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Is rashism a form of fascism? Comparison of definitions
Full text linkThe article aims to compare the concept of “rashism” with fascism. The term “rashism” gained popularity after the Russian invasion of Ukraine and is understood as a synthesis of the “Russian spirit” with fascism, which is believed to be the cause of the aggressive and imperial policies of the Russian Federation. By reviewing the proposed definitions of rashism, alongside definitions of fascism and fascist source texts, and examining Vladimir Putin’s speeches, the article concludes with a critical assessment that challenges the validity of the rashism concept
Gut Microbiota and Insulin Resistance: Mechanisms, Therapeutic Strategies, and Future Directions
Full text linkThe gut microbiota, a complex ecosystem of microorganisms within the gastrointestinal tract, has emerged as a critical regulator of metabolic health. This review explores the intricate relationship between gut microbiota and insulin resistance, focusing on the underlying mechanisms, compositional changes, and therapeutic implications. Dysbiosis, characterized by reduced microbial diversity and an imbalance between beneficial and pathogenic species, contributes to insulin resistance through impaired short-chain fatty acid (SCFA) production, gut barrier dysfunction, and systemic inflammation. Key bacterial taxa, such as Akkermansia muciniphila and Faecalibacterium prausnitzii, play pivotal roles in maintaining metabolic homeostasis, while alterations in the Firmicutes-to-Bacteroidetes ratio and increased endotoxin production exacerbate metabolic dysfunction. Evidence suggests that modifiable factors, including diet, physical activity, and microbiota-targeted therapies like probiotics, prebiotics, and fecal microbiota transplantation (FMT), offer potential avenues for restoring microbial balance and mitigating insulin resistance. Despite advancements, research in this field faces challenges, including methodological variability, interindividual microbiota differences, and a need for standardized clinical approaches. Future studies should focus on long-term, large-scale interventional trials, personalized microbiota-based interventions, and elucidation of the gut microbiota's molecular mechanisms. This review underscores the promising role of gut microbiota in managing insulin resistance and highlights opportunities for integrating microbiota-targeted strategies into clinical practice
Role of ketamine in treatment-resistant depression
Full text linkIntroduction: Depression, affecting 350 million people globally, is a leading cause of disability. Common symptoms include low mood, sadness, guilt, anxiety, and suicidalthoughts. Current treatments, mostly monoamine-based antidepressants, have limitations such as delayed effects and low efficacy, with over 60% of patients not achieving lasting remission. Ketamine, an NMDA antagonist, has shown rapid antidepressant effects, and research suggests glutamatergic dysfunction plays a role in TRD, highlighting the need for faster, more effective treatments.
Current state of knowledge: Ketamine, an NMDA receptor antagonist, has gained attention for its rapid antidepressant effects, particularly in treatment-resistant depression. It works by modulating the glutamatergic system, enhancing synaptic plasticity, and involving other systems like GABA and 5-HT. Clinical trials have shown ketamine's efficacy in reducing depressive symptoms and suicidal ideation within hours, contrasting with traditional antidepressants that take weeks. The intravenous route is most effective, with lower bioavailability in other forms. While ketamine shows promise, its potential for addiction and side effects necessitate careful monitoring.
Conclusion: Evidence supports ketamine for treating refractory depression, enhancing neuroplasticity and regulating affective symptoms through anti-inflammatory effects. Variations exist in administration route, bioavailability, and patient age. Common adverse effects include dissociative symptoms and cardiovascular issues, requiring careful monitoring and management. 
Adenomyosis and it's impact of female infertility
Full text linkIntroduction: The aim of this review is to explore the relationship between adenomyosis and infertility. The issue of adenomyosis and infertility is the subject of numerous scientific studies due to the mechanisms that may establish a correlation between them. These mechanisms present a dilemma for many researchers, and efforts to address it lead to increasingly innovative solutions for treating infertility and improving the reproductive health of women diagnosed with adenomyosis.
Material and methods: We have gathered the available materials and scientific reports, analyzing and summarizing them in a single study. An English-language literature review was conducted. We analysed studies from PubMed up to October 2024 regarding the correlation between adenomyosis and infertility.
Aim of study: We aimed to summarize the studies conducted so far by analyzing the available scientific reports to answer the question about adenomyosis correlation in infertility and understand it.
Conclusion: The article examines the relationship between adenomyosis and infertility, emphasizing its negative impact on the reproductive potential of women of reproductive age. Adenomyosis reduces pregnancy rates, increases the risk of miscarriages, and hinders embryo implantation, particularly in patients undergoing assisted reproductive techniques. Long protocols with GnRH analogs can improve treatment outcomes in both medical procedures and natural conception attempts. Surgical treatment may enhance fertility but carries risks of complications, and the effectiveness of surgery remains a topic of debate. Accurate diagnosis, appropriate therapy, and improved prenatal care for patients with adenomyosis are essential. Further research, including randomized controlled trials (RCTs), is needed to better understand the impact of adenomyosis on fertility and to develop effective treatment methods
Acute Inflammatory Demyelinating Polyneuropathy: a comprehensive literature review
Full text linkIntroduction and purpose
Guillain-Barré Syndrome (GBS) is an acute, immune-mediated polyneuropathy characterized by rapid-onset muscle weakness and areflexia. It typically follows an infection and can lead to severe complications, such as respiratory failure or autonomic dysfunction. It is a significant concern in neurology and critical care due to its unpredictable course and potential to cause long-term disability. This article aims to present a comprehensive review of Guillain-Barré Syndrome, focusing on its key clinical and prognostic aspects, according to current literature.
