To summarize, being an attractive research topic, the radiogenomics of PCa currently is not a comprehensively investigated area of oncourology. According to preliminary research findings conducted in this field, the combination of genomics and radiomics (and presumably metabolomics, proteomics, and transcriptomics) as integrative parts of precision medicine in the future has the potential to become the foundation for a personalized approach to the management of PCa. However, there are a number of hindrances to achieving this goal, such as relatively small numbers of patients included in current studies, a lack of available large randomized controlled trials, the need to use complex integrated methods of big data analysis, the comparatively high cost of genomic profiling and imaging methods, and the question of whether, before we include any potential genomic or transcriptomic marker into radiogenomic analysis, it should first be validated in order to prove its separate clinical value. If so, it greatly and significantly shifts the horizon of the actual use of radiogenomics in clinical practice, owing to the need for a huge body of future research. 

Abstract

The research aims at improving the quality assessment of clinical audit results in Ukraine using the complex of statistical methods and studying statistical methods in foreign reports of the clinical audit and personal experience.

Materials and Methods. The research was performed by analyzing the reports of clinical audit (n=62), held during 2021 by the Healthcare Quality Improvement Partnership. The spectrum of statistical methods was extended by the analysis of the example of a sociological survey of patients (n=405) regarding the quality assessment of medical care. The methods applied in the current study included systemic approach and analysis, structural and logical analysis, correlation and regressive analysis, calculation of relative values.

Results and Discussion. All 100% clinical audit reports, carried out by the Healthcare Quality Improvement Partnership were based on the results of the statistical calculations. The most common method of processing results is the epidemiological statistics (93.5%), ratio of chances/risks (30.6%), probability assessment by Х² Pearson's method (21.0%). It is noteworthy that for pointing the central tendency almost in half of the cases (46.8 %) the median and the Interquartile Range were used. Complex mathematical methods such as the survival assessment by Kaplan- Meier and method multiple regression were used in 6.5 % та 4.8 % reports, accordingly.

Conclusions. Based on our own experience, we suggested implementation of standardization methods, a detailed correlation and regressive analysis, neuro networks and power analysis into the methodology (technique) of the clinical audit. Implementation of spectrum of evidentially substantiated methods of statistical analysis will allow to increase the evidence level and to deepen the statistical analysis of databases when conducting the clinical audit, аnd therefore, the quality assessment of clinical audit results will increase.

SARS-CoV-2 and side effects of SARS-CoV-2 vaccination show tropism to nervous system structures. Neurological side effects from the central and peripheral nervous systems have been observed quite rarely after vaccination against COVID-19 compared to a large number of vaccinated individuals. The article presents a clinical case of simultaneous damage to the central and peripheral nervous systems in the form of acute autoimmune inflammatory encephalomyelopolyradiculoneuropathy, which occurred after receiving the first dose of the BNT162b2 mRNA vaccine. The severe course of encephalomyelopolyradiculoneuropathy with peripheral tetraplegia, sensory disturbances, bulbar syndrome, and dysautonomia, followed by the occurrence of pneumonia, secondary bacterial meningoencephalitis, the need for longterm mechanical ventilation led to the occurrence of pneumothorax and multiple organ failure, which caused the patient’s death after one and a half months of intensive therapy. Thus, the acute autoimmune inflammatory encephalomyelopolyradiculoneuropathy can be considered as a probable rare neurological complication of SARS-CoV-2 vaccination with mRNA-based vaccines. Encephalomyelopolyradiculoneuropathy can have a severe course, accompanied by multiple complications and leading to death. Establishing of the causal relationships of the occurrence of rare neurological pathological conditions close in time to vaccination against SARS-CoV-2 with mRNA-based vaccines requires additional further researches. 

The literature data of the last three decades on the problem of comorbidity of multiple sclerosis (MS) and epilepsy have been analyzed, such as issues of pathogenesis, clinical course, prognosis, and treatment of this dual pathology. Epileptic seizures occur in 2–3% to 5.9% of patients with MS, which is 3–6 times more common than in the general population. The incidence of epilepsy raises with increasing duration and severity of MS, with its
progressive course, and also depends on the effect of drugs for the treatment of MS. There is no unanimity in the literature on the age and gender characteristics of the occurrence of  epileptic seizures in MS. Probable mechanisms of MS comorbidity and epilepsy are analyzed. Data on certain common pathophysiology of MS and epilepsy and the concept according to which the model of epilepsy in MS is considered as a network disease are presented. Data on clinical manifestations and diagnosis of comorbid MS with epilepsy are presented. Epileptic seizures can occur at any stage of MS: before the clinical manifestations, at the onset of the disease, in the late stages, or can indicate exacerbation of MS. Types of epileptic seizures with a dual diagnosis (MS + epilepsy) are diverse. The majority of patients (up to 87.5%) have focal seizures (aware or unaware) or focal seizures to bilateral tonic-clonic, and a small share of patients have seizures of unknown origin. Most researchers believe that patients with MS and epilepsy have a more severe MS course and a worse long-term prognosis. The main directions of MS treatment and the impact of such treatment on the development of epileptic seizures are highlighted. Data on the effect of some disease-modifying drugs for the treatment of MS on the course of epilepsy and, on the other hand, on the impact of some antiseizure medications on the course of MS are presented. It is concluded that patients with MS have individual profiles and interindividual variability of epileptogenicity. The principles of treatment of epileptic
seizures/epilepsy in patients with MS are proposed.

Taras I. Pupin, Zoriana M. Honta, Ihor V. Shylivskyy, Oksana M. Nemesh, Khrystyna B. Burda

ABSTRACT

This work presents an analysis of the literature data of modern scientific research regarding the assessment of pathogenetic mechanisms of the impact of adaptive stress response on the condition of periodontal tissue. Chronic stress and depression suppress the immune system, predetermine hormonal imbalances, lead to metabolic disorders in tissues and increase the risk of dystrophic and inflammatory processes in periodontal tissues. All this leads to impaired masticatory function, tooth loss, pronounced psycho-emotional instability and significant decline in quality of life. That is why the problem of studying the adaptive stress response of the body requires further research to gain a deep understanding of its role in the etiology and pathogenesis of dental diseases and justify effective treatment and prevention measures.

KEY WORDS: periodontal tissues, generalized periodontitis, psychoemotional stress, adaptation, maladaptation, psycho-emotional disorders.