Modern Pediatrics. Ukraine

Autoimmune hemolytic anemia and pediatric Hodgkin lymphoma: a clinical case

N.I. Makieieva, V.A. Koval, O.S. Boldyreva, M.V. Kucherenko, A.V. Derkach — Fri, 28 Nov 2025 00:00:00 +0200

Autoimmune hemolytic anemia (AIHA) in combination with Hodgkin lymphoma (HL) is a rare occurrence in pediatric practice. AIHA can pose significant diagnostic challenges, masking or diverting clinical attention from the underlying oncological process.

Clinical case. This article presents a case of an 11-year-old boy diagnosed with both AIHA and HL. Initially, the patient was diagnosed with AIHA; however, further evaluation revealed the presence of HL. Standard therapy for AIHA proved to be ineffective, necessitating a change in treatment strategy. Sustained remission was achieved only after protocol-based combination chemotherapy targeting the primary oncological disease.

The article also includes a review of current scientific literature regarding the coexistence of AIHA and HL. Analysis of published clinical cases helps to better understand the pathogenetic mechanisms, diagnostic difficulties, and therapeutic approaches in such rare presentations.

Conclusions. This case emphasizes the importance of early recognition of the oncohematological nature of AIHA in pediatric patients. Further research is needed to improve our understanding of the immunopathogenesis of AIHA in the context of HL, which will support the development of better treatment strategies and improve patient outcomes.

The study was carried out according to the principles of the Declaration of Helsinki. Agreement of parents was obtained for the study.

Authors declare no conflict of interest.

Biliary atresia in children. A clinical case

O.V. Kuleshov, L.I. Laiko, I.V. Chyhir, O.O. Kurets, V.S. Oliinyk — Fri, 28 Nov 2025 00:00:00 +0200

Biliary atresia (BA) is an intra- and/or extrahepatic inflammatory cholangiopathy that is characterized by progressive obliteration of the bile ducts within the first weeks of life, leading to liver fibrosis development. BA is one of the causes of terminal stage chronic liver diseases formation in children. The pathogenesis is based on the obliteration of the bile ducts, which causes impaired bile outflow, intrahepatic cholestasis, accumulation of toxic bile acids, and progressive damage to hepatocytes. Clinical manifestations of the disease usually occur within the first weeks of life and include prolonged jaundice, acholic stool, and as, a result, the development of hepatosplenomegaly and signs of portal hypertension appearance. In the absence of timely diagnosis and early surgical intervention, many children may have a rapid progression of liver fibrosis with the formation of biliary cirrhosis. In case of late BA diagnosis or impossibility of performing portoenterostomy by Kasai, liver transplantation remains the only radical treatment method.

Aim - to inform medical practitioners of the main clinical signs, volume of necessary additional examination methods, course of BA in children, and the directions of differential diagnosis.

Clinical case. The authors described a clinical case of BA. The main diagnostic characteristics of the clinical picture were highlighted: complaints, anamnesis features, data from laboratory and instrumental research methods, as well as treatment methods with mandatory early surgical intervention.

Conclusion. Timely verification of BA diagnosis depends on the correct diagnostic algorithm, which ensures early detection of pathology. This allows the patient to be referred for surgical treatment in a timely manner, which contributes to the liver functional capacity preservation, prevents the progression of the disease, and the development of complications. In addition, early diagnosis improves the prognosis and quality of life.

The study was carried out according to the Declaration of Helsinki. The agreement of parents was obtained for the study.

Authors declare no conflict of interest.

Ventricular tachycardias in children: contemporary approaches to diagnosis, monitoring, and treatment

Fri, 28 Nov 2025 00:00:00 +0200

Heart rhythm disorders in children are characterized by disturbances in impulse generation or conduction, which may lead to both benign and life-threatening conditions.

Aim - to summarize current approaches to the early diagnosis and management of children with life-threatening arrhythmias (LTA), taking into account international recommendations and personal clinical experience, which should contribute to improving the quality of medical care in Ukraine.

