Background. Connective tissue disease, in particular rheumatoid arthritis (RA), is characterized by a progressive joint damage and polymorphism of extra-articular lesions that affect the patient’s quality of life. Although the widespread implementation of basic therapy through the use of disease-modifying antirheumatic drugs has a positive effect on social consequences, the experience gained shows the impossibility of achieving a stable remission of the disease or reducing the activity of autoimmune inflammation against the background of using these medicines in all patients for a number of reasons. One of these reasons is the presence of comorbid pathology, which requires a personalized approach to each person. The objective was to study the quality of life of patients with RA in combination with type 2 diabetes mellitus (T2DM), hypertension and obesity depending on the T-786C polymorphism of the endothelial nitric oxide synthase gene promoter. Materials and methods. A laboratory and instrumental examination involved 110 patients who were treated at the clinical base of the Department of Internal Medicine of Bukovinian State Medical University, Chernivtsi Regional Endocrinology Center, Chernivtsi Regional Clinical Hospital, and Reference Center for Molecular Genetic Research of the Ministry of Health of Ukraine. Results. When assessing the quality of life in the studied groups, a decrease in indicators on all scales was detected. Thus, in RA combined with hypertension and obesity, PF was 1.73 times lower, RP — 1.97 times, BP — 1.44 times, SF — 1.46 times, MH — 1.26 times , RE — 1.66 times, GH — 1.35 times (p < 0.05) lower than in patients with isolated RA. Taking into account the T-786C polymorphism of the eNOS gene, it can be asserted that all indicators of quality of life were reduced in the carriers of the СС genotype, in contrast to the carriers of the T-allele: PF — by 2.06 (pTT < 0.05) and 2.46 times (pTС < 0.05); RP — by 2.0 (pTT < 0.05) and 2.87 times (pTС < 0.05); BP — by 1.86 (pTT < 0.05) and 2.52 times (pTС < 0.05); SF — by 1.55 and 2.07 times (рTС < 0.05); MH — by 1.42 (pTT < 0.05) and 1.53 times (pTС < 0.05); RE — by 1.30 (pTT < 0.05) and 1.54 times (pTС < 0.05); VT — by 3.34 (pTT < 0.05) and 3.72 times (pTС < 0.05); GH — by 2.32 (pTT < 0.05) and 2.38 times (pTС < 0.05), respectively. Conclusions. When comparing the quality of life in the studied groups, it can be stated that the lowest indicators on all scales were in patients with RA combined with hypertension, obesity and T2DM and in carriers of the СС genotype of the analyzed gene, which reflected the worst physical condition and psychosocial status.

The relevance of the study is conditioned by the fact that each student of a higher education institution, in particular in the medical field, is a person, who has their own worldview, temperament, and personality, perceives the educational material differently, and therefore, requires an individual approach to learning. The purpose of the study is to determine the role of student typology in the perception of educational material. The research methods were individual typological questionnaires by L. Sobchyk and “Goal-Means-Result” by O. Karmanov. Students of the second and fourth years of study took part in the survey. It was found that among the fourth-year students, introversion and sensitivity reached the lowest indicators, against the background of increased anxiety, lability, extraversion, spontaneity, aggressiveness, and rigidity. In the second-year students, introversion reached higher scores than anxiety and lability. In the training system, both in the second and fourth years, there is a high motivation to study the material, but the achievement of the desired result is found to be higher among the second-year students. Students of the second and fourth years of study have harmonious and accentuated features that would help them choose their future profession. However, the fourth-year students who are inclined to leadership and have a well-formed mindset always focus their attention on the specific chosen medical field. Confidence in own knowledge sometimes leads to the establishment of an incorrect conclusion, since in medicine there is always a comorbidity of conditions. Knowledge of the students’ typology would help the teacher determine the characteristics of each student and find the right approach to the presentation of educational material, which would contribute to a better perception of medical topics.