The aim of this article was to study clinical and morphological features of luminal A subtype of breast cancer to assess its relationship with disease progression. Methods: This study included 79 patients with luminal A subtype of breast cancer who treatment in 2017 at the Lviv State Oncological Regional Treatment and Diagnostic Center. The Luminal A subtype was identified by immunohistochemistry (IHC) as ER+, PR+/-, HER2- and Ki-67 less than 20 percent on surgically resected breast cancer tissue. Results: The mean age of patients was 60,41±12,25 (range, 32–85 years), 26 (32,9%) were under 55 years. Nottingham Histologic Grade distribution was as follows: G1 – 10 (12,66%), G2 – 56 (70,88%), and G3 – 13 (16,46%) cases. Clinical stage II – 35 (44,3%) and III – 31 (39,24%) was observed. Menopausal status was in 67,1% of cases. Morphological analysis of the tumor tissue showed that except alveolar structures, there were trabecular, solid, tubular structures and separately located groups of tumor cells. The stromal component of the tumor was weak or moderate, most tumors showed minimal or marked inflammatory infiltration and low proliferative activity. Conclusions: To predict the probability of lymphogenic metastasis should be considered: menstrual function, histologic grade, the presence of alveolar structures in the infiltrative component, the different
types of structures in the infiltrative component, hyalinosis in the stroma of the tumor node and
inflammatory infiltration of tumor.

UDC 611.31.018:616-008.87

The experiment investigated the qualitative and quantitative composition of bacterial groups in the microbiotopes of the oral cavity of intact rats (20) for twenty-eight days. The material for microscopic and bacteriological studies was the microflora from the biotope of the oral cavity of animals, in particular, from microbiotopes of the tooth surface in the gingival margin, mucous membrane of oral vestibule and mucous membrane of oral cavity proper. During the experiment, stable microbiocenoses were formed from the gram-positive and gram-negative microorganisms of different species common to all intact animals in the studied biotope, however, they differed in quantitative composition in different microbiotopes of the oral cavity. The quantitative indicator of α hemolytic streptococci significantly decreased in the microbiotopes of the mucous membrane of oral vestibule and of oral cavity proper, compared with the corresponding indicator of the microbiotope of the tooth surface in the gingival margin during the experiment, which testified to the initial stages of formation of dental biofilm in this nishe of the oral cavity. The qualitative and quantitative composition of normal and opportunistic microbiota in the population of rats kept under standard conditions stabilized on the twenty-eighth day of the experiment.

УДК:611.843

The need of modern medicine for effective painkillers has led to the widespread, often unreasonable and uncontrolled use of analgesic drugs, including
opioid drugs. Nowadays, much work is being done to study the effects of opioids on 80 the body. [6-21]. During the study of changes in the retinal layers that appear in the early stages of opioid exposure, we came to the conclusion that they arise in response to the toxic effect of the drug, as well as due to the disruption of the blood supply to the studied structures.

The multi-sided damages caused by the large-scale invasion of Russia has become a great challenge for the medical care system of Ukraine. This research is aimed at studying, analyzing and summarizing data from scientific publications, personal experience, and open sources of relevant information concerning changes that occur in the work within Ukraine’s healthcare system and the activity of medical staff due to the Russian invasion. Special attention has been paid to processes related to relocations of medical staff and health care establishments, field hospitals as an important tool during martial law, as well as for the different types of support provided by the international partners of Ukraine. Data concerning demographic shifts in Ukraine due to the 2022 Russia-Ukraine war are also presented. Moreover, SWOT analysis of changes in the system of health care in Ukraine during martial law has been performed. Keywords: health care system of Ukraine, healthcare quality, demographic shifts, internally displaced people, relocations, field hospitals.

UDC 616.379-008.65--06:616-056.5:616.34-008.87]-085.27.4

The process of regulating intake and consumption to maintain energy balance is called lipostasis. Disruption of this system and metabolism can lead to disorders that may also cause changes in the structure of the gut microbiota. Insulin and leptin are key feedback signals. Their complex interaction with specific receptors in the central nervous system influences human eating behavior (pioglitazone) and leptin resistance (metformin) in patients with type 2
diabetes mellitus, helping to restore normal lipostatic function.
Key words: insulin resistance, leptin resistance, gut microbiota, type 2 diabetes mellitus, metformin, pioglitazone.