The aim is to analyze current scientific data on the prevalence of thyroid dysfunction in patients with COVID-19 and to evaluate the relationship between possible complications of COVID-19 and vaccination. Materials and methods. Open digital archive of journal articles on biomedical and biological sciences of the National Institutes of Health (USA), developed by the National Center for Biotechnological Information of the National Medical Library (USA) – PubMed, Google Academy and Academic Journals. Results. The development of thyroid diseases in SARS-CoV-2 may be associated with various mechanisms of its damage, including an excessive immune response, infection-induced immunodeficiency, or direct cell damage due to significant tissue tropism and high affinity of SARS-CoV-2 to thyroid tissue. Possible mechanisms of formation of post-vaccination dysfunction of the thyroid gland are proposed. Conclusions. Thyroid hormone deficiency is associated with an increased risk of adverse events and in-hospital mortality of COVID-19 and depended on the age of the patient. The severe course of Covid-19 is characterized by an increase in the prevalence of TT secondary to destructive or inflammatory thyroiditis. Thyroid-related thyrotoxicosis exacerbates the clinical course of comorbidities and long-term consequences, such as autoimmune hypothyroidism, which occurs in patients of all ages and with any severity of COVID-19. The prevalence of TD in patients with COVID-19 varies from 13 to 64 %. 2. The presence of thyroid dysfunction is positively correlated with the clinical severity of COVID-19. Patients with confirmed thyroid disease should receive COVID-19 vaccine to reduce the risk of morbidity and mortality from COVID-19 infection

The usage of the principle of optimal management, namely such effects on complicated forms, when the course of the disease is close to that of uncomplicated course of the disease is very promising in drug therapy of patients with generalized periodontitis. The aim is to study the intensity and duration of the phases of wound healing of the mucosa after spontaneous periodontitis surgery accompanied by normo-, hyper- and hyporeactivity of the body by cytological examination of smear-imprints of wound exudate. Materials and methods: The experiments were performed on 24 adult mongrel dogs divided into three equal groups. In the first group, drugs that disrupt the reactivity of the organism were not used (normoreactivity of the organism). In the second group, the animals were simulated a сondition of hyperreactivity, in the third group – the hyporeactivity of the organism. All the animals with spontaneous periodontitis underwent a patchwork surgery. In the period after surgery, cytological examination was performed on the 1st, 4th, 6th and 9th day of the experiment. Results: It has been revealed that in cases of the normal reactivity of the organism the following periods of cellular reactions during the healing of the gums mucous membrane can be differentiated within the appropriate terms: the period of degenerative-inflammatory changes (1st day), active granulocyte-macrophage reaction (4th day), reparations (6th day) and the period of increase of reparative processes with a decrease in the overall cellular response (9th day). Examination of smear-imprints after surgical treatment in animals with spontaneous periodontitis with hyper- and hyporeactivity of the body allowed to identify the same periods of cellular reactions during the healing of the gingival mucosa, as in cases of normoreaction with hyperreation.Tthe intensity and duration of the wound healing phases differed from those which are typical for normoreactivity of the body: granulocyte-macrophage reaction was more pronounced and lasted longer until the 6th day, so later only on the 9th day there were cellular signs of regeneration. With hyporeaction, the intensity and duration of the wound healing phases differed from those which are typical for normoreactivity of the body: granulocyte reaction occurred later (only on the 6th day) and lasted longer, signs of active regeneration appeared later on the 9th day. Therefore, postoperative wound healing in animals with impaired body reactivity was delayed for 3-4 days. Conclusions: Thus, direct medical correction with transforming intensity and duration of the phases of the wound process which are characteristic for impaired reactivity of the body into the phases which are typical for normoreaction is essential. It provides synchronization of necrotic and reparative processes and creates conditions for normal uncomplicated healing of periodontal soft tissues

