An analysis of the world literature on approaches to the diagnosis and treatment of bone cysts in children, as well as pathological fractures resulting from a decrease in bone strength associated with the thinning of its cortical layer, was carried out. To date, there is not enough clarity about the need to use one or another method of treatment, which indicates the relevance of this problem and the need to develop a differentiated approach to managing patients with this pathology. The main direction in the research and development of the approach is the combination of the puncture method of treatment with steroid injections in combination with elastically stable intramedullary reinforcement, which practically excludes the possibility of a pathological fracture, with simultaneous equalization of intracanal pressure and the creation of an additional drainage system using TEN (Titanium Elastic Nail).

Dysplastic lesion of the connective tissue accounts for 5 % of all systemic diseases. It is caused by a genetic breakdown, therefore, it requires monitoring and treatment throughout life. One of the manifestations of dysplasia on the part of the heart and large vessels is the presence of small anomalies. Such anomalies are mild forms of pathology, they are not hemodynamically significant and are not fatal, but require constant maintenance therapy. There is no specific prevention of connective tissue dysplasia and minor heart anomalies. Leading is a healthy lifestyle. Modern drugs and medical procedures allow maintaining the quality of life of patients at a high level.

The article presents a short literature review of on first aid for severe external bleeding, and analyzes possible approaches to training. The review takes into account the recommendations of the European Resuscitation Council 2021 and the recommendations of the Red Cross and Red Crescent Society 2020 on first aid, resuscitation and education, American Heart Association and American Red Cross Focused Update for First Aid 2020, as well as other recent scientific papers on this topic. New changes in international recommendations in comparison with the previous ones are highlighted, their assessment is given. Special attention is given on the stages of training and the conditions required for it.

International recommendations and own experience in external bleeding first aid teaching for non-healthcare professionals and healthcare professional are compared. The key components of the first aid algorithm have been identified. Practical recommendations for assessing the situation and completing the first-aid kit, for training in pressure on the wound, the use of a commercial or improvised tourniquet, pressure and hemostatic bandage are given.

The dynamics of hospital morbidity and lethality rate in acute biliary pancreatitis are analyzed; demographic regularities of acute biliary pancreatitis morbidity are determined; general characteristics of clinical observations are presented.

The increase in the absolute number of patients with acute pancreatitis of biliary etiology and necrotic pancreatitis of biliary etiology in many respects determines the growth of acute pancreatitis morbidity in general.

The morbidity of acute pancreatitis of biliary etiology is almost evenly distributed between men and women with the ratio 1,4:1. The peak of morbidity (36,1 %) falls on elderly age. In the age structure of acute biliary pancreatitis the share of elderly and senile age was 62,6 %. Every third patient sought medical help during the first 12 hours, 64,4 % – during the first 24 hours, 78,1 % – during the first 48 hours of the disease onset. The category of patients with the highest proportion (14,2 %) were elderly men, who came for treatment in the first 24 hours after the onset of the disease.

In 82,7 % of patients with acute biliary pancreatitis the premorbid status was aggravated by two or more concomitant diseases, every 5th patient had CHD manifested by angina pectoris, postinfarction cardiosclerosis or rhythm disturbances. Premorbid status has a significant influence on the overall mortality in acute pancreatitis of biliary etiology.

The relapses of acute pancreatitis of biliary etiology make up 9,6 % of all the attacks of the disease and 25,3 % of all relapses of acute pancreatitis, and in 47,6 % of cases of recurrent acute pancreatitis of biliary etiology the disease has an equally or more severe course with possible lethal outcome.

