Laser angioplasty has been used in clinical practice since the 1980s. The technique has evolved from the use of continuous laser radiation with unfavorable results in the form of occlusion of more than 2/3 of treated arteries in the early postoperative period due to severe thermal damage of surrounding tissues to the implementation and use of pulsed lasers with a significantly lower thermal effect. Currently, in the world practice, the excimer laser is used for laser angioplasty in the vast majority cases. The article analyzes the parameters of this laser, identifies problems and discusses possible solutions. It is determined that the excimer laser cannot be considered effective in the long term: the wavelength, the energy that is well absorbed by hemoglobin and iodine-containing contrast, impossibility to transmit high energy density of laser radiation from the laser source into the artery through an optical fiber, high frequency of pulse generation, that increases thermal damage of intact tissues of the arterial wall and following risk of vessel restenosis. At a laser radiation wavelength of 600—1000 nm, the vast majority of tissues are optically transparent and there is little absorption by both atherosclerotic plaque and surrounding tissues. The search for selection of an additional chromophore having absorption spectrum in this range, which would be selectively accumulated only by atherosclerotic tissues and not by intact vascular wall, seems promising. The effect of pulsed laser radiation with a wavelength of 600—1000 nm and a low frequency of pulse generation would selectively destroy atherosclerotic plaque without damaging the surrounding structures.

Objective. To evaluate the effectiveness of optical coherence tomography in the diagnosis of keratoconus, and to establish reliable indicators for diagnosing keratoconus. Materials and methods: The study included data from 142 people (280 eyes) divided into four groups: Group 1 — 63 eyes (32 people) of patients with refractive errors; Group 2 — 181 eyes (91 people), patients with a confirmed diagnosis of grade 1—3 keratoconus (according to Amsler); Group 3 — 36 eyes (19 people), healthy volunteers without ophthalmological pathology; The 4th group represents the combined data of the 1st and 3rd groups — 99 eyes (51 people). Results and conclusions. ROC-analysis data of the most reliable indicators: central corneal thickness (CCT), minimum corneal thickness (MCT), difference in pachymetry (DP) and difference in the epithelium (DE). Threshold level of CCT 515 µm with AUC ROC-curve 0,862 (95 % CI (0.816—0.900); p < 0.0001), Se = 79.0 % and Sp = 78.8 %, threshold level of MCT 483 µm with AUC ROC curve 0,922 (95 % CI (0.884—0.951); p < 0.0001), Se = 75.1 % and Sp = 90.9 %. The cut-off point of the difference indicators was as follows: DP 15 μm AUC ROC-curve 0,936 (95 % CI (0.901—0.962); p < 0.0001), Se = 88.4 % and Sp = 89.9 %, DE 5 µm AUC ROC-curve 0.893 (95 % CI (0.851—0.927); p < 0.0001), Se = 79.56 % and Sp = 89.86 %. Optical coherence tomography is a highly informative, reliable and accurate method for examining the cornea and diagnosing keratoconus. The most reliable and accurate indicators for diagnosing keratoconus using optical coherence tomography are: CCT ≤ 512 µm, MCT ≤ 483 µm, DP > 18 µm and DE > 5 µm. Exceeding these threshold levels will indicate that the patient is diagnosed with keratoconus. The proposed method for diagnosing keratoconus using optical coherence tomography can be widely used by ophthalmologists in the clinical practice of healthcare institutions providing care in the field of ophthalmology.

The problem of critical values of laboratory parameters is actively discussed by the world community. The system of critical values is important for patient safety and is an important component of ensuring the quality of work of medical organizations, therefore, the development of lists of critical indicators and improvement of the reporting procedure for them are pressing issues, the solution of which requires close interaction between clinical laboratory diagnostic specialists and clinicians. Objective. Analysis of lists of critical values of laboratory analytes and documentation regulating work with critical indicators in clinical diagnostic laboratories of the healthcare system of the Republic of Belarus. Materials and methods. The study was conducted using online questionnaires. The survey involved 278 clinical diagnostic laboratories of healthcare organizations representing all regions of the Republic of Belarus. Statistical processing of the obtained data was carried out using Microsoft Excel. Results. It has been shown that work on the formation of lists of critical values of laboratory analytes and the work procedure for their establishment in a number of healthcare organizations is not carried out in full and requires some improvement. Conclusion. Lists of critical values should be compiled in each healthcare organization, taking into account its profile and patient population. The lists must be regularly updated, and for their formation it is useful to use the data provided in literature sources.

We analyzed scientific articles describing the reasons of the diaphragm disfunction and the peculiarities of associated breathing disorders. The relevant clinical observations are demonstrated. The recognition of the disorder is challenging due to difficult dynamical visualization of diaphragm working. The differential diagnostics is based on the thorough investigation of patient’s complaints and specificity of breathlessness as well as patient’s anamnesis which can refer to the genesis of the disorder with following instrumental verification.

Assessment of the satisfaction of foreign consumers with medical care received by them in healthcare organizations in Grodno, as well as an opinion on the comfort of conditions in healthcare organizations and on the availability of medical services in Belarus for foreign citizens. The peculiarity of the sample was exclusively the English language of communication with medical professionals.

