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Документ Effect of root canal obliteration on the success of endodontic treatment(Полтавський державний медичний університет, 2023) Nazarenko, Z. Yu.; Mikitenko, V. O.; Tkachenko, I. M.; Brailko, N. M.; Lyashenko, L. I.; Vodoriz, Ya. Yu.; Назаренко, Зоряна Юріївна; Микитенко, В. О.; Ткаченко, Ірина Михайлівна; Браїлко, Наталія Миколаївна; Ляшенко, Лілія Іванівна; Водоріз, Ярослав ЮрійовичObliteration is a pathological process characterized by the narrowing or complete closure of the root canal lumen due to the formation of tertiary dentin. In general, there are few etiological factors for the development of this pathological process, but they are considered quite unfavourable and can affect the success of both subsequent therapeutic and repeated endodontic treatment. Our study aimed to study the prevalence of obliteration of root canals during endodontic treatment and possible complications associated with this process, to analyze the causes of occurrence and to determine the most effective methods of treatment of this pathology. To determine the prevalence of the obliteration phenomenon of root canals, we surveyed practising dentists in the city of Poltava regarding the frequency of this problem during endodontic manipulations, the causes of its occurrence, methods of prevention and treatment. During the research, we conducted a comprehensive search of literature data in the MEDLINE, PubMed, and GOOGLE Scholar databases for 2002-2022 and a manual search of cited sources. Considering the obtained results, a patient with obliterated root canals complicated by perforation was treated with an analysis of the dynamics of the treatment process. After analyzing a questionnaire among practising dentists on the therapeutic profile of medical institutions in the city of Poltava (73 doctors), we determined that the vast majority of them - 93.3% - encountered the phenomenon of obliteration of root canals in their practice, and a certain proportion even repeatedly - 28.5%. The survey found that many doctors are not sufficiently informed about the leading new treatment methods for obliterated root canals. During the endodontic treatment of this pathology complicated by perforation, we established a significant therapeutic effect of the used technique. More than 90% of practising endodontists have encountered the phenomenon of obliteration, therefore, determining the optimal method of work when identifying this pathological process, its causes and complications is a rather important aspect and subject of research. During their practice, 32.3% of dentists encountered a complication during the treatment of obliterated canals - an iatrogenic perforation. The main reasons for this were: lack of necessary material and technical support (lack of increase, incorrect selection of tools and methods), lack of theoretical knowledge and practical skills.Документ Structural organization of the adrenal glands medulla of rats in normal and after influence of food additive complex(Полтавський державний медичний університет, 2023) Donchenko, S. V.; Bilash, S. M.; Донченко, Світлана Владиславівна; Білаш, Сергій МихайловичTaste plays a significant role in the life of every person. Our taste buds are responsible for recognizing flavors, determining the suitability of foods, protecting against harmful substances, and regulating food intake. A person always gets pleasure from tasty food, and sweet dishes cause positive emotions. Unfortunately, we consume food that contains many food additives and preservatives daily, although we know that it can be harmful. Tasty but not healthy food has become extremely common and available, and it is difficult for us to resist the temptation to eat it. Many nutritional supplements have been created to meet the needs of the food industry, as mass production of products is different from home cooking. These additives are necessary to preserve the product's appearance but should not harm buyers' health or mislead them. Today, there are many food additives that consumers are unaware of but which can affect human organs, particularly the adrenal glands. Some of the most common food additives we study include monosodium glutamate (E621), sodium nitrite (E250) and Ponceau 4R (E124). Consuming large amounts of dietary supplements can have the following effects: chest and abdominal pain, migraines, nausea, rapid heart rate (tachycardia), obesity, weakness, and allergic reactions. Particular attention should be paid to the effect of these supplements on the adrenal glands, as they can disrupt the function of these organs and contribute to the development of oncological diseases. Research on the morphology of the adrenal glands has been ongoing for many years. In recent decades, there has been an increase in the pathology of the adrenal glands as the negative influence of external and internal factors increases, which leads to disturbances in the structure and functioning of the glands. Adrenal glands play an essential role not only in the hypothalamic-pituitary-adrenal system but also in the endocrine system. Interest in changes in the structure of the adrenal glands does not fade among experimental medicine and scientists. Thanks to the improvement of computer diagnostic methods, the detection of both hormonally active and inactive, benign and malignant neoplasms of the adrenal glands is increasing. The most common endocrine disorders are hyperaldosteronism, adrenergic and estrogenic balance disorders. Computed tomography significantly improves the detection of tumors of various origins in the adrenal glands. Diagnosis and treatment of diseases of the adrenal glands is an urgent medical and social problem.