Surgery plays a central role in the management of acquired valvular heart disease. Prosthetic valve thrombosis is a rare but serious life-threatening complication of valve replacement, most often encountered with mechanical prostheses. The risk of valve thrombosis depends on the type of prosthesis, the adequacy of anticoagulant therapy, the position of the valve and the presenceof prothrombotic conditions. Inadequate level of anticoagulation is the most important factor involved in the pathogenesis of prosthetic valve thrombosis. The severity of symptoms highly depends on the degree of valve obstruction caused by the prosthetic valve thrombosis. Multimodality imaging is crucial in the diagnosis and management of prosthetic heart valve thrombosis and also for differential diagnosis between thrombus and pannus. Optimization of anticoagulant therapy, thrombolysis and surgical intervention are the main methods of treatment of patients with valve thrombosis. Thrombolytic therapy has become an alternative to surgery in the treatment of obstructive prosthetic valve thrombosis in recent years. The use of low-dose slow or ultraslow intravenous infusion of tissue plasminogen activator under the control of transesophageal echocardiography leads to high efficiency of thrombolysis with a low level of complications and mortality. The efficacy and safety of thrombolysis compared to surgery should be confirmed with the results of large observational and randomized trials.

Reducing salt intake is an effective way to improve health and reduce the non-communicable diseases (NCDs) burden. The territorial level preventing diseases measures are implemented in the state preventive project «Healthy cities and towns» (project).

Objective: to estimate how effective reducing salt intake measures in residents of settlements participating in the project.

Materials and methods. The work was carried out within the initiative research «To develop an algorithm for assessing the effectiveness of the state preventive project». The data of sociological study of the prevalence of behavioral risk factors for NCDs are used. The study includes 18–69 years old respondents from 6 regional centers in 6 regions of the Republic of Belarus (n = 1608).

Results. 26.1 % of respondents always or often add salt or salty sauces before eating or directly with food, 44.8 % – use during cooking, 15.9 % consume a high salt foods. Such proportion decreases with age. 44.6 % of respondents are well aware about serious health problems possibility from high salt consumption (with women more often than men), 19.7 % pay attention to the salt content on the foods labels, 49.1 % try to limit high salt foods consumption, 25.3 % buy alternative low salt foods, 45.7 % use without salt spices, 37.4 % apply three or more measures to reduce salt intake.

Conclusion. The efficiency of reducing salt consumption measures to disseminate knowledge among the population was demonstrated. This allowed to identify reserve opportunities and target audiences for potential preventive effects.

Objective. To analyze data on the use of blood proteins, traditional cancer markers, in the diagnosis and prediction of disease recurrence in non–small cell lung cancer.

Results. The r eviews ummarizes literature data on the u se of tumor-associated b lood proteins CYFRA 21-1 (cytokeratin fragment 19), SCC (squamous cell carcinoma antigen), NSE (neuron-specific enolase), REA (cancer embryonic antigen), PKM2 (pyruvate kinase M2) and ProGRP (progastrin releasing peptide) as biomarkers for diagnosis and prognosis the return of the disease in non-small cell lung cancer.

Conclusions. Traditional cancer markers are not very effective in diagnosing and predicting the return of the disease in non-small cell lung cancer.

Calcaneal fractures are not uncommon injuries. The treatment is accompanied by significant difficulties. Complex shape of the calcaneus requires special radiologic projections (axial, Broden series) or CT for the evaluation of injury and pre-operative planning. Soft-tissues in the calcaneal region are vulnerable to the injury, so extreme oedema and fracture blisters can develop within few hours after the injury. This makes surgical treatment dangerous for several days (up to two weeks after the injury) until the condition of the soft-issues becomes normal. Non-operative treatment is accompanied by high rate of malunions with subsequent significant functional impairments, comparable to those after myocardial infarction. Surgical treatment with extended lateral approach provides possibility of restoration of calcaneal anatomy, but for the cost of the high rate of wound complications, which are difficult to treat. One of perspective directions is the use of minimal tarsal approach for direct reduction of the posterior articular facet and closed reduction of the extra-articular fragments. Current evidences are based on small number of cases, thus further investigations in this direction shall be performed.