Iron deficiency is the most common cause of postpartum anemia due to food habits, insufficient maternal iron reserves at the beginning of pregnancy, increased iron requirements associated with pregnancy, and blood loss during childbirth. As a non-drug treatment the use of hyperbaric oxygen therapy (HBO) is proposed. The main essence of the action of HBO is reduced to a rapid increase in oxygen tension in tissues due to an increase in the amount of dissolved oxygen in the blood, an increase in its diffusion rate between the blood and the hypoxic tissue site. Non-specific adaptive reactions developing during the use of HBO provide a wide range of therapeutic effects. At the same time, along with the beneficial effect, hyperoxia can also have a toxic effect, the clinic of which depends on the duration of exposure, individual sensitivity to oxygen, on the influence of concomitant factors: temperature environment, physical activity, density of the gas mixture. The implementation of the compensatory capabilities of HBO is promising only with timely optimal use of the method.

Fibula plays important role in the stability of the ankle joint. Precise restoration of its length, axis and rotation is critically important in intraarticular malleolar and distal tibia fractures. Open reduction and internal fixation with plate is widely accepted method of treatment of the fractures of lateral malleolus and fibular shaft. Nevertheless, substantial number of complications accomplishes this treatment modality. Danger of wound complications is associated with borderline blood supply in the zone of surgery and with wide surgical exposure performed on swollen soft-tissues. Risk of secondary displacements is associated with advanced osteoporosis. Both factors lead to significant increase of number of complications in the elderly patients with impaired bone mineral density and altered nutrition of the soft-tissues. These dangers has led to the development of less invasive methods of intramedullary fixation in the lateral malleolus and fibular shaft. This article provides data on evolution of the methods of surgical fixation of these fractures.

At the end of 2019, the world faced a serious problem – an outbreak in China of a new coronavirus infection caused by SARS-CoV-2.

Aim. To study the dynamics of the clinical and functional state of patients, the state of humoral immunity after coronavirus infection at different time intervals.

Materials and methods. The study included 153 patients hospitalized in the 10th City Clinical Hospital in Minsk with a confirmed diagnosis of coronavirus infection in the period from 12/01/2021 to 12/31/2021. Depending on the severity of the disease, patients were divided into 3 groups: severe (n = 54), moderate (n = 51), mild (n = 48). All patients underwent standard laboratory and instrumental studies. After discharge, the patients were under dynamic observation. After 3, 6 and 9 months, the clinical and functional state was assessed, the content of IgG to SARS-CoV-2 was determined.

Results. In the group with a severe course of COVID-19, subfebrile body temperature persisted (11.1 % of patients), saturation of 94–90 % (5.6 % of patients), an increase in blood pressure by 9 months after the disease, while in groups with a moderate and mild course of the disease, the indicators normalized by the 6th month. The most pronounced humoral immune response was observed 3 months after the disease in the group of patients with a severe course (IgG to SARS-CoV-2 was detected in 88.9 %) compared with a moderate course (72.5 %) and mild (37.5 %). An increase in ferritin levels >330 μg/l may indicate the persistence of the humoral immune response beyond 36 weeks.

Conclusion. Subfebrile body temperature, low saturation, and a statistically significant increase in blood pressure by 9 months after the illness persisted in patients who underwent severe COVID-19. At the same time, these patients showed the most pronounced immune response to SARS-CoV-2.

A comprehensive examination and treatment of 61 patients who were hospitalized at the 3 E. V. Klumov City Clinical Hospital in the period from 2020 to 2022 was carried out. All puerperas included in the study were divided into three groups: group 1 (main) – 20 patients (mean age 24.2 ± 2.5), who, along with intramuscular administration of oxytocin, 5 IU with an interval of 12 hours, received PGE1 (mirolute tablets) 200 mcg orally every 12 hours, group 2 (comparison) – 21 patients (mean age 23.7 ± 2.0), receiving standard uterotonic therapy (intramuscular injection of 5 IU of oxytocin 2 times a day for 3–4 days). The control group consisted of 20 women with uncomplicated postpartum period (mean age 23.2 ± 2.1). Procedures of alternating magnetic field (AMF) were carried out for all puerperas on the area of projection of the uterus 1 time per day every day. It has been established that the use of prostaglandin E1 in the conservative treatment of primary uterine subinvolution without signs of an inflammatory process increases its effectiveness by 2.86 times compared with the use of oxytocin alone.

