UDC 611.7:615.8]:378.1.096

The number of victims with serious injuries in Ukraine is increasing daily, and these are tens of thousands of military personnel and civilians. Most of the injured require long-term treatment and rehabilitation. The first plac among traumatic injuries is occupied by injuries to the limbs and pelvic bones. At the same time, with the increase in the number of victims, the need for medical rehabilitation increases, the clinical facilities and capacities of which in
Ukraine do not meet modern requirements. The available amount of medical literature, scientific articles in professional publications, manuals and educational videos on Internet resources dedicated to the issues of physical therapy and rehabilitation of these patients is also insuficient. Given the challenges of today, martial law in Ukraine, and the large flow of injured people, the training of physical therapists should be supplemented with new approaches, forms, and methods of the educational process, among which a consistent examination of the patient according to the principles of the vital superficial anatomy of the human body, including the lower limb and pelvis, should take an important place. Vital surface anatomy is underrepresented in medical literature, medical textbooks, and books. Some authors use elements of surface anatomy in their works when examining patients, but anatomical terms are used quite arbitrarily, not adhering to international anatomical terminology. A search was conducted on the YouTube platform for available educational videos in Ukrainian for physical therapists and doctors, explaining the technique of manual examination of surface anatomy of the head, neck, trunk, and extremities. This search resulted in the following result: there are no such educational videos. The work presents a detailed descriptive manual examination of surface anatomy of the pelvis and lower limb, based on self-examination and peer examination of students in practical classes. It is proposed to supplement modern domestic textbooks and manuals on anatomy, traumatology and physical therapy with sections on vital surface anatomy, in compliance with modern international anatomical terminology. It is recommended to develop and release a series of educational videos with a sequential examination of various areas of the human body, based on the principles of surface anatomy, and to place them on Ukrainian-language
platforms and channels available to students, including YouTube and university repositories. It has been proven that the method of sequential manual examination of surface anatomy of the lower limb is effective, as it allows to form professional practical skills for physical therapists and doctors who will provide assistance to patients with damaged limbs, including injuries from martaal law in Ukraine.
Key words: surface anatomy, bony landmarks, lower limb, physical therapy and rehabilitation.

UDC 611.842-076.1-08

The diabetes mellitus (DM) epidemic, which progresses every year, is usually combined with the obesity epidemic, which is one of the major public health crises facing both developed and developing countries [1, 2]. Of the two major forms of diabetes, type 2 diabetes significantly exceeds type 1 diabetes (DM1) in prevalence and poses a greater challenge to modern health care systems. DM1 is considered an autoimmune disease,possibly caused by a viral infection, with an acute onset that includes insulins and islet cell infiltration, but persists as a chronic disease [3, 4], whereas type 2 diabetes (DM2) is a chronic disease caused by metabolic dysfuncfunction and insulin resistance. Both conditions are characterized by hyperglycemia and dyslipidemia, which are considered major risk factors for the development of common macro- and microvascular complications [5, 6], as well as neurological dysfunction; in additoon, these two conditions can coexist [7, 8].

The effectiveness of methods for diagnosing and treating eyeball angiopathies in diabetes is based on an in-depth and detailed study of the morphological structure of the organ of vision. The results of morphometric research of the choroid of the rat eyeball can serve as a foundation for solving problems in clinical ophthalmology.

Introduction: The widespread introduction of radiation examination methods into cardiology clinics, among which the safest is ultrasound examination of the heart, opens up new prospects for studying the cardiovascular system. When examining patients’ internal organs using ultrasound methods, the doctor sees the reflection of their sections, not the organs themselves. To solve the problems of anatomical-ultrasound comparisons and objectification of data
obtained in the cardiology clinic, it is important to introduce the production of educational anatomical preparations of the heart in an “expanded form” into the curricula of national universities.

УДК 616.34-008.1-053.2/.5

Функціональні гастроінтестинальні розлади, зокрема, синдром подразненого кишечника (СПК), є однією з найпоширеніших причин звернень до дитячого гастроентеролога.

Мета - визначити мікросоціальні фактори ризику виникнення СПК та їхній вплив на розвиток захворювання.

