Objective. To conduct a clinical, instrumental and microbiological examination of patients with middle ear cholesteatoma and characterize the main ultrastructural markers of the proliferative-dystrophic process in cholesteatoma biopsies.
Materials and methods. The study included data from 16 patients who were examined and treated at the Republican Scientific and Practical Center of Otorhinolaryngology. All patients underwent a comprehensive clinical and instrumental examination, including bacteriological examination of the discharge of the external auditory canal and the tympanic cavity for opportunistic microflora. In order to indicate the DNA of various intracellular pathogens (Ch. trachomatis, M. genitalium, herpes simplex viruses types 1 and 2, papillomaviruses, etc.), biopsy material from cholesteatoma was analyzed.
Results. According to the results of a clinical and instrumental examination, the following signs were found: hearing loss (81.25 %), periodic suppuration (100 %), noise in the ear (31.25 %), dizziness (37.5 %). In 100 % cases with computer tomography a pathological soft-tissue process in middle ear cavity was detected. Microbiological analysis established the following species: S. aureus, S. epidermidis, P. aeruginosa. The results of the analysis for the presence of pathogens in the cholesteatoma tissue allowed us to state the presence in some cases of bacterial agents, belonging to the Chlamydiaceae and Mycoplasmataceae families. The molecular biological analysis did not reveal the DNA of intracellular pathogens.
Conclusion. Ultrastructural analysis made it possible to systematize the pathomorphosis of the main extraand intracellular compartments of cholesteatoma and to assess collagen destruction in the stromal-mesenchymal layer. For the first time, evidence is presented of the presence of intracellular bacterial agents belonging to the Chlamydiaceae and Mycoplasmataceae in the epithelial cells of cholesteatoma. The obtained results indicate the etiological significance and involvement of opportunistic microorganisms and intracellular pathogens in the multifaceted damaging effects on middle ear cells

Based on modern literature data, a comprehensive analysis of the problem of rare causes of anaphylaxis in children and adolescents is provided. It is emphasized that this is a complex task in terms of diagnostics, which takes place in the work of a practicing physician. Many authors point out that doctors have insufficient knowledge of the clinical significance of rare causes of childhood anaphylaxis and call for a more indepth coverage of these issues. The article provides a detailed review of anaphylaxis associated with exercise, alpha-gal syndrome, oral storage mite anaphylaxis, mast cell activation syndrome, etc. Understanding the role of these unusual triggers is critical for physicians to ensure accurate diagnosis and effective treatment of childhood anaphylaxis, emphasizing the need to increase clinical awareness to improve treatment outcomes and enhance the quality of life of children and adolescents at risk for anaphylactic reactions. The information presented is of great practical importance for practicing physicians.

Early diagnosis of autism spectrum disorders (ASD) is a key factor in ensuring timely intervention and improving long-term outcomes for children with this pathology. The development and validation of effective screening tools for use in primary health care are of significant clinical interest.
Objective. To evaluate the effectiveness of a test for the early diagnosis of ASD, developed for use in outpatient health care organizations.
Materials and methods. In the 2023—2024 study, 1984 children were screened using an original screening test developed by specialists in the healthcare system of the Republic of Belarus. The test included 24 questions grouped into six scales: sensory sphere, emotional sphere, visual contact, social interaction, speech development and cognitive sphere. The test results were assessed on a scale from 24 to 96 points with the following interpretation: 24—36 points — high risk of ASD; 37—63 points — average risk; 64—96 points — low risk. The diagnostic value of the test was assessed using ROC analysis with determination of sensitivity, specificity, positive and negative predictive value.
Results. Of the 1984 examined children, 64 (3.23 %) had a clinically confirmed diagnosis of ASD. The average test score was 76.16 (±13.14) in the overall group; 30.31 (±4.05) in the group with ASD; 77.69 (±13.14) in the group without ASD. The area under the ROC curve (AUC) was 0.9931, indicating excellent discriminatory ability of the test. The optimal threshold for detecting ASD is 38 points with a sensitivity of 100 % (95 % CI (100—100)) and a specificity of 97.60 % (95 % CI (96.92—98.29)). With a standard high risk threshold of 36 points, the test showed a sensitivity of 96.88 % and a specificity of 98.07 %, a positive predictive value of 62.63 % and a negative predictive value of 99.89 %.
Conclusion. The developed screening test demonstrates high efficiency for the early detection of ASD in young children. The optimal threshold for clinical practice is 38 points, but the standard threshold of 36 points also provides a good balance between sensitivity and specificity. The test can be recommended for widespread use in outpatient practice as a screening tool for the primary diagnosis of ASD.

