Ureteral stenting is most often performed for urinary stasis secondary to urolithiasis and acute obstructive pyelonephritis. Among stenting complications, the most clinically significant are urinary tract infection and stent encrustation. Preventive measures for ureteral stenting complications have not yet been developed. This article presents a literature review of promising medications that can be used to prevent urinary tract infection associated with ureteral stents and their encrustation.

Children with hearing impairment suffer from voice and speech problems more often than children with normal hearing, because they cannot control their own voice due to the lack of auditory feedback. However, the problem of diagnosing voice disorders in children remains relevant despite the urgency of this problem. The article presents a subjective analysis of the voice of children with hearing impairment.

Introduction. Posterior extramural ethmoid air cells, particularly sphenoethmoidal cells (Onodi cells), are an important object of study in modern othorhinolaryngology due to their close relationship with critical neurovascular structures of the skull base and the high risk of intraoperative complications.

Aim. To systematize current data on the variants of structure, classification, and clinical significance of sphenoethmoidal cells based on cone-beam computed tomography (CBCT) data.

Objects and methods. An analysis of literary data was conducted, including original studies, systematic reviews, and meta-analyses found in PubMed, Google Scholar, and CyberLeninka databases. The search was performed using the following keywords in both English and Russian: «Onodi cell», «sphenoethmoidal cell» and «cone-beam computed tomography». Special attention was paid to works published in the last 10 years that used CBCT imaging methods.

Results. The review demonstrates a significant diversity of variants of extramural extension of posterior ethmoid cells. Based on CBCT data, a modified classification of Onodi cells is proposed and detailed, including five types (I – superior, II – superolateral, III – lateral, IV – superoposterior, V – intersphenoidal).

Conclusion. Knowledge of anatomical variations of sphenoethmoidal cells is of great importance for ensuring the safety of endoscopic interventions. CBCT imaging allows for a detailed assessment of these air cells and their relationship to critical anatomical neurovascular structures. A thorough preoperative evaluation, taking into account existing classifications, should become the standard for planning operations in the area of the sphenoid sinus and posterior ethmoid labyrinth to prevent iatrogenic injuries.

This article examines the biological role and potential medical significance of endogenous hydrogen cyanide (HCN). Its exogenous analogs (hydrocyanide, sodium cyanide, potassium cyanide, etc.) were previously considered exclusively toxic to humans – lethal poisons. It addresses the toxic effects of exogenous cyanide compounds, the metabolism of endogenous cyanide in the body, and the regulation of hydrogen cyanide formation and breakdown in cells. It also examines methods for determining endogenous hydrogen cyanide levels in the body, the sites of action, and the mechanisms by which HCN influences individual vital processes in health and certain pathologies. Several studies have shown that both a deficiency and an excess of endogenous cyanides in the body can be associated with the onset and progression of various vital disorders. It has been demonstrated that by altering endogenous hydrogen cyanide levels in the body by influencing its synthesis and breakdown, it is possible to regulate metabolic reactions, physiological processes, and pathological processes. In this regard, various technologies are currently being developed to prevent and treat various life-threatening disorders using substances that regulate endogenous cyanide levels in the body. The diagnostic value of measuring endogenous hydrogen cyanide in exhaled air is being substantiated for various human respiratory diseases. Some researchers consider hydrogen cyanide, which is produced in the cells of bacteria, plants, animals, and humans, to be a universal regulatory factor, adding to the group of lowmolecular gaseous signaling biological regulators – gasotransmitters. Research in this area is rapidly gaining momentum.

Objective. To systematize and analyze current evidence on the use of ultrasound Doppler (USD) and dermoscopy in the differential diagnosis of cutaneous-limited vasculitides.

Materials and methods. A systematic meta-analysis of clinical studies was conducted, focusing on patients with cutaneous-limited vasculitis (including leukocytoclastic and urticarial vasculitis). Literature search was performed in PubMed, Scopus, and Web of Science databases (2000–2024). Fourteen studies involving a total of 1124 patients met the inclusion criteria.

Results. USD demonstrated characteristic features of vascular wall inflammation, perivascular edema, and hemodynamic alterations, thus improving diagnostic accuracy in differentiating vasculitis from vasculopathies. Dermoscopy allowed visualization of vascular changes (capillary loops, hemorrhagic spots, telangiectasias), complementing clinicopathological assessment. Combined use of USD and dermoscopy increased diagnostic sensitivity up to 89 % and specificity up to 84 %.

Conclusion. Ultrasound Doppler and dermoscopy are complementary, non-invasive techniques that enhance the accuracy of differential diagnosis in cutaneous-limited vasculitides and support optimal therapeutic decision-making.