Матеріали і методи. До дослідження залучено 54 пацієнти віком 6-12 років із діагнозом СПК, встановленим відповідно до Римських критеріїв ІV, а також 50 практично здорових дітей із групи контролю з використанням «family history» (описово-феноменологічний збір анамнезу життя в когось із батьків пацієнта). Для статистичного аналізу отриманих даних використано програми «Microsoft Excel» і «GraphPad Prism 5». Для порівняння частотних показників незалежних груп застосовано критерій Xi-квадрат Пірсона (χ²) без поправки Єйтса на безперервність. Величину p<0,05 прийнято статистично вірогідною.

Результати. У групі дітей із СПК виявили такі сімейні фактори ризику, як схильність до соматизації в матері; частоту відвідування лікарів дитиною >6/рік; частоту відвідування лікарів мамою >6/рік; авторитарний стиль виховання мамою, гіперпротективний - батьком та обтяжений анамнез щодо інших психосоматичних розладів. Для дітей із СПК були більш характерними часті переїдання та харчові непереносимості. Теплі стосунки в сім’ї та демократичний стиль виховання з боку обох батьків можна розглядати протективними факторами щодо виникнення СПК у дитини.

Висновок. Мікросоціальні фактори ризику та протекції мають вагомий вплив на формування СПК у дітей.

Functional gastrointestinal disorders, in particular irritable bowel syndrome (IBS), are one of the most common reasons for referral to a pediatric gastroenterologist.

Aim - to determine microsocial risk factors for irritable bowel syndrome.

Materials and methods. The study involved 54 patients aged 6-12 years with a diagnosis of IBS established according to the Rome IV criteria, as well as 50 practically healthy children from the control group using "family history" (descriptive and phenomenological collection of life history from one of the patient's parents). For statistical analysis of the data obtained, Microsoft Excel and GraphPad Prism 5 programs were used. For the comparison of frequency indicators of independent groups, Pearson's Chi-square (χ²) test was used without Yates' correction for continuity. A p-value < 0.05 was considered statistically significant.

Results. In the group of children with IBS, the following family risk factors were identified: a tendency to somatization in the mother; frequency of visits to doctors by the child >6/year; frequency of visits to doctors by the mother >6/year; authoritarian parenting style by the mother, hyperprotective parenting style by the father, and a burdened history of other psychosomatic disorders. Children with IBS were more likely to have frequent overeating and food intolerances. Warm family relationships and a democratic parenting style on the part of both parents can be considered protective factors for the occurrence of IBS in a child.

Conclusion. Microsocial risk and protective factors have a significant impact on the formation of IBS in children.

 UDC: 616-089.844.168.1-06:616.211-00724

Background, Pollybeak deformity is the most common delayed complication o f rhinoplasty. The pre­
vention practicehave not been fully determined. The purpose was to analyze and evaluate the results o f using
different variants ofsurgical approaches and modified methods of preservation rhinoplasty and their importance in
preventing the development o f pollybeak deformity. Materials and methods. The study included 154 patients with
similar aesthetic nasal deformities. They were divided into 3 groups, depending on the techniques and methods of
rhinoplasty applied. In group l (68 patients), the cartilaginous skeleton of the nasal Up was isolated supraperiehon-
drially, then, crossing the Pitanguy’s ligament and the scroll ligament complex, the dorsum o f the nose was isolated supraperichondrially in the cartilaginous part, and subperiosteally in the bone part. In group 2 (27patients), the cartilaginous skeleton of the tip of the nose was isolated subperichondrially and, without crossing the Pitanguy’s ligament, scission o f this ligament was performed vertically. In this type of access, the scroll ligament complex was no damaged. The dorsum of the nose was excised subperichondrially and subperiosteally. In group 3 (59 patients), soft tissue separation was performed under the perichondrium and under the periosteum. A suture was placed between the anterior septal angle and the Pitanguy’s ligament in the supratip region. Results. Pollybeak deformity ingroups /, 2, and 3 occurred in 14(20.6 %), 3(11.1 %), and 2(3.4 %) cases, respectively. 11 (16.2 %), 3(11.1 %), and 2 (3.4 %) patients developed a mild degree., respectively. Moderatand severe cases were detected only in group Jo f the study: in  2 (2.9 %)  and 1(1.5%) patients, respectively. The rhinoplasty method used ingroup 3 allowed to significantly (p < 0.05) reduce the overallfrequency of mild pollybeak deformity compared to group l. Conclusions.
Preventing the development of pollybeak deformity involves the application of modified techniques.
Keywords: preserving rhinoplasty; complications; pollybeak deformity; prevention