CLINICAL AND PATHOHISTOLOGICAL MANIFESTATIONS OF ACUTE KIDNEY INJURY AMONG PATIENTS WITH ACUTE DRUG POISONING (OVERDOSE).

OBJECTIVE: The aim: To investigate clinical and pathohistological manifestations of acute kidney injury among patients with drug poisoning (overdose). PATIENTS AND METHODS: Materials and methods: A cohort retrospective analysis of medical data of 86 patients treated in 2017-2021 with a diagnosis of "acute drug poisoning" com¬plicated by the development of acute kidney injury syndrome was conducted. A forensic medical examination of deceased patients (7 persons) was carried out. Histological samples were examined using an microscope OPTON Axioskop (Germany) in transmitted light, at magnifications of 100 and 400 times. Statistical analysis of the obtained data was carried out using the IBM SPSS Statistics 29.0.0.0 program, Pearson's correlation analysis was used, p≤0.05. RESULTS: Results: Acute renal failure in drug poisoning occurs under the influence of prerenal (hypoxia, r=0,66, р=0,0021; hypovolemia, r=0,61, р=0,0333) and renal factors (toxic effect of chemical components of the drug and rhabdomyolysis, r=0,743, р=0,0034). In the tissue samples, erythrocyte stasis in the capillaries, general fullness of blood vessels, signs of the sludge effect and small diapedesis hemorrhages were found; vasculitis and perivascular sclerosis are noted; foci of mononuclear infiltration of the stroma, focal edema, necrosis and interstitial fibrosis; desquamation, degenerative-dystrophic changes of the nephrothelium, tubular atrophy were found; hyaline casts in separate tubules; focal glomerular changes with segmental increase of the mesangial matrix and proliferation of endothelial cells, atrophy and hyalinosis of individual glomeruli were noted. CONCLUSION: Conclusions: The multifactorial effect of opioids is confirmed by microcirculation disorders, vascular, interstitial, tubular and glomerular changes in the kidneys.

ASSESSMENT OF THE CONSEQUENCES OF THE DETERIORATION OF THE EPIDEMIOLOGICAL SITUATION DURING HOSTILITIES.

OBJECTIVE: The aim: Scientific substantiation of the methodology for predicting the consequences of the worsening of the epidemic situation on the territory of Ukraine during military operations for the timely adoption of measures for the medical protection of military personnel in conditions of biological contamination. PATIENTS AND METHODS: Materials and methods: Determination and generalization of the impact of biological contamination due to the use of biological weapons were carried out considering the main determinants of the epidemic process using the index and coefficient of medical protection. Applied methods of scientific research: epidemiological, system, and information approach. RESULTS: Results: The authors proposed indicators that consider the pathogenicity of the infectious agent, contagiousness, the degree of non-specific protection of servicemen, specific protection of servicemen, and the sanitary-epidemiological state of the area of operations of troops (forces). Relevant epidemic situations were simulated, and the index and coefficient of medical protection were calculated to predict the consequences of the worsening of the epidemic situation to make timely decisions regarding the implementation of medical protection measures for military personnel in conditions of biological contamination during the repulsion of armed aggression. CONCLUSION: Conclusions: In the conditions of biological contamination, when biological weapons and biological terrorism are used, the epidemic process in the army is intensified, which requires timely decisions regarding the implementation of medical protection measures for military personnel in conditions of biological contamination.

Borys I. Palamar, Liliia M. Hrynevych, Liudmyla L. Khoruzha, Mariia V. Bratko, Svitlana P. Palamar, Olena O. Muzyka, Inna V. Leontieva PSYCHOEMOTIONAL PROBLEMS OF PARTICIPANTS IN THE EDUCATIONAL PROCESS UNDER MARTIAL LAW: FROM EMERGENCE TO OVERCOMING.

