Objective: To analyze the organization and specific approaches to providing emergency medical care for polytrauma at the prehospital stage.

The analysis reviews literature data highlighting key problems in providing medical care in emergency situations (ES): personnel and resource shortages, and the necessity of triage. Special attention is paid to optimizing the diagnosis of polytrauma under time constraints, and to modern approaches to treatment at the prehospital stage, including stabilization, evacuation, and documentation. The article contains a comparative analysis of emergency medical service (EMS) organization models, with an emphasis on polytrauma, and prospects for optimizing the service, identifying problematic aspects for further discussion.

The paper provides an analysis of the current regulatory framework governing medical care for civil aviation in comparison with international experience based on materials from the ICAO, the IATA, and the PUBMED database. The directions of further improvement of medical support for civil aviation flights are proposed: consideration of effective radiation doses for flight personnel, development and development of a passenger health monitoring system, critical revision of the list of investments included in first-aid kits for equipping aircraft, the need for additional training of medical personnel in the specifics of providing emergency care on board aircraft.

The article presents data from the analysis of 97 cases of operated aneurysms and aortic dilations in patients under 45 years of age. An analysis of clinical symptoms and structural and functional parameters of the heart was conducted.

The article presents the results of the use of endoscopic total extraperitoneal hernioplasty (TEP) in the surgical treatment of abdominal hernias. The study included 634 patients who underwent surgery in 2017–2023 at the 2nd City Clinical Hospital in Minsk. The surgical technique of TEP, anatomical guidelines, features of interventions for various types of hernias (including recurrent and combined), complications and clinical results are described. Advantages of the method: low complication rate (2.7 %), minimal injury, short hospital stay (average 3.7 days), method of choice in the treatment of inguinal hernias.

Varicose veins of the lower extremities in their various manifestations affect up to 80 % of the general population, and clinical treatment practice is heterogeneous worldwide. There is no single set of definitive recommendations, making clinical practice extremely heterogeneous.

Objectives: To evaluate intraoperative compression therapy with a pelot within 24 hours after phlebectomy. Methods: 60 lower limbs with varicose disease classified as C1–C3 were randomized to 1 of 2 groups: intervention group (36 limbs) with intraoperative compression then elastic bandaging after phlebectomy and control group (24 limbs) with elastic bandaging after phlebectomy. We compared the pain syndrome in the lower limb after surgical treatment. Results: the use of the pellot reduced the pain syndrome in patients (the average value of the CRS with compression was 3.36, without compression 5.13, Student’s t-test = 2.15, the differences are statistically significant (p = 0.037), the number of degrees of freedom f = 54, the critical value of the Student’s t-test = 2.005, at a significance level of α = 0.05).

The aim of the study was to evaluate the effect of mesenchymal stem cells (MSCs) application in liver transplantation and their impact on renal function recovery. An interventional randomized prospective study (n = 60) was performed: the main group (n = 30) received MSC therapy, while the control group (n = 30) received standard immunosuppressive therapy. Method included combined application of MSCs: intraportal intraoperatively (20×10⁶ cells) and twice intravenously (on the day of surgery and on the 4th postoperative day at dose of 2×10⁶ MSCs/kg of recipient body weight).

Patients in the main group received delayed reduced doses of tacrolimus. The results showed that the use of MSCs allows achieving adequate immunosuppression with reduced tacrolimus concentration (4.4 ng/ml in the MSC group compared to 5.5 ng/ml in the control group on day 10, p = 0.029) and later initiation of its administration (from day 3 compared to day 2, p = 0.03). MSCs application contributed to faster recovery of kidney function: creatinine level on day 14 was 92 μmol/L in the MSC group compared to 115 μmol/L in the control group, GFR on day 7 was 38 ml/min compared to 27 ml/min (p < 0.05). The duration of hospitalization in the MSC group was 17 (15; 23) days, in the control group 20 (16; 26).

The article presents the results of a study concerning the number and age structure of the living and deceased male working-age population of the Republic of Belarus in 1990–2019. A decrease in the number and «aging” of the male working-age population has been established in a 30-year retrospective, characterized by a decreased proportion of the younger (15–29 y.o.) and an increased proportion of the middle (30–49 y.o.) and the older (50–64 y.o.) age groups in the age structure. The effect of the age structure change factor on the mortality rates and dynamics among working-age men in the Republic of Belarus in 1990–2019 has been studied.

It has been shown that despite increases in the frequency of laboratory testing of 25(OH)D in the general population and increases in the consumption of prophylactic doses of vitamin D, the benefitrisk ratio of this for reducing the incidence of musculoskeletal, metabolic, cardiovascular, malignant, autoimmune and infectious diseases remains uncertain. However, due to the moderate amount of sunny days in Belarus and the difficulty in meeting the need for vitamin D through diet, taking vitamin D as a food supplement is often recommended to maintain good health.An analysis of the vitamin D content in the blood serum of people of different ages, genders, at different times of the year, living in the metropolis of the Republic of Belarus (RB) was made.

Recommendations of the International Endocrine Society on the use of prophylactic doses of vitamin D (2024) are provided.

The data of direct measurements of[137] Cs activity in military personnel were analyzed in comparison with the population of Luninets district over 5 years. Similar gender differences in the accumulation of[137] Cs were found (in women, the accumulation of[137] Cs is higher than in men), the absence of age differences in the accumulation of[137] Cs in military personnel, while in the population as a whole there are reliable differences. For military personnel, the effect of the density of contamination of the territory on the accumulation of[137] Cs was also not found, while in the population as a whole these differences are present.

The syndrome of consequences of intensive care (PICS-CCI) occurs in those patients of intensive care units who survived a critical condition, if the duration of treatment in such units exceeded more than 14 days and was accompanied by organ dysfunction. It should be noted that in addition to extremely low rates of long-term rehabilitation, they also have significantly reduced physical functions associated with health, compared with other patients.