The following criteria for the effectiveness of complex therapy for puerperas were established: a significant decrease in the size of the uterine cavity in comparison with the traditional treatment group by 1.8 times (11.3 ± 0.2 and 6.2 ± 0.2 mm, respectively; p₁ = 0.022). In patients with subinvolution, an inverse pronounced relationship was found between the size of the uterine cavity and the content of oxytocin (r = –0.9784; p = 0.013) and prostaglandin E2 (r = –0.9566; p = 0.015) in the blood serum, which dictates the need prescribing means and methods that increase the contractile properties of the uterus during its subinvolution.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. In this pathology, the morphofunctional characteristics of the endometrium have features that cause violations of the realization of reproductive function and unfavorable outcomes of gestation, as well as the risk of developing endometrial cancer. According to the study, the normal characteristic of the endometrium was found in 22 (44.9 %). In the structure of endometrial pathology in patients with PCOS, endometrial polyps accounted for a significant proportion – 16 (32.6 %) patients, chronic endometritis – 30 (61.2 %), simple endometrial hyperplasia – 7 (14.2 %). Functional pathology was also noted: proliferative endometrium with pathology (anovulatory endometrium) was found in 9 patients (18.3 %), endometrial hypoplasia – in 7 (14.2 %). PCOS has a high incidence of endometrial pathology, which necessitates the development of clinical approaches for the diagnosis and correction of the pathology.

Type 2 diabetes mellitus is an urgent problem of health care. Comparison of the structure of the Rivaroxaban with the structure of a number of experimental drugs, which are Glucokinase activators, revealed the perspectives of its evaluation in the drug design for the treatment of type 2 diabetes. In in silico experiments, the interaction of Rivaroxaban with glucokinase, which is involved in glucose phosphorylation in liver and pancreas cells, has been studied. Using molecular docking methods, complexes of Rivaroxaban with a protein in the allosteric center responsible for the action of glucokinase activators, were generated: the minimum binding energy was found 9.41 kcal/mol. The results obtained in the experiment in silico open the perspectives of design and development of the new effective antidiabetic drugs as well as investigation of the concomitant action of the anticoagulant Rivaroxaban.

The modern step in development of restorative medicine for patients with cerebralin farction (CI) is associated with phenotype-oriented medical rehabilitation based on a biomechanical analysis of specific motor impairments that reflect the nature of motor adaptations. The aim of the study was to evaluate the dynamics of adaptive kinematics (ADK)and the clinical picture of CI under the influence of adaptive kinesitherapy (AK). The object of the study were healthy volunteers (n = 92) and a cohort of CI patients treated according to the complex therapy program (groups “P” (n = 50) and “O” (n = 57)) and AK (group “O”) The subject of the study was a comprehensive assessment of the data obtained from clinical testing and biomechanical data in comparison with normal values. As a result of the study, it was found that AK significantly (p < 0.022) improves ADK in patients with various patho biomechanical phenotypes (PBP) of CI. Similarly, AK has a positive effect on the dynamics of the level of daily activity (p < 0.006), mobility level (p < 0.001), gait stereotype function (p < 0.001), and fatigue level (p < 0.001), increasing the overall effectiveness of the complex therapy program (p < 0.003) with an odds ratio of 4.03 (95 % CI 1.44–11.24):5.1 (95 % CI 1.17–22.51) in patients with PBP 1 (p < 0 .02); 8.1 (95 % CI 1.15–55.61)in patients with PBP 2 (p < 0.02), and 7.71 (95 % CI 1.76–33.72) in patients with PBP 3(p < 0.003), with excellent diagnostic quality (AUC = 0.92).

