Medical perspectives (Medicni perspektivi)

4-8

Authors: Pelo I.M., Reva T.D., Nizenkovska I.V., Kozak N.D., Konovalova L.V.

The article identifies and characterizes the leading trends in the development of the pharmaceutical industry in Ukraine, namely: observance of ethical principles of work of the expert of pharmaceutical industry; a focus on European standards for the quality of pharmaceutical services; development of a national system for the production of medicines. Emphasis is placed on the fact that the teachers of the University have a goal to convey to students ideas that are important for forming the humanistic foundations of a pharmacist’s work. The initial instruction, according to the authors, is to provide each participant of the educational process with the conditions for self-realization in learning and future professional activity. At the same time, in the formation of the content of pharmaceutical education a deep understanding of the value of a person’s health is the highest personal and social value. It is noted that an integral characteristic of the modern development of pharmacy in Ukraine is its dependence on imported medicines. During the educational process at the Faculty of Pharmacy of O.O. Bogomolets National Medical University, students and teachers believe that in Ukraine there are a number of prerequisites for overcoming the dependence of the domestic pharmaceutical market on imported medicines, namely: Ukraine has joined the International System of Cooperation of Pharmaceutical Inspections; the country has created a system of registration of medicines and adopted an international format of registration dossier; the State Pharmacopoeia of Ukraine was developed and put into operation; mandatory requirements for compliance with the rules of Good Manufacturing Practice and Good Distribution Practice were introduced; to the licensing conditions for the production and sale of medicines in Ukraine European recommendations regulating the development and research of medicines have been adapted and updated.

17-21

Authors: Kolomiets L.V., Orobey V.F., Lymarenko O.M., Ovcharov Y.V., Tsilvik O.V.

The paper presents modeling of denture specimens with different surface reliefs under the action of static loading using modern numerical methods - finite and boundary elements. Based on the analysis of literature, it is shown that the most effective approaches for calculating the stress-strain state (SSS) of dentures is the finite element method (FEM), which allows you to create 3D models with any complexity of geometry and surface, as well as the boundary element method (BEM), which allows in some cases to obtain more accurate calculation results than finite element method. The algorithm and procedure for exact integration of differential equations of hollow shells according to the algorithm of Kantorovich-Vlasov variational method are presented for the formation of the calculated finite element method ratios. The analytical expressions for the parameters of the hollow shells used for calculations of the state of dentures are given. Finite element method is represented in the work by the universal package SolidWorks. Different stages of solid-state modeling of prototypes of dentures with different surface reliefs are shown in detail. Dental stress-strain state calculations were performed by two methods. The results of the calculations are in good agreement with each other, which proves the reliability of both models developed and the results of the stress-strain state received. It is shown that the smallest values of stresses occur in dentures with a rhombic lattice; they are 5.9% less than prosthesis with a smooth surface, and 18.78% less than in prosthesis with a square lattice. Equivalent displacement of a rhombic lath prosthesis is less by 3.864% than that of a smooth surface prosthesis and 8 52% less than a square lattice prosthesis.

30-39

Authors: Lievykh А.E., Bondarenko N.S., Dronov S.N., Mamchur V.I., Tverdokhlib I.V., Zhyliuk V.I.

Chronic hyperglycemia, insulin resistance, endothelial dysfunction, and disturbance of the integrity of the blood-brain barrier are considered as strategically important links in the development of cognitive deficits in diabetic encephalopathy. Taking this into account, one of the modern trends in the optimization of the treatment of cognitive impairments induced by prolonged hyperglycemia is the co-administration of agents with antihyperglycemic and nootropic activity, in particular, metformin with piracetam. It has been shown that under conditions of experimental alloxan-induced hyperglycemia, piracetam has insufficient nootropic potential for eliminating cognitive deficits. Metformin has a weak nootropic effect in short-term use in low doses, without exhibiting these properties in prolonged administration. When combined with piracetam, metformin potentiates its antiamnesic properties, which helps to restore cognitive functions impaired by hyperglycemia. It is assumed that the mechanisms of such synergism are mediated by a decrease in the content of early and late markers of the destruction of protein molecules, the level of stable nitric oxide metabolites in the cerebral cortex, as well as a significant limitation of the manifestations of ultrastructural destructive changes in hippocampal neurons with a simultaneous improvement in the state of its microvasculature. The obtained results indicate the expediency of the combined use of metformin with nootropic agents for the prevention or treatment of cognitive impairments that occur as a result of diabetes mellitus.