In the presented work, we have assessed the features of peripheral oxygenation in children with congenital malformations of the surgical profile under various types of combined anesthesia.
 The aim of the study. To assess the state of peripheral oxygenation in newborns and infants with congenital malformations with various types of anesthetic support.
 Materials and research methods. A retrospective study included 150 newborns and infants with congenital malformations of the surgical profile, depending on the anesthesia (inhalation + regional anesthesia; inhalation + intravenous anesthesia and total intravenous). The parameters of pulse oximetry were analyzed: peripheral oxygenation, heart rate. Additionally, the concentration of oxygen in the respiratory mixture of children was taken into account.
 Research results. Peripheral saturation did not critically decrease at all stages of observation, with the exception of a decrease in the indicator in children of group I compared with group III at the stage of induction into anesthesia (97.79±2.45 versus 98.79±1.63, at p˂0.05, respectively) and at the most painful moment of the operation (96.29±3.47 versus 98.10±2.47, with p˂0.05). At the painful moment of the operation, it was in children of group I that a drop in heart rate was noted compared to group III (127.98±13.77 and 136.10±15.37, respectively, with p˂0.05) and group II (134.02±18.43, at p>0.05) against the background of a decrease in SpO2. Newborns and group I infants required higher oxygen concentrations in the breathing mixture. A significant difference in the indicator is noted between groups I and III at the traumatic stage – 0.47±0.29 and 0.33±0.2, with p˂0.05, respectively, and immediately after the operation – 0.34±0,19 and 0.26±0.13, with p˂0.05, respectively.
 Conclusions. The expediency and effectiveness of pulse oximetry for children with congenital malformations at all stages of anesthetic support during surgical treatment was confirmed. The risk group for the formation of oxygen deficiency in organs and tissues, the occurrence of pain during the operation were newborns and infants, for whom combined anesthesia was chosen in the form of an inhalation method and regional anesthesia. In the case of the appointment of this type of anesthetic support, it is necessary to more closely monitor the indicators and promptly correct the deterioration of the child's condition

The aim. To investigate the dynamics of stress markers and the state of cognitive functions in the perioperative period during laparoscopic cholecystectomy in elderly patients.
 Materials and methods. We examined 84 patients aged 68.1 ± 0.6 years, with diagnosed gallstone disease, acute cholecystitis, who underwent laparoscopic cholecystectomy. Patients were randomized into 2 groups: Group I - inhalation anesthesia based on sevoflurane with mechanical ventilation; Group II - TBA based on propofol with mechanical ventilation. Hemodynamic parameters, dynamics of stress markers (cortisol, insulin, glucose) and cognitive function were investigated.
 Results. Glucose and insulin levels in both groups remained within normal limits at all stages of the study. The baseline cortisol level was higher than normal in both groups, but at 4, 5, 6 stages of the study decreased significantly compared with baseline values (p<0.001).
 In the study of cognitive functions by the Luria test and the MMSE scale, a significant decrease was found in both groups on the day after surgery.
 According to the Luria test, the score in group I significantly decreased the day after surgery against the period before premedication by 8.7% (p<0.001), in group II - by 10.1% (p<0.001); according to the MMSE scale, the score in group I significantly decreased on the day after surgery against the period before premedication by 6.0% (p<0.001), in group II - by 6.3% (p<0.001).
 On the fifth postoperative day, no significant differences in baseline values ​​between the Luria test and the MMSE scale were detected.
 Conclusions. The comparative analysis of the dynamics of stress marker levels in both groups revealed some advantages of general sevoflurane-based anesthesia in antistress protection of patients in the perioperative period during laparoscopic cholecystectomy compared with total intravenous anesthesia based on propofol. However, the effectiveness of anti-stress protection of both types of anesthesia was sufficient.
 According to the correlation analysis, an inverse correlation was found between the state of cognitive functions in the postoperative period and the level of cortisol in the intraoperative period

Chromium galvanic production have leaded to biosphere pollution. Therefore advisable to study of role in the neurodegenerative development in retinal diseases under experimental conditions. The aim is to study the Enterosgel effect on morphological changes in rats retina with Cr(VI) – induced retinopathy. Materials and methods. An experimental study had carried out on 72 outbred white male rats. The rats had divided into 3 groups: I – control group of intact rats (n = 24). Control rats were received drinking water, II group – rats (n = 24), were received drinking water with Cr (VI) (K2Cr2O7) – 0.02 mol/L, III group – animals (n = 24) were received drinking water with K2Cr2O7– 0.02 mol/L and hydrogel methylsilicic acid (Enterosgel) at a dose of 0.8 mg/kg per day as a corrector. The animals had been decapitated under ether anesthesia. The retina had been studied on days 20, 40 and 60 of the experiment. Morphologically and morphometrically they had analyzed. Results. According to histological studies, it has proved that Cr (VI) causes dystrophic and degenerative changes in all rats retina layers. They increase as the duration of the experiment. The use of Enterosgel as a corrective therapy showed positive results in restoring the morphological structure of rats retina. After Enterosgel 20 days using as a corrector of Cr (VI) exposure, there is a barely noticeable swelling of the outer and inner nuclear layers. Other layers of the retina, morphologically, look undamaged. Forty days Enterosgel treatment have outer and inner nuclear layer edema of retina of animals persists but does not increase. It is easy noticeable swelling of the outer and inner layers of mesh, but no signs of damage processes of cell populations nuclear layers. State ganglionic layer and nerve fiber layer entirely satisfactory. These pathological changes are not critical. After 60 days from the beginning of loading of Cr (VI) and application of Enterosgel in the retina of rats there are initial degenerative changes in the photosensory layer. Cystic dilated outer segments of rods and cones were visible throughout, and areas of their fragmentation were observed. Ganglion neurons are not damaged, but their axons appear somewhat thickened and fluffy. But in general, the typical structure of the retina is preserved. Conclusions. Chromium-induced toxicity in rats is characterized by pronounced histological and morphometric changes and retinal thickness, which appear after 20 days, increase by 40 days and acquire maximum transformations after 60 days of the experiment. The use of Enterosgel improves picture morphological structures of the retina in rats under the influence of Cr (VI). The changes were expressed on days 20 and 40, which indicates the presence of protective properties for the retina

