Among medical students, deduction remains the main method in making a diagnosis or diagnostic conclusion after examining patients or their detailed examination. This method gives the opportunity to clearly and objectively formulate an opinion and assess the patient's condition according to the diagnosis. Therefore, deduction and its methods are relevant both among medical students and among medical staff. The role of application of the deductive method among medical students is substantiated. It is established that the application of deduction while studying in a medical higher educational institution will allow influencing the already developed personality of the student and developing in him or her the “building” type of personality orientation. Therefore, this method constitutes a topical issue of today. The purpose of the study is to evaluate the specific features of the deductive method among medical students based on literature analysis. To implement the goals and objectives, three stages of studying the features of the deductive approach among medical students were proposed. In the first stage of the research the role of deduction in the educational process, its advantages and disadvantages were determined by means of processing the literature according to the method of analysis and synthesis; during the second stage the types of personality, ways of influencing its development are determined, the interrelation between the type of personality and its level of thinking is traced; The third stage of the study included the assessment of deductive methods that allow students to form clarity and correctness of action, as well as to develop students' thinking by setting a position, justifying it with an example and forming a conclusion. The study identified the essential role of the deductive method among medical students in the development of personality orientation and development of mental activity. It is found that the use of the PRESS method will make it possible to clearly define the position, justify the result, and draw a correct conclusion (diagnosis), which is mandatory in the analysis of pathological conditions in medicine. Proper pedagogical education allows obtaining the desired result. By adhering to the criteria of teaching material, such as conceptuality, logic of the process, system, controllability, efficiency, and reproducibility, the teacher will attract the attention of a medical student and interest him or her in analysing the subject

Objective — to investigate the functional state of endothelium and methods of correction of endothelial dysfunction in patients with gastric and duodenal peptic ulcers (GPU and DPU)  in combination with hypertension (AH) and type 2 diabetes mellitus (DM2). Materials and methods. The investigation involved 100 patients, who were divided into the groups: group 1 consisted of  20 apparently healthy individuals (AHI), group 2 included  40 patients with GPU (n = 23) and DPU (n = 17) without signs of AH and DM2, group 3 involved 40 patients with GPU (n = 15) and DPU (n = 25) in combination with hypertension and DM2. The groups were sub‑divided into subgroups A and B depending on the H. pylori strains’ toxigenicity:   group A included patients with CagA+ VacA+ strains’  combination, groups  B — infected with H. pylori with a combination of strains of CagA+ or VacA+. All patients were administered the traditional antihelicobacter therapy (AHBT) (esomeprazole 20 mg twice daily + amoxicillin 1.0 g twice daily + clarithromycin 500 mg twice daily for 10 days). To increase the effectiveness of eradication therapy, 40 patients  in addition to AHBT, received a combined probiotic (Bifidobacterium bifidum, B. lactis, Enterococcusus acidophilus, L. paracasei, L. plantarum, L. rhamnosus, L. salivarius) 1 sachet twice a day for 1 month. Eradication control was monitored 4 weeks after completion of treatment. Results. The increased expression of the vascular cell adhesion molecule‑1 (VCAM‑1) and the number of desquamated endothelial cells (DEK) and improvement of the oxidant‑antioxidant system have been established. Before the treatment, in comparison with the levels in AHI,  levels of sVCAM exceeded in 5.88 times (р < 0.05), of erythrocytic malondialdehyde in 1.92 times (р < 0.05), and levels of the reduced glutathione was lower by 46.39 % (р < 0.05). The use of triple therapy improved the endothelial condition and the state of the oxidative‑antioxidant system, and additional application of probiotic promoted more effective correction of the indices of endothelial state and oxidative‑antioxidant system by means of maximal decrease of the levels of sVCAM and erythrocytic malondialdehyde and increase of the reduced glutathione levels. Conclusions. The presence of H. pylori, in particular its toxigenic strains, results in the development of endothelial disfunction in patients with GPU and DPU, combined with arterial hypertension and DM 2.  When combined with hypertension and DM2, the course of GPU and DPU is accompanied with «mutual burden» syndrome resulting in the exhaustion of the antioxidant defense system and increased indexes of the glutathione system.

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Вищий державний навчальний заклад України «Буковинський державний медичний університет»,Чернівці У статті розглянуто діагностичні методи визначення патології нирок у хворих на ревматоїдний артрит з урахуванням основних патогенетичних механізмів прогресування хронічної хвороби. Мета роботи: проаналізувати сучасні напрямки діагностики прогресування хронічної хвороби нирок у хворих на ревматоїдний артрит згідно з даними медичної літератури. У роботі наведено дані щодо важливості визначення морфофункціональних властивостей еритроцитів, низькомолекулярних білків у крові та сечі, цитокінів у крові як маркерів пошкодження нирок. З метою визначення темпів прогресування хвороб нирок з успіхом використовується динаміка показників β 2 -мікроглобулінемії та трансформуючого фактора росту β 1 плазми крові хворих. Висновок. Вивчення та впровадження нових підходів до діагностики ревматичної нефропатії сприятиме своєчасному виявленню та лікуванню даної патології. Ключові слова: хронічна хвороба нирок, ревматоїдний артрит, діагностика, β 2 -мікроглобулін, трансформуючий фактор росту β 1 .