Ukrainian Medical Stomatological Academy Research Articles

Шляхи оптимізації впровадження інформаційних технологій у післядипломну підготовку сімейних лікарів на кафедрі сімейної медицини і терапії в Українській медичній стоматологічній академії

У статті висвітлені питання оптимізації впровадження інформаційних технологій у післядипломну підготовку на кафедрі сімейної медицини і терапії в Українській медичній стоматологічній академії. Впровадження інформаційних технологій в системі дистанційного навчання є одним із пріоритетів модернізації сучасної медичної освіти, спрямованої на підвищення фахового рівня підготовки майбутніх сімейних лікарів, від діяльності яких залежить безпека та здоров’я нації.

Peculiarities of surgical treatment of cervico-mediastinal goiter

Objective. To analyze a surgical tactics and a component of operative interventions, performed for goiter of cervico-mediastinal localization; to formulate the operative technique peculiarities, which give positive effect.
 Materials and methods. Into the investigation the materials of clinical work in 2005 - 2019 yrs were incorporated of Department of Surgery No 2 of the Second Municipal Clinical Hospital of Poltava City, which constitutes a base of the Department of Surgery No 1 of Ukrainian Medical Stomatological Academy. There were analyzed the results of surgical treatment of 530 patients, suffering various forms of goiter.
 Results. Basing on data of complex clinic-instrumental and cytological investigations several tactically different operative interventions were performed, the content of which was directly dependent on anatomic peculiarities present. In 155 patients a cervico-mediastinal goiter was present.
 Conclusion. In big mediastinal goiter a severe operative situation occurs, necessitating nonstandard surgical decisions making. That is why the neck surgical access of the authors own in accordance to Kocher method was proposed. Extrafascial procedures may prevent some iatrogenic complications.

Комплексна терапія пацієнтів після ендоскопічних хірургічних втручань у носовій порожнині

У роботі наведені результати дослідження клінічної ефективності застосування назального спрея СептаНазал у комплексній терапії пацієнтів після перенесених ендоскопічних оперативних втручань у носовій порожнині. Дослідження проводились на базі кафедри оториноларингології з офтальмологією Вищого державного навчального закладу України «Українська медична стоматологічна академія» та ЛОР-відділення Полтавської обласної клінічної лікарні. Встановлено значне регресування суб’єктивної симптоматики та об’єктивних показників одужання пацієнтів, які застосовували спрей СептаНазал. У даній групі спостерігалось більш швидке покращення стану щодо початкового на 1,5 бала порівняно з контрольною групою. Закладеність носа зменшилась на 50 % в обох групах, при цьому відновлення нюхової функції спостерігалось у 87 % пацієнтів основної групи та 50 % — контрольної. На 7-му добу жоден пацієнт основної групи не скаржився на біль.

Досвід викладання вибіркової дисципліни «Сучасні принципи діагностики та лікування дизонтогенетичної патології щелепно-лицевої ділянки»

Sustainable development of public health care in Ukraine, in particular dental care, requires highly qualified specialists with skills in the field of diagnosis, treatment, rehabilitation and prevention of various human diseases. Therefore, improving the quality of training of health care professionals in compliance with the standards of higher education is very important current issue. The Ukrainian Medical Stomatological Academy has created all the necessary conditions for the formation of individual educational trajectory of students of the second (Master’s) level of higher education in the specialty 221 “Dentistry” due to the balance of compulsory and elective educational components in the curriculum “Dentistry”. It contains a large list of elective components created by the UMSA faculty staff at the initiative of the academy and the recommendations of stakeholders, including “Current principles of the diagnosis and treatment of dysontogenetic pathology of the maxillofacial area”, which comprehensively studies the etiology, pathogenesis, clinical presentation, current methods of diagnosrics, treatment of diseases of dysontogenetic origin in children; develops skills of making a rational plan of examination of a patient with diseases caused by embryogenetic disorders and the ability to analyze the resulting data; identifies the key symptoms and syndromes of dysontogenetic origin and differential diagnosis with justification and making the diagnosis, principles of comprehensive treatment of patients; contributes in prediction and prevention of complications of these diseases in children. The paper highlights the experience of teaching the elective component of the curriculum “Current principles of the diagnosis and treatment of dysontogenetic pathology of the maxillofacial area” at the Department of Pediatric Oral Surgery of UMSA, which showed the prospects of teaching it to the 5th – year dental students and received positive feedback. This inspired the faculty staff of the Department to continue activities on improving the academic process.

