The lack of a unified methodological approach to the treatment of newborns with Hirschsprung's disease in medical institutions of the country, non-standardized diagnostic and surgical treatment programs lead to late detection of the disease and, accordingly, late surgical treatment. Therefore, one of the important principles of organizing the work of specialists from various services is mutual continuity and understanding at each stage of work. 
Aim. Analysis of diagnostics and principles of surgical treatment of patients in the first months of life with Hirschsprung's disease. From 2010 to 2019, diagnostics (X-ray and morphological examinations) were carried out at the Republican Scientific and Practical Center for Pediatric Surgery in 51 newborn patients in whom Hirschsprung's disease was confirmed. The patients were divided into 2 groups with uncomplicated and complicated course of the disease: uncomplicated form – 36 patients with persistent constipation, 32 of whom were radically operated on before the age of 3 months; complicated form – 15 patients who had a stoma removed due to intestinal obstruction, peritonitis or necrotizing enterocolitis.

In modern clinical otorhinolaryngology, there are different opinions regarding the choice of the surgical approach for interventions on the paranasal sinuses. There are two main options for access to the paranasal sinuses – these are extra- and endonasal approaches, each of which has advantages and disadvantages. In some cases, when using open access, a bone defect of the anterior sinus wall occurs, leading to the development of various pathological conditions. Analyzing the possible outcomes of postoperative changes in the sinuses, many researchers are unanimous in the opinion that the presence of postoperative defects in the walls of the sinuses larger than 1 cm lead to the development of scar changes in the mucous membrane, deformation of the sinus, the development of postoperative neuralgia of the second branch of the trigeminal nerve associated with compression of the nervous ending with a postoperative scar. Variants of using various materials for plastics of postoperative bone defects of the paranasal sinuses are considered, the main advantages and disadvantages of using materials based on autobone, allogeneic bone and cartilage grafts, and various materials of non-biological origin are analyzed. Clinical experience of using allogeneic materials for plastics of facial bone defects is presented.

In the general structure of childhood diseases, infections of the urinary system (IUS), including pyelonephritis (PN), in terms of prevalence (more than 5 % in girls and 1–2 % in boys) rank second after respiratory tract infections. It is still unsolved how to detect early and retard the progression of kidney diseases of various etiologies with the delay in the formation of chronic kidney disease (CKD), and to decrease the risk of complications caused by renal dysfunction. It has been known that already at I–II stages of CKD, more than half the children have nephrogenic anemia (NA). It is characterized not only by a decrease in the hemoglobin content in the blood but also by a decrease in the number of erythrocytes below 4–4.5*10 12 /l, and a normochromic-normocytic character, namely, a normal level in the average volume of erythrocytes (MCV) – to more than 75 fl, and a color index close to 0.85. Out of 650 sick children aged 2 months to 3–4 years who were treated in the infectious diseases department of early age 3 GDKB from January to November 2021, NA was detected in 49 children with IMS, of which NA in combination with iron deficiency anemia (IDA) in 19 patients. In all these patients, NA was affected by leukocyturia, proteinuria, bacteriuria; 39 were diagnosed IUS with and 10 with PN. But in 3 more patients, NA was affected by anomalies of the urinary system (duplication of the kidney, hypoplasia of one kidney, etc.), without leukocyturia. Considering the above, the identification by pediatricians of NA in young children with IUS, or with other pathology of the kidneys and urinary tract should serve as an indication for the urgent referral of these patients to a nephrologist for further examination and the prescription of proper treatment.

Gonarthrosis is a chronic progressive degenerative-dystrophic disease of the knee joint, characterized by destruction of the articular cartilage, changes in the articular surfaces of the epiphyses of the bones and periarticular soft tissues. Total knee arthroplasty (TKA) is an effective and often the only way to restore lost limb function when conservative treatment or joint-preserving surgery fails. TKA is a reconstructive surgical intervention that consists in replacing pathologically altered articular surfaces of the femur and tibia (in some cases, the patella) with artificial ones to eliminate or reduce the intensity of the pain syndrome, restore mobility in the knee joint and support ability of the lower limb. Dissatisfaction with the quality of postoperative pain relief (TKA) requires the search for new schemes and methods of treatment. In recent years, the use of local infiltration anesthesia and peripheral nerve blocks has become increasingly popular. The object of the study is 138 patients (114 women and 24 men) with knee arthroplasty who were treated at the 6th City Clinical Hospital of Minsk from 2019 to 2020.

