Резюме. У статті розглядається дуже важливе питання інтеграції онлайн-навчання у вищих навчальних закладах. У зв’язку із розвитком пандемії задля забезпечення карантинного режиму усі навчальні заклади було переведено в режим онлайн-навчання з використанням онлайн-платформ, таких як ZOOM, Microsoft TEAMS, Google Classroom та інші. Проаналізувавши світовий досвід навчання у різних університетах, зокрема і в медичному університеті, ми побачили, що у Європі наші колеги-викладачі давно практикують змішаний тип навчання. А саме: частина лекцій та семінарських занять, усі домашні завдання, атласи, книги, відеоматеріали та відеолекції студент отримує у своєму особистому кабінеті або класі (який знаходиться на серверах університету). Викладачі мають доступ до цих особистих кабінетів та можуть відстежувати прогрес студентів, а саме: кількість опрацьованого матеріалу, чи переглянуті відео повністю, чи здані домашні завдання, чи вирішені тести. Практична частина, а саме відпрацювання певних навиків, які є необхідними кожному студенту-медику у своїй майбутній медичній практиці, відбувається циклом у різних відділеннях та лікарнях. Така схема змішаного навчання дозволяє студентові опрацьовувати теоретичний матеріал у зручний для нього час. Українські університети до періоду пандемії були виключно на офлайн формі навчання. І, на жаль, в умовах жорсткого карантину, реалізувати змішану форму навчання вкрай важко, зважаючи на певні загальнодержавні обмеження. Існувала така ймовірність, що студенти-медики продовжать навчання онлайн з осіннього семестру. Було б доцільно з боку керівництва першочергово провести детальний та ретельний інструктаж щодо освоєння онлайн-платформ для якісного проведення пар, лекцій чи семінарських занять.

Aim: To determine the effectiveness of the influence of the use of mineral medicinal water on the functional state of the liver of patients after laparoscopic cholecystectomy in a long period of rehabilitation in the conditions of the Morshynkurort health resort complex. Materials and Methods: An analysis of 100 medical records of patients after laparoscopic cholecystectomy who were undergoing rehabilitation at the Morshynkurort health resort complex in 2017 and 2018 was carried out. Medical records were selected by a randomized method using the Random Allocation Rule program. Blinded evaluators while processing medical records. The method of comparison of indicators of the functional state of the liver of patients before the beginning of rehabilitation and after its completion was carried out by the method of mathematical statistics – Student’s t-test. The studied parameters: total protein (g/l), thymol test (unit), total bilirubin (mkmol/l), activity of alanine transpeptidase (ALT, (units/hour • l)), aspartate transaminase (AST, (units/hour • l)), total cholesterol (mmol/l), triglycerides (mmol/l), blood glucose (mmol/l). All patients were examined before and after treatment. There was no dropout from the study among the surveyed. Results: Mathematical statistics revealed a significant (p <0,05) improvement in such indicators as: thymol test, alanine transpeptidase activity, total cholesterol. Conclusions: Hydrotherapy for 14 days MPO well No. 3-k and groundwater source No. 4 in Morshyn diluted to mineralization 3,0-3,4 g/dm³ at a long stage of rehabilitation leads to an improvement in liver function in patients after laparoscopic cholecystectomy.

The article considers research methods and features of the functional state of the vestibular apparatus and vestibular disorders in children with sensorineural hearing loss. We used the methods of analysis, generalization and systematization of data from domestic and foreign literature sources on methods of studying the vestibular apparatus in children with sensorineural hearing loss. It was determined that the function of balance and coordination of movements is one of the most complex, and consists of several analyzers - visual, vestibular, proprioceptive and tactile. When studying the physical development of children with this pathology, attention is paid to the formation of the main static-dynamic and coordination capabilities according to the age of the child. In children with congenital sensorineural deafness, and especially double deafness, there are signs of vestibular insufficiency and impaired translational control, movement and gait. This affects the development of gross motor functions, such as sitting and walking, to a lesser extent affects fine motor skills, if there are no layers of other pathologies of the central nervous system. The pathological process in the auditory analyzer changes the function of the vestibular apparatus, due to their close location in the labyrinth and innervation by one cranial nerve, and in turn changes in the vestibular apparatus contribute to the formation of motor disorders. Therefore, we can observe a certain general principle of operation of the auditory and vestibular systems. At children who have low vestibular stability any turns, inclinations, sharp change of a direction of movement causes imbalance of coordination and balance of movements. All these delays in physical development, according to many authors, are cumulative in character and are caused by the hearing defect itself, insufficient information from the environment, difficulty expressing thoughts and desires verbally, as well as the state of the motor analyzer and vestibular activity. Children with hearing impairment have an insufficient level of coordination development, physical development, static and dynamic balance, spatial orientation. Researches of the vestibular apparatus, namely the functions of coordination and balance are carried out in several categories: the research of tonic vestibular reactions, coordination of movements and static and dynamic balance. Researches of tonic vestibular reactions are performed on the following tests: the test with outstretched arms, Vodak-Fisher test, pointing test Barani, finger-nose test, Holmagi test. Researches of static and dynamic equilibrium are carried out on the samples of Romberg, Grahe, Oppenheim, walking in a straight line. When analyzing these samples, we can talk about the degree of violation of coordination and stato-dynamic balance. As a result of vestibular compensation, children with sensorineural deafness can catch up with their peers with normal hearing with the help of visual and somato-sensory systems, pyramidal and extra-pyramidal systems.

