The article presents an analysis of the experience of using the TKB-1 hemostatic tourniquet. The data on mechanical damages that were identified during the active use of turnstiles for training personnel in first aid are presented. Data on employee satisfaction with the performance characteristics of the TKB-1 tourniquet were also obtained.

In recent years the role of advanced training of specialists has increased as a factor in improving discipline and quality in the educational process.

Objective. Identification and assessment of socio-behavioral risk factors for the formation of irritable bowel syndrome (IBS) among military personnel and members of their families (ARC).

Material and technique. IBS was diagnosed according to Rome IV criteria. The level of emotional stress (ES) on the Rider scale. A total of 1977 cadets (aged 17–22) were examined. 326 officers (aged 24–55) and 257 of their wives (aged 23–51).

Results and discussion. The detection rate of IBS among SCD varies from 18.7±2.2 to 22.2±2.6% (P > 0.05). IBS-C (constipation) is most often detected than IBS-D (diarrhea), because patients with diarrhea are more likely to visit doctors and receive treatment. In general, the medical negotiability of patients is poor and averages 30.7±2.3%, and 37.3±2.4% of patients carry out self-treatment, another 32.0±2.3% of patients tolerate the clinical manifestations of IBS (P > 0.05). When IBS is combined with other syndromes, medical negotiability increases to 62.1±9.2%. During the period of adaptation to the conditions of life and study at the school, the level of strong ES in cadets increases to 32.3±2.3%, as adaptation (after 4 years) it decreases to 3.4±1.1% (P < 0.001) . The incidence of IBS is higher in patients with poor housing conditions, incomplete marital status and tobacco addiction.

Conclusion. Effective management of the identified socio-behavioral risk factors for the formation of IBS can significantly reduce the risk of SCD and their families with IBS.

The article is about the fact that 15 years ago Belarusian scientists created an antiseptic drug for prevention and treatment of wound infection on the basis of polyhexamethylene biguanide – «Mukosanin», and nowadays the use of such medications has become a worldwide trend in wound infection.

The special military operation of the Russian Federation in Ukraine has led to an increased possibility of using nuclear weapons. The use of nuclear weapons during the bombing of the Japanese cities of Hiroshima and Nagasaki in August 1945 led to severe injuries and death of thousands of people, burns, mechanical trauma. Ionizing radiation lesions were new and specific, causing significant difficulties in the diagnosis and management of this pathology. Since then, there have been a number of accidents at nuclear power plants, the largest of which were the accidents at the Chernobyl and the Fukushima. During this time, the concepts of acute and chronic radiation syndromes were introduced into medical practice, and methods for treating these diseases were developed. Today, in connection with the threat of the use of a "dirty bomb" in Ukraine, as well as with the increasing likelihood of using tactical nuclear weapons, there was a need to form certain skills and concepts of actions in case of injuries from ionizing radiation among doctors and paramedical personnel.

Thearticle presents current data on the syndromeof joint hypermobility. Theanalysis of themainmorphometric parameters of the cardiovascular system detected by ultrasound examination of the heart in medical students with joint hypermobility syndrome in the age group of 20–28 years was carried out. A high prevalence of left ventricular false tendons, mitral valve prolapse, with a changes in the geometry of the heart, with an increase in the longitudinal dimensions of the left atrium and left ventricle without changes in the volumes of the left heart, with an increase in the longitudinal dimensions and volume of the right atrium in comparison with those in practically healthy individuals were revealed. Recommendations are given on the necessity for screening of this nosology in young patients with signs of connective tissue disorders.

Osteoarthritis of the knee is a degenerative disease, usually the result of wear and tear and progressive loss of articular cartilage. Osteoarthritis is a progressive disease that can eventually lead to disability. Total knee replacement is considered an effective surgical treatment for severe degenerative osteoarthritis of the knee, to relieve pain, increase mobility, and improve quality of life in cases with excellent surgical outcomes. However, total knee replacement is associated with moderate to severe postoperative pain. Pain control remains a problem due to its subjective nature and the diversity of patients, which requires the search for new regimens and treatment methods. In recent years, the use of peripheral nerve blocks has become increasingly popular. Blockade of the adductor canal can significantly reduce opioid consumption and side effects associated with their use, which contributes to the early mobilization of operated patients. The object of the study was 138 total knee arthroplasty performed at the 6th City Clinical Hospital of Minsk in the period from 2017 to 2020.

