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Background: As breast cancer survival improves, cardiovascular toxicity has emerged as a major determinant of long-term outcomes. Cancer therapy-related cardiac dysfunction is particularly prevalent among postmenopausal women with increased cardiovascular risk, highlighting the need for early cardiotoxicity detection and targeted cardio-oncology surveillance.

Objective: To assess correlations between longitudinal changes in Global longitudinal strain, conventional Left Ventricular systolic-diastolic echocardiographic parameters, and cardiac biomarkers for prediction and early detection of cancer therapy-related cardiac dysfunction.

Methods: A prospective 24-month single-center study (December 2019-March 2024) assessed 74 postmenopausal patients with primary breast cancer receiving anthracycline or anthracycline-trastuzumab. Left ventricular systolic and diastolic function and N-terminal pro-B-type natriuretic peptide was measured at baseline and seven follow-up visits. Cardiotoxicity was defined by Ejection Fraction and Global Longitudinal Strain changes. Outcomes were analyzed using multiple regression, paired t-tests, ANOVA, and survival analyses (Kaplan-Meier, Cox), with cardioprotective therapy administered to high-risk patients and those with worsening left ventricular systolic parameters; p<0.05.

Results: In 74 breast cancer patients receiving anthracycline-based therapy, CTRCD incidence increased from 13.5% to 36.5% over 24 months. GLS detected cardiotoxicity earlier and more frequently than EF. NT-proBNP >125 pg/mL was associated with early and moderate CTRCD, peaking at 3 months with high sensitivity (94.1%) and specificity (90.9%), whereas NT-proBNP >300 pg/mL identified a smaller subgroup with more severe biomarker elevation. Diastolic dysfunction progressed biphasically, with E/e' >15 observed exclusively in high-risk CTRCD patients. Overall, NT-proBNP thresholds provided robust short-term biomarkers for early and severe CTRCD surveillance. ROC analysis demonstrated good diagnostic performance of NT-proBNP for CTRCD detection (AUC=0.779; 95% CI 0.656-0.901; p<0.001). Among the evaluated thresholds, 125 pg/mL demonstrated the most balanced diagnostic performance, achieving 100% specificity and 48.3% sensitivity.

Conclusion: In a 2-year study of postmenopausal breast cancer patients receiving anthracycline-containing regimens, GLS was the most sensitive and robust predictor of cardiotoxicity, outperforming EF. Early changes GLS predicted both early and late events, while diastolic indices showed temporal associations without independent predictive value; E/e' increased mainly in high-risk patients, NT-proBNP demonstrated diagnostic utility but was not independently predictive.

The research presented in the article was conducted in response to the challenges to family well-being arising from the 2020 military operations and subsequent migration in Armenia. It is also grounded on the 3rd goal of the United Nations sustainable development programs, which is particularly relevant in Armenia․ The aim of the study is to examine the relationships between key psychological factors that contribute to mental health within the family. Specifically, the study focuses on personal values, psychological safety, and well-being as psychological factors. They are considered important for ensuring mental health and are discussed in various approaches and research. The central research question explores whether the connections between well-being, psychological safety, and personal values play a primary role in maintaining mental health. The study involved 100 adult participants (51 female and 49 male), all over the age of 18․ The sample was randomly selected, and the principle of voluntary participation was maintained. Based on well-being indicators, the participants were divided into three study groups: a/ low well-being (n=12), medium well-being: n=56 and high well-being: n=32. Each group was analyzed separately. The findings indicate that individuals at different levels of well-being structure their value systems differently. In the low well-being group, the values of self-affirmation and pleasure, were less pronounced, in the medium group, psychological safety and stability are more prominent, while in the high well-being group, self-realization and harmonious expression of psychological safety prevail. The research confirms that values and psychological safety are interconnected and may be considered key prerequisites for promoting well-being and ensuring mental health within the family.

Background: Colorectal carcinoma (CRC) remains one of the most common malignancies worldwide and a leading cause of cancer-related mortality. Accurate prediction of recurrence is essential for risk stratification and individualized postoperative management. This study aimed to evaluate the prognostic and predictive significance of tumor budding (TB), lymphovascular invasion (LVI), and perineural invasion (PNI) in colorectal carcinoma.

