PARAMETERS OF ENDOTHELIAL DYSFUNCTION AND IMMUNE RESPONSE IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH AND WITHOUT ISCHEMIC HEART DISEASE.

OBJECTIVE: The aim: To determine changes in endothelial dysfunction and immunological response in patients with rheumatoid arthritis with and without coronary heart disease. PATIENTS AND METHODS: Materials and methods: The study involved 151 patients with RA and coronary heart disease. The ED was assessed by examining the NO system in RA for determination of the content in the blood of the product of NO synthase - the final metabolites of NO2- and NO3- and the level of VEGF and CD28 in the serum. RESULTS: Results: The results of the study of the levels of metabolites NO2- and NO3- in the first and second groups showed their increased content. Analysis of the content of VEGF in the blood for patients with different durations of the disease showed that the concentration of the studied protein grows larger with increasing duration of the disease. The maximum of sCD28 concentration was found in middle-aged patients, and the minimum (the difference was significant) - in the elderly. CONCLUSION: Conclusions: As the duration of the disease increases, the content of VEGF in the blood of patients increases, which, at the same time, did not show age dependence on RA and did not change further with concomitant coronary heart disease. Detected concentrations of sCD28 are higher in patients with less prolonged RA, and begin to decrease with increasing duration of the disease.

MELATONIN AND GRHELIN AS "EARLY" PROGNOSIS MARKERS OF PROGRESSION OF ARTERIAL HYPERTENSION AND OSTEOARTHRITIS IN THE CASE OF THEIR COMORBIDITY.

OBJECTIVE: The aim: Of the study was to investigate the effect of melatonin on the serum levels of ghrelin in patients with hypertension combined with osteoarthritis in order to identify them as informative and reliable markers of early diagnosis of progression of these comorbid diseases. PATIENTS AND METHODS: Material and methods: To achieve the goals and objectives of this study, 60 patients with hypertension combined with osteoarthritis were involved and examined, in particular, serum ghrelin and melatonin levels were determined twice and divided into two groups. RESULTS: Results: It was found that in patients of group I on the background of the four-week main course of treatment with the addition of melatonin (3 mg 1 time per day before bedtime), the average value of ghrelin increased by an average of ± 2.05 ng/ml (p <0,05). In patients of group II, who, in addition to their usual treatment, did not receive additional melatonin, the dynamics of ghrelin growth was lower, on average increased by ± 0.54 ng/ml (p <0.05). It was also found that the higher the BMI, the lower the serum ghrelin in the examined patients (r = -0.56, p <0.01). CONCLUSION: Conclusions: The data obtained show the correlation between ghrelin and melatonin concentrations (r = +0.72, p < 0.001) in patients with hypertension associated with OA. Therefore, indicators of their levels can be used as "early" reliable prognostic markers of development and progression of these mentioned comorbid pathologies.

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.