Research objective. Analysis of injury incidence among officers in Armed Forces of the Republic of Belarus for 18 years (2003–2020).

Materials and methods. We studied the annual medical reports about the state of health and morbidity among the officers in the Armed Forces of the Republic of Belarus (the form №3/med).

Results. Average annual injury incidence among officers in Armed Forces of the Republic of Belarus in 2003– 2020 was (13.37±1.43)‰, the proportion in the structure of primary morbidity for all ICD-10 classes was (1.8±0.1)%, hospitalizations – (7.13±0.81)‰ and (3,7±0.3)%, respectively, days of labor losses – (299.9±25.6)‰ and (7.0±0.5)%, respectively, dismission rates – (0.118±0.022)‰ and (2.8±0.5)%, mortality – (33.37±5.40) per 100 thousand servicemen and (44.0±5.4)%. With different in significance coefficients of determination, polynomial trends of the listed medical and statistical indicators demonstrate a decrease in data. In the structure of the integral assessment – the military and epidemiological significance of injuries for health disorders among officers 86.9% was the sum of the proportions of injuries of the hip joint and lower extremities (8-10th group), head injuries (1st group), injuries of several body areas (11th group), injuries of the shoulder girdle and upper extremities (5-7th group) and chest (3rd group). Injuries related to the performance of official duties among officers accounted 38.8%, not related to the performance of official duties – 61.2%.

Conclusion. Analysis of the data on injury incidence among officers with the use of an integral assessment will improve medical support. Injury is not exclusively a medical problem. It is necessary to fully involve interested officials of the Armed Forces to study the cause-and-effect relationships and circumstances of the occurrence of injuries, with the improvement of preventive measures to prevent injuries among military personnel.

The cause of bacterial sinusitis can be both a decrease in reactivity and a weakening of the macroorganism, which occurs as a result of an acute respiratory illness or hypothermia, and as a result of trauma, deformation of the nasal septum, the presence of a foreign body and other factors. Biofilms and, as a consequence, antibacterial resistance are an important predictor of bacterial sinusitis. To date, it is assumed that 90% of the studied types of microorganisms are capable of forming biofilms. The topic of the species spectrum of microorganisms and their associations capable of film formation is poorly studied.

When prescribing antibiotic therapy, one has to be guided by epidemiological data on the types of possible pathogens, their ability to form film and sensitivity to groups of antibacterial drugs in accordance with current clinical protocols.

The aim of the study was to study the microbial landscape of patients with acute and chronic sinusitis, to determine the ability to form biofilms.

To determine the microbial spectrum, a one-stage cross-sectional study was carried out, the coverage of which was 52 patients with a diagnosis of «Acute maxillary sinusitis» and 61 patients with a diagnosis of «Chronic maxillary sinusitis».

In all patients, a quantitative determination of the microflora of the paranasal sinuses was performed, followed by taking into account patients with microorganisms isolated in an etiologically significant amount and determining the ability to biofilm formation.

It was found that the most common microorganisms in patients with acute sinusitis were Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumoniae; with chronic – Staphylococcus aureus, Klebsiella oxytoca, Escherichia coli, Pseudomonas aeruginosa

Mixed infection was detected in 28% of patients with acute sinusitis and 17% with chronic sinusitis.

The ability to form biofilms was exhibited by 88% of isolates isolated from patients with acute sinusitis and 93% of isolates from patients with chronic sinusitis.

Thus, the study of the spectrum of microorganisms that form biofilms is an integral part of the study of the etiology and pathogenesis of acute and chronic sinusitis.

The article provides information on the frequency of detection of fungi of the genus Candida in HIV-positive and HIV-negative patients with chronic sinusitis. Information on the frequency of verification of this microorganism made it possible to calculate the probability of a fungal etiology of chronic inflammatory pathology of the paranasal sinuses and to substantiate the need for the use of antifungal agents in the treatment of chronic sinusitis in immunocompromised individuals. To assess the likelihood of fungal etiology, data on the clinical stage of immunodeficiency and the level of CD4 lymphocytes were used. As a result of the study, the indications for the appointment of antifungal agents in the treatment of chronic sinusitis in HIV-positive patients were determined, taking into account the clinical stage of HIV infection and the number of CD4 lymphocytes.

