Distance learning: opportunities and challenges in quarantine.

The urgent introduction of distance education into the learning process due to the COVID-19 pandemic has become a spontaneous experiment, requiring urgent decisions, effective mechanisms to implement into the educational process and analysis of ongoing educational process. The possibilities of modern digital technologies made it possible to quickly set up the information component of education and to controle student’s knowledge. A detailed analysis of the communication between the faculty members of the department among themselves and analysis of the features of teaching and self-education of students in the field of medical radiology and oncology based on answers and comments with using Google classroom, Socrative, Messenger Telegram, etc. was made. Issues of communicative interaction between faculty members and students, psychological aspects of distance communication, language of instruction, logistics of distance education and methodological problems are described in details. It has been suggested that distance education may be equally effective for theoretical subjects in full-time study form, but when studying clinical disciplines, the priority should be given to traditional methods of teaching, involving student's bedside training. Taking into account technical possibilities and high risk of development of extreme and emergency situations, it is suggested to introduce permanent readiness for distance education, to create all – Ukrainian distance imitation service of patients’ follow-up. The importance of using the state language in training as the basis for mastering the professional Ukrainian and English language as the basis for mastering international medical experience is indicated

Breast cancer. From molecular biology to personified therapy.

Advances in molecular biology had changed approaches to systemic treatment of breast cancer. Clinical decisions on the choice of optimal treatment regimens are performing on the basis of immunohistochemical and molecular genetic classifications. Their increasing uses have contributed changes of paradigm for cancer treatment - from the empirical to the individualized and personalized. The basis for such approaches is knowledge of molecular epidemiology, heterogeneity of expression of molecular subtypes, prognostic and predictive biomarkers of breast cancer. Breast cancer is a widely heterogeneous disease with 20 histological types, 8, molecular-genetic, 6 genomic subtypes, which are characterized by specific molecular and biochemical properties, different clinical course and different outcomes. Molecular genetic classification, created not on the basis of clinical, anatomical and morphological heterogeneity of tumor cells, and on the basis of their molecular-genetic heterogeneity is widely used in clinical practice. This allowed to separate the patients with breast cancer to molecular 4 subtypes - luminal A, luminal B, HER / 2 positive and triple-negative. The significant role of immunohistochemical tissue tumor markers, estrogen and progesterone receptors, HER / 2-neu, Ki-67, p53 for selection the optimal treatment strategy is analyzing in this review. To increase the effectiveness of breast cancer treatment is possible, using a differentiated and personalized approach based on new molecular genetic classification of breast cancer (gene profiling) or to its analogue - expression classification of breast cancer, based on the principle of diversity of immunohistochemical tumor tissue. Personification of cancer treatment involves a therapy based on the study of individual characteristics of tissue is not only the primary tumor but also its metastases

Endoscopy and minimally invasive surgery in the diagnosis and treatment of precancerous diseases and cancer of the stomach in the early stages

One of the most urgent problems of modern oncology is cancer of the stomach, which takes one of the leading places in the structure of cancer incidence. Given the high prevalence of gastric cancer and aggressive course of the disease it is extremely necessary to solve the problem of early diagnosis based on evidence-based medicine and meticulously comply with this disease screening protocols. The review highlights the main precancerous processes and conditions prior to the appearance of tumor, especially degeneration of precancerous lesions to cancer. In particular, to precancerous conditions include chronic atrophic gastritis, pernicious anemia, intestinal metaplasia of the gastric epithelium, the appearance of polyps, endured surgery on the stomach, Menetries disease. These diseases with different frequencies give rise to different degrees of severity of dysplasia, and metaplasia of the stomach epithelium, and ultimately cancer. Understanding precancerous states helps to shape risk and carefully carry out the selection of patients for screening activities to develop the tactics of treatment of precancer and early gastric cancer. The standard diagnosis is endoscopy, which allows to perform a biopsy of the alleged pathological focus for subsequent histological examination is necessary for morphological verification of diagnosis and patient management. To improve the method used technique of chromoesdoscopic examination. Thanks to the introduction of new technologies into clinical practice, such as particular zoom magnification endoscopy, endoscopic examination in a narrow spectral range, endoscopic ultrasound, has become possible to more accurately determine the boundaries of the tumor, depth of invasion into the stomach wall and correctly assess the state of the regional lymph nodes. Diagnosis of early forms of gastric cancer has opened opportunities for sparing endoscopic interventions, namely endoscopic mucosal resection of the stomach, endoscopic submucosal dissection by layer, photodynamic therapy and laser destruction. All these techniques can improve patient survival and quality of life by improving the methods for early diagnosis of the disease and organ sparing surgery

Possibilities of Immunogistochemical Investigation in Respons Prognosis to Treatment and Modification of Treatment Activities at Luminal Breast Cancer (Literature Review).

This article is concerned with both standard (estrogen and progesterone receptors, Her2/neu and Ki67) immu­nohistochemical investigation in hormonal therapy tactics decision for luminal breast cancer and additional in­vestigation of such hormonal sensibility marker as cyclin D1, Bcl-2, AIB1, Her1, p53, IGF-IR, COX-2 and its influence on modified hormonal therapy impact on tumor. It was shown that tumors expressing Her2/neu, AIB1, Her1, p53 or tumors, that have more than 30% expression of cyclin D1 are resistant to antiestrogen but sensible to aromatase inhibitors. IGF-IR and COX-2 tumors are resistant to aromatase inhibitors. Metformin usage for IGF-IR hyperexpression and oxygenase selective inhibitors for COX-2 expression promotes sensibility increase for aromatase inhibitors

Distance Learning: Opportunities and Challenges in Quarantine.

The urgent introduction of distance education into the learning process due to the COVID-19 pandemic has become a spontaneous experiment, requiring urgent decisions, effective mechanisms to implement into the educational process and analysis of ongoing educational process. The possibilities of modern digital technologies made it possible to quickly set up the information component of education and to controle student's knowledge. A detailed analysis of the communication between the faculty members of the department among themselves and analysis of the features of teaching and self-education of students in the field of medical radiology and oncology based on answers and comments with using Google classroom, Socrative, Messenger Telegram, etc. was made. Issues of communicative interaction between faculty members and students, psychological aspects of distance communication, language of instruction, logistics of distance education and methodological problems are described in details. It has been suggested that distance education may be equally effective for theoretical subjects in full-time study form, but when studying clinical disciplines, the priority should be given to traditional methods of teaching, involving student's bedside training. Taking into account technical possibilities and high risk of development of extreme and emergency situations, it is suggested to introduce permanent readiness for distance education, to create all – Ukrainian distance imitation service of patients' follow-up. The importance of using the state language in training as the basis for mastering the professional Ukrainian and English language as the basis for mastering International medical experience is indicated