The article describes the main disorders that occur in patients after gastrectomy and also the comparison has made with the disorders arising after resection of the stomach. It is shown that the most important problems after gastrectomy are a deficiency of body weight and anemia. After resection, depletion was observed to a much lesser degree, whereas anemia was sufficiently pronounced.

The article outlines the procedure for conducting medical examination of citizens studying under the training programs for reserve officers at military departments and military faculties of institutions of higher education of the Republic of Belarus. Identified problem issues and proposed solutions for their solution.

The dynamics of hospital morbidity and mortality levels, a general characteristic of clinical observations, methods and results of treatment of acute pancreatitis for the period from January, 1 1997 to December, 31 2016 are presented.
The analyzed period was marked by the growth of the absolute number of patients with acute pancreatitis and necrotizing pancreatitis, as well as the proportion of patients with necrotizing pancreatitis.
The analysis of 1067 cases of acute pancreatitis (804 – the first attack, 263 – repeated attacks) was done in a retrospective observational study. It was determined, that among patients with acute pancreatitis the most numerous group consists of males, young and middle-aged, admitted on a treatment after the alcohol consumption and/or an error in nutrition 24 hours later from the onset of the disease. In etiological structure of acute pancreatitis, the specific gravity of regional circulatory disorders of the hepatopancreatoduodenal zone reaches 8%. The premorbid status of each tenth patient with acute pancreatitis is burdened with CHD, manifested by stenocardia, postinfarction cardiosclerosis or rhythm infringement. The absolute number of patients of elderly and senile age suffers from two and more concomitant diseases.
In 37% of cases of repeated attacks of acute pancreatitis, the disease is characterized by an equal or more severe course with possible lethal outcome.
In sterile (not infected) pancreonecrosis and limited forms of infected pancreonecrosis, treatment should be performed in the option of multicomponent intensive care combined with a minimally invasive surgery. In widespread forms of infected pancreonecrosis, operative management is indicated in the option of «open» drainage with the subsequent performance of repeated programmed sanitations is advised with the purpose to actively monitor all areas of necrotic destruction and infection for the prevention of development of intra-abdominal complications.
The expediency of allocation of compelled and staged modes of interventions in tactics of surgical treatment of necrotizing pancreatitis is substantiated. 
During the analyzed period, the overall mortality from acute pancreatitis has made 8,2%, from necrotizing pancreatitis without differentiation of its clinic-morphological form – 25,9 %, postoperative mortality has made – 47,6%.
By terms (2 weeks before/after) from the disease onset, lethal outcomes from acute pancreatitis are distributed evenly. However, in the structure of causes the proportion of septic conditions is 1,8 times higher than the frequency of aseptic. The cause of the death of each fifth patient died from the necrotizing pancreatitis was hemorrhagic complications.

The paper highlights the main problems associated with the management of the perioperative period when performing surgical correction of scoliotic deformation from the point of view of an anesthesiologist. The effectiveness of various methods of perioperative anesthesia was evaluated. The data on the volumes of intra- and postoperative blood loss, the ways of its correction are presented. It is established that the use of epidural analgesia in combination with the restriction of infusion therapy provides the most adequate antinociceptive protection, helps to reduce blood loss, and also reduces the number of postoperative complications.

Antibacterial therapy in the complex treatment of widespread peritonitis is important. For effective antimicrobial therapy continuous monitoring of the selected flora is required, allowing you to reduce the percentage of adverse outcomes infections and increase the survival of patients. Range of causative agents of widespread peritonitis and indicators of sensitivity to antibacterial medicines are constantly changing. Therefore, the aim of the investigation was to create an empirical antimicrobial therapy, taking into account differences in the spectrum of pathogens at different levels of integrity of the gastrointestinal tract. As a result of the work modern data were obtained concerning the etiologic structure of causative agents of widespread peritonitis, as well as the range of their resistance to antibacterial drugs, most commonly used in multidisciplinary hospitals of the Republic of Belarus in the treatment of patients with widespread peritonitis. Effective schemes empiric antimicrobial therapy for the most commonly identified pathogens widespread peritonitis at different levels of the integrity of the gastrointestinal tract are offered. The use of effective schemes of empirical antibiotic therapy is a background for improving patient outcomes and growth slowdoun of pathogenic microorganisms resistance development to antimicrobial drugs.

