bluuebunny/crossref_metadata_2025 huggingface dataset:
ROLE OF THE FAMILY PHYSICIAN IN THE TREATMENT OF PATIENTS WITH POLYTRAUMA ON THE OBESITY BACKGROUND ON AN AMBULATORY STAGE
Authors: Khimich Sergii D. , Chemerys Orest M.
Published: October 2020

Introduction: Obesity rates have continued to increase recently, what is connected to the reduction of physical activity of population.
The aim: To determine the peculiarities of treatment of patients with obesity, who sustained a severe concomitant body trauma on an outpatient basis by family physicians.
Materials and methods: Clinical material composed of 67 patients who sustained severe concomitant body trauma.
Results: On the grounds of the long-term outcomes assessment cards developed by us, treatment of the severe concomitant trauma in persons with obesity, we found typical
complications of the traumatic disease, which family physicians faced on an ambulatory stage. These cards contained by system analysis of consequences of the sustained
polytrauma on the systems and organs respectively to the body mass index meaning. In general, treatment of such patients was complex and included applying of the diet
therapy (a low-calorie diet with enough protein, vitamins and low levels of animal fats and carbohydrates, especially easily digestible), pharmacological therapy (antibiotics,
mucolytics, solvents) as well as therapeutic exercise, which played almost dominant role. In particular, therapeutic massage was prescribed for improvement of general body
tone, activation of peripheral circulation and lymph flow, oxidation-reduction and metabolic processes, retroaction to the impaired motor-evacuation function of the large
intestine, eliminating fatigue and increasing muscle tone and functioning.
Conclusions: Role of the family physician in the process of traumatic disease treatment is especially important and lies in the organization of medical treatment of patients
on an ambulatory stage.
INTERACTION BETWEEN CLINICAL AND PSYCHOLOGICAL CHANGES AMONG PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND PULMONARY TUBERCULOSIS CO-MORBIDITY
Authors: Zhovanyk Natalia V. , Tovt-Korshynska Mariana I.
Published: October 2020

Introduction: The association of chronic obstructive pulmonary disease and pulmonary tuberculosis is an important medical and social problem with a significant burden in terms of morbidity and mortality. The course and prognosis of chronic diseases such as chronic obstructive pulmonary disease and pulmonary tuberculosis is greatly influenced not only by the clinical features but also by the psychological characteristics of the patient. The aim: To study the interaction between clinical changes and psychological characteristics considering gender differences among patients with chronic obstructive pulmonary disease in association with pulmonary tuberculosis. Materials and methods: We studied 41patients with chronic obstructive pulmonary disease (grade 2, 3, groups А, B, С, D) and infiltrative pulmonary tuberculosis co-morbidity (11 women and 30 men). All patients underwent general clinical examination, Acid-Fast Bacillus Testing, spirometry, Spielberg anxiety scale, Beck depression scale. Results: Patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity with more severe symptoms (according to Assesment Test scores) were older and, regardless of it, showed elevated depression and personal anxiety scores while situational anxiety scores were significantly lower compared to those with less severe symptoms. The correlation between symptoms severity and airflow limitation or smoking history was very mild. The elevated depression and personal anxiety could cause more severe symptoms. The revealed discrepancy between the symptoms severity and low levels of situational anxiety may be due to adaptation with displacement mechanisms to illness related chronic life stressors. We also observed elevated personal anxiety and depression scores together with less severe symptoms among female versus male chronic obstructive pulmonary disease/pulmonary tuberculosis patients, possibly reflecting physically ill women’s higher risk for depressive and anxiety related symptomatology relative to ill men. Conclusions: We revealed that among patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity symptoms severity was largely influenced by the patients’ age, gender and psychological factors (depression and personal anxiety), but, unexpectedly, much less – by airflow limitation and smoking history. We also found higher emotional distress, namely elevated personal anxiety and depression scores, in combination with less severe symptoms among female versus male patients with chronic obstructive pulmonary disease and pulmonary tuberculosis co-morbidity.
THE PARAMETERS OF LIVER FUNCTIONAL STATE AS A RISK FACTOR OF EDEMATOUS PANCREATITIS DEVELOPMENT PROVIDING OF GENETIC DETERMINATION OF IL-4 PRODUCTION
Authors: Ivashchuk Sergiy I. , Sydorchuk Larysa P.
Published: October 2020

Introduction: One of the main pathophysiological mechanisms of acute pancreatitis development is the damage of pancreas cells and hepatocytes with enzymes activation. Recently, a powerful mechanism of the immune system involvement in the acute pancreatitis pathogenesis, in particular, from the position of genes polymorphism influence attracts more attention. The aim: To study the parameters of liver functional state as risk factors for the development of edematous pancreatitis under the conditions of genetic determination of IL-4 production. Materials and methods: The study involved 101 patients with acute and the exacerbation of chronic pancreatitis in whom the polymorphic variants of gene IL-4 (C-590T), the activity of ALT, AST, GGTP, LDG and bilirubin fractions levels were determined. Results: Among the patients with T-allele of IL-4 gene was more commonly encountered the excess of the activity of AST and ALT standarts than those with CC-genotype - by 27.94% and 24.33% respectively. The increase of the GGTP concentration was recorded in 79.21% of patients. The serum GGTP level was significantly higher in the TT-genotype owners than in those with C-allele. Hyperbilirubinemia by the total bilirubin, indirect and direct fractions was diagnosed more often in TT-genotype carriers than in CC-homozygotes. Conclusions: The dysfunction of hepatopancreatobiliary system is more significant in the TT-genotype carriers of IL-4 gene by the AST, ALT, bilirubin and its fractions high levels, however, were found to be risk factors the high levels of total bilirubin and its direct fraction.
THE ROLE OF SMALL INTESTINAL BACTERIAL OVERGROWTH IN THE PATHOGENESIS OF HYPERLIPIDEMIA
Authors: Kvit Khrystyna B. , Kharchenko Natalya V. , Kharchenko Vyacheslav V. , Chornenka Olga I. , Chornovus Romania I. , Dorofeeva Uljana S. , Draganchuk Oksana B. , Slaba Oksana M.
Published: October 2020

