Objective. To study the parameters of systolic and diastolic blood pressure during coronary artery bypass grafting (CABG) under artificial circulation (AC) with extracorporeal autohemomagnetic therapy (EAHMT) in patients with coronary artery disease with the presence of gene polymorphisms of angiotensin-1 receptor (AGT2R1 A1166C) (rs 5186), endothelin-1 (Lys198asn) (rs 5370), endothelial nitric oxide synthase (NOS3 C786T) (rs 2070744). To calculate the cost-effectiveness and length of stay (bed-days) of patients in the Anesthesiology and Resuscitation Department No. 1, cardiac surgery hospital after the use of EAHMT.
Materials and methods. All patients were divided into two groups. Group 1 (60 patients) included standard anesthesia for CABG under cardiopulmonary bypass without the use of EAGMT. Group 2 (63 patients) included standard anesthesia for CABG under cardiopulmonary bypass with the use of EAGMT. Systolic (SBP), diastolic (DBP), and central venous (CVP) pressures were assessed. The relative change in SBP, DBP, and CVP was calculated individually for each patient. Then, using Statistica 10.0 (Statsoft Inc., USA), descriptive statistics of the specified parameters were obtained in the form of Me [Q1; Q3] (where Me is the median, Q1 is the first quartile 25 %; Q3 is the third quartile 75 %) or M [min; max] (where M is the mean value, min is the minimum; max is the maximum). The statistical significance of the change in the numerical parameter in the group was determined using the nonparametric paired Wilcoxon test. When comparing two independent groups by a numerical indicator, the nonparametric Mann-Whitney U-test was used. To analyze the length of patients’ stay in hospital, Kaplan-Meier survival curves were constructed using the licensed IBM SPSS Statistics 27.0 (Free trial) program. The log-rank criterion was used to compare survival curves. All patients in both groups underwent intraoperative venous blood sampling from a central venous catheter. Then, using the polymerase chain reaction method and the Rotor Gene Q 5plex HRM apparatus (QIAGEN, Germany), a study of the genotypes of the polymorphisms of the genes of the angiotensin-1 receptor (AGTR1 A1166C), endothelin-1 (EDN1 Lys198Asn), endothelial nitric oxide synthase (NOS3 C786T) was performed with further processing of the obtained results (Pearson chi-square, odds ratio, Akaike and Bayesian information criteria, Hardy-Weinberg equilibrium) using the SNPStats online service.
Results. When using EAGMT in addition to standard anesthesia, a statistically significant improvement in the studied parameters (SBP, DBP) was observed, as well as a relative change in these parameters. No changes in CVP or a relative change in this parameter were observed. No relationship was found between the polymorphisms of the genes of the angiotensin-1 receptor (AGT2R1 A1166C) (rs 5186), endothelin-1 (Lys198asn) (rs 5370), endothelial nitric oxide synthase (NOS3 C786T) (rs 2070744) and the SBP and DBP parameters. Not only a statistically significant decrease in bed days in the Anesthesiology and Intensive Care Unit No. 1 and in the cardiac surgery hospital in group 2 compared with group 1 was noted, but also a decrease in the costs of the treatment performed in group 2.
Conclusions. The use of EAGMT is not only effective in maintaining systemic hemodynamic parameters, which proves the absence of a negative effect of this method in the intraoperative period during CABG under CPB conditions. The use of this technique helps to reduce the length of hospital stays and save money on patients’ stays in hospital. Genotypes of polymorphisms of the genes of the angiotensin-1 receptor (AGT2R1 A1166C) (rs 5186), endothelin-1 (Lys198asn) (rs 5370), endothelial nitric oxide synthase (NOS3 C786T) (rs 2070744) do not affect the studied parameters of invasive hemodynamics.