Objective. To evaluate the prevalence of functional and anatomical changes in the lower extremities of pregnant women and discuss their possible causes and current therapeutic recommendations.

Patients and methods. To assess changes in the lower extremities, 100 pregnant women at 38.5±1.3 weeks of gestation age were consecutively enrolled in an individual direct questionnaire. Patients’ ages ranged from 19 to 43 years (mean 31.4±5.3). The number of previous pregnancies and labours were 2.4±1.5 and 1.8±1.2 respectively. The demographic part of the questionnaire included information on age, height, body weight and shoe size before pregnancy and antepartum, medical and obstetric history and physical activity. The clinical section of the original questionnaire contained sections related to the assessment of skin, vascular, neurological and musculoskeletal disorders.

Results. During pregnancy, there was an increase in women’s body weight from 66.6±14.8 kg to 78.8±14.6 kg and an increase in casual shoe size by 0.3 cm from 37.9±1.3 to 38.2±1.2 (in 27% of observations). More than half (57%) of study participants described their level of daily physical activity as moderate. The study showed that 85% of pregnant women reported functional or anatomical changes in the lower extremities, which included dermatological changes in 53%, vascular changes in 49%, peripheral nerves changes in 22%, and musculoskeletal changes in 69%.

Conclusion. The gestational period is characterised by significant endocrine, immunological and metabolic changes of the pregnant woman, which provokes a range of both physiological and pathological conditions. Establishing the prevalence of lower limb symptoms and syndromes will provide the basis for developing an effective system of medical prevention and treatment of undesirable lower extremities effects.

The use of intraosseous dental implants allows solving many issues with partial and complete loss of teeth, restoring chewing function and improving facial aesthetics. And the rapid formation of a strong connection between the implant and the bone is the key to a successful result of the dental surgery. In this regard, it is of interest to develop a method for improving the biointegration of dental implants using magnetophoresis of medicinal substances, which significantly increases therapeutic efficacy. However, the issues of calcium content in its serum under the influence of the used therapeutic agents (surgical, physiotherapeutic, pharmacological) have not been sufficiently studied. Therefore, the purpose of this study was to determine the calcium content in the blood serum of experimental animals after the application of magnetophoresis solutions of 10% calcium gluconate and 5% retabolil. 16 rabbits of the «chinchilla» breed served as objects for fulfilling the goal of our work. The study made it possible to conclude that the magnetophoresis effects of calcium gluconate and retabolil solutions did not lead to a change in blood biochemistry and contributed to a short-term increase in the content of calcium and phosphorus in the blood serum of animals.

Based on the subjective assessment of the patient, the effectiveness of the treatment of postnasal syndrome caused by vasomotor rhinitis, developed by the method of laser photocoagulation of the distal branches of the vidian nerve, was determined. The use of this method made it possible to reduce the intensity of patients‘ anxiety about difficulty breathing through the nose (main group – 1,8±0,13 points, control – 2,4±0,15) and mucus flow down the back of the throat (main group – 0,7±0,36 points, control – 4,2±0,16, p < 0,05). The developed method made it possible to statistically significantly improve the quality of life of patients already one month after the surgical intervention (main group 8,3±1,8 points, comparison group 14,3±2,8 points, p < 0,05).

Progression of the atherosclerotic process with the development of clinical manifestations is associated with an increased level of atherogenic fractions of lipids, primarily low-density lipoprotein cholesterol. The most studied group of lipid lowering drugs, which have proven their effectiveness in reducing cardiovascular morbidity and mortality, and the first choice drugs in the treatment of dyslipidemia are statins. The updated international guidelines for the treatment of dyslipidemia revised approaches to cardiovascular risk stratification and lipid lowering therapy tactics in different patient cohorts.