Treatment of patients with widespread peritonitis requires health institutions of considerable financial outlay, with the budget of a multidisciplinary hospital antibacterial drugs accounts for up to 40% of the cost. Definition of the effectiveness empirical antimicrobial therapy in patients with widespread peritonitis is an important factor in successful treatment.
On the basis of our data on the identification and determination of susceptibility to antibacterial medicines microflora of peritoneal exudate in patients with widespread peritonitis developed schema of empirical antibiotic therapy, taking into account the levels of integrity of the gastrointestinal tract. Solved pharmacoeconomic analysis of antimicrobial therapy in 319 patients with widespread peritonitis. Economic evaluation of the effectiveness of the treatment was carried out on the basis of the «cost-effectiveness» and «minimize cost». The calculation is made according to the formula, using as units of the efficiency coefficient of avoided complications and deaths averted.
Antibacterial therapy costs in total costs of medicines amounted to 55,1% in traditional methods of bacteriological research and treatment, 63,3% when applying the developed test-systems for identification and microflora sensitivity to antibacterial medicines, 60,7% – if you use schema developed empirical antibiotic therapy. Based on an analysis of cost-effectiveness, it was found that savings when using schemas empirical antibiotic therapy in the treatment of one patient was $579,2 compared to traditional treatment, total savings $45756,8.
Thus, application schema developed empirical antimicrobial therapy, taking into account the levels of integrity to the gastrointestinal tract in patients with widespread peritonitis can significantly reduce the cost of treatment and have high economic efficiency.

In this paper, the concept of life quality in medicine is given. The psychoemotional component of the disease with persistent facial palsy is emphasized. The main tools for studying the quality of life of patients with facial paralysis are described and analyzed. The main scales of assessment of QoL, used in assessing the effects of surgical treatment of facial paralysis, are evaluated. The dynamics of QoL was analyzed in 14 patients, after surgical treatment of facial paralysis by various methods using the SF-36 questionnaire. The main indicators of the questionnaire were evaluated, correlation with literature data was revealed. It was concluded that it is necessary to further study the parameters of QoL evaluation and adaptation of specific scales to assess QoL of patients with facial paralysis.

In this paper, the main methods for evaluating the results after reconstructive interventions for facial paralysis are highlighted. The separation of methods into subjective and objective methods is indicated. The shortcomings of the existing subjective methods of assessing the severity of facial paralysis are reflected. The analysis of facial paralysis in 14 patients operated since 2014 in the Republican Center for Reconstructive and Plastic Microsurgery was conducted on the basis of the microsurgical department of the Minsk Regional Clinical Hospital. Comparative characteristics of the methods for assessing the severity of facial paralysis are exemplified by the example of the House-Brackman scale and SMILE smile symmetry scale, and correlation is revealed.

The aim of the study was to assess the possible direct effect of anticancer therapy with methotrexate (MTX) in bio liquids on the oral mucosa in the development of oral mucositis (OM). Twenty one children and adolescents participated in this study. Chemotherapy with MTX was administered in the following concentrations of 1, 2, 5 g/m2 of body surface area during 24 hours (including four episodes with OM). Twenty seven episodes of chemotherapy with high dose MTX were assessed in the samples of saliva on the 6th, 12, 24, 42, 48, 54 hour from the start of infusion and in the samples of blood on the 42, 48, 54 hour from the start of infusion.
It was determined that excretion of MTX in the oral cavity repeated its clearance in blood. MTX concentration in saliva was less than 1/10 from its concentration in blood. During the first day, MTX concentration had decimicromol level and then until 54 hour it had santimicromol level. MTX concentration in saliva on the 6, 12, 24 hour in children with OM was lower by 2 times than in children without OM (p < 0,001). There was no significant difference in those parameters between two groups (with or without OM) in the following observed hours. This data does not support hypothesis concerning involvement of salivary MTX in OM pathogenesis.

A comparative analysis of male urban and rural population mortality based on specific (crude) and standardized mortality rates within 1959–2015 is presented in the article. The effect of age structure change on mortality rates is established. For the study period, standardized mortality rate among urban men increased by 1.5 times and among rural men by 2.1 times (specific by 2.4 and 3.3., respectively). Since 2002, a tendency to reduced mortality among urban men has been formed, and that for rural men with a similar rate of annual mortality decrease has been observed since 2005. In 2015, a standardized rate among urban men has been revealed to correspond to that of 1962 and among rural men to 1990.

