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Introduction. The impact of traumatic experiences has always been a part of human life. According to Judith Herman, an American psychotherapist, and professor at Harvard Medical School, "traumatic events overload a person's usual strategies for adapting to life, his usual security systems that give a sense of control, connection, and meaning." Also, traumatic events, for the most part, contain close personal contact with violence and death and pose a threat to life or physical integrity. For almost one year of the war, Ukrainian society faced a large number of negative phenomena capable of causing severe psychological trauma: disruption of the usual lifestyle, loss of family friends, and property, lack of many vital needs for a person, forced migration, uncertainty, a constant threat for health and life, etc. The purpose of the study was to analysis of scientific and literary data reflecting the history of the formation of the concept of "post-traumatic stress disorder" as a nosological unit, as well as the peculiarities of its manifestation and prevalence, diagnostic criteria. Materials and methods: A systematic search was conducted in the main electronic medical databases, such as PubMed, Scopus, Web of Science, Google Scholar, and processed publications that studied the history of the formation of "post-traumatic stress disorder" as a nosological unit, the features of its manifestation and prevalence. diagnostic criteria. Eligible studies were identified using keywords: post-traumatic stress disorder, psychotraumatology, trauma, physioneurosis, history of medicine. All types of articles were reviewed, including original studies, systematic reviews, and meta-analyses. Review and discussion: For a long time, there was a stigmatization of combat-related disorders in society. The path to the development of PTSD as a psychiatric diagnosis is long and thorny. After the World War II, there was an urgent need to introduce a standard unified nomenclature that would enable doctors from all over the world to have a common language for discussing the psychopathology of this disorder, establishing a diagnosis and determining disability. Over 60 years, starting in 1952, when the American Psychiatric Association (APA) introduced the concept of "brutal stress reaction" in its first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I) and up to 2013 (DSM-5) formation of post-traumatic stress disorder as a nosological unit was taking place. Conclusions: Despite the non-acceptance, stigmatization, indifference and other difficulties, PTSD finally achieved official status in the recognized list of diagnoses.

Introduction.According to scientific data, unemployed, lonely and students are most prone to procrastination. And what about teachers, in particular, higher education institutions? There is not enough data in the available literature. As practice shows, in the case of teachers, procrastination or postponement can manifest itself in the form of stress caused by failure to fully realize goals and plans vital to the individual. Negative consequences are expressed both in reduced work capacity and in acute emotional experiences of one's own failure, dissatisfaction with the results of one's work. The aim of the study .was to investigate and evaluate the level of anxiety, depression and the nature of manifestations of procrastination among teachers of the Ivano-Frankivsk National Medical University during the period of altered psycho-emotional state during forced social distancing in connection with the COVID-19 pandemic and its impact on social functioning and quality of life. Materials and methods: The survey was voluntary and anonymous. The research was approved by the Bioethics Committee of Ivano-Frankivsk National Medical University and conducted according to the principles of the Helsinki Declaration. We used two clinical test methods to identify emotional disturbances: the Hospital Anxiety and Depression Scale (HADS) and the Montgomery-Asberg Depression Rating Scale (MADRS) (Zigmond A.S. et.al.,1983; Svanborg P., 2001). In order to assess the degree of expressiveness of the propensity to postpone matters "for later" among the surveyed teachers, we created a special Google questionnaire created on the basis of data."Questionnaire to study the propensity of the individual to procrastination" (Shivari ,O.A., 2015), which is a modification of the "General Procrastination Scale" (Lay, C., 1986) and consists of two scales: "Personally conditioned procrastination scale" (Scale I) and "Situationally conditioned procrastination scale" (Scale II). Scale I indicates the general level of procrastination, and Scale II - motivational procrastination, its high indicators suggest that the questionnaire will perform some work only in the presence of motivation. In addition, in order to assess the quality of life, the data of "The Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF)" were evaluated. (Endicott J; Rapaport MH; Clary C; Fayyad R). The statistical analysis of the results was performed using STATISTICA 7.0 software packages and the package of statistical functions of Microsoft Excel. Results and discussion: Were interviewed 214 teachers of various departments of the Ivano-Frankivsk National Medical University: 174 (81.6%) women, 40 (18.6%) - men. 58 interviewees (27.1%) worked at theoretical departments, 156 (72.9%) – at clinical departments. The analysis of the results of the survey according to the «Personally conditioned procrastination scale» showed that 32 (14.9%) of the teachers interviewed by us have had a low, 96 (44.8%) - medium, and 86 (40.3%) - a high level of personal tendency to procrastination. Data of "Situationally conditioned procrastination scale"showed that 54 (25.2%) have had a low level of situational procrastination,76 (35.5%) - medium and 84 (39.3%) - high, respectively.Based on the results of the survey on the HADS scale, a normal level of anxiety-depressive symptoms (0-7 points on a scale) was found in 9 (15.5%) workers from the theoretical departments and in 52 (33.3%) - clinical departments. According to the data of the conducted questionnaire according "The Quality of Life Enjoyment and Satisfaction Questionnaire - Short Form (Q-LES-Q-SF), the least satisfied respondents were by daily functioning, present depressed mood, inability to perform housework efficiently and to spend leisure time interestingly, engage in hobbies or even perform professional duties. Conclusions. The complex of research methods made it possible to comprehensively consider procrastination as a model of the behavior of the subjects and to determine the factors influencing its occurrence during the period of changes in the psycho-emotional state caused by forced distancing in connection with the Covid-19 pandemic and to study the relationship of procrastination with the level of quality of life (from the point of view of satisfaction and enjoyment of life). The main reasons for procrastination were dominated by: lack of motivation to work; stress, as a result of uncertainty and fear of the future; laziness; limited "live" communication and an excess of virtual, external distractions. It is noteworthy that among teachers this phenomenon is not limited to academic procrastination, in most cases everything is fine in this cluster, but more often it extends to homework, interpersonal communication, social and personal life. Attention is drawn to the fact that among teachers this phenomenon is not strictly limited to academic procrastination, but extends to household tasks, interpersonal communication, social and private life.

Introduction: Eating disorders - a class of psychogenic behavioral syndromes associated with eating disorders. The class of these disorders includes anorexia nervosa, bulimia nervosa, compulsive overeating, as well as several other disorders, which are included in the international classification, to section F 50-F 59. Purpose: The purpose of our study is to trace the dynamics of individual eating disorders in patients with various mental illnesses under the influence of corrective therapy. Methodology: Were examined 77 patients with various mental diseases who have had eating disorders. The first (I) group included 33 patients. They have added Metoclopramide at a dose of 20 mg/day to the main treatment. The second group (II) - 44 patients who received the drug Ondansetron at a dose of 4 mg/day, respectively. The condition of all patients was assessed according to the following scales: Eating Attitudes Test (EAT-26), 36-Item Short-Form Health Status (SF-36). Body mass index (BMI) was calculated to study the dynamics of weight. All examinations of patients were performed at the beginning and after 14 days of treatment. Results: According to the EAT-26 scale the average score in the I group was 29 ± 2.8 points, and in the II - 30.1 ± 2.4, respectively. According to the SF-36 questionnaire, the average total score in the I group was - 69.5 ± 1.8 before treatment, 79.5 ± 1.6 - after treatment improved by 12.5% (p

When the structure of the connective tissue is disturbed, the probability of developing pathology of the internal organs increases. The gastrointestinal tract is one of the systems that is most often involved in the pathological process in the case of such disorders. Due to its mesenchymal origin, the esophagus is one of the first to suffer. Normalization of mineral metabolism, correction of immunological and bioenergetic status are the main tasks in the treatment of such patients. Therapy with magnesium drugs, vitamins, anabolic drugs, ?-blockers, aldosterone antagonists, and amino acid drugs should also be used for this purpose. Patients in this group should also take drugs that contain vitamin D3

Introduction. In the case of gastroesophageal reflux disease (GERD) on the background of undifferentiated connective tissue dysplasia (UCTD) causes an even more significant deterioration in the QOL, including sleep disturbances and the onset of excessive daytime sleepiness (EDS). Thus, the study of the peculiarities of GERD on the background of connective tissue dysplasia and determining the impact of comorbid pathology on the QOL of patients with GERD is a topical issue in internal medicine. It has significant socio-economic significance. We believe that monitoring the most important variables that affect the quality of life of patients with GERD can help raise public awareness in this regard. In addition, it can guide the health care system to address these issues. Purpose. The purpose of the work is to increase the awareness of medical workers about the scale of the problem and ways to solve it. to study the features of the dynamics of quality of life in patients with gastroesophageal reflux disease comorbid with connective tissue dysplasia under the influence of the proposed complex therapy. Methodology. 