Modern medical technology

Dynamics of anemia panel in patients after sleeve gastrectomy in the long-term follow-up

O. O. Kalashnikov, I. M. Todurov, A. A. Hrynevych, S. I. Mazii — Thu, 25 Dec 2025 00:00:00 +0200

Obesity and bariatric surgery are global challenges; however, long-term postoperative patients may develop disorders of iron and vitamin metabolism that culminate in anemia. Timely laboratory surveillance is essential to detect preclinical deficiencies.

The aim of the study: to evaluate changes in anemia panel indicators in patients after sleeve gastrectomy in the long-term postoperative period.

Materials and methods. A retrospective cohort of 114 adults with morbid obesity who underwent primary sleeve gastrectomy was analyzed. Preoperative anthropometry and anemia panel were within reference limits. Laboratory follow-up included hemoglobin, ferritin, serum iron, transferrin, and vitamin B12, assessed preoperatively and at 36 months after SG (overall observation period up to 60 months). Statistics: Kolmogorov–Smirnov, Levene, Wilcoxon for paired non-normal data, Pearson correlations, and multivariate linear regression (predictors: serum iron, ferritin, transferrin, vitamin B12); significance p < 0.05.

Results. At 36 months, anemia was present in 23.7 % (27/114). Compared with baseline, Hb decreased from 143 [136.0–150.0] to 136.7 [127.7–142.0] g/L (p = 0.001), serum iron from 20.8 [17.0–23.7] to 11.6 [3.9–18.8] μmol/L (p = 0.001), and ferritin from 126.2 [90.7–191.0] to 10.9 [9.4–95.5] ng/mL (p = 0.001); vitamin B12 showed no significant change (p = 0.053). Overall, anemia-panel disorders were frequent: latent iron deficiency 26.3 %, iron deficiency without anemia 15.8 %, iron-deficiency anemia 15.8 %, anemia without iron deficiency (likely B12/folate) 5.3 %, and combined deficiency 2.6 % (total 65.8 % with any disorder). Hemoglobin correlated with serum iron (r = 0.443; p = 0.001) and ferritin (r = 0.359; p = 0.001). In multivariate regression (F = 8.47; p < 0.001; R² = 0.237), independent predictors of hemoglobin were serum iron (β = 0.410; p = 0.001) and vitamin B12 (β = 0.180; p = 0.038); ferritin and transferrin were not independent predictors; no critical multicollinearity (VIF < 2.2).

Conclusions. Three years after sleeve gastrectomy, nearly one quarter of patients develop anemia and two thirds exhibit anemia-panel abnormalities, predominantly iron-related. Monitoring limited to hemoglobin misses a large burden of latent deficiency. A standardized follow-up that includes ferritin, serum iron, transferrin, and vitamin B12-alongside timely nutritional correction-should be routine to prevent progression to manifest anemia and its complications.

Clinical-endoscopic features and clinicopathological correlations of laryngopharyngeal reflux in young adult men: an observational cross-sectional study

O. V. Hancheva, V. M. Kryshtal, I. O. Sinaiko, T. V. Strohonova, V. I. Troian — Thu, 25 Dec 2025 00:00:00 +0200

Aim. To determine clinical and morphological manifestations of laryngopharyngeal reflux (LPR) in young adult men using validated diagnostic instruments (RSI, RSS-12, RSA) in a single-center, cross-sectional comparative study.

Materials and methods. The study was conducted at the Medical Educational and Scientific Center “University Clinic” of Zaporizhzhia State Medical and Pharmaceutical University between July 2024 and June 2025. Two groups of young men were formed: the main LPR group (MG, n = 91) and a conditionally healthy control group (CG, n = 64). Comprehensive diagnostics included medical history, general clinical examination, standardized questionnaires, and videoendoscopy. Endoscopic verification was performed using MedStar UE 3000 and KARL STORZ systems, applying the Reflux Sign Assessment (RSA) scale (threshold > 14). Symptoms severity was assessed using the Reflux Symptom Index (RSI) (threshold ≥ 13) and Reflux Symptom Score-12 (RSS-12) (threshold ≥ 11), including the quality of life (QoL) subscale. Psycho-emotional status was evaluated using the Hospital Anxiety and Depression Scale (HADS).