Allogeneic hematopoietic stem cell transplantation (alloHSCT) is the only radical therapy for a number of hemablastoses and hematopoietic depressions. The probability of finding a related fully compatible donor is no more than 25 %. Hematopoietic stem cell donor registries increase the chances of finding an unrelated donor. Taking into account the increase in alloHSCT due to unrelated fully and partially compatible donors, there is a need to identify additional risk factors for the development of post-transplant complications, such as acute graftversus-host disease (aGVHD) in order to select an adequate immunosuppression regimen after alloHSCT.This article presents the results of a retrospective analysis of risk factors for the development of aGVHD based on the study of clinical and demographic indicators of recipients, as well as laboratory and demographic characteristics of donors and cellular characteristics of the graft.

Based on the statistical materials of the analytical report, the data of the register of results of “Tuberculosis” and scientific research, the analysis of the prevalence of tuberculosis in Belarus at the turn of the 21st century and in the first quarter of the 21st century was carried out. The epidemiological situation of tuberculosis in the period 2000—2005 was alarming: the incidence rate was 49.9—54.3 per 100 thousand of the population, the mortality rate was 7.3—12.1 per 100 thousand. This required the adoption of legislative measures at the state level. Program-targeted planning of tasks to combat tuberculosis in the framework of the implementation of state programs to ensure the achievement of epidemiological situations. By 2019, the incidence of tuberculosis decreased by 65.8 % (18.6 per 100 thousand), the mortality rate from tuberculosis — by 81.8 % (2.2 per 100 thousand). The achieved positive dynamics of the main epidemiological indicators for tuberculosis were disrupted by the COVID-19 pandemic. The detection of tuberculosis has sharply decreased due to serious examinations. After exiting the pandemic (2022), the system of preventive medical examinations was restored, new medical technologies for diagnostics and chemotherapy, strict monitoring of tuberculosis and control over the development of the epidemiological situation were developed and introduced into practice. However, a serious problem in phthisiology remains the prevalence of multidrug-resistant tuberculosis, accounting for 36.2 % among new cases and 61.0 % among treated patients, as well as in combination with HIV infection (13.5 %) and viral hepatitis C. (19.7 %). A deterrent to ensuring the best results in stopping the spread of tuberculosis is the relapse of the disease, among which in 85.0 % of cases the isolation of bacteria with multidrug resistance of the pathogen was diagnosed. The incidence of tuberculosis, taking into account relapses in 2023, is 16.8 per 100 thousand population, mortality is 0.96 per 100 thousand population.

Objective. To describe a modern epidemiology of acute infectious lung destruction (AILD) requiring surgery.
Materials and methods. There were investigated all patients with AILD requiring surgery of the thoracic purulent surgery department and intensive care unit of the Vitebsk Regional Clinical Hospital in 2011—2021.
Results. The incidence of AILD requiring surgery ranged from 2.2 to 6.0 (Me [25 %; 75 %] — [2.4; 4.0]) cases per 100 thousand adults. Male (male/female ratio — 6 to 1) of middle age dominated in the structure of patients. Hospitalizations were evenly distributed throughout the year. AILD were a complication of acute viralbacterial pneumonia in 92.8 % cases. Acute lung abscess was found in 29.4 % patients, acute gangrenous lung abscess — in 25.5 %, and lung gangrene — in 45.1 %. The right lung was affected 2.2 times more often than the left. The purulent-destructive focus was localized within one lobe in 75.6 % of cases. The frequency of complicated AILD increased according to the severity of clinical and morphological form of AILD (p = 0.00). The frequency of complicated AILD requiring surgery (pleural empyema, sepsis, etc.) was 60.9 % and did not tend to change over time (p = 0.24). Patients with AILD requiring surgery were characterized by high multi- and comorbidity (80.8 %).
Conclusion. AILD continue to be an important medical and social problem.

