Доц. К.В. Вовк, доц. О.В. Сокруто, доц. О.Г. Резніченко, доц. С.В. Гріднєва, ас. М.В. Мартиненко Харківський національний університет імені В.Н. Каразіна Кафедра загальної практики-сімейної медицини Тактика сімейного лікаря при захворюваннях жовчовивідної системи (діагностичні критерії) Family doctor's tactics for biliary tract diseases (diagnostic criteria) PHD Vovk K.V., PHD Sokruto O.V., PHD Reznichenko O.G., PHD Gridneva S.V., as. Martynenko M.V.Volumes of work of the family doctor include diagnostics, treatment, multifactorial prevention of diseases of internal organs, which do not require treatment in the hospital. Diseases of the biliary system are one of the leading problems of medicine, in particular gastroenterology. The scope of work is extended through specialized assistance provided by the family physician on their own without involving "narrow" specialists. Functional diseases of the biliary system (FDBS), which exist for a long time, contribute to the development of organic diseases of the gallbladder (GB). Diseases of the biliary system are often combined with functional disorders of the gastroduodenal zone. Diagnostic complex includes analysis of results of radiation methods of research, visualendovascular methods with the possibility of biopsy research, various modifications of duodenal sounding with subsequent microscopy and biochemical analyzes of the obtained material. The rational combination of modern methods of diagnostics makes it possible to detect violations of the bile-forming and bile-secreting function of the liver, the motor function of the biliary tract in a timely manner, and to determine the basic links in the treatment and prevention of these pathological conditions.

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Abstract. Among biliary pathology, chronic acalculous cholecystitis (CAC) occupies one of the central places. The important role of the hormonal system in the regulation of the functioning of the biliary tract has been known for a long time, but the specific mechanisms of these influences remained unclear. Based on the results of a comprehensive clinical, laboratory, biochemical and instrumental examination, all patients with chronic acalculous cholecystitis were divided into three groups depending on the variant of impairment of the motor-kinetic function of the gallbladder. The first group consisted of patients with CAC and hypertensive-hyperkinetic gallbladder dyskinesia (group I) – 17 people; the second – patients with CAC with mixed hypotonic-hyperkinetic gallbladder dyskinesia (group II) – 19 people; the third – patients with САС and hypotonic-hypokinetic dyskinesia of gallbladder (III group) – 29 people. The level of free FT3, FT4, and thyroid-stimulating hormone (TSH) was determined by the immunofluorescence method using BREAHMS test systems (Henning Berlin GMBH). The disproportion between the thyroid hormones and the quantitative predominance of the inactive form made it possible to identify the relative hypothyroid syndrome in group I patients. The disproportion between the biologically inactive and active forms of thyroid hormones with a quantitative predominance of the inactive form made it possible to judge the presence of a relative hypothyroid syndrome in group II patients. In group III patients, a significantly increased TSH level was revealed, which was a response of the hypothalamic-pituitary system to a decrease in the level of FT3.

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Abstract. The problem of student health has become of great importance in recent decades and remains unresolved at the current time. The article presents the data of the study of acute morbidity of students of higher educational establishments, its frequency and structure, the gender peculiarities and the state of resistance of their organism are analyzed. Highlighted the priority diseases groups, their specificity and differences. According to the results of the study, the state of adaptation of the students' body in the first year of study was revealed. At the same time, there are signs of tension and breakdown of these mechanisms, decrease in body resistance may be primarily due to sudden changes in the habitual environment of students, impaired diet and quality of work-rest cycle, the presence of a large number of students who have bad habits, constant increase of educational and information load in the present conditions. Only 18.46 ± 1.16 % of medical high schools and even fewer students of technical high schools have 7.81 ± 0.63 % satisfactory indicators of resistance to the body, which indicates a possible discrepancy between the impact of the educational complex and external factors to the adaptive capacity of the student body. In the structure of acute morbidity prevail respiratory diseases in both study groups (KhNMU − 80.16 ± 2.58 %, KhNURE − 80.37 ± 2.61 %). Also, quite a large part was taken by diseases of the digestive system and urogenital system. Students of a technical university had worse indicators of body resistance compared to students of a medical university. It was also found that boys had poorer body resistance compared to girls in all groups. In future all this has negative social and economic consequences for the country as a whole.