bluuebunny/crossref_metadata_2025 huggingface dataset:
THE COMPARISON OF THE MACRO- AND SONOGRAPHIC STRUCTURE OF ADENOLYMPHOMA. RETROSPECTIVE ANALYSIS
Authors: Dudareva I. V. , Lastovka A. S. , Kushnirov A. I.
Published: November 2021

The article presents the data of 22 patients with adenolymphoma of the salivary glands having undergone treatment in the Maxillo-Facial Surgery Ward No.1 at the age 36-72. In the preoperative period, all the patients were performed ultrasound, X-ray computer and / or magnetic resonance imaging of the salivary glands. We singled out groups of patients depending on the types of the macroscopic structure of the tumor and described basic and advanced features of ultrasound diagnosis of each variant of adenolymphomas. The received results will make it possible to predict the development of adenolymphoma of salivary glands during the preoperative period.
THE COMPARATIVE DESCRIPTION OF THE ADSORPTION PROPERTIES OF ENTEROSORBENTS
Authors: Filippova V. A. , Lysenkova A. V. , Ignatenko V. A. , Dovnar A. K.
Published: November 2021

The aim of research: comparative study of adsorption capacity and selectivity of enterosorbents of different generations. Material and methods. The subject of the study is enterosorbents widely applied in clinical practice. They belong to different generations and exhibit different adsorption capacities and different doses of daily application. Results. It was found out that enterosorbents differed from one another and the latest generation had more perfect and diverse adsorption properties. The experimental data confirmed that enterosorbents of the fourth generation, in particular white carbon, whose main component is silicon dioxide exhibited a highly developed active surface and high adsorption capacity relative to highly toxic heavy metals, while its ability to bind and remove useful components (biometals and vitamin C) in organism was negligibly low. Conclusions. The enterosorbent of the fourth generation «White coal» possess high adsorption capacity toward heavy metals and simultaneously are characterized by negligibly low capacity to bind and remove bioactive compounds such as biometals and vitamin C.
КЛИНИКО-ЭКОНОМИЧЕСКИЕ АСПЕКТЫ ОПТИМИЗАЦИИ ОКАЗАНИЯ МЕДИЦИНСКОЙ ПОМОЩИ ПАЦИЕНТАМ С ОФТАЛЬМОПАТОЛОГИЕЙ
Authors: Ostrovsky A. M. , Sharshakova T. M.
Published: November 2021

The article considers the questions of economic efficiency of rendering medical aid to patients with pathology of the organ of vision. Using the example of Gomel region we have given the assessment of the parameters of economic efficiency of medical aid to patients with ophthalmopathology. The work points out the importance of applying techniques that make it possible to justify the necessity and the profitability of the expenses for the preservation and restoration of vision properly, to determine the efficiency of medical aid to the patients by assessing the resource provision, adequacy of treatment and diagnostic process, financial support, and patient satisfaction.
PREVENTIVE MEASURES AIMED AT REDUCING THE CARDIOVASCULAR DISEASE RISK FACTORS
Authors: Budnik Ya. I.
Published: November 2021

This analytic review of literature deals with the studies on preventive measures against the risk factors for cardiovascular diseases (CVD)
PHENOTYPES AND STATES OF UNCONTROLLED BRONCHIAL ASTHMA
Authors: Ruzanov D. Yu. , Davidovskaya E. I. , Baranouskaya T. V. , Shebusheva T. T. , Buynevich I. V. , Aleshkevich L. V. , Gavrilenko V. E.
Published: November 2021

Aim: analyzing the causes of the uncontrolled course of bronchial asthma (BA) to reveal the states and phenotypes influencing the efficiency of therapy. Material and methods. 762 patients seeking medical advice or referred for specialized pulmonogical aid have been comprehensively examined. Results. We have defined the prevalence of different phenotypes and states of asthma and the risk for the uncontrolled course of BA. Conclusion. Patients with chronically severe distal and unstable BA detect the highest risk for the uncontrolled course in the absence of compliance, in irrational therapy, asthma-COPD overlap syndrome, decompensated chronic severe pathology and critical mistakes in the application of dosage aerosol inhalators.
FEEDING OF INFANTS DURING THEIR FIRST YEAR OF LIFE: PROBLEMS AND WAYS OF THEIR SOLUTION
Authors: Kozlovsky A. A. , Kozlovsky D. A. , Kozlovskaya I. A.
Published: November 2021

The article deals with the problem of the organization of nutrition of one-year-old infants. It considers the advantages of breastfeeding of infants and enumerates the differencies between breast milk and cow`s milk, which is used for production of most of milk formulae. The results of medical and social questionnaire surveys have revealed considerable violation of terms of introduction of supplemental feeding and its succession, which can increase the incidence of illnesses of digestive, endocrine, cardiovascular and other systems. A complex of measures promoting the competence of medical personnel and parents in questions of rational feeding of infants during their first year of life is needed.
CONGENITAL HYPOTHYROIDISM
Authors: Nikolayenko N. V.
Published: November 2021

Congenital hypothyroidism (CH) is the most common congenital endocrine disorder whose incidence in newborns is 1:2,000 to 1:4,000. It is the leading cause of mental retardation. Neonatal Screening Programs make it possible to identify the disease at an early stage and to start the adequate therapy of the children, thanks to which it is possible to avoid complications related to the hormone deficiency.
Cornelia de Lange syndrome in children
Authors: Bubnevich T. E.
Published: November 2021

