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Aim. To study the effect of inhalation therapy with an active hydrogen (AH) on the protein composition of exhaled breath condensate (EBC) in patients with post-COVID syndrome (PCS).Material and methods. This randomized controlled parallel prospective study included 60 patients after coronavirus disease 2019 (COVID-19) with PCS during the recovery period and clinical manifestations of chronic fatigue syndrome who received standard therapy according to the protocol for managing patients with chronic fatigue syndrome (CFS). The patients were divided into 2 groups: group 1 (main) — 30 people who received standard therapy and AH inhalations (SUISONIA, Japan) for 10 days, and group 2 (control) — 30 medical workers who received only standard therapy. Patients in both groups were comparable in sex and mean age. All participants in the study were sampled with EBC on days 1 and 10. Samples were subjected to tryptic digestion and high-performance liquid chromatography combined with tandem mass spectrometry analysis using a nanoflow chromatograph (Dionex 3000) in tandem with a high-resolution time-of-flight mass spectrometer (timsTOF Pro).Results. A total of 478 proteins and 1350 peptides were identified using high resolution mass spectrometry. The number of proteins in samples after AH therapy, on average, is 12% more than before treatment. An analysis of the distribution of proteins in different groups of patients showed that only half of these proteins (112) are common for all groups of samples and are detected in EBC before, after, and regardless of hydrogen therapy. In addition to the qualitative difference in the EBC protein compositions in different groups, quantitative changes in the concentration of 36 proteins (mainly structural and protective) were also revealed, which together made it possible to reliably distinguish between subgroups before and after treatment. It is worth noting that among these proteins there are participants of blood coagulation (а-1-antitrypsin), chemokine- and cytokine-mediated inflammation, and a number of signaling pathways (cytoplasmic actin 2), response to oxidative stress (thioredoxin), glycolysis (glyceraldehyde-3- phosphate dehydrogenase), etc.Conclusion. The use of hydrogen therapy can contribute to the switching of a number of physiological processes, which may affect the success of recovery in PCS patients. In particular, the obtained results indicate the activation of aerobic synthesis of adenosine triphosphate in mitochondria by hydrogen therapy, which correlates well with the decrease in the blood lactate level detected by laboratory studies. At the same time, this therapy can inhibit pro-inflammatory activity, negatively affecting the coagulation and signaling pathways of integrins and apoptosis, and, in addition, activate protective pathways, tricarboxylic acid cycle, FAS signaling, and purine metabolism, which may be essential for effective recovery after COVID-19.

One of the causes of dentine hypersensitivity is the presence of various periodontal diseases in patients. In order to obtain long-term results in reducing the level of pain in hypersensitivity of the teeth, it is necessary to optimize existing treatments. The aim of this study is to evaluate the effectiveness of treatment of dentine hypersensitivity in patients with generalized periodontitis of chronic course with the combined use of low-intensity laser therapy and propolis tincture. Object and methods. The study involved 104 patients with dentine hypersensitivity and generalized periodontitis of chronic course. In group 1, treatment was performed using a varnish based on sodium fluoride, in 2 – propolis tincture, in 3 – low-intensity laser therapy, in group 4 – using a combined use of propolis tincture and low-intensity laser therapy. To assess the severity of used the method of pulp testing. Indicators of the excitability threshold of the tooth pulp were measured according to the generally accepted method at classical points, as well as in the area of increased sensitivity of the teeth. The obtained values were evaluated before treatment, immediately after treatment, one week, 1 month, 3 months, six months and one year after treatment in each group. Statistical significance of the results was assessed in IBM SPSS Statistics, Trial (Armonk, NY: IBM Corp.). Research results. At the classical points, the indicators were approximately the same throughout the study period and no statistical significance was found when comparing them (p>0.05). When measured in areas of hypersensitivity, statistical significance was found as early as one month after treatment in the third and fourth groups. One year later, the rates were significantly higher than before treatment (p

Particular attention today is attracted by dentine hypersensitivity that occurs in patients with periodontal tissue diseases. The severity of pain varies from mild to severe; this can negatively affect the psycho-emotional state of the patient and reduce his performance. The aim of this study is to evaluate and compare the effectiveness of the treatment of dentine hypersensitivity in patients with generalized periodontitis of a chronic course using varnish based on sodium fluoride, ethanolic extract of propolis, low level laser therapy and the combined usage of low level laser therapy and ethanolic extract of propolis. Object and methods. 104 patients with dentine hypersensitivity and generalized chronic periodontitis were divided into 4 groups in accordance with the treatment method. In group 1 a varnish based on sodium fluoride was used, 2 – ethanolic extract of propolis, in 3 – low level laser therapy (wavelength 810 nm), in group 4, treatment was performed using the combined use of tincture of ethanolic extract of propolis and low level laser therapy (wavelength 810 nm). The severity of dentine hypersensitivity was evaluated using a visual analogue scale. The obtained values of indicators on a visual analogue scale were evaluated before treatment, immediately after treatment, in a week, 1 month, 3 months, six months and a year after treatment in each group. The patients of all groups were instructed not to rinse after applying of treatment, eat or drink for 30 minutes after the treatment and to avoid using any other desensitizing agent in the all period of the research. All the data were entered into Microsoft Excel sheet. The statistical significance of the results was evaluated in IBM SPSS Statistics, V. 25.0 (Armonk, NY: IBM Corp.). Values of p < 0.05 were accepted as statistically significant. Research results. 104 patients completed our study. Treatment in all four groups was effective immediately after receiving it, as evidenced by a significant decrease in the average values of sensitivity indicators on a visual analogue scale. The average values of the indicators on the visual analogue scale did not return to the values received for treatment in all four groups; a year later, the lowest values were obtained in group with combined treatment using ethanolic extract of propolis and diode laser (810 nm). Intergroup comparison results are statically significant (p

