Closed heart injuries are one of the urgent problems of emergency surgery. The results of treatment of this category of victims depend on the quality of diagnosis and the provision of emergency care at the prehospital stage of the organization of specialized surgical care in the conditions of inpatient and intensive care. The most informative diagnostic method is ECG.

According to scientists, the formation of adhesions in the abdominal cavity is a polyetiological, multifactorial pathological process. At the same time, the use of best practices makes it possible to reduce the likelihood of progression of adhesion formation only in a narrow number of clinical cases. The aim of the study was to develop new approaches to the management of patients with abdominal adhesive disease. To solve this problem, 66 patients with abdominal adhesive disease were examined and surgically treated in the departments of emergency and minimally invasive surgery of the ME «City Clinical Hospital 2» in Minsk, who underwent surgery using laparoscopic techniQThe complex treatment of patients is based on the positions of accelerated recovery surgery «fast-ues. track», as well as the principle of damage control «damage control». As a result of the study, it was found that a personalized approach, the use of staged seQuential programmable laparoscopic surgical interventions based on the principle of damage control and the basic principles of accelerated recovery surgery can improve treatment outcomes.

The study included 88 patients with vertebral infection (nonspecific spinal osteomyelitis M46.3, spinal epidural abscess G06.1), of which 24 (27.3%) had diabetes. If the patient had impaired glucose metabolism, the lethality increased by 3.9 times. A key factor in the development of severe neurological deficit in patients with vertebral infection was the combination of epiduritis and diabetes. With the help of cluster analysis, it was found that the highest mortality (45%) is observed in patients who, in addition to the inflammatory focus in the spine, had diabetes, coronary heart disease and nephropathy.

Trophic disorders in chronic venous insufficiency of the lower extremities is currently an important problem.

In countries with developed economies, in chronic venous insufficiency, 15–18% of the population has decompensated forms with severe trophic skin disorders.

We studied 10326 case histories and statistical charts of patients with varicose veins of the lower extremities, of which 2275 patients had chronic venous insufficiency C4-C6 (from 2010 to 2019). The paper shows the structure of the incidence of chronic venous insufficiency C4-C6, the influence of the age of men and women on the development of trophic disorders in varicose saphenous veins of the lower extremities. Causes of chronic venous insufficiency C4-C6 are shown.

The aim of the study was to determine the informative value of electropuncture testing in patients with salivary stone disease.

Objects and methods. The study was performed at the clinical bases of the Department of Surgical Dentistry of the educational institution «Belarusian State Medical University». Using electropuncture testing, 74 patients aged 2558 years (the main group) with diagnosis of salivary stone disease of the submandibular salivary gland were examined. The control group was represented by 30 practically healthy persons. The data obtained during the survey were subjected to statistical processing using the application software package «Statistica 10.0».

At the end of the study, the diagnostic effectiveness of electropuncture testing was determined. 

Results. Functional deviations of auricular points corresponding to the function of the endocrine glands, kidneys 46%, and the excretory system 30% were determined in 41% of patients. In 3% of patients, there were no changes in these systems and organs that can affect the metabolic processes of the body. In addition, 3% of the patient had significant functional abnormalities in organ systems that did not affect metabolic processes.

Conclusion. Electropuncture testing has a diagnostic efficiency of 98% in the analysis of organs and systems responsible for and involved in metabolic processes in patients suffering from salivary stone disease and allows at least 49% of observations to reliably (for two or more interested organ systems) identify metabolic disorders in individuals of this category which is an indirect confirmation of one of the links in the pathogenesis of the disease under study.

Specialists of the republican unitary enterprise «Scientific and Practical Centre of Hygiene» have developed a questionnaire that allows medical workers of healthcare organizations of outpatient and inpatient profile to assess the body’s state during the operation of medical masks in a favorable and unfavorable epidemic situation. 270 medical workers were interviewed, of which physicians 24%, middle medical staff 60%, junior medical staff 16%.