Документ Clinical case: synchronous malignancy: left breast and ovarian cancer associated with hereditary BRCA1: 5382 INS C – mutation(Полтавський державний медичний університет, 2023) Kravchenko, O. V.; Bashtan, O. P.; Chornobai, A. V.; Mukovoz, O. E.; Hahal, O. V.; Кравченко, О. В.; Баштан, Володимир Петрович; Чорнобай, Анатолій Валентинович; Муковоз, Оксана Євгенівна; Гагал, Олександр ВолодимировичBreast cancer (BC) is a heterogeneous group of malignant neoplasms of epithelial origin from cells of the ducts or lobes of the parenchyma of the mammary glands, which arises as a result of complex interactions between body systems that affect the transformation of cells under the influence of various carcinogens. In the structure of oncological morbidity in Ukraine, breast cancer occupies the first place. The incidence rate of breast cancer has increased 2.5 times over the past 30 years, with an annual increase of 7.1%. Ovarian cancer (OC) is a malignant tumour arising from the epithelial tissue of the ovaries. This type of cancer is the fifth most common among women. This work reviews the literature on the hereditary aspect of breast and ovarian tumours. Hereditary mutation in the BRCA1/2 genes, typically expressed in the tissues of the breast, ovaries and other organs to eliminate DNA damage or cell apoptosis, where DNA repair is not possible, cause in women the development of "Syndrome 2 BC/OC". This syndrome develops in women with this mutation, usually at a young age and causes the appearance of synchronous or metachronous pathology of the mammary gland and ovaries. Methods of laboratory detection of BRCA1/2 mutation, methods of early diagnosis, treatment and prevention of pathology are described in work on the example of the described clinical case, features of the course of tumours with the mutation mentioned above. International recommendations for patients requiring the mandatory determination of mutagenic status, who already have an existing oncological pathology, are considered for choosing a more effective treatment method. The importance of adequately examining patients to detect early forms of breast and ovarian cancer, which, according to the WHO definition, is curable in 85-95% of cases, is highlighted.Документ Peculiarities of clinico-psychopathological manifestations and sleep quality in patients with anxiety disorders depending on the level of stress load(Полтавський державний медичний університет, 2023) Zhyvotovska, A. I.; Isakov, R. I.; Животовська, Анастасія Ігорівна; Ісаков, Рустам ІсроїловичModern scientific studies indicate a close connection between psychological distress, anxiety and impaired sleep quality. The assessment of psychopathological symptoms and components of sleep disorders in 81 patients with anxiety disorders of neurotic origin was carried out using clinical-psychopathological, psychodiagnostic and statistical methods. The psychodiagnostic method included the use of the Psychological stress measure (PSM-25), the Symptom Check List-90-Revised (SCL-90-R) and the Pittsburgh Sleep Quality Index (PSQI). All respondents, depending on the level of psychological stress, were divided into 3 groups, representative by age and gender: 1st group (n=25) – patients with a low level of stress, 2nd group (n=29) – with an average level, 3rd group (n=27) – with a high level of stress. In patients of group 1, indicators on all scales of the SCL-90-R questionnaire were significantly lower than in group 2 (p<0,05) and group 3 (p<0,01). Significant differences were found between group 1 and groups 2 and 3 on the PSQI total score and on the scales of subjective sleep quality, sleep latency, sleep duration, and sleep efficiency. Significantly higher indicators were found in group 3 compared to group 1 on the daily dysfunction scale. The severity of obsessive-compulsive symptoms, additional symptoms, hostility, interpersonal sensitivity, and phobic anxiety had a positive correlation with deterioration in sleep duration, subjective sleep quality, sleep efficiency, sleep latency, and daytime dysfunction according to the PSQI (p<0,01). Disturbances during sleep were positively correlated (p<0,01) with the somatization index. The obtained data should be taken into account when conducting personalized pharmacotherapy and psychocorrection of this cohort of patients.