The development and course of periodontal disease in young people is characterized by sluggish clinical symptoms, and at the initial stage are asymptomatic, which greatly complicates its timely diagnosis. Therefore, it is especially important to find methods of early diagnosis and prediction of periodontal disease, which will allow for a rational comprehensive prevention. Among the causes of periodontal disease, the main role belongs to the microorganisms of dental plaque, which has important diagnostic value.The aim of the study. To investigate the composition of mixed microcultures of subgingival plaque bacteria in young people with different nosological forms of periodontal disease and to assess the degree of influence of microbial factors on the development of periodontal diseases.Materials and methods. The state of microbiocenosis in the subgingival zone in 104 people with periodontal disease and in 94 people with intact periodontal tissues were studied. To assess the severity of the influence of the types of selected microcultures of the subgingival zone on the development and progression of periodontal disease in young people, the method of alternative sequential analysis of Wald and Bayes’s formula was used.Results. With the development of the inflammatory process in periodontal tissues in most cases revealed cultures characterized by the presence of polymorphic gram-negative bacteria that developed, fixed on the solid phase, and in the liquid phase contained coccal microflora (53.01±5.48 %). During the development of generalized periodontitis, an increasing number of microcultures with a predominance of gram-negative microflora with pronounced adhesive properties was detected, which led to the development of these microcultures on the solid phase (61,9±10,6 %). The calculation of prognostic coefficients showed that the presence of microcultures that developed in the planktonic phase, but contained gram-negative rod-shaped bacteria and cocci were highly important in terms of the development of periodontal disease (+7.46).Conclusions. With the development of the pathological process in periodontal tissues, the state of the microflora changed in the direction of increasing gram-negative polymorphic microflora with pronounced adhesive properties that are capable of aggregation (up to 53.01 % in patients with catarrhal gingivitis, up to 90,48 % – with generalized periodontitis). The result of calculation of the severity of isolated types of microcultures from subgingival zone on the development and progression of periodontal disease in young people showed that the presence of microcultures that developed in the planktonic phase, but contained gram-negative rod-shaped bacteria and cocci were highly important in terms of the development of periodontal disease

The aim of the work – conduct a literature review to study the most important and complex aspects in the diagnosis and treatment of gastroesophageal reflux disease that are encountered in the practice of a family doctor.\n\nResults. Gastroesophageal reflux disease is becoming an increasingly important disease for the young and able-bodied population, which gives it not only a medical, but also an economic aspect. This is one of the most common pathologies in the practice of not only a therapist, family doctor and gastroenterologist, but – due to the presence of extraesophageal manifestations – in a wider range of medical specialties. Since gastroesophageal reflux disease has many “masks”, this leads to delayed diagnosis and treatment. This disease does not have a “gold standard” in routine diagnostics, and the presence of its refractory forms leads to treatment failures and complications. With a comorbid course of gastroesophageal reflux disease, both diagnosis and treatment require an integrated approach.\n\nConclusions. Gastroesophageal reflux disease remains one of the most common diseases in the practice of a family doctor. Despite the extensive study of this pathology, it continues to remain difficult in terms of diagnosis and treatment, which is associated with the presence of extraesophageal manifestations, comorbid and refractory course. This requires an additional study of pathogenetic mechanisms and the development of therapeutic and diagnostic measures on the basis of this

