The publication is devoted to the spread of respiratory diseases in the Armed Forces of the Republic of Belarus as having the greatest military-epidemiological   significance. The study examined the reasons for the rise in infectious diseases among conscripts during the absence of a seasonal rise; a rise in morbidity associated with the formation of a military team at the time of the arrival of young recruits has been proven; Data were obtained on the characteristics of the spread of acute respiratory infection among conscript military personnel. The features of the development of the epidemiological process of respiratory diseases in military units are shown.

The article analyzes the path of development that the system of medical examination of the adult population of the Republic of Belarus has gone through during its formation over the last ten years. The analysis identifies key approaches that can be used to improve the medical examination of military personnel of the Armed Forces.

Information on the results of medical examination of citizens associated with military duty after arthroscopic treatment of intra-articular injuries of the knee joint

Aortic aneurysm remains one of the most common causes of sudden cardiac death, despite the use of screening programs, constant improvement of imaging methods and surgical techniques. Further search for additional factors is required to justify a more aggressive strategy of surgical interventions on the ascending aorta. The data of the analysis of 97 cases of operated aneurysms and aortic dilations in patients under 45 years of age are presented. The severity of aortic root remodeling in aneurysms in patients under 45 years of age depends on the etiology of the disease. An increase in the aortic diameter between the fibrous ring and the sinotubular ridge can help in choosing a surgical intervention. The size of the aortic root at the level of the sinotubular ridge can serve as an independent sign of ascending aorta pathology and progression of aortic insufficiency.

This article is devoted to pharmacodopplerography in the diagnosis of vasculogenic erectile dysfunction. The work analyzes the spectral characteristics of the blood flow of the cavernous arteries at rest and after administration of a vasoactive substance (alprostadil). The data of a survey of 17 young and middle-aged men with complaints of inadequate erection are presented. In 5 (29.4 %) patients, the test result was negative, the erection was limited to varying degrees of swelling of the cavernous bodies in the absence of rigidity.

Hemolytic disease of the fetus and newborn (HDFN) is an isoimmune hemolytic anemia that occurs due to maternal-fetal blood group incompatibility based on erythrocyte antigens. In this condition, antigens are present on the fetal erythrocytes, while antibodies against them are produced in the mother‘s body. Depending on the type of immunological conflict, incompatibility may occur in the ABO system, Rh-factor system, or due to rare blood group antigens. Pathological hemolysis results in severe indirect hyperbilirubinemia and progressive anemia. A characteristic feature of HDFN is an increased reticulocyte count, which reflects a compensatory response of the erythroid lineage of the bone marrow to hemolysis. The frequency and severity of late-onset anemia following any type of isoimmune conflict are notably high, reaching up to 83 %. However, the true regenerative capacity of the bone marrow in infants after HDFN remains a matter of debate.

The authors present a case of Rh-factor hemolytic disease of the newborn (severe icteric form) complicated by anemia requiring two blood transfusions during the neonatal period. The study analyzes the patient’s hematopoietic regenerative function through reticulocyte parameters, including absolute reticulocyte count, reticulocyte percentage, reticulocyte index, RET-He, Delta-He, IRF, LFR, MFR, and HFR.

Cardiovascular risk factors studied in people aged 18–26 years with grade 1–2 arterial hypertension. Obesity, hyperuricemia and smoking identified as the leading causes. A significant relationship between hyperuricemia and impaired fat metabolism and the abuse of drinks containing fructose revealed. Assessment of structural and functional parameters of the heart did not reveal signs of pathological remodeling. The data obtained indicate the need for routine assessment of uric acid levels in young patients with hypertension and prehypertension. Correction of eating behavior in young people may potentially be more significant in reducing blood pressure and preventing cardiac remodeling compared to patients in older age groups.

Frequency of visits of patients with pollinosis to the allergologist of the 6th City Clinical Hospital in Minsk showed that 49 % have sensitization to tree pollen, 66 % to grass pollen, 14 % to weed pollen. 29 % of patients have polysensitization to several groups of pollen allergens. An important part of the research on pollen allergens is to study new pollen allergens for the Republic of Belarus: canadian goldenrod, pellitory, thuja occidentalis, common juniper, ash-leaf maple, mountain pine, evergreen cypress. Four pollen seasons were identified in the pollen spectrum: spring (woody plants), spring-summer (pine, juniper, thuja, cypress), summer (cereals), autumn-summer (weeds). A Belarussian pollen calendar in 2024 allows us to predict the frequency of exacerbations of hay fever, depending on the pollen concentration in the air.

The article presents the results on the structure of diseases of the upper gastrointestinal tract in 2020–2023, their dynamics over a ten-year period (2020–2023 and 2010–2013) and data on primary resistance of Helicobacter pylori infection to clarithromycin in 2024 in men aged 18–26 years. The data obtained on the structure of diseases of the upper gastrointestinal tract and the resistance of Helicobacter pylori to clarithromycin may be of broader importance, as they indirectly indicate the level of population morbidity and resistance to clarithromycin.

Introduction

Artificial intelligence has been widely used in the fight against COVID-19. Very few studies have focused on creating algorithms and IT products to predict the length of hospital stay of COVID-19 patients, primarily using functional markers of respiratory failure.

