Introduction. Acinetobacter lwoffii is a rare cause of bacterial meningitis, particularly in immunocompetent individuals without prior healthcare exposure. To date, only a very limited number of cases have been documented in the literature.

Case Report. A 17-year-old male patient presented with fever, severe headache, meningeal irritation, and neurological symptoms. Cerebrospinal fluid analysis revealed neutrophilic pleocytosis and elevated inflammatory markers. Phenotypic analysis with the Vitek 2C system identified the cerebrospinal fluid isolate as A. lwoffii. Empirical antibiotic therapy was initiated and subsequently adjusted based on sensitivity testing, improving clinical and laboratory parameters.

Conclusions. This case highlights the pathogenic potential of A. lwoffii to cause severe central nervous system infections in healthy individuals. It emphasizes the importance of early microbiological diagnosis and targeted antibiotic therapy. The clinical picture, diagnostic approach, treatment strategy, and outcome are discussed in relation to the existing evidence.

УДК: 616. 832-004.2-036.864-06:616.833:616.831-073.8]-053.2

Розсіяний склероз (РС) із початком у дитячому віці є рідкісною, але суттєвою загрозою для здоров’я дітей. Він має специфічні клінічні та патофізіологічні особливості як порівняти із початком у дорослому віці. Якість життя (ЯЖ) є ключовим індикатором загального благополуччя хворих на РС дітей, проте її взаємозв’язок з об’єктивними нейробіологічними маркерами, як-от об’єм структур головного мозку, залишається недостатньо вивченим у педіатричній популяції. Метою цього дослідження було визначення кореляційних зв’язків між показниками волюметрії головного мозку та індексами ЯЖ, оціненими за опитувальником PEDSQL 4.0, у когорті дітей із РС. Дослідження охопило 39 хворих на РС дітей. Для аналізу зв’язків між суб’єктивною оцінкою ЯЖ та об’єктивними МРТ‐даними використаний коефіцієнт кореляції Спірмена (R).
Встановлено значущі кореляції між ЯЖ за самооцінкою дітей та об’ємами основних структур головного мозку. Зокрема, виявлено сильний прямий зв’язок з волюметрією таламуса (до R = 0,55). Оцінки ЯЖ за опитувальниками, надані батьками (проксі-оцінка), не виявили значущих кореляційних зв’язків з жодним із волюметричних показників. Ці результати підкреслюють важливість волюметрії таламуса як потенційного морфометричного біомаркера прогресування хвороби, який корелює із суб’єктивним сприйняттям пацієнтом з POMS свого стану. Незважаючи на виявлену розбіжність між самооцінкою дітей та оцінкою батьків, ми дотримуємося думки про важливість інтеграції обох точок зору, щоб забезпечити всебічну оцінку стану дитини в клінічній практиці та подальших дослідженнях.

Pediatric-onset multiple sclerosis (POMS) is a rare but significant neurological condition that poses a considerable threat to children’s health. Compared to adult-onset multiple sclerosis (AOMS), POMS is characterized by distinct clinical and pathophysiological features. Quality of life (QoL) is a crucial indicator of overall well-being in children with MS; however, its relationship with objective neurobiological markers — such as brain volumetric parameters — remains insufficiently explored in the pediatric population. This study aimed to examine the correlations between brain volumetric indices and QoL scores, as assessed by the PedsQL 4.0 questionnaire, in a cohort of children diagnosed with MS. The study included 39 pediatric MS patients. Spearman’s rank correlation coefficient (R)
was used to analyze the associations between subjective QoL assessments and objective MRI‐derived brain volumetric data. Significant correlations were observed between self-reported QoL scores and the volumes
of key brain structures. Notably, a strong positive correlation was found with thalamic volume (up to R = 0.55). In contrast, proxy-reported QoL scores provided by parents showed no significant correlations with any of the examined volumetric parameters. These findings highlight the potential role of thalamic volumetry as a morphometric biomarker of disease progression that aligns with the patient’s subjective experience of their condition. Despite the discrepancy between child and parent reports, we emphasize the importance of integrating both perspectives to ensure a comprehensive assessment of the patient’s status in clinical practice and future research.

Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disorder with left ventricular (LV) wall hypertrophy which is not caused by abnormal loading conditions [1]. The clinical course of HCM is complicated with diastolic dysfunction, arrhythmic disorders, sudden cardiac death (SCD), and stroke. At the late stage of HCM patients present with systolic heart failure (HF), probably caused by myocardial fibrosis. Recently the risk
factors of SCD were extensively studied in patients with HCM and a great progress has been done in this field. We have newly proposed risk factors including late gadolinium enhancement (LGE) percentage by magnetic resonance imaging (MRI), apical aneurysm, and high-risk genetic mutations. The mortality from SCD in HCM decreased thanks to the improved risk assessment and increased number of implanted cardioverters defibrillators
(ICD). However, the problem of HF in HCM patients is not resolved. Progress is achieved in patients with LVOT obstruction due to the surgical septal reduction together with procedures on mitral valve apparatus. Of note, a decrease in LVOT gradient does not exactly mean prevention of myocardial fibrosis. In some patients with nonobstructive form of HCM, we can see a large amount of intramyocardial fibrosis which increases heart muscle
stiffness and leads to diastolic and finally systolic HF [2]. An early detection of subclinical myocardial impairment is needed to predict which patients are more prone to transition to overt HF. In this context, it is essential to assess the role of the comorbidity such as diabetes mellitus (DM) increasingly reported in HCM and to evaluate its effect on myocardial mechanics. To address the question, Badran et al. presented in the recent issue of Echocardiography [3] a report on the impact of DM on prognosis and myocardial function in patients with HCM.

Abstract
Objective: Congenital absence of the pericardium (CAP) is a rare heart disorder, frequently misdiagnosed due to an
unspecific clinical picture and leading to diagnostic challenges. The purpose of this case presentation is to show how
cardiac imaging methods can aid in accurate diagnosis of CAP.
Case presentation: A case of the complete congenital absence of the pericardium in a 40-year-old man with
complaints on dyspnea and fatigue is presented. Echocardiography revealed a dilated right ventricle with good
contractility; normal dimensions and function of the left ventricle, and normal heart valve function. Pulmonary
hypertension and atrial septal defect were excluded during echocardiography. Computed tomography revealed
abnormal heart axis rotation leftward and posteriorly, raising suspicion of CAP. The diagnosis was confirmed by
cardiac magnetic resonance imaging . The diagnostic flowchart for the CAP is discussed.
Conclusion: Multimodality cardiac imaging provides clues to the diagnosis of CAP.

Objective. The study aims to evaluate the severity of endogenous intoxication and characterize morpho-functional liver changes during experimental acute generalized peritonitis (AGP) in diabetic rats.
Methods. Fifty-six adult male Wistar rats were used, including 8 controls and 48 males with experimental pathology. Diabetes mellitus was induced by an intraperitoneal (i.p.) injection of streptozotocin (60 mg/kg). On day 14, AGP was induced by i.p. injection of a 10% filtered fecal suspension. Endogenous intoxication was assessed by measuring hydrophilic and hydrophobic molecular products in the blood. Liver function was evaluated by serum aminotransferase activity, total protein, and protein fractions. Histological analysis of liver tissue was performed using standard hematoxylin-eosin staining.
Results. A progressive increase in endogenous intoxication was observed peaking on day 7. This was marked by a significant elevation in middle molecular weight molecule (MMWM) concentrations at wavelengths of 254 nm and 280 nm by 103.0% (p<0.001) and 340.0% (p<0.001), respectively. The erythrocyte intoxication index (EII) increased by 148.8% (p<0.001) compared to controls. Concurrently, aminotransferase activity increased, while serum total protein and albumin levels decreased. Histologically, inflammatory infiltration and vascular congestion were evident on day 1 progressing to hepatocellular dystrophy and necrosis by day 3. By day 7, signs of hepatic failure were present including disruption of trabecular architecture, hydropic degeneration, intracellular cholestasis, and portal tract expansion due to vascular hyperemia.
Conclusions. Experimental acute generalized peritonitis in diabetic rats resulted in a pronounced endogenous intoxication accompanied by progressive morpho-functional liver damage culminating in hepatic insufficiency by day 7.