Odessa National Medical University Research Articles

Professor hygienist from Odessa Aron Iosyfovych Burshtein (1890–1965)

The study was conducted for the first time in detail to study the life and work of a prominent representative of preventive science in Ukraine, Professor Burshtein A.I., who in 1933–1941 & 1944–1962 headed the Department of Food Hygiene at the Odessa Medical Institute (now Odessa National Medical University). For this purpose, Odessa archives were examined and the search was crowned with success. The discovered documents, which are being introduced into scientific circulation for the first time, made it possible to highlight the main milestones of his biography: doctor (1918), associate professor (1930), professor (1934), doctor of medical sciences without defending a dissertation (1935), honored worker of science of the Kazakh SSR (1945). It was shown that he was a student of Professor Kostyamin M.M. In addition, searches were conducted for published works by Burshtein A.I. were conducted. The main body of his works was identified, which made it possible to determine the main directions of his scientific work – the problems of occupational hygiene and food hygiene. In addition, it was found that throughout his scientific career, he paid considerable attention to the compilation of manuals on methods of sanitary and hygienic research. In 1916 in Odessa, he published a short guide on methods of hygienic research; in 1918 he republished the book there. In 1934, in Kyiv, he published a manual on methods for studying aerosols; in 1954, he also published a manual on methods for studying dust and smoke levels in the air, which was actually the second supplemented and expanded book edition 1934 book. In 1950, in Kyiv, he published a manual on methods of sanitary and hygienic research. And finally, in 1963, in the same Kyiv publishing house, where all his previous manuals, saw the light of the day the state medical publishing house published a manual on food research methods. Keywords: hygiene, public health, 20th century, Ukraine.

Functional assessment of differentiated therapeutic approach effectiveness in ovarian cancer treatment: impact on qol and survey results

Background. Ovarian cancer presents a formidable challenge, primarily due to the high prevalence of resistance to platinum drugs, which hampers treatment success. Despite notable strides in chemotherapy regimens, over 40% of patients remain unresponsive to initial treatment. Delving into the underexplored realm of functional assessment regarding treatmentʼs impact on patientsʼ quality of life emerges as pivotal for refining therapeutic outcomes and enhancing their well-being. The absence of standardized evaluation methods and limited data underscore the imperative for further investigation into understanding how different treatment modalities influence patientsʼ quality of life. Leveraging questionnaires such as the EORTC QLQ-C30 and FACT-G proves invaluable in gauging this aspect of healthcare. Integrating the findings of quality of life assessments into clinical practice promises to catalyze the development of optimal therapeutic strategies tailored to enhance the well-being of ovarian cancer patients. Purpose – is to investigate how a tailored therapeutic approach influences the quality of life among patients grappling with platinum-resistant ovarian cancer. Our focus extends to considering the degree of pharmacoresistance alongside the utilization of varied chemotherapy strategies. Materials and methods. The study was conducted at the University Clinic of the Odessa National Medical University spanning from 2014 to 2024. A cohort of 350 patients diagnosed with stage III-IV ovarian adenocarcinoma, who had undergone cytoreductive surgeries, formed the basis of our research. This investigation adhered to the clinical protocol approved by the Ministry of Health of Ukraine. The methodology of our differentiated treatment strategy involved predicting patientsʼ responses to platinum-based therapy, classifying them as platinum-refractory, resistant, or sensitive. Subsequently, patients were categorized into four clinical groups based on the treatment regimens employed. To assess the quality of life, we utilized hierarchical clustering methodology along with the EORTC QLQ-C30 and FACT-G questionnaires. Evaluations were conducted at 6 and 12 months post-treatment completion. Results and discussion. Patiens of different groups had different symptoms and side effects: those who received standard chemotherapy had leukopenia and other side effects; those who received doxorubicin complained of nausea and stomatitis. Patients with comprehensive metabolic support had a smaller number of subjective complaints. During the catamnestic follow-up, we detected changes in parameters of quality of life, which may be associated with treatment of ovarian cancer. The differentiated treatment approach led to improvement of quality of life, decrease in side effects, and better well-being of the patients. These changes remained stable for a long period of time after cessation of active treatment, thus encouraging the use of a similar approach in the future. The results confirm the importance of an individualized treatment with metabolic support for achieving better clinical results and improving quality of life of patients with ovarian cancer. Conclusions. Our study underscores the effectiveness of a differentiated therapeutic approach in managing ovarian cancer, considering both pharmacoresistance levels and diverse chemotherapy strategies, thereby enhancing patientsʼ quality of life. Notably, cytoreductive surgeries and varied chemotherapy regimens yielded distinct side effects and symptoms among patients, contingent upon the treatment modalities applied. Encouragingly, post-active treatment phases witnessed a consistent amelioration in patientsʼ quality of life, underscoring the pivotal role of individualized approaches complemented by metabolic support in fostering superior clinical outcomes.