The article discusses the main approaches to the observation of women with epilepsy, focuses on the feasibility of planning pregnancy, the importance of pregravid preparation, including the comprehensive observation of doctors of related specialties, the competent choice of antiepileptic therapy and the selection of an effective dosage of the drug. According to modern studies, transferring women to monotherapy with the minimum effective dosage significantly reduces the risk of pregnancy complications and the occurrence of congenital malformations of the fetus. The article also indicates that with a comprehensive interdisciplinary approach and adherence to the recommendations of doctors, delivery of women with epilepsy through the vaginal birth canal is not contraindicated, given the compensated condition of the mother and fetus. In the postpartum period, this group of women is recommended to pay due attention to the sleep and wakefulness regimen in order to prevent the occurrence of epileptic seizures. In this connection, the issues of quality and hygiene of sleep in the postpartum period and the influence of sleep and wakefulness on the course of epilepsy remain controversial, therefore our research in these areas continues.

Juvenile idiopathic arthritis (JIA) is one of the most common and most disabling rheumatic diseases in children. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with unknown etiology, which is based on a genetically determined dysregulation of immunity. In recent years, the view of JIA and SLE as potentially incurable and prognostically unfavorable diseases has been revised. This is largely due to the expansion of the possibilities of early diagnosis of JIA, SLE, which allows starting active therapy at the onset of the disease, the development of a new class of basic anti-inflammatory drugs, and scientific research in the genetics of both diseases. A large number of genes associated with immune responses can, induce an autoimmune response – the leading pathogenetic link in both diseases. The article presents modern data on the possible pathogenesis, spectrum of clinical manifestations of juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE) in children. A brief description of the pathological changes in JIA and SLE is given. Possible factors are considered, incl. genetic, affecting the predisposition to the disease, the process of the formation of organ damage. The issues of assessing the activity of diseases, assessing the quality of life of patients are discussed in detail.

The article presents the results of clinical studies of patients with osteoarthritis of the knee joint at early radiological stages. Overweight and obesity were identified as significant risk factors for the development of osteoarthritis, which were identified in almost half of the patients. Among the factors capable of influencing the development of the disease, heredity for early osteoarthritis and transverse flat feet were significant. The most frequent clinical manifestations were short-term episodes of pain with overload of joints, discomfort when going down / upstairs, as well as various combinations of symptoms: stiffness at the beginning of movement with pain in the “squatting position”.

The article presents the results of the analysis of the incidence of temporary disability (hereinafter – TD) of year-round workers employed in the production of anticancer drugs. Оbjectives: to study the dynamics and structure of morbidity with temporary disability of workers employed in the production of antitumor drugs. Materials and methods. For the study of the incidence with TD for the period from 2015 to 2019, two groups of workers were formed (exposed – 486 year-round person-years and unexposed – 1458 year-round person-years). The material for the study was the data of 3497 sheets of temporary disability for the period under study. Conclusion: According to the results of the analysis of indicators of morbidity with temporary disability in the exposed group in dynamics for the studied period, a tendency to an increase in the number of sick people was found. The level of morbidity among the workers of the exposed group was assessed as below average. It has been established that the leading place in the structure of morbidity with temporary disability of workers is occupied by diseases of the respiratory system, diseases of the musculoskeletal system and connective tissue, trauma and poisoning. Statistically significant differences in morbidity rates among workers of the compared groups by gender were revealed, and age groups with maximum and minimum values of temporary disability indicators were established.