Achalasia of the cardia is a neuromuscular disease of the esophagus. There are various surgical approaches for the treatment of achalasia of the cardia, which indicates the complexity and insufficient knowledge of this pathology. Currently, the «gold standard» of surgical treatment of achalasia of the cardia is Heller’s laparoscopic operation with incomplete Dor esophagofundoplication. However, this operation is not ideal for the treatment of achalasia of the cardia, due to the high level of postoperative complications and relapses of the disease. Our clinic has developed an original side-to-side stapler esophagofundostomy method for the treatment of achalasia of the cardia. This article provides a comparative analysis of Heller’s surgery and stapler esophagofundostomy. The proposed method successfully eliminates the symptoms of dysphagia in patients with achalasia cardia, and it also has an advantage over the Heller operation in reducing the incidence of intraoperative complications, in restoring the passage of food through the esophagus more effectively, and in improving the motility of the esophagus and eliminating the spasm of the lower esophageal sphincter. In the postoperative period after stapler esophagofundostomy, the likelihood of developing gastroesophageal reflux is higher, therefore, in our opinion, it should be combined with a more reliable anti-reflux barrier, for example, Nissen fundoplication. The indication for performing a side-to-side stapler esophagofundostomy, in our opinion, is achalasia of the cardia of stage III–IV according to Petrovsky’s classification, with the development of fibrous scarring of the cardia and esophagus, since during Heller’s operation, in this case, there is a certain risk of intraoperative perforation of the cardia and esophageal mucosa, with possible subsequent the development of serious complications.

The study analyzed the clinical, hormonal, and metabolic characteristics of women with infertility and polycystic ovary syndrome (PCOS) depending on body mass index (BMI) and waist-to-height ratio (WHtR). The mean age of participants was 29 years and did not differ significantly between groups, whereas body weight, BMI, and WHtR showed significant differences. In women with elevated BMI and clinical obesity (BMI ≥ 25 and WHtR ≥ 0.5), menarche occurred earlier, and menstrual cycles were characterized by oligomenorrhea, reflecting the impact of obesity on the hypothalamic-pituitary-ovarian axis. The frequency of primary infertility and spontaneous miscarriages did not differ significantly between groups. Endocrine evaluation revealed decreased SHBG levels and increased LH, free testosterone, and estradiol, indicating enhanced peripheral androgen aromatization and hyperandrogenism against the background of metabolic disturbances. Women with obesity also showed a trend toward lower AMH levels, suggesting the influence of insulin resistance on ovarian reserve. Endometrial changes, including glandular polyps and signs of chronic endometritis, were more common in subgroups with obesity. Leptin levels were elevated in women with clinical obesity, confirming the presence of leptin resistance, which negatively affects oocyte quality, implantation, and outcomes of assisted reproductive technologies. These findings indicate that metabolic factors, including obesity and leptin resistance, play a key role in the pathogenesis of reproductive dysfunction in PCOS and are associated with hormonal disturbances and an increased risk of endometrial pathology.

Objective. To determine clinical and laboratory differences in women with threatened abortion and a history of spontaneous abortion in order to identify the most significant factors associated with the development of recurrent miscarriage.

Materials and Methods. This prospective cohort study included 242 women with threatened miscarriage, divided into two groups based on their reproductive history. The «exposed» group consisted of 97 women with a history of spontaneous abortion and a history of recurrent miscarriage, while the «unexposed» group included 145 patients without a history of recurrent miscarriage. Patient complaints, medical history, general medical and gynecological examination data, and laboratory test results obtained on the day of hospitalization were assessed. Statistical processing of the final data was performed on a personal computer with the Windows 8.1 operating system using Microsoft Excel and the Statistica 10 statistical software package. The null hypothesis of the absence of statistically significant differences was rejected at p < 0.05.