The survey showed that the operation time of medical devices for respiratory tract protection in an unfavorable epidemic situation exceeds than in a favorable epidemic situation both in outpatient and polyclinic healthcare organizations and in inpatient healthcare organizations. Increasing operation time of medical devices for respiratory tract protection during one work shift is accompanied by increasing number of symptoms of the fatigue process and their severity. In this case, the nature of these symptoms is different for medical workers of various health care organizations.

The presented paper is devoted to the epidemiological characteristics of systemic lupus erythematosus as one of the most common systemic connective tissue diseases. Data on age, sex, racial and geographical differences of this pathology in different countries are given. Much attention is paid to a detailed review of data on primary morbidity (incidence) and general morbidity (prevalence). The results of authors’ own study of prevalence and incidence of systemic lupus erythematosus in the urban population of the Republic of Belarus are analyzed. An example of using the results obtained to calculate the need in specialized inpatient medical care for patients with systemic lupus erythematosus within its rational planning is proposed.

Today the development of 3D technologies, the spread and improvement of 3D printers, as well as the development and application of new printing materials have contributed to the widespread introduction of 3D printing in medicine. There are many options for using 3D technologies, however, one of the most commonly used areas is preoperative planning. Modern imaging techniques are an important component of the preoperative stage in surgical practice. Using a personalized 3D model the surgeon in detail works out on it the optimal surgical approach, the most important stages of the upcoming operation, taking into account the individual anatomical features of the structure of the area of interest. The realism and practical significance of the operation on a 3D model is achieved due to the complete identity of the area of surgical interest with the patient‘s organs on a 1:1 scale. The purpose of this review was to present up-todate information on the possibilities and prospects of using 3D printing in planning surgical interventions in otorhinolaryngology, using 3D modeling technologies in teaching students at the Department of Ear, Nose and Throat Diseases of Belarusian State Medical University. Thus, the prospects for 3D technologies are very large-scale, and they will undoubtedly become one of the most dynamic areas in medicine in the future. 

In the article gives information on the therapeutic application of the shock-wave method, based on the transfer of energy of the shock-wave pulse from the apparatus[’] s contact hеad (nozzle) of the applicator to the tissues of the human body. The perspectivity et high efficiency of using the method shockwave therapy of clinical practices of the physiotherapist.

The article provides a comparative analysis of the functional results of total knee arthroplasty and knee postoperative stability in the Sagittal plane in 124 patients (22 men and 102 women) suffering from gonarthrosis, aged 51 to 83 years (average 69.8 years), operated on with using a standard technique (n = 62) or using a computer navigation system (n = 62), observed for 6 to 36 months. from the time of surgery. The use of the navigation system made it possible in some cases to perform more accurate resection in the sagittal plane of the femur and tibia (9,6% of cases of deviations from the sagittal plane versus 25,8 % in the control group), as well as to achieve the optimal range of motion after arthroplasty: 124,8±1,7 versus 127±4,7 (p < 0.05).

Today, in surgery of the arteries of the lower extremities in diabetes mellitus and atherosclerosis, the autovein is the gold standard. It does not require any selection, conservation, or other preparation methods necessary for its application. However, its use in some cases is limited due to their parametric characteristics (length, diameter), loss of time for their preparation, and their absence. For these categories of patients, the method of choice is the use of vascular allografts.

The article presents the experience of 25 cases of post-mortem donor vascular grafts in 24 patients with lower limb revascularization with critical ischemia. All patients were divided into 2 groups: 13 patients were included in the first group with neuroischemic form of diabetic foot syndrome, and 11 patients were included in the second group with obliterating atherosclerosis of vessels (arteries) of the lower extremities.

Positive results were noted in 20 patients (83.3%). In the immediate and long-term periods after revascularization with a donor graft (1 artery, 3 vein), high amputations were performed in 4 (16.7%) cases, all patients with diabetes mellitus.

