Objectives. To analyze the age-related changes of morphometric parameters of the vascular network in various structural zones of the prostate gland and their relationship with indicators of extraorgan vessels. Material and Methods. Blood vessels were examined on the autopsy material from 47 men distributed into three age groups (22-35 years, 36-60 years, and 61-75 years). Structural and morphometric changes in the prostate intraorgan arteries, veins, capillaries in its different zones and prostate periorgan arteries and veins were studied using histological and morphometric methods. Results were processed using STATISTICA 10 software package. Results. Age-related changes in the vascular network of the prostate gland were found to be zone-specific. A decrease in capillary density, thickening of vessel walls, and an increase in venous diameter were observed with advancing age. In elderly men (61–75 years), pronounced degenerative changes were noted, including the development of paravasal fibrosis and tissue hypoxia. For prostate periorgan arteries and veins, a moderate correlation has been established between age and their internal diameter, as well as the thickness of their walls. Conclusions. The age-related changes in the prostate vascular network while maintaining well-known patterns and involution stages are zone-specific.
The article presents the etiological and epidemiological aspects of multiple sclerosis in children. The association of genetic and infectious factors with the occurrence of the disease has been established. The influence of seasonality on the epidemiology of multiple sclerosis is shown. The frequency of clinical signs at the disease onset in the pediatric population has been revealed. The non-specificity of clinical manifestations at the multiple sclerosis onset in children has been determined. The average age of the disease onset has been established in pediatric patients, as well as in women and men. The dependence of clinical manifestations on the patients’ gender at the onset of multiple sclerosis (MS) has been revealed. The ratios among children and adults at the onset of the disease are shown. The characteristic of clinical manifestations at the MS onset in children is shown. The average score on the EDSS scale and its average standard deviation have been calculated in the examined group of school-age patients and in the adult population. The article describes the first- and second-line drugs used to treat both adults and school-age children that change the course of multiple sclerosis. The role of infectious diseases at the disease onset among adults and school-age patients has been revealed. The ratio of the viral agent influence on the onset of multiple sclerosis in adults and children has been demonstrated. The role of vitamin D in the occurrence of the multiple sclerosis onset has been determined. Difficulties in diagnosing the disease in school-age patients because of the clinical manifestation non-specificity have been identified. The article presents the results of the data analysis of the electronic register of the adult population with the confirmed diagnosis of MS.
Carpal tunnel syndrome is currently the most common form of tunnel neuropathy. The problem of diagnosis and adequate treatment of the disease in the Republic of Belarus remains relevant. This may be due to insufficient awareness of outpatient clinicians conducting differential diagnostic searches and initiating treatment tactics. Targeted study of complaints and anamnesis, the use of clinical provocative tests, questionnaires, neurological examination, instrumental research methods make it possible to verify and confirm the diagnosis. The article presents modern methods of conservative and surgical treatment for this disease, their effectiveness assessment from the point of view of evidence-based medicine. Algorithms of diagnostic process and therapeutic tactics have been proposed.
Peroxisomes are single-membrane organelles that participate in a wide range of important metabolic processes in the cell (alpha- and β-oxidation of long-chain fatty acids; synthesis of bile acids, detoxification of glyoxylate in mammals; formation and inactivation of reactive oxygen species, in particular hydrogen peroxide; synthesis of plasmalogens, which are crucial in the formation and functioning myelin; oxidation of D-amino acids), due to the content of numerous enzymes. In addition, peroxisomes also perform important defensive functions against pathogens and viruses, emphasizing their broader importance in human health and diseases. Violation of peroxisome biogenesis, leading to loss or disruption of peroxisomal functions resulted from genes mutations of encoding peroxins, peroxisomal enzymes or transporter proteins, leads to serious metabolic disorders in humans, in particular, to characteristic lesions of the central nervous system, in the form of severe neurological disorders associated with impaired brain development, demyelination, loss of integrity processes of neurons, neuroinflammation or other neurodegenerative processes. Paroxysmal dysfunction is also considered one of the causes of Alzheimer’s disease and multiple sclerosis. The objective of this review is to systematize current data on biogenesis, regulatory and metabolic functions of peroxisomes, as well as pexophagy in the cells of the nervous system.