120 patients were included: 65 men and 55 women. In 75 of them (Study Group) GERD was in the background of UCTD, in 45 (?omparison Group ) - developed as an independent disease. The Study Group was divided into three groups. ?omparison Group - 45 patients with GERD without UCTD, received basic standard therapy, which included PPI "Panocid" 40 mg once a day and alginate-antacid formulation (Gaviscon Double Action Liquid) 20 ml, 3 times per day after meals and before bedtime. I Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Magne-B6" for 2 tablets 3 times per day. II Group - 25 patients with GERD +UCTD, which to the standard basic therapy was added "Calcium-D3 Nicomed" 1 tablet 3 times per day. III Group - 25 patients with GERD +UCTD, who used the drug "Magne-B6" 2 tablets 3 times per day and "Calcium-D3 Nicomed" 1 tablet 3 times per day on the background of standard basic therapy. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36), the Gastrointestinal Symptom Rating Scale (GSRS), and the scale of "Personal and social performance" (PSP) - were used to study patients in detail. A comprehensive examination of patients was performed twice: before and after 30 days of comprehensive treatment. Results and Discussion. Under the influence of the basic therapy in Comparison Group the General Health (GH) improved by 33.03%. While in the groups on the background of complex treatment is increased by 42.52% in patients of the I Group, by 13.10% in patients of the II Group, and 46.28% in patients of the III Group (p1, p2, p3

Introduction. We live in time of rapid technical development. And this in turn contributes to the formation of a technical approach to the doctor-patient relationship. The rapid and easily accessible flow of information, excessive awareness of patients sometimes complicates compliance - the cooperation of the doctor with the patient (Mandal, J., et.al., 2016 ). In world practice, compliance is considered excellent when the patient follows 75% of the doctor's instructions. In addition patient safety is a persistent issue in public health that has taken a new connotation in the contemporary sanitary context (Façanha, T. R.et.al., 2019). Purpose. The purpose of the paper is to investigate what qualities a doctor of the 21st century should have from the point of view of a modern patient in order to improve compliance, cooperation of the doctor with the patient. Methodology. The survey was completely anonymous and voluntary. If the answer is yes, the patient had to choose from the proposed options the one that would most fully reflect his needs. In order to exclude subjectivity and systematic errors, the survey was conducted in various medical institutions of Ivano-Frankivsk. We interviewed 120 patients: 75 (group I) were hospitalized, 45 (group II) - outpatient. The special questionnaire developed by us consists of 30 questions, which are grouped into groups, each of which reflects certain qualities: competence and personal experience of the doctor; review features; the ability to explain to the patient the essence of the disease; appearance.Some items of the questionnaire were: "Does age or gender of the doctor matter to you?"; "Did you have problems with" doctor's handwriting "? Did it in any way affect your cooperation with the doctor on the way to better health? ? ». Results and Discussion. The study found that among the main qualities of the doctor, 88% of patients of group I and 80% of group II distinguish competence and professionalism; 42.66% vs 46.5% - attention; 60.0% vs 53.2% - patience and kindness; 90.6% vs 80.0% - the ability to easily and informatively answer questions of concern to the patient. The distribution of the qualities of the doctor and the manifestation of the need for them among the studied patients are shown in Figure 1. Significantly fewer patients focused on the doctor's appearance or age. Significantly fewer patients focused on the doctor's appearance or age. However, there has been a trend: most respondents prefer middle-aged female doctors. Causal analysis of the problem of poor handwriting of doctors showed the following data: 42.6% of patients of group I and 53.2% of group II complained of poor handwriting of doctors. And 6.6% and 2.2%, respectively, consider it illegible. According to the patients, they had the experience of buying and even using drugs issued incorrectly in the pharmacy due to the "medical handwriting" of 5 patients of group I and 1 patient of group II. However in the conditions of inpatient treatment this problem was quickly solved thanks to good cooperation of the doctor-nurse. It is almost impossible to control the same problem in the conditions of outpatient reception. Practical value. The results of our study were successfully implemented in the educational and scientific process of the Department of Propaedeutics of Internal Medicine and the Department of Psychiatry, Narcology and Medical Psychology at Ivano-Frankivsk National Medical University and can be used in lectures and workshops on occupational therapy and rehabilitation, medical psychology, the psychology of creativity, general, pedagogical psychology, pedagogy, sociology, philosophy, etc. Conclusion. The results of the study are statistically processed and allow to develop a model of the relationship between doctor and patient. It is possible that this study will promote better collaboration between physicians and patients. And medical students to think about what qualities should be nurtured in themselves for successful work