Aim. Conducting a pilot study to assess the effect of thermal heliox on the state of the respiratory tract by studying of the exhaled breath condensate protein composition before the thermal heliox procedure, immediately after and after three hours of relaxation Materials and methods. A comparative study of the exhaled breath condensates (EBC) protein composition of five non-smoking healthy donors was carried out. The EBC was taken before the respiratory procedure, immediately after a 20-minute inhalation by mixture of He/O2 gases (70/30) heated to 70C and 3 hours later. The protein composition was determined by chromatography-mass spectrometric analysis after selective tryptic hydrolysis. The results were processed using the Mascot program and the UniProt database. Results. After the heliox procedure, the volume of the collected condensate (11.5 ml) decreases by an average of 32% and is practically restored after three hours of relaxation. Most proteins were consistent for all samples, regardless of the thermal heliox procedure. These are keratins, several proteins of the immune system (immunoglobulins, compliment proteins), tubulin. In samples after thermal heliox, the appearance of small amounts of additional proteins is observed. These are proteins of muscle metabolism (actin and calmodulin), fibrinogen, traces of hemoglobin, apolipoprotein, type B creatine kinase. After three hours of relaxation, tubulin disappears in the EBC. Conclusion. Most exhaled proteins are the same before, after the procedure, and for three hours of relaxation. The results obtained demonstrate the relative safety of the use of high temperature heliox as a therapeutic agent.

Active hydrogen inhalation (H(H2O)m) has powerful antioxidant and antiapoptotic effects. In recent years, it has been used in a number of experimental and clinical studies.Aim. To study the safety and effectiveness of inhalation of the “active form of hydrogen” (AFV;(H(H2O)m)) in the rehabilitation program of coronavirus disease 2019 (COVID-19) survivors during the recovery period.Material and methods. This randomized controlled parallel prospective study included 60 COVID-19 survivors with post-COVID-19 syndrome (ICD-10: U09.9) during the recovery period, with clinical manifestations of chronic fatigue syndrome (CFS), who received standard therapy in accordance with the management protocol of patients with CFS (ICD-10: G93.3): physiotherapy and medication therapy with drugs containing magnesium, B vitamins and L-carnitine. The patients were divided into 2 groups. The experimental group (n=30) included patients who received hydrogen inhalation for 90 minutes every day during 10 days (SUISONIA hydrogen inhalation device, Japan). The control group (n=30) consisted of patients who received standard therapy. In both groups, patients were comparable in sex and mean age: in the experimental group — 53 (22; 70) years, in the control group — 51 (25; 70) years. Biological markers of systemic inflammation, oxygen transport, lactate metabolism, intrapulmonary shunting, 6-minute walk test, and vascular endothelial function were determined in all patients on the 1st and 10th days of follow-up.Results. In the experimental group, a decrease in following parameters was revealed: stiffness index (SI), from 8,8±1,8 to 6,8±1,5 (p

The example of the analysis of patent activity shows the solution of the problem related to the assessment of the development potential of technical systems. The main possibilities of modern information resources of patent analytics are described. It is shown how the analysis of patent information helps to select the most promising scientific and technical solutions and technologies for development, to identify trends in the industry, to analyze the market situation to determine the main competitors and partners, to assess the competitiveness of the developed products, to form requirements and to draw up a plan for research and development, to develop a strategy for innovative development of the enterprise.

