Preventive role of self-education in the formation of personality

Спроба об’єднати фактори, що зумовлюють процес розвитку особистості, у провідні блоки на основі їх спорідненості дозволяє, з одного боку, значно розширити поле для дослідження, а з іншого – дає можливість на основі загальних теоретичних положень більш глибоко і ґрунтовно дослідити окремі підсистеми загальної системи факторів. Між групою об’єктивних факторів(природні, соціальні) та таким суб’єктивним фактором, як власне природа особистості, чільне місце посідає такий об’єктивно-суб`єктивний фактор, як духовність. З одного боку, її стан та зміст зумовлені об’єктивними факторами, а з іншого – форми її прояву мають суб’єктивний характер. Аналіз рівня розвитку особистості на цьому етапі дозволяє визначити позитивний та негативний результати процесу виховання, обрати та апробувати шляхи корекції поведінки вихованців. Виявлення та наукове обґрунтування основних тенденцій взаємодії провідних блоків системи факторів формування особистості дозволяє визначити та науково обґрунтувати найбільш ефективні шляхи превентизації прояву особистості в негативних формах її поведінки.Ще один шлях полягає в зміні, за допомогою уяви, інформації що надходить. У даному випадку невротична реакція полягає в зміні ситуації таким чином, щоб поразки та неуспіхи не могли поставити під сумнів переконання даної особи у своїй величі. З цією метою досить, наприклад, уявити себе талановитою людиною, якій заступають шлях і яку не визнають або якій шкодять заздрісні посередності і зрадлива доля. Раціональне мислення змінюється ірраціональним, яке визнає бажане і приємне за дійсне. Ідеальне «я» ототожнюється з реальним «я». Самовиховання в такому разі стає зайвим, індивід послуговується лише уявою.

The Study of the Awareness of Healthcare Workers on Organizational Aspects of Vaccination

Aim. To analyze the awareness of healthcare workers on the organization of vaccination. Materials and Methods. In 2018 – 2019 sociological survey was conducted among 1384 healthcare workers from 4 Ukrainian regions: 353 primary care physicians, 233 specialized medical care doctors, 88 healthcare managers, 700 nurses, and 10 others. Results. Gaps in the knowledge and beliefs of health professionals associated with the organization of vaccination were founded: less than half of the surveyed health workers understand that vaccination is carried out with any certified vaccine, regardless of the country of origin; a significant part of respondents tend to prescribe drugs not recommended by international guidelines (53.6%), antihistamines (15.9%) and anti-inflammatory (8.0%) drugs before vaccination; do not know about the possibility of doing several vaccinations in one visit (47.3%) and that the cold chain breach affects the effectiveness of the vaccine (52.4%). It was found that the most knowledgeable about the organization of immunoprophylaxis of the population are the health care managers and medical personnel who have passed special training on vaccination vs the least informed specialized medical care doctors. Conclusions. It is necessary to develop a set of scientifically based measures to improve the awareness of health professionals about the organization of vaccination in order to improve the coverage of the population with immunoprophylaxis.

Gender Peculiarities of Protein and Lipid Peroxidation of the Oral Liquid Under the Conditions of Preclinical Iodine and Iron Deficiency

The prevalence of somatic pathology in children increases significantly with each passing year, which is associated with socio-economic, environmental conditions, the complex interaction of exogenous and endogenous factors. This problem may be related to micronutrient imbalances, among which iodine deficiency and sideropenia are quite common. Objective. The aim of the study is to learn the peculiarities of peroxidation of proteins and lipids, the system of antioxidant defence of oral fluid in conditions of preclinical iodine and iron deficiency. Materials and Methods. The study included 115 children aged 6-18 years. The level of peroxidation of proteins was characterized by the content of oxidative modification of protein products (aldehyde derivatives of the main nature) in the oral fluid. Peroxidation of lipids of oral fluid was assessed by the accumulation of diene conjugates (DCs) of polyunsaturated fatty acids and products responding to thiobarbituric acid (TBA-RP). Results. It has been determined that in case of iodine and iron deficiencies, their combination causes significant activation of protein and lipid peroxidation processes in the oral fluid of children, accompanied by an imbalance of the prooxidant-antioxidant system of the oral cavity. Conclusion. Such changes can be predictors of the development of dental pathology