The most common arrhythmia in childhood is tachycardia. LTA often manifest without previously diagnosed heart disease and require immediate diagnosis and risk stratification. The true incidence of ventricular arrhythmias in children remains unknown, and clinical manifestations vary significantly depending on age and type of arrhythmia. Timely detection of LTA is crucial to prevent the development of left ventricular dilation and dysfunction, which can be reversible with appropriate therapy. Given the wide range of clinical scenarios — from incidental findings during routine examinations to syncopal events with high risk — there is a need to standardize approaches to the diagnosis and management of ventricular tachyarrhythmias in the pediatric population. Based on the European Society of Cardiology (2022) recommendations, approved by the Association for European Paediatric and Congenital Cardiology, a national Clinical Guideline «Life-Threatening Arrhythmias in Children» and the corresponding Standard of Medical Care were developed and approved by the Ministry of Health of Ukraine in 2025 (Order of the Ministry of Health of Ukraine No. 1235 dated August 6, 2025).

Conclusions. Early diagnosis and risk stratification of Life-threatening arrhythmias (LTA) in children are key points for preventing the development of severe complications. The implementation of the national Standard and Clinical Guidelines (Order of the Ministry of Health No. 1235 of 06.08.2025) generalizes treatment approaches and significantly improves the quality of medical care for children with complex rhythm disorders.

The authors declare that there is no conflict of interest.

Рreparation for breastfeeding: how to provide a successful start?

V.S. Oliinyk, О.V. Kuleshov, G.I. Mantak, T.O. Kovtiukh, L.O. Yushchenko — Fri, 28 Nov 2025 00:00:00 +0200

Despite significant efforts to protect, promote, and support breastfeeding, less than half of infants worldwide are exclusively breastfed in the first six months, which is why the overwhelming majority of official sources recommend starting informational preparation for couples during the first trimester of pregnancy.

Aim - to provide an overview of current recommendations that ensure reliable preparation for breastfeeding long before the baby is born.

As usual, the first consultation starts with a history of feeding, discussing sources of support, benefits, and challenges a woman may face during the breastfeeding period. It is important to discuss with the woman who has not breastfed expected advantages and disadvantages of formula feeding, what might be helpful for her for breastfeeding older children, and to inquire about family history, in which case breastfeeding will be particularly essential for the child. Education about feeding conducted during the antenatal period increases the mother's self-efficacy and influences both success and outcome. This means the confidence and determination of the mother in her ability to breastfeed the child, the efforts she makes, her type of thinking, and ways of overcoming difficulties. A key role in establishing and maintaining breastfeeding belongs to all medical professionals who care for women and children in the postpartum period and thereafter. The effective establishment of breastfeeding is crucially dependent on robust planned care practices for pregnant women by competent medical staff aimed at educating and elevating women's awareness about the importance of natural feeding, promoting breastfeeding in the country, involving the family to provide support, and creating a positive microclimate within the family.

In case of any issues or difficulties, it is necessary to consider of referring to a doctor specializing in breastfeeding medicine or to a breastfeeding consultant.

No conflict of interests was declared by the authors.

Development of a child’s personality as a purposeful activity in the process of implementing a genetic program: psychological features

Fri, 28 Nov 2025 00:00:00 +0200

Аim - to conduct a theoretical analysis of scientific sources that describe the psychological features of the development of a child’s personality as a purposeful activity in the process of implementing a genetic program.

