Background. Thanks to vaccinations, many infections, including whooping cough, diphtheria, tetanus, poliomyelitis, measles, mumps, rubella, hepatitis B, hemophilic infection, pneumococcal infection, meningococcal infection, rotavirus infection, chicken pox, hepatitis A, papillomavirus infection, etc., can be prevented. According to the WHO research, it was established that if the level of vaccination coverage of the country's population drops by several percents, it creates favorable conditions for the spread of infectious diseases, that the lower the collective immunity, the higher the probability of outbreaks and epidemics. The Aim. Тo study and analyze the impact of risk factors on reducing the level of vaccine prophylaxis in the childhood population. Materials and Methods. This study was conducted using the questionnaire method, for which a questionnaire was developed. Group 1 consisted of 280 children who received a vaccination and group 2 consisted of 180 children who were not vaccinated. The parents of these children were interviewed using the author's questionnaire and gave their consent to use the medical data of the children for scientific research. Non-parametric statistical analysis for two independent sample populations was used to compare median values Mann-Whitney test. Fisher's test was used to compare proportions. Results. During the study, it was found that the most frequent reasons for parents' refusal to vaccinate their children were: religious views of family members 2.4 times increase the risk of non-vaccination in children; in single-parent families where the parents are divorced, children did not receive any vaccination 2.6 times more than in full-parent families; unfinished average of 35.7 times and lack of education 24.1 times increase the impact on the lack of vaccination in children. Conclusions. We identified the following risk factors that influence the vaccination rate, namely: demographic, socio-economic, biological and socio-psychological. Keywords: vaccine prevention, statistics, infectious diseases, risk factors.

Background. According to the WHO, about 830 women die every day worldwide from preventable causes related to pregnancy and childbirth. In the recent years, Kharkiv region remains one of the problematic regions of adverse pregnancy outcomes according to the integrated assessment of the Ministry of Health of Ukraine. Against the backdrop of an unfavorable demographic situation, the problem of researching various aspects of the pregnancy period is becoming more and more urgent. Most of the complications that occur during pregnancy are considered from the side of general medical approaches, including hormonal disorders, infectious complications, immunological disorders, etc. The aim of the work was to study and assess the influence of risk factors on pregnancy complications. Materials and Methods. For the study, the pregnant women were distributed into two groups: the Main Group (MG) included 299 pregnant women who had complications during pregnancy, and the Control Group (CG) – 199 pregnant women with a normal pregnancy. The median (minimum; maximum) age was in MG was 32 (21; 44) years, in CG – 31 (24; 45) years (p>0.05). The median values of the pregnancy period during the survey were 28 weeks for the MG and 26 weeks for the CG (p>0.05). Results and Conclusions. It was determined that biological, socio-economic and socio-psychological lifestyle factors have the greatest influence. The presence of diseases of the cardiovascular system (including hypertension) and diseases of the genitourinary system in a pregnant woman increased the risk of complications during pregnancy by 31.4 times in MG; and by 23.3 times – in CG. The presence of stress in everyday life and, as a result, the deterioration of the psychological state of the pregnant woman increased the chances of pathology of the course by 42.6 and 40.7 times, respectively. Low financial status of the family increased the risk by 16.5 times. Keywords: pathology of pregnancy, preventable deaths of pregnant women, stress.

