Aim. To evaluate physical rehabilitation complex used after surgical treatment of patients with lateral hyperpressure of the patella syndrome in combination with "Synolis V-A" hyaluronic acid supplement treatment.  Material and Methods. 25 patients with diagnosed grade 1-3 chondromalacia of the patella, lateral hyperpressure of hereditary disposed genesis were treated surgically. The patients were divided into two groups: 13 patients were included in the main group, and 11 in the control group. All patients underwent the same surgical intervention - reconstruction of the knee joint extensor, control of pain syndrome by the pain visual analogue scale, and measurement of the knee flexion angle. The patients received a comprehensive 4 week rehabilitation course. The patients of the main group at postoperative day 14 were injected intra-articular medication "Synolis V-A". All the data obtained were processed with mathematical statistical Dell's "StatSoft" program.  Results and Discussion. 42 days postoperatively, and 28 days after the commencement of the complex rehabilitation, the patients of both groups underwent the second test. Test one, at the postoperative day 14, demonstrated that knee pain visual analogue scale score was 67.7±11.0 in controls and 59.8±11.1 in those of the main group. The difference of the values did not reach statistically significant level (p=0.847). Test two which was performed at the postoperative day 42 showed that the visual analogue scale pain scores reduced statistically significantly (p=0.001) in both groups. Meanwhile, on the observation day 42 the knee pains in patients of the main group 14.2±11.1 were statistically significantly (p=0.01) less than those in patients in the control group 53.6±9.2. The knee range of motions during the test one was on the average of 14.0±2.0  in both groups, after the performed rehabilitation (test two), the range of motions in the knee joint in both groups increased statistically significantly (p=0.001), but in the main group it reached the level of 102.0±3.0°, and in the control group it was statistically significantly (p = 0.001) less - of 82.0±8.0 . Conclusions. Сomprehensive postoperative rehabilitation is essential and effective; inclusion of "Synolis V-A" medication in the rehabilitation complex is considered to be an innovation for postoperative rehabilitation in the patients with the syndrome of lateral hyperpressure of the patella.

A literature survey concerning application of lectin histochemistry methods for investigating the effect of hypo- and hyperthyroidism on the organ systems. It was established that redistribution of lectin receptor sites on the background of thyroid hormones imbalance showed signs of species and organ specificity. It was demonstrated that hypo- and hyperthyroidism cause a violation of the regulatory influence of the hypothalamic-pituitary axis on the function of peripheral endocrine organs; change the intensity of metabolism and the rate of cell proliferation; and stimulate destructive changes and apoptosis phenomena in target organs. Specifically, in the salivary glands, the thyroid imbalance caused the accumulation of terminal carbohydrate residues DGal and DGalNAc in combination with reduction of DMan, DGlcNAc, NeuNAc and LFuc determinants; on this basis, was formulated the hypothesis of incompleteness of the final glycosilation steps in conjunction with lysosomal glycosidase synthesis disorders, both these processes causing the accumulation of abnormal glycoconjugates in tissues. Storage of secretory products in the glandular cells may be associated with blocking of exocytosis mechanisms. Hypothyroidism caused a decreased reduction rate of DGal and DGalNAc embryospecific carbohydrate determinants (lectin PNA, SBA, HPA receptor sites), which apparently indicate a delay in organ morphogenesis. On the background of maternal hypothyroidism in the testes of offspring rats there was documented an increased proliferation of spermatogenic epithelium, Sertoli and Leydig cells contents, in combination with the increased apoptosis of spermatogenic epithelium. A hypothesis on possible role of HPA lectin receptors as markers of human sperm cells apoptosis on the background of thyroid gland dysfunction was formulated. Hyperthyroidism induced the enhanced collagen synthesis by fibroblasts in the endometrium and ovarian interstitium. New data on the possibilities of lectins application for selective histochemical labeling of distinct cell types and their subpopulations were obtained. In addition, it has been shown that lectins SBA, PNA, SNA can be used for monitoring acrosomal maturation; lectins WGA and HPA - for monitoring the process of gastric glands secretion; WGA, CNFA, SNA, VAA - for monitoring secretion of lingual salivary glands. Since the available literature contains no information concerning the modification of carbohydrate determinants in the adrenal glands of progeny developing under the conditions of maternal hypo- and hyperthyroidism, a conclusion is made on prospective use of lectin histochemistry methods for the experimental investigation of inflences of maternal hypo- and hyperthyroidism on morphogenesis, glycocode and hystophysiology of the progeny adrenal glands. We suppose these data can be of particular interest for basic and applied endocrinology, giving new insight into thyroid-adrenal interactions.

