The aim: Make complex study of bone density in patients with primary osteoarthritis and exocrine pancreatic insufficiency and patients with primary osteoarthritis without exocrine pancreatic insufficiency. Materials and methods: There were examined 140 patients with primary osteoarthritis without exocrine pancreatic insufficiency and combination osteoarthritis and exocrine pancreatic insufficiency. Diagnosis of osteoarthritis was based on diagnostic X-Ray criteria – according to J.H. Kellgren and J.S. Lawrence. The level of exocrine pancreatic insufficiency was based on result of Elisa test. State of mineral bone density was examined by using dual-photon densitometry. Results: It was established that there was a progressive, statistical, significant increase of mineral density of bone tissue in the 1-st group patients with osteoarthritis. Patients in the 2-nd group, with osteoarthritis in the comorbidity with exocrine pancreatic insufficiency, the densitogram rates were statistically significantly lower than in patients in the 1-st group. Conclusions: The changes of bone tissue can be explained by the formation of trophological insufficiency as a result of exocrine pancreatic insufficiency. One of the symptoms of trophic failure is bone and mineral changes, in particular, the decrease of bone density.

The aim: To investigate the effectiveness of complex protocol treatment with the additional inclusion of a course of the sublingual form of hepatoprotector on the clinical manifestations of patients with chronic pancreatitis in combination with type 2 diabetes mellitus. Materials and methods: We studied 57 outpatients with chronic pancreatitis in the phase of stable or unstable remission in combination with diabetes mellitus in the phase of stable or unstable remission. Two groups were formed according to randomization principles to study the effectiveness of the proposed correction programs: 1stgroup (30 patients) took protocol treatment for one month, 2nd group (27 patients) – received protocol treatment with a course of hepatoprotector. Results: It was found the results of the impact of two treatment programs on some clinical symptoms and syndromes in patients with chronic pancreatitis. Positive dynamics of clinical symptoms/syndromes were found in both groups of patients, but the therapeutic effect in the 2nd group was more significant. Analysis of the dynamics of the Quality of Life parameters on the scales of a specialized gastroenterological questionnaire under the influence of two treatment programs found statistically significant (p<0.05) changes in the group with the inclusion of hepatoprotector for treatment for all parameters in contrast to the group of protocol treatment, where statistically significant changes on three scales (abdominal pain, gastric reflux, and dyspepsia). Conclusions: It is proved that the proposed inclusion in the protocol treatment of a combination of CP and DM2 course of sublingual a demethion in eledtoan increase in its effectiveness in the correction of abdominal pain - by 8.2%, dyspepsia - by 17.8%, constipation - by 7.4% , diarrhea - by 12.9%, astheno-neurotic - by 21.5%, allergic – by 15.9%, autonomic - by 20.1% (p<0.05). Found higher efficacy of treatment with the in clusion of a demethion in relation to that in the group of PL on the dynamics of the parameters of the scales of the GSRS questionnaire by a total of 13.7%, p <0.01: abdominal pain decreased by 22.6% vs. 16.7%, gastricreflux - by 34.7% against 16.9% (p <0.05), diarrhea - by 23.9% against 8.2% (p<0.001), constipation - by 20.6% against 5.9% (0.01), dyspepsia - by 32.4% against 17.9% (p <0.01), respectively. It proved the feasibility of using sublingual demethion in the complex rehabilitation treatment of patients with comorbidity of CP and diabetes mellitus in order to correct clinical symptoms..

The aim: Study of the clinical and pathogenetic role of IL-17, IL-35 and their correlation in the development of infertility in men with chronic ureoprostatitis. Materials and methods: 82 male aged 20 to 40 were examined. The patients were divided into three groups: the first – 10 practically healthy men, in which the levels of IL-17 and IL-35 in semen were taken as normal; second – 33 infertile men with chronic urethroprostatitis; third – 39 fertile men with chronic urethroprostatitis. In addition to conventional clinical and laboratory (clinical blood and urine tests) studies, all men in semen were tested for IL-17 and IL-35 cytokine levels. Results: The levels of the studied cytokines were found to have opposite tendencies to shifts in the semen of men with chronic urethroprostatitis. The level of IL-17 in sperm increases and the level of IL-35 decreases. The IL-17/IL-35 index increases more strongly in men with impaired fertility. Conclusions: Increas IL-17 concentrations, decreas IL-35 levels and increas their correlation may be an indicator of infertility in men with chronic ureoprostatitis. Determining the IL-17 / IL-35 correlation in general clinical practice will allow to single out a group of men with a high likelihood of developing infertility for follow-up and treatment by a doctor of family medicine.

