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Документ Changes of endothelial function indices and pro-inflammatory cytokines level in comorbid course of essential hypertension(NGO European Scientific Platform, 2022-08-05) Burmak, Y. H.; Petrov, Ye. Ye.; Ivanytska, T. A.; Іvanytskyi, І. V.; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Іваницька, Тетяна Анатоліївна; Іваницький, Ігор ВалерійовичIt should be noted that the peculiarity of internal pathology at present time is its comorbidity, besides essential hypertension (EH) sintropy worsens disease on the whole. Combination of EH with duodenal peptic ulcer (DPU) is frequent. It can complicate diagnostics, modify clinical symptoms and worsen treatment quality. The study aimed to identify the features of the changes of endothelial function parameters and pro-inflummatory cytokines level in patients with EH and comorbid DPU.Документ Changes of some immune and metabolic indices as burdening criterion of chronic systemic inflamation in the presence of the essential hypertension comorbidity(2017) Burmak, Yu. G.; Kazakov, Yu. M.; Treumova, S. I.; Shilkina, L. N.; Petrov, Ye. Ye.; Kozlenko, T. V.; Бурмак, Юрій Григорович; Казаков, Юрій Михайлович; Треумова, Світлана Іванівна; Шилкіна, Людмила Миколаївна; Петров, Євген Євгенович; Козленко, Тетяна ВікторівнаThe article highlights the cytokine profile features, severity of oxidative stress, changes of endothelium functions in patients with isolated course of essential hypertension and its combination with duodenal peptic ulcer. It describes evaluation of chronic systemic inflammation data: the level of serum cytokines (tumor necrosis factor -α, interleukins -1β, -6, -10), content of intermediate and end products of lipid peroxidation in blood (conjugated dienes, malondialdehyde), activity of antioxidant defense enzymes (superoxide dismutase, catalase), change of endothelium function (level of stable metabolites of nitrogen oxide in blood serum and severity of ristomycin-induced platelet aggregation). It was discovered that in the presence of tendency to increasing of interleukin-10 (р>0,05) , content of tumor necrosis factor -α, interleukins -1β and -6 in patients under condition of comorbidity significantly exceeded the reference data (р<0,001) and the data of patients with isolated course of essential hypertension. Thus was predetermined significant increase of ratio of pro-inflammatory cytokines to interleukin-10 that emphasized the presence of the highest pro-inflammatory activity of blood in patients with comorbid pathology. Later on in patients with comorbid pathology were identified the most significant manifestations of oxidative stress that was reflected in the highest level of conjugated dienes and malondialdehyde (р<0,001). It also turned out that the process of lipid peroxidation was proceeding under the condition of superoxide dismutase and catalase activity deficit that caused the greatest decrease of integrated indscator of the antioxidant capacity of the blood (р<0,001). It was discovered the negative relationship between high pro-inflammatory activity and low antioxidant ability of blood, reflecting the commonality of immune and metabolic processes in the mechanisms of the comorbid pathology development. This was also confirmed by the presence of inverse relationship between low total content of stable metabolites of nitrogen oxide in blood, as a reflection of the severity of endothelium dysfunction, and high pro-inflammatory blood activity (р<0,01) that also had a direct relationship with high ristomycin-induced platelet aggregation (р<0,01), as a high thrombogenic risk indicator in this category of persons. Therefore, identifying the relationship between indicators of chronic systemic inflammation in patients with essential hypertension in combination with duodenal peptic ulcer should be considered as a manifestation of a single mechanism of comorbid pathology formation, and most of their severity - as a burdening criterion of essential hypertension comorbidity.Документ Comparative analysis of assessment and self-assessment of media literacy of students of higher medical education at bachelor's and master's level(Полтавський державний медичний університет, 2023) Ivanytska, T. A.; Petrov, Ye. Ye.; Kuzmenko, N. V.; Burmak, Yu. H.; Sakevych, V. D.; Іваницька, Тетяна Анатоліївна; Петров, Євген Євгенович; Кузьменко, Наталія Валентинівна; Бурмак, Юрій Григорович; Сакевич, Вікторія ДмитрівнаThe article is devoted to the study of the level of media competence among students of higher medical education at the master's and bachelor's levels and a comparative analysis of the obtained results. The difference in the use of media literacy skills among the surveyed students was revealed. Part of the interviewees does not know how to check the source of information correctly, which causes the spread of unreliable information. The skill of correctly searching for medical data on the Internet and checking it is also insufficiently developed. Almost half of the respondents in both groups use the links offered by the search engine regardless of the source of information. A rather low number of medical education students use specialized medical databases. The majority of the students use information from textbooks to avoid mistakes. Some respondents believe that medical information cannot be unreliable. The vast majority of students, regardless of the educational level of higher education (bachelor's or master's), believe that they have mastered the basics of media literacy, although the skill of showing a critical attitude to information sources in the course of independent activities is not sufficiently developed. Therefore, there is a need to deepen media competences not only among students of higher medical education at the bachelor's level, but also at the master's level.