Objective. To analyze changes in platelet aggregation indicators in patients with abdominal sepsis in comparison with healthy people and postoperative patients.
   Materials and methods. The prospective cohort study included 74 patients. Three study groups were identified: group 1 — healthy blood component donors (n = 26); group 2 — trauma patients in the postoperative period after replacement of large joints (n = 23); group 3 — patients with surgical pathology of organs abdominal cavity and the presence of sepsis, after abdominal operations (n = 25). Determination of platelet aggregation activity in each of the subjects was carried out once. We used an automatic platelet aggregation analyzer AR 2110 (ZAO “SOLAR”, Belarus), which allows us to study the aggregation properties of platelets in vitro using the turbidimetric method.
   Results. Platelet aggregation activity in patients with joint replacement was reduced compared to a group of healthy blood component donors. The degree of aggregation reached with the inducer adrenaline 2.5 µM — 41.9 [26.2; 59.4] % versus 71.6 [68.5; 76.6] % (p < 0.001), adrenaline 5.0 µM — 52.0 [27.9; 62.7] % versus 76.3 [74.0; 79.0] % (p < 0.001), collagen 2.0 mg/ml — 67.7 [47.7; 81.3] % versus 83.9 [82.5; 86.9] % (p < 0.01). In patients with abdominal sepsis, aggregation activity was also reduced compared to healthy donors. The degree of aggregation was with the inducer adrenaline 2.5 µM — 37.6 [17.1; 60.1] % versus 71.6 [68.5; 76.6] % (p < 0.001), adrenaline 5.0 µM — 39.5 [24.6; 63.8] % versus 76.3 [74.0; 79.0] % (p 0.001).
   Conclusion. In patients with abdominal sepsis, aggregation activity was reduced in comparison with healthy donors and patients with joint replacement.

   Objective. To study the long-term effectiveness of continuous sacral neuromodulation in patients with spinal cord injury.
   Materials and methods. From August 2020 to September 2023, 30 surgeries to install a sacral neuromodulator were performed at the neurosurgical departments of the Republican Scientific and Practical Center of Neurology and Neurosurgery together with a urologist, according to indications. Patients were divided into two groups: group 1 — 20 patients (with partially or completely preserved urination); group 2 — 10 patients (without preserved urination). In one patient from group 2, the neuromodulator was ineffective, and therefore the pulse generator was removed.
   Results. The patients were examined after 6 and 12 months: after 6 months, a questionnaire and voiding diaries were filled in; after 12 months, a comprehensive urodynamic study (CUDS) was performed, and a questionnaire and voiding diary were filled in. In patients in group 1, 6 months after the installation of a permanent SUI, the quality of life according to the SF-Qualiveen questionnaire scale improved from the initial 3.2 ± 0.7 points to 1.6 ± 0.4 points (an improvement of 50 %), and after 12 months it remained at 1.7 ± 0.3 points (an improvement of 46.8 %). In group 2 the dynamics of the indicators were less pronounced than in group 1, but the changes were also statistically significant (p < 0.05). In group 2, after 6 months, the quality of life according to the SF-Qualiveen questionnaire improved from the initial 3.5 ± 0.4 points to 2.4 ± 0.3 points (improvement by 31.4 %) and after 12 months remained at the level of 2.5 ± 0.3 points (improvement by 28.6 %). The urodynamic index maxPdet obtained during the cystometry initially and 12 months after the installation of a permanent SNM had the following dynamics: in group 1, this index decreased from 40.8 ± 12 to 32.5 ± 8.3 cm H2O (improvement by 20.3 %); group 2, this index increased from 5.8 ± 1.2 to 7.0 ± 1.1 cm H2O (improvement by 17.1 %).
   Conclusion. The quality of life of patients with neuromuscular dysfunction of the bladder after traumatic spinal cord injury after the installation of permanent neuromodulators improved in both group 1 and group 2 (p < 0.05).

   Objective. To develop a method of determining the severity of alcohol dependence syndrome using the automated program complex NeuroSMG.
   Materials and methods. The study involved 397 practically healthy participants, as well as 251 patients of the narcology department of the Vitebsk regional clinical center of psychiatry and narcology and citizens staying in the treatment and labor preventorium № 4 of Vitebsk. Vitebsk. The participants were tested in the automated program complex of neuropsychological diagnostics NeuroSMG. Statistical processing of the results was carried out in the R environment version 4.4.1.
   Results. The following indices had the greatest predictive ability: time of correct CBT responses, time of No-Go GNG, proportion of yellow ball RAT saves, number of CBT errors, wrong CBT time, sum of RAT gains, SCT response duration, duration of red ball RAT touches, average TMT path length. Based on these, a decision tree was constructed. During validation, the high quality of the obtained decision tree was shown: thus, the accuracy of the model was 91.05 % (with 95 % confidence interval equal to 88.58—93.13 %).
   Conclusion. As a result of this study, a method for determining the severity of alcohol dependence syndrome using the NeuroSMG automated software package was proposed. The obtained data demonstrate high sensitivity of the method: 97.73 % for the comparison group, 86.78 % and 74.62 % for the groups of patients with the initial (first group) and middle (second group) stages of alcohol dependence syndrome, respectively. Specificity rates were also high, amounting to 86.85 % for the comparison group and 98.10 % and 97.10 % for the first and second groups.

   Immune reconstitution after allogeneic hematopoietic cell transplantation (alloHSCT) is a key factor determining the clinical course after transplantation, since most clinical situations in the post-transplant period, such as acute graft-versus-host disease (аGVHD), infectious complications, and relapse are associated with the speed, quantity, and quality of immune cell reconstitution.
   This article presents the results of a study of immune reconstitution in patients after alloHSCT, with an emphasis on the features of immune reconstitution in patients with and without аGVHD.