OBJECTIVE: The aim: To study the peculiarities of psycho-emotional problems and needs of the subjects of the educational process and to determine the priority areas of their psychological and pedagogical support in the conditions of martial law. PATIENTS AND METHODS: Materials and methods: To update the aspects of the problem, we used the methods of analysis of normative and scientific sources, system analysis and generalizations, the results of our own empirical studies, materials of the questionnaire, to study the specifics of psycho-emotional problems and needs of the subjects of the educational process. RESULTS: Results: The problem of socio-psychological protection and support of all participants in the educational process in the conditions of martial law, especially children, is extremely important. Challenge for schools in Kyiv is the organization of the educational process for children who are abroad but continue to obtain general secondary education according to Ukrainian educational standards and programs. This ensures the realization of their constitutional right to education and demonstrates certain support for our citizens who do not yet have the opportunity to return to Ukraine. CONCLUSION: Conclusions: Considering the massive nature of traumatization of the population during military operations, there is a need to involve social institutions in the maintenance of public health, for which assistance to the population is not the main function, but which they can perform in these extraordinary circumstances. This can form the basis for establishing psychological and pedagogical support for war-traumatized children and adults.

AGE AND GENDER-SPECIFIC FEATURES OF CYTOGENETIC CHANGES IN BUCCAL EPITHELIUM IN INDIVIDUALS RESIDING IN THE «SICK BUILDING¼.

OBJECTIVE: The aim: The study of cytomorphological and cytogenetic features of the buccal epithelium of residents of apartments who complained of unpleasant odors in their homes. PATIENTS AND METHODS: Materials and methods: The state of buccal epithelium in residents of multi-story buildings was studied. A total of 237 individuals were examined, 117 males and 120 females, aged from 6 to 81 years. Buccal cells were collected using a sterile spatula and stained with a 2.5% solutionofaceto-orcein and 1% light green. The preparations were examined using a light microscope OPTON Axioskop (Germany) with oil immersion at a magnification of x1000. Statistical processing of the data was performed using IBMSPSS Statistics 29.0.0.0 (t-Student criterion; Mann-Whitney; ANOVA: Tukey; T3-Dunnett), with p≤0.05. RESULTS: Results: Cytomorphological and cytogenetic abnormalities, compared to physiological limits, were mainly manifested as karyorrhexis, nuclear doubling, the appearance of epitheliocytes with perinuclear vacuoles, or nuclear vacuolization. The frequency of micronuclei was observed in the range of (0.3-2.8 ‰). The highest micronucleus index (per 1000 cells, ‰) was observed among males aged 15-39 years and females over 65 years old. In both sexes, the lowest micronucleus indices were found in the age group of 6-14 years. CONCLUSION: Conclusions: in the «sick building¼ an increase in the frequency of micronucleus occurrence among males and females was observed simultaneously with increasing age.

PSYCHOLOGICAL FACTORS OF STUDENTS' VITALITY DURING THE WAR IN UKRAINE.

OBJECTIVE: The aim: A theoretical analysis of the problem of the hardiness of a person who suddenly found himself in extreme conditions and an empirical study of his individual and psychological factors that contribute to the strengthening of this personal characteristic and mobilize the internal reserve of student youth. PATIENTS AND METHODS: Materials and methods: The following psychodiagnostic methods were used in the empirical study: "Methodology for the diagnosis of hardiness" by S. Muddy, "Test for the diagnosis of properties of the nervous system" by Y. Strelyau, "Methodology for the diagnosis of character accentuations" by K. Leonhard, "Mini-Mult Test", "Psychological Stress Scale", "Coping Behavior Questionnaire" by R. Lazarus, S. Folkman, "Test of Meaningful Life Orientations" by D. Leontiev, Life orientation test C. Scheyer, M. Carver. The study was conducted from September 2022 to January 2023. RESULTS: Results: It was established a direct connection of hardiness with a strong and mobile nervous system, hyperthymic and demonstrative accentuations of character. Inversely related to hardiness are pedantic, unbalanced, dysthymic, and exalted accentuations of character, all personality disorders. People with a high level of hardiness are characterized by expressed optimism, the meaningfulness of life, and the use of adaptive coping strategies. CONCLUSION: Conclusions: The study showed the high importance of hardiness for the full functioning of student youth during martial law and its conditioning by the properties of the nervous system and individual psychological characteristics. This emphasizes the need for making efforts to increase their level of vitality.