Документ Estimation of systolic and diastolic function of the left ventricular myocardium among patients with chronic cor pulmonale of broncho-pulmonary genesis in combination with hypertensive disease(2020) Treumova, S. I.; Petrov, Ye. Ye.; Burmak, Yu. G.; Треумова, Світлана Іванівна; Петров, Євген Євгенович; Бурмак, Юрій ГригоровичChronic obstructive lung disease is the main reason for the development of chronic cor pulmonale. Comorbidity of this disease with cardiovascular pathology is the most important, reflecting the unity of cardiorespiratory system, becoming a summary integral factor of a negative prognosis: chronic obstructive lung disease and cardiovascular diseases are considered as “criminal partners”. The aim of the study was to investigate the functional state of left ventricular myocardium in patients with chronic cor pulmonale of broncho-pulmonary genesis combined with hypertensive disease.Документ Evaluation and self-assessment of media literacy level of medical university students with an undergraduate degree and those who are high school graduates: there is still work to be done(Полтавський державний медичний університет, 2022) Ivanytska, T. A.; Petrov, Ye. Ye.; Burmak, Yu. G.; Kuzmenko, N. V.; Sakevych, V. D.; Іваницька, Тетяна Анатоліївна; Петров, Євген Євгенович; Бурмак, Юрій Григорович; Кузьменко, Наталія Валентинівна; Сакевич, Вікторія ДмитрівнаThe article highlights the main components of media competence. Special attention is paid to the level of media literacy of medical university students. The survey showed that there was no significant difference between the level of media literacy among undergraduate students and high school graduates. But there is a noticeable difference in the practical use of these soft skills, especially when using medical information. The majority of students of higher medical education believe they have media literacy skills and independently search for the necessary data on the Internet without noticing the source of information. Only 35% of respondents are interested in the author of the message or article. When preparing for classes, more than 75% of students use textbooks. Among high school graduates, only 20% use specialized medical databases, in the group with undergraduate degree, this share is below 10%. Almost 40% of high school graduates do not check the reliability of the source of medical information. To improve the skills of medical university students for selective perception of information, teachers of clinical disciplines should pay more attention to the development of critical thinking skills and data analysis of the professional information.Документ Features of cytokine profile and endothelial function in comorbid course of essential hypertension(2018) Burmak, Yu. G.; Petrov, Ye. Ye.; Treumova, S. I.; Ivanitskaya, T. A.; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Треумова, Світлана Іванівна; Іваницька, Тетяна АнатоліївнаAppearance of the new terminology such as “endothelial dysfunction” and “chronic systemic inflammation” has designated a new round in the study of essential hypertension (EH), namely – to defining the role of the immune inflammatory mechanisms in the development and progression of vascular pathology [1, 6, 8]. It should be noted that the peculiarity of internal pathology at present time is its comorbidity [2, 9, 10], besides EH comorbidity worsens disease on the whole [3, 4]. Combination of EH with duodenal peptic ulcer (DPU) is frequent. It can complicate diagnostics, modify clinical symptoms and worsen treatment quality [7]. The foregoing formed basis of this study. The study aimed to identify the features of the changes of the cytokine profile and endothelial function in patients with EH and comorbid DPU.Документ Gender and age aspects in the pathogenesis of bone mineral density disorders(Aluna Publishing, 2023-09) Chekalina, N. I.; Plaksa, V. M.; Kazakov, Yu. M.; Tribrat, T. A.; Shut, S. V.; Petrov, Ye. Ye.; Ivanytskay, T. A.; Чекаліна, Наталія Ігорівна; Плакса, Вікторія Михайлівна; Казаков, Юрій Михайлович; Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Петров, Євген Євгенович; Іваницька, Тетяна АнатоліївнаOsteoporosis is a systemic progressive disease of the musculoskeletal system, caused by the loss of bone mass with the disrupted microarchitectonics of bone tissue, which leads to an increase in bone fragility and the risk of fractures. This disease is observed in all age groups, regardless of gender and race, but the highest prevalence is observed in Caucasians (white race), postmenopausal women, and the elderly. With an aging population and a decrease in life expectancy, osteoporosis is increasingly becoming a global epidemicДокумент Hypomagnesemiaas a predictor of early remodeling of blood vessels in young men with essential hypertension(Yerevan State Medical University #2 Koryun St., Yerevan. 