The article deals with modern ideas about the regulation of the reproductive system and its interaction with the endocrine system in the female body. The article assesses the relationship of reproductive health of a woman with its endocrine status, considers the role of endocrine factors in the formation of anovulatory infertility. According to modern scientific studies, the frequency of infertility reaches 25 %, and a significant part of its structure belongs to anovulatory infertility associated with endocrine disorders. This requires any obstetrician-gynaecologist to be able to assess hormonal disorders in order to identify the primary problem and, having received information, to refer the patient to the appropriate specialists if necessary. The article specifies the most common approaches to the diagnosis of endocrine disorders in clinical practice and the influence of the formation of reproductive disorders. The conclusion discusses problematic issues that require further scientific study

The effectiveness of prophylactic aerosol disinfection with neutral anolyte studied in the infectious zones of the laboratory premises, which works with opportunistic microorganisms and pathogenic biological agents. Electrochemically activated chlorine­containing disinfectant “Anolyte neutral” with pH 7.2, redox potential + 880 mV and active chlorine content 200 mg/dm3 is highly effective when wiping surfaces in rooms with high microbial contamination and in aerosol volumetric and directed air disinfection. Minimal damage is caused to the processed objects. Aerosol volumetric disinfection of air with a «dry» fog using a cold fog generator leads to a significant decrease in microorganisms in the air by 91.1–94.7 % and is not inferior to ultraviolet radiation in terms of disinfection efficiency (90.7–91.1 %). During aerosol volumetric air treatment, harmful effects on personnel are prevented, objects in the room are not damaged, and bactericidal ultraviolet lamps are not needed. Aerosol directed disinfection of surfaces with a “moistened” fog using a cold fog generator completely destroys microorganisms on smooth accessible surfaces and is not inferior to wiping in terms of disinfection efficiency. Aerosol directed disinfection of hard­to­get rough surfaces with a “moist” fog leads to a decrease in bacterial contamination by 97.9–98.9 % and even exceeds the efficiency of wiping (95.8–96.1 %).With aerosol directed treatment, hard­to­get surfaces are effectively disinfected, disinfectant consumption is reduced, labor costs for cleaning and additional equipment are reduced by 3–4 times, there is no need to use ladders for processing of lamps, ceilings, ventilation grilles and moving equipment for processing hard­to­get places.For daily and general cleaning in healthcare organizations, aerosol volumetric air treatment and aerosol directed surface treatment with neutral anolyte can be recommended.

The requirements for medical university graduates in modern conditions imply a broad mastery of professional competencies, including not only theoretical knowledge, but also practical medical skills. The rapid development of medical science and practice doesn`t allow us to limit ourselves to the traditional «academic» approach to learning, the basis of which is the memorization of large amounts of information, but dictates the necessity to teach students the skills of self­education and self­improvement throughout their lives. Andragogical approach, which requires the introduction of other methods and principles into the educational process, corresponds to the achievement of this goal.An important component of modern learning technology is the motivation of a studentto master a future profession, the acquisition of skills in the analysis and synthesis of information, the principles of a scientific approach, the formation of an individual trajectory of the educational process. In this regard, we need to discuss possible ways to increase the motivation of not only the student, but also the teacher to master and implement andragogical models and principles. A graduate of a medical university, starting an independent medical activity, should have the skill of teamwork, quick decision­making, which can be formed only if the principle of joint training of a teacher and a student is observed.

The effectiveness of the treatment of thermal burns in experimental animals using the developed skin tissue equivalent based on cultured skin fibroblasts and keratinocytes (TES) was studied.The terms of wound healing in experimental and control groups of animals with thermal burns IIIAB­IV degree were studied. An analysis was carried out using morphological methods for studying sections of biopsy specimens of burn wounds of the skin of animals at various periods of healing. The stimulating effect of TES on regenerative processes in wounds was revealed. When using TES in animals with solid and mosaic burns, there was a shortening of the wound healing time by 1.64 times compared with the control group of untreated animals.