Methods: A retrospective cohort study was conducted including patients treated at the Clinic of Abdominal Surgery and the Department of Pathology, University Clinical Center of Kosovo (UCCK), between January 2020 and June 2025. Follow-up data collection continued until December 2025, and only patients with a minimum follow-up duration of 6 months were included in the final analysis. Clinical, surgical, and histopathological data were collected, including TB, LVI, and PNI status. Statistical analysis included descriptive methods, chi-square test, binary logistic regression, receiver operating characteristic (ROC) curve analysis with area under the curve (AUC), and Kaplan-Meier disease-free survival (DFS) analysis with the log-rank test.

Results: High tumor budding (BD3) was identified in 29.2% of patients, LVI in 34.1%, and PNI in 26.7%. At least one invasive histopathological factor was present in 48.6% of the cohort. All three markers were significantly associated with disease recurrence (p<0.001). Multivariate logistic regression demonstrated that independent predictors of recurrence were LVI (OR 4.72; 95% CI 2.46-9.03), PNI (OR 3.91; 95% CI 1.98-7.72), and TB (OR 3.24; 95% CI 1.67-6.29). LVI showed the highest predictive accuracy in ROC analysis (AUC = 0.781). Kaplan-Meier survival analysis demonstrated significantly shorter median disease-free survival (DFS) in patients with one or more positive invasive histopathological factors compared with patients without such factors. Median DFS was 22.4 months (95% CI: 18.7-26.1) versus 35.1 months (95% CI: 31.4-38.8), respectively (log-rank p<0.001) Conclusions: Tumor budding, lymphovascular invasion, and perineural invasion are independent prognostic markers in colorectal carcinoma. Among them, LVI demonstrated the strongest predictive value for recurrence. Routine incorporation of these parameters into pathological reports may improve prognostic assessment and support therapeutic decision-making.

Background: Diabetic foot is one of the most serious complications of type 2 diabetes mellitus, often leading to ulcers, infections, and amputations.

Aim of the study: To assess the risk factors of diabetic foot among patients with type 2 diabetes.

Methods: A case-control study including 200 type 2 diabetic patients was conducted. Patients were selected by a convenience sampling technique. The sample consisted of 100 patients with diabetic foot (cases) and 100 patients without diabetic foot (controls). Multiple logistic regression analysis was used.

Results: Older age was prominent with most aged ≥ 60 years and the male-to-female ratio was 3:2. Multivariable logistic regression identified HbA1c ≥ 7% (OR=59.47, p<0.001), diabetic duration≥15 years (OR=59.66, p<0.001), neuropathy (OR=7.82, p=0.008), hypertension (OR=8.99, p=0.003), unemployment (OR=14.33, p=0.032), foot deformities (OR=22.32, p=0.014), history of corns and calluses (OR=51.67, p=0.001), lack of foot care awareness (OR=4.51, p=0.031), and not using emollients (OR=21.36, p=0.002) as independent predictors of diabetic foot.

Conclusion: Diabetic foot is strongly linked to multiple modifiable risk factors. Early identification and proper management are essential to reduce complications and improve outcomes.

Objective: A significant research gap exists regarding the association between metabolic disorders and acute respiratory viral infections (ARVIs) in children. This paper aims to investigate the ARVIs associated metabolic complications within the pediatric population.

Methods: The conducted review followed PRISMA 2020 guidelines. To ensure eligibility against defined inclusion criteria (children presenting with acute respiratory viral illness and concomitant metabolic dysfunction; publications spanning 2020 to 2025) and exclusion criteria (non-human studies; individuals over eighteen years of age), manual screening of full-text titles and abstracts was performed. Evaluation of risk of bias was done using the Newcastle-Ottawa Scale (NOS) and the JBI Critical Appraisal Checklist, for the two study designs selected.

Results: Only two studies were finalized for inclusion based on general methodological techniques. The outcomes show that children with recurring ARVIs unveil strong metabolic alterations, characterized by eminent thyroid-stimulating hormone (TSH) concentrations and tapered vitamin D levels.

Conclusion: During the acute phase of viral respiratory infections, research investigation highlights a transient metabolic alteration that does not appear to affect long-term health outcomes. Notably, further exacerbating the infectious period among ARVI patients, metabolic dysfunction increased with age. A higher susceptibility to vitamin D deficiency and TSH elevation was observed in older children, showing an immuno-inflammatory pathways linkage, signifying that metabolic instability in children encourages respiratory infections severity. A critical gap was addressed through the scientific literature study, providing a foundation for future research. Conversely, the small sample size and geographic restrictions do not support specific changes to clinical practice yet.

