Policy and strategy in the field of health protection

EDUCATIONAL AND PROFESSIONAL ENVIRONMENT AS A FACTOR OF FORMATION OF PROFESSIONAL IDENTITY OF FUTURE HEALTHCARE PROFESSIONALS

PUMTS. 2021; 42(2): 5-10.
https://doi.org/10.31071/promedosvity2021.02.005

Habilitation of modern specialists of the health service sphere in a higher educational institution envisages the purposeful formation of their standard professional identity that will provide their future professional sustainability. This shaping of professional identity in the higher educational institution as a task for educational and professional process needs to reproduce compliant pedagogical conditions, e.g., creation and organization of functioning of the educational-&-professional community as a site for professional and communicative self-affirmation and for professional self-determination of a future specialist. Creating and functioning of the educational-&-professional community in modern university actualizes in two forms — real (full-time) and virtual (remote). A pedagogical management which helps to form the professional identity in the conditions of the educational-&-professional community envisages organization of its functioning, solving educationally and professionally prompted tasks by the students, referring the pedagogical request to the specialists who will join this community and will provide fulfillment of the identity processes via students’ vocational self-presentation and reflective self-analysis, via experts’ assessment, facilitation and analysis of adequacy for the students’ vocational choice — these will serve as the basis of further perfection of educational and professional development of a higher educational institution. Approving the teaching doctors’ pedagogical willingness to create the educational-&-professional community may be achieved within the cyclic retraining which has confirmed its efficiency.

REFERENCES
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  2. Razumna A. H. (2020). Formuvannia profesiinoi identychnosti maibutnikh fakhivtsiv medychnoii haluzi u zakladakh vyshchoii medychnoii osvity [Formation of the professional identity of the future medical specialists in the higher medical educational institutions]. Candidate’s thesis. Kyiv.
  3. Razumna, A. H., Karunyk, K. D., & Kharkivskyi, V. S. (2021) Profesiina identychnist maibutnioho fakhivtsia iak chynnyk ta pokaznyk iakosti medychnoii osvity [Professional identity of the future specialist as a factor and indicator for the quality of medical education]. Proceedings from the Current problems of the higher medical education: Vseukraiinskaya nauk.-prakt. konferentsia z mizhnarodnoiu uchastiu — All-Ukrainian scientific and practical conference with international participation (pp. 162–164). Kharkiv.
  4. Humeniuk, O. M., Humeniuk, V. V., & Tsiura, S. B. (2019). Metodychni zasady formuvannia profesiinoii identychnosti maibutnikh medychnykh sester [Methodological principles in shaping of the professional identity of the future nurses]. Visnyk natsionalnoii akademiii Derzhavnoii prykordonnoii sluzhby. Seriia Pedahohika. — Bulletin of the National Academy of the State Border Guard Service. Series Pedagogics, 1. Retrieved from: http://nbuv.gov.ua/UJRN.
  5. Razumna, A. H. (2019). Pedahohichni chynnyky formuvannia profesiinoi identychnosti maibutnoho medychnoho fakhivtsia v umovakh ZVO [Pedagogical factors of formation of professional identity of the future medical specialist under the conditions of higher education establishments]. TiPUSS, 1, 16–27.
  6. Kasyanova, O., Razumna, A., Strizhenko, T., & Zyuzko, V. (2020). Zmistovi skladovi profesiinoi identychnosti maibutnikh fakhivtsiv sfery okhorony zdorovia [Content components of the professional identity of future healthcare professionals]. Proceedings from the Continuing professional development of doctors and pharmacists in the context of health care reform: nauk.-prakt. konferentsia z mizhnarodnoiu uchastiu — Scientific and practical conference with international participation (pp. 77–81). Kyiv: NMAPE named after P. L. Shupik.
  7. Kasianova, O. M., & Razumna, A. H. (2020). Profesiina identychnist yak chynnyk ta rezultat bezperervnoi osvity likariv [Professional identity as a factor and result of continuing education of doctors]. Proceedings from the Current issues of continuing education in the information society (pp. 323–325). Kyiv.
  8. Stryzhenko, T. O., & Shakhova, H. A. (2020). Suchasni tendentsii rozvytku pisliadyplomnoi medychnoi osvity v informatsiinomu suspilstvi [Current trends in the development of postgraduate medical education in the information society]. Proceedings from the Current issues of continuing education in the information society (282–283). Kyiv.
  9. Kasуanova, O. M., & Razumna, A. H (2019). Vplyv navchalno-profesiinoho seredovyshcha na formuvannia profesiinoii identychnosti [The impact of the learning professional community on formation of the professional identity]. Proceedings from the Modern higher education: problem and perspective: VII Vseukr. nauk.-prakt. konf. studentiv, aspirantiv i naukovtsiv — VII all-Ukrainian scientific and practical conference for students, PhD students and young scholars (pp. 109–112). Dnipro.
  10. Kasуanova, O. M., & Razumna, A. H. (2021). Do problemy formuvannia normatyvnoi profesiinoi identychnosti maibutnikh medychnykh pratsivnykiv [To the problem of formation of normative professional identity of future medical workers]. Proceedings from the Current issues of improving the quality of the educational process: nauk.-prakt. konferentsia z mizhnarodnoiu uchastiu — Scientific and practical conference with international participation (pp. 141). Ivano-Frankivsk.
  • Medical education

