Objective. To determine the possibility of clinical use of the method of treatment patients with postoperative ventral hernias (POVH) using hernioplastics with a polypropylene mesh with platelet rich plasma (PRP) applied to it.
Materials and methods. Under experimental conditions on 24 male rats (3 groups of 8 animals), morphological changes occurring in the tissues of the anterior abdominal wall of laboratory animals upon implantation of fragments of a polypropylene mesh
were studied. The clinical study included 28 patients with POVH with PRP-treated polypropylene mesh surgically implanted. The comparison group consisted of 37 patients with POVH, operated in 2013—2015 using the standard sublay technique.
Results. Application of PRP to the polypropylene mesh at a concentration of at least 1 million/μl in the experiment promotes active proliferation and activation of fibroblasts resulting in thickened fibrous capsule (599.20 μm) around the implanted material, which creates a fibrous framework 3.2 times thicker compared to the fibrous layer in the area of the implanted mesh without PRP treatment (187.55 μm). When using PRP-treated polypropylene mesh, the number of postoperative complications decreased from 10.8 to 7.1 % and the duration of treatment decreased by 22.4 %.
Conclusion. The obtained results of clinical use of PRP in plastic surgery of the anterior abdominal wall with a synthetic implant allow us to consider its practical use to improve the effectiveness of this type of surgical interventions justified.

Objective. To evaluate the possibilities of determining molecules of apoptosis and endothelial dysfunction in urine as indicators for screening chronic kidney diseases in children.
Materials and methods. 141 patients with chronic kidney diseases were examined. The comparison group included conditionally healthy children (n = 48) without signs of kidney damage and autoimmune process. Quantitative determination of granzyme B, cytokeratin-18, and intercellular adhesion molecule-1 (ICAM-1) was performed by enzyme immunoassay.
Results. The concentration of granzyme B in urine is 0.021 or higher, indicating that the patient has chronic kidney disease. The diagnostic accuracy of this test according to the ROC analysis was 87.0 % (95 % CI (69.0—100.0), sensitivity (Se) of the test was 90.5 %, specificity (Sp) was 93.0 %). The level of cytokeratin-18 in urine of 0.036 and higher also indicates the presence of chronic nephropathy (diagnostic accuracy — 94.9 % (95 % (CI 89.4—100.0), Se — 90.0 %, Sp — 91.3 %). In the case of the ICAM-1 test, the presence of chronic kidney disease can be indicated if the value of this marker in urine is less than 9.8 (diagnostic accuracy according to ROC analysis is 97.4 % (95 % (CI (93.3—100.0); Se — 90.0 %, Sp — 97.6 %). As a result of a comparative assessment of clinical usefulness, the use of a test with the determination of cytokeratin-18 and granzyme B in urine turned out to be the most promising.
Conclusion. When conducting a two-stage screening with sequential tests for the determination of granzyme B and cytokeratin-18 in urine in a population of children containing 0.275 % (1 in 364) of patients with chronic kidney disease, the probability of chronic nephropathy in a patient with a double positive test will be 26.94 %.

Objective. To analyze the spectrum and frequency of comorbid conditions in children with early anemia of prematurity depending on the gestational age.
Materials and methods. A retrospective cohort study was conducted of 110 premature newborns with early anemia of prematurity. The babies was divided depending on the gestational age at birth into 3 groups: group 1— up to 28 weeks of gestation (n = 16); group 2 — with a gestational age of 28—31 weeks (n = 63); group 3 — with a gestational age of 32—37 weeks (n = 31). We were analyzed the absolute majority of pathological conditions that preceded or accompanied the development of early anemia of prematurity in children. Statistical calculations were carried out in the R statistical package, version 4.3.
Results. In this cohort were not installed statistically significant difference in the timing of manifestation of early anemia of prematurity depending on the gestational age at birth. There is a statistically significant trend towards a decrease in the number of such serious diseases as retinopathy of prematurity and bronchopulmonary dysplasia, with increasing gestational age in premature infants with anemia. We was revealed a decrease in the incidence of congenital pneumonia and neonatal sepsis with increasing gestational age. At the same time, a statistically significant trend is recorded towards an increase in the frequency of an unspecified infection specific to the perinatal period with increasing gestational age.
Conclusion. The identified trends in the analysis of comorbid conditions in premature infants of different gestational ages with anemia are most likely associated with a defect in immune-endocrine regulation due to premature birth. The increased frequency of infection specific to the perinatal period in the group of newborns with late prematurity is due to a higher level of organism reactivity in children with a longer gestation period, which limits the process of generalization and severe course of the infection.