0025, Armenia, 2020-04) Ivanitskaya, T. A.; Burmak, Yu. G.; Ivanitskiy, I. V.; Petrov, Ye. Ye.; Kazakov, Yu. M.; Shut, S. V.; Іваницька, Тетяна Анатоліївна; Бурмак, Юрій Григорович; Іваницький, Ігор Олексійович; Петров, Євген Євгенович; Казаков, Юрій Михайлович; Шуть, Світлана ВолодимирівнаThe article highlights the features of changes in the level of magnesium in the serum, the elasticity of the vascular wall and shows their relationship in young men with essential hypertension and abdominal obesity. The indices of magnesemia, the markers of the arterial wall elasticity (the augmentation index, the arterial stiffness index and the pulse wave velocity), and the thickness of the perivascular adipose tissue (extra-media of car otid arteries) were evaluated. Clinical manifestations of magnesium deficiency were identified in more than half of the cases and the risk of its development was found in a third of patients with essential hypertension and obesity, it correlated with the results of laboratory studies of serum magnesium levels. Besides, the severity of hypomagnesemia was inversely proportional to the blood pressure (r=-0.58, p=0,022).Evaluation of vascular wall stiffness markers in patients with essential hypertension and obesity showed their significant increase not only in comparison with the similar indicators of practically healthy individuals but also with the parameters of patients with essential hypertension without obesity. The correlation analysis revealed that the magnesium level in the serum of such patients had a strong negative relationship with both the augmentation index (r =-0.68, p =0.023) and the arterial stiffness index (r=-0.55, p=0,042).The extra media index in patients with essential hypertension and obesity was twice as high as one in practically healthy individuals. It was also revealed that the extra-media indicator in these patients was positively related to the level of blood pressure (r=+0.68, p=0.033), the augmentation index (r =+0.48, p=0.018), and negatively related to magnesium content in serum (r= +0.61, p=0.023). It was concluded that young men with essential hypertension and abdominal obesity have clinical signs of hypomagnesemia. The identified correlations between the serum magnesium content, the increase in arterial wall stiffness and the level of the blood pressure in such patients make it possible to consider hypomagnesemia as a predictor of early vascular remodeling.Документ Justification of increasing the blood flow velocity in the arteries of the thyroid gland in autoimmune thyroiditis as a reflection of endothelial changes due to inflammatory status(Bentham Science, 2019) Chekalina, N. I.; Burmak, Yu. H.; Petrov, Ye. Ye.; Borysova, Z. O.; Trybrat, T. A.; Shut, S. V.; Kazakov, Yu. M.; Чекаліна, Наталія Ігорівна; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Борисова, Зінаїда Олексіївна; Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Казаков, Юрій МихайловичAbstract: Objective: The aim of the research was to determine the dependence of the blood flow velocity in the thyroid arteries in patients with autoimmune thyroiditis (AIT) on the presence of atherosclerotic carotid disease and the level of systemic blood pressure. Method: The research involved 20 patients with AIT in euthyroid state, 30 patients AIT in euthyroid state with stable coronary heart disease (CHD), 30 patients with stable CHD and 30 healthy individuals. Participants of the research were examined using ultrasound of carotid arteries and inferior thyroid arteries. Parameters of blood flow velocity were compared with the level of systemic blood pressure. Results: In AIT peak systolic velocity and resistance index in the inferior thyroid arteries were sig- nificantly higher than in healthy individuals and patients with CHD (p<0.05). In patients with CHD velocity parameters in carotid arteries were high, unlike in the healthy individuals and patients with AIT (p<0.05). In patients with AIT without CHD the atherosclerotic changes of carotid arteries were not found. Increased systemic blood pressure was noticed in all patients with CHD without significant differences between groups.Документ Medical ethics and deontology in clinical practice(ТОВ НВП «Укрпромторгсервіс», 2015) Чекаліна, Наталія Ігорівна; Петров, Євген Євгенович; Chekalina, N. I.; Petrov, Ye. Ye.The textbook for students contains information about moral and ethical postulates in the relationship of the doctor and the patient, the solution of complex problems associated with moral choice, with respect of the patient’s rights, ethics in relationships in the medical team. A large section is devoted to medical errors, rules of clinical trials, issues of bioethics. The textbook for students is recommended for students who are learning English, but can also be useful to masters, residents, intern-doctors, trainees, medical practitioners and teachers; У навчальному посібнику наведені основні морально-етичні принципи професійної діяльності лікаря. Розглянуті моделі стосунків між лікарем та хворим, питання морального вибору, правової відповідальності лікаря. Велику увагу приділено правилам проведення медичних досліджень, біоетиці. Навчальний посібник призначений для самостійної підготовки до практичних занять, перш за все, студентів, які навчаються англійською мовою, проте може бути корисним магістрам, аспірантам, лікарям-інтернам, курсантам, практикуючим лікарям, викладачам.