Results. Clinical, demographic, and clinical anamnestic parameters of patients in the compared groups did not differ significantly (p > 0.05). However, women with a history of AS were twice as likely to be diagnosed with hypothyroidism compared to those without a history of AS (OR 2.0; 95 % CI 0.9–4.3; p = 0.073); however, the difference was not statistically significant. In both groups, women with the second A(II) blood group predominated: 43.3 % (24/97) in the «exposed» group, 43.5 % (63/145) in the «unexposed» group (p = 0.981; χ ² = 0.00). Three quarters of patients in both groups had a positive Rh factor status: 74.2 % (72/97) in the «exposed» group, 77.9 % (113/145) in the unexposed group (p = 0.505; χ ² = 0.44). A decrease in the ferritin level below 30 μg/l and an increase in prothrombin time to more than 12.5 sec turned out to be a significant factor for all patients with threatened abortion (UA). Urinalysis results did not differ significantly between the groups; bacteriuria was detected in 14.4 % (14/97) of patients in the exposed group and 18.6 % (27/145) in the unexposed group (p = 0.394; χ ² = 0.72). Analysis of microscopic examination data from urogenital secretions did not reveal statistically significant differences between the groups (p > 0.05).

Conclusion. Factors such as decreased ferritin levels and increased prothrombin time are associated with the risk of miscarriage. The likelihood of hypothyroidism in women with a history of miscarriage is twice as high as in women without a history of AS. When preparing for pregnancy, women who have experienced AS in the past should pay attention to ferritin levels and thyroid function, which will help reduce the incidence of UA, medical prevention of recurrent AS and, consequently, habitual miscarriage.

To identify early forms of dysphonia, an integrated approach is required, considering anamnestic data, existing risk factors for vocal disorders, functional and acoustic studies, as well as assessing the significance of the effect of a particular symptom or sign on the patient’s vocal function. Despite its long history, acoustic voice analysis is currently a relatively new but dynamically developing area of clinical research in patients with impaired vocal function. Now, there is no research base and normative indicators of acoustic voice analysis in children of the Belarusian population. The purpose of this study is to develop a mathematical voice model that will form the basis of a national program for acoustic analysis of children’s voices. During the research, a national program on acoustic voice analysis with biofeedback in children was developed.

The aim of the study was to determine the effect of mometasone, nortriptyline, and a combination of these agents on the proportion of Th (CD4+) lymphocyte isolated from the blood of patients with allergic rhinitis that contained the proinflammatory cytokines IFN-γ, IL-4, and IL-17A.

Methods. The study included six subjects with allergic rhinitis aged 18–19 years. Blood mononuclear cells were isolated by centrifugation and incubated in the presence of mometasone, nortriptyline, or a combination of these agents. Recombinant proteins were then addedto stimulate immune responses of types 1, 2, or 17. After 3 days of culture, the percentage of CD4+ cells containing IL-4, IL-17A, and IFN-γ was determined by flow cytometry.

Results. According to data obtained, mometasone effectively suppresses the intracellular expression of proinflammatory cytokines IFN-γ, IL-4, and IL-17A induced by immune responses of types 1, 2, and 17. Nortriptyline, acting on the same cells under stimulated type 1, type 2 or type 17 of immune responses, reduces the proportion of cells expressing IL-4 and IL-17A, and IFN-γ (the latter only under stimulated type 17 of immune response). The combination of mometasone and nortriptyline further suppresses the expression of IL-4 by CD4+ cells in all the studied immune responses, IL-17A – under activation types 2 and 17 of immune response, and IFN-γ – in type 1, compared to mometasone alone.

Conclusion. The results of the study demonstrate the ability of nortriptyline to enhance the effect of glucocorticosteroids in suppressing the immune response of CD4+ lymphocytes in patients with allergic rhinitis.

Mandibular cortical plate thickness is frequently cited as a factor limiting the efficacy of pulpal infiltration anesthesia. It is generally assumed that cortical thickness increases with more distal tooth positioning and advancing age in children; however, this assumption requires empirical validation.