Psychological features of the development of a child’s personality are determined by purposeful activity in the process of implementing a genetic program. Medical genetics or human genetics are directly related to the substantiation of the psychological features of the development of a child’s personality, which is determined by purposeful activity in the process of implementing a genetic program. The development of a child’s personality is decisive in the relationships in the process of developing a holistic personality of a child and its individual mental structures. Pedagogical management of the development of a child’s personality is a necessary component of the development of a child’s personality, which is determined by purposeful activity in the process of implementing a genetic program. Psychological features determine the development of a child’s personality in the process of implementing a genetic program. have differences in the personal formation of a child with normotypical development and with special development. The leading role in the process of developing a child’s personality is played by interaction with the environment of adults. The formation of children’s self-awareness occurs in the process of development selectively on the basis of training, upbringing, socialization. Adaptation to social conditions of existence as a result of upbringing, training and socialization is associated with the interaction of the child’s personality in the process of development in society.

The development of a child’s personality depends on cognitive activity and should be considered as a volitional purposeful action. Such action affects activity in the cognitive process and forms independence in the process of finding answers to questions that interest the child. Three types of cognitive activity are important for the development of a child’s personality: active cognitive orientation to the environment, cognitive orientation, cognitive passivity.

The authors declare the absence of a conflict of interests.

Formation of social health of Ukrainian adolescents in the process of patriotic education

Fri, 28 Nov 2025 00:00:00 +0200

Aim - to conduct a systematic analysis of scientific sources on the formation of social health of Ukrainian adolescents in the process of patriotic education.

In conditions of martial law, the formation of social health of Ukrainian adolescents in the process of patriotic education requires taking into account the components of social activity and important elements of the formation of civic maturity of adolescents, as well as physical development, motor activity, a healthy lifestyle and civic competence. This process requires the popularization and improvement of the qualifications of social sphere specialists, pediatricians, and specialists in the inclusive sector who provide support to children affected by military actions. In conditions of military actions, Ukrainian adolescents often experience social isolation, which leads to the loss of social contacts and social activity. The result of social isolation in adolescence is the emergence of deviant behavior, instability of the emotional state and deterioration of social health in the process of patriotic education. To create effective conditions for the formation of social health of Ukrainian adolescents in the process of patriotic education, it is necessary to ensure a dialogue between specialists participating in this process. The social health of adolescents is associated with social activity. In the process of forming the social health of Ukrainian adolescents, it is necessary to use methods of active forms of educational work. These are interactive methods that form positive motivation of adolescents, as well as form models of correct behavior and forms of organizing preventive education. Taking into account civic competence as the ability of Ukrainian adolescents to responsibly treat their civic duties forms the social health of this age category more effectively.

There is an urgent need to increase the quantity and quality of popularization of patriotic education as one's own responsibility for the development of the future of Ukraine. Adolescent children develop according to current biosocial conditions, where social conditions for the formation of social health are much more effective.

The authors declare the absence of a conflict of interest.

Analysis of the functional activity of salivary glands in children with influenza and other respiratory viral infections

N.O. Gevkaliuk, Y.M. Martyts, V.M. Mykhailiuk — Fri, 28 Nov 2025 00:00:00 +0200

Acute respiratory viral infections (ARVI) occupy the first place in the structure of children's infections. Rashes on the mucous membranes in the oral cavity reflect the patterns of the infectious process as a whole. Aim - to is aimed at evaluating the secretory function of salivary glands, physico-chemical, and morpho-structural features of oral fluid in different forms of severity of influenza stomatitis in children.

Materials and methods. The rate of salivation in 318 children with ARVI lesions of the oral cavity was performed on an empty stomach without stimulation in graduated tubes to further morphological examination. Qualitative analysis of secretion was determined visually. Determination of the viscosity was performed on a capillary viscometer Oswald; the buffer capacity was determined as described Krasse, the pH was determined, and crystalography of oral fluid was conducted. The research on the secretory function of salivary glands was conducted by sialometri method.

Results. The rate of salivation in patients with acute viral stomatitis caused by the influenza virus decreased with increasing severity of disease in severe ARVI 3.17 times compared to children in the control group. Counting the functioning of minor salivary glands showed their reduction to 11.46±0.14 with severe acute viral stomatitis. The qualitative analysis showed that salivary gland secretions increase their viscosity and the presence of visible inclusions. Determination of the pH of the oral fluid showed a shift to the acidic side. The buffer capacity is directly dependent on the rate of salivation and pH. The nature of changes in the crystals of the oral fluid is determined by the severity of lesions of the oral mucosa.