DISTINCTIVE FEATURES OF FUNCTIONING OF PREVENTIVE MEDICINE SERVICE OF THE MINISTRY OF INTERNAL AFFAIRS OF UKRAINE.

OBJECTIVE: The aim: Conducting a scientific analysis of domestic and foreign sources of information on modern views on the organization and implementation of preventive measures among the personnel of the Ministry of Internal Affairs of Ukraine. PATIENTS AND METHODS: Materials and methods: Used methods of historical-bibliographic and systematic approach. CONCLUSION: Conclusions: The article defines the structure, tasks and functions of the Center for Preventive Medicine of the Ministry of Internal Affairs in accordance with current legislation and substantiates the feasibility of reforming the preventive medicine service to monitor the health of servicemen, environment and dangerous or harmful factors.

THE INFLUENCE OF DYNAMIC SOCIETY ON STUDENTS' HEALTH.

OBJECTIVE: The aim: The article examines the impact of a dynamic society on the health of students of pedagogical specialties, identifies approaches to the formation of self-preserving and health-preserving behavior in student youth. PATIENTS AND METHODS: Materials and methods: A set of methods was used in one-step (cross-sectional) research: general scientific (analysis, synthesis, comparison, systematization, generalization), empirical (observations, interviews, questionnaires) to determine the impact of negative factors of a dynamic society on student health. The object of research is the process of the impact of a dynamic society on student health. Subject - factors influencing the dynamic environment on the health of students of the first (bachelor's) educational level of pedagogical specialties. RESULTS: Results: In our opinion, the dynamism of modern society is an important factor in changing the personality of a young person to understand the value of their own health, awareness of the relationship of physical, social, spiritual, and intellectual development in health. The results of the study are based on a survey of students. The questions were formulated in such a way as to investigate the influence of the factors of a dynamic society on the well-being and health of the respondents. The study was conducted remotely during the COVID-19 pandemic using a Google questionnaire. CONCLUSION: Conclusions: The results of the survey of students provided an opportunity to study the impact of dynamic society factors on the well-being and health of respondents and find out the importance of responsible self-preservation and health-preserving behavior and professional career.

RESULTS OF RESEARCH OF PERSONAL HYGIENE PRODUCTS FOR SUITABILITY FOR SPECIAL PROCESSING IN ZONES OF CHEMICAL, RADIOACTIVE CONTAMINATION AND IN COMBAT CONDITIONS.

OBJECTIVE: The aim: Research of personal hygiene products with detoxification properties by evaluating their formulation composition, emulsifying and complexing ability to heavy metal ions and radionuclides. PATIENTS AND METHODS: Materials and methods: The complex-forming ability of raw materials with heavy metal ions was determined in vitro, the content of heavy metals was determined by the method of atomic emission spectrometry with inductively coupled plasma (BS EN 13805:2014); determined the content of 137Cs, 232Th, 40K, 226Ra, 90Sr in washings from the surface of the skin of hands treated with personal hygiene products. The means were tested for compliance with the standard on scintillation spectrometers of gamma radiation energy «SEG-001¼ «AKP-S¼ and beta radiation (SEB-01-70); methods used: MI 12-04-099 and MI 12-05-099. RESULTS: Results: A high complexing ability of the pectin-containing «Liana¼ shampoo was found in relation to heavy metal ions (Co2+, Cu2+, Zn2+, Cd2+, Pb2+), as well as in their combined presence. It was established that the effectiveness of removing fatty impurities from the surface of the skin of the «Liana¼ product was 10.1 times higher than that of liquid soap (p<0.001). A high level of deactivating, degassing and antibacterialproperties of the personal care products «Bastion¼ and «Bastion-M¼ was revealed. CONCLUSION: Conclusions: Today, there is significant potential in the creation of formulations for special (sanitary) skin and hair surface treatment, containing natural complexing agents as detoxicants, and can be used in special professional activities associated with the risk of exposure to CBRN factors.

