Testicular cancer is the most common malignancy in young men, with early and accurate diagnosis being critical for effective management and prognosis. Traditionally, the diagnostic approach relies on scrotal ultrasound and serum tumor markers, which, while effective, have limitations in characterizing complex lesions and detecting small, non- palpable tumors or metastatic disease. Recent advancements in imaging technology have introduced multiparametric MRI (mpMRI) as a promising tool in the diagnostic armamentarium for testicular cancer. MpMRI combines multiple imaging sequences, including T2-weighted imaging, diffusion-weighted imaging (DWI), and dynamic contrast- enhanced MRI (DCE-MRI), providing detailed anatomical and functional information about testicular lesions. This systematic review consolidates and evaluates current evidence regarding the role of mpMRI in the diagnosis, staging, and follow-up of testicular cancer. 
Key findings from the literature suggest that mpMRI offers superior sensitivity and specificity compared to conventional imaging techniques, particularly in distinguishing between benign and malignant lesions. It is also highly effective in the precise localization and staging of tumors, including the detection of small lymph node metastases, which are often missed by ultrasound or CT. This review highlights the potential of mpMRI to enhance diagnostic precision and influence treatment strategies in testicular cancer, while also identifying areas for further research, such as the optimization of imaging protocols and the assessment of mpMRI's impact on long-term clinical outcomes. The review underscores the importance of mpMRI as a non-invasive, highly informative imaging modality that could lead to more personalized and effective management of testicular cancer. 

Abstract

Androgen deprivation therapy (ADT) remains a cornerstone in the treatment of prostate cancer, but patient responses vary significantly. 
This systematic review evaluates the role and application of genomic and transcriptomic markers in assessing ADT efficacy and resistance. 
We analyzed 40 studies focusing on key markers such as AR-V7, TMPRSS2-ERG, RNA expression profiles, and the 23-gene signature. 
Our findings highlight the potential of these markers to personalize ADT, improve patient stratification, and guide treatment decisions. 
Despite promising results, challenges remain in standardization, cost, and clinical integration. 
Corresponding author. Mytsyk Yulian, Regional Specialist Hospital, Wroclaw, Poland, mytsyk.yulian@gmail.com 

UDC 577.151.042:616.72-002.772:616.72-007.274

Summary
Introduction. Identification of microorganisms that colonize combat wounds and cause wound infection is of primary importance for the subsequent successful treatment of the patient. The resistance of microorganisms to antimicrobial drugs makes the efforts of modern medicine in the fight against infectious agents ineffective. The problem of infertility is closely related to combat injuries, their infection, stress, and neurotic disorders.
Aim. Obtaining and summarizing data on microbial colonization of mine-blast wounds of pelvic organs and the microbiome of the genitourinary system of combatants.
Materials and methods. 84 smears were taken from 56 wounds of 36 patients with injuries of the pelvic organs who were being treated. 73 patients with injuries were examined for the presence of mycoflora in the urogenital tract. Isolation of pure bacterial cultures was carried out by inoculating the studied material using meat-peptone agar, blood agar, chromogenic agars. For the diagnosis of urogenital or other infections by the PCR method, a scraping from the back wall of the urethra was taken from the patients.
Results. Predominant microorganisms in positive cultures of smears were non-fermenting gram- negative rods, which in 28 % of cultures belonged to the genus Acinetobacter, in 26 % to the genus Pseudomonas. As for associated infections, 20 % of them consisted of the genus Acinetobacter, 32 % – Enterobacter, 4 % – Klebsiella and 29 % – Pseudomonas. Gram-positive cocci were isolated in 37 % of positive smear cultures. The frequency of isolation of the genus Streptococcus in monoinfection was 2.5 %, followed by the genus Clostridium – 2 %, Bacillus – 3 %, Enterococcus – 4 % and Actynomycceas – 4 %. In associated infections, the frequency of isolation of the genus Streptococcus was 4 %, followed by the genus Clostridium – 2 %, Bacillus – 4 %, Enterococcus – 3 % and Actynomycceas – 5 %. When analyzing the microflora of the genitourinary system, it was found that the priority role belongs to the combined infection, when there are associations of specific pathogens such as Ureaplasma spp., Mycoplasma spp., Chlamidia spp., Neisseria gonorrhoeae, Trichomonas vaginalis, Streptococcus spp., Enterococcus faecalis, which is 80 % of the entire microbiome.
Conclusions. Acinetobacter baumanii and Klebsiella pneumoniae are the dominant microflora complicating the course of combat wounds during almost two years of Russia’s full-scale war against Ukraine. Probably, the duration of hostilities, the large number of wounded, and the forced mass unsystematic use of various antibiotics lead to rapid changes in the spectrum of pathogens of combat wounds. Combat wounds and their infection, stress, and nervous disorders lead to an imbalance of microflora, in particular microflora of the genitourinary system, which can be one of the causes of infertility. Chlamydia and Ureaplasma are the most common microorganisms that colonize the urogenital tract of men injured as a result of hostilities.
Keywords: sombat wound, microbial flora, genitourinary system, infertility