The most significant epidemiological features of the pandemic with a new coronavirus infection are presented in the article. The mechanisms of penetration of SARS­CoV­2 into the body, ways and factors of transmission, immunological mechanisms of interaction of the virus with the cellular receptor apparatus are indicated. The issues of the formation of population immunity to COVID­19 through specific prevention are considered. Modern biological platforms of vaccines and their comparative characteristics, safety profile, immunological and epidemiological effectiveness of vaccination in the conditions of continuous emergence of SARS­CoV­2 variants of concern are discussed. The predicted epidemiological models of the pandemic development and the main directions of the complex system of prevention of coronavirus infection in Belarus are presented.

The incorporation of ⁴⁰ K in the body of residents of the Luninets district of the Brest region was studied based on the results of 58809 measurements on a human radiation spectrometer for the period from 2016 to 2020. Significant differences were established in the specific content of potassium in body tissues according to such criteria as place of residence, residence at the time of the Chernobyl accident, age, gender. Of these, age and gender are recognized as the most significant and determining. Linear regression models have been created that describe the accumulation of ⁴⁰K in the body of residents of the area, depending on age and gender. It was found that modeling the age­dependent content of ⁴⁰ K shows the best results with a preliminary separation of the population by gender.

The aim is to conduct a comparative assessment of the effectiveness of arthrodesis and arthroplasty of the first metatarsophalangeal joint (MPJ) in combination with the resection of the heads of the II­V metatarsals in the treatment of rheumatoid forefoot. The results of surgical treatment of the forefoot deformities in 36 patients with rheumatoid arthritis (RA) have been studied, 47 feet were operated on. In group 1 (n = 25 feet), arthrodesis of the first metatarsophalangeal joint was used (arthrodesis group). In group 2 (n = 22 feet), arthroplasty of the first metatarso­phalangeal joint was performed using the Keller­Brandes method (arthroplasty group). In both groups resection of the heads of the II­V metatarsals was performed. The American Orthopedic Foot and Ankle Society Hallux Scale (AOFAS­I) was used for clinical evaluation. The Hallux Valgus Angle (HVA) and 1–2­Intermetatarsal Angle (1–2­IMA) were measured for radiographic evaluation. The condition of the feet was assessed before surgery and in 6 and 24 months after surgery. We obtained better clinical results according to the AOFAS­I scale at 6 and 24 months after the surgery in group 1 with arthrodesis of the first metatarsophalangeal joint, compared with group 2 with arthroplasty according to the Keller­Brandes method. In contrast to arthroplasty to the Keller­Brandes method, arthrodesis of the first MPJ, allows to achieve stable correction of the Hallux Valgus Angle and reduce the 1–2­Intermetatarsal Angle.

The article presents an analysis of the surgical treatment of 106 young and middle­aged male patients who underwent inguinal hernia repair: 64 patients underwent the Liechtenstein operation, 42 – TEP technique. The duration of surgical treatment, the need for the use of analgesics, early and late postoperative complications were analyzed in detail. Patients operated using TEP technique needed less analgesia in the early postoperative period, they had fewer postoperative wound complications, and their ability to work was restored faster. However, TEP surgery can only be performed under endotracheal anesthesia and is longer than the Liechtenstein procedure.The Liechtenstein operation can be performed under local anesthesia, which is important for comorbid middle­aged patients.

Over the past two years, COVID­19 has continued to be a worldwide problem. Large­scale vaccination of the population is aimed at achieving herd immunity. The presence of 80 % or more immune people in the population should lead to the end of the pandemic with the least human losses. The purpose of the study: to assess the impact of vaccination on the incidence of COVID­19 infection among students of the medical faculty of the Belarusian State Medical University. Information on cases of COVID­19 infection among students (total sample N = 351 people) from the beginning of 2020 to December 31, 2021, as well as data on specific prophylaxis with various vaccine options, were obtained. In the group of unvaccinated students, 46,15 % were ill with COVID­19 infection; among vaccinated students (n = 249 people), 9,24 % had COVID­19 infection after vaccination – as of December 31, 2021. A comparative analysis did not reveal significant differences in efficacy between the two most commonly used vaccines in 2021 in the Republic of Belarus – Sputnik V (Gam­COVID­Vak) and Vero Cell (Sinopharm). After the achievement of herd immunity (as of November 1, 2021, the pool of conditionally immune students reached 79,20 % of the total sample), only isolated cases of the disease were registered in November and December 2021.

