Objective. To evaluate the possibility of correcting hemodynamic disturbances in patients with coronary heart disease during coronary artery bypass grafting under artificial circulation using extracorporeal autohemomagnetotherapy in the presence of polymorphisms of the angiotensin-1 receptor (AGTR1 A1166C), endothelin-1 (EDN1 Lys198Asn), endothelial oxide synthase genes nitrogen (NOS3 C786T) as potential factors of hemodynamic disorders.

Materials and methods. Initially, all patients were divided into two groups. Group 1 (60 patients) included standard anesthetic care for coronary artery bypass grafting under cardiopulmonary bypass without the use of extracorporeal autohemomagnetic therapy (EAHMT). Group 2 (63 patients) included standard anesthesia for coronary artery bypass surgery under cardiopulmonary bypass with the use of EAHMT. Indicators of mean arterial pressure (MAP), heart rate (HR) and relative data indicators were assessed. For each patient, the relative change in MAP and HR was calculated individually. Next, using Statistica 10 software (Statsoft Inc., USA), a descriptive analysis of the obtained data was carried out (Me [25 %; 75 %]). The significance of the results was assessed by the method of dependent characteristics using the nonparametric Wilcoxon test. When comparing independent groups with a non-normal distribution of values of one or two quantitative characteristics, a nonparametric method was used – the Mann – Whitney U test.

All patients of both groups underwent intraoperative venous blood sampling from a central venous catheter. Next, by polymerase chain reaction (PCR) using a Rotor apparatus Gene Q 5 plex HRM (QIAGEN, Germany) carried out the study genotypes polymorphisms of the angiotensin-1 receptor genes (AGTR1 A1166C), endothelin-1 (EDN1 Lys198Asn), endothelial nitric oxide synthase (NOS3 C786T), with further processing of the results obtained (Pearson Chi-square, odds ratio, Akaike information criterion, Hardy – Weinberg equilibrium) using the online service SNPStats.

Results. The relative change in mean arterial pressure in group 2 was 1.36 %, in group 1 this figure was – 8.99 %. In group 1 and group 2 there was a statistically significant increase in heart rate. The relative change in heart rate in group 1 was 16.55 %, in group 2 this parameter was 20 %. The presence of the C/C genotype of endothelial nitric oxide synthase (NOS3 C786T) may be a factor in correcting changes in MAP and heart rate during the intraoperative period during coronary artery bypass grafting under artificial circulation. The presence of genotypes T/C, T /T of endothelial nitric oxide synthase (NOS3 C786T) may indicate possible difficult-to-control hemodynamic disturbances during these operations. No correlation was found between polymorphisms in the genes of the angiotensin-1 receptor (AGTR1 A1166C), endothelin-1 (EDN1 Lys198Asn) and hemodynamic status in the intraoperative period.

Conclusion. The EAGMT method in the presence of the C/C genotype of endothelial nitric oxide synthase (NOS3 C786T) can be used when performing CABG under artificial circulation to maintain the stability of invasive hemodynamics and prevent hypotension.

Currently, it is customary to distinguish between self-harm and suicidal behavior, but studies devoted to this topic are rare.

Materials and methods. The study involved 252 people divided into three groups:

– first group (100 people) – persons who have committed suicide attempts using various methods of self-harm;

– second group (72 people) – persons who made a true suicide attempt using highly lethal methods of self-harm;

– third group (the comparison group, 80 people) – persons undergoing inpatient treatment with a diagnosis of «adjustment disorder», who have not made suicidal attempts.

Results. The first and the second groups did not differ significantly from each other in the prevalence of mental disorders. The most pronounced level of depression (25,2 points) and motivation to commit suicide was noted in the second groups, the least pronounced depressive symptoms in the first group, the severity of motivation to commit suicide in the third group. The study groups did not differ significantly in the severity of psychosocial stress. It was noted that males aged 45–60 years from suicide risk groups (first group – p ≤ 0,001; second group — p = 0,030) were significantly more likely to live alone (p = 0,034). In the second group, compared to the third group, the proportion of people raised in single-parent families is significantly higher (p ≤ 0,05). In the first and the second groups, persons with a phlegmatic type of temperament predominated (p ≤ 0,001), however, they significantly differed from each other in the character trait «stuck».

Conclusions. The first and the second groups differed significantly from each other not only in the methods of self-harm, but also in the severity of motivation to commit suicide, depressive symptoms and the character trait «'stuck».

Alpha-1-antitrypsin (A1AT) deficiency is an under-diagnosed hereditary disorder characterized by reduced serum levels of alpha1-antitrypsin (A1AT) and increased risk to develop lung and liver diseases at an early age. A1AT is encoded by the highly polymorphic SERPINA1 gene. In most cases the clinical manifestations of A1AT deficiency are associated with PiZZ genotype, less frequently, deficient or null alleles may be present. A1AT deficiency is diagnosed by a combination of serum A1AT levels, A1AT phenotyping and/or A1AT genotyping. An accurate diagnosis facilitates the physician’s ability to actively intervene with measures such as smoking cessation and perhaps augmentation therapy.

Current literature data on the history of discovery, prevalence, features of the clinical and histomorphological manifestation of a rare lung pathology from a heterogeneous group of diseases characterized by the accumulation of Langerhans cells in various organs and tissues with the formation of granulomas with eosinophilic infiltration – histiocytosis are presented. Difficulties in differential diagnosis and treatment of this disease are noted. Own observation is presented.

Objective. To study the association of arterial hypertension (AH), body mass index (BMI) >30 kg/m², smoking, age over 65 years, cardiac troponin levels (cTnI and cTnT) and NT-proBNP levels with the risk of early cardiotoxicity (CT) in patients with established breast cancer receiving doxorubicin therapy.