    TEACHING OF THE CHAPTER «DISESES OF THE MUCOUSE MEMBRANE OF THE ORAL CAVITY» UNDER THE CONDITIONS OF DISTANCE LEARNING

    PUMTS. 2021; 42(2): 11-13.
    https://doi.org/10.31071/promedosvity2021.02.011

    The pandemic around the world has made adjustments not only in our lives, but also in the educational process in particular. Prolonged quarantine caused by COVID-19 has forced teachers in most higher education institutions to go online. If other higher education institutions could conduct mixed forms of education, the specifics of medical universities, where most classes are held at medical bases of hospitals and clinics, left no choice and focused exclusively on distance education. It is very important that the performance of the department’s distance workload fully meets the planned workload of the departments, all the requirements of the educational process and quality preparation of fifth-year students for the licensing exam KROK 2 and certification of graduates. Relevant changes also affected the teaching of the section «Diseases of the oral mucosa» at the Faculty of Dentistry. According to the working curriculum and regulations on the educational process, classes are held according to the method of a single day and last 6 hours. The Microsoft Teems system was proposed for consideration by the university administration for practical classes and lectures. In addition to the actual online communication, this system provided many different features. In accordance with the decision of the meeting of the department, the following time schedule was approved. А lesson on consideration and discussion of a new topic begins. After that, practical work and a break are provided. Since this course is a final one, a lot of attention should be focused on preparing for the licensing exam. Upon completion of the discipline, students defend their medical history. Photos of the paper version are dumped by the teacher for verification on the university mailbox. Actually, the defense of the story takes place online with a short presentation of the works.

    REFERENCES
    1. Vankova N. A., Rizhov O. A. (2020). Model pedagogichnoii sistemi elektronnogo distantsiynogo navchannya na bazi hmarnih servisiv [Model of pedagogical system of electronic distance learning on the basis of cloud services]. Medychna osvita — Medical Education, 3, 34–42.
    2. Volosovets O. P., Vigovska O. V., Krivopustov S. P. (2020). Distantsiyne navchannya yak informatsiyno-komunikativna tehnologiya dodiplomnoii pidgotovki likariv z pediatriii v umovah suchasnih viklikiv [Distance learning as an information-communicative technology of undergraduate training of pediatricians in the conditions of modern challenges]. Medychna osvita — Medical Education, 3, 9–12.
    3. Volosovets O. P., Zozulya I. S., Slonetskiy B. I. (2020). Osoblivosti distantsiynogo navchannya v ramkah pislyadiplomnoii pidgotovki likariv z meditsini nevidkladnih staniv [Features of distance learning in the postgraduate training of emergency physicians]. Medychna osvita — Medical Education, 3, 5–8.
    4. Hutor N. S. (2019). Vikoristannya aktivnih form navchannya ta suchasnih informativnih tehnologiy yak zasobu intensifikatsii navchalnogo protsesu [Active forms of learning and modern information technologies as a means of intensifying the learning process]. Medychna osvita — Medical Education, 4, 47–79.
    5. Kuznetsov, S. V., Olkhovska, O. M., Kucherenko, O. O., Zharykova, T. S. (2019). Navchalno-metodychne zabezpechennia osvitnoho protsesu pidhotovky inozemnykh studentiv na kafedri dytiachykh infektsiinykh khvorob KhNMU [Educational and methodical support of the educational process of training foreign students at the Department of Pediatric Infectious Diseases of KhNMU]. Proceedings from: XVI Vseukrainska naukovo-praktychna konferentsia z mizhnarodnou uchastiu «Innovatsiyi u vischiy medichniy ta farmatsevtichniy osviti Ukrayini» — XVI All-Ukrainian scientific-practical conference with international participation «Innovations in higher medical and pharmaceutical education of Ukraine». (pp. 136–137). Ternopil.
    6. Manashchuk, N. V., Chornii N. V. (2014). Vykladannia kursu parodontolohii v ramkakh kredytno-modulnoi systemy za metodykoiu yedynoho dnia [Teaching a course of periodontology within the credit-modular system according to the method of a single day]. Medychna osvita — Medical Education, 3, 149–151.
    7. Manashchuk, N. V., Chornii, N. V., Boitsaniuk, S. I. (2019). Robochyi zoshyt z parodontolohii yak odyn iz elementiv navchalnoho protsesu [Workbook on periodontology as one of the elements of the educational process]. Problemy bezperervnoi medychnoi osvity ta nauky — Problems of Uninterrupted Medical Training and Science, 4(36), 11–13.
    8. Mudryk, M. V., Boiarchuk, O. R., Volianska, L. A., Burbela, E. I. (2020). Vykorystannia aktyvnykh form navchannia ta suchasnykh informatyvnykh tekhnolohii yak zasobu intensyfikatsii [The use of active forms of learning and modern information technologies as a means of intensification]. Medychna osvita — Medical Education, 3, 94–99.
    9. Prymirnyi navchalnyi plan pidhotovky fakhivtsiv druhoho (mahisterskoho) rivnia vyshchoi osvity haluzi znan 22 «Okhorona zdorovia» u vyshchykh navchalnykh zakladakh MOZ Ukrainy za spetsialnistiu 221 «Stomatolohiia» kvalifikatsii osvitnoi «Mahistr stomatolohii», kvalifikatsii profesiinoi «Likar-stomatoloh» [Exemplary curriculum for training specialists of the second (master’s) level of higher education in the field of 22 «Health Care» in higher educational institutions of the Ministry of Health of Ukraine in specialty 221 «Dentistry» qualification educational «Master of Dentistry», professional qualification «Dentist»]. (2016). 26.07.2016
  • Up-to-date problems in medicine