Документ Significance of the glutamate system in neurotic pathology(Полтавський державний медичний університет, 2023) Sydorenko, A. H.; Сидоренко, Антоніна ГригорівнаEvery third Ukrainian suffers from an anxiety disorder. The help that patients receive is not always effective. The high prevalence of this disease and the insufficient effectiveness of the existing treatment require the need to study the pathogenesis of neuroses and look for new treatment methods. The work aims to show the role of the glutamate system in developing neurotic pathology. Glutamic acid is the primary excitatory neurotransmitter. It interacts with glutamate receptors (mGlu), divided into ionotropic and membranotropic. There are three groups of ionotropic receptors. Membranotropic glutamate receptors are divided into three subgroups of receptors. Some of them are presynaptic autoreceptors. The participation of the glutamatergic system in the pathogenesis of neuroses is evidenced by the fact that competitive NMDA agonists have anticonvulsant and neuroprotective properties, as well as an anxiolytic effect. NMDA receptors are closely related to neurological and psychiatric disorders, including neurodegenerative diseases, stroke, epilepsy, schizophrenia, Alzheimer's disease and Parkinsonism. AMPA glutamate receptors are the main mediators of fast excitatory neurotransmission in the central nervous system. They play an essential role in the occurrence of epileptic seizures. Metabotropic glutamate receptors (mGluRs) are a relatively new biotarget. The basis of the search for effective and safe drugs for treating anxiety is modulators of glutamatergic neurotransmission. The study of this system is necessary for understanding the pathogenesis and development of such common pathologies as anxiety, neurosis, depression, epilepsy, addiction, and neurodegenerative diseasesДокумент Problem-oriented learning in medical institutions of higher education: a systematic review and analysis of the global experience of educational programs(Полтавський державний медичний університет, 2023) Samoilenko, S. O.; Самойленко, Сергій ОлександровичThe second half of the 20th century was marked by the transition from reproductive forms of education to forms with the active participation of students in the process of acquiring knowledge in medical education, in particular, a problem-oriented approach in education and research education. The introduction of such forms of education is due to the limitation of the assessment of theoretical knowledge in the general structure of the graduate's knowledge, the inconsistency of the level of theoretical training with the level of formation of his professional competencies, the inconsistency of theoretical knowledge and practical skills for their application in medical activity. The purpose of the study was to analyze the effectiveness of problem-oriented learning in the educational process of a medical institution of higher education and various educational programs based on methods of problemoriented learning to determine the methodological difficulties of implementing specific methods of problem-oriented learning in a medical institution of higher education. One of the postulates of problem-oriented learning in medical education is early clinical experience. Teachers must present the whole volume of didactic material – interactive patients, multimedia case histories, virtual laboratory work, video instructions for classes, patient databases, sets of exercises and tasks for independent work of students. Ensuring that students independently process the material while studying the fundamental disciplines of the medical and biological profile should also provide close integration with the disciplines of practical and professional direction. All types of work (practical, laboratory, individual) should motivate students to study clinical disciplines, critical thinking, and experience using previously acquired knowledge to solve practically-oriented tasks.Документ The use of surgical threads in kidney surgery(Полтавський державний медичний університет, 2023) Vihtenko, V. O.; Pronina, O. M.; Віхтенко, Віталій Олександрович; Проніна, Олена МиколаївнаThe work highlights the topographic and anatomical location of the kidney and its importance in the life process; the history of development and research of the kidney, as well as diseases and surgical treatment are essential topics in the field of kidney surgery, understanding the anatomy and physiology of the kidney is necessary for the correct diagnosis and treatment of kidney diseases, taking into account the factors affecting the effectiveness and duration of suture resorption, the immune response to suture material and drug treatment are among the factors that affect the success of surgical procedures, drug treatment is given as an example of dialysis, disease and surgical treatment that play an essential role in the treatment of various kidney diseases, including kidney tumours, kidney cysts, kidney stones, in which such surgical methods as partial nephrectomy, radical nephrectomy, lithotripsy, surgical materials are widely used. Examples of suture materials such as Polydioxanone (PSD), Polyglecapron (Monocryl), Polyglactin 910, Desmosin, and Silk are given. Each of these threads has its composition, structure, features, advantages and tissue reaction to suture material. Further research on suture materials in kidney surgery is necessary to increase the effectiveness and safety of surgical interventions and their relevance in further research on suture materials in kidney surgery.