The relevance of investigating the topographical and anatomical features of the internal female genital organs during postnatal ontogeny is driven by the necessity to understand their normal development and maturation, which is crucial for preventing pathologies of the female reproductive system.

To determine the topographical, anatomical, and morphometric characteristics of the uterine tubes during postnatal ontogenesis in order to identify patterns of their development and define periods of intensive growth.

We examined uterine tubes (autopsy specimens) from 24 girls aged 0 to 15 years, who had died from causes unrelated to genital tract pathology or congenital malformations.

The study established that during ontogeny from 0 to 15 years, the topographic horizontal position of both the right and left uterine tubes becomes stabilized, with the infundibulum of the organ predominantly assuming a descending orientation by adolescence.

Analysis of the dynamics of linear parameters regarding the length of the right and left uterine tubes revealed a statistically significant increase in the length of both sides. Furthermore, distinct periods of intensive longitudinal growth were identified. For the right uterine tubes, significant growth was observed during infancy (10 days–1 year), early childhood (1–2 years), and adolescence (12–15 years). For the left uterine tubes, a significant increase in length was found during infancy (10 days–1 year) and the second childhood period (8–11 years).

This article presents the results of studies modeling endometritis in rats using a single administration of bacterial lipopolysaccharide (LPS). The induced inflammatory process was accompanied by morphological changes, including leukocyte infiltration of the endoand myometrium, and decreased uterine tone and contractility. Systemic complex administration of antilysosomal drugs against the background of antibacterial and uterotonic therapy for 7 days caused a decrease in the intensity of the inflammatory process and the severity of neutrophilic infiltration of the endo- and myometrium, activation of the tone and contractile function of the uterus. A conclusion was made about the possibility of modeling acute endometritis in rats by a single intravaginal administration of LPS, as well as the high efficiency of a new method of treating endometritis using antilysosomal drugs (ovomin).

Purpose. Pneumococcal infections, caused by the diversity of Streptococcus pneumoniae serotypes, remain a significant concern in pediatric practice. Since the effectiveness of vaccine prophylaxis directly depends on the match between vaccine serotypes and circulating strains, the aim of this study is to comprehensively assess the serotype structure of S. pneumoniae in unvaccinated children, their associated clinical manifestations, and to provide a pharmacoeconomic rationale for a vaccination strategy for the pediatric population of Belarus.

Materials and methods. Serotyping was performed on 297 clinical S. pneumoniae isolates obtained from unvaccinated children in Minsk (2020–2023). The pharmacoeconomic analysis of the vaccination effectiveness for infants in their first year of life (with 95 % coverage) was conducted using a Markov model and a cost-benefit analysis approach for the healthcare system of Belarus. Pneumococcal conjugate vaccines (PCV) PCV-10 and PCV-13 were compared assuming an identical cost per full vaccination course (3 doses).

Results. Serotypes 19F, 3, 19A, 14, and 23F predominated, constituting 73,9 % of all S. pneumoniae isolates. Non-typeable strains (8,4 %) were strongly associated with acute purulent otitis media (80,0 %; p < 0.001). Multiple serotype isolation (5,7 % of patients) was predominantly observed in bilateral otitis media (81,3 %); serotype 19F dominated in these cases (75,0 %). PCV-13 demonstrated a significantly higher coverage of circulating strains (85,5 %) compared to PCV-10 (62,9 %; p < 0.05), and was comparable to PCV-20 (90,9 %; p > 0.05). Pharmacoeconomic modeling confirmed the advantage of PCV-13: maximum reduction in pneumonia incidence (68,0 % vs 22,0 %, respectively; p < 0,001) and otitis media incidence (78,0 % vs 67,1 %, respectively; p < 0,001), along with twofold superiority in budget savings (26,6 % vs 13,0 %, respectively). Based on high serotype coverage and proven clinical-economic effectiveness, PCV-13 represents the optimal choice for inclusion in the National Immunization Schedule of Belarus.

Despite the widespread use of transvaginal ultrasonography (TVUS) to assess the depth of myometrial invasion, its diagnostic accuracy remains limited – particularly in women with obesity and in the presence of uterine fibroids – underscoring the need for a more accurate prediction model to improve preoperative assessment and to substantiate fertility-sparing treatment in reproductive-age patients with stage I endometrioid carcinoma.

Objective: to improve the diagnostic performance for detecting myometrial invasion in reproductive-age patients with stage I endometrioid carcinoma, enabling consideration of fertility-sparing management.