Документ The changes of the functional indices of endothelium state and clinicofunctional parallels in patients with chronic obstructive pulmonary disease and in conditions of its comorbidity with essential hypertension(2018) Burmak, Yu. G.; Petrov, Ye. Ye.; Treumova, S. I.; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Треумова, Світлана ІванівнаAn analysis of the data about the functional state of endothelium, the structural-functional indices of the right and left ventricles and the indices of bronchial patency in 64 patients with chronic obstructive pulmonary disease (COPD), the II stage (females – 22, males – 42, mean age – 54.8 ± 2.5), among whom 32 patients had comorbid essential hypertension (EHT), is presented in the article. It has been showed that the patients with COPD in conditions of its comorbidity with EHT have the most apparent manifestations of the endothelial dysfunction. Participation of some indices of the endothelial function in mechanisms of early development of myocardial dysfunction of ventricles and intensity of the changes of bronchial patency was determined; В статията се представя анализ на данни относно функционалното състояние на ендотела, структурно-функционалните индекси на дясната и лявата камера и индексите на бронхиалната проходимост при 64 пациенти с ХОББ, 2 стадий (жени – 22, мъже – 42, средна възраст 54,8 ± 2,5 г.), като 32 от пациентите са с коморбидна есенциална хипертония (ЕХТ). Доказва се, че пациентите с ХОББ в условията на коморбидност с ЕХТ имат най-силно изразени прояви на нарушена ендотелна функция. Направена е оценка на участието на някои показатели на ендотелната функция в механизмите на ранното развитие на нарушена миокардна функция на камерите и на интензитета на промените на бронхиалната проходимост.Документ The dynamics of the change of leukotrienes synthesis and lipoperoxidation activity during the early period of the treatment of the patients with duodental peptic ulcer in comorbination with essential hypertension(2019) Burmak, Yu. G.; Petrov, Ye. Ye.; Nemchenko, L. B.; Ivanitskaya, T. A.; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Немченко, Любов Борисівна; Іваницька, Тетяна АнатоліївнаProspects for further research. The dynamics of the change of the leukotrienes content and the lipid peroxidation activity during the early period of the treatment of the patients with duodenal peptic ulcer in combination with essential hypertension suggests clarification of pathogenetic mechanisms of their synthesis’ activation and determines the search of the possible ways of the revealed disorders’ correction.Документ The effectiveness of the influence of a bioflavonoid and enterosorbent combination on changes in the content of leukotrienes and oxidative stress products in the early terms of treatment of comorbid peptic ulcer in patients with essential hypertension(Singapore, Republic of Singapore, 2023) Burmak, Y. H.; Petrov, Ye. Ye.; Ivanytska, T. A.; Іvanytskyi, І. V.; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Іваницька, Тетяна Анатоліївна; Іваницький, Ігор ВалерійовичThe presence of local and systemic modulating effects in leukotrienes (Ltt), their influence on the initiation of the production of platelet activating factors and neutrophil binding, the release of lysosomal enzymes, the formation of superoxide anions, as well as their direct participation during inflammation suggest that the dynamics of changes in the content of Ltt and lipid peroxidation products are one of the possible indicators of the effectiveness of the treatment of the disease. Taking into account the possibility of qualitative and quantitative changes in the content of biologically active substances and changes in metabolic parameters in patients under conditions of syntropy, we undertook the present study, the purpose of which was to study and analyze the dynamics of changes in the content of lipoxygenase metabolites of arachidonic acid and products (intermediate and final) of lipid peroxidation in early terms of treatment of peptic ulcer of the duodenum (DPU) and in patients with essential hypertension (EH). In the treatment of comorbid pathology, our attention was drawn to two drugs: the enterosorbent silicon dioxide (atoxyl), which effectively adsorbs products of incomplete metabolism from the intestine and blood, and the representative of bioflavonoids, the antioxidant and antihypoxant quercetin.Документ The expression of metabolic changes and factors of non-specific resistance in patients with chronic bronchitis and comorbid peptic ulcer at different termsof treatment and outpatient observation(Кембридж, Великобританія, 2023-08-18) Burmak, Y. H.; Petrov, Ye. Ye.; Ivanytska, T. A.; Іvanytskyi, І. V.; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Іваницька, Тетяна Анатоліївна; Іваницький, Ігор ВалерійовичThe process of recovery after treatment of an exacerbation of chronic bronchitis (ChB) with conventional pathogenetic therapy most often proceeds for several weeks, while various residual effects in the form of post-infectious asthenia can be observed, and the presence of comorbidity can negatively affect the course of the disease and contribute to its progression. During the progression of respiratory diseases, there is a violation of phagocytosis with an increase in the activity of pro-inflammatory cytokines, the intensity of lipid peroxidation, with a decrease on the activity of the antioxidant system, and a significant role is played by a violation of