Background. The modern understanding of health is related to the need to prevent diseases caused by infections, lifestyle, environmental and genetic factors. Ukrainian legislation guarantees health care, but the practice of implementing laws is imperfect. The teaching of valeological disciplines in educational institutions is of great importance for the prevention of diseases. But the content of these disciplines requires constant revision from the point of view of evidence-based medicine, and the creation of new preventive programs requires theoretical justification. Aim. To determine the content and practical significance of the modern understanding of health care in public health care and education. Materials and Methods. Methods of bibliosemantic and system analysis were used. Results. The theory of health and health-saving is considered using cross-cultural, discursive, norm-centric, phenomenological, holistic, axiological and integral approaches, from the perspective of evidence-based and "4P" medicine. Health-saving is shown as derived from a healthy lifestyle and valeological competence formed in the population. The best environment for the formation of a healthy lifestyle is shown to be an educational environment, the tools of formation are valeological disciplines and education of medical and social non-government organizations. The need for joint efforts of the population and medical workers to achieve better results in the prevention of socially significant diseases is determined. Conclusions. Improvement of the preventive direction of valeological education is closely related to the competence approach, in particular, with the formation of valeological competence. The public health system should use the potential of educational valeological programs to form a healthy lifestyle in new generations during their studies at higher education institutions. For the formation of high-quality valeological programs, a permanent partnership of educators and medical professionals is necessary. Keywords: valeological competence, evidence-based medicine, 4P medicine, Health Pedagogy.

Introduction. The impact of circulating amino acid levels and their combinations on the pathogenesis of ischemic heart disease and atrial fibrillation is a current issue, otherwise, the platelets amino acid spectrum is still under discussion, despite the known pathogenetic role of platelets in these disorders. Aim. To compare changes in the plasma and platelets amino acid spectrum in patients with coronary artery disease and atrial fibrillation as well as to find their connections. Materials & Methods. 300 patients were divided into 3 groups: I group – 149 patients with coronary artery disease without arrhythmias, II group – 124 patients with coronary artery disease and atrial fibrillation paroxysm, and the control group – 27 patients without coronary artery disease and arrhythmias. Plasma and platelet amino acid levels were detected by means of ion exchange liquid column chromatography. Results & Conclusions. In platelets amino acid spectrum, a significant rise in leucine (12.63%), isoleucine (10.73%), and Fishers’ ratio (6.37%); a decrease in threonine (23.05%), valine (30.83%) levels, glycine (32.21%), serine (5.06%), and glycine+serine sum (20.51%) in group 2 patients was found compared with group 1, p<0.05. In the plasma amino acids spectrum, a significant increase in glutamate, branched-chain amino acids, and Fishers’ ratio and a decrease in glycine in group 2 patients was checked in comparison with group 1, p<0.05. Only 10 moderate strength correlations were revealed between the plasma and platelets amino acid spectrum of investigated patient’s groups. These changes in platelets and plasma amino acids spectrum were not significantly congruent in patients with coronary artery disease and atrial fibrillation. Plasma and platelets amino acid spectrum should be analyzed separately in patients with coronary artery disease and atrial fibrillation for further studies and evaluation of new prognostic markers and pathogenetic clues to their development. Keywords: myocardial ischemia, heart rhythm violations, proteins, metabolomics.

Today, Great Britain has one of the best hospice care systems for palliative patients in the world, which leads to interest in the path of building a Hospice and Palliative Care (НPC) system in this country. The hospice care system is mainly financed by the volunteer sector, which indicates a significant development of the state-society partnership in the organization of НPC. The national НPC system consists of inpatient care, day palliative care, care in the community and emergency hospitals. 2004–2008 is considered the key moment in the formation of the country's НPC system, which will be the focus of this study. For specialist palliative care, the National Health Service of Great Britain allocated almost £50 million a year in those days until 2004. At the same time, volunteer support was about 4 times greater. More than 220 volunteer support groups for palliative patients operated in the country. The success of building a national НPC system is described in the Palliative Care White Paper. A number of interrelated national programs may be used as a standard of palliative care in 20 years by many other countries. The development of the НPC system has influenced the British homes for the elderly, the system of primary care, the attitude to the НPC problem of doctors, local communities and society as a whole, increased the quality and availability of palliative care. Palliative care since those years has been provided 24/7, managed by coordination centers located outside medical facilities and hospices. High national НPC standards and mechanisms for monitoring their compliance have been created. Narcotic analgesia for palliative patients with chronic pain, the necessary medical, psychological, social and spiritual care is mostly available. The public debates the question of a dignified death without restrictions. The value for money of НPC is recognized by British society as acceptable. Therefore, studying the British experience of НPC organization as one of the "best practices" is useful for other countries with less developed НPC systems. Keywords: "best practices", place of death, palliative care quality standards.