Materials and methods. Analyzed 171 reproductive-age patients (24–55 years; median 46) with stage I endometrioid carcinoma who underwent evaluation – including transabdominal and transvaginal ultrasound – and surgery (pan-hysterectomy with bilateral salpingo-oophorectomy or extended hysterectomy with pelvic lymphadenectomy) at the N. N. Alexandrov Centre in 2011–2015 and 2023–2025. Operating characteristics of TVUS for detecting myometrial invasion were calculated. A multivariable predictive model was built using logistic regression with myometrial invasion as the outcome. Internal validation was performed by bootstrap resampling. ROC analysis and decision-curve (net benefit) analysis were applied. Two-sided p-values p < 0.05 were considered significant.

Results. In reproductive-age women with stage I EC and tumor grade G1–G2, myometrial invasion was significantly associated with preoperative variables: age, body mass index (BMI), tumor grade, and tumor size. We developed a multivariable model incorporating these variables together with TVUS findings to predict the probability of myometrial invasion. The model achieved an AUC of 0.821 (95 % CI 0.758–0.884; p < 0.001) and outperformed TVUS alone (DeLong p < 0.001); diagnostic sensitivity exceeded that of TVUS by 17.1 percentage points (p = 0.006). Internal validation confirmed model performance. A nomogram was constructed to graphically estimate individual probability of invasion, and decision-curve analysis demonstrated superior net benefit versus TVUS alone across threshold probabilities.

Conclusions: the proposed multivariable model significantly improves the accuracy of detecting myometrial invasion in reproductive-age patients with stage I G1–G2 endometrioid carcinoma and supports more informed selection of fertility-sparing treatment strategies.

Purpose – to perform a comparative analysis of the clinical and cost-effectiveness of hybrid, cement and screw fixation of dental prostheses to dental implants in orthopedic treatment of patients with partial secondary adentia.

Methods. There were examined 103 patients with adentia who were in the department of orthopedic dentistry of the 2nd city clinical hospital in Minsk in 2019–2024, which were stratified into 3 groups: the main one, in which the hybrid method of fixing dental implants was used (n = 35, average age 40.8 ± 4.7 g); reference group 1 using cement fixation method (n = 35, 41.3 ± 4.5 g); comparison group 2 using screw fixation of dental implants (n = 33, 42.6 ± 5.2 g); healthy group (n = 30, 39.8 ± 5.0 g). Clinical follow-up was performed with index score, Hounsfield bone density, peri-implant tissue microcirculation status and orthopedic construct stability in patients before and at 1, 6, 12, and 18 months after treatment.

Results. Hybrid orthopedic treatment resulted in good treatment outcomes in 97.1 % of patients, which compared with the results in comparison groups 1 and 2 consisted of a 1.1-fold increase in periimplant bone density (p = 0.000) and 1.2 times, respectively (p = 0.000), attenuation of inflammatory events, improvement of microcirculation by 1.3 times (p = 0.028) and 1.2 times (p = 0.025), respectively, in maintaining the stability of the cement-screw connection throughout the entire period of clinical observation.

Conclusion. A hybrid method of dental implantation with partial secondary adentia was developed, experimentally substantiated and introduced into clinical practice, the cost-effectiveness of which exceeded it by 26.0 % with traditional methods of orthopedic treatment with cement and screw fixation.

Objective: to develop objective criteria for planning surgical treatment of abdominal hernias, taking into account the individual characteristics of patients.

Materials and methods. The study was conducted in two phases. First, a retrospective analysis of 2514 hernia repair cases was performed, and logistic regression was used to identify key predictors for mesh implantation. Based on this, a tripartite algorithm was developed, incorporating clinical factors (Block A), complication risk from fat mass metrics (Block B), and physiological reserve from active tissue parameters (Block C). Subsequently, a prospective cohort study was undertaken with 120 patients, randomized into a Control group (standard care, n = 60) and a Study group (algorithm-guided treatment, n = 60). Outcomes were assessed via ROC-analysis, Clavien-Dindo complication rates, and serial SF-36 quality of life surveys.

Results. The regression model confirmed hernia defect > 4 cm, BMI ≥ 30 kg/m², history of abdominal surgery, and age > 60 years as significant predictors for mesh use. The algorithm, using a threshold score of 3 in Block A, demonstrated excellent predictive performance in the Study group, with 90 % sensitivity and 95 % specificity (AUC = 0.916). Algorithm-guided management led to a non-significant but notable reduction in infectious complications (0 % vs. 8.3 % in Controls) and yielded a statistically significant acceleration in the recovery of physical and psychosocial quality of life metrics within the first six postoperative months.

Conclusion. The integration of bioimpedance analysis with established clinical factors into a personalized decision-making algorithm proves highly effective. It standardizes surgical strategy, reduces unwarranted mesh use, and enhances early postoperative recovery and quality of life, offering a refined tool for personalized hernia care.