the function of the endothelium.The above actively affects the remodeling of the bronchial tract and the development of bronchial obstruction, damage to vessels of various calibers and changes in systemic and microhemodynamics, and in conditions of comorbidity, long-term maintenance of a local inflammatory process which implies the search for ways to correct these changes. We did not exclude the possibility of changes of non-specific immune resistance, the intensity of lipid peroxidation and changes in nitric oxide metabolism in patients with ChB and comorbid peptic ulcers of the duodenum (PDU), the presence of which required timely correction. The aim of the study was to investigate the effect of combination of sodium desoxyribonucleate and vitamin-antioxidant complex with selenium on the phagocytic activity of monocytes (PhAM), the intensity of lipid peroxidation (LPO) and the metabolism of nitroxide (NO) in patients with ChB (before/after exacerbation) and comorbid PDU at different terms of treatment and outpatient observation.Документ The peculiarities of the change of the endothelial function in the patients with chronic obstructive pulmonary disease in conditions of its comorbidity with essential hypertension(2019) Petrov, Ye. Ye.; Burmak, Yu. G.; Gordiychuk, I. Yu.; Treumova, S. I.; Петров, Євген Євгенович; Бурмак, Юрій Григорович; Гордійчук, Інна Юріївна; Треумова, Світлана ІванівнаProspects for the further research. The established peculiarities of the change of the endothelial function in the patients with COPD and comorbid EHT are a prerequisite for the study of their possible interconnection with hemostasis factors and for the specification of their role in genesis of atherothrombosis.Документ The peculiarities of the changes of some cardiohemodynamic and microcirculatory indices in conditions of the comorbid course of essential hypertension(The New Armenian medical Journal., 2020) Burmak, Yu. G.; Petrov, Ye. Ye.; Kazakov, Yu. M.; Chekalina, N. I.; Treumova, S. I.; Tribrat, T. A.; Ivanitskaya, T. A.; Kozlenko, T. V.; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Казаков, Юрій Михайлович; Чекаліна, Наталія Ігорівна; Треумова, Світлана Іванівна; Трибрат, Тетяна Анатоліївна; Іваницька, Тетяна Анатоліївна; Козленко, Тетяна ВікторівнаThe peculiarities of cardiohemodynamics, microcirculation, and microvasculature are presented in the article; their correlation with significance of the oxidative stress, the level of antioxidative blood potential and endothelial function in the isolated course of essential hypertension and in conditions of its comorbidity with duodenal peptic ulcer was carried out. The structural-functional indices and parameters of cardiohemodynamics, indices of microcirculation and microvasculature, the content of the intermediate and the final products of lipid peroxidation in the blood, activity of enzymes of the antioxidant protection system and indices of endothelial function were estimated. It was established that the presence of the remodeling left ventricle (a significant increase of the left heart chambers, symmetrical myocardial hypertrophy) with the unchanged contractile function, and maximal intensity of both resistivity of the peripheral vascular system (р <0.001), and disorders of microcirculation and microvasculature on the perivascular, vascular, and intravascular levels (р <0.001) is typical of the patients with the comorbid course of essential hypertension. The next results showed that manifestations of oxidative stress were the most significant (the increase of diene conjugates and malondialdehyde content (p <0.001) among the patients with the combinative pathology. The index of the antioxidative ability of blood serum was low in these patients (p <0.001); besides, it had the negative correlation relationship with the index of the total changes of microhemocirculation and microvasculature (r = -0.467; p <0.05). At the same time the index of ristomycin- inducted platelet aggregation as reflection of the changed endothelial function and a marker of the thrombogenic risk was also the highest in case of the comorbid course of essential hypertension (p <0.001); besides, its positive correlation relationship with the index of the total changes of microhemocirculation and microvasculature (r = +0.465; p <0.05) was established.Документ Адаптивні та ушкоджуючі механізми розвитку стресу(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2017) Треумова, Світлана Іванівна; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Треумова, Светлана Ивановна; Бурмак, Юрий Григорьевич; Петров, Евгений Евгеньевич; Трибрат, Татьяна Анатольевна; Шуть, Светлана Владимировна; Treumova, S. I.; Burmak, Yu. G.; Petrov, Ye. Ye.; Trybrat, T. A.; Shut, S. V.Вчення про стрес – один з провідних розділів сучасної медицини. Основоположником цього напрямку, є канадський вчений – фізіолог Г.