50-61

Authors: Pertseva T.A., Bielosludtseva K.O., Kirieieva T.V., Konopkina L.I., Krykhtina M.A., Basina B.A., Matykina N.N., Turchin N.A.

The diagnosis of community-acquired pneumonia (CAP) on the background of COVID-19 is especially actual due to the prevalence of this pathology and the possible aggravation of the pathological process. The aim of our study was to improve the principles of CAP diagnostics on the background of COVID-19 and to determine risk factors for aggravating of the pathological process. Patients with respiratory symptoms who were hospitalized with suspected COVID-19 were examined. General clinical research methods were carried out, determination of SARS-CoV-2 virus RNA by PCR method, computer tomography (CT) to identify the features of lung tissue damage was performed. The main observation group consisted of 37 patients (men – 19 (51.4%), average age – 61 (57; 69) years) with pneumonia on the background of confirmed COVID-19. According to the severity of coronavirus disease, all patients of the main group were divided into 3 subgroups: subgroup 1 included 17 people with moderate COVID-19, subgroup 2 – 13 people with severe COVID-19, subgroup 3 – 7 people with critical COVID- 19 course. The levels of markers of systemic inflammation (C-reactive protein (C-RP) and fibrinogen) were also determined. Since patients with COVID-19 of moderate severity (which is characterized by the presence of community-acquired viral pneumonia) belong to the risk group of severe and critical course, it is suggested to consider the following risk factors for aggravating the pathological process as: temperature over 38.5°C, heart rate over 90 per minute, respiratory rate over 20 per minute, SpO2 ≤ 93%; absolute lymphopenia (less than 0.9 G/L) and an increase in serum levels of C-RP more than 50 mg/L and fibrinogen more than 5 g/L.

71-76

Authors: Bosdriesz J.R., Semenov V.V., Kuryata O.V.

Chronic kidney disease puts an individual at a higher risk of all-cause and cardiovascular death. Coronary artery calcium score reflects the accumulation of calcium in the walls of the coronary arteries and a higher coronary artery calcium score is associated with lower survival rates. It is unclear if control of conventional risk factors is enough to reduce cardiovascular risk in patients with chronic kidney disease. The aim of this study was to investigate if the association between estimated glomerular filtration rate and coronary artery calcium score in the Ukrainian population differs by sex, age, blood pressure, and total cholesterol. This cross-sectional study was conducted on a sample of patients who underwent measurement of coronary artery calcium score at Dnipropetrovsk Mechnikov Regional Hospital, Dnipro, Ukraine. Inclusion criteria: age >40 years old, available data about coronary artery calcium score and estimated glomerular filtration rate. Exclusion criteria: the presence of known cardiovascular disease, diagnosis of diabetes mellitus, estimated glomerular filtration rate <30 ml/min and extreme coronary artery calcification (coronary artery calcium score >1500 Agatston units). 137 patients (54 males and 83 females), median age 59.0 [54.0;67.0] years were enrolled in the study. In the patients with lower eGFR there was non-significantly higher coronary artery calcium score (p=0.07). In males with eGFR ≥90 ml/min, 60-89 ml/min, and 30-59 ml/min coronary artery calcium score didn’t differ significantly, while in females a lower estimated glomerular filtration rate was associated with a higher coronary artery calcium score. A lower estimated glomerular filtration rate was significantly associated with a higher coronary artery calcium score in the patients with systolic blood pressure ≥140 mmHg (p=0.04), but not in patients with diastolic blood pressure ≥90 mmHg. In the patients with total cholesterol <5.0 mmol/l and ≥5.0 mmol/l coronary artery calcium score tended to be higher in the patients with lower estimated glomerular filtration rate. A lower estimated glomerular filtration rate in our study was associated with a higher coronary artery calcium score in females, patients aged ≥55 years old and in patients with systolic blood pressure ≥140 mmHg.

87-95

Authors: Zabolotny D.I., Sambur M.B., Savchenko T.D., Krіvokhatskaуа L.D., Zayets T.A., Tymchenko M.D.