The results of surgical treatment of 206 patients with multiple hernias of the cervical spine were analyzed. They were operated using various minimally invasive surgical techniques (puncture laser microdiskectomy, open microdiskectomy, and a combination of the above methods). The average age of the patients was; – 49±0,56 years. Puncture laser microdiscectomy was performed in 79 patients, open microdiskectomy followed by installation of a cage, 78 patients were performed, 49 patients were operated using combined methods. The severity of the pain syndrome was assessed according to the VAS scale. In patients who underwent puncture laser microdiskectomy, the pain syndrome regressed from 5.8±1.4 points to 4.8±1.2 in the early postoperative period, 6 months to 2.45±1.7, and 1 year to 1,8±0,11, patients who underwent open microdiskectomy pain regressed from 9,8±1,6 to 1,5±1,4 in the early postoperative period, in 6 months to 1,2±1,3, through 1 year to 0.7±0.23, after application of the combined technique, the pain syndrome regressed from 9.7 ± 1.3 to 1.5±1.4 in the early postoperative period, after 6 months to 1.0±1.2 , and accordingly about 1 year to 0.8±0.6.
Thus, the differentiated application of surgical techniques is a highly effective minimally invasive method for treating patients with multiple hernias of the cervical spine.

The article describes the relevance of infections connected with the provision of medical care, the main prerequisites for their occurrence and distribution in healthcare organizations. The presented data set influences on the making of the nidus of the infection epidemiological research.

Scientific research institute of sanitary, hygiene and occupational diseases of the MoH of Republic of Uzbekistan, Academy of the Ministry of Internal Affairs of Republic of Uzbekistan.
Given the fact that the level of human‘s vitamin coverage is most sensitive indicator of human adaptation at the performance of line of duty in the conditions of restricted feeding. An actual content of water-soluble vitamins in the food and urine of young men in age 18-21 y.o. was detected. The close correlation between urine egestion of vitamins and vitamins content in the diet is determined (r = + 0,4). Based on the comprehensive approach, the system of detection, correction and prevention of watersoluble vitamins‘ deficiency people in organizations, being on a restricted feeding, was developed.

The analysis of the incidence of sickness with temporary disability (TD) among employees of the enterprise was carried out, the structure of morbidity by the main groups of nosologies was identified. The data obtained in conjunction with the hygienic assessment of working conditions made it possible to identify occupational risks of the development of diseases in employees for subsequent management decisions.

Successful experience of complex multi-stage surgical treatment of chronic wounds is presented in article. The complex of the surgical and conservative receptions offered in work has allowed to achieve the accelerated course of wound process, to completely liquidate an extensive wound in functionally active area, to reach good functional and cosmetic effect.

Proposed a semi-automatic mode of computer simulation algorithm for the nerve canal, based on computer tomography data processing. The discussed research deals with the adaptation of the classical «snake» method to the segmentation of images divided into a sequence of parallel planes. Arising problems and ways of eliminating them are considered. Used the threedimensional visualization algorithm, which takes into account the variability of the dimensions and shape of the nerve canal with high precision.

The presented article is devoted to the study of caries prophylactic efficacy of fluoride-containing varnish VOCO Profluorid Varnish and protective cream Remin Pro on permanent teeth during the orthodontic treatment by the bracket system.
131 patients-volunteers, being on treatment of dentoalveolar anomalies with a bracket-system, took part in this study. By randomization, all participants were divided into 3 groups. Patients of group 1 (37 persons) were applied 4 times a year with VOCO Profluorid Varnish. Patients of group 2 (29 people) used a protective cream Remin Pro daily after teeth brushing for a month, the courses were repeated 4 times a year.
Patients of group 3 (32 people) were treated with VOCO Profluorid Varnish lacquer 2 times a year and 4 times a year with a protective cream Remin Pro.
The comparison group 4 consisted of 33 people who refused to participate in the prevention program, but agreed to collect data for this study.
As a result of the study, a lower increase in the intensity of caries in the group of patients in group 3 and group 2 was found and a reduction in the increase in the intensity of caries in the group of 1 to 40.48% was established, in group 2 – 57.14% and in group 3 – 69.05%.
Thus, this study confirmed the cariesinhibiting effect of VOCO Profluorid Varnish when applied twice a year and Remin Pro protective cream four times a year by monthly courses in patients who are on orthodontic treatment with non-removable devices. The most pronounced preventive effect was observed when using VOCO Profluorid Varnish in combination with Remin Pro protective cream.

In article have analyzed the differences between the effects of laser radiation impact with wavelengths of 1470 and 1560 nm on biological tissue from the standpoint of their physical properties, have determined clinical value of the detected differences based on usage of the mentioned LR wavelengths in treatment of varicosis of the lower limbs.