THE FORMATION OF MEDICAL STUDENTS’ RESEARCH SKILLS IN TEACHING PROFESSIONAL ENGLISH

The mastery of research methods, the ability to understand effectively English medical terminology, to quickly process and analyze new information, use it productively for optimal treatment of patients provide increased competitiveness of family physicians. The article focuses on the diagnostics of the future family doctors’ research skills using testing methods and expert assessment of the level (high, medium, low). Among the main research skills of medical students, we have identified such as formation of purpose, hypothesis, choice of effective methods; analysis of sources, systematization of scientific information; organization of the experiment; conversations with scientists; argumentation; generalization of the results; presenting the new research results; analysis of positive and negative experience; characteristics of the individual difficulties in organizing the experiment. The assessment followed by the formation of these skills was organized on the basis of Cherkasy Medical Academy and Odessa National Medical University. In addition, a system of tasks for the formation of students’ research skills in teaching professional medical terminology in English is presented. The future family physicians were involved in different kinds learning activities that were aimed at expanding their knowledge of medical terminology and mastering research skills in the educational component “English for Professional Purposes”, and involved working in the student research laboratory and student science club.

CONCEPTUALISM OF THE ORGANIZATION OF EDUCATIONAL AND METHODICAL ACTIVITY AS A KEY MODEL FOR ENSURING THE QUALITY OF EDUCATION

The main purpose of the paper is to analyze the process of the organization of educational and methodical activity of educational institutions as a key model for ensuring the quality of education. Methodology. This study combines the analysis of organizational and methodical activity in different Ukrainian educational institutions and the analysis of their organizational tools. The method of qualimetric scales for measuring organizational and methodical activity proposed in this study can be used in organizing quality control of methodical support and support of educational programs at various levels. The background for this analysis is the data of Odessa National Medical University, Kyiv National Economic University named after Vadym Hetman, Yuriy Fedkovych Chernivtsi National University. Findings. In the article the problem of assessment of quality of education in general was considered. The authors have analyzed the problem of assessment of quality of educational and methodical support. In the paper the basic principles of formation of educational and methodical complex and defined levels of assimilation of educational material were revealed. The authors have considered the criteria of assessment of quality of educational and methodical complex. The frequency of their use is determined. On the basis of the frequency of use the criteria for evaluation of the pedagogical and methodical complex in educational institutions are identified and described. Practical implications. The results of the research are a methodological and practical basis for improvement of the organizational mechanism of educational and methodical activity of educational institutions. The results of the conducted research could be a framework for formation of effective educational system in Ukraine, providing constant development of the system of ensuring the quality of education. The main proposals could be used by the Ministry of Education and Science of Ukraine, also they should be taken into consideration by educational institutions.

VESTIBULAR DYSFUNCTIONS IN CHRONIC BRAIN ISCHEMIA IN THE POST COVID PERIOD.

