An increase in the incidence of skin tumors and the subjectivity of visual examination and dermoscopy necessitate the application of machine learning technologies to introduce mass screening for this disease group in primary medical care. The article reviews current and promising artificial intelligence technologies for the diagnosis of skin neoplasms and highlights the challenges of their application.

Positioning of the glenoid component is one of the keys to successful shoulder arthroplasty. Severe glenoid deformity may compromise baseplate support during reverse shoulder arthroplasty and force excessive medialization if correction is attempted by reaming alone. This paper summarizes the rationale for glenoid bone grafting, presents a structured operative technique and reports early institutional experience. A narrative review of key publications on glenoid bone loss, bony increased-offset reverse shoulder arthroplasty, metallic augments and scapular notching was combined with a descriptive analysis of 5 operated patients. Based on the literature and clinical experience, indications for bone grafting are formulated, the key stages of preoperative planning and a step-by-step surgical technique are described. In the presented series, the mean age was 69.6 years; patient-specific instrumentation was used in 3 cases. Mean operative time was 142 minutes and follow-up ranged from 6 to 18 months.

Graft remodeling and good functional results according to the Constant-Murley score were observed in all cases. Conclusion. Glenoid bone grafting in in reverse shoulder arthroplasty is not a routine substitute for eccentric reaming or metallic augmentation. It is most useful when bone stock restoration and biological lateralization are required, provided that stable fixation and graft-host bone contact can be achieved.

Background. Endothelial injury is one of the key factors contributing to thrombosis, intimal hyperplasia, and restenosis after vascular interventions. The Er:YAG laser equipped with a spatially modulated ablation (SMA) handpiece is used to stimulate soft-tissue repair; however, its effect on arterial wall healing after mechanical injury has not previously been investigated.

Objective. This study aimed to evaluate the morphological features of vascular wall repair and endothelial layer restoration after mechanical injury to the rabbit femoral artery following transadventitial Er:YAG laser irradiation delivered via an SMA handpiece.

Materials and Methods. The experiment was performed in 42 rabbits; 84 femoral artery segments were examined. Two injury models were used: compression injury and arteriotomy followed by vascular suturing. Laser irradiation was applied from the adventitial side using the following parameters: wavelength 2940 nm, pulse duration 0,3 ms, fluence 2.1 J/cm², SMA handpiece. Morphological assessment was performed on days 3, 14, 30, and 60.

Results. On day 3 after mechanical injury, endothelial denudation, focal intimal and medial injury, and inflammatory infiltration were observed. Isolated SMA exposure of intact arteries was not associated with morphologically detectable damage to the vascular wall. By day 14, the lasertreated groups demonstrated earlier restoration of a continuous endothelial layer: in 80 % of segments after compression injury and in 100 % of segments after suture injury, without signs of thrombosis. In the control groups, inflammatory changes and luminal obliteration by organizing thrombotic material persisted. At later time points after SMA exposure, remodeling was predominantly limited to the intima, whereas in the control groups hyperplasia extended into the medial layer.

Conclusion. Transadventitial Er:YAG-SMA exposure after mechanical arterial injury was associated with earlier re-endothelialization, absence of thrombosis in the suture injury model, and less pronounced pathological remodeling of the vascular wall. These findings support further preclinical evaluation of this technology as a local method for modulating vascular repair.

A sore throat, whether as the sole symptom or in combination with other symptoms of acute respiratory infections, is the most common reason for consulting general practitioners, paediatricians and ENT specialists. A sore throat lasting longer than 14 days is classified as chronic and, in most cases, is the result of a chronic inflammatory condition of the throat: pharyngitis or tonsillitis.

A healthy throat microbiota acts as a barrier against pathogens and is essential for maintaining respiratory health. When the respiratory microbiome becomes unbalanced, dysbiosis develops.

Determining whether pharyngeal dysbiosis is a risk factor for recurrence or chronicity of the pathological process is of social and economic interest. The aim of this review article is to analyse the role of pharyngeal dysbiosis in the development of chronic pharyngitis and/or chronic tonsillitis. To examine the results of scientific research on pharyngeal dysbiosis, we used the scientometric databases PubMed, Scopus, Web of Science, and e-Library. The keywords used to search for the necessary information were: «pharyngeal microbiome», «pharyngeal dysbiosis», «chronic pharyngitis» and «chronic tonsillitis.» All articles reviewed were published between 2020 and 2025.