Background. Pathological changes in the tissues of the oculo-conjunctival region caused by the activity of the Demodex mite is represented by the development of inflammatory process. On detection of the parasite on eyelashes, the presence of the Demodex mite is diagnosed in half of adult patients seeking ophthalmic care. Pathomorphological descriptions of specific patterns associated with the presence of Demodex infection are practically absent. During pathological examination, in the vast majority of cases it is almost impossible to see the parasite in the test material. There are pathomorphological patterns associated with the presence of the mite as a commensal, not only on the eyelid surface or in the conjunctiva, but also in morphological structures formed against the background of pathological processes in this area. Aim. To find out the morphological patterns reflecting the pathomorphosis of some tumor processes in the eyelid thickness caused by demodectic invasion, which have not been identified so far in ophthalmopathological studies. Materials and Methods. We analyzed the archival material from the oculo-conjunctival region submitted to the ocular pathology laboratory within the period of 2020–2023. Surgical and biopsy specimens were processed by standard histologic methods. Results. One of the pathognomonic patterns of demodecosis are calcifications with fragments of the dead mite and cysts. When a mite rapidly destroys tissue, it leaves the site until it dies without retaining its fragments. Post-demodecosis pathomorphosis in basal cell carcinoma of the eyelids complicates the pathomorphologic diagnosis of the biopsy. Conclusions. Our results prove the presence of mites in tumor tissues and illustrate their influence on the development of the pathomorphological picture, which should be taken into account in the practical activity of a pathologist. Keywords: demodex mite, pathomorphology, ophthalmopathological examination, oculo-conjunctival region.

Background. White-coat hypertension is a controversial issue of a modern cardiovascular medicine. It is a common condition in clinical practice, in which office blood pressure is elevated while out-of-office measurements (ambulatory or home) are normal. The aim of this review is to address a number of issues related to white-coat hypertension, in particular, its definition, prevalence, etiology, symptoms, and consequences, emphasizing the need to improve diagnosis, management and prognosis of this disease. Results. Recent studies demonstrate that white-coat hypertension is associated with cardiovascular risk factors, including the progression to sustained hypertension and the development of target organ damage. Timely and accurate diagnosis of white-coat hypertension is incredibly important as it allows postponing its conversion to sustained hypertension and prevents alterations of target organ structure and function. The need for improved patient-doctor interaction to enhance diagnosis and management of white-coat hypertension cannot be overstated. Other measures include exploring standardized measurements, improving communication and relationship establishing between physicians and patients, as well as investigating innovative interventions such as health education and telemedicine. The importance of the understanding of the emotional components contributing to white-coat hypertension are highlighted and strategies to improve patient outcomes through early diagnosis, reduced anxiety, and optimal healthcare experiences are proposed. Conclusion. A comprehensive approach, encompassing standardized measurements, improved communication, and innovative interventions, is essential for effectively managing white coat hypertension. Keywords: blood pressure, cardiovascular risk, communication, healthcare, anxiety.

Background. The role of immunological disorders in the pathogenesis of uveitis has been proven by numerous studies. However, there are different views on the timing and methods of immunocorrection. In our opinion, this issue should be solved on the basis of determining the mechanisms of the formation of immunodeficiency states in uveitis. The purpose of this work was to develop a classification of secondary immunodeficiency states in uveitis according to the mechanism of formation. Materials and Methods. The paper presents the results of the examination of 370 patients with uveitis (416 eyes; 179 were men, 191 were women, aged from 16 to 87 years; the duration of the disease ranged from 1 month to 32 years) who were treated in Kharkiv Regional Clinical Hospital, were under dispensary supervision at Kharkiv Regional Anti-Tuberculosis Dispensary and Kharkiv Regional Dispensary for Radiation Protection of the Population, or were examined, consulted and treated on an outpatient basis. The observation period was up to five years. Results. Based on the study of immunological changes in patients with uveitis, the dynamics of immunological disorders in relapses of the inflammatory process in the uveal tract, clinical and immunological features of various forms of uveitis, and the results of correction of immunological disorders in patients with uveitis, a classification of secondary immunodeficiency states in uveitis according to the mechanism of their formation was proposed. On its basis, the principles of correction of immunodeficiency states in patients with uveitis were developed. Keywords: infectious uveitis, noninfectious uveitis, cellular immunity, humoral immunity, correction principles, immunological disorders.