Objectives. To study the main indicators of the incidence of oncological diseases, including lung and bronchial cancer, and to determine their prognosis in the Republic of Uzbekistan. Material and methods. The research materials were the main statistical indicators on cancer, including malignant neoplasms of the bronchi and lung in the Republic of Uzbekistan for the period 2010-2022. The research methods used were mathematical statistics, graphical method, method of simple small squares, trends, multifactor mathematical modeling, systematization of nonlinear processes in medicine in software methods and reasoning methods. Results. Having studied the epidemiology of cancer for 2010–2022, we can assume that the absolute number of newly diagnosed patients in the forecast for 2026 will be 28,609 cases; the incidence rate per 100,000 population is 75.4, the absolute number of lethal outcomes is 17,037 people. The mortality rate was found to be 44.9 patients per 100,000 population. At the end of the estimated reporting year, the indicators for 2026 are: the absolute number of patients will be 141,641 people, and the morbidity rate per 100,000 population will be 373.5 people. By 2026, the number of permanent residents of the Republic of Uzbekistan is expected to be 37 million 916 people. According to the results of an analysis of the epidemiology of lung and bronchial cancer for 2011–2022, it was established that the forecast for the absolute number of newly diagnosed patients in 2026 will be 1,816 people, this figure will be 4.8 persons per 100,000 inhabitants, and at the end of the reporting period – 3,107 people, also the incidence rate per 100,000 population is 8.2, the predicted absolute number of lethal outcomes will make up 1,429 people. It has been established that the morbidity forecast rate will be 3.8 patients per 100,000 population. Conclusions. Based on the above, we can conclude that oncological diseases, including lung and bronchial cancer, tend to incidence increase in the Republic of Uzbekistan, thanks to improved detection by primary care medical workers, improving diagnostic and treatment standards. The reason for this growth is also the increase in the number of permanent residents of the Republic of Uzbekistan.
TTV DNA is detected in the vast majority of healthy individuals as well as in patients with infectious pathology, regardless of its severity, and makes up 85.4% in patients with severe bacterial infection. Objectives. To evaluate the intensity of the cellular immune response in patients with bacteremia at different levels of TTV DNA in the blood plasma. The average level of viral load (M) in patients with bacteremia was 28,748 copies/ml (CI 95%; 3620; 53876 copies/ml), which significantly exceeds similar values in healthy individuals. At the same time, in healthy individuals the level of viral load does not exceed 18,475 copies/ml. In patients with severe bacterial infection, the functional activity of T- and B-cell immunity in response to activation by mitogens is significantly lower compared to healthy individuals (p<0.001). The level of TTV DNA in the blood plasma of patients with generalized bacterial infection reflects the intensity of the immune response to mitogens in the RBTL and can be used as an additional marker for assessing the immune status. A TTV DNA level exceeding 2300 copies/ml can serve as a fairly specific additional criterion for reducing the intensity of the immune response and the risk of a more severe course of the disease. The determination of the TTV DNA level can be used as a marker for assessing the immune status and the presence of immunosuppression in patients with bacteremia.
Follow-up observation is a form of organizing specialized medical care for premature infants in order to reduce the risks of developing persistent disorders of body functions and limitations in life activity due to perinatal pathology. The article presents the characteristic features of organizing follow-up observation of premature babies in the Republic of Belarus. A significant contribution to the nosological structure of patients observed in follow-up rooms is made by pathologies that, in accordance with ICD-10, belong to the class “Diseases of the nervous system” (delayed developmental stages), “Diseases of the respiratory system” (bronchopulmonary dysplasia and its consequences), “Diseases of the eye and its adnexal apparatus” (retinopathy of prematurity). The work of the follow-up service makes it possible to effectively correct deviations caused by the peculiarities of the nervous system maturation, taking into account the individual development profile of a premature baby and concomitant somatic pathology. The activities of early intervention centers are an integral element in providing assistance to premature babies and lead to high results.