Newborns with congenital defects usually have a burdened perinatal history, and their mothers' pregnancy proceeds against the background of severe complications and exacerbation of chronic pathology. In modern obstetrics, many indicative scales are used to determine the degree of risk of perinatal and maternal pathology, including a point assessment on the Coopland scale.The aim. Conduct a clinical and epidemiological analysis of perinatal and maternal risk factors according to the A. Coopland scale and analyze the frequency of perinatal pathology in newborns with congenital defects in the early neonatal period.Materials and methods. We retrospectively and selectively analyzed 88 birth histories of mothers of newborns with congenital malformations who received surgical treatment in the neonatal center and scored risk factors for perinatal and maternal pathology according to the A. Coopland scale.Results. It was revealed that mothers of newborns with congenital defects were included in the groups of high (3 - 6 points) and very high (7 or more) predicted risk of perinatal and maternal pathology. The high-risk group included 28 (32%) mothers, and 60 women (68%) - the very high-risk group of perinatal and maternal pathology.Conclusions. In women with more than 15 points on the A. Coopland scale 4.7 times more often children were born with intrauterine infection, gastrointestinal disorders, NEC and severe respiratory disorders in the early neonatal period compared with mothers who gave birth to newborns with the same gestational age and a group of low and high risk of perinatal and maternal pathology

Methotrexate (MTX) is a cornerstone of therapy worldwide for juvenile idiopathic arthritis (JIA). Despite the fact that fibrosis molecular mechanisms as well as MTX elimination and fibrosis indexes were studied a lot there is still not enough information for adolescence.\n\nThe aim was to study dynamics of molecular-cellular mechanisms activation of fibrotic processes development in the liver in adolescents with juvenile idiopathic arthritis treated with methotrexate by determining the content of fibroblast growth factor and hepatocyte growth factor.\n\nMaterials and methods: A total of 68 children with juvenile idiopathic arthritis, were enrolled in the study. 25 boys (36.8 %) and 43 girls (63.2 %) were examined. Children were divided into four groups in accordance with cumulative dose (CD) of methotrexate. The following data were analyzed: liver function tests (aspartate aminotransferase (AST) (U/L), alanylaminotransferase (ALT) (U/L)), lactate dehydrogenase (LDH) (U/L), adiponectin (μg / ml), BFGF (pg / ml), HGF (pg / ml), liver fibrosis indexes APRI and FIB-4 Score.\n\nResults. Positive effect of JIA treatment with MTX on the liver is noted. When CD MTX reaches 1 and3 grams, liver state studying is needed. When the CD MTX of1 gram is reached, regulatory mechanisms are involved that provoke liver regeneration. When the CD MTX reaches3 grams, the liver condition may deteriorate, which in the future can lead to irreversible processes of liver fibrosis.\n\nConclusions: Thus, it is important to control possible liver disorders in adolescence treated with MTX. Monitoring the processes of liver fibrosis is appropriate at all stages of JIA treatment, but it is most advisable when the MTX cumulative dose is reaching 1 and3 grams

During the development of the acute phase of ischemic stroke (IS), the cytoplasmic membranes of cells and receptor complex are primarily damaged. Structural changes in brain tissue are accompanied by violations of its electric physical characteristics, which are quite qualitatively possible to record using microwave dielectrometry.The aim of the study was to learn the features of changes in the dielectric properties of peripheral blood erythrocytes of patients with IS during in vitro exposure to adrenergic drugs depending on the severity of the disease to optimize diagnosis.Material and methods of research. Measurements of complex dielectric constant (CDC) were performed by EHF dielectrometry at a fixed frequency of 39.5 × 109 Hz, which is in the region of γ-dispersion. The work was based on the materials of a comprehensive examination of 350 patients with the first in the life of IS on the 1st, 10th and 21st day of the disease.The severity of the condition and the degree of neurological deficit were determined using the stroke scale of the US National Institutes of Health (NIHSS) in the first hours of the disease, in the dynamics of treatment on the 10th and 21st day. There were 2 clinical groups: 1st (n = 183) – patients in a state of moderate severity (mean score on the NIHSS scale 11.74±0.33); 2nd (n = 167) – patients with severe IS (average score on the NIHSS scale 24.06±0.29).Results. In the control group, there was a significant decrease after exposure to adrenaline solution. The reaction to adrenaline in patients with IS was almost absent. It indicates a decreasing of erythrocytes β-adrenoceptors (β-ARs) sensitivity to stimulants due to their desensitisation. In patients with moderate severity, erythrocytes are more reactive than in patients with more severe IS.Conclusions. The deviation of CDC of erythrocytes induced by adrenergic drugs in vitro is a manifestation of a specific response of cells to biologically active substances and depends on the functional state of the sympathoadrenal system