Cornelia de Lange syndrome is a multisystem malformation syndrome recognized primarily on the basis of characteristic facial dysmorphism, including low anterior hairline, arched eyebrows, synophrys, anteverted nares, maxillary prognathism, thin lips, «carp» mouth, in association with prenatal and postnatal growth retardation, mental retardation and, in many cases, upper limb anomalies. However, there are clinical options with milder phenotypes in this syndrome. The prevalence of the syndrome is 1:10,000-30,000 live births, occurs equally, regardless of gender. Although this syndrome is considered rare, experts agree that it is likely underdiagnosed.
COMPLEX ASSESSMENT OF COMPENSATION IN DIABETES MELLITUS TYPE 1 ACCORDING TO THE RESULTS OF CONTINUOUS GLUCOSE MONITORING
Authors: Makhlina E. S. , Kapliyeva M. P. , Navmenova Ya. L. , Savasteyeva I. G.
Published: November 2021

Objective: to give complex assessment of compensation in diabetes mellitus type 1 (DM 1) using the continuous glucose monitoring system. Material and methods. The study included 162 patients with DM 1 who were examined using the complex of methods: questionnaire survey, clinical and anamnestic analysis, laboratory investigation of glycohemoglobin level, and continuous glucose monitoring using a CGMS system. Results. The data analysis has showed that only 23% examined patients have adequate control of DM 1. The quality of DM 1 control did not depend on age, DM 1 duration and body mass index (BMI). The highest glycemia variability depended on the total daily dose of injected short action insulin. We have found a high risk for development of hypoglycemia episodes independently of DM 1 quality control. Conclusion. In order to prescribe correct treatment for patients with DM 1, besides the main target criteria of compensation, it is very important to determine the hypoglycemia and hyperglycemia risk indices as well as clinical hypoglycemic reactions for the assessment of DM 1 compensation.
Long QT syndrome and its role in THE development of severe heart rhythm disturbances and sudden death
Authors: Kovalchuk L. S.
Published: November 2021

The article presents information from national and foreign sources on the significance of long QT syndrome on the electrocardiogram as a predictor of severe heart rhythm disturbances and sudden death. It considers the pathologic physiology of the present syndrome, the deficiency of intracellular magnesium plays an important part in its mechanism, which determines the therapeutic aspects leading to normalization of the QT interval
ANALYTICAL ASSESSMENT OF OUT-PATIENT TREATMENT OF PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Bakalets N. F. , Nikiforova O. L.
Published: November 2021

Objective: to carry out the analytical assessment of outpatient management of patients with rheumatoid arthritis in real clinical practice and study the structure of comorbid pathology. Material and methods. The medical records of 88 patients have been analyzed at 6 outpatient clinics of Gomel. The Charlson comorbidity index was applied for the quantitative assessment of the comorbid status. Results. The most common provoking factors of the development of rheumatoid arthritis were acute respiratory viral infections and exacerbation of chronic diseases; and the background disease was thyroid pathology. The most frequent complications of rheumatoid arthritis were osteoarthritis, anemia of chronic inflammation, osteoporosis, coronary heart disease. Comorbid pathology occured in 97.7 % of the patients with rheumatoid arthritis. Conclusion. At present, the problems of management of patients with rheumatoid arthritis are late diagnostics; discrepancy of real treatment to the modern recommendations of EULAR; insufficient use of disease-modifying antirheumatic drugs; absence of individual approach aimed at early detection of comorbid pathology and its adequate treatment.
MODELING OF ACUTE VASCULAR SPIRAL ORGAN DAMAGE
Authors: Naumenko A. N. , Vasiliev A. V. , Deyeva Yu. V. , Nebor I. Ya.
Published: November 2021

The article describes the results of our development of a model of acute vascular spiral organ damage by the carotid artery ligation in mice, and using perfusion fixation as an optimal method for saving of the morphological structure of the spiral body tissue.
THE ORGANIZATIONAL ASPECTS OF ORIGINATION OF THE AMBULANCE SERVICE OF GOMEL REGION (1919-1939)
Authors: Kapliyev A. A. , Kapliyeva M. P.
Published: November 2021

The work analyzes the organizational aspects of development of the ambulance service in Gomel region. Materials on history of medicine from the funds of the state archives of Belarus became sources for the study. The authors characterized the progressive development of the organizational structure and transformation ofemergency medicine institutes in Gomel region from their origins in 1919 in the form of night duties of physicians and the ambulance itself till the end of 1930s, when the ambulance became a stratified professional service which included national, regional, city and rural sublevels.
RADIAL METHODS OF VISUALIZATION OF CALCIFIC TENDINOSIS OF SHOULDER JOINT
Authors: Mikhailov A. N. , Domantsevich V. A.
Published: November 2021

Objective: to assess the diagnostic efficacy of the most wide-spread radial methods of examination of non-traumatic injuries of the shoulder joint: X-ray, sonography and magnetic resonance tomography. Material and methods. Сalcific tendinosis was detected in 23 cases within 117 examined patients with degenerative-dystrophic diseases of shoulder joint. 15 patients were included into comparative group. Study results. There was carried out a comparative analysis of the results of radiological method of 23 joints within the patients with calcific tendinosis of the rotatory cuff and 30 joints within asymptomatic volunteers. The assessment of the informativity of radiography and magnetic resonance imaging in the diagnostics of calcific tendinosis was given. Conclusion. We have proved the secondary character of appearance of signs of impingement syndrome in calcific tendinopathy and showed high information value of ultrasound in this injury.
LOW BACK PAIN SYNDROME, COMPARISON OF VIEWS ON THE PROBLEM
Authors: Gamanovich A. I. , Drivotinov B. V.
Published: November 2021