Objectives. To determine the efficacy and safety of using a pneumatic tourniquet in primary total knee arthroplasty. Material and methods. 70 patients who underwent total knee arthroplasty were included in prospective randomized study. For patients in group 1, the operation was performed using a pneumatic tourniquet, for patients in group 2, the operation was performed without using it. The following indicators were assessed in the groups: hemoglobin level, the number of red blood cells, hematocrit, the volume of perioperative blood loss, pain syndrome severity according to the visual analogue scale, the range of active movements in the knee joint, the operation duration, the number of complications in the postoperative period. Results. In the postoperative period, no statistically significant intergroup differences were found in the level of hemoglobin, the number of red blood cells, hematocrit, the volume of perioperative blood loss, the severity of pain syndrome, the functional outcome and the number of complications. The average duration of surgery in patients with the pneumatic tourniquet use was 70 [60; 75] minutes, whereas in patients without using it – 75 [70; 85] minutes, which was statistically significantly longer (p<0.007). Conclusions. The pneumatic tourniquet use in knee arthroplasty, provided that fibrinolysis inhibitors are used, is not associated with an increase in the volume of blood loss, the intensity of pain syndrome, the frequency of postoperative complications and a decrease in rehabilitation potential. Therefore, the final decision regarding the pneumatic tourniquet use can be made by an orthopedic surgeon on the basis of individual p References and taking into account the specific clinical situation.
Autogenous, allogeneic and synthetic materials are used in ear surgery for filling mastoid cavities after mastoidectomy. Autografts have the advantage over other materials due to full biological compatibility and are used for mastoid obliteration in the absolute majority of cases. Allogeneic tissues could be an alternative in case of the patient’s tissue deficiency. Modern technologies allow performing sufficient antigenic purification and disinfection of allografts, so one can be sure in their biological safety. Artificial materials, in particular, hydroxyapatite has an excellent biocompatibility and osteoinductive properties, as it is the bone mineral matrix. The choice of a method for the ear intervention and mastoid obliteration in chronic suppurative otitis media is determined by the prevalence of the pathologic process, the presence of changes in the middle ear cavities caused by previous interventions, the surgeon’s skills and technical and economic possibilities of using particular surgical technique. Obliteration of the mastoid cavity improves functional results and reduces recurrent cholesteatoma incidence; therefore, it should be routinely used in the otosurgical practice on a permanent basis.
Graft-versus-host disease (GVHD) is a serious complication after allogeneic hematopoietic stem cell transplantation, which is the main cause of death in more than 10% of patients. This review summarises the information about the immunological mechanisms of the development of acute and chronic GVHD. The analysis has shown that we have a large theoretical knowledge base about the developmental process and the role of various subpopulations of T-cells in GVHD. Growing understanding of the mechanisms of GVHD will expand the possibilities of using new therapeutic approaches for the prevention and treatment of this complication of allogeneic hematopoietic stem cell transplantation.
Objectives. To investigate the effect of heat pre-treatment of purple coneflower herb on the yield of hydroxycinnamic acids (HCAs) during extraction. Material and methods. The object of the study was purple coneflower herb. The total HCAs content was determined quantitatively by spectrophotometry. The qualitative composition of HCAs was determined by high-performance liquid chromatography by comparing with standards. Heat pre-treatment of the herb was carried out in the air sterilizer at different temperatures. The HCAs content was compared with the activity of polyphenol oxidase. Results. The temperature, duration of pre-treatment, presence of packaging, thickness of the processed medicinal plant raw material layer and degree of medicinal plant raw material grinding statistically significantly affect the HCAs yield during extraction. With 60ºС pre-treatment temperature in the package, 0.5-2 h duration, 2-4 cm thickness of the layer of processed medicinal plant raw material powder, the HCAs yield during extraction increases by 2.8 times, the qualitative composition and ratio of the main HCAs do not change. Polyphenol oxidase activity significantly influences the yield of HCAs during extraction from medicinal plant raw materials subjected to heat treatment in the temperature range from 40 to 100ºС. A different nature of the temperature and time dependence of the of HCAs yield during extraction for thermally treated and native medicinal plant raw materials has been revealed; from heat pre-treated medicinal plant raw materials, the yield during extraction in a boiling water bath for 1.5-2 hours is almost three times greater than the HCAs. Conclusions. The criteria for heat pre-treatment of purple coneflower herb have been experimentally substantiated and selected, which increase the yield of HCAs during extraction without changing their qualitative composition and ratio. These parameters allow obtaining HCAs -enriched extracts from purple coneflower herb.