Abstract. In recent decades, scientists have been attracted by the idea of developing methods for targeted transport of drugs and diagnostic drugs directly into the area of inflammation. Experimental and single clinical studies have revealed high efficiency and prospects for targeted delivery of various drugs. Most known carriers have a number of disadvantages, both in the range and amount of drugs they can bind, and in their ability to prevent contact of transport drugs with healthy tissues. In addition, there are difficulties associated with the toxicity and immunogenicity of carriers, their availability, cost, complexity of preparation. Transport systems that use the body's own cells are the most advantageous in terms of biocompatibility. Among them, erythrocytes, platelets and leukocytes are used as vehicles. Currently, the most promising in terms of drug transport is the use of erythrocyte containers. Pharmacokinetic studies have shown that with this route of administration, the concentration of antibiotic in the bile in patients with inflammatory diseases of the biliary tract, 4.7 times higher than with other routes of administration, and their therapeutic activity is maintained for a much longer time. When the erythrocyte containers were applied topically, the antibiotic concentration in the wound and surrounding tissue was 10 times higher than that achieved by traditional soft tissue puncture. In order to prove the ability of erythrocyte containers to capture drugs and concentrate in the inflammatory focus in 10 patients with this pathology at the beginning of treatment was injected into the femoral artery 1% - 1 ml of nicotinic acid in 0.9% - 2 ml of saline, and the following day the same patient in the same dose it was administered in erythrocyte containers. The time of onset of the reaction and the duration of the drug were determined, taking into account subjective and objective data. The ability of erythrocyte containers to seize drugs is evidenced by the results obtained by us: with the introduction of nicotinic acid in its pure form, the reaction occurred after 115411 ± 0,0411and lasted 715211 ± 0,0311. Objectively, there was a gradual reddening of the face and mild hyperemia. With the introduction of erythrocyte containers with nicotinic acid, the reaction occurred through 214311 ± 0,0311  and lasted 1112411 ± 0,0211. Subjectively, patients were characterized by a milder course of the reaction. The development of granulation tissue in the wound with the introduction of erythrocyte containers with antibiotics began on day 8-9, and the marginal epithelialization - on day 10-12. In the control group, the appearance of granulation tissue and epithelialization in the wound were on 12-13 and 14-15 days, respectively.

The history of the development of occupational therapy from the beginning of its establishment due to changes in different views of the formation of the essence of occupational therapy intervention is considered in the article. However, mostly occupational therapy as a separate specialty was formed after the Second World War, when society faced the problem of a large number of young people who became disabled as a result of hostilities, and the urgent need for their rehabilitation. These people needed to be re-taught both self-care and social adaptation, as such people often developed depression, which complicated not only the possibility of their recovery, but also the lives of relatives and friends of such patients. In 1952, the World Organization of Occupational Therapists was established, and in 2016 its members became representatives of 92 countries. There is a wide network of centers and a large number of occupational therapists in Western Europe, the United States and Canada. In Ukraine, occupational therapy as a separate specialty appeared at the beginning of the XXI century, as a separate specialty "physical therapy and occupational therapy" in Ukraine registered since 2015, the first master's program for students majoring in "occupational therapy" in Ukraine introduced at the Ukrainian Catholic University, later the training of occupational therapists began in other Ukrainian universities, including Ivano-Frankivsk National Medical University and the National Medical University named after Bogomolets. The Ministry of Health of Ukraine also recommended to involve students majoring in "Physical Rehabilitation" and "Physical Therapy, Occupational Therapy" in the practice of hospitals in Ukraine. Modern views on occupational therapy are based on a scientifically sound level and cover the main areas of human life: "man, environment, occupation." Training of occupational therapists in Ukraine should be carried out taking into account all requirements and standards, this will promote the formation of highly qualified specialists, and practical experience and research in this field will in the future develop occupational therapy at a professional level. Occupational therapy techniques in habilitation and rehabilitation - is the development, restoration and maintenance of functional capabilities of the child, which are necessary to perform important actions. Occupational therapy is used in various spheres of human life and is an important part of modern rehabilitation programs. The history of occupational therapy is a constant change in the system of views on the essence of occupational therapy, which goes hand in hand with scientific and technological progress, social events and the challenges they cause. The modern development of occupational therapy is important, scientifically sound, based on evidence-based practice, and covers the main areas of human life - Man-environment, occupation. Training of occupational therapists in Ukraine should be carried out taking into account all the characteristics of modern occupational therapy, which will promote the formation of highly professional specialists, and the accumulated experience of practical and scientific activities in this field of knowledge in the future will certainly enrich world science.