EFFICIENCY OF THE ADMINISTRATION SYSTEM AT THE FACULTY IN THE FORMATION OF THE PERSONALITY OF THE FUTURE DOCTOR

The main task of a higher educational establishment is to train and educate highly qualified specialists. At a Medical University the object of study and the subject of the future activity of a specialist is a person, and the quality of training for a medical graduate should be at the top level. In the system of administration of a higher educational establishment, the basic level is faculty one. At the educational establishment each faculty has its own specified task and a part of the eventual goal is the training of a qualified specialist who is able to decide important tasks for the protection and preservation of population health. Medical faculty No 1 is one of the main organizational and educational-scientific structural subdivisions of the Ukrainian Medical Stomatological Academy, which was founded by the decision of the Academic Council, combines various departments, and works in accordance with the normative base.
 At each faculty, the dean works directly with the students. All dean's office members work with students directly at all stages of students’ molding as specialists and personalities. The dean's office of the medical faculty No 1 supports the organization and control of the educational process at the faculty; provides information for the assuring of high-grade educational process; controls the training of medical students; provides office work and document circulation according to the legislation.
 To provide effective educational process, the dean of the medical faculty No 1 and dean’s officers monitor the success and attendance of classes carefully and systematically, assist tutors in charge in organizational work with academic groups. Obligatory work of the dean’s office administration is participation in the group meetings, courses’ gathering according to organizational and educational issues, and realization of routine site meetings.
 Cultural, sports, health-improving, public, and volunteer kinds of work are very important for interest of young people in education. In the process of learning it is important to form a comprehensively developed personality.
 The dean and his mates deal with the issue of providing the medical students with hostels or other accommodation. 
 Control for the organization and performing of professional training course is constant duties of the dean's office. This is one of the most important stages in the education of a future doctor.
 The specificity of the medical profession requires constant contact with colleagues, because there are different situations that require consultation with leading specialists, who are highly qualified professionals.
 At many public and private medical establishments pedagogical activity and medical-consultative work are carried out by the teachers of the academy, who ensure the professional development of young medical specialists.
 Thus, the administrative work of the dean's office is constantly improved and modified in accordance with current conditions. According to modern challenges of organizing the educational process on line, the dean's office members work on the digital platforms, master the information technology, and develop new methods of work that ensure the formation of a highly educated and competitive specialist as a modern doctor.

Напрями і стратегічні орієнтири безперервного професійного розвитку науково-педагогічних працівників Української медичної стоматологічної академії