An analysis of the literature has shown that chronic inflammatory diseases of the pharynx are caused not only by pathogens, but also by a complex balance between them, the commensal microbiota and the immune response. Findings from studies of the oropharyngeal microbiome highlight the importance of adopting comprehensive, patient-centred strategies for diagnosis, treatment and medical prevention – specifically, the modulation of the oropharyngeal microbiome – which represents a promising avenue of research given the growing global problem of antibiotic resistance.

We believe that a deeper fundamental understanding of the composition of the pharyngeal microbiome and its complex bacterial communities will shed light on why some people develop chronic pharyngeal conditions whilst others do not.

Definitions:

microbiota is the composition of all microorganisms in a particular area;

microbiome is the collection of microorganisms, their genes and environmental factors in a particular area;

dysbiosis is an imbalance of pathogenic and beneficial bacteria.

Cognitive impairments in schizophrenia spectrum disorders are a central and often defining element in the structure of schizophrenia spectrum disorders, directly affecting patients’ ability to social and professional functioning. The purpose of this work was a comprehensive analysis of current scientific ideas about the nature, diagnosis and correction of cognitive deficit within the framework of schizophrenia spectrum disorders. This study is based on a theoretical analysis of domestic and foreign publications, including systematic reviews, meta-analyses and clinical guidelines for the period 2012–2025. The results show that cognitive impairments are highly prevalent (75–85 % of patients) and significantly heterogeneous. To date, four main cognitive subtypes have been identified: those with global cognitive deficits (25–30 %), those with isolated executive dysfunction (25–35 %), those with reduced information processing speed (20–30 %), and those with minimal cognitive impairments (15–25 %). The MATRICS Consensus Cognitive Battery (MCCB) is commonly used as a “gold standard” for objectively assessing cognitive impairment in schizophrenia spectrum disorders. Among the treatment methods, cognitive remediation has the most proven effectiveness, demonstrating a consistent, albeit moderate, positive impact. In conclusion, this article emphasizes the need to transition to personalized rehabilitation strategies that integrate the traditions of Russian pathopsychology with modern international diagnostic and therapeutic standards.

The article presents a systematic analysis of the gender characteristics of mental disorders in women. The role of hormonal factors (estrogens, progesterone, cortisol) in the pathogenesis of affective, anxiety, eating and other disorders is considered. The psychological features of the female response are described – rumination, codependency, and a tendency to internalize emotions. The critical periods of the female reproductive cycle (premenstrual syndrome, perinatal period, menopause) are analyzed, in which the risk of manifestation or decompensation of mental disorders increases significantly. The necessity of gender-oriented approaches in psychiatric practice is substantiated.

Objective. To analyze data on the use of inflammatory response and cell adhesion biomarkers in the diagnosis and prognosis of disease recurrence in non-small cell lung cancer.

Results. This review analyzes data on the use of blood cells, the cytokines (CXCL5 and CXCL8), their receptors (CXCR1 and CXCR2), the cell adhesion receptor (CD44v6), and C-reactive protein as diagnostic and prognostic biomarkers of disease recurrence in non-small cell lung cancer. The potential of this approach and its limitations are demonstrated.

Conclusions. To improve the diagnosis and prognosis of relapse-free survival in non-small cell lung cancer, a comprehensive determination of cytokines, their receptors – participants in the body's inflammatory response to a developing tumor, and the CD44v6 receptor, selected on the basis of multiple regression analysis, is promising.

Purpose To evaluate the feasibility of ultrasound for determining muscle mass and diagnosing sarcopenia in working-age patients with arterial hypertension (AH) and obesity.

Materials and Methods. A cross-sectional (comparative) single-center study was conducted, including 160 patients (96 men and 64 women) with stage I–II AH and obesity, aged 30 to 64 years. The average age of the study participants was 47.8 ± 7.99 years. All patients underwent anthropometric measurements, assessment of skeletal muscle strength and function, and dual-energy X-ray absorptiometry (DXA) using a Lunar Prodigy GE (core Version 18.0, USA). Ultrasound examination of the rectus femoris, vastus intermedius, and subcutaneous fat was performed using an EPIQ expert-class ultrasound system manufactured by Philips Ultrasound Inc. (USA). Statistical analysis of the obtained data was performed using SPSS 27.0 (IBM, USA) and Statistica (version 10.0, StatSoft, Inc., USA). Results were interpreted as reliable, and differences between parameters were considered significant at p < 0.05.