The aim: The aim of the study is the clinical-pathogenetic reasoning of vestibular dysfunctions (VD) development against the background of chronic brain ischemia in the presence of degenerative changes in the cervical spine (CS) in the post COVID period. Materials and methods: 82 patients, in the conditions of the clinical base of the Odessa National Medical University in 2019-2021 were examined. Group I with VD against the background of chronic brain ischemia (CBI) at the compensated phase; Group II with VD against the background of CBI at the subcom¬pensated phase (33 men; 49 women), aged from 18 to 55 years. The control group (CG) consisted of 20 patients of the corresponding gender and age. The condition of the state of the autonomic nervous system, vestibular functions, cervical spine, cerebral arteries and emotional condition were examined. Results: Vestibulo-ataxic disorders were higher compared to CG and increased along with the degree of brain damage. An important aspect of the development of VD is autonomic dysfunction against the background of pathological autonomic characteristics with predominant parasympathetic orientation of autonomic tone, especially in the case of insufficiency of autonomic recativity (AR) and pathological autonomic support of activity. Such changes significantly increased in the presence of subcompensation of CBI. The correlation between psychoemotional disorders and changes in autonomic characteristics with VD against the background of CBI with initial regularities depending on the degree of brain damage was defined. The progression of CBI is facilitated by coronavirus infection and manifested in autonomic and psychoemotional dysfunctions. A characteristic hemodynamic feature in groups with compensated and subcompensated CBI is the presence of reduced perfusion in basilar (BA) and vertebral (VA) arteries. Changes in cerebral vascular reactivity with a decrease in cerebrovascular reactivity indicators were characteristic of the subcompensated phase of CBI. Hyperactivity to rotational functional loads in both clinical groups has a high correlation with the presence of stair descent and, to a lesser extent, isolated instability in CS. Conclusions: 1. The occurrence of VD is facilitated by the presence of autonomic dysfunction and degenerative-dystrophic changes in the CS, especially in case of subcompensation of CBI. 2. Psychoemotional changes were a characteristic feature of patients with VD against the background of CBI and had certain regularities depending on the phase of CBI. 3. Suffered coronavirus infection contributes to the progression of VD and further decompensation of CBI due to direct damage to the autonomic and vascular systems of the brain. 4. Changes in cerebral hemodynamics in the form of reduced perfusion in BA and VA, a decrease in cerebrovascular reactivity, and an increase in reactivity to rotational functional load were determined in patients with VD against the background of subcompensated CBI.

EXPERIENCE OF PRIMARY HPV TESTING IN CERVICAL CANCER SCREENING

REVIEWS EDITIONS SUBSCRIPTION EDITORIAL POLICY CONTACTS N 1–2 (179–180) 2022. P. 93–96 EXPERIENCE OF PRIMARY HPV TESTING IN CERVICAL CANCER SCREENING O. V. Bondar, A. I. Rybin, V. V. Muzyka Odesa National Medical University , Odesa, Ukraine The main cause of cervical cancer in almost 100% of cases is the human papillomavirus (HPV), which is also involved in the development of other cancers of the lower genital tract. The malignant transformation of the cervical epithelium is a continuous process that takes decades to develop, and early detection of HPV can prevent the long-term development of cervical cancer and the unfavourable course of the disease. The aim of the study is an evaluation of the effectiveness of HPV testing as primary screening project of the cervical cancer on the base of University clinic of Odessa National Medical University. Materials and methods. The results of a project on HPV-testing by the Hybrid Capture technology (digene HC2 HPV DNA Test) of 294 women in the Оdessa were summarized. Results. The frequency of high-risk HPV infection in the studied region was 10.5%, the average viral load was 319.97 RLU / COV ratio in the total sample, which corresponds to a high viral load (more than 3×107 genomic equivalents). In 10.7% of HPV-positive women, cervical pathology was revealed, cervical cancer in the early stages was detected in 28% women (2 cancer in situ and 1 cancer IA). Conclusions. Thus, the introduction of new screening and prevention technologies using simple and standardised methods shows effective results aimed at reducing female morbidity and mortality. The successful experience of the study makes it possible to recommend the introduction of HPV testing at the compulsory stage of medical examination of the population as a more effective screening in terms of clinical and economic aspects. Key words: cervical cancer, human papillomavirus, HPV- testing, viral load, cervical dysplasia

The results of personificated ovarian cancer patients with peritoneal carcinomatosis treatment