Brain infarction often leads to perceptual disorders, in particular visual object agnosia (VOA). In the clinical picture of the local brain injuries it has been noted that neuropsychological tests containing conventional tasks may have low sensitivity in the diagnosis of mild VOA, whereas nonconventional tasks have higher sensitivity in the diagnosis, which increases the probability of detecting mild VOA. At the mild cognitive impairment (MCI) stage, non-conventional tasks are required. In the presence of concomitant disorders that impede visual recognition of non-conventional visual objects and their images, the most sensitive neuropsychological test for diagnosing VOA in persons with MCI is the recognition of crossed-out images. At the stage of dementia for neuropsychological diagnostics of VOA it will be sufficient to present conventional tasks: recognition of realistic objects and their images.
In modern society, the issues of assessing the health and working capacity of persons with disabilities are essential. The concept of “disability” includes various impairments that impede learning, self-care, employment and social interaction. The study of working capacity in this context is extremely important from the point of view of the integrative and objectifying nature of this concept and the changes concerning persons engaged in labor. An additional impetus for the development of this area is the fact that in recent times the global working environment has witnessed certain trends related not only to the labor force aging, but also to new forms of employment (part-time and remote employment, freelancing, platform employment, outsourcing, employee sharing), as well as to the increased turnover and intensity of work, which noticeably affects the psychophysical strain and well-being of a worker. All this emphasizes the need for an integrated approach to human resource management aimed at creating a safe and productive working environment. Such measures contribute to improving the quality of life of individuals and society as a whole, enhancing economic well-being.
Objectives. To analyze the data of clinical studies and discuss an interesting clinical case of morphological diagnosis of lung cancer against the background of hamartoma. Material and methods. Publications were searched in eLibrary, CyberLeninka, Scopus, Web of Science, PubMed, Google Scholar in English and Russian. The articles published between 2016 and 2023 were selected for analysis. Results. A 66-year-old patient was diagnosed with a lung tumor, which is of interest in terms of the complexity of morphological differential diagnosis. The neoplasm described had to be differentiated between primary micropapillary lung adenocarcinoma, metastasis of the papillary thyroid cancer, metastasis of serous carcinoma of the ovary and malignant hamartoma. The immunohistochemical study was conducted followed by the molecular genetic testing. A rare case of the lung adenocarcinoma of the micropapillary structure, grade 3 arising within chondromatous hamartoma with foci of osteoformation was identified in the patient. Conclusions. Thus, the presented clinical case demonstrates a rare histological type of micropapillary adenocarcinoma of the lung against the background of hamartoma. The focal mass in the lung was detected using radiological diagnostic methods. However, a comprehensive morphological study including immunohistochemical study and molecular genetic testing was required to identify the process.
Objectives. To analyze the number of circulating endothelial cells (CEC) in the blood of pregnant women for investigating the pathogenetic mechanisms of diagnosing fetoplacental insufficiency. Material and methods. In the course of this study, a two-step analysis procedure was carried out. At the initial stage of the study, women with fetoplacental insufficiency predisposition participated. Their CEC levels were measured at various stages of pregnancy. At the second stage, CEC levels were compared in pregnant women with regular physical activity (at least 150 minutes per week) and in women of the control group who did not exercise. Results. The given study revealed that the CEC level in all the examined groups significantly exceeded the standard values (8-10×104 cells per 1 liter of plasma). The highest values of the CEC level were observed during the 12th-16th weeks of pregnancy. In pregnant women at risk with regular physical activity, the median CEC level was 27.80×104 per 1 liter of plasma, which is significantly lower than in the control group (41.90×104 per 1 liter of plasma). A statistically significant difference between the groups (p<0.05) indicates a positive effect of physical activity on the vascular endothelium state. Conclusions. An increased level of circulating endothelial cells (CEC) indicates the endothelium dysfunction and can be considered as an early marker of the fetoplacental insufficiency. Regular physical activity helps to reduce the CEC level in pregnant women at risk for fetoplacental insufficiency. This is due to the improvement of the vascular endothelium state and, as a result, a decreased risk of this complication development.