Results. An inverse correlation was found between subcutaneous fat thickness and muscle mass and strength. Conversely, rectus femoris thickness was directly related to these parameters. The greater the subcutaneous fat thickness, the more pronounced the muscle dysfunction (the patient required more time to complete the 5-times chair stand and 4-meter walk tests). Conversely, the greater the thickness of the right rectus femoris and vastus intermedius muscles, the less time the patient required to complete these tests. AUROCs for US parameters of the thigh soft tissue, specifically subcutaneous fat thickness and right rectus femoris thickness, for identifying reduced skeletal muscle mass (according to the appendicular skeletal muscle mass to body weight ratio, DXA) in patients with obesity and hypertension were 0.752 (0.639–0.864)/0.604 (0.487–0.720) and 0.628 (0.490–0.766)/ 0.669 (0.525–0.812) in men and women, respectively. The AUROC for the total thickness of the rectus femoris and vastus intermedius muscles according to US data in determining sarcopenia was 0.633 (95 % CI: 0.532–0.733).

Conclusion. Ultrasound assessment of the thigh soft tissue (subcutaneous fat and muscle thickness) is a promising method for screening for sarcopenia in patients with AH and obesity. Verification of muscle loss using ultrasound imaging of the thigh muscles in this patient population can be used as an alternative to DXA for detecting sarcopenia in its early stages.

An experimental evaluation of cellular and tissue responses was conducted following implantation of a commercial hernia repair mesh prosthesis and its modification with a developed biodegradable coating.

Twenty-four Wistar rats participated in the experiment. The animals were sacrificed on days 7, 14, 30, and 60 postoperatively. Modification of the polypropylene mesh prosthesis with a biodegradable coating based on a polyvinyl chitosan complex with gentamicin resulted in a more favorable tissue response compared to the commercial prosthesis without a coating.

The degree of maturity of the capsule around the implant was higher in the experimental group at all observation periods. On the 7th day of the experiment, maturing granulation tissue was detected in animals in both the control and experimental groups. Collagen fibers along the periphery of the implant formed capsule-like structures. The number of macrophages was statistically significantly lower in the experimental group (p < 0.001). A higher number of fibroblasts was detected in the experimental group (p = 0.026). On the 14th day, a statistically significant decrease in the number of neutrophils (p = 0.002) and lymphocytes (p < 0.001), as well as plasma cells (p < 0.001) was observed in the experimental group, indicating a more rapid resolution of inflammation and a reduced humoral immune response. On days 14–30, a significantly higher number of fibrocytes (p < 0.001) and fibroblasts was observed, contributing to the formation of mature connective tissue. By the 60th day, the inflammatory infiltrate was completely absent in the experimental group, while single lymphocytes, plasma cells, and giant multinucleated cells remained in the control group. The study revealed patterns of tissue formation in response to mesh implantation. A modified polypropylene prosthesis with a developed biodegradable coating demonstrated a lower degree of inflammatory response and promoted the formation of more mature connective tissue compared to uncoated samples.

Aim of the study is the functional recovery of the neuromuscular and vascular systems of the upper extremities in children with humeral shaft fractures after minimally invasive osteosynthesis with titanium rods and conservative treatment.

Material. An analysis of the functional state of the neuromuscular and vascular systems was conducted at various points in the recovery period in children (n = 20, average age 12,3 ± 2,5 years) with humeral shaft fractures treated with minimally invasive osteosynthesis using elastic rods (group 1, n = 10) and conservative osteosynthesis (group 2, n = 10). The control group consisted of 8 children of the same age without traumatological and orthopedic pathology.

Results. In all children with humeral shaft fractures, regardless of the treatment method, the most complete and intensive restoration of blood supply and motor function (by 4–6 months postoperatively) was observed in the muscles of the shoulder girdle (deltoideus, supraspinatus, and infraspinatus) on the fractured side. The functional state of the injured shoulder muscles (biceps brachii, triceps brachii) and the corresponding peripheral nerves (n. radialis, n. musculocutaneus) was restored later: no earlier than 9 and 12 months in both groups. Quantitative assessment of neuromuscular and vascular function at these time points indicated more complete recovery in patients in group I compared to patients in group II.