Introduction. It has been scientifically confirmed that the risk of developing gastroesophageal reflux disease (GERD) increases especially with generalized or regional disruption of connective tissue structure, which is widespread among the population. Patients with such comorbid pathology may have a wide range of symptoms that may go beyond the general symptoms of heartburn and regurgitation. The symptoms and complications of GERD affect general health, daily and social functioning, physical and emotional activity. It also affects the quality of life (QoL) associated with health through frequent breaks during sleep, work and social activities. Purpose. study the dynamics of the level of quality of life and social functioning in patients with gastroesophageal reflux disease in combination with the syndrome of undifferentiated connective tissue dysplasia. Methodology. A total of 120 patients were included in the study: 65 men and 55 women: in 75 of them (Group II) GERD occurred on the background of UCTD, in 45 (Group I) as an independent disease. The control group consisted of 12 healthy individuals. The study was comprehensive. The Medical Outcomes Study 36-Item Short-Form Health Status (SF-36),the Gastrointestinal Symptom Rating Scale (GSRS) and the scale of "Personal and social performance" (PSP) - were used to study patients in detail. Results and Discussion. Analyzing the results obtained on the basis of the GSRS questionnaire (Table 1), in patients with GERD on the background of UCTD, compared with patients of group I and the control group, there is a significant increase in three and four from the five scales. QoL in patients of Group II on the scale "Abdominal pain" were 14.3 ± 0.4 points, in Group I - 5.6 ± 1.3 points, in the Control Group - 2.4 ± 0.8 points, on the scale "Reflux syndrome": 13.7 ± 0.9, 10.5 ± 1.3 and 3.1 ± 0.9, respectively. "Dyspeptic syndrome" - 15.3 ± 0.4 points in Group II, 12.2 ± 0.6- in Group I and 6.1 ± 0.3- in the control group. "Constipation syndrome" 9.5 ± 0.8, 5.6 ± 1.03 and 5.7 ± 0.4, respectively (p

The objective of the research was to study the effectiveness of course application of magnesium and calcium-containing drugs on the background of conventional therapy on the changes in the content of macronutrients in red blood cells and the activity of matrix metalloproteinase - 9 in the patients with a co-existence of undifferentiated connective tissue disease and gastroesophageal reflux disease. Materials and Methods. All 75 patients with gastroesophageal reflux disease associated with undifferentiated connective tissue disease were divided into three groups: Group I included 25 patients who received Magne-B6 at a dose of 2 tablets 3 times a day in addition to the standard background therapy with “Panocid” at a dose of 40mg once a day; Group II comprised 25 patients who received “Ca-D3 Nycomed” at a dose of 1 tablet 3 times a day in addition to the standard background therapy; Group III included 25 patients who received a combination of “Magne-B6” and “Ca-D3 Nycomed” in addition to the standard background therapy. Results. In Group I, the proposed complex therapy resulted in a significant increase in Mg2+ by 40.9%. Mg2+ dynamics was less significant in Group II; this index reached the level of 17.9 ± 2.04 µg/g (р"˃0.05); in its turn, Ca2+ level increased to 80.6 ± 2.12 μg/g (p"

Introduction: One of the features of modern clinical medicine is that the diseases lose their mononosological character and more often have a comorbid course. Chronic pathology of the gastrointestinal tract (GIT) combined with syndrome of undifferentiated connective tissue dysplasia (UCTD) occupies a special place. And although scientists have increasingly investigated the relationship between gastroesophageal reflux disease (GERD) and UCTD syndrome in recent years, but the available scientific literature provides an extremely limited amount of material directly on the subject. Aim: To analyze literature data on the features of the course and treatment of gastroesophageal reflux disease in patients with syndrome of undifferentiated connective tissue dysplasia. Methods: A systematic literature search of Web of Science Core Collection, MEDLINE, PubMed, EMBASE, and the Cochrane Library until December 2019 with keywords "gastroesophageal reflux disease", "syndrome of undifferentiated connective tissue dysplasia", "ghrelin", "matrix metalloproteinase-9", "prostaglandin E2", "prostoglandin F2α", "oxyproline", "micro- and macronutrients", was performed Results: According to scientific data, the digestive system is the second system of the body according to the frequency of involvement in the dysplastic process after the cardiovascular system (Bodolay E. et.al., 2003). The high degree of collagenation of the digestive system allows us to expect a variety of manifestations of UCTD. Dysplastic changes in the gastrointestinal tract include insufficiency of cardia, diaphragmatic hernia, ptosis of abdominal organs, anomalies of shape and structure of esophagus, stomach, duodenum, esophageal diverticula and various departments of intestines. In this case, the presence of UCTD syndrome causes certain features of metabolism, adaptation and existence of the organism in conditions of defective collagen (Nica A. E et.al., 2016). From a clinical point of view, UCTD is a heterogeneous and polymorphic condition, which underlie various defects in the formation of collagen and elastin fibers as a result of genetic predisposition, which lead to disorders at the tissue and organism levels (Chemodanov V. and others. , 2018). Acording to the