Встановлено, що застосування фізичних вправ з гирями формує базу для розви-тку основних фізичних якостей, позитивно впливає на покращення резерву функцій зовнішнього дихання, функціонального стану серцево-судинної системи, відновлення частоти серцевих скоро-чень, сприяє розвитку м’язової системи та покращенню рівня фізичного здоров’я студентів. Доведено, що студенти, які займалися фізичними вправами з гирями, досягли «безпечної зони» рівня фізичного здоров’я, що сприяло покращенню їхнього самопочуття, підвищенню ефективнос-ті навчання та готовності до виконання завдань майбутньої професійної діяльності.

The widening of the vestibular dimension of lateral ventricles > 10 mm should be considered a symptom rather than a definitive diagnosis. In fact, fetal ventriculomegaly (VM) is a defect with ’multifaceted‘ clinical consequences in the child’s further neurodevelopment. Isolated fetal ventriculomegaly can cause neurological defects ranging from mild neurodevelopmental delay to severe

complications in the form of ongoing palliative care to the death of patients at various developmental periods. The spectrum of compilations often depends on the severity of the ventriculomegaly. In the prenatal period, the combined diagnostic tools include the following: ultrasound/MRI and genetic, infectious tests that form the basis of reliable counseling. We hypothesize that advances in the diagnostic process allow the identification of ‘probably’ isolated forms of severe VM (ISVM). The review

authors electronically searched MEDLINE, EMBASE, and the Cochrane Library databases, describing the evidence-based validity and option of prenatal decompression for ISVM. The purpose of this review is to present the evolution of diagnostic techniques and views indicating the possibility and limitations of implementing prenatal decompression in severe ISVM. In conclusion, after reviewing

the available data, we want to introduce the idea that perinatal centers are close to or have reached the necessary capability, expertise, and competence to perform ISVM decompression procedures. Endoscopic ventriculostomy of the third ventricle (ETV) appears to be promising, as it seems to be associated with minimal perinatal complications and better neurological outcomes for the newborn. However, long-term follow-up results for the neurodevelopment of patients who underwent ETV

have not been reported. Looking ahead, randomized trials with the long-term neurodevelopmental follow-up of children who underwent prenatal decompression due to ISVM are needed.

Pharmaceutical education plays an important role for the education and health care system of the country and the world, because errors related to the action of medicines can sometimes be fatal. Pharmaceutical education programs are regulated at the legislative level and require constant improvement to solve problems of modern society. Our research is aimed at determining the main principles of modern pharmacological education in Ukraine and Europe. According to the literature, a paradigm shift in the training of pharmacists from a production direction to a patient-oriented model has been determined. In accordance with this paradigm, the competencies and skills that must be mastered while studying in pharmaceutical schools have been formed such as: flexibility, communication, analytical and critical thinking, ethics, the ability to learn quickly, etc. In order to achieve competitive competencies, educational programs should be student-oriented, teachers should be creative and highly qualified, and educational institutions should be provided with a sufficient level of material and technical support.

УДК 616-06+616-036.8+616.24

Data analysis of numerous studies was carried out and trends and directions in the management of patients 
with сhronic obstructive pulmonary disease (COPD) were analysed. Studying the characteristics of factors 
contributing to disease development без коми allows us to understand that the smoking epidemic, the aging of 
the world population and the lack of disease-modifying therapy will lead to a further increase in mortality from 
COPD. Each COPD exacerbation increases both the risk and frequency of subsequent exacerbations, and the 
development of local or systemic changes and complications has also been established. Not only severe but also 
moderate COPD exacerbations (those that do not require hospitalization and could be treated on an outpatient 
basis) also increased the risk of subsequent exacerbations and death. The degree of increase in risk was propor-
tional to the number of exacerbations per year. Thus, two moderate exacerbations per year increased the risk of 
death by 80 % (hazard ratio — 1.80 (95 % confidence interval (CI): 1.19—2.70)), while increased frequency of 
exacerbations to 5 increased the hazard ratio to 2.33 (95 % CI: 1.45—3.76).
The effectiveness of the treatment of patients with COPD and the dependence of the latter on various factors 
were evaluated. Based on the received data, the specialists have concluded that the presence of one severe or 
two or more moderate COPD exacerbations during one year indicates a high risk of exacerbations in the future 
and is associated with an increased risk of premature death. Therefore, a high-risk group patient requires special 
attention when choosing the tactics of his management. This is reflected both in international and national 
consensus documents. A single-inhaler triple therapy (specifically a fixed combination of budesonide/glycopyr-
ronium/formoterol), administered within the first 30 days after an exacerbation, is currently the only pharma-
cotherapeutic option that has been proven to reduce mortality in COPD patients.
Keywords 
Сhronic obstructive pulmonary disease, modifying factors of exacerbations, effective three-component therapy, 
mortality prevention.

Objective: Aim: To clarify the association between different types of uterine contractility dysfunction and the inflammation of the uterus and chorioamniotic membranes.

Patients and methods: Materials and Methods: The association between the inflammation of the uterine layers, chorioamniotic membranes, umbilical cord, and different types of labor activity abnormalities was examined in 382 patients with singleton pregnancies at 28-42 weeks' gestation who underwent Caesarean section (CS) for abnormal uterine contractions and other complications. Statistical analyses included the Mann-Whitney U, Chi-squared test, and logistic regression.

Results: Results: In the control group, slight infiltration with polymorphonuclear leukocytes (PMNs) and macrophages of the myometrium and decidua of the lower uterine segment at term pregnancy was found in 59.7% and 73.6% of cases. The main clinical risk factors for placental and decidual membrane inflammation in patients with excessive uterine activity (EUA) were prematurity, multiparity, group B streptococcus (GBS) colonization, and duration of ruptured fetal membranes before the CS. Moderate or marked myometrial inflammation of both uterine segments in the EUA group was diagnosed only in patients with cervical dilation of >6 cm and duration of labor of >8h. In women with hypotonic uterine activity (HUA), decidual and myometrial inflammation was significantly associated with nulliparity and intrapartum factors, such as protracted active first stage of labor, advanced cervical dilation, and number of vaginal examinations. In all cases, inflammation of the myometrium was accompanied by deciduitis.

Conclusion: Conclusions: Mild inflammation of the decidual membrane and myometrium of the lower segment at term pregnancy is a common physiological phenomenon contributing to labor initiation. Uterine hyperfunction comes as the response of the unaffected myometrium to the release of high concentrations of proinflammatory cytokines produced by the inflamed decidual and chorioamniotic membranes into the bloodstream. Marked myometrial inflammation that occurs in prolonged labor is an additional factor aggravating the hypotonic uterine activity.