Psoriasis is the most common chronic inflammatory skin disease. Stress is considered to be one of the causes of this pathology. The subjective perception of stress and the individual’s ability to cope with stress are closely related to the person’s ability to understand feelings and emotions, coping strategies, psychological defense mechanisms, stress resistance and executive functions (cognitive flexibility). 
Objective. To study the severity of psychological and neuropsychological parameters in relation to the clinical manifestations of psoriasis. 
Materials and methods. 67 patients with psoriasis were enrolled in the study. Research methods: anamnesis, Visual Analogue Scale (for itch intensity), The Mayer–Salovey–Caruso Emotional Intelligence Test, Life Style Index, Social Readjustment Rating Scale, The Ways of Coping Checklist, Screening for Somatoform Symptoms and computer version of the Wisconsin Card Sorting Test. 
Results. Low emotional intelligence, maladaptive coping strategies, primitive psychological defense mechanisms, somatization, low stress resistance and impaired executive functions are increasing the chances of developing a more severe clinical picture in patients with psoriasis. 
Conclusions. The research findings are indicating the importance of a multidisciplinary treatment approach to psoriasis (dermatologist, psychologist or psychotherapist). Perhaps, team approach can be useful on the early intervention strategies, for treatment improvement and relapse prevention in patients with psoriasis.

Currently, there is ongoing discussion about the timing and methods of tracheostomy in patients infected with Covid-19 and in need of artificial lung ventilation. The object of the study was 182 patients with Covid-19 who were on artificial lung ventilation. At the initial stage of tracheostomy, Covid-19 infected patients had complications in the form of intra- and postoperative bleeding (diffuse) against the background of continued titration of heparin (12 cases out of 26, – 46.1 %). In 75.8 % of cases, tracheostomy was performed within 3 to 14 days of being on artificial lung ventilation, in 24.2 % of cases – within 14 days of being on artificial lung ventilation. Indications for tracheostomy, including the timing and method of its implementation, in patients with Covid-19 who are on artificial lung ventilation should take into account the clinical and laboratory indicators of the severity of the condition and the likelihood of a favorable prognosis, the availability of safety resources for health workers involved in the operation and management of the postoperative period, as well as the possibility of constant dynamic monitoring of the patient.

A comprehensive examination and treatment of 77 patients with uterine subinvolution after childbirth was carried out, 29 of which received electromagnetic stimulation from the CETA device (a course of 5 daily procedures), 28 patients of the comparison group received standard uterotonic therapy (intramuscular injection of 5 IU of oxytocin 2 times a day in within 5 days). 
The results of the clinical efficacy of the compared methods of treatment were evaluated for the first time according to the data of uterine tonusometry during hysterography using the SMART F 9 device. 
As a result of the studies, it was found that under the influence of CETA in a stimulating mode, aimed at increasing the contractile ability of the myometrium, in puerperas there is a significant decrease in the size of the uterine cavity, an increase in the tone of the myometrium according to tonusometry and an increase in the tone of the uterine arteries. It has been established that under the influence of electromagnetic stimulation, the frequency of complicated course of the postpartum period with the development of hypotonic postpartum endometritis decreases in comparison with the group of patients who received uterotonics. The favorable effect of magnetic stimulation on the tone of the uterine arteries was evidenced by a significantly more significant increase in the Doppler parameters of the uterine arteries, reflecting an increase in peripheral resistance and a decrease in the risk of bleeding, compared with patients who received only drug therapy.

Introduction. Hirschsprung's disease (HD) is a congenital malformation characterized by the absence of intramural ganglia in the intestinal wall. Frequent complications of Hirschsprung's disease and other disorders of intestinal motility are problems of late or erroneous diagnosis, and sometimes to a greater extent than complications of surgical techniques when performing surgical interventions [1, 2].
Aim. The lack of statistical data characterizing the incidence of HD on the territory of the Republic of Belarus became the reason for conducting an epidemiological study based on the annual statistical reports of the Republican Scientific and Practical Center for Pediatric Surgery.
Materials and methods. A descriptive epidemiological study of the incidence of Hirschsprung's disease on the territory of the Republic of Belarus was carried out on the basis of data from the surgical departments of the Republican Scientific and Practical Center for Pediatric Surgery for the period from 01.01.2010 to 31.12.2019 (10 years).
Results. During the study period, 130 patients born in the period 2010–2019 were radically operated with different forms of BG. According to the data presented in Table 1, from 7 to 20 cases of HD were detected annually (13 (10 ÷ 17) cases/year according to the median), which was 11.90 (8.37 ÷ 14.34) cases per 100 thousand newborns. The incidence of HD ranged from 1 in 5889 to 1 in 15 432 population. No dependence of the number of HD cases per year on the birth rate was found. The incidence of HD in the Republic of Belarus averages 1: 9250. According to the literature, the incidence of HD in the world was 20.64 (18.05 ÷ 22.43) cases per 100,000 newborns, while in the Republic of Belarus for the period from 2010 to 2019 years the incidence was lower and amounted to 11.90 (8.37 ÷ 14.34) cases per 100,000 newborns.
Conclusion. The incidence of HD in the Republic of Belarus averages 1:9250, which is significantly less than in foreign countries according to the literature. The reasons for this are different, but, apparently, the main one is the insufficient alertness of pediatricians and pediatric surgeons in relation to HD and, accordingly, insufficient diagnostic coverage of pediatric patients with impaired colon function. Compliance with the principles of work of specialists on continuity in the work of specialists, starting from the neonatal period, the wary attitude of doctors towards HD will improve the diagnosis of HD in children.