Background. The methodical article covers to problematic issues of higher education in general, and medical education in particular, as well as specialized teaching of biological and bioorganic chemistry in medical institutions of higher education, for students studying in the specialty "Pediatrics" and the importance of mastering the relevant skills and abilities taking into account the chosen specialization in the field of medicine. The aim of the study was to analyze, systematize and develop general approaches to the further improvement of specialized educational materials in biological and bioorganic chemistry for level 2 (master’s degree) students majoring in specialty 228 "Pediatrics". Materials and Methods. General scientific research methods, namely analysis and synthesis were used. Scientific literature, educational programs and normative documents of higher medical education were investigated. Bibliosemantic method and system analysis method were used. Results. The issues of professional competence formation of future doctors studying under the educational and professional program (EPP) "Pediatrics" were considered, taking into account the age characteristics of metabolic processes and regulation of biochemical processes. The problems and relevance of the level of formation of the professional competence of teachers of medical institutions of higher education and its development in our time, taking into account the socio-economic and political situation and the ongoing russian aggression, were discussed. The effectiveness of the profiling process largely depends on the creation of optimal methods of learning, which include the preparation of profiled EPPs, work programs of educational disciplines and syllabuses created on their basis. Owing to the study of issues of age-related biochemistry, peculiarities of biochemical processes in childhood, students’ motivation to learn the educational material increases and a stable interest in the chosen profession is formed. Conclusions. One of the tasks for the integration of the higher school into the European educational space is to increase the level of competence of pediatricians studying by EPP "Pediatrics" from the point of view of the teaching staff’s mastery of innovative teaching methods and readiness for their implementation in the pedagogical process due to profiling of various sciences for their more thorough study. Keywords: specialized teaching, age biochemistry, pediatrics, quality of medical education.

Background. Chronic diabetic foot ulcers and wounds are significant complications associated with diabetes, comprising approximately 85% of purulent-necrotic lesions affecting the lower extremities. The development of these wounds is influenced by pathogenetic factors such as hyperglycemia, neuropathy, and existing infections, which contribute to metabolic disturbances, including tissue hypoxia and the activation of proteolytic enzymes known as matrix metalloproteinases (MMPs). Aim. To explore the therapeutic potential of autologous plasminogen in facilitating the healing process of diabetic wounds through the modulation of MMP activity. Materials and Methods. The study enrolled 45 patients diagnosed with chronic diabetic wounds, who were assigned to two distinct groups. The control group (n=25) received conventional treatment approaches, while the intervention group consisted of 20 patients treated with autologous plasminogen applications. Results. After 18 days of treatment, a substantial reduction of 3.5-fold in MMP-2 and MMP-9 activity was observed within the intervention group, accompanied by complete wound closure in 16 patients. Additionally, four patients underwent autodermoplasty, successfully achieving wound defect closure through effective graft integration. In contrast, the control group exhibited consistently elevated MMP activity levels throughout the entire observation period. Conclusions. The activity of matrix metalloproteinases (MMPs) in chronic diabetic wounds reaches dramatic levels, making spontaneous wound healing impossible. The application of autologous Pg allows modulation of this activity and creates favorable conditions for wound healing by reducing excessive MMP activity, improving blood supply, and resolving inflammatory processes. Keywords: chronic wounds, diabetes mellitus, matrix metalloproteinases, plasminogen, autodermoplasty.