This part of the article begins with a description of the clinical manifestations and their causes in the pathology of the small intestine in patients who complain of excessive bloating, recurrent abdominal pain, and violation of the bowel movement with a tendency to relax. Such patients repeatedly return to the doctor. 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 food history, identify products that provoke a violation of the membrane digestion. The classification of carbohydrates with the indication of products containing them is given. It explains the essence of repeated and non-passing clinical manifestations due to a violation of membrane digestion and absorption of carbohydrates in the small intestine, which leads to their appearance in the large intestine in different volumes, which is accompanied by the breakdown 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 goes to the doctor. It describes the essence of a diet with a restriction of carbohydrates – this is the low FODMAP diet and its’ decoding.
These products contain oligosaccharides that can be broken down 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 food history and the necessary correction of eating behavior is the main idea of this part of the article, which is devoted to the same type of clinical picture with different degrees of manifestations of its symptoms.

The article presents the results of determining the levels of markers of cartilage remodeling of type II collagen (CTX II) in urine and oligomeric matrix protein of cartilage (COMP) in blood plasma in patients of the main group with 0-1 radiological stages of osteoarthritis of the knee joint and the control group, which are compared with clinical data, results of MRI and ultrasound studies. The authors evaluated the effectiveness of various treatment regimens for osteoarthritis in groups with different levels of cartilage metabolism. In patients with a high level of cartilage tissue degradation, monotherapy was accompanied by a statistically significant increase in “MRT-WORMS, sum”, while in patients on combination therapy, stabilization of the process (assessed by “MRT-WORMS, sum”) was noted.

The infection caused by the SARS-CoV-2 coronavirus continues to spread throughout the world. The high social and medical significance of this disease has led to a tangible increase in the number of publications about COVID-19 in many well-known publications. Currently, there is no systematic analysis of information on the diagnosis and treatment of concomitant conditions in patients with coronavirus infection, therefore, in this article, we have analyzed the revealed changes in clinical and laboratory parameters in patients with coronavirus infection and concomitant cardiovascular pathology, as well as their significance for practical medicine.

Objective. To assess the features of changes in the clinical and laboratory parameters of patients with COVID-19 and concomitant cardiovascular pathology and to find out their significance.

Materials and methods. A randomized retrospective analysis of medical records of 82 patients was carried out on the basis of the 4 N. E. Savchenko State Clinical Hospital. Clinical and laboratory parameters of 82 men (age 54±5.6 years) were studied for the period August 2020 – January 2021. The results of a detailed biochemical blood test, analysis of the acid-base state, hemostasiogram, and analysis for cardiomarkers were taken into account. All patients were divided into 3 groups: the first group – patients with the presence of COVID-19 without concomitant pathology, the second group – patients with the presence of cardiac pathology without coronavirus infection, the third group – patients with coronavirus infection and concomitant cardiovascular diseases (ischemic heart disease, arterial hypertension).

Results. When comparing the values of biochemical blood test indicators in patients of the third group, with those in patients of the first group, it was revealed: an increase in the content of blood ferritin in 2.69 times (p < 0.05), C-reactive protein – in 2.13 times (p < 0.05), activity of lactate dehydrogenase - 1.26 times (p < 0.05). When comparing the indicators of the third group with the second, an excess of triglycerides was found – 1.36 times (p < 0.05), LDL – 1.14 times (p < 0.05), atherogenic index – 1.36 times (p < 0.05), a decrease in the level of HDL – 1.37 times (p < 0.05). When comparing the values of the acid-base state in patients of the third group, with those in the patients of the first group, it was found: a decrease in PaO2 in 1.05 times (p < 0.05), and sO2 – in 1.14 times (p < 0.05). When comparing the values of hemostasiogram indicators, it was found: an increase in the content of fibrinogen in 1.09 times (p < 0.05), D-dimers – in 1.23 times (p < 0.05), INR – in 1.14 times (p < 0.05) and a decrease in APTT in 1.09 times (p < 0.05). When comparing the values of clinical and laboratory indicators of these groups, an extension of the length of stay in the hospital was revealed: the number of bed-days in men increased 1.32 times (p < 0.05). It is worth noting that, apparently, in conditions of COVID-19 infection, complicated by concomitant cardiovascular pathology, the processes of using glucose as an energy substrate is inhibited. As a result, lactate becomes a new substrate.

Conclusion:

1. In patients with COVID-19 and concomitant cardiovascular pathology, respiratory and tissue hypoxia is aggravated by circulatory hypoxia, which leads to more severe consequences of COVID infection and leads to an increase in the number of bed-days spent in the hospital.
2. The violation of energy supply processes is the most important factor, the cause of impaired glucose metabolism and leads to the development of tissue hypoxia.
3. The processes of inflammation in the body caused by COVID-19 infection are aggravated in conditions of concomitant cardiovascular pathology.

