Acute respiratory tract infections (ARTI) place an enormous impact on patients and primary healthcare system due to their extraordinary incidence. In 2019, the world prevalence of ARTI reached 17.2 billion and accounted for 43.8% of all causes of the global disease burden [1]. Respiratory infections are the most common reason for seeking medical attention, with personal recurrence rates ranging from 2 to 6 times per year [2]. Although usually mild and self-limiting, ARTIs significantly affect work productivity and quality of life [3].

Emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing corona virus disease 2019 (COVID-19) brought a new challenge, being both common and severe, affecting upper and lower airways with considerable constitutional symptoms. As with other respiratory infections, the management of outpatients with mild COVID-19 without risk of progressing to severe disease, remains supportive and include close observation for early recognition of the life-threatening symptoms, reduction the risk of further SARS-CoV-2 transmission, advising on when to seek an in-person evaluation [4]. Absence of the effective specific measures in most COVID-19 cases serves a rationale for exploration of a new complementary approaches, one of which may be the use of probiotics.

Indirect evidence shows that patients with COVID-19 and diarrhea have more severe disease, increased concentration of inflammatory cytokines, markers of tissue damage, suggesting the intestinal cells can serve an additional entry and reservoir for SARS-CoV-2 [5, 6]. As with type II alveolar cells, intestinal and colonic enterocytes express angiotensin I converting enzyme 2 (ACE2), a receptor though which SARS-CoV-2 inoculates the body [7]. Bifidobacteria and lactobacilli adhering to enterocytes can hypothetically interfere with infection process and disease manifestation [8,9,10]. Interestingly that bacteria may potentially downregulate amide and peptide metabolism in the gut including angiotensin-converting enzyme 2 (ACE2) [11, 12]. It may explain the reason that cell cultures exposed to probiotics yielded lesser amount of transmissible gastroenteritis coronaviruses [13]. Additionally, the beneficial effects of probiotics in respiratory infections can be realized via several non-specific mechanisms discussed within the gut-lung axis paradigm [14], including enhancement of innate antiviral immune defense [15]. A recent systematic review of 23 randomized clinical trials involving a total of 6950 participants with ARTI, demonstrated fewer cases, shorter case duration, and reduced antibiotic prescription rates in patients taking probiotics [16].

The objective of this study was to assess the role of short-term ingestion of probiotics in mild symptomatic COVID-19, post-disease symptoms, and humoral immune response to SARS-CoV-2 in outpatients.

Abstract.

Ensuring the monitoring of the quality of educational services and the educational process in higher education institutions (HEIs), that offer Educational Programs to train specialists in medical and pharmaceutical branches is one of the health care obligations that Ukraine as a state undertakes. Traditionally, specialists for pharmaceutical manufacturing were trained mostly at the HEIs, which were subordinated to the Ministry of Education and Science of Ukraine (MES), and those for pharmacies and hospital pharmacies were trained at the HEIs, subordinated to the
Ministry of Health of Ukraine (MOH).
In 2016, a single specialty 226 "Pharmacy" was introduced, and in 2017 the title name of the specialty was specified as 226 "Pharmacy, Industrial Pharmacy". The draft of Resolution of the Cabinet of Ministers of Ukraine (CMU) "On the Amendments to the List of a branch of knowledge and specialties for higher education" provides dividing of the specialty 226 "Pharmacy, Industrial Pharmacy" into two separate specialties: 226 "Pharmacy", which remains in the branch of knowledge 22 "Health Care", and 188 "Industrial Pharmacy", which potentially will be transferred to the branch of knowledge 18 "Manufacturing and Technology". The dividing of specialty into two separate ones is pertinent; however, the problem of transfer significantly affects the training of highly qualified human resources. That is why it is important to take out this problem from a limited circle of specialists in the pharmaceutical branch to the general public.
The research aimed to study and summarize the legislation on the current state of specialists training for the pharmaceutical branch by the specialty 226 "Pharmacy, Industrial Pharmacy", as well as the search for possible ways to solve the educational problem. The following methods were applied: meta-analysis, desk research, comparative analysis and modeling.
It is established the necessity to save the specialty "Industrial Pharmacy" in the field of knowledge 22 "Health Care", as its removal levels the results of specialists training and makes it impossible for the functioning pharmaceutical industry of Ukraine. As a result of this process, obstacles will be created for the research realization, development, and implementation of new medicines and generic drugs. It is extremely important to save the specialty "Industrial Pharmacy" in the field of knowledge 22 "Health Care". This is the only possible way to guarantee the quality of the drugs according to the Complex of Good Pharmaceutical Practices (GMP, GLP, GCP, GDP, GPP, GSP, GEP, GPEP) at all stages of its promotion from manufacturer to the patient, that will facilitate scientific research and development of new safe, effective, high-quality medicines, and also will allow providing training of highly skilled specialists for pharmaceutical branch.