The aim of the study is to determine di­sorders of immune homeostasis in patients with laryngeal papillomatosis at different periods after complex treatment with the inclusion of the “Gardasil” quadrivalent vaccine in the adjuvant therapy. Studies of the immunity state were conducted in 26 patients with laryngeal papillomatosis (LP) before, 2-12 and 13-29 months after complex treatment, consisting of surgical removal of papillomas and anti-relapse therapy, including inhalation of Laferobion, taking a vitamin-mineral complex and a course of vaccination with antiviral “Gardasil” quadrivalent vaccine according to which the second and third injections were administered in 2 and 6 months after the first. Significant disorders of cellular and humoral immunity indices in patients with LP were revealed in the form of multidirectional changes in the functional activity of natural killer cells, a decrease in the total number of T lymphocytes, mainly due to CD4 + subpopulation, increase in circulating immune complexes level in blood serum and concentration of secretory IgA in the secretion of the oropharynx. Disbalance in the patient’s cytokine system resulted in increased γ-IFN and TNF-α serum levels, an increase in spontaneous production of interferon and inhibition of stimulated production of λ - and γ-interferon by blood cells in vitro. Complex treatment with the use of the “Gardasil” quadrivalent antiviral vaccine in the postoperative period contributed to the normalization of most immunological reactivity indices that were altered in patients. The results indicate the prospects of using the antiviral vaccine as part of adjuvant antirelapse therapy after surgical treatment of LP patients and indicate the advisability of long-term clinical and immunological monitoring at different periods after vaccination.

104-110

Authors: Gashynova K.Yu., Suska K.S., Dmytrychenko V.V.

Chronic respiratory tract infection and relapsing exacerbations worsen the quality and reduce the life expectancy of patients with bronchiectasis. This work aimed to identify the spectrum of pathogens and to determine their profile of antibiotic resistance in the sputum of patients with bronchiectasis in the Dnipro region. Sputum of 60 patients in a stable phase with confirmed bronchiectasis was a subject to microbiological examination and determination of antibiotic sensitivity according to generally accepted CLSI recommendations. According to the results of the study, it was found that 70% of patients have sputum colonization by pathogens in the stable phase of the disease, and the most common pathogens are Pseudomonas aeruginosa and Haemophilus influenzae, which is in line with the global trend. Haemophilus influenzae was sensitive to ampicillin, amoxicillin, amoxicillin/clavulanate, piperacillin/tazobactam, cefuroxime, ceftriaxone, cefotaxime, cefepime, cipro­floxacin, levofloxacin and moxifloxacin in a hundred percent of cases. However, more than half of the strains of Pseudomonas aeruginosa were resistant to one or more drugs with anti-Pseudomonas activity. In particular, the highest level of resistance was identified to such drugs as imipenem, aztreonam, ceftazidime. The problem of antibiotic resistance is alarming and once again indicates the need for the regular microbiological examination of the sputum of patients with bronchiectasis even in a stable phase for subsequent rational administration of antibacterial therapy.

117-124

Authors: Revenko H.O., Mavrutenkov V.V., Chykarenko Z.O.

