Kyrylo Savichan

RESEARCH, TEACHING, or OTHER INTERESTS

Gastroenterology, Health Policy, Hepatology, Internal Medicine

Scopus Publications

Comprehensive analysis of scientific research on penetrating neck wounds in the world and Ukraine
V.V. Chorna, V.V. Fedotova, V.V. Kolomiets, V.M. Lypkan, M.V. Rybinskyi, K.V. Savichan, and L.S. Hudzevych
Publishing House Zaslavsky
Neck injuries remain a serious problem for combat medicine, and timely premedical care is crucial for the survival of military personnel with such trauma. The purpose is to conduct a retrospective analysis of scientific papers on the structure, location of penetrating neck wounds, complications during military conflicts around the world, and the provision of premedical and surgical care. Materials and methods. A literature search was conducted on the structure, location of penetrating neck wounds, complications and provision of premedical care in limited resources and surgical care during military conflicts in 73 modern scientific papers using the MEDLINE/PubMed, Karger, Embase/Ovid databases. After reviewing the articles and reading their full texts, 37 sources were selected. The search on the penetrating neck injury, premedical care was conducted for 2004–2024. Gunshot wounds to the larynx and pharynx are among the most serious neck injuries in military settings. They cause potentially life-threatening complications such as asphyxia, massive bleeding, and hypovolemic shock. The experience of Ukrainian doctors complements the strategy of new prehospital treatment protocols focused on airway management and stopping critical bleeding. Improvements in these approaches can significantly reduce combat morbidity and mortality among military personnel. The article presents 4 clinical cases of penetrating wounds of the head, neck, and face and the medical interventions performed at the second stage of evacuation to transfer to the next stage of treatment. Conclusions. It is recommended to continue research in this area based on the experience of Ukraine for new protocols at the prehospital stage of treatment focused on airway management and stopping critical bleeding. Improvement of these approaches can significantly reduce combat morbidity and mortality among military personnel.


VITAMIN THERAPY IN THE TREATMENT OF MILD TRAUMATIC BRAIN INJURY: NEW HORIZONS OF CLINICAL PRACTICE
A. V. Shvets, K. V. Savichan, and Ya. M. Klymenko
Ukrainian Military Medical Academy
Objective: To investigate the main aspects of the impact of vitamin therapy on the treatment effectiveness of patients with mild traumatic brain injury and to illustrate it on the example of individual clinical cases.Materials and Methods. The analysis of scientific sources of information in various electronic databases (PUBMED, ScienceDirect, Reserch4life, MEDLINE) on the ability of vitamins to reduce oxidative stress, stimulate neuroprotection, and improve cognitive function in people with mild traumatic brain injury over the past 10 years. The search included the following keywords and terms: vitamins (with separate letters B, C, D, E) and omega-3 fatty acids, mTBI, TBI, oxidative stress, micronutrients, physiological process, cognitive function, and biochemical and neurological consequences. To describe clinical cases, in addition to the well-known methods of examination of patients with mild traumatic brain injury, scales for assessing the psychoemotional state were used, namely the Hospital Anxiety and Depression Scale (HADS) for patients in somatic inpatient departments.Results. According to scientific sources of information, a positive effect of vitamins C, E and D on reducing oxidative stress was demonstrated, while B vitamins contributed more to the normalization of neuronal energy metabolism. Patients with mild traumatic brain injury treated with complex vitamin therapy demonstrated a reduction in the duration of mild traumatic brain injury symptoms, in particular headache, and improvement of psychoemotional state, mainly during the first 10 days of treatment.Conclusions. Since traumatic brain injury (TBI) is a complex clinical condition accompanied by both primary brain damage and a secondary biochemical cascade that contributes to prolonged neuroinflammation, oxidative stress, and cellular dysfunction, its treatment and rehabilitation require the development of new approaches, in particular with the use of vitamin therapy, which aims to support the function of the nervous system by providing neuroprotection, antioxidant action, and support for cellular energy metabolism. Clinical examples demonstrate a phenomenological tendency to a more pronounced recovery of the psycho-emotional state in a patient who was prescribed thiamine hydrochloride 100 mg, pyridoxine hydrochloride 100 mg, cyanocobalamin 1 mg (Vitaxon) by mouth once daily. The data from preclinical and clinical studies in recent years confirm the prospects of using vitamin supplements as part of the complex therapy of mild traumatic brain injury to reduce secondary brain damage, improve cognitive function, and accelerate patient recovery. Further research of the mechanisms of action of vitamins, optimal dosages, time windows of use, and impact on long-term outcomes is needed to improve the treatment of patients with mild traumatic brain injury, which may become an important component of personalized TBI therapy aimed at reducing functional deficits and improving patients' quality of life.