The objective: to analyse of the experience of cytoreductive surgery using and hypenermic intraperitoneal chemperfusion (HIPEC) in patients with ovarian cancer IIIC stage, as well as overall and relapse-free survival in such patients. Materials and methods. 119 patients with ovarian cancer of the IIIC stage were involved into the study from 2013 to 2020 and they were treated at the University Clinic of Odessa National Medical University. Patients were divided into two groups: the clinical control group (n=53) included persons after suboptimal cytoreduction; the patients of the main group (n=66) had optimal or complete cytoreduction, and in some cases with subsequent intraoperative hyperthermic intraperitoneal chemotherapy. During the initial analysis of these groups, time (preoperative period, duration of surgery, number of postoperative bed-days), as well as the presence of complications in the postoperative period were determined. Results. In the main group there was an increase operation time due to large surgery volumes and the implementation of the HIPEC procedure with primary cytoreduction (p=0.001). In the postoperative period, an increase in the number of bed-days in the hospital in patients of the main group in relation to the control group was established, especially in those who had HIPEC (p=0.001). There was an increase in the number of surgical complications of class III-IV according to the Clavien-Dindo classification (from 5 % to 22.2 %) in patients after HIPEC. An increase in relapse-free survival from 10 months in the control group to 13-19 months in the main group was revealed. The recurrence median in the postoperative period in the control group was 10±1.3 months, and after interval cytoreduction and primary cytoreduction with HIPEC – 13±1.5 and 19±6.3 months, respectively. The index of relapse-free survival in the first 6 months in the control group was 63.2 %, in patients after optimal or complete cytoreduction – 88.0 %, in patients after optimal or complete cytoreduction and HIPEC – 90.4 %. One-year recurrence-free survival rate was 37.5 %, 63.2 % and 60.1 %, respectively, the average values of overall survival – 27.7±4.1 months versus 24.5±1.8 and 24.1±2.2 months, respectively. Conclusions. Cytoreductive surgery and methods of intraoperative hyperthermic intraperitoneal chemotherapy are perspective options of treatment of patients with peritoneal carcinomatosis by ovarian cancer regarding recurrence of the disease and survival, although they are accompanied by more postoperative complications and number of bed-days in hospital.

Стратегія розвитку сучасної вищої медичної освіти

Today, the role of information and telecommunications systems in any area of life is growing. Modern medical education involves a combination of conventional education of students with simulation training, distance learning and the use of information technology. This is a difficult period of life for the skin participant in the illuminating sphere. This is a difficult period of life for every participant in the institution of higher education. Nowadays, the use of innovative educational technologies will facilitate the presentation and visualization of materials, contribute to memorization of information and make the educational process easier and more interesting. Digital skills have become a necessary additional component for any scientist, modern educator and practicing physician of almost all specialties. Purpose - to analyze the state of modern problems, opportunities and ways of development in higher medical school during the transformation of society period using digital intelligence. The article presents the experience of medical training at the Department of Obstetrics and Gynecology of Odessa National Medical University in modern conditions. Taking into consideration that the Department of Obstetrics and Gynecology is a well-equipped clinical department of the university, it has become customary not only to participate in various international conferences, communication platforms, webinars and videoconferences, but also to organize and conduct videoconferences, master classes with demonstration of operations in real-time mode, the so-called «live surgery». Post-graduate studies of specialists are one of the key priority of the university. Improvements in practical skills are provided in high-tech simulation centers. But there is needed to ensure academic mobility, choice of training bases, improved work of internship bases for internship doctors and the organization of training in the practical part of the internship training. However, the transformation of the medical industry requires a reform of the educational process in medical education institutions. No conflict of interests was declared by the authors.

Main stages of the development of the specialty "Orthopedics and traumatology"

The most significant components of the educational process at the Department of Traumatology and Orthopedics of the Odessa National Medical University (Ukraine) under modern conditions are highlighted. Purpose: To determine the future orthopedist-traumatologist professional training main stages, including the means of implementing the development of the specialty. Materials and methods. The specific conditions of the specialty "Orthopedics and Traumatology" development under certain circumstances (COVID-19 pandemic; martial law) in the phased professional training of specialists. The following empirical methods were used: observation, test, questionnaire method and method of conversation and interview. Results: It has been determined that there is a significant difference between full-time and distance/on-line learning for higher education applicants, since most clinical competencies require the personal presence of a doctor. It is live contact at the bedside of the patient, as well as with the staff of the in - patient departments and colleagues of the chairs will create a situation of real professional growth, which cannot be replaced by any virtual technology of a specialty practical mastery. Conclusions: The main stages of education affect the development of the specialty, depending on the pace and body of acquired knowledge and skills. The professional qualities of an orthopedist- traumatologist are subject to education by all available methods and means, starting from the student bench of a medical university. Further deepening and improvement of knowledge and skills should continue until the end of one’s professional activity, especially in difficult and unforeseen situations.