Документ Oxidative stress: classic doctrine and its update(Полтавський державний медичний університет, 2023) Vazhnichaya, E. M.; Baliuk, O. Ye.; Bobrova, N. O.; Важнича, Олена Митрофанівна; Балюк, Олена Євгенівна; Боброва, Нелля ОлександрівнаThe concept of oxidative stress is widely used to describe damage caused by reactive oxygen and nitrogen species. This concept is actively developing and is the basis for the rational use of antioxidants. The purpose of the work is to analyze the literature data on the development of the doctrine of oxidative stress and its role in normal and pathological conditions. Literary sources were searched in PubMed and Google Scholar databases and the sources analyzed in this work were selected. The founders of the doctrine of oxidative stress have described that it can be a result of not only external factors, but also internal cellular mechanisms. This condition is characterized by the generation of reactive forms of oxygen and nitrogen in the cell, changes in antioxidant protection, oxidative modification of macromolecules and impaired redox balance. An important discovery was the fact that redox reactions are used in the cell signaling. Oxidative stress was detected in physiological conditions and involved in many diseases as their cause or consequence. The development of the oxidative stress doctrine relates to the improvement of strategies for its detection and quantitative evaluation, so the previously used indicators are supplemented with new ones, a comprehensive approach based on indices is introduced. It is believed that intense oxidative stress should be diagnosed to prevent the development of free-radical pathology and premature aging in a timely manner. Understanding of oxidative stress developed to the idea of oxidant-antioxidant equilibrium and the need for its normal slight shift to the side of oxidative processes to maintain homeostasis. This approach warns against excessive administration of exogenous antioxidants, which can disrupt the balance.Документ Effectiveness of herbal antiseptics in the complex treatment of generalized periodontitis(Полтавський державний медичний університет, 2023) Moshel, T. M.; Gancho, O. V.; Boychenko, O. M.; Krutikova, A. D.; Мошель, Тетяна Миколаївна; Ганчо, Ольга Валеріївна; Бойченко, Ольга Миколаївна; Крутікова, Анна ДмитрівнаAbstract. The source of antimicrobial agents in the treatment of periodontal diseases can be extracts from medicinal plants, the peculiarity of which is that their biologically active substances are in a certain ratio, which contributes to the optimal effect on the human body. Phytopreparations rarely cause allergic reactions, macro – and microorganism adaptation does not develop to them, they are low-toxic. The purpose of this research is to study the antimicrobial action and clinical effectiveness of the herbal antiseptic «Timsal» in comparison with the well-known drugs «Rotokan» and «Phytodent». The study of the antimicrobial activity of «Timsal», «Rotokan» and «Phytodent» was carried out by the method of serial dilutions. Museum strains were used as test cultures: gram-positive bacteria – Staphylococcus aureus, gram-negative – Escherichia coli, fungi – Candida albicans. The periodontological status of patients with chronic generalized periodontitis of the I and II degrees of severity against the background of the combined course of chronic cholecystitis and pancreatitis was determined on the basis of clinical examination, functional tests, indices of PMA, PI according to Russel, orthopantomography. The hygienic condition of the oral cavity was studied according to the Fedorov-Volodkina index. In the course of microbiological studies, it was established that «Rotokan» and «Phytodent» had a bactericidal effect only against E. coli at a concentration of 12.5% (1:32 dilution). Antiseptic «Timsal» had a bactericidal effect on S. aureus in the form of a 6% solution (dilution 1:16), and in relation to fungi of the genus C. albicans – undiluted preparation. After a course of treatment with the use of the herbal preparation «Timsal» in patients with generalized periodontitis, the intensity of gum inflammation decreased by 2,5 times, and the depth of periodontal pockets by 1,28 times. There was also an improvement in the hygienic condition of the oral cavity by 1,7 times. On the basis of clinical and laboratory indicators, the high clinical effectiveness of the use of «Timsal» in the form of instillations in periodontal pockets has been established.