Introduction: Small intestinal bacterial overgrowth may cause the hyperlipidemia appearance by enterohepatic circulation disturbance which evolves on the background of
the early bile acids deconjugation with further endotoxin production and oxidative stress in the liver with hyperproduction of cholesterol and atherogenic lipoproteins.
The aim: the determination of prevalence and features of SIBO in a series of patients with hyperlipidemia and in control subjects.
Materials and methods: Nineteen patients with hyperlipidemia and ten control subjects were studied. Small intestinal bacterial overgrowth was assessed by a lactulose
breath test. Such biochemical markers as CRP, ALT, AST, GGTP, apolipoprotein B, bilirubin, cholesterol and lipid profile were determined. Except the routine interpretation
of lactulose breath test, which contains the SIBO detection, small intestinal transit time and hydrogen level evaluation with next comparison between groups of patients
was realized.
Results: Small intestinal bacterial overgrowth was present in 78.9% of patients with hyperlipidemia and 40% in control subjects. The maximal dose of H2 was particularly
higher in patients with hyperlipidemia in comparison with control group (94,7±13,69 vs. 36,13±5,4). There was a strong correlation between AST level and SIBO existence
in both groups (r=1). Positive connection between LDL, TG, VLDL and the dose of exhaled hydrogen on 120 minute (r=0.6, r= 0.62, r=0.7 respectively) and strong negative
correlation between HDL and 120 minute dose (r=-0.74) in main group was marked.
Conclusions: Patients with hyperlipidemia have a higher prevalence of small intestinal bacterial overgrowth and there is a relationship between H2 rate and LDL, TG, VLDL.
THE LEVEL OF SOME HORMONES IN THE BLOOD WOMEN WITH
ENDOMETRIOSIS WHICH ASSOCIATED WITH INFERTILITY
Authors: Bakun Oksana V. , Yurkiv Oksana I. , Slobodian Ksenia V. , Kolesnik Oksana V. , Maruschak Aliona V.
Published: October 2020

Introduction: The work has been dedicated the study of pituitary hormone concentration in the blood of women with endometriosis-associated infertility on 2-3 days of the
menstrual cycle and the day of the puncture of ovarian stimulation superovulation in the cycle.
The aim of our study was to examine the concentration of pituitary hormones in the blood of women with endometriosis associated with infertility.
Materials and methods: For the purpose of the research we have conducted a special study of protein (lutropin - LH, folitropin -FSH) hormones level in the blood plasma
of women with endometriosis associated with infertility, which formed the main group of 20 people. Similar studies of protein hormones level were performed in the control
group, which made somatically healthy women of reproductive function preserved, whose age corresponded to the age of patients of the main group.
The value of p (authenticity difference) was determined by Student’s table-Fischer. Differences between contrasting averages were considered significant at p <0.05.
Results and conclusions: Analized the results of our research stated that women with endometriosis associated with infertility 2-3 days of the menstrual cycle endocrine
function of gonadotropocites anterior pituitary did not differ from that of the control group. This fact appeared to have an additional criteria for the formation of a main group.
In patients with endometriosis associated with infertility found significant violation of rhythm and secretion of blood gonadotropin hormones that are proportionate to the
degree of severity of the disease.
PSYCHOEMOTIC FEATURES, STATUS OF COGNITIVE FUNCTIONS AND ASSESSMENT OF BRONCHIAL ASTHMA PATIENTS’ QUALITY OF LIFE
Authors: Velichko Valentyna I. , Bazhora Yana I. , Danilchuk Galyna O. , Kolotvina Larysa I.
Published: October 2020