The severity of pulmonary involvement in patients with spondylarthritеs and rheumatoid arthritis is determined by the nature of lung affection and functional disorders.

Objective. To single out severe affection of the lungs among the varieties of pulmonary involvement in patients with spondylarthritеs and rheumatoid arthritis and to devise a model predicting the risk of development of severe lung affection in patients with spondylarthritеs and rheumatoid arthritis.

Materials and methods. The study involved 172 patients with spondylarthritеs and rheumatoid arthritis. The patients were interviewed. The presence of antibodies to atypical lung infections in blood was determined. The multispiral computer tomography of thorax was performed. The diffusion lung capacity was tested. In order to process the data Statistica 10 software package was used. With aim to predict the risk of development of severe lung affection logistic regression was carried out, also a logistic model was built.

Results. Varieties of lung involvement leading to a decrease in the diffusion lung capacity were qualified as severe lung involvement. In view of the revealed risk factors a logistic model was built which predicted the risk of development of severe lung affection in patients with spondylarthritеs and rheumatoid arthritis. The predictive value of the model was 80,7%. According to ROC-analysis the cut-off point was 0,47. AUC = 0,81±0,05; р < 0,001. Model sensitivity was 83,9%, its specificity was 70,0%. Its working capacity was confirmed on an independent sample of patients. In accordance with the check results the predictive value of the model was 78,1%.

Conclusion. Severe lung affection in patients with spondylarthritеs and rheumatoid arthritis leads to a decrease in the lung gas exchange. The logistic regression model makes it possible to predict the risk of development of severe lung involvement in this group of patients.

The authors present the clinical and epidemiological features of West Nile fever among adults in Belarus. To solve the set tasks in this research, we used methods of epidemiological diagnostics and statistical research methods. To identify predictors of a severe disease patterns and an unfavorable outcome of the disease, we analyzed various parameters with the calculation of the odds ratio. According to the results obtained, the Republic of Belarus is characterized by summer seasonality when infected with the West Nile virus.

According to the results obtained, the Republic of Belarus is characterized by summer seasonality when infected with the West Nile virus. In the age structure of patients with West Nile fever, the largest proportion is provided by young people (72.7%). A direct relationship has been established between the time of seeking medical care and the outcome of the disease.

The share of patients injured in working and weekends by the same agents (hot liquids, flames, solid hot objects, electric currents) having the defeat of the same name topographic parts of the body, as well as the same area and the degree of burns, were not statistically significant. At the same time, taking into account the gender structure of victims in working days among men, it was 6 times more affected by electric shock, 1.6 times more victims from exposure to chemicals and 1.5 times from contact with solid hot objects, as well as persons with a more frequent lesion of the skin of the head (1.6 times) and the respiratory tract (2.1 times), with extensive (more than 25% of the body surface) and deep (IV degree) of skin cuts (1.8 and 1.5 times, respectively).

The article presents an overview of the basic requirements for objects that are sources of electromagnetic radiation in the radio frequency range, a brief technical characteristics of radar stations, and the peculiarities of the effect of microwave radiation on the human body. Measures of medical control are recommended, carried out during the commissioning of radar stations, certification, as well as the organization of production control.

The purpose of this study was to determine the features of adaptation to extreme conditions, depending on the level of physical activity in sports students. 70 people studying at the Belarusian State University of Physical Culture were examined. The first group consisted of 40 students studying at the health faculty, who do not train and do not participate in competitions at the present time. The second group consisted of 30 students who have increased physical activity (cyclic sports), who are currently training and participating in competitions. The results of the study showed that as physical activity increases, the tendency to display symptoms of sports addiction increases; at the same time, there is a high psychological stability in extreme conditions against the background of higher emotional stability, a lower level of anxiety and fears; a significantly lower number of restrictions associated with sports addiction.

The article presents the results of a study conducted among 755 doctors. 446 doctors worked at night (main group), 309 did not work at night (comparison group).

Respondents who work shifts at night had significantly worse indicators on all subscales of the SF-36 (36-Item Short-Form Health Survey).

With the exclusion from the main group of doctors working in emergency medical care, as well as doctors who are constantly on duty at night (obstetricians, resuscitators), the results of a comparative assessment of the SF-36 subscales for doctors on duty and not on duty at night did not change.