Aim. Assessment of the dynamics of the structural and functional state of the myocardium in patients with non Q-wave myocardial infarction in 3 and 6 months depending on the use of the blocker of the mineralocorticoid receptors eplerenone. Material and Methods. We examined 77 patients (63.6% males) with non Q-wave myocardial infarction aged from 50 to 79 (mean 64.1±1.0) years. Hospital management strategy was elaborated in accordance with modern standards for the treatment of acute coronary syndrome without ST-elevation, which envisaged stratification of risk on the GRACE scale (estimated risk of mortality in the near future) and the choice of adequate procedure of the invasive strategy. The structural and functional state of the myocardium was evaluated using echocardiography, which was performed in the M-, B- and D-modes. Results and Discussion. A substantial increase in the total score of echocardiographic dynamics at the 6th month was demonstrated, as compared to the 3rd month of treatment, indicating a certain association of positive hemodynamic changes with the duration of basic treatment. An analysis of the total score of echocardiographic dynamics during the 3rd and 6th months of treatment indicated a significant increase in the indicator for all periods of observation in the eplerenone group, which showed a more convincing anti-remodeling effect in the group of patients with non-Q myocardial infarction who were administered the drug. Conclusions. The use of eplerenone in addition to basic treatment is associated with more convincing anti-remodeling and hemodynamic effects during the 3rd and 6th months of treatment. Positive hemodynamic effects of the drug exhibit a certain dependence on the duration of treatment, which is characterized by more powerful dynamics of most echocardiographic parameters on the 6th compared to the 3rd month of observation.

Aim. The aim is to study the state of morbidity and prevalence of mental and behavioral disorders due to the use of psychoactive substances in Ukraine in 2010-2017. Material and Methods. To analyze and assess the prevalence and morbidity of the population related to the use of psychoactive substances in Ukraine and its regions, the materials of the State Statistics Service of Ukraine, the Center of Medical Statistics of the Ministry of Health of Ukraine were used. The regional principle was applied using the geographical location, and historical and cultural features of the territories. Five groups of regions were created. The following methods of scientific research: bibliosemantic, medical, statistical, and systematic approach and analysis were used.  Results and Discussion. The prevalence of mental and behavioural disorders due to the use of psychoactive substances in the regional aspect in 2017 per 100,000 of the respective population was the highest in the North-Eastern and southern regions, 1545.54 and 1538.05 per 100 thousand population, respectively. At the same time, the incidence of this disorder was the highest in the Central region (113.31). The main active ingredient that causes mental and behavioral disorders is alcohol. In 2017, the highest prevalence of this pathology caused by alcohol consumption was observed in the North-Eastern region - 1381.23 per 100,000 of the corresponding population. A slight increase in prevalence from 2010 to 2017 was registered in the southern region, where the main role was played by its increase by 24.07% in the Mykolaiv region. The prevalence of mental and behavioural disorders due to drug use was prevalent in the South-Eastern and southern regions. The dynamics of changes in this indicator over 2010-2017 as well as the level of morbidity at the same time indicate the need to pay attention to the system of measures to counteract the use of narcotic substances in the Transcarpathian, Lviv, Zhytomyr and Mykolaiv regions. Conclusions. The results obtained allow us to recommend a regional approach to the analysis of prevalence and morbidity of the population regarding the use of psychoactive substances, which will enable the coordination of the interaction of individual branches of government and intersectoral cooperation of the regions to achieve positive results.  