Селье, який у 1936 році узагальнивши результати своїх досліджень, висунув концепцію стресу. У перекладі з англійської мови слово «стрес» означає «натиск, тиск, напруження». Стрес – складова частина життя, у помірних дозах він надає життю смак і аромат, як писав Г. Сельє. Залежно від подразника, який діє на людину, розрізняють два види стресу: дистрес – дія негативних емоцій (горе, нещастя, хвороба), що знижує опір організму до несприятливих чинників середовища, виснажує людину, заважає їй мобілізуватися; еустрес – дія позитивних емоцій, натхнення, творчого осяяння, кохання, коли за плечима ніби крила виростають. Всі різновиди стрес-реакцій можна розділити на адаптивні і патогенні . При адаптивній стрес-реакції, активація функцій органів і систем в умовах дії стресорного агента запобігає відхиленню параметрів гомеостазу за межі нормального діапазону, а надзвичайний фактор характеризується помірною силою і тривалістю впливу. Формується стан підвищеної резистентності організму до стресу. Патогенна стрес-реакція – надмірно тривалий або частий повторний вплив сильного стресорного агента на організм, не здатний попередити порушення гомеостазу. Це може привести до значних розладів його життєдіяльності, розвитку захворювань, навіть смерті; Учение о стрессе – один из ведущих разделов современной медицины. Основоположником этого направления, является канадский ученый – физиолог Г. Селье, который в 1936 году обобщив результаты своих исследований, выдвинул концепцию стресса. В переводе с английского языка слово «стресс» означает «нажим, давление, напряжение». Стресс является составной частью жизни, в умеренных дозах он придает жизни вкус и аромат, как писал Г. Селье. В зависимости от раздражителя, который действует на человека, различают два вида стресса : дистресс – действие негативных эмоций (горе, несчастье, болезнь), что снижает сопротивление организма к неблагоприятным факторам среды, истощает человека, мешает ему мобилизоваться; еустрес – действие положительных эмоций, вдохновения, творческого озарения, любовь, когда за плечами словно крылья вырастают. Все разновидности стресс-реакций можно разделить на адаптивные и патогенные . При адаптивной стресс-реакции, активация функций органов и систем в условиях действия стресорного агента предотвращает отклонением параметров гомеостаза за границы нормального диапазона, а чрезвычайный фактор характеризуется умеренной силой и длительностью воздействия. Формируется состояние повышенной резистентности организма к стрессу. Патогенная стресс-реакция – чрезмерно длительное или частое повторное воздействие сильного стресорного агента на организм, не способный предупредить нарушение гомеостаза. Это может привести к значительным расстройствам жизнедеятельности, развития заболеваний и даже смерти; Most people are under the influence of stress in modern society. We live in the period of the scientific-technical revolution when human mental activity intensifies. It is connected with necessity of learning and processing of the great amount of information. That is why the problem of stress occurs. Two-thirds of industrial countries’ population die from development of stress and overstrain of their organisms’ physiological systems under influence of a stimulus. The stress theory is one of the leading parts of modern medicine. Hans Selye, a Canadian scientist, is a founder of this school. In 1936 he put forward the stress conception having generalized the results of his research. According to his definition “stress is a non-specific response of an organism to any demand to him. It’s everything leading to fast organism’s aging or causing diseases”. “Stress” means “pressure or tension” in translation from English. The term “stress” had been mentioned in literature before H.Selye used it. It was used for the first time by the poet R.Mannin in 1903. A dictionary gives the following definition of stress: “It is a combination of protective physiological reactions which occur in organisms of animals and people as a response to an influence of different unfavorable factors (stressors).” According to modern definition, passed at the international congress, this phenomenon is interpreted as a non-specific organism’s response to any influence upon it. There is a mechanism in a normal, healthy organism directed at the struggle against an unfavorable factor, the influence of which can lead to the organism’s death. There are two types of stress depending on a stimulus which has an effect on the individual: they are distress which is defined as bad stress and eustress - good stress. So, distress is an effect of negative emotions in situations of misfortune, grief. It decreases the organism’s resistance to unfavorable factors of environment, exhausts the person. Eustress is an effect of positive emotions, inspiration, and creativity. The most dangerous stage of stress is when it transforms into some disease. Adrenal glands begin to produce in addition to adrenalin dangerous hormone cortisone at this stage. It can provoke memory impairment, cardio-vascular diseases, diseases of a gastrointestinal tract, weakening of immunity, and premature aging. Hormones are released and the work of many organs and systems is changed when stress is present. Destruction of proteins occurs under influence of stress, the amount of vitamins A, E, C decreases, and “oxidation stress” develops. According to H. Selye there are three stages in the stress-reaction: the 1st stage is a phase of anxiety, the 2nd stage is a phase of resistance, and the 3rd stage is a phase of exhaustion which reflects the dynamics of an organism’s response to the acting stressor of long duration. The stage of anxiety is shaking of the whole organism, a call “to arms!”, the mobilization of all the protective mechanisms including endocrine ones. The organism’s endurance towards this stressor increases, the production of somatotropin and thyroid hormones decreases, and the production of glucocorticoids