Influence of latent iron deficiency on cognitive abilities in students

The aim of the study is to assess the impact of latent iron deficiency on students' cognitive abilities. Material and methods. The study was conducted during 2018-2021 at the Department of Hygiene and Medical Ecology of Odessa National Medical University. A survey of 188 medical students aged 18-20 was conducted using a screening survey. Estimation of the qualitative content of iron compounds in the diet was performed by a calculation method using the USDA / FDA database. Persons with probable iron deficiency were examined for hemoglobin, erythrocytes, hematocrit (general clinical blood test) and serum ferritin. Additionally, the cognitive abilities of people with latent iron deficiency were assessed using MoSA, TMT, GPB, Schulte tables and TAS-20. As a control, 30 students aged 18-20 years who showed no signs of latent or overt iron deficiency were interviewed. Statistical processing was performed by methods of variance and correlation anamnesis using the software Statistica 13.0 (TIBCO, USA). Results. When evaluating diets, probable iron deficiency was identified in 69 (36.7%) students surveyed. A significant number of students reported signs of iron deficiency, namely general weakness (27 or 14.4%), increased fatigue (30 cases or 15.9%), pale skin and mucous membranes (6 or 3.2%), drowsiness (8 or 4.3%), dry mouth (11 or 5.9%), brittle hair (4 or 2.1%), bleeding gums (3 or 1.6%). In isolated cases, hyposmia, dysgeusia and dysphagia have occurred. Probable iron deficiency was found at the previous stage of the study in 29 (15.4%) patients, they subsequently underwent verifying laboratory tests. In the analysis of the obtained data, the diagnosis of mild iron deficiency anemia was confirmed in 2 (6.9%) girls. Latent iron deficiency was identified in 16 (55.2%) students, among whom girls predominated (10 people or 62.5%). Subsequent studies have shown that a significant number of students with latent iron deficiency showed moderate signs of decreased cognition. Conclusions: 1. The frequency of latent iron deficiency in the surveyed contingent was 8.5%, with an absolute predominance of girls (62.5%). 2. Latent iron deficiency in student youth can be manifested by cognitive impairment, and therefore affect academic performance. 3. The most pronounced correlation was found for ferritin content and severity of alexithymia (r = -0.61).

FEATURES OF LAPAROSCOPIC APPENDECTOMY WITH THE ATYPICAL LOCATION OF THE APPENDIX IN PATIENTS WITH A HIGH RISK OF CARDIOPULMONARY INSUFFICIENCY

Objectives. The purpose of the work was to expand the capabilities of laparoscopic appendectomy in the atypical location of the destructively altered appendix in patients with a high risk of cardiopulmonary pathology, through the use of new surgical techniques. Material and methods. In the clinic of Department of Surgery No. 2, Odessa National Medical University, from 2015 to 2020, there were operated on 57 patients for acute appendicitis with an atypical location of the appendix with the presence of concomitant cardiopulmonary pathology. All patients were divided into 2 groups. The first group consisted of 21 (36.8%) patients with an atypical location of the appendix and a high risk of cardiopulmonary failure, who underwent an appendectomy. The second group consisted of 36 (63.2%) patients with an atypical location of the appendix and a high risk of cardiopulmonary failure, who underwent laparoscopic appendectomy. The procedure was performed according to two methods: with the imposition of pneumoperitoneum in 24 (42.2%) patients and in 12 (21%) patients with the imposition of laparolifting, due to severe cardiopulmonary pathology. Results. Postoperative complications in group 2 were less than in patients in group 1. Average stay in the hospital of patients of the second group, after laparoscopic appendectomy, was 4.9 ± 2.35 days. In patients of the first group, with appendectomy – 10.6 ± 5.1 days. After minimally invasive interventions, patients were in the hospital on average 5 days less than patients who underwent open appendectomy. Conclusions. The use of laparoscopic and video-assisted approaches, in an atypical location of appendicitis, can reduce the incidence of postoperative complications and deaths, which generally improves the results of the treatment.

Cardiotoxic effect of bleomycin with a single administration in the experiment

The aim of the study was to evaluate the effect of a single injection of bleomycin on the heart
 Material and methods. The study was conducted in the Research Institute of Transport Medicine during 2016-2021. The experimental model of the cardiotoxic effect of the bleomycin was performed using the medication "Bleocin" manufactured by Nippon Kayaku Co., Ltd. (Japan). According to the task, the study was performed on 10 mature rats of both sexes of the Wistar line with a body weight of 237 ± 20 g.
 Rats were housed in standard vivarium conditions of Odessa National Medical University. Animals were divided into 2 groups: experimental group (n = 5) and control (n = 5). Bleomycin animals of the experimental group were obtained intraperitoneally at a dose of 0.5 IU / kg once. Withdrawal of animals from the experiment was performed on the 5th day of the experiment, followed by morphological and morphometric examination.
 Statistical processing of the obtained data was performed by methods of variance, correlation and regression analysis using Statistica 14.0 software (TIBCO, USA)
 Results. Single administration os bleomycin causes changes in macroscopic parameters (myocardial weight, visual changes) are minimal. The main changes at the microscopic level are represented by contractural degeneration with segmental and / or partial-lateral lysis, ie there is not total but partial myocardial damage.
 Conclusion. A single injection of bleomycin can cause inflammatory-dystrophic changes of the myocardium.