Aim/Objective. To specify of the indications for spleen-preserving distal pancreatectomy (SP DP) and performing a prospective analysis of its results.

Materials and methods. The results of treatment in 17 patients (follow-up 12–36 months) who underwent SP DP for complications of chronic pancreatitis (CP) from 01.01.2009 to 01.01.2024 have been analyzed. There were 14 men and 3 women. Age of patients: Me = 41 [38;45,5] years. The aetiology of CP was alcohol related in 14/82.4 % (95 % CI:73,1–99,7) of these patients.

Results. There were no fatal outcomes in the immediate postoperative period. Postoperative complications were reported in 4 cases or 23.5 % (95 % CI:10,7–37,7): wound infection in 3 cases (17.6 (95 % CI:7,9–31,9)) and incomplete external pancreatic fistula in one patient (5.9 (95 % CI:2,7–12,0)). It is advisable to perform SP DP in cases where the inflammatory process is limited by tail of the pancreas, and the expansion of the main pancreatic duct is no more than 5 mm, even in cases of the “disconnected of the main pancreatic duct”. The results of the “quality-of-life” assessment obtained in the follow-up group on the eve of surgery and 12 months after SP DP (W-test, p < 0.01) confirm the feasibility of performing it in the presence of complications of CP in the distal part of the pancreas. The assessment of the relationship between the method of surgical intervention and the probability of the occurrence of “T3cDM” after SP DP made it possible to establish the presence of a mean relationship (C = 0.582).

Conclusions. Despite the relatively high incidence of postoperative complications (23.5 % (95 % CI:10.7–37.7)), SP DP is advisable to perform in cases, where the inflammatory process is separated by the tail of the pancreas. The probability of postoperative diabetes “T3cDM” (C = 0.582) is medium after SP DP.

Sepsis is a serious global problem, resulting in significant healthcare costs. The World Health Organization recognizes sepsis as a priority.

The aim of this study was to identify predictors of sepsis caused by gram-positive and gram-negative bacteria based on a comparative analysis of clinical manifestations and laboratory parameters.

Materials. A retrospective analysis of clinical data and laboratory parameters was conducted for 96 patients with sepsis treated at the Minsk City Children's Infectious Diseases Clinical Hospital from 2009 to 2023. To conduct a comparative analysis, patients were divided into groups based on the pathogen: Group 1 – 53 patients with sepsis caused by gram-positive bacteria, and Group 2–43 patients with sepsis caused by gram-negative bacteria.

Results. Septic shock developed in approximately half of the patients in both groups (47.2 % and 58.1 %, respectively), the median time from the onset of the first symptoms to the development of sepsis was 4 days (2–5) in Group 1 and 8 days (3–28) in Group 2 (p < 0.01), organ failure assessment using the Pelod, pSofa, Phoenix, and Prism scales revealed a trend toward higher scores in Group 2 (sepsis caused by Gram-negative bacteria).

Conclusion. According to the analysis, it was established that patients in Group 2 had a more severe course (according to clinical and laboratory data) and more often an unfavorable outcome.

Endoscopic rhinosinus surgery is a modern, minimally invasive technique. The primary focus is on the practical advantages of this method, which directly impact treatment outcomes and patient quality of life. It has been demonstrated that ERCS, as a minimally invasive technique, minimizes surgical trauma, leading to rapid recovery and reduced downtime. The use of endoscopic technology provides the surgeon with excellent visualization, increasing the radicality and safety of the intervention. The study also highlights the comprehensive positive impact of ERCS on the healthcare system, resulting in a reduced complication rate and resource savings due to shorter hospital stays. The study results confirm that ERCS represents not only technical progress but also a significant advance in the quality of medical care.

Research Objective. To evaluate the proportion and trends of endoscopic surgeries in rhinosinus surgery at the hospital, comparing them to open interventions during two periods: 2017–2019 and 2023–2024 (pre- and post-COVID).

Materials and Methods. A retrospective analysis of medical records (patient histories, surgical logs) was conducted for the specified periods. The 2020–2022 period was excluded due to pandemic restrictions that distorted statistics. The study focused on surgeries on the maxillary, ethmoid, and sphenoid sinuses. Frontal sinus surgeries were not studied due to the technical inability to perform them endoscopically.

Conclusion. A clear annual upward trend in endoscopic surgeries is observed, driven by shorter hospitalization periods, reduced costs, improved visualization, and effectiveness in training medical personnel.

