Tubal factor infertility is one of the most pressing problems of our time, as this condition makes it impossible for a mature organism to produce offspring. The issue of restoring and preserving reproductive health is one of the priority problems of modern gynaecology and reproductive medicine. Therefore, in terms of reproductive health care as a fertility factor, the main focus is on those strategies that can help reduce reproductive losses. In recent years, Ukraine has been experiencing an insufficient level of reproductive health due to the negative impact of socio-economic instability in the country, martial law, falling living standards, and natural conditions. In addition, the ongoing opioid epidemic is a major burden on society and has a detrimental impact on future generations. Many literary sources contain information about the significant adverse effects of opioids on women's reproduction. The fallopian tube is crucial in the mother's interaction with gametes and embryos. For both human and female laboratory white rats, it takes almost four days for the oocytes to pass through the fallopian tube to the uterus. Defects associated with these processes can lead to infertility, which has motivated a wide range of research into the causes and treatments of pathological conditions of the fallopian tube.The article highlights the links of tubal-peritoneal infertility, namely the effect of the narcotic analgesic Nalbufin on the morphometric parameters of the components of the mucous membrane of the ampulla of the fallopian tube: the thickness of the mucous membrane, the thickness of the mucous membrane lamina propria, the width and length of the fold of the mucous membrane of the ampulla of the fallopian tube of the female white rat.

Аssociation between incidence of caries of temporary teeth and pathology of the musculoskeletal system in preschool children, considering biochemical markers of connective tissue metabolism. Bodnaruk N.I., Smolyar N.I., Chukhray N.L., Mashkarinets O.O., Gan I.V. The aim is study biochemical markers of connective tissue metabolism in children with musculoskeletal disorders and their association with dental caries of temporary teeth. There were examined 232 children at the age of 5 (202 children with musculoskeletal disorders and 30 conditionally healthy children without somatic pathology). Among children with musculoskeletal disorders 68 (33.66%) had flat feet, 59 (29.21%) – postural impairment and 75 (37.13%) – combined pathology of the musculoskeletal sestem. For further research, the children were divided into three groups, 30 people in each. Group І included children with pathology of the musculoskeletal system, dental caries, without oxyproline in urine; group ІІ – with pathology of the musculoskeletal system, dental caries and oxyproline in urine; group ІІІ – with dental caries and without oxyproline in urine. Urinary excretion of glycosaminoglycans using a nephelometric test with cetylpyridinium chloride was determined. The concentration of creatinine in urine was measured in units of weight in the formation of a chromogenic complex of a solution of picric acid with creatinine in an alkaline medium. Dental status was assessed in terms of caries prevalence, deft index and severity of dental caries. The prevalence of caries of temporary teeth in 5-years old children with musculoskeletal disorders was on average 90.6±2.05%, deft index ─ 6.62±0.20, being significantly higher than in children without somatic pathology (respectively 70.83±4.45% and 5.15±0.34, р<0.001). Oxyprolin was detected only in the urine of children with combined pathology of musculoskeletal system (on average 3.53±0.11 units). The excretion rates of glycosaminoglycans in children with pathology of the musculoskeletal system, dental caries and oxyproline in urine (gr.ІІ) were two times higher than the reference range (415.37±15,09 CPCh units / 1 g creatinine, р<0.001). In theabsence of oxyproline in urine, both in somatically healthy children (gr. ІІІ) and in children with pathology of the musculoskeletal system (gr. І), the levels of excretion of glycosoaminoglycans were within the reference range (respectively 198.83±10.71 and 203.87±12.52 CPCh units / 1 g creatinine. The levels of daily excretion of creatinine were within the normal range in children of gr. ІІІ (1.17±0.13 g/day; in children of gr. І they were 2.85 times lower (0.41±0.05 g/day, p<0.001); in children of gr. ІІ – 6.5 times lower (0.18±0.02 g/day р<0.001). In children of gr. ІІ, a negative correlation was found between the levels of creatinine and oxyproline (τ= -0.68, p<0.05). The absence of oxyproline in the urine of children of gr. І and ІІІ indicates the absence of collagen decay in their bodies. In children with pathology of the musculoskeletal system against the background of undifferentiated connective tissue dysplasia (gr. ІІ), a strong, positive correlation was found between the deft index and levels of urinary excretion of oxyproline (τ= +0.77, p<0.05) and glycosaminoglycans (τ= +0.90, p<0.05), which indicates that the development of dental caries depends on the severity of the pathology of the musculoskeletal system. 

Первинно злоякісні пухлини серця – рідкісне захворювання, відтак метастатичне  ураження серця трапляється частіше. Метастази гепатоцелюлярної карциноми (ГЦК),  які можуть уражати серцево-судинну систему та легені, мають тенденцію до поширення через внутрішньопечінкові кровоносні судини, лімфатичні шляхи або прямий інфільтрат. Результати аутопсії свідчать про частоту передсердних метастазів  ГЦК у 2,7–4,1%. Різні серцеві симптоми або прояви, як-от: задишка, набряки нижніх  кінцівок, раптова смерть або розширення яремних вен, як правило, спостерігають у пацієнтів з ГЦК з внутрішньосерцевим ураженням.  ГЦК є найпоширенішою первинною пухлиною печінки, що становить 75–85% випадків . За захворюваністю це шосте місце у світі після раку грудної залози,  легенів, колоректального раку, раку передміхурової залози та шлунка [2]. За рівнем смертності ГЦК – на третьому місці для обох статей, та показники захворюваності та  смертності у чоловіків порівняно з жінками у 2–3 рази вищі. 
Представляємо рідкісний випадок вторинного mts-ураження серцево-судинної  системи та легень у молодого пацієнта без вираженої клінічної симптоматики з  радіологічно встановленим діагнозом гепатоцелюлярної карциноми

ABSTRACT
The aim: To study medical and pharmaceutical specialists’ approaches to outpatient injection treatment and their impact on the quality of medical care.
Materials and methods: The object of the study was the answers of health care professionals (n=1408) to the questions on the use of injectable pharmacotherapy in personal treatment, listed in a specially designed questionnaire on a single protocol. System analysis, questionnaire survey, statistical, comparative-and-analytical methods were used.
Results: The quality of outpatient injectable pharmacotherapy, according to the results of a survey of medical and pharmaceutical specialist, can be considered inappropriate, as in 52.9% of respondents the local adverse reaction were significantly more likely to develop compared to the respondents who did not have any local adverse reaction (χ2=21.7819, p<0.05). Most often, the following complications of injectable pharmacotherapy occurred in the analyzed respondents: pain – 45.8%; hardening – 28.3% and reddening – 21.7%. When conducting home-based treatment, 42.8% of the respondents involved persons without medical education for the execution of procedures, which is significantly more frequent (χ2=26.5556, p<0.05) in comparison with the respondents who invited medical personnel (27.0%) and used the method of self-injection (30.2%).
Conclusions: The results of a survey of medical and pharmaceutical specialists revealed that home-based injectable treatment, based mainly on their own experience, is common in the occupational environment of health care professionals.