Achalasia cardia is a rare esophageal motility disorder based on the loss of myenteric neurons in the distal esophagus and lower esophageal sphincter. The etiology and pathogenesis of achalasia of the cardia remain unclear, therefore, to date there is no etio-pathogenetic treatment for this pathology. At present, drug, endoscopic and surgical methods are used in the treatment of achalasia of the cardia. Medication methods include calcium channel blockers and long-acting nitrates; endoscopic methods — botulinum toxin injections, mechanical dilatation, oral endoscopic myotomy; surgical methods — laparoscopic cardiomyotomy according to Heller with incomplete fundoplication according to Dore, esophagectomy with one-stage gastric tube plasty. This review summarizes the main methods of treatment of cardia achalasia, their advantages and disadvantages.

The article examines the experience of medical accreditation of the treatment and rehabilitation stage of medical rehabilitation in state healthcare organizations of the Republic of Belarus and analyzes the shortcomings in the organization of this stage.

Objective. Detection of etiology, pathogenetic factors and variants of the course of widespread purulent pulmonary destruction end therapeutic tactics.
Materials and methods. Among 780 patients with purulent-necrotic lung destruction widespread purulent destruction (PGD) was revealed in 141 (18.1 %) patients. The clinical form of the disease was diagnosed by clinical and radiologic studies. Bronchoscopy was performed in 94 patients and bronchography in 36 patients. 32 patients with pyopneumothorax and 28 with closed pleural empyema underwent videothoracoscopy and drainage of pleural cavity. Bronchial contents, purulent exudate obtained from the pleural cavity were investigated to identify etiology.
Results. Clinical and radiologic, laboratory investigations were highly informative and sufficient in the diagnosis of RHD. When etiology is revealed, the study of sputum and bronchial contents obtained at bronchoscopy gives false information due to bronchial infestation with conditionally pathogenic microflora. The etiology was established in 28 patients with closed pleural empyema during the study of purulent pleural exudate obtained at the first pleural puncture. Non-spore-forming anaerobes in large quantities (10⁷—10⁹ in 1 ml) were detected. 4 variants of course were identified: bronchogenic and hematogenous; pulmonary and pulmonary-pleural RHD.
Conclusion. Identification of the dominant role of nonspore-forming anaerobes in the etiology of RHD, variants of clinical course allowed to improve therapeutic tactics and treatment results. At complex treatment complete cure was achieved in 66 (46.8 %) patients, clinical cure — in 47 (33.3 %). Chronic purulent destruction developed in 17 (12.1 %). 11 (7.8 %) patients died in the acute period of the disease. Improvement of treatment results and reduction of cases of acute process transition to chronic process was promoted by constant interaction with therapists and pulmonologists on timely referral of patients to pulmonary surgery departments.

Herlin — Werner — Wunderlich syndrome (HWWS) is a very rare defect of the genitourinary system, which occurs due to abnormal development of the Mullerian ducts. The defect is characterized by a variety of forms and combinations. Most often, uterine duplication occurs in combination with OHVIRA syndrome (Obstructed HemiVagina and Ipsilateral Renal Anomaly). Hence the difficulties in diagnosing and treating this pathology.
The article presents a description of a clinical case of HWWS in a 14-year-old patient and a brief review of the literature. Also described: clinical picture, diagnostic methods, observation and surgical treatment. In this patient, HWWS was complicated by hematopiocolpos, hematometra and hematosalpinx on the left. A description of a clinical case of this syndrome in the Republic of Belarus is provided for the first time.

The purpose of this publication is a systematic presentation of current socio-medical problems of psychosomatics and ways to resolve them. The socio-medical factors contributing to the formation of psychosomatic disorders are considered. The essence of psychosomatics is characterized in the context of the main issues of socio-medical practice. The principles of treatment of psychosomatic patients are revealed and described. The main directions for the prevention of psychosomatic disorders are presented.
The article uses materials from the media library named after. M. E. Tikotsky Department of Service for the Faculties of Journalism and Philosophy and Social Sciences of the Fundamental Library of the BSU and elements of the educational portal of the BSU FFSN.