Introduction. In the patients with angina pectoris, in case of the iodine deficiency, the metabolism processes, hemodynamics and autonomic regulation can often change. Aim. To find out the peculiarities of the changes of the natriuretic propeptide NTproBNP, diastolic function of the left ventricle and heart rate variability (HRV) in patients with stable angina pectoris in combination with subclinical hypothyroidism. Materials and methods. To understand the features of the clinical signs, the changes of the natriuretic propeptide – NT-proBNP, left ventricular diastolic function and heart rate variability (HRV) in the patients with the stable angina pectoris, combined with subclinical hypothyroidism, 2 groups of the patients were observed: 39 patients with coronary artery disease: stable angina pectoris of II-III functional class (FC) and 44 patients with the stable angina pectoris in combination with subclinical hypothyroidism. In addition to the routine laboratory and instrumental examination methods, the levels of NTproBNP, thyroid stimulating hormone (TSH), triiodothyronine, thyroxine and peroxidase antibody concentrations were determined, also echocardiography, ECG Holter monitoring with providing the heart rate variability testing were performed. Results. The feature of the clinical manifestations of angina pectoris in the patients with the reduced function of the thyroid gland (TG) is frequent attacks of breathlessness and rapid fatigue, meanwhile the anginal pain occurs rarely. Besides, the symptoms of hypothyroidism join and worsen the course of the main disease. The level of the NT-proBNP in the examined patients with angina pectoris and subclinical hypothyroidism is 25,08 ± 0,66 fmol/ml and is significantly higher, compared to the patients with no hypothyroidism (14,24 ± 0,51 fmol/ml) and compared to the control group of the healthy individuals (3,91 ± 0,22 fmol/ml). In the patients with angina pectoris, combined with subclinical hypothyroidism, compared to the patients with isolated stable angina pectoris of the appropriate FC, more pronounced disorders of the left ventricular diastolic dysfunction with more frequent detection of the pseudonormal type are recorded. In the patients with the angina pectoris, combined with subclinical hypothyroidism, the value of TP was 2415,70 ± 37,31 ms2, sympathetic-vagal index was increasing till 2,20 ± 0,04, indicating the decrease of HRV and hypersympathicotonia, meanwhile in the patients with angina pectoris and preserved thyroid function these changes were less pronounced and were 3015,90 ± 38,72 ms2 and 2,07 ± 0,05 respectively. Conclusions. The study of changes of the level of NT-proBNP, the state of cardiohemodynamics and state of autonomic nervous system in patients with angina pectoris in case of iodine deficiency is very important due to the fact that the course of ischemic heart disease is significantly altered – clinical signs of angina are sunken, often symptoms of heart failure are present in the foreground, and this is an important aspect for timely and adequate pathogenetic treatment.

Introduction. One of the decisive mechanisms of the influence of xenobiotics on a human organism is the disturbance of calcium-phosphorous homeostasis and oxidative metabolism of cells due to the changes in the intracellular flow of calcium (Ca) and phosphorus (P), their replacement on specific receptors, and subsequent activation of calcium-dependent enzymes and hormones. Even in the case of short hypoxia, and during the action of xenobiotics, prolonged tissue hypoxia occurs, homeostasis of such trace elements as Na+, K+, Ca++, P+++, Mg++, Mn+++, Cu++ and Fe++, that correlates with the decrease of the level of intracellular ATP and the activity of most metal enzymes. Aim. To find out the effectiveness of advanced standard treatment of lesions of the bone system in children from ecologically disadvantaged areas (EDAs) based on the study of calcium-phosphorous homeostasis and mineral density of bone tissue. Materials and methods. We investigated 239 children from ecologically polluted regions and 70 children from ecologically clean area. Children’s age is from 3 to 18 years, sex – 48, 0 % boys and 52, 0 % – girls. Level of calcium and phosphorus in the blood and urine in these children before and after the treatment was analyzed by the biochemistry examination. Bone mineral density and bone system degree of changes were measured by ultrasound densitometry. Results. Level of calcium and phosphorus in the blood in observed children from polluted region was reduced. Level of calcium in the urine was increased in the majority of observed children from the radiation polluted region and in children from the chemistry polluted regions. And level of phosphorus in the urine was increased in the majority of observed children from chemistry polluted regions. The level of the bone mineral density in these children was reduced. Indicators of calcium and phosphorus content in blood and urine and bone mineral density in the examined children after a complex, individually selected treatment were normalized. Indicators of bone mineral density of children from all EDAs irrespective of the nature of contamination and ways of getting xenobiotics into the organism, have significantly decreased and are within the age range compared with the indicators of healthy children after the treatment. Conclusions. In the majority of the examined children in radiation and chemically contaminated areas there was a significant hypocalcemia, hypophosphatemia and hypercalciuria, hyperphosphaturia, which managed to be corrected by the proposed treatment.