Aim. To investigate the blood lipid profile, indices of functional condition of the liver in patients with unstable angina in the treatment of statins in combination with alpha lipoic acid.  Material and Methods. 61 patients (21 males and 40 females) with unstable angina have been examined. Patients' average age was 68.3±11.3. Patients were divided into 2 groups due to therapeutic management. Patients of the first group received conventional therapy according to the standards required with necessarily intake of statins; patients of the second group received alpha lipoic acid in combination with conventional therapy. 20 almost healthy individuals of appropriate age and gender comprised the control group. To assess blood lipid spectrum were determined: total cholesterol, low-density lipoprotein cholesterol lipoprotein very low density, high-density lipoprotein cholesterol, triglycerides, atherogenic ratio by conventional methods. Functional status was evaluated by determining hepatic levels of total bilirubin and transaminases. Statistical analysis was done using Microsoft Exel and Statistica 6.0 statistical analysis method definition Student t-test. Results and Discussion. In patients with unstable angina compared with the control group before treatment revealed a significant increase in total cholesterol, low-density lipoprotein cholesterol, lipoprotein cholesterol very low density, triglycerides and the atherogenic factor. Levels of bilirubin, transaminases did not differ from that of the control group. After treatment in both groups revealed a significant decrease in total cholesterol, low-density lipoprotein cholesterol, lipoprotein cholesterol of very low density, triglycerides. The results indicate hypolipidemic effect of statins and correspond to the results of other authors. The level of total bilirubin after treatment in both groups did not change. In the first group of patients after treatment was improving by 29.7% aspartate aminotransferase, alanine aminotransferase 24.6%. In the group of patients taking rosuvastatin in combination with alpha-lipoic acid after treatment revealed a marked reduction in total cholesterol by 8.6%, low-density lipoprotein cholesterol by 13% atherogenic ratio of 14% (p<0.05) as compared to patients taking rosuvastatin. Treatment of patients with unstable angina statin in combination with alpha-lipoic acid did not significantly affect the level of transaminase levels. Comprehensive treatment of unstable angina rosuvastatin with alpha-lipoic acid improves hypolipidemic effect of statins has a positive effect on the functional state of the liver. Conclusions. Rosuvastatin combined with alpha-lipoic acid leads to a significant normalization of lipid profile compared to just taking rosuvastatin. Alpha lipoic acid prevents the negative effect of statins on the functional state of the liver.

Aim of the work is to assess the impact of the rehabilitation complex on the level of general physical capacity and aerobic productivity by the veloergometry results of the middle school age girls with weakened vision. Material and Methods. On the basis of the Zaporizhia Classical Lyceum from September 2015 to May 2016, 90 girls aged 11-14 years were under observation, which had a weakening of visual functions, but with the correct eye position, binocular vision and without organ pathology. Among them were girls with uncorrected visual acuity of 0.1-1.0 and with vision correction up to 1.0. The degree of astigmatism ranged from 0.25 to 1.5 diopters. The distribution of children in terms of the astigmatism degree was the same in all age groups. For physical education classes, they were assigned to the main medical group. To assess the general physical capacity, we chose a test with submaximal exercise power PWC170. Physical performance was evaluated in W. The MOC level was calculated by the formula of VL. Carpman: MOC=1.7ґPWC170 (kgm/min)+1240, ml/min. All those examined were divided into three groups: a control group and two main groups that were suitable for comparison and did not statistically differ in age and degree of visual impairment. They were engaged in the generally accepted school curriculum for physical education. In both main groups, the rehabilitation complex that we developed, which includes special exercises and self-massage of the eyes, special exercises for posture and feet, volitional breath control and aerobic exercises, was additionally offered for practicing  on assignment at home. Results and Discussion. In the main groups, in which individual  aerobic exercise was assigned, under the influence of the rehabilitation complex the absolute numbers PWC170 and MOC significantly increased, and a strong positive tendency was revealed concerning the surveyed adolescents' body weight, which significantly increased in the course of the school year. Namely, a relative indicator PWC170 increased in the main groups by 5.6% and 5.2% and amounted to 2.05±0.06 W/kg (t=1,52; p>0.05) and 1,99±0.05 W/kg (t=1.71; p>0.05); the MOC component increased by 9.83% and 10.23% and equaled 49.57±1.72 ml/min/kg (t=1.84, p>0.05) and 47.92±1.93 ml/min/kg (t=1.80, p>0.05). The absolute PWC170 rates increased in main groups by 14% and 16.2% to 98.59±4.12 W (t=2.31; p<0.05) and 107.12±4.67 W (t=2.53, p<0.05). Absolute MOC parameters improved in the main groups by 16.5% and 20.6%, amounting to 2619,71±110 mL/min (t=2,49; p<0.05) and 2797,87±118 mL/min (T=2.95, p <0.001).  Conclusions. At the primary examination in the control and main groups, statistically significant differences in the indicators of general physical capacity and maximum oxygen consumption were not observed. After the rehabilitation course, the changes in all the studied parameters in the control group were also statistically unreliable. In the main groups under the influence of the rehabilitation complex, the absolute indices of PWC170 and MOC significantly increased, and a pronounced positive trend was revealed cocerning the surveyed adolescents body weight, which  increased significantly during the school year. The obtained results make it possible to recommend for implementation a rehabilitation complex containing aerobic exercises for self-practice on assignment at home according to the individual motor regimen. 