    PROSPECTS FOR USE OF THE PREPARATION «CYTEAL» IN PATIENTS WITH PERIODONTAL PATHOLOGY

    PUMTS. 2021; 42(2): 39-42.
    https://doi.org/10.31071/promedosvity2021.02.039

    The modern interpretation of the principles of therapy of periodontal pathology brings individualized treatment of patients to the first place. The basic principle of local therapy of periodontal diseases, in our opinion, is drug therapeutic treatment. The success of the treatment of periodontal diseases, the duration of remission and the prevention of complications largely depends on the quality of the impact on the oral cavity microflora. Recently, antiseptics of complex action have been successfully used. One of the representatives of the group of antiseptics is the drug «Citeal», which contains active substances: hexamidine, chorhexidine, chlorcresol. The purpose of the work is to increase the effectiveness of treatment of patients with periodontal pathology due to the use of three-component antiseptic agent of complex action — «Citeal». The results of a comprehensive examination of patients after the end of treatment show an improvement in oral hygiene, a decrease in the PMA index in comparison with the data before treatment. The Schiller-Pisarev test also became negative after the treatment. It is recommended to carry out professional hygiene with the use of antiseptic solution «Citeal» in a 1:10 dilution in the form of application to the marginal and alveolar part of the gums and irrigation of periodontal pockets, followed by mandatory rinsing of the mouth with water to remove residues. It was found that an individualized and differentiated approach to the treatment of patients with various forms of gingivitis and generalized periodontitis, who have orthopedic structures, prevents exacerbation of the disease during the year.

    REFERENCES
    1. Nikolishin, А. (Ed.). (2012). Теrаpеvtichnа stоmаtоlоgіya [Therapeutic dentistry]. Vinnitsa: Nova Kniga.
    2. Popovich, I. Yu., & Petrushanko, T. O. (2018). Міstseviy меdikamentozniy suprovid porozhnini rota patsientiv pislya dentalnoi імplantatsii [Local medication of patient’s
      mouth cavity after the dental implantation]. Suchasna stоmаtоlоgіya — Modern dentistry, 4, 46–48.