Improving the quality of higher education requires constant professional development and growth of both young and more experienced university teachers. Undoubtedly, professional growth is necessary, first of all, for young teachers of higher educational institutions, because they have no experience of working with students and insufficient knowledge of the discipline they teach. The professional growth of a teacher, which takes place throughout his/her creative activity, is aimed at improving the previously acquired and acquiring new competencies within the framework of his/her professional activity. Scientific and pedagogical workers systematically update the acquired professional knowledge and skills, master modern educational technologies and develop their professional and personal qualities. The continuous professional development of healthcare professionals occupies a special place. The systematic process of training and improving professional competencies after specialists receive higher and postgraduate education in internship, gives them the opportunity to maintain and improve the standards of professional activity in accordance with the needs of healthcare. The provision of high-quality educational services in medical universities is carried out by highly professional teachers who constantly improve their knowledge, skills and abilities through continuous professional development. The administration of the Ukrainian Medical Dental Academy constantly and in every possible way contributes to the professional development of the teachers of its institution, creating the necessary conditions for this, and also helps in choosing forms of increasing and improving pedagogical skills. Based on the results of work over the past year, the staff of the academy took part especially actively in the work of international scientific and methodological conferences, international webinars, online seminars, distance courses, courses for improving pedagogical skills, and also have numerous publications of the scientific and methodological direction in publications included in Scopus database, Web of Science and materials of educational and methodological conferences. Research and teaching staff of the Ukrainian Medical Stomatological Academy created a personal educational portfolio based on the results of continuous improvement of pedagogical skills. Each type of work is evaluated by a certain number of credits, which makes it possible to summarize the results of continuous professional growth of scientific and pedagogical staff of the academy for each year of their work. In Ukraine, each university forms its own model of professional development of research and teaching staff, depending on the direction of training of specialists and the specifics of the educational process. Continuing professional development is an integral part of the activities of higher education institutions and contributes to the acquisition of new and improvement of acquired professional competencies by research and teaching staff within their professional activities, which corresponds to modern trends in the educational process

ANTAGONISTIC ACTIVITY OF REPRESENTATIVES OF ORAL BIOCENOSIS

The aim: Calculate the antagonistic activity of representatives of the oral biotope. Materials and methods: The mathematical techniques used in biotechnology and dentistry. The calculations were carried out on the basis of the research data obtained by the investigators from Ukrainian Medical Stomatological Academy (UMSA) (Poltava). Results: The paper shows that the oral biocenosis is a group of microorganisms that have similar characteristics within the group, but different outside. This may indicate to the relationships between the bacteria, existing within such groups. A graphical demonstration of the associates of the oral biotope with different DMF represents their growth phases depending on the intensity of dental caries. The different slope and phases of the logistic curve of their growth may indicate certain relationships arising between groups of microorganisms. Conclusions: The symbiotic relationships within the oral biocenosis can be manifested by the antagonism, as indicated by the index of antagonistic activity, which in most cases can be calculated. Antagonistic activity can be determined more precisely, for which special techniques have been developed. Antagonistic activity of associates of biocenosis can serve as an indicator of the "conditionally pathogenic - pathogenic" transformation. Data on antagonistic activity can be used in oral hygiene activities and treatment of dental caries to impact the oral microbiocenosis. Data on antagonistic activity may have a predictive value.

ORGANIZATION OF STUDENTS’ INDEPENDENT ENGLISH LANGUAGE LEARNING IN THE COURSE OF PREPARATION TO SUBTEST OF LICENSING EXAMINATION «KROK 1. DENTISTRY»

Over two decades Ukrainian system of medical professional training has been providing a single pathway for primary licensure of all graduates of medical schools by licensing examinations «Krok 1», «Krok 2» and «Krok 3». Since their inceptions, the examinations provide the valid and reliable independent assessment of medical examinations in order to demonstrate they have knowledge and clinical skills for the unsupervised general practice of medicine, and thus, to grant the primary license to practice medicine. The aim of this study is to analyze ways of the organization of student’s self-learning at the Department of Foreign Languages with Latin and Medical Terminology, Ukrainian Medical Stomatological Academy, which will promote the confidence in own English language command and ensure demonstrating high performance of English subtest «Krok 1». Independent learning using additional texts should help students, concerning with previously studied elements of terminology, lexis and grammar, to figure out faster phrases and constructions in texts based on the contex and extra linguistic clues.
 The analysis of the factors influencing the students’ performance when doing the Krok tests, we have found the guided language exposure and scheduled amount of time for independent work according to the curriculum can help to overcome typical linguistic obstacles. Moreover, the English language instructors elaborated the questionnaire and surveyed the students to identify self-learning routine peculiarities, resources commonly used for self-training to licensing examination, which are the most effective from their point of view. The study included 155 third year dental students (2019-2020 academic year). The students actively use mobile applications from the playmarket, namely K-test, which they can use for independent practice at individual pace. Computer technologies can significantly improve the efficiency of foreign language teaching and learning and help us in organizing independent work of the students. According to result obtained, testkrokorg.ua internet resource ranks the second position. 19.35% of students chose this site as it gives an opportunity to check the knowledge, to get graded and to get the right answers. 17.41% of the respondents used testcentr.org.ua by reviewing and uploading Krok test booklets. 11.61% of the students used social network groups, which post materials, news and results to licensing examinations. 9.67% of students are found to prefer booklets; methodical instructions for students’ training that are on the site of our department. 3.2% of the responders suggest that lifehacks in YouTube contains the experience of bloggers and due to them the youth can learn new things. The obtained results have shown that the computer appliances are of great recourses for independent learning when used purposefully and guided by the instructors.