We have studied one of the characteristics of the epidemic process of infectious mononucleosis – the continuity of the epidemic process. When analyzing the data, we found that in Minsk in the year 2012–2019 there were between 0 and 10 cases per day with intervals of varying duration. During the analysis period (according to the average multi­year data), days with 2 cases per day were more common (25,43 % ± 0,03 %), less often – days with 1 case (23,03 % ± 0,03 %) and with 3 cases (18,45 % ± 0,03 %) per day. Short intervals (from 0 to 3 days) were more common between days with a small number of cases. The proportion of 0 and 1 day intervals for 1 and 2 cases per day was 22,50 %, 21,16 % and 26,31 %, 19,06 % respectively. For days with a small number of cases their share decreased with an increase in the length of the intervals (for the interval of 16 days or more it was 0,94–4,08 % for days with 1–3 cases per day). With the increase in the number of cases per day (from 4 or more) there was an increase in the number of long intervals (for days with 4 and 5 cases per day, the frequency of 8–10 days, 11–15 days and 16 days or more was 10,95–13,91 % and 10,86–33,14 % respectively). At the same time, the low rate of hospitalization in the first days of the disease (15,58 % on the first or second day) contributed to the further spread of the infection and the formation of days with several (not one) cases of the disease. Thus, the current frequency of different intervals between days with different numbers of cases per day ensures the continuous spread of infectious mononucleosis in the territory of the city of Minsk.

The peculiarities of the behavior of children and adolescents are the result of the influence on the body not only of hereditary predisposition and actual state of health, in particular mental, but also as a result of the influence of microsocial risk factors (family, in­school). The article presents the results of a comparative analysis of the prevalence of attention deficit hyperactivity disorder (ADHD) and the deviating behavior of children and adolescents of two groups raised in residential institutions and raised in families. A larger number of children with ADHD were identified among pupils of residential institutions, including those with a pronounced degree of severity of this pathology, with a higher tendency to implement aggressive and addictive behavior in comparison with children raised in families (37,2 ± 7,4 % and 11,1 ± 4,7 %, respectively; P < 0,05). In each group, children with a tendency to self­injurious and self­destructive behavior, a commitment to commit offenses and control behavioral manifestations of emotional reactions are found with equal frequency.

The results of the study of persons with syncope are presented. The aim of the study was to determine the frequency and cause of syncope in young people. Study of the relationship between syncope and diagnosed changes in laboratory, instrumental research methods and testing of psychoemotional status. In the course of the work, the method of social anonymous survey on the basis of Google Forms of medical university students was applied, the case histories of patients of the neurological department were analyzed. The reasons for syncope in the surveyed respondents in the study group were various mechanisms: neurogenic, reflex and orthostatic hypotension. According to the data of an in­depth examination of patients of the neurological department, the relationship between syncope and diagnosed nonspecific abnormalities in the results of laboratory and instrumental research methods was shown. An interdisciplinary approach has allowed us to expand our understanding of the mechanisms of syncope development and to prevent recurrent syncope.

Infectious mononucleosis at various stages of the pathological process and depending on the severity, presence of complications is characterized by polymorphism of the clinical features, which greatly complicates its early diagnosis.Features of the course, clinical manifestations of acute infectious mononucleosis in 55 children and adolescents aged 1 to 14 years, at various stages of the diagnostic process were analyzed. Common combination of clinical syndromes, which allows to suspect the presence of infectious mononucleosis, were identified.To establish the diagnosis of infectious mononucleosis, an integrated approach is required, taking into account the dynamics of the disease during the first week of the disease, the dataof laboratory and instrumental studies.Infectious mononucleosis is distinguished by the polymorphism of the clinical picture, depending on the prevalence of general inflammatory syndrome, endotoxicosis syndrome, lymphoproliferative, hepatolienal and other syndromes, as well as its complicated and uncomplicated course. Most often at the prehospital stage, the “masks” of MI were: acute respiratory viral infection (43.8 ± 7.16 %), acute allergic reaction (35.4 ± 6.9 %), acute community­acquired pneumonia (16.7 ± 5.38 % of cases), follicular and lacunar tonsillitis (8.3 ± 3.98 %).Diagnosis of MI is also difficult due to the rather late (on the second week of the disease) appearance of atypical mononuclear cells in the peripheral blood of patients, with a parallel long­term absence of clinical symptoms sufficient for the diagnosis of infectious mononucleosis in 41.7 ± 7.12 % of patients.