Objective. To evaluate the long-term effects of the developed comprehensive medical habilitation (MН) of premature infants with assessment of motor, static-locomotor and oculomotor disorders at the corrected age of 2 years.
Materials and methods. The study included 212 premature infants with a gestational age of 26-36 weeks. Two groups were formed: group 1 — patients who underwent MA in accordance with the main directions of the developed methodology in full (n = 89); group 2 — patients, who underwent MA in accordance with standard approaches (n = 123). A cohort prospective longitudinal comparative study was conducted using the purposive sampling method. Inclusion criteria: premature infants with a gestational age of less than 37 weeks, spontaneous breathing, parental consent to the developed MH. Exclusion criteria: congenital malformations, genetic metabolic diseases, artificial lung ventilation, aggressive retinopathy, lack of parental consent for MH.
Results. The use of complex multimodal medical habilitation with the beginning of implementation in the neonatal period (up to 44 weeks of PCA) in the remote period (corrected age of 2 years) showed that premature babies have a 9-fold reduction in the risk of developing cerebral palsy (RR = 0.11, 95 % CI (0.03—0.45); p_{Cochrane — Mantel — Haenszel} = 0.0002), 4.8 times the risk of spastic paresis (RR = 0.21, 95 % CI (0.06—0.68); p_{Cochrane — Mantel — Haenszel} = 0.006); 4.4 times the risk of developing static-locomotor disorders (RR = 0.23, 95 % CI (0.11—0.45); p_{Cochrane — Mantel — Haenszel} = 0.006) and 3 times the risk of developing oculomotor disorders (RR = 0.33, 95 % CI (0.15—0.73); p_{Cochrane — Mantel — Haenszel} = 0.0049).
Conclusion. Thus, the early application of the complex multimodal medical habilitation developed by us with the beginning in the neonatal period in the late period (corrected age 2 years) shows its effectiveness. 

Stroke is one of the leading causes of mortality and disability, making it a significant medical and social issue. Special attention is given to the restoration of upper limb motor function, which is one of the most complex aspects of rehabilitation. Early initiation and the use of individualized methods contribute to better outcomes. Among the well-known methods for restoring upper limb function are motor imagery training, mirror therapy, and constraint-induced movement therapy (CIMT). The market of robotic rehabilitation systems for upper limb recovery includes devices such as ArmeoSpring, MIT-MANUS, MIME-robot, and others. Despite significant advancements, the use of these technologies is hindered by their limited accessibility and the need for specialized medical staff training. This factor warrants further analysis and the search for alternative rehabilitation methods for post-stroke patients

This article examines the issues of the relevance of quality as the basis of the state policy of the republic, as well as the main goals, principles and approaches of the quality management system. A comparative analysis of the requirements of international and national standards in the field of development of quality management systems is presented, including the new standard ISO 7101:2023 “Management of healthcare organizations. Quality management systems in healthcare organizations. Requirements”, which is specialized for implementation in the healthcare system.

Objective. To evaluate the pharmacokinetic features of cefiderocol in a patient with sepsis.
Materials and methods. In this research, we studied the pharmacokinetics of cefiderocol in a patient who was admitted to an oncohematology hospital for the treatment of primary immunodeficiency — chronic granulomatous disease with a concomitant diagnosis of sepsis caused by Burkholderia cepacia. Cefiderocol was administered in three different doses: 3 times a day at 30, 45 and 60 mg/kg. The serum concentration of the antibiotic was determined by high-performance liquid chromatography — tandem mass spectrometry (HPLC-MS/MS) with subsequent construction of a pharmacokinetic curve and calculation of pharmacokinetic parameters.
Results. The studied B. cepacia strain showed a high level of resistance to standard antibiotics. The prescribed cefiderocol had a shortened half-life, which could probably be due to increased values of the glomerular filtration rate (GFR) and massive infusion therapy (3 l/m² /day). The obtained values of the area-under-the-time-versus-concentration curve (AUC) AUC = 362.1 mg^×h/l and Cmax = 117.1 mg/l were closest to the data given in the instructions (AUC = 394.7 mg^×h/l and Cmax = 138 mg/l) only in the case of the prescribed dose of 60 mg/kg 3 times a day. Moreover, in the case of prescribing this dose, a decrease in the time of serum concentration below four times the minimum inhibitory concentration (MIC) (fT < 4 × MIC) was observed — 17.4 %, against 39.9 % and 40.2 % at a dose of 30 mg/kg and 45 mg/kg and an increase in the time of serum concentration above (fT > 10 × MIC) — 50.2 %, against 11.4 % and 13.4 %.
Conclusion. The use of HPLC-MS/MS to determine the serum concentration of cefiderocol is an effective approach to therapeutic drug monitoring of cefiderocol. Its use can be a useful tool for selecting an effective and safe dose, which allows for timely dose adjustments, especially for critically ill patients.

Ultrasound examination of bone injuries has recently become increasingly important. This is especially important in treatment of pediatric patients with injuries, because of peculiarity of) the physiology of a growing organism, the effect of ionizing radiation in X-ray diagnostics, can lead to undesirable health consequences. The purpose of our study is to describe the practical aspects of ultrasound examination of fracture forearm bones in children with fractures, as well as ultrasound control during closed manual reduction of fractures with displacement of fragments. We provide practical advice on probe placement, as well as features of assessing the ultrasound image of bone in health and with injuries, depending on the type of fracture and displacement of bone fragments.