According to the WHO, the prevalence of vitamin D deficiency has reached the level of a global pandemic. Despite the fact that deficiency and insufficiency of vitamin D are noted in various population groups all over the world, there are quite limited data on the status of 25(OH)D blood serum among residents of the Southern regions of Ukraine, who live in conditions of sufficient insolation. The purpose of the study was to analyze the prevalence of vitamin D deficiency in residents of Southern Ukraine, depending on the season. In the course of the study, 928 residents of the Southern region of Ukraine aged from 19 to 82 were examined. The study took place during a calendar year, which made it possible to evaluate the fluctuations of the 25(OH)D level in different months with different duration of insolation. The prevalence of deficiency, insufficiency and sufficient level of vitamin D in the study group was 33.6%, 33% and 33.4%, respectively. Fluctuations in 25(OH)D levels depending on the season of the year are described. The results obtained in the course of the study contradict a previous study conducted in Ukraine, which recorded a higher prevalence of vitamin D deficiency states, but confirms the majority of regional European studies that reflect the status of 25(OH)D in blood serum. Key words: vitamin D deficiency, vitamin D insufficiency, prevention, risk factors, population of Ukraine.

The search for new and safe drugs has led to a purposeful synthesis of coordination compounds of metals with bioligands based on metals - hermacite (magnesium bis (citrate) germanate), gercocyte (magnesium bis (citrate) germanate). The aim of the study was to investigate the morphological changes in the liver of rats after administration of (Mg, Co) bis (citrate) germanates in subacute and subchronic experiment. Materials and methods of research. The experiment was performed on mature male Wistar rats weighing 180-250 g, which for 28 days and 3 months intraperitoneally administered (Mg, Co) bis (citrate) germanates at doses of 1/40, 1/110 and 1/135 LD50 and studied morphological changes in the liver. Research results and their discussion. The course of administration of compounds at doses of 1/40 LD50 for 28 days was accompanied by dyscirculatory changes in the liver, as well as moderately pronounced dystrophic changes in hepatocytes. In general, more pronounced changes in the tissues of rats were observed under the influence of hercocytes (foci of destruction of liver tissue). The course of administration of doses of 1/40 LD50 for 3 months was marked by more pronounced dystrophic changes in the liver. Subchronic course administration of compounds at doses of 1/110 LD50 was accompanied by minor morphological changes. When comparing morphological changes in rat tissues, cobalt-containing compound had a slightly more pronounced effect. It is noteworthy that toxic effects did not accompany the course of administration of BAS with doses of 1/135 LD50 and liver tissue did not differ from the control group. Key words: (Mg, Co) bis (citrate) germanates, subacute toxicity, morphological changes.

Modern directions of scientific research and practical implementation in this area of dentistry, despite certain successes, have not made it possible to achieve complete control over dental caries, and the disease still remains the most common on the globe. The review presents the analysis of studies devoted to the multifactorial interaction that leads to the development of dental caries and the effectiveness of the comprehensive approach to dental prevention among children. The results of numerous experimental and clinical studies are presented, which confirm the importance of oral fluid in the formation of tooth enamel resistance, the role of which is to normalize enamel permeability, activate mineralization processes, and form tooth enamel resistance to the action of cariogenic factors. The data that formed the basis of local preventive methods and treatment of dental caries are described. Current approaches to the treatment of dental caries should aim to manage caries risk and identify carious lesions as early as possible to avoid invasive treatment, but use the least invasive methods when indicated. Special attention is paid to the experimental and clinical studies analysis devoted to non-invasive and micro-invasive methods of initial dental caries treatment in children. The caries-infiltration method in the treatment of initial dental caries, which demonstrates its effectiveness relative to some types of remineralization therapy, is analyzed in detail. The experience of using new drugs for non-invasive and micro-invasive treatment of dental caries, which showed good results, is given by the number of authors. A systematic review of sources on the treatment of initial dental caries showed that the use of non-invasive and minimally invasive approaches to stop the progression of initial caries is encouraging and promising. However, to confirm the effectiveness of non-invasive and minimally invasive methods for the treatment of initial caries in temporary and permanent teeth, high-quality, long-term clinical studies are needed, preferably in general dental practice. Key words: initial dental caries, remineralizing therapy, carious infiltration, micro-invasive treatment methods.