The use of neurophysiological and Dopplerographic research methods in children with fractures of the humeral diaphysis made it possible to determine the physiological mechanisms of restoration of neuromuscular and vascular functions in the process of reparative osteogenesis after minimally invasive surgical and conservative treatment, which allowed for timely correction of the rehabilitation plan aimed at restoring motor activity of the injured limb.

Mastoid obliteration after middle ear surgery is a promising rehabilitation method for patients with chronic atticoantral otitis media, which can avoid the disadvantages of both canal wall up and wall down techniques. In cases of autogenous tissue deficiency, especially during revision procedures, the use of allogeneic materials is relevant. At the Republican Scientific and Practical Center of Otolaryngology (Minsk), reconstructive middle ear surgery involving obliteration of the mastoid cavity and restoration of the posterior wall of the external auditory canal was performed in 30 patients with chronic atticoantral otitis media after canal wall down surgery using two types of bone allografts. Postoperative follow-up lasted 1 year, and a comprehensive assessment of the effectiveness of mastoid cavity obliteration was performed using the developed algorithm. The algorithm included an assessment of local status, functional indicators (tonal threshold audiometry, tympanometry, auditory tube patency test) and radiological data (computed tomography, magnetic resonance imaging). Good results of obliteration were observed in 22 (73,3 %) patients, with no rejection reactions during the observation period. The analysis did not reveal any statistically significant differences in the degree of cavity obliteration after 12 months between the groups of demineralised and non-demineralised bone grafts (p > 0.05).

Acute respiratory distress syndrome is one of the most current problems in modern medicine. Being an outcome of many different pathologies, ARDS affects patients of various ages, occupations, anamnesis and risk groups. The status of the most popular cause of ARDS manifestation is given to sepsis or septic shock, which are followed by generalized bacterial infections and bacterial pneumonia. This research displays the effect of bacterial lipopolysaccharide intrapulmonary admission in lab animals, hemostatic disorders in experimental ARDS, role of ribonucleases in respiratory tract pathology and the interconnection in between immune, hemostatic and enzymatic branches of homeostasis regulation. Increased expression of eosinophilic ribonucleases in lung tissue showed the connection between experimental ARDS and RNAse local activity. Serum ribonuclease activity showed a response to the release of proinflammatory cytokines aimed at correcting, among other things, hemostatic disorders. Thus, tissue ribonuclease expression and serum ribonuclease levels can serve as a criterion for assessing the intensity of immune responses in the context of respiratory diseases and also provide a rationale for the use of RNase-containing drugs for immunomodulation and the prevention of coagulation disorders.

Prevention of incorrect posture in modern conditions requires an integrated approach. The purpose of the study was to determine the prevalence and significance of socio-hygienic risk factors for the formation of scoliotic spinal deformity in organized children. The study involved 618 children aged 6–11 years studying in schools in Minsk, among which an analysis was made of the prevalence of ontogenetic and behavioral factors, factors of the educational environment and lifestyle, disorders of organs and body systems that affect the formation of incorrect posture among children of organized groups. To determine the significant factors analyzed, two study groups were formed: the main group (196 children with scoliosis) and the comparison group (422 children without scoliosis).

Among the studied risk factors, the most common are: the number of children in the family is more than two, the presence of chronic pathology in the mother before pregnancy, infectious history of (colds) disease, onset of teething earlier than 8 months and later than 12 months and permanent teeth earlier than 6 and later than 7 years, irrational work position or lack of control over it, insufficient frequency and duration of summer country rest, deficiency of daily physical activity, lack of outdoor exposure, irregular use of vitamin-mineral complexes, irrational organization of a sleeping place, the presence of violations of the eye and its accessory apparatus. The most important in the formation of scoliotic spinal deformity are: psycho-emotional stress, fatigue, material problems in the family, chronic fatigue in the child, irrational height of the bedside, frequent headaches, chronic diseases in the mother before pregnancy, chronic diseases in the father before the birth of the child, hereditary diseases in the history of parents, rickets in the child history. For all significant risk factors, their informativity and prognostic coefficients were calculated, on the basis of which a prognostic table for determining the likelihood of scoliosis formation was formed and a method for medical prevention of scoliosis in organized children was developed. Management decisions at the individual and collective levels among organized children aimed at preventing of scoliosis, preserving and strengthening the health of schoolchildren are justified.