Introduction: The worldwide pandemic of bronchial asthma (BA) is creating severe challenges for health care specialists. Asthma patients feature a number of psycho-emotional
and cognitive impairments, mark the reduction of quality of life which limits response to therapy.
The aim: to investigate psycho-emotional features, state of cognitive function and assess bronchial asthma patients quality of life.
Materials and methods: 142 patients (61 men and 81 women) with bronchial asthma aged 19 - 57 y.o. were examined. The main group consisted of 78 patients with
an uncontrolled course of asthma (UCBA). 64 patients with controlled asthma (CBA) were included in the comparison group. The subjective assessments of quality of
life by questionnaire SF-36, assessment of asthma-dependent quality of life (AQLQ) was made. The patients’ emotional and psychological profile was assessed using
the following tests and scales: MMSE, Montreal Scale for Assessing Cognitive Function, Hospital Alert and Depression (HADS) scale with a qualitative and quantitative
assessment of the results.
Results: According to the results obtained, the averaged profiles of the patients’ quality of life demonstrated the negative effects of asthma, especially its uncontrolled form.
There were statistically significant differences in the quality of life in patients with UCBA according to the five criteria of the MOS SF-36 questionnaire as compared to the CBA
group ( physical functioning, role-playing, caused by physical condition, general health, social functioning, viability). A comparison of the specific quality of life with the help of
the AQLQ questionnaire revealed a significant negative effect of the uncontrolled course of the illness on the patients’ quality of life. The correlation analysis of the relationship
between the course of asthma and the parameters of a specific life qality showed a close correlation between the level of asthma control and the overall evaluation of specific
quality of life (r = 0 , 62; p < 0.001). The results of neuropsychological examinations in UCBA patients showed the presence of light predemention cognitive impairments.
Manifestations of anxiety-depressive disorders were found in 44 (56.41%) patients in the main group, while in the comparison group, the symptoms of anxiety and depression
were observed in 14 (21.88%) cases. Patients with UCBA noted a higher level of anxiety (11.5 ± 1.2 versus 6.9 ± 1.4, p <0.05), depression (8.3 ± 2.3 versus 5.6 ± 3.9) on the
HADS scale compared with patients with CBA
Conclusion: The psycho-emotional features revealed in UCBA patients can determine the prognosis of the disease and justify the expediency of additional diagnostic and
therapeutic psychotherapeutic measures.
EUTHANASIA OR PALLIATIVE CARE: LEGAL PRINCIPLES OF THE IMPLEMENTATION IN THE CONTEXT OF THE REALIZATION OF HUMAN RIGHTS TO LIFE
Authors: Chekhovska Iryna V. , Balynska Olha M. , Blahuta Roman I. , Sereda Valeriy V. , Mosondz Serhii O.
Published: October 2020

Introduction: The right to life – is natural inherent human right, the fundamental principle of the existence of mankind, recognized by all civilized countries. It is enshrined
in numerous international and national legal acts as the most important benefit of a man. However, there are discussions about the use of euthanasia. Therefore, the problem
of the legalization of euthanasia requires careful study.
The aim: The purpose of this article is to analyze and systematize existing problems of the legalization of euthanasia. The main objective of the article is to study the legal
grounds for the introduction of euthanasia in the context of realizing the right to life, to study the content of palliative care, to distinguish the barriers to its development, and
to formulate propositions for their elimination.
Materials and methods: Theoretical (analysis, synthesis, generalization, systematization, etc.) and empirical methods (observation, survey, classification, etc.) were used in
the course of the research.
Results: The author has revealed the negative attitude of medical staff to the possibility of using different forms of euthanasia during the study. The reasons for the
positive attitude of patients, who were in the thermal stage to the euthanasia, have been determined. It has been established that the correction of most causes
leads to a significant reduction in the percentage of positive attitude to euthanasia. The arguments of opponents and supporters of the legalization of euthanasia
procedure have been analyzed. On this basis the author has proved the objective absence of legal grounds for the legalization of euthanasia procedure and direct
violation of human rights to life.
Conclusions: The author has proved the expediency of the development of palliative care as an alternative to euthanasia, has outlined the obstacles to its development, has
offered to develop regulatory base for the legal regulation of the provision of palliative care, to establish the National Coordination Council on palliative and hospice care, to
form the system of state control over the quality of provision of palliative care and observance of the rights of patients.
A MEDICAL ERROR: DOES LAW HELP OR HINDER
Authors: Nikitchenko Nataliia V. , Khankevych Andrii M. , Slynko Dmytro V. , Savchuk Tetiana I. , Lazariev Viktor V.
Published: October 2020

Introduction: Health systems and health policies across the European Union are becoming more and more interconnected and also more complex. This increased
interconnection raises many health policy issues, including health care quality. Mistakes in medical care can occur anywhere in the health care system – at hospitals,
doctor’s offices, nursing homes, pharmacies, or patients’ homes - and in any part of the treatment process involving wrong medication, improper treatment, or incorrect
or delayed test results.
The aim of the article is to develop adequate theoretical and scientific-practical proposals for the modernization of the legal regulation to protect patients’ rights aimed at
observance of constitutional rights and freedoms.
Materials and methods: In order to obtain the results the analysis of medical, labor and civil law norms are investigated. The article uses analysis and synthesis methods, as
well as a comparative legal method.
Review: A number of proposals are given for improving legislation in the area of eliminating obstacles to provision of qualitative primary care / medical-preventive care, prevention
of formal attitude towards the patient, the implementation of preventive protection measures which should notify in advance about the violation of the law in the medical sphere.
Conclusions: Ukraine urgently needs a legal mechanism to protect the rights of patients; it will become a systemic phenomenon and will consist of legal means, forms, ways
by which the restoration of violated patients’ rights is provided, the support of protected interests by the law is maintained, legal disputes are resolved and other obstacles to
realization of patients’ rights are overcome.
MODERN METHODS OF GREAT OBSTETRICAL SYNDROMES
PROGNOSTICATION (LITERATURE REVIEW)
Authors: Lemish Natalia Y.
Published: October 2020

