Objective. To evaluate the long-term results of treatment of patients using surgical endoscopic method and classical

external accesses.

Materials and methods. Within the framework of the present study, the data of two groups of patients undergoing surgical treatment at the N. N. Aleksandrov NCC of Belarus were used and analysed. The first group, retrospective (70 patients), was treated using classical external accesses, both independently and as part of a combined or complex approach, in the period from 2009 to 2018. The second group, prospective (44 patients), underwent endoscopic endonasal surgical treatment from 2019 to 2022.

Results. The analysis of the long-term results of patients treated with endoscopic treatment (prospective group) and classical external access (retrospective group) showed their comparability. The overall one-year survival rate was

90.2 ± 4.6 % in the prospective group and 95.7 ± 2.4 % in the retrospective group, three-year survival rates were

69.0 ± 8.2 % and 74.3 ± 5.2 %, respectively (p = 0.892). The adjusted one-year survival rates were 97.4 ± 2.6 % and

98.5 ± 1.5 %, three-year survival rates were 76.8 ± 8.1 % and 80.6 ± 4.8 %, respectively (p = 0.939). Recurrence-free one- year survival was 90.2 ± 4.7 % in the prospective group and 81.0 ± 4.7 % in the retrospective group, three-year survival was 73.6 ± 7.2 % and 62.8 ± 5.9 %, respectively (p = 0.608).

Conclusion. Taking into account comparable oncological indicators of both groups, it should be noted that the application of the developed method of endoscopic endonasal surgical treatment of patients with malignant tumours of paranasal sinuses and nasal cavity is reasonable. This method allows to avoid disfiguring facial incisions, damage of the upper alveolar nerve and soft tissues depression of the cheek, which occur when removing the anterior wall of the maxillary sinus. The use of video endoscopic equipment with optics of different angles makes it possible to perform a more precise removal of the tumour under visual control in the pterygopalatina and infratemporalis fossae, the projection of the sinus sphenoidalis, the lamina cribrosa and other parts of the skull base. This significantly improves the functional and aesthetic result of surgical treatment without reducing its radicality.

Long-term risk factors for suicide (mental disorders, social factors, suicide attempt) have been fairly well studied, but they are poor short-term predictors of suicide.

Materials and methods. Аnalyzed the socio-psychological, hormonal and biochemical data of individuals who attempted suicide, as well as the frequency of occurrence of genotypes and alleles of 9 genes more or less associated with the risk of suicide. The study was conducted during 2016—2022. The obtained data were processed using classical methods of mathematical statistics and machine learning methods, carrier vector algorithms (SVC ROC) were used; random forest method (RandonForest ROC); nearest neighbor method (KNeighborsClassifier ROC) regression analysis (LogisticRegression ROC). Results. The study made it possible to distinguish between short-term and long-term risk factors for suicide. Short-term risk factors include the presence of depression, being raised in a single-parent family, the presence of character traits: “hyperthymia” and “demonstrativeness,” as well as low levels of serotonin and norepinephrine in the peripheral blood. For long-term risk factors, the presence of frequent punishment in childhood, lack of higher education, phlegmatic type of temperament, accentuation of the character trait “demonstrativeness”, as well as polymorphism of the 5HTT gene. The resulting models had good predictive value (0.91 for short-term factors; 0.95 for long-term factors).

Conclusion. A distinction should be made between short-term and long-term risk factors for suicide. When taking into account short-term risk factors, socio-psychological and hormonal-biochemical risk factors should be taken into account. When taking into account long-term risk factors, molecular genetic and socio-psychological risk factors.

The purpose of the study is to develop a conceptual framework for monitoring external evaluation for medical universities, which can be considered as a necessary additional indicator to the accreditation indicators of the education system. The article reveals the concept of external evaluation monitoring by employers and consumers (patients), its goals and objectives, organization principles. The object, subject and subjects of monitoring are defined. Its functions are described, as well as a scheme for creating a monitoring system. Three levels of consumers of monitoring information are distinguished. The concept of technological support for monitoring and the criteria for its effectiveness are disclosed.

The article presents the results of the introduction of a sociological method in a number of healthcare organizations in the Grodno region to study the satisfaction of foreign consumers of medical care with received medical services, as well as an assessment of the ease of navigation in healthcare organizations and preferred sources of information for marketing the export of medical services.

Objective. Identification of the etiology and pathogenesis of acute purulent-necrotic destruction of the lungs (APDL).

Materials and methods. The results of examination and treatment of 780 patients with OGDL who were in two pulmonary surgery departments over 12 years were studied. Clinical forms and course options were determined by clinical and radiological studies. In 34 patients, the test material was taken during puncture of abscesses through the chest wall in the phase of their formation, and the pathogen was identified by a quantitative method and by cultivating bacteria in an Oxoid anaerostat.

Results. Among the patients observed with APDL, limited purulent destruction was diagnosed in 69.2 %, widespread purulent destruction — in 18.1 %, limited gangrene — in 10.6 %, widespread gangrene — in 2.1 %. With bacteriological examination of sputum, it is impossible to obtain reliable information about the