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Документ A phase IIa active-comparator-controlled study to evaluate the efficacy and safety of efinopegdutide in patients with non-alcoholic fatty liver disease(Elsevier, 2023-06-22) Romero-Gómez, Manuel; Lawitz, Eric; Shankar, R Ravi; Chaudhri, Eirum; LH Lam, Raymond; Skrypnyk, Igor; Bassan, Isaac; Скрипник, Ігор МиколайовичMethods: This was a phase IIa, randomized, active-comparator-controlled, parallel-group, open-label study. A magnetic resonance imaging-estimated proton density fat fraction assessment was performed to determine LFC at screening and Week 24. Participants with an LFC of >− 10% at screening were randomized 1:1 to efinopegdutide 10 mg or semaglutide 1 mg, both administered subcutaneously once weekly for 24 weeks. Participants were stratified according to the concurrent diagnosis of type 2 diabetes mellitus (T2DM). Both drugs were titrated to the target dose over an 8-week time period. The primary efficacy endpoint was relative reduction from baseline in LFC (%) after 24 weeks of treatment. Results: Among 145 randomized participants (efinopegdutide n = 72, semaglutide n = 73), 33.1% had T2DM. At baseline, mean BMI was 34.3 kg/m2 and mean LFC was 20.3%. The least squares (LS) mean relative reduction from baseline in LFC at Week 24 was significantly (p <0.001) greater with efinopegdutide (72.7% [90% CI 66.8–78.7]) than with semaglutide (42.3% [90% CI 36.5–48.1]). Both treatment groups had an LS mean percent reduction from baseline in body weight at Week 24 (efinopegdutide 8.5% vs. semaglutide 7.1%; p = 0.085). Slightly higher incidences of adverse events and drug-related adverse events were observed in the efinopegdutide group compared with the semaglutide group, primarily related to an imbalance in gastrointestinal adverse events.Документ Changes in the periodontium against the background of systemic vascular reactions in young individuals with obesity(Wroclaw Medical University, Poland / Вроцлавський медичний університет, Польща, 2023) Skrypnyk, Maksym; Petrushanko, Tatiana; Neporada, Karine; Petrushanko, Vladymyr; Skrypnyk, Igor; Скрипник, Максим Ігоревич; Петрушанко, Тетяна Олексіївна; Непорада, Каріне Степанівна; Петрушанко, Володимир Миколайович; Скрипник, Ігор МиколайовичBackground. Overweight and obesity are defined as abnormal or excessive fat accumulation that impairs health. The global prevalence of obesity has been increasing significantly among all age groups. Furthermore, obesity is a comorbid factor for numerous diseases, including cardiovascular and periodontal pathologies. Objectives. The present study aimed to investigate the influence of overweight and obesity on the periodontium of young adults in relation to the functional state of the cardiovascular system. Material and methods. The oral health status of 132 males and females aged 18–22 years was examined. They were divided into 4 groups according to their body mass index (BMI): normal weight; overweight; class I obesity; and class II obesity. A periodontal chart, the records on oral hygiene and caries, and periodontal indices were provided for each participant. The main functional parameters of the cardiovascular system were measured before and after the dental examination. Results. Overweight or obesity did not affect the intensity of caries in young adults. The prevalence and severity of gingivitis were significantly higher in obese individuals. A moderate correlation was found between gingivitis and BMI in patients with class I and II obesity. Disturbances in the cardiovascular system function and in the autonomic nervous system tone were also diagnosed in obese patients. An impaired vascular response and significant functional changes in the cardiovascular system developed against the background of obesity. These changes show the development of subcompensation in young adults with obesity. Conclusions. In obese individuals, significantly worse oral hygiene was observed as compared to normalBMI patients. Moreover, the clinical manifestation and intensity of gingivitis in obese individuals were high even in those with satisfactory oral hygiene. In young obese individuals, the periodontal disease manifested as gingivitis is due to significant adaptive and compensatory mechanisms.