The article presents the results of the use of a heated oxygen-helium mixture for the rehabilitation of people with arterial hypertension who are in the sanatorium conditions of the health resort. The dynamics of the activity indicators of the body’s regulatory systems, electrophysiological dispersion characteristics using the hardware and software complex “Ecosan-2007” (Varicard and Cardiovisor) and the results of laboratory markers are analyzed. Objective. Was to use inhalations with a heated oxygen-helium mixture in sanatorium conditions of health resorts for people with diseases of the cardiovascular system. Materials and methods. The controlled study included persons with pathology of the cardiovascular system (arterial hypertension of the 1 and 2 st., low and medium risk) who are undergoing rehabilitation in sanatorium resort conditions, USE “Sanatorium Krinitsa”. Inhalations with a heated oxygen-helium mixture were carried out using the INHALIT V2-01 device developed by employees of the Institute of Biomedical Problems of the Russian Academy of Sciences (registration certificate for a medical device no. RZN 2015/2466). The activity indicators of the body’s regulatory systems were recorded for 5 minutes using the Varicard hardware and software complex, electrophysiological dispersion characteristics were assessed by recording ECG microalternations for 60 seconds on the Cardiovisor heart screening system. Studies of venous blood serum were carried out on kits manufactured by Diasens (Belarus) and a BS-200 biochemical analyzer (Mindray, China). Statistical analysis of the data was carried out using the STATISTICA 7.0 software. Conclusion. The results of the study indicate an improvement in the general condition of people with hypertension. A positive effect was noted in all those recovering and receiving a course of inhalations with a heated oxygen-gel mixture. Since inhalations with a heated oxygen-helium mixture do not have side effects, they can be successfully used as a physical factor of recovery and recommended for use in sanatorium-resort resorts.

Fever of unknown origin (FUO) is mostly due to infections, with rheumatic diseases (RD) and oncologic pathology being its fewer common causes. Rheumatologists periodically encounter this problem, which requires a thorough examination. Objective. To study the structure of diagnosed causes of FUO among patients of the Rheumatology Department and present some cases with difficulties in diagnosis with an emphasis on RD. Materials and methods. We observed 85 patients with a diagnosis of FUO referred to the Rheumatology Department (City Clinical Hospital № 11, Minsk). All patients were examined according to existing algorithms for FUO. Results. In the structure of FUO causes, infections accounted for 43 (50.6 %), oncological and hematological pathology with FUO was detected in 14 (16.5 %) of patients. Among patients with RD, FUO was observed at the onset of RA in 6 (24 %) cases, in Still’s disease — 1 (4 %), SLE — 4 (16 %), histone lupus — 2 (8 %), systemic vasculitis — 12 (48 %) (giant cell vasculitis — 3 (12 %), nonspecific aortoarteritis — 1 (4 %), Behcet’s disease — 1 (4 %), ANCA-associated vasculitis — 7 (25 %), in total 25 (29.4 %) cases. Other causes of FUO account for 3 (3.5 %). 5 (5.9 %) cases of periodontitis occurring with FUO are presented, in 2 cases cone beam computed tomography (CBCT) was made after excluding other infections and neoplasms, although dental radiography was negative. Some cases of RD were presented with diagnostic search analysis. Conclusion. In most patients admitted to the Rheumatology Department 50.6 % infections were found to be responsible for FUO. RD accounted for 29.4 %, and tumours and other causes made a smaller proportion. The periodontitis may be a cause of FUO that occurs atypically, not always routinely detected by dental radiography, therefore, CBCT is advisable. CBCT should be included in the algorithms for examining the patients with FUO without a unknown cause.

Object. To estimate folate cycle parameters in patients with joint hypermobility syndrome (JHS). Materials and methods. The group of patients with JHS consisted of 105 people (90 women and 15 men), the control group — 57 people (49 women and 8 men) aged 20 to 28 years (average age is 22 [21; 23] years). All persons underwent: general clinical examination; determination of levels of homocysteine, folic acid, vitamins В₆ and В₁₂ by enzyme immunoassay (“Fine Test” Wuhan Fine Biotech Co., China), determination of polymorphic variants of C677T, A1298C of the methylenetetrahydrofolate reductase (MTHFR) gene, which was carried out by polymerase chain reaction (“Syntol”, Russia). Results. In patients with JHS, there is a decreasing in levels of folic acid, vitamin В₁₂ compared to those in the control group, the obtained values of homocysteine and vitamin В6 were comparable in both groups. The frequency of mutations of the MTHFR gene among patients with JHS was: 38.6 % — allele 677T, 18.1 % — genotype 677TT, 36.2 % — allele 1298C, 17.1 % — genotype1298CC, for a group of practically healthy individuals: 33.3 % — allele 677T; 12.3 % — genotype 677TT, 31.6 % — allele 1298C, 17.1 % — genotype 1298CC. Patients with JHS, carriers of genotype 1298AA of the MTHFR gene have lower values of folic acid and vitamin В₁₂, carriers of CT+TT genotypes of the polymorphic locus C677T of the MTHFR gene have lower values of folic acid compared with carriers of these genotypes of the control group. Conclusion. The high prevalence of MTHFR gene polymorphism and decreasing of folic acid and vitamin В₁₂ levels in patients with JHS indicate a possible pathogenetic relationship between the studied parameters and this disease, which requires further study to form the principles of timely diagnostics and treatment.

The purpose of this publication is a systematic presentation of current socio-medical problems of urbanization and ways to resolve them. The socio-medical factors that have a positive impact on the health of the urban population are considered. The characteristics of stress factors in the urban sociocultural space are given. The main directions of creating a friendly urban environment are revealed and described. The article uses materials from the media library named after. M. E. Tikotsky Department of Services 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.