Introduction: The term “Great Obstetrical Syndromes” (GOS) was widely implemented to clinical practice after 2009, due to publications of G. C. Di Renzo and R. Romero. The
effective prognostical methods are still being searched for early correction of the disorders and decrease of negative consequences on mother and fetus.
The aim: To analyze the up to date data concerning prognostication of Great obstetrical syndromes.
Materials and methods: Used database Pubmed from 2004 up till 2019 to search clinical studies of great obstetrical syndromes.
Conclusions: The literature review summarizes the data about existing methods of prognostication of GOS based on history of the patient and the results of additional clinical
and laboratory investigations.
LEGAL BASES FOR IMPROVING LEGISLATION ON THE TRANSPLANTATION OF HUMAN ANATOMICAL MATERIALS
Authors: Shulzhenko Nadiia V.
Published: October 2020

Introduction: From January 1, 2019, the Law of Ukraine “On application of the transplantation of anatomical materials to a human being” dated May 17, 2018, № 2427-VIII
(hereinafter referred to as Law № 2427), which defined a new system of legal relationship in the field of transplantation and related activities. Simultaneously the validity of the
Law of Ukraine “On transplantation of organs and other anatomical materials to a human being” adopted in July 16, 1999. № 1007-XIV was canceled. The development of medical
science overlooks the prospect of humanity’s salvation from many incurable diseases. One of the directions of medical advancing is the development of transplantation, which
is special method of treatment that involves the transplantation of anatomical human material from a donor to a recipient and a focuses on the restoration of human health.
Admitting the fact that life or health can be saved for hundreds of thousands of people with its’ usage today and the need for it is growing relentlessly. Therefore, research and
improvement of legislation on the transplantation of human anatomical materials is well-grounded and timely.
The aim: To establish and specify the problematic issues of legal regulation that arise in the transplantation of human anatomical materials sphere.
Materials and methods: During the study, international acts, national legislation and Conclusions of scientists were used. The article is based on dialectical, legal comparative,
systemic, historical and complex methods of research.
Review: In this paper the main problems of legal regulation of transplantation of human anatomical materials according to the Ukrainian legislation are analyzed and specific
suggestions for their solution are proposed.
Conclusions: The solution to this problem is to create a legislative framework and provide an effective and effective mechanism for regulating and implementing transplantation
of human anatomical materials.
ORGANIZATIONAL AND LEGAL DETERMINANTS OF IMPLEMENTING
INTERNATIONAL EXPERIENCE IN THE HEALTH CARE SECTOR OF
UKRAINE
Authors: Teremetskyi Vladislav I. , Knysh Serhii V. , Stratonov Vasyl M. , Khramtsov Oleksandr М. , Stashchak Mykola V.
Published: October 2020

Introduction: The reform of the health care system, which is taking place in Ukraine today, is aimed at increasing the efficiency of providing timely and quality medical care.
The aim of the paper is to provide theoretical and practical study of existing models of organizing the health care system in the leading foreign countries, as well as to substantiate
the possibility of implementing the most optimal of them in Ukraine.
Materials and methods: The author of the article has used the methods of analysis and synthesis, as well as comparative and legal method. In particular, the author has
carried out the analysis of the experience of different countries in organizing the health care system.
Review: The author has studied international experience of legal regulation of the relations in the health care sphere, which use private, state and mixed models of the
organization and financing of the health care system.
Conclusions: The author has emphasized on the necessity of using the latest achievements of the leading foreign countries in the sphere of the organization of the health
care system and the establishment of additional guarantees for the financially disadvantaged groups of citizens, through the development and financing of social programs
for the availability of medical care (based on the model of existing Medicare and Medicade programs in the USA); the application of marginal maximum prices for health
services provided by private health care facilities (Japan); introduction of compulsory payment to the insurance fund from the income of legal entities employing hired
labor (Germany), etc.
CHURG-STRAUSS SYNDROME: CLINICAL CASE AND ITS FEAUTURES
Authors: Katerenchuk Ivan P. , Tkachenko Lidiya A. , Yarmola Tetyana I. , Talash Viktoriya V. , Rustamyan Savetik T. , Pustovoyt Anna L. , Katerenchuk Oleksandr I.
Published: October 2020

Introduction: The article describes the clinical case devoted to the features of the clinical course of Churg-Strauss syndrome (eosinophilic granulomatous with systemic necrotizing
vasculitis). Churg-Strauss syndrome is a disease that is rarely diagnosed because of presenting by high-variability clinical syndromes, that causes difficulties in diagnostic process,
especially on the first visit of patient to the general practioner.
The aim of the article is to show the clinical course feautures of the Churg-Strauss syndrome in the time of disease progression, as well as pecullarities and possibilities of
in-time diagnosis of this disease.
Clinical case: It was described a clinical case of Churg-Strauss syndrome in a 46-year-old woman, presenting with successively appeared signs of the disease that resulted in
some difficulties of making in-time diagnosis.
Conclusions: As Churg-Strauss syndrome is a low-spread disease presenting with high-variety of clinical signs and despite of the presence of clear diagnostic criterias Churg-Stross
syndrome was diagnosed with delay in this clinical setting. General practitioner should remember that if the disease debuts by the signs of pneumonia with further appearance
of signs of bronchial obstruction and eosinophilia, its necessary to perform diagnostic approaches with the aim to carry out the presence of the Churg-Strauss syndrome.
THE INTENSITY OF CHRONIC CATARRHAL GINGIVITIS IN CHILDREN DEPENDING ON THE AGE
Authors: Hasiuk Petro A. , Malko Nataliia V. , Vorobets Anna B. , Ivanchyshyn Viktoriya V. , Rosolovska Svitlana O. , Korniienko Mariia M. , Bedenyuk Oleksandr A.
Published: October 2020