Conclusions. Changes in physico-chemical properties, acid-salt metabolism, morpho-texture pecularities, changes in the crystals of oral fluid occurring against the background of hiposalivation show a decrease in functional activity of salivary glands in ARVI in children with disease manifestations in the oral cavity.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Bioethics Commission of an institution. For each child, the informed consent of their mother to participate in the study was obtained.

The authors declare no conflict of interest.

Vitamin D status, leptin, and lipid profile in adolescents with hypothalamic dysfunction

Fri, 28 Nov 2025 00:00:00 +0200

Aim - to investigate the vitamin D status, lipid profile and leptin levels in a cohort of adolescents with hypothalamic dysfunction (DH) for early identification of possible risk factors for cardiovascular and metabolic disorders

Materials and methods. 246 adolescents (including 133 boys) aged 10-17 years with DH accompanied by excess body weight (BW)/obesity were examined. Body mass index, levels of total cholesterol (TC), triglycerides (ТG), high (HDL-C) and low density lipoprotein cholesterol, leptin, atherogenic index (IA), and blood 25-hydroxyvitamin D (25(OH)D) were determined.

Results. Excess BW was found in 82 (31.0%) patients, obesity of the I degree - in 84 (32.0%) children, II degree - in 51 (19.0%) children, III degree - in 29 (11.0%) children. The indicators of 25(OH)D in the blood corresponded to the deficiency of vitamin D. The increase in the degree of obesity was accompanied by a significant increase in the leptin level and a decrease in the 25(OH)D level. The increase in the deficiency of vitamin D was associated with significantly increased levels of TС and IA and a decrease in the HDL-C level. The most significant changes in lipid fractions were observed in patients with DH and III degree of obesity, who had the lowest content of 25(OH)D in the blood.

Conclusions. The present study found the certain significant changes in some lipid fractions, namely TC, IA and HDL-C in adolescents with hypothalamic dysfunction associated with excess BW/obesity and vitamin D deficiency, which is a high risk factor for cardiovascular and metabolic disorders and requires early intervention and the introduction of preventive measures.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. Informed consent was obtained from the children's guardians for the study.

The authors declare no conflict of interest.

Some features of the current course of ANCA-associated systemic vasculitides in children

O.A. Oshlіanska, K.A. Yats, А.G. Artsymovych, T.G. Nadtochiy — Fri, 28 Nov 2025 00:00:00 +0200

Aim - to analyze the pathomorphism of the clinical course of ANCA-associated systemic vasculitides in children in Ukraine, considering clinical manifestations, serological profile, disease activity, and treatment outcomes.

Materials and methods. A single-center retrospective non-comparative study was conducted. A total of 4,173 medical records of children with rheumatic diseases treated between 2005 and 2025 were reviewed. Fifteen patients (0.36%) were diagnosed with ANCA-associated systemic vasculitis. Clinical features, laboratory and serological markers (PR3-ANCA, MPO-ANCA), imaging findings, and biopsy results were analyzed. Disease activity was assessed using BVAS and PVAS scores, and treatment effectiveness was evaluated 6 months after therapy initiation.

Results. Adolescent girls predominated among the patients. In most cases, the time to diagnosis exceeded 12 months. Constitutional symptoms and involvement of the respiratory tract, kidneys, and musculoskeletal system were most common. PR3-ANCA positivity was detected in 66.7% of patients. After 6 months of treatment, a significant reduction in disease activity was observed, and medical remission was achieved in 60% of cases. Two fatal outcomes were recorded.

