Aim of the study: Among the key genes involved in the development of non-alcoholic fatty liver disease (NAFLD) are genes encoding the synthesis of glutathione S-transferase (GST). Material and methods: Deletion polymorphism of GSTT1 and GSTM1 genes was investigated in 104 NAFLD patients and 45 healthy individuals. Biochemical blood analysis, tumor necrosis factor-α (TNF-α), interleukin-10, leptin and adiponectin plasma levels were studied. Results: The distribution of deletion vs. non-deletion genotypes of the GSTT1 gene in NAFLD patients was 18 (17.3%) vs. 86 (82.7%) patients and in healthy people it was 6 (13.3%) vs. 39 (86.7%) individuals. The genotype distribution of the GSTM1 gene was as follows: 52 (50.0%) NAFLD patients had null genotype vs. 52 patients (50.0%) with non-deletion genotype; in the control group-23 (51.1%) vs. 22 (48.9%) individuals. Deletion of the GSTT1 gene in NAFLD patients was associated with twice as high (p = 0.01) TNF-α level in the blood as compared to patients with normal genotype. Higher concentration of leptin in blood by 37.1% (p = 0.04) was observed in patients with null genotype of the GSTM1 gene, as compared to those with normal genotype. Conclusions: Deletion polymorphism of GSTT1 and GSTM1 genes distribution among NAFLD patients did not differ as compared to healthy individuals. Null-genotype GSTT1 gene carriers were characterized by higher TNF-α concentration and null-genotype GSTM1 gene carriers were characterized by elevated leptin level as compared to normal genotype carriers.

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Мета роботи -оцінити ефективність проведення навчальних симуляційних тренінгів на практичних заняттях із дисципліни "Про-педевтика внутрішніх хвороб" у студентів ІІІ курсу зі спеціальності "Лікувальна справа" у підвищенні якості освітнього процесу.Основна частина. Відпрацювання практичних навичок на тренажері дає можливість студентам краще оволодіти методиками, зокрема можливість повторення і відпрацювання її до автоматизму. Також збільшуються можливості викладача як проконтро-лювати певний навик, так і доповнити його елементами ускладнення: поєднувати норму з патологією (наприклад: норма -серцево-судинна система, патологія зі сторони системи органів дихання), а також поєднувати різну патологію даних систем.Висновки. Симуляційне навчання доповнює підготовку студентів до реальної клінічної практики. Крім того, воно забезпе-чує контроль викладача за якістю виконання кожним студентом практичних навичок і також сприяє формуванню у студентів професійної компетентності.Ключові слова: симуляційне навчання; пропедевтика внутрішніх хвороб; студенти.The aim of the study -to evaluate the effectiveness of conducting stimulation training courses during practical classes of subject "Propaedeutic of Internal Diseases" with 3 rd year students of the "Medicine" specialty, to improve the quality of the educational process. The main body. Practical skills improvement on the simulator enables students to learn with the help of better methods, including the possibility of repetition and working to automatism. There are increasing opportunities when teacher is able to control certain skills, and complement its complications elements, combined with pathology normal (e.g. normal -on the cardiovascular system and pathology on the part of the respiratory system) and to combine different pathologies of these systems.Conclusion. Simulation training complements the training of students to real clinical practice. In addition, it provides control of the teacher for quality performance of each student practical skills and also contributes to the each student's professional competence.Key words: simulation training; propaedeutic internal diseases; students.Вступ. Реформування вищої медичної освіти ви-магає пошуку нових методик для підготовки сту-дентів, які були би професійно компетентними по закінченні вузу. В Україні в останні роки все біль-шого поширення набуває симуляційне навчання, слідуючи світовим тенденціям і керуючись Зако-ном України "Про вищу освіту" від 01.07.2014 року № 1556-VІІ, а також як один із шляхів створення і впровадження нових конкурентоспроможних техно-логій для забезпечення інноваційного розвитку су-спільства та підготовки фахівців інноваційного типу.Отримано численні докази, які свідчать про успішний перенос набутих лікарем навичок ро-боти на лікування пацієнта [1][2][3][4] Історія сучасного симуляційного навчання почи-нається з початку XX століття, коли в 1909 році в авіації був вперше застосований тренажер для від-працювання навиків управління літаками Антуа-нета. В 1929 році американський інженер Едвін Лінк запатенту...