    3. Petrushanko, T. O., Skripnikov, P. М., Lytovchenko, I. Yu., & Коlomiets, S. V. (2014). Таktika mіstsevogo likuvannya khvorikh nа khronichniy generalizovaniy parodontit I-II stupeniv tyazhkosti [Local Treatment Tactics of Patients with Chronic Generalized Periodontitis of І–ІІ Degrees]. Visnik problem biologii і меditsini — Bulletin of Problems of Biology and Medicine, 4(116), 4, 351–353.
    4. Lytovchenko, I. Yu., Popovich, I. Yu., Petrushanko, T. O., Іlenko, N. М., & Nikolishyna, Е. V. (2020). Sposib likuvannya virazkovo-nekrotichnogo gingivitu: informatsiinyi lyst pro novovvedennia v sferi okhorony zdorovia № 35-2020 [A method of treatment of ulcerative necrotic gingivitis: information letter on innovations in the field of health care № 35-2020]. Kyiv.
    5. Divnich, Т. Ya., Rozhko, М. М., & Кutsik, R. V. (2007). Zmina mikroflory rotovoi porozhnyny v zalezhnosti vid terminu korystuvannia znimnimi konstruktsiiamy zubnykh proteziv [Microflora of the oral cavity change depending upon the duration of removable dentures use]. Galitskiy likarskiy visnik — Galician Medical Journal, 14, 2, 26–29.
    6. Kuznetsov, V. V. (2002). Zаlezhnist stanu міkroflori porozhnini rota pri koristuvanni znimnimi plastinkovimi protezami vid tekhnologii ikh vigotovlennya [Dependence of the state of the oral microflora when using removable plate prostheses on the technology of their manufacture]. Visnik problem biologii і меditsini — Bulletin of Problems of Biology and Medicine, 3, 98–102.
    7. Nikonov, А. Yu., Romanova, Yu. G., & Коvalchuk, Yu. А. (2013). Vliyanie subnogo eliksira, soderzhashchego fitoadaptogeni, nа mikrobiotsenoz polosti rtа nа etape adaptatsii k semnim zubnim protezam [Influence of a dental elixir containing phytoadaptogens on the microbiocenosis of the oral cavity at the stage of adaptation to removable dentures]. Sovremenniy nauchniy vestnik — Modern scientific bulletin, 9(148), 63–68.
    8. Bobirev, V. М., Petrova, Т. А., Оstrovcka, G. Yu., & Ryabushko, М. М. (2014). Farmakoterapiya v stоmаtоlоgіi [Pharmacotherapy in stomatology]. Vinnitsa: Nova Kniga.
  • Dicsussions

    PROBLEM ASPECTS OF COMPILING AND OBTAINING INFORMED VOLUNTARY CONSENT FOR ORTHODONTIC TREATMENT

    PUMTS. 2021; 42(2): 55-59.
    https://doi.org/10.31071/promedosvity2021.02.055

    Today, it should be recognized that the legislation of the Ministry of Health of Ukraine on obtaining informed voluntary consent of the patient to medical intervention, in the vast majority relate to general medical and dental practice. The use of orthodontic methods of treatment of dental pathology, especially in combination with modern surgical techniques, requires medical records to reflect specific issues: what information, to what extent it is necessary to inform the patient before orthodontic treatment. Insufficient disclosure leads to problems in the patient’s coordination of the plan, timing of treatment and understanding of possible complications, which can lead to aggravation of the doctor-patient relationship. The article analyzes more than 100 results of the completion of orthodontic interventions for the period of 2018–2020 years of practical activity, which revealed exciting questions from patients and made it possible to compile a generalized list of reasons for the occurrence of possible conflict situations. In the course of treatment, they were successfully eliminated and analyzed, which made it possible to establish the priority components of the practically useful volume of information in the text of the patient’s voluntary consent with the peculiarity of performing orthodontic work. Taking into account these aspects, the doctor gets the opportunity to provide specific argumentation and defense of his actions, prevention of professional misunderstandings and legal issues in dental practice.

    REFERENCES
    1. Babich, O., Krasnik, S., Yudin, O., & Nadutiy, K. et al. (2019). Profesiyni ta pravovi aspekti diyalnosti likarya-stomatologa [Professional and legal aspects of the dentist’s activity]. Stomatologichne zdorovya — integralna skladova zdorovya natsiyi. Zdorovya Ukrayini 21 storichchya — Proceedings of the 5th National Ukrainian Dental
      Congress Dental health — an integral component of the nation’s health. Health of Ukraine of the 21st century. 22(467), 21–22.

