Ukraine's state policy in the field of local self-government isbased primarily on the interests of local communities and provides for radicalchanges and systemicreforms, decentralization of power, ie the transfer of muchpower, resources and responsibility from the executive branch to local governments.The provisions of the European Charter of Local Self-Government and the best worldpractice of public relationsin this area are the basis of policy. The need for a radical change in the structure of power and its territorial base atall levels, the implementation of real steps to stimulate the development of thecountry, the proper response to modern challenges required legislative action

UDC 616.89-008.615.1-02:613.861.3]:159.942.5:355.11

   The full-scale invasion of Ukraine by Russia on February 24, 2022, tragically and profoundly changed the lives and destinies of millions of people in Ukraine, becoming a severe ordeal for all Ukrainians. Today, we have thousands of casualties from Russian shelling and violence, and millions of Ukrainians have become internally displaced persons or refugees who have fled beyond Ukraine’s borders. This is a new tragic experience and, at the same time, a new relevant reality for Ukrainian society. The war between Ukraine and separatists, which began in 2014, is not a closed topic for the younger generation, who understand well that they will be participants in this war to fight for their land. The enrollment of adolescents directly from their school desks into the Hetman Petro Sahaidachnyi National Academy of Ground Forces confirms the motivated stance of the country’s young rising generation. Students deeply empathize with what is happening in Ukraine. When entering the academy, young people understand that they will participate in the struggle against aggressors. Their motivated choice gives them confidence that they will cope with such an important task as defending their homeland.

Background. The study of the problem of physical and mental health of people who have survived combat trauma is a component of a wide field of research on the problem of stress, which manifests itself at all levels of the organization of the body. Combat injuries, in particular those of the areas of pelvis and genitourinary system, stressful events, lead to the development of erectile dysfunction (ED). In recent decades, a sufficient number of scientific facts have been accumulated, which confirm the significant influence of stress factors on the reduction of sexual desire and sexual activity. Therefore, determination of Ca²⁺,Mg²⁺- and Na⁺,K⁺-ATPase activity on a convenient model like peripheral blood lymphocytes add complexity to the understanding of the development of the pathophysiological and pathobiochemical mechanisms of the body, the result of which is the development of ED.

Materials and methods. The research was conducted on peripheral blood lymphocytes of men injured as a result of combat operations (shrapnel and bullet wounds) in the Russian-Ukrainian war and treated at the Military Medical Clinical Center of the Western Region. The research group of men with combat injuries was divided into two subgroups: men aged 20–39 years (subgroup 1) and men aged 40–53 years (subgroup 2). The control group consisted of 48 practically healthy men without complaints of sexual dysfunction or cardiac, neurological or endocrinological pathology. Among the men of the control group were 30 men aged 20–39 years (subgroup 3) and 18 men aged 40–53 years (subgroup 4).

Results. It has been shown that in the peripheral blood lymphocytes of men injured as a result of hostilities, there is a decrease in Na⁺,K⁺-ATPase activity and Ca²⁺,Mg²⁺-ATPase activity of the plasma membrane and endoplasmic reticulum, which leads to overloading of the cytosol with Na⁺ and Ca²⁺ ions, respectively, which is characteristic of pathological processes.

Conclusion. Erectile dysfunction due to combat trauma is accompanied by a decrease in both Ca²⁺,Mg²⁺-ATPase activity of the plasma membrane and Ca²⁺,Mg²⁺-ATPase activity of endoplasmic reticulum of blood lymphocytes. As the age of patients with disorders of sexual function increases, the decrease in Ca²⁺,Mg²⁺-ATPase activities becomes more expressed. In men with erectile dysfunction due to combat trauma, the activity of Na⁺,K⁺-ATPase is also inhibited. According to the ROC curve, Ca²⁺,Mg²⁺-ATPase activity of the endoplasmic reticulum in blood lymphocytes is a potential biomarker of erectile dysfunction

UDC 616.89-008.46/.47-057.36-056.83-039.51:616.89-008.19]-07

   The article presents the results of a psychodiagnostic study aimed to identify cognitive impairment and comorbid depressive states in the military with alcohol-induced mental and behavioral disorders. Up to 50 % of borderline cognitive disorders were found in patients of both groups (N = 85). Depressive symptoms were found in 100 % of patients in the experimental group; 95.21 % demonstrated anxiety symptoms. Depression has been shown to correlate with cognitive impairment in patients with alcohol-induced mental and behavioral disorders. To reduce cognitive impairment, the patients of both groups were administered Cytoflavin metabolic drug in combination with traditional treatment. Following the course of treatment with addition of Cytoflavin, in 68 (80 %) patients of both groups there was a decrease in the cognitive dysfunction symptoms, normalization of sleep, and improvement of mood, which affected the quality of life in patients of both groups.

   У статті викладено результати психодіагностичного дослідження з метою виявлення когнітивних порушень та коморбідних депресивних станів у військових з розладами психіки та поведінки внаслідок вживання алкоголю. У пацієнтів обох груп (N=85) виявлено до 50% пограничних когнітивних відхилень. У 100% пацієнтів дослідної групи виявлено депресивні симптоми; у 95,21% - симптоми тривоги. Доведено, що депресія корелює з проявами когнітивних порушень у пацієнтів з розладами психіки та поведінки внаслідок вживання алкоголю. Для усунення когнітивних порушень пацієнтам обох груп було призначено в комплексі до традиційного лікування метаболічний препарат цитофлавін. У 68 (80%) пацієнтів обох груп після курсу лікування з додатковим призначенням цитофлавіну відзначалися зменшення проявів когнітивної дисфункції, нормалізація сну, покращення настрою, що впливало на якість життя пацієнтів обох груп.

Background: Human granulocytic anaplasmosis (HGA) is a vector-borne natural focal disease that is not officially registered in Ukraine. The first 13 cases of HGA in adults in Ukraine were identified in 2007. The purpose of our study was to develop a predictive model of HGA based on clinical and laboratory characteristics to develop a three-level standard case definition of HGA.
Materials and Methods: Researchers examined 498 patients with suspected tick-borne infections and carried out a retrospective clinical and epidemiological analysis of 60 cases recruited from Lviv regional infectious disease hospitals. Logistic regression was used to create a model of the probability of the diagnosis of HGA depending on the presence of certain clinical and laboratory factors that, when examined, together may help to confirm a case of HGA. For logistic regression, eight clinical and laboratory factors were selected: history of tick bite, hyperthermia, signs of pharyngitis, changes in chest X-ray picture (enhancement of the pulmonary pattern and enlargement of the lung root boundaries), increased bilirubin (>21 lmol/L), increased alanine aminotransferase (ALT >36 U/L), erythema migrans, and detected Lyme disease.
Results: In the presence of all eight factors, the probability of HGA is 95.7%. When the five main signs are absentsigns of pharyngitis, changes in chest X-ray picture, increased bilirubin and ALT, and a history of tick bite the probability of HGA in the patient dramatically decreases to 6.8%, meaning that HGA might be excluded.
Conclusions: Based on the analysis of epidemiological, clinical, and laboratory signs, criteria for establishing a suspected, probable, and confirmed diagnosis of HGA have been developed to improve diagnosis