Olexandr Ivanovych Bodnia

The article is devoted to Alexander Ivanovich, Doctor of Medical Sciences, Professor of the Department of Traumatology and Orthopedics, Odessa National Medical University.

New aspects of pedagogical activity in the distant form of pathological physiology teaching to medical university students

Distance learning (DL) is a completely new and unique form of education, which got forced to switch to by the current pandemic of coronavirus disease.
 Note that until now, distance learning technologies have been used at the department of general and clinical pathological physiology and some other departments of the Odessa National Medical University (ONMedU).
 The aim of this analytical article is to analyze the efficacy of ONMedU General and Clinical Pathological Physiology Department staff during the one and a half year period of the coronavirus infection pandemic with an accent to psychological approach to students modified teaching. The urgent need of time and the primary desire to protect students and their own lives during 2020-2021 requires us to improve our own pedagogical approaches in the further on-line teaching of students.
 We see success in systematic methodological work with students, the implementation of which will make it possible to evoke and increase their motivation to study histology. The importance of this methodological technique, supported in the senior years of medical universities by the integration of teaching theoretical and clinical disciplines, the approximation of teaching to specific clinical cases will help optimize the assimilation of morphological knowledge by students at least and, undoubtedly, in the near future will lead to a better assimilation of clinical disciplines.
 In connection with the ideas of individualized and developmental learning, the use of psychological capabilities of learning tools in the virtual environment brings both pedagogy and psychology to a new level of understanding the mediation of mental, creative, communicative and executive learning and learning activities.
 The use of distance learning helps the students to acquire skills of independent work, creates comfortable conditions for creativity, increases the creative and intellectual potential of the student through self-organization, the ability to interact with computer technology and make responsible decisions, creates favorable conditions for individual creative expression in the process of learning, for the development of the student's personality.
 The authors are convinced that the optimization and improvement of the educational process in medical universities is to draw students' attention to the problems that the medical community is dealing with on a daily basis today.

Педіатрична клініка Одеського національного медичного університету: якість невідкладної медичної допомоги дітям

Мета роботи — обговорити питання підвищення якості невідкладної допомоги дітям при найбільш поширених захворюваннях. Матеріали та методи. Якість медичної допомоги включає 6 показників: ефективність, обґрунтованість, економічна доступність, прийнятність/зосередженість на пацієнта, рівність, безпека. Результати. У педіатричній клініці Одеського національного медичного університету (ОНМедУ) створений блок інтенсивного спостереження, основним завданням якого є надання невідкладної допомоги дітям, які потребують моніторингу дихання та серцевої діяльності, проведення кисневої терапії та регідратаційної терапії великого об’єму. У клініці діє система сортування пацієнтів за тяжкістю стану з урахуванням даних обстеження і пульсоксиметрії. Запорукою ефективності медичної допомоги є локальні протоколи, розроблені на принципах доказової медицини; всі ліки, включені в них, входять у Лист необхідних ліків Всесвітньої організації охорони здоров’я. Прийнятність медичної допомоги визначають пацієнторієнтовані технології: спільне перебування матері та дитини; перевага надається оральній регідратації, а не внутрішньовенному введенню рідини; мінімізація болю і відмова від внутрішньом’язових ін’єкцій; зволоження повітря навколо пацієнта та ін. Середня тривалість перебування у блоці інтенсивного спостереження — 2 дні. Культура безпеки пацієнтів є пріоритетом і включає в себе: зміну ставлення співробітників до медичної безпеки; виявлення тригерів і ризиків медичної допомоги; виявлення медичних помилок і промахів; використання безпечних технологій і простих алгоритмів дій; навчання медичного персоналу. Було проведено більше 40 лекцій і практичних занять для медичного персоналу, включаючи тренінги на манекенах Code Blue. Висновки. Заходи, спрямовані на підвищення якості невідкладної медичної допомоги дітям в педіатричній клініці ОНМедУ, включають: 1) організацію блоку інтенсивного спостереження і його оснащення сучасним обладнанням для діагностики та лікування дітей; 2) сортування пацієнтів за тяжкістю стану за об’єктивними критеріями; 3) скорочення термінів госпіталізації; 4) стандартизацію медичної допомоги шляхом розробки локальних протоколів на принципах доказової медицини; 5) підвищення прийнятності медичного обслуговування за рахунок впровадження технологій, орієнтованих на пацієнта; 6) впровадження культури безпеки пацієнта; 7) постійне навчання медичного персоналу.