Objective: to compare the effectiveness of two approaches to the treatment of patients with low back pain syndrome: the traditional approach based on the classification of I.P.Antonov (1984) and more modern one based on the criteria of nonspecific pain. Material and methods. The work gives the data of complex examination and treatment of 628 patients of the main group and 79 patients of the comparison group. Results and discussion. Both the groups detected abnormalities from normal values with greater frequency in laboratory and tool methods of research. The duration of inpatient treatment of the patients of the main group was statistically significantly shorter due to a differentiated traditional approach to the treatment of patients with vertebrogenic lumbosacral pain syndrome. Conclusion. The traditional approach to the concretization of pain syndrome in lumbar osteochondrosis substantially in terms of effectiveness exceeds the concept of nonspecific pain in the lower back, references for which dominate in English-language sources.
RUSSIAN EXPERIENCE OF PROFESSIONAL TRAINING OF PHYSICIANS IN THE SPECIALTY «ORGANIZATION OF PUBLIC HEALTH SERVICE AND PUBLIC HEALTH»
Authors: Reshetnikov A. V. , Tregubov V. N. , Mikerova M. S.
Published: November 2021

The article analyzes and generalizes the experience of the Department of the First MSMU I.M. Sechenov in the professional training of physicians in the specialty «Organization of public health service and public health». Educational and methodological materials, planning and report documents of the department over 2016-2017 were used in the work. The main directions of the activities in training of specialists at the department were career guidance of trainees, assistance to students in self-determination, professional education and quality holding of academic classes, maintenance of contacts with graduates of the residency, master and PhD programs. The complex approach to the work of the teaching staff of the Department of Public Health and Public Health Service named after N. A.Semashko creates conditions for professional training of prospective public health managers.
THE COMPARATIVE ANALYSIS OF ADHERENCEOFPATIENTS WITH ARTERIAL HYPERTENSION TO THE TREATMENT AFTER PREVENTIVE CONSULTATION PROVIDED BY LOCAL THERAPISTS AND PHYSICIAN ASSISTANTS
Authors: Budnik Ya. I.
Published: November 2021

Purpose: toperform the comparative analysis of adherence of patients with arterial hypertension to the treatment after preventive consultation provided by local therapists and physicianassistants in outpatient conditions. Material and methods. The research was carried out on the basis of the branches of the Central CityPoliclinic of Gomel. 220 patients of the employable age (the average age was 47.1±3.4) suffering from arterial hypertension made the selection group.The selection groupwas divided into two groups. The first group consisted of 110 men and women with arterial hypertension who were given individual consultations by physician assistants. The second group included 100 patients who were given individual consultations by local therapists. Results. On the basis of the received results the indices of the efficiency of updating of a way of life (EUWL),efficiency of medicinal therapy (EMT) and efficiency of medical support (EMS) have been calculated. It has appeared that they are indicative of high efficiency of the preventive consultation, as the expected efficiency of medicinal therapy (1.5) and that of medical maintenance (1.3) inboth the groups are identical. The final index of the expected efficiency of treatment (IEET)did not show any difference in the first and second selection groups (1,4). Conclusion . The preventive consultationsprovided by health care workers in the outpatient conditions have the comparable efficiency. The results of the research aimed at the assessment of adherence of able-bodied patients with arterial hypertension to the treatment afterthe preventive consultations providedby both the therapists and physician assistants have shown that it promoted positive changes in their way of life concerning the importance of modification of way of life, medicinal therapy, and constant medical maintenance.
HYGIENIC SUBSTANTIATION OF DIMENSIONS OF SANITARY PROTECTIVE ZONES FOR MEDIUM SIZE PIG FARMS WITH A GLANCE TO CHARACTERISTICS OF DISTRIBUTION OF ODORIGENIC CHEMICAL AGENTS IN ATMOSPHERIC AIR
Authors: Slautenko E. .. , Petrosyan A. ..
Published: November 2021

The high frequency of complaints from the local population on the appearance of reflex and vegetative reactions associated with chemical pollution of the atmospheric air makes actual the effectiveness of establishing sanitary protection zones around the agro-industrial enterprises in accordance with existing regulatory documents. Thereby raises the need to search new approaches and methods for establishing the safety of such enterprises. Conducted field studies of pollutant concentrations in the atmospheric air at the border of the sanitary protection and residential areas from the industrial squares of pig farms with a 30,000 head capacity before and after the conversion of manure storage facilities, as well as further comparison of the obtained results indicate a change in the level of contamination of the ground atmosphere layer by emissions of certain chemical agents in dynamics. Whereas a repeated feature of the pollution increasing near the residential area, which adjoins the industrial squares, was noted. The exceeding of odor limen for certain polluting chemical agents is noted in the absence of excess of its state hygienic norm in the atmospheric air. The results obtained after the realization of engineering, constructive and environmental solutions and usage of limit values for odors made it possible to adjust the standard sizes of the sanitary protection zone for the production area of the pig farm at the southeastern direction.
CORRELATIVE INTERRELATIONS OF THE TUMOR MICROENVIRONMENT AND RELATIVE RISK OF UNFAVOURABLE OUTCOME OF ENDOMETRIOID ADENOCARCINOMA OF THE CORPUS UTERI
Authors: Zinovkin D. A.
Published: November 2021