Objective. To evaluate the buccal cortical plate thickness at the level of the distal root apex of the first and second primary molars in children aged 5, 6, 7, 8, 9, and 10 years using archived cone-beam computed tomography (CBCT) scans.

Materials and Methods. Archived CBCT scans of 81 children, divided into six age groups, were analyzed. Measurements were performed on 123 first and 152 second primary molars. Statistical analysis was conducted using non-parametric (Mann-Whitney U test, Spearman’s rank correlation) and parametric (Student’s t-test) methods.

Results. Cortical thickness values ranged from 1.3 mm to 2.10 mm (Mean ± SD = 1.85 ± 0.09 mm. No statistically significant differences were observed between the first and second primary molars in any age group. Notably, cortical thickness significantly decreased between the ages of 5 and 10 years in the regions of both the first (r = –0.74; p < 0.01) and second (r = –0.73; p < 0.01) molars.

Conclusions. According to CBCT data, the buccal cortical plate thickness at the root apices of the first and second primary molars does not differ significantly between children of the same age. Furthermore, this thickness decreases significantly in children during the period from 5 to 10 years of age.

Septic shock is a form of sepsis with a significantly increased mortality rate due to serious circulatory and/or cellular metabolism disorders. The WHO estimates that there are about 24 million cases of septic shock worldwide each year. Special attention should be paid to the problem of septic shock in children, the prevalence of which, according to current research, varies from 2.2 % to 15.4 %.

Objective: to predict the development of septic shock in children based on a comprehensive assessment of laboratory predictors.

Materials and methods: two groups of patients were formed – the standard risk group (n = 109, sepsis proceeded without septic shock) and the threatened risk group (n = 72, shock developed on days 1–3 after admission of patients to the hospital).

Results. During the analysis, it was found that the indicators associated with the development of septic shock are: lactate (OR 2.4; 95 % CI 1.2–5; p = 0.02), APTT (OR 4.3; 95 % CI 1.4–16; p = 0.017), urea (OR 2.3; 95 % CI 1.1–4.7; p = 0.026) and protein (OR 1.3; 95 % CI 0.6–3; p = 0.475), on the basis of which a model was developed to determine the likelihood of developing septic shock.

Conclusion. The presented model, which includes 4 laboratory indicators, is available for execution and is easy to use.

Objective. To identify and analyze the factors influencing the development of the longterm course of COVID in children and adolescents.

Materials and methods. The study was performed in the period 2023–2025 retrospectively by random selection based on medical records of 278 children and adolescents aged 8–17 years who were hospitalized in 2022 at the «Minsk City Children's Infectious Diseases Clinical Hospital» with a diagnosis of coronavirus infection. The influence of various factors on the development of postcovid syndrome in children and adolescents was studied in the context of demographic characteristics (gender and age), duration of hospitalization, concomitant chronic somatic diseases and symptoms present during the acute period of coronavirus infection.

Results. The development of postcovid syndrome was found in 18.7 % of children after acute COVID infection, which is slightly lower than the available international data. These results may be related both to the peculiarities of the genotype of the virus that dominated the territory of the Republic of Belarus, and to the peculiarities of the individual immune reactivity of the country's child population. The predominant manifestation of postcovid disorders was asthenic syndrome, which occurred in the framework of postcovid disorders in 100 % of cases. In 86.7 %, it was moderate in severity, and the most common neurological complaint was headaches (100 % of children with postcovoid syndrome). Significant risk factors for developing postcovid syndrome in children and adolescents are hyperthermia in the acute period of the disease (90.4 % of cases, p < 0.05), respiratory diseases (25 % of cases, p < 0.05). The age and gender of the patient, the duration of hospitalization in the acute period, diseases of the circulatory system, congenital malformations and minor abnormalities of the heart, skin and subcutaneous tissue diseases, digestive diseases, diseases of the endocrine system, eating disorders and metabolic disorders have no significant effect on the development of postcovoid syndrome. Diseases of the nervous system (headaches, disorders of the autonomic nervous system) in the anamnesis of children included in the study were very rare and did not have an aggravating effect on the course of the COVID-19 recovery period. Pathology of the acute period: the cough, sore throat, runny nose, difficulty breathing; weakness, dizziness, loss of consciousness; decreased appetite, diarrhea, abdominal pain, vomiting also did not affect the development of postcovoid syndrome in children.