science data, assignment of patients to the UCTD group is possible if its manifestations are not specific for such connective tissue diseases as rheumatoid arthritis (RA), scleroderma, systemic vasculitis, myositis, systemic lupus erythematosus, Sjogren's syndrome (Antunes M. et al., 2019.) The complexity of the morphology and the variety of connective tissue functions also determine the prevalence of visceral manifestations of UCTD. Moreover, as the phenotypic signs UCTD increases, the likelihood of detecting pathological changes in the internal organs increases. The degree of damage to the internal organs and usually determines the severity of the clinical picture and individual prognosis. (Usenko O. Yu et al., 2017; Denaxas K. et.al., 2018). GERD is a multifactorial disease in the occurrence of which play a role as a support (stress, obesity, smoking, intake of some medications, nutritional features) and determining factors that include cardiac insufficiency, gastric reflux and resistance of the mucous membrane of the esophagus due to a decrease in its clearance. The risk of developing GERD also increases with generalized or regional disruption of connective tissue structure that is widespread in the population (Kadurina T. I. et.al., 2010). Cardia insufficiency is one of the manifestations of UCTD, and there is a direct relationship between the degree of UCTD and the incidence of gastroesophageal reflux (Denaxas K. et.al., 2018). On the background of UCTD, in combination with gastroesophageal refluxes (GER), a pronounced inflammation of the mucous membrane of the lower third of the esophagus was more often found. Frequent GER may affect the state of the autonomic nervous system through the nerve and anatomical ligaments of the esophagus and deepen connective tissue dysfunction. In some works, it was found, that on the background of UCTD syndrome, the symptoms inherent in GERD were detected more often than in patients without signs of the first. In particular, these patients complained more frequently of heartburn, severe chest pain, more frequent gastroesophageal and duodenogastric refluxes and erosion of the mucous membrane of the lower third of the esophagus. Thus, as can be seen from the above data, conditions for such important pathogenetic links of the development of GERD, such as impaired function of the lower esophageal sphincter (LES), reduction of the barrier capacity of the mucous membrane of the esophagus, an increase in the number of acid and mixed refluxes. (Kamataki A. et.al., 2015; Baia X. et. Al., 2019). The exclusive role of PGE2 in maintaining mucosal integrity, preventing acid reflux, and esophagitis by modulating various gastrointestinal functions has been scientifically validated (Baia X. et al., 2019). At the same time, in the available literature, we have not identified any studies examining the role of different classes of prostaglandins in protecting mucous membrane of the esophagus in UCTD. Peptide hormone such as ghrelin has a pronounced effect on gastric motility. This hormone is mainly released from the stomach and has many physiological actions, such as stimulating food intake, regulating the motility of the gastrointestinal tract, stimulating the release of growth hormone, lowering blood pressure and regulating the complex process of energy metabolism, through the correction of hunger signals. As ghrelin stimulates gastric motility and accelerates gastric emptying, the effect of this intestinal hormone on GIT motility is being actively studied, in particular in pathological GER (Kitazawa T. et.al., 2018). At the same time, the role of ghrelin in GERD as an independent disease and its combination with UCTD has not been studied. Involvement of the esophagus in the pathological process of UCTD is also explained by the accumulation of the extracellular matrix in its walls, remodeling and degradation of collagen and other compounds, and the key regulators of these processes, both under physiological and pathological conditions are matrix metalloproteinases (ММР’s) (Chen et al., 2009). The cofactors of matrix metalloproteinases are micro- and macroelements that are involved in the formation of collagen, giving elasticity to the connective tissue matrix (Ismail AA, 2016). At the same time, the level of micro- macroelements in blood and MMP-9 activity was not studied in patients with GERD on the background of UCTD. With regard to drug therapy of this combined pathology in adults, in cases of development of GERD on the background of UCTD pathogenetically justified complex therapy has not been developed, which also determines the relevance of this study. Conclusion: A study of the literature on the comorbidity of GERD and UCTD has shown that variability in clinical pathology markers is not fully reflected in publications on this topic. This complicates early diagnosis, making the right diagnosis at the initial examination of the patient. The clinic for such combined pathology remains poorly understood. In this regard, the treatment of this pathology is not prophylactic, aimed at preventing possible complications, but remains symptomatic. Therefore, the next step in this study will be: to study the frequency of combination of GERD with phenotypic and biochemical markers of UCTD syndrome; establishment of features of clinical manifestations, changes in gastric motility, indicators of daily pH-metry, condition of the mucous membrane of the lower third of the esophagus in patients with GERD in combination with syndrome UCTD