The aim: To assess carbohydrate and lipid metabolic profiles of tuberculosis patients with bilateral injuries of the lungs and mycobacteria excretion. Materials and methods: Seventy two newly diagnosed pulmonary TB patients were examined. Group I – 17 newly diagnosed TB patients who had unilateral pulmonary lesions and had no mycobacteria excretion. Group II – 55 newly diagnosed TB patients who had bilateral pulmonary lesions and mycobacteria excretion. The control group included 20 healthy persons. Fasting insulin level, indices of lipidogram were measured, oral glucose tolerance test was performed. Statistical processing of the obtained results was carried out by analyzing the contingency tables using the StatisticaBasicAcademic 13 for Windows software package. Results: Tuberculosis patients develop insulin resistance – condition that is a precursor to developing type 2 diabetes and metabolic disorder of lipid exchange – dyslipidemia. Patients with bilateral pulmonary lesions and mycobacteria excretion have the most pronounced disorders of carbohydrate and lipid metabolism compared to patients with limited lesions of the lungs. Conclusions: We suppose that mycobacteria excretion and bilateral lesions of lungs may be the markers of the degree of carbohydrate and lipid metabolism disorders in patients with pulmonary tuberculosis. KEY WORDS: pulmonary tuberculosis, mycobacteria excretion, glucose metabolism, lipidogram

OBJECTIVE. The purpose of our comprehensive analysis is to assess the prospects for the effects of the interaction between coronavirus disease 2019 (COVID‑19) and tuberculosis (TB) and to strategize the risks of spreading TB infection in a coronavirus pandemic. MATERIALS AND METHODS. Test access to full-text and abstract databases was used. RESULTS AND DISCUSSION. An analysis of the available literature has shown that a 3-month lockdown and a long 10-month recovery worldwide could lead to an additional 6.3 million TB cases and another 1.4 million TB deaths between 2020 and 2025. On average, the detection of TB in Ukraine decreased by 27.4 %, and the incidence of TB among children decreased by 34.5 %. This is an alarming figure because we know very well that within 6 months the number of patients with TB has not decreased, they simply stopped being detected. In addition, COVID‑19 may accelerate the activation of latent TB infection and thus increase the number of active cases. CONCLUSIONS. The overall incidence of TB in 2021 will increase to the level that was last observed between 2013 and 2016. The epidemiological indicators of TB control are expected to deteriorate for at least 5-8 years due to the COVID‑19 pandemic. Long-term results can be strongly affected by the rate of short-term recovery. Priority should be given to all governments, during a pandemic, to ensure the continuity of basic health care, including the implementation of national TB programs.

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Objective — to find the mainCOVID-19-associated psychiatric disorders and mechanisms of their development basing on the literature analysis. Materials and methods. 112 literature sources from the PubMed database for the queries «Covid AND mental health», «Covid AND mental disorders» were analyzed and 36 of them were selected for detailed study. Results and discussion. It were found that patients with COVID-19 often have multiple neurological and mental disorders, such as agitation (69 %), signs of damage to the corticospinal tract (67 %), confusion (65 %) and neuropsychological disorders (33 %). Among the mental disorders that are observed after a coronavirus disease, the most common are insomnia (42 %), decreased concentration and attention (38 %), anxiety (36 %), memory disorders (34 %), depression (33 %), confusion (28 %) and other disorders of consciousness (21 %). The most vulnerable contingents of the population are children, adolescents and the elderly, who suffer not only from the disease itself, but also from the consequences of isolation. Special attention should be paid to healthcare professionals, who often have anxiety (12—20 %), depression (15—25 %), insomnia (8 %) and post-traumatic stress disorder (35—49 %). Conclusions. The COVID-19 pandemic has already profoundly strongly influenced the mental health of the population. This was especially reflected in such groups of the population as patients with psychiatric pathology, medical workers, the elderly and people in difficult financial situations. Given the potential for new waves of COVID-19 disease and increased quarantine restrictions, as well as the possibility of new epidemics in the future, it is important to make clear guidelines that will help mitigate the impact of the pandemic crisis and restrictive measures and prevent massive mental health deterioration.

І нфекції дихальних шляхів залишаються основ ною причиною захворюваності та смертності від інфекційних захворювань у всьому світі. До кінця грудня 2019 р. лише три патогени фігурували в списку пріоритетних проектів ВООЗ для досліджень та розробок: коронавірус тяжкого гострого респіраторного синдрому (SARS) (SARS-CoV), коронавірус респіраторного синдрому Близького Сходу (MERS) (MERS-CoV) та мікобактерії туберкульозу [13].У січні 2020 р. SARS-CoV-2, який є причиною COVID-19, було додано до списку пріоритетів. З тих пір SARS-CoV-2, що поширився за межі Китаю на всі континенти, спричинює не тільки смерть та економічні кризи, а й викликає значне занепокоєння серед національних, регіональних та міжнародних спільнот [12].Мета проведеного нами комплексного аналізу -оцінити перспективи щодо наслідків взаємозв'язку COVID-19 з туберкульозом (ТБ), який, як і раніше, посідає перше місце серед причин смерті від однієї інфекційної хвороби у світі, та знизити ризики поширення туберкульозної інфекції в умовах пандемії, не втративши показників ефективності лікування.