FEATURES OF PSYCHOLOGICAL EXPERIENCES IN SEVERE QUARANTINE DURING THE COVID-19 PANDEMIC: THE ROLE OF TOLERANCE FOR UNCERTAINTY.

OBJECTIVE: The aim: To examine the features of experiences during quarantine relating to the tolerance for uncertainty. PATIENTS AND METHODS: Materials and methods: 306 volunteers aged 18-65 years participated in this study. All participants were tested during strict quarantine in April 2020. In order to diagnose the personality traits related to ambiguity tolerance, we used Budner's scale of tolerance-intolerance of ambiguity. To determine the features of experiences we used the survey, which included 40 statements and 12 emotional states related to the cognitive, emotional-evaluative, and behavioral components of the person's self-image. RESULTS: Results: The overwhelming majority of volunteers perceive the pandemic as a dangerous, threatening, uncertain situation and make hasty decisions on the base of polar judgments, react with anxiety, attempt to avoid uncertainty, rejection of everything unusual. Their experiences were filled with feelings of powerlessness and deterioration in mood. For the majority of our subjects, the situation of uncertainty is the source of intolerance. Negative consequences appeared in the behavior (loss of time management skills, laziness). There are direct relationships between the factor of shock and anxiety with the sources of intolerance, novelty and complexity, and general intolerance. The cognitive component of the experience was the least pronounced and involved only after an emotional experience. CONCLUSION: Conclusions: It has been established that cognitive rethinking of the self-isolation during the COVID-19 pandemic is possible after an emotional response and leads to a change in the behavioral stereotypes.

RESEARCH OF THE ACTUAL ENERGY CONSUMPTION OF THE MILITARY PERSONNEL OF THE ARMED FORCES OF UKRAINE TO SUBSTANTIATE THE CORRECTION OF THEIR DAILY DIET.

OBJECTIVE: The aim: Is to determine the actual energy costs of servicemen on the qualification course of special operations of the Armed Forces of Ukraine to substantiate the adequate nutritional and energy value of their diet. PATIENTS AND METHODS: Materials and methods: The actual average daily energy consumption of 85 servicemen of the qualification course (hereinafter - Q-course) of special operations of AF of Ukraine was determined by time-table and instrumental methods. By laboratory, calculation and questionnaire methods, the compensatory possibilities of their actual nutrition were assessed. RESULTS: Results: The data obtained indicate that the highest indicators of energy expenditures among servicemen were during the first phase of selection of the Q-course at the level of an average value of 6853 ± 963.9 kilocalories (hereinafter - kcal) per day. At the same time, the calorie content of actual food consumed only by 55.7% provided compensation for the average daily energy costs. In this regard, we have developed and implemented "Organizational and Methodological Guidelines for Rational Nutrition of Servicemen of SOF of AF of Ukraine". CONCLUSION: Conclusions: The actual nutrition of the military personnel on the Q-course of SOF of AF of Ukraine does not fully compensate for their real energy losses. The nutritional and energy value of the daily diet requires revision and bringing it into line with the actual energy consumption, depending on the preparation phases.

VALUE-MOTIVATIONAL COMPONENT OF A HEALTHY LIFESTYLE OF MODERN UNIVERSITY STUDENTS: THE REAL STATE AND LOGIC OF FORMATION.

