Armed conflicts have detrimental effects on family life of (grand)mothers and children. Two years after the Russian fullscale military invasion in 2022, we measured with an online survey burnout and medicine use of (grand)mothers (N=415) in four types of families in Ukraine. Burnout was defined as exhaustion in the parental role, emotional distancing from the children, and feeling ineffective. The overall parenting burnout prevalence in Ukraine of 58% was substantially larger than burnout prevalences before the 2022 Russian invasion (11%) or worldwide (3%). Burnout was highest in grandmother-led households (70%). Higher parental burnout was related to more harsh parenting and mood-regulating medicine use signaling an acute need for policies for supporting families with
young children in war-stricken Ukraine.

Aim. Nitric oxide (NO) and the variants of the endothelial nitric oxide synthase gene (NOS3) in multiple sclerosis (MS) have become a focus of active scientific interest in recent years. The NOS3 gene is constitutively expressed in neuronal and epithelial cells. Moreover, the endothelial NO synthase enzyme (eNOS) activity, which plays a pivotal role in developing endothelial dysfunction, is regulated by variants of the NOS3 gene, including the 4a/b variant.
Objective. To evaluate the influence of the 4a/b variant of the NOS3 gene on the susceptibility to and progression of multiple sclerosis.
Materials and Methods. The study included 113 patients diagnosed with MS. Genotyping for the 4a/b variant of the NOS3 gene was performed using the polymerase chain reaction method.
Results. Our findings indicate that the presence of the 4bb genotype is associated with a reduced risk of developing MS, whereas the 4a allele of the NOS3 gene is linked to an increased risk. Clinical characteristic analysis revealed that patients with the 4ba and 4bb genotypes exhibited a significantly higher body mass index
(BMI) (p=0.007) than those with the 4aa genotype. Additionally, patients with the 4bb genotype were substantially more likely to experience a severe disease course (p=0.0489). Binary logistic regression analysis identified a gene-environment interaction between the NOS3 4a/b variant and BMI (p=0.037), suggesting a combined effect of these factors on MS progression.
Conclusions. The results underscore the significant and complex role of the NOS3 4a/b variant in the pathogenesis and progression of MS. Further investigation is warranted to deepen our understanding of the mechanisms underlying this genetic factor and its interplay with other contributing variables.
Keywords: multiple sclerosis, NOS3, 4a/b variant, genotype frequency, body mass
index, EDSS

SARS-COV-2 – нейротропний вірус, здатний у майбутньому спровокувати масштабний спалах неврологічних ускладнень. Вірусу SARS-COV-2 притаманні нейроінвазивні та нейротропні властивості, які дають йому змогу проникати в центральну нервову систему (ЦНС) й інфікувати нейрони, накопичуватись у нервовій тканині, сприяти розвитку уповільнених нейродегенеративних процесів. Серед неврологічних ускладнень SARS-CoV-2 сьогодні виділяють групу демієлінізуючих уражень ЦНС. Описано два клінічні випадки важкої форми COVID-19, які супроводжувалися неврологічними порушеннями та мультифокальним ураженням білої речовини на МРТ, що може відповідати демієлінізуючому захворюванню ЦНС. Обидва випадки можуть бути проявом гострого інфекційного демієлінізуючого процесу, який пов’язаний із захворюванням на COVID-19, оскільки клінічна картина була відповідною, а нейровізуалізація виявила мультифокальні ураження білої речовини. Іншими клінічними ознаками, що підтверджують цей діагноз, стали попередньо підтверджена гостра вірусна COVID-19 інфекція та відсутність в анамнезі демієлінізуючих захворювань, таких як розсіяний склероз, у обох пацієнтів. Спостереження за такими пацієнтами може допомогти ліпше зрозуміти та виявити фактори розвитку захворювання на ранніх стадіях і визначити предиктори його прогресування. У подальшому, це також дасть змогу розробити ефективні стратегії лікування та можливість знизити ризик розвитку демієлінізуючого процесу або його прогресування під час інфекції SARS-CoV-2.

SARS-COV-2 is a neurotropic virus that can trigger a large-scale outbreak of neurological complications in the future. SARS-COV-2 virus has neuroinvasive and neurotropic properties allow it to enter the central nervous system (CNS) and infect neurons, accumulate in nervous tissue and promote the development of delayed neurodegenerative processes. Among the neurological complications of SARS-CoV-2 to date, we can distinguish a group of demyelinating lesions of the CNS. The paper describes two cases of severe COVID-19, which were accompanied by neurological disorders and multifocal white matter lesions on MRI, which may correspond to demyelinating CNS disease. Both cases may be a manifestation of an acute infectious demyelinating process associated with COVID-19, as the clinical picture was appropriate, and neuroimaging showed multifocal lesions of the white matter. Other clinical signs confi rming this diagnosis were previously confi rmed acute viral COVID-19 infection and the absence of a history of demyelinating diseases such as multiple sclerosis in both patients. Monitoring such patients can help to understand better and identify factors in the early stages of the disease and to predict its progression. In the future, it will also allow the development of eff ective treatment strategies and the ability to reduce the risk of demyelinating process or its progression during SARS-CoV-2 infection.