The article presents the results of observation of a group of servicemen (n = 251) in the process of performing urgent military service who were treated for general somatic diseases (n = 151), coronovirus infection (n = 50) caused by COVID­19, and healthy individuals (n = 50). The relationship of general somatic diseases and coronovirus infection COVID­19 with telogen hair loss in the study population was studied. The relationship between temperature and body mass index and telogen hair loss has been established. Analysis of the data obtained showed that even with a mild course of the underlying disease, an accelerated transition from the anagen phase of hair growth to the telogen phase can be observed in 12 %, and in the group with COVID­19 infection, such a transition was observed in 94.0 % of patients.

Purpose. Assessment of the quality of life of patients with postnasal syndrome with vasomotor rhinitis before and after surgical treatment using the SNOT-22 questionnaire (RUS) and using a visual analogue scale (VAS – 10-point subjective scale).
Materials and methods. Two groups were formed: the main group – 30 patients (15 men and 15 women), who, along with laser photocoagulation of the inferior turbinates, underwent photocoagulation of the distal branches of the vidian nerve. The comparison group consisted of 30 patients (15 men and 15 women) who underwent only laser photocoagulation of the inferior turbinates.
Results. Assessment of the quality of life of patients in the preoperative period using a specialized questionnaire SNOT-22 (RUS) and according to the VAS corresponds to the scale of moderately disturbing (main group – 40.8 ± 3.35 points, comparison group – 42.2 ± 3.17, breathing through nose and smell before surgery in the main group according to VAS – 9.6 ± 0.33 points, in the comparison group – 9.5 ± 0.25 points Complaints about mucus drainage along the posterior pharyngeal wall in the main group – 8.8 ± 0, 27 points, in the comparison group – 8.7 ± 0.18 points), in the postoperative period there is a progressive decrease in indicators (1 month after the operation in patients of the main group, respiratory and olfactory function – 1.8 ± 0.13 points, patients comparison groups – 2.4 ± 0.15 points Complaints about mucus drainage along the posterior pharyngeal wall patients of the main group – 0.7 ± 0.36 points, comparison groups – 4.2 ± 0.16 points Quality of life of patients using specialized questionnaire SNOT-22 (RUS) 1 month after surgery in the main group – 8.3 ± 1.85 points, in groups e comparison – 14.3 ± 2.86 points.
Conclusions. Vasomotor rhinitis with postnasal syndrome reduces the quality of life of patients. The proposed methods of minimally invasive surgical treatment can improve the quality of life of patients in the postoperative periods.

According to various authors, obesity programming factors act at the early stages of development: fetus – newborn – young child. High birth weight indicators may be due to a genetic predisposition to obesity in childhood and contribute to an imbalance of energy systems in adults. We conducted a longitudinal observational study, during which we analyzed the absolute numbers and frequency of births of large­weight newborns for 20 years (the period from 2002 to 2021) in Health Care Institution “5th City Clinical Hospital of Minsk”. The purpose of our study was to evaluate the anthropometric characteristics of mothers of large­weight newborns in the pre­ and gravidar period, as well as to study the features of early neonatal adaptation of these children. It was found that the birth rate of large­weight children has no tendency to decrease, as well as to increase. Metabolic syndrome and hypothyroid state of the mother may be predictorsof the formation of macrosomia in the fetus. Large­ weight newborns belong to the risk group for the development of hypoglycemia in the early neonatal period.Conflict of interests. The authors declare that there is not conflict of interests.