Auditory Neuropathy Spectrum Disorders, ANSD is a state of the auditory system in which the patient has otoacoustic emissions (OAEs) and/or cochlear microphonic potential (CMP), and auditory brainstem responses (ABRs) are absent or significantly reduced. In contrast to sensorineural hearing loss, where the outer and inner hair cells of the cochlea are damaged, in ANSD the outer hair cells are preserved. The complexity of ANSD detection and the variety of clinical symptoms of this disorder make it difficult to differentiate this disease from sensorineural hearing loss.
Purpose. Improvement of the differential diagnosis of ANSD and sensorineural hearing loss by defining the main anamnestic and audiological criteria.
Materials and methods. The research included 2 groups of patients: the core group – 48 patients with bilateral ANSD and the control group – 30 patients with bilateral chronic sensorineural hearing loss. All patients underwent assessment of the anamnesis data, impedance measurement, tone threshold audiometry, registration of OAE (TEOAE), registration of ABR with allocation of CMP, registration of stationary auditory evoked potentials.
Results. In patients with ANSD the incidence of prematurity, low birth weight, and hyperbilirubinemia is significantly higher (p < 0.05) than in patients with sensorineural hearing loss. In patients with ANSD the 35delG mutation in the GJB2 gene was not identified, in contrast to patients with sensorineural hearing loss (genetic factor was confirmed in 23.3 %) (p < 0.05). Newborn hearing screening on both sides was conducted in 15 children (31.3 %) with ANSD and only 1 child (3.3 %) with sensorineural hearing loss (p < 0.05). In 8 patients (16.7 %) with ANSD was recorded TEOAE during the initial audiological diagnosis, in contrast to sensorineural hearing loss (TEOAE was not recorded in 100 % of patients) (p < 0.05). In contrast to sensorineural hearing loss, the ABR thresholds in ANSD did not correspond to the behavioral hearing thresholds. CMP was recorded on the right and left ear in all patients (100 %) with ANSD and remained unchanged during the observation process, in contrast to patients with sensorineural hearing loss, in whom CMP was not recorded on both sides (p < 0.05).
Conclusions. The structure of the main risk factors for hearing loss in children with ANSD and sensorineural hearing loss is different. In the differential diagnosis with sensorineural hearing loss, the possibility of TEOAE disappearance in ANSD should be taken into account. Registration of ABRs with the allocation of CMP is the most informative method of ANSD diagnostics. CMP registration should be conducted for all patients who do not have ABR peaks at the maximum stimulus intensity, regardless of the OAE registration results.

The results of laparoscopic and “traditional” open appendectomy for acute appendicitis were studied, and postoperative complications were analyzed. The retrospective analysis of surgical treatment of 518 patients with acute appendicitis was carried out. In 433 (83.6 %) cases laparoscopic appendectomy was performed, in 84 (16.2 %) – open appendectomy. In laparoscopic surgery the ligature method of appendectomy was used, in open surgery invagination method was used. Indications for drainage of the abdominal cavity during laparoscopic and open appendectomy did not fundamentally differ. According to the results of a morphological study phlegmonous appendicitis was observed in 463 (89.4 %) cases, gangrenous – in 55 (10.6 %). After open appendectomies complications were detected in 11 patients, the overall incidence of postoperative complications was 13.1 %. After laparoscopic appendectomies complications were detected in 4 patients, the overall incidence of postoperative complications was 0.9 %. The rate of postoperative complications after laparoscopic appendectomy was statistically significantly lower than after open appendectomy. The nature of complications in laparoscopic and open appendectomy differs. In open appendectomy infectious complications of the surgical wound are observed, which do not require surgical treatment. In laparoscopic appendectomy intra-abdominal complications are observed, which in some cases require repeated surgical interventions. During laparoscopic appendectomy, there were such complications as stump leaks with peritonitis and inflammatory infiltrates of the abdominal cavity.

