The aim of the work was to study the epidemiology of Alzheimer’s disease in the Odesa region. Materials and methods. The study was carried out on the basis of the Regional Mental Health Center (Odesa) in 2016–2021. The data of the primary referral of patients with a verified diagnosis of Alzheimer’s disease were analyzed. Statistical processing of the obtained data was performed by frequency analysis methods using standard MS Excel packages (Microsoft Inc., USA). The population of the Odesa region was determined according to the State Statistics Service of Ukraine. Results. According to the retrospective analysis over the past 5 years, there was a constant increase in the number of identified patients with Alzheimer’s disease, from 4.9 cases per 100,000 population in 2016 to 6.0 cases in 2020 with a slight predominance of women in the structure of cases. Brain MRI was performed only in 29 (4.6 %) patients, EEG in 41 (6.5 %) patients. There were no cases of familial Alzheimer’s disease or early-onset Alzheimer’s disease. In 2020, Alzheimer’s and dementia deaths reached 14,196 or 2.54 % of total mortality in Ukraine. Conclusions. The prevalence of Alzheimer’s disease was 6.0 cases per 100,000 in the population of the Odesa region at the end of 2021, which was an order of magnitude less than the global average. The mean score on the MMSE scale was 18.6 ± 0.5. The analysis on subscales has shown the prevalence of memory, spatial orientation and verbal disorders. The Ukrainian population is characterized by the small number of patients of the older age group (3.3 %) and the predominance of female patients (59.4 %).

The purpose of the study was to determine the prognostic role of finger extension and to assess the function of the upper extremity in patients with stroke. Materials and methods. The study was performed on the basis of the Medical Center "Expert Health" and clinical units of Petro Mohyla Black Sea National University, Mykolaiv, Ukraine during 2020-2021. 89 patients who underwent acute cerebrovascular accident by ischemic type with paresis of the upper extremity were examined. All patients were examined in accordance with current clinical protocols in 3 and 6 months after undergoing stroke. Additionally, patients underwent a standard hand function test – Action Research Arm Test, as well as an extended test – Action Research Arm Test +in its own modification (IsoTren LTD). Statistical processing was performed by methods of analysis of variance and correlation using Statisica 13.0 software (TIBCO, USA). Results and discussion. When assessing the functional status of patients, the average values of Barthel Index were 65.4±1.4 points, which corresponded to 2.7±0.3 points by modified Rankin Scale. The main difficulties were observed in such skills as writing (d170), use of means of communication (landline and mobile phone, computer, gadgets – d360), fine motor movements (d440), cooking (d630), eating (d550), washing (d510), personal hygiene (d520) and toilet use (d530), etc. When evaluated according to the standard Action Research Arm Test 3 months after the stroke, the average score was 39.9±1.5, according to the subtest of the Extensors’ Function Assessment Test – 8.3±0.4 points, which corresponds to the overall score for Action Research Arm Test +of 48.1±1.4 points. After 6 months, the score of the Action Research Arm Test 3 months after the stroke, the average score was 43.4±1.2 points ( = +8.8%), according to the subtest of the Extensors’ Function Assessment Test – 9.9±0.4 points ( = +19.3%), which corresponds to the overall score on Action Research Arm Test +of 53.2±1.3 points ( = +10.6%). Correlation analysis showed that the results of the subtest of the Extensors’ Function Assessment Test and Action Research Arm Test significantly correlate with each other (r = 0.72 p <0.01). The developed original test to assess the function of extensors has a specificity of 95.6% with a sensitivity of 98.5% (J = 0.95). This estimate corresponds to LR += 24.75, which allows us to assess the prognostic value of finger extension as very high. When assessing the internal consistency of the standard test Action Research Arm Test and Action Research Arm Test +, it was found that Cronbach = 0.87, which indicates a high degree of consistency of the tests. Conclusion. It is advisable to use the extensor function assessment test together with the standard Action Research Arm Test (modified Action Research Arm Test +)

Мета роботи – оцінка перспектив застосування сучасних інформаційних технологій при навчанні в інтернатурі за фахом “Неврологія”. Основна частина. Проведений аналіз застосування інформаційних технологій у викладанні фахових дисциплін лікарям-інтернам, що займаються за спеціальністю “Неврологія”. Основними формами є засоби програмованого контролю, електронні підручники, телеконференції, застосування мультимедійних симуляційних технологій, розсилки навчальних матеріалів в електронному вигляді, електронні шаблони медичної документації для курації пацієнтів та використання електронних репозиторіїв. Технологія BODY INTERACT ™ надає можливість інтеграції у процес вивчення новітніх досягнень медицини та інформаційних технологій, розробки навчальних концепцій та обміну досвідом через реальні клінічні ситуації, створюючу основу для культури відкритих комунікацій і співробітництва. Академічна успішність інтернів упродовж періоду спостереження на проміжних контролях відповідала медіані 4 (3;4), на кінцевих – 4 (3;5). Результати опитування показали зростання зацікавленості інтернів у застосуванні інформаційних технологій при викладанні фахових дисциплін. На кафедрі неврології Одеського національного медичного університету на всіх етапах підготовки інтернів активно застосовуються засоби програмованого контролю. Показана доцільність регулярного перегляду навчальних програм для навчання лікарів-інтернів з фаху “Неврологія” з урахуванням  можливостей сучасних інформаційних технологій. Висновок. Врахування пріоритетів підготовки лікарів-інтернів за фахом “Неврологія” із широким впровадженням сучасних інформаційних технологій дозволяє вдосконалити теоретичні знання та практичні навички, оптимізувати взаємодію у форматі мультидисциплінарної команди з фахівцями інших спеціальностей.

No abstract

The study was aimed to evaluate the effectiveness of IRP implementation in patients of a specialized clinic providing long-term care to neurological and neurosurgical patients. Material and methods. The study was conducted in 2020-2021. on the basis of the MC "Expert Health" (Odessa, Ukraine). 83 patients undergoing neurorehabilitation program were examined. The correspondence of the fulfillment of key rehabilitation tasks in terms of time and quality was assessed. Additionally, the level of motivation and compliance of the patient was assessed using the MOT-Q questionnaires (for patients with previous TBI (n = 13), SRMS (for patients with stroke (n = 54) and with SRQ-E (for patients with other types of neurological pathology (n = 16). The overall level of compliance was assessed using the General Rehabilitation Adherence Scale (GRAS). The level of safety was assessed according to the following criteria: the presence of FAST certificates for personnel, a system for monitoring vital functions, equipment and consumables for the provision of emergency care. Statistical processing was carried out by methods of variance and correlation analysis, using the MedCalc 1.3 software. Results. There were not recorded any significant violations of safety principles in the provision of rehabilitation assistance in the certification of personnel according to FAST. The frequency of detecting cases of improper implementation of IRP did not exceed 6.0% (5 cases out of 83 analyzed). When assessing the relationship between the effectiveness of IRP and the level of compliance, a strong positive correlation was found - r = 0.78 Conclusion. 1. Provision of rehab services for neurological patients in the long term requires coordination of the actions of specialists at the intra-, inter-, and transdisciplinary levels. 2. A necessary condition for the functioning of a multidisciplinary team in the provision of rehabilitation care is certification of staff in the BLS systems - for allied health specialists and ACLS for physicians. 3. The effectiveness of IRP depends on the patient's compliance level (r = 0.78). 4. For the continuity of the rehabilitation process, it is necessary to involve relatives and facilitate their training in the basics of "home" rehabilitation.