Документ The dependence of the oral biofilm on the galvanism of the oral cavity(Полтавський державний медичний університет, 2023) Zaitsev, A. V.; Kotelevska, N. V.; Perepelova, T. V.; Koval, Y. P.; Lugova, L. O.; Semenenko, I. P.; Nikolishyn, A. K.; Зайцев, Андрій Володимирович; Котелевська, Наталія Василівна; Перепелова, Тетяна Василівна; Коваль, Юрій Павлович; Лугова, Любов Олександрівна; Семененко, Іван Павлович; Ніколішин, Анатолій КарловичDentistry uses fixed prostheses as a tertiary prevention. Prostheses in the oral cavity are foreign bodies. Therefore, they lead to a violation of the biological balance. It can cause complications during treatment. The purpose of the work was to determine the influence of galvanism on the composition of the microbiocenosis of the oral cavity in patients who used orthopaedic structures made of different materials, depending on the design features of the prosthesis. An examination of 81 persons who were prosthetics with fixed structures was carried out. They determined the composition of periodontal plaque bacteria. A plaque sample was taken from the surface of the cervical area of the vestibular surface of orthopaedic structures (crowns) close to the gingival margin (without touching or injuring it) on the maxilla and mandible to do this. The multiplex polymerase chain reaction method was used in real-time to determine microflora's bacterial mass and quantitative ratios. Biopotentials of the oral cavity were also determined. The potential difference was evaluated between the extreme points of the metal prosthesis (metal-metal) and the metal inclusion and the mucous membrane of the oral cavity. The presence of galvanism was established in all patients with fixed orthopaedic structures. It was determined that individual representatives of the microflora have different sensitivities to changes in the electrical potential of the oral cavity. The microbiome as a whole is a stable entity with a certain homeostasis. These phenomena should be considered when conducting orthopaedic treatment and recommending the patient's hygiene after orthopaedic treatment.Документ Medico-orthodox problems of deaf children in Ukraine(Полтавський державний медичний університет, 2023) Kuroedova, V. D.; Sokolohorska-Nykina, Y. K.; Куроєдова, Віра Дмитрівна; Сокологорська-Никіна, Юлія КостянтинівнаHearing impairment is one of the most common diseases worldwide. The maxillofacial apparatus of children with hearing deprivation has a number of morphological features due to the lack of specific speech articulation due to the pathology of the auditory analyzer. The prevalence of bite pathology in the deaf is quite high. Also, the prevalence of caries is quite high in children with hearing impairments. The purpose of our study was to assess the condition of teeth and maxillofacial anomalies in children with hearing impairments, to assess their level of knowledge about oral hygiene, to study the condition of the soft tissues of the oral cavity and to identify accompanying pathology, namely posture pathology. 61 children with hearing impairments were examined. All the examined (100%) had abnormalities of the maxillofacial system. The most common pathology of the bite in the examined children is the pathology of the 1st class. according to Engle – 73.77%. Caries occurred in 77.05%, with age, the number of children with at least one sign of caries (KPV) increases 4 times. Only one-fifth of deaf children (19.67%) were not found to have abnormalities of attachment of the soft tissues of the mouth during the examination. During the examination together with the orthopedist, it was established that only 5.26% of the examined were relatively healthy, in 94.74% of cases there were some or other disorders of the musculoskeletal system. Therefore, in order to increase the effectiveness of providing dental and orthodontic care to children with hearing impairments, dentists (orthodontists) need to take into account the anatomical and physiological features of patients and pay more attention to the facial reactions of deaf patients.Since the prevalence of malocclusion and deformities in children with hearing impairment is 100%, in order to prevent severe forms of dento-maxillofacial anomalies in such children, it is necessary to conduct scheduled examinations for the purpose of early diagnosis and timely elimination of the etiological factor of their development. The vast majority of examined children with hearing impairments (80.36%) have abnormalities of the attachment of soft tissues of the oral cavity, which is a significant complication of orthodontic pathology. The study of this problem is quite relevant for the determination of methods of prevention and the development of special recommendations for improving the provision of dental care to children and adults with hearing impairments. Key words: malocclusion, deaf children, caries, posture.