Проблеми геріатричної кардіології — одні з найважливіших аспектів знань не лише для сучасного лікаря-кардіолога, але й геріатра і сімейного лікаря, особливо при високій інвалідизації внаслідок серцево-судинних захворювань (ССЗ), а саме через артеріальну гіпертензію (АГ). Частка пацієнтів похилого і старечого віку, хворих на АГ, в останні десятиріччя відповідно збільшилася. Тому стаття присвячена вивченню особливостей патогенезу, клініки, перебігу та лікування АГ у старшому віці.

The problems of geriatric cardiology are one of the most important aspects of knowledge not only for a modern cardiologist, but also for a geriatrician and a family doctor. Especially with high disability due to arterial hypertension (AH) that share of elderly and senile patients with hypertension has increased accordingly in recent decades. Therefore, the article is devoted to the study of the features of the pathogenesis, clinic, course and treatment of hypertension in the elderly.

Abstract

The research aims at improving the quality assessment of clinical audit results in Ukraine using the complex of statistical methods and studying statistical methods in foreign reports of the clinical audit and personal experience.

Materials and Methods. The research was performed by analyzing the reports of clinical audit (n=62), held during 2021 by the Healthcare Quality Improvement Partnership. The spectrum of statistical methods was extended by the analysis of the example of a sociological survey of patients (n=405) regarding the quality assessment of medical care. The methods applied in the current study included systemic approach and analysis, structural and logical analysis, correlation and regressive analysis, calculation of relative values.

Results and Discussion. All 100% clinical audit reports, carried out by the Healthcare Quality Improvement Partnership were based on the results of the statistical calculations. The most common method of processing results is the epidemiological statistics (93.5%), ratio of chances/risks (30.6%), probability assessment by Х² Pearson's method (21.0%). It is noteworthy that for pointing the central tendency almost in half of the cases (46.8 %) the median and the Interquartile Range were used. Complex mathematical methods such as the survival assessment by Kaplan- Meier and method multiple regression were used in 6.5 % та 4.8 % reports, accordingly.

Conclusions. Based on our own experience, we suggested implementation of standardization methods, a detailed correlation and regressive analysis, neuro networks and power analysis into the methodology (technique) of the clinical audit. Implementation of spectrum of evidentially substantiated methods of statistical analysis will allow to increase the evidence level and to deepen the statistical analysis of databases when conducting the clinical audit, аnd therefore, the quality assessment of clinical audit results will increase.

The aim of the work. Comparative analysis of the educational programs' components of higher education institutions of different subordination, which train specialists for the pharmaceutical industry, and study the experience of design and assessment of the similarity level of the components of these programs.Materials and Methods. The educational and professional programs "Pharmacy, Industrial Pharmacy" of higher education institutions, namely Lviv Polytechnic National University and Danylo Halytsky Lviv National Medical University, have been used. The research was conducted using content analysis, comparative analysis, decomposition, and modeling methods.Results and Discussion. The analysis of educational programs of specialty 226 "Pharmacy, Industrial Pharmacy," which provides training of specialists at the Lviv Polytechnic National University (bachelors and masters in pharmacy, industrial pharmacy) and Danylo Halytsky Lviv National Medical University (Masters of Pharmacy) testifies to a significant amount of similar educational components, especially the pharmaceutical directions, which is a positive sign for the creation of future Education Standards. However, it should be noted that in the educational-professional bachelor's program in pharmacy, industrial pharmacy provides a large number of disciplines for general and vocational training. These disciplines are necessary and compose a basis for future educational program components that directly affect the specialist's becoming in industrial technology of medicines. The acquired competencies will allow performing qualitative work qualitatively and successfully implementing the acquired knowledge in the conditions of industrial pharmaceutical production.Conclusions. The creation and approval at the state level of the Education Standard for specialty 226 "Pharmacy, Industrial Pharmacy" is an essential and relevant element in the development of pharmaceutical education in Ukraine, which will harmonize and lead to a single format and content list of components of educational programs, unify state certification and guarantee competitiveness in the labor market for all higher education applicants.

SARS-CoV-2 and side effects of SARS-CoV-2 vaccination show tropism to nervous system structures. Neurological side effects from the central and peripheral nervous systems have been observed quite rarely after vaccination against COVID-19 compared to a large number of vaccinated individuals. The article presents a clinical case of simultaneous damage to the central and peripheral nervous systems in the form of acute autoimmune inflammatory encephalomyelopolyradiculoneuropathy, which occurred after receiving the first dose of the BNT162b2 mRNA vaccine. The severe course of encephalomyelopolyradiculoneuropathy with peripheral tetraplegia, sensory disturbances, bulbar syndrome, and dysautonomia, followed by the occurrence of pneumonia, secondary bacterial meningoencephalitis, the need for longterm mechanical ventilation led to the occurrence of pneumothorax and multiple organ failure, which caused the patient’s death after one and a half months of intensive therapy. Thus, the acute autoimmune inflammatory encephalomyelopolyradiculoneuropathy can be considered as a probable rare neurological complication of SARS-CoV-2 vaccination with mRNA-based vaccines. Encephalomyelopolyradiculoneuropathy can have a severe course, accompanied by multiple complications and leading to death. Establishing of the causal relationships of the occurrence of rare neurological pathological conditions close in time to vaccination against SARS-CoV-2 with mRNA-based vaccines requires additional further researches. 

The literature data of the last three decades on the problem of comorbidity of multiple sclerosis (MS) and epilepsy have been analyzed, such as issues of pathogenesis, clinical course, prognosis, and treatment of this dual pathology. Epileptic seizures occur in 2–3% to 5.9% of patients with MS, which is 3–6 times more common than in the general population. The incidence of epilepsy raises with increasing duration and severity of MS, with its
progressive course, and also depends on the effect of drugs for the treatment of MS. There is no unanimity in the literature on the age and gender characteristics of the occurrence of  epileptic seizures in MS. Probable mechanisms of MS comorbidity and epilepsy are analyzed. Data on certain common pathophysiology of MS and epilepsy and the concept according to which the model of epilepsy in MS is considered as a network disease are presented. Data on clinical manifestations and diagnosis of comorbid MS with epilepsy are presented. Epileptic seizures can occur at any stage of MS: before the clinical manifestations, at the onset of the disease, in the late stages, or can indicate exacerbation of MS. Types of epileptic seizures with a dual diagnosis (MS + epilepsy) are diverse. The majority of patients (up to 87.5%) have focal seizures (aware or unaware) or focal seizures to bilateral tonic-clonic, and a small share of patients have seizures of unknown origin. Most researchers believe that patients with MS and epilepsy have a more severe MS course and a worse long-term prognosis. The main directions of MS treatment and the impact of such treatment on the development of epileptic seizures are highlighted. Data on the effect of some disease-modifying drugs for the treatment of MS on the course of epilepsy and, on the other hand, on the impact of some antiseizure medications on the course of MS are presented. It is concluded that patients with MS have individual profiles and interindividual variability of epileptogenicity. The principles of treatment of epileptic
seizures/epilepsy in patients with MS are proposed.