Conclusions. ANCA-associated systemic vasculitides in children in Ukraine are characterized by delayed diagnosis and frequent multisystem involvement. Despite treatment in accordance with international guidelines, the risks of disability and mortality remain high, emphasizing the need for earlier diagnosis and a multidisciplinary management approach.

The authors declare no conflict of interest.

Protection against poliomyelitis in children with primary immunodeficiency

A.P. Volokha, A.M. Lisovska, I.V. Demchyshyna — Fri, 28 Nov 2025 00:00:00 +0200

The polio virus has been almost completely eliminated worldwide due to the widespread use of the oral polio vaccine. However, in patients with primary immunodeficiencies (PID), protection after vaccination may be absent, which poses a threat of developing the disease. .

Aim - to study the status of protection against poliomyelitis in patients with PID in order to improve immunization approaches.

Materials and methods. Determination of total levels of antibodies against polioviruses was carried out in 53 children with PID and 25 immunocompetent children of the control group. Children with congenital immunodeficiencies were divided into two groups: 21 children with PID with preserved antibody production function and 32 children with PID with severe antibody deficiencies or combined immunodeficiencies, who received regular replacement therapy with intravenous immunoglobulin.

Results. The majority (66.7%) of PID patients with preserved antibody production function had protective levels of specific antibodies against poliomyelitis, which was comparable to 60,0% of poliovirus-protected children in the control group. Only 37.5% of PID children receiving immunoglobulin replacement therapy had protective pretransfusion levels of poliomyelitis antibodies.

Conclusions. Vaccination of children with PID with inactivated polio vaccine is important for the formation of a protective level of immunity in children with preserved antibody production function. Most children with severe hypogammaglobulinemia on replacement therapy with intravenous immunoglobulin have insufficient immune protection against polio at the time of the next dose of immunoglobulin, which requires optimization of the dose and regimen of the drug.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an institution. For each child, the informed consent of its mother to participate in the study was obtained.

The topography of major salivary glands in human prenatal ontogenesis period

N.O. Gevkaliuk, N.I. Sydliaruk, O.P. Venger, M.S. Mysula — Fri, 28 Nov 2025 00:00:00 +0200

The issues of salivary gland embryogenesis and perinatal diagnosis are poorly understood and ambiguous. Clarifying the features of the laying, development and formation of the topography of the salivary glands in the prenatal period of ontogenesis is important for a holistic understanding of the structural and functional organization of the salivary apparatus and the oral cavity, the interaction of organs and structures of the oral cavity.

Aim - to study the basic morphological processes of embryogenesis of the major human salivary glands, including the formation of rudiments of secretory and non-secretory acinar glands to assess the immune functions of the fetus and newborn.

Materials and methods. Material for the study of human salivary gland development in the prenatal period was obtained at the Ternopil Regional Pathological Bureau. The collected samples were fixed in 10% neutral formalin solution. From paraffin and epoxy blocks, we received thin slices. From epoxy blocks - cuts, painted with toluidine blue. On paraffin sections, general histological colorings were performed with hematoxylin-eosin, shik-alcian blue, shik-Alzianium blue + Bergan, immunohistochemical studies with grades CX-34, VEGF, and electron-microscopic studies.

Results. In the first stage of embryogenesis, the primary oral fossa was covered by a cuticle of peripheral epithelium. The determination of its immunohistochemical characteristics showed that it contained two varieties of epithelial cells that synthesize keratogialin. The germ of the salivary gland was formed as a result of the growth of the cuticular epithelium in the subjective mesenchyme. The immunohistochemical reaction to VEGF has shown that epithelial rudiments of mesenchyme gave enhanced expression of the marker. There was a phenomenon of vegetation because of the germic factor VEGF presence - the growth of the epithelium in subjective mesenchyme with the formation of primary excretory ducts. The third stage of gland embryogenesis was characterized by the appearance of inserted sections, as well as cross-strapped ducts, which had cells with Bergman-positive grains that formed the APUD system. The fourth stage was characterized by the formation of acinus rudiments, the epithelial cells of which had a shik-positive cytoplasm and a rounded nucleus, indicating a high synthetic activity of the cells.

