The cause of the maladjustment syndrome of the cardiovascular system of the newborn (SDSSS), which is a functional disorder of the CVS during this period, is predominantly postponed chronic antenatal and intrapartum hypoxia. Factors contributing to the delay in the formation of mature cardiomyocytes, impaired neurohumoral regulation of vascular tone, including in the coronary bed, congenital viral and bacterial infections, and congenital heart defects make a significant contribution to the occurrence of SDSS. The problem of coronavirus infection has worried the whole world since 2019. At the same time, the issues of infection of newborn children remain unclear, the issue of vertical transmission of the virus from mother to child is being discussed. The aim of our study was to analyze all cases of SDSS in children born to mothers with confirmed COVID-19 infection and from mothers not sick with COVID-19 on the eve of childbirth, as well as to identify the factors that influenced the development of this syndrome and to establish options for its course. It was revealed that in newborns whose mothers contracted coronavirus infection COVID-19 immediately before childbirth, SDCCS manifested itself as a violation of cardiac conduction, and in children from mothers uninfected with coronavirus infection, SDCCS was expressed as a disturbance of arousal. Laboratory methods of research in newborns of both groups reflected the indirect effect of a damaging factor on the cells of the heart muscle.

The article presents the results of a clinical study conducted in 2018 and 2020 to determine the antibiotic resistance indicators for N. gonorrhoea strains in Belarus. One hundred and fourteen (114) cultures of N. gonorrhoeae from Mogilev were included in the works: thirty six (36) cultures were isolated from patients in 2017, nineteen (19) in 2018 and fifty nine (59) in 2019. All samples were obtained from the cervical canal in women or the urethra in men, with an established diagnosis of gonorrhea. Men concluded 82 persons equal to 72 %, and women 32 equal 28 %. The average age of men was 23.5 (range: 17–44 years), women 23,5 (range: 17–74 years). The susceptibility to ceftriaxone, cefixime, azithromycin, ciprofloxacin, spectinomycin, benzylpenicillin, tetracycline and gentamicin were determined using the Etest for determination of the minimum inhibitory concentrations. Recommendations on the use of certain antimicrobial agents in the treatment of gonorrhea is based on data obtained.

The lecture contains the short historical background about the creation of the Belorussian embryology institution studying of suprarenal gland’s development. The main part of the lecture is concerned with the basic data about the sources and periods of primordia’s forming of the suprarenal gland: joining and mutual influence between epithelial and nerve tissues; about the main processes of its cortex and medulla differentiation, about the structure of adrenal gland of the newborn and child’s early years. At the end of the lecture some complex issues concerning the gestation of a structure and function of the suprarenal gland are discussed: repeated migration of the cells of the permanent cortex; the reasons of the conflicting timescales of housing and differentiation cells of the medulla; the role of the “medullary balls”; the importance of the fetal cortex and its involution; the reasons of the abundant housing of the cortex by the sympatogonia and slight development medullar in human suprarenal gland.

A survey was carried out of 186 puerperas (average age 25.1 ± 2.3), who were inpatient treatment in the physiological postpartum department and the department of postpartum complications of the 3rd city clinical hospital named after E. V. Klumov in Minsk in the period from 2017 to 2020. All patients were divided into the following groups: 1st – 87 puerperas with HPE (among them 15 puerperas at the hypotonic-stagnant stage of HPE and 72 puerperas at the hypotonic-inflammatory stage of HPE (mean age 25.2 ± 2.7); 2-I – 68 puerperas with IPE (average age 25.7 ± 3.1). The control group consisted of 31 puerperas with physiological postpartum period (average age 25.4 ± 2.8 g). Histological examination of scrapings from the uterine cavity, which received by curettage of the uterine cavity in order to remove the pathological substrate Smooth myocytes were visualized in scrapings in 22 puerperas with HPE and 13 puerperas with IPE.

Supracondylar fractures of the humerus in children are difficult injuries. Thorough assessment and documentation of the neuro-vascular condition of the arm on admission and during the treatment are needed. Radiological evaluation allows to classify the injury and to choose treatment strategy. Extension mechanism is prevailing in these injuries. Displaced fractures require closed reduction and transcutaneous wire fixation, ideally performed by the senior surgeon. During plaster cast immobilization flexion in the elbow shall be avoided as it may provoke vascular disturbances. When normal blood supply of the limb is maintained, surgical treatment may be delayed until skilled surgical team and other resources are available. In cases with the disturbances of the distal flow urgent reduction of the fracture is indicated, which allows to restore the blood supply in 80 % of cases. When after reduction the absence of pulsation on a.radialis is associated with the pink hand – surgical revision and exploration of humeral artery is indicated.