Первый опыт дистанционного обучения в медицинских вузах Украины в условиях COVID-19-карантина

Статья посвящена первому опыту дистанционного обучения дисциплине «педиатрия» студентов 5-го и 6-го курсов медицинского и международного факультетов Одесского национального медицинского университета, а также врачей в системе непрерывного профессионального развития в условиях всеукраинского карантина вследствие пандемии COVID-19.

EXPERIENCE OF IMMUNOCORRECTIVE TREATMENT IN THE MANAGEMENT OF PATIENTS WITH CERVICAL INTRAEPITHELIAL NEOPLASIA ON THE BACKGROUND OF GENITAL PAPILLOMAVIRUS INFECTION

Introduction. Human papillomavirus (HPV), its highly oncogenic types, is considered to be the initiating factor in the development of dysplasia and cervical cancer The role of immunomodulatory therapy in reducing the risk of cervical cancer in women with cervical intraepithelial neoplasia (CIN) associated with HPV infection remains in the focus of researchers. Aim of the study: to evaluate the effectiveness of the use of the immunomodulator Allokin-alfa in the complex treatment of cervical intraepithelial neoplasia against the background of genital papillomavirus infection. Materials and methods. We examined 60 women who received CIN1- 2 treatment on the background of HPV infection of high oncogenic risk in the multidisciplinary medical center of the Odessa National Medical University. The patients were divided into 2 groups: 1 (main) group consisted of 30 women who received cold plasma ablation of cervical dysplasia in combination with immunomodulatory therapy with alloferon, group 2 (comparison) consisted of 30 patients who received standard cold plasma ablative treatment without immunomodulators. The control group consisted of 30 healthy women. All women underwent cytomorphological examination of the cervical epithelium, HPV testing, colposcopy, and targeted biopsy. Immunological status was assessed by indicators of cellular and humoral immunity, the content of α- and γ-interferon. Results. In patients with CIN1-2 against the background of HPV, an increase in the level of serum Ig A, CD8 level, a decrease in the CD4 content and immunoregulatory index, CD19 content were revealed, which indicated immunosuppression. Immunocorrective therapy witn alloferon (Allokin-alfa) in complex, with cold plasma ablation, treatment of CIN1-2 promoted the normalization of the parameters of immunity and interferon status, which contributed to the acceleration of epithelialization, (OR — 15,48; 95% CІ: 2,05-136,45; р=0,0094). a decrease in the frequency of residual lesions, and a HPV elimination. Conclusions. Complex treatment of CIN1-2 using cold plasma ablation and immunocorrection by perioperative administration of alloferon (Allokin-alfa) is accompanied by better functional results, compared only with the use of cold plasma ablation: accelerated epithelialization, improved colposcopic picture, decreased frequency of relapses, elimination of HPV, normalization of immunе and interferon status.

Experience of psychiatry distance teaching to english speaking international students

The article describes the difficulties of transition to distance learning (DL) at a medical university when students pass clinical disciplines, using the example of the subject of "psychiatry". The negative impact of the pandemic on international cooperation in the field of education and science was also noted, in particular, attracting foreign students to further education.
 Based on the above, the following tasks were set: to study the features of the transition to distance learning the subject of "psychiatry" at the Odessa National Medical University, to identify the features of distance work with English-speaking foreign students during their learning of this discipline and to present proposals for optimizing this process.
 During the transition to DL, a significant decrease in the quality of education was noticed during the absence of an existing learning management system, since this transition was a certain stress for all participants in the educational process, both students and teachers. Significant problems have arisen in the DL of clinical disciplines for English-speaking students. The greatest difficulty is the teaching of psychiatry, since it is difficult to explain to students in English not only the description of psychopathological symptoms and syndromes, but also the mental characteristics of people with other nationalities. It is proposed to use movies, with the main heroes suffering from mental disorders, as a thematic guide for mastering practical skills. Although some of the positive aspects of DL have been noted by medical students, they agree to DL only as a forced short-term measure.

