Today, the prevalence of overweight and obesity is pandemic. This disorder is defined as “a complex chronic disease in which abnormal or excess body fat impairs health, increases the risk of long-term medical complications, and decreases life expectancy”.This article presents evidence-based clinical guidelines for the management of obese patients, as well as excerpts comments on pharmacological treatment.Treatment approaches for overweight and obese patients include behavioral interventions, lifestyle adjustments, etc. One of the methods is pharmacological therapy, based on the following principles: therapy for weight loss can be used starting already at a body mass index ≥ 27 kg/m2 or ≥ 30 kg/m2 with complications associated with excess body fat. As drugs can be used liraglutide, combination of naltrexone + bupropion, orlistat. Pharmacotherapy must be accompanied by lifestyle modification, including if necessary therapeutic diet, increased physical activity on ongoing basis with its mandatory control, and behavioral or cognitive-behavioral therapy. Pharmacotherapy can be used to support the weight loss achieved through lifestyle modifications and to prevent weight gain. It is forbidden to use over-the-counter drugs unless they are approved for weight control. Patients with metabolic obesity should be consulted by specialists to assess the feasibility of bariatric surgery, followed by treatment with this specialist.Every clinician must have sufficient knowledge to diagnose obesity and offer their patients an individualized, long-term, evidence-based weight loss regimen. The success of obesity treatment depends on the patient's trust the doctor and on the doctor's knowledge in this area.

Abstract. In light of the coronavirus pandemic (COVID-19), we carried out a regular review of the information resources of international organizations specializing in combating infectious diseases, as well as governmental and intergovernmental organizations of the world's leading countries with strong economies and stringent regulatory systems in January-December 2020.          The analysis of the materials accumulated on the monitoring results revealed some differences in the legislation and practice of health care organization in Ukraine. First of all, this is a small number of registered clinical trials on COVID-19 prevention and treatment, as well as the lack of permit to use medicines for the indications which are not in basic prescribing information, in particular, "compassionate treatment" programs or emergency access to medicines, which are in clinical trials.          In the absence of traditional evidence of the health interventions effectiveness, it is necessary to emphasize the importance of identifying reliable information sources, transparency, quick and widespread information disclosure and experience exchange on challenging issues of resource and risk management, communication and public health activities, discussion of organizational forms and clinical activities in public health in the vast majority of countries. The establishment of independent monitoring and analytical centers, the participation of professional communities in various studies is an example of the rapid scientific data acquisition and supporting recommendations on various aspects of countering the pandemic. Based on the analysis of international data published in reliable sources, the legislation has been changed in Ukraine, the approaches to planning the transformation of the health care system have been identified to increase its resistance to the infectious diseases epidemic, the quarantine measures and other restrictions have been justified, the standards of medical and pharmaceutical care have been presented, the measures to ensure the availability of medical care for patients with health disorders of other etiologies and priority areas for the development of health care facilities to protect medical staff and patients have been identified.

were questioned/ Most of them 188 (80%) live in Moscow, 47 (20%) -in the Moscow region. The average term of labor was 39 ± 2 weeks. 99 (42%) had first pregnancy, 82 (35%) -the second, 31 (13%) -the third, in 24 (20%) -4 or more pregnancies. 160 patients (68%) had no problems with movements, moderate difficulties were noted in the remaining 75 (32%) of the respondents. Also, the majority -193 (82%) didn't experience difficulties with self-service, 42 (18%) experienced moderate difficulties. Daily activity wasn't impaired in 153 (65%) patients, and 82 (35%) had some problems with the daily routine. 60 respondents (25.5%) didn't complain about pain and discomfort during pregnancy, more than half: 155 (66%) experienced moderate pain and discomfort. 20 (8%) of the women surveyed experienced severe pain and discomfort. Only 49 respondents (20%) didn't experience anxiety and depression, 136 (57%) noted a slight anxiety, in 30 women (13%) these feelings were strongly pronounced. The average score of QOL measured with the visual analogue scale (VAS) was 0.76 ± 0.15. Data of QOLwere higher in patients attened special group for physical exercices during pregnancy (p<0,05). ConClusions: in most cases there were no changes in physical activity of patients, psycho-emotional changes, such as anxiety and depression, pain and discomfort were noted. It can be improved by physical activity.

The aim: Of the work was to develop clinical and organizational regulations ensuring infectious safety and epidemiological response in the work process (the case of COVID-19) based on the current legislative acts of Ukraine to combat the spread of coronavirus disease (COVID-19), as well as on the data from international practices. Materials and methods: The research objective was carried out in accordance with the Methodology for the development of medical and technological documents for the standardization of medical care. Results: The Protocol includes organizational elements to prevent the spread of coronavirus disease, such as “The development of general provisions on infectious safety and antiepidemic measures during the COVID-19 pandemic in the company's workplaces, taking into account the legislative acts of Ukraine and international practices”, which include: the development of “Health Questionnaire” (epidemiological data questionnaire) for daily monitoring of the company employee health; the development of “Checklist for self-assessment of the workplace”, “Checklist for self-assessment of the public space”; the development of “Analytical report on compliance with the infectious safety rules in the workplace and in the public space on the basis of self-assessment”, thirteen Appendices. Conclusions: “The Protocol for infectious safety and antiepidemic measures in the work process” is a detailed instruction that provides a balance of compliance with medical standards and reasonable needs of employees and employers through the implementation of scientific evidence base in antiepidemic and infectious safety measures in the workplace.

The aim: Identification of methodological processes to accelerate the development of clinical guidelines in an emergency situation (in particular, coronavirus disease COVID-19), analysis of the practice of implementing clinical guidelines and clinical pathway. Materials and methods: The processes of developing COVID-19 clinical guidelines are described on the websites of the developers. Implementing the patient’s own clinical pathway. Survey of 117 health professionals involved in medical care at COVID-19 on management information. A retrospective pragmatic study of organizational and clinical aspects of medical care for 9,259 patients over 18 years with COVID-19 from March 18, 2020 to March 31, 2021. Results: Acceleration of the methodology of clinical guidelines, changes in legislation have contributed to the improvement of medical care for patients with COVID-19. Clinical pathway (CPw) professionals surveyed: 88.2% satisfied with the structure of CPw, 91.0% were in favor of local instructions and explanations, templates of registration forms, 72.7% needed on-the-job training, 78.1% needed training on medical features, 74.5% noted the positive impact of remote interaction, 61.6% required standard operating procedures. 9259 patients with suspected COVID-19 confirmed PCR in 55.2%. Among those checked, 31.2% of chest computed tomography confirmed pneumonia in 95.7% of CT; 9.3% were hospitalized; fatalities 5.5% of hospitalized or 0.5% of verified. Conclusions: Changes in the methodology of clinical guidelines, changes in legislation, education based on clinical guidelines have contributed to improving the results of management in COVID-19.