Tracheobronchopathia osteochondroplastica (TO) is a rare chronic disease of the airways characterized by the growth of cartilage and/or bone tissue in the submucosal layer of the trachea and large bronchi with varying degrees of their lumen narrowing. In a significant percentage of cases diagnosis is made only posthumously due to the late onset of clinical manifestations and the considerable complexity of life-time diagnostics.The objective of the research was to conduct the clinical observation of OT.Materials and methods. A patient Sh., 49 years of age, was admitted to the department of differential diagnostics of regional clinical pulmonology center to determine the cause of prolonged cough and bronchial obstruction syndrome. Only fiber-optic bronchoscopy (FBS) was the only informative method of examination. On the mucous membrane of the trachea and right main bronchus the dense white protuberance was found. The biopsy material was taken. Histological examination revealed areas of calcified cartilage located in subepithelial layer. Results. Taking into account the reasearch data, the TO was suspected. The disease has a benign course for many years and is asymptomatic at initial stages. However, deformation and narrowing of the lumen of the trachea and the large bronchi with epithelial atrophy causes a disturbance of phlegm discharge. This promotes the development of infectious and inflammatory processes in the lung tissue. Patients complain of cough, hemoptysis, shortness of breath, chest pain. X-ray examination of the lungs may detect the infiltrative changes. The indicators of lung function are normal or correspond to the type of obstructive disorders. CT radiograph and virtual bronchoscopy determine the deformation and narrowing of the trachea and the large bronchi due to the elements of cartilage and bone tissue. Definitive diagnosis is possible only according to the results of FBS and histological examination.Conclusions. Awareness on such rare pathology as TO is essential, especially in patients with chronic cough. In case of absence of specific clinical and radiographic changes, the computed tomography of the chest and FBS with for histological examination sampling should be performed to confirm the diagnosis.

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Sarcoidosis is a multisystem disease of unknown etiology, at the basis of which there is an inflammatory granulation epithelioid process without a pronounced exudative reaction and without caseous necrosis. This disease has various manifestations. The aim of the study was to investigate the clinical case of generalized sarcoidosis with bone lesion in a patient M., born in 1987. There were performed X-ray examinations, computed tomography (CT), fibrobronchoscopy, determination of calcium levels, angiotensin converting enzyme (ACE), soluble IL-2 receptor in the blood. Dynamic observation was performed for 10 months. The patient started methylprednisolone therapy at a dose of 20 mg/day. Significant positive effect of this treatment was noted. Thus, when patients complain of the bone and joint system problems, examination plan should include radiological examination of thoracic organs, which will allow us to avoid late diagnosis of sarcoidosis or other multisystem diseases that may have similar clinical manifestations.

56±0,10) SD, (p<0,001). Ступінь зниження мінеральної щільності кісткової тканини залежав від ступеня зниження ОФВ1 та стадії ХОЗЛ (r= 0,65; р<0,01), а також від тривалості захворювання (r= -0,43; р<0,01

Primary health care plays an important role in the fight against COVID-19 in Ukraine. The objective: is to analyze the activities of primary health care centers in the context of a coronavirus pandemic. Materials and methods. An analysis of the work of the Municipal non-profit company «Center for Primary Health Care of the Yamnitsa Village Council» from March 2020 to February 2021 was carried out. Results. Since March 2020, methods for diagnosing coronavirus disease have been actively introduced: PCR tests, rapid tests for detecting COVID antigen and detecting antibodies to coronavirus. Information on the number of PCR (+) patients, the number of suspicions, the number of patients who recovered, died are reported in the Internet resources of the community. A significant increase in the incidence of coronavirus infection in the Yamnitsa united territorial community was noted in October-November 2020 and in February 2021. Since the start of the pandemic in March 2021, 8 residents of the community have died from COVID-19. Treatment of patients with mild and moderate-severe forms of coronavirus disease is carried out on an outpatient basis. For such needs 5 oxygen concentrators for oxygen support of patients in day hospitals of outpatient clinics or FAPs were purchased from funds the local budget. This became relevant in the context of a sharp limitation of beds in hospitals in the region. Two sets of IDIS2GO telemedicine equipment were purchased at the expense of a targeted state subvention. Telemedical consultations regarding the tactics of managing patients with coronavirus disease and pneumonia are carried out with the pulmonologists of the Department of Therapy and Family Medicine of postgraduate education of Ivano-Frankivsk National Medical University. This allows to limit contacts, save time for the patient and the doctor, and maintain the quality and speed of medical care. Соnclusions. The COVID-19 pandemic has significantly changed the routine of primary care physicians. The load and the risk of infection have increased, but the reform system has not stopped, the experience has been enriched, the possibilities for providing assistance, and the introduction of information technologies have expanded.