ANALYSIS OF RESULTS OF LICENSING INTEGRATED EXAM KROK IN UKRAINIAN MEDICAL STOMATOLOGICAL ACADEMY OF STUDENTS OF THE MEDICAL FACULTY №1

The primary task of Ukrainian Medical Stomatological Academy is an integration to the European educational system. This process is possible only due to conditions of strategic reform and improvement of future physicians’ training, improvement of teaching and learning quality. The aim of the paper is to analyze the results of the external independent testing and licensing integrated exams «Krok 1`General medical training» and «Krok 2. General medical training» in students of the medical faculty №1 of the Ukrainian Medical Stomatological Academy, who entered Academy in 2013. It has been established, that students who have low percentage of the results of «Krok 1» possibly had worse test results of external independent testing in Ukrainian, Biology and Chemistry / Physics (subject of choice). Insufficient knowledge, which was demonstrated by students, can lead to difficulties to passing «Krok 2. General Medical Training». Higher percentage during passing of the subtests «Krok 1» in students with low level of training and during passing «Krok 2» may indicate that the insufficient level of knowledge can be demonstrated by different students. Students, who had low results of «Krok 1» passing test, subtests in Therapy passed in 13,4% worse (р<0,001) in comparison with results during the whole training course. These students passed Surgery and Pediatrics in 17,7% (р<0,001) lower than other ones. This category of students was characterized by possibly lower results in Obstetrics and Gynecology and Hygiene. It has been indicated that students who had low results during external independent testing include the risk group that can lead to unsuccessful passing of licensing integrated exam «Krok» in educational institution. That’s why, after entering Educational Establishment, it is necessary to highlight group of students with lower indices of results of external independent testing and additionally step by step cooperate with them on other departments.

Morphological condition of the pulp of intact and affected by caries third molars

To date, there is a theory that increased resistance to caries is observed in the teeth, which for any reason underwent destructive changes in the pulp. That is why there is a need to study the impact of pulp vitality on the development of the carious process. The aim of the research was to study the microscopic structure of epoxy sections of intact and carious third molars. We studied 4 intact and 6 carious third molars. For this purpose, specimens were made taking into account the free penetration of the fixative solution into the pulp. To this end, immediately after the tooth was removed, we cut off its roots almost near the crown, preserving the integrity of the latter. The method relied on the impregnation of specimens with epoxy resin, according to the method of epoxy plastination of tooth specimens, developed at the Department of Human Anatomy of Ukrainian Medical Stomatological Academy. The epoxy blocks were cut with a disk into two halves until the hard tissues of the tooth crown were exposed together with the pulp. We found that the hard tissues (dentin and enamel coating) of intact third molars did not have any structural defects. However, their pulp chamber contained mainly an amorphous substance, devoid of any typical pulp tissue structures. That is, the pulp was in a state of complete devolution. Quite the opposite presentation was observed in specimens of carious teeth. We found that their pulp chamber contained quite noticeable tissue structures typical of the dental pulp. It is interesting that in the subodontoblastic layer, in front of the carious alteration of the enamel, there was compaction of the pulp, which may be due to infiltration of perivascular connective tissue by immunocompetent cells. It was found that on the border with carious destruction of enamel, there was a compacted spot of altered dentin, whose matrix was intensely pigmented in brown colour, due to the accumulation of melanin on the dentino-enamel junction. Its excessive formation is associated with the destruction of protein-carbohydrate complexes of organic matter in the deep layers of dentin. We found that the pulp compaction and the focus of carious alteration of the enamel are projectively connected by a radial cord of altered dentin, known in the literature as “dead tracts”. Hence, there is reason to believe that the identified changes indicate a latent form of caries, with a pulpogenic mechanism of development. Thus, it can be argued that the teeth, which for any reason underwent degenerative changes in the pulp, are not prone to carious lesions, whereas in carious teeth, the pulp is active and involved in the pathogenesis of the carious process.

