of healthcare facilities and disrupted delivery of healthcare and supplies. The war is an ongoing humanitarian crisis given the continuing destruction of infrastructure and services that directly impact the well-being of human lives. The devastation, trauma and human cost of war will impact generations of Ukrainians to come.

COMPARISON OF PREVALENCE OF TOBACCO USE AMONG YOUNG PEOPLE IN DIFFERENT COUNTRIES.

OBJECTIVE: The aim: The prevalence analysis of three ways of tobacco use among young adults: traditional (smoking of cigarillos or cigars) and alternative (hookah smoking and use of E-cigarettes) as well as the development of ways of tobacco smoking prevention. PATIENTS AND METHODS: Materials and methods: Cross-section anonymous survey among young adults 18-44 years of age (n=410) has been conducted. The obtained results were compared with the data of the similar studies from different countries. The statistical methods (analysis of the mean and relative values), structural and logical analysis and systemic approach. RESULTS: Results: Among those who were interviewed, aged 18-44 years, there are 24.15±2.11 % of respondents - hookah smokers, 9.02±1.42 % persons prefer the traditional method of tobacco use (smoking of cigarillos or cigars), while 6.34±1.20 % ones use E-cigarettes. Such forms of smoking are more common among males. The smokers of cigarillos, cigars and hookahs have appreciated their high availability when buying - 9 (7;10) points out of 10 possible. The study has found that 11.54±1.58 % of smokers of E-cigarettes and 8.08±1.35 % of hookah smokers consider them safe types of smoking and harmless to their health. CONCLUSION: Conclusions: The prevention methods of smoking prevalence among young people must be based on the tougher rules of tobacco market and latest devices for smoking at the legislative level.

MULTIDISCIPLINARY APPROACH TO MANAGEMENT OF PEDIATRIC PATIENTS WITH SKIN SYMPTOMS OF FOOD ALLERGY.

OBJECTIVE: The aim: To determine the significance of multidisciplinary approach to management of pediatric patients with skin symptoms of food allergy. PATIENTS AND METHODS: Materials and methods: The study included of 36 patients aged 4 to 6 years with skin manifestations of food allergy, of which 18 were randomly included in the study group and had a multidisciplinary approach to treatment and the other 18 patients constituted a comparison group and used a standard therapy regimen. Observation of children was carried out for 3 months. RESULTS: Results: Assessment of the severity of the cutaneous form of food allergy by SCORAD score showed the average degree of disease activity in the groups of the study at the beginning of treatment and significantly better dynamics in patients of the study group (p=0.0055). In 88.9% (n=16) of patients in the study group and 61.1% (n=11) of the control group, the process became mild. CONCLUSION: Conclusions: The application of a multidisciplinary approach allows the integrated implementation of medical, nutritional, and psychological aspects, which significantly increases the effectiveness of treatment and improves the quality of life of patients and their parents.

Effect of intraabdominal hypertension on splanchnic blood flow in children with appendicular peritonitis.

BACKGROUND AND AIMS: Intraabdominal hypertension (IAH) is poorly diagnosed condition that cause splanchnic hypoperfusion and abdominal organs ischemia and can lead to multiple organ failure. There are no scientific data regarding effect of intraabdominal pressure (IAP) on splanchnic circulation in children. MATERIAL AND METHODS: Ninety-four children after surgery for appendicular peritonitis were enrolled in the study. After IAP measurement children were included in one of two groups according IAP levels: "without IAH" (n = 51) and "with IAH" (n = 43). Superior mesenteric artery (SMA) and portal vein (PV) blood flows (BFSMA, BFPV, mL/min) were measured, and SMA and PV blood flow indexes (BFISMA, BFIPV, ml/min*m2) and abdominal perfusion pressure (APP) were calculated in both groups. RESULTS: Median BFISMA and BFIPV in group "with IAH" were lower by 54.38% (P < 0.01) and 63.11% (P < 0.01) respectively compared to group "without IAH". There were strong significant negative correlation between IAP and BFISMA (r s = -0.66; P < 0.0001), weak significant negative correlation between IAP and BFIPV (r s = -0.36; P = 0.0001) in group "with IAH" and weak significant negative correlation between IAP and BFISMA (r s = -0.30; P = 0.0047) in group "without IAH". There were no statistically significant correlations between IAP and BFIPV in group "without IAH", between BFISMA and APP in both groups and between BFIPV and APP in both groups. CONCLUSION: Elevated IAP significantly reduces splanchnic blood flow in children with appendicular peritonitis. BFISMA and BFIPV negatively correlate with IAP in these patients. There is no correlation between BFISMA/BFIPV and APP in children with IAH due to appendicular peritonitis.