Results. The mean RSA endoscopic score was significantly higher in the MG compared with the CG (20.64 ± 9.49 vs 6.28 ± 3.32; p < 0.01). The most frequent complaints were throat dryness (52.74 %) and burning (64.84 %), which are not captured by standardized questionnaires and emerged only through detailed history taking. Videoendoscopy revealed variable pharyngeal and laryngeal mucosal changes; due to neuro-reflex and sensory mechanisms in LPR pathogenesis, findings ranged from minimal or absent to pronounced. Questionnaire data showed markedly higher scores in the MG compared to the CG: RSI – more than threefold higher, RSS-12 – approximately sevenfold higher, and QoL – 4.7-fold higher.

Conclusions. Among patients with LPR, reflux-associated laryngitis was most prevalent (78.02 %), followed by pharyngitis (52.74 %), chronic cough (56.04 %), and dysphonia (49.45 %). The “globus” symptom complex was reported by one-third of patients (34.07 %). Less common morphological alterations were detected in 14.28 % of cases, including laryngeal granulomas (5.49 %), edematous-polypoid laryngitis (3.30 %), and squamous papillomas of the oropharynx (5.49 %). Digital and visual endoscopic visualization of the laryngopharyngeal complex of patients with LPR demonstrated changes ranging from mild-to-moderate to markedly expressed (maximum RSA = 56, minimum = 7), indicating distinct clinical phenotypes, the absence of a single pathogenetic mechanism, and the necessity of individualized diagnostic and therapeutic strategies. The range of total scores in the RSI questionnaire survey of patients with LPR was 13–44 points, and in the RSS-12 questionnaire survey, it was 16–175 points.

Assessment of the psychological state of medical students in wartime depending on their location

Thu, 25 Dec 2025 00:00:00 +0200

The aim of the study is to analyze the psychological state of medical students, including those in postgraduate training, in the city of Zaporizhzhia and comparing these indicators with a similar cohort in the city of Chernivtsi, with the cohort of temporarily displaced medical students in other regions of Ukraine and abroad.

Materials and methods. An assessment of anxiety and depression levels was conducted among 613 medical students. The study was implemented through an online survey using a questionnaire-based method, structured according to the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Patient Health Questionnaire (PHQ-9), both of which have been properly adapted for use in Ukraine.

Results. For the group of respondents from Zaporizhzhia, when compared to the group of respondents from Chernivtsi, the number of “clinically significant” cases of anxiety was significantly lower (p = 0.016). The number of “clinically significant” cases of depression did not show significant differences compared to other groups. At the same time, for the group of respondents from Chernivtsi, compared to the group of respondents from other regions of Ukraine, the number of “clinically significant” cases of anxiety was significantly higher (p = 0.019). The number of “clinically significant” cases of depression, when compared to the group of respondents from other regions of Ukraine, was also significantly higher (p = 0.019).

Conclusions. Qualitative analysis demonstrates prevalence of “significant” cases of anxiety according to the GAD-7 in the group of respondents from Chernivtsi compared with the group from Zaporizhzhia (42.6 % vs. 30.1 %, p = 0.016). Compared with the group of respondents from other regions of Ukraine, this indicator is also higher in the Chernivtsi group (42.6 % vs. 28.2 %, p = 0.002). Qualitative analysis shows a predominance of “significant” cases of depression in the group of respondents from Chernivtsi compared to a similar group from other regions of Ukraine (48.8% vs. 37.2%, p = 0.019), while no predominance of “significant” cases was found in comparison with a similar group from Zaporizhzhia (48.8% vs. 39.7%, p = 0.068). Quantitative analysis shows that statistically significant differences in self-assessment of anxiety levels are observed only between groups of respondents in Chernivtsi and other regions of Ukraine, with a predominance in the group of respondents in Chernivtsi (p = 0.006). Similarly, differences in quantitative indicators of self-reported depression levels according to PHQ-9 are also observed only between groups of respondents from Chernivtsi and other regions of Ukraine, with a predominance of moderate depression severity in the group of respondents from Chernivtsi (p = 0.012).

Results of a Survey “Ethacizine evaluation for acute and chronic treatment of atrial fibrillation in real practice: Ukrainian national survey (ETERNITY)”

N. M. Sydorova, M. Yu. Kolesnyk — Thu, 25 Dec 2025 00:00:00 +0200

The aim of the study: based on a survey of physicians, the study aims to identify the real clinical practices regarding the use of class IC antiarrhythmic drugs in Ukraine, particularly ethacizine, for restoring sinus rhythm in paroxysmal and persistent forms of atrial fibrillation, employing a methodology similar to the “pill-in-the-pocket” approach.