Patients with Marfan syndrome and aortic root aneurysm require pre-surgical analysis of aortic root geometry for aortic reconstruction. The aim of this study is to perform the morphometric analysis of the sinus of Valsalva height and correlation between the former, age, weight, height, body mass index (BMI), and body surface area (BSA) in patients with Marfan syndrome and aortic root aneurysm. Data from 34 patients (28 men, 6 women) with Marfan syndrome and an ascending aortic diameter exceeding 45 cm were obtained using computed tomography angiography.Gender-based differences were observed in the height of the left aortic sinus – by 47.23% (36.47±12.48 mm in men against 24.77±4.26 mm in women, р=0.0003). In men, a strong direct correlation has been identified between height and the right aortic sinus height (r=+0.75, р<0.0001), the posterior aortic sinus height (r=+0.71, р<0.0001), and the left aortic sinus height (r=+0.75, р<0.0001). Moderate reverse correlation has been discovered between the sinus of Valsalva height and BMI. No correlations have been identified between weight, BSA and the sinus of Valsalva height (р>0.05). In women, a strong direct correlation (Pearson) has been identified between age and the right aortic sinus height (r=+0.84, p=0.04), between weight and the left aortic sinus (r=+0.73, p=0.04) and between BSA and the left aortic sinus (r=+0.73, р=0.04).Aortic sinus height in men increases with height and decreases with higher BMI and age. Weight and BSA do not affect the sinus of Valsalva height. In women, the sinus of Valsalva height is impacted by age, weight and BSA.

The results of the study show that with a two-week opioid exposure, the most prognostically favorable indicators were in the group where complete withdrawal was carried out with subsequent correction with the drug pentoxifylline. It can also be concluded that during the correction of opioid retinopathy, it cannot be carried out with drugs of the  antibradykinin group (pentoxifylline) without complete withdrawal of the opioid because  this contributes to a sharp increase in pathomorphological manifestations in the layers of the retina and is a prognostically unfavorable moment. 

УДК 616.441-008.61/.64-092.9

Порівняльний аналіз експе-риментальних форм гіпо- та гіпертироїдних станів.
Актуальність. Моделювання гіпо- та гіпертироїдизму в лабораторних тварин широко застосовується у сучасній експериментальній біології та медицині для вивчення патогенетичних механі-змів розвитку захворювань щитоподібної залози, проблем її лікування, а також дослідження впливу дис-балансу тироїдних гормонів на різні органи та системи організму. Найбільш поширеним сучасним мето-дом створення моделі експериментального гіпотироїдизму є введення в організм лабораторних тварин хімічних речовин, здатних блокувати функцію щитоподібної залози. Найбільш уживаним фармакопей-ним тиростатиком є мерказоліл, який застосовують як у клініці для лікування захворювань щитоподібної залози, що супроводжуються гіпертироїдизмом, так і в практиці експериментальних досліджень. Моде-лювання гіпертироїдизму здійснюють шляхом уведення в організм піддослідних тварин препаратів тиро-їдних гормонів. Мета роботи - визначення оптимальних доз препаратів, необхідних для досягнення стій-кого гіпертироїдного або гіпотироїдного станів а також корекції останнього в експериментальних щурів. Методи. Дослід поставлено на 65 статевозрілих самках білих щурів лінії Wistar масою 200-250 г. Усі тварини були поділені на 5 груп: контроль, гіпо- та гіпертироїдизм (по 15 тварин у групі), а також 2 гру-пи з корекцією гіпотироїдизму (по 10 тварин у групі, табл. 2.1). Гіпотироїдний стан моделювали за допо-могою мерказолілу (“Здоров’я”, Харків) у добовій дозі 10 мг/кг; гіпертироїдизм викликали L-тироксином (“Фармак”, Київ) у добовій дозі 100 мкг/кг маси тіла тварин. В усіх дослідних групах мерказоліл і тирок-син у вигляді порошку додавали в їжу щоденно протягом двох тижнів, після чого тварин піддавали евта-назії передозуванням діетилового ефіру. Структуру щитоподібних залоз вивчали на гістологічних препа-ратах, забарвлених гематоксиліном та еозином традиційним методом. Результати та висновки. Під час аналізу мікроморфології щитоподібних залоз тварин, що отримували мерказоліл, була встановлена на-явність струмогенної реакції слугувала доказом гіпотироїдного стану, індукованого у цій групі тварин. Дослідження щитоподібних залоз щурів, яким разом із мерказолілом вводили тироксин у дозі 1,6 мкг/кг маси (перша група корекції), показало, що їх морфологія, як макро-, так і мікроскопічна, не відрізнялася від групи, що отримувала лише мерказоліл, тобто була наявною струмогенна реакція. Це було свідчен-ням недостатньої дози тироксину. При використанні замісної дози тироксину 30 мкг/кг маси тіла (друга група корекції) струмогенна реакція не розвивалася – будова щитоподібних залоз відповідала нормі. Та-ким чином, саме ця доза тироксину компенсувала антитироїдну дію мерказолілу. При дослідженні будо-ви щитоподібних залоз щурів, які отримували тироксин у дозах 100 мкг/кг, були отримані ознаки їх атрофічного стану. Таким чином, макро- та мікроморфологія щитоподібних залоз щурів цієї групи свід-чили, що використана доза тироксину була достатньою для моделювання стійкого гіпертироїдизму.
Ключові слова: щитоподібна залоза, гіпотироїдизм, гіпертироїдизм, мерказоліл, тироксин.

