ACUTE MYOCARDITIS IN YOUNG AGE MIMICKING AS ST-ELEVATION MYOCARDIAL INFARCTION: CASE REPORT.

Acute myocarditis remains a diagnostic issue with a wide spectrum of clinical manifestations that could mimic ST-elevation myocardial infarction (STEMI). We present a case of a 26-year-old male with left-sided intense squeezing chest pain associated with elevated troponin, ST-segment elevations, and reduced ejection fraction. The patient was initially suspected of having a STEMI with non-obstructed coronary arteries (MINOCA). However, due to positive pair troponin tests, increased inflammatory markers there was suspected myocarditis and cardiac MRI confirmed this diagnosis. This case highlights the clinical significance of assessment of laboratory markers and cardiac MRI in diagnostics of myocarditis.

IMPROVEMENT OF QUALITY OF LIFE FOR PATIENTS WITH ASEPTIC NECROSIS OF THE FEMORAL HEAD AND NON-PSYCHOTIC MENTAL DISORDERS.

The problem of interaction between aseptic necrosis of the femoral head (ANFH) and mental disorders is of interest according to modern research. It is known that with ANFH, altered brain activity is detected in areas related to pain, emotions, and cognition, which proves the influence of joint disease on the formation of non-psychotic mental disorders (NPD). The current NPR along with somatic symptoms, affect the quality of life of patients. Quality of life is related to health and can be used to assess the quality of health, diagnose the nature, severity and prognosis of the disease, and evaluate the results of treatment.; Purpose - studying the quality of life of patients with ANFH and non-psychotic mental disorders in the course of treatment; 137 patients (92 men (67.2%), of whom 96 completed the study) were included in the study. A clinical-psychopathological study was conducted to determine the leading syndrome of non-psychotic mental disorders, and socio-anamnestic data were collected. Quality of life was assessed using a questionnaire quality of life SF-12 Patients of the first clinical group included participants with a duration of ANFH up to 5 years, and the second main clinical group included patients with a duration of ANFH of more than 5 years.; The average index of the mental component of the quality of life for the duration of ANFH up to 5 years was 43.46±9.00 points, and for the duration of more than 5 years - 36.55±10.35 points. The obtained results of the quality-of-life indicator of the patients in the study indicate a lower quality of life compared to the average population indicator (50±10 points). As the duration of ANFH increases, the quality of life deteriorates, and the mental component to a greater extent than the physical. Considering the selected leading syndromes, correction of NPR psychological and psychopharmacological interventions (antidepressants and/or anxiolytics depending on the clinical form of NPR) was carried out. Under the influence of the NPR correction, the following features were revealed: in the first main group, the physical component of the quality of life improved by 3.25 points (p<0.05), the mental component of the quality of life increased by 6.4 points (p<0.05). In the second main group, the physical component of the quality of life increased by 4.55 points (p<0.05), and the mental component of the quality of life changed positively by 10.55 points (p<0.05).; When the duration of the disease is up to 5 years, the leading syndrome of NPR affects the quality of life in various ways. In the presence of anxiety-depressive or depressive-hypochondriac syndromes, it is possible to restore the mental component of QoL to a normal level. The leading astheno-apathetic syndrome does not affect the quality of life of patients. When the duration of ANFH is more than 5 years, the mental component of QOL is most reduced in leading anxiety-depressive and depressive-hypochondriac disorders.

[SOME ASPECTS OF THE IMPACT OF THE COVID-19 PANDEMIC ON THE MENTAL STATE OF PEOPLE WITH THE HUMAN IMMUNODEFICIENCY VIRUS].

The purpose of this article is to study individual aspects of the impact of the COVID-19 pandemic on the mental state of PLHIV. The study covered 146 patients with HIV-related diseases who attended the outpatient department of the communal enterprise "Dnepropetrovsk Regional Center for Socially Significant Diseases of the Dnepropetrovsk Regional Council" during September-October 2020. HIV-infected were interviewed using a self-developed questionnaire. We used integrative test of anxiety by A.P. Bizyuk to investigate anxiety. The frequency of increased anxiety over the past half year among respondents is 15.75%; frequency of insomnia, weight loss, eating disorders - 12.32%; In 10.42% (n=15) cases, PLHIV had episodes of acute feelings of fear, palpitations, shortness of breath, chest tightness, panic while watching news about COVID-19. A high level of average value of situational anxiety among PLHIV was revealed - 7.8 (1.3) stanins - M (SD), in the structure of which "social defense reactions", a phobic component and anxious assessment of prospects prevail. 74.6% of HIV-infected strictly adhered to additional protection against COVID-19; 63.01% - considered crowded places a threat to their health; 52.74% were afraid to get sick with COVID-19; 49.31% - had an increased interest of PLHIV in COVID-19 in Ukraine and the world. The respondents used the following additional methods of protection: self-isolation (60%), strict adherence to distance (75%), disinfection of their belongings and household items (10%). The mental state of PLHIV during the coronavirus pandemic indicates the presence of symptoms of distress: the manifestations of anxiety-depressive disorders, insomnia have increased, a fixation has appeared on their physical condition, social isolation and distancing have increased. Further research into the characteristics of the psychoemotional state of PLHIV will help improve the organization of medical and social assistance in the current situation of the COVID-19 pandemic.