The aim: To determine the degree of severity of the inflammatory process in periodontal tissues of
children living in different ecological conditions.
Materials and methods: With the purpose of estimation of the condition of periodontal tissues the
epidemiology examination of 642 children that live on territory with the high level of pollution and
natural deficit of iodine and fluorine was conducted.
Results: The study found that the increase of age of examined children causes the decrease of
percentage of easy degree of severity of chronic catarrhal gingivitis, giving way to the advanced
forms of the disease, and this process was more pronounced in children living in ecologically polluted
region. In children-inhabitants of ecologically clean region easy degree of severity of chronic
catarrhal gingivitis met more often than their peers living in environmentally polluted region. At the
same time, average and heavy degree of severity of chronic catarrhal gingivitis in children living in
ecologically contaminated region met more often than their peers, inhabitants of ecologically clean
region.
Conclusions. It was found that with increasing age of the examined children decreases the
percentage of chronic catarrhal gingivitis of moderate severity.
IMPACT OF CERTAIN PUBLIC HEALTH FACTORS ON THE DURATION OF INPATIENT TREATMENT OF MI PATIENTS
Authors: Terenda Natalia O. , Shulhai Arkadii H. , Petrashyk Yurii M. , Lytvynova Olha N. , Panchyshyn Natalia Y. , Slobodian Natalia O. , Lishtaba Liudmyla V. , Smirnova Valentyna L. , Zaporozhan Larysa P.
Published: October 2020

The aim was to study the impact of predictors on the duration of inpatient treatment of MI patients.
Materials and methods: We copied data of 462 inpatient medical records of myocardial infarction patients who underwent hospital treatment by different methods (coronary artery stenting, thrombolytic therapy, conventional drug therapy). We determined basic predictors and duration of inpatient treatment of MI patients. Impact of the parameters was studied using Cox regression.
Results: We built models of hazard ratios of coronary artery stenting impact on treatment duration for myocardial infarction patients, which proved that this treatment method significantly reduced the treatment duration, even after correction of confounders like sex (HR=1.32; p=0.041), age over 60 (HR=1.31; p=0.048) and heart failure Stage 2A-2B (HR=1.36; p=0.020).
Conclusions: The results we obtained indicate a statistically significant effect of CAS on MI patients’ treatment duration, both separately and combined with multiple effects of confounders, indicating its medical effectiveness and the need for widespread introduction of this treatment method in medical practice in every region of Ukraine.
FEATURES OF THE COURSE OF ENAMEL BIOMINERALIZATION PROCESSES IN VARIOUS ANATOMICAL AREAS OF THE TOOTH
Authors: Kalashnikov Dmytro V. , Hasiuk Petro A. , Vorobets Anna B. , Rosolovska Svitlana O. , Kindiy Dmytro D. , Hrad Anna O. , Zubchenko Serhii G. Zubchenko
Published: October 2020

The aim: To establish the features of the structural organization of enamel in various anatomical areas of the tooth and determine their influence on the characteristics of the course of biomineralization processes.
Materials and methods: The study of the structural features of enamel and dentin was performed on thin sections of various groups of teeth. Then morphological, histochemical and electron microscopic examination methods were used.
Results: The study found that there are three structural and functional barriers to biomineralization of enamel, which are located in different anatomical areas of the tooth crown. Each of them has both general and specific features. Enamel biomineralization is a continuous process of exchange of calcium ions, donor of which is brushite. The stepwise process of biomineralization turns the latter into calcium octaphosphate, which then turns into hydroxyapatite. The latter, when destroyed by carbon dioxide, forms carboxyapatite.
Conclusions: In the result of conducted study was established peculiarities of enamel mineralization processes in different anatomical parts of tooth.
MODEL OF MEDICAL-SOCIAL MONITORING OF OBESITY IN CHILDREN (STRUCTURE AND FUNCTIONS AT THE LEVEL OF HEALTH CARE INSTITUTION)
Authors: Diachuk Dmytro D. , Yashchenko Yurii B. , Zabolotna Iryna E. , Yashchenko Liudmyla V.
Published: October 2020

The aim: To substantiate conceptual directions and organizational technology of medico-social monitoring of obesity and risk factors of its development in schoolchildren at the level of health care institution.
Materials and methods: Modern strategies and recommendations for the prevention of obesity in children, local normative documents for the organization of preventive medical examinations of children where analyzed. The basis for developing a functional-structural model of medical and social monitoring of obesity in children based on the results of own research, its concept and organizational technology are developed on the basis of methodology of systematic approach and systematic analysis using informationanalytical method.
Results: In the procecc of monitoring we saw the health of children and the harmony of their physical development, nutrition and lifestyle, hereditary risk factors for overweight, and the dynamics of the child’s physical development. The program of medical and social monitoring of obesity in schoolchildren allows to check among the attached for medical care children the risk factors for the development of overweight, predict health disorders that are associated with it, plan preventive programs.
Conclusions: The model of organization of medico-social monitoring of obesity in children is developed for the health care institution, the peculiarities of which are: – enhancing the role of primary care physicians in the provision of medical assistance to the pediatric population in monitoring the health of children and implementing of preventive measures; – involveming parents in monitoring of the risk factors for overweight and preventing obesity at the individual level.
РHYSIOLOGICAL-HYGIENIC STANDARDS OF MOTOR ACTIVITY OF STUDENTS OF HIGHER EDUCATION INSTITUTIONS AND SCIENTIFIC SUBSTANTIATION OF WAYS OPTIMIZATION IN THE CONTEXT OF FORMATION OF EFFECTIVE PUBLIC HEALTH SYSTEM
Authors: Serheta Ihor V. , Mostova Olha P. , Panchuk Olexander Y. , Drezhenkova Inna L.
Published: October 2020

