UDC  618.03-06:616.441-002-073.7:612.882.3

Background. Maternal thyroid dysfunction, including euthyroid goiter and subclinical hypothyroidism, is associated with complications of pregnancy mediated through placental insufficiency. Alterations in placental structure and uteroplacental and fetoplacental hemodynamics represent a possible mechanism linking thyroid disease to adverse perinatal outcomes.

Summary of work. A total of 164 pregnant women were examined by ultrasound placentography and Doppler mapping of the mother–placenta–fetus system. Group I included women with euthyroid goiter, Group II — with subclinical hypothyroidism and diffuse goiter, Group III — controls without thyroid disease. Placental maturation, localization and pathology were assessed, together with uterine and umbilical artery S/D ratios, uterine artery resistance index, and pulsatile index in the fetal aorta and middle cerebral artery.

Summary of Results. Structural placental abnormalities and discordant maturation occurred in nearly half of women with thyroid disease but were absent in controls. Premature maturation predominated in euthyroidism, while delayed maturation predominated in subclinical hypothyroidism. Doppler assessment revealed increased resistance and S/D ratios in the uterine arteries in both thyroid-disease groups, especially in subclinical hypothyroidism and on the placentation side. Peripheral placental resistance increased with gestation. Cerebral fetal indices remained largely compensated.

Discussion and Conclusion. Maternal thyroid dysfunction is associated with a high frequency of placental structural changes and impaired uterine perfusion. These hemodynamic changes likely reflect trophoblastic invasion defects and microvascular dystrophy in thyroid disease. Doppler findings enable early identification of placental insufficiency and inform preventive perinatal strategies in this at-risk population.

Take-home Messages. Thyroid disease in pregnancy is strongly associated with placental structural and hemodynamic abnormalities.

Subclinical hypothyroidism shows clinically significant Doppler impairment.

Doppler surveillance allows early prediction of placental insufficiency in thyroid-affected pregnancies.

Chest injury in military personnel is one of the most common combat injuries among military personnel. This is the result of explosive waves, falls, contusion or compression with heavy objects withoutpenetration into the chest cavity. The most typical clinical manifestations include the contusion of the chest wall, fractures of the ribs, lung damage, ventilation disorders and respiratory failure. These conditions canlead to a decrease in physical activity, impaired respiratory function and reduce the quality of life in the affected persons. The aim is to analyze current scientific evidence and clinical guidelines regarding physical therapy for military personnel after blast-related thoracic trauma. Materials and methods. Storing,analysis and systematization of scientific literature published between 2019 and 2024 based on search inPubMed, Scopus and Web of Science Databases. Results. Clinical recommendations, protocols, systematic examinations and results of original physical therapy studies after a blast-related thoracic trauma of chest in military personnel illuminate the need to supplement traditional methods of physical therapy such as early mobilization, breathing gymnastics, posture drainage daily activities. Individualized physical therapyprograms are developed and implemented to address the specific needs of patients during the pre-operative,in-hospital, and post-hospital periods, focusing on the prevention of long-term complications. This systematic approach effectively contributes to the restoration of respiratory function, improved physical capacity,and reduced risk of complications.Conclusions. Physical therapy – including breathing exercises, positional treatment, occupational therapy and motor rehabilitation – is a key component in the recovery process after breastfeeding. Despite itsprevalence, the rehabilitation management of the military after breast trauma remains a lot of investigated,especially in the context of constant military conflict.

Introduction Stress urinary incontinence (SUI) is a common complication following radical prostatectomy, affecting up to 60.0% of men. The artificial urinary sphincter (AUS) has been the gold standard for treating severe SUI since its introduction in 1973. Despite its efficacy, long-term complications such
as device failure and recurrent incontinence are relatively common, often necessitating revision surgeries. This review focuses on cuff downsizing as a revision strategy for non-mechanical AUS failure.
Material and methods A literature review was conducted using PubMed/Medline, covering studies published between January 2000 and December 2023. Key words included: “artificial urinary sphincter”, “cuff downsizing”, “urethral atrophy”, “non-mechanical failure” and "male urinary incontinence revision”.
Inclusion criteria were studies addressing cuff downsizing as a primary revision for non-mechanical failures. Only English-language studies were reviewed. We analyzed the timing of revisions, follow-up duration, and outcomes such as continence rates, complication rates, and device survival.
Results Six retrospective studies involving 206 patients were included in the present review. Cuff downsizing was performed as the sole intervention in 3 studies and in combination with other approaches in the remaining 3 studies. The median cuff size decreased from 4.5 cm preoperatively to 4.0 cm postoperatively, with 8.0–12.0% of patients receiving a cuff downsized by more than 1.0 cm. Across all studies, continence rates after revision surgery ranged from 52.0% to 90.0% based on patientreported outcome measures (PROMs). Device survival rates varied from 64.0% to 95.0%, with infection and urethral erosion being the leading causes of device explantation.
Conclusions Cuff downsizing is a reasonable revision strategy for non-mechanical AUS failure, offering similar continence outcomes and complication rates compared to alternative techniques.