Autoimmune Hemolytic Anemia Associated with COVID-19 Infection in a Patient with High Cardio-metabolic Risk
Galyna V Osyodlo, Svitlana A Husieva, Svitlana V Svicharova, and Kyrylo V Savichan
Oxford University Press (OUP)
ABSTRACT The article analyses data on the occurrence of hematological abnormalities in severe acute respiratory syndrome 2 infection. Among these hematological abnormalities, the majority of patients develop a hypercoagulable state associated with thromboembolic complications and poor prognosis. Approximately one-third of patients with severe acute respiratory syndrome 2 infection are diagnosed with mild to severe thrombocytopenia. Another hematological autoimmune disease observed in patients with coronavirus disease 2019 is autoimmune hemolytic anemia. A clinical case with the development of autoimmune hemolytic anemia in the setting of coronavirus infection was described. The diagnosis was based on the presence of anemia, reticulocytosis, a significant decrease in haptoglobin levels, and a positive antiglobulin test (Coombs test). Given the comorbidity, the risks of adverse effects of severe coronavirus disease were high, despite this, it was possible to achieve clinical and hematological remission of autoimmune hemolytic anemia by prescribing pathogenetic therapy with anti-CD-20 monoclonal antibody (rituximab), recombinant erythropoietin and glucocorticoid hormones. This clinical case demonstrates the possibility of successful treatment of patients with severe hemolytic anemia. Special attention should be paid to the discrepancy between the severity of the condition and objective data. This case demonstrates the need for a more in-depth approach to each patient with anemia associated with coronavirus disease infection, namely, in the presence of anemic syndrome, it is imperative to include a full range of laboratory tests.


DISSEMINATED HIV-ASSOCIATED VENOUS THROMBOSIS (A CASE REPORT)
S. A. Guseva, Ya. P. Goncharov, N. I. Bilous, V. V. Tretiakov, and K. V. Savichan
Ukrainian Military Medical Academy
Introduction. In 1983, Robert Gallo (USA) and Luc Montagnier (France) discovered the human immunodeficiency virus (HIV). Today, about 39 million people are living with HIV worldwide. Thanks to antiretroviral therapy (ART), HIV has become a manageable chronic condition for most patients. However, the number of associated complications, including cardiovascular disease and thrombosis, is increasing. HIV-associated venous thrombosis, such as deep vein thrombosis and pulmonary embolism, requires attention and research due to their serious consequences.
 The purpose was to summarize, analyze, and demonstrate the clinical sequence, diagnostic difficulties and treatment of a rare case of disseminated venous thrombosis in the setting of HIV infection.
 Materials and methods. Periodical medical publications, patient records, and materials of scientific and practical conferences were used. Research methods: historical, bibliographic, systematic approach, analytical, generalization.
 Results. The article analyses in detail the data on a severe complication of HIV infection - disseminated venous thrombosis. To establish the final diagnosis, differential diagnosis with infectious, rheumatological, and myeloproliferative diseases was performed. As a result of the differential diagnosis, a multidisciplinary team of doctors established homozygous carriage of the MTHFR 1298 gene, which determines an increased risk of thrombosis. The addition of HIV infection could be a trigger for the development of severe thrombosis with impaired internal organ function. 
 Conclusions. All countries of the world continue to face the problem of HIV infection, which requires constant detection among the population, including military personnel. In the case of thrombosis under consideration, both HIV infection itself (reduced CD4 T-cell counts, late HIV detection) and genetic factors could be the cause. The patient's multidisciplinary management proved to be effective, which allowed him to achieve a positive result, and his fight against the disease will continue.