Introduction. Despite the significant advances in the study of pathogenesis, clinics, diagnostics and treatment of acute coronary syndrome (ACS), it remains one of the most common cardiovascular diseases, the severity of which is complicated by concomitant type 2 diabetes mellitus, since atherosclerosis in patients with type 2 diabetes develops 10-15 years earlier than in the general population, and it is characterized by accelerated damage of large subepicardial vessels, its severity increases faster and more often leads to complications. Diabetes mellitus almost doubles the risk of death from cardiovascular diseases, which is comparable to the risk after transferred myocardial infarction, because there is a high frequency of multiple damage of the coronary vessels, increased activation of intra-vascular inflammation on the background of hyperglycemia and hyperinsulinemia, increased activity of all parts of the hemostasis system. There is a marked increase in the risk of cardiovascular death, not only in case of true diabetes, but also in case of its subclinical forms, glucose intolerance. In case of diabetes mellitus, high mortality rate is also high, and its percentage increases in the next 1-5 years after the myocardial infarction. Therefore, patients with type 2 diabetes mellitus remain the most vulnerable group, as their mortality rate decrease is negligible. The results of the study have shown that intensive glycemic control significantly reduces the risk of microvascular complications of diabetes, but does not significantly affect the macrovascular complications and overall mortality. The aim of the study. To make a review of the literature and a description of the clinical case in order to clarify the peculiarities of the clinical condition and pathogenesis of acute coronary syndrome in patients with type 2 diabetes. Materials and methods. Cochrane Library, Research Gate for the key words: GKS, diabetes, acute coronary syndrome, diabetes mellitus, hypercholesterolemia, dyslipidemia, insulin resistance, hyperglycemia. 130 sources were analyzed in the English and Ukrainian languages. Sources are selected, which highlight the clinical and pathogenetic features of ACS in patients with type 2 diabetes. A clinical case is described. Results. ACS in patients with diabetes mellitus often occurs with less severe pain syndrome (often complete absence of typical pain syndrome), shortness of breath while walking, palpitations. The frequency of asymptomatic ischemia is 2.0-4.0 % in the general population of patients with type 2 diabetes mellitus and in 30.0-50.0 % of patients with type 2 diabetes mellitus with ischemic heart disease. The absence of pain in the cardiac area is due to the neuropathy of the nerves branched out in the cardiac muscle, and the absence of an initial irritation signal during ischemia, as well as myocardial infarction with necrosis of the sensitive receptors. The absence of pain means the loss of the limiting factor of physical activity, which, accordingly, increases the risk of acute myocardial infarction and sudden cardiogenic death in diabetic patients. The main mechanisms of vascular lesions in patients with diabetes mellitus: mechanical obstruction (atherosclerotic plaque), dynamic obstruction (spasm of normal or atherosclerotically changed arteries), microvascular dysfunction. Specific risk factors for vascular damage in the presence of type 2 diabetes mellitus include: hyperglycemia, hyperinsulinemia, insulin resistance, dyslipidemia. Pathologic mechanisms that underlie diabetes mellitus and its macrovascular complications include oxidative stress and inflammation. According to modern presentations, diabetes is considered a condition of acute inflammation with prothrombogenic changes in hemostasis and fibrinolysis, which increases the risk of vascular damage. Proinflammatory cytokines in patients with diabetes mellitus affect not only the formation of insulin resistance of peripheral tissues, but also play an important role in reducing the insulin-producing capacity of the pancreas. The main mechanisms for the implementation of the effect of hyperglycemia include: activation of the polyolic pathway of glucose metabolism (sorbitol/aldose reductase); glycosylation of proteins; the effect of oxidative stress; increase of the role of diacylglycerols and activation of protein kinase isoforms as a result of enhanced formation of superoxide radical by inflammatory blood cells, smooth muscle cells, endothelial cells. In patients with diabetes mellitus the glycosylation of lipoproteins with the acquisition of proatherogenic properties is present. The process of glycosylation of proteins, especially apo-proteins of very low density and low density lipoproteins, arises as a result of the ability of glucose to non-enzymatically attach to them, which complicates the recognition of these modified lipoproteins by tissue B, E-receptors, causes inhibition of their elimination from the blood and enhanced capture by macrophages, followed by the formation of foam cells. In addition, glucose is capable of auto-oxidation and activation of free radical processes, which is one of the most important mechanisms of modification of lipoproteins. When combined ACS with type 2 diabetes mellitus there is a sharp decline in functional activity of the endothelium of the vascular wall: flow-dependent vasodilation, anticoagulant, antiplatelet and anti-fibrinolytic activity, which correlate with the severity of carbohydrate metabolism violations. The pathogenetic mechanisms of endothelial damage on the background of insulin resistance contribute to the prevalence of thromboembolic complications, threatening arrhythmias, and the development of congestive heart failure precisely in patients with acute myocardial infarction with concomitant type 2 diabetes mellitus. It is known that in case of hyperglycemia the structure of the intercellular matrix and the basal membrane are violated. The reason of this is the development of insulin resistance, which causes the activation of components of the extracellular matrix: MMP and TIMMP, which leads to remodeling of the basal membrane in case of type 2 diabetes mellitus and, as a consequence, contributes to heart failure severity increase. Conclusions. Consequently, the key problems in managing the patients with ACS and diabetes mellitus are timely and accurate diagnosis, risk assessment, disease prognosis and the adequate treatment algorithm administering. In view of this, it is important to consider the peculiarities of the connections between the individual pathogenetic mechanisms of accelerated atherogenesis in patients with diabetes, which will expand the therapeutic potential of these processes. The role of insulin resistance, endothelial dysfunction, disorders in the system of metalloproteinases and cytokines, immunoinflammatory markers of adipose tissue in the destabilization of the atherosclerotic process and the correlation of these factors with lipid disorders are still insufficiently studied. The problem of the influence of insulin resistance on the system of extracellular matrix is ​​controversial. The effect of each individual pathogenic marker on the clinical course and complications of these patients remains undetermined; therefore, the study of the clinical course of ACS with comorbid type 2 diabetes mellitus and the prediction of complications are important for improving the prognosis in these patients. Therefore, a detailed study of the pathogenetic foundations, mechanisms, and approaches to timely diagnosis can not only reduce the risk but also lead to a qualitatively new strategic position in the prevention and treatment of such patients.