Surgical treatment of patients, suffering goiter with compressive syndrome

Objective. To analyze the operative interventions character, performed in patients, suffering goiter of large size and cervico-retrosternal localization of thyroid gland with signs of compressive syndrome, and to determine preventive measures for prophylaxis of suboperative complications.
 Materials and methods. The data were obtained, concerning operative treatment of 331 patients, suffering various forms of large size goiter, coincided with compressive syndrome and changes in anatomic-topographic interrelationship of the thyroid gland and adjacent organs and structures with their activity disorders, in Department of Surgery of the Second Clinical Hospital of Poltava (clinical base Department of Surgery No 1 of Ukrainian Medical Stomatological Academy) in 2004 - 2018 yrs period.
 Results. There were depicted the operative interventions character, peculiarities of operative technique for patients, suffering large size goiter, as well as the ways for optimal prevention of injury of laryngeal nerves, parathyroid glands and other adjacent organs and structures. Original procedure of suboperative determination of the tracheomalacia presence and creation of external tracheal carcass was depicted.
 Conclusion. The measures and procedures in operations, performed for goiter of large size proposed, have permitted to reduce the operative morbidity risks.

INTERRELATION OF TEMPOROMANDIBULAR JOINT DYSFUNCTION IN PATIENTS WITH GYNECOLOGICAL CHANGES IN ANAMNESIS ACCORDING TO THE QUESTIONNAIRE SURVEY

INTERRELATION OF TEMPOROMANDIBULAR JOINT DYSFUNCTION IN PATIENTS WITH GYNECOLOGICAL CHANGES IN ANAMNESIS ACCORDING TO THE QUESTIONNAIRE SURVEY

Переваги та недоліки дистанційного навчання майбутніх лікарів стоматологів

Advantages and disadvantages of distance education of future dentists in Ukrainian Medical Stomatological Academy during quarantine were highlighted. It has been proved that quarantine is not an obstacle to learning, but a reason to study in a new way. In the era of the latest technologies such resources as Internet ones, platforms for online communication, and social networks are the main components for instructors. Different approach to present and perceive educational material is one of the main difficult components during distance education for instructors, students, interns and other audience. Both instructors and interns must master new skills in computer program for on-line communication. Adaptation and perception of distance education occurred in different ways. Majority notes that their time sheet during distance education increased, but opportunities for new methods of training also enhanced. Somebody did not take new method of training because full instructors’ control is absent, so it is necessary to motivate interns to training and self-control. Besides, patient communication should be real not theoretical for future physicians. Development of problem situations, video presentations, and video material prompts to mastering of individual practical skills. So, the experiences in distance education and mastering of dental disciplines by students, interns, physicians give an opportunity to reconstruct educational process in accordance with requirements of modernity for further integration in European (worldwide) medical spread.