PSYCHOLOGICAL/PSYCHIATRIC CARE SERVICES IN UKRAINE DUE TO THE CONSEQUENCES OF FULL-SCALE WAR




Blood serum concentration of aminotransferases in the gunshot victims
K.V. Savichan
Publishing House Zaslavsky
Актуальність. У структурі сучасного травматизму все більшої актуальності набувають вогнепальні кульові та мінно-вибухові поранення. Вогнепальні поранення характеризуються важким перебігом із частим розвитком місцевих та загальних ускладнень, серед яких важливе місце посідає печінкова дисфункція, що найчастіше проявляється збільшенням маркерів цитолізу в плазмі крові — трансаміназемією. Метою дослідження було визначення діагностичного значення трансаміназемії у постраждалих із вогнепальними пораненнями. Матеріали та методи. Здійснено ретроспективний аналіз 373 історій хвороби військовослужбовців, поранених під час озброєного конфлікту на Сході України в 2014–2020 рр., які знаходились на стаціонарному лікуванні в Національному військово-медичному клінічному центрі та у військово-медичних клінічних центрах Північного, Південного, Східного регіонів Міністерства оборони України. Проаналізовано концентрацію аланінамінотрансферази (АЛТ) та аспартатамінотрансферази (АСТ) у 1–2, 3–13 та на 14-ту добу і більше після травми. Результати. Установлено, що в постраждалих із вогнепальними пораненнями вже в 1-шу — 2-гу добу після травми майже у двох третинах випадків спостерігається збільшення концентрації амінотрансфераз. Через два тижні та більше значне підвищення рівня трансаміназ (більше 80 ОД/л) зберігається більш ніж у 40 % поранених. На всіх етапах дослідження більш значимо збільшувалась концентрація АСТ порівняно з концентрацією АЛТ. Коефіцієнт Де Рітіса в першому та другому періоді спостереження в більшості випадків був більше 1,3, а через два та більше тижні після травми значно зростала кількість поранених із коефіцієнтом Де Рітіса менше 0,8. Висновки. 1. Трансаміназемія в постраждалих із вогнепальними пораненнями в посттравматичному періоді спостерігається майже в 75 % випадків. 2. Причиною трансаміназемії в поранених може бути ураження не тільки печінки, але й інших тканин, що були ушкоджені під час первинної травми або в результаті вторинних системних розладів. 3. Для інтерпретації трансаміназемії необхідно враховувати не тільки сам факт збільшення, але й локалізацію та особливості поранення, ступінь збільшення амінотрансфераз, їх співвідношення та динаміку в посттравматичному періоді, що потребує подальшого вивчення.


The novel marker of reactive hepatitis in injured with gunshot wounds
G. V. Osodlo and K. V. Savichan
Zaporizhia Medical Academy of Post-Graduate Education
Objective. The aim of the study was to improve the diagnosis of reactive hepatitis in injured with gunshot wounds.
 Methods. A retrospective analysis of 373 medical histories of servicemen wounded during the war in eastern Ukraine in 2014-2020, 233 of whom were hospitalized at the National Military Medical Clinical Center (NMMCC) and military medical clinical centres of the North, South, Eastern regions of the Ministry of Defense of Ukraine for more than 14 days. All servicemen had laboratory examinations using unified methods of laboratory tests. The obtained data were processed using non-parametric statistical methods.
 Results. The median baseline of ALT and, to a greater extent, AST (in the first period of traumatic illness) exceeds the upper limit of normal (40 IU / l). The highest values ​​of ALT were observed in the second period of traumatic illness on the 5th and 10th day of observation with a slight decrease in the next stage of the study. The concentration of AST increased significantly in the first period of traumatic illness, almost did not decrease in the second period, but approached normal values ​​≥14 days after injury. The strongest correlation between transaminases and albumin levels was found. A new calculated indicator in the form of the ratio of ALT concentration to albumin concentration (coefficient of reactive hepatitis of the injured, CRGI) is proposed. The development of post-traumatic reactive hepatitis was confirmed in all cases with the wounded with the value of CRGI ≥2.0.
 Conclusions.
 1. Based on a retrospective analysis of 373 case histories of wounded in different periods after a gunshot wound, a new calculated indicator is proposed - the coefficient of reactive hepatitis of the injured (CRGI) in the form of the ratio of ALT/albumin concentrations, the increase of which indicates hepatocellular damage of hepatocytes with simultaneous suppression of the protein-synthetic function of the liver on the background of catabolic reactions.
 2. CRGI ≥2 indicates the development of reactive hepatitis, is most often observed in the second period of traumatic illness and tends to normalize in the background of effective treatment. In the wounded who died as a result of injuries, CRGI steadily increased and was significantly higher than in the wounded with the uncomplicated course, especially in the third period of traumatic illness - after 14 days or more (4.0 vs. 2.3, respectively), which indicates the possible use of the proposed indicator as a prognostic criterion for worsening the prognosis in the wounded.

RECENT SCHOLAR PUBLICATIONS

Comprehensive analysis of scientific research on penetrating neck wounds in the world and Ukraine
VV Chorna, VV Fedotova, VV Kolomiets, VM Lypkan, MV Rybinskyi, ...
TRAUMA 26 (1), 11-20 2025



Vitamin therapy in the treatment of mild traumatic brain injury: new horizons of clinical practice
AV Shvets, KV Savichan, YM Klymenko
Ukrainian Journal of Military Medicine 5 (4), 187-197 2024



Autoimmune Hemolytic Anemia Associated with COVID-19 Infection in a Patient with High Cardio-metabolic Risk
GV Osyodlo, SA Husieva, SV Svicharova, KV Savichan
Military Medicine 189 (9-10), e2274-e2279 2024



A Clinical Case of Timely Diagnosis and Successful Treatment of Budd-Chiari Syndrome With Fulminant Cytolysis in the Setting of a First-time Diagnosed Myeloproliferative Disease
SA Husieva, GV Osyodlo, AV Husiev, KV Savichan
Military Medicine, usae331 2024



