УДК: 616–057:61:378

Introduction. Occupational diseases are those that result from exposure to unfavorable, harmful, or dangerous factors in the production environment and work process. These factors can directly or indirectly cause health disorders in employees. Professional pathology has long been and continues to be a crucial component of a physician's comprehensive training, culminating in the attainment of a master's degree. The primary objective of the occupational diseases learning curriculum is to instruct students in the techniques of patient examination, diagnosis, and treatment of prevalent occupational ailments, as well as in organizational strategies to prevent their occurrence, and the principles of professional selection and labor examination. It is essential to maintain vigilance in identifying and addressing occupational diseases in patients. Doing so will not only help in addressing medical concerns related to prevention and the escalation of severity among working individuals, but also in mitigating social and economic issues. These include preserving the productivity of the nation's workforce and reducing the need for social benefits due to work incapacity. Given the unpredictable nature and life-threatening potential of certain pathologies, it is imperative that doctors across all specialties possess knowledge about the clinical aspects, specific diagnostic features, and treatment of occupational diseases. Mastering the discipline "Occupational diseases" involves obtaining certain competencies by students.

The aim of the study. To investigate the problem of teaching the discipline "Occupational diseases" at Danylo Halytskyi Lviv National Medical University.

Materials and methods. The analysis of the number of hours allocated to the average statistical group of students during the period since 2005 till 2023 at Danylo Halytsky Lviv National Medical University has been conducted.

Results. During period under investigation, there was a threefold decrease in the total number of hours, as shown in graph 1. The maximum number of academic hours - 48 - was documented in academic year 2009-2010, and the minimum - 16 - was in 2022-2023. The number of academic hours allocated for practical classes has also undergone significant changes, as depicted in graph 2. The number of practical hours is calculated for one academic group. The decline in the number of hours for practical classes corresponds to the decrease in the total number of academic hours in the discipline "Occupational diseases" for the specified period. During this period, the hours for writing and processing the medical history of a patient with symptoms of an occupational disease were reduced. Academic hours for the lecture presentation of the material were also significantly reduced: the maximum hours per student group was 18 – in academic year 2005-2006, and till academic year 2013-2014 it was reduced threefold. The indeces for academic year 2023-2024 are similar to those of the period 2022-2023.

Conclusion. Occupational diseases have been and continue to be a significant issue within the healthcare system, not only in Ukraine, but worldwide, in terms of both morbidity and mortality rates. Given the efficient functioning of industries with unfavorable or harmful working conditions, there is little chance for a rapid decrease in these indeces. Between the academic years 2005-2006 and 2023-2024, there has been a notable reduction in the total number of academic hours and hours allocated for lectures and practical classes in the discipline "Occupational diseases." Furthermore, there has been a complete absence of hours allocated for writing the history of the disease for almost a decade. This concerning trend, despite the acquisition of relevant knowledge and skills, significantly limits the amount of processed information at the master's level of education. We believe that improving the "Occupational diseases" syllabus can be achieved by engaging various didactic mechanisms into the learning curriculum for this discipline. This improvement requires an increase and a fixed number of academic hours to support the professional growth of students in higher education, particularly those in the field of 22 "Healthcare" and the specialty of 222 "Medicine".

Background: The patients with liver cirrhosis (LC) have autonomic nervous system (ANS) imbalance that can be evaluated by the heart rate variability (HRV) study. ANS imbalance results into cirrhotic cardiomyopathy (CCMP) and the most easily diagnosed feature of CCMP is the prolonged QT interval. Usually, in the literature not all HRV parameters are characterized, or their assessment period is short, not allowing covering all the important moments and therefore needing further study.

Material and Methods: In a randomized way with the preliminary stratification by the presence of LC 33 patients after signing the informed consent were examined. In addition to routine screening methods, all patients underwent 24-hour ECG monitoring.

Results: Patients with LC and syntropic CCMP have the ANS disorders with a HRV decrease, predominance of the sympathetic over the parasympathetic system, heart rate regulation at the humoral-metabolic level. The ANS disorders severity depend on the LC severity according to C. G. Child - R. N. Pugh criteria. During the analysis of the received results the significant positive correlation between the SDNN index and maxQT, avg QT, positive correlation between HF and max QTc, avg QTc were found. The diagnostic sensitivity of SDNN index and HF was high in the patients with LC and CCMP.

Conclusions: The ANS imbalance can be regarded as syntropic comorbid disorder in the cirrhotic patients. The diagnostic sensitivity of SDNN index and HF was found to be high in the patients with LC and CCMP, serving as diagnostic markers of CCMP.