We studied the treatment outcomes in 124 patients (102 women and 22 men) aged 51 to 83 years (median 69 [65; 76] years) on 124 knee joints. Patients were divided into 2 groups: the study group – 62 people aged 51 to 83 years (median – 69.1 [64;74] years), who used computer navigation, and the comparison group – 62 people aged 56 to 83 years (median 69 [65;78] years), in which surgical intervention was performed according to the standard technique. Long-term results were studied in terms of 3 to 36 months. During the examination, the deformity variant was determined, radiometric parameters of the knee joints were measured using the Knee Society Score (KSS), Functional Knee Society Score (FKSS), and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scales. Also, functional stress tests were performed to assess the stability of the knee joint in the frontal plane and functional indicators of the range of motion.

After surgery, in the study group, the WOMAC values decreased by 5.90 times and the median value to 11 [8;15] points (p < 0.001), in the comparison group they decreased by 4.81 times to 13.5 [8;16] points (p < 0.001), KSS increased by 3.88 times. Median KSS in the study group increased 3.91 times and reached 86 [84;95] points (p < 0.001), in the comparison group it increased 3.86 times only to 85 [77;95] points (p < 0.001). FKSS data increased by 1.75 times. The median FKSS in the study group increased 2.08 times and reached 94 [85;99] points (p < 0.001), in the comparison group it increased 1.60 times only to 93 [83;95] points (p < 0.001).

The aim of the presented study was to study the level of intra-abdominal pressure (IAP) and its effect on respiratory status indicators in patients with acute necrotizing pancreatitis (АNP). The severity of the course, the dynamics of IAP and a number of indicators of respiratory status in 53 patients in the early phase of acute pancreatitis were analyzed. Depending on the IAP, 3 clinical groups were identified at admission: group 1 – 18 patients with IAP at 12–15 mmHg, group 2 – 22 patients with IAP at 16–20 mmHg, group 3 – 13 patients with IAP at 21 or more mmHg. The close relationship of a high level of IAP has been proven (16–20 mm Hg and above) with the severity of the course of acute pancreatitis. It was found that a decrease in the level of IAP to 12 mmHg in patients with ANP is accompanied by stabilization of respiratory status indicators (an increase in the respiratory index, pO2 in arterial blood aand lung compliance). Thus, IAP is one of the criteria for the severity of the condition of patients with ANP.

Elimination of the etiopathogenetic factor plays a key role in the treatment of venous trophic ulcers. Currently, preference is given to operations using laser energy. Also, at present, in the treatment of trophic ulcers and long-term non-healing wounds, methods of cell transplantation and cell therapy are being actively researched and implemented. The use of methods of cell transplantation and cell therapy, according to the authors, can accelerate the healing of trophic ulcers and reduce the risk of recurrence.

Goal and objectives. To introduce into clinical practice and evaluate the results of the elimination of vertical and horizontal venous reflux by endovenous laser-beam coagulation in combination with autotransplantation of dermal fibroblasts in patients with venous trophic ulcers.

Materials and methods. Surgical correction of venous reflux with following autotransplantation of dermal fibroblasts was carried out in 18 patients with trophic ulcers of venous etiology during 2018–2022.

Results and its discussion. The effect of usage of autologous dermal fibroblasts was registered in 100 % of cases. All 18 patients achieved complete healing of ulcers within 2 to 4 weeks after cell transplantation. Patients were examined 1 year after cell autotransplantation. There were no recurrences of trophic ulcers.

Conclusions. The usage of laser-beam methods for correction of venous reflux in combi- nation with autotransplantation of dermal fibroblasts made it possible to achieve complete healing of ulcerous defect in patients with trophic ulcers of venous etiology. When evaluating long-term results, the absence of relapses was also noted in 100 % of cases.

