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.

UDC: 616.33/.342–002.446–018.73:612.32]–085.243]–037

Introduction. Evaluating acid-reducing medications through their effect on various gastric juice parameters in peptic ulcer patients provides deeper insight into the complex mechanism of gastric secretion, which includes acidity levels, pepsin, electrolytes, bicarbonates, and mucus.

The aim of the study. To determine the prognostic value of gastric secretion parameters and their constellations for predicting parietal cell response to submaximal pentagastrin stimulation and the blocking effect of famotidine in patients with gastric and duodenal peptic ulcer disease.

Materials and methods. The study included 40 randomized Helicobacter pylori-positive patients (28 women, 12 men, aged 18-68) with endoscopically confirmed duodenal ulcer disease in the acute phase. Modified fractional probing was used to assess changes in gastric secretion.

Results. H⁺ debit in basal secretion showed a significant direct correlation with multiple parameters. Different acid responses to stimulation were associated with specific baseline parameter constellations. Weak response to H₂-blocker was confirmed in patients with hyperacidity after stimulation, combined with elevated HCl and increased total acidity in basal secretion. A strong response to H₂-blocker was confirmed in several parameter constellations, with the best predictive constellation (p < 0.01) including elevated N-acetylneuraminic acid, normal K⁺, normal pepsin debit, normal pepsin, and elevated Na⁺ in basal secretion.

Conclusions. The prognostic value of gastric secretion parameters and their constellations allows tailoring blocker dosage: higher doses for patients predicted to have a weak response and lower doses for those predicted to have a strong response to stimulation.

Introduction
War is a relentless force that leaves no aspect of life untouched, weaving itself into the fabric of
daily existence and reshaping even the most intimate connections. This story, written from the
perspective of a mother, a wife, and a professional, seeks to capture the enduring effects of war
on relationships, identity, and resilience.
2021: Prelude
“Froggy, I’m thinking of getting an AR-15. I want to learn how to shoot.”
“I thought hunters knew how to shoot.”
“That’s different. I need to learn how to shoot in warfare.”
“Come on. They won’t dare.”
February 24th, 2022: The first day
The day began with a summons. My husband, part of the territorial defense forces, became a
company commander. I was left with our three children, glued to the news, unable to leave the
house.
The weight of resentment
During those first weeks, my emotions spiraled between resentment, anger and despair. The
injustice felt suffocating. My husband, a father of three, was not supposed to be sent to war. Why
him?The days were a blur of rage and survival. The uncertainty of his safety permeated every
waking thought.
A constant state of waiting
Every day began with checking his messages: “Good morning, everyone, everything’s fine.”
A short, reassuring phrase that became a lifeline. But the thoughts came anyway. What if he’s
injured? What if he loses a limb? His eyesight? His mind?
The first death
In autumn, the war claimed its first victim from his company. Standing at the military burial
field during the funeral, I couldn’t help but think: “I don’t want my husband to lie here. I want
my grave to be next to his.”
The burden of survival
In the winter his battalion was moved to Kreminna. The place used to be a nature reserve with
lush pines now all turned into charred stumps. My husband, always protective, shared little.
Desperation drove me to check his messages one day. What I found was a video of one of his
soldiers captured by the Russians, naming my husband among his commanding officers.
Eventually, he was demobilized after the remnants of his company were withdrawn from the
frontline. He returned home, miraculously with only two concussions.
Life after the frontline
Though physically unscathed, nothing is truly the same. He resumed the rhythms of family life,
attending school functions and teaching our son to ride a bike. I watched for signs of trauma, but
he remained the man I married–resilient and kind.
Yet, the shadow of war lingers. The awareness of how close we came to losing each other has
deepened our connection. Petty disagreements seem absurd now. But the memories of loss–of
others’ losses–are never far away.
Every time there’s a POW exchange I scan the list for that young soldier’s name, and it’s never
there.It’s been two years.
A fragile hope
On the morning of my son’s seventh birthday, drones and missiles attacked our city. As we
rushed to the basement, my husband, unbelievably, counted the explosions.
“Is it like this on the frontline?”
“No, Froggy. It’s much worse.”
Conclusion
This story has no ending. It is one of countless others–stories of bravery, grief, resilience, and
loss. Stories that must be told again and again, in the hope that by bearing witness, we can create
change.

Наукові дослідження кафедри загальної гігієни з екологією Львівського національного медичного університету імені Данила Галицького охоплюють широкий спектр гігієнічних проблем на кожному етапі її існування. Напрацювання упроваджені у практичну діяльність закладів охорони здоровʼя і профілактичної медицини, навчальну роботу медичних закладів вищої освіти.

Scientific research of the Department of General Hygiene with Ecology of Danylo Halytsky Lviv National Medical University covers a wide range of hygienic problems at each stage of its existence. The developments are implemented in the practical activities of health care and preventive medicine institutions, educational work of medical institutions of higher education.