Materials and methods. Data were analysed from 100 anonymous voluntary questionnaires. We used snowball sampling to collect the responses. Participants had the option to skip questions, and calculations were based on the number of respondents who answered each question.

Results. More than half of the respondents actively prescribe class IC antiarrhythmic drugs (AADs), with ethacizine being the most commonly prescribed (56.8 % of respondents). Notably, 61.4 % of respondents had never prescribed flecainide, 34.3 % had never prescribed propafenone, and 18.6 % had never prescribed ethacizine. The primary indication for prescribing class IC AADs was atrial fibrillation (AF) (43.3 %), followed by the combination of ventricular and supraventricular rhythm disturbances (34.4 %). Only 13.8 % of respondents initiate therapy with class IC AADs exclusively in inpatient settings, while 31.9 % primarily did so in outpatient settings with ECG monitoring. More than half of the respondents reported experience restoring sinus rhythm (SR) in AF with ethacizine using a regimen similar to “pill-in-the-pocket”; over a quarter of these cases were decisions made by patients already on ethacizine for SR maintenance. More than a quarter of respondents had experience using ethacizine for the “acute treatment” of AF in single doses higher than the standard 100 mg (125 mg – 6.8 %; 150 mg – 20.3 %). At the same time, 31.9 % of respondents prescribed ethacizine for SR restoration in AF as discrete regimens, prescribing low doses at shorter intervals (1–3 hours).

Conclusions. The survey results indicate that class IC AADs, especially ethacizine, are actively prescribed in real clinical practice not only for arrhythmia prevention, including AF, but also for SR restoration. This underscores the need for high-quality clinical studies to assess the efficacy and safety of such treatment strategies for ethacizine, which remains less studied within class IC AADs.

Sagittal profile of knee joint morphotypes in osteoarthritis

R. I. Blonskyi, L. O. Kylymniuk — Thu, 25 Dec 2025 00:00:00 +0200

The aim of the study was to characterize the features of sagittal morphology of knee joints in osteoarthritis, considering the structural variant of the joint determined by our own cluster system.

Materials and methods. A total of 100 knee radiographs from 70 patients diagnosed with osteoarthritis were analyzed. Based on the proposed classification system, morphotype I was identified in 21 patients (21.00 %), morphotype II in 38 (38.00 %), morphotype III in 29 (29.00 %), and morphotype IV in 12 patients (12.00 %). The following radiographic parameters were assessed: posterior distal femoral angle (PDFA), posterior condylar offset ratio (PCOR), posterior tibial slope (PTS), tuberosity-modified tibial slope (TMTS), and tibial tuberosity inflection angle (TTIA). Statistical analysis was performed using Statistica 13 software. Statistical significance was defined at p ≤ 0.05.

Results. The mean PDFA was 84.98 ± 5.62°. Mean values across morphotypes were: morphotype I – 89.27 ± 1.79°, morphotype II – 87.20 ± 4.50°, morphotype III – 83.11 ± 4.33°, and morphotype IV – 75.43 ± 2.64° (p < 0.00001). The mean PCOR was 0.44 ± 0.08. The index value in patients with morphotype I was 0.45 ± 0.05, morphotype II – 0.44 ± 0.10, morphotype III – 0.45 ± 0.07, morphotype IV – 0.39 ± 0.06 (p = 0.14). The mean PTS was 9.00 ± 4.18°. The highest values were found in patients with morphotype I – 11.82 ± 4.00°, patients with morphotype II – 9.72 ± 4.72°, morphotype III – 7.58 ± 2.91°, and morphotype IV – 5.86 ± 1.46° (p = 0.01). The average TMTS was 36.48 ± 6.28°. The angle value in patients with morphotype I was 35.36 ± 3.78°, morphotype II – 34.92 ± 7.17°, morphotype III – 37.45 ± 5.78°, morphotype IV – 41.14 ± 5.52° (p = 0.045). The mean TTIA was 160.54 ± 6.81°: in individuals with morphotype I – 157.91 ± 8.81°, morphotype II – 158.62 ± 5.90°, morphotype III – 162.74 ± 6.07°, and morphotype IV – 165.57 ± 4.31° (p = 0.008). A significantly higher likelihood of morphotype III was observed in patients with PDFA values 79–87° (OR = 5.66, 95 % CI: 1.71–18.68, p = 0.003). A higher probability of morphotype II development was associated with PCOR values >0.44 (OR = 3.34, 95 % CI: 1.06–10.50, p = 0.03). The presence of PTS values > 8° increases the odds of morphotype I formation (OR = 6.43, 95 % CI: 1.22–33.95, p = 0.01).