Based on the survey of doctors on their attitude to physical education, the availability of knowledge and skills in the prevention of diseases by means of physical culture, optimal motor activity of patients, it is concluded that half of the doctors pay little attention to physical education and have insufficient knowledge of disease prevention by means of physical culture culture. However, the overwhelming majority of doctors point out that it is necessary to carry out work on the prevention of diseases by means of physical culture with patients, but subject to the availability of visual materials and time. More than 60 % of doctors would like to improve their knowledge in this area. Most doctors believe that it is necessary to form knowledge and skills on optimal motor activity of patients during training in institutions of higher medical education, as well as the organization of advanced training courses for doctors on this topic.

Introduction. The problem of penetrating ocular injuries with a retained intraocular foreign body is socially important; the assessment of the prognosis of the visual outcome in patients remains relevant.

Materials and Methods. The objects of the study were 122 patients (119 men, 3 women) with a penetrating ocular injuries with the presence of an intraocular foreign body, who were treated in the microsurgery department № 2 of the 10-th city clinical hospital for a 10-year period. A set of methods was used, including a basic ophthalmological examination and additional instrumental methods. Two groups of patients were distinguished – with favorable (final best corrected visual acuity ≥0,3) and unfavorable (<0,3) outcomes.

Results. The general group of the patients was characterized by the predominance of people of young working-age (34.0 [26.0; 47.0] years). The percentage of unfavorable visual outcome was 40.16 %. Retinal detachment (p = 0,012), vitreous hemorrhage (p = 0,041), inflammatory complications, incl. endophthalmitis (p = 0,001), intraocular foreign body volume (U = 984,0, p < 0,0001) were significantly associated with poor outcome of penetrating injury. The intraocular foreign body volume associated with poor visual outcome was determined to be more than 4,5 mm³.

Conclusion. Establishing of the factors associated with an unfavorable outcome will make it possible to develop effective predictive models for identifying risk groups at an early stage and improve the tactics of treating patients with a penetrating ocular injuries with a retained intraocular foreign body.

The purpose of this work was to study the incidence in children born and living in the territory of the Stolin district of the Brest region, irradiated in utero due to the incorporation of radioactive iodine (I-131), as a result of the Chernobyl accident, compared with the health status of children who were born later and were not exposed to such irradiation. The study group included 123 individuals, the comparison group included 113 residents from the same area, identical in their status, but born in 1988. It has been established that the transplacental intake of radioactive iodine into the thyroid gland (TG) of the fetuses of pregnant women formed smaller absorbed doses than that of their mothers. Increased morbidity among those irradiated in utero was recorded immediately after the accident and remained at a higher level thereafter. In the control group, the incidence has stabilized after about 2000. An increase in the incidence of mental and behavioral disorders, diseases of the nervous system, circulatory system and diseases of the genitourinary system was recorded. The study of gender characteristics revealed more frequent changes in the health status of females. In this article, the data obtained are discussed from the point of view of the instability of specific genes of thyroid cells after the incorporation of I-131, which are capable of being responsible for the synthesis of thyroid hormones, which may be reflected in the subsequent appearance of various pathologies.

The article presents the results of a study of erythrocyte and reticulocyte indices in patients with juvenile idiopathic arthritis (JIA).

The aim of the study was the possibility of early diagnosis of anemic syndrome in patients with JIA based on the study of reticulocyte indices.

Materials and methods. 118 patients with JIA at the age of 11 (6; 14) years underwent a general blood test with the determination of reticulocyte parameters. The comparison group included 30 healthy children.

 Results and conclusions. Revealed a significant decrease in hemoglobin (p = 0.001) less than 120 g/l in 22.9 % of patients with JIA. A statistically significant difference from the comparison group was a decrease in the average concentration of hemoglobin in an erythrocyte (p = 0.03). An increase in the content of reticulocytes with a predominance of immature forms was found in 28.8 % of patients with JIA. A decrease in the hemoglobin content in the reticulocyte and erythrocyte was detected in 28.8 and 44.9 % of cases. The systemic form of the disease affects erythropoiesis in the form of an increase in the content of reticulocytes with an increase in the content of immature forms (37.5 %), a decrease in the concentration of hemoglobin in the reticulocyte and erythrocyte (25 and 58.8 %).