    2. Nakaz MOZ Ukrayini “Informovana dobrovilna zgoda patsienta na provedennya diagnostiki, likuvannya ta na provedennya operatsiyi ta znebolennya” № 110 of 14.02.2012 [Decree of the Ministry of Health of Ukraine «Informed voluntary consent of the patient for diagnosis, treatment and surgery and analgesia» № 110 of 14.02.2012]. (2012). Kyiv. URL: https://zakon.rada.gov.ua.
    3. Nakaz MOZ Ukrayini “Pro vnesennya zmin do formi pervinnoyi oblikovoyi dokumentatsiyi № 003-6/o ta instruktsiyi schodo yiyi zapovnennya” № 2837 09.12.2020 [Decree of the Ministry of Health of Ukraine «On amendments to the form of primary accounting documentation № 003-6/о and Instructions for its completion» № 2837 of 09.12.2020]. (2020). Kyiv. URL: https://search.ligazakon.ua.
    4. Protokoli nadannya medichnoyi dopomogi za spetsialnostyami “Ortopedichna stomatologiya”, “Terapevtichna stomatologiya”, “Hirurgichna stomatologiya”, “Ortodontiya”, “Dityacha terapevtichna stomatologiya”, “Dityacha hirurgichna stomatologiya”: normativne virobnicho-praktichne vidannya [Protocols of medical care in the specialties «Orthopedic Dentistry», «Therapeutic Dentistry», «Surgical Dentistry», «Orthodontics», «Pediatric Therapeutic Dentistry», «Pediatric Surgical Dentistry»: normative production-practical edition]. (2014). Kyiv : Medinform.
  • Scientific reviews and clinical lectures

    CATESTATIN AS A REGULATOR OF SYMPATHETIC NERVOUS SYSTEM ACTIVITY AND ITS INFLUENCE ON THE DEVELOPMENT AND PROGRESSION OF ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS

    PUMTS. 2021; 42(2): 49-54.
    https://doi.org/10.31071/promedosvity2021.02.049

    The article analyzes the results of conducted studies about the effect of catestatin on the development of arterial hypertension and type 2 diabetes mellitus, since hyperactivation of the sympathetic nervous system is a powerful pathogenetic mechanism of their progression. This paper considers the causes of increased secretion and release of catecholamines due to the activity of the sympathetic nervous system and its impact on the reduction of catestatin levels, which has an inhibitory effect blocking nicotinic acetylcholine receptors. Non-synonymous single nucleotide polymorphisms of the catestatin domain Gly364Ser, Pro370Leu, Arg374Gln, Gly367Val and the difference of their antiadrenergic activity in comparison with the wild type of catestatin are studied, the reasons of changes in the efficiency of catestatin alleles are determined. It is estimated the pathogenetic significance of low levels of catestatin in the development of hypertension through the mechanisms of impaired vasodilation and inhibition of catecholamines. The predictive significance of catestatin is based on decrease in its level in persons with hereditary predisposition to the development of arterial hypertension. The anti-inflammatory effect of catestatin determines its role in the pathogenesis of diseases accompanied by chronic inflammation, including type 2 diabetes mellitus and atherosclerosis. The role of catestatin in the regulation of glucose metabolism due to an insulin-like effect and inhibition of glucose secretion by hepatocytes, as well as improving glucose tolerance and insulin sensitivity, has been established. The perspectives of catestatin are determined as a potential biomarker of arterial hypertension and type 2 diabetes mellitus.