Cumulative cardiotoxic effect of bleomycin in experiment

The aim of the study was to evaluate the cumulative toxic effect of bleomycin under experimental conditions
 Material and Methods. The study was conducted in the Research Institute of Transport Medicine during 2016-2021. The experimental model of the cardiotoxic effect of the bleomycin was performed using the medication "Bleocin" manufactured by Nippon Kayaku Co., Ltd. (Japan). According to the task, the study was performed on 10 mature rats of both sexes of the Wistar line with a body weight of 237 ± 20 g.
 Rats were housed in standard vivarium conditions of Odessa National Medical University. Animals were divided into 2 groups: experimental group (n = 5) and control (n = 5). Bleomycin animals of the experimental group were obtained intraperitoneally at a dose of 0.5 IU / kg on 1st and 8th days. Withdrawal of animals from the experiment was performed on the 5th, 14th and 28th day of the experiment, followed by morphological and morphometric examination.
 The material after weighing and morphometry was fixed with a neutral 10% formalin solution and poured into paraffin. Histological sections were stained with hematoxylin-eosin, MSB, Van Gizon. Performed light microscopy.
 After two weeks there was a decrease in myocardial weight by 7-10% from baseline, there were pronounced dystrophic changes in the myocardium. Repeated administration of bleomycin has a cumulative cardiotoxic effect leading to irreversible changes in the myocardium and endothelial dysfunction clinically manifested by heart attack, vascular pathology at significant cumulative doses of bleomycin. Morphofunctional changes of the right ventricle are prominent and considered to be pathognomic for bleomycin toxicity.
 Conclusions: 1. Bleomycin has a cumulative toxic effect on the myocardium of mammals
 2. The severity of the cardiotoxic effect of bleomycin is proportional to the tissue concentration of the drug, which is proportional to the duration of exposure

Evalution of the effect of obesity-associated inflammation on the response to complex therapy in hypertensive elderly patients with coronary artery disease

Object: to identify factors that limit the effectiveness of pharmacotherapy of hypertension (HT) with comorbid coronary artery disease (CAD) in elderly obese patients by determining laboratory and spectroscopy features related to inflammation. Material and methods: 60 patients (68.2 ± 5.9 y.o.) were observed and treated in Internal Medicine Department of University Clinic of Odessa National Medical University. Patients were divided into 2 groups. The 1st group included patients (n = 30) with body mass index (BMI) ≤25 kg/m2, HT and co-morbid CAD; the 2nd group (n = 30) - patients with BMI≥30 kg/m2, HT and with co-morbid CAD. For each patient’s group antihypertensive combination of Lisinopril and Bisoprolol was prescribed. The Laser correlation spectroscopy (LCS) was a special method for investigation. Results: before pharmacotherapy (PT) in both groups according to LCS 11-150 nm particles are prevailing. But in obese patients 75th percentile of 31-70 nm particles exceeds that one in non-obese group (56.7% vs 30.5%). During PT systolic blood pressure (SBP) value normalized in the patients of 1st group (without obesity), while in the obese patients (2nd group) SBP remained above target level. Creatinine level increased in patients of 1st group (without obesity) by 16.5 μmol / L (p <0.05) with a decrease in GFR by 17.1 ml/min/1.73 m2 (P <0.05). LCS data during PT show increase of 11-30 nm and decrease of 75-150 nm particles in non-obese patients, while in obese patients 71-150 nm particles are prevailing and 150 nm particles have appeared (p<0.05). Conclusions: 1. In elderly hypertensive patients with concomitant CAD, obesity is a factor limiting the effectiveness of complex antihypertensive therapy. 2. An increase of proportion of allergic-directed and appearance of autoimmune-directed homeostatic shifts in serum according to LCS are associated with a decrease of antihypertensive therapy efficacy in elderly hypertensive patients with CAD and obesity. 3. In hypertensive non-obese patients with CAD under the influence of complex antihypertensive therapy deteriorating of renal function is observed while in obesity renal function is not changed. 4. Homeostatic changes revealed in the second group by LCS values probably reflect manifestation of low grade inflammatory process caused by excessive activity of adipose tissue.