Мета роботи – підвищити ефективність навчання та якість знань студентів шляхом оптимізації практичної підготовки фахівців загальної практики – сімейної медицини на додипломному рівні навчання.Основна частина. У статті наведені сучасні оригінальні технології проведення практичних занять із використанням інтерактивної форми пізнавальної діяльності. З метою активного залучення всіх студентів до навчання, мотивування у кожного відчуття інтелектуальної спроможності, розвитку комунікативних якостей використовувалась парна та групова робота. Серед методів навчання було обрано моделювання клінічних ситуацій, ситуаційний аналіз із вирішенням творчих завдань (використання методу Едварда де Боно) та колективне розв’язання проблеми на завершення.Стаття присвячена проблемі підвищення ефективності підготовки фахівців із загальної практики сімейної медицини на додипломному рівні навчання. Запропоновано впровадити у навчальний процес оригінальні розробки інтерактивних технологій для оптимізації практичної частини занять. Визначено організаційно-методичні аспекти цього нововведення, наведено комплекс реалізованих та запланованих заходів, вивчено їх дієвість. Цілеспрямоване, систематичне й послідовне впровадження в практику новаторських інтерактивних способів, що базуються на активній взаємодії учасників процесу та охоплюють цілісний навчальний процес від визначення його мети до очікуваних результатів, дасть можливість істотно поліпшити засвоєння дисципліни.Висновок. Інтерактивні методи навчання дозволяють стимулювати пізнавальну активність студентів, вдосконалити навики розв’язання комплексних завдань, виробити у майбутніх фахівців з сімейної медицини навички конструктивного співробітництва.

SUMMARY.The signs of compensatory mechanisms disruption and increased autonomic nervous system imbalance with a decrease in ductility autonomous processes in the load were determined in patients with hypertonic disease upon accession the concomitant chronic pancreatitis. The combination of pathologies is also accompanied by manifestations of endogenous intoxication, significant violations of antioxidant and kallikrein-kinin systems.KEY WORDS: hypertonic disease; chronic pancreatitis; autonomic nervous system; heart rate variability; antioxidant system; kallikrein-kinin system; endogenous intoxication.Introduction. Patients with hypertension have accompanying pathology in 58.4 % of cases. This determines the relevance of research processes maintaining homeostasis with a combination of various diseases [1,5].The aim of the study -to examine and compare the character of vegetative, antioxidant, kallikreinkinin system and parameters of endogenous intoxication disorders in the patients with combination of hypertonic disease (HD) and chronic pancreatitis (CP).Materials and Methods. The study involved 40 patients with HD and concomitant CP in nonremission phase, 15 healthy people. The middleaged was (47.7±1.2) years. Research of autonomic regulation conducted by definition of standard statistical and spectral heart rate variability (HRV) [3]. Laboratory research of standard parameters of antioxidant, kallikrein-kinin systems and the severity of endogenous intoxication were conducted.Results. Here vegetative background of 65.0 % of patients was appropriate to eutonia, 25.0 % -sympathicotonia, 10.0 % -vagotonia. Also at comorbidity a significant reduction in total power of spectre (ТР -(678.6±90.3) ms 2 ), component nervous of heart rate regulation (HF -(16.55±1.57) %, LF -(19.83±1.61) %) and increase in humoral and metabolic effects (VLF -(63.63±3.00) %) were observed.The laboratory data in patients shows a reduction of antioxidant protection of the body: superoxide dismutase -(39.83±0.50) U/ml erythrocytes; reduced glutathione -(38.86±0.64) mmol/l; catalase -(45.24±1.37) %; medium molecular size peptides (MMSP) with a maximum absorption at 254 nm -