Objectives. To evaluate the primary morbidity, mortality, local prevalence, recurrence rate and recurrence-free period, disease progression in patients with the first-detected urothelial carcinoma of the urinary tract in Vitebsk region, Republic of Belarus in the period from 2018 to 2022 inclusive. Material and methods. The discharge records of the Belarusian Cancer Registry of 712 patients with the first-detected transitional cell carcinoma of the urinary tract in the period of 2018-2022 in Vitebsk and Vitebsk region were assessed. Results. Urothelial carcinoma of the urinary tract localized mainly in the bladder (679 patients) is 3,4 times more often diagnosed in men, whose average age is 71.6±10.0 years. In 68,8% of cases the invasion of the bladder mucous and submucosal layers corresponding to non-muscle-invasive bladder cancer was diagnosed. The recurrence rate in non-muscle-invasive bladder cancer was 31,2%, with an average period of 16 months before recurrence, whereas in muscle-invasive bladder cancer the recurrence rate was 32,7%, with an average period of 9,7 months before the first recurrence of the disease. The period until the development of the first relapse was statistically significantly 2,4 times longer in the non-muscle-invasive bladder cancer group than in the MIBC group (354 days [194; 737] and 147,5 days [106.5; 358.5], respectively, p=0,0007). The period to progression in MIBC was 277.7±54,9 days [126; 331] and in NMIBC 374,7±103,3 days [125; 520]. Conclusions. The period before the first relapse in muscle-invasive is 2,4 times shorter than in non-muscle-invasive bladder cancer. Process progression in non-muscle-invasive bladder cancer was 3,6 times less common than in muscle-invasive urothelial bladder carcinoma. While analyzing morbidity and mortality from urothelial carcinoma of the upper urinary tract and the bladder in the territory of Vitebsk region no significant fluctuations were detected. The highest incidence was determined in 2019 and the highest mortality in 2022.
On January 5, 1919 the Commissariat of Health was established, in February 1919 it was transformed into the People’s Commissariat of Health, in March 1946 – into the Ministry of Health of the BSSR. On July 11, 1990 the ministry from union-republican became republican with subordination only to the Council of Ministers of the BSSR. Regulations on the Ministry were approved on April 3, 1969 and August 7, 1995. People’s Commissars of Health of the BSSR: January 20 – March 30, 1919, May 28, 1919 – August 1, 1920 – I.I. Puzyrev. People’s Commissars of the Lithuanian-Belarusian SSR: Andris Domašavičius; March 30 – May 28, 1919 – V.I. Lensky. People’s Commissars of Health of the BSSR: from July 15, 1920 – S.D. Kaminsky; from October 1920 – S.V.Balkovets; 1921 – S.I. Borkusevich; November 6 – December 1921 – S.D. Kaminsky; December 19, 1921-1922 – A.A.Senkevich; 1922-1924 – M.L.Stokovsky; September 19, 1924-1930 – M.I. Barsukov; 1930-1933 – S.Y. Tsintsiper; May 10 – September 4, 1933 – G.M.Shpektorov; 1933-1936 – I.Z.Surta; 1936-1937 – P.P.Burachevsky; 1937-1938 – K.V.Kiselev; 1938-1940 – I.A. Novikov; 1940-1948 – M.I. Kovalyonok. Ministers of Health of the BSSR: 1948-1966 – I.A. Insarov; 1966-1987 – N.E. Savchenko; 1987-1990 – V.S. Ulashchik; 1990-1994 – V.S.Kazakov; 1994-1997 – I.M.Drobyshevskaya; 2001-2002 – V. A.Ostapenko; 2002-2006 – L.A.Postoyalko; until May 2006 – Acting Minister of Health V.P. Rudenko; 2006-2017 – V.I. Zharko; 2017-2019 – V.A.Malashko; 2019-2020 – V.S.Karanik; 2020-2024 – D.L.Pinevich; 2024 – to date. – A.V. Khodjaev.