Objective. To develop a model for predicting the development of atrial fibrillation (AF) in patients with arterial hypertension (AH), considering echocardiographic parameters and the main risk factors (RFs) for cardiovascular diseases (CVD).
Materials and methods. 120 patients with stage I and II AH were examined. Of these, 60 patients, the study group, had paroxysmal AF, and 60 patients without AF formed the comparison group. All patients underwent measurement of anthropometric data, assessment of the key CVD RFs, and transthoracic echocardiography.
Results. The following predictors were included in the created model for predicting the AF development: high-density lipoprotein cholesterol level, left atrial volume/height2 index (> 18.5 ml/m2 in men and > 16.5 ml/m2 in women), left ventricular end-diastolic size index, maximum speed of transmitral blood flow in the late filling phase (peak A). Sensitivity and specificity were 70 %, AUC — 0.769 (95 % CI (0.683—0.856)).
Conclusions. The developed predictive model makes it possible to verify individuals at high risk of developing AF among patients with AH and can be used in both outpatient and inpatient basis.

Modern virtual reality is a technology that allows a person to immerse themselves in a simulated environment. This field is increasingly being used in various fields of activity. Development of simulation technologies for improving professional skills is especially relevant for specialists who perform their professional duties in dangerous conditions, such as rescuers, aviation pilots, representatives of law enforcement agencies, military personnel, ambulance workers, professional drivers, highly qualified athletes and many others. Virtual reality can also become a useful tool in the practice of medical and psychological support for the early detection and prevention of unwanted emotional reactions. It can also be successfully applied for functional restoration and for correcting mental disorders of prenosological level in the practice of medical and psychological support of hazardous professions and highly qualified athletes due to the possibility of recreating controlled and safe, but realistic stress factors.

Objective. To perform a comprehensive analysis and to assess the problematic issues in clinical and pathohistologic diagnostics of oral potentially malignant disorders end oral epithelial dysplasia on the Minsk Region example in the period of 2021—2023.
Materials and methods. 185 patients underwent histopathologic examination between 2021 and 2023 from the Minsk
Regional Dental Polyclinic were included in the study. Clinical and histopathologic data were analyzed by the method of continuous selection, taking into the age and gender of patients, anatomical-topographical localization of the pathological process, technique of biopsy, clinical diagnosis and histopathologic report.
Results. The rate of patients with oral potentially malignant disorders underwent a biopsy was 6.5 %. The dentists in 21.5 % of cases incorrectly formulate the clinical diagnosis, in 13.5 % of cases do not specify and in 75.1 % of cases incorrectly specify the technique of biopsy, in 15.7 % of cases do not mention the anatomical-topographical localization of the pathological process, thus complicating the interpretation of the revealed morphological changes during histopathological examination. Morphologically oral potentially malignant disorders were verified in 1.1 %, dysplasia — in 1,6 % of all performed biopsies and accounted each for 16.7 % of all cases clinically idenificated as oral potentially malignant disorders. In 30.8 % of all performed biopsies and in 50.0 % of clinically idenificated as oral potentially malignant disorders, the morphological diagnosis was absent and was provided as a descriptive conclusion in the form of present histologic changes announcement.
Conclusion. The performed complex analysis revealed hypodiagnostics of oral potentially malignant disorders both at clinical and morphologic levels. Identified problematic issues in the diagnostic process among dentists and pathologists indicate the need to improve the professional training of specialists involved in the evaluation of oral cavity diseases, as well as the development and implementation of guidelines for medical care of patients with oral potentially malignant disorders.

The purpose of this publication is a systematic presentation of innovative aspects of the formation of healthy aging and active longevity of elderly people within the framework of the course “Social Medicine”.
The concepts of “healthy aging”, “active longevity” and “quality of life of elderly people” are considered, which unite all elderly people, including physically weakened individuals. The content of motivation for a healthy lifestyle of elderly people is disclosed and described with the aim of their correct behavior and maintaining healthy habits. Measures to ensure healthy aging and active longevity are separately presented.
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 FFSS.