A survey was carried out of 186 puerperas (average age 25.1 ± 2.3), the following groups: 1st – 87 puerperas with hypotonic postnatal endometritis (HPE); 2-th – 68 puerperas with infectious variants of postnatal endometritis (IPE). The subjects were given an individual card, in which the data of the anamnesis, objective clinical examination, the results of laboratory and instrumental studies were noted. The control group consisted of 31 puerperas with physiological period (average age 25.4 ± 2.8). Histological examination of endomyometrial scrapings in puerperas with hypotonic and infectious variants of postpartum endometritis showed a difference in their morphological picture, indicating the separation of the pathogenetic mechanisms of the formation of HPE and IPE.

The aim of this research was to study the effectiveness of different medicinal forms of the products for local fluorine prophylaxis in vitro. The object of study was the intact first premolars removed on orthodontic indications. The extracted teeth were kept in saline solution. Then the Flairesse line product (DMG, Germany) for local fluorine prophylaxis (on the producer’s instruction) was applied onto the proximal surfaces. In all studied groups the depth of penetration into an enamel of ions of fluorine was recorded up to 20 мm. The difference in radiation levels is significant (p = 0.0125). Groups of teeth with a focus of subsurface demineralization formed under laboratory conditions, on the surface of which fluorine-containing preparations were applied (comparison groups), had statistically significantly higher concentrations of fluoride ions at a depth of 15 html5-dom-document-internal-entity2-956-endm than teeth with enamel caries in the stage of spots on the proximal surface, on which fluorine-containing preparations were applied (control) (p < 0.0125).

The purpose of the work is to assess the participation of β- and  γ-herpes viruses in the development of infectious mononucleosis in children. The study observed 47 children aged from 10 months to 10 years. Determination of the genome of herpes viruses was carried out by the method of quantitative polymerase chain reaction in “real time”. According to our data, the causes of infectious mononucleosis in children are Epstein-Barr virus (EBV) in 21.4 % of cases, human herpesvirus 6B (HHV-6B) – in 15 % of cases as monoinfection or in combination with EBV and/or human herpes virus type 7 (HHV-7). HHV-7 monoinfection, as well as cytomegalovirus (CMV) as a cause of infectious mononucleosis, was not recorded in our study. In 14.3 % of children, HHV-6B can manifest itself as an acute respiratory disease. The HHV-6B strain of the virus is predominantly circulating in our region.

The authors present the clinical and epidemiological features of leptospirosis among residents in Belarus. The main reservoirs of infection are described. We have demonstrated a clinical case of severe leptospirosis. To solve the set tasks in this research, we used methods of epidemiological diagnostics and statistical research methods. According to the results obtained, the incidence of leptospirosis in Belarus for the studied interval (2007–2020) was unevenly distributed over the years. The maximum and minimum indicators differed six times. The average long-term incidence rate was 0.25 cases per 100 000 population (95 % CI 0.2–0.3). The analyzed period was characterized by a stable long-term epidemic trend towards a decrease in morbidity. Severe clinical signs of leptospirosis have been associated with L. incterohaemorragiae in a male patient. The highest average annual incidence rates of leptospirosis were noted in the Mogilev and Gomel regions (0.85 %00 and 0.49 %00), and the lowest rates were recorded in the Brest region (0.03 %00).

Intervention in the sleep-wake cycle affects the physical and mental state of the body, the social and professional functioning of the doctor working at night shift. This article presents the results of a study conducted among 755 doctors, 446 of them work at night shifts (the main group), 309 don’t work at night shift (the comparison group). Significantly worse results were obtained in the main group in relation to the comparison group with indicators of all Pittsburgh Insomnia Rating Scale (PIRS) subscales with a significant effect. Unmarried respondents of the main group showed significantly worse results on a number of PIRS subscales. In the comparison group, the differences in the PIRS subscales between married and unmarried respondents were statistically unreliable. Male respondents, who work at night shifts, are less vulnerable to such sleep disorders as falling asleep, the duration of sleep, the frequency of nighttime awakenings and the state of dissatisfaction of sleep's quality. The main group of respondents who had to work two consecutive night shifts during the month showed significantly worse results in a few PIRS subscales in relation to their colleagues who didn’t have two or more consecutive night shifts. The obtained results allow for consider the doctors over 40 y.old and working at night shifts as more vulnerable to sleep disorders then their colleagues under 40. Respondents with morning and intermediate types of circadian rhythms are less vulnerable to circadian desynchronosis and showing the best results on the most PIRS subscales in relation to the respondents with an evening type of daily rhythm.

Introduction. The development of microsurgical techniques has made it possible to successfully restore large bone defects of the forearm bones, but the methods currently available have disadvantages. The development of new original methods of vascularized plastic surgery of diaphyseal defects of both forearm bones is still relevant.

Purpose – develop a new method of bone grafting of large bone defects of both forearm bones using a single vascularized divided bone flap of the fibula, which allows to reduce the duration and traumatic nature of the operation with good functional outcomes.