Conclusion. The data obtained are important in developing a strategy for monitoring children at risk for the development of long-term postcovoid syndrome in order to minimize possible consequences and the possibility of prescribing early medical rehabilitation.

Frontal sinus fractures (5–15 % of maxillofacial injuries) pose significant clinical challenges due to risks of cosmetic defects, functional impairment, and complications like post-traumatic sinusitis. This study presents a minimally invasive surgical technique for depressed comminuted fractures using external fragment immobilization.

Methods: 3 6 p atients (aged 1 6–27) w ith 7–10mm d isplaced f ractures u nderwent C T with 3D reconstruction. Surgical treatment involved percutaneous reduction using Limberg’s hook through a 1.5–3mm incision, followed by fixation with a perforated titanium plate removed on day 5.

Results. All cases showed excellent anatomical restoration and sinus function. Latepresentation cases (17–56 days post-injury) required more extensive reduction but achieved comparable outcomes. Bacterial growth was detected in 62.5 % of cases, with 3rd-gen cephalosporins proving most effective.

Conclusions. The developed method combines minimal invasiveness, precise repositioning of fragments and reliable fixation, which ensures a good cosmetic and functional result. The optimal time for intervention is up to 5–6 days after injury.

Introduction. Superior mesenteric artery syndrome develops due to compression of the horizontal branch of the duodenum by the superior mesenteric artery and leads to chronic duodenal obstruction.

Objective. The aim of the study was to analyze the patient’s own observations of diagnosis and treatment of superior mesenteric artery syndrome.

Materials and Methods. The results of laboratory and instrumental studies, as well as clinical observation of the patient before and after treatment for superior mesenteric artery syndrome, are presented. Laparoscopic side-to-side duodenojejunostomy was performed as the surgical treatment.

Results. Successful surgical treatment resulted in the disappearance of disease symptoms, as confirmed by objective examination and instrumental examination.  Discussion. It is important to be aware of the existence of rare pathologies such as superior mesenteric artery syndrome and to utilize modern, more effective diagnostic methods. If conservative treatment methods are not indicated or have been exhausted, and satisfactory treatment results are not achieved, surgical methods of treating the syndrome should be used.

Conclusions. The most commonly used surgical treatment method for superior mesenteric artery syndrome is currently the creation of a duodenojejunostomy, which is associated with good results. Moreover, the laparoscopic method of creating anastomosis is considered the «gold standard» for this pathology, good results of which were observed during the study presented in the article.

Chronic polypous rhinosinusitis is a common heterogeneous disease characterized by chronic inflammation of the nasal and paranasal mucosa with mucosal remodeling and the formation of recurrent polyps. Given the unfavorable course of this pathology, the reduced quality of life of patients, and the short-term effectiveness of conservative and surgical treatment, this topic remains relevant both among practicing physicians and in scientific research. The study of this rhinosinusitis distinguishes phenotypic, endotypic, and genotypic characteristics. The endotypic division of polyps has led to the development of the theory of T2-mediated inflammation, which in turn has shaped a new approach to treating patients with monoclonal antibodies.

Objective: t o e valuate t he e ffectiveness o f t herapy w ith D upilumab i n t he t reatment of chronic polypous rhinosinusitis.

Study objects and methods. An analysis of the medical records of patients diagnosed with chronic polypous rhinosinusitis who received Dupilumab injections for 6 months was conducted. Treatment progress was monitored using laboratory and instrumental testing results. Statistical data processing was performed using an online service for creating feedback forms, using Microsoft Excel analysis. Comparative analysis was performed using the Student’s t-test.