Introduction. Pathological effects of obesity are realized primarily through arterial hypertension, hypercholesterolemia, glucose intolerance, the prevalence of which is increasing among people with excessive body weight. However, numerous epidemiological studies have shown, an increased mortality rate from coronary heart disease and other non-infectious diseases is observed among the people with a low body mass index compared with the patients with an average body mass index. Aim. Finding out the features of structural-geometric, systole-diastolic remodeling of the left ventricle and endothelial dysfunction of the vessels, as an early marker of atherosclerosis, in patients with hypertension and varying body weight. Materials and methods. The study included 119 patients with arterial hypertension stage II, diagnosed according to the recommendations of the Ukrainian Association of Cardiologists (2008), aged 60 to 85 years (on average 75.0 ± 5.9 years). Of these, 45 had concomitant abdominal obesity, 35 – deficiency of body weight, 39 – normal body mass. A determination of the structural and morphological, systole-diastolic parameters of the left ventricular remodeling and vascular endothelial function parameters, endothelium function, using reactive hyperemia (endothelium-dependent vasodilation) and nitroglycerin (endothelium-independent vasodilation) tests was made. Results. Conventionally considered to be a normal reaction is a dilatation of the brachial artery in the case of reactive hyperemia of over 10,0 % of its diameter prior to the test, if it’s value is less or there is a vasoconstriction, it is considered to be pathological. In hypertensive patients with concomitant abdominal obesity the thickness of the interventricular septum and the posterior wall of the left ventricular, the end-systolic size and end-diastolic dimensions as well as the index of left ventricular mass were significantly bigger than in other groups of patients with hypertension, indicating the tendency to develop mainly concentric left ventricular hypertrophy. The changes, detected by the transmitral blood flow analysis, have the same direction in all groups of patients and reflect the formation of the hypertrophic type of diastolic function disorder. However, the intergroup analysis of the diastolic function changes in patients with normal body mass and abdominal obesity showed that most violations of diastolic filling of the left ventricle occurs in patients with concomitant abdominal obesity. Analysis of echocardiographic parameters in patients with deficiency of the body mass showed a tendency to form a concentric left ventricular hypertrophy and diastolic dysfunction of the first type. In patients with low body mass compared to a group of patients with satisfactory weight, there is a significantly smaller left ventricular mass, indicating a slightly lower level of left ventricular hypertrophy and decrease of the deceleration time of the early diastolic filling caused by an increase in myocardial stiffness, which adversely affects the contractility of the heart. ?onclusions. In patients with the second stage hypertension there was observed a significant decrease in abnormal endothelium-dependent vasodilatation of the brachial artery and a decrease of its sensitivity to shift tension, regardless of body weight, although more pronounced in patients with underweight and in patients with the concomitant abdominal obesity. At the same time the endothelium-independent vasodilation in response to nitrates was preserved.