The implementation of the latest medical reforms requires the synchronization of the system of training and education of medical education with the reform processes in the health care system. Objective — analysis of promising areas of development and improvement of higher medical education in Ukraine and possible ways to implement them in the framework of reforms of practical health care and medical education. Materials and methods. The principles of the strategy «Development of medical education in Ukraine» and the data of available domestic and foreign publications that contain information on possible ways to improve higher medical education were analyzed. Results and discussion. According to the Strategy for the Development of Medical Education in Ukraine, patients are the main value of the medical system, so they should receive high quality services, which can be achieved only with the perfect development of practical skills by future physicians. One of the mechanisms for achieving professional technique of practical skills may be the usage of simulation learning technologies, as it was introduced at the Bukovina State Medical University, along with increasing the number of practical hours for clinical disciplines.To achieve high professionalism and ethics of future physicians, teachers must teach medical students to master the skills of quality search for the most relevant information and ways to improve their professional skills, to form a base of ethical principles of the doctor.With the rapid development of innovative technologies and evidence­based medicine, teachers need to constantly monitor, process and communicate to students only the latest information, in turn, every future doctor should be as interested as possible not only domestic but also global innovations in medicine.Due to the current requirements for the medical labor market, it is reasonable to select only highly motivated students for higher education, who will meet the latest requirements for certification of students and form a strong market for competitive medical knowledge and skills.Conclusions. The process of reforming the medical sector in Ukraine requires a change in many approaches to the organization of the educational process and the quality of medical education. This is a complex process, the implementation of which is possible only with the joint participation of state mechanisms for financing, organizing and controlling the educational process, as well as the direct participation and hard work of educational institutions that train medical professionals.

Background. A statistical analysis published in the WHO report for 2019 showed that almost 10.0 million people (about 9.0-11.1 million) fell ill with tuberculosis (TB) worldwide in 2018. The purpose of a systematic examination and analysis of the WHO report is to summarize the achievements and study of complex issues in overcoming tuberculosis in the world at the present stage, that need more attention, more scrutiny, or a change in approach to addressing specific challenges towards achieving the strategic global goals for eradicating this infection. Materials and methods. We used test access to such full – text and abstract databases: a single package of the information database EBSCO; the largest abstract and citation database of peer-reviewed literature Scopus; Google Scholar; MEDLINE with Full Text; MEDLINE Complete; Dyna Med Plus; EBSCO eBooks Clinical Collection; Web of Science Core Collection WoS (CC); SCIE (Science Citation Index Expanded); SSCI (Social Science Citation Index); AHCI (Artand Humanities Citation Index). Results and discussion. By geography, most TB cases in 2018 were reported in the WHO regions: Southeast Asia – 44 %, African – 24 % and Western Pacific – 18 %. Lower percentages were recorded in the Eastern Mediterranean (8 %), America (3 %) and Europe (3 %). Eight countries account for two – thirds of the world’s total TB cases: India (27 %), China (9 %), Indonesia (8 %), Philippines (6 %), Pakistan (6 %), Nigeria (4 %), Bangladesh (4 %) and South Africa (3 %). These and 22 other countries on the WHO list of 30 high tuberculosis countries account for 87 % of TB worldwide. Multidrugresistant tuberculosis (MDRTB) continues to be a public health threat worldwide. In 2018, about half a million new cases of rifampicin-resistant tuberculosis were reported (of which 78 % had multidrug-resistant tuberculosis). The three countries with the largest share of the global MRTB burden are India (27 %), China (14%) and the Russian Federation (9 %). Globally, 3.4 % of new cases of tuberculosis and 18% of previously treated cases are tuberculosis with extensively resistance or rifampicin-resistant (MDR/RR-TB), with the highest rates of detection (>50 % in previously detected cases) in the countries of the former Soviet Union. Conclusion. The epidemic situation in TB in the world and Ukraine remains complex and at this stage has certain peculiarities, and the prognosis for its overcoming shortly is rather doubtful. There is a tendency to reduce the incidence of tuberculosis, but several complex and controversial issues have been outlined for the eradication of this infectious disease by WHO’s End TB strategy.

L'étude des types de la mort cellulaire et les stades de l'apoptose des leucocytes chez les patients atteints de la tuberculose pulmonaire aux différents programmes de traitement antimycobactérien L'objectif. D'évaluer l'état des membranes cytoplasmiques des leucocytes et étudier leur viabilité, déterminer les variétés et les stades de la mort cellulaire des leucocytes chez des patients avec tuberculose pulmonaire traités par différents schémas de traitement antimycobactérien. Matériaux et méthodes. L'étude a été réalisée sur 30 patients atteints de tuberculose pulmonaire: 1er groupe-12 patients traités par un schéma thérapeutique standard avec des médicaments en ligne; 2-ème groupe-patients traités individuellement avec les médicaments de la gamme I et II. Le groupe témoin comprenait 12 donneurs en bonne santé. L'étude a été réalisée par la cytométrie en flux sur un cytomètre en