The problem of studying the mechanisms of steatohepatosis development and its correction remains relevant, despite the significant number of scientific studies on the pathogenesis of metabolic-associated fatty liver disease. This is con-firmed by the increase in morbidity, which may be associated with a wide range of factors that cause liver steatosis and the lack of effective therapeutic and preventive agents. The study aims to establish the lipid and phospholipid composition of the inner mitochondrial membrane of rat hepatocytes under conditions of diet- and glutamate-induced steatohepatosis and to evaluate the corrective effect of nanocrystalline cerium dioxide on the formation of steatohepatosis induced by neonatal administration of monosodium glutamate. The direction of the experiments included the study of the mechanisms of de-velopment of diet- and glutamate-induced visceral obesity in 4-month-old rats and the determination of the lipid and phos-pholipid composition of the inner membrane of hepatocyte mitochondria in rats under conditions of high-calorie diet and after neonatal administration of monosodium glutamate against the background of periodic administration of nanocrystal-line cerium dioxide. It was established that rats that were on a high-calorie diet with a high content of fats, carbohydrates, and a reduced content of proteins for 4 months, and rats that were administered monosodium glutamate in the neonatal period, developed visceral obesity without the manifestation of hyperphagia, characterized by dyslipidemia and the devel-opment of steatohepatosis. A feature of the development of diet- and glutamate-induced steatohepatosis is mitochondrial dysfunction, which is characterized by changes in the lipid and phospholipid composition of the inner membrane of hepatocyte mitochondria. Not only structural changes occur in the membrane, but also dysfunctional changes in the mito-chondria as a whole, manifesting themselves in the fact that ROS are generated in the respiratory chain instead of ATP, and this causes the development of oxidative stress in both the mitochondria and the entire hepatocyte. Periodic admin-istration of nanocrystalline cerium dioxide to rats with glutamate-induced steatohepatosis significantly restored the lipid and phospholipid composition of the inner membrane of hepatocyte mitochondria, reduced manifestations of oxidative stress, and reduced the content of oxidized forms of phosphatidylcholine and phosphatidylethanolamine in the inner mem-brane of hepatocyte mitochondria against the background of normalization of cardiolipin content, which indicates the antioxidant effect of this drug and the possibility of its use for the prevention of steatohepatosis.
UDC 616–07–08–036.8].001.36(063)
The 10th McMaster International Review Course in Internal Medicine (MIRCIM 2025), held in Kraków, Poland, confirmed its status as a high-impact scientific forum promoting evidence-based medical practice. With over 100 speakers from more than 40 countries, MIRCIM fostered multidisciplinary discussions on pressing topics in cardiology, rheumatology, pulmonology, and digital health.
The cardiology section focused on current evidence regarding angina and ischemia with non-obstructive coronary arteries, tailored oxygen therapy strategies in non-hypoxemic patients, the role of complete revascularization post-ST-elevation myocardial infarction, the impact of iron deficiency in heart failure, and perioperative cardiovascular risk management in non-cardiac surgical patients.
The rheumatology track emphasized stratified, biomarker-guided treatment strategies for rheumatoid arthritis, systemic lupus erythematosus, (аnti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis, calcium pyrophosphate deposition disease, fibromyalgia, and adult-onset J. F. Still’s disease. These strategies involve integration of phenotypic, immunologic, and serologic data, as well as imaging findings and reduction of long-term
corticosteroid exposure.
Pulmonology sessions addressed the fundamental lung physiology, updated Global Initiative for Asthma (GINA 2025) guidelines, especially in children under six years old, early detection of lung cancer using low-dose computed tomography, and strategies for perioperative pulmonary complication prevention.
The gastroenterology section focused on several key topics of contemporary clinical relevance. The management of diverticular disease was discussed with particular emphasis on current therapeutic approaches. The treatment of irritable bowel syndrome (IBS) was addressed in detail, with a symptom-based and comorbidity-oriented management
strategy highlighted. The section also explored the prevention of gastrointestinal cancers, analyzing various cancer prevention strategies and emphasizing the implementation of evidence-based methods into clinical practice.