Objective: to analyze the data of literary sources touching upon the issues of such chronic critical conditions as the syndrome of consequences of intensive care; to emphasize the need for further multidisciplinary approach in the study of this phenomenon, as well as in the management and treatment of this category of patients, which will contribute to an increase in the percentage of survival and improve the quality of life of patients with PICS-CCI.

The phenotype «chronic critical illness» includes various endotypes: critical illness polyneuromyopathy, acquired weakness syndrome in the intensive care unit, persistent inflammation, immunosuppression and catabolism syndrome (definition of the UF SCIRS Sepsis and Critical Illness Research Center of the University of Florida [Fr. Moree et al, 2012].

Considering the increasing prevalence of PICS in patients with chronic critical illness (as well as the number of rehospitalizations, disability and mortality), there is an urgent need for scientific research on such conditions.

The aim of the work: to analyze the data of literature reviews concerning new aspects of knowledge about chronic critical illness, to a greater extent, the syndrome of consequences of intensive care (PICS-CCI).

Hereditary spherocytosis is one of the most common hereditary hemolytic anemias, the pathogenetic link of which is erythrocyte membranopathy. The disease is heterogeneous in the severity of clinical manifestations and varies from asymptomatic forms to frequent severe hemolytic crises. Clinical manifestations can occur at any age – from the neonatal period to old age. Despite the well-studied etiopathogenetic and clinical-diagnostic aspects of the disease, the issues of diagnosis and treatment tactics for Minkowski-Chauffard anemia in the neonatal period raise a number of controversial issues. Features of fetal hematopoiesis (physiological macrocytosis in newborns, a large amount of fetal hemoglobin, physiological hemolysis, a significant number of immature erythrocyte forms) complicate the early diagnosis of the disease. The article deals data on hemolytic anemia – MinkowskiShoffar disease: causes, pathogenesis, clinical signs, severity, features of diagnosis and treatment This article discusses two cases of hereditary microspherocytosis that manifested in the neonatal period; The regenerative functions of hematopoiesis were analyzed (reticulocyte level in absolute numbers and in %, reticular index, RET-He, Delta-He, IRF, LFR, MFR, HFR) in specific patients.

The study was conducted on 86 female patients from the civilian population who received stab wounds to the pelvic area during local armed conflicts in the Russian Federation. The local armed conflicts included military operations during the Chechen campaign and the special military operation. The patients ranged in age from 18 to 50 years, with an average age of 24 ± 6 years. The study did not include women under the age of 18 or over the age of 50, as well as patients with combined injuries to the head, chest, or extremities. The study showed that in total, diagnostic errors in women with pelvic gunshot wounds were noted in 50,0 % of cases. All identified errors can be conditionally divided into several groups: organizational errors in 32,5 % of observations; diagnostic errors 9,3 % and technical errors in 8,1 % of cases.

The conducted study of the immediate postoperative period in 165 civilian patients who received gunshot wounds to the abdomen. All the patients were in the war zone during the Chechen campaign and in the area of the special military operation. There were 108 (65,4 %) male patients, and 57 (34,5 %) female patients, i.e. male patients predominated. All the wounded were divided into two groups: Group A and group B. Group A included wounded with shrapnel wounds to the abdomen, and Group B included gunshot wounds. Group A included 87 (52,7 %) people, group B 78 (47,2 %). The study showed that gunshot wounds of the abdominal cavity are characterized by various injuries to internal organs. The most severe injuries, accompanied by numerous wounds, occur with shrapnel gunshot wounds. However, despite the greater number of singly damaged organs in group A, the immediate postoperative period was more severe in group B. So, of the 41,2 % of complications that were registered in the two compared groups, the largest number of them was noted in group B 27,3 %, while in group A their number was 13,9 %, the most severe complication, of which gunshot peritonitis can be distinguished. The development of this complication was noted in 22,4 % of cases, in group A in 9,7 %, in group B in 12,7 % of cases. The total number of deaths was 34,5 %, in group A 12,7 %, in group B 21,8 %. The analysis made it possible to identify the main factors that influence the development of complications and deaths and identify ways to reduce them.

Penetrating traumatic brain injury caused by a knife is a fairly rare injury, and therefore the full treatment algorithm has not yet been described. The fatal outcome for such injuries reaches 45 %. The main features of these injuries are the occurrence of intracranial hemorrhages along the wound canal, which after the removal of the traumatic object can increase and form a hematoma. This type of injury is often complicated by local infectious processes. This article describes a rare clinical case of a penetrating knife wound to the skull. The volume of the surgical intervention performed and the correct treatment tactics in the postoperative period contributed to a favorable outcome of the injury.

There is an increasing number of scientific studies indicating a link between eating disorders (ED), including their risk factors, and mental health problems such as suicidal behavior, depressive disorders, anxiety disorders, and others.

The aim of this study was to examine the characteristics of eating disorders (ED) in patients with mental and behavioral disorders and to determine their relationship with nosological forms.

The authors describe a clinical case of a patient with a schizotypal disorder and deviant eating behavior, demonstrating the exceptional importance of comprehensive diagnostics in patients with mental disorders. They are also provide a literature review on the presence of eating disorders in individuals with mental and behavioral disorders.

Introduction: Varicose veins of the lower extremities in their various manifestations affect up to 80% of the general population, and clinical treatment practice is heterogeneous worldwide. There is no single set of definitive recommendations, making clinical practice extremely heterogeneous. 

The article tells about Ion Dmitrievich Sarychev, Doctor of Medicine, acting state councilor, the author of the first doctoral dissertation in the history of Russian military medicine on a sanitary and tactical topic, his professional and life path, achievements and awards.