The exact reason for the occurrence of Crohn’s disease remains unknown. It is believed that pathology can be carried out by infectious and viral pathogens, deviations from the norm of natural balance of the microflora of the gastrointestinal tract (hereinafter – the gastrointestinal tract). Many researchers indicate an abnormal autoimmune response of the body on food stimuli – in favor of such an assertion indicates the systematic impression of the internal organs. However, for the emergence and development of this disease, there are significant impacts with harmful habits, such as: smoking, alcoholic beverages and medicines, unbalanced nutrition and the presence of chronic inflammatory gastroids. The inflammatory process begins in the mucous membrane, gradually affects all layers of the wall of the gastrointestinal wall, leads to its destruction and fibrosis and the formation of fistish and stenoses. Therefore, early diagnosis and timely treatment prevents the development of complications, including such severe such as bleeding, perforation of the intestinal wall, intra-abdominal abscesses, internal and external fists, adhesions of the intestine with the development of obstruction. Purpose: on the basis of a specific case of HC to investigate and analyze the features of diagnosis and treatment of these patients using an analytical method and a systematic approach. Materials and methods: The material was a clinical case of HC, methods of instrumental diagnosis and objective analysis. The results: The concrete case of HC is investigated, features of inspection and diagnostics are defined. Conclusions: A feature of the diagnosis and treatment of patients with HC is a constant vigilance about the occurrence of complications, the key to the prevention of which is a multidisciplinary approach in the tactics of diagnosis and treatment of these patients. Key words: Crohn’s disease, features of examination and diagnosis.

The etiological factors of erythema of the face in rosacea are analyzed in the article. The role of vasoactive peptides, inflammatory mediators and ticks of the genus Demodex in the pathogenesis of the disease has been determined. The main methods of treatment of the disease are considered, including phototherapy with narrowband pulsed radiation and platelet autologous plasma (TAP). Current data indicate the acceleration of natural mechanisms of skin regeneration due to the presence of platelet-derived growth factors and modulation of endothelial reparative function, so the introduction of platelet autologous plasma is a promising method of treating patients with this dermatosis. Key words: rosacea, platelet autologous plasma, facial erythema, platelet growth factors.

Aim. Identify changes in the optic disc and vascular membrane by OCT, as well as features of hemodynamics and the possibility of communication between these parameters. Materials and methods. In 150 patients with idiopathic monolateral anterior uveitis, ophthalmic (visometry, refractometry, tonometry, perimetry, biomicroscopy, direct, reverse ophthalmoscopy), examination, rheophthalmography (ROG) and optical coherence tomography (OCT) of structures were performed. Patients received treatment according to the protocol, including, if necessary, antibacterial, antiviral, steroidal and nonsteroidal anti-inflammatory, immunosuppressive, desensitizing, vasodilating, immunomodulatory drugs. Statistical analysis was performed using Statistica 10.0 using Student's coefficient, pairwise correlation and Spearman's rank correlation Research results. The OCT results of the eyes of patients with optic neuritis on the background of anterior uveitis showed a significant increase in the thickness of the layer of peripapillary nerve fibers and vascular membrane by 34.3 and 38.9% relative to the data in anterior uveitis without complications. ROG revealed a significant increase in the tone of small and large vessels of the eye in neuritis on the background of anterior uveitis by 14.2 and 17.2% compared to those without neuritis. There was a direct significant strong relationship between the thickness of peripapillary fibers and the thickness of the vascular membrane with volumetric pulse blood filling, the volume of volumetric blood filling, tonic properties of large and small vessels (r = 0,699-0,909); average - between the diameter of the optic nerve at the entrance to the orbit and the parameters of the ROG (r = 0,647-0,797); weak - determined in the retrobulbar and middle department (r = 0.241-0.453). The development of neuritis in uveitis is accompanied by an increase in the thickness of the peripapillary fibers and vascular membrane, the diameter of the optic nerve at the entrance to the orbit, in the retrobulbar and middle department, as well as volumetric pulse blood filling, volumetric connection in all cases (Spearman r 0.421-0.754). Conclusions 1. The results of OCT of the eyes with optic neuritis on the background of anterior uveitis showed a significant increase in the thickness of the layer of peripapillary nerve fibers and vascular membrane relative to the data in persons with anterior uveitis without complications. 2. The horn of the tonic properties of the vessels revealed a significant increase in the tone of small and large vessels of the eye with optic neuritis on the background of anterior uveitis relative to those without neuritis. 3. The direct strong reliable correlation of indicators of thickness of peripheral fibers and a vascular cover with volume pulse blood filling, speed of volume blood filling, tonic properties of large and small vessels is revealed. Average connection - between the diameter of the optic nerve at the entrance to the orbit and the parameters of the ROG, weak connection with the diameter of the optic nerve in the retrobulbar and middle department. 4. The development of optic neuritis against the background of anterior uveitis is accompanied by an increase in the thickness of the peripheral fibers and choroid, the diameter of the optic nerve at the entrance to the orbit, in the retrobulbar and middle section. The tonic properties of large and small vessels, volumetric pulse blood filling, and the speed of volumetric blood filling, as indicated by the presence of a significant direct correlation. Key words: chronic anterior idiopathic uveitis, optic neuritis, OCT, eye hemodynamics.

