Differential diagnosis of patients with angina can be challenging. It is difficult to ascertain the presence of angina pectoris in a middle-aged woman, and a primary diagnosis of coronary heart disease is rarely considered. The purpose of the work is to discuss another cause of myocardial infarction in a patient without atherosclerosis of the coronary arteries.

Introduction. Community-acquired pneumonia (CAP) is a disease associated with a high risk of complications and mortality, which depends on various risk factors. Smoking is one such factor that contributes to an unfavorable prognosis
in various conditions.
Objectives. This study aimed to assess the impact of smoking status on the course of CAP and to explore the relationship between smoking, pneumonia severity, and lipid metabolism. A total of 255 patients with CAP were included and divided into two groups: those with moderately severe pneumonia (119 patients) and those with severe pneumonia (136 patients). Among the examined patients, men predominated, and the vast majority were young. The most common complications included pleurisy, myocarditis, and renal dysfunction.
Results. The incidence of complications and severe clinical course of CAP was similar in smokers and non-smokers. However, decreased body mass index (BMI) was slightly more common in smokers. Notably, low body mass was twice as frequent among smokers with severe pneumonia compared to non-smokers with severe disease. Systolic and diastolic blood pressure values were significantly lower in smokers. The number of peripheral blood leukocytes was significantly higher in smokers. C-reactive protein (CRP) levels were elevated in both groups. While the average fibrinogen levels did not differ significantly between groups, hyperfibrinogenemia (>10 g/L) was more common in smokers with severe pneumonia. Cholesterol levels were significantly lower in smokers, especially in those with severe CAP.
Conclusions. The observed association between smoking and reduced cholesterol levels highlights a potential impact of smoking on lipid metabolism. Smoking cessation may improve lipid profiles and reduce the risk of severe complications in pneumonia and other diseases.
Keywords: community-acquired pneumonia, smoking, lipids, lipid metabolism, complications.

УДК: 616. 832-004.2-036.864-06:616.833:616.831-073.8]-053.2

Розсіяний склероз (РС) із початком у дитячому віці є рідкісною, але суттєвою загрозою для здоров’я дітей. Він має специфічні клінічні та патофізіологічні особливості як порівняти із початком у дорослому віці. Якість життя (ЯЖ) є ключовим індикатором загального благополуччя хворих на РС дітей, проте її взаємозв’язок з об’єктивними нейробіологічними маркерами, як-от об’єм структур головного мозку, залишається недостатньо вивченим у педіатричній популяції. Метою цього дослідження було визначення кореляційних зв’язків між показниками волюметрії головного мозку та індексами ЯЖ, оціненими за опитувальником PEDSQL 4.0, у когорті дітей із РС. Дослідження охопило 39 хворих на РС дітей. Для аналізу зв’язків між суб’єктивною оцінкою ЯЖ та об’єктивними МРТ‐даними використаний коефіцієнт кореляції Спірмена (R).
Встановлено значущі кореляції між ЯЖ за самооцінкою дітей та об’ємами основних структур головного мозку. Зокрема, виявлено сильний прямий зв’язок з волюметрією таламуса (до R = 0,55). Оцінки ЯЖ за опитувальниками, надані батьками (проксі-оцінка), не виявили значущих кореляційних зв’язків з жодним із волюметричних показників. Ці результати підкреслюють важливість волюметрії таламуса як потенційного морфометричного біомаркера прогресування хвороби, який корелює із суб’єктивним сприйняттям пацієнтом з POMS свого стану. Незважаючи на виявлену розбіжність між самооцінкою дітей та оцінкою батьків, ми дотримуємося думки про важливість інтеграції обох точок зору, щоб забезпечити всебічну оцінку стану дитини в клінічній практиці та подальших дослідженнях.

Pediatric-onset multiple sclerosis (POMS) is a rare but significant neurological condition that poses a considerable threat to children’s health. Compared to adult-onset multiple sclerosis (AOMS), POMS is characterized by distinct clinical and pathophysiological features. Quality of life (QoL) is a crucial indicator of overall well-being in children with MS; however, its relationship with objective neurobiological markers — such as brain volumetric parameters — remains insufficiently explored in the pediatric population. This study aimed to examine the correlations between brain volumetric indices and QoL scores, as assessed by the PedsQL 4.0 questionnaire, in a cohort of children diagnosed with MS. The study included 39 pediatric MS patients. Spearman’s rank correlation coefficient (R)
was used to analyze the associations between subjective QoL assessments and objective MRI‐derived brain volumetric data. Significant correlations were observed between self-reported QoL scores and the volumes
of key brain structures. Notably, a strong positive correlation was found with thalamic volume (up to R = 0.55). In contrast, proxy-reported QoL scores provided by parents showed no significant correlations with any of the examined volumetric parameters. These findings highlight the potential role of thalamic volumetry as a morphometric biomarker of disease progression that aligns with the patient’s subjective experience of their condition. Despite the discrepancy between child and parent reports, we emphasize the importance of integrating both perspectives to ensure a comprehensive assessment of the patient’s status in clinical practice and future research.

Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disorder with left ventricular (LV) wall hypertrophy which is not caused by abnormal loading conditions [1]. The clinical course of HCM is complicated with diastolic dysfunction, arrhythmic disorders, sudden cardiac death (SCD), and stroke. At the late stage of HCM patients present with systolic heart failure (HF), probably caused by myocardial fibrosis. Recently the risk
factors of SCD were extensively studied in patients with HCM and a great progress has been done in this field. We have newly proposed risk factors including late gadolinium enhancement (LGE) percentage by magnetic resonance imaging (MRI), apical aneurysm, and high-risk genetic mutations. The mortality from SCD in HCM decreased thanks to the improved risk assessment and increased number of implanted cardioverters defibrillators
(ICD). However, the problem of HF in HCM patients is not resolved. Progress is achieved in patients with LVOT obstruction due to the surgical septal reduction together with procedures on mitral valve apparatus. Of note, a decrease in LVOT gradient does not exactly mean prevention of myocardial fibrosis. In some patients with nonobstructive form of HCM, we can see a large amount of intramyocardial fibrosis which increases heart muscle
stiffness and leads to diastolic and finally systolic HF [2]. An early detection of subclinical myocardial impairment is needed to predict which patients are more prone to transition to overt HF. In this context, it is essential to assess the role of the comorbidity such as diabetes mellitus (DM) increasingly reported in HCM and to evaluate its effect on myocardial mechanics. To address the question, Badran et al. presented in the recent issue of Echocardiography [3] a report on the impact of DM on prognosis and myocardial function in patients with HCM.

Abstract
Objective: Congenital absence of the pericardium (CAP) is a rare heart disorder, frequently misdiagnosed due to an
unspecific clinical picture and leading to diagnostic challenges. The purpose of this case presentation is to show how
cardiac imaging methods can aid in accurate diagnosis of CAP.
Case presentation: A case of the complete congenital absence of the pericardium in a 40-year-old man with
complaints on dyspnea and fatigue is presented. Echocardiography revealed a dilated right ventricle with good
contractility; normal dimensions and function of the left ventricle, and normal heart valve function. Pulmonary
hypertension and atrial septal defect were excluded during echocardiography. Computed tomography revealed
abnormal heart axis rotation leftward and posteriorly, raising suspicion of CAP. The diagnosis was confirmed by
cardiac magnetic resonance imaging . The diagnostic flowchart for the CAP is discussed.
Conclusion: Multimodality cardiac imaging provides clues to the diagnosis of CAP.