Introduction. Inflammatory conditions affecting the anterior segment of the eye, including keratitis and posterior blepharitis, remain one of the most significant challenges in current ophthalmology due to their high prevalence, tendency to become chronic and recurrent, and the risk of causing permanent morphological and functional abnormalities.

Purpose. To investigate the therapeutic potential of 1 % low-molecular-weight sodium hyaluronate administered by injection in patients with inflammatory conditions affecting the anterior ocular surface.

Materials and methods. A total of 40 patients (55 eyes) with acute anterior segment inflammation were included. The cohort comprised individuals with combined keratitis and posterior blepharitis, as well as patients with isolated posterior blepharitis accompanied by evaporative dry eye. All participants received conventional anti-inflammatory therapy. In selected cases, treatment was supplemented with topical hyaluronate followed by subconjunctival and subcutaneous administration after reduction of acute inflammation. Clinical evaluation included assessment of corneal epithelial integrity, eyelid and meibomian gland function, and tear film characteristics over a 30-day observation period.

Results. The addition of low-molecular-weight sodium hyaluronate contributed to more rapid epithelial recovery and earlier resolution of inflammatory signs. Improvement in meibomian gland performance was associated with better tear film stability and normalization of its lipid component. In patients with advanced gland dysfunction, recovery was less pronounced and required repeated interventions.

Conclusion. The findings indicate that injectable sodium hyaluronate may enhance regenerative processes and improve clinical outcomes in ocular surface inflammation. Its use can be considered as part of a comprehensive treatment strategy, with repeated courses justified in cases with persistent or recurrent dysfunction.

Purpose of the study. To analyze the clinical case of a patient with hiatal hernia in a short esophagus and to show the importance of preoperative esophageal length assessment in deciding surgical tactics and possible intraoperative risks and postoperative complications.

Material and methods. An analysis of the results of diagnostics and surgical treatment of a patient who was being treated in the surgical department of the 5th city clinical hospital in Minsk in 2025 and in 2026 was carried out.

Results and discussion. When performing laparoscopic interventions in patients with hiatus hernias with grade I esophageal shortening, it was almost always possible to lower the abdominal segment of the esophagus into the abdominal cavity. In case when grade II esophageal shortening took place, some technical difficulties occurred in the operation. When the esophagus being brought down into the abdominal cavity in the operation and the posterior cruroraphy, the position of the distal part of the esophagus could be changed with a length of 5–6 cm and the left dome of the diaphragm could be shifted upward, which can cause impaired functions of the cardiovascular and respiratory systems in the postoperative period.

Conclusion. A timely diagnosis of a short esophagus and adequate surgical treatment are the key to success in performing anti-reflux operations. When performing laparoscopic operations in patients with a short esophagus, the degree of shortening of the esophagus, the presence of inflammatory and sclerotic changes in the esophagus and paraesophageal zone, and the condition of nearby chest organs should be taken into account.

Aim. The aim of the study is to assess the incidence and risk factors of bacteremia in hospitalized patients with COVID-19 during different periods of the pandemic.

Methods. The study included 11203 patients diagnosed with COVID-19 who were hospitalize in Minsk City Clinical Infectious diseases Hospital, from 1 June 2021 to 30 June 2023. The incidence of bacteremia and risk factors associated with its development in conditions of competing risks were assessed using Cox cause-specific regression models. Statistical analysis was performed in R 4.3.4. Results. The study included 11203 patients, of whom 1496 patients had 2971 blood culture tests. The cumulative incidence of bacteremia was 0.86 % during the COVID-19 pandemic before the Omicron variants and 1.63 % during the period of prevalence of SARS-CoV-2 Omicron variants. The predominant etiology was K. pneumoniae (31,7 %), S. aureus (15,3 %), E. coli (15,3 %), A. baumanii (14,2 %). Respiratory failure – HR 3.69 [95 % CI 2.18–6.25], p < 0.01, obesity – HR 3.04 [95 % CI 1.83-5.06], p < 0.01, age – HR 1.04 [95 % CI 1.02–1.07], p < 0.01, male gender – HR 1.94 [95 % CI 1.17–3.20], p < 0.01 were associated with bacteremia incidence in pre-Omicron SARS-CoV-2. During Omicron variants, bacteremia incidence was associated with the presence of liver disease – HR 4.26 [95 % CI 2.37–7.67], p < 0.01, respiratory failure – HR 3.72 [95 % CI 2.14–6.44], p < 0.01, COPD – HR 5.11 [95 % CI 1.50–17.40], p < 0.01. Antibacterial therapy before admission was not associated with incidence of bacteremia – HR 0.86 [95 % CI 0.51–1.16], p = 0.58 pre-Omicron; HR 1.07 [95 % CI 0.52-2.18], p = 0.86 during Omicron).