ANALYSIS OF DISABILITY AND REHABILITATION NEEDS OF THE ANTI-TERRORIST OPERATION/JOINT FORCES OPERATION PARTICIPANTS IN UKRAINE.

The purpose of the study - to conduct an analysis of the disability of ATO/JFO participants in 2014-2021 with a detailed comparative analysis of data of 2021 and determination of the needs of the mentioned contingent in rehabilitation devices. Operational information was collected according to the statistic form of ATO/OOS participants examined at the medical and social expert commissions: developed by the authors statistical form "Report on the causes of disability, indications for medical, professional and social rehabilitation in ATO participants for _____ year", which was summarized and processed. Materials were collected from 2014 to 2021. More than a half of those recognized for the first time as disabled, 2,997 people in 2021 (86.0%), 2,624 people in 2020 (81.2%), 3,297 people in 2019 (79.3%), 2,848 people (75.5%) in 2018 and 1,859 people (65.0%) in 2017 - received the disability group not as a result of traumatic injuries, but for other unspecified reasons that did not have a traumatization factor. The main causes of disability were diseases of the circulatory system (47.9%), musculoskeletal system (13.4%), mental and behavioral disorders (7.2%), neoplasms (3.8%), diseases of the nervous system (3.3%), endocrine diseases, nutritional disorders, and metabolic disorders (3.2%), diseases of the digestive organs (2.0%), some infectious and parasitic diseases (1.6%), respiratory diseases (1.3%) and other reasons (0.7%). In 2021, less than » (14.0%) of ATO/JFO participants were initially recognized as disabled due to various traumatic injuries, which is 25.5% less than in 2020. Among the patients with injuries of the musculoskeletal system, prevailed the victims with injuries of the lower extremities - 92 people, with injuries of the upper extremities - 44 people, polytraumas 38 people, combined injuries - 22 people. Traumatic lesions of the spinal cord led to the onset of disability in 7 persons, traumatic eye lesions in 12 persons. Medical rehabilitation services, including restorative treatment, reconstructive surgery, and orthotics, were the most needed among the examined ATO/JFO participants. More than half of the participants of ATO/JFO received the disability group due to other reasons that did not have a trauma factor, not traumatic injuries. Traumatic brain lesions accounted for 6.9% of the total number of ATO/JFO participants recognized as disabled, musculoskeletal injuries - 3.9%. 1.1% were recognized as disabled due to polytraumas, 0.2% due to combined injuries. Traumatic lesions of the spinal cord led to the onset of disability in 0.2%. With a traumatic eye injury, 0.3% were recognized as disabled. Complicated limb injuries with damage to peripheral nerves accounted for 0.1% and blood vessels - 0.1%. Medical rehabilitation services, including restorative treatment, reconstructive surgery, and orthotics, were the most needed among ATO/JFO participants examined. The increase in the number of ATO/JFO participants initially recognized as disabled due to reasons not related to traumatic lesions requires further careful analysis, determination of the reasons for such a situation and the development of effective measures for the prevention of disability and the return of lost functionality in the specified contingent, which will become the topic of further research.

[; PSYCHOLOGICAL PORTRAIT OF A PARTICIPANT OF MILITARY ACTIONS AND STRESS-ASSOCIATED VIOLATIONS].

The problem of studying, diagnosing and correcting stress-associated disorders resulting from exposure to psychogenic factors, the sources of which are various traumatic events, is one of the most relevant.; The purpose of the work is to create a psychological portrait of a combat participant for the subsequent development of preventive measures for stress-associated disorders. To study the psychological characteristics and psycho-emotional state, a comprehensive clinical and psychological examination of 147 military personnel was carried out after mostly mine-blast injuries received while performing official duties in the ATO zone.; The state of mental functions, and the emotional-volitional sphere and personality traits were evaluated. The points and characteristics of the test methods were analyzed, the total number of points was calculated separately on each scale.; A generalization of the results of the study allowed us to determine the main aspects of the psychological portrait of a military man. The essence of the portrait consists in harmonious restructuring from conscious to unconscious psychological attitudes and vice versa, in changing the subjective hierarchy of values and also to note that the character of the traumatic situation is not important in the portrait of the ATO participant, but the personal attitude of the participant and his environment.