Materials and methods. The study involved 5 patients (3 men and 2 women) with a major defect in both forearm bones. The average age of the patients was 40.6 years (from 10 to 64 years). The sizes of defects of both forearm bones ranged from 6 cm to 7 cm (on average, 7.2 cm).

Results and discussion. In order to improve the technique, we have developed a new method of bone grafting of large bone defects of both forearm bones using a single vascularized divided bone flap of the fibula.

Conclusion. The developed new method of bone grafting of large bone defects of both forearm bones using a single vascularized divided fibular bone flap allows to reduce the duration and traumatic nature of the operation with excellent and good functional outcomes. A patent for the invention was obtained (patent No. a 20130741) and two instructions for the method were developed (instructions for use. The registration number is 035-0515 and 036-0515.

Diagnostics of allergic diseases today remains relevant, despite the growing importance of infectious pathology. Diagnosis of allergic conditions is based on determining the level of total serum and specific immunoglobulins E (tIgE) as a key part in the allergic reaction. Non-allergic factors affecting the level of tIg E include age, gender, place of permanent residence, and smoking. The study involved 181 patients, of which 104 patients formed the atopy group, the second group consisted of 38 patients diagnosed with chronic obstructive pulmonary disease phenotype with partially reversible obstruction (COPD/NAA) and 39 healthy volunteers made up the control group. The groups were matched for gender and age. The study evaluated the influence of these factors on the level of tIg E in patients with atopy and COPD/NAA. As a result, tIg E was higher in patients under 40 years old, living in the city, with a smoking experience of more than 10 years. The relationship between the change in lipid metabolism and the level tIg E was not revealed.

Introduction. During the global pandemic, several studies have been published examining various functional parameters of the respiratory system in COVID-19 patients at different stages of recovery. However, there is no evidence of respiratory dysfunction in the acute phase of SARS-CoV-2.

Aim. We aimed to study impaired respiratory function in patients with SARS-CoV-2 at the hospital stage of treatment.

Material and method. The study cohort consisted of 103 patients with COVID-19, aged 62 ± 13 years, who were treated in the infectious diseases department from December 2020 to May 2021. All of the patients, in addition to standard clinical, laboratory and instrumental examinations to determine the subgroups with severe and moderate severity of the infectious process, underwent a study of the respiratory function with МАС2-БМ (BY) spirometer. Statistical analysis was performed using the t-test or chi-square test, and the Pearson correlation test was used to determine whether there was a relationship between variables at a statistically significant level of p < 0.05.

Results. Pathological changes in the function of external respiration were detected in 73 patients (71 %), mainly with a restrictive type of pulmonary dysfunction (46 %) and less often with obstructive (15 %) and mixed (10 %) types. The incidence of functional impairment (89 %) was significantly higher (p = 0.0048) in the subgroup of patients with severe COVID-19 compared with the subgroup of moderate severity (62 %). Moreover, a statistically significant negative correlation (r = –0.305411, p > 0.05) was established between the percentage of parenchymal lung lesions according to computed tomography and the % of predicted values of lung vital capacity by spirometry.

Conclusion. Dysfunctions of external respiration, predominantly restrictive nature, were identified in more than two-thirds of the COVID-19 patients in the acute phase, and an increase in the percentage of damage to the lung parenchyma was associated with a decrease in the vital capacity of the lungs.

Sinus cysts are common pathology in otorhynolaryngology. Often localized in the maxillary sinuses.

The article presents the age and gender characteristics of patients with a cyst of the maxillary sinus.

The most common complaint was a feeling of pressure, distention or pain in the projection of the maxillary sinus with a cyst (82.8 %). CT data were the most informative of the imaging methods (87.5 %). During endoscopy of the nasal cavity in patients with a cyst of the maxillary sinus, curvature of the nasal septum most often occurred (42.3 %), as well as structural features of the ostiomeatal complex of the ethmoid bone: deformation of the uncinate process and hypertrophy of the ethmoid vesicle (31.2 %), deformity of the middle turbinate (28.3 %), bulla of the middle turbinate (18.7 %).

Access to timely diagnosis and patient-friendly drug-resistant TB treatment regimens is a priority in the fight against TB.

The aim of the work is to improve the efficiency of treatment of patients with tuberculosis in outpatient and inpatient settings by developing a new procedure for the provision of anti-tuberculosis care.

Materials and methods. The object of a retrospective cohort study was 15617 patients with tuberculosis who underwent treatment in the period 2015–2019.

Results and discussion. Despite the annual decrease in the total number of reported cases of tuberculosis, the pattern of cases of multidrug-resistant tuberculosis has a heterogeneous trend. There has been a decrease in the proportion of MDR-TB cases among previously treated cases and an increase in new cases. There is an increase in the proportion of cases that successfully completed treatment in all patient cohorts.