Документ Dependence of the Dental Status of Young Individuals with Different Body Weights on their Eating Behavior(Faculty of Medicine Nis, 2022) Skrypnyk, Maksym; Petrushanko, Tatiana; Neporada, Karine; Skrypnyk, Roman; Petrushanko, Vladymyr; Skrypnyk, Igor; Скрипник, Максим Ігорович; Петрушанко, Тетяна Олексіївна; Непорада, Каріне Степанівна; Скрипник, Роман Ігорович; Петрушанко, Володимир Миколайович; Скрипник, Ігор МиколайовичObesity is a global problem of modern society. According to the WHO, in 2016, more than 1.9 billion adults are overweight and about 650 million adults are obese. Numerous studies indicate the role of overweight, obesity and metabolic status on periodontal health, however, the mechanism of their development is not fully understood. The aim of the study was to explore the mechanism of periodontal disease development in patients with diverse body mass index and the mechanism of extra weight and obesity onset in these patients. The study involved 132 Ukrainian males and females, 18 - 22 years old. Body mass index was determined in all patients. Information on life history, illness and family history was collected. The assessment of dental status was conducted by indicating the oral and tongue hygiene indices and periodontal indices. Eating behaviour was assessed using the standardised Dutch eating behaviour questionnaire (DEBG) and the three-factor eating questionnaire (TFEQ R-18). Diet assessment was determined by standardized diet questionnaire. More than 60% of young people with the 1st and 2nd degree obesity had eating disorders, the most prevalent were disturbance of cognitive restraint and emotional eating components of eating behavior. The prevalence of periodontal disease was significantly higher in obese individuals, up to 87% in patients with the 1st and 2nd degree obesity. Eating behavior disturbances play a crucial role in the development of obesity in young adults and onset of gingivitis. The cause of non-plaque-induced gingivitis in patients with the 1st and 2nd degree obesity is a impaired general host response to the pathogenic factors of the oral cavity, caused by excess adipose tissue, which led to the development of chronic systemic mild inflammation. That is why these patients need a specific, integrated periodontal treatment.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 Quality of life impairment in patients with newly diagnosed multiple myeloma who suffered from russian military aggression in ukraine: a single center experience(EHA. HemaSphere, 2023) Lymanets, Tetiana; Skrypnyk, Igor; Maslova, Anna; Gusachenko, Iuliia; Лиманець, Тетяна Володимирівна; Скрипник, Ігор Миколайович; Маслова, Ганна СергіївнаBackground: A number of factors influence the quality of life (QoL) of patients with multiple myeloma (MM). First of all, the fact of hemato-oncological diagnosis itself and the prognosis for life and work capacity. From February 24, 2022, all patients in Ukraine have an additional factor of negative impact on their QoL: military hostilities, lack of opportunity to live in their own houses and be treated in hospitals in their Region. This fact requires a detailed study in order to timely identify and prevent severe cases of anxiety and depression. Aims: to assess QoL in patients with newly diagnosed MM, who were internally displaced to more safe central region of Ukraine due to russian military aggression from the territories of active hostilities. Methods: The study involved 42 patients with newly diagnosed MM. All patients were treated in Hematology department of Poltava Regional Clinical Hospital n.a.M.V.Sklifosovsky during 2022 year. The cohort consisted of 24 (57%) males and 18 (43%) females, mean age 64.2±9.6 years, ECOG I-III. The patients were divided into two groups: I (n=31) – MM pts, who were native citizens of Poltava region; II (n=11) – MM pts, internally displaced persons from the regions of active hostilities: 9 were from Kharkiv Region, 1 patient from Sumy region and 1 – Luhansk region. The compared groups did not significantly differ by age, gender, ECOG score and ISS staging. QoL of patients was assessed using EQ-5D-5L questionnaire, which included descriptive data and visual analog score (EQ-VAS) data. The study was approved by the local ethic committee and all patients gave a written consent before they were included. Results: Patients of groups reported violations of mobility, self-care, usual activities and pain/discomfort data, that were not significantly different between groups. The anxiety/depression EQ-5D-5L component in patients of group I showed the presence of this violation in 14 (45.2%) cases: 6 (19.4%) patients had slight problems, 4 (12.9%) pts – moderate and 4 (12.9%) pts –severe. Meanwhile, 9 (81.9%) patients of group II, who have suffered from russian military aggression reported the presence of anxiety/depression: 3 (27.3%) pts had slight problems, 3 (27.3%) pts – moderate, 2 (18.2%) pts – severe and 1 (9.1%) patient had extreme problems. Thus, the need to move to another region due to hostilities definitely leads to increase in anxiety and depression, X2 (1, N=42) = 4.4, p < .05. The mean self-rated health score (EQ-VAS) for pts of group I was 57.42 (SD 3.32), which was significantly higher in comparison with the results of group II responders 45.45 (SD 4.64), which is 1.3-fold lower than the indicators of group I, t(42)= 2.4, p = .01.