Objective. To analyze the factors influencing the long-term results of reconstructive surgeries on the arteries of the lower extremities.

Materials and methods. Retrospective analysis of 98 medical records of patients with chronic obliterating diseases of the arteries of the lower extremities after open surgeries on the arteries of the femoral-popliteal region. Two groups of patients: the first group – with intermittent claudication (n = 34), the second group – with critical ischemia (n = 64). The results of the study were processed by applied statistics methods using MS Excel and the software package for statistical analysis Statistica v. 8.0. Differences were considered statistically significant at p < 0.05.

Results. According to angiography, stage III according to the GLASS classification was present in 58.82 % of patients with CLI 2b, in 71.31 % of patients with CLI 3, 4. The length of the SFA occlusion in patients with CLI 2b is 230 [200; 300] mm, with CLI 3, 4 – 300 [105; 300] mm. A positive result after surgery was observed in 79.41 % of cases in patients with intermittent claudication and in 46.88 % of cases in patients with chronic ischemia threatening limb loss (p < 0.05). Limb preservation within 2 years after revascularization is 88.24 % in patients of the first group, 70.31 % in patients of the second group. Patients taking antiplatelet drugs and abstaining from smoking were more likely to have a positive effect after surgery (p < 0.05).

Conclusion. Patients with atherosclerotic lesions of lower extremity arteries after open reconstructive surgeries have low adherence to conservative therapy and lifestyle changes (all recommendations were followed in 8.2 % of cases). Major adverse events in the extremities in patients not taking antiplatelet agents and not quitting smoking occurred significantly earlier than in patients following recommendations in the long-term period (p < 0.05).

Objective. Optimization preoperative planning for initial tangential excision in burn patients during acute toxemia phase with high DIC risk.

Materials and methods. We conducted a single-center retrospective-prospective cohort study of 39 burn disease patients (28 retrospective and 11 prospective cases). All patients underwent primary tangential wounds excisions. For predicting the risk of DIC syndrome development, a model proposed earlier by the authors was used, accounting for the multiplicative effect of injury characteristics, age, physical examination data, and a laboratory indicator of fibrin degradation (D-dimer), while blood loss volume was calculated according to the Janelidze Research Institute of Emergency Medicine methodology.

Results. Application of the calculation algorithm for primary radical tangential wounds excisions area during burn toxemia – incorporating DIC syndrome risk, circulating blood volume, and relative blood loss per unit area of wounds excisions in high-risk DIC patients – resulted in: reduced blood loss relative to TBV (p = 0.005), lower mortality during burn toxemia (from 71.4 to 27.3 %, U = 86.0, p = 0.013) and increased survival time until fatal outcome (from 7 [7; 12] to 18 [8; 30] days, U = 52.5, p = 0.014).

Conclusion. The developed algorithm for calculating primary tangential necrectomy area – incorporating DIC syndrome risk, circulating blood volume, and relative blood loss per unit wounds excisions area in high-risk DIC patients – demonstrates high clinical efficacy.

Objective. To analyze the functional results of surgical treatment of Hirschsprung's disease in patients under 3 years of age.

Materials and methods. Over a 10-year period, 119 patients under 3 years of age with Hirschsprung's disease were operated on at the Republican Scientific and Practical Center for Pediatric Surgery. Two main groups of patients were identified: group 1 – patients underwent Duhamel (Duhamel – Martin) surgery; group 2 – patients underwent transanal endorectal bowel reduction. The study of remote functional results was carried out by subjective methods (complaints, anamnesis, questionnaires) and objective (examination, irrigoscopy, instrumental methods) ones.

Results. In the period of 1 – 3 years after the operation, the functional results of surgical interventions were monitored, with the primary assessment being the regularity of bowel movements and the absence of constipation (81.0 %), the presence of fecal smearing (14.2 %) or episodes of fecal incontinence (1.8 %). Irrigoscopy allowed us to assess the motor-evacuation function of the intestine. The study was conducted on 52 patients after radical correction of Hirschsprung's disease, who had complaints of constipation or fecal smearing. Preservation of a uniform diameter of the colon without its expansion along the entire length during irrigoscopy, the presence of haustration, and timely emptying of the colon were considered as a favorable radiographic picture, and were detected in 71.2 % of cases. Changes in the intestine, characterized by its dilation, smoothing of haustration, and slow emptying were regarded as unfavorable, and were detected in 28.8 %. The quality of life of patients under 3 years of age, according to the questionnaire, was practically not affected.