The aim: Scientific substantiation of physiological-hygienic standards of motor activity of students of higher education institutions and ways of its optimization in the context of formation of an effective public health system. Materials and methods: The criteria for physiological-hygienic assessment of students’ motor activity were: the values of daily energy, the quantity of locomotions, the duration of dynamic component in daily budget of time. Results: The data of complex assessment of the modern students’ motor activity studying in the institution of higher medical education showed its low level. At the same time the application of measures aimed at optimizing motor activity of students ensured an improvement (p<0.01-0.001) of the functional characteristics of the mobility and balance of nervous processes and index of coordination of movements. Conclusions: In the course of the researches the physiological-hygienic standards of motor activity of students are scientifically substantiated: values of daily energy consumption – 9000-11000 kJ in young women, 11500-13500 kJ in young men, the quantity of locomotions in the daily cycle – 14000-18000 steps and 15000-19000 steps respectively, the duration of dynamic component in daily budget of time – 130-180 min and 140-190 min respectively.
THE ROLE OF BASIC PHARMACOTHERAPY IN THE PREVENTION OF LATE ADVERSE EVENTS AFTER ELECTIVE CORONARY ARTERY BYPASS GRAFTING
Authors: Yepanchintseva Olga A. , Mikhaliev Kyrylo O. , Shklianka Inga V. , Zharinov Oleg J. , Todurov Boris M.
Published: October 2020

The aim: To determine the role of adherence to the guidelines on basic pharmacotherapy in prevention of late major adverse clinical events (MAEs) in patients with stable CAD for three years following isolated CABG.
Materials and methods: A prospective single-centre study included 251 consecutive patients with stable CAD (mean age (61±9) years, 218 (86.9%) males), after isolated CABG. In three years MAЕs occurred in 55 (21.9%) patients. The data on pharmacotherapy at follow-up were obtained in 250 patients: 196 (78.4%) patients without MAEs (at scheduled visit) and 54 (21.6%) patients with MAEs (based on in-hospital or archive data).
Results: Basic CAD pharmacotherapy after CABG was comparable in MAEs vs. no-MAEs groups, with the vast majority of patients receiving guideline-recommended therapy with angiotensin-converting enzyme inhibitors (ACEII) or angiotensin-II receptors blockers (ARBs), statins and antiplatelet drugs. At three years follow-up, MAEs group, as opposed to no-MAEs group, was characterized by the lower usage of ACEII/ARBs (68.5% vs. 87.2%, respectively; p=0,001) and statins (59.3% vs. 86.7%, respectively; p<0,001), as well as basic triple therapy (ACEII or ARBs/statins/antiplatelet drugs: 35.2% vs. 70.4%, respectively [p<0,001]).
Conclusions: At three – year follow-up MAEs in patients with stable CAD after CABG were associated with more frequent discontinuation of previously prescribed basic pharmacotherapy, namely ACEII/ARBs and statins, as well as triple therapy (ACEII/ARBs, statins and antiplatelet drugs).
COMPLEX TREATMENT OF PURULENT WOUNDS WITH THE USE OF HIGH-PRESSURE AERODISPERSE MIXTURE
Authors: Shaprynskyi Volodymyr O. , Skalskyi Stepan S. , Shaprynskyi Yevhen V. , Verba Andriy V. , Makarov Viktor M.
Published: October 2020

The aim: To investigate the effectiveness of complex treatment of purulent wounds with the use of high pressure aerodispersed mixture of antibacterial drug using sorbents and correction of hydrogen index.
Materials and methods: In total, 54 patients were treated, out of which there were 26 patients with purulent wounds in the main group and 28 patients in the control group.
Patients in the main group were treated according to the developed method, patients in the control group were treated with traditional antiseptics and water soluble ointments.
Results: Within patients of the main group, there was a decrease in the duration of inflammatory process, decrease in the quantity of microorganisms in the wound; slight changes in the sensitivity of the microorganisms to antibacterial preparations, compared with the control group, which showed a high percentage of development of resistant strains; decreased edema and secretion from wounds, the early appearance of granulation.
Conclusions: The use of the proposed approach reduces the microbial burden on the wound, accelerates its purification from purulent-necrotic tissues and reduces the duration of the inflammatory process due to the presence of the microbial factor.
INFLUENCE OF MAGNESIUM ON THE STATE OF THE CARDIOVASCULAR SYSTEM IN CHILDREN WITH CHRONIC TONSILITIS
Authors: Smiyan Oleksandr I. , Man'ko Yuliia A. , Loboda Andrii M. , Popov Sergii V. , Vysots'kyy Igor YU. , Petrashenko Victoria O. , Martsovenko Igor M. , Smiian Kateryna O. , Plakhuta Valentina A. , Serhiyenko Volodymyr M. , Ovsyanko Olena. L. , Aleksakhina Tatiana O. , Bara Al-Rawashdeh
Published: October 2020