Antiretroviral therapy has made HIV infection a chronic controlled disease, where aspects of the immunoprophylaxis of infectious diseases have acquired important clinical significance. The goal of the study was to determine the clinical and laboratory predictors of antitoxic immunity against diphtheria and tetanus in HIV-infected adults. The study included 90 HIV-infected patients aged 22 to 60 years (main group). The control group consisted of 49 immunocompetent volunteers of the corresponding age. The levels of anti-diphtheria and anti-tetanus antibodies were determined by ELISA using the diagnostic test systems RIDASCREEN Diphtheria IgG and RIDASCREEN Tetanus IgG (R-Biopharm AG, Germany). Statistical processing was performed using the licensed software product STATISTICA v.6.1. Significant differences were found between the titers of antitoxic antibodies in HIV-infected and immunocompetent adults. According to the correlation analysis, the decrease in the titers of antidiphtheria antibodies was revealed with an increase in the age of the HIV-infected patient (rs=-0.21; p=0.05). The fact of smoking (rs=-0.31; p=0.003), lowered body weight (BMI<18.5 kg/m2) (rs=-0.29; p=0.006), the presence of arterial hypertension (rs=-0.38; p<0.001), a history of bone fractures over the past 5 years (rs=-0.38; p<0.001), anemia (rs=-0.21; p=0.049), thrombocytopenia (rs=-0.44; p<0.001), accelerated ESR (rs=-0.61; p<0.001), the presence of hairy leukoplakia of the tongue (rs=-0.23; p=0.027), frequent infections caused by herpes simplex (rs=-0.52; p=0.003) and varicella zoster virus (rs=-0.34; p=0.013) are associated with low levels of antidiphtheria antibodies. A direct relationship was found between the intensity of anti-diphtheria immunity and patients receiving OST (rs=+0.54; p=0.003) and with a history of injuries with impaired skin integrity (rs=+0.31; p=0.003). Decreased anti-tetanus immunity in HIV-infected patients was also associated with smoking (rs=-0.48; p<0.001), decreased BMI (rs=-0.71; p<0.001), anemia (rs=-0.33; p=0.002), thrombocytopenia (rs=-0.75; p<0.001), a history of bone fractures over the past 5 years (rs=-0.67; p<0.001); the total number of HIV-associated opportunistic diseases (rs=-0.42; p<0.001), including the presence of oropharyngeal candidiasis (rs=-0.23; p=0.032) and hairy leukoplakia of the tongue (rs=-0.57; p<0.001), history of Herpes Zoster in the past (rs=-0.48; p<0.001), with frequent relapses of diseases caused by herpes simplex viruses (rs=-0.78; p<0.001) and repeated episodes of herpes zoster (rs=-0.74; p<0.001), as well as with pathology of the skin (rs=-0.55; p<0.001). Protective predictors of anti-tetanus antitoxic immunity strength were established: male gender (rs=+0.22; p=0.039), parenterally acquired HIV infection (rs=+0.21; p=0.05), HIV-infected patients receiving OST (rs=+0.40; p=0.041). A direct relationship was found with the decreased level of hemoglobin (rs=+0.41; p<0.001), the increase of relative number of lymphocytes in the blood (rs=+0.21; p=0.05), as well as with living in rural areas (rs=+0.40; p<0.001) and the presence of injuries with impairment of skin integrity (rs=+0.84; p<0.001). Clinical and laboratory predictors of strength of antitoxic immunity against diphtheria and tetanus in HIV-infected adults were identified, which allows us to create an individual “vaccination roadmap” for patients in this category.

132-139

Authors: Shevchuk I.M., Snizhko S.S.

The goal of the work is to improve the results of treatment of patients with esophageal perforations complicated by purulent mediastinitis. Examination and treatment of 30 patients with esophageal perforation (EP) complicated by purulent mediastinitis were performed. The causes of EP were foreign body damages in 12 (40%) of 30 patients, spontaneous rupture of the esophagus – in 11 (36.6%), iatrogenic damage to the esophagus – in 7 (23.4%) patients. The main method of surgical treatment of esophageal perforations complicated by acute purulent mediastinitis is thoracotomy with suturing of the perforated wall of the esophagus and sanation of mediastinal tissue. In case of purulent melting of the esophageal wall and total mediastinitis with severe endogenous intoxication, surgical interventions should be aimed at minimizing surgical trauma and elimination of the purulent process in the mediastinum using video-assisted thoracoscopy. The use of developed surgical tactics for the treatment of esophageal perforations complicated by acute purulent mediastinitis with intramediastinal administration of antibacterial drugs and the method of irrigation of the esophageal sutures contributes to a significant rapid reduction in endogenous intoxication, namely leukocytosis units up to 2.103±0.182 d. units (p<0,001) with normalization of the indicator on the 5th day from the beginning of treatment, the severity of the condition on the APACHE II scale in the modification of Radzikhovsky AP from 14.91±1.80 points at the time of hospitalization to 9.4±0.3 points on the second day after surgery (p<0.001), the severity of patients’ condition on the SOFA scale on the 3rd day to 3.221±0.445 points, on the 5th day – 1.832±0.219 points (p<0.001), the level of C-reactive protein on the 2nd day after surgery decreased from 236.2±21.4 mg/l to 144.3±9.3 mg/l, and on the 3rd day was 112.1±7.2 mg/l (in both cases p<0.001), reducing the content of procaltcytonin from 8.7±0.9 ng/ml to 3.828±0.251 ng/ml on the 2nd day after surgery. The use of this surgical tactic allows you to quickly eliminate the purulent process in the mediastinum, reduce the healing time of the perforation of the esophagus and reduce mortality from 28.5 to 6.2%.

144-152

Authors: Gudaryan O.O., Mashchenko I.S., Kucherenko T.O.