Comparative analysis of experimental forms of hypo- and hyperthyroid conditions. 

The relevance. Modeling of hypo- and hyperthyroidism in laboratory animals is widely used in modern exper-imental biology and medicine to study the pathogenetic mechanisms of the development of thyroid gland diseases, the prob-lems of its treatment, as well as the study of the impact of thyroid hormone imbalance on various organs and systems of the body. The most popular method of creating a model of experimental hypothyroidism is the entry of chemicals capable of blocking the function of the thyroid gland into the body of laboratory animals. The most widely used pharmacopoeial thyro-static is mercazolil, which is used both in clinic for the treatment of thyroid gland diseases which accompanied by hyperthy-roidism, as well as in practical experimental studies. Modeling of hyperthyroidism is carried out by entry thyroid hormone preparations into the body of experimental animals. The aim of the work was to determine the optimal doses of drugs, which are necessary to achieve stable hyperthyroid or hypothyroid states, as well as its correction in the experiment. Methods. The experiment was carried out on 65 sexually mature female white rats Wistar line, weighing 200-250 g. All animals were di-vided into 5 groups: control, hypo- and hyperthyroidism (15 animals in each group), as well as 2 groups with correction of hypothyroidism (10 animals in each group, Table 2.1). The hypothyroid state was modeled with Mercazolil (Zdorovya, Kharkiv) in a daily dose of 10 mg/kg; hyperthyroidism was induced by L-thyroxine (Farmak, Kyiv) in a daily dose of 100 μg/kg body weight of animals. In all experimental groups, mercazolil and thyroxine, in the powder form, were daily added to the food for two weeks, after which the animals were euthanized by an overdose of diethyl ether. The structure of thyroid glands was studied on histological slides stained with hematoxylin and eosin by the traditional method. Results. During the analysis of the micromorphology of the thyroid glands of animals treated with mercazolil, the presence of a goitrogenic reac-tion was established, which served as evidence of the hypothyroid state induced in this group of animals. A study of the thy-roid glands of rats who received thyroxine together with mercazolil at a dose of 1.6 μg/kg of weight (the first correction group) showed that their morphology, both macro- and microscopic, didn`t differ from the group that received only merca-zolil, i.e. goitrogenic reaction was present. This indicates an insufficient dose of thyroxine When using a replacement dose of thyroxine of 30 μg/kg of body weight (the second group of correction), the goitrogenic reaction did not develop - the struc-ture of the thyroid glands corresponded to the norm. Thus, it was this dose of thyroxine that compensated for the antithyroid effect of mercazolil. When studying the structure of the thyroid glands of rats treated with thyroxine at a dose of 100 μg/kg, we found signs of their atrophic state. Thus, the macro- and micromorphology of the thyroid glands of rats in this group indi-cated that the used dose of thyroxine was sufficient to simulate persistent hyperthyroidism.

Key words: thyroid gland, hypothyroidism, hyperthyroidism, mercazolil, thyroxine.