Conclusion. The morphological study of large salivary glands during embryogenesis showed the stereotypical stages of morphogenesis: formation of a cuticle-peridermal epithelium in the primary oral fossa; its epithelial ingrowth into the underlying mesenchyme; formation of intercalated and striated ducts; formation of rudiments of secretive and non-secretive acinus glands.

The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Bioethics Commission of an institution. For each fetus, informed consent from the mother to participate in the study was obtained.

The authors declare no conflict of interest.

Predictors of poor treatment response in pediatric autoimmune hepatitis and autoimmune sclerosing cholangitis

M.B. Dyba, V.S. Berezenko, T.D. Zadorozhna — Fri, 28 Nov 2025 00:00:00 +0200

Autoimmune hepatitis (AIH) and autoimmune sclerosing cholangitis (ASC) in children require long-term immunosuppressive therapy; however, complete biochemical response is not achieved within 12 months in a proportion of patients, which adversely affects prognosis.

Aim - to identify predictors of treatment non-response at 12 months in children with AIH and ASC in order to optimise monitoring and guide timely treatment adjustment.

Materials and methods. A retrospective analysis included 55 children with AIH/ASC treated in 2018-2024: responders with complete biochemical response (n=34) and non-responders (n=21). Baseline clinical and laboratory data and liver biopsy findings were assessed. Relative risk (RR), odds ratio (OR) and 95% confidence interval (CI) were calculated.

Results. Non-response was associated with ASC (RR=1.73; 95% CI: 1.07-2.82), anaemia (RR=2.78; 95% CI: 1.30-5.92), thrombocytopenia (RR=9.71; 95% CI: 1.26-75.16), splenomegaly (RR=1.71; 95% CI: 1.17-2.50) and inflammatory bowel disease (IBD) (RR=2.63; 95% CI: 1.32-5.26). Histological predictors included cholangitis activity ≥2 (RR=2.65; 95% CI: 1.58-4.44), ductopenia (p<0.01), biliary interface activity (RR=3.51; 95% CI: 1.58-7.81), and ductular epithelial expression of p16 (RR=1.95; 95% CI: 1.15-3.31) and p21 (RR=5.00; 95% CI: 1.62-15.39).

Conclusions. Individual clinical and laboratory indicators, comorbid IBD, and histological features of biliary injury and cellular senescence activation (p16/p21) were associated with treatment non-response at 12 months and may inform intensified monitoring and timely adjustment of therapy.

The study was conducted in accordance with the Declaration of Helsinki. The protocol was approved by the local ethics committee. Written informed consent was obtained from the children’s legal guardians.

The authors declare no conflict of interest.

Epigenetic modification of SIGIRR genes ın necrotizing enterocolitis and a prognostic model of peritonitis

Fri, 28 Nov 2025 00:00:00 +0200

Necrotizing enterocolitis (NEC) is a non-inflammatory disease caused by infectious factors against a background of immature innate defense mechanisms and hypoxic-ischemic injury of the intestinal mucosa.

Aim - to investigate the relationship between epigenetic alterations in the SIGIRR gene profile and the development of peritonitis in complicated cases of NEC.

Materials and methods. A total of 44 preterm infants diagnosed with necrotizing enterocolitis were included in the study. The results from 8 practically healthy preterm infants were used as a control group. Epigenetic changes caused by the methylation of 36 gene loci of the SIGIRR gene were examined in the blood samples of the infants. A comparative analysis of the SIGIRR gene profile changes was performed between 10 newborns with NEC who developed peritonitis and 42 newborns without peritonitis (34 with NEC and 8 practically healthy).