The aim of the study was to evaluate the condition of the cardiovascular system and the effect of the combined preparation of magnesium and vitamin B6 in children with secondary cardiomyopathy on the background of chronic tonsillitis.
Materials and methods: 100 children at the aged of 13–17 years were surveyed, including 60 patients with secondary cardiomyopathy with chronic tonsillitis. And the group I consisted of 45 children receiving standard treatment, group II – 15 patients who, along with standard treatment, received the drug magnesium. The control group consisted of 40 healthy children. To assess the condition of the cardiovascular system and vegetative regulation, we performed electrocardiographic examination (ECG), exercise test and ECG control, cardiointervalography with clinoortostatic test. The concentration of magnesium in the serum was determined by atomic absorption spectrophotometry. Also, we have provided the requirements of the principles of bioethics and drafted a protocol in accordance with the basic principles of the Helsinki Declaration.
Results: In addition to the standard treatment of children with magnesium drug, there was a significant decrease in the frequency of sinus arrhythmias, disorders of the intraventricular conduction, and the processes of repolarization, extrasystole, sinus suchchardia were not observed in any of the patients. The normalization of magnesium in the serum of patients was observed.
Conclusions: Supplementation of combination therapy with magnesium and B6 helped to improve myocardial electrophysiology and cardiac output, as well as to normalize the serum magnesium in children with secondary cardiomyopathy.
FEATURES OF THE INTERCONNECTION OF TRADITIONAL RISK FACTORS AND IL-10 WITH THE ACTIVITY OF THE INFLAMMATORY PROCESS AND ATHEROSCLEROSIS DEVELOPMENT IN PATIENTS WITH PSORIATIC ARTHRITIS
Authors: Khimion Liudmyla V. , Boiko Alina V.
Published: October 2020

The aim: To determine the features of atherosclerotic process, cardiovascular risk in patients with PsA.
Materials and methods: The study included 42 patients with PsA who did not have atherosclerotic CVD, diabetes, chronic kidney disease and other serious diseases, did not take statins, the comparingl group consisted of 20 patients with psoriasis (PS) and 20 practically healthy individuals who had no signs of rheumatic, infectious and other inflammatory diseases were screened.
Results: It was revealed that in patients with PsA, the severity of the atherosclerotic process is more compared with patients with PS (the RF profiles were the same). The highest levels of C-reactive protein, fibrinogen, uric acid, intima-media complex thickness, atherosclerotic plaque frequency were found in patients in the PsA group, which may indicate a pathogenetic association of additional RF with the development of a more common atherosclerotic process.
Conclusions: In the development of the atherosclerotic process in patients with PsA, the pro-traditional risk factors play an important role as the immune-inflammatory factors (CRP, IL-10) and additional risk factors (uric acid).
THE PECULIARITIES OF THE BODY’S EXTERNAL STRUCTURE AND INDICATORS OF CENTRAL HEMODYNAMICS OF VOLLEYBALL PLAYERS OF DIFFERENT POSITIONS
Authors: Sarafinjuk Larisa A. , Khapitska Olga P. , Fedoniuk Larysa Ya. , Fomina Lyudmila V. , Merkulova Daria A. , Kyrychenko Yuriy V. , Sarafinjuk Petro V.
Published: October 2020

The aim was to determine the main differences in the external structure of the body and the of central hemodynamics parameters in of high-level sports skills volleyball players of the juvenile age with the role of libero, hitters and setters.
Materials and methods: 116 volleyball players of high level athletic skill of the youth age from 16 to 20 years old. The control group included 140 practically healthy girls who were not engaged in sports of the corresponding age. Anthropometric investigation was performed according to Bunak’s V.V. and Martirosov’s E.G. method, rheographic – according to the method of Ronkin M.A. and Ivanov L.B. The reliability of the difference between independent quantitative values was determined using Mann–Whitney U-test.
Results: It was established that volleyball players have significantly higher total, longitudinal, circumferential dimensions of the body, width of distal epiphyses, transverse diameters of the chest and pelvis in comparison with girls, who are not involved in sport. According to the most parameters of the body external structure the hitters are predominate than setters and libero. In hitters and setters, most anthropo-somatotypological parameters are larger than in nonathletes. The stroke and minute volumes, the impact index, the volume velocity of the blood and the capacity of the left ventricle in volleyball players are significantly higher. Specific peripheral resistance is significantly lower than that of girls who are not involved in sports. Between the volleyball players of different positions in the value of the central hemodynamics parameters, there were no significant differences, except for the impact index, which is significantly higher in libero than in the hitters.
Conclusions: The external structure of the body, anthropometric parameters and indicators of central hemodynamics depend of volleyball player’s position and have some peculiarities.
PROFESSIONAL POSTGRADUATE TRAINING OF FAMILY DOCTORS – AN IMPORTANT PART AND CONDITION OF THE OPTIMAL PALIATIVE AND HOSPISE CARE SYSTEM IMPLEMENTATION IN UKRAINE
Authors: Mykhalchuk Vasyl M. , Goida Nina G. , Tsarenko Anatolii V.
Published: October 2020