Conclusion. Incidence of bacteremia increased almost two-fold during SARS-CoV-2 Omicron predominance. Risk factors for bacteremia in the pre-Omicron period included respiratory failure, obesity, male gender, and age, while in the Omicron period, risk factors were liver disease, respiratory failure, and chronic obstructive pulmonary disease. Antibacterial treatment before admission was not associated with in-hospital bacteremia incidence.

Purpose – to study the cardioprotective efficacy of postconditioning with L-lactate (PostL) during myocardial ischemia-reperfusion in young and old rats and to elucidate the role of NOsynthase (NOS) and M-cholinergic reactive system (M-CRS) activity in its implementation.

Methods. The study was conducted on young and old anesthetized nonlinear white male rats. The animals were ventilated with room air via a tracheostomy. The right carotid artery and left internal jugular vein were cannulated to measure blood pressure and administer drugs. An electrocardiogram (ECG) was continuously recorded in lead II throughout the experiment. The animals underwent coronary occlusion (30 min) and reperfusion (2 h). The size of the necrotic zone and the risk zone were assessed using computerized planimetry. PostL was modeled 25 min after the start of reperfusion by administering a solution of L-lactate neutralized with NaOH at a dose of 10 mg/kg. The NOS inhibitor NG-nitro-L-arginine methyl ester (L-NAME) was administered to rats at a dose of 25 mg/kg immediately after coronary occlusion, and the 0.2 % M-CRS blocker atropine at a dose of 2 mg/kg was administered 10 min before PostL.

Results. PostL exerts a cardioprotective effect and leads to a decrease in the size of the necrotic zone in the left ventricular myocardium in young and old animals by 26.7 and 25.5 % (p < 0.01), respectively. Pretreatment with both the NOS inhibitor L-NAME and the M-CRS blocker atropine abolished the cardioprotective effect of PostL in young but not old rats, indicating the importance of NOS and L-NAME in mediating the cardioprotective effect of PostL in young but not old rats.

Conclusion. The activity of M-СRC, like NOS, is important in the implementation of the cardioprotective effect of PostL during myocardial ischemia-reperfusion in rats, depending on their age.

Following systemic administration of both the NOS inhibitor L-NAME and the M-CRS blocker atropine, the cardioprotective effect of PostL is maintained in old but not young rats.

The article describes of the features of the clinical course and outcome in an adolescents girl with a large uterine leiomyoma (fibroid).

Purpose of the study. To evaluate the possibilities of early diagnosis of celiac disease in adults based on clinical and anamnestic data and a study plan including laboratory markers of celiac disease, as an autoimmune disease, as well as markers of inflammation and increased intestinal permeability.

Materials and methods (two cases from practice). A thorough study of the medical history, the stages of previous treatment in the conditions of the regional clinical hospital and in the departments of the surgical clinic made it possible to conclude that there was insufficient medical knowledge about such a disease as celiac disease. Despite the recurrent course of gastroenterological pathology in the studied patients, no available laboratory parameters were prescribed for the presence and level of antibodies to tissue transglutaminase: their determination is a sensitive and specific method for diagnosing celiac disease. There were no studies for fecal calprotectin, indicating the presence of inflammation, and fecal zonulin, which often rises before inflammation begins. Zonulin is a marker of increased intestinal permeability. The performance of these studies, as well as instrumental and morphological, during the last hospitalization of patients made it possible to diagnose the main diagnosis celiac disease, in one case at the age of 49, in the other at 61.