In Parkinson‘s disease (PD), several types of progression are conditionally distinguished. Determination of reliable criteria for identifying patients with a rapid type of PD progression in the early stages of the disease will allow us to begin the development of therapy aimed at inhibiting its development.

The aim of the study was to determine the clinical and laboratory predictors of the rapid type of PD progression in the Belarusian cohort of patients.

Patients with PD underwent a general somatic and neurological examination. Non-motor symptoms were assessed by completing the appropriate scales. Laboratory studies included the determination of antibodies to α-synuclein, the study of the levels of cortisol, IL-1β and IL-10, the calculation of the albumin coefficient (Qalb). Longitudinal study with three groups: 1) rapidly progressive type of PD, 2) slowly progressive, and 3) indeterminate. Candidate predictors were obtained by comparing clinical and laboratory parameters of patients with fast or slow types of PD progression. During dynamic monitoring of patients with an indeterminate type of progression, the sensitivity and specificity of predictors were determined.

113 people with PD: group 1 – 32 patients, group 2 – 26, group 3 – 55. Threshold values of indicators were obtained by comparing the clinical and laboratory characteristics of groups 1 and 2 by the Mann-Whitney method and then by ROC analysis to determine the probability of a fast type progression : Qalb less than 83.95, antibodies to α-synuclein in serum more than 4.11 ng/ml, MoCA less than 26 points. Depending on these indicators, patients of group 3 were divided into 2 subgroups: 3a) «possibly rapidly progressive» course (n = 21) and 3b) «possibly slowly progressive» course of PD (n = 34). In 16 (76%) patients from group 3a, the rapid type of progression was confirmed. In 28 (82%) patients from group 3b, a slow type of progression was confirmed.

The obtained results testify to the high sensitivity and specificity of the indicators. Further research is needed to develop therapies that change the course of PD.

By the WHO data, cardiovascular diseases are the most common causes of death all over the world, thus more four of five death cases from cardiovascular diseases occur as a result of an infarct and a stroke and has premature character. One of the reasons of development of these diseases is the thrombosis, i.e. formation of potentially lethal thrombs in vessels. Therefore working out and application antithrombotic agents is priority in medicine. This short review is dedicated to these drugs.

The article describes the clinical manifestations and their causes in the pathology of the small intestine in patients who complain of excessive bloating, recurrent abdominal pain syndrome, stool disorders with a tendency to relaxation. Such patients repeatedly return to the doctor. The evidence of a decrease in the activity of disaccharidases in this cohort of patients is presented. The emphasis is placed on the need to study the nutritional history, to identify products that provoke a violation of membrane digestion. The classification of carbohydrates with indication of products containing them is given. The essence of repeated and persistent clinical manifestations due to impaired membrane digestion and absorption of carbohydrates in the small intestine is explained, which leads to their appearance in the large intestine in different volumes, which is accompanied by the splitting of carbohydrates with the formation of gases. On the one hand, this is a normal process, but when it gets out of control, the patient gets to the doctor. The essence of a carbohydrate–restricted diet is described – this is the low FODMAP diet and its decoding. The products containing oligosaccharides are indicated, which are capable of being cleaved by the enzyme alpha-galactosidase, which is absent in the human body, but is present in the microflora of the large intestine. Advice is given on limiting the intake of such products, both in terms of the frequency of intake and the volume of portions containing them, in order to avoid excessive amounts of intestinal gases, the development of a clinically painful condition.

A thorough study of the nutritional history and the necessary correction of eating behavior is the main idea of this article, dedicated to the same type of clinical picture with varying degrees of manifestations of its symptoms.

The epidemiological data and modern ideas concerning the pathogenesis of acute biliary pancreatitis are presented. Acute pancreatitis of biliary etiology is a widespread pathology with the lethality rate of 2–7%, and at a severe course – 17–39%. The leading pathogenetic mechanism of acute pancreatitis of biliary etiology is pancreaticobiliary ductal hypertesion. During the conservative treatment the relapse rate of acute biliary pancreatitis reaches 90% with the lethality rate up to 31%. The only risk factor of the relapse development is refusal to perform cholecystectomy after the first attack of acute biliary pancreatitis to the patients whose condition permitted to survive the intervention.