Introduction. Since cholesterol is a substrate for the synthesis of sex hormones, including testosterone, changes in androgen availability in patients taking statins can be expected. At the same time, the effect of statins on androgenic provision of patients with coronary artery disease was studied selectively, mainly in males. In particular, published single reports of a decrease in total testosterone (TT) in men taking statins. Aim. To investigate the status of androgen support in patients with stable angina pectoris (SAP) in combination with type 2 diabetes mellitus (DM) and its modifications under the influence of statin treatment. Materials and methods. The effect of statin treatment on the indices of androgen availability of 120 SS patients in combination with DM type 2 on the basis of determination of the TT, testosterone-estradiol-binding globulin and free androgens index (FAI) was analyzed. Among the patients with SAP in combination with DM type 2, 53 (44.17 %) men and 67 (55.83 %) women. The average age of patients was 60.10 ± 0.78 years (57.85 ± 1.12 years – males and 61.88 ± 1.03 – females). SAP diagnostics were conducted in the accordance with the recommendations of the European Association of Cardiologists for the management of patients with stable coronary artery disease (2013), type 2 diabetes – the recommendations of the European Diabetes Policy Group and WHO (2011). Results. It demonstrates the definition of the levels of TT, testosterone-estradiol binding globulin (TEBG) in plasma and free androgen index calculation (FAI) = TT•100/TE?G. The androgen imbalance was studied and established that an average TT in men with SA in conjunction with type 2 DM was significantly reduced. It was determined that in women with SA and type 2 diabetes were increase both statins and FAI. In both men and women in the main group was established a decrease of TE?G in comparison with the control patients (p = 0.009 for men and p = 0.05 for women). The effect of the treatment with statins on the androgenic provision indicators was dose-dependent. Both men and women receiving high-dose statins showed a reduction in the average level of TT and FAI. In patients treated with statins in standard doses a significant impact on the androgenic provision indicators was not found (p > 0.05). Conclusions. In men with with type 2 DM, the SS passes with a decrease in TT level. The use of high doses of statins deepens the androgen deficiency (reduces the rates of TT and IVA). In women with DM, SS is accompanied by an increase in TT and IVA. The appointment of statins to patients with DM type 2 in combination with CC, corrects the androgenic imbalance.

Introduction. The problem of cardiovascular diseases is one of the most important in medical science and practical public health. The most urgent problem of hypertension is in groups of working population suffering from the harmful factors of production environment and labor process such as noise, vibration, harmful industrial climate and so on. Aim. To develop the criteria of professional competence of employees with hypertension working under the harmful and dangerous factors of production environment and labor process. Materials and methods. The analysis of general and occupational diseases were carried out on the results of periodic medical examinations of individuals working under the influence of the hazardous and dangerous conditions on the basis of the general medical reports. The analysis was provided by 35 medical commissions in Kyiv that carried out preventive medical examinations for people working in hazardous and hazardous working conditions during 2009-2013. It was studied the main forms of general diseases taking into account ICD-10 and occupational diseases. Results. The dynamics of the occupational diseases in the enterprises of Kyiv shows that in recent years there was a decrease of occupational diseases which is consistent with the general trend in Ukraine. General diseases were diagnosed in 30.5 % of employees. The analysis of the total morbidity of workers in Kyiv in recent years shows that the cardiovascular diseases (39.6 %) were the most widespread. The prevalence of hypertension was 42.3 %, vegetative-vascular dystonia – 31.4 % and coronary heart disease – 20.8 %. Therefore, in the diagnosis and treatment of hypertension, the modern clinical, laboratory and instrumental methods should be used, according to the unified clinical protocol of primary, emergency and secondary (specialized) medical care, clinical recommendations for arterial hypertension. The chairpersons of medical commissions conducting the periodic medical examinations and determining the proficiency of a worker with hypertension to a profession under the conditions of harmful and dangerous manufacturing factors, must use the criteria of professional suitability in accordance with the order of the Ministry of Health of Ukraine N 246 dated May 21, 2007 “On Approval of the Procedure for Carrying Out the Medical Examinations of Employees of the Certain Categories” and to form groups of dispensary observation. Conclusions. It is necessary to adhere to the sanitary-and-gygienic requirements regulating the permissible level of production norms in the workplace; rational use of remedies of individual and collective protection; to introduce the principles of time protection, the system of the training of the administration, the services of the labor protection on the enterprises on the basis of healthy lifestyle, socio-psychological adaptation, the preservation of health in the workplace, etc. The requirements for further improvement of normative acts on the examination of the proficiency and performance of the certain categories of workers with existing the general and occupational diseases are needed.