Objectives. To make a histological analysis of wound defects of the skin of rats during treatment with gels based on tinctures of black alder and gray alder leaves. Material and methods. For assessing the regenerative properties of black alder and gray alder leaves on a model of a planar full-thickness skin wound, we used 6 series of gels, which had been prepared previosly. Four series of phytogels: two of them containing tinctures of gray alder leaves (based on 30% and 70% ethyl alcohol) and two containing tinctures of black alder leaves (based on 30% and 60% ethyl alcohol). Two series without herbal tinctures served as a placebo. 5% dexpanthenol gel and Reparef-2 ointment were used as comparison drugs. The study was performed on 81 white male Wistar rats. The skin and subcutaneous tissue were excised from an area of the rats’ backs shaved from fur. The wounds were left open and beginning with the second day of the experiment they were treated daily once a day. Histological examination was carried out on the 5th, 9th and 13th days of the experiment. The material was collected by excision of scar tissue and the adjacent wound edge. The obtained material was fixed in 10% formaldehyde, dehydrated in alcohols of increasing density, embedded in paraffin, and then microslides were made from it, stained with hematoxylin and eosin. Results. The results of the morphological study showed that the phytogels used stimulate the proliferative and functional activity of granulation tissue cells. At the same time, the gel containing a tincture of black alder leaves based on 60% alcohol showed maximum effect. Conclusions. The dynamics of the morphological picture of wounds treated with phytogels and Reparef-2 ointment indicated their clearly expressed wound-healing effect, while the morphological characteristic of tissue defects treated with placebo gels corresponded to that in the control group.
Diagnosis of congenital anomalies during pregnancy is a challenge, which has been solved mainly using ultrasound imaging methods. Results. While analyzing the examination results of 30 pregnant women with the fetus congenital malformations, with the exception of the group of the brain and spine malformations, the diagnostic accuracy of the isolated use of the ultrasound imaging method for the specified anomalies was 78% with 76% sensitivity. The diagnostic accuracy of the isolated use of MRI was 97% with approximately 96% sensitivity. At the same time, the diagnostic accuracy when using the combination of ultrasound and MRI was 100%, the sensitivity at the validation stage was 98%. Conclusions. Fetal MRI increases diagnostic options in assessing developmental defects, exept for the group of congenital malformations of the brain and spine. MRI allows obtaining a high-quality image of the fetal structures in cases where such an image cannot be obtained during ultrasound examination due to artifacts. The MRI method is characterized by comparative superiority over ultrasound in the differential diagnosis of congenital malformations, being a means of obtaining additional diagnostically significant information. The results obtained during the use of fetal MRI often serve as the basis for changing the initial prenatal diagnosis of congenital malformations detected with ultrasound.
Objectives. To assess morphological changes in the histaminergic neurons of the E2 nucleus of hypothalamus in the offspring of rats that were consuming alcohol during pregnancy in the dynamics of postnatal ontogenesis. Material and methods. The research was carried out on 12female outbred white rats that received 15% ethanol solution throughout the entire gestation period and their offspring – 60 rat pups. Decapitation of rat pups was carried out on the 5th, 10th, 20th, 45th and 90th days after birth. The subject of the research was the structure of histaminergic neurons of the posterior hypothalamus of rat pups brain on micropreparations stained using the Nissl method. Studied parameters: minimum and maximum diameters, perimeter, area, volume of neurons, form factor, elongation factor. The micropreparations were examined using an Axioskop2 plus light microscope (Zeiss, Germany). The obtained data were processed using the Statistica10.0 program for Windows (StatSoft Inc., USA) applying nonparametric methods. Results. It has been revealed that in the early period after birth (days 5-10) swelling of histaminergic neurons of the E2 nucleus of hypothalamus occurs, as evidenced by an increase in the minimum and maximum diameters, perimeter, area and volume of perikaryons. At the same time, in the later period (45-90 days), inhibition of growth and rounding of the neurons perikaryons was noted based on a decrease in the perikaryon perimeter, area and volume, as well as a decrease in the maximum diameter and elongation factor, an increase in the form factor in 90 days after birth. Conclusions. Alcohol consumption by female rats throughout pregnancy disrupts the structure of histaminergic neurons in the hypothalamus of their offspring, which confirms the participation of the histaminergic system of the brain in modulation of the addictive and toxic effects of ethanol. The identified disorders may affect the cognitive, emotional and behavioral functions of the brain of offspring born with fetal alcohol syndrome.
