Gerontological ageism and its overcoming among medical students The relevance of the research topic is due to the high prevalence of gerontological ageism in modern society in general, and in health care in particular. Gerontostereotypes and gerontological ageism that form at the same time among the younger generation of doctors may later manifest themselves in insufficiently attentive or incorrect behaviour of doctors with elderly patients, based on the stereotypical picture of the characteristics of the elderly, the needs and abilities of the elderly. The survey method studied attitudes towards aging, old age, as well as towards people of the older age groups of students at a medical higher educational institution. The analysis of the causes and degree of relevance of the problem of gerontological ageism among future doctors has been carried out. Survey data show that most students are aware of the features of working with older people, however, the formation of gerontological ageism among medical students is a fairly common problem. In this regard, the necessity of purposeful work with medical students at junior courses to overcome gerontostereotypes and gerontological ageism has been proved and substantiated. This will further prevent the stereotypical thinking of future doctors when working with the elderly population.

Aim. To assess the changes in endothelial dysfunction in patients undergoing cardiac surgery with minimally invasive extracorporeal circulation (MiECC). Methods. The study included 50 patients who were undergoing coronary artery bypass grafting (CABG) surgery with cardiopulmonary bypass (CPB). The patients were divided assigned to either a minimally invasive cardiopulmonary bypass system (group 1, n=15) or standard extracorporeal circuit (group 2, n=35). Changes in the laboratory parameters were assessed 5 times: before the operation, 5 minutes after protamine sulfate administration, 12 hours after the operation, 7 days after the patient's discharged from the hospital and one month after the operation. The activity of von Willebrand factor, factor VIII, and the number of activated platelets were examined in all patients in venous blood. Results. After protamine sulfate administration, the activity of von Willebrand factor was increased to 164% in the group 1, and up to 193% in the group 2, with a tendency to increase the indicator after 12 hours. The peak of endothelial dysfunction, with the growth of von Willebrand factor and factor VIII, occurs on the 7th day after the operation. In patients of the group with MiECC, von Willebrand factor activity was decreased at the hospital discharge and returned to normal in 1 month. The number of activated platelets increases mainly in group 2 (6% versus 4% in group 1, p=0.29). The expression of P-selectin was significantly higher in group 2 at the hospital discharge (5.5% versus 3.1% in group 1, p 0.001), and in 1 month (4.5% versus 2.3% in group 1, p 0.001). Conclusion. In patients with minimally invasive cardiopulmonary bypass, platelet activation decreases, endothelial dysfunction, accompanied by an increase in the von Willebrand factor and factor VIII activity, is less pronounced; the seventh day after surgery is a period of the high risk of thrombogenic complications.

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The article presents modern approaches to the social adaptation of elderly people in inpatient social institutions as part of the creation of a long-term care system.