We present a case of successful combined treatment for dendritic stone (K-IY according to classification of Scientific Research Institute of Urology) in the left kidney of a patient with comorbid pathology (diabetes mellitus II type, CHI risk I, lumbar osteochondrosis). Feature of this case is that during operative transcutaneous endoscopic intervention we removed ≈80% of an easily available pelvic part of a stone, and to avoid excessive trauma of parenchymatous tissue for the purpose of the maximum preservation of renal function, we left intact hard to reach calyceal fragments of a concrement. Considering data of рН metric 3-day monitoring which revealed constantly sharp sour reaction of urine (0 U), activity of all enzymes are reduced as their activation requires long (10–15 day) stay of рН urine in narrow limits (

In today’s world economy, the innovation model of economic development, covering all spheres of life of society, becomes dominant. The innovative economy necessitates improvement of the quality of training of specialists and develops new requirements to the educational system, actualizing the problematics of its improvement. Given that the change in the education system requires a long time to ensure rapid changes in this sphere, the authors propose the creation of a new type of educational institutions – the engineering schools (ES). This is closely related to the formation of a national innovation system in Ukraine, both in terms of training specialists and in terms of supporting innovation projects. The article substantiates the primary importance of education for intensification of innovative processes from the point of view of human capital development, dissemination of knowledge, support of innovative entrepreneurship, etc. The reasons for the need to create ES in general and especially in Ukraine are defined. A review of the theoretical and methodological bases of creation of the ES (noosphere approach, methodology of vertical integration of knowledge, model of the paradigm-based innovative development) is conducted. The basic elements of the conception of ES are formulated. They are presented as an element of the innovative infrastructure, the basic idea of their business model is defined. The directions of analytical work, directions of development and increase of efficiency of ES in the national innovation system are presented.

This article is devoted to defining the principles of the fiscal decentralization. It was established the essence of the decentralization as one of the components of the management process aimed at reducing the dependence of local governments from the central government. It was considered the theoretical principles of the fiscal decentralization and proved its effect on the formation of local budgets. The features of the revenue of local budgets under decentralization through tax and non-tax revenues and other revenues (without transfers) were founded. Analyzed the revenues of local budgets in Ukraine for 2010-2016 years., the benefits and positive effects of decentralization. Systematized the features of the financial decentralization in Ukraine. Formed the choice of areas oriented on growth of economic and financial independence of regions of Ukraine. The article is examining the theoretical foundations of the fiscal decentralization, ordering features of the fiscal decentralization in Ukraine and factors of influence on the formation of the local budgets. The basic objectives of the fiscal decentralization were formed. It was established that if addressing legal, organizational and social problems the budgets of administrative units will have sufficient funds for delegated powers.

The purpose of this work was to evaluate the antimicrobial activity of povidone-iodine solution as a photosensitizer and effective optical range of laser activation identification in vitro. Materials and Methods. As the test cultures reference strains of Candida albicans ATCC 885-653, Staphylococcus epidermidis ATCC 14990, Escherichia coli ATCC 25992, Pseudomonas aeruginosa ATCC 27853, Enterococcus faecalis ATCC 6783 were used. 10 % povidone-iodine solution was added to Petri dishes with the microorganisms on agar and was left in situ for 60 seconds. Fifteen test Petri dishes were irradiated using the remote handle VRV4 λ = 658 nm (Test 1), the other fifteen – with the handle VRIP1 λ = 810 nm (Test 2). Four controls were carried out: the first control (C1) – Petri dishes with inoculated culture without the povidone-iodine solution and laser irradiation influence. The second control (C2) – the photosensitizer was not irradiated. The third control (C3) – it was the irradiation by wavelength 658 nm without chromatophore using. The fourth control (C4) – it was the irradiation by wavelength 810 nm without chromatophore using. Results. The obtained data have shown that povidone-iodine solution was activated in the infrared optical range, as evidenced by the complete absence of test microorganisms growth in Petri dishes “Test 2”. It was found out a reliable decrease in the number of microorganisms colonies in the Petri dishes “Test 1”, but it was achieved by the povidone-iodine antimicrobial activity, rather than by laser activation. This is confirmed by the fact that the number of microorganisms colonies in the Petri dishes ”Test 1” was not statistically different from the number of colonies in the second control group where povidone-iodine solution was not irradiated. Conclusions. It has been proved that the photosensitizer 10% povidone-iodine solution was activated by 810-nm wavelength laser irradiation in the infrared optical range. There had been no growth of microorganisms in nutrient media in test plates compared to the control.