Aim: this study aims to identify the most representative functional markers of respiratory failure to create algorithms for predicting the length of hospital stay (LOS) of patients with COVID-19.

Materials and methods

A comparative analysis was performed using a database of 487 patients with COVID-19 hospitalized from December 2020 to May 2022, in whom a surrogate oxygenation index (SpO₂/FiO₂), ROX ((SpO₂/FiO₂)/respiratory rate) were measured during the first three days of treatment, and spirometry (n = 103, 62 ± 13 years) was also performed simultaneously to calculate “ventilatory reserve” (VR = MVV/MV) or measurement (n = 384, 61 ± 16 years) of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Eleven logistic regression (LR) models were constructed/ selected, followed by ROC analysis and description of sensitivity (SE), specificity (SP), area under the operating characteristic curve (AUC) and accuracy (Ac). The least squares method and the coefficient of determination R2 was used to assess the possibility of constructing algorithms for calculating the prognosis of the Prolonged Length of Stay (PLoS) with the selected markers.

Results

The constructed algorithms for calculating the probability of discharge within seven days using ROX, SpO2/FiO2, and ventilation reserve showed that a fifth-degree polynomial approximating function discriminates fairly well against patients at risk of prolonged hospitalization (R2 = 0.87, 0.82, and 0.85, respectively).

Conclusion: the most effective functional markers for creating predictive algorithms for the duration of hospitalization of patients with COVID-19 are the integral SpO2/FiO2, ROX indicators, combined with the indicators of reserve and strength of the VR and MIP respiratory muscles, the use of which is promising in the development of tools for predicting respiratory failure of various etiologies using artificial intelligence.

The article presents an overview of modern approaches aimed at treating varicose veins of the lower extremities. A comparative analysis of the effectiveness of their use is carried out. An assessment of the advantages and disadvantages of individual treatment methods is carried out, based on the observations of various foreign and domestic authors.

The article presents an analysis of literature data on the use and efficacy of intraoral devices in the treatment of obstructive sleep apnea syndrome. The use of intraoral applicators is currently one of the standard techniques, recommended for the conservative treatment of obstructive sleep disordered breathing during sleep. There are two fundamentally different types of intraoral devices by their mechanism of action: acting on the position of the mandible or fixing the tongue. If in the first case, increasing the lumen of the upper airway is achieved by extending the lower jaw, in the second case prevents tongue retraction during sleep. Intraoral devices are characterized by high compliance and patient adherence. Currently, mandibular advancement devices are considered a possible alternative to CIPAP therapy or surgical treatment and are the method of choice for mild to moderate obstructive sleep apnea syndrome. To identify relevant studies we searched in Pubmed, Medline and Cochrane Library, Elibrary, Google Academy databases using key terms related to intraoral devices.Using key terms related to intraoral devices in obstructive sleep apnea syndrome.

The article discusses some of the new provisions regarding the classification and treatment of COPD that have appeared in the latest GOLD guidelines.

Purpose: to study the literature data and analyze the immediate and long-term results of various modern methods of surgical treatment of patients with chronic post-traumatic lateral instability of the ankle joint.

Objective: to determine whether any of the proposed methods of surgical treatment of this pathology is optimal for reconstruction of the anterolateral ligament complex; to classify and unify approaches to the treatment of patients with chronic lateral instability of the ankle joint.

Materials and methods: Surgical treatment of lateral ligament instability was first described in 1932 based on the work of W.E. Gallie (1913) in paralytic clubfoot. Since then, many configurations of the peroneal tendon have been presented in the literature, including methods that involve rerouting from the peroneus brevis muscle around the lateral malleolus, including those of R. Watson-Jones (1952), D.L. Evans (1953), O.D. Chrisman, and G.A. Snook (1969). The non-anatomical method involves stabilization by tenodesis using the peroneus brevis tendon. Initial scientific reports were quite promising, but studies comparing the methods with longer-term follow-up generally favor the anatomical method of ligament reconstruction. The most common fundamental technique of anatomical reconstruction of the lateral ligaments of the ankle joint is the operation of L. Brostrom (1966). Anatomical reconstruction gives good and excellent results of ankle joint stability in 85 % of patients who underwent the modified Brostrom operation. No study has shown the superiority of more complex methods over the classic Brostrom method. However, the main disadvantage of anatomical reconstruction remains its dependence on potentially weak local tissues. A review of the literature revealed that studies that compared the Chrisman-Snook operation with the modified Brostrom reconstruction generally confirm a favorable outcome of both operations. Some authors came to the conclusion that in the treatment of CNG, the Brostrom operation gives better results than the Chrisman-Snook operation, others, due to the lack of statistically significant data, did not come to a conclusion about which surgical method of reconstruction is a priority. At the present stage, further studies are being conducted to determine the most effective method of surgical treatment of CNG. In studies examining the results of the modified Brostrom procedure, excellent functional scores were achieved, in addition to a successful clinical and radiographic outcome with 100 % excellent and good results at two-year follow-up. M. Glazebrook et al. (2016) showed that the ligament reconstruction surgery can be performed percutaneously using a single fibular tunnel to reconstruct the “Y” configuration of the anterior talofibular and calcaneofibular ligaments. To determine the best location for drilling holes in the fibula, the group of authors developed a template using CT scanning. As a result of the operations, patients experienced significant improvement in postoperative functional scores and radiographic stability compared to other ligament reconstruction techniques. An attempt has been made to speed up the healing process by improving the repair of ankle ligaments using catgut and screw interference, called the TM internal fixation device (Arthrex, Naples, FL), which is currently being actively discussed by the global trauma community.