Allogeneic plasma enriched with platelets (hereinafter ALPEP/PRP) is often used in various branches of medicine. The scope of application of PRP therapy varies from stimulation of bone regeneration, healing of wounds and ulcers, musculoskeletal injuries to increasing the possibilities in the engraftment of various types of transplants. Due to the native properties of platelet-enriched plasma, its introduction into the human body is one of the promising manipulations in tissue regeneration. After the destruction of platelets, ALPEEP contains html5-dom-document-internal-entity2-945-end-granules, from which, after activation, many factors are released, such as transforming growth factor-beta (TGF-html5-dom-document-internal-entity2-946-end), vascular endothelial growth factor (VGFF) and epidermal growth factor (EGF).

The article presents the results of our own studies of clinical, anamnestic and laboratory parameters in patients with severe COVID-19. The aim of the study was to identify possible clinical and laboratory predictors of an unfavorable outcome of a severe course of Covid-19 in patients with diabetes mellitus and hyperglycemia. A retrospective analysis of data from primary medical records of 320 patients was performed. All patients received medical care in the intensive care unit of the infectious hospital in Minsk from June 2020 to March 2022. Based on the results of the assessment of glycemic parameters, all patients were divided into the following groups: 224 people with hospital hyperglycemia (HH), 51 patients with a history of diabetes mellitus (DM) and/or newly diagnosed and 45 people without glycemic disorders. Covid-19 infection confirmed by a positive PCR or antigen test from respiratory swabs. Patients with HH and DM had higher levels of ESR, procalcitonin, CRP, LDH, neutrophils, more pronounced lymphopenia, which indicated a more pronounced inflammatory process. The level of D-dimers was assessed as a biomarker of the coagulopathy process, it was also higher in the groups of patients with DM and HH. According to the results of the study, 70 % of patients with severe COVID-19 had newly diagnosed hyperglycemia, and from day 4, patients with an unfavorable outcome showed a tendency to persistent hyperglycemia, which potentially indicates its role as a prognostic parameter.

Gunshot wounds of extremities are the most frequent among gunshot and explosive injuries. Debridement is the main method of treatment of this type of damage. Surgeons of civil hospital organizations have difficulties in determining the scope of surgical intervention and the priority of the performed activities in most cases. This is due to the lack of clinical experience in providing medical care to patients with a gunshot injury. The concept of «First contact surgery» is a set of the minimum required amount of the debridement aimed at saving the patient's life and preventing the development of serious complications. The author considers in details the content of each element of the debridement, options for its implementation, depending on the equipment of the hospital and the surgeon's qualifications. The main aims for the surgeon at the first contact with a patient with a gunshot injury are to stop external bleeding, determine the state of the main blood flow in the limb, eliminate uncompensated ischemia of the limb, wide the wound open, refuse the primary wound suture, perform immobilization, if necessary, and prescribe antibiotic therapy.

Health planning is an integral part of the state plan for economic and social development.

The principles of planning were developed at the dawn of the construction of a new state and have been developing throughout its subsequent history.

Planning tasks are comparable to the most important branches of economic activity.

Their implementation in all its diversity is in the line of life support. The political acceptability of the criteria for organizing the health care system is important. Public medicine is class medicine. A public doctor cannot be apolitical. Without broad involvement of the public, it is impossible to make the work of health care alive, capturing the interests of the population.

The article deals with the influence of the activity of juvenile idiopathic arthritis (JIA) on the state of the reticulocyte link of erythropoiesis. The aim of the study was to study the effect of the activity of the inflammatory process in JIA on erythropoiesis by studying reticulocyte parameters.