It has been a clear increase in the number of enteroviral infection (EI) activation in recent years. EI are the widespread agents of infectious diseases in children and adults. Moreover this virus affects various organs and tissues and it results in different symptoms of EI in patients of different age groups. All these facts lead to the difficulties in diagnostics, treatment and prophylactics of the EI clinical forms. Aim of the study was to improve diagnostics of the enteroviral infections (EVI) in children and adults based on the epidemiological features of the definitive clinical forms in season 2016. Materials and Methods. The study was carried out as a part of the Grant Agreement between Zaporizhzhia State Medical University (ZSMU) and "Regional Training Centre of Research in the HealthCare System" (theRepublic ofKazakhstan). 185 patient’s medical documentation was analyzed in the inpatient department. Only symptomatic patients with clinical manifestation of enteroviral infection different forms were included into the study. Polymerase chain reaction (PCR) was used for enteroviruses detection. Results and Discussion: Enterovirus was identified in biological liquids in 36.7 % (68 patients) of cases. Patients with meningitis (35) prevailed among them. Other 9 patients had: exanthema, gastroenteritis, herpangina. An increase in the incidence of morbidity has been noted in August - November with the prevalence of meningitis in August – September, herpangina – in November. Most frequently EVI was detected in children aged 7 – 12 years and in young children. Meningitis dominated in school-aged children, exanthema – in children up to 3 years old. Conclusions. EVI is widespread cause of meningitis, vesicular or ulcerative lesions of the posterior oropharyngeal structures and exanthemas in young and early school-age children. Clear association between season and age features with type of the EVI clinical manifestation has been noted. enteroviral infection; epidemiology; adults; children

The article is devoted to the major trends and issues of development of local budgets in Ukraine. A study of the essence of fiscal decentralization as one of the components of the management, aimed at reducing the dependence of local governments from the central government with regard to foreign experience. Particular attention is paid to local budgets under decentralization of own and delegated financial powers. The theoretical principles of fiscal decentralization and its proven impact on the socio-economic development. Studied the European countries model of local budgets. The features of formation of revenues of local budgets under decentralization. The role in shaping tax revenues of local budgets in foreign countries and Ukraine. The analysis of state policy of financial support for regional development in Ukraine. The structure of tax revenue in the context of changes in the budget and tax legislation in a decentralized tax powers. Systematized features of fiscal decentralization in Ukraine. Problems and grounded main ways of optimizing the formation of local budgets in a decentralized tax powers. Formed selection of areas targeted as ways to increase economic and financial independence of regions of Ukraine.

This article focuses on the definition of the conceptual bases of the fiscal decentralization. It was investigated the essence of decentralization as one of the components of the management process aimed at the reducing the dependence of local authorities from the central government. The theoretical bases of fiscal decentralization were considered and its impact on the social and economic development was proved. The state and assessment of the level of decentralization of the financial system in Ukraine were investigated. We paid attention to the classification of the models of fiscal decentralization. It was analysed the indicators of the level of fiscal decentralization in Ukraine for 2005-2014 years, advantages and positive effects of decentralization. Are systematized the features of fiscal decentralization in Ukraine. Are formed selection of directions oriented as ways to increase the economic and financial independence of the regions of Ukraine. The recommendations for conducting the fiscal decentralization in Ukraine are formed. Purpose of the article is to examine the theoretical basis of fiscal decentralization, ordering features of fiscal decentralization in Ukraine and formation of the growth of economic and financial independence of the regions of Ukraine.

Perforation of hard tissue of teeth is one of the severe complications in endodontic practice. Research of the thermometric indicators of the mucous membrane in the treatment of perforations is an urgent task of endodontics. It can make results of treatment objective. The purpose of research - to determine the temperature indicators of the gum on the various stages of perforations of dental hard tissues treatment. Depending on the method of treatment, the patients were divided into two groups: basic and comparison group. Chronic apical periodontitis was detected in all the patients. Depending on the form of chronic periodontitis of patients in each group, two subgroups have been allocated. Thermometric indexes were detected by the method Lysov and Smolyanko. Temperature measuring was carried out using a digital thermometer (manufacturer «Microlife») with an accuracy of scale 0.01 °C. 264 measurements were obtained. According to the results obtained parameters were calculated on the rate of standardized indicators. After 1 month of observation in two main sub-groups temperature rise to indicators of 34,8 ± 0,44 ºC was observed, and in the subgroups of comparison results were 32,9 ± 0,43 ºC. At 6 months follow-up in both groups there was a significant reduction of the local temperature to -2.16% in 1 basic subgroup and 2.82% in the 2 basic subgroup (p 0.05).

The article presents the clinical observation of the patient's organ-preserving treatment with 31 g of cervical pregnancy. Research methods included MRI to visualize gestational sac, the definition of the boundaries between the chorion and the stroma of the cervix; determining b-subunit of human chorionic gonadotropin in serum; clinical tests. Superselective embolization of uterine artery was successfully performed incombination with subsequent scraping of the cervical canal and uterine cavity. Blood loss was 30 mL. The postoperative period was 5 per bed-day. Organ preserving treatment of cervical pregnancy with uterine artery embolization and subsequent curettage of the cervical canal and the uterine cavity under FSPTS possible to reduce the risk of bleeding and preserve reproductive function in young woman.