Results. At the time of the first visit of patients, the average Ig E value was 395.05 ± 68.9 IU with a norm of 0–86 IU; the absolute number of eosinophils was 0.6* 10^9/L ± 0.1 with a norm of 0.02–0.5, the relative number of eosinophils was 16.63 % ± 2.2 with a norm of 0.5–5.0. At the time of the last injection, the Ig E indicators were 99.49 ± 14.3 IU, the absolute number of eosinophils was 0.89*10^9/L ± 0.42, the relative number of eosinophils was 11.88 ± 5.8 %. During the analysis of the endoscopic examination, a decrease in the volume of polyps in the nasal cavity was noted, and patients reported an improvement in nasal breathing and sense of smell. According to the MSCT data of the paranasal sinuses, before treatment, all patients had total or subtotal darkening of the paranasal sinuses, obstruction of the middle nasal passages, however, at the time of the last injection after 6 months of therapy, the sinuses became more pneumatized, and partial or complete release of the nasal passages from polypous tissue was also noted.

Conclusion. Biological therapy is a promising treatment option for patients with chronic polypous rhinosinusitis induced by T2-type inflammation. However, it should be noted that effective treatment requires patient compliance, given the long duration of biological therapy.

Aim/Objective. To assess the usefulness of the individual diagnostic approach and the results of endoscopic or surgical treatment of inflammatory fibroid polyps (IFP / Vanek’s tumor), that are rare in the emergency abdominal surgery.

Materials and methods (2 сases report). We analyzed the results of the diagnostic and surgical treatment two patients with complications of Vanek's tumor, who have been treated at the 10th City Clinical Hospital in 2025 and at the City Clinical Hospital of Emergency Care in Minsk in 2022.

Results. In our clinical observations, we have been analyzed two cases of Vanek’s tumor different localization and complications, which fully represent the difficulties in the diagnostic and treatment these patients. The results of the diagnostics and treatment were described, which relate to own sightings of the complications of Vanek’s tumor: antral gastric IFP with recurrences of bleeding and duodenal obstruction. In the second report: the distal ileum with ileocecal intussusception. Our results highlight the effectiveness of the endoscopic treatment, especially in the localization of IFP in the stomach, and need performed laparotomy in cases of the small intestine tumors. The prognosis after complete removal of IFP is very good, since only one case of recurrence after endoscopic removal of IFT of cardia of the stomach was described in more than 1000 cases in adults.

Conclusions. Diagnostic approaches weren’t differed from generally accepted in the emergency surgery for gastrointestinal bleeding or intestinal obstruction. Endoscopic or surgical management are the methods of choice for treatment complications caused by Vanech’s tumor localized in the stomach or small intestine.

Medical science is fundamentally characterized by an ethically determined methodology, a necessity arising from its unique object of study – the human being. This ethical foundation, reflecting the philosophical synthesis of empiricism and theory, is institutionally realized in international Good Clinical Practice (GCP) guidelines. These standards, a response to historical ethical failures and tragedies like the thalidomide disaster, prioritize participant rights, safety, and well-being over scientific objectives, while ensuring data reliability for regulatory approval. The cornerstone of GCP is informed consent, a formal process confirming voluntary and understanding participation.

Evidence-based medicine (EBM) is built upon a hierarchy of study designs, with the randomized controlled trial (RCT) remaining the «gold standard» for establishing causal inference due to its high internal validity. This validity is achieved via key methodological safeguards: randomization (mitigating selection bias), blinding (preventing expectation bias), and statistically powered sampling. A central challenge lies in balancing this internal validity with external generalizability–often necessitating pragmatic trial designs to ensure real-world relevance.

The 21st-century methodological landscape is now significantly expanded by real-world data and evidence (RWD/RWE), derived from sources like electronic health records and patient registries. While not supplanting controlled trials, RWD/RWE plays an increasingly critical role in post-marketing surveillance, orphan drug development, and expanding therapeutic indications. This creates a dynamic ecosystem of complementary research approaches, from RCTs to observational studies. Successfully navigating this ecosystem requires researchers to exercise sophisticated scientific and practical judgment to integrate evidence across methodologies.