COMPARATIVE ANALYSIS OF THE MAIN SOCIAL HEALTH DETERMINANTS OF LIFE EXPECTANCY AND INFANT MORTALITY IN UKRAINE AND POLAND.

OBJECTIVE: The aim: To analyze the data of social health determinants - life expectancy of population and infant mortality in neighboring countries: Ukraine and Poland in cut-away of territory habitation. PATIENTS AND METHODS: Materials and methods: The statistical materials of the Ukrainian and Polish information sources were used in this work: SI "The center of medical statistics of the Ministry of Health of Ukraine", The state statistics service of Ukraine, The central statistical management of Poland (Glówny Urzad Statystyczny). Methods of system approach, bibliosemantic, statistical, analytical were used for analysis. RESULTS: Results: In both countries, Poland and Ukraine, the general dynamics as to the growth of an average life expectancy (ALE) among men and women was observed during 28 years of surveillance, and in both countries it was revealed that the ALE indices in women were much higher than in men. Within the last five years, there is a considerable tendency of decrease in the infant death rate in Ukraine, while in Poland this index is particularly invariable. This may be due to the fact that the level of infant mortality in Poland is half the level in Ukraine; moreover, this correlation is approximate within the last five years of observation. A significant place in the structure of all the causes of infant mortalityin 2019 is occupied by the Ð¥VІ chapter in accordance with ICD-10 "Certain conditions originating in the perinatal period" - 54.39 % in Ukraine and 53.05 % in Poland, the last - "Diseases of the Urogenital system" (chapter ХІV) - 0 % and 0.7 %, correspondingly. CONCLUSION: Conclusions: With a view of an incessant improvement of a high-quality information which is registered when the statistical data are formed, it is necessary to promote a broad intersector cooperation inside the countries and international collaboration between the countries.

Food Hypersensitivity in Children Aged 0-3 Years of the Lviv Region in Ukraine: A Cross-Sectional Study.

Aim: To determine the prevalence and to estimate factors associated with food hypersensitivity in young children of the Lviv region in Ukraine. Methods: A prospective cross-sectional survey study was conducted between 2016 and 2017 in the Lviv region of Ukraine. A specially designed questionnaire about food hypersensitivity of young children developed and validated by M. J. Flokstra-de Blok was used after translation into the Ukrainian language. The questionnaire included 34 questions, grouped into general and detailed information. Parents of children aged 0-3 years were asked to complete the questionnaire at pre-schools and medical institutions. Results: Among 4,500 distributed questionnaires, 3,214 (71%) were completed and processed. Parents reported that 25% of their young children had food hypersensitivity. According to the survey the most common agents involved in food hypersensitivity in young children were cow's milk (34%), egg (28%), and wheat (24%). Hypersensitivity to milk occurred in 50% of children in the age group of 1-2 years. Regional differences associated with food hypersensitivity were also found. Namely, in the Carpathians, there was more hypersensitivity to fish (27%) and honey (22%) than in other regions, while hypersensitivity to soy was detected mostly in Lviv City residents (8.5%). Unknown causes of food hypersensitivity were highly reported (34%) in the Carpathians. Conclusion: Prevalence and some distinctiveness of food hypersensitivity revealed in four geographic and climate zones as well as in Lviv City have a considerable practical use for formulation of recommendations for children with food hypersensitivity.

Low infiltration of tumor-associated macrophages in high c-Myb-expressing breast tumors.

