Problems of Uninterrupted Medical Training and Science
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The experience of educational work in conditions of quarantine and lockdowns allowed in practice to study the possibilities of distance learning and to form an objective assessment of it in the structure of continuous medical education (CME) for doctors. The survey participants noted the following disadvantages of online distance learning events: the lack of an opportunity to receive information that is of interest to the listener in an in-depth format and in a specific form, because the prevailing volume of videoconferences does not allow for discussions, exchange of experience, review of clinical cases, etc. Distance learning significantly limits the possibilities of practical skills and abilities, the mastering of which is up to 75% of the study time in the format of full-time and part-time education. The positive aspects, from the point of view of distance learning participants, include: the opportunity to get points for registering a teaching staff without interrupting their main work, the ability to choose topics and the modernity of information events. However, the traditional full-time and part-time forms of education also have their drawbacks, namely, for example: to travel and live in the cities where events are held in the absence of state funding for these expenses, that is, at the expense of the doctor himself. The use of innovative educational technologies, such as distance learning and online communication, in the training of doctors cannot fully replace the classical forms of education. The optimal are the combined forms of the educational process organization, which make it possible to rationally use the resource of the participants in the educational process.

The article is devoted (dedicated) to topical problems of socially significant parasitosis, peculiarities of toxoplasmosis and toxocariasis in the conditions of the COVID-19 pandemic, measures of prevention of these parasitic invasions. Ways of infection, clinical features of chronic toxoplasmosis in the acute stage, and toxocariasis are described. An overview of modern methods of diagnosis of toxoplasmosis and toxocariasis is presented, the necessity of line-blot analysis in our country is described, first of all, to clarify the stage of the disease in congenital toxoplasmosis, as well as for differential diagnosis of stages of this disease. treatment of patients with toxoplasmosis invasion. Indications for examination of patients with toxoplasmosis are presented. The main measures for the prevention of congenital toxoplasmosis, which is dangerous for newborns, are outlined. Preventive measures to prevent toxocariasis infection are described, which is a necessary basis for improving the system of epidemiological surveillance for the spread of toxoplasmosis and toxocariasis in all regions of our country. Emphasis was placed on the need to strengthen control by government agencies to prevent parasitological pollution, the urgency of establishing a National Program for surveillance of parasitic infestations in the near future to control their spread and prevent serious consequences for the health of infected, the need and feasibility of specialized treatment centers. and rehabilitation of patients with parasitic infestations, primarily toxoplasmosis and toxocariasis. The necessity of dispensary observation for persons from risk groups for severe toxoplasmosis – pregnant women, immunocompromised persons, persons with immunodeficiency of different genesis, the main solutions for the prevention of these parasites.

The aim of our work was to highlight the importance of an interdisciplinary approach in the study of pediatric surgical dentistry. The introduction of the Standard of Higher Education in Specialty 221 “Dentistry” Field of Knowledge 22 “Health Care” for the second (master’s) level of higher education has allowed us to revise and improve a number of provisions regarding the study of pediatric surgical dentistry. First of all, the updated educational-professional program 221- “Dentistry” outlines the list of competencies and learning outcomes in the discipline “Pediatric Surgical Dentistry” and clearly defines the prerequisites on which the study of pediatric surgical dentistry is based. In the study of pediatric surgical dentistry, namely issues related to inflammatory processes of the maxillofacial area, attention should be paid to the etiology and pathogenesis of acute and chronic inflammatory odontogenic processes directly in the age aspect. At the same time, it is important to emphasize the need for preventive dental measures, timely therapeutic intervention, especially during the eruption of permanent teeth and urgent radical treatment to prevent complications. In addition, an important component in the study of this topic are issues related to the age of the formation of organs and systems of the child, the tendency to hyperergic reactions and generalization of the inflammatory process, the factor of minimal anti-inflammatory potential. The presented methodological approach in terms of practical application of interdisciplinary links in the study of pediatric surgical dentistry, according to our observations allowed to increase the level of knowledge within the professional competence of students with a score of “5” from 20% in IV year to 68% V year. Thus, the list of components of the educational process analyzed in this paper creates a promising direction for further improvement of teaching methods at the Department of Pediatric Surgical Dentistry.