Background: Ischemic stroke is a major cause of death and disability worldwide. Recent evidence highlights the role of systemic inflammation in stroke pathophysiology and prognosis. The neutrophil-to-lymphocyte ratio (NLR), an accessible biomarker from routine blood tests, has been shown to be associated with stroke severity and outcome, but more research is needed to corroborate these findings.

Objective: To study the association between NLR at admission and stroke severity and probability of death in patients with acute ischemic stroke.

Methods: This prospective cohort study included 241 patients with confirmed ischemic stroke admitted to a regional hospital in Aktobe, Kazakhstan. Neurological status was assessed using the NIH Stroke Scale (NIHSS), Modified Rankin Scale (mRS), and Glasgow Coma Scale (GCS) on days 1 and 10. NLR was calculated from admission blood tests. Due to skewed distributions, data were presented as medians (Q1; Q3), and non-parametric tests were applied. Multivariable logistic regression analysis was performed to assess factors associated with in-hospital mortality, with adjusted odds ratios (ORs) and 95% confidence intervals (CIs) reported.

Results: The median NLR at admission was 2.67 (1.85; 4.36). Patients who died during hospitalization had significantly higher NLR values compared to survivors (4.73 [2.30; 8.91] vs. 2.50 [1.83; 3.77]; p<0.001). Higher NLR was associated with greater stroke severity and poorer functional outcomes, reflected by higher NIHSS and mRS scores on days 1 and 10. In multivariable analysis, log-transformed NLR was associated with 50% greater odds of in-hospital mortality; however, this association did not reach statistical significance (p=0.142).

Conclusion: Elevated NLR at admission is associated with more severe neurological deficits, worse functional outcomes, and in-hospital mortality in unadjusted analyses. Although NLR was not an independent predictor in multivariable analysis, it needs to be further studied as a simple and cost-effective potential additional biomarker for early risk stratification in acute ischemic stroke. Further large-scale, multicenter studies are needed to clarify the prognostic value of NLR in clinical practice.

This study investigates the relationship between emotional states and respiratory dynamics in drivers operating under varying levels of cognitive load. The research integrates psychophysiological measurements with emotional self-reports to examine how affective processes influence respiratory patterns during driving tasks. A total of 1,000 professional drivers participated in simulated and real-world driving, with 859 valid datasets retained after quality control procedures. Respiratory parameters, including respiratory rate, tidal volume, inspiratory duration, and inspiratory flow, were recorded using wearable sensors. Emotional states were assessed using the Self-Assessment Manikin (SAM) scale and a structured emotional questionnaire measuring stress, negative emotions, fatigue, and related indicators. The results revealed stable associations between emotional states and respiratory dynamics. Negative emotional states were associated with reduced inspiration time and decreased respiratory variability, indicating more constrained breathing patterns. In contrast, strong emotional activation was associated with increased tidal volume and inspiratory flow, reflecting greater respiratory amplitude. Correlation analysis demonstrated a strong physiological relationship between tidal volume and inspiratory flow (r≈0.90). Overall, the findings suggest that respiratory parameters represent sensitive psychophysiological markers of emotional regulation during driving tasks under cognitive load and may contribute to the development of driver monitoring systems aimed at detecting stress and cognitive overload.

Objective: To analyze cesarean scar endometriosis as a long-term complication of cesarean section and to evaluate its clinical presentation, latency period, diagnostic features, and surgical outcomes.

Design: Retrospective descriptive case series.

Setting: Tertiary referral medical center, 2018-2025.

Participants: Among 36 patients treated for various forms of endometriosis during the study period, five women with histologically confirmed post-cesarean scar endometriosis were included.

Main outcome measures: Latency period between cesarean section and symptom onset, diagnostic delay, depth of tissue involvement, surgical management, and recurrence during follow-up.

Results: Patients' age at diagnosis ranged from 31 to 42 years (mean 36.4 years). The latency period varied from 6 to 14 years (median 9 years). Four of five patients (80%) received an incorrect preliminary diagnosis at the prehospital stage. Lesion size ranged from 15 to 35 mm. Aponeurotic or muscular involvement was identified in two cases (40%), requiring extended surgical resection. Diagnostic laparoscopy performed in all patients revealed no concomitant pelvic endometriosis. Complete surgical excision with histopathological confirmation was achieved in all cases. No postoperative complications or recurrences were observed during follow-up.

