Objective. To evaluate the possibility of using neuron-specific proteins to confirm brain disorders in patients with isoimmunization for the AB0 and Rh systems.

Materials and methods. The main group included patients with AB0 and/or Rhesus factor isoimmunization (n = 57), the comparison groups included patients with neonatal jaundice (n = 30), hypoxic-ischemic encephalopathy (n = 35) and practically healthy newborns (n = 35). Concentrations of neurospecific proteins, immunoglobulins, complement system components by solid-phase Enzymelinked immunoassay and hyaluronidase activity by the method developed by us were evaluated.

Results. Increased level of neuron specific enolase and hyaluronidase activity as well as decreased level of brain-derived neurotrophic factor, immunoglobulins G3 and C5a component of complement system in patients with isoimmunization and brain disorders were found.

Conclusion. In our study, patients with isoimmunization showed elevated NSE levels comparable to hypoxic-ischemic encephalopathy (p = 0.1).

It was found that BDNF and hyaluronidase activity levels were decreased in patients with isoimmunization and brain disorders. It was found that patients with isoimmunization in the ABO and Rh systems had brain disorders associated with activation of the complement system by immunoglobulins of class G3.

To confirm the presence of disorders, studies of neuron-specific enolase, brain-derived neurotrophic factor and hyaluronidase activity levels can be used.

Objective. To improve the effectiveness of medical habilitation of premature infants by developing a set of medical habilitation (MH) measures in the neonatal period and infancy, to evaluate the effectiveness and impact on neurodevelopmental outcomes at the corrected age of 2 years.

Materials and methods. The object of the study is premature infants with a gestation period of 26—36 weeks. The study included 212 premature infants. Two groups were formed: group 1 —patients, who underwent MH in accordance with the main directions of the developed methodology in full (n = 89); group 2 — patients, who underwent MH in accordance with standard approaches (n = 123). A cohort prospective longitudinal comparative study was conducted.

Results. A multimodal complex MH of premature infants, starting in the first months of postnatal life, was developed. The results showed that in the group 1 at the age of 2 years, in 71.9 % (64/89) cases, children had normal motor, locomotor, speech, and mental development, compared with a similar indicator in the group 2 — 5.7 % (7/123). It has been shown that the use of the developed MH method for premature infants reduces the risk of neurodevelopmental disorders at the age of 2 years by 12.5 times (OR = 12.5, 95 % CI (6.03—23.03); pFisher < 0.001), compared to the group 2, in which children received standard medical rehabilitation.

Conclusion. An effective method of complex MA for premature infants with multi-vector impact aimed at activating the functioning of the body systems of a premature infant that have the maximum risk of impairment due to prematurity and perinatal damage to the central nervous system has been developed. The absence of adverse events confirms the safety of use with the onset in the neonatal period.

Objective. To establish clinical parameters that are significant in the neonatal period and determine the high and low risk of developing neurological disorders at the age of 1,6 year, adjusted for gestation at birth, in premature infants with different gestational ages.

Materials and methods. A retrospective-prospective study included 212 premature babies born between 26 and 37 weeks of gestation. Four groups were formed depending on the gestational age at birth: up to 28 weeks (n = 36); 28—31 weeks (n = 51); 32—33 weeks (n = 55); 34—36 weeks (n = 70).

Results. A quantitative risk scale for the development of neurological disorders in premature infants at postconceptual age of 1,6 years has been developed. Based on the total score, this scale allows a particular child to be classified into a high or low risk group for neurodevelopmental disorders. It was found that the studied model has a predictive accuracy of 86.3 % (95 % CI (0.853—0.908)), specificity of 0.672 (95 % CI (0.653—0.748)) and sensitivity of 0.912 (95 % CI (0.888—0.958)).

Conclusion. The definition of risk groups is scientifically substantiated and has advantages, in particular, it allows for a unified approach in assessment not only by rehabilitation doctors, but by pediatricians, neonatologists, and neurologists. It is easy to use, does not require computer programs or technical equipment, which eliminates additional costs.

Objective. To evaluate the possibility of using laboratory determination of cytokeratin-18 in the complex diagnosis of chronic kidney diseases in children.

Materials and methods. 137 patients with chronic kidney diseases were examined. The comparison group included conditionally healthy children without signs of kidney damage and autoimmune process. Quantitative determination of cytokeratin-18 levels was performed by enzyme immunoassay.

