THE ROLE OF ADVERSE CHILDREN'S EXPERIENCE IN THE DEVELOPMENT OF PSYCHOLOGICAL DISORDERS AMONG PARTICIPANTS IN ANTI-TERRORISM OPERATION.

OBJECTIVE: The aim: The sense of our research was to examine the reason for the consequential links between negative childhood experiences and the mental state of participants of anti-terrorist operations. PATIENTS AND METHODS: Materials and methods: A standard "Adverse Childhood Experiences (ACEs)" questionnaire was used to obtain primary data. Conflict tactics scales were used to determine emotional, physical, and domestic violence in respondents. RESULTS: Results: The study evaluated 7 categories of ACEs: physical indifference (lack of care and protection); emotional neglect (lack of love); physical violence (pushing, grabbing or slapping); emotional violence (scolded, insulted or suppressed); sexual violence; domestic violence and a family history of mental disorders, diseases or alcohol abuse. All respondents were divided into two groups: those who had psychological disorders and those who were healthy. CONCLUSION: Conclusions: The data obtained in the study indicate that the chances of having psychological disorders increase in those fighters who complained of emotional violence - the feeling of humiliation; physical violence - those who were beaten in childhood; domestic violence was manifested in the fact that the mother was beaten; disadvantaged families where a family member has used drugs or abused alcohol; the presence of depression in parents.

RELATIONSHIP BETWEEN CERVICAL CANCER AND THE LEVEL OF PREVENTIVE ONCOLOGICAL EXAMINATIONS.

OBJECTIVE: The aim: Of this study is to determine the relationship between the development of cervical cancer and the level ofconducting of preventive oncological examinations. To identify risk factors of cervical cancer, we considered seven prognostic variables, that are associated with the development of cervical cancer. PATIENTS AND METHODS: Matherials and methods: We conducted a survey of 120 women, among them 40 (33.3%) women had a confirmed diagnosis of cervical cancer, and 80 (66.7%) women were healthy. RESULTS: Results: We find, that factors that increase risk of cervical canser is age after 40 years increases the chances of cervical cancer by 14 times; untimely medical examinations increase by 5,4 times; the number of sexual partners, more than 4 - in 6 times. CONCLUSION: Conclusions: A comprehensive medical and social study has established a reliable relationship between the development of cervical cancer and the level of preventive cancer examinations.

Comparative analysis of the dynamics of modified risk factors of non-communicable diseases among the population of China and Ukraine.

OBJECTIVE: Introduction: In the modern world, the problem of non-communicable diseases, which nowadays constitute the main cause of social and economic losses, is extremely topical: the main causes of disability and mortality of the working population are caused by non-communicable diseases. The aim is a comparative analysis of the prevalence and dynamics of the risk factors of the NCDs, and the overall mortality rate between the economically developed country - China and the developing country - Ukraine. PATIENTS AND METHODS: Materials and methods: To achieve the set goal, the method of data analysis was used - the alignment of dynamic rows with the definition of increasing rates, the determination of reliability between two unrelated aggregates, triangulation. Material: annual reports of the State Statistics Service of Ukraine and the National Bureau of Statistics of China. RESULTS: Review: As a result of the study, it was found that with the tendency to reduce the mortality rate, the mortality rate in Ukraine exceeds the rate in China, especially among men (2.5-3 times); the percentage of smoking is 6 times higher among Ukrainian women; an increase in malnutrition is observed in Ukraine, while in China it is constantly decreasing; in both countries there is an increase in the frequency of obesity in both sexes, but in Ukraine the prevalence is 4-6 times higher. CONCLUSION: Conclusions: Thus, using the obtained data, one can conclude that, despite the difference in the level of economic development between countries, behavioral risk factors remain an extremely important problem.

Epidemiology of diseases of the circulatory system among the population of Poltava region.