OBJECTIVE: The aim: The article presents the theoretical substantiation of the value-motivational component of a healthy lifestyle, the diagnostic procedure, the results of quantitative and qualitative analysis of the real state of its formation in students of modern universities; the pedagogical tools of health-oriented, containing interactive and reflexively oriented forms and methods of educating a healthy lifestyle are presented; specific examples of their implementation are given. PATIENTS AND METHODS: Materials and methods: A set of general scientific methods (analysis, synthesis, comparison, systematization, generalization) and diagnostic standardized methods (M. Rokich's "Value orientations" method, R. Berezivska's questionnaire "Attitude to health" (value-motivational scale), questionnaire "Motivational component of a healthy lifestyle" (N. Voloshko, V. Rybalka). RESULTS: Results: A healthy lifestyle is a way of life based on the value attitude to maintaining, improving and strengthening health through motivated activities aimed at improving living conditions, which ensures quality self-realization of the individual in all spheres of life. An essential component of the structure of a healthy lifestyle is the value-motivational component as a set of motives, needs, attitudes to maintain one's own health and fostering a sense of responsibility for it. The pedagogical tools of health orientation are a set of interactive and reflexively oriented forms and methods of forming a healthy lifestyle, which are based on the partner subject-subject interaction of teacher and students, their dialogue, polylogy and cooperation. CONCLUSION: Conclusions:Theoretical understanding and the results of diagnostic research made it possible to determine the nature and structure of a healthy lifestyle, to determine the real state of formation of its value-motivational component and to develop pedagogical tools of health orientation.

ALEXITHYMIA FORMATION AS AN ADAPTATION TO EVERYDAY STRESS IS DETERMINED BY THE PROPERTIES OF THE NERVOUS SYSTEM.

OBJECTIVE: The aim of the study was to determine the psychological nature and mechanisms of alexithymia formation by way of the analysis of its relation to the properties of the nervous system, mental states, and characteristics of the emotional sphere of the personality. PATIENTS AND METHODS: Materials and methods: In the process of the study, for the diagnostics of alexithymia, we used the 26-item Toronto Alexithymia Scale (TAS-26) developed by G.J. Taylor and a block of psycho-diagnostic methods aimed at the diagnostics of properties of the nervous systems, the emotional sphere and mental states of respondents. The relationships were evaluated using Spearman's rank correlation coefficient and Pearson's correlation coefficient. RESULTS: Results: The main factors related to alexithymia were weak nervous system, low stress resistance and such characteristics of the emotional sphere as marked extraversion, high level of trait anxiety, neuroticism, indirect verbal aggression, low levels of aggressiveness. The emotional exhaustion and reduction of personal achievements, the Resistance Phase, chronic fatigue and depression were the most pronounced within the alexithymia group. The alexithymic personality type demonstrated less developed spatial anticipation. CONCLUSION: Conclusion: In accordance with our results, the weakness of the nervous system and high Trait Anxiety facilitate the adaption to stressful situations by avoiding and crowding out negative emotions, lead to the inability of verbal description and expression of emotions. A low level of stress resistance conduces to neurotization, chronic fatigue, and emotional burnout. The predominance of refractory and dysphoric reactions causes a negative vision of the situation and can provoke the development of psychosomatic disorders.

Preparation content updating of future dentists to professional interaction.

OBJECTIVE: Introduction: One of the most important indicators of the professional training of future dentists, their competitiveness is the development of professional interaction. The aim of the article is to update the content of the training of future dentists to engage in professional interaction. PATIENTS AND METHODS: Materials and methods: The study, completed during 2015-2018, was attended by 292 students of the specialty "Stomatology". The research uses the following methods: theoretical - analysis, synthesis, systematization and synthesis of scientific literature; empirical - testing, survey, monitoring, pedagogical experiment to find out the effectiveness of the developed content of training future dentists; methods of mathematical statistics. RESULTS: Results and conclusions: For realization of the research purpose it was specially developed a discipline "Professional interaction of dentists" which is aimed at the realization of the tasks: the acquisition of future dentists theoretical knowledge on problems of communication and interaction; increasing the need for communication, implementing a variety of interactions; the formation of future dentists readiness for the implementation of professional interaction, positive communicative attitude to team interaction and receiving satisfaction from it. The program results of the study of the indicated discipline are presented, content of its modules is disclosed. Interactive forms which are used in the process of training future dentists (trainings, business games, problem situations, etc.) and teaching methods (dialogue-discussion, polygon, brainstorming, method of ideas generation, situational dialogues, etc.) are described. The components of future dentist's readiness for professional interaction are developed: motivational, cognitive, operational and personal. The results of the pedagogical experiment, which proved the effectiveness of the implementation of the special course "Professional Interaction of Dentists¼, are presented. Statistical analysis of the results of the study made it possible to establish that after studying the special course in the experimental group there was a noticeable significant increase in the number of students assigned to the high level, in addition, the number of future dentists with a low level was significantly reduced.