Description of the state of knowledge
Guillain-Barré Syndrome is a complex condition with diverse clinical presentations and pathophysiological mechanisms. It is widely recognized as an immune-mediated disorder, often triggered by infections such as Campylobacter jejuni or cytomegalovirus. The key pathological process involves molecular mimicry, leading to an autoimmune attack on peripheral nerves, resulting in demyelination or axonal damage. Immunotherapy with intravenous immunoglobulin (IVIG) or plasma exchange (PE) is the foundation of treatment, while supportive care is essential for managing respiratory failure and autonomic dysfunction.
Conclusions
GBS remains a complex condition requiring rapid diagnosis and management. While immunotherapy significantly improves recovery, challenges persist, particularly in the most severe cases. Further research into pathophysiological mechanisms and experimental therapies is essential to refine treatment approaches and improve patient outcomes
Iron Deficiency Anemia in Inflammatory Bowel Disease
Full text linkInflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract. It includes Crohn's disease (CD) and ulcerative colitis (UC). It occurs with periods of exacerbations and remissions. One of the most common complications of IBD is iron deficiency anemia (IDA). In IBD, iron deficiency anemia (IDA) often occurs concomitantly with anemia of chronic disease, caused by chronic inflammation of the gastrointestinal tract. Disturbance of iron homeostasis in IBD results from inflammation of the intestinal mucosa, which causes increased blood loss from the gastrointestinal tract and poor iron absorption. A key role is played by hepcidin, which, by acting on ferroportin, inhibits iron absorption in the intestines, despite its deficiency. Less common causes of anemia in IBD include vitamin B12 deficiency, folate deficiency, hemolysis, drug-induced aplasia, or liver disease such as primary sclerosing cholangitis. Symptoms of iron deficiency depend on the severity and chronicity of the anemia. Anemia reduces the quality of life of patients, so diagnosis and treatment of iron deficiency anemia in IBD is essential. Regular monitoring of anemia and iron homeostasis is recommended. Tests should be performed at the time of IBD diagnosis, every 3 months in active disease and every 6-12 months in periods of remission. In all patients with IBD, it is necessary to follow an appropriate diet, but also to treat anemia with iron preparations, oral or intravenous. The choice of the method of iron administration, oral or intravenous, depends on the hemoglobin level, IBD activity, and the patient's tolerance to oral preparations. Regular monitoring is essential because anemia in IBD often recurs.  
Assessment of knowledge concerning prevention of infection with HCV among nurses employed in surgical wards
Full text linkBackground and study aims. Infection with hepatitis C virus (HCV) may lead to acute or chronic hepatitis. About 3% of the world's population is infected, while in Poland approximately 2%. Occupational exposure among nurses is related with the provision of care to patients in surgical wards which are an important source of infection with HCV. The aim of the study was assessment of the level of knowledge concerning prevention of HCV infection among nurses employed in surgical wards.
Materials and Method. The study included 148 nurses working in surgical wards in Polish hospitals, and was conducted by the method of a diagnostic survey, using an author-constructed questionnaire and a modified questionnaire designed by the Polish HCV Expert Group.
Results. The majority of nurses in the study had a mediocre level of knowledge concerning hospital-acquired infections transmitted through blood, methods of prevention of hospital-acquired infections with HCV, and methods of protection against occupational exposure to HCV infection. The majority of respondents provided correct answers regarding the risk of infection with HCV. The deficit of respondents’ knowledge concerned the lack of vaccine against hepatitis C and the possibility of curing a person infected with HCV as long as the disease is diagnosed early.
Conclusions. Nurses employed in surgical wards should be motivated to expand their knowledge concerning prevention of HCV infections. Training courses should include the methods of prevention of infections with HCV, ways to protect against occupational exposure to HCV infection, and the possibilities of treatment of persons infected with HCV
Quality of life patients with type 2 diabetes among patients aged 65-75 years
Full text linkIntroduction: Type 2 diabetes is a chronic disease that contributes to the occurrence of limitations in the patient's life. In order to assess the quality of life of patients with diabetes, the following aspects should be taken into account: age, gender, education, presence of complications,
Material and methods: The study was conducted using the diagnostic survey method. The research tools were: a survey questionnaire consisting of metrics and clinical parameters, the ADDQoL questionnaire, The study was conducted on a group of 104 patients (including 58 women and 46 men) in the Diabetes Clinic at the Provincial Hospital in Bielsko-Biała in the period from April 20, 2018 to September 1, 2018.
Results: Diabetes has been shown to have a negative impact on all 19 ADDQoL domains. The most negative feelings concern the future, freedom in eating, and enjoying leisure activities.