The aim of the work is a comprehensive assessment of the teaching quality at the Department of Internal Medicine №1 of the Poltava State Medical University. The assessment of monitoring was an anonymous online survey of VI year education medical students that was trained at the modules “Current practice of internal medicine” and “Emergency conditions in the clinic of Internal Medicine” in the context of the COVID-19 pandemic. It was shown that, despite the greatest difficulty of the “Cardiology” and “Hematology” cycles, the overall assessment of the teaching availability for all cycles was 4,16±0,416 points and the value of any cycle was not lower than 4 (5-point system). Given the conditions of distance learning in connection with the COVID-19 pandemic caused by the coronavirus SARS-CoV-2 the average score of student satisfaction with the skills acquired was 3.59 ± 0.593. Students noted that the most difficult mastering practical skills were on the “Emergency” (16.14%) and “Cardiology” (15.18%) cycles. This indicates that any cases, situational tasks, demonstration videos can’t replace live communication with the patient, under the guidance of a teacher-mentor, work with modern equipment and simulators. These results reflect that students need bedside teaching activities on patients’ experiences with teacher-mentor. A targeted approach to teaching and evaluating the learning process encourages feedback from students to improve the quality of educational services. Thus, the data allow us to analyze the effectiveness of distance educational quality using anonymous questionnaires, to get feedback and respond to the identified shortcomings.

As the use of medicines in the provision of medical services is an important component, it is advisable to constantly update the knowledge of doctors and monitor regulatory and market changes in the field of pharmaceutical supply. The purpose of this work is to identify educational and practical issues in the pharmaceutical field, knowledge of which contributes to the proper management of the provision of drugs to the medical organizations, motivated choice, appointment, rational therapy of diseased – patients of the doctor. General information on providing relevant knowledge to physicians in the cycles of thematic improvement in health management and economics on a number of issues are presented, including: legal and marketing regulation of health care organizations and the population with medicines; state regulation of drug prices; determining the need for drugs and purchasing for budget funds; regulatory requirements for prescriptions; features of use, storage and accounting in inpatient and outpatient settings of narcotic, psychotropic drugs and precursors, etc. Given that the development of the pharmaceutical healthcare sector is influenced by the market mechanism, it is advisable to familiarize yourself with the marketing management of its subjects. It is shown that knowledge of the main issues of medical care of health care institutions and the population contributes to the quality of professional duties of organizers and specialists on the basis of legal regulation, rational use of drugs, compliance with existing restrictions and standards, and forms the principles of professional interaction and ethical communication between health professionals.

Colorectal cancer (CRC) is the second leading cause of mortality among cancers after tumors of the respiratory system. One of the most significant prognostic criteria of CRC are the features of stromal component, which are not implemented in clinical practice. The aim was to study the main morphological features of the stroma of CRC T3N0-2M0 and to search for prognostic criteria of their recurrence and death. Group I included primary CRC without recurrences. Group II – primary CRC with recurrences; IIA – with recurrences that did not lead to death; ІІВ – with recurrences and fatal outcome from generalization of tumor process during 5 years from lethal outcome from the moment when the tumor was removed. The microslides of CRC were made by using the standard methods with G + E staining; immunohistochemical (IHC) reaction was performed by using monoclonal antibodies to smooth muscle actin alpha and vimentin. CRC with a stromal-parenchymal ratio (SPR)>50% were in 43.3% (26/60) of cases. SPR>50% is a prognostic criterion for recurrence (p<0.05), shorter disease free survival (p<0.001) and metastasis to regional lymph nodes (p<0.001). Immature stroma type of CRC IIA-IIIB stages is associated with the presence of tumor budding (p<0.001), G3 differentiation (p<0.01), shorter disease-free survival (p<0.001), metastatic activity (p<0.05); among recurrent CRC, the immature type of stroma is associated with the death of patients (p<0.05). A diffuse presence of tumor-activated fibroblasts is one of the criteria for immature CRC stroma (p<0.003), however, as an independent prognostic feature, it has limited prognostic value. SPR>50% and immature type of stroma are prognostic features for recurrence, metastasis and term of recurrence for CRC pT3N0-2M0; the presence of an immature type of stroma was associated with patient death.

The relevance of the infection caused by COVID-19 today is beyond doubt. According to the Protocol “Provision of medical care for the treatment of coronavirus disease (COVID-19)” approved by the order of the Ministry of Health of Ukraine dated April 2, 2020 № 762, antibacterial drugs are prescribed only in the presence of confirmed bacterial co-infection ( after receiving positive bacteriological results) blood and / or sputum analysis). But given that the results of the analysis must wait a few days, antibiotics, under certain indications, can be prescribed empirically. The aim of our work was to analyze the structure of the oropharyngeal microbiome, patients with viral and bacterial pneumonia who received antibiotics, to determine clinically significant strains and their sensitivity to antibacterial agents. In the structure of the oropharyngeal microbiome, fungi of the genus Candida significantly prevailed, which were found in 50 (45.6%) subjects, in second place in terms of frequency of detection were S. pneumoniae – 29 (26.4%). Much less often from the oropharynx of patients with viral-bacterial pneumonia associated with COVID-19 were isolated K. pneumoniae – 13 (11.8%), S. aureus – 11 (10.0%) and E. coli – 7 (6.4 %). Among the isolated S. pneumoniae, the maximum number of resistant strains was detected for such fairly new antibiotics as ceftriaxone – 37.9% and azithromycin – 31.0%. Among fungi of the genus Candida resistant to nystatin and amphotericin were 38.5% and 26.9%, respectively. Therefore, the administration of antibacterial agents, taking into account the sensitivity of clinically significant strains, will guarantee effective treatment, prevent the development of antibiotic resistance, prevent the development of oropharyngeal and intestinal dysbiosis, and thus reduce the cost of treatment of antibiotic side effects, including probiotics.