The article gives a description of the section of diseases of the operated stomach – post-gastroresection syndromes. It has been noted that over the past decades the number of resection interventions due to complicated gastroduodenal ulcer has decreased. This was facilitated by the improvement of drug therapy, the emergence of new antiulcer drugs, including proton pump inhibitors, and the improvement of endoscopic methods for diagnosing and treating this pathology. Therefore, the number of post-gastroresection syndromes remains significant. The paper describes the ethology, pathogenesis, clinical manifestations of postgastrectomy syndromes. Diagnostic methods using the X-ray method, esophagogastroduodenoscopy, ultrasound examination of the abdominal organs, and computed tomography are considered in detail. Methods of conservative therapy are described, indications for surgical treatment are determined. The characteristic of classical and new methods of performing operational aids is given, and an assessment of their effectiveness is given.

The article presents the tasks of the medical service, carried out in order to plan and organize measures to protect personnel from exposure to hazardous chemicals in the event of emergencies at chemically hazardous industrial facilities, and to eliminate the consequences of such accidents. A brief description of the methods for predicting the consequences of a chemical accident is given, sources for obtaining information about hazardous production facilities are identified.

Perforation of the small bovel diverticulum is a fairly rare pathology in the structure of all emergency surgical diseases of the abdominal cavity and it is 0,5–2,3%. The absence of pathognomonic clinical manifestations makes it difficult to diagnose disease.

Purpose: to asses and to analyze early and long-term results of the hand reconstructions of the extensive soft tissue defects with posterior interosseous flap of the patients with hand injuries.

Objective: find out whether this type of operation is optimal for the reconstruction of soft tissue defects of the hand; improve the quality of life of patients with soft tissue defects of the hand

Materials and methods: the results of reconstruction of soft tissue defects of the hands with the posterior intercostal flap of the forearm in 6 patients (5 men and 1 woman) aged 31 to 67 years were analysed.

In all 6 cases, reconstruction of the posterior interosseus flap was performed during the phased treatment of the patient with severe post-traumatic defects in the soft tissues of the hand. In all 6 cases, the reconstruction of soft tissue defects of the hands was combined with complex traumatic and orthopedic operations (autocost plasty with a cortical-spongiotic graft, removal or resection of one of the rays of the hand with the formalion of narrow – fingered hand, osteosynthesis and rheosynthesis by spokes, microscrews and microplates, necrectomy and amputations). Preoperative preparations included ultrasound Doppler of the forearm with visualization of posterior interosseus vessels. In all cases, reconstructive operations were performed using binocular optics with an increase of 30–35 times. In the postoperative period, the condition of vascularization of f laps was monitored by thermal imaging.

Results: the flaps has taken root in all 6 cases. Postoperative complication in the form of marginal flap necrosis in it’s local venosus insufficiency was determined in one patient, which indicates the variability of vascular anatomy of the flap.

Conclusion: 1 year after operation, all patients were satisfied with the function of the hand the aesthetic appearance of the hand and donor area on the forearm. Survey Disabilities of the Arm, Shoulders, and Hand (DASH) was used to assess postoperative results in all patients after 1 year.

This article will focus on the well-known symptom of heartburn and a disease closely related to it – GERD. In a concise and accessible presentation, the causes and mechanism of the development of the disease and symptom in particular, as well as their complications, will be described.

Detailed recommendations for adjusting lifestyle are given. It will be useful both for specialists with medical education and for a wide range of readers.

The article presents the history of the creation and development of the military department of the Vitebsk State Medical Institute (University), the training of medical personnel from the moment of its formation to the present, as well as brief information about the activities of the department staff.

The article presents the main historical milestones associated with the formation of the hospital in 1943, its location during combat work during the Great Patriotic War and medical activity in the post-war years. The management staff of the hospital, medical and service personnel of the institution for the period from 1943 to 2014 are presented.