Influence of Physical Therapy and Cholinergic Medication on the Life Quality Parameters in Post-Stroke with the arm Motor Dysfunction

Motor dysfunction makes the greatest contribution to the patient’s functional independence and has a significant impact on the quality of life (QOL) of post-stroke patients. The objective of the research was to evaluate the impact of different physical therapy approaches and choline alphoscerate on the functional independence and quality of life in patients in 1 year after ischemic stroke. Materials and methods. There were 104 patients examined in 1-year period after first anterior circulation ischemic stroke. Neurological status, functional independence and QOL were assessed according to the National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Functional Independence Measurement (FIM) and Stroke Specific Quality of Life Scale (SS-QOL). Patients in Group 1 received secondary stroke prevention therapy and performed the exercises complex for general muscle function improvement for 2 months; patients in Group 2 also performed the exercise complex for hand motility improvement for 2 months; patients in Group 3 received choline alphoscerate 400 mg twice a day for 2 months in addition to the abovementioned physical therapy. Results. 2 months of physical therapy in Group 1 resulted in increase of “Transfer” and subtotal motor scores. A significant increase in the “Self-care”, “Transfer” and therefore subtotal motor and total scores was observed in the patients in Group 2 and Group 3; the motor subtotal and total scores in Group 3 were 11.4% and 11.6 % higher than the same indices in Group 1, respectively. The most significant improvement of QOL parameters was observed in patients in Group 3, whose total score increased by 36.8% from the baseline (p<0.05), and exceeded the same index of Group 1 by 17.1% (p<0.05). Conclusions. Adding of hand exercise into the physical therapy complex for post-stroke patients contributes to better upper extremity motor performance and therefore functional independence. Stimulation of cholinergic neurotransmission with the choline alphoscerate may also increase the efficacy of physical therapy and contribute to patients’ general mobility, upper extremity function and QOL.

Assesment of Iodine Deficiency in Patients with Nodular Goiter Living in the Precarpatian Region

The objective of the research was to assess the state of iodine supply of patients with nodular goiter living in the Precarpathian region. Materials and methods: 56 patients with nodular goiter were examined (38 women and 18 men), the average age of patients was 48 years. WHO / UNICEF / ICCIDD guidelines were used to assess the severity of iodine deficiency: goiter frequency according to palpation and ultrasound examinations, median of iodine excretion in urine, thyroid-stimulating hormone (TSH) and thyroglobulin levels. Determination of iodine concentration in urine was conducted by the method of “blind”, closed randomized study in single portions of urine according to the Sandell-Kolthoff reaction by the method of Dunn et al. in the laboratory of epidemiology of endocrine diseases at the State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism” (supervisor – Professor VI Kravchenko). Results. According to the results of the study of iodine in the urine, the data with an average value of 85.9 μg/l were obtained. The median of thyroglobulin serum was in the range of 12.27 ng/L. Levels of thyroid-stimulating hormone were average in patients with nodular goiter of I and II grades constituting 3.13 mU/l (table 2). The level of thyroglobulin median was noted to be the highest in patients with thyroid size corresponding to grade II. Conclusions. The results of the study of iodine in the urine of patients with nodular goiter of grades I and II living in the Precarpathian region indicated a mild level of iodine deficiency. The presence of iodine deficiency necessitated both mass (the use of iodized salt by the population) and individual iodine prevention (prescribing potassium iodide).