Elevated levels of D­dimer are not uncommon in patients with SARS­CoV­2 infection,and interpretation of this phenomenon is challenging for clinicians. Pulmonary embolism (PE) is an extremely severe complication and frequent event among patients with COVID­19.Objective: to establish the clinical and laboratory features of the course of PE verifiedby computed tomography angiography (CTA) of the pulmonary arteries in a group of individuals with confirmed SARS­CoV­2 infection and elevated D­dimer levels at the time of admission.Мaterials and methods. Analysis of medical records of 3664 in patients with confirmed SARS­CoV­2 coronavirus infection, hospitalized at “4th Сity Clinical Hospital named afterN. E. Savchenko” of Minsk in the period from 01.01.2021 to 31.12.2021 was performed,the prevalence of patients with PE and COVID­19 was 3.1 % (n = 113). Two groups of patients with confirmed COVID­19 with elevated D­dimer level (>500 ng/ml) at the time of admission were defined: the study group (“PE+”) included COVID­19 patients with verified PE by CTA (n = 15), the comparison group (“PE–”) included those with PE excluded by CTA (n = 22).Results. The findings showed that individuals with COVID­19, elevated D­dimer leveland developed PE at the time of admission had a more marked respiratory insufficiency, higher leukocytosis and neutrophil levels; the proportion of patients with increased prothrombin time (PT) was higher in the “PE+” group compared to the “PE–” group. A moderately strong association between outcome (PE) and elevated PT levels (html5-dom-document-internal-entity2-981-end = 0.43, p < 0.05), elevated leukocyte levels (html5-dom-document-internal-entity2-981-end = 0.34, p < 0.05), direct correlations between a number of inflammatory and hemostasis indicators were found.Conclusion. The findings indicate the presence of COVID­19­associated coagulopathy in patients with confirmed SARS­CoV­2 infection and elevated D­dimer level at the time of hospitalization. The pathogenetic basis and thrombogenic risk factors in patients with COVID­19 require further clarification.

The purpose of the study was to analyze the characteristics of the adipocytokine status and lipid spectrum in large for gestational age (LGA) in the dynamics of the neonatal period, to assess the influence of the metabolic status of mothers on the analyzed indicators of their infants. 348 full­term newborns were examined. 3 groups of LGA were distinguished, taking into account the presence of type 1 diabetes mellitus in the mother (Gr1), overweight or obesity (Gr3) or the absence of disorders of carbohydrate and fat metabolism (Gr2). Group 4 (Gr4) – normal weight from mothers without changes in carbohydrate­lipid metabolism. The content of adipocytokines, lipids, glucose and vitamin D was studied in the “mother­child” dyads, blood serum of children in the dynamics of the neonatal period. An adipocytokine imbalance and hyperlipidemia were revealed in mothers of the examined groups of LGA, more pronounced with overweight and obesity. The TG/HDL ratio was significantly higher in Gr3. The influence of metabolic disorders in women on indicators of physical development, parameters of hormonal status and lipid profiles of children was established. Leptin levels at birth were significantly higher in LGA of all three groups compared to normal­weight children (p < 0.001, p = 0.002, p < 0.001). In the dynamics of the early neonatal period, a statistically significant decrease in leptin was observed against the background of an increase in total serum cholesterol. Maternal HDL, leptin, and cord blood IGF­1 levels were associated with neonatal size. The identified perinatal hormonal and metabolic patterns have a pronounced effect not only on the condition and anthropometric status of LGA newborns, but also program the pace of physical development in the neonatal period.

Cysts of maxillary sinuses in both children and adults haven’t specific clinical manifestations and are often findings on CT or MRI and have an odontogenic or non­odontogenic origin.Systematized data of the prevalence and flow characteristics of this pathology in children are insufficient.Objectives: clinical and epidemiological analysis of cystic maxillary sinusitis in children. Material and methods: data of 42 patients of the children’s ENT­department who were operated for non­odontogenic cysts of maxillary sinuses.Results. Age of group patients in which the studied pathology was diagnosed most frequently was 10–17 years old. Correlation of the cysts of maxillary sinus with pathology of the nasal cavity and nasopharynx were analyzed: septal deviation (68 %), rhinitis (42 %), adenoids (10 %), anthroanal polyp (25 %) was noted. Pathomorphological examination of the material obtained at endoscopic removal of cysts presence of inflammatory in 78 % of biopsy.Conclusion. In most cases a patient with a cyst of maxillary sinus is subject to dynamic observation by an otorhinolaryngologist and endoscopic examination of the nasal cavity is an essential element for timely detection of pathology of the ostiomeatal complex or choanal polyp accompanying the cyst development.