Conclusions: Cesarean scar endometriosis is an underrecognized long-term complication of cesarean section characterized by prolonged latency and frequent initial misdiagnosis. Thorough imaging assessment and complete surgical excision ensure favorable outcomes. Increased clinical awareness is essential for timely diagnosis.

Introduction: Treatment of biofilms is a priority in purulent surgery. A biofilm consists of 75-85% extracellular polymeric matrix and 15-20% microbial cells. Polysaccharides, proteins, and extracellular DNA within the matrix protect bacteria from adverse environmental factors (pH, antibiotics, phagocytosis). Communication between bacteria occurs through the "quorum sensing" system. Bacteria within biofilms are 100-1000 times more resistant to antibiotics compared to planktonic forms. This is explained by the limited penetration of antibiotics into the matrix and the reduced metabolic activity of the cells. Bacteria of the genus Staphylococcus, particularly Staphylococcus aureus, are currently recognized as the main causative agents of purulent-inflammatory diseases.

Objective of the study: to comprehensively assess the biofilm-forming activity of staphylococcal strains isolated from patients with purulent-inflammatory diseases of soft tissues (PIDs), as well as to determine the characteristics of their sensitivity to the main antimicrobial agents.

Materials and methods: To achieve the objectives of the study, we conducted a research project and examined 80 strains of the genus Staphylococcus isolated from purulent-inflammatory diseases. Of these, 50 belonged to the main group (MG) and 30 to the control group (CG). The identification of species characteristics of the 80 strains from the main and control groups was carried out based on their morphological, cultural, and biochemical properties. In addition, these strains were identified using MALDI-TOF mass spectrometry.

Results: Analysis of the obtained results showed that S. aureus was predominant in both groups. During the study, 50 staphylococcal strains and two species-S. aureus and S. epidermidis-were identified among samples collected from patients with purulent-inflammatory diseases. In the control group, out of 30 strains, only one species-S. aureus-was identified. Biofilm-forming activity was also assessed based on microcolony size, and the morphological and tinctorial properties of isolated biofilm samples were studied. The field of view, number of objects, and their proportion within the field of view were calculated using digital images of the samples. The following microcolony sizes were taken into account: up to 10 µm², from 10 to 100 µm², from 100 to 1000 µm², from 1000 to 10,000 µm², and over 10,000 µm².

Background: Periodontitis is a prevalent chronic inflammatory disease characterized by progressive destruction of periodontal supporting tissues, yet its precise molecular mechanisms remain incompletely understood. This study aimed to identify key pathogenic genes and elucidate the underlying molecular mechanisms of periodontitis through integrated bioinformatics analysis.

Methods: Periodontitis-related gene expression datasets were retrieved from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified using the limma package and visualized via volcano plots. Gene set enrichment analysis (GSEA) was performed to characterize enriched biological pathways. A protein-protein interaction (PPI) network was constructed using the STRING database and visualized in Cytoscape. Functional enrichment analysis was conducted using the ClueGO plugin, incorporating Reactome, Gene Ontology (GO), and KEGG annotations. Hub genes were identified using the cytoHubba plugin with five topological algorithms (Degree, MNC, MCC, Closeness, and EPC), and key genes were determined through Venn diagram analysis. Individual GSEA was subsequently performed for each key gene. Finally, a competing endogenous RNA (ceRNA) regulatory network was constructed based on the lncRNA-miRNA-mRNA axis.

Results: A total of 7 key genes were identified: IL1B, CXCR4, FCGR3B, SELL, CD19, CXCL8, and CD38. Functional enrichment analyses revealed significant involvement of cytokine-cytokine receptor interaction, hematopoietic cell lineage, collagen degradation, and chemokine signaling pathways. GSEA of individual key genes further confirmed the central roles of immune and inflammatory pathways in periodontitis. The ceRNA network revealed regulatory interactions among lncRNAs, miRNAs, and key genes, particularly centered on IL1B, SELL, and FCGR3B.

Conclusion: This integrated bioinformatics study systematically identified key genes and regulatory networks in periodontitis, offering promising candidates for future therapeutic development.