Introduction. Modernization of society, rapid and massive urbanization, overburdened societal demands, chronic shortages of time lead to an increase in the impact of stress factors on human health in general and on mental health, in particular. Studies have found that people capable of building close social relationships have less stress-related disorders and higher recovery potential after psychotraumatic situations and illnesses. The study of the illness factors in the relationships can be cunducted in the context of the mental health. Consequently, technology, social mobility, family structure change; prolonging the search period for a partner, increasing the age of marriage, waivers of formal legalization of relationships and procreation, non-prolonged relationships and low satisfaction rates. In addition, the character of interpersonal communication has recently changed: it acquires features of independence, remoteness, isolation, loneliness and loss of intimacy. Aim. To describe the primary models of family relationships as a predictor of mental health. Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of research of actual scientific researches concerning the primary models of family relations as a predictor of mental health were used. Results. The interest of science covers the origins of the relationships based on an attachment as a significant factor. If the patient in a search of support calls to a doctor and, in particular, to psychotherapist, it indicates the existence of a particular causative agent that enabled this man’s attachment system. The theory of attachment reflects only a part of the dynamics of personality formation, namely, one that has a decisive influence on the “building” of the relationships. If a patient in search of support seeks a doctor, and in particular a psychotherapist, this indicates the existence of a particular agent that has activated the attachment system of this person. Therefore, it is clear that the knowledge of various manifestations of such patterns of affection and preconditions for their occurrence is necessary for physicians of all specialties. This will increase the diagnostic care of the doctors to the repertoire of the factors of health and mental health including. With such knowledge it is easier to establish an effective compliance with the patient. At the same time, there is a possibility of fruitful application of the attachment postulates in the prevention of bodily and mental illness. Conclusions. The processing of the mentioned system provides an opportunity for the formation of new accents in psy?hoeducation and setting the effective compliance with the client.

Introduction. Doctors of various specialties – endocrinologists, endocrine surgeons, oncologists – pay much attention to the choice of tactics of treatment of small focal forms of thyroid gland. However, despite the tangible progress, the transition to a molecular or genetic level of the diagnosis is a reality of the next decades, but today we should not underestimate the need to improve the existing diagnostic methods. Aim. To find out the informativeness of preoperative examinations and causes of diagnostic errors in patients with thyroid nodes = 1.0 cm. Materials and methods. A retrospective analysis of information from out-patient cards, history of diseases and protocols of operations of randomly selected 1 266 patients operated on thyroid lesions (thyroid nodules up to 1.0 cm) in the surgical department of the Kyiv Regional Clinical Hospital N 1 in 2009-2014 was conducted. The results of the pathomorphological, cytological and ultrasound findings were compared, the sensitivity and specificity of the ultrasound examination and the fine needle aspiration biopsy using the ultasound in a diagnosis of the subsantimetric thyroid nodes, including microcarcinoma were evaluated. The frequency of the erroneous results of the histological and ultrasound diagnostics of the thyroid microcarcinoma were determined. Results. Sensitivity and specificity of commonly used diagnostic methods of thyroid ultrasonography and thyroid gland with the following cytological examination are 73.9, 79.5 and 71.9 and 83.9% respectively, and therefore can not be applied separately for the verification of small thyroid glands. The reason for the diagnostic errors, in our opinion, in each case is a separate, rather than a comprehensive analysis of the results of the survey. Obtaining the informative material from the patients with the nodes less than 1 cm in diameter in the thyroid gland, depends on the concerted actions of the doctor of ultrasound and the surgeon, as well as the correct choice of nodes, which need to point out first. Conclusions. Today, for the early diagnosis of thyroid cancer in sub-arterial nodes, a comprehensive evaluation of the results of ultrasound scans and an aiming thin-blooded aspiration biopsy with the subsequent cytological study of the material are most optimal.