Results and discussion. The article presents two cases of celiac disease in adults. Celiac disease is an immune-mediated systemic disease that occurs in response to gluten consumption by genetically predisposed patients and is characterized by a combination of gluten-dependent clinical manifestations, the production of specific antibodies (to tissue transglutaminase, endomysium, deaminated gliadin peptides), the presence of haplotypes HLA-DQ2 and/or HLA-DQ8 and enteropathy [1].

Although primarily associated with children, research suggests that adult celiac disease is a condition that requires broader awareness. Recognizing symptoms and confirming the correct diagnosis is critical to effective treatment tactics. Adults suffering from this autoimmune disease should follow a strict diet that excludes gluten, a protein commonly found in wheat and other grains. When consumed even in small amounts, gluten can cause serious disorders not only from the intestines, but also various systemic problems.

In patients with celiac disease, gluten present in cereals crosses the epithelium of the small intestine, induces the production of proinflammatory cytokines, interepithelial junctions (MEAs) are disrupted, and intestinal permeability (AUC) is increased [2]. As a result of this constantly maintained inflammatory process in tissues, primarily the gastrointestinal tract, diverse clinical manifestations develop, which we want to demonstrate in cases of celiac disease diagnosis in two adult patients.

Conclusions. Frequent exacerbations of digestive diseases, persistent symptoms of dyspeptic syndrome, weight fluctuations with a tendency to reduce it, recurrent pain syndrome require a differential diagnosis among digestive diseases with the exception of celiac disease. To do this, it is necessary to study the level of antibodies to tissue transglutaminase, fecal zonulin – a marker of impaired intestinal permeability, and fecal calprotectin, indicating the presence of inflammation.

CHARGE syndrome is a disorder with an autosomal dominant inheritance pattern and a population incidence of 1 in 8,500–15,000 live births. It is caused by a nucleotide sequence change in the CHD7 gene. Major criteria for the syndrome include coloboma of the eyes, choanal atresia or stenosis, midline defects (cleft lip and/or palate), and congenital malformations of the outer, middle, and inner ear. CHARGE syndrome is characterized by pronounced clinical polymorphism, which complicates diagnosis. In the neonatal period, bilateral choanal atresia can lead to respiratory distress syndrome, which is a frequent cause of neonatal mortality. Other causes of early death include congenital heart disease complicated by heart failure. The manifestations of CHARGE syndrome are extremely variable, leading to molecular genetic confirmation of the diagnosis. However, approximately 30 % of patients do not harbor the mutations. In such clinical situations, the diagnosis is established based on the presence of three core symptoms included in the CHARGE acronym, or two core symptoms and one additional symptom.

Patients with CHARGE syndrome require care from a multidisciplinary team, including a pediatrician, neurologist, endocrinologist, ophthalmologist, otolaryngologist, cardiologist, and cardiac surgeon. In severe cases, the child may need to be admitted to the anesthesiology and intensive care unit. This article describes a clinical case of a newborn with CHARGE syndrome and reviews the current literature on this rare condition.

This article discusses the challenges associated with conducting research involving the use of experimental animals. It presents documents and regulations that researchers must adhere to when adhering to biomedical ethics. It describes the stages of animal experiments, including the selection of animal species, their number, procedures for collecting material, and animal euthanasia.

Objective. To determine the structure of emotional and motivational barriers that hinder the successful participation of medical postgraduate students in scientific discussion, and to propose a program to overcome them.

Material and methods. A theoretical analysis of scientific publications on the problems of motivation of scientific activity, communicative anxiety, and psychological barriers in communication was carried out. Methods of theoretical analysis, synthesis, generalization, and pedagogical design were used.

Results. The structure of scientific discussion culture as a component of professional competence of a researcher is clarified; its cognitive, motivational-value, operational-activity and reflexiveregulatory components are identified. A typology of barriers in scientific discussion is presented. It is substantiated that the key barriers for novice researchers are emotional and motivational barriers, including deficits in the motivational sphere, increased level of communicative anxiety and lack of self-regulation skills. A program of psychological and pedagogical support aimed at overcoming them is developed.

Conclusion. The proposed program is a promising tool for overcoming emotional and motivational barriers and can be recommended for implementation in the system of training scientific and pedagogical personnel in medical universities.