Документ Morphogenesis of peritubular macrophages in the interstitial space of the rat testes under central blocking of luteinising hormone synthesis by tryptorelin on days 180 and 270 of observation(Полтавський державний медичний університет, 2023) Stetsuk, Ye. V.; Shepytko, V. I.; Boruta, N. V.; Rud, M. V.; Skotarenko, T. A.; Vilkhova, O. V.; Стецук, Євген Валерійович; Шепітько, Володимир Іванович; Борута, Наталія Володимирівна; Рудь, Марія Володимирівна; Скотаренко, Тетяна Анатоліївна; Вільхова, Олена ВікторівнаTestosterone has a significant impact on the functional state of macrophages in the body. Under the influence of testosterone, macrophage polarisation towards the pro-inflammatory phenotype (M1) is inhibited, resulting in a reduction in the production of cytokines such as interleukin 1β and interleukin 6. Cytokines suppress steroidogenesis at the level of the adrenal glands, testes and ovaries. In the adrenal glands, macrophages and lymphocytes physiologically infiltrate the adrenal cortex extensively, whereas adrenocortical and chromaffin cells also produce cytokines such, TNFalpha, leukaemia inhibitory factor and IL-18, playing a key role in immune-adrenocortical communication. Thus, testosterone has a pronounced anti-inflammatory and immunomodulatory effect, and in conditions of its deficiency, tissue damage may develop due to excessive polarisation of macrophages according to the M1 phenotype.Документ Features of the functional morphology of the placenta in case of premature amniotic fluid discharge(Полтавський державний медичний університет, 2023) Hromova, A. M.; Mitiunina, N. I.; Shafarchuk, V. M.; Martynenko, V. B.; Prylutska, N. O.; Liakhovska, T. Y.; Громова, Антоніна Макарівна; Мітюніна, Ніна Іванівна; Шафарчук, Валентина Михайлівна; Мартиненко, Віталій Борисович; Прилуцька, Неоніла Олексіївна; Ляховська, Тетяна ЮріївнаPremature discharge of amniotic fluid creates conditions for ascending infection of the placenta, fetus and newborn, disruption of uteroplacental blood circulation with the subsequent development of fetal distress. The placenta is one of the first barriers that help limit exposure to harmful substances. Dysfunction of the placenta can contribute to complications that increase the morbidity and mortality of both the fetus and the newborn. The study aimed to determine the morphological features of the placenta in case of premature discharge of amniotic fluid. Ninety placentas of women with the premature and timely discharge of amniotic fluid were examined using a standardized method of organo- and morphometry. In 42% of cases, there was a central attachment of the umbilical cord, in 35% (24/69) – lateral and in 1% – membrane. The length of the umbilical cord was 61.6±8.3 cm, and the distance from the place of the membranes to the edge of the placenta was 14.36±3.8 cm. In 41% (28/69) placentas, the course of the vessels was main, in 40% (27/69), it was mixed and in 20% (14/69) dispersed. The intervillous space with the premature discharge of amniotic fluid was empty in only three observation cases (4%). In other cases (96%), it is uneven, in some places sharply narrowed, up to its complete disappearance (the focus of acute infarction). In 10 observations (15%), the intervillous space was centrally expanded with the accumulation of blood and the formation of haemorrhages. In others, it is filled with single erythrocytes and exfoliated syncytial elements. In 8 observations (12%) in the intervillous space, single and concentrated accumulations of segmented nuclear leukocytes were found - focal intervillitis. Early signs of "ageing" of the placenta with the premature discharge of amniotic fluid and disruption of uteroplacental blood flow were revealed. The presence of "infarctions" of the placenta, partial thrombosis, and uneven blood vessels contributed to a synchronous increase in fetal distress.Документ The role of paraplacental tissues in fetal homeostasis(Полтавський державний медичний університет, 2023) Hromova, A. M.; Mitiunina, N. I.; Shafarchuk, V. M.; Martynenko, V. B.; Prylutska, N. O.; Ketova, O. M.; Krutikova, E. I.; Громова, Антоніна Макарівна; Мітюніна, Ніна Іванівна; Шафарчук, Валентина Михайлівна; Мартиненко, Віталій Борисович; Прилуцька, Неоніла Олексіївна; Кетова, Олена Миколаївна; Крутікова, Елла ІванівнаThe amniotic sac and amniotic membranes are of great importance in the release of childbirth activity, the biomechanism of childbirth, as a factor that contributes to the physiological processes of smoothing and opening of the cervix. We studied the changes in the morphological structure of 30 amniotic membranes during premature rupture and 10 during timely rupture. A clinical-morphological study with premature rupture of the amniotic membranes was carried out taking into account changes in the vaginal discharge depending on the duration of the waterless interval. In contrast to membranes with premature spillage of amniotic fluid, with