The purpose of the study was to analyze the indicators of the lipid spectrum of blood in patients with rheumatoid arthritis individually and in combination with coronary heart disease. Materials and methods. 91 patients with rheumatoid arthritis were examined, which were divided into 2 subgroups – patients with rheumatoid arthritis without concomitant pathology of the cardiovascular system and patients with rheumatoid arthritis with coronary heart disease. The groups were matched in age and gender. The control group consisted of 31 patients with coronary heart disease. When entering the hospital a detailed clinical and biochemical examination with the determination of the pain scale, the number of painful and swollen joints, the duration of the morning stiffness, functional condition, lipid profile of blood was carried out. Results and discussion. In the study of the lipid spectrum of blood, a probable difference between the number of patients with signs of previously undiagnosed hyperlipidemia among patients with rheumatoid arthritis and rheumatoid arthritis with coronary heart disease was detected. At the same time, they observed dependence on the duration of the disease and the age of patients. The most significant changes were detected in the analysis of levels of total cholesterol, high density lipoprotein and low density lipoprotein, atherogenic coefficient. The indicators of blood triglycerides content had only a trend towards an increase in the subgroup of patients with combined nosology, which was not statistically confirmed. The incidence of hypercholesterolemia was 43.4% in the population of patients with rheumatoid arthritis, and 57.6% in patients with rheumatoid arthritis with coronary heart disease. Low density lipoprotein levels exceeded 3.0 mmol/l in 62.7% of rheumatoid arthritis patients and in 81.2% of patients with rheumatoid arthritis with coronary heart disease. The quantitative content of high density lipoprotein less than 1.0 mmol/l was found in 22.9% of patients with rheumatoid arthritis and in 39.6% of patients with rheumatoid arthritis with coronary heart disease. Conclusion. Among patients with rheumatoid arthritis without concomitant cardiovascular disease, and for the combination of rheumatoid arthritis with coronary heart disease, there is a high percentage of patients with hyperlipidemias. Patients with rheumatoid arthritis with concomitant coronary heart disease have reliably higher rates of total cholesterol and low density lipoprotein in the blood, and a reliably lower high density lipoprotein content. The growth of atherogenic coefficient above 3.5 in young and middle-aged patients for the combination of rheumatoid arthritis and coronary heart disease indicates a higher risk of developing cardiovascular disease and their complications in these age groups

Introduction. Major cardiovascular and pulmonary comorbidities, as well as diabetes mellitus and certain cancers, are associated with worse clinical outcomes of coronavirus disease-2019 (COVID-19). Meanwhile, the impact of concomitant liver diseases on the COVID-19 natural course together with the influence of the COVID-19 on the hepatic tissues have been rarely investigated. The aim of the study was to analyse the available data regarding impact of liver pathologies on COVID-19 natural course and outcome, and, reciprocally, hepatic injuries development induced by COVID-19. Materials and methods. Content analysis, systematic and comparative analysis, bibliosemantic method of investigation of current scientific research results on liver damage associated with COVID-19 were used. Results. The potential mechanism of liver injury in COVID-19 is complex and includes direct cytopathic viral injury, proinflammatory cytokine outbreak, hypoxia/reperfusion damage and potential drug induced liver injury. Among the medications used for the treatment of COVID-19 patients, there are certain that could potentially cause drug-induced liver injury. Treatment of liver transplant patients can be challenging taking into consideration the possible necessity of immunosuppressive therapy correction combined with the needs to find a balance between the risk of graft rejection and effective elimination of the virus. Conclusions. Current review of the available database revealed that liver diseases are among substantive comorbidities in COVID-19 patients alongside with liver injuries which are rather frequent complications of COVID-19 treatment. Potential drug-induced liver injuries in patients subjected tocertain antiviral agents in combination with supportive therapy drugs should be taken into consideration. Special precautions are required to prevent potential drug-to-drug interactions in case of COVID-19 treatment in liver transplant patients.