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    7. Cheung, B. M. Y., & Li, C. (2012). Diabetes and Hypertension: Is There a Common Metabolic Pathway? Curr Atheroscler Rep, 14, 160-166. https://doi.org/10.1007/s11883-012-0227-2.
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    24. Simon, J. P., Bader, M. F., & Aunis, D. (1988). Secretion from chromaffin cells is controlled by chromogranin A-derived peptides. Proc. Natl. Acad. Sci. USA, 85(5), 1712-1716. https://doi.org/10.1073/pnas.85.5.1712.
    25. Mahata, S. K., Mahata, M., Wen, G., Wong, W. B., Mahapatra, N. R., & Hamilton, B. A., et al. (2004). The Catecholamine Release-Inhibitory «Catestatin» Fragment of Chromogranin A: Naturally Occurring Human Variants with Different Potencies for Multiple Chromaffin Cell Nicotinic Cholinergic Responses. Molecular Pharmacology, 66(5), 1180-1191. https://doi.org/10.1124/mol.104.002139.
    26. Sahu, Bh. S., Obbineni, J. M., Sahu, G., Allu, P. K. R., Subramanian, L., & Sonawane, P. J., et al. (2012). Functional genetic variants of the catecholamine-release-inhibitory peptide catestatin in an Indian population: allele-specific effects on metabolic traits. The Journal of Biological Chemistry, 287(52), 43840-43852. https://doi.org/10.1074/jbc.M112.407916.
    27. Sahu, Bh. S., Obbineni, J. M., Sahu, G., Singh, P. K., Sonawane, P. J., & Sasi, B. K., et al. (2012). Molecular interactions of the physiological anti-hypertensive peptide catestatin with the neuronal nicotinic acetylcholine receptor. Journal of Cell Science, 125, 2323-2337. https://doi.org/10.1242/jcs.103176.
    28. O’Connor, D. T., Kailasam, M. T., Kennedy, B. P., Ziegler, M. G., Yanaihara, N., & Parmer, R. J. (2002). Early decline in the catecholamine release-inhibitory peptide catestatin in humans at genetic risk of hypertension. Journal of Hypertension, 20(7), 1335-1345. URL: https://doi.org/10.1097/00004872-200207000-00020.
    29. O’Connor, D. T., Zhu, G., Rao, F., Taupenot, L., Fung, M. M., & Das, M., et al. (2008). Heritability and Genome-Wide Linkage in US and Australian Twins Identify Novel Genomic Regions Controlling Chromogranin A. Circulation, 118(3), 247-257. https://doi.org/10.1161/CIRCULATIONAHA.107.709105.
    30. Meng, L., Ye, X., Ding, W., Yang, Y., Di, B., & Liu, L., et al. (2011). Plasma catecholamine release-inhibitory peptide catestatin in patients with essential hypertension. J Cardiovasc Med, 12(9), 643-647. https://doi.org/10.2459/JCM.0b013e328346c142.
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    33. Mahapatra, N. R., O’Connor, D. T., Vaingankar, S. M., Hikim, A. P. S., Mahata, M., & Ray, S., et al. (2005). Hypertension from targeted ablation of chromogranin A can be rescued by the human ortholog. J. Clin. Invest, 115, 1942-1952. URL: https://doi.org/10.1172/JCI24354.
    34. Alam, Md. J., Gupta, R., Mahapatra, N. R., & Goswami, S. K., et al. (2020). Catestatin reverses the hypertrophic effects of norepinephrine in H9c2 cardiac myoblasts by modulating the adrenergic signaling. Molecular and Cellular Biochemistry, 464(1-2), 205-219. URL: https://doi.org/10.1007/s11010-019-03661-1.
    35. Zhu, D., Xie, H., Wang, X., Liang, Y., Yu, H., & Gao, W. (2017). Catestatin-A Novel Predictor of Left Ventricular Remodeling After Acute Myocardial Infarction. Scientific Reports, 7, 44168. https://doi.org/10.1038/srep44168.
    36. Muntjewerff, E. M., Dunkel, G., Nicolasen, M. J. T., Mahata, S. K., & Bogaart, G. (2018). Catestatin as a Target for Treatment of Inflammatory Diseases. Frontiers in Immunology, 9, 2199. https://doi.org/10.3389/fimmu.2018.02199.
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  • To help the practicing physician

    FEATURES OF DIAGNOSIS AND TREATMENT OF A PATIENT WITH FUNCTIONAL DYSPEPSIA ON THE EXAMPLE OF CLINICAL CASE

    PUMTS. 2021; 42(2): 60-63.
    https://doi.org/10.31071/promedosvity2021.02.060

    Today, the diagnosis of functional dyspepsia is quite common and is very common in the practice of a physician, family doctor and gastroenterologist. Functional dyspepsia is the presence of symptoms in the gastroduodenal area without the presence of organic, systemic or metabolic disorders. This condition is defined as a feeling of discomfort and pain in the epigastric region in the absence of symptoms of reflux. Symptoms of dyspepsia are found in many patients, but not all of them seek medical attention. To date, the issues of etiology and pathogenesis remain unexplored. But much of the role is given to genetic factors, the polymorphism of some genes. Lifestyle, eating fatty, fried, spicy foods, smoking, drinking alcohol, infections, and psychogenic factors are also likely to be important. These factors include the characteristics of the patient’s character, the presence of chronic stress, psychological states accompanied by depression, anxi-ety and others. Patients with functional dyspepsia have the following complaints: epigastric pain, early satiety, burning in the epigastrium, postprandial overflow. But keep in mind that this diagnosis is an exclusion diagnosis. That is, it is necessary to make sure that the patient has no symptoms of anxiety (progressive dysphagia, unmotivated weight loss, anemia, fever, etc.), that the patient does not take nonsteroidal anti-inflammatory drugs, no Helicobacter pylori infection, endoscopy, which revealed no abnormalities. Patients with prolonged symptoms should be excluded from the psychological connection with the disease or the possible presence of food intolerance.