Objective : to identify correlative interrelations among the parameters of the tumor microenvironment of endometrioid adenocarcinoma and relative risk of its prognosis. Material and methods. Immunohistochemic and morphometric studies were performed on the histological material of 60 patients. Results. Correlative interrelations were revealed among the studied parameters in groups with favorable and unfavorable outcomes. Relative risks for progression of endometrioid adenocarcinoma of the corpus uteri were determined. Conclusion. The revealed differences in the interrelations among morphological and immunohistochemical parameters in female patients with endometrioid adenocarcinoma of the corpus uteri of different survival potential reflect biological features of the tumorous growth and the disease progression.
OPTIMIZATION OF VITAMIN D LEVEL WITH AN ASSESSMENT OF THE EFFECT ON THE MORPHOFUNCTIONAL STATE OF THE MYOCARDIUM IN PATIENTS WITH CHRONIC HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Morgol A. S. , Yakubova L. V.
Published: November 2021

Objective: to evaluate the effectiveness of intake of vitamin D-containing drugs at different dose modes with an assessment of 25-hydroxy-cholecalciferol (25(ОН)D) level and echocardiography parameters in patients with chronic heart failure with preserved ejection fraction (CHF-PEF). Material and methods. 82 patients with CHF-PEF and D-hypovitaminosis were divided into 4 groups: group I (n = 26) - received Cholecalciferol 2000 IU/day, group II (n = 16) - 1000 IU/day, group III (n = 23) - a vitamin D-containing food additive, the comparison group (n = 17) - underwent only complex pathogenetic CHF therapy. Results. The 25(OH)D level in group I reached the optimal level in 84.6 % persons, in group II - in 56.2 % (p = 0.04), in group III - in 69.6 %, in the comparison group in 29.4 % (p = 0.0006). The level of 25(OH)D was negatively associated with the thoracic aorta diameter and end-diastolic volume of the left ventricle (EDV-LV). Conclusion. Optimization of 25(OH)D has a positive effect on the thoracic aorta diameter, anterior-posterior size of the left atrium and EDV-LV.
CHARACTERISTICS OF M.TUBERCULOSIS DRUG RESISTANCE DETERMINED BY MOLECULAR GENETIC AND PHENOTYPIC METHODS
Authors: Bondarenko V. N. , Shtanze V. A. , Zolotukhina L. V.
Published: November 2021

Objective: to determine the genetic and phenotypic drug resistance of M . tuberculosis to first-line and second-line anti-TB drugs. Material and methods. Gene mutations in 247 strains of M. tuberculosis (MBT) associated with drug resistance to isoniazid, rifampicin, fluoroquinolones, and aminoglycosides were studied. Genetic resistance of a tuberculosis causative agent was determined by means of LPA (GenoType® MTBDRsl MTBDRplus and MTBDRsl, ver.2.0). The results of the study are confirmed by the determination of phenotypic drug resistance in the automated system BACTEC ™ MGIT ™ 960. Results. The drug resistant MBT strains circulating around Gomel region have been determined, and the high reliability of molecular and genetic determination of MBT drug resistance has been confirmed by microbiological methods (isoniazid and rifampicin - 97.2 %, fluoroquinolones - 85.1 %, aminoglycosides - 92.3 %). A considerable number of drug resistant MTB strains with gene mutations (45.1 %) which are not included in the GenoType® MTBDRsl system were detected. Conclusion. Тhe considerable genetic variability of drug-resistant MBT strains requires complex application of all the methods of drug resistance testing.
MORPHOLOGICAL EVALUATION OF INTENSITY OF DYSTROPHIC CHANGES IN ILIOLUMBAR, SACRO-ILIAC AND SACROTUBERAL LIGAMENTS: POTENTIAL FOR BIOPSY
Authors: Yurkovskiy A. M. , Achinovich S. L. , Nazarenko I. V.
Published: November 2021

Objective: to evaluate the potential of the use of a diagnostic puncture for the analysis of intensity of dystrophic changes in ilio-lumbar, sacro-iliac, and sacro-tuberal ligaments. Material and methods. The work presents the comparison of the results of the semi-quantitative morphological evaluation (Bonar scale) of the sectional material and the material obtained during biopsy of the iliac-lumbar, sacroiliac and sacro-ligamentous ligaments from 15 corpses (the average age at death was 64.5 ± 6.5). Results. The comparison of the sectional data and biopsy data detected differences in the evaluations of intensity of dystrophic changes in the part concerning the evaluation of fibroblasts that lead to a decreased final Bonar score by 1 point. Conclusion. Biopsy material can be used for approximate evaluation of intensity of dystrophic changes according to the criteria «interstitial substance», «collagenous fibers» and «vascularization». The evaluation according to the criterion «fibroblastic programed differentiation cells» can be decreased by 1 point, which should be taken in account in the data interpretation.
Morphologic and Morphometric Parameters of the Liver Tissue of Laboratory Animals After Modeling of Chronic Stress
Authors: Litvinenko A. N. , Zinovkin D. A. , Ugolnik T. S.
Published: November 2021