 616.69-008.6(079.5)

Сучасне наукове розуміння еректильної дисфункції вказує на переважну вторинність сексуальних розладів стосовно захворювань, що їх спричиняють. Це значною мірою стосується чоловіків, постраждалих внаслідок бойових дій. Основою роботи стали результати анкетування 298 чоловіків, постраждалих внаслідок бойових дій (осколкові та кульові поранення) з використанням анкет Міжнародного індексу еректильної функції-5 (МІЕФ-5). Дослідна група була розділена на дві: чоловіки віком 20–39 років (група 1) і чоловіки віком 40–53 роки (група 2). До контрольної групи увійшли 48 практично здорових чоловіків без скарг на сексуальну дисфункцію чи кардіологічну, неврологічну або ж ендокринологічну патологію. Серед чоловіків контрольної групи – 30 чоловіків віком 20–39 років (група 3) і 18 чоловіків віком 40–60 років (група 4). Показано, що у 196 чоловіків 1-ї групи віком 20–39 років спостерігається легка форма ЕД – сумарний бал – 19,57 ± 0,44. У 102 чоловіків 2-ї групи віком 40–53 роки теж наявна легка форма ЕД, однак сумарний бал значно нижчий – 17,94 ± 0,41. Показники окремих 5 компонентів статевої функції чоловіків і шкала твердості ерекції також були нижчими в пацієнтів 2-ї групи. Найбільш показово знижується домен ЕД-МІЕФ-5 зі ступенем тяжкості ЕД. Усі домени МІЕФ достовірно знижуються при ЕД порівняно зі здоровою групою респондентів, проте диференціація за тяжкістю ЕД відсутня. Тобто, при ЕД будь-якої вираженості одночасно страждають всі інші сексуальні функції – сексуальне бажання, впевненість в ерекції, твердість та підтримання ерекції, задоволення від статевого акту та статевого життя.

The development of oxidative and nitrative stress and the processes of free radical oxidation are associated with many pathological processes. Damage of any origin leads to the activation of free radical processes not only in the place of damage, but also in the whole organism. The aim of the study is to assess the state of lipid peroxidation, content of GSH and GSSG and the activity of NO-synthase and arginase in lymphocytes and peripheral blood serum in men with erectile dysfunction due to combat trauma. The research was conducted on peripheral blood lymphocytes of men injured as a result of combat operations (shrapnel and bullet wounds) in the Russian-Ukrainian war, and who were treated at the Military Medical Clinical Center of the Western Region (Lviv, Ukraine). The research group of men with combat injuries was divided into two age groups: men aged 20–39 years and men aged 40–53 years. The MDA content in the blood serum of patients of both age groups was 1.35 times higher than in the control group. In peripheral blood lymphocytes, the MDA content in patients of the young age group was 1.27, and in patients of the middle age group in 1.39 times higher than in the control group. Simultaneously, no significant changes in the concentration of oxidized glutathione in blood serum and blood lymphocytes were found between men with erectile dysfunction due to combat trauma and healthy men. GSH content in blood serum in patients of both age groups was significantly lower than in the control group. The arginase/NOS ratio in blood serum was 9.75 times lower in the young age group and in 20.45 times lower in the middle age group compared to healthy men. It was established that in the blood serum and blood lymphocytes of men with erectile dysfunction due to combat trauma, processes of lipid peroxidation were intensified and the GSH level was reduced. The GSH/GSSG ratio was reduced only in blood serum. It was found that the oxidative stress is associated with development of nitrative stress. The arginase/NOS ratio was shifted towards increased NOS activity. Activation of iNOS was accompanied by significant inhibition of cNOS. Further study of biochemical mechanisms is important to understand the triggers of erectile dysfunction due to combat
trauma.
Keywords: trauma; erectile dysfunction;MDA content; glutathione;NO-synthase; arginase.