Background: Narrowing or blocking blood vessels in the neck and legs can lead to life-threatening consequences, including stroke, insufficient blood supply to the legs, and delayed wound healing.
Methods: A systematic literature review was conducted using the Cochrane database from 2019 to 2024. Thirteen relevant studies were included using MeSH keywords, encompassing randomized controlled trials (RCTs) and cohort studies.
Results: This review analyzed data from 13 studies conducted between 2019 and 2023, with diverse sample sizes and follow-up durations. A major RCT in 2019 involved 4,754 participants and a follow-up period of 12.4 years. All studies focused on stenotic-occlusive vascular lesions in peripheral lower limb and extracranial arteries. Surgical interventions included bypass surgery, endarterectomy, and endovascular stenting. Outcomes demonstrated high primary patency rates, improved ankle-brachial index (ABI), limb salvage, and enhanced functional results, such as increased walking distance and better quality of life. For instance, SUPERA stenting reported 100% primary patency at 12 months and a procedural success rate exceeding 98%. Complications, including infection, thrombosis, and bleeding, were noted but with low periprocedural mortality. Success rates depended on patient-specific factors and precise surgical planning. Additional follow-up revealed that long-term durability of surgical techniques varied across patient groups, emphasizing the importance of tailored management.
Conclusion: Surgical procedures, including bypass surgery, angioplasty, stenting, and endarterectomy, are highly effective for treating arterial occlusion or stenosis. These approaches significantly improve survival chances and functional outcomes while reducing risks when proper management is ensured. Advancing surgical techniques remains critical for enhancing vascular intervention success rates.
Type 2 diabetes (T2D) and hypertension are common health conditions that often occur together, suggesting shared biological mechanisms. To explore this relationship, we analysed large-scale multiomic data to uncover genetic factors underlying T2D and blood pressure (BP) comorbidity. We curated 1,304 independent single-nucleotide variants (SNVs) associated with T2D/BP, grouping them into five clusters related to metabolic syndrome, inverse T2D-BP risk, impaired pancreatic beta-cell function, higher adiposity, and vascular dysfunction . Colocalisation with tissue-specific gene expression highlighted significant enrichment in pathways related to thyroid function and fetal development. Partitioned polygenic scores (PGS) derived from these clusters improved risk prediction for T2D-hypertension comorbidity, identifying individuals with more than twice usual susceptibility. These results reveal complex genetic basis of shared T2D and BP mechanistic heterogeneity, enhancing comorbidity risk prediction. Partitioned PGSs offer promising approach for early risk stratification, personalised prevention, and improved management of these interconnected conditions, supporting precision medicine and public health initiatives.
Background: In recent years, dramatic political changes and the ensuing war in Ukraine have led to a
signifcant increase in the number of stress-related disorders, in particular among military personnel.
The study was designed to evaluate the prevalence and distribution of mental health disorders among
the Ukrainian military referred to inpatient assessment and treatment at a large military psychiatric
hospital located in Kyiv, Ukraine.
Methods: The study was a retrospective analysis of 9109 inpatient admissions to the psychiatric clinic
of national military medical clinical centre in Kyiv, Ukraine, between January 2014 and December
2018. Most of the patients were contracted military service ofcers, 2014-2018.
Results: The population sufered from a wide range of mental illnesses. Neurotic, stress-related, and
somatoform disorders were predominant among the ofcers, while psychotic disorders, personality
disorders, and mental retardation were prevalent among the conscripts. In 2016-2018, the nosological
structure of mental disorders remained stable with the highest prevalence of stress-related and
somatoform disorders, except a decrease in substance use disorders and an increase in psychotic
disorders. Among the outpatients discharged (n=128) in 2017-2018, the majority had sleep disturbances
and fashbacks (73%); anxiety and irritability (84%); and sufered from fatigue and low mood (80.9%).
The level of satisfaction with the social benefts and support from the authorities of the veterans was
extremely low (7.4%).
Conclusion: The study revealed the impact of war trauma on the mental health of the service
members, necessitating the development of specifc preventive measures and digital mental health
tools to support military personnel resource shortages and stigma.
Human autonomy in the field of healthcare as one of the fundamental principles in medical practice, the value of legal medicine and a tool for the formation of a human-centered healthcare system has been researched. Medical sorting and autonomy in decision-making have been considered, clinical and priority triage has been allocated, key principles of priority sorting have been proposed. It has been found out that the principle of autonomy in priority medical sorting is subject to significant restrictions, which negatively affect the observance of human rights in the field of healthcare. It has been noted that ensuring the individual mobility of persons with disabilities with the maximum possible degree of their autonomy, independence from outside assistance will guarantee the constitutional principle of equality of all people in their rights and freedoms.
The spectrum of definitions of the notion “medical tourism” has been outlined based on the results of the original review, and the authors’ vision of the said definition has been proposed. The WMA Statement on Medical Tourism has been analyzed and general principles for the functioning of medical tourism have been identified. The basic provisions for patients receiving services in the field of medical tourism and physicians involved therein have been crystallized on the basis of the said Statement. The experience of foreign countries in which the outlined sphere of tourism is actively developing, and which have the recognition of quality by WHO, has been covered. Authors’ axioms for the development of medical tourism, which can be useful for any country that is willing to build legal medical tourism, have been proposed.