increases at the stage of resistance. The stage of exhaustion can cause the death of the organism - “the means of defense” are already absent. It is not necessary that stress should have all the mentioned stages; it can finish at the first or second stages. All the types of stress-reactions can be subdivided into adaptive and pathogenic-damaging. In case of adaptive stress-reaction, activation of functions of organs and systems in conditions of stressor agent’s action prevents the deviation of hemostasis parameters outside the normal diapason, and extraordinary factor is characterized by the moderate strength and duration of influence. The state of the increased organism’s resistance to stress forms, its adaptation to an acting agent increases. The pathogenic stress-reaction is an extremely durable or frequent repeated influence of a strong stressor agent on an organism incapable to prevent the disorders of homeostasis. It can cause significant disorders of the organism’s vital activity, the development of an extreme and even terminal state (shock, collapse). The excessive stress factors can be a reason for different diseases, even for tumors. Thus, all the main adaptive effects transform into damaging in case of a durable and intensive stress-reaction and can become a basis for stressor diseases in this way. It is not necessary to avoid stress at all; it should be used for prophylaxis and therapy. So, the main aim of a physician is supporting of a valeokinesis system at the high level. Stress can be useful: facing threats makes us think about our life, learn to be patient and reserved, improve ourselves. But human psychoemotional stress must occur occasionally for the changed physiological functions to return to the normal level. One should remember H. Selye’s statement: “Stress is a component of life and it gives the life taste and aroma when it is moderate”.Документ Антиоксидантная обеспеченность организма и перекисное окисление липидов у больных язвенной болезнью желудка и двенадцатиперстной кишки(Лікарська справа. Врачебное дело, 1996) Петров, Евгений Евгеньевич; Petrov, Ye. Ye.; Петров, Євген ЄвгеновичДокумент Березовий сік в лікуванні метаболічного синдрому(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2011) Казаков, Юрій Михайлович; Боряк, Віктор Петрович; Гольденберг, Юрій Миронович; Петров, Євген Євгенович; Настрога, Тетяна Вікторівна; Казаков, Юрий Михайлович; Боряк, Виктор Петрович; Гольденберг, Юрий Миронович; Петров, Евгений Евгеньевич; Настрога, Татьяна Викторовна; Kazakov, Yu. M.; Boriak, V. P.; Goldenberg, Y. M.; Petrov, Ye. Ye.; Nastroga, T. V.Було досліджено вплив березового соку на перебіг метаболічного синдрому. Застосування збродженого березового соку на тлі базисної терапії викликало суттєве покращення суб’єктивного стану хворих та сприяло покращенню деяких показників перекисного окислення ліпідів та реології крові, що обгрунтовує доцільність його подальшого вивчення з перспективою застосування у клініці; Было исследовано влияние березового сока на течение метаболического синдрома. Применение березового сока на фоне базисной терапии вызвало существенное улучшение субъективного и объективного состояния больных, и привело к улучшению некоторых показателей перекисного окисления липидов и реологии крови, что обосновывает целесообразность его дальнейшего изучению с перспективой применения в клинике; It was investigated the influence of birch sap on an implications of metabolic syndrome. Use of the ferment birch sap an addition of basic therapy has caused substantial improvement of subjective and objective condition of patients and promoted improvement of some indicators of peroxidation of lipids and rheology of blood that causes expediency of its further application in clinic.Документ Возможности влияния иммунотропного и антиоксидантного средств в коррекции измененной неспецифеской резистентности и метаболических сдвигов у больных с хроническим бронхитом и коморбидной пептической язвой(Вищий державний навчальний заклад України «Українська медична стоматологічна академія», 2016) Бурмак, Юрий Григорьевич; Петров, Евгений Евгеньевич; Треумова, Светлана Ивановна; Шилкина, Людмила Николаевна; Бурмак, Юрій Григорович; Петров, Євген Євгенович; Треумова, Світлана Іванівна; Шилкіна, Людмила Миколаївна; Burmak, Yu. G.; Petrov, Ye. Ye.; Treumova, S. I.; Shilkina, L. M.У 43 больных (основная группа; возраст от 25 до 59 лет) с коморбидным течением обострения хронического бронхита (ХБ) и пептической язвой (ПЯ) двенадцатиперстной кишки (ДПК), получавших наряду с традиционным лечением натриевую соль дезоксирибонуклеата (Деринат) в комбинации с витаминно-антиоксидантным комплексом с селеном (Триовит), до и после лечения было проведено изучение состояния фагоцитарной активности моноцитов – ФАМ (фагоцитарный индекс (ФИ), фагоцитарное число (ФЧ), индекс аттракции (ИА), индекс переваривания (ИП), показатели активности перекисного окисления липидов - ПОЛ (диеновые конъюгаты (ДК), малоновый диальдегид (МДА) и уровень стабильных метаболитов оксида азота (NО2, NO3) и их сумма (NOх); группа сравнения, сопоставимая по полу и возрасту, включала 33 больных указанной выше патологией, получавших только общепринятое лечение; контрольную группу составили 15 практически здоровых лиц. Показано, что после проведенного лечения у больных основной группы происходило достоверное увеличение сниженных ФИ, ФЧ, ИА и ИП - в 1,51, 1,46, 1,26 и 1,91 раза