Introduction. Vegetative disorders are a term that unites varieties of origin and manifestations of the violation of vegetative functions of the organism, which are caused by the disorders of their neurogenic regulation. Regarding the pathogenesis of the autonomic nervous system (NS) dysfunction in the presence of systemic lupus erythematosus (SLE), there are several hypotheses: the occurrence of vasculitis with the involvement of vessels of the nerves, or secondary amyloidosis; the influence of immunological factors, in particular, circulating antibodies to the structures of the NS were detected. However, none of them has a definitive confirmation. The aim of the study was to describe the autonomic NS state in the patients with SLE with the different activity degree of the disease according to the heart rate variability indices. Materials and methods. 83 patients were examined. Among them, 65 women (78.3%) and 18 men (21.7%) aged 18 to 74 years (mean age 44.2 years), who were diagnosed with SLE according to the criteria of the American College of Rheumatologists (1982, 1997). Patients are divided into three groups according to the randomized principle with pre-stratification on the activity of the pathological process of the underlying disease – SLE at the time of the heart rate variability (HRV) conducting: the first group – with the first degree of activity, the second group – with second degree of activity, the third group – with the third degree of activity. There were also 40 practically healthy persons (27 women (67.5%) and 13 men (32.5%)) aged 19-70 years old (mean age 41.8 ± 4.2 years), of which the control group was formed. Recording of the HRV was performed for 5 minutes in the lying position (state to the physical activity) and for 6 minutes in standing position (after physical activity, orthostatic test). Results. The value of the heart rate allows to characterize the balance between the tone of the sympathetic and parasympathetic parts of the autonomic NS, since the change in the heart rate is a universal reaction of the organism to various stimuli of the internal or external environment. The state of the autonomic NS in patients with SLE with varying degrees of activity is characterized by a decrease in the total activity of vegetative effects on the heart rhythm due to the reduction of sympathetic and parasympathetic effects, as well as the humoral component. Conclusions. Based on the reduced total spectral power in patients with SLE, an unbalance of the autonomic NS is observed due to the predominance of the sympathetic NS, especially expressed in the sample before the physical activity.

Introduction. For the treatment of complicated peptic ulcer (PU) of gastroduodenal zone (GDZ) gastrectomy (GE) is still preferred, but in 78.3% of operated post-gastrorectomy disease (PGD) occurs, which can be in a form of 17 syndromes-urogenital, immunological, hormonal-metabolic, pancreatic-hepato-biliary, cardiovascular, etc. Due to the demographic crisis in Ukraine, caused by a decrease in fertility, and given the fact that GE is more often conducted to men of reproductive age, the impact of the operation on the state of the genitourinary system (GUS) requires more in-depth study, and the active interest in this problem is fully justified. In isolated cases, there is information that the activation of lipid peroxidation (LP) and weakening of the antioxidant system (AOS) play an important role in the pathogenesis of GUS lesions, but these processes in patients with GUS lesions after GE due to PU of GDZ have not been studied until now. Aim. To characterize the state of LP and the activity of the AOS in men with lesions of GUS after GE due to the ulcer of the gastroduodenal zone (GDZ). Materials and methods. In a randomized manner, 330 men, that 5 years or more had GE due to the complicated PU of GDZ were selected. The stomach resection according to the classic Balroth-I method was performed for 116 patients, according to Bilroth-II in the modification of the Gofmeister-Finsterer-214. In 67 patients, 1/2 of the stomach was cut, in 232 – 2/3 of the stomach, in 31 – 3/4 of the stomach. For all 330 patients clinical, laboratory tests (complete blood count and urinalisys, Zimnitskiy urine test, Nechyporenko urine test, urine sterility and sensitivity to antibiotics test, Reberga – Tareyev test, levels of creatinine and urea, basal concentration of testosterone in blood serum and instrumental examination (ultrasonographic examination of the urinary system, chest x-ray, radionuclide renography, scintigraphy, excretory urography, cavernosometry,cavrnosography, biostesiometry) were made. To verify the diagnosis the consulting of urologist and sexologist have been received. The treatment was carried out in the therapeutic department of Lviv Regional Clinical Hospital during 28-30 days. Results. It was found, that in late terms after GE due to the PU of GDZ in men with erectile dysfunction and chronic pyelonephritis there is a significant disturbance of LP and antioxidant protection. In most cases, these changes are manifested by the increase of LP, activation of enzymatic antioxidant and decrease of the membrane antioxidant. Conclusions. In our opinion these scientific results will help in the pathogenetic conservative treatment of patients with urogenital lesions after the GE with the application of antioxidants and unsaturated fatty acids.

