Мета дослідження: вивчення частоти та рівня дистресу, структури, клінічних проявів психоемоційних розладів та кризи ідентичності в жінок із доброякісними новоутвореннями та злоякісними
пухлинами жіночої репродуктивної системи після завершення хірургічного лікування в об’ємі щонайменше гістеректомії.
Матеріали та методи. Дослідження охоплювало 75 жінок віком від 38 до 70 років, яким було проведено гістеректомію, із них 53 особи – зі злоякісними пухлинами жіночої репродуктивної системи
(група 1) та 22 особи – з доброякісними пухлинами (група 2). Усім пацієнткам для визначення рівня дистресу та виявлення психоемоційних розладів до та після перенесеного хірургічного лікування було
проведено опитування з використанням NCCN-дистрес-термометра, української версії 2.2022.
Результати. Отримані в ході дослідження дані засвідчили, що хоча до хірургічного втручання не було статистично значущої різниці в рівні дистресу між групами жінок зі злоякісними та доброякісними
пухлинами, після гістеректомії в групі хворих зі злоякісними пухлинами відмічався вірогідно вищий рівень емоційних проблем (зокрема, за параметрами наявності смутку та депресії, втрати інтересу
або здатності отримувати задоволення, самотності та відчуття нікчемності), соціальних проблем (стосунки з дітьми, членами сім’ї, друзями або колегами, комунікація з медичними працівниками), а
також проблем практичного характеру. Водночас за показниками проблем фізичного характеру, а також низки проблем емоційного, соціального та практичного характеру пацієнтки з доброякісними
пухлинами продемонстрували такий же високий рівень дистресу, як і пацієнтки зі злоякісними пухлинами.
Висновки. Результати дослідження дають змогу зробити висновки про необхідність активного скринінгу для оцінки рівня дистресу. Психоемоційні розлади та кризи ідентичності після гістеректомій
були виявлені не тільки в групі пацієнток зі злоякісними пухлинами, але й у жінок із доброякісними новоутвореннями репродуктивної системи. Як інструмент такого скринінгу може бути використаний
опитувальник NCCN-дистрес-термометр.

Objective of the study: to evaluate the psychoemotional condition in patients with benign and malignant tumors of the reproductive system after hysterectomy and successfully completed treatment.
Materials and methods. The study included 75 women aged 38 to 70 years who had undergone hysterectomy, including 53 women with malignant tumors of the female reproductive system (group 1) and 22
women with benign tumors (group 2). All patients were surveyed using the NCCN Distress Thermometer (Ukrainian version 2.2022) to determine the level of distress and identify psychoemotional disorders before and
after surgical treatment.
Results. The data obtained during the study allowed to establish that although before the surgical intervention was no statistically significant difference in the level of distress between the groups of women with
malignant and benign tumors, after hysterectomy in the group of patients with malignant tumors was noted a significantly higher level of emotional problems (in particular, according to the parameters of the sadness
and depression, loss of interest or ability to get pleasure, loneliness and feelings of worthlessness), social problems (relationships with children, family members, friends or colleagues, communication with medical
professionals), as well as practical problems. At the same time, according to indicators of physical problems, as well as a number of emotional, social and practical problems, patients with benign tumors demonstrated
the same high level of distress as patients with malignant tumors.
Conclusions. The results of the study allow us to draw conclusions about the need for active screening to assess the level of distress. The presence of psychoemotional disorders and identity crises after hysterectomies
was evident not only in the group of patients with malignant tumors, but also in women with benign tumors of the reproductive system. NCCN Distress Thermometer can be used for the purpose of such screening

Abstract. Background. Obesity is one of the most acute health care problems. Numerous methods of combating excess body weight have been developed, but the existing strategies do not lead to permanent and proportional weight loss, some of them have a number of contraindications and side effects, so new methods of body weight correction are constantly being sought. A short-term low-carbohydrate and low-fat diet with additional use of amino acids is promising. The purpose of the study was to evaluate the efficacy of a 21-day low-carbohydrate and low- fat diet with the additional use of an amino acid complex for weight loss.
Materials and methods. Thirty-seven women with a diagnosis of obesity were involved. They were randomly divided into two groups — experimental (19 women) and control (18 women), with the same age, body weight and results of bioimpedance analysis. The patients of the control group were put on a hypocaloric Mediterranean diet, and the patients of the experimental group — on a low-carbohydrate, low-fat diet with the additional use of an amino acid complex. Duration of observa- tion was 21 days. Before and after completion of observation, all patients underwent anthropometric measurements.
Results. After 21 days, the experimental group had a greater decrease in body weight compared to the control group (6.7 ± 0.4 % vs. 3.8 ± 0.7 %, p < 0.05), in body volumes (chest volume: 4.3 ± 0.4 % vs. 1.9 ± 0.4 %, waist volume: 5.2 ± 0.2 % vs. 2.2 ± 0.4 %, hip volume: 5.1 ± 0.3 % vs. 2.3 ± 0.5 %, all p < 0.05). In this group, there was also a greater decrease in adipose tissue (13.6 ± 0.8 % vs. 7.0 ± 2.0 %, p < 0.05), and in the degree of visceral obesity (2.0 ± 0.2 units vs. 0.9 ± 0.3 units, p < 0.05); the amount of muscle tissue, on the contrary, increased (–2.3 ± 0.6 % vs. 2.6 ± 0.7 %, p < 0.05).
Conclusions. There was a significantly greater decrease in body weight, in main body volumes, a greater reduction in adipose tissue and the degree of visceral obesity in patients who were on a low-carbohydrate and low-fat diet with additional use of amino acids compared to patients who ate according to the conventional method.
Keywords: obesity; normalization of body weight; ketogenic diet; bioimpedance analysis