Conclusion. The main number of losses for follow-up is recorded at the outpatient stage of treatment, which is associated with problems in the formation of patient adherence to treatment, as well as with insufficient quality management and clinical and laboratory tracking of adverse drug events. Bed efficiency indicators for the treatment of MDR-TB patients indicate insufficient bed efficiency.

Postoperative septic anterior mediastinitis is the most dangerous complication after heart transplantation which is associated with high lethality. An analysis of diagnostic and successful treatment for postoperative mediastinitis and multiple septic complications after heart transplantation in patient with novel coronaviruses infection is presented. Treatment includes using topical negative pressure wound therapy and combined omentomyoplasty for closure of postresectional chest wall defect.

The article presents data on the topographic and morphometric features of the myocardial bridges (MM) and the sections of the branches of the coronary arteries located under them, established by computed tomography (retrospectively) in the hearts of patients with cardiovascular pathology. It was found that the majority (92.1 % of cases) of MM occur over the anterior interventricular branch (LAD) of the left coronary artery. In most cases (74.29 %), MM was located in the second segment of the LAD, less often (20 % of cases) – in the third segment, extremely rarely (5.71 %) – in the first segment of the artery. The features of their structure depending on the dominance of the coronary circulation are shown. The height of MM in hearts with the right-dominant coronary circulation significantly exceeds the height of MM in hearts with the codominant coronary circulation, which indirectly indicates a greater probability of developing cardiovascular pathology in the arteries under MM in hearts with the right-dominant circulation. Three variants of the origin of the first septal branch from the LAD were identified: up to MM (64.29 % of cases), at the level of the beginning of MM (14.28 %) and from the segment of the vessel located under MM (21.43 %). The features of the passage of the segment of the LAD located under MM through the myocardium of the interventricular septum are described.

This article shows the peculiarity of the course and difficulties of diagnosing Still's disease in adults. Still disease is a rare multisystemic inflammatory disease of unknown nature. The incidence of Still's disease is 0.1–0.4 cases per 100 thousand population. Therefore, each case of the disease is of significant interest to doctors of various specialties. The article presents patient B. at the age of 20, who entered a urological hospital with long-term fever, signs of systemic inflammatory response syndrome, suspected kidney carbuncle. The patient underwent a comprehensive examination. As a result of the examination, the diagnosis of kidney carbuncle was excluded and the presence of Still's disease in adults was confirmed. After intensive care, persistent remission of the disease was achieved. This clinical case have demonstrated peculiarities of the course and diagnostic of patient with Still 's disease.

The article presents the epidemiology of ectopic pregnancy. According to world statistics, the frequency of ectopic pregnancy occurs from 3 to 5.5 %. At the same time, the mortality rate is slightly less than 1 % (10 cases per 1000 people). The main reasons for the abnormal attachment of the ovum in the cervix are atrophic and dystrophic changes in the mucous membrane of the uterine cavity, as well as the presence of isthmic-cervical insufficiency and features of the ovum itself. Particular attention is paid to the modern diagnostic capabilities of cervical pregnancy, as well as differential diagnosis. The modern methods of treatment of this pathology are indicated. Cervical pregnancy is a gynecological emergency and requires an urgent comprehensive approach in both diagnosis and treatment. Particular attention is paid to modern trends in treatment – organ-saving technologies. The article presents 4 clinical cases of cervical pregnancy with a differentiated approach to treatment tactics.

Systematized, non-collisional legislation is a required condition of the medical officers legal culture making. Modern medical care circumstances underline the need of the current Law of the Republic of Belarus from June, 18th 1993 № 2435-XII «About health care» revision. The new Law of the Republic of Belarus from December, 11th 2020 № 94-З «About health care and psychological help laws changes» makes some conceptual changes to the current health care legislation. In the process of improving legislation in the field of healthcare, the goal of healthcare management is determined - strengthening the health of the population, expanding, inter alia, the preventive direction, informing and motivating patients to a healthy lifestyle, promoting a healthy lifestyle, for specialists – advanced training, the use of high-tech treatment methods.

In 207 patients with different stages of CKD and 60 individuals in the comparison group, the parameters of the renin-angiotensin-aldosterone system and their relationship with renal function and PTH levels were determined. It was found that patients with CKD are characterized by a tendency towards a lower level of aldosterone in the blood serum, up to the terminal stage of CKD, as well as hyperreninemia in the early stages of CKD and its decrease with the progression of the disease. The highest incidence of hyperaldosteronism was recorded in dialysis and transplant patients. A weak correlation was found between PTH and aldosterone levels in patients with CKD. At the same time, multidirectional changes in the medians of blood concentrations of aldosterone and renin were revealed in subgroups of patients with the presence and absence of SHPT.