Objective: to study changes in the morphologic and morphometric parameters of the liver tissue in male Wistar rats under chronic Ortiz stress. Material and methods. The study was conducted on 50 male Vistor rats. The experimental group of the animals was subjected to 10-day chronic stress by Ortiz. The morphologic and morphometric parameters of the liver tissue of the animals exposed to chronic stress were studied. Results. The morphologic changes in the liver of the animals which had sustained chronic stress were characterized by impaired blood circulation and degenerative changes of hepatocytes. At the same time, a statistically significant increase in the percentage of binuclear hepatocytes (p = 0.046) and functional cariocellular index (p = 0.03) was found. Conclusion. The effect of chronic stress leads to a change in the morphologic and morphometric parameters of the liver tissue with activation of reparative processes.
Tactics of Surgical Treatment of Instability of the Long Head of Biceps Tendon
Authors: Danilenko O. A. , Makarevich E. R.
Published: November 2021

Objective: assess effectiveness of the tactics and methods developed by the authors for surgical treatment of instability of the long biceps head tendon. Material and methods. The results of the treatment of 66 patients with instability of the long head of biceps tendon over 2004-2017 have been studied. Depending on the diagnosed type of instability of the long head of biceps tendon, the subjects were divided into 5 groups by Bennet classification (2003). Patients with type 1 and type 2 of damage were prescribed a course of conservative therapy, patients with type 3-5 were recommended surgical treatment using arthroscopy and the methods developed by the authors. Results and discussion. According to the OSS, 66 patients, who had undergone treatment, revealed 38 (57.6 %) excellent, 13 (19.7 %) good, 14 (21.2 %) satisfactory and 1 (1.5 %) unsatisfactory treatment outcomes. The result of the assessment is presented in the form of Me [Q25; Q75] and made up 56 points before the treatment [46; 56], and 14 [12; 32] after it. The tactics and methods of surgical treatment developed by the authors aimed at eliminating damage to the rotator-bicipital complex have confirmed their effectiveness. Conclusion. The tactical approaches aimed at correcting damage to the rotator-bicipital complex is a promising way to improve the clinical results of the treatment.
Comparative Anatomic Description of the Mucosal Folds of the Duodendrum in Newborns and Adults
Authors: Kovalenko V. V. , Shesterina E. K. , Balako A. I.
Published: November 2021

Objective : to reveal distinctive features of the structure of the mucosal folds of each part of the duodenum in newborns and adults. Material and methods . We have performed a comparative anatomic and morphometric study of the folds of the duodenal mucosa of 40 newborns and 93 adults aged 31-75. Results . We have obtained new data on general signs and distinctive features of the structure of the folds of the duodenal mucosa in newborns and adults. Conclusion . Complicated relief of the mucous membrane in each part of the duodenum expressed in changes of qualitative and quantitative characteristics of its folds should be considered as a morphological manifestation of adaptation to the type of food having changed in the conditions of extrauterine life. General signs of the macroscopical structure of the folds of the duodenal mucosa of newborns and adults are reflexion of the general plan of the structure of the relief of the human duodenal mucosa.
The Features of Pubertal Abnormal Uterine Bleedings in Gomel Region
Authors: Korbut I. A. , Garmaza U. S.
Published: November 2021

Objective : to analyze the risk factors, as well as the features of abnormal uterine bleedings in adolescent girls of Gomel region. Material and methods : The retrospective analysis of 143 records of in-patients of the Gynecological Ward of Gomel Regional Clinical Hospital over 2014-2017 has been carried out. The statistical analysis determining the proportion and standard error of the proportion - P ± sp%, the median and quartiles, OR (95 % CI), has been performed. Results and discussion. 31 (21.7 ± 3.5 %) patients with juvenile uterine bleedings (JUB) were diagnosed with low nutrition, 63 (44.1 ± 4.2 %) of the examined patients revealed anemia. The anamnesis of the girls was burdened with somatoform vegetative dysfunction of the nervous system (18.2 ± 3.2 %) and thyroid pathology (35.7 ± 4.0 %), as well as chronic tonsillitis (2.8 ± 1.4 %) and chronic pyelonephritis (4.9 ± 1.8%). Conclusion . The anamnesis of JUB patients is burdened with somatoform vegetative dysfunction of the nervous system, thyroid pathology inflammatory infectious ENT and kidney disorders. A long-term JUB episode leads to the development of anemia in adolescent girls. In autumn the risk for the development of the above pathology is higher.
Etiological verification of infectious exacerbation of chronic obstructive lung disease using molecular genetics methods
Authors: Ruzanov D. Yu. , Voropaev E. V. , Vorobey V. A. , Mironova S. V. , Osipkina O. V. , Semenova L. N. , Buynevich I. V. , Zyatkov A. A. , Rubanik N. N. , Bonda N. A.
Published: November 2021

Objective: To study the possibilities of the method of determining the 16S rRNA gene of bacteria in the determination of the bacterial spectrum of acute exacerbation of chronic obstructive pulmonary disease (COPD) using a protected material sampling Materials and Methods: 68 Hospitalized patients with acute exacerbation of COPD were prospectively evaluated. Molecular genetic determination of the 16S rRNA gene of bacteria and cultural microbiological techniques from sputum and a bronchial tree material obtained using a protected brush biopsy were used. Results: Bacterial agents were detected in 91,2 % of cases of acute exacerbation of COPD. Pseudomonas aeruginosa was detected in the biopsy material 1.8 times more often than with the use of routine methods. Patterns of COPD with frequent exacerbations, infectious exacerbations and Pseudomonas etiology of exacerbations were determined. Conclusion: Using the method of molecular-genetic determination of the 16S rRNA gene allows to verify the bacterial spectrum of acute exacerbation of COPD.
The Modern View on the Epidemiology and Etiopathogenesis of Concomitant Strabismus
Authors: Larionova O. V. , Dravitsa L. V.
Published: November 2021

