UDC 616–089.5:253.1(477.63)

Abstract. This year, the Department of Anesthesiology and Intensive Care of the Danylo Halytsky Lviv National Medical University celebrates its 50th anniversary. The development of classical anesthesiology began almost two centuries ago with the invention of ether. At the beginning of this path, surgeons, dentists, obstetricians stood, who needed anesthesia in their daily practice. Classical anesthesiology as a profession and science is less than 100 years old. The anesthesiology community of the world remembers its titans, it is easy to find publications about their life and scientific way. It is important to popularize the great figures of Ukrainian history, especially during this historical period. Ivan Dmytrovych Tymchuk, who stood at the origins of teaching anesthesiology in 1965 within the Department of Thoracic Surgery, is one of such people. The emergence of the Department of Anesthesiology was
preceded by the selfless and long-term work of enthusiasts and highly qualified doctors with broad erudition. On January 28, 1975, the Department of Anesthesiology and Resuscitation of the Faculty of Postgraduate Education of the Lviv State Medical Institute was organized. The first head of the Department was professor Ivan Dmytrovych
Tymchuk. His enthusiasm and energy became the driving force behind the creation of the history of the Department, the training of anesthesiologists, and scientists. This article is dedicated to the bright memory of Ivan Dmytrovych, a talented scientist, teacher, organizer of the anesthesia service, patriot, and a man of a generous soul and extraordinary principles.
Keywords: anesthesiology and intensive care; history of the Department; anniversary

Background. The full-scale russian-Ukrainian war has dramatically increased limb amputations. Neuropathic residual limb pain (NRLP) following combat trauma represents a major disabling complication. Symptomatic neuromas and inflammatory mediators are considered key peripheral contributors. Despite multiple injectable modalities proposed, the quality and homogeneity of evidence remain limited.

Summary of work. An evidence-based review of MEDLINE/PubMed, Embase, and Scopus databases was conducted without time restriction. The review was structured according to PRISMA, OCEBM, and critical appraisal standards. Sixty-four studies that investigated epidemiology, mechanisms, diagnosis, and injection therapy of NRLP were included following predefined inclusion/exclusion criteria.

Summary of Results. Combat-related amputations demonstrate a higher prevalence of chronic residual limb pain (≈61–64%) than civilian amputations (22–27%). Symptomatic neuroma is the dominant etiology. Alcohol neurolysis and radiofrequency ablation show comparable analgesic efficacy; steroids and emerging agents show variable and often transient results. High-quality randomized data remain scarce, especially in homogeneous combat cohorts.

Discussion and Conclusion. Neuropathic residual limb pain after combat trauma is common, mechanistically driven largely by peripheral neuroma-associated hyperexcitability and inflammation. Injection therapy of symptomatic neuromas is a promising minimally invasive strategy; however, heterogeneity of populations and insufficient methodological rigor prevent establishing a definitive therapeutic hierarchy. Standardized terminology, diagnostic classification, and controlled studies in military populations are urgently needed.

Take-home Messages. Combat trauma–related amputations yield markedly higher NRLP prevalence versus civilian cases.

Symptomatic neuromas represent the principal targetable driver of NRLP.

Alcohol injection and radiofrequency ablation demonstrate comparable benefit profiles.

Evidence quality is limited; standardized methodology and homogeneous cohorts are required.

UDC  618.03-06:616.441-002-073.7:612.882.3

Background. Maternal thyroid dysfunction, including euthyroid goiter and subclinical hypothyroidism, is associated with complications of pregnancy mediated through placental insufficiency. Alterations in placental structure and uteroplacental and fetoplacental hemodynamics represent a possible mechanism linking thyroid disease to adverse perinatal outcomes.

Summary of work. A total of 164 pregnant women were examined by ultrasound placentography and Doppler mapping of the mother–placenta–fetus system. Group I included women with euthyroid goiter, Group II — with subclinical hypothyroidism and diffuse goiter, Group III — controls without thyroid disease. Placental maturation, localization and pathology were assessed, together with uterine and umbilical artery S/D ratios, uterine artery resistance index, and pulsatile index in the fetal aorta and middle cerebral artery.