    REFERENCES
    1. Ralston, S. H., Penman, I. D., Strachan, M. W., & Hobson, R. (Eds.). (2018). Davidson’s Principles and Practice of Medicine E-Book. Elsevier Health Sciences.
    2. Sharma, A., Schauer, D. P., Kelleher, M., Kinnear, B., Sall, D., & Warm, E. (2019). USMLE Step 2 CK: best predictor of multimodal performance in an internal medicine residency. Journal of graduate medical education, 11(4), 412.
    3. Beeckmans, D., Farré, R., Riethorst, D., Keita, A. V., Augustijns, P., & Söderholm, J. D., et al. (2020). Relationship between bile salts, bacterial translocation, and duodenal mucosal integrity in functional dyspepsia. Neurogastroenterology & Motility, 32(5), e13788.
    4. Vanheel, H., Carbone, F., Valvekens, L., Simren, M., Tornblom, H., & Vanuytsel, T., et al. (2017). Pathophysiological abnormalities in functional dyspepsia subgroups
      according to the Rome III criteria. American Journal of Gastroenterology, 112(1), 132–140.

    5. Masuy, I., Van Oudenhove, L., & Tack, J. (2019). treatment options for functional dyspepsia. Alimentary pharmacology & therapeutics, 49(9), 1134–1172.
    6. Wauters, L., Talley, N. J., Walker, M. M., Tack, J., & Vanuytsel, T. (2020). Novel concepts in the pathophysiology and treatment of functional dyspepsia. Gut, 69(3), 591–600.
    7. Fallone, C. A., Chiba, N., van Zanten, S. V., Fischbach, L., Gisbert, J. P., & Hunt, R. H., et al. (2016). The Toronto consensus for the treatment of Helicobacter pylori infection in adults. Gastroenterology, 151(1), 51–69.
    8. Vanheel, H., Carbone, F., Valvekens, L., Simren, M., Tornblom, H., & Vanuytsel, T., et al. (2017). Pathophysiological abnormalities in functional dyspepsia subgroups according to the Rome III criteria. American Journal of Gastroenterology, 112(1), 132–140.
    9. Nakagawa, K., Hara, K., Fikree, A., Siddiqi, S., Woodland, P., & Masamune, A., et al. (2020). Patients with dyspepsia have impaired mucosal integrity both in the duodenum and jejunum: in vivo assessment of small bowel mucosal integrity using baseline impedance. Journal of gastroenterology, 55(3), 273–280.
    10. Stanghellini, V., Chan, F. K., Hasler, W. L., Malagelada, J. R., Suzuki, H., Tack, J., & Talley, N. J. (2016). Gastroduodenal disorders. Gastroenterology, 150(6), 1380–1392.
  • Tribune of young scientist

    PREDICTIVE VALUE OF ATRIAL FIBRILLATION CATHETER ABLATION ON COGNITIVE FUNCTIONS IN PATIENTS WITH CHRONIC HEART FAILURE

    PUMTS. 2021; 42(2): 75-81.
    https://doi.org/10.31071/promedosvity2021.02.075

    Atrial fibrillation (AF) directly leads to a cognitive function decline regardless of the cerebrovascular fatal events, but it is unclear whether the sinus rhythm restoration and reducing the AF burden can reduce the rate of this decreasement. Data on the effect of radiofrequency ablation on patients’ cognitive functions are conflicting and need to be studied. The aim of the study was to evaluate the prognostic value of atrial fibrillation radiofrequency catheter ablation on cognitive functions in patients with chronic heart failure with preserved left ventricular ejection fraction. The impact of AF radiofrequency catheter ablation on cognitive function in 136 patients (mean age 59.7 ± 8.6 years) with chronic heart failure with preserved left ventricular ejection fraction and compared with 58 patients in the control group (58.2 ± 8.1 years), which did not perform ablation and continued the tactics of drug antiarrhythmic therapy was investigated. Cognitive function was assessed using the Montreal Cognitive Test (MoCA) at the enrollment stage and 2 years follow-up. Decreased cognitive function was defined as a MoCA test score < 26 points, cognitive impairment < 23 points. Two years after the intervention, there was a positive dynamics (baseline MoCA test — 25,1 ± 2,48, 2-year follow-up — 26,51 ± 2,33, p < 0,001) in the ablation group and negative in the control group (25,47 ± 2,85 and 24,57 ± 3,61, respectively, p < 0,001). Pre-ablation cognitive impairment was significantly associated with improved cognitive function 2 years after AF ablation according to polynomial regression analysis. The obtained data suggest a probable positive effect of AF radiofrequency ablation on cognitive functions in patients with preserved left ventricular ejection fraction.