The modern treatment strategy for various forms of generalized periodontitis includes the use of a wide arsenal of drugs, which in turn leads to an excessive drug load on the body, this actualizes the search and use of drugs that have a systemic effect. The aim of the study is to develop and study the effectiveness of the use of systemic enzyme therapy in the treatment of aggressive (rapidly progressing) generalized periodontitis. The work is based on the results of comprehensive clinical and laboratory studies of 61 patients with an aggressive form of generalized periodontitis, without concomitant pathologies (30 main groups and 31 comparison groups). A control group consisted of 20 healthy donor volunteers. We used standard clinical, paraclinical, laboratory diagnostic methods, supplemented by dental volumetric tomography. In patients of both observation groups, standard protocol therapy was used, in the comparison group supplemented pathogenic therapy, and in the main group – multienzyme drug (Wobenzym) and rhBMP-2 injections. A comparative analysis of clinical, paraclinical, and laboratory studies has shown that the use of systemic enzyme therapy supplemented with recombinant morphogenetic protein (rhBMP-2) in patients with aggressive (rapidly progressing) generalized periodontitis is comparable to that of standard polymedicine therapy supplemented with pathogenic therapy, and leads to a faster control (average 13.7±0.7 days) of an active inflammatory and destructive process, normalization of indices of local humoral immunity, cytokine profile, free radical oxidation and antioxidant defense system, achievement of clinical and radiological remission in more than 90% of patients.

161-168

Authors: Savushina I.V., Pavlenko O.I., Zos'ka Y.V.

The number of people in need of phoniatric help is constantly increasing. People with voice problems are of working age. The object of researche: lowering risk of progression of vocal pathology based on a comprehensive system of management of teachers’ occupational risks. Hygienic, epidemiological, sanitary-statistical, in-depth medical examination method and mathematical-statistical methods were applied. Working conditions of teachers are characterized by complex effects of harmful production factors, which can reach 3d degree of 3d class of harmful work by intensity (according to the calculated points 3,63), 2nd degree of 3d class of harmful pressure on vocal apparatus (27,52±3,54 hours), 1st degree of 3d class of harmful by equivalent noise level and unfavorable microclimate. The most widespread pathologies of the vocal apparatus are chronic hypertrophic laryngitis (190,20±22,61) and chronic catarrhal laryngitis (131,00±15,07 cases). Almost 70% of occupational laryngitis cases are in the age group of 46-60 years. The critical length of service influenced by voice load is 10-19 years. The length of service more than 20 years in conditions of voice load increases the etiological percent of occupational pathology causes to 81,8%. Therefore, an age of 45,8±0,5 and older is dangerous for the occupational laryngitis progression and requires a special approach of development and imple­mentation of preventive measures aimed at maintaining of occupational health. Suggested complex of measures increase the healthy life by 7,3 years and reduce the loss of healthy life years determined by the impact of voice activity by 7,1 years. At the same time for physical health component (PH) by 4,5 and 4,3, and the psychological health component (MH) by 10,3 and 10,1 years QALY respectively.

176-183

Authors: Kuznetsova О.M., Ostanina N.V.

This article shows a study of different aspects of dietary supplement (DS) consumption by the population of Ukraine, the probability of using poor-quality DS is determined. As a part of this project, a questionnaire-based survey on the issue of DS consumption was conducted among residents of the following Ukrainian cities: Kyiv, Poltava, Kharkiv and Vyshneve (Kyiv region). The following data were analyzed: statistical data of the Ukrainian population, presence of pharmaceutical facilities in regions of Ukraine, DS sales volumes and laboratory data concerning correspondence of DS with the claimed content of active ingredients. Statistical analysis was carried out with use of the standard software Microsoft Excel 2007 and STATISTICA 8.0 portable The survey allowed to evaluate health level of respondents who take DS, obtain information concerning purposes or recommendations for DS taking, detect channels of purchase of such products, identify the risks of taking poor-quality DS. According to the survey results, about 72% of respondents are taking DS. The survey results indicate that 39% of respondents that take DS consider themselves healthy, almost half of respondents have insignificant health problems and about 12% of respondents have serious health problems. 79% of respondents purchase DS in pharmacies, which allows to conclude that about 59.7 million packaging of DS were consumed in Ukraine in 2019. It was confirmed that the presence of pharmaceutical facilities is even in all regions of Ukraine and, therefore, residents have access to necessary DS through pharmacies. Taking into account the results of laboratory tests of DS quality, the risks of poor-quality DS consumption in Ukraine in 2019 may be estimated as 9.5%. The research results of test purchases demonstrate that the aforementioned risks may increase significantly.