Results: a group of authors conducted a detailed review of domestic and foreign literature on this issue. Descriptions of inventions to author’s certificates and patents of the Republic of Belarus and other countries were studied. The review showed that various methods of anatomical and non-anatomical reconstruction of chronic instability of the ankle joint have been developed and clinically tested. Most modern effective methods that provide good clinical and functional treatment results are closely related to the need for specialized structures and instruments. Questions remain open about planning and choosing a method of surgical treatment for chronic lateral instability of the ankle joint depending on the stage of the pathology, the duration of the primary injury, the technique of surgery depending on the patient’s age, rehabilitation treatment depending on the type of surgery and the permissible periods of partial and full load on the limb.

Conclusion: in general, the literature analysis convinces us that chronic ankle instability remains a common problem after acute trauma in people with an active lifestyle. The effectiveness of anatomical (Brostrom operation) and non-anatomical (Chrisman-Snook operation) methods of ligament restoration in chronic ankle instability has not been sufficiently studied. Risk factors for pathological processes that negatively affect the results of surgical treatment of patients with this nosology continue to be studied both in the Republic of Belarus and abroad.

The article presents the results of analyzing the quality of life of 90 patients who were hospitalized from 2017 to 2023 after various methods of inguinal hernioplasty. The SF-36 questionnaire assessing 8 quality of life scales was used. Patients were divided into 4 groups according to the type of surgery. Total extraperitoneal plasty is an effective and minimally traumatic method providing high quality of life of patients after the operation. Lichtenstein operation and local tissue plasty are associated with more pronounced postoperative limitations and pain syndrome, which worsens the quality of life indicators.

The article presents the results of research on the clinical and morphological justification of the term «clinically significant muscle injury», the criteria for its formulation and the definition of therapeutic tactics. At the first stage of the study, a retrospective analysis of the medical records of inpatient patients with traumatic limb muscle lesions in the period from 2017 to 2019 was carried out, 245 patients with limb muscle damage of varying severity were selected. The evaluation revealed statistically significant differences in the frequency of local complications, duration of treatment, and the need for additional surgical interventions (fasciotomies) for various degrees of muscle damage considered in the AO classification. The identified features made it possible to combine moderate and severe muscle damage into one tactical group: clinically significant muscle damage. At the second stage of the study, a retrospective analysis of patients with closed and open limb injuries accompanied by clinically significant muscle damage was performed (77 patients). Signs of muscle damage were assessed in each fascial case of the limb segment using ultrasound diagnostics or during surgical treatment. The criteria of clinical detail and the algorithm of surgical tactics are determined depending on the degree of damage to muscle tissue.

This article reflects the problematic issues of the work of military surgeons for their intended purpose in the conditions of modern military conflict. The main directions of theoretical and practical training of surgical specialists to provide assistance to patients with gunshot and mine-explosive wounds are considered. The ways of development and maintenance of theoretical and practical skills in the treatment of gunshot wounds in peacetime are shown.

Binge eating disorder and comorbid obesity remain a serious threat to human life and health due to the high prevalence of morbidity and mortality in both these nosologies and associated comorbidities. Lifestyle changes, including a combination of limited daily calorie intake, exercise, and behavioral changes, are widely recommended as a step-by-step approach to the control/treatment of binge eating disorder and, accordingly, obesity. However, these measures usually lead to only a slight decrease in weight with a short period of its maintenance – results similar to the results of pharmacotherapy. Moreover, the results of surgical treatment of obesity in the next 5-year period have significantly better indicators [1].

Thus, the treatment of binge eating disorder and other comorbid disorders is a difficult task in medical practice; most of the results of scientific studies touching on the described problem remain quite contradictory.

The aim of the work: to analyze the data of literature reviews on the issue of treatment of compulsive overeating and comorbid obesity with an analysis of a clinical case from practice.

The article presents modern views on the organization of medical support for troops (forces) in peacetime and wartime and criteria for evaluating its effectiveness based on an analysis of the activities of medical support services in peacetime and wartime, taking into account the requirements of regulatory legal acts of the Republic of Uzbekistan.

Colonel m/s retired Voit Vladimir Petrovich February 26, 2025 marks the 70th anniversary of a military doctor, teacher, veteran of the Afghan War, holder of the Orders of the Red Banner and For Service to the Motherland in the USSR Armed Forces of the III degree and many medals, senior lecturer of the Department of Organization of Medical Support for troops and Disaster Medicine of the Military Medical Institute in an educational institution «Belarusian State Medical University» to retired medical service colonel Vladimir Petrovich Voit.