   Objective. To assess the initial level of knowledge of general practitioners (GPs), depending on work experience, the availability of a medical category and the need for professional training.
   Materials and methods. 65 GPs took part in the survey and were divided into four groups: group 1 — 29 people (44.6 %) had 10 years or more work experience in the specialty; group 2 — 36 people (55.4 %) less than 10 years of experience; group 3 — 29 people (44.6 %) had qualification categories; group 4 — 36 people (55.4 %) without qualification category.
   Results. The article provides an assessment of the initial level of knowledge of GPs who took advanced training courses at the department of general medical practice and outpatient therapy according to 10 questions of a questionnaire developed at the department.
   An insufficient level of knowledge of GPs on current issues of therapy was revealed, with a low percentage of correct answers for: chronic obstructive pulmonary disease — 32 %; osteoporosis — 18.5 %; target lipid levels — 26 %; ischemic disease heart disease — 52 %; supraventricular tachycardia — 44.5 %. GPs’ awareness of most of the proposed issues does not depend on their length of service or category. Only knowledge of diagnostic criteria for osteopenia and osteoporosis was higher in the presence of a category (31.0 % versus 8,3 %, p = 0.02).
   Conclusion. In today’s world, to achieve success, you need to improve every day. This means that a doctor should not only receive a «lifelong education» but also continue «lifelong education».

   The main principles of comprehensive medical rehabilitation of patients with chronic lung disease in the terminal stage before and after lung transplantation are to evaluate the indications and contraindications for medical rehabilitation, expert and rehabilitation diagnosis of functional disorders, disability, levels of rehabilitation potential. Principles of medical rehabilitation of patients with chronic lung disease before and after lung transplantation are: early activation in the postoperative period after the pulmonology transplantation; 12—16-week comprehensive individual programs, including physical therapy, interval and continuous exercise training, patient education, psychological activities, methods of extracorporeal membrane oxygenation and Nordic Walking. Еvaluation of the effectiveness of programs that can significantly improve tolerance to functional activity, survival and quality of life of patients and reduce medical and social consequences of the main disabling disease.

   This article discusses the issues of carrying out the administrative procedure for medical accreditation. An overview of the regulatory legal framework governing the conduct of administrative procedures in the Republic of Belarus is presented. The main inconsistencies identified in government healthcare organizations based on the results of the administrative procedure are presented.

   Objective. To determine the prevalence of markers of parenteral viral hepatitis B in donors of blood and its components in the Republic of Belarus.
   Materials and methods. The study included 61 blood serum/plasma samples collected from donors from all regions of the country. All samples were examined by CLIA/ELISA and PCR for the presence of hepatitis B virus markers.
   Results. As studies have shown, out of 61 sequenced samples, 58 (95.1 %) belonged to genotype D, and 3 (4.9 %) to A. Genotype D in 47 (81.1 %) cases was represented by the D2 subgenotype, in 5 (8.6 %) samples, the D1 subgenotype was detected, in 5 (8.6 %) — D3 and in 1 (1.7 %) sample the D4 subgenotype was detected, all samples of genotype A belonged to the A2 subgenotype. All DNA sequences of the D1 and D3 subgenotypes were assigned to the ayw2 subtype, D4 — to the ayw3 subtype, most samples of the D2 subgenotype were of the ayw3 subtype, and one sample each was assigned to the ayw2 and ayw4 subtypes. All DNA sequences of the A2 subgenotype belonged to the adw2 subtype.
   Conclusion. The HBV variants identified in donors during phylogenetic analysis were in the same cluster with previously described sequences from Belarus, which indicates that the epidemiological process of hepatitis B in the country is supported by “local domestic” viruses.

   Objective. Identification of the etiology, clinical forms and variants of the clinical course of lung gangrene, therapeutic tactics.
   Materials and methods. Out of 952 patients with purulent necrotic lung destructions, lung gangrene was detected in 118 (12.4 %). The diagnosis of gangrene was carried out by clinical, radiological and laboratory studies. Microbiological examination of sputum, bronchial aspirate, and pleural exudate was performed. Bacteriological examination of pus obtained directly from the lesion site during lung puncture through the chest wall was performed in 36 patients. All patients with diagnostic and therapeutic purposes underwent bronchoscopy.
   Results. Among 952 patients with acute purulent necrotic lung destructions, limited gangrene was diagnosed in 101 (10.6 %), widespread gangrene in 17 (1.8 %) patients. Sputum examination revealed various conditionally pathogenic microflora in small quantities (104—105 in 1 ml). Reliable information to establish the etiology was obtained in the study of purulent detritus taken in the phase of gangrene formation in 36 patients directly from the lesion with a puncture needle. At the same time, non-spore-forming anaerobes were detected in large quantities (107—109 in 1 ml). The regressive and progressive variants of gangrene course against the background of intensive therapy were identified, which made it possible to develop differentiated treatment tactics. In the regressive variant, complex intensive therapy continued until remission appeared, and then, if necessary, surgical treatment. With a progressive course, surgical treatment was performed in the acute period for vital indications.
   Conclusion. Timely hospitalization of patients in the thoracic department, the identification of two clinical forms (limited and widespread gangrene) and two variants of the course (regressive and progressive) and the developed differentiated treatment tactics made it possible to achieve a two-fold reduction in mortality compared with the average results presented in the literature.