The Structural-Functional Peculiarities of Heart in Patients with Acute Coronary Syndrome

Acute coronary syndrome (ACS) is associated with very high morbidity and mortality. The American Heart Association estimates – approximately every 40 seconds an American has a myocardial infarction. The aim of this study was to evaluate the structural-functional peculiarities of heart remodeling in patients with acute coronary syndrome. Material and Methods. In this observational cohort trial there were observed 184 patients with ACS. Coronary angiography was performed at admission, and lesions that reduced the lumen area at 50% or more were considered angiographically significant. Transthoracic echocardiography was performed in accordance with recommendations of the American Society of Echocardiography. Results. The mean age of all observed patients with ACS was 64.6±11.9 years; 93 (50.5%) were males. ACS with persistent ST segment elevation more often was presented as the anterior-lateral myocardial infarction with persistent ST segment elevation (STEMI) – in 70 (50.0%) cases. Among patients with STEMI the left anterior descending coronary artery (LAD) was mostly affected as infarction-related artery (IRA): in 74 (52.9%) cases at initial urgent coronary angiography. Multivessel disease (MVD) was identified in 22 (15.7%) patients with STEMI. The most significant variations of EchoCG parameters were observed in STEMI patients with MVD on coronary angiography (Table 2): dilatation of left atrium and left ventricle (increased of End-diastolic volume (EDV), End-systolic volume (ESV), End-diastolic diameter (EDD) and End-systolic diameter (ESD)) and low ejection fraction (EF) of left ventricle. Low EF of left ventricle was observed in 6 patients with culprit of LAD, 3 patients with culprit of LCx and in 6 patients with MVD (φ=0.244; p<0.05). Conclusion. Acute STEMI is caused by significant left ventricle remodeling (dilatation and ejection fraction decrease) in case of multivessel disease in coronary angiography.

Notification of Ukrainian Diploma as a Doctor-Pharmacist in Poland

The article represents the peculiarities of recognizing higher medical education obtained in Ukraine in Poland. Nostrification (from German Nostrifikation derived from Latin Noster – “our”, and Latin Facere – “to do”) is a procedure for the recognition of diplomas issued by educational establishments of other countries. All the certificates and diplomas obtained in Ukraine can be legalized in Poland. The paper describes the procedure for preparing the documents needed and the basic legal components of a successful nostrification of diploma in medicine, pharmacy. The recognition of foreign diploma grants you the right to continue your education and professional activity in Poland and is carried out on an individual basis. If you want your diploma to be recognized in Poland, you should contact the Ministerstwо Nauki i Szkolnictwa Wyższego or Polish National Agency for Academic Exchange – NAWA. An Agreement between the Government of Ukraine and the Government of Republic of Poland on Mutual Recognition of Education Documents and Scientific Degrees was signed on May 31, 2006 (Resolution of the Cabinet of Ministers of Ukraine No. 769). Thus, the Polish documents of secondary education, higher education levels, as well as academic degrees provide the opportunity to continue education in Ukraine and, accordingly, such documents received in Ukraine guarantee this opportunity in Poland. However, the agreement does not apply to certain professional rights including extra payments for academic degrees or ranks. The confirming university shall confirm or refuse to confirm the completion of studies at a specified level within 90 days from the date of submission of the request. In case of differences in study curriculum, learning outcomes or duration of studies, the confirming university may oblige the person to take specific examinations or undergo a professional traineeship. Obtaining a certificate of nostrification allows you to continue the process of recognizing higher medical education in order to ultimately be able to work as a doctor in the European Union.