Aim. Traditionally, one of the most important and precise parts of orthognatic interventions will always be planning. After this stage, the surgeon knows exactly which bones and in what way must be rebuilt to get the best result. Earlier, the conducting of a "virtual operation" was not possible. Everything has changed with the advent of the 3D scanners and printers and related software. Accordingly, the task of the study was to confirm the effectiveness of the application of virtual planning in general, and on the example of the application of specific software, in particular, 3D printing technologies in the execution of bilateral sagittal split osteotomy of the mandible, and to introduce this complex into routine surgical practice. Material and Methods. For the virtual planning of the surgical intervention, we selected the software complex DDS PRO of the manufacturer Natrodent (Lodz, Poland). A clinical example of the first application in the clinic of the department of the university and the department of the hospital of software for virtual simulation of orthognatic operations was the case of patient P. with progeny and open bite - a class III skeletal defect  with a significant cosmetic and functional defect (indistinct language and difficulty in eating). As a method of surgical treatment, a bilateral sagittal split osteotomy of the mandible was selected. Results and Discussion. Before the start of treatment, the patient underwent a detailed examination of the maxillofacial area by the surgical team in conjunction with the orthodontist, and underwent orthodontic preparation. Immediately before the operation, gypsum models were made and scanned in 3D scanners. These files, as well as pre-operative spiral computed tomography, were uploaded to the DDS PRO software. The simulation of surgical intervention with bilateral sagittal split osteotomy of the mandible on the previously obtained combined 3D model was performed. A virtual 3D operating template was created and printed. Subsequently, an operation was performed. After osteotomy of the mandible, the dental arches of both jaws were reduced to the position of the expected occlusion by using a template and were fixed together with the IMF screws with wires. Fixation of the fragments was performed following the well-known method of M. Champy et al. (1975). The treatment period passed  without complications. On the 10th day, the patient was discharged from the department for post-hospital observation. The resulting occlusion and changes in the shape of the face fully met his psychological and cosmetic expectations. Conclusions. The use of computer 3D visualizations provides real help to the surgeon in planning future interventions, and evaluating their likely effects and outcomes. The result of this activity is the creation of a surgical template, which is the quintessence of all diagnostic and preparatory activities that precede the surgery. Of course, 3D planning cannot replace a patient's clinical examination, but it has all the prerequisites to supplement it. DDS PRO software is easy to learn and work with. It has a convenient, informative user interface. The manufacturer of the software has the ability to provide technical support to the user. All of the foregoing suggests that the DDS PRO software can be implemented in the routine process of preparing and planning patients with jaw and (or) bite deformations before conducting orthognatic interventions.

West Nile fever is an important viral transmissible natural focal disease in the world. Protecting the population from infection with this virus is organized considering the epizootic and epidemiological situation, assessment and analysis of which is based on the standards on epidemiological surveillance of transmissible infections. Information database includes characteristics of circulating strains; range of reservoirs; sources and vectors of the virus; hydrological, climatic and geographical description; data of monitoring of incidence and prevalence of the disease; and the risks of human infection. The estimation of the latter requires conducting of targeted descriptive-evaluative and analytical epidemiological research. Aim. To perform statistical processing and analysis of epidemiologically important information on the results of survey of respondents with determination of epidemiologically important risk factors of human infection with West Nile virus; to establish the nature of the relationship of identified risk factors in case of their combined impact. Materials and Methods. Systematization of epidemiological information of 120 respondents was performed by creating a computer database. Statistical analysis of the data was conducted using nonparametric mathematical methods: multivariate linear regression analysis, logistic regression, discriminant analysis, neural networks method (neural networks software package Statistica 8.0) Results and Discussion. Grouping and systematization of data are based on a hypothesis about the factors' impact on the likelihood of infection with the virus. Epidemiological information is divided into semantic units to differentiate the type of risk: behavioral, occupational, recreational, etc. It is determined that the estimated parameter t has to equal 1.979280117 and more (degrees of freedom k (124) 95% (P<0.05)). Evaluation of reliability of the discrepancies of alternative features detected 11 signs with significant difference (P<0.05). The study of combined factors' influence on human infection with West Nile virus using linear and logistic models showed no such effect. The use of neural networks showed unacceptable levels of initial approximation of the observed data (coefficient of determination R2 <0.3). Conclusions. Eleven epidemiologically significant risk factors for human infection with West Nile virus were found. Multivariate analysis denied their combined effect on the infection of people: each of the features is independent, and the presence of only one of them has a high risk of human infection. The results showed that the area of research is the active natural focus of West Nile fever.