Conclusions. Given the identified morphotype-specific differences in sagittal knee joint morphology in osteoarthritis, further studies are needed to justify a personalized approach to orthopaedic surgical planning.

Peculiarities of Bcl-2, p53 and c-Kit protein distribution in endocrinocytes of pancreatic islets in SHR rats with arterial hypertension

T. V. Ivanenko, Yu. M. Kolesnyk, A. V. Abramov — Thu, 25 Dec 2025 00:00:00 +0200

Arterial hypertension is a concomitant disease in type 2 diabetes and the coexistence of both conditions increases the risk of microvascular and macrovascular complications in patients, as well as leads to a threefold increase in the risk of other cardiovascular diseases.

Aim. Identify quantitative distribution patterns of Bcl-2, p53 and c-Kit proteins and the magnitude of their expression in endocrinocytes of pancreatic islets in SHR rats with hereditary arterial hypertension.

Materials and methods. The study was conducted on 10 white Wistar rats and 10 SHR rats with hereditary arterial hypertension. Insulin, glucagon, c-Kit, Bcl-2 and p53 proteins were detected by immunofluorescence using antibodies produced by Santa Cruz Biotecnology (USA). The immunofluorescence reaction was studied using an AxioImager-M2 fluorescence microscope (Carl Zeiss, Germany) equipped with an AxioCam-5HRm camera (Carl Zeiss, Germany), using 38NE and 43NE high emission light filters (Carl Zeiss, Germany).

Results. A distinctive feature of the organization of pancreatic islets in hypertensive SHR rats was characterised by a 30 % (p < 0.05) decrease in the average area of pancreatic islets, a 14 % (p < 0.001) decrease in the number of beta cells in them, combined with an 18 % (p < 0.001) increase in the number of alpha endocrinocytes compared to normotensive Wistar animals. At the same time, insulin concentration in beta-cells of hypertensive animals was decreased by about 20 % (p < 0.001), and glucagon concentration in alpha-cells was increased by 36 % (p < 0.001). Examination of immunoreactivity to Bcl-2, p53 and c-Kit proteins in normotensive and hypertensive rats showed patterns of high and low expression in endocrinocytes of pancreatic islets. The present study shows that SHR rats develop diverse changes in the functional state of endocrine cells of the pancreas, based on which several pathogenetic aspects can be suggested to explain the remodelling of pancreatic islets in hereditary hypertension: a decrease in the number of beta cells expressing Bcl-2 protein reduces their anti-apoptotic potential and thus facilitates the formation of pro-apoptotic proteins of the BCL-2 family that activate the mitochondrial pathway of apoptosis However, against the background of a decreasing population of beta-endocrinocytes in the pancreas, such a mechanism should be regarded as ineffective.

Conclusions. Formation of hereditary hypertension in SHR rats leads to a reduction in the population of beta-cells in the pancreatic islets, a decrease in insulin concentration in them and an increase in the number of alpha-endocrinocytes. In the beta-cells of hypertensive SHR rats, the expression of proliferation factor c-Kit protein increases, the expression of the anti-apoptotic protein Bcl-2 decreases and the intracellular concentration of pro-apoptotic protein p53 remains at the level of normotensive animals. In alpha-cells of hypertensive SHR rats, the expression of c-Kit protein is suppressed against the background of the increase in the total content of pro-apoptotic protein p53 in islets, while the content of anti-apoptotic protein Bcl-2 in islets remains at the level of normotensive animals.

Role of p38 activation in changes of nitric oxide production in rat biceps femoris muscle during metabolic syndrome

O. Ye. Akimov, A. O. Mykytenko, V. O. Kostenko — Thu, 25 Dec 2025 00:00:00 +0200

Transcriptional changes in organism and muscles especially during development of metabolic syndrome (MetS) is still highly understudied. Role of p38 MAPK activation during MetS is highly debatable.

The aim of this study is to evaluate influence of administration of selective inhibitor of p38 MAPK on production and metabolism of nitric oxide in rat biceps femoris during metabolic syndrome modelling.