Introduction. So far, there is no consensus in the medical community regarding the optimal method of postoperative tamponade of the auditory canal. Key aspects remain controversial: the shape and material of the tampon, the duration of tamponade, as well as the tamponage technique depending on the type of surgery performed. As a result, there is no unified approach to this procedure. Purpose. To conduct a comparative analysis of the use of a cellulose tampon in patients after surgical interventions on the middle ear based on the data of a microbiological study.

Objects and methods. The article presents the results of a comparative analysis of microbiological studies in patients who underwent middle ear surgery and who received cellulose and medical gauze tampons during the postoperative period.

Results. According to the microbiological analysis, in the postoperative period, in patients who underwent surgery on the middle ear using a cellulose tampon, the composition of the microflora was practically the same as in patients who used a gauze tampon. No statistically significant differences in microbiological indicators were found between the main and control groups.

Conclusion. Our study did not reveal any dependence of the species composition of the microflora on the tamponade material, which allows us to consider cellulose as a promising material for the development of ear tampons and their subsequent introduction into clinical practice.

The article presents the results of a multicenter open comparative controlled cohort study, which included 120 pregnant women with moderate preeclampsia and 40 pregnant women with a physiological pregnancy who were treated and delivered by cesarean section in “5th City Clinical Hospital”, “6th City Clinical Hospital” in Minsk for the period 2010–2024. The aim of the study was to study the clinical and pathogenetic features of pregnancy with moderate preeclampsia. The results were obtained: preeclampsia in pregnant women leads to an increase not only in weight gain (p = 0.0123), but also in hospital stay (p = 0.0000), according to ultrasound data, disorders such as fetoplacental blood flow disorders were more common (I–III) and fetal growth retardation, a combination of pathology (p = 0.0142), as well as a a decrease in the average concentration of hemoglobin in red blood cells (MCH) of 29.1 [24.1; 35.8] pg was detected, while the average volume of red blood cells (MCV) was 87 [75.5; 142.2] fl), an increase in cortisol to 1021.23 [927.85; 1205.30] ng/ml (p = 0.0128) and the severity of endogenous intoxication as in the mother (the MWM was statistically 80.7 % higher than compared with a physiologically occurring pregnancy and amounted to 0.47 [0.46; 0.55] conl. opt. pl., p = 0.0146, and in a newborn (the MWM in umbilical cord blood was significantly higher by 100 % compared with a physiologically occurring pregnancy and amounted to 0.46 [0.46; 0.52] conl. opt. pl., p = 0.0231). A glycemic level of more than 4.31 mmol/l (AUC = 0.689, p < 0.01, Sensitivity 84.6, Specificity 50.0) was determined as a predictor of the development of preeclampsia.

The article presents the theoretical foundations of conducting medical and biological research, including the most important issues of their planning related to testing statistical hypotheses. The classification of statistical hypotheses, statistical criteria and stages of testing hypotheses based on the assessment of statistical criteria are described. The characteristics of type 1 and type 2 errors, statistical power, and statistical criteria that can be used to test hypotheses about the data distribution laws are given. It is shown that the choice of a statistical criterion for testing a statistical hypothesis depends on the purpose and objectives of the study, design, type of variable and data distribution, the number of sample populations and the number of observations in them, the power of the statistical criterion itself, which allows identifying differences or rejecting the null hypothesis.

The aim of this article is to attempt to demonstrate the need for testing statistical hypotheses at various stages of biomedical research used in evidence-based medicine. The importance of determining the optimal number of observations of the study group at the stage of research planning is shown, taking into account statistical power and errors of the 1st and 2nd types, ensuring the validity of the results of hypothesis testing. We hope that this article will help researchers to plan the study, correctly use statistical criteria for the analysis and interpretation of the obtained results based on the testing of the statistical hypothesis.

This article presents the rationale for the diagnosis of hyperemesis gravidarum, as well as the symptom of vomiting as a manifestation of many extragenital diseases. The materials reflect current understanding of the etiology of the disease. Particular attention is paid to an interdisciplinary approach to diagnosis and appropriate treatment. Hyperemesis gravidarum is a diagnosis of exclusion, the diagnosis of which requires a thorough anamnesis and laboratory and instrumental studies according to a clear algorithm. The clinical case presented in the article clearly demonstrates that vomiting during pregnancy can not only be an adaptive response to pregnancy but also a symptom of other diseases, in particular, tumors of the abdominal organs. The coordinated work of obstetricians and gynecologists in collaboration with specialists in related fields allowed the patient to receive timely qualified care.

This article examines the culture of verbal communication in medical practice. Particular attention is paid to the personal and professional qualities of physicians. The key components of a healthcare professional's communicative competence are described. The ability to establish effective communication with patients will enable physicians to address professional challenges.