The presence of lung involvement in patients with spondyloarthritеs or rheumatoid arthritis always causes concern with regard to the choice of disease­modifying anti­rheumatic drugs.Objective. To determine clinical and instrumental peculiarities of severe lung disorders and to assess the disease­modifying anti­rheumatic drugs (methotrexate) impact on the respiratory system in patients with spondyloarthritеs and rheumatoid arthritis in the presence of severe lung disorders. Material and methods. The research involved 172 patients with spondyloarthritеs and rheumatoid arthritis. The patients were interviewed and examined. The nature of the current medication was specified. The multispiral computer tomography of thorax was performed in order to determine the presence of lung affection. Lung function was tested by means of spirometry and body plethysmography. In order to process the data Statistica 10 software package was used.Results. Lung disorders were found in 77,5 % of patients with spondyloarthritеs and 90,0 % of patients with rheumatoid arthritis. Out of all disorders severe lung disorders were found in 48,4 % of patients with spondyloarthritеs and 70,0 % of patients with rheumatoid arthritis. The patients with severe lung disorders had dyspnea, they also showed a decrease in lung function parameters. The patients with severe lung disorders who were taking methotrexate showed higher parameters of forced vital capacity and vital capacity than the patients with similar lung disorders who were not taking methotrexate.Conclusion. Severe lung disorders in patients with spondyloarthritеs and rheumatoid arthritis can be manifested by respiratory complaints and a decrease in lung function parameters. Methotrexate shows a beneficial effect on the lung function in patients with spondyloarthritеs and rheumatoid arthritis who have severe lung disorders.

Aim of the study. To evaluate the effectiveness of resection arthroplasty of the metatarsophalangeal joints (MTP joints) in the surgical treatment of hammer toe deformity of the II­III­IV toes, accompanied by severe overload metatarsalgia.The results of surgical treatment of hammertoe deformity of 102 toes on 50 feet in 36 patients (32 women and 4 men) aged 39 to 79 years (median age 58 [54; 64] years) were studied. Long­term results were followed­up from 8 to 50 months (median – 30 [25; 38] months). Treatment outcomes were assessed by determining the placement of hammer toes in the joints, measuring the passive range of motion (PROM) in the MTP joint, calculating the forefoot X­ray parameters, using the Visual Analogue Scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society Lesser Toe Scale (AOFAS­II­V). The measurement the PROM in the 2nd, 3rd and 4th MTP joints showed a decrease in their amplitude by 20.3–22.8 % in the long­term period after surgery. The pain assessment according to the VAS scale showed a decrease in the median value from6 [6; 7] points before surgery up to 2 [1; 4] – after the surgical procedure, and the median score on the AOFAS­II­V scale increased from 35 [30; 45] to 79 [65; 85] points. Positive outcomes were achieved in 88 % of cases. The results of the study indicate the effectiveness of resection arthroplasty of the MTP joints in the treatment of overload metatarsalgia with hammer toe deformity of the 2nd, 3rd and 4th toes. Shortening of the middle metatarsals easily correct hammer toe deformity and eliminate pain. At the same time, the disadvantage of the technique is a decrease range of motion (ROM) in the resected MTP joints, therefore, early and active development of movements in the postoperative period is necessary.

To date, markers of endometrial implantation susceptibility in patients with endometrial hypoplasia have not been sufficiently studied. 59 patients with endometrial hypoplasia were examined, in whom treatment in accordance with clinical protocols (hormonal and/or in vitro fertilization) did not yield results (the main group), 16 women with endometrial hypoplasia who became pregnant after standard therapy (comparison group), and 23 somatically healthy fertile women (control group). There were no age differences in the groups.The analysis of clinical and anamnestic data was carried out, three­dimensional ultrasound and immunohistochemical studies of the endometrium were performed. It is shown that the main markers of implantation susceptibility in endometrial hypoplasia are the presence of unsuccessful attempts of in vitro fertilization in the anamnesis, the uniformity and presence of a three­layer structure of the endometrium, the volume of the endometrium and the cellular density of the endometrial stroma. Immunohistochemical markers of implantation susceptibility in endometrial hypoplasia are the expression of receptors for estrogens html5-dom-document-internal-entity2-945-end in the endometrial stroma, integrin html5-dom-document-internal-entity2-945-endvhtml5-dom-document-internal-entity2-223-end3 – in the glandular layer of the endometrium, and the gene NOHA10 and the surface marker EMSC SUSD2 – both in the glandular tissue and in the endometrial stroma.

