УДК: 614.2+336.14:614+339.13.012:614.2 

РЕЗЮМЕ: Актуальність. Повоєнне відновлення України потребує стрімкого економічного та соціального розвитку, зокрема в сфері охорони здоров’я. Якість життя та активна участь у суспільстві значною мірою залежать від міцного здоров’я, особливо для громадян, які зазнали фізичних та психологічних травм через російську агресію. Мета роботи – дослідити потенціал експорту медичних послуг з України та приваблення міжнародних пацієнтів. Матеріали та методи. Огляд літератури щодо розвитку світових медичних послуг та ринків охорони здоров’я; аналіз статистичних даних про стан і можливості сектора охорони здоров’я України; вивчення найкращих практик інших країн у галузі медичного туризму; оцінка економічних показників та їх кореляція зі зростанням міжнародних медичних послуг. Результати та їх обговорення. Дослідження показує, що Україна має значний потенціал для розвитку міжнародних медичних послуг. Цей потенціал зумовлений високою кваліфікацією українських лікарів, відносно низькою вартістю медичних послуг і наявністю сучасних медичних технологій у деяких лікарнях. Сприяння розвитку міжнародних медичних послуг може залучити іноземні інвестиції, підвищити якість медичних послуг і принести значні економічні вигоди. Приплив міжнародних пацієнтів генерує експортні надходження, що сприяє державному бюджету та балансуванню національної платіжної системи. Проте для повної реалізації цього потенціалу необхідно подолати такі виклики, як покращення інфраструктури, забезпечення міжнародної акредитації та ефективний маркетинг.

Висновки. Розвиток міжнародних медичних послуг в Україні може значно покращити національну економіку та систему охорони здоров’я. Стратегічний фокус на цей сектор може принести такі вигоди, як підвищення якості медичних послуг, збільшення іноземних інвестицій та значні економічні повернення. Для успіху важливо подолати існуючі виклики та використати сильні сторони країни у сфері охорони здоров’я.

Ключові слова: охорона здоров’я України, світові медичні послуги, економічний розвиток, міжнародні пацієнти, глобалізація, медичний туризм.

ABSTRACT: Background. Post-war recovery in Ukraine necessitates rapid economic and social development, including in the healthcare sector. The quality of life and active participation in society are highly dependent on robust health, especially for citizens affected by physical and psychological trauma due to the russian aggression. Purpose – to explore the potential for exporting medical services from Ukraine and attracting international patients.

Materials and Methods. Review of the literature on the development of global medical services and healthcare markets; analysis of statistical data on the state and capa-bilities of Ukraine’s healthcare sector; study of best practices from other countries in the field of medical tourism; assessment of economic indicators and their correlation with the growth of international medical services.

Results. The study reveals that Ukraine has significant potential to develop its international medical services sector. This potential is driven by the high qualifications of Ukrainian doctors, the relatively low cost of medical services, and the availability of advanced medical technologies in some hospitals. Promoting international medical services can attract foreign investment, enhance the quality of healthcare, and generate substantial economic benefits. The influx of international patients would generateexport revenues, contributing to the state budget and balancing the national payment system. However, challenges such as infrastructure improvements, international accreditation, and effective marketing need to be addressed to fully realize this potential.

Conclusions. Developing international medical services in Ukraine can significantly enhance the national economy and healthcare system. Strategic focus on this sector can yield benefits like improved healthcare quality, increased foreign investment, and significant economic returns. Addressing challenges and leveraging the country’s strengths in healthcare are essential for success.

Key words:Ukrainian healthcare, global medical services, economic development, international patients, globalization, medical tourism.

The effects of natural clinoptilolite originated from the Transcarpathian region in the Western Ukraine and its composites doped with metal ions were studied toward: (1) cultured pseudo-normal mammalian cell and murine macrophages; (2) neutrophils of blood of healthy human donors; (3) mice immunized with model antigen; (4) mice under air-pouch model for estimation of microvasculature damage; (5) Candida albicans fungi. Silver doping enhanced cytotoxic action of natural clinoptilolite, while zinc doping did not do that. Clinoptilolite-Ag(NH₃)²⁺ was non-toxic for murine macrophages and moderately toxic for human HEК293 cells. Toxicity of clinoptilolite-Ag⁺ composite toward HEК293 cells was comparable with the effect in positive control. Natural clinoptilolite and its silver derivatives enhanced the humoral immune response in mice and the levels of antibodies were comparable with such levels at response to standard adjuvant, which, however, damaged the microvasculature in mice. Furthermore, natural and Ag-enriched clinoptilolite were capable of activating neutrophils with a release of neutrophil extracellular traps. Finally, we showed that both clinoptilolite-Ag(NH₃)²⁺ and clinoptilolite-Ag+ possessed much higher antifungal activity toward Candida albicans compared to such activity of the nonmodified clinoptilolite, while their doping with zinc did not show such enhancement. Thus, the Transcarpathian clinoptilolite possesses low toxicity toward mammalian cells and activates neutrophils in vitro, while silver doping enhanced the cytotoxicity of this material. Silver-doped derivatives demonstrated stimulating action on antibody production and the antifungal effect. Thus, the developed clinoptilolite-based composites are perspective for use as novel natural immuno-stimulators and antifungal agents.