OBJECTIVE: Introduction: In Ukraine more than half of deaths have been caused by cardio-vascular diseases (CVD). Among the able-bodied population, the share of CVD in the structure of causes of mortality is 29,9%. In the structure of causes of mortality among the persons of retirement age, CVDs accounted for 75,9% and exceeded the proportion of neoplasms in 6,5 times. The aim is to analyze of morbidity and mortality rates of diseases of the CVD among the population of Ukraine and Poltava region, to conduct a comparative analysis of data to identify possible ways to improve the situation. PATIENTS AND METHODS: Materials and methods: A retrospective study of morbidity and mortality rates by age, gender and cause (2014-2018) was conducted and the statistical method was used to analyze dynamic (time) series. RESULTS: Review: An analysis of the dynamics of population mortality indicates significant fluctuations in it`s levels over ten years. At the same time, by the method of alignment of the dynamic series, a tendency to a slight decrease in the mortality rate of the population from 17,1‰ to 16,9 ‰ was established. The mortality of the population of Ukraine in 2018 from diseases of the circulatory system was 1000,8 per 100 thousand people. Data on mortality rate in the Poltava region significantly higher than those in Ukraine. CONCLUSION: Conclusions: The age structure of the population of Poltava region belongs to the regressive type. The mortality rate among the population of Poltava region is slightly decreasing but remains at a very high level (16,9 ‰). In the structure of causes of death, diseases of the circulatory system are at the first place (70,8%), the second place belongs to neoplasm (13,5%), and third are the external causes of death (4,8%).

Planning of effective evaluation of the activities of hospital district at the example of poltava region.

OBJECTIVE: Introduction: Increasing of the availability and quality of health care in rural areas is one of the priority directions of public health and regional development policy. The need for reforming of the network of secondary health care facilities is due to the fact, that they are unable to meet the needs of the population in this specialized type of medical care in the conditions of the existing structure and funding system. The aim: to analyze the existing legislation regulating the establishment and operation of hospital districts; to determine the methodology for monitoring and evaluating of the activity of the hospital district on the example of the Poltava region. PATIENTS AND METHODS: Materials and methods: In this work a set of methods is used: system approach, bibliosemantic, legal, logical modeling. RESULTS: Review: A managerial tool capable of tracking the process and demonstrating the impact of projects, programs and development policies is monitoring and evaluation. The basis of evaluation is the creation of different indicators and indexes. The system of these indicators provides an opportunity to assess the social, medical, economic and environmental aspects of development of hospital district. The monitoring and evaluation program should include monitoring of implementation (contributions and activities) and monitoring of the results of work of the hospital districts (short-term and long-term). CONCLUSION: Conclusions: Hospital districts are created with the aim of optimizing of the organization and functioning of the network of health facilities. The Management Board's decision should be based on valid, reliable information on the development of the hospital district. Compliance with the monitoring and evaluation methodology makes it possible to provide the health care system with qualitative and timely data at all stages of its reformation.

52-week results of the phase 3 randomized study comparing SB4 with reference etanercept in patients with active rheumatoid arthritis.

Objective: To compare the 52-week efficacy and safety of SB4 [an etanercept biosimilar] with reference etanercept (ETN) in patients with active RA. Methods: In a phase 3, randomized, double-blind, multicentre study, patients with moderate to severe RA despite MTX treatment were randomized to receive 50 mg/week of s.c. SB4 or ETN up to week 52. Efficacy assessments included ACR response rates, 28-joint DAS, Simplified and Clinical Disease Activity Indices and changes in the modified total Sharp score (mTSS). Safety and immunogenicity were also evaluated. Results: A total of 596 patients were randomized to receive either SB4 (n = 299) or ETN (n = 297) and 505 (84.7%) patients completed 52 weeks of the study. At week 52, the ACR20 response rates in the per-protocol set were comparable between SB4 (80.8%) and ETN (81.5%). All efficacy results were comparable between the two groups and they were maintained up to week 52. Radiographic progression was also comparable and the change from baseline in the mTSS was 0.45 for SB4 and 0.74 for ETN. The safety profile of SB4 was similar to that of ETN and the incidence of anti-drug antibody development up to week 52 was 1.0 and 13.2% in the SB4 and ETN groups, respectively. Conclusion: Efficacy including radiographic progression was comparable between SB4 and ETN up to week 52. SB4 was well tolerated and had a similar safety profile to that of ETN. Trial registration number: ClinicalTrials.gov NCT01895309, EudraCT 2012-005026-30.