192-197

Authors: Bilynska М.М., Suray I.G., Vasiuk N.O., Savina T.V.

Purpose of the article is to determine the training needs of healthcare managers in Ukraine in the specialty "Public administration and management". As the main method, we used a written survey (questionnaire survey) of experts in the field of healthcare, using modern computer technologies. Participation of experts in this study is entirely voluntary. Confidentiality of information is guaranteed by anonymity of the questionnaire. Expert poll of healthcare leaders was conducted in March-April 2020 in order to determine training needs of the specialty "Public administration and management." A total of 54 respondents took part in the expert poll. Majority (96.3%) of respondents need to undergo training in the specialty "Public administration and management" (specialization "Management in the field of healthcare"). The overwhelming majority of them would like to undergo training on the topics: "personnel management in healthcare organizations (leadership, communication management, time management, stress management, self-management, psychological foundations of management in healthcare, etc.)" (64.8%) and "healthcare management "(59.3%). Summarizing results of the study, it has been proved that in order to improve the professional competencies of leaders in the health sector, it is desirable to introduce the training program "Leadership and Management in Health Care", which is aimed at solving problematic issues of management in the field of health protection; application of strategic management in the field of health care, quality management of medical care; obtaining communication skills and building an effective team; effective application of the knowledge gained in the environment is changing rapidly, etc. We believe that improving the mechanisms of training, retraining and raising their qualifications should be an important issue in the development of human resources in health care, especially managers. In particular, this applies to innovative forms of education, including trainings, online training, etc.

204-210

Authors: Kotelevska T.M., Pryimenko N.O., Dubynska H.M., Koval T.I., Iziumska O.M., Zviagolska I.M.

West Nile Fever (WNF) is the most common arbovirus infection with a transmission mechanism caused by West Nile Virus (WNV), present on all continents, except for Antarctica. WNV has a high epidemic potential and is dangerous for health of the population all over the world, due to rapid global spread, the formation of new natural foci and the ability to cause epidemics in endemic areas. Over the past 20 years, there have been numerous epidemic outbreaks of the disease among people, birds and horses, associated with WNV. On the territory of Ukraine WNV was first detected in the 70s of the XX century, but at present clinical and epidemiological aspects have been understudied. This study analyzed the epidemic situation regarding WNF in Poltava Region in 2011-2018, and clarified the epidemiological and clinical manifestations of serologically confirmed cases of acute WNF. This is the first actual survey of WNF cases in Poltava Region, its results indicate the prevalence of WNV in the central part of Ukraine. The aim of the study was to study the epidemiological and clinical characteristics of West Nile Fever in Poltava Region. The cases of WNF in Poltava Region in 2011-2018 have been analyzed, according to the annual reporting forms of the Ministry of Health of Ukraine. A serological study of pair blood sera for specific IgG-class antibodies to WNV of 232 patients with febrile conditions, requiring screening for WNF, was conducted. The clinical course was studied in a retrospective analysis of 14 case histories of patients with WNF under treatment in the Poltava Regional Clinical Infectious Diseases Hospital. The analysis demonstrated that in Poltava Region in 2011-2018 35 serologically confirmed cases of acute WNF were registered, with the largest number (14) in 2012. Serologic examination of the specific markers of WNV in 232 patients with febrile conditions allowed to detect 57 (24.6%) seropositive patients. Acute WNF was diagnosed in 35 (15,1%) patients, past WNF – in 22 (9,5%) persons. Analysis of case histories of patients with acute WNF showed that the most susceptible ones were females (64.1%), and the average age of the persons was 46.28±0.30 years old. According to the epidemiological history, the city residents dominated among the patients (71.4%), all of them (100%) marked mosquito bites, and the disease was of a seasonal nature, with the largest (78.6%) number of cases in July-August. The clinical course of WNF in all (100%) patients was moderate-severe and characterized by polymorphism of clinical manifestations. The leading clinical syndromes were: intoxication (100.0%), fever (100.0%), catarrhal (50.0%), allergic (42.8%), dyspeptic (35.7%) syndromes and lymphadenopathy (28.5 %). Thus, the conducted researches have shown that there are all conditions for formation of a natural center of WNF on the territory of Poltava Region. WNF was characterized by a typical course of the disease.