When dividing the study sample of respondents into age groups by percentiles and subsequent comparison, it was revealed that young doctors of the main group under the age of 26 years do not have significant differences in any of the SF-36 scales from doctors under 26 years of age in the comparison group. In each subsequent age group, the number of parameters significantly differing for the worse among the respondents on duty is growing.

Within the main group and within the comparison group between the first (up to 26 years old) and the second (27–32 years old) age groups, there were no significant differences in the SF-36 indicators. When compared with older age groups, the differences increased and became significant. Interestingly, in the main group and the comparison group, the changes were multidirectional. Among the older respondents of the main group, a number of SF-36 indicators, especially those affecting physical functioning, significantly worsened. The older respondents in the comparison group had an improvement in the SF-36 indicators, affecting mainly mental functioning, while the quality of physical functioning did not change.

Topicality. The transjugular intrahepatic portosystemic shunt (TIPS) is widely used in the treatment of portal hypertension. However, this procedure has several major potential complications, which include hepatic encephalopathy as well as shunt dysfunction. In this connection, the development of TIPS modifications aimed at reducing the incidence of complications after this procedure seems relevant.

Purpose of the study. To study the results of a modified portal vein puncture method, depending on its variant anatomy, as well as the combined use of autohemomagnetotherapy to prevent shunt thrombosis and progression of hepatic encephalopathy during TIPS.

Materials and methods. In the course of a prospective randomized controlled study in the period from 2014 to 2020, the results of treatment of 37 patients were studied. Modification of the standard TIPS procedure was performed in the main group of patients: the choice of the optimal puncture point of the portal vein was carried out on the basis of the anatomical variant of the divergence of the right anterior branch of the failures and complications. Autohemomagnetotherapy was performed in the same group after performing transjugular intrahepatic portosystemic shunting daily for 5 days.

Results and discussion. It was noted that the anatomical variant of the portal vein structure affects the success of TIPS (the correlation coefficient of the variant anatomical type of portal vein branching and the occurrence of technical difficulties in the group of the standard TIPS technique R = 0.81, p = 0.000003). The proposed method of puncture of the portal vein is quite effective for the prevention of this complication. When using the modified TIPS, significantly less progression of hepatic encephalopathy was noted compared to the standard technique. The proposed method allows for the prevention of early thrombosis of shunts and recurrent bleeding from varicose veins of the esophagus and stomach.

Conclusions. The proposed modified method of transjugular portosystemic shunting is effective, available and can be widely used in clinical practice.

This publication presents an analytical review of the literature and analyzes our own research results of strength characteristics studies of the developed anchor retainers models using automated strength calculation modules.

The issues of postgraduate training to minimize the health consequences of emergencies are considered. 

In recent years, considerable attention has been paid to the spread of bacterial resistance to antibiotics, disinfectants, and antiseptics. There are few effective antimicrobial drugs left, the creation of new ones requires significant costs. The WHO defines bacteriophages as a «new therapeutic approach» as an alternative in the fight against bacterial pathogens. Undoubtedly, healthcare organizers, epidemiologists and clinicians currently need an up-to-date assessment of the evidence regarding the benefits, efficacy and safety of bacteriophage therapy, as well as the use of phages for the control and prevention of infections (for example, in a complex of anti-epidemic measures, biological disinfection).

Developed in the last 15 years, a new class of sugar-lowering drugs – glucagon-like peptide-1 receptor agonists – has become one of the leaders in the treatment of type 2 diabetes mellitus, prediabetes and obesity. Numerous studies have proven the cardiovascular safety of this medicine class, their cardioprotective and nephroprotective effects. That served as the basis for making changes to clinical recommendations on the management of patients with type 2 diabetes mellitus.

Disruption of the integrity of the liquor space (regardless of the cause) and liquorrhea as a consequence have a high risk of pyo-inflammatory intracranial complications in the patient: the incidence of nasal liquorrhea intracranial complications reaches 25–35%. The risk at liquorrhea lasting more than 3 months increases up to 60%, and the development of intracranial complications in a patient in 78.8% of cases was observed more than once. The mortality rate from intracranial complications against the background of basal liquorrhea can be up to 50%. At the same time the incidence of basal liquorrhea, including delayed (a few months or years after injury) is increasing as well as the prevalence of injuries with damage to the skull base including iatrogenic kind is increasing too. Therefore, early diagnosis of liquorrhea is important. An otorhinolaryngologist in his practice may encounter any type of basal liquorrhea: nasal liquorrhea, otoliquorrhea and even orbital liquorrhea. These article based on a literature review and provid recommendations for the primary diagnosis of by head-neck specialists including otorhinolaryngologists.