 Keywords Clinoptilolite · Cytotoxicity · Immune-stimulation · Antifungal activity

The technology of tracking eye movements, known as oculography, has become an incredibly innovative research tool, gaining increasing popularity in the field of developmental cognitive neuroscience. This article presents an assessment of the ability to differentiate and interpret visual stimuli in a group of children, both healthy and with diagnosed developmental issues such as Asperger's syndrome. Dedicated computer games, operated using an eye tracker, were utilized for the study. During the research, eye tracking technology was utilized, enabling real-time measurement of eye movements. This technology employs a specialized device called an eye tracker, which consists of an integrated camera recording infrared radiation and emitting it towards the child being examined. The eye tracker records the reflection of radiation from the eye's fundus, allowing precise measurement of eye movements, pupil position, and duration of observation. This facilitated tracking of gaze during interactions with various stimuli such as images, text, or game animations. This method ensured accurate and non-invasive recording of children's visual reactions during interactions with dedicated computer games. The assessment of visual perception in each child was conducted using behavioral paradigms, including tasks involving gaze tracking, concentration, and memorization of moving or stationary objects. To successfully achieve the objectives of the study, data analysis, extraction, and feature selection were performed on the obtained behavioral paradigms. This analysis was based on oculographic data such as saccades, fixations, and pupillometric data. Studies employing oculography among both healthy children and those with autism spectrum disorders. The analysis of gaze and fixation values indicated significant visual preferences and reactions to stimuli present in the examined games, allowing for a better understanding of cognitive processes and the child's interaction with visual content. Observed differences in parameter values, such as saccade duration and the number of outliers, suggest varying levels of visual skills and visual reactions among the studied children. The existence of differences among individual children in their ability to react quickly and focus during interactions with computer games may have significant implications for the design of user interfaces and digital content accessible to this age group. Furthermore, the research results may have practical applications in tailoring intervention strategies and supporting perceptual development in children.

The objective of this study was to assess the consumption of antibiotics in children using the «AWaRe» classification of antibiotics (WHO, 2017) and metrics such as days of therapy (DoT) and length of therapy (LoT) per 1000 patientdays (PD). Antibiotics were administrated to 91.1% of inpatients in 2019 and 68.2% in 2021 (p<0.05). The main reason for antibiotic prescription was acute bronchitis in both study periods. Total DoT/1000 PD increased from 717.0 in 2019 to 760.0 in 2021 (p<0.05), and total LoT/1000 PD from 679.0 to 717.4 (p<0.05). Administration of antibiotics from the Access group decreased from 2.1% in 2019 to 1.8% in 2021 (p>0.05), antibiotics from the Watch group increased from 90.7% to 97.3% (p>0.05). Although a statistically significant reduction in the antimicrobial prescription rate, we found a considerable increase in (1) prescription antibiotics with a high risk of antimicrobial resistance, and (2) the main units of antimicrobial consumption.

UDC 615.03:615.276

The aim. To assess pharmacotherapy of hospitalised patients with coronary heart disease in Ukraine, identify the types of drug-related problems, and recommend interventions to improve the management of cardiac inpatients.

Materials and methods. The objects of the study were 25 medical records of inpatients with coronary heart disease complicated by heart failure and atherosclerotic cardiosclerosis. Methods applied: systematisation, generalisation, comparison, clinical and pharmaceutical approach. The statistical analyses were performed using the SPSS Trial.

Results. A comprehensive retrospective study was conducted to assess the management of cardiovascular diseases. In total, 25 patients were prescribed 62 drugs. It was established that 53.5 % of medicines were "Agents affecting the cardiovascular system"; out of them, 26.9 % were "other cardiac drugs" (C01E) used for enhancing cardiac energy metabolism. The study identified 597 drug-related problems (DRPs) (23.9±12.6 DRPs per patient) with the drug-drug interactions prevalence (62.6 %). Other common groups of DRPs were: (1) no indications for drug administration (8.5 %), and (2) despite indications, the drug was not prescribed (8.2 %). 99 DRPs (16.6 %; 95 % CI:13.7-19.8 %) were associated with "other cardiac drugs". They included 4 types of DRPs: (1) no indications for drug administration (33.3 %); (2) insufficient duration of the treatment (31.3 %); (3) drug-drug interactions (22.3 %); and (4) insufficient dosage or frequency of use (13.1 %).

Conclusion. Our findings suggest that the treatment of cardiac inpatients is associated with numerous DRPs. Thus, we formed a list of recommendations to improve the management of cardiovascular diseases in hospitalised patients