UDC 617.55-002.5-07:616.155-097.36-07

Despite the high level of development of modern diagnostics, there is still a problem of diagnosing extrapulmonary and latent forms of tuberculosis. The purpose of the study was to determine the features of the immune status during the Koch immunoprovocation test. Studies were conducted in the venous blood of 50 patients with abdominal tuberculosis before and 72 hours after the Koch skin test. Indicators of cellular immunity were determined by the indirect immunofluorescence method and the content of cytokines by the immunoenzymatic method. The existence of statistically significant differences in the immunogram and in the cytokine profile of the examined patients before and after the Koch test was proved. The Koch immunoprovocation test
exacerbates the pathogenetic manifestations of the chronic inflammatory process, which is manifested by a change in the cytokine spectrum of the blood and makes it possible to clarify the diagnosis of abdominal tuberculosis. Determination of the level of TNFα in the blood serum of patients after the Koch test can be a marker of the latent form of the course of abdominal tuberculosis. Key words: immune system, cytokines, extrapulmonary tuberculosis, Koch test. 

Background. It is known about wide variety of individual reactions to stress explained by genetics factors. On the other hand, it is also known about aerobic fitness variability between individuals. From the above it follows the hypothesis that inter-individual differences in normal conditions determine the characteristics of the body's response to acute stress. The purpose of this study is to test the hypothesis. Material and methods. The experiment is at 58 rats (28 males) Wistar line. Animals were tested for resistance to hypoxic hypoxia and aerobic muscular performance by swimming test. On the basis of the received data two qualitatively equivalent groups in a ratio 10/48 were formed. After a week of recovery over the next 10 days, one animal remained intact and 5 other rats were exposed to water-immersion and restraint stress. The next day after stress, the ECG recorded and some endocrine, metabolic and immune parameters determined as well as erosive-ulcerative lesions of the gastric mucosa evaluated. Results. Four clusters by hypoxic and swimming tests were created retrospectively: normal resistance to hypoxia and muscular endurance (n=11); moderately reduced resistance to hypoxia and normal swimming test (n=25); drastic increased swimming test and normal hypoxic test (n=3); significantly increased resistance to hypoxia and normal swimming test (n=9). Each cluster is characterized by specific (correctness of classification 100%) post-stress changes in 6 neuro-endocrine, 12 immune, 10 metabolic and 2 ECGs parameters, as well as the index of damage to the gastric mucosa. The swimming test determines the post-stress state of the registered parameters by 63,8%, the hypoxic test - by 57,5%, and taken together - by 79,1%. Conclusion. The post-stress neuro-endocrine, immune and metabolic parameters as well as injuries of myocardium and gastric mucosa in rats are determined significantly by innate muscular endurance and resistance to hypoxia.

The first scientific publication on general adaption syndrome, or as we know today biologic stress has been published in Nature in 1936 by the 29-year old Hans Selye.¹ Szabo et al² in the anniversary review "Stress" is 80 Years Old” conclude that despite the extensive and multidisciplinary research on stress during the last 80 years, a lot of basic and clinical research is needed to better understand the manifestations, central and peripheral molecular regulators of stress response, especially the modes of prevention/management of distress or its transformation into eustress and the treatment of stress-related diseases.

In the vast majority of publications on stress, the HPA-, HPG- and autonomous systems are the objects of research, while the place in the general adaptation syndrome of such important hormones as calcitonin and PTH has been studied only in a few publications. Another methodological shortcoming of most studies is that the subjects of analysis are limited to a single neuro-endocrine system.

Therefore, we set ourselves the goal: to analyze relationships between some adaptation hormones, HRV, calcitonin, and PTH as well as electrocardiogram and gastric mucosal damage in naїve and post stressed rats.

УДК 378.147:[378.22:61

Анотація. Метою написання статті визначено здійснення критичного аналізу змісту наукових досліджень, присвячений підготовці майбутніх магістрів медицини до педагогічної діяльності. Використано методи теоретичного аналізу наукової літератури, порівняння, сепарування, узагальнення. Встановлено, що проблема професійної підготовки магістрів медицини окреслюється здебільшого у вітчизняних дослідженнях. Узагальнено, що закордонні дослідники зосереджують увагу на різних аспектах міжособистісної взаємодії на рівні «лікар – пацієнт» у роботі практикуючих лікарів. Одним із актуалітетів наукових розвідок визначено формування педагогічної компетентності лікарського персоналу, що виявляється: у здатності комунікувати з пацієнтами, ефективно використовуючи весь обсяг медичних і психолого-педагогічних знань. Перспективи подальших наукових досліджень у цьому напрямі вбачаємо у методичному забезпеченні системи професійної підготовки майбутніх магістрів медицини до педагогічної діяльності.

Ключові слова: професійна підготовка, педагогічна діяльність, магістри медицини, лікарі.

Abstract

The purpose of the article is to clarify the content and carry out a critical analysis of scientific research devoted to the preparation of future masters of medicine for teaching activity. Methods. In the preparation of the article, the methods of theoretical analysis of scientific literature were used to determine the actualities of training future masters of medicine at the current stage of the development of medical education. The methods of separation various aspects of the pedagogical activity of doctors were used to specify the content of scientific investigations in the context of comparing the directions of professional training of medical personnel in Ukraine and abroad. The methods of summarizing the results of scientific research were aimed at determining promising directions of scientific research in the context of professional training of future masters of medicine for pedagogical activity. Results. It has been established that the problem of the pedagogical activity of medical personnel in the systems of medical education and health care attracts the attention of researchers. It was found that the problem of professional training of medical students in the master’s degree is outlined mostly in domestic studies. It is summarized that foreign researchers mostly devote their research to various aspects of interpersonal interaction at the “doctor-patient” level in the work of practicing doctors. Conclusions. One of the actualities of scientific research is the formation of pedagogical competence of medical personnel, which is manifested in the ability to teach and educate themselves and patients, as well as people who care for them, effectively using the entire scope of medical and psychological and pedagogical knowledge. An important task is outlined - to improve the system of master’s training of future medical specialists with the aim of purposefully forming the readiness of master’s graduates for teaching activities. We see the prospects for further scientific research in this direction in the methodical provision of the system of professional training of future masters of medicine for pedagogical activity.

Keywords: professional training, pedagogical activity, masters of medicine, doctors.