Research methods: 118 patients with JIA and 30 patients of the comparison group were included in the study. Patients underwent a complete blood count with the determination of the following parameters: the absolute and relative reticulocyte count (Ret# and Ret‰), the amount of hemoglobin in the reticulocyte (Ret-He) and erythrocyte (RBC-He), the fraction of immature reticulocytes (IRF), the distribution of reticulocytes by degrees of light scattering into high fluorescent (immature, HFR), medium fluorescent (immature, MFR) and low fluorescent (mature, LFR).

Results. Statistically significant differences were found in the content of reticulocytes and in the qualitative ratio of reticulocytes, the content of hemoglobin in the reticulocyte and erythrocyte, delta-hemoglobin, depending on the activity of the inflammatory process.

Findings. The activity of the inflammatory process affects erythropoiesis in the form of an increase in the production of reticulocytes, predominantly immature forms with a peak at a high degree of activity. As the activity of the inflammatory process increases, the need for iron increases in order to maintain adequate hemoglobin synthesis. As disease activity increases, the risk of microcytic anemia increases.

During the social adaptation of children with autism spectrum disorders, there are many difficulties associated with both speech disorders of varying severity and the problem of establishing emotional ties. Social adaptation is an adaptation to the environment, the relationship between a person and the environment, during which the requirements and expectations of the parties gradually begin to coincide. Children with autism spectrum disorders have a desire to maintain constancy, the avoidance of communication, as well as emotional and physical contact, the desire for loneliness. The aim of the work is to discuss the need for such children to be in the environment of an ordinary children’s team, accepting the experience of peers, the preservation of intelligence. The authors describe one clinical case of a patient with an autism spectrum disorder who graduated from a general education school accompanied by a tutor and regular speech therapy classes.

Granulomatosis with polyangiitis is generally a rare disease although prevalence data are varying. In children this disease occurs at a rate of 1 per 2 million. There are no definite statistics about this pathology in Belarus. The clinical picture of granulomatosis with polyangiitis is characterized by a triad: involvement of ENT-organs, lungs and kidneys. Affection of the upper respiratory tract in adults occurs in 87–94 % of cases. According to various data, in children upper respiratory tract involvement at the beginning of the disease occurs in 35–90 %. Diagnosis of granulomatosis with polyangiitis is difficult. Only 50 % of patients are diagnosed within the first 3–6 months of onset, and 7 % are not diagnosed even within 5–16 years of the first clinical symptoms because there is no “gold standard" for diagnosis. The article presents its own clinical observation of a rare case of granulomatosis with polyangiitis in an adolescent who complained of prolonged nasal congestion, nasal bleeding, unpleasant (purulent) smell from the nose when breathing, prolonged subfebrile fever in the evening, headaches, increased blood pressure, night sweats, increased lymph nodes, weight loss. As a result of the search for the rigid course of ENT-pathology and concomitant syndromes this patient was diagnosed with granulomatosis with polyangiitis.

Semashko N. A. came to the leadership of the healthcare industry at a historical period when there was the greatest social need for such a leader.

Builder of new healthcare. He had a fighting temperament, lived a bright, fruitful, struggle-filled life.

A skilled organizer, the breadth of his interests was combined with high productivity.

The activity is distinguished by the depth of perception of reality, versatility and versatility.

His quick response to the questions put forward by life is striking. A talented teacher, his work is a chronicle of healthcare.

In every major event of the Soviet government, he saw a deep hygienic meaning. The quality of medical care was considered the central task of health authorities.

The article summarizes historical information about the outstanding South African cardiac surgeon and transplant surgeon, scientist, interesting writer, public figure and philanthropist Christian Nietling Barnard.

The main data from his unusual biography, personal life, multifaceted highly professional activity, including the world's first unique operation – heart transplantation from person to person are given.

Interesting, little-known facts from the history of heart transplants in the world, the Union of Soviet Socialist Republics, as well as in the Republic of Belarus are given.