Background Renal cell carcinoma (RCC) is a prevalent malignancy with highly variable outcomes. MicroRNA-15a
(miR-15a) has emerged as a promising prognostic biomarker in RCC, linked to angiogenesis, apoptosis, and proliferation.
Radiogenomics integrates radiological features with molecular data to non-invasively predict biomarkers, offering
valuable insights for precision medicine. This study aimed to develop a machine learning-assisted radiogenomic
model to predict miR-15a expression in RCC.
Methods A retrospective analysis was conducted on 64 RCC patients who underwent preoperative multiphase
contrast-enhanced CT or MRI. Radiological features, including tumor size, necrosis, and nodular enhancement, were
evaluated. MiR-15a expression was quantified using real-time qPCR from archived tissue samples. Polynomial regression
and Random Forest models were employed for prediction, and hierarchical clustering with K-means analysis
was used for phenotypic stratification. Statistical significance was assessed using non-parametric tests and machine
learning performance metrics.
Results Tumor size was the strongest radiological predictor of miR-15a expression (adjusted R2 = 0.8281, p < 0.001).
High miR-15a levels correlated with aggressive features, including necrosis and nodular enhancement (p < 0.05),
while lower levels were associated with cystic components and macroscopic fat. The Random Forest regression
model explained 65.8% of the variance in miR-15a expression ( R2 = 0.658). For classification, the Random Forest classifier
demonstrated exceptional performance, achieving an AUC of 1.0, a precision of 1.0, a recall of 0.9, and an F1-score
of 0.95. Hierarchical clustering effectively segregated tumors into aggressive and indolent phenotypes, consistent
with clinical expectations.
Conclusions Radiogenomic analysis using machine learning provides a robust, non-invasive approach to predicting
miR-15a expression, enabling enhanced tumor stratification and personalized RCC management. These findings
underscore the clinical utility of integrating radiological and molecular data, paving the way for broader adoption
of precision medicine in oncology.

УДК: 616.24056.306: 616.24002]07: 616.155.3097.3707]092.908

Метою роботи було вивчити характер змін рівня про та протизапальних цитокінів у сироватці крові морських свинок у різні терміни формування експериментального алергійного альвеоліту поєднаного з експериментальною пневмонією та оцінити ефективність впливу на них корвітину та L- аргініну за досліджуваної патології.
Матеріали і методи. Для дослідження були сформовані: контрольна група тварин, група тварин з експериментальним алергійним альвеолітом, асоційованим з пневмонією, група тварин, яким уводили корвітин та група тварин, яким уводили корвітин та L-аргінін. Досліди проводили на морських свинках (самцях), вагою 0,18 — 0,22 кг, з дотриманням вимог міжнародних біоетичних принципів. Модель експериментального алергійного альвеоліту та експериментальної пневмонії відтворювали за методом Регеди М.С. (2024). Визначення рівня FNP-a, інтерлейкіну — 6 та інтерлейкіну — 10 проводили на 7-му, 14-у та 21-у доби розвитку експерименту та на 21 добу в результаті корекції корвітином та корвітином і L- аргініном. Вміст цитокінів визначали за допомогою твердофазного імуноферментного аналізу (ELISA). При цьому використовували набір реактивів для кількісного імуноферментного аналізу вілповідного цитокіну виробництва ”Diaclone” (Франція).
Результати і обговорення. У результаті дослідження встановлено поступове і достовірне підвищення рівня FNP –a та інтерлейкіну — 6 (ІL-6) у сироватці крові морських свинок з експериментальним алергійним альвеолітом поєднаним з експериментальною пневмонією. Найвищий їх рівень був зафіксований на 21 добу експерименту порівняно з контрольною групою. У результаті лікування корвітином, та корвітином з L-аргініном, зафіксували достовірне зниження рівня вказаних цитокінів, особливо, під час поєднання двох засобів: корвітину та L-аргініну. Відповідно, рівень
інтерлейкіну — 10 (ІL-10) змінювався наступним чином: впродовж формування експерименту його концентрація достовірно знижувалася, з найнижчим показником на 21 добу. Уведення корвітину, а особливо корвітину з L% аргініном призвело до достовірного підвищеного рівня ІL-10, наближеного до показника інтактних тварин.