In the article the component structure of the educational complex is defined, its main structural units are analyzed. Established what factors influence the placement of heterogeneous schools in Chernihiv region The dynamic of the educational establishments of the region and inter-regional differences of their distribution are defined. Now, research educational complex deals with many scientists. Actually geographers study conducted diverse educational complex at different levels, namely national, regional. Also, studies of functional components and complex relationships that are formed as a result of functional and components. Scientists are trying to make every effort to improve the operation of the educational sector and develop appropriate programs that also contribute to the improvement of the educational complex whole. After analyzing the component structure of the educational complex of Chernihiv region we can make the following conclusions: Firstly: the heterogeneous distribution of educational institutions in theterritoryofChernihivregion is affected by a number of demographic, settlement and socio-economic factors. Secondly, for the full existence of the educational complex all its structural components must operate in full force. Each component becomes important. So when the reforms in the education sector take place, it should be taken into account that a change of one structural component will lead to the changes of other structural components of the educational complex.Thirdly, only coordinated work of state and local government of educational complex will function properly.

The article is devoted to the relationship between depressive disorders and cardiovascular diseases. According to epidemiological studies, roughly one in five patients with coronary artery disease suffers from depression. The combination of anxiety-depressive disorder and CHD complicates diagnosis and treatment of both diseases and worsens the prognosis. The authors emphasize the need for a differentiated approach to the management of such patients; special attention is given to the treatment of insomnia in patients with CAD.

Aim. Article presents the current data on the clinical and epidemiological issue of leishmaniasis. Methods and results. Leishmaniasis is endemic disease in 88 countries, mainly in tropical and subtropical climates. Probability of importation of American cutaneous leishmaniasis in our country is practically zero, but, given the rarity of this disease, we present own clinical observation of imported cutaneous leishmaniasis in Zaporozhye. At the beginning of the third millennium has greatly increased the urgency of tropical parasitic diseases, including leishmaniasis. According to WHO, the world's 14 million people are infected each year there is about 2 million new cases and about 350 million live in areas at risk. Leishmaniasis - a group of vector-borne protozoal disease in humans and animals characterized by lesions of the internal organs (visceral leishmaniasis) or the skin and mucous membranes (cutaneous leishmaniasis), which is the vector mosquitoes. We present their own clinical observations of American cutaneous leishmaniasis imported. Patient S., 41 years was hospitalized in Zaporozhye Regional Clinical Hospital infectious on 07.17.2013, with suspected cutaneous leishmaniasis. From the history of the disease is known that for the first time in February 2013 the patient have got relative to blade area redness and bump that appeared above the skin, and had a magnitude of 2,3 mm brownish-red. To the doctor the patient has not addressed. After 1,5-2 months bump grew and he began to stand out ichor, which dries and formed a crust on top of the hump. Further small ulcers that did not bring discomfort and pain to the patient appeared. However, every month ulcer increased. In July, after vacation at sea, rose weeping sores and perifocal inflammation appeared. Ulcer size reached 2 cm in diameter. The patient first applied to the dermatologist at the beginning of July 2013. Dermatologist excluded secondary syphilis and tuberculosis skin and sent to an infectious diseases doctor with suspected cutaneous leishmaniasis (Mexican?). The patient was admitted to the department number 1 in Zaporizhzhya Regional Infectious Hospital. From the epidemiological history it was known that in December 2012 the patient was in Mexico, in its southeastern part. Tours visited the waterfall, located in the jungle. By the waterfall he was in a bathing suit and does not exclude the bites of mosquitoes. Objective status on admission: no complains. Local Status: In a field of ulcerative blade element 2 cm in diameter, covered with dry serous crust with a raised edge. Ulcerative element palpation painless. On the periphery of the ulcer there were inflammatory small roller, moderately thick, smooth. Perifocal inflammation of about 0,5 cm in removing the crusts revealed crater hole, the bottom close-grained, ulcer edges are rough, eroded occurred granulation. Discharge from the ulcers were scarce, sero-purulent character turned into a drying brownish crust. To confirm the diagnosis of leishmaniasis patient passed tests. The prepared area for scraping was anesthetize, then the end of the scalpel scrape small pieces of tissue, while scraping with sanious liquid is transferred to a glass slide, fixed and stained by the Romanovsky- Himze. So after taking clarify technical characteristics of the material for this specific study was conducted repeated studies that included biopsies of ulcerative item. Ultimately, the only element of ulcer biopsy taken on the periphery of the ulcer site with regional infiltration at the site of fresh granulation, gave a positive result. In preparation pathogen was detected - Leishmania sp., Amastihotna form. Conclusion: The clinical observation demonstrates the case of importation to Ukraine rather exotic disease - cutaneous leishmaniasis. This case should alert healthcare workers about the possibility of re-importation of cases of this disease in our country, which requires mandatory specific confirmation of the diagnosis, which is possible only with some technical features of the study material.