The article presents a scientific analysis of modern aspects of the pathogenesis of postoperative abdominal hernia in accordance with the positions of biochemical and biomechanical theories of their origin and progression.

In the last decade, the interest of researches and consumers to the impact of bioactive diet on human health and its widespread use in everyday life for prevention and treatment of many chronic diseases has increased. It was found that the most successful was the use of natural medicine – bioactive foods, mainly plant origin – in liver diseases (in 81%). The increase in the incidence of chronic liver pathologies is called the second epidemic of our century. In presenting our review of the data of modern foreign studies, we focused attention on the mechanisms of exposure to nutrients of natural food products – those with hepatoprotective properties, safe and without negative side effects, and which are recommended to be included in diet, especially at high risk of chronic liver diseases.

The daily clinical practice today in many respects is defined by modern international managements which key positions are under construction on results of the most demonstrative data received at carrying out of clinical researches. In the last (2017 year) wording the Global Initiative for Chronic Obstructive Lung Disease(GOLD) new principles of chronic obstructive pulmonary disease(COPD) diagnosis and treatment of which at an assessment of weight of a condition of patients consider not only respiratory function, but also expressiveness of semiology, as well as propensity to aggravations are stated. New principles of COPD diagnosis allow to estimate more full features of disease of the patient and more differentially to approach to the therapeutic problems decision.

Microangiopathic hemolytic anemia (MAHA) is the hemolytic anemia of non-immune origin associated with mechanical damage of the erythrocyte membrane. Their causes can be: diseases of the kidneys, cardiovascular system, liver, certain infections, the taking of some medicines. They can also occur after transplantation of organs and tissues, severe burns, with malignant tumors, disseminated intravascular coagulation syndrome, giant hemangioma, and others. These anemia are often accompanied by impaired renal function, up to acute renal failure, dysfunction of other organs and systems, including the Central nervous system due to damage of the microvessels. In the peripheral blood smears revealed a «fragmented» red blood cells (helmets cells, Schistocytes) and thrombocytopenia. Free plasma hemoglobin and indirect bilirubin levels rise, haptoglobin decreases, in the urine – hemoglobin, hemosiderin. Anemia have hyperregenerative character, with reticulocytosis. Treatment should be aimed at cupping the primary pathological process.
The review presents the most frequent microangiopathic anemia – haemolytic-uremic syndrome (HUS), or Gasser‘s disease, and Moskowitz disease, or thrombotic thrombocytopenic purpura (TTP). Presented their epidemiology, etiopathogenesis, clinic, diagnostics, differential diagnosis, treatment and prognosis.

The method of phlebectomy by W. Babcock with various improvements was used by most surgeons of the world and was the standard for the treatment of varicose veins for 100 years. The method of W. Babcock was replaced by minimally invasive methods of treatment. In a comparative aspect, modern data on the effectiveness of EVLA, RFO, echocontrolled foam sclerotherapy are presented. The listed methods are minimally invasive outpatient methods performed under local tumescent anesthesia with a relapse rate not exceeding that for «classical» phlebectomy. The analysis of publications showed the safety and high effectiveness of EVLA in the treatment of varicose veins, as well as the need to continue further study of the results of the use of EVLA in clinical practice.

The article gives brief information concerning arbovirus infections the most important in the epidemiological terms for the Republic of Belarus, their laboratory diagnosis and prevention in the light of the pathogens potential use in bioterrorism. The need for measures to ensure the safety of the population is substantiated.

The purpose of the research was to study the preferences of dentists in Belarus in the choice of ways to preserve the anatomical shape of the root canals and the technique of preparing the curved root canals. It has been established that respondents have a high awareness of the advantages of preserving the anatomical shape of the root canals and most of them (90.45±1.98%) always try to preserve it. Among the methods used by the respondents to preserve the anatomical shape of the root canals, carpet path technique predominates with usage of rigid steel files. To work in curved root canals, respondents prefer to use K-files, H-files and S-files in most cases rationally choosing the maximum size of the endodontic file. The majority of respondents (92.27±1.80%) met in their practice with complications in the treatment of root canals with great curvature. Most often this is a file breakage in the root canal, the ledge formation, obturation with debris and perforation of the root wall.