PROBLEM OF PAIN IN THE INTERNIST'S PRACTICE

Introduction. Pain is an important problem in current medical practice and a fundamental issue of medical research. More than 75% of population suffers from chronic pain syndrome. One on seven patients who visit out-of-patient departments complains on painful feelings in joints or muscles. Moreover, in 30% of cases the symptoms of rheumatic diseases or the back pain syndrome are present that considerably impacts the quality of life. The aim of the study was to evaluate the effectiveness of the combined therapeutic strategy in the treatment of patients with osteoarthritis and comorbidities. The therapy included: glucosamine sulfatis in forms of solution for IV administration and powder for oral administration; patented form of undenaturated cartilaginous collagen (natural) type II (UC-ІІtm); non-steroidal anti-inflammatory drugs (meloxycam), angiotensin receptor type 2 blockers (valsartan), statins (rosuvastatin). Materials and methods. This prospective study was performed at the Department of Family Medicine and Therapy, Ukrainian Medical Stomatological Academy, and at Regional Rheumatology Centre of Poltava M. Sklifosovsliy Regional Clinical Hospital. 30 in- and out-patients aged 52-67 years having previously diagnosed primary gonarthrosis of X-ray stages ІІ–ІІІ by the Kellgren and Lawrence classification and any of the comorbid conditions (arterial hypertension, coronary arteries disease, chronic back pain syndrome, NSAIDS-induced gastropathy) were enrolled to the study, which lasted for 12 months. Results. Analyzing the effectiveness of the combined therapy for the patients with diagnosed osteoarthritis and concomitant conditions during the 12-month period of the study, we have found better results in the patients, who received chondroprotectors parenterally and orally. Significant clinical effect presumably caused by chondroprotectors in mixed forms among the patients with osteoarthritis and comorbid pathology was proved by the improvement in the following clinical parameters as the Leken index and WOMAC. In 6 months of the therapy, we achieved a significant decrease in the total functional Leken index (10.88 ± 2.07), p<0.0001 in the patients of the main group who received chondroprotectors in a mixed form compared to the control group (12.68 ± 2.08, p<0.0001). A significant decrease in the Leken index in the main group was also observed in 12 months since the theraoy started (p<0.0001), indicating the presence of long-term effects. We also observed the reducing in pain severity at rest and on movement, decline in the level of daily activities restrictions according to WOMAC questionnaire filled in 6 months since the therapy began. The findings supporting positive therapeutic effects fwere found in both groups, but in the main group they were more significant. The total WOMAC questionnaire score in 6 month treatment period was 676.08 ± 215.63 in the main group that was significantly lower compared to the control group (858.46 ± 167.64, p <0.0001). This clinical indicator was also significantly lower in the main group (564.82 ± 187.34) compared to the control group (797.12 ± 218.10, p <0.0001) in 12 month period.

MICROBIOLOGICAL TESTS AS INDICATORS OF CARIES RISK

Fixed orthodontic appliances are widely used in the correction of dentoalveolar anomalies. Examinations prior the beginning of orthodontic treatment revealed numerous cases of dental caries of moderate intensity; moreover, caries prevalence increases with age that is the number of carious teeth goes up, while the number of filled teeth and the level of oral hygiene become lower. A voluminous body of reports indicates that children and adolescents wearing orthodontic appliances have a significantly higher incidence of caries than patients who do not wear them. Plaque microflora is one of the main risk factors for the development of caries. According to the researchers, caries is initiated by streptococci, lactobacilli, actinomycetes, and Candida fungi. To assess the content of cariogenic microorganisms (Streptococcus mutans and Lactobacillus), there are special microbiological tests available. Kits for rapid tests are manufactured in different countries around the world. In 2013, the researchers of the Department of Therapeutic Dentistry and the Department of Microbiology, Virology and Immunology, Ukrainian Medical Stomatological Academy investigated the microbiocenosis in the oral cavity in young people aged 19-25 years with different intensity of the carious process. The percentage and quantitative content of microflora was studied. The results of the study showed that an increase in the intensity of dental caries is accompanied by changes in the balance in the composition of the oral microflora. This study elaborated the indicators for identifying lactobacilli, streptococci (including haemolytic streptococci, which include S. mutans), fungi of the genus Candida and actinomycetes. But the results obtained did not match the application range of the above mentioned tests. It means the tests reflecting the number of representatives of the studied microbiocenosis in order to determine their activity, are not sufficiently objective. However, rapid tests assessing the indices of cariogenic microflora are in demand in dental practice that allows us to recommend their application in orthodontics. Further study of microbiocenoses should be carried out to determine their functional properties.