Introduction. Obstructive sleep apnea (OSA) – a condition accompanied repeated, stop of breathing due to complete (apnea) or partial (hypopnea) narrowing of the airways during sleep at throat and termination of pulmonary ventilation with preserved respiratory effort which appears snoring, reduced partial pressure Blood oxygen, fragmentation of sleep with frequent short-term awakening and daytime sleepiness. Awakening becomes a protective mechanism that activates muscles-dilators of the upper respiratory tract and prevents asphyxiation. Aim. To review the literature on sleep disorders in medical practice of internists, to identify the risk factors of OSA in patients with essential hypertension (EH) and obesity (OB). Materials and methods. A review of literary sources on clinical signs and diagnoses of OSA syndrome was made. We examined 41 patients with EH of the 2nd stage, 1-3rd degree and 1st degree of gynecology. The CG included 27 people (15 men and 12 women) aged 50.2±2.2 years with a body mass index (BMI) 34.0±1.0 kg/m2, with complaints of snoring and sleep disorders. The CG included 14 people (7 men and 7 women) at the age of 47.1 ± 2.9 years, with BMI 31.5±1.1 kg/m2. All the patients were routinely screened according to the Ministry of Health of Ukraine N 384 dated May 24, 2012, and were interviewed by the American Apnea Sleep Association questionnaire. Results. The main symptoms that help to suspect OSA are neurocognitive: pronounced daytime sleepiness, annoyance, weakening of memory and attention, suppression of emotions, apathy, intellectual degradation. The increase of the severity of the syndrome leads to disorders of the cardiovascular system, in particular, increased blood pressure, occurrence of atrial and ventricular arrhythmias. In the main group of surveyed patients, the average score of the questionnaire was 12.6 points. All men and 91.7% of women showed a high probability of sleep apnea (> 10 points). In CG the average score was 7.4 points (p<0.05), and a high probability of sleep apnea was detected only in 3 persons. It is important that EH with OB and snoring were associated with the presence of nodes in the thyroid gland. Moreover, the higher score of the questionnaire means the larger sonographic size of the node. In addition, in the patients from the experimental group were significantly higher waist circumference (108 (102; 110) cm vs. 99 (89; 108) cm, p<0.05), systolic and pulse arterial pressure (160 (160 ; 180) vs 150 (140; 160) mm Hg, p <0.05) and (70 (60; 90) vs 60 (50; 60) mm Hg, p <0.05) than in the persons of the CG, which is evidence of a higher cardiovascular risk in such patients. Conclusions. In patients with EH, stage II, 1-3th degree with OB of 1st degree that were snoring at night revealed very high likelihood of OSA. Snoring is associated with a higher waist circumference, higher levels of systolic and pulsed arterial pressure, and frequent detection of nodular goiter, requiring special attention for internists, cardiologists and endocrinologists.