Materials and methods. The study was conducted on 24 mature male Wistar rats weighing 200–260 g, which were divided into 4 groups of 6 animals each: I – control group; II – MetS (received 20 % fructose for 60 days); III – SB203580 administration (received SB203580 intraperitoneally in a dose 2 mg/kg once every 3 days for 60 days); IV –SB203580 + MetS modelling. We studied activity of enzymes responsible for NOS-dependent and NOS-independent NO production and content of nitrites, peroxynitrites and nitrosothiols in rat biceps femoris.

Results. MetS modelling increased production of nitric oxide from NO-synthases and nitrtate-nitrite reductive pathway, elevated content of nitrosothiols and peroxynitrite, while SB203580 during MetS modelling attenuated these changes in production of nitric oxide and nitrosothiols and peroxynitrite content.

Conclusions. P38 MAPK activation during MetS modelling increases NOS-dependent and NOS-independent NO production and leads to accumulation of nitrosothiols and peroxynitrite in rat biceps femoris.

Changes in biochemical and molecular parameters of blood in patients with chronic generalized periodontitis during a course of treatment with interleukin-1 receptor antagonist

O. O. Dmytriieva, S. O. Chertov, I. F. Bielenichev, V. I. Salnykov, I. B. Samura — Thu, 25 Dec 2025 00:00:00 +0200

The aim of the study was to conduct a laboratory and biochemical assessment of the complex therapy of chronic generalized periodontitis (CGP) with the inclusion of an IL-1 receptor antagonist (Anakinra) in the therapy.

Materials and methods. Examination and treatment of 60 patients with CGP of moderate severity and 30 patients with intact periodontium aged 40 to 65 years (35 women and 25 men) were conducted. Patients were divided into 2 groups: main and control, 30 people in each. Examination and treatment were carried out with the consent of the patients in accordance with GCP standards (1996) and the principles of the Declaration of Helsinki (World Medical Association – WMA, 2013). Patients with CGP of both groups received standard complex therapy for 30 days, which included oral hygiene; vector therapy; curettage; fixation of teeth in the correct position with specialized materials; anti-inflammatory and antiseptic medications. In addition, patients in the main group were prescribed Anakinra (1 mg/day) in the form of intraoral transgingival electrophoresis on both jaws (5 sessions). Biochemical studies included monitoring of the activity of lactate dehydrogenase (LDH), succinate dehydrogenase (SDH), glutathione peroxidase (GPx), glutathione reductase (GR); enzyme immunoassay of endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), nitrotyrosine and metalloproteinase-2 (MPP-2) in the blood of patients of the control and main groups before treatment and after 30 days of treatment. Statistical processing of the results was performed using the software package Statistica for Windows 13 (StatSoft Inc., No. JPZ804I382130ARCN10-J), as well as “SPSS 16.0”, “Microsoft Excel 2003”.

Results. It was found that the additional inclusion of Anakinra in the complex treatment of CGP potentiated the anti-inflammatory effect of the therapy that was manifested in a more pronounced, compared to the control group, decrease in the level of MMP-2, and clinical signs (depth of periodontal pockets, bleeding, tooth mobility, etc.); enhanced antioxidant action, which was confirmed by a more pronounced decrease in nitrotyrosine level, an increase in GR and GPx activity (p < 0.05) compared to similar indicators in patients in the control group. The inclusion of Anakinra enhanced the anti-ischemic effect of complex therapy that was manifested in a decrease in LDH levels and an increase in SDH concentration (p < 0.05); and also contributed to a decrease in iNOS expression and an increase in eNOS expression (p < 0.05) compared to similar indicators of patients in the control group.

Conclusions. The results obtained demonstrate a promising strategy of pharmacological blockade of IL-1β receptors, which may have new prospects for the treatment of patients with CGP.

Pharmacotherapeutic effect of quercetin delivery systems in experimental acute respiratory distress syndrome induced by acid aspiration

Thu, 25 Dec 2025 00:00:00 +0200

Predictive justification and experimental confirmation of the pharmacotherapeutic effect of quercetin incorporated into the phosphatidylcholine liposomes or the povidone matrix in a model of acute respiratory distress syndrome induced by intratracheal aspiration of hydrochloric acid are presented.

Aim. To establish the phenomenon of the pharmacotherapeutic action of quercetin in transport systems in acute respiratory distress syndrome caused by acid aspiration, using various methods of administration in order to provide experimental justification for the broader clinical translation of known quercetin formulations.