In recent years, researchers have noted an increase of mental pathology among healthcare professionals.
The article presents the results of a study conducted among 755 doctors, 446 of whom were on night shifts (main group), 309 did not work at night (comparison group).
Age, night shifts, proffesional burnout, decreased motivation, and mental asthenia were identified as some predictors of the formation of severe psychopathological symptoms in all surveyed respondents (n = 755) using binary logistic regression (MFI-20 questionnaire). A statistical model was developed as a regression equation, which makes it possible to predict the formation of severe psychopathological symptoms in doctors. The model is consistent with the initial data (according to Hosmer-Lemeshev p = 0.100) and statistically significant (χ2 = 275.952; p < 0.001). According to the results of the ROC-curve plotting, the AUC indicator was 0.825 ± 0.015 (CI 95 %, 0.796–0.854; p < 0.001), which corresponds to a very good quality of the predictive model. The sensitivity of the developed prognostic model is 71.0, specificity is 77.0.
Marriage, chronotype (MEQ-SA questionnaire), decreased motivation (MFI-20 questionnaire), level of emotional burnout and General TS sleep assessment (PIRS questionnaire) were identified as some predictors of the formation of severe psychopathological symptoms in doctors working during nights (n = 446), using binary logistic regression. A statistical model was developed as a regression equation, which makes it possible to predict the formation of severe psychopathological symptoms in doctors working during nights. The model is consistent with the initial data (according to HosmerLemeshev p = 0.819) and statistically significant (χ2 = 211.985; p < 0.001). According to the results of the ROC-curve plotting, the AUC indicator was 0.863 ± 0.017 (CI 95 %, 0.830–0.896; p < 0.001), which corresponds to a very good quality of the predictive model. The sensitivity of the developed prognostic model is 74.9, the specificity is 80.7.

Modern medicine faces the problem of the steady growth of alcoholic pathology. And as you know, morbidity and mortality with regular consumption of alcoholic beverages is associated with the toxic effects of ethanol on the most important human organs and, first of all, the liver. To date, a sufficient number of facts have accumulated indicating the importance of liver arginase in vital processes in health and disease.
The aim of the study was to elucidate the significance of liver arginase in the detoxification processes and the development of oxidative stress in rats with chronic ethanol intoxication of different severity.
In experiments on rats using modern physiological, biochemical research methods and a pharmacological approach, it was found that liver arginase participate in changes in liver detoxification function and the development of oxidative stress induced by chronic ethanol intoxication. The direction and severity of changes in arginase activity and liver detoxification function during chronic alcoholism depends on the severity of chronic alcohol intoxication. Under the influence of daily intragastric administration for 60 days, a 30 % aqueous solution of ethanol (3.5 g 92 % ethanol per kg of body weight) in animals under conditions of development of oxidative stress inhibited the activity of arginase and detoxification function of the liver, and the introduction of 10 % aqueous solution of ethanol (1.0 g 92 % ethanol per kg of body weight) for 2 months leads to an increase in the activity of liver arginase and detoxification processes. The action in the body of the arginase inhibitor Nω-hydroxynor-L-arginine contributes to the development of characteristic changes in the processes of detoxification and lipid peroxidation in the liver during chronic alcohol intoxication caused by intragastric the introduction of ethanol at a dose of 3.5 g/kg for 60 days.