Introduction. Attention to the problem of Valgus deviation of the first toe (VDFT) does not weaken for about 200 years, due to its considerable population distribution (18,0-20,0%), as well as the lack of treatment efficacy, the recurring nature of deformation Aim. To optimize the treatment of VDFT, improving the methods of osteosynthesis after the corrective osteotomy of the I pectoral bone. Materials and methods. The results of treatment of 42 patients with severe forms of VDFT were analyzed. The average age of patients was 52 years. The clinical, orthopedic, and roentgenologic examination according to standard methods was conducted. The angle of the VDFT was more than 35°, the first inter-axial angle was more than 18°, the first finger was pierced, and in the I-membranous-phalangeal joint – subluxated, the displacement of the lateral sesameiform bone reached 100.0%. All the patients were treated with proximal corrective osteotomy of the I pectoral bone with an osteosynthesis using screw according to the technique we upgraded. Results. Postoperative wounds in all cases were healed by the initial tension. The consolidation of osteotomy based on the results of the X-ray examination took place in the period of five to six weeks. According to the assessment of the AOFAS scale, in three cases (7.1%) satisfactory results were noted. Of these, in one patient (2.4%), although there was a good correction of the shape of the foot, contracture in the I plexus- phalangeal joint arose because of the patient’s late removing of the syringe. In two patients (4.8%) the correction was partially lost (up to 10 °) with a satisfactory foot function and no pain. This correlated with the phenomena of osteoporosis of the bones of the foot in these patients. In 39 operated patients (42.4%) there were good and excellent results. In particular, in 17 patients (40.5%) – the average score was 82.4 and in 22 (52.4%) – 95.7. The results of the treatment were consistent with the results obtained in patients operated with the use of plates with angular stability, which today are considered as “golden standard” of osteosynthesis in foot surgery, but compared with them, the proposed method is less traumatic, technically simpler, significantly lower (on average in 10 times cost of implants. Conclusions. Fixing the fragments of the I pectoral bone after osteotomy due to VDFT with a long screw according to our modified method provided early activation, comfortable treatment and a good cosmetic and functional result. The applied method of fixation is effective, technically simple, minimally invasive, economically viable, and allows to improve the results of treatment of patients with VDFT.

Introduction. Interest in the problem of chronic gastritis (CG) is due to the fact that this disease is characterized by chronic course, the severity of which is increasing, gradual atrophy of the gastric glands, the formation of secretory insufficiency, and it is reasonably attributed to the precancerosis. Aim. To optimize the treatment of patients with CG using “Multisal” and “Walnut Greek Tincture”. Materials and methods. Under the dynamic observation, there were 126 patients (51 (40.5%) and 75 women (59.5%)) at the age of 53.3±1.73 years. The diagnose was based on the results of the clinical, laboratory and instrumental examination acccording to th eorders of the Ministry of Health of Ukraine. The material for the study was obtained using a sighting forceps multiple biopsy. The biopsy material was used for histological and cytologic studies. In order to diagnose Helicobacter pylori, a rapid urease test and a cytological method (smear, brush-method) were used. The state of acid-forming function of the stomach was determined using basal topographic pH-metry in all parts of the stomach according to the method developed by V. M. Chernobrov. Results. The results of evaluation of clinical signs of CG dynamics showed that adherence of “Multisal” and “Walnut Greek Tincture” to traditional treatment or their combination contributed to a stable positive dynamics of clinical symptoms in patients with CG, probably, due to the action of proposed treatment. The obtained information allows us to state that based on the results of the evaluation of the dynamics of the macroscopic signs of CG, the treatment complex with simultaneous use besides the basic drugs “Multisal” and ” Walnut Greek Tincture ” is most effective. For all the patients with positive urease test, regardless of the proven treatment it was provided Helicobacter pylori eradication. Conclusions. The adding of “Multisal” and “Walnut Greek Tincture” to the standardized base complex enables to optimize the treatment of CG, improve the subjective well-being of patients, level the endoscopic signs of inflammation of the mucous membrane of the stomach, improve the basal acidity of the stomach, due to the healing properties of “Walnut Greek Tincture”. The obtained results can serve as a basis for their use in clinical practice.