The aim: To substantiate measures of optimization of the system of postgraduate training of GPs-Family Doctors (GP-FDs) on providing palliative and hospice care (PHC) in outpatient settings.
Materials and methods: Regulatory documents of Ukraine and International Professional Organizations; domestic and foreign literary sources; official statistics data; results of sociological research. The research methods were used: biblio-semantic, sociological (questionnaires), systemic approach and systemic analysis, and conventional medicalstatistical methods.
Results: Based on the analysis of regulatory documents, the socio-medical importance of PHC and the importance of GP-FDs on PHC are shown. The results of the sociological survey determine: the estimated needs for PHC in Ukraine; insufficient number of inpatient beds for palliative patients (PPs); the absence of a PHC-mobile-teams service, which necessitates the involvement of GP-FDs for PHC at home. The results of the survey indicate an insufficient level of knowledge and an urgent need for special PHC education of GP-FDs.
Conclusions: Multidisciplinary professional training for GP-FDs is of great importance for creating a PHC System. This will allow GP-FDs, together with social workers, NGOs to provide comprehensive PHC to PPs and their families, including medical, psychological, social and spiritual components.
TRAUMATISM AND SOME ASPECTS OF TRAUMA CARE IN TRANSCARPATHIAN REGION AS A PART OF PUBLIC HEALTH
Authors: Brych Valeriya V. , Slabkiy Hennagy О. , Vasylynets Mykhailo М. , Dub Mariana М.
Published: October 2020

The aim is to study and analyze the levels of general traumatism of the population, some aspects of trauma care in Transcarpathian region regarding administrative units.
Materials and methods: Medical-statistical, graphic and biblio-semantic methods were used. The data of sectoral statistical reporting in Transcarpathian region for 2014-2018 formed the base of the study.
Results: It is determined that the highest rates of traumatism (over 470 per 10 thousand population) are characteristic for the eastern districts of the region; the average indicators (260-470 per 10 thousand population) – for the northern and southern ones, and the lowest (less than 260 per 10 thousand population) – for the central and western parts of the region. The inequality of distribution of traumatological beds in the region in relation to the levels of injury in the administrative territories was determined.
Conclusions: With the established tendency to decrease of general traumatism in Transcarpathian region for the period 2014-2018, significant inequalities of the specified indicator and inconsistency of traumatological beds availability in the administrative territories were revealed.
REDUCING HEALTH INEQUALITIES AS A COMPONENT OF THE HEALTH TRAINING PROGRAMS
Authors: Gruzieva Tetiana S. , Hrechyshkina Nataliia V. , Diachuk Mykhаilo D. , Dufynets Vasyl A.
Published: October 2020

The aim: identifying the characteristics and trends of inequalities in the health of the population to substantiate the educational content of the curriculum for the training of Master in Public Health.
Materials and methods: Bibliographic, sociological, medical-statistical and information-analytical methods were used in the study. Ukraine’s healthcare institutions were the scientific base of the study. The data on the average life expectancy, morbidity, mortality, satisfaction of medical needs of different groups of the population for revealing the social gradient are analyzed. Documents on strategies to reduce health inequalities have been examined.
Results: Health inequalities between WHO countries have been identified, including a difference in the average life expectancy at birth of 17.1 years in premature mortality due to differences in the levels of economic development of countries. The inequality in the prevalence of diseases and the difference in the satisfaction of specific medical needs among the first and tenth decile population of Ukraine were determined. The prevalence of diseases of the genitourinary system in the population older than 60 years with low rates by 27.3% was higher than the figure among financially insured persons. The incidence of ocular pathology among adults with different income levels varied 1.8 times. The provisions of the WHO strategic documents on reducing health inequalities and its protection and on developing the public health system are analyzed. We justify the necessity of expanding the coverage of the problems of reducing disparities in health and health care in the course of training of the Master in Public Health. A modern curriculum “Social Medicine, Public Health” has been developed with the inclusion of inequalities in public health and appropriate educational and methodological support.
Conclusion: The strategic goal of reducing inequalities in public health and its care requires integrating these issues into a modern master’s in public health program. The curriculum developed covers various aspects of health inequalities and health care, including the identification and assessment of disparities, the clarification of causes, the identification of counter-measures. Created educational and methodological support allows acquiring theoretical knowledge and practical skills that form the necessary competencies of professionals in the context of overcoming inequalities in health.
ARTERIAL HYPERTENSION ASSOCIATED WITH HYPERURICEMIA: FEATURES OF HEART DAMAGE
Authors: Chernatska Olha M. , Prystupa Liudmyla N. , Fadieieva Hanna A. , Liashenko Alina V. , Smiianova Yuliia O.
Published: October 2020

The aim is the analysis of hyperuricemia influence on the heart features in patients with arterial hypertension.
Materials and methods: We include 75 patients with arterial hypertension which were divided in two groups according to the level of uric acid in the blood, 30 practically healthy people. Patients from the I group (n = 40) had arterial hypertension and coexistent hyperuricemia; ІІ (n = 35) – arterial hypertension. Left ventricular mass index was determined for left ventricular hypertrophy confirmation. We used clinical, anthropometric, biochemical, instrumental, statistical method. Serum uric acid level was observed by the reaction with uricase. Left ventricular mass index was calculated as left ventricular mass to body surface area ratio. The results were analyzed statistically by SPSS 21 and Graphpad.
Results: Left ventricular mass index was significantly higher (р = 0,0498) in patients from the І group (109,7 ± 3,21) g/m2 comparable with the ІІ (97,6 ± 5,35) g/m2 and increased in proportion to the biggest level of uric acid (r = 0,31; p = 0,04) in patients with arterial hypertension and hyperuricemia.
Conclusions: Concentric and excentric left ventricular hypertrophy, increased left ventricular mass index proportionally to uric acid levels (r = 0,31; p = 0,04) is the confirmation of important role of hyperuricemia in the left ventricular hypertrophy development in patients with arterial hypertension.