The correct diagnosis of allergic diseases at the early stages is important nowadays, despite the growing importance of infectious pathology. The basic tests for allergy diagnosis are the determination of the level of total serum and specific immunoglobulins E (Ig E), as a key link in the development of type1 allergic reaction. Allergic factors affecting the level of Ig E include the nature and degree of sensitization of patients to one or more groups of allergens.
The study included 143 patients, of which 104 patients with atopy were divided into allergic asthma + allergic rhinitis patient’s group (58 patients) and group of 46 patients who had just allergic rhinitis. 39 healthy volunteers were the control group. The groups were matching by gender and age. The study evaluated the influence of allergic factors on the level of total Ig E in patients with allergic diseases. Higher values of Ig E total were obtained in patients with allergic asthma and polysensitization. About half of patients with rhinitis and 15 % of patients with asthma have normal total Ig E level, that is one of the reasons to change approaches to normal values of this allergy marker.

The purpose of this work is to determine the level of brain neurotrophic factor (BDNF, brainderived neurotrophic factor) in the blood serum of individuals with alcohol dependence syndrome in the dynamics of alcohol withdrawal syndrome (COA), as well as to compare the results obtained with the clinical picture and the effectiveness of the therapeutic program.
Material and methods. The level of BDNF in the blood serum was determined using ELISA. The dynamics of the severity of alcohol withdrawal syndrome (COA), as well as indicators characterizing the psychoemotional status and cognitive abilities of patients, were evaluated using appropriate psychometric scales. The studies were conducted on the 2nd, 8th and 21st days of abstinence. There were examined 70 patients with alcohol dependence syndrome in the dynamics of COA, who met the inclusion criteria and gave informed voluntary consent to participate in the study.
Results and discussion. As the symptoms of COA decreased, there was a significant increase in the level of BDNF in the blood serum: on the 21st day of abstinence, the level of BDNF was significantly higher than the values on the 2nd and 8th day of abstinence. On the 8th day of abstinence, BDNF in the blood serum forms a direct correlation with the level of personal anxiety measured using the H scale Ch. Spielberger in the modification of Y. L. Khanin. According to multiple regression analysis on the 21st day of abstinence, BDNF can predict the severity of attraction to alcohol, established using the Pennsylvania scale of attraction to alcohol.
Conclusion. Thus, the content of BDNF in the blood serum can act as an independent prognostic marker of the success of care in the treatment of COA.

The article presents the results of a study of changes in the indicators of general, biochemical blood tests and individual coagulogram parameters in patients with COVID-19 pneumonia who were in hospital. The authors found that patients with COVID-19 pneumonia had leukopenia, accelerated ESR, thrombocytopenia, lymphopenia, neutrophilia, which were more often observed in patients with lesions of 25 % or more of lung tissue. Leukocytosis was only in 3 (3.7 %) patients and only in severe lung damage. An increase in the plasma level of D-dimer, fibrinogen, procalcitonin, lactate dehydrogenase, an increase in the value of the prothrombin index, a decrease in the level of plasma albumin was detected only with a lesion of 50 % or more of lung tissue. There was also an increase in the plasma levels of creatinine, alanine aminotransferase, aspartate aminotransferase, creatine phosphokinase, and C-reactive protein in the examined patients. The possibility of risk stratification and assessment of the need for hospitalization of patients with COVID-19 pneumonia, determination of the severity of the course of viral interstitial SARS-CoV-2 pneumonia, evaluation of the effectiveness of prescribed therapy and its correction using laboratory predictors is relevant, among other things, to reduce the risk of post-infectious complications, prevention of possible death.

The most important regulators of the rate of growth and physical development in children are rational nutrition and hormones. The aim is to evaluate the effect of breastfeeding on the anthropometric parameters and hormonal profile of large and small for gestational age children in the dynamics of the first two years of life. 280 full-term newborns were examined with dynamic follow-up during 2 years of life. The main group 1 (Gr1) – 110 large for gestational age, Gr2 – 95 small for gestational age, the control group – 72 with indicators corresponding to the gestational age. The dynamics of anthropometric indicators, the nature of feeding, nutritional and hormonal status were analyzed, taking into account body weight at birth. It has been established that infants with low birth weight during the first year of life are significantly less likely to receive exclusively breast milk. The proportion of children who received exclusive breastfeeding in the neonatal period is lower than in the control group (p = 0.002). Correlations between the duration of breastfeeding and indicators of physical development and adipokines status in newborns and young children have been established. Threemonth-old low birth weight infants treated with breast milk substitutes showed a higher level of IGF-1 (p = 0.047) and a lower concentration of adiponectin (p = 0.045) in blood serum. In large for gestational age infants, a higher content of IGF-1 (p = 0.029) and insulin (p = 0.015) was established. The revealed features of anthropometric and hormonal status substantiate the importance of providing conditions for long-term breastfeeding, continuity in the provision of medical care to small and large for gestational age babies, and educational work with parents.