SURGICAL TECHNIQUE OPTIONS IN THYROID OPERATIONS

The article highlights the analysis of 552 surgical interventions on different types of goiter performed on at the clinical base of the Department of Surgery No. 1, Ukrainian Medical Stomatological Academy (Poltava). The study included 491 women (88.9%) and 61 men (11.1%). Diffuse toxic goitre was diagnosed in 48 (8.7%) individuals, thyrotoxic adenoma occurred in 8 cases (1.5%), unilateral nodular goitre in 162 (29.3%), multinodular goitre in 334 (60.4%) patients. 20 (3.6%) patients were operated on relapsed goitre. The large size of the goitre, the adhesive process, and the cervical-retrosternal location of the thyroid gland complicate operating situation and often require innovative surgical decisions. Original methods for preventing the damage to the laryngeal nerves and thyroid glands, which are successfully used in non-standard surgical situations, as well as a method of mobilizing the thyroid gland in cervical and thoracic goitre. Complications during surgery were avoided by using extrafascial techniques for manipulating on the thyroid gland, using reliable controlled haemostasis and accuracy during the operation. The main factor to prevent specific intraoperative complications during surgery on the thyroid gland is a reasonable combination of the latest technology and the experience of the surgeon. Postoperative transitory hypoparathyroidism on days 7-8 was observed in 9 (1.6%) patients with normalization of clinical manifestations and calcium levels; 6 (1.1%) complained of hoarseness and weakening of the voice for 3 weeks. Most of these complications occurred in the first half of the period that was analyzed. These variants for performing surgery in difficult situations have enabled to improve the results of surgical treatment.

CURRENT STRUCTURE OF PATIENTS SEEKING FOR ORTHODONTIC CARE

Now an orthodontist is a very demandable dental specialist due to increasing number of patients seeking for orthodontic care. Analysis of patients by their age, diagnosis and sex can allow orthodontists to understand more clearly which pathology and which patients are the most prevalent and to find the best approaches to satisfy the clients’ demands. This analysis provides the potential to create more targeted approach in diagnosis, treatment and prevention of malocclusions. At the Department of Postgraduate Education of Orthodontists, Ukrainian Medical Stomatological Academy, we performed an analysis of 2,359 outpatient medical cards (1296 patients, who took treatment in 2019, and 1063 patients, who took treatment in 1999). It is noteworthy that for the 20-year period the number of people seeking for orthodontic care has risen in 9.9 times, despite the rapid development of private dentistry services. The data of the analysis have demonstrated that today adults make up the larges share of the orthodontic patients. Therefore, orthodontic correction by using fixed appliances has become a priority. Moreover, female individuals ask for help more often that is determined by the increase in women's social attitude to their appearance. All this confirms social and psychological significance of orthodontics. As for the male individuals seeking for orthodontic care, their number has been found out to increase in the age 14 – 18 that may be related to the findings revealed at pre-military medical checkups. As for the commonest types of malocclusions for these two periods, I class malocclusion by Angle has been found out as the most prevalent, II class by Angle is ranking the second position and III class by Angle and a deep bite are sharing the third position.