соответственно (в группе сравнения – в 1,12, 1,06, 1,05 и 1,43 раза соответственно), отмечалось достоверно более значимое снижение повышенных ДК (в 1,9 раза) и МДА (в1,7 раза) (в группе сравнения – в 1,3 раза), а также значительное повышение сниженных до начала лечения NО2, NO3, и NOх – в 1,29, 1,48, 1,39 раза (в группе сравнения – в 1,03, 1,06 и 1,05 раза); У 43 хворих (основна група; вік від 25 до 59 років) із коморбідним перебігом загострення хрончного бронхиту (ХБ) і пептичної виразки (ПВ) дванадцятиппалої кишки (ДПК), що отримували поруч з загальноприйнятим лікуванням натрієву сіль дезоксирибонуклеата (Деринат) в комбінації з вітамінно-антиоксидантним комплексом із селеном (Триовіт), до та після лікування було проведено вивчення стану фагоцітарної активності моноцитів – ФАМ (фагоцитарний індекс (ФІ), фагоцитарне число (ФЧ), індекс аттракции (ІА), індекс перетравлення (ІП), активності перекисного окислення ліпідів - ПОЛ (диєнові кон'югаты (ДК), малоновий диальдегід (МДА) та стану метаболізму нітроксиду за показниками стабільних метаболітів (NО2, NO3) та іх суми (NOх); група зіставлення, що відповідала основній за статтю та віком, вмикала 33 хворих вказаної вище патології, що отримували тільки загальноприйняте лікування; в контрольну групу увійшли 15 практично здорових осіб. Показано, що після проведеного лікування у хворих основної групи мало місце вірогідне підвищення знижених ФІ, ФЧ, ІА та ІП - в 1,51, 1,46, 1,26 та 1,91 рази відповідно (в групі зіставлення – в 1,12, 1,06, 1,05 та 1,43 рази відповідно), відмічалось вірогідно більш значне зниження підвищених ДК (в 1,9 рази) та МДА (в1,7 рази) (в групі зіставлення – в 1,3 рази), а також значне підвищення знижених до початку лікування NО2, NO3, та NOх – в 1,29, 1,48, 1,39 раза (у групі зіставлення – в 1,03, 1,06 та 1,05 рази); The process of recovery after an exacerbation of chronic bronchitis (ChB) means the generally accepted pathogenic therapy of most often runs for several weeks, while, on the part of convalescents in the future may experience residual effects in the form of postinfectious asthenia. The aim of the study was to investigate the effect of combination of sodium desoxyribonucleate and vitamin-antioxidant coplex with selenium on the phagocytic activity of monocytes (PhAM), the intensity of lipid peroxidation (LPO) and the metabolism of nitroxide (NO) in patients with co-morbid for ChB (exacerbation) and peptic ulcers of the duodenum (PDU). Object and methods of research. We examined 76 patients with ChB (exacerbation) in combination with the PDU in age from 25 to 59 years old (37,4±1,4 years), from them 40 persons - men (52,6%) and 36 women (47,4 %). The complex treatment of patients of the main group (45 patients), along with the conventional means, was added of sodium desoxyribonucleate (Derinat) of 1,5% solution (5,0 ml intramuscular once a day for 5 days, followed by 5,0 ml intramuscular once time per three days 5 injections) in combination with the vitamin-antioxidant complex (Triovit) - 2 caps/day; 31 patients in the comparison group received conventional treatment. Twice (at the beginning of treatment and on its completion) investigated PhAM peripheral blood (assessed by phagocytic index (PI), phagocytic number (PhN), the index of attraction (IA) and the index of digestion (ID); activity of lipid peroxidation (LPO) (content in serum diene conjugate (DC) and malonic dialdehyde (MDA) and metabolism of nitric oxide (on the content of stable metabolites in plasma (NO2, NO3) and their sum (NOx); control group to define the norm of immunological and metabolic parameters consisted of 15 practically healthy persons. The results obtained and their discussion. It is revealed that before treatment patients had violations PhAM: reduce PhI more than 1,5 times (P<0,001), decreased PhN, IA – about 1,4 times (P<0,001); the proportion of ID in the main group and the comparison group was reduced almost twice (P<0,001). All patients showed (P<0,001) increase blood level of DC (2,2 fold) and MDA (2,9 times), reduction of NO2, NO3, and their total level was decreased more than in 3 times (P<0,001). Re-examination (after treatment) it is shown that in the main group there was an increase in the PhI 1,52 times (P<0,001) – from 16,8±0,8% to 25,6±1,1% (in the comparison group. – 1,12; P>0.05), PhN 1.46 fold (from 2,8±0,06 to 4,1±0,25; P<0,01), IA – 1,27 times (from 10,9±0,8% to 13,8±0,6%; P<0,05) and ID (to 24,6±1,5%; P<0,001), reaching values of the reference standards (in the comparison group – in 1,31 times (P<0,05) - to 18,1±0,8%). In the dynamics of treatment changes of LPO products: in the main group there was a decrease of the content as a DC in 2 times (from 20,2±0,4 µmol/l to 10,4±0,5 μmol/l; P<0,001) and MDA – 1,7 times (from 9,7±0,3 µmol/l to 5,6±0,3 μmol/l; P<0,001), and the content of both metabolites were significantly (P<0,05) lower than that of patients of group (15,2±0,6 µmol/l and 7,2±0,3 μmol/l, respectively). Furthermore, after patients of the main group showed a significant (P<0,001) increase in the content of stable metabolites of nitroxide, which is reflected in the increase of NOx (from 17,9±1,2 μmol/l to 25,0±1,7 μmol/l), while its value was higher than patients in the comparison group (18,8±1,3 µmol/l), and the differences with the reference norm was erased. Note also that in main group of patients the long-term preservation of clinical remission CB was higher.