Документ The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge?(Elsevier, 2022) Lazarus, Jeffrey V.; Mark, Henry E.; Villota-Rivas, Marcela; Palayew, Adam; Skrypnyk, Igor; Скрипник, Ігор МиколайовичBackground & Aims: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas. Methods: We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemiology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied.Документ Using innovative technologies in medical education of Ukraine under martial law(Journal of Positive School Psychology, 2023) Skrypnyk, Igor; Maslova, Hanna; Shaposhnyk, Olha; Shevchenko, Tetyana; Sorokina, Svitlana; Kudria, Iryna; Honchar, Olha; Скрипник, Ігор Миколайович; Маслова, Ганна Сергіївна; Шапошник, Ольга Анатоліївна; Шевченко, Тетяна Іванівна; Сорокіна, Світлана Іванівна; Кудря, Ірина Павлівна; Гончар, Ольга ОлександрівнаReforming medical education, changing the paradigm towards ensuring the quality of professional training of future doctors, forming a modern educational space and harmonization with international standards on innovative technologies was interrupted by the Covid-19 pandemic and Russian military aggression. The relevance of the conducted research is called by determination of the directions of educational innovation, implemented by medical institutions of higher education in wartime conditions. The methodological base of the research is the methods of scientific acknowledgement, structural and logical analysis. The scientific novelty of the issue lies in the comprehensive study of the peculiarities of organizing the training of higher medical education applicants through the prism of innovative educational technologies and interactive teaching methods use. Based on the results of the research it is recommended to use a number of modern innovative technologies that are not yet sufficiently known to the general educational community. Among such we may note «flipped classroom», gamification, brainstorming, quest-task, training based education, STEM education. However, the implementation of the specified technologies and methods should be selected according to the individual capabilities and conditions for study of medical education applicants. The research also determines the peculiarities of knowledge assessment of higher medical education applicants in the conditions of innovative education and the change of the teacher's role in the educational process. The practical significance of the work lies in the possibility to organize the training of medical students in accordance with the tasks of training professionals of the new era.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.Документ Життя всеціло віддане науці, людям та улюбленій справі (до 80-річчя з дня народження Тарасенко Лідії Мусіївни)(Українська академія наук (м.Київ), Вищий державний навчальний заклад України «Українська медична стоматологічна академія» (м.Полтава), 2017) Скрипник, Ігор Миколайович; Непорада, Каріне Степанівна; Петрушанко, Тетяна Олексіївна; Skrypnyk, Igor; Neporada, K. S.; Petrushanko, T. O7 листопада 2017 року виповнилось би 80 років відомому вченому в галузі фізіології і патофізіології екстремальних станів, дійсному члену Нью-Йоркської Академії наук, відміннику охорони здоров'я України, відміннику вищої школи України, доктору медичних наук, професору Лідії Мусіївні Тарасенко. Висока кваліфікація та наукова ерудиція Лідії Мусіївни дозволили їй виконати чимало фундаментальних досліджень, результати яких мають велике теоретичне та практичне значення. Предметом наукового пошуку Тарасенко Л.М. була проблема стресу, вивченню якої вона присвятила майже 50 років. Наукові пріоритети Л.М. Тарасенко стосувались вивчення молекулярних механізмів стресорного ушкодження органів та тканин. Під її керівництвом виконано 16 дисертацій: 3 докторських (проф. Петрушанко Т.О., проф. Скрипник І.М., проф. Непорада К.С.) та 13 кандидатських. Тарасенко Л.М. була постійним науковим консультантом викладачів клінічних кафедр. Тарасенко Л.М. була членом Міжнародного патофізіологічного, Українського патофізіологічного та біохімічного товариств, членом спеціалізованих вчених рад по захисту докторських дисертацій у ВДНЗУ «Українська медична стоматологічна академія» (м. Полтава) та Харківському національному медичному університеті. Ім’я Лідії Мусіївни Тарасенко назавжди залишиться в історії вітчизняної медичної науки, в серцях її учнів і тих, хто особисто знав чи вчився на її наукових працях.