Conclusion. Analysis of the results of treatment of Hirschsprung's disease with various methods of surgical treatment showed that complete adaptation of patients when following rehabilitation recommendations occurs 1 – 3 years after radical surgical treatment with satisfactory functional results in 87.4 % of cases, including patients with complications.

We present a clinical case detailing the course and management of avascular necrosis of the femoral heads occurring during a twin pregnancy following in vitro fertilization. Avascular necrosis is a multifactorial condition predominantly affecting young individuals, often leading to severe secondary osteoarthritis of the hip joints and subsequent disability. Timely diagnosis of this condition in both outpatient and inpatient settings is critically important. A differentiated approach to progesterone administration, specifically in terms of dosage and duration, can effectively prevent and manage gestational complications, while significantly reducing the risk of irreversible trophic disturbances in bone tissue. The present report provides an in-depth clinical description of the case, highlighting diagnostic considerations and management strategies.

Objective. To analyse the results of studies of the use of melatonin preparations in pediatric practice and to identify the main possible directions for the use of melatonin based on nosological and syndromic indications.

Materials and methods. We have analyzed 21 scientific publications in MEDLINE, PubMed, Google Scholar, eLIBRARY database (using keywords «melatonin», «children», «epilepsy», «neuroprotection»): clinical trials, randomized controlled trials, systematic reviews, clinical cases from 1997 to 2024. The article reviews the main clinical directions on the use of melatonin in pediatric practice: epilepsy, headaches, sleep disorders, sepsis, neuroprotection.

Results. Taking into account the experience of foreign colleagues, we consider that the use of melatonin as an adjunctive therapy in pediatrics is acceptable in the absence or insufficient effectiveness of other methods of treatment, in case of the insufficient theoretical and practical basis (because of the possibility of aggravation of symptoms). It should also be noted that the use of this hormone should be carried out under control of its concentration in blood plasma and dynamic monitoring by an endocrinologist. In this case, treatment can be started from 6 months, but preference is given to the age range from 7 years because of the gradual reduction of nocturnal concentration peaks. It should also be noted that the dosage should be increased gradually: 0.2 – 0.5 mg per week to 3 – 9 mg per day.

Conclusion. Melatonin plays a key role in modulation of various physiological processes of the organism and is successfully used in pediatric practice for treatment of epilepsy, primary headaches, sleep disorders, sepsis, as analgesic therapy during invasive manipulations, and as a neuroprotector. Melatonin is a promising therapy in a number of nosologies associated with sleep-wake cycle disorders. However, for justified and relevant prescription it is necessary to conduct complex multivectoral studies, including, in particular, daily monitoring of melatonin concentrations taking into account age and gender aspects.

The article provides an overview of foreign and domestic literature on the assessment of the burden of demographic aging in the epidemic process of community-acquired pneumonia. The mechanisms of immune aging, which leads to an increase in the susceptibility of elderly and senile people to pathogens of infectious diseases, are revealed. The results of studies of the etiological structure and the epidemic process of community-acquired pneumonia in the elderly and their effect on comorbid (polymorbid) conditions are summarized. The trends of increasing demographic aging have been identified, which determine the formation of a new epidemiological model of morbidity, disability and mortality patterns, which requires adequate measures from the healthcare system aimed at maintaining active longevity of the population. An effective and economically affordable means of achieving «Health for all» is immunoprophylaxis, which reduces mortality from infections, increases life expectancy and ensures active longevity. In order to reduce morbidity and mortality from community-acquired pneumonia and associated comorbid conditions, the need to develop a strategy for vaccinating elderly and senile people against pneumococcal infection within the framework of the National Calendar of Preventive vaccinations for epidemic indications has been determined and scientifically substantiated.

The article presents current literature data on the history of discovery, prevalence, clinical and histomorphological features of a rare lung pathology from a heterogeneous group of diseases characterized by vasculitis and the presence of sarcoid-like granulomas with the formation of conglomerates with necrotic changes. Difficulties in differential diagnosis and treatment of this disease are noted. Own observation is presented.

This study analyzes the dynamics of medical service exports at Grodno University Clinic during 2021–2024 following service improvements implemented based on a 2021 foreign patient trust assessment. The identified trust drivers physician professionalism, communication transparency, and service comfort informed targeted enhancements in patient information support systems. The research evaluates the long-term impact of these interventions through objective export performance metrics, including changes in service volumes and structure as effectiveness indicators.

The purpose of this publication is a systematic presentation of the areas of social rehabilitation of disabled people using the International Classification of Functioning, Disability, and Health (ICF).

The advantages of using the ICF are considered. The content of modern areas of social rehabilitation of disabled people is 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 FFSS.