The analysis of the results of bacteriological examination of blood samples of patients aged from 1 month to 18 years was carried out. A retrospective analysis was carried out based on the results of the virus-bacteriological laboratory of the City Children's Infectious Clinical Hospital of Minsk for the period from 2009 to 2020. It was found that gram-positive bacteria predominate in the spectrum of bacteremia pathogens in patients (59.4 %), among which coagulase-negative types of staphylococci dominate, which corresponds to numerous modern studies from other countries, according to which the most common pathogens of bacteremia are coagulase-negative staphylococci.

Aims/Objectives. The purpose of this work is to analyze the diagnosis and treatment of a neuroendocrine tumor of the caecum complicated by wall necrosis, peritonitis in the presence of COVID-19 infection. 
Materials and methods. The results of the examination and treatment of a 63-year-old patient L., who was hospitalized in the surgical department with a diagnosis of acute intestinal obstruction, were analyzed. History of appendectomy. Biological material was tested for Covid-19 infection (September 5, 2021): SARS-CoV-2 coronovirus RNA was not detected. When controlling the passage of barium suspension through the intestines, it was established: a contrast mass along the colon. There are abnormal fluid levels in the mesogastrium. Areas of narrowing of the right and left flanks of the large intestine are determined. On the third day, symptoms of peritoneal irritation appeared. Operated. There is a cloudy effusion in the abdominal cavity. In the right iliac region, an infiltrate is determined, formed by the caecum, ascending colon, terminal ileum, sigmoid, strand of the greater omentum. There are also fibrin plaques here.
The dome of the caecum is black. In the intestine, palpation is determined by volume formation dense, spreading to the proximal section of the ascending colon and the terminal section of the ileum. Performed right-sided hemicolectomy with anastomosis “end to side”, lymph node dissection D 2. Performed sanitation and drainage of the abdominal cavity.
Results and discussion. The next day after surgery, the patient is in the ICU. Severe condition. Not adequate. Excited. Body temperature – 36.4 °С. Breathing is independent, auscultatory is somewhat weakened in the lower sections, single dry rales. Respiratory rate – 16/minute, SpO2 – 97–98 % against the background of humidified oxygen insufflation at a rate of 1.5 liters/minute. Hemodynamics stable: blood pressure – 137/105 mm Hg. Art. Heart rate – 80 beats/min. Cardio monitoring – sinus rhythm. Abdomen: responds to palpation in the area of the postoperative wound. Peristalsis is sluggish. Rapid test for SARS-CoV-2 antigen No. 784 is positive. Ag SARS-CoV-2 – detected (09/08/2021). Histological conclusion: highly differentiated neuroendocrine tumor of the caecum with germination of the intestinal wall, ingrowth into the periintestinal fatty tissue.
Resection margins: no tumor growth. Phlegmonous-ulcerative typhlitis. Focal phlegmonous-purulent peritonitis. Omentit. On the 6th day the patient is conscious and takes food. Removed drainage from the abdominal cavity. On the 7-th day, he was transferred to the infectious diseases department of another hospital for aftercare.

The article deals with the use of biotechnological drugs (BTLG) in the treatment of children of the Republic of Belarus, mainly suffering from rheumatoid arthritis. This group of drugs is a new, very promising and insufficiently studied group in the world pediatric practice. The work assessed the effectiveness of the use of BTLG, taking into account the indications in pediatric practice.The results of studying the structure of patients receiving BTLG depending on the nosological unit of the disease, age, sex, place of residence of patients are presented; analyzes the effectiveness of de-escalation of therapy, switching to another drug, «escape» of the effect when using BTLG. The authors substantiate the need for a further differentiated approach to the use of the BTLG group in the treatment of severe forms of rheumatoid arthritis in children, the need to take into account the effects of the therapy.