Purulent meningitis is defined by high indices of sickness and lethality rates, a great risk of cerebral and extracerebral complications development, steady residual consequences formation. During neuroinfections, the state of adaptation mechanisms, which is characterized by exhaustion of regulatory systems with the development of decompensation, plays a crucial part. Heart rate variability clearly reflects the degree of regulatory system tension caused by the influence of both physiological and pathological factors. Research aim: to increase the autonomic dysfunction diagnostics efficiency for patients suffering from purulent meningitis in the disease dynamics based on the complex of clinical evidence and functional status of autonomic nervous system. Materials and methods. There were 60 patients with purulent meningitis under medical observation. Wein’s questionnaire was used for the detection of clinical presentations of autonomic dysfunction. Functional status of autonomic nervous system was diagnosed using the method of computer-based cardiointervalometry. The screening group was formed of 20 healthy individuals. Research findings and theirs discussion. Cerebral meningeal symptom was dominant among the patients suffering from purulent meningitis at the peak of the disease. At hospitalization every fifth person (23,3%) had the objective evidence of autonomic dysfunction in the form of a postural tremor of upper limbs and eyelids. The analysis of autonomic nervous system parameters functional status among the patients suffering from purulent meningitis at the peak of disease showed heart rate variability decrease in the main branches of autonomic regulation and the presence of autonomic imbalance towards vagotonia. Since the second week, clinical signs of autonomic dysfunction prevailed in the dynamics of patients suffering from purulent meningitis in the course of standard treatment, which was proved by Wein’s survey of the patients. The predominance of the autonomic dysfunction signs in the clinical picture was combined with the prolonged decreasing rating of humoral effects’ spectrum (p

Relevance of hepatitis B due to the high incidence complexity of pathogenesis, ineffective treatment, severe consequences of the disease. Among combined lesions of the liver, special attention is paid to viral-alcoholic type. One of the mechanisms of chronic hepatitis of different etiology is violation of the functional activity of the autonomic nervous system. The aim of this work- to determine the dynamics of spectral indices of heart rate variability in patients with acute hepatitis B from chronic use of alcohol in hepatotoxic doses. Materials and methods. 133 patients with acute hepatitis B were under observation. Patients were divided into groups taking account the presence or absence of chronic use of alcohol in hepatotoxic doses and using the classification of alcohol consumption based on the frequency and dose of consumed alcohol. I group comprised 52 patients with chronic use of alcohol in the hepatotoxic doses, II group consisted of 81 patient without this factor. Heart rate variability was diagnosed using computer cardiointervalometry performed by electrocardiographic diagnostic system CardioLab-2000. 20 healthy individuals were in the control group. Results and discussion. Prodromal period in patients of the I group was longer (p0,05). However, only patients in group I had marked hemorrhagic manifestations (5,8 %) and itching (7.7%). Average serum total bilirubin level was higher (p

In the article changes are analysed to the order of forming and implementation of local budgets in accordance with the norm of the new Budgetary code; the principles of the formation of the local budgets of Ukraine with the accordance of the present legal basis are studied here. The stress is maid on the existing problems which arise during the distribution of the budget resources.

Physical health of a child is inseparable from his emotional state. At present time it is defined that stress and negative life situations (for example, sudden changes in environment and order of day, beginning and ending of school year, examinations and preparation to them, parents’ divorce or dismissal, parting with close friends, interviews etc.) are responsible for increase of distress symptoms in children and adolescents and decrease their ability to self-control. Moreover psychological processes interfere in life activity and can lead to negative consequences in future. The state that emotional and other types of stress can prevent normal psychological and social development in many children is proved in this article. Such disturbances can lead to severe long-term consequences and increase the demand in medical resources, which requires measures aimed to improvement of resistance to stress in childhood and adolescence. During this millennium methods of therapeutic and preventative measures, based on molecular and cellular magnesium-dependent pathogenetic mechanisms of stress formation and consequences of magnesium insufficiency, gain more and more popularity. Recommendations on following certain motional regimen and appropriate for stress condition nutrition do not lose their urgency.

Article is dedicated to the problem of headache in children. This pathology is being found more frequently in pediatric and children’s neurologic practice. The authors examine headache pathogenesis from the position of magnesium deficiency. Analysis of results of the modern studies on magnesium deficiency and its correction in patients with headache indicates that magnesium metabolism may play an important role both in pathogenesis of different headache types and in its treatment and prevention.

The use of distance learning technologies in the organization of students’ independent work are discusses in the article.

The experience of English speaking students teaching the infectious diseases was summarized, an attempt to establish the recommendation of the organization of the learning process in the specialty was made.

Abstract As a result of the analysis of 330 archival patient’s cards of patients with HIV/AIDS who received highly active antiretroviral therapy with the inclusion of tenofovir in the treatment scheme, kidney affection has been fixed in 1,5 % of cases only in patients with the acquired immunodeficiency syndrome, accompanying chemotherapy concerning tuberculosis and/or pneumocystosis, existence of other background somatic pathology.

In the work the range of extrahepatic implications in patients with chronic hepatitis C depending on the infection with different genotypes of virus and level of virus load is analyzed. Prevalence of infection with 1st and 3rd genotypes of virus and low virus load is shown. Frequency of development of separate extrahepatic implications doesn’t depend on virus genotype and level of virus load. The range of extrahepatic implications is characterized by the most frequent development of mixed cryoglobulinemia with the advent of corresponding clinical symptoms and thyroid disorders.