Millions of people have died from acute infections in the past century, but they have been effectively fought through the development of modern vaccines, antibiotics and infection control measures. Chronic infections are slower than acute infections, and the symptoms are often vague, difficult, and sometimes impossible to cure with antibiotics. Important signs of chronic biofilm infections are extreme resistance to antibiotics and many other common antimicrobials, as well as the extraordinary ability to avoid the host’s defenses. One such disease is chronic inflammatory lesions of the tonsils, the main infectious agents of which are gram-positive cocci, strains Staphylococcus spp., Streptococcus spp. The purpose of the study of the ability of strains of Staphylococcus aureus to form a biofilm isolated from the surface of the epithelium of the upper respiratory tract of children. Clinical strains of Staphylococcus aureus bacteria obtained from the oropharynx of 32 children with tonsils affected by the inflammatory process at the age of 4-12 years (median – 7) were studied. The results of microbiological examination of biomaterial obtained from children with chronic inflammatory lesions of the tonsils showed that in 32 samples 25 strains of S. aureus were identified, 12 of them (48%) are capable of forming a biofilm, and 13 strains (52%) (not adhesive) are not had this ability. The study of the dynamics of biofilm formation by selected strains of S. aureus showed an increase in optical density (OS) during three days of cultivation, ranging from 0.143

The widespread prevalence of pulp and periodontal diseases indicates the need for continuous improvement of the method of endodontic treatment and determines the relevance of the development of new methods of complex therapy. The primary etiologic agents of apical periodontitis are microorganisms and their by-products that have invaded the pulpal space and established multispecies biofilm communities in the root canal system. Biofilms are involved in all stages of root canal infection and can be found on root canal walls, in dentinal tubules, and on extraradicular surfaces. The success of endodontic dental treatment is determined by careful mechanical processing using modern instruments, drug treatment and subsequent three-dimensional hermetic obturation of the root canal. Only a high-quality and optimal solution to the three problems allows you to achieve high-quality long-term results of treatment. Instrumentation disrupts biofilms which colonize infected soft and hard tissues and provides access for irrigation and exposure to antimicrobial solutions for disinfection of the root canal system. Disinfection is achieved by the use of both antimicrobial agents and the mechanical flushing action of irrigation, with the goal being the disruption, displacement and removal of pulpal remnants, microorganisms, metabolic byproducts, debris and the smear layer created during instrumentation. The multistage, duration and laboriousness of drug treatment of root canals makes it not always effective, which can subsequently cause unsuccessful endodontic treatment. A practicing dentist should be able to rationally and efficiently utilize standard disinfection protocols in the irrigation and medication of root canal spaces.

Modern scientific advances in medical science and practice require a new perspective on the life and rights of the individual, starting from its embryo in the womb, and therefore the discussions devoted to the study of various aspects of the human right to health and life are simply condemned to a particular relevance in current conditions. Modern bioethics is designed to address ethical issues of medicine and biology, as well as related technologies, considering social, legal and environmental aspects. The objective of the study is to identify current ethical issues in medicine and biology as well as related technologies, considering social, legal and environmental aspects. The article analyzes the directions for the development of bioethics in the health system, human rights as a source of bioethical principles and behavioral criteria in various fields of its application. The bioethics problems of the major achievements of modern biological and medical sciences – stem cell therapy, human cloning, euthanasia, organ and tissue transplantation, certain aspects of resuscitation, which often conflict with moral and ethical criteria. The problem of emerging infections that create local or international emergencies is discussed. A clear example is the pandemic of a new disease – the COVID-19, which confirms humanity’s unpreparability to resist the spread of respiratory viral infections. Conclusion. Modern biological and medical research requires a rethinking of existing bioethical and legal postulates. They must go through a certain path of transformation to meet the requirements of today. It is important to improve the legal regulation without which the boundary between the subject and the object of study will remain potentially uncertain.