УДК: 616.155.3-097.37-07:615.262.1.454.1]-092.9

 Various pro- and anti-inflammatory cytokines play crucial roles in the development of acute inflammatory processes. Depending on their effect on inflammatory processes, interleukins are divided into pro-inflammatory (IL-6) and anti-inflammatory (IL-10). The aim of the study was to analyze the dynamics of pro- and anti-inflammatory cytokines in the blood plasma of rats in an experiment using hydrogel dressings saturated with silver ions and an antioxidant drug for the local treatment of inflammatory processes. The experimental study was conducted on 80 sexually mature male rats. The healing of an experimental infected wound was studied using hydrogel dressings saturated with medicinal substances. The effectiveness of local therapy was assessed using biochemical methods. Analysis of the dynamics of the pro- and anti-inflammatory balance showed that the greatest manifestation of the inflammatory process and suppression of the body's compensatory reactions was observed on the third day. Indicative data on the relative ratio of the course of the inflammatory process were obtained on the seventh day. The highest result was in the control group – 2.719±0.55 IU, which clearly reflected the general tendency towards the equalization of pro- and anti-inflammatory reactions in the animals' bodies. However, in the third experimental group, it was even lower (1.094±0.23 IU) than the normal value, which indicates the predominance of anti-inflammatory reactions of the body to damage when using hydrogel dressings saturated with silver ions and an antioxidant preparation. On the 10th day, the body's anti-inflammatory defense mechanisms intensify, with parallel processes of inflammation subsiding. The results obtained on the 14th day of the experiment did not differ statistically significantly from the norm in all animal groups. The use of hydrogel dressings reduces the duration of treatment of the inflammatory process. 

Uniformed personnel are highly exposed to occupational stress, which increases the risk of mental health problems. This study examined whether coping styles moderate the relationship between perceived stress and satisfaction with life among uniformed personnel treated for bodily distress disorder or post-traumatic stress disorder. Methods: A cross-sectional study was conducted with 183 participants (81% male, aged 30–66 years). Standardized questionnaires were administered: the Perceived Stress Scale (PSS-10), Satisfaction with Life Scale (SWLS), and Coping Inventory for Stressful Situations (CISS). Pearson correlations with 95% confidence intervals were computed, and moderation analyses were conducted using separate regression models for each coping style with bootstrap estimation (1000 samples). Gender differences were examined using t-tests with Cohen’s d. Results: Perceived stress was negatively correlated with life satisfaction (r = −0.43, 95% CI [−0.54, −0.29], moderate effect). Emotion-oriented coping correlated negatively with life satisfaction (r = −0.28, 95% CI [−0.42, −0.14]), while social diversion correlated positively (r = 0.21, 95% CI [0.07, 0.35]). Women reported higher stress (Cohen’s d = 0.60) and lower life satisfaction (Cohen’s d = −0.50) than men. Moderation analysis revealed that emotion-oriented coping significantly intensified the negative effect of stress on life satisfaction (B = −0.01, p = 0.019). Conclusions: Perceived stress strongly impairs life satisfaction in uniformed personnel, particularly among those relying on emotion-oriented coping. Targeted interventions, such as emotion regulation training, mindfulness, and cognitive restructuring, may enhance resilience and mitigate stress-related declines in well-being in this high-risk occupational group.

UDC 616.12-005.4-036.12-06:(616.12+616.61+616-056.5)]-008 

Cardio-renal metabolic syndrome (CRMs) is believed to be a holistic, systemic disorder with multiorgan dysfunction and a high number of adverse cardiovascular outcomes. It involves complex interconnection mechanisms between renal dysfunction, cardiovascular disease and metabolic disorders. Our study's feasibility was determined by several unresolved issues regarding the peculiarities of the course of CRMs. A deep understanding of the interrelationships of these conditions requires a comprehensive approach aimed at studying and evaluating risk factors and pathophysiological mechanisms. Studying the features of CRMs will allow optimising lifestyle, involving an interdisciplinary team in treatment and, in the future, developing a unified protocol for the management of such patients.
The study aimed to evaluate the clinical manifestations and characteristics of CRMs in patients with chronic coronary heart disease.
For this purpose, 113 patients with chronic coronary heart disease (CHD) were examined, chronic heart failure (CHF) I-III functional class (FC) according to the NYHA, who were diagnosed with CRMS according to the criteria: diagnosed CHD with CHF; body mass index (BMI) > 25 kg/m2; fasting glucose level > 6.1 mmol/l or previously diagnosed type 1 or type 2 diabetes mellitus (T2D) or use of hypoglycaemic therapy; glomerular filtration rate (GFR) < 80 kg/mkmol; blood creatinine above normal.
The results of the study indicate that 15.92% of patients with chronic coronary artery disease can be diagnosed with complete cardio-renal metabolic syndrome. Patients with complete CRMs were younger but had higher BMI, systolic hypertension and tachycardia, hyperlipidemia and leptin resistance, higher levels of total fibrinogen and leukocytes, leukocyte intoxication index, lipid ratios and triglycerides. The deterioration of metabolic parameters was
accompanied by activation of inflammation and endogenous intoxication, cytolysis and an increase in leptin.