Conclusions: Patients with type 2 diabetes have a negative impact on their quality of life. Patients with diabetes require greater focus on educational activities aimed at adhering to a rational diet and psychological support
Management of Acute Respiratory Distress Syndrome (ARDS): A Review of Current Ventilatory and Pharmacological Strategies
Full text linkIntroduction and Purpose. Acute Respiratory Distress Syndrome (ARDS) is a severe inflammatory lung condition associated with high mortality. Despite advances in intensive care, optimal management remains a challenge. This review synthesizes current ventilatory and pharmacological strategies, emphasizing precision medicine to improve outcomes.
Material and Methods. A comprehensive literature search was conducted using PubMed and Google Scholar, focusing on ARDS management studies published since 2015. Keywords included "ARDS," "mechanical ventilation," "prone positioning," "pharmacological therapy," and "precision medicine."
Brief Description of the State of Knowledge. Lung-protective ventilation, utilizing low tidal volumes and prone positioning, significantly reduces mortality in ARDS. Positive end-expiratory pressure (PEEP) optimization and extracorporeal membrane oxygenation (ECMO) serve as adjunct strategies in severe cases. Pharmacological approaches, including early corticosteroid administration and neuromuscular blocking agents, show selective benefits, particularly in hyperinflammatory ARDS phenotypes. Novel therapies, such as mesenchymal stem cells, IL-1β inhibitors, and machine learning-assisted ventilation strategies, represent promising future directions.
Conclusions. ARDS management is evolving toward a personalized, phenotype-driven approach integrating ventilatory and pharmacological strategies. Despite significant advances, challenges remain in optimizing corticosteroid use, PEEP titration, and ECMO application. Future research should focus on biomarker-driven therapies and artificial intelligence-assisted ventilation to enhance patient outcomes and reduce mortality
Hepatoprotective Therapy Efficacy in Obstructive Hepatobiliary Diseases: A Prospective Randomized Study
Full text linkIntroduction and purpose
Obstructive diseases of the hepatobiliary system present a complex set of clinical challenges characterized by impaired bile outflow and progressive hepatocellular damage. Despite significant advances in interventional and surgical approaches, liver dysfunction associated with these disorders continues to substantially impact patient morbidity and mortality. Hepatoprotective agents have emerged as a potential adjunctive therapeutic strategy, although their efficacy in managing hepatobiliary obstruction remains insufficiently investigated.
The purpose of our article was to assess the efficacy and clinical feasibility of hepatoprotective therapy in obstructive hepatobiliary diseases.
Materials and methods
A prospective randomized cohort study was conducted from 2020 to 2024 at the Surgical Department №2 of the Kyiv Municipal Clinical Hospital of Emergency Medical Care, analyzing the treatment results of 139 patients with obstructive biliary disease (54 men, 85 women). Patients were randomly stratified into two groups: a control group receiving standard conservative therapy and a hepatoprotective therapy group receiving supplementary treatment with Remaxol, Silymarin, and S-adenosylmethionine for 21 consecutive days.
Results
Biochemical parameter analysis revealed significant improvements in patients receiving combined hepatoprotective therapy compared to the control group. On day 7, patients administered hepatoprotectors demonstrated a 46.7% decrease in total bilirubin (reducing to 111.2±22.1 μmol/L), compared to a 39.5% decrease (to 128.0±23.5 μmol/L) in the control group (p<0.05). Liver enzyme levels exhibited a more pronounced improvement in the hepatoprotector therapy group, with alanine aminotransferase (ALT) decreasing from 175±25 U/L to 52±5 U/L (a 70.3% reduction) on day 7, contrasted with a 45.6% decrease in the control group (from 182±22 U/L to 99±10 U/L) (p<0.001). Cholestatic markers also demonstrated superior responsiveness to hepatoprotective therapy. Alkaline phosphatase (ALP) decreased by 53.4%, and gamma-glutamyl transpeptidase (GGTP) decreased by 60.0% after 7 days, compared to decreases of 44.0% and 23.1% in the control group, respectively (p<0.01 for both parameters). By day 21, both groups exhibited significant improvement; however, the hepatoprotective therapy group maintained statistically significant advantages across all parameters (p<0.01), particularly in transaminase normalization (ALT: 31±3 U/L vs. 66±8 U/L, p<0.001; AST: 25±5 U/L vs. 61±3 U/L, p<0.001).
Conclusions
The implementation of hepatoprotectors facilitates a statistically significant acceleration in the normalization of liver function biochemical indicators, specifically bilirubin, transaminases, and cholestasis markers. The most pronounced differentiation was observed in the reduction of ALT and AST (p<0.001), which indicates a substantial mitigation of cytolytic syndrome under hepatoprotective intervention. An integrated therapeutic approach incorporating hepatoprotectors for obstructive hepatobiliary diseases enables more rapid restoration of hepatic functional status and potentially mitigates the risk of complications.
Based on the obtained data, the protocol demonstrated particular effectiveness in transaminase normalization (ALT: 31±3 U/L vs 66±8 U/L in controls), supporting its incorporation into clinical guidelines for obstructive hepatobiliary disease management, we recommend incorporating hepatoprotectors into standard treatment protocols for patients presenting with obstructive diseases of the hepatobiliary system