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Документ Formation of clinical reasoning for quality improvement in medical education(East European Institute of Psychology, 2016) Skrypnyk, Igor; Gopko, Oleksandr; Maslova, Ganna; Prykhodko, Nataliia; Скрипник, Ігор Миколайович; Гопко, Олександр Феліксович; Маслова, Ганна Сергіївна; Приходько, Наталія ПетрівнаFor successful implementation of the National Health Reform strategy problems of higher medical education in Ukraine should be solved. The problem of clinical reasoning is a cornerstone of competence in current medical education. The best methods for teaching and evaluating clinical reasoning skills among medical students have not yet been elucidated. The introduction of the test assessment system requires professional knowledge combined with increasing practical and theoretical training of medical students. It accomplishes through the introduction of role-playing games, improving material, technical base and means of distance education.Документ JAK2-positive acute myeloid leukemia de novo or secondary transformed from myeloproliferative neoplasm? Case report(Lithuanian Society of Hematology, 2024-05-24) Skrypnyk, Igor; Maslova, Ganna; Lymanets, Tetiana; Gusachenko, Iuliia; Скрипник, Ігор Миколайович; Маслова, Ганна Сергіївна; Лиманець, Тетяна Володимирівна; Гусаченко, Юлія ОлександрівнаIntroduction and Aim. JAK2 V617F mutation is typically found in Ph-negative myeloproliferative neoplasms. This molecular abnormality very rarely occurs in de novo acute myeloid leukemia (AML). Data on the effective treatment of AML with JAK 2 mutation are limited. Our case report presents the results of successful patient’s management with JAK2-positive AML, treated by azacitidine and ruxolitinib combination. Case Report A 65-year-old man presented to the hematology department in October 2021 with complains of discomfort in the right half of the body, the presence of a dense formation (intermuscular hemorrhage) on the back on the right, general weakness, shortness of breath, fatigue. From anamnesis it is known that symptoms developed rapidly during the previous week. Anamnesis vitae: in 2012 patient underwent complex treatment of Ca pulm. sinistra T2aN0M0, gr. IB, clinical group ІІ. Physical examination revealed large intermuscular hematoma of the back on the right, blood imbibition of soft tissues from the neck to the lower back. The computed tomography showed massive hemorrhagic infiltration of the trunk muscles on the right, infiltration of the upper mediastinum, mediastinum shifted to the left (after operative treatment in 2012), splenomegaly 74×125×155 mm. In hemogram: erythrocytes (RBC) 5.1×1012/L, hemoglobin (HGB) 89 g/L, platelets (PLT) 999×109/L, leukocytes (WBC) 32.2×109/L, blast cells 5%, monocytes 39%. In myelogram: bone marrow hypercellular, polymorphic, infiltrated with blast cells 36.8%, some of which contained Auer's rods; the erythron was hyperplastic, without rejuvenation, with signs of dyserythropoiesis; the granulocytic line narrowed, with a predominance of mature forms of granulocytes; the megakaryocytic line with reactive changes. Bone marrow flow cytometry revealed signs of pronounced clonal proliferation of blast cells of myeloid origin (makes up to 34% of all nuclear cells in the sample): 1st clone up to 18%, with phenotype: CD34+19- 117+38(dim)+10-36-14-HLA-DR-; 2nd clone up to 16%, with the phenotype: CD34- 19-117-38+10-36+14+HLA-DR(dim)+/-11c+11b+3-4+/-56-. Molecular-genetic tests: FISH BCR/ABL1; FLT3 ITD; Inv(16)(p13q22) were not detected. Karyotyping: cytogenetically normal male karyotype was revealed 46,XY [20]. These changes corresponded with AML (М4).Документ Oxidative stress potentiates the disorders of L-arginine citrulline cycle in patients with progression of multiple myeloma(Lithuanian Society of Hematology, 2024-05-24) Ostrovskyi, Vladyslav; Skrypnyk, Igor; Maslova, Ganna; Островський, Владислав Леонідович; Скрипник, Ігор Миколайович; Маслова, Ганна СергіївнаBackground and Objectives. The progression of multiple myeloma (MM) is characterized by the accumulation of reactive oxygen species, which is represented by the activation of macrophages and follows the hyperproduction of inducible nitric oxide synthase. That leads to the development of endothelial dysfunction. Material and Method The study examined 20 patients with MM progression who were treated in the hematology department of the Poltava Regional Clinical Hospital named after M.V. Sklifosovsky from 2021 to 2023. The ratio of men to women was 12(60%)/8(40%), the average age of the subjects was 5.5±8.8 years. The study included patients whose general condition according to ECOG corresponded to I-II. There are two groups: І (n=20) – patients with MM progression and II (n=20) control-group consisting of practically healthy individuals with an average age of 25±1.6 years. The concentrations of L arginine, citrulline, thiobarbituric acid reactive substances (TBARS), arginase, and catalase activity were measured in blood serum. The statistical processing of the results was performed.Документ VRd Regimen for Treatment of Vertebral Plasmacytoma with Spinal Cord Compression(Lithuanian Society of Hematology, 2022-05-26) Skrypnyk, Igor; Maslova, Ganna; Gusachenko, Luliia; Lymanets, Tetiana; Скрипник, Ігор Миколайович; Маслова, Ганна Сергіївна; Гусаченко, Юлія Олександрівна; Лиманець, Тетяна ВолодимирівнаCase report Our case report involves a patient born in 1971, with light Kappa chains Multiple myeloma stage III A (Durie, Salmon), with bone lesions of the skull, ribs, spine (wedge-shaped vertebrae deformation C6, Th3, 5, 7, 8, 9), pelvic bones, femurs, vertebral plasmacytoma at the level of Th5-Th7 with secondary acute spinal cord compression, ischemic myeloneuropathy and senestopathic syndrome. In August 2020 she was hospitalized to the hematology department of PE "Poltava Regional Clinical Hospital n.a. M.V. Sklifosovsky PCR" with complaints of pronounce sensitivity decrease, paresthesia in the lower extremities, gait disorders, loss of pelvic functions control.