Additionally, the current management of metabolic-associated steatotic liver disease (MASLD) was reviewed in accordance with the latest 2024 European Association for the Study of the Liver (EASL) - European Associationm for the Study of Diabetes) (EASD) - European Association for the Study of Obesity (EASO) guidelines, with a focus on therapeutic interventions targeting metabolic dysfunction-associated steatotic liver disease.
The session on artificial intelligence in medicine explored the current applications and limitations of generative language models such as Generative Pre-trained Transformer (GPT) in medical decision-making, telemedicine, education, and public health awareness. Benefits such as enhanced access to knowledge and reduced clinical burnout were noted, along with necessary precautions in clinical implementation.
MIRCIM 2025 once again affirmed its position as a key platform for advancing interdisciplinary medical knowledge, fostering international cooperation, and enhancing evidence-based healthcare delivery in both global and local contexts.
УДК 616.36–004:616.24–008.811.6–036
The aim of the study. To determine the frequency and character of syntropic extrahepatic lesions in cirrhotic patients depending on the hepatopulmonary syndrome severity degree.
Materials and methods. In a randomized manner with preliminary stratification by the presence of hepatopulmonary syndrome were studied 93 patients with liver cirrhosis, who underwent the comprehensive clinical-laboratory and instrumental examination.
Results. According to the obtained results, most often in patients with liver cirrhosis associated with hepatopulmonary syndrome syntropic extrahepatic lesions affected other organ systems as follows: digestive system - 100.0 % patients under investigation; hematopoietic system - 84.9 %; nervous system - 81.7 %; integumentary system and mucous membranes - 78.5 %; blood circulatory system - 76. 3 %; osteoarticular system - 67.7 %; urinary system - 22.6 %. Increased severity of hepatopulmonary syndrome significantly (p < 0.05) correlated with thein creased frequency of lesions.
Among syntropic polymorbid lesions of the integumentary system and mucous membranes, 68.8 % patients with hepatopulmonary syndrome had jaundice, 66.7 % - telangiectasia. Among lesions of the osteoarticular system osteopenia was diagnosed in 44.7 % of patients, osteoporosis - in 27.7 %. Among lesions of the circulatory system 52.7% of patients suffered from heart rhythm disorders, 49.5 % - from arterial hypotension, 20.4 % - from cirrhotic cardiomyopathy. Among lesions of the hematopoietic system anemia (76.3 %), coagulopathy (73.1 %) and thrombocytopenia (61.3 %) were diagnosed most often. Digestive system lesionsinclude esophageal veins varicosities (94.6 % of patients), hemorrhoidal veins varicosites (68.8 %), and cirrhotic gastropathy (62.4 %). Among lesions of the urinary systemin 21.5 % of patientswas diagnosed type II hepatorenal syndrome. Among the lesions of central nervous system in 81.7 % of patientswas diagnosed hepatic encephalopathy. The frequency of syndromes and nosological units increased significantly (p < 0.05) with the increase of hepatopulmonary syndrome severity.
Conclusions. 100.0 % patients with liver cirrhosis accompanied byhepatopulmonary syndromewere affected by syntropic polymorbid lesionsof the digestive system, 94.6 % of which were represented by esophageal vein varicosites. Out of 84.9 % of patients with hematopoietic lesions anemia was diagnosed in 76.3 %, coagulopathy - in 73.1 % of cases. Of total 81.7 % patients withnervous system injurieshepatic encephalopathy was diagnosed in 81.7 % patients. In 78.5 % cases of damaged skin, its appendages and mucous membranesjaundice covered 68.8 %, and telangiectasia 66.7 % of cases. In 76.3 % of cardiovascular system lesions arrhythmias were diagnosed in 52.7 %. With the increasing severity of hepatopulmonary syndrome, the frequency of the above lesions increased significantly (p < 0.05).
УДК 615.5–002.525.2:616.1]–06–07
Introduction. Systemic lupus erythematosus (SLE) due to damage to numerous organs or systems still requires comprehensive study.
The aim of the study. To find out the clinical markers of the blood vessels syntropic lesions in patients with systemic lupus erythematosus, their diagnostic value.
Materials and methods. 118 patients with SLE with syntropic lesions of the circulatory system were examined (107 women (90.68 %) and 11 men (9.32 %) aged 18 to 74 years (average age 42.48 ±1.12 years)).
