685.34.042:612.014.46:547.962.3:616-001:54.024

The combined use of cellular, extracellular research methods for studying the toxic effect of shoe glues is an additional tool for screening and assessing the potential risks of their use. The aim of the work was to investigate the mechanisms of the toxic effect of shoe glues at the cellular, molecular and biochemical levels. Rubber, polychloroprene and polyurethane shoe glues were used. Three experimental approaches were applied: measurement of survival of mam­malian cells, a spectroscopic study of conformational changes of albumin, and a free radical measurement. Cytotoxicity testing was performed on murine fibroblasts Balb/c-3T3 line, human embryonic kidney cells HEK-293 and human keratinocytes of the HaCaT line treated for 24 and 72 hours with glues samples. A survival of treated cells was monitored using MTT-test. Changes in the spectral characteristics of albumin were monitored during exposure for 24 hours and 21 days with "fresh" and "dried" samples of glues. Content of free radicals was evaluated in the reaction with DPPH reagent. The cytotoxicity was increased with increasing exposure time, and depended on both the type of glue and the type of treated cells. The polyurethane glue demonstrated the most pronounced cytotoxic effect. Balb/c-3T3 fibroblasts were the most sensitive to the action of all types of glues, a reliable maximum increase in cell death was manifested in 72 hours exposure (28.9-19.1% of living cells).While cells of HEK-293 and НаСаТ lines were more resistant. At 24 hours contact, their viability was 99.12-79.22% and 99.0-56.9%, respectively. Increased exposure up to 72 hours reliably caused a decrease in the survival of these cell lines – 96.24-68.1% and 82.2-51.7%. The loss of the solvent didn’t affect the cytotoxic effect of the studied glues. Conformation changes in albumin were manifested during its long-term contact with both "fresh" and "dried" glues. Manifestations of the toxic effect of glues on biomolecules were increased in the sequence: rubber > polyurethane > polychloroprene. Shoe glues demonstrated an ability to generate free radicals in the sequence: rubber > polychloroprene > polyurethane. These manifestations were increased in a time period of 4 hours – 24 hours. That may create risks when they are used. The results can be used to determine the targets and mechanisms of the toxic effect of shoe glues and to obtain new knowledge in the field of research of industrial toxicants.

Massive bleeding remains one of the leading causes of death among military personnel in armed conflicts, which leads to a constant need to improve the means of temporary bleeding control. The combat application tourniquet continues to be the standard in tactical medicine due to its proven clinical effectiveness, high speed of application and reliability during hostilities. Its use significantly reduces mortality in injuries with critical bleeding from the extremities, especially at the pre-hospital stage of medical care. The purpose was to analyze the impact of using tourniquets by military personnel in cases of massive/critical bleedings, traumatic amputations of limbs, and to assess the timeliness of the conversion in the world and in Ukraine. Particular attention is paid to the rationale for the expediency and inexpediency of using tourniquets, the duration of application, as well as the study of possible complications associated with their excessive or untimely use during intense hostilities and delays in evacuating the wounded. Materials and methods. The work was carried out through a systematic review, meta-analysis, content analysis of articles in the scientometric databases Scopus, PubMed, ResearchGate. The literature search was carried out using the following keywords: “tourniquet”, “stop the bleeding”. The study included descriptions of clinical cases of applying tourniquets by the servicemen of the Armed Forces of Ukraine, retrospective analyses and literature reviews. After reviewing the articles and reading their full texts, 8 sources were selected. The search covered the period from 2012 to 2025. The study was conducted based on one surgical hospital (Role 2) in April-May 2024 and April-May 2025. The use of means to temporary stop critical bleeding, its appropriateness, duration and risks of complications were analyzed in 135 servicemen who were in the combat zone. Results and conclusions. The duration of hemostasis in most cases (60.0 in 2025 %, an increase by 10 % vs. 2024) exceeds 2 hours, and the duration of tourniquet use exceeding 3 hours (compared to 2024, the frequency has increased by 5.0 % in 2025) indicates a prolonged evacuation of the wounded as a result of intense hostilities, which, in turn, increases the risk of ischemic complications and requires careful clinical monitoring. In 70.0 % of cases, one tourniquet is enough to stop the bleeding, while in 30.0 %, two or more tourniquets are required, which indicates the more severe nature of the wounds caused by the modernization and increased destructive power of modern weapons. Ischemic complications are recorded in almost half of the cases, the main reason for which is the prolonged application of a tourniquet.