Innovative and interactive teaching methods as a means of optimizing the educational process of higher medical education.

OBJECTIVE: Introduction: The public need prompts the modern school to find new ideas and technologies, to share and adopt the advanced pedagogical experience. Achieving the ultimate goal of the educational process in universities is training of highly qualified and competitive specialists in health care. The aim of the study is to assess the results of using the innovative and interactive teaching methods implemented in the national system of higher medical education. PATIENTS AND METHODS: Materials and methods: Official documents; the academic studies of leading Ukrainian scientists-pedagogues; textbooks and manuals on pedagogy, the results of our own pedagogical practice. CONCLUSION: Conclusions: The widespread adoption of digital technologies into the educational process at clinical and theoretical departments of medical universities significantly simplifies the assimilation of the disciplines, optimizes and generalizes the results of the educational process. The innovative path of education development is a "social elevator" that raises people to higher levels of social development.

Epidemiological support for HIV / AIDS in the armed forces of ukraine: problem questions and ways for decision-making

The article assesses of the system of epidemiological surveillance of HIV / AIDS in the Armed Forces of Ukraine. It has been established that now the current system of epidemiological surveillance is imperfect. There is a risk of increasing the incidence of HIV infection in organized military groups. Existing gaps in the epidemiological surveillance system create problems in planning and implementing measures to prevent the emergence and spread of HIV among the military.

Didactical determinants use of information and communication technology in process of training of future specialists.

In the article the author touches upon the subject of significance of computer equipment for organization of cooperation of professor and future specialists. Such subject-subject interaction may be directed to forming of professional skills of future specialists. By using information and communication technologies in education system range of didactic tasks can be solved. Improving of process of teaching of subjects in high school, self-learning future specialists, motivating to learning and self-learning, the development of reflection in the learning process. The authors considers computer equipment as instrument for development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems on the creative basis. Based on results of researches the author comes to certain conclusions about the effectiveness of usage of computer technologies in process of teaching future specialists and their self-learning. Improper supplying of high schools with computer equipment, lack of appropriate educational programs, professors' teachers' poor knowledge and usage of computers have negative impact on organization of process of teaching disciplines in high schools. Computer equipment and ICT in general are the instruments of development of intellectual skills, potential and willingness of future specialists to solve communicative and communication tasks and problems. So, the formation of psychosocial environment of development of future specialist is multifaceted, complex and didactically important issue.

Didactic aspects of cognition of human as a bio-psycho-socio-cultural personality.

Modern education, according to leading Ukrainian scientists, requires the development of a new paradigm, which will consider the phenomenon of man holistically. The article describes didactic aspects of cognition of human as a bio-psycho-socio-cultural personality, as social fact, as a phenomenon. For the actualization of the didactic aspects of the problem, the authors used the methods of scientific literature analysis, systemic analysis and generalizations, analysis own practice of didactic and methodological character. Reforming the systems of education and medicine should occur in the context of providing active, creative, productive human life. Practice of system analysis proved that man as a subject of study should be considered as a biological entity, a social being, the bearer of consciousness and culture. A holistic approach to the study of man, viewing him as creatures of the natural (bodily) and social individual (society, culture) and the subject of mental and spiritual (creative and deliberate) activity can reveal its unique originality. The uniqueness of the phenomenon of man as the subject and object of research lies in its indivisibility, which is based on the unity of the laws of nature and society. Therefore, when studying the person should take into account the interests of social and natural Sciences. This once again confirms the idea of the necessity of human studies with the help of a systematic approach, which generates true and holistic view of the person, that involves the development of meta-perception of world and ourselves.