Disseminated HIV-associated venous thrombosis (a case report)
SA Guseva, YP Goncharov, NI Bilous, VV Tretiakov, KV Savichan
Ukrainian Journal of Military Medicine 5 (1), 148-155 2024



Досвід організації роботи військово-лікарських комісій в умовах передової госпітальної бази
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Наука і оборона, 8-13 2023



Psychological/psychiatric care services in ukraine due to the consequences of full-scale war
VV Chorna, MV Rybinskyi, LS Hudzevych, KS Savichan, AM Shevchuk
Georgian medical news 2023



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ТОМ 3 3.2022 (додаток) 2022, 87 2022



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ВО Кузнєцов, КВ Савічан
ТОМ 3 3.2022 (додаток) 2022, 85 2022



Effectiveness of reactive hepatitis therapy in injured with ballistic wounds
S Kyrylo
The Ukrainian Scientific Medical Youth Journal 131 (2), 61-69 2022



THE NOVEL MARKER OF REACTIVE HEPATITIS IN INJURED WITH GUNSHOT WOUNDS
GV Osodlo, KV Savichan
Modern medical technology, 49-54 2022



Концентрація амінотрансфераз у сироватці крові постраждалих із вогнепальними пораненнями
KV Savichan
EMERGENCY MEDICINE 18 (1), 54-58 2022



Effectiveness of reactive hepatitis therapy in injured with ballistic wounds
K Savichan
Ukrainian Scientific Medical Youth Journal 2022



Концентрація амінотрансфераз у сироватці крові постраждалих із вогнепальними пораненнями
КВ Савічан
2022



ФАКТОРИ РИЗИКУ ТА ПРОГНОЗУВАННЯ ПЕЧІНКОВОЇ ДИСФУНКЦІЇ У ВІЙСЬКОВОСЛУЖБОВЦІВ З ВОГНЕПАЛЬНИМИ ПОРАНЕННЯМИ
КВ Савічан
Український журнал медицини, біології та спорту 7 (№ 2 (36)), 129-135 2022



ЕФЕКТИВНІСТЬ АРГІНІНУ ГЛУТАМАТУ ПРИ ПЕЧІНКОВІЙ ДИСФУНКЦІЇ У ПОРАНЕНИХ ВІЙСЬКОВОСЛУЖБОВЦІВ-УЧАСНИКІВ АТО/ООС
ІАЮ Савічан К.В., Трачук Н.А.
Запоріжжя 2020



Clinical and epidemiological analysis of liver diseases in combatants from ATO/JFO
GV Osyodlo, KV Savichan, AM Hubar, SM Prokopchuk, KO Volkivska, ...
Current Aspects of Military Medicine 27 (1), 112-121 2020



Залежність виникнення печінкової дисфункції від локалізації поранення
ІАЮ Савічан К.В., Трачук Н.А.
2020



ЗАЛЕЖНІСТЬ ВИНИКНЕННЯ ПЕЧІНКОВОЇ ДИСФУНКЦІЇ ВІД ЛОКАЛІЗАЦІЇ ПОРАНЕННЯ
КВ Савічан, НА Трачук, АЮ Іванова
За редакцією, 176 2020



ОГЛЯД НАУКОВИХ ПУБЛІКАЦІЙ, ПРИСВЯЧЕНИХ ВТОРИННІЙ ГЕПАТОПАТІЇ ПІСЛЯ ТРАВМИ
KV Savichan
Ukrainian Journal of Military Medicine 19 (2), 69-77 2019

MOST CITED SCHOLAR PUBLICATIONS

Psychological/psychiatric care services in ukraine due to the consequences of full-scale war
VV Chorna, MV Rybinskyi, LS Hudzevych, KS Savichan, AM Shevchuk
Georgian medical news 2023
Citations: 2



ОГЛЯД НАУКОВИХ ПУБЛІКАЦІЙ, ПРИСВЯЧЕНИХ ВТОРИННІЙ ГЕПАТОПАТІЇ ПІСЛЯ ТРАВМИ
KV Savichan
Ukrainian Journal of Military Medicine 19 (2), 69-77 2019
Citations: 2



Порівняльна характеристика захворюваності внутрішніми хворобами учасників АТО, поранених і травмованих у кінцівки та в тулуб
КВ Савічан
Військова медицина України, 44-50 2017
Citations: 2



A Clinical Case of Timely Diagnosis and Successful Treatment of Budd-Chiari Syndrome With Fulminant Cytolysis in the Setting of a First-time Diagnosed Myeloproliferative Disease
SA Husieva, GV Osyodlo, AV Husiev, KV Savichan
Military Medicine, usae331 2024
Citations: 1



Залежність виникнення печінкової дисфункції від локалізації поранення
ІАЮ Савічан К.В., Трачук Н.А.
2020
Citations: 1