Tumor-associated macrophages (TAMs) are prominent components of tumor stroma that promotes tumorigenesis. Many soluble factors participate in the deleterious cross-talk between TAMs and transformed cells; however mechanisms how tumors orchestrate their production remain relatively unexplored. c-Myb is a transcription factor recently described as a negative regulator of a specific immune signature involved in breast cancer (BC) metastasis. Here we studied whether c-Myb expression is associated with an increased presence of TAMs in human breast tumors. Tumors with high frequency of c-Myb-positive cells have lower density of CD68-positive macrophages. The negative association is reflected by inverse correlation between MYB and CD68/CD163 markers at the mRNA levels in evaluated cohorts of BC patients from public databases, which was found also within the molecular subtypes. In addition, we identified potential MYB-regulated TAMs recruiting factors that in combination with MYB and CD163 provided a valuable clinical multigene predictor for BC relapse. We propose that identified transcription program running in tumor cells with high MYB expression and preventing macrophage accumulation may open new venues towards TAMs targeting and BC therapy.

The significance of νо gas transmitter and nucleases in shaping the sequelae of traumatic brain injury

Introduction: Traumatic brain injuries are at present remaining an important worldwide medical problem due to substantial percentages of incapacitation and lethality, especially among people of working age. All therapeutic interventions in TBI and their timeliness and efficacy depend on timely and quality diagnosis of patient's condition, including laboratory parameters of blood and urine. The aim: To assess for peculiar patterns in changes of NO gas transmitter levels in patients with severe traumatic brain injury during the treatment period and to investigate into its relationship with nuclease enzymes in the context of various treatment outcomes. Material and methods: This research work has used clinical data, history and diagnostic tests obtained in 72 patients with severe traumatic brain injury, age 18 to 76 years (mean age 42.26±15.02 years), who six months later have been divided into the following four groups according to Glasgow outcome scale: "Death", "Severe disability", "Moderate disability" and "Recovery". Results: Biochemical assessments in patients with severe traumatic brain injury have shown supranormal levels of urinary nitric oxide and serum DNAses. Going forward, nitric oxide levels significantly decreased over the time of treatment in subjects with favorable outcomes ("Moderate disability" and "Recovery" groups) and increased with treatment time in subjects with unfavorable outcomes ("Severe disability" and "Death" groups). The diagnostic markers of further unfavorable survival outcomes may be present at the onset of treatment (Day 1) and may include urinary levels of nitric oxide below 1.1 µmol/L and DNAse levels below 26 µU/mL. A positive diagnostic sign of favorable survival and health outcomes may include DNAse І levels over 30.0 µU/mL from Day 7 of treatment. Conclusions: The findings of this work can be used when making a diagnosis/selecting an optimal treatment schedule and predicting the sequelae of traumatic brain injury in a patient, which may cumulatively minimize the impact of the injury.

Influence of risk factors on insulin resistance in patients with overweight and obesity.

OBJECTIVE: Introduction: Obesity is a multifactorial, heterogenic disease, associated with an increased risk of morbidity and mortality due to cardiovascular diseases, diabetes, cancer, chronic liver and kidney diseases. Excessive body weight and obesity are serious medical and social problems, since their incidence is constantly increasing and has reached global epidemic proportions. The aim: Determining the influence of risk factors on insulin resistance level in patients with overweight and obesity. PATIENTS AND METHODS: Materials and methods: The study included 127 patients with overweight and obesity. Anthropometric measurement was performed for determination of the degree and type of obesity by WHO and IDF (2015) criteria. The levels of ALT, AST, uric acid, lipids, glucose, insulin, glycated hemoglobin in the blood were measured. HOMA-IR index was calculated and multiple regression method with inclusion of reliable signs was applied. RESULTS: Results: By multiple regression method, we identified four signs which, in combined action, affect HOMA-IR index: AST, triglycerides, insulin level and atorvastatin dose. Value of determination coefficient indicates that the level of insulin resistance in overweight and obese patients is by 37% explained by the factors included in regressive model. However, we did not investigate the influence of behavioral risk factors and burdened family history of type 2 diabetes mellitus, which significantly affect insulin resistance level. CONCLUSION: Conclusions: We assume that modification of lifestyle and individual approach to pharmacologic correction of dyslipidemia in overweight and obese patients help to avoid the development of insulin resistance, which is a predictor of type 2 diabetes mellitus.