In conclusion, modern clinical research methodology represents a deliberate synthesis of scientific philosophy, rigorous procedural standards (GCP and statistics), and uncompromising ethics. This integrated framework is designed to generate robust, actionable knowledge for improving human health.

This paper presents classic recommendations for preparing scientific multimedia presentations. The author summarizes «common knowledge» on the topic and offers brief recommendations for young researchers ranging from principles to rules for working on each element of a multimedia presentation. There are several reasons why it makes sense for a young researcher to learn how to prepare multimedia presentation manually. First, intellectual products created by neural networks are still far from perfect. Before delegating these duties to artificial intelligence, one should master the algorithm for evaluating its performance. Second, using neural networks to create scientific presentations does not contribute to young scientists» cognitive potential development. The content of this paper can serve a working tool to those who want to learn how to create multimedia scientific presentations manually.

The article explores the dangerous trend of medical dehumanization. There is a growing tendency to view the patient as a purely biological organism, neglecting their spiritual dimension. Understanding the prevailing situation largely revolves around social assessments, while a fundamental reason lies in the realm of worldview, subsequently «sprouting» into social relationships – the dehumanization of medical education. A significant factor in the decline of the status of humanitarian knowledge in the modern medical education environment is the clash between two scientific methodological paradigms: reductionism and holism. Modern biology and medicine are saturated with reductionist ideas, which are absorbed from the very first courses in medicalschool. As a result, the ideal physician, armed with the philosophy of reductionism, is a biotechnologist, where the human is viewed as a biomechanical machine, illness as its malfunction, and treatment as repair. A reductionist doctor doesn't see the sick person; for them, all patients are merely complex physicochemical systems. The world of reductionism is devoid of life, lacking values, meanings, and purposes; it is merely a matter of nerve irritations and reflexes.

Professional medical knowledge is influenced by a rigid reductionism that reduces the «living» to the «non-living» at the level of atoms and molecules, whereas humanistic knowledge is permeated by ideas of holism and the irreducibility of human essence to physic-chemical reality. The foundation of humanitarian knowledge is a holistic worldview, where life and the human being are understood as primary and autonomous entities in existence. At the same time, the main thing is the phenomenon of values, which are understood as primary foundations, «humanitarian atoms» incapable of being reduced to anything else. The conflict between two worldviews is projected into the schism of core medical subjects and humanities, which serves as the methodological basis for the dehumanization of medical education. In the training of a physician, it is necessary to reconcile the types of rationality found in natural science and humanities knowledge.

The article explores potential solutions to the issue of dehumanization in medical education. It has been noted that technological progress has given rise to new ethical challenges related to the medicalization, commercialization and overdiagnosis in medicine. This highlights the growing importance of a physician’s humanitarian training. However, a trend towards reducing the teaching of humanities is observed in medical education. The discrepancy between the vast spiritual and moral potential of humanitarian knowledge and its presence as a general educational “appendage” to specialized medical subjects has been indicated. The crucial feature of humanitarian knowledge – its ability to reflect the uniqueness and individuality of each person – remains unaddressed. None of the natural sciences are capable of completing this task. It has been emphasized that no universally recognized system of medico-humanitarian education exists. The most common practice is the integration of a complex of humanities disciplines Medical Humanities into medical education (literary studies, philosophy, history, sociology, anthropology, religious studies, ethics, aesthetics, painting, theater and music). The goal is to complement the scientific and technological advancements in medicine with a deep human understanding, to help future physicians develop empathy, communication skills, curiosity and a drive for new knowledge. Medical Humanities is integrated into the academic programs of the majority of medical schools and university medical departments across the USA, Canada, Europe and Australia. Competencies gained from studying disciplines within Medical Humanities have been characterized. The integration of humanities into medical education will help address the challenge of training physicians with a stable value system, a necessary set of general cultural and professional knowledge, skills and abilities, enabling them to responsibly and effectively perform their professional duties.