A dynamic prospective examination of 93 newborn was conducted to study the growth trajectories of anthropometric indicators in large for gestational age newborns in the first two years of life. The differences in the speed of the body weight and body weight gain trajectories in large-bodied children in the two-year period dynamice were revealed, including taking into account the gender trai. Statistically significantly shorter duration of breastfeeding was established in overweight infants at the age of 2 years. Large for gestational age infants at the 2 years age had advanced growth trajectories starting from 3 months of life. The data obtained substantiate the importance of monitoring the trajectories of anthropometric indicators of a child in the first 2 years of life, with a special emphasis on body mass index in the interval from 3 to 12 months of life.

The article presents the results of a study on the assessment of the incidence of clinically significant muscle damage in the structure of limb injuries. A retrospective analysis of medical records of inpatients with traumatic lesions of the muscles of the limb in the period from 2017 to 2019 was carried out. Taking into account the inclusion criteria, 245 patients with limb muscle injuries of varying severity were selected for the study. High-energy damage was detected in 111 cases (45.3 %), low-energy damage was detected in 134 cases (54.7 %). The degree of damage to muscle tissue was assessed. Muscle damage within one muscle sheath was considered minimal, and damage within two muscle sheaths was moderate. Severe muscle damage was characterized by the destruction of striated muscles in more than two fascial sheaths. Minimal damage was classified as clinically insignificant, moderate and severe to clinically significant muscle damage. Clinically significant muscle damage occurred in 62.9 % of cases. The analysis took into account the average duration of treatment, the need for fasciotomy, complications and death. The presence of clinically significant muscle damage did not affect the increase in mortality rates, but led to a significant increase in the number of complications, additional surgical interventions, and an increase in the duration of patient treatment.

The issue of choosing the optimal laboratory animal for modeling wound defects of the mucous membrane of the hard palate is considered. It has been established that the rabbit is the optimal laboratory animal for experimental modeling of wound defects in the mucous membrane of the hard palate. A technique for the operation of modeling wound defects of the mucous membrane of the hard palate has been developed and described. For the experiment, 10 Chinshila rabbits were used as models. Modeling of wound defects of the mucous membrane of the hard palate was performed under general anesthesia by the formation of two symmetrical defects of the mucous membrane of the hard palate for the entire thickness to the bone of a given geometric shape and specified dimensions using a modified manual instrument. The developed method for simulating the same wound defects of the mucous membrane of the hard palate makes it possible to study the course of the wound process using different methods of treatment in identical conditions on one animal and to conduct an objective mathematical assessment of the healing process of wound surfaces in a comparative aspect.

The article presents its own data and summarizes the literature data concerning the causes, methods of diagnosis and treatment of fetal growth restriction. Chronic placental insufficiency and fetal growth restriction are relevant obstetric problems that require a careful approach to diagnosis, follow-up dynamics, treatment and collegial resolution for choosing a strategy for the method and timing of delivery. According to the opinion of researchers, IGR is diagnosed on the basis of a decrease in the body weight of a particular fetus in comparison to the average weight corresponding to the gestational age. A comparative analysis of the reliability of diagnoses of chronic placental insufficiency and fetal growth restriction at the outpatient and inpatient clinics was carried out. It has been shown that the introduction of the INTERGROWTH-21st scale into the clinical practice allows not only to punctually diagnose fetal growth restriction, but also to a certain extent reduce the frequency of unjustified diagnosis of IGR and associated with it early operative delivery.

The article is devoted to the outstanding scientist-neurologist, Doctor of medical sciences, honored doctor of the Republic of Belarus, honorary academician of the Belarusian Academy of Medical Sciences, Professor Boris Vladimirovich Drivotinov. The article presents the main stages of biography and scientific way of professor B. V. Drivotinov, his merits in the development of Belarusian scientificpedagogical school and practical medicine are marked. B. V. Drivotinov was the founder of Belarusian scientific and pedagogical school of vertebrooneurology; he participated in the development of clinical classification of peripheral nervous system diseases. The scientist created a new direction in neurological science associated with the development and substantiation of autoimmune pathogenesis of spinal osteochondrosis and its clinical manifestations. For the first time, he applied computational cybernetic methods for early diagnosis, prediction of the severity of the course and outcome of neurological manifestations of spinal osteochondrosis and other diseases of the nervous system. Professor B. V. Drivotinov was a reformer and innovator in the field of neurological practice and education.