History of the department of foreign languages with latin and medical terminology of Ukrainian medical stomatological academy

The article summarizes the activities of the Department of Foreign Languages with the Latin language and medical terminology over 90 years of existence. The authors consider the key stages of the functioning of this structural unit at different historical stages. Research methods: chronological, historical and system analysis method. Scientific novelty. For the first time, the activities of the Department of Foreign Languages with the Latin language and medical terminology are comprehensively reflected. Scientific, methodological, educational achievements throughout the years 1931-2020 are presented. Conclusions. It is shown that one of the priorities of the department at the present stage is the formation of the communicative competence of medical students, ensuring their successful quasi-professional and professional activities. Differentia specifica of the studied period - providing the educational process with high-quality educational, reference literature with a focus on the implementation of interdisciplinary connections in the process of teaching Latin, medical terminology and English for special purposes. Confirmation of this thesis is the number of winners of national and international competitions prepared at the department over the past 15 years

COVID-19: the time for reconsidering and improving on-line learning in the context of medical education in Ukraine

The purpose of this review article is to highlight peculiarities of distance learning and methodology of its implementation and improvement at the Department of Microbiology, Virology and Immunology, Ukrainian Medical Stomatological Academy under the quarantine during the COVID-19 pandemic.
 Current paper highlights the main differences of distance learning from traditional classroom education in Ukraine. Moreover, we emphasise methods and forms of distance learning and some difficulties, which we faced in the state of COVID-19 emergency. However, transition from the traditional, in-person, learning to distance learning in the Ukrainian Medical Stomatological Academy during the COVID-19 pandemic was successful

GOUT AND ARTERIAL HYPERTENSION: THERAPY PECULIARITIES

The article highlights the issues on comorbidity between gout and hypertension. Emphasis is placed on the necessity in searching for a well-balanced approach toward the treatment this type of comorbidity. Gout is a major social and economic problem in the modern society that leads to a progressive physical incapability, limitation of professional activity, thus impairing the quality of life. Arterial hypertension occurs in patients with gout in 5 - 50% of cases, and in combination with components of metabolic syndrome its prevalence rises up to 80%. As a result, the development of hypertension in patients with gout leads to a deterioration of the kidney functioning due to the combination of two pathological conditions for which the kidneys are either functioning organs or target organs. Management of arterial hypertension by general practitioner requires the searching for the most optimal approach in using metabolically neutral antihypertensives to avoid provoking medication-induced exacerbation of arthritis. In addition, the treatment of such category of patients should also provide the optimal nephroprotective effect and decrease the uric acid concentration in the serum that will contribute to the additional prevention of gout attacks.
 The aim of the study is to evaluate the nephroprotective, antihypertensive, hypolipidemic effects of the proposed combined therapy in the patients with comorbidity between gout arthritis and arterial hypertension.
 The study was conducted at the Regional Medical and Diagnostic Centre of Rheumatological Diseases, M.V. Sklifosovskyi Poltava Regional Clinical Hospital, which is the clinical base of the Department of Family Medicine and Therapy, Ukrainian Medical Stomatological Academy. 60 patients with mean age of 54.2 ± 8.6 years were enrolled to the study. The patients suffering from gout arthritis and comorbid hypertension formed the main group. The control group consisted of 60 patients matched by age, demographic and clinical parameters.
 Following the 12-month treatment period, we have registered clinical effects of the combination therapy proposed in patients with gout and comorbid hypertension. We observed a decrease in blood lipids values in the study groups: total cholesterol decreased by 16.0% in the main group and by 8.0% in the control group, high-density lipoproteins – by 5.6% in the main group and by 6.4% in the control group, low density lipoproteins – by 3.3% in the main group and by 3.4% in the control group, triglycerides – by 22.2% in the main group and 12.3% in the control group.
 We observed statistically significant improvement in the glomerular filtration rate in the main group (6.4% of cases vs. 1.3% in the control group). The blood creatinine in the both study groups decreased significantly. The uric acid blood concentration decreased by 32.6% in the main group compared to 24.6% in the control group. During the six month period of the therapy the necessity for non-steroidal anti-inflammatory drugs cut down by 58% in the study group vs. 37% in the control group.
 Conclusions. After 12 month period of therapy proposed, the patients with gout and comorbid hypertension demonstrated clinically confirmed improvement in both study groups (87.7% of patients in the main group vs. 48.6% in the control group). The efficacy of the proposed treatment was assessed by physicians up to 87%, vs. 88% efficacy assessed by the patients in the main group.