Materials and methods. The study was conducted in compliance with bioethical standards using Balb/c mice (25–30 g, both sexes) from the vivarium of the State Institution “Institute of Pharmacology and Toxicology of the National Academy of Medical Sciences of Ukraine”. Acute respiratory distress syndrome (ARDS) was modeled by intratracheal instillation of 0.1 N HCl after propofol anesthesia. Control animals received sterile saline. Two drugs were studied: Lipoflavon® (liposomal quercetin formulation) and Corvitin® (water-soluble quercetin derivative). The samples were administered intravenously and/or by inhalation according to different regimens for 5 days. Therapeutic efficacy was assessed by survival, body weight dynamics, clinical status, and histological examination of lungs and heart. Tissue samples were fixed in formalin, paraffin-embedded, sectioned, stained with hematoxylin-eosin, and examined by light microscopy. Statistical analysis was performed using the Shapiro–Wilk normality test, one-way analysis of variance (ANOVA), or Kruskal–Wallis criterion (p ≤ 0.05). The analysis was performed in Microsoft Excel and using the Statistics Kingdom online calculator.

Results. The phenomenon of the therapeutic and prophylactic effect of the studied quercetin transport systems (drugs Lipoflavon and Corvitin) was established in terms of their protective effect on the dynamics of survival (growth up to 100 %), normalization of the clinical condition and weight of animals during ARDS induction by acid aspiration. The pharmacotherapeutic effect of inhalation and injection administration of the studied quercetin preparations was visualized by the histo-morphological picture of structural restoration and anti-inflammatory process in the target lungs and bronchi, which are deeply affected in the ARDS model.

Conclusions. The obtained experimental results should contribute to the justification of the clinical translation of drugs based on quercetin transport systems in the medical technology of ARDS treatment.

Brexit and the UK pharmaceutical industry: regulatory measures, accessibility of medical technologies and experience for Ukraine

Yu. V. Filei, O. H. Aleksieiev — Thu, 25 Dec 2025 00:00:00 +0200

The issue of legal regulation of the pharmaceutical sector is highly relevant today, as it affects not only economic stability of the country, but also public health and safety of its citizens. Following its withdrawal from the EU, the United Kingdom faced the need for a restructuring of the regulatory system, which was previously based largely on European legislation. After Brexit, the country encountered the challenge of developing an autonomous framework that takes into account national interests and international obligations.

The aim of the study is to analyse the transformation of the legal regulation of the pharmaceutical industry in the United Kingdom after Brexit and to identify the possibilities of adapting this experience to improve Ukrainian legislation in the field of pharmaceuticals.

Materials and methods. The empirical basis includes UK and EU legislation, international standards (ICH, PIC/S), as well as scholarly publications and reports from regulatory authorities (MHRA, EMA) and international organizations. Data were retrieved from eur-lex.europa.eu and legislation.gov.uk using the key terms “Brexit,” “pharmaceutical activity,” and “regulatory activity.” A combination of systemic, comparative, historical, and content analysis enabled the identification of post-Brexit legal changes and the assessment of their impact on the pharmaceutical industry.

Results. It is proved that the legal framework governing the pharmaceutical sector in the UK at the beginning of Brexit, which had been formed over many years, was stable and effective. The authors analyse the legal status of the main regulator of the UK pharmaceutical sector – UK Medicines and Healthcare products Regulatory Agency (MHRA). It is emphasised that despite political and economic changes, the MHRA has maintained its independence and efficiency in issuing licences, controlling the circulation of medicines and introducing innovative approaches to regulation. It is thanks to this that British pharmaceutical companies have been able to adapt to the new conditions, maintain their competitiveness and even expand their influence in international markets. At the same time, the process of regulating the industry has not been without problems, on the contrary, numerous difficulties have arisen. Attention is paid to the interaction of the MHRA’s interaction with European regulators, in particular the EMA. Based on the analysis, ways of using the UK’s experience to improve Ukrainian pharmaceutical legislation are proposed.

Conclusions. Brexit has had a significant impact on the UK pharmaceutical market, creating both opportunities and challenges for the regulatory system. The UK’s experience in adapting its pharmaceutical legislation after leaving the EU can be applied by Ukraine in some areas. For example, the creation of a more flexible registration system based on international standards will help reduce the bureaucratic burden. Integration with international regulators, such as the FDA and EMA, will facilitate the export of Ukrainian medicines and increase confidence in the national quality control system