Aim. To study dynamic changes of heart rate variability, structural and functional changes in myocardium in patients with myocarditis. Materials and Methods. We examined 42 patients with acute myocarditis confirmed by cardiac magnetic-resonance imaging. Patients were devided into two groups: 22 patients were included in the 1st group, in which we observed the recovery of left ventricular ejection fraction (>40%) in 6 months after the disease onset. The 2nd group consisted of 20 patients who did not undergo restoration of myocardial contractile function - left ventricular ejection fraction Ј 40% after 6 months of observation. The following indicators of Holter monitoring of the electrocardiogram were studied: the percentage of ventricular extrasystoles, presence of non-sustained ventricular tachycardia and parameters of heart rate variability: the mean square deviation of the intervals between ventricular complexes, square root of the mean square of the difference in interval between ventricular complexes, the ratio of the spectrum of high frequency waves to the power of low frequency waves intervals between the ventricular complexes. By the use of 2D-echocardiography the end-diastolic volume index and the ejection fraction of left ventricle were measured, the speckle-tracking method of the echocardiography measured the values of longitudinal global systolic strain, circumferential global systolic strain and radial global systolic strain. Results and Discussion. The frequency and spectral parameters of heart rate variability in the 1st group were significantly lower in comparison with the 2nd group. In addition in both groups after 6 months, there was an increase in the main parameters of heart rate variability - square deviation of the intervals between the ventricular complexes and the ratio of high frequency/low frequency waves, but in the 2nd group these indicators were on 16.1% and 21.3% lower respectively. According to the results of speckle-tracking echocardiography during the 6 months of observation in the 1st group we observed a significant increase of longitudinal strain on 31.8% (P<0,02) and circumferential strain on 28.9% (P<0,05), at the same time, no significant changes were documented in the 2nd group. By the use correlation analysis in the 2nd group we established inverse correlation between the value of square deviation of the intervals between the ventricular complexes on the 1st month after the onset of the disease and the presence of unstable ventricular tachycardia after 6 months of observation (r=-0,52; P<0,02).  Conclusions. In patients who didn't have a significant increase in the parameters of the global and segmental contractile function of the myocardium during the 6 months a decrease in the baseline heart rate variability indicates a marked violation of the autonomic regulation of the cardiac rhythm and the tendency to development of arrhythmias. The decrease in the frequency and spectral values of heart rate variability on the background of persistent systolic left ventricular dysfunction in patients with myocarditis is associated with the presence of ventricular arrhythmias and persistence of unstable ventricular tachycardia after 6 months.

For prognostic evaluation of blood lipid profile There exist several calculated indexes for prognostic evaluation of blood lipid profile; however, it is not yet established, which integrative parameter is the most exact predictor of cardiovascular diseases. This fact makes our research feasible.  Aim. To  review modern scientific theories about calculated indexes of the lipidogram and to investigate correlations of these indexes with clinical, laboratory and instrumental parameters. Matherial and Methods. We have reviewed contemporary scientific points of view on calculated indexes of the lipidogram (28 references on this topic) and investigated correlations of these indexes with clinical, laboratory and instrumental parameters in 1140 patients of a diagnostic centre aged 18-89 years, which underwent various diagnostic procedures including lipidogram. The analyzed indexes and calculated parameters of the lipidogram (monocyte to high-density lipoproteins ratio, atherogenic index and coefficient, Castelli indexes I and II) correlated with some clinical, laboratory and instrumental parameters.  Results and Discussion. Modern scientific points of view onthe indexed lipid parameters suggest that monocyte-to-high-density-lipoproteins ratio is an indicator of inflammation and oxidative stress, which together with endothelial dysfunction play a major role in the development of arterial hypertension and target organ damage; atherogenic index of the plasma is a sensitive indicator of atherosclerosis risk, which directly demonstrates the ratio of protective and atherogenic lipoproteins; atherogenic coefficient of A.M. Klimov, which is mainly used in post-Soviet countries, is a marker of progression of arterial hypertension; and Castelli risk indexes are non-direct criteria of the amount of particles of proatherogenic low density lipoproteins, tightly connected with atherosclerosis and cardiometabolic risk.  Conclusion. According to our own analysis of 1140 lipidograms, atherogenic index had the biggest amount of associations including structural parameters of echocardiography. This fact makes atherogenic index the best for prognostic evaluation of not only lipid metabolism, but also of the heart condition. Associations of all the analyzed indexes with fasting glucose level underline the importance of its normalization for treatment and prevention of cardiovascular diseases. In case of normal absolute values of lipids calculation of atherogenic index (not atherogenic coefficient) allows to establish real blood atherogenicity and to reveal the group of patients which need statins. Active implementation of calculation of atherogenic index instead of more traditional for domestic healthcare institutions atherogenic coefficient of A.M. Klimov can facilitate comparison of Ukrainian scientists' data with foreign investigations results. It can also allow bringing received parameters to world standards.