Results. Differences in cytokeratin-18 concentrations in the blood serum of patients of all groups (p < 0.001), were noted. Differences in cytokeratin-18 levels in urine according to the Kraskel — Wallis test also showed statistical significance (p < 0.001). When the cytokeratin-18 level is > 0.07 in the blood serum, the odds ratio of the risk of chronic kidney disease (OR) is 34.04 (95 % CI (9.5—122)). ROC analysis showed diagnostic accuracy of 85.0 % (95 % CI (76.9—93.1)), sensitivity — 81.6 %, specificity — 88.5 %. With cytokeratin-18 levels > 0.09 in urine, the OR was 26.5 (95 % CI (8.4—84.3)), diagnostic accuracy was 83.7 % (95 % CI (74.9—92.6)), sensitivity was 73.8 %, and specificity was 84.6 %.

Conclusion. Determination of cytokeratin-18 levels in the blood serum and urine of pediatric patients can be used in the diagnosis of chronic kidney diseases in children, including for the differential diagnosis of glomerular and non-glomerular chronic kidney diseases, as well as glomerulopathies among themselves. However, it is not possible to use this marker of apoptosis to predict the progression of the disease and assess the severity of the process at this stage of the study.

Objective. To investigate the influence of alcohol dependence syndrome (ADS) severity on visual-spatial processing parameters assessed with CBT, TMT and MRT, and to develop a prognostic model for classifying disease stages based on neuropsychological indices.

Materials and methods. The study included 444 practically healthy volunteers (comparison group), 125 patients with the initial stage of ADS (group 1) and 152 patients with the middle stage of ADS (group 2). All participants underwent CBT, TMT and MRT tests in the automated software package NeuroSMG including. Statistical analysis of data was performed using R software environment version 4.3.3. Analysis of variance (ANOVA), Kraskell — Wallis test and linear mixed-effects models were used to compare groups. The rpart library was used to create a decision tree model.

Results. Patients with ADS showed a significant increase in response time and number of errors in all tests compared to the comparison group. In the CBT test, a decrease in the ability to remember and reproduce spatial sequences was observed. In the TMT test, patients with ADS showed longer maze time and increased path length. In the MRT test, patients with ADS showed longer task completion times and more errors. Based on the key scores of CBT, TMT and MRT tests, a decision tree model was developed with an accuracy of 84.11 % (95 % CI (80.30—87.45)).

Conclusion. The study confirmed that the severity of alcohol dependence syndrome is associated with impaired visual-spatial function, as manifested by slower reaction times and increased errors. The developed decision tree model based on neuropsychological tests demonstrates high accuracy in classifying the stages of alcohol dependence and can be used for diagnostics and monitoring of the disease.

Objective. To identify pathogenetic factors of the development of chronic lung abscesses, to determine the clinical course options, to develop differentiated therapeutic tactics.

Materials and methods. Of the 605 patients with acute purulent-necrotic lung destructions, 158 (26.1 %) had non-scarred cavities in their lungs after the end of treatment. Clinical and radiological studies examined the features of the course of the initial disease, the timeliness of diagnosis, the volume of the lesion, the morphological substrate, the etiological factor, the state of regional ventilation, and the treatment methods used.

Results. Of 158 patients with non-scarred cavities, 68 (43.0 %) developed a chronic abscess during treatment, 58 (36.7 %) with a morphological substrate in the form of large residual cavities or severe fibrosis with impaired regional ventilation remained a clear threat of exacerbation. Within 2—4 months after the end of treatment, 17 (10.8 %) patients had scarring of residual cavities, 15 (9.5 %) patients had false cysts formed at the site of abscesses without signs of inflammation. Surgical treatment was indicated for 126 (79.7 %) of 158 patients. 114 (72.2 %) underwent surgical treatment of various volumes. 12 (7.6 %) patients refrained from surgical treatment, they underwent bronchosanation treatment for preventive purposes.

Conclusion. The quality of treatment of acute purulent-necrotic processes depends mainly on the volume of the lesion, the timeliness of diagnosis and treatment. The triggering factors leading to the development of chronic inflammation in the bronchi and chronic abscess are pronounced fibrosis and impaired regional ventilation in the lung tissue around the intra-pulmonary residual cavity. According to the peculiarities of pathogenesis and morphological substrate, differentiated therapeutic tactics have been developed.

The purpose of this publication is a systematic presentation of the medical and social aspects of nutrition within the framework of the course «Social Medicine» for students, postgraduates and teachers of higher educational institutions of the humanities.

The medical and social aspects of malnutrition are considered. The content of healthy nutrition, therapeutic and preventive and therapeutic nutrition and their medical and social role in the health preservation of modern society are disclosed and described.

The article uses materials from the M. E. Tikotsky Media Library of the Department of Service of the Faculties of Journalism and Philosophy and Social Sciences of the Fundamental Library of BSU and elements of the educational portal of BSU FFSN.