premature rupture of the amniotic membranes near their edge, pronounced swelling of all elements of the membranes is noted. With premature discharge of amniotic fluid and a minimal waterless interval, degenerative changes in the membranes in women with premature rupture occur much earlier. Destruction of epithelial cells and their degenerative changes were observed in the amnion. There is no clear border between the amnion and the smooth chorion. With a waterless interval of 8 or more hours, parietal deciduitis develops first, then chorioamnionitis. Placental basal and septal deciduitis and less often intervillosis join. When the water-free period increased for more than 10 hours, dystrophic changes of the epithelium were noted, marked transformation into a continuous cuticular formation. The detected changes in the amnion and chorion, with a minimal waterless interval, are characterized by the destruction of epithelial cells, degenerative changes, the absence of a clear border between the amnion and the chorion, changes in the intercellular space, swelling and thickening of the walls of blood vessels, which suggests that with their premature rupture, the most characteristic degenerative-dystrophic changes. Inflammatory reaction is joined when the waterless interval is lengthened.Документ Edema-swelling of the brain in the clinic of infectious diseases: pathogenesis, clinic, diagnosis, treatment(Полтавський державний медичний університет, 2023) Poltorapavlov, V. A.; Bodnar, V. A.; Iziumska, O. M.; Lymarenko, N. P.; Syzova, L. M.; Marchenko, O. H.; Zdor, O. I.; Полторапавлов, Володимир Анатолійович; Боднар, Вадим Анатолійович; Ізюмська, Олена Михайлівна; Лимаренко, Ніна Петрівна; Сизова, Людмила Михайлівна; Марченко, Олена Геннадіївна; Здор, Олег ІвановичНабряк-набухання головного мозку – патологічний стан, обумовлений набряком тканин головного мозку із збільшенням його в об`ємі та підвищенням черепно-мозкового тиску. На сьогодні все ще дискутуються питання про класифікацію, етіологічні відмінності, характер "пускових механізмів", співвідношення процесів, що лежать в основі розвитку набряку-набухання головного мозку і намагання від диференціювати набряк від набухання під час лікування хворого. Також актуальним є питання про найбільш раціональні терапевтичні підходи. Необхідно провести аналіз сучасних клінічних концепцій, діагностичних і лікувальних підходів, які представлені в літературі, щодо проблем раннього діагнозу набряк-набухання головного мозку, значущості його клінічного визначення та лікування на догоспітальному і госпітальному етапах. У клініці інфекційних хвороб набряк-набухання головного мозку виникає найчастіше при запальних процесах в мозку і мозкових оболонках: при бактеріальних і вірусних менінгітах, енцефалітах; захворюваннях, які супроводжуються розвитком церебрального васкуліту (важкі форми грипу, геморагічні лихоманки, малярія), тому правильна діагностика і лікування цього патологічного синдрому має вирішальне значення для успішної терапії багатьох інфекційних хвороб. З погляду патоморфології набряк, набряк-набухання і набухання головного мозку – це окремі патологічні процеси, що перебігають самостійно, або одночасно, можуть доповнювати і переходити один в одного. Клінічно ці стани проявляються однаково, натомість потрібно дотримуватись різних принципів лікування. Набряк-набухання головного мозку за інфекційних хвороб патогенетично більше відноситься до цитотоксичної форми і потребує призначення препаратів які посилюють внутрішньоклітинний метаболізмДокумент The features of comorbidity among elderly and senile patients(Полтавський державний медичний університет, 2023) Trybrat, Т. А.; Shut’, S. V.; Ivanytska, T. A.; Sakevych, V. D.; Boriak, V. P.; Трибрат, Тетяна Анатоліївна; Шуть, Світлана Володимирівна; Іваницька, Тетяна Анатоліївна; Сакевич, Вікторія Дмитрівна; Боряк, Віктор ПетровичAging is a global demographic phenomenon. Chronic diseases have become the most important disease burden and the main cause of death for the global population. It is estimated that chronic disease-related deaths accounted for 73.9% of the total deaths in 2019, ranking first among the causes of death.Документ Рябушко Микола Миколайович (до 60-річчя з дня народження)(Полтавський державний медичний університет, 2023) Гринь, Володимир Григорович; Білаш, Сергій Михайлович; Драбовський, Віталій Сергійович; Саргош, Оксана Володимирівна; Рибалка, Ярослав Володимирович; Hryn, V. H.; Bilash, S. M.; Drabovskyi, V. S.; Sargosh, O. D.; Rybalka, Ya. V.Успіх кожного колективу залежить від його людей, а тим більше від керівника відповідного структурного підрозділу. Колектив деканату медичного факультету №1 Полтавського державного медичного університету пишається професійним, талановитим, цілеспрямованим, відданим своїй справі керівником, яким є РЯБУШКО Микола Миколайович – лауреат Державної премії України, декан медичного факультету №1, кандидат медичних наук, доцент закладу вищої освіти кафедри фармакології, клінічної фармакології та фармації.