Relevance of an echinococcosis is caused by case rate body height, late diagnostics, augmentation of number of the complicated forms, growing number of patients with atypical localizations of echinococcosis cysts. The aim of this work: to analyze clinical-epidemiological features of echinococcosis in Zaporozhye region. During 2005-2012 years 36 cases of echinococcosis in the Zaporozhye region are analyzed. For confirmation of the diagnosis were used instrumental (ultrasonic research, computer tomography), serological (identification of antibodies to echinococcus), histological (after cyst excision) methods. The obtained data were processed by a method of variation statistics. Results of the conducted research showed that among the adult patients (86,1%) aged from 21 till 79 years are prevailed. Women are prevailed: 75 against 25% of men. Among the patients the most part had risk to become infected by an echinococcosis: owners of animals which didn’t passed dehelmintization. 33,3% of patients had no epidemic factor. Localization of echinococcus cysts mainly became perceptible in a liver (77,8 %) and lungs (11,0 %). In isolated cases echinococcus cysts were localized only in kidneys (2,8 %), abdominal cavity (2,8 %). In 5,6% cases multiple lesions took place. At localization of echinococcus cyst in a liver and abdominal organs (32 patients) clinical signs of invasion persisted within several weeks, months or 2-3 years constantly amplifying. Main symptoms were: pain in combination with asthenia and dyspepsia disorders. In 9% of cases echinococcosis of the liver was diagnosed "casually". Instrumental methods were main in identification of echinococcus cysts of liver and abdominal organs. At 45,5% of patients despite existence of clinical implications of disease and existence of echinococcus cysts according to the ultrasonic research no specific antibodies were detected. Echinococcosis in the lungs was diagnosed in 4 patients. Clinical-radiological data in 3 cases demanded carrying out differential diagnostics with pneumonia and pulmonary tuberculosis. Special difficulties in diagnostics of echinococcosis arose in the case of the multiple localization in the organs. In 2 patients multiple localizations of echinococcosis was diagnosed with difficulties and only finally n autopsy. Treatment of patients with echinococcosis included surgical excision of the cysts (85,3 %). Only conservative therapy by albendazol was used in 3 patients because of failure of the surgical treatment, or impossibility of surgical treatment because of the multiple lesion of liver. Echinococcosis recurrence after treatment was registered in 13,9% of cases. During 2005-2012 in Zaporozhye region quantity of the echinococcosis diagnosed patients became perceptible. The majority of patients (66,7 %) had epidemiological risk of infection (58,4 %). Most often localization of Echinococcus granulosus cysts were registered in a liver (77,8 %) and lungs (11,0%). Difficulties in clinical diagnostics were caused by a polymorphism of symptomatology and low level (54,5 %) of identifications of specific antibodies by enzyme immunoassay method. Echinococcosis recurrence after treatment was achieved in 13,9 % of cases.

In patients with measles we revealed the decrease of parameters of general power of vegetative regulation and power of spectra of humoral influences with the development of vegetative imbalance towards the parasympathicotonia. In the dynamics of the disease in convalescence period we noted the increase of the total power of heart rate variability and sympathetic activity, although these indices are reduced as compared with healthy people ones.

We show that the feature of the clinical symptoms of serous and purulent meningitis is a frequent dissociation of meningeal signs, the most pronounced in serous meningitis (62.1 vs. 30.4%). Difficulty deciphering the etiologic diagnosis is confirmed by the low level of detection of the etiologic factors: in purulent meningitis etiology confirmed in 52.1% of cases, and in serous only 13.7%.

It is shown that inclusion of erbisol into the complex pathogenetic treatment of chronic hepatitis C with mixed cryoglobulinemia helps to restore cytokine balance by increasing concentrations of interferon-γ and decreasing of interleukin-4 in blood serum, helps to decrease cryocrit level, to reduce cytolysis syndrome and clinical manifestations of cryoglobulinemic syndrome.

Abstract It is shown that inclusion of immunomodulating remedy with antioxidant properties (erbisol) into the basic treatment in patients with chronic hepatitis C with mixed cryoglobulinemia can increase the effectiveness of pathogenetic treatment. Against the background of treatment by erbisol in these patients recovery of prooxidant-antioxidant balance and reduce of cytolytic syndrome severity are observed.

The examination of 82 patients with chronic hepatitis C showed that disbalance in the system of cytokines in patients with chronic hepatitis C with mixed cryoglobulinemia is most pronounced and characterized by the lowest content of interferon-γ and the highest content of interleukin-4 in blood serum. The disbalance in the cytokine system plays an important role in the development of signs of mixed cryoglobulinemia.

This year, a new subject, Ethics, will be introduced for fifth- and sixth-graders. It is a cultural course of a secular nature, it lacks religious education. Children of ten to twelve years will be introduced to moral norms and universal values, will try to help determine their own life position. The authors of the program and textbooks expect that school ethics lessons written once a week will teach children to be friendly, polite, attentive and responsive to other people, make our children more tolerant and compassionate, and teach morality and immorality.

Clinical observation shows a case of the HCV-associated immune thrombocytopenia which is infrequent extrahepatic manifestation of chronic hepatitis C. The case peculiarity is the manifestation of chronic HCV-infection by hemorrhagic syndrome at minimum expressed hepatic manifestations and absence of hepatocirrhosis signs.