The number of orthopedic operations using bone cement is growing every year around the world, and therefore the number of patients with bone cement implantation syndrome will inevitably increase. Awareness of risk factors, pathophysiology, clinical manifestations, timely diagnosis, treatment and prevention of this pathology, both on the part of the orthopedic traumatologist and the anesthetic and operating teams, will help to optimize the results of treatment of patients requiring orthopedic operations. The problem of bone cement implantation syndrome remains poorly understood. Based on a review of a number of scientific publications in the Pubmed, eLibrary system (up to June 2020), the article discusses the etiology, pathogenesis and principles of providing emergency medical care for this complication of a number of orthopedic surgical interventions.

The adaptive immune system is important for fighting viral infections. The main components of the adaptive immune system are B-lymphocytes, CD4 and CD8 T-lymphocytes. In this article we reviewed publications dealing with humoral and cellular responses in humans to SARS-CoV-2 infection. The COVID-19 disease in question has resulted in high morbidity and mortality worldwide in a short period of time. Scientific advances in understanding the new disease have been extraordinarily rapid, a testament to the work of the international scientific community, both in academia and industry, under extremely stressful conditions. In this article we will look at the current understanding of adaptive immunity responses in COVID-19 and vaccination. It should be borne in mind that the immune response contributes not only to host protection but also to immunopathology. By obtaining answers to questions concerning the adaptive immune response to SARS-CoV-2, the practical challenges facing health professionals and society can be addressed.

This article is devoted to assessing the impact of motivational counseling and information on effectiveness of prevention of manifestations of multi-organ inflammatory syndrome in the oral cavity after the transfer of Covid-19

The psychophysiological status of 12–14 year old basketball players from the Republic of Belarus and the People’s Republic of China was assessed. With the help of the program “NS-Psychotest” the indicators characterizing the state of the nervous system of young basketball players were studied. The indicators of the functional mobility of nervous processes indicated the relative inertia of the nervous system and the absence of significant dynamics as basketball players from Belarus and China grew up. Indicators of lability of the nervous system in the process of maturation of basketball players reached the average level by the age of 14. The speed and precision qualities of basketball players as they grow up tended to decrease the number of movements, improve psychomotor reactions. The peculiarities of concentration and attention switching were assessed according to the indicators of the test “Red-black tables”: the duration of the test and the number of errors. For basketball players from the Republic of Belarus, the duration of testing by the age of 13 was significantly reduced compared to the age of 12, for basketball players from China it remained without significant dynamics. The number of mistakes among basketball players from Belarus and China did not significantly differ between the groups in all age periods. The accuracy of the movements of fingers and hands was determined: among basketball players from the Republic of Belarus, an increase in accuracy was noted as they grew older; basketball players from the PRC did not change the accuracy of their movements. A significant difference was revealed: the indicators of movement accuracy by the age of 14 among young basketball players from Belarus were higher than among basketball players from China.

A herniated disc is the most frequent manifestation of the degenerative-dystrophic process in the spine, which manifests itself in the most working age. Often, when a herniated disc is detected, such patients are referred for surgical treatment. Published meta-analyzes have shown that there are no significant differences in the effectiveness of surgical treatment of disc herniation and conservative tactics in a long-term comparison. The ineffectiveness of epidural blockade with glucocorticosteroid hormones and long-term use of non-steroidal anti-inflammatory drugs has been shown. All this dictates the need to study other methods of effective treatment of patients with discogenic pain syndrome. This article provides an overview of the study of the mechanisms of spontaneous resorption of intervertebral hernias, which is essentially a sanogenetic response of the body. The focus on patterns, connected to development of neurological manifestations, is vital. This direction in the study of degenerative disc disease, in our opinion, is the most promising at the present stage of development of medical science.

The article is dedicated to the outstanding scientist-epidemiologist, doctor of medical sciences, professor, academician, major general of the medical service Vitaly Dmitrievich Belyakov. The main stages of the biography and scientific path of Academician V. D. Belyakov, noted for his services in the development of epidemiology and medicine in general. V. D. Belyakov was a reformer and innovator in the field of epidemiological practice and education in the field of all preventive medicine. The theory of internal regulation of parasitic systems developed by the scientist, which describes the mechanisms of formation and manifestation of the epidemic process, is the theoretical basis of epidemiology.