The growing prevalence of multidrug­resistant pathogens is a huge challenge for modern medicine, and this is especially true for patients in intensive care units (ICU). This article presents the results of monitoring the isolates of microorganisms and their resistance to antibiotics in the ICU of therapeutic and surgical profiles. As a result of the study, the following results were obtained: the greatest sensitivity of Klebsiellapneumoniae in therapeutic resuscitation is shown to colistin (100 %) and tigecycline (100 %), in surgical resuscitation – to extended­spectrum beta­lactamase (ESBL) (93.2 %) and tetracycline (58.9 %); Acinetobacter baumanii: in the therapeutic – to colistin (100 %), in the surgical – to colistin (100 %); Coagulase­negative staphylococci: in the therapeutic – to nitrofurantoin, linezolid, tigecycline, vancomycin (100 %); Staphylococcusaureus: in the therapeutic field – resistance to most of the drugs used, with the exception of benzylpenicillin; Pseudomonas aeruginosa: in the therapeutic – colistin (100 %), in the surgical – to colistin (100 %). This study emphasizes the importance of interdisciplinary interaction of hospital doctors, including ICUs with clinical bacteriologists and epidemiologists, as well as the role of timely correction of antibiotic therapy.

The interaction between the growing cases of eating disorders and schizophrenia spectrum disorders is a complex area that has received little attention. Its study raises conceptual and methodological questions in both areas of psychiatry with the aim of timely diagnosis and treatment of patients with anorexia syndrome.The aim of the work is to discuss the possible differences in the outcomes of inpatient treatment of people with eating disorders, depending on the true nosological affiliation of the anorexia syndrome and, accordingly, associated with different times of psychopharmacological interventions. The authors describe two clinical cases of patients with deviant eating behavior, demonstrating the exceptional importance of an integrative assessment of the anorexia syndrome in the psychiatrist’s work (on the example of using the method of differential diagnosis of eating disorders and schizophrenia in psychiatric hospitals).

The most important factor in the prevention of overwork among students is the rationaldistribution of the study load during the school day and week. It depends on compliancewith hygiene requirements when designing a lesson schedule. The ordinal scale of the difficulty of educational subjects which is currently in use in our republic was proposed in the 70s of the last century by I. G. Sivkov. The ordinal scale does not take into account the specifics of modern education and is not differentiated for grades 5 to 9. The method of expert assessments was used to develop a modern ranking scale for the difficulty of subjects. We designed a questionnaire containing questions about the difficulty and tediousness of teaching academic subjects. We inter­viewed a random sample of students (1191 students of grades 5–9 in schools and gymnasiums of the republic) in accordance with the quentionnaire. We have established that indicators of difficulty and fatigue significantly differ from the ordinal scale that is currently in use, and they vary depending on the year of study. The results obtained were used to develop a modern ordinal scale for the difficulty of academic subjects that takes into account the specifics of national education system and the year of study. The revealed statistically significant differences in the difficulty and fatigue of school subjects for students of schools and gymnasiums determined the need to develop an algorithm for developing ordinal scales for the difficulty of school subjects, taking into account the characteristics of training in an educational institution. It will help to maintain working capacity at an optimal level, prevent overwork and facilitate growth and development of students.

Congenital deficiency of biotinidase is a rare congenital metabolic disorder that most often occurs in newborns and young children. Since the activity of the enzyme in the nervous tissue is low, it is the most sensitive and vulnerable, which is manifested primarily by muscle hypotension, convulsions, ataxia, and dermal disorders. Clinically, there are two forms of biotinidase deficiency, which are determined by the residual activity of the enzyme: early (deep deficiency), late (partial). The leading laboratory tests are the detection of metabolic acidosis in the patient, the study of urine for organic acids, low enzyme activity, hyperammonemia, and the detection of mutations in the sequencing of the BTD gene. The features of neurological disorders in biotinidase deficiency are analyzed on the example of a clinical case and a review of the literature. Early diagnosis and administration of biotin therapy play an important role in preventing disease progression and clinical signs.