Diseases associated with bacterial vaginosis lead to chronic inflammatory processes of the internal genitals, the development of adhesions of the pelvic organs, infertility, spontaneous abortion at different times, as well as the development of malignant neoplasms. Vaginal microflora is an indicator of a woman’s health, which can form changing in hormonal and immunological status during various pathological conditions. The aim of the study was to create a system for prediction of the dysbiosis development according to the levels of nonspecific humoral factor of immune defense. Materials and methods. The study was performed in 298 women aged 16 to 64 years, 53 of whom were diagnosed with normocenosis, and 245 have dysbiosis. Women were divided into 3 groups according to age. Regression analysis was used. Research results and their discussion. Our previous research have shown a correlation between increased levels of anti-inflammatory cytokines in the blood and vaginal secretions with the stage of dysbiosis. A logistic regression model was constructed during the study, which showed that the risk of developing dysbiosis in terms of normobiota increases with increasing levels of interleukin 2 in the blood, tumor necrosis factor α. Significant features of the three-factor model for predicting the risk of developing dysbiosis (IL2, IL4 and TNFα) were selected by the method of genetic algorithm. The levels of these indicators in the blood were related to the severity of dysbiosis according to the results of discriminant analysis. Conclusions. Thus, a linear neural network model was developed for determination of dysbiosis severity according to the levels of nonspecific humoral factors of immune defense such as the C4 component of the complement system and γ-interferon in vaginal secretions, as well as the amount of circulating immune complexes and tumor necrosis factor α in the blood. Kappa Cohen’s agreement for this model on the training set was 0.87 (95% CI 0.82-0.91), and on the confirmatory set was 0.89 (95% CI 0.77-1.00). These indicators show the adequacy of the constructed model. The interface of the expert system for the dysbiosis severity prediction has been created. Key words: normobiota, bacterial vaginosis, linear neural network model for determination of the dysbiosis severity, humoral factor of immune defense.

In patients oral liquid with type 2 diabetes mellitus, who were referred for orthopedic treatment using implants, an increased content of triglycerides, cholesterol and glucose was found. Such state of oral cavity in type 2 diabetes cannot but affect the results of dental implantation. In this regard, patients of the main group were prescribed regular courses of drugs regulating carbohydrate metabolism and microbiocenosis, enhancing immunity and resistance in oral cavity, as well as antioxidant and osteotropic drugs. Biochemical studies of oral liquid showed a fairly high efficiency of proposed complex, which contributes to the normalization of impaired metabolism. Key words: dental implantation, diabetes mellitus, oral liquid, biochemical parameters.

The study involved 240 patients with skeletal polytrauma. The aim of the study was to improve the results of treatment of victims with skeletal polytrauma by substantiating methods for predicting and preventing various complications after interhospital transportation and in the intensive care unit. We found that after interhospital transportation of patients, the following complications were detected: fatty embolism (11.6%), anemic syndrome (51.7%), acute respiratory failure (20.3%), pneumonia (13.4%). The main defects at the hospital stage were: incomplete laboratory and instrumental studies (81.7%), untimely surgical osteosynthesis (49.2%), undiagnosed complications (31.2%), underestimation of the severity of the condition (30%), inadequate correction of hypovolemia, anemic syndrome, coagulopathy (51.7%, 81.7%, 63.3%, respectively), inadequate prevention of thromboembolic complications and fatty embolism (70%, 51.7%), inadequate correction of acid-base disorders and dyselectrolytemia (100%). Key words: Polytrauma, complications, intensive care, medical errors.

The recurrence rate for inguinal hernia repair is up to 15%. The purpose of the work is to determine the optimal method of surgery for recurrent inguinal hernias. From 2007 to 2011, a clinical study was conducted involving 146 patients (randomized – 82, prospective – 64) with recurrent inguinal hernias, previously operated on using different methods. Less pain syndrome and fewer complications after laparoscopic interventions were noted. In total, 68 patients were operated on laparoscopically, 78 patients were operated by open method (according to Lichtenstein). The number of recurrences after laparoscopic surgery – 3, after open – 8. Conclusion: the laparoscopic method for recurrent inguinal hernias can reduce the duration of the operation, the number of complications, reduce pain after operation and reduce the number of reccurences. Key words: inguinal hernia, TAPP, Lichtenstein's operation, recurrent inguinal hernia.