Summary of Results. Structural placental abnormalities and discordant maturation occurred in nearly half of women with thyroid disease but were absent in controls. Premature maturation predominated in euthyroidism, while delayed maturation predominated in subclinical hypothyroidism. Doppler assessment revealed increased resistance and S/D ratios in the uterine arteries in both thyroid-disease groups, especially in subclinical hypothyroidism and on the placentation side. Peripheral placental resistance increased with gestation. Cerebral fetal indices remained largely compensated.

Discussion and Conclusion. Maternal thyroid dysfunction is associated with a high frequency of placental structural changes and impaired uterine perfusion. These hemodynamic changes likely reflect trophoblastic invasion defects and microvascular dystrophy in thyroid disease. Doppler findings enable early identification of placental insufficiency and inform preventive perinatal strategies in this at-risk population.

Take-home Messages. Thyroid disease in pregnancy is strongly associated with placental structural and hemodynamic abnormalities.

Subclinical hypothyroidism shows clinically significant Doppler impairment.

Doppler surveillance allows early prediction of placental insufficiency in thyroid-affected pregnancies.

Chest injury in military personnel is one of the most common combat injuries among military personnel. This is the result of explosive waves, falls, contusion or compression with heavy objects withoutpenetration into the chest cavity. The most typical clinical manifestations include the contusion of the chest wall, fractures of the ribs, lung damage, ventilation disorders and respiratory failure. These conditions canlead to a decrease in physical activity, impaired respiratory function and reduce the quality of life in the affected persons. The aim is to analyze current scientific evidence and clinical guidelines regarding physical therapy for military personnel after blast-related thoracic trauma. Materials and methods. Storing,analysis and systematization of scientific literature published between 2019 and 2024 based on search inPubMed, Scopus and Web of Science Databases. Results. Clinical recommendations, protocols, systematic examinations and results of original physical therapy studies after a blast-related thoracic trauma of chest in military personnel illuminate the need to supplement traditional methods of physical therapy such as early mobilization, breathing gymnastics, posture drainage daily activities. Individualized physical therapyprograms are developed and implemented to address the specific needs of patients during the pre-operative,in-hospital, and post-hospital periods, focusing on the prevention of long-term complications. This systematic approach effectively contributes to the restoration of respiratory function, improved physical capacity,and reduced risk of complications.Conclusions. Physical therapy – including breathing exercises, positional treatment, occupational therapy and motor rehabilitation – is a key component in the recovery process after breastfeeding. Despite itsprevalence, the rehabilitation management of the military after breast trauma remains a lot of investigated,especially in the context of constant military conflict.

Introduction Stress urinary incontinence (SUI) is a common complication following radical prostatectomy, affecting up to 60.0% of men. The artificial urinary sphincter (AUS) has been the gold standard for treating severe SUI since its introduction in 1973. Despite its efficacy, long-term complications such
as device failure and recurrent incontinence are relatively common, often necessitating revision surgeries. This review focuses on cuff downsizing as a revision strategy for non-mechanical AUS failure.
Material and methods A literature review was conducted using PubMed/Medline, covering studies published between January 2000 and December 2023. Key words included: “artificial urinary sphincter”, “cuff downsizing”, “urethral atrophy”, “non-mechanical failure” and "male urinary incontinence revision”.
Inclusion criteria were studies addressing cuff downsizing as a primary revision for non-mechanical failures. Only English-language studies were reviewed. We analyzed the timing of revisions, follow-up duration, and outcomes such as continence rates, complication rates, and device survival.
Results Six retrospective studies involving 206 patients were included in the present review. Cuff downsizing was performed as the sole intervention in 3 studies and in combination with other approaches in the remaining 3 studies. The median cuff size decreased from 4.5 cm preoperatively to 4.0 cm postoperatively, with 8.0–12.0% of patients receiving a cuff downsized by more than 1.0 cm. Across all studies, continence rates after revision surgery ranged from 52.0% to 90.0% based on patientreported outcome measures (PROMs). Device survival rates varied from 64.0% to 95.0%, with infection and urethral erosion being the leading causes of device explantation.
Conclusions Cuff downsizing is a reasonable revision strategy for non-mechanical AUS failure, offering similar continence outcomes and complication rates compared to alternative techniques.