Materials and methods. The study included 100 patients (breast cancer) from the medium and low risk group according to HFA-ICOS. CT criterion is a relative reduction in global longitudinal myocardial strain of more than 12 %, echocardiography method.

Results. It was revealed that the frequency of occurrence of the factor smoking is statistically significantly higher in the CT+ subgroup and its presence is associated with the risk of developing CT after the end of chemotherapy, OR 4,14 (95 % CI (1,3–12,9)). No relationship was found between CT and hypertension, BMI > 30 kg/m², age over 65 years, cTnI, cTnI and NT-proBNP levels after the end of chemotherapy. Hypertension was statistically significantly more common (p < 0,05) among patients with preserved early CT signs after 12 months OR 6,8 (95 % CI (0,6–71,2)). Statistically significant differences between the percentage of patients with and without a risk factor for smoking (p < 0,05) OR 3,3 (95 % CI (0,9–11,6)) were observed 12 months after chemotherapy.

Conclusion. It has been established that smoking is associated with the development of early CT during chemotherapy with doxorubicin in patients from low and intermediate risk groups (HFA-ICOS). This factor can be used to predict the risk of developing CT after and 12 months after the end of chemotherapy. At the same time, hypertension is not associated with the development of early CT at the stage after and 12 months after the end of chemotherapy, however, it can be used as a predictor of prolongation of CT after 12 months, when the primary CT was diagnosed immediately after the end of chemotherapy.

Objective. To analyze the experience of performed explantations of vascular allografts in the Republic of Belarus and to improve their results.

Materials and methods. The study covers the time period from January 1, 2010 to December 31, 2022 and includes data on all performed explantations and implantations of vascular allografts in the Republic of Belarus. A system of classification, coding and certification of vascular allografts were developed and introduced.

Results. During the study period, 1668 vascular allografts were explanted from 744 deceased donors in the Republic of Belarus. Of the explanted vascular allografts, 576 (34,53 %) were used for transplantation, 1092 (65,47 %) were disposed of.

Conclusion. The development of the system for coding, classification and certification of vascular allografts makes it possible to improve organizational approaches to vascular transplantation in Belarus, which has been proven to increase from 9,54 to 82,55 % of effectiveness of the use of explanted arterial types of vascular allografts and to increase from 4,29 to 58,82 % of effectiveness of the use of explanted venous type of vascular allografts.

Objective. Studying the state of mucosal immunity, identifying age-related differences depending on the stage of histochemical and physical-immunological development in children with chronic stomatitis.

Materials and methods. The study involved 120 pediatric patients aged 4–18 years, of both sexes. The diagnosis is made on the basis of complaints, anamnesis and clinical examination. First group (n = 42) included patients with chronic stomatitis in the stage of primary formation of the mucous membrane (4–7 years), second group (n = 38) included children with the same pathology in the stage of secondary formation of the mucous membrane (8–18 years). The control groups included healthy children aged 4–7 years (third group, n = 20) and 8–18 years old (fourth group, n = 20). The groups were comparable by gender and age (p > 0,05). Enzyme immunosorbent and biochemical analysis of oral fluid included assessment of the levels of lysozyme, lactoferrin, lactoperoxidase, myeloperoxidase, alpha-amylase, immunoglobulin M and secretory immunoglobulin A.

Results. The study revealed that healthy children aged 4–7 years and 8–18 years had statistically significant differences in the studied indicators. In children aged 4–7 years, the level of myeloperoxidase is higher by 122,91 u/l (p < 0,05) compared to the level of this enzyme in children 8–18 years old. In older children, the levels of lysozyme, lactoferrin, alpha-amylase and secretory immunoglobulin are statistically significantly higher (p < 0,05) compared to children 4–7 years old. When studying the indicators in children with chronic stomatitis and healthy children, it was revealed that in the group of young children the level of lysozyme was 2,19 ng/ml, lactoferrin 11,73 ng/ml, secretory immunoglobulin A 12,46 ng/ml, which was statistically significantly different from children of the control group of the same age (p < 0,05). In the older age group, the level of lactoferrin was 8,85 ng/ml, which was significantly lower than the control group (p < 0,05), and the level of lysozyme was 1,51 [0,78; 5,23] ng/ml, which was statistically significantly different from patients in the control group of the same age (p < 0,01). In both age groups of patients with chronic stomatitis, the level of myeloperoxidase was statistically significantly different from the control group (p < 0,05), so in children aged 4–7 years the level of myeloperoxidase was 361,21 u/l, and in children 8–18 years 431,11 u/l.

Conclusion. When analyzing the obtained indicators of mucoprotective immunity in chronic stomatitis in different age groups, changes were revealed that reflected the dysfunction of local immunity. However, the nature of the changes does not always coincide in children 4–7 years old and 8–18 years old. For example, the change in lysozyme had statistically significant differences in both age groups from the control groups, however, in young children there was an increase, while in 8–18 years old there was a decrease in this factor relative to the control group. At the same time, in healthy children 8–18 years old, this figure is significantly higher than in the control group 4–7 years old, which is probably due to the development of the immune system, a change in the stages of histochemical and physicoimmunological development, and an improvement in the functions of mucosal immunity with age.

The pathogenesis of closed and open injuries of the heart and large vessels, their characteristic pathomorphological changes in the myocardium, the mechanism of injuries, clinical manifestations, diagnostic criteria available for the prehospital stage, possible complications, and principles of emergency care are considered.

The article presents information about the outstanding Belarusian anatomist and talented teacher, an active public figure and organizer of science Peter Iosifovich Lobko. The main data from his biography and professional activity are presented.