The results of treatment of 24 patients with acute mesenteric obstruction analyzed. The intervention performed on the superior mesenteric artery (SMA) or the superior mesenteric vein (SMV) in order to restore blood flow. The age of patients is from 65 to 89 years. 6 patients diagnosed on the basis of clinical data alone, 16 – CT scans with bolus enhancement, and 2 – angiography of the aorta and its branches.
Operative interventions for acute abdominal ischemia must necessarily include revision of the superior mesenteric artery. The following sequence of actions suggested: 1) resection of the necrotic bowel; 2) revision of the superior mesenteric artery with an attempt to eliminate occlusion; 3) assessment of the viability of the remaining part of the bowel, additional resection of sites whose viability is questionable; 4) in the presence of conditions - the imposition of a primary anastomosis. This algorithm allowed maximally keep the intestine in case of its ischemia and avoided imposing high enterostoma, which are extremely unfavorable for patients.
In the case of venous gangrene of the intestine, thrombectomy from the superior mesenteric vein may performed through its brunches, revealed during resection of the necrotic part of the intestine. It allowed to reduce the volume of resection of the small intestine and completed the operation with a primary entero-enteroanastomosis.

Graves‘ disease takes the main place among the diseases of the thyroid gland, accompanied by its hyperfunction. The most dangerous are manifestations of the cardiovascular system. The article presents a case of thyrotoxic cardiomyopathy on the background of Graves‘ disease.

According to the World Health Organization, more than a billion diarrheal diseases are registered worldwide each year, with more than half of those occurring in early childhood age. Viral intestinal infections play an important role in infectious diseases in children of different ages. Rotavirus infection refers to the prevalence of viral diarrhea in young children. In acute intestinal infections structure the part of rotavirus infection is about 30–40% (more than 50% amongst intestinal infections with the known agent). In most cases, rotavirus infection ends with a complete recovery of the patient with the appointment of pathogenetic and symptomatic therapy. It is well known that intestinal manifestations are typical for rotavirus infection. However, the fact of generalization of infection with the defeat of various organs and systems (nervous system, liver, kidneys, heart, pancreas) is proved. This article presents a clinical cases and discusses the possibility of damage to the nervous system during rotavirus infection. 

The problem of organization and contents of surgical care to the wounded in the modern Armed Forces of the Russian Federation in conditions of armed conflicts is discussed in the article.

The quality of medical care in emergency situations depends on the rationality of the organization of evacuation measures. In this article the basic directions of evacuation of victims are substantiated. Medical triage criteria based on the nature of pathologies of victims in providing medical care in emergency situations.

Combat operations in Donetsk and Lugansk regions demand from Disaster Medicine Service solving many issues related to the organization and provision of emergency medical care to the affected population. One of the major problems is the identification of victims and medical personnel, basic equipment in the management system of the organization and provision of emergency medical care. In the study of identification methods associated with the organization and provision of emergency medical care to the affected population in the combat zone, these methods are identified as most optimal: bar code identification, radio frequency identification (RFID), biometric identification, plastic smart cards. Application of automatic identification methods in the system of organization and provision of emergency medical care to the affected population in the combat zone allows to identify the victims, to increase their safety, determine the location of patients, medical and non-medical staff of disaster medicine service on the territory and the premises of medical institutions. The use of methods of automatic identification optimizes traffic and allows to locate the necessary medical, sanitary, economic and special equipment, to get it in the shortest possible time and to use most effectively and to prevent spreading and use of illicit and counterfeit medicines.

The article covers the events covering the period from 1943 to 1995. And associated with the resumption of training of medical personnel in the Belarusian (Minsk) State Medical Institute in Yaroslavl (01.1943-07.1444) and after the evacuation of the Institute in Minsk (10.1944-08.1995), as well as brief information about the activities of military personnel Chairs of the Vitebsk, Grodno and Gomel medical institutes (universities) – from the moment of their formation to the present time.

The article presents a historical facts and a period of formation of blood transfusion center of Armed Forces of Republic of Belarus 

The article is devoted to the analysis of the activities of the Civil Protection and Disaster Medicine Department of the State Institution «Zaporizhzhya Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine» on the occasion of the Department‘s 50th anniversary. The goal is to study and summarize the experience of the teaching staff of the Civil Protection and Medicine of Disaster Department, to track the dynamics of changes in the educational and pedagogical process, educational and methodological work and scientific achievements, to evaluate them, to draw conclusions for further improvement of the educational process and scientific activities. Archival and current materials of organization and activity of the State Institution «Zaporizhzhya Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine» and the Civil Protection and Medicine of Disaster Department for 1926–2017 years were studied. Materials of educational, methodical, pedagogical and scientific activities of the teaching staff are analyzed and summarized.