    REFERENCES
    1. Jin, M., Kim, T., Kang, K., Yu, H., Uhm, J., Joung, B., et al. (2019). Atrial Fibrillation Catheter Ablation Improves 1-Year Follow-Up Cognitive Function, Especially in Patients With Impaired Cognitive Function. Circulation: Arrhythmia And Electrophysiology, 12(7). https://doi.org/10.1161/circep.119.007197.
    2. Medi, C., Evered, L., Silbert, B., Teh, A., Halloran, K., & Morton, J., et al. (2013). Subtle Post-Procedural Cognitive Dysfunction After Atrial Fibrillation Ablation. Journal Of The American College Of Cardiology, 62(6), 531–539. https://doi.org/10.1016/j.jacc.2013.03.073.
    3. Graves, K. G., May, H. T., Jacobs, V., Bair, T. L., Stevens, S. M., Woller, S. C., Crandall, B. G., Cutler, M. J., Day, J. D., Mallender, C., Osborn, J. S., Peter Weiss, J., & Jared Bunch, T. (2017). Atrial fibrillation incrementally increases dementia risk across all CHADS2 and CHA2DS2VASc strata in patients receiving long-term warfarin. American heart journal, 188, 93–98. https://doi.org/10.1016/j.ahj.2017.02.026.
    4. Junejo, R. T., Lip, G., Fisher, J. P. (2020). Cerebrovascular Dysfunction in Atrial Fibrillation. Frontiers in physiology, 11, 1066. https://doi.org/10.3389/fphys.2020.01066.
    5. Gardarsdottir, M., Sigurdsson, S., Aspelund, T., Rokita, H., Launer, L. J., Gudnason, V., et al. (2018). Atrial fibrillation is associated with decreased total cerebral blood flow and brain perfusion. Europace: European pacing, arrhythmias, and cardiac electrophysiology: journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 20(8), 1252–1258. https://doi.org/10.1093/europace/eux220.
    6. Smith, E. E., Schneider, J. A., Wardlaw, J. M., Greenberg, S. M. (2012). Cerebral microinfarcts: the invisible lesions. The Lancet. Neurology, 11(3), 272–282. https://doi.org/10.1016/S1474-4422(11)70307-6.
    7. Conen, D., Rodondi, N., Müller, A., Beer, J. H., Ammann, P., Moschovitis, G., et al. (2019). Relationships of Overt and Silent Brain Lesions With Cognitive Function in Patients With Atrial Fibrillation. Journal of the American College of Cardiology, 73(9), 989–999. https://doi.org/10.1016/j.jacc.2018.12.039.
    8. Frey, A., Sell, R., Homola, G. A., Malsch, C., Kraft, P., Gunreben, I., et al. (2018). Cognitive Deficits and Related Brain Lesions in Patients With Chronic Heart Failure. JACC. Heart failure, 6(7), 583–592. https://doi.org/10.1016/j.jchf.2018.03.010.
    9. Adamski, M. G., Sternak, M., Mohaissen, T., Kaczor, D., Wierońska, J. M., Malinowska, M., et al. (2018). Vascular Cognitive Impairment Linked to Brain Endothelium Inflammation in Early Stages of Heart Failure in Mice. Journal of the American Heart Association, 7(7), e007694. https://doi.org/10.1161/JAHA.117.007694.
  • Anniversaries

    HISTORY OF ORTHOPEDIC DENTISTRY DEPARTMENT – 1 KHARKIV MEDICAL ACADEMY OF POSTGRADUATE EDUCATION

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    The article is devoted to the history of the formation and development of the Department of Orthopedic Dentistry 1 Kharkiv Medical Academy of Postgraduate Education. The department was officially established in 1930 as the department of odontologists at the All-Ukrainian Institute for Advanced Medical Studies. Since 1931, the department became known as the dental department and dentists began to improve their qualifications in the department. In September 1941, the department ceased its work. In 1958, the department resumes work. Since 1959, the Ukrainian Institute of Advanced Medical Studies at the Department of Dentistry created an assistant professor specialization course for orthopedic and orthodontic doctors. In 1965 for the first time in the history of the institute, a separate department was created for the teaching of orthopedic dentistry, headed by M.A. Napadov.
    The staff of the department under the guidance of prof. M.A. Napadov Developed the main domestic structural and auxiliary dental materials.
    From 1992 to 1995 – he was in charge of the candidate sciences A.P. Golubnichy. From 1995 the department is headed by a doctor of medical sciences, professor Grizodub V.I.
    Is head of the department of Professor V.I. Grizodub: 12 candidate dissertations were defended and approved by Candidate of Medical Sciences (I. Dnistransky, I. Isakov, L. Ivanishchenko, K.V. Zhukov, A.A. Chelyapina, Badalov R.M., D.V. Gryzodub, E. V. Gryzodub, S. Gordienko and 2 Author of foreign citizens).