Results. The most significant changes were observed in loci %C35, %C58, and %C292. The Spearman correlation coefficients (ρ) for %C35 and %C58 were positive (0.319 and 0.332, respectively), indicating a potential direct association between variations in the SIGIRR gene and the development of peritonitis (p<0.05). The methylation of loci %C35 and %C58 of the SIGIRR gene was found to be a valuable biomarker for identifying infants with NEC who are at risk of developing peritonitis.

Conclusion. In preterm infants with SIGIRR gene modifications, early antibiotic therapy guided by clinical signs such as abdominal distension and feeding intolerance, along with laboratory, bacteriological, and radiological monitoring, as well as timely surgical consultation and early surgical intervention, may reduce the incidence of sepsis, peritonitis, and neonatal mortality.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the institution’s local ethics committee. The informed consent was obtained from patients.

The authors declare no conflict of interest.

Cholestatic liver diseases in children: clinico-morphological features and strategies for optimizing treatment and transplantation

H.V. Kurylo, L.Ya. Dubey, N.V. Dubey, B.R. Kotsai — Fri, 28 Nov 2025 00:00:00 +0200

Cholestatic liver diseases in early childhood are characterized by rapid fibrosis progression, high risk of liver failure, and the need for timely surgical or transplant intervention. Early risk stratification requires integration of clinical, laboratory, morphological, and molecular markers.

Aim - to perform a comprehensive assessment of clinical, laboratory, morphological, and immunohistochemical features of cholestatic liver diseases in young children and to develop a pathogenetically justified algorithm for optimizing surgical and transplant management.

Materials and methods. Eighty-two children aged 1 month to 3 years with various forms of cholestatic liver disease were studied. Clinical evaluation, biochemical and coagulation tests, ultrasonography, elastography, and MRI were performed. Liver biopsy specimens were assessed using METAVIR and Ishak scoring systems; immunohistochemistry evaluated α-SMA, CK19, and Caspase-3 expression. Statistical analysis included parametric and non-parametric tests with significance set at p<0.05.

Results. Biliary atresia was the most common form of cholestasis, associated with earlier disease onset, higher direct bilirubin and γ-glutamyl transferase levels, and more frequent severe fibrosis (F3-F4) compared to other forms (p<0,05). Intrahepatic and genetic-metabolic forms showed slower morphological progression with predominantly mild fibrosis (F1-F2), although some patients exhibited high fibrogenic activity. Significant correlations were found between bile acids, direct bilirubin, alanine aminotransferase activity, and α-SMA expression (r=0.72-0,82; p<0.001). The integrated clinicopathological approach allowed optimization of surgical timing and transplant indications, accompanied by improvement in liver function tests (p<0,01).

Conclusions. Comprehensive evaluation of clinical, laboratory, morphological, and immunohistochemical parameters enables early identification of children at high risk of fibrosis progression, personalization of treatment, and reduction of early liver transplantation.

The authors declare no conflict of interest.

Interactive methods of online teaching of pathological anatomy for international students: psychological and cultural aspects in conditions of war and pandemic

Fri, 28 Nov 2025 00:00:00 +0200

This article provides an overview and comparative analysis of modern approaches to distance teaching of pathological anatomy to international students in medical universities in Ukraine and Europe under conditions of war and pandemic.

Aim - to analyze and summarize the experience of applying interactive online methods for teaching pathological anatomy to international students in the context of martial law and the pandemic, with a focus on the psychological and cultural aspects of the educational process.

Psychological, cultural, and didactic aspects of the organization of the educational process are examined, as well as features of adapting educational materials and implementing interactive technologies in a distance learning environment. Effective strategies for using multimedia tools, online platforms, and visualization methods to improve the quality of morphological knowledge acquisition are identified. Special attention is paid to intercultural communication, support for academic motivation, and social integration of international students.

The results indicate that interactive forms of online learning, focused on interpersonal interaction and individual student needs, contribute to increased learning efficiency and the formation of a positive educational experience.

Authors declare no conflict of interest.