The Changes of Prooxidant-Antioxidant and Energy Homeostasis in Rates with Impaired Glucose Tolerance

Topicality.Violation of glucose utilization leads to disruption of all types of metabolic processes. Particularly dangerous in the prognostic aspect is the combination of carbohydrate metabolism disorders and other endocrine pathologies, in particular hypothyroid dysfunction. The objective of the study was to examine prooxidant-antioxidant changes ofblood serum, teeth pulp and oral mucosa in rats with impaired glucose tolerance on the background of iodine deficiency. Materials and Methods. The studies were carried on 60 female rats, which were divided into two research groups - rats with impaired glucose tolerance and insulin resistance on the background of iodine deficiency. Lipid peroxidation processes were evaluated due to the content of diene conjugates and active products that react with thiobarbituric acid in blood serum, teeth pulp and oral mucosa. Antioxidant defence of blood serum was characterized by catalase, ceruloplasmin, superoxide dismutase, glutathione peroxidase, glutathione reductase activity and iron transferrin saturation. Energy metabolism was examined by the activity of succinate dehydrogenase, malate dehydrogenase and lactate dehydrogenase in blood serum. Results.Impaired glucose tolerance was foundto lead to the activation of lipoperoxidation, mainly due to the accumulation of final products of lipid peroxidation in all studied tissues against the background of redistribution of the activity of antiradical enzymes. Under these experimental conditions, different changes in the activity of energy synthesis enzymes were observed. The development of combined endocrine pathology has led to more pronounced changes in the prooxidant-antioxidant system and significant suppression of serum dehydrogenase activity. Conclusions.The development of insulin resistance on the background of iodine deficiency causes the activation of oxygen-dependent processes in periodontal tissues against the background of reduced antiradical defence and disruption of energy synthesis system.

Age features of morphological changes of vessels of testicular hemomicrocirculatory flow in streptozotocin diabetes mellitus

Medico-social problem of diabetes is caused by early disability and mortality of patients due to specific complications of micro- and macroangiopathies. Therefore, the aim of our study was to establish morphological changes in vessels of the hemomicrocirculatory flow of the testes of immature rats with experimental streptozotocin diabetes mellitus (SDM). The material for the study were the testicles of 20 two-month-old immature (weighing 65-95 g) white outbred male rats, which were divided equally into 2 groups: experimental and control ones. SDM in animals of the experimental group was simulated by a single intraperitoneal injection of streptozotocin (dissolved in 0.1 M citrate buffer solution with a pH of 4.5) at a dose of 7 mg per 100 g of mass. The control group of animals received intraperitoneally an equivalent dose of 0.1 M citrate buffer. Histological, electron microscopic, biochemical, morphometric and statistical research methods were used. It was found that in the early stages of SDM (14th day) on the background of hyperglycemia in the hemomicrocirculatory flow of the testes there is a spasm of the vessels of the afferent link, which is confirmed by a decrease in the area of arterioles lumen and an increase in their VI. On the 56th day of SDM, on the background of elevated levels of glucose and glycosylated hemoglobin in the links of the hemorrhagic circulatory flow of the testes there are initial signs of diabetic microangiopathy, manifested by: hemorheological disorders in micro-hemo-vessels (erythrocyte sludges, adhesion of erythrocytes and platelets, microclasmatosis), decreased capacity of arterioles and capillaries (increase in VI, respectively by 1.2 and 1.9 times), microclasmatosis, thickening and proliferation of the basement membrane of capillaries. Thus, on the 56th day of SDM in the hemomicrocirculatory flow of the testes, the development of diabetic microangiopathy is observed, which leads to the disruption of the blood-testis barrier, and as a consequence, to a violation of spermatogenesis.

Clinical practice in Obstetrics and Gynecology in the context of the implementation of a competency-based approach to the organization of education of modern students

The article shows the role of clinical practice in Obstetrics and Gynecology in the context of the implementation of a competency-based approach to the organization of education of modern students. The indisputable advantages of the orientation of the educational process onto the achievement of professional competencies for the training of competitive specialists with flexible practical-meaningful thinking are determined. Priority in the system of medical education is the development of new approaches, methods and forms of training in order to form readiness for the professional activity of a medical specialist. The efficiency of algorithmization and pedagogical potential of the case-method in the structure of clinical practice teaching is proved.