Arterial hypertension and diabetes mellitus established large risk factors for cardiovascular diseases associated with atherosclerosis are among the most common comorbidities in patients with coronavirus infection. Each of the pathologies, and especially their combination increases the cardiovascular risk, and in case of SARS-Cov-2 infection, the risk of severe course of infection and mortality. The article discusses the mechanisms of mutual burden of coronavirus infection, arterial hypertension and diabetes mellitus, provides a new concept of activating the immune system in hypertension, considers modern approaches to antihypertensive therapy in patients with diabetes mellitus.

Fournier‘s gangrene is a rare disease with a severe course and high mortality, the prognosis of which depends on timely diagnosis and timing of surgical intervention. Nonspecific clinical manifestations and the rapid development of the inflammatory process create certain difficulties for surgeons in making the correct diagnosis and treating such patients. This review presents the issues of diagnosis and treatment of Fournier‘s gangrene at the present stage of development of medicine.

In the fourth part of our literary review devoted to diseases of the small intestine, information is provided about celiac disease, i.e. about «suffering from intestinal disorder» (translated from Greek). According to the classification, autoimmune and allergic conditions associated with gluten, as well as non-celiac gluten sensitivity are considered. The modern possibilities of diagnosis and differential diagnosis of these disorders are presented. Gluten itself, an important fraction of wheat, rye and barley, is characterized.

Accurate diagnosis of celiac disease at the present stage is the possibility of conducting second–order tests to detect antibodies to deaminated gliadin peptides, antibodies to endomysium and its main antigen the enzyme tissue transglutaminase. Histological changes by stages, the role of HLA-DQ2/DQ8 in the pathogenesis of celiac disease are presented. The basis of treatment is compliance with an elimination diet.

Further described are herpetiform dermatitis, gluten ataxia, variants of wheat allergy, which includes more than three hundred proteins, thirty of them are recognized as allergenic. Modern tests for determining specific IgE, available for prescribing and detecting allergens. Non–celiac sensitivity (NCCHG) to gluten is the diagnosis of exclusion. NCCHG triggers. Solerno criteria. Risk groups for celiac disease.

Brugada syndrome is a congenital channelopathy with an autosomal dominant type of inheritance and low penetrance, characterized by the presence of a typical clinical and electrocardiographic symptom complex, including a special form of blockade of the right bundle branch block with ST segment elevation in one or more right chest leads on the electrocardiogram, the absence of organic pathology of the heart and various life-threatening ventricular arrhythmias, which can lead to the development of sudden cardiac death. The article defines the concept of «Brugada‘s syndrome», the geography and frequency of occurrence of the disease. It is indicated that more than 450 pathogenic variants in 24 genes are involved in the development of Brugada syndrome. The article presents two main hypotheses of pathogenesis, describes the electrocardiographic picture, three types of ECG changes, clinical manifestations and classification of the Brugada syndrome. Listed diseases with which it is necessary to carry out differential diagnosis of Brugada syndrome. Various aspects of the treatment of Brugada syndrome are presented: non-drug methods, pharmacotherapy, installation of an implantable automatic cardioverter-defibrillator, epicardial catheter ablation of abnormal areas of the anterior part of the outflow tract of the right ventricle.

Modern information on the problem of thyroid nodules is represented. The main diagnostic methods are discussed. The characteristic of the thyroid nodule, multinodular process and goiter is given. It is noted that inadequate preand intraoperative diagnostics, incorrect interpretation of research results often lead to inadequate scope of surgical intervention and unsatisfactory long-term results of treatment. One of the main conclusions is the search for new, more informative and safer methods for diagnosing the nature of thyroid nodules, which is crucial in choosing a treatment method that is adequate to the extent of the operation.

The article presents the main historical milestones associated with the creation, formation and functioning of the 73rd Internship of the medical staff of the Red Banner Turkestan Military District of the Armed Forces of the USSR in the period from 1938 to 1992 and its successor the internship of the medical staff of the medical service of the Armed Forces of the Republic of Uzbekistan in the period from 1992 to 2012.