Objective. To develop a modified corneal crosslinking technique with personalized excimer laser photoablation and evaluate its effectiveness and safety.

Materials and methods. The study included 55 patients (64 eyes) with stage 1—3 keratoconus (Amsler — Krumeich classification) with confirmed progressive course. Depending on the type of surgical treatment performed, the patients were divided into 2 groups: Group 1 — 28 patients (31 eyes) who underwent corneal crosslinking with personalized excimer laser photoablation, according to our proposed technique, and Group 2 — 27 patients (33 eyes) who underwent corneal crosslinking according to the standard technique (the «Dresden Protocol»).

Results. The value of uncorrected visual acuity did not differ significantly between the groups throughout the entire observation period, and the best-corrected visual acuity was significantly higher from the first month in Group 1. The central corneal thickness was statistically greater in Group 1 starting from the 6th month after treatment, and the value of the minimum thickness did not differ significantly throughout the observation period. Maximum keratometry became significantly lower already from the 1st month after surgical treatment in Group 1, and remained so throughout the observation period. There were no postoperative complications in any group.

Conclusions. The proposed combined method of corneal crosslinking with excimer laser photoablation provides safe and effective treatment of keratoconus and has a stabilizing effect on the progressive nature of the disease. At the same time, due to the use of an excimer laser, the duration of corneal syndrome decreases, corneal irregularity decreases, and visual functions improve in the postoperative period, which leads to the fastest visual, professional and social rehabilitation of patients with keratoconus after corneal crosslinking.

Objective. To analyze markers that determine high residual platelet reactivity (HRPR) when taking acetylsalicylic acid (ASA) as part of dual antiplatelet therapy in patients with myocardial infarction (MI) during the scarring period.
Materials and methods. 405 patients with MI underwent the following studies: multielectrode aggregometry, blood test with platelet indices, enzyme-linked immunosorbent determination of soluble CD40 ligand, sP-selectin, von Willebrand factor and endothelin-1. All studies were performed on days 28—30 of MI. Based on the results of aggregometry, patients were divided into 3 groups: group 1 —14 people with low residual platelet reactivity to ASA; group 2 —288 people with optimal platelet reactivity; group 3 —103 people with HRPR to ASA.
Results. When conducting a univariate linear regression analysis, the following factors were identified that independently influenced the ASPI-test value: waist circumference (β = 0.18, 95 % CI (0.027—0.33); p = 0.02); erythrocyte sedimentation rate (β = 0.3, 95 % CI (0.11—0.49); p = 0.0016); leukocyte count (β = 2.1, 95 % CI (1.2—3.0); p = 0.000007); platelet count (β = 0.045, 95 % CI (0.019—0.07); p = 0.00062); thrombocrit (β = 43.0, 95 % CI (16.2—69.8); p = 0.0017); C-reactive protein (β = 0.23, 95 % CI (0.069—0.39); p = 0,0052); TRAP-test (β = 0.19, 95 % CI (0.13—0.26); p < 0.000001); endothelin-1 (β = 1.5, 95 % CI (0.59—2.43); p = 0.0014). To determine the probability of developing HRPR to ASA, a binary regression equation with a logit link function was constructed, which included the following indicators: body mass index (BMI), TRAP-test values, endothelin-1 level (sensitivity — 75.61 %, specificity — 75.73 %, classification accuracy — 75.69 % for this model). 

Conclusion. On days 28—30 of MI, 3.5 % of patients with an excessive response to ASA and 25.4 % with an insufficient response to ASA were identified. Markers of HRPR to ASA during the period of MI scarring are BMI, TRAP-test values, endothelin-1 level.

Objective. Assessment of the frequency of H. pylori infection in the period 2020—2023 in men of military age (18—26 years). Materials and methods. The frequency of contamination of the gastric mucosa with H. pylori in men aged 18—26 years with/without symptoms of dyspepsia in 2020—2023 (1006 people) was studied by morphological method. Of these, 760 were called up from urban areas, 246 from rural settlements; 607 patients had symptoms of dyspepsia, 399 did not.

Results. H. pylori infection in the period 2020—2023 in the group of male conscripts, regardless of the presence/absence of dyspepsia, the degree of contamination and localization in the stomach, macro- and microscopic changes in the upper gastrointestinal tract were detected in 488 (48.5 %; 95 % CI (45.4—51.6)) people. In military personnel drafted from urban settlements, the infection rate was (45.3 %; 95 % CI (41.8—48.8)) and was lower compared to rural (58.5 %; 95 % CI (52.3— 64.5)) — the differences were statistically significant (χ² = 13.11; p < 0.001). In individuals without symptoms of dyspepsia, the infection rate was 47.4 % (95 % CI (42.5—52.3)), in the presence of dyspepsia — 49.3 % (95 % CI (45.3—53.2)) without statistically significant differences (χ² = 0.34; p = 0.56).

Conclusion. In 2020—2023, the incidence of H. pylori infection in men aged 18—26 years (conscripts, n = 1006) with/ without dyspepsia was 48.5 % (95 % CI (45.4—51.6)). In military personnel drafted from rural settlements (n = 246; 58.5 %; 95 % CI (52.3—64.5)), the incidence of H. pylori infection was higher compared with those drafted from cities (n = 760; 45.3 %; 95 % CI (41.8—48.8); χ² = 13.11; p < 0.001), in including in the presence (57.6 %; 95 % CI (49.5—65.4) vs. 46.7 %; 95 % CI (42.2—51.2); χ² = 5.31; p < 0.02) and in the absence of dyspepsia (59.8 %; 95 % CI (50.1—68.8) vs. 43.1 %; 95 % CI (37.6—48.8); χ² = 8.5; p = 0.004).

This article discusses the results of medical accreditation of state healthcare organizations. An analytical review of the results of the administrative procedure and the work of the commissions is presented. The main inconsistencies identified in state healthcare organizations are presented based on the results of the administrative procedure and a list of measures aimed at eliminating them.

Objective. To detect the presence of pseudoaneurysm of the gastroduodenal artery (GDA) and to demonstrate the capabilities of modern interventional endovascular surgery, which in most cases allows to correct the situation with the greatest benefit for the patient.

Materials and methods. The article presents our own observation of a rare pathology detected with modern instrumental diagnostic methods. Literature data on the prevalence, localization in the human body, features of the clinical picture, tactics of management of pseudoaneurysms in general and of GDA in particular are provided.

Results. Using CT angiography, the exact localization of pseudoaneurysm was established and IES-embolization of GDA was performed, which made it possible to achieve the desired clinical effect.

Conclusion. Pseudoaneurysm of GDA can manifest not only with bleeding, but also with severe mechanical jaundice. Modern endovascular technology in most cases allows to correct the pathology with the most positive effect for the patient.

Objective. To evaluate the feasibility and effectiveness of using telemedicine technologies for the timely diagnosis of thyroid nodules in patients with autoimmune thyroiditis.

Materials and methods. An ultrasound examination of the thyroid gland was performed on a patient using real-time telemedicine consultations.

Results. A thyroid nodule classified as TIRADS 4 was confirmed, and a fine-needle aspiration biopsy was recommended.

Conclusion. Telemedicine technologies improve diagnostic accuracy and enable timely adjustments to examination strategies.

The aim of this publication is to present systemically the socio-medical aspects of palliative care to the population as a contemporary area of public health. The content of the concepts of «palliative care» was considered. Characteristics of private sections of palliative care are given. Basic palliative measures are disclosed and described.

The article uses materials from the media library named after M.E. Tikotsky 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.