The study included the identification of clinical markers of blood vessels syntropic lesions, determination of the diagnostic value of individual clinical markers and their constellations in terms of sensitivity, specificity and accuracy in patients with SLE, and the identification of one of them with the most reliable diagnostic value.
Results. Clinical markers for detecting A. G. M. Raynaud’s syndrome in patients with SLE are morning stiffness, new rashes, paleness of the fingers and toes in the cold, chilliness of the extremities, memory problems, symptomatic hypertension - skin dryness, legs swelling, shortness of breath, palpitations, headache, increased blood pressure, displacement of the left border of the heart to the left, accent of the second tone on the aorta, livedo reticularis - skin dryness, chilliness of the extremities, shortness of breath, retinal angiopathy - morning stiffness, paleness of the fingers and toes in the cold, legs swelling, shortness of breath, palpitations, headache, increased blood pressure, displacement of the left border of the heart to the left, accent of the second tone on the aorta, pulmonary hypertension - morning stiffness, legs swelling, shortness of breath, palpitations, memory problems, accent of the second tone on the pulmonary artery, atherosclerosis - muscle ache, shortness of breath, memory problems, venous thrombosis - legs swelling, shortness of breath, palpitations, capillaritis - headache.
The optimal value for the diagnosis of A. G. M. Raynaud’s syndrome in patients with systemic lupus erythematosus is the constellation of clinical markers "joint pain + chilliness of the extremities", symptomatic hypertension - a separate clinical marker accent of the second tone on the aorta, livedo reticularis - "joint pain + new rash + shortness of breath", retinal angiopathy - "joint pain + increased blood pressure", pulmonary hypertension - a separate clinical marker accent of the second tone on the pulmonary artery or the constellation "joint pain + accent of the second tone on the pulmonary artery", atherosclerosis - a separate clinical marker shortness of breath or the constellation "joint pain + shortness of breath", venous thrombosis - "joint pain + photosensitivity + shortness of breath", capillaritis - "palpitations + headache + increased blood pressure".
Conclusions. In patients with systemic lupus erythematosus the optimal diagnostic value among clinical monomarkers and their constellations for the detecting of A. G. M. Raynaud’s syndrome have chilliness of the extremities, "joint pain + chilliness of the extremities" with an advantage in the constellation, symptomatic hypertension - accent of the second tone on the aorta, "joint pain + accent of the second tone on the aorta" with an advantage in the monomarker, livedo reticularis - shortness of breath, "joint pain + new rash + shortness of breath" with an advantage in the constellation, retinal angiopathy - increased blood pressure, "joint pain + increased blood pressure" with an advantage in the constellation, pulmonary hypertension - accent of the second tone on the pulmonary artery or the constellation "joint pain + accent of the second tone on the pulmonary artery", atherosclerosis - shortness of breath or the constellation "joint pain + shortness of breath", venous thrombosis - legs swelling, "joint pain + photosensitivity + shortness of breath" with an advantage in the constellation, capillaritis - headache, "palpitations + headache + increased blood pressure" with an advantage in the constellation.
Aim: To assess the correlation between lipoprotein(a) levels and traditional lipid profile markers in statin-naive men and women without established atherosclerotic cardiovascular disease.
Materials and Methods: Sixty-seven statin-naive adult patients without a prior history of established atherosclerotic cardiovascular disease were included in the study. Lipoprotein(a) levels were determined using nephelometry in all patients.
Results: According to the results of the correlation analysis, it was found that there is no statistically significant correlation between lipoprotein(a) level and traditional parametres of lipid profile in both groups (p>0.05). Reliable direct correlation of moderate strength was observed between lipoprotein(a) and age
in the group A (R=0.46, p=0.04).
Conclusions: Elevated lipoprotein(a) levels, independent of other lipid profile parameters, can significantly contribute to cardiovascular risk, emphasizing the importance of routine lipoprotein(a) screening in clinical practice. It is particularly noteworthy that lipoprotein(a) concentrations tend to increase after menopause, potentially placing postmenopausal women at an elevated risk for cardiovascular events. Consequently, it is imperative to monitor lipoprotein(a) levels in females, especially during the peri-menopausal and postmenopausal stages, to more accurately assess and manage cardiovascular risk in this population.