Medical evaluation of efficiency of optimized models for early detection and primary prevention of cardiovascular diseases.

INTRODUCTION: Nowadays cardiovascular disease occupies a leading place in the structure of the prevalence, incidence, disability causes and mortality of the adult population in Ukraine and in the whole world. The prevalence of hypertension in the adult population ranges from 25 - 40%, coronary heart disease is almost 20% of people aged 50-59 years while 24.3% of them have a form of silent coronary artery disease. The feasibility of study is justified by the need to perform health institutions Law of Ukraine dated 07.07.2011 year №3611-VI ≪On Amendments to the Basic Laws of Ukraine on health care on improvement of care" and MoH of Ukraine from 24.07.2013 № 621/60 "On the system of cardiac care in health facilities of Ukraine" therefore extremely important is to develop an optimized model of early detection and primary prevention of cardiovascular diseases at primary level of health care. The aim of the research is to develop methods and evaluation models optimized for early detection and primary prevention of cardiovascular diseases at a general practitioner of family medicine. MATERIAL AND METHODS: The methodical apparatus is of complex of medical and social research methods that meet the requirements of public health: bibliosemantyc, systematic approach and analysis, statistical, expert evaluations. To determine the effectiveness of medical evaluation was conducted in its 33 clinics of general practice in Poltava region, including 7 urban and 26 rural. In expert opinion is taken 825 patients, of which 175 urban and 650 in rural areas. The results of the study found that 193 patients (23.4%) achieved target blood pressure through the implementation of the recommendations concerning the optimization behavior towards of risk factors, lifestyle.

A phase III randomised, double-blind, parallel-group study comparing SB4 with etanercept reference product in patients with active rheumatoid arthritis despite methotrexate therapy.

OBJECTIVES: To compare the efficacy and safety of SB4 (an etanercept biosimilar) with reference product etanercept (ETN) in patients with moderate to severe rheumatoid arthritis (RA) despite methotrexate (MTX) therapy. METHODS: This is a phase III, randomised, double-blind, parallel-group, multicentre study with a 24-week primary endpoint. Patients with moderate to severe RA despite MTX treatment were randomised to receive weekly dose of 50 mg of subcutaneous SB4 or ETN. The primary endpoint was the American College of Rheumatology 20% (ACR20) response at week 24. Other efficacy endpoints as well as safety, immunogenicity and pharmacokinetic parameters were also measured. RESULTS: 596 patients were randomised to either SB4 (N=299) or ETN (N=297). The ACR20 response rate at week 24 in the per-protocol set was 78.1% for SB4 and 80.3% for ETN. The 95% CI of the adjusted treatment difference was -9.41% to 4.98%, which is completely contained within the predefined equivalence margin of -15% to 15%, indicating therapeutic equivalence between SB4 and ETN. Other efficacy endpoints and pharmacokinetic endpoints were comparable. The incidence of treatment-emergent adverse events was comparable (55.2% vs 58.2%), and the incidence of antidrug antibody development up to week 24 was lower in SB4 compared with ETN (0.7% vs 13.1%). CONCLUSIONS: SB4 was shown to be equivalent with ETN in terms of efficacy at week 24. SB4 was well tolerated with a lower immunogenicity profile. The safety profile of SB4 was comparable with that of ETN. TRIAL REGISTRATION NUMBERS: NCT01895309, EudraCT 2012-005026-30.