Strabismus (heterotropy, strabism) is a permanent or periodic misalignment of the eyes characterized by the deviation of one or two eyes from a common visual axis and violation of binocular vision. Heterotropy is not only a cosmetic defect that affects the psyche and formation of the children`s character, but also is accompanied by expressed functional deficiency. Due to the absence of binocular vision, the perception of the external world, movement, and orientation in space are limited.
Assessment of the Progression Risk of Chronic Lymphocytic Leukemia
Authors: Kravchenko D. V. , Yarets Yu. I. , Martinkov V. N. , Silin A. E. , Svirnovsky A. I.
Published: November 2021

Objective: to identify the interconnection of laboratory parameters with different courses of chronic lymphocytic leukemia (CLL) and to develop a comprehensive model for the assessment of the risk of the disease progression. Material and methods. The study included 127 patients with CLL whose laboratory parameters were evaluated (general and biochemical blood tests, β2-microglobulin, thymidinekinase, tissue polypeptide antigen (TPA), immunophenotypic markers, and also NOTCH1 gene mutations). Results. For the prediction of the course of the disease the most informative were such markers as β2-microglobulin, thymidinekinase, ZAP-70, CD38, and TPA. Based on the obtained data, a model of the risk assessment for CLL progression with high sensitivity and specificity was developed. The progressive-free survival (PFS) was evaluated in two groups of the patients of different risk (low and high) assigned to them according to the prognostic model. In the patients from the low-risk group PFS was determined to be 60 months, and in the high-risk group it was equal to 29.4 months. And it was found out that the patients without progression at the time of inclusion in the study with the presence of mutations of the NOTCH1 gene had a shorter PFS in comparison with the patients without mutations, which may indicate a link between the mutations of the NOTCH1 gene and the unfavorable prognosis for the disease progression. Conclusion . The integrated application of the prognostic factors in the form of a CLL progression risk assessment model allows to stratify CLL patients into high and low risk groups and to predict the probability and progression rate at the time of the diagnosis and during the treatment.
Autoimmune Polyglandular Syndrome Type II
Authors: Mamchenko I. L. , Malaeva E. G.
Published: November 2021

The article presents a clinical case of autoimmune polyglandular syndrome type II and analyzes the literary sources, clinical data, and results of laboratory tests.
Some Problems in Teaching the Methods of Statistical Data Analysis and Opportunities of Modern Information Technologies for their Solution
Authors: Kovalev A. A. , Ignatenko V. A. , Yadchenko A. A.
Published: November 2021

The problems in teaching the methods of statistical data analysis in evidencebased medicine place high demands on their application. The rigor of the approach requires extensive knowledge in both the direct professional sphere and in areas of knowledge that go far beyond the limits of medicine. It is not enough to simply type groups for the study or calculate average values and draw some conclusions based on this. It is important to recruit groups and evaluate the statistical parameters of the obtained results correctly. Moreover, it is requisite to know the purpose of the research, formulate the appropriate hypotheses even before the beginning of the experiment [1] or data collection, and not to invent them during the analysis of an array of heterogeneous numbers and names when writing articles. The material of data processing presented at the level of schemes and algorithms in combination with the use of the appropriate programs is greatly simplified and, most importantly, streamlined. In this case, the subject of statistics is perceived not as something abstract, but as a complex component of the principles of evidencebased medicine, without detaching it from specialized training.

The involvement of specialists of the core subjects of the university sharing the examples of studies using the statistical processing and planning methods into the training will make it possible to improve orientation in a variety of the existing statistical methods of data processing, as well as to understand the importance and relevance of the use of statistics in medical research.
The Response of Tumor Microenvironment to Radiation Therapy: Analysis of the Disease-Free Survival of Patients with Endometrioid Adenocarcinoma of the Corpus Uteri
Authors: Zinovkin D. A. , Nadyrov E. A.
Published: November 2021

Objective: to identify the threshold values of FoxP3, CD56, PGRMC1, and Galectin-1 expression, to analyze the survival rate of female patients based on the obtained threshold values, to determine the statistical differences in groups depending on the presence/absence of radiotherapy.

Mаteriаl аnd methods. The group with radiotherapy (LT+) included 42 female patients, the group without radiotherapy (LT-) included 38. The ROC-analysis was performed to determine the threshold values. The analysis of the survival rate was performed using the logrank test. The groups were compared using the tables 2×2 (Fisher's twosided test), as well as the odds ratio (OR) was calculated. The differences were considered statistically significant at p < 0.05.

Results. The study of the Galectin-1 parenchymatous expression showed that statistically significant differences (p<0.0001) were revealed in the study of the relapsefree survival rate based on the obtained threshold value. Gamma ray therapy reduced the parenchymatous expression of Galectin-1 below the threshold value (OR = 0.490 95% CI 0.288-0.800). The analysis of the relapsefree survival rate on the basis of the obtained threshold value of the stromal expression of Galectin-1 revealed statistically significant differences (p = 0.0002). Gamma ray therapy reduced the stromal expression of Galectin-1 below the threshold value (OR = 0.289 95 % CI 0.112-0.742).

Conclusion. At a low relapsefree survival rate, a statistically significant increase above the threshold values of the parenchymatous (p < 0.0001) and stromal (p = 0.0002) Galectin-1 expression was observed most frequently.
A Clinical Case of Conjoined Twins
Authors: Mishin A. V. , Bortnovskaya N. P. , Brundukov V. V. , Martemyanova L. A. , Turchenko S. Yu.
Published: November 2021

The article presents the report of a clinical case of conjoined twins, provides the data on ultrasound diagnostics, and describes morphological changes in this pathology.
Cosmetic results of reconstruction of full thickness nasal alar defects using cheek skin flaps
Authors: Ivanov S. A. , Yadchenko V. N. , Poddubny A. A. , Ivanova E. S.
Published: November 2021

Objective: to analyze cosmetic results following reconstruction of nasal alar defects using cheek skin flaps. Material and methods. The results of 29 operations were analyzed. The reconstruction was performed with nasolabial flaps and jigsaw puzzle flaps. The cosmetic outcomes were evaluated by the five-point scale by means of patient-report and specialist-report questionnaire. Results. Acceptable overall outcomes were achieved in 22 cases according to the experts’ assessment and in 24 cases according to the patients’ assessment. The highest scores were noted for alar color and position, and the lowest scores - for alar size, shape, and nostril size. The complication rate was 11.1 %. Delayed surgical corrections were undertaken in 10 patients. Conclusion. The reconstruction of full thickness nasal alar defects using cheek skin flaps made it possible to achieve acceptable outcomes with minimal donor site damage in the majority of the patients.
A healthcare organizational model of secondary prevention of cervical cancer among women of reproductive age
Authors: Harelik T. M. , Naumov I. A.
Published: November 2021

Objective: to develop a healthcare organizational model of secondary prevention of cervical cancer.

Material and methods. The work analyzes the quality of medical care given to women of reproductive age living in Grodno region in whom cases of cervical intraepithelial neoplasia and cervical cancer were detected from 2010 to 2019. On the basis of the results of questioning of 200 women who had been treated in Oncology Ward No.3 of Grodno University Clinic, the most significant risk factors of the development of the pathology were identified. Statistical processing was performed by means of the program «Statistica» 10.0.

Results. An effective model of secondary prevention of cervical cancer has been developed: from 2015 to 2019 compared to the previous quinquennium the detectability of cervical intraepithelial neoplasia and non-invasive cervical cancer increased by more than 17 % and 25 %, and the average parameters of the newly diagnosed morbidity were 69.97 ± 2.42 and 19.91 ± 2.28 per 100,000 women of reproductive age (p < 0.05). This made it possible to take timely measures for carcinogenesis interruption.

Conclusion. The implementation of the healthcare organizational model of secondary prevention of cervical cancer contributes to improvement of the quality of medical care, and, therefore, maintainance of perspective realization of the child-bearing function for women of reproductive age.
Clinical and laboratory characteristics of patients with common variable immune deficiency
Authors: Prokopovich S. S. , Novikova I. A. , Salivonchik A. P.
Published: November 2021

Objective: to identify clinical and laboratory features of common variable immune deficiency (CVID) in different age groups of patients. Material and methods. The clinical and anamnestic characteristics of 36 patients (16 men and 20 women) aged 15 to 65 (the average age was 37.0±12.7) diagnosed with CVID were studied. Results. Among the examined patients the disease was manifested at the mature age in 25 people (69.4 %) - the 1st group, while in 11 people (30.5 %) the debut of the disease occurred during childhood (from 4 to 17) - the 2nd group. Among the patients of the first group, the greatest number of cases (10 cases, 40.0 %) was found at the age of 20-30; in the children's age group, the greatest number of cases (8 cases, 72.7%) occurred at the age of 13-17. Non-infectious manifestations were significantly more common in adult patients at the onset of the disease (64 %; χ2 = 15.68; p < 0.001). Infectious and inflammatory diseases of the ENT organs and respiratory tract were observed with the same frequency in both the groups. Children significantly more often than adults (72.7 %; χ2 = 26.6; p < 0.001) observed a deficit in the three classes of immunoglobulins (Ig) (IgA, IgM, and IgG), whereas in patients with CVID manifestation in adulthood, the concentrations of IgA and IgG were mainly reduced, and meanwhile the degree of the decrease in the immunoglobulin level was more pronounced (72.0 %; χ2 = 14.47; p < 0.001). Conclusion. Significant differences in the clinical and laboratory parameters of CVID manifestation in the patients depending on age have been revealed.
Socio-psychological aspects of medical students’ attitude toward health
Authors: Gapanovich-Kaidalov N. V.
Published: November 2021

Objective: to identify the socio-psychological features of medical students’ attitude toward health. Material and methods. The methods of theoretical analysis of philosophical, psychological and pedagogical literature on the research problem; methods of questioning, observation; statistical analysis of empirical data ( j * - Fisher's criterion, Spearman's rank correlation method) were used. Results. The performed study has made it possible to determine the theoretical bases for the formation of modern notions about health and a healthy lifestyle in medical students. The analysis of the socio-psychological aspects of junior medical students` attitude toward health has showed that mainly stereotyped notions such as («sport is health») and inadequate understanding of the relation of a health status and commitment to a healthy lifestyle are typical for the study participants. Conclusion. In order to ensure high quality of professional medical education, it is necessary to form notions about health and a healthy lifestyle based on the concept of positive health in medical students. Health providers should understand a special importance of healthy lifestyle promotion among population, which will be ineffective if future doctors themselves will not pay enough attention to their health.
Assessment of the risk factors of glycemic variability in patients with diabetes mellitus type 2
Authors: Makhlina E. S. , Navmenova Y. L. , Kononova O. N.
Published: November 2021

Objective: to assess the presence of glycemic variability in patients with diabetes mellitus type 2 (DM Type 2), as well as to identify the risk factors which affect the degree of expression of the variability indices. Material and methods. Glycemic variability indices were assessed in 92 patients with DM Type 2 receiving different hypoglycemic therapy regimens. Results . It has been found that glycemic variability in 78 % of the examined patients with DM Type 2 was expressed and depended on the regimen of hypoglycemic therapy. The use of insulin therapy in the treatment regimen in patients with DM Type 2 and a BMI of less than 28.6 kg/m2 is a risk factor that increases glycemic variability. Postprandial hyperglycemia (2 hours after breakfast) is caused by high variability regardless of the regimen of hypoglycemic therapy. SD variability indices and glycemic amplitude are the assessment criteria for the degree of glycemic variability in the postprandial period of time. Conclusion . Glycemic variability in patients with DM Type 2 is expressed and depends on the regimen of hypoglycemic therapy. Calculation of glycemic variability indices in glycemic self-control will improve individual target glycemia values and it will make it possible to correct the tactical scheme of hypoglycemic therapy on an outpatient basis.
Surgical anatomy of anastomoses of the umbilical artery
Authors: Kuzmenko A. V.
Published: November 2021

Objective: to identify the variants of the development of anastomoses and their number in the umbilical artery.

Material and methods. 206 dead bodies of men (22–82 years of age) and 113 dead bodies of women (32–93 years of age) who had died of causes not related to pelvic pathology were used as the material for the study. The preparation method, vascular injection method, and statistical method were used to achieve the objective.

Results. It has been established that the anastomoses of the umbilical artery in both the men and women are most often found in the proximal third of the artery, significantly more rarely — in its middle third. We have determined no linear correlation between the sizes of the diameters of the umbilical artery and the sizes of the diameters of its arterial anastomoses on both the sides of the pelvic cavity in the females and on the right side in the males but have found such a correlation on the left side in the males.

Conclusion. The performed study has demonstrated that anastomoses of the umbilical artery in males and in females have a definite pattern of their origination.
Dirofilariasis of the pleura
Authors: Tishchenko G. V. , Shalyga A. I.
Published: November 2021

Dirofilariasis is the most common transmissible zoonotic nematodosis in Europe, whose clinical manifestations are caused by the migration of immature helminths through human tissues or internal organs. Clinically, it is characterized by slow development and a long-term course, and morphologically — by chronic granulomatous inflammation, often with microabscess.

The work presents the description of a clinical case of dirofilariasis of the pleura, the diagnosis of which was performed only at the stage of the histological examination of the surgical material.
Analysis of clinically approved guidelines for the treatment of patients with eosinophilic esophagitis
Authors: Chechenkova E. V. , Savanovich I. I.
Published: November 2021

Objective: to present modern views of the professional medical communities of the USA, Europe and Russian Federation on the issue of eosinophilic esophagitis (EoE) published in the form of clinically approved recommendations and guidelines for the treatment of patients with this pathology.

Material and methods. To achieve the above objective, we analyzed modern literary sources dealing with this issue.

Results. We have reviewed the main clinical guidelines on this topic taking into account the comparison of methodological aspects, recommendations and their results, and highlighted the main problems associated with the diagnosis and treatment of patients with eosinophilic esophagitis.

Conclusion. Over the past years, the study of EoE has reached a qualitatively new level. However, the pathogenesis of eosinophilic esophagitis, as well as the methods of its diagnosis, treatment and prevention, are still at the stage of their deep study and improvement. The issue of eosinophilic esophagitis should be considered as an interdisciplinary one, since it involves the interaction of a pediatrician and/or therapist, allergist, gastroenterologist, nutritionist, endoscopist, and pathomorphologist.
Erfassung von Merkmalen kindlicher Bindung in familienrechtlichen Verfahren: Methodische Überlegungen
Authors: Spangler Gottfried , Zimmermann Peter
Published: November 2021

Child attachment characteristics are important for family court decisions. This article provides a description of relevant attachment characteristics and their assessment criteria (presence of attachment, differences in attachment quality, attachment disturbances). In addition, potential problems and pitfalls of attachment assessments in psychological court expert reports are addressed, including the topics of deficits in knowledge of basic attachment concepts and behavioural criteria, poor internal validity of easy accessible diagnostic attachment or relationship tools, and the limits of transferring valid and sound attachment research methods to the psychological assessments in expert court reports. We recommend an eclectic approach informed by attachment theory, of aggregating and integrate several attachment indicators, including characteristics of attachment figures and different levels of attachment assessment (behaviour and representation). Finally, discuss the use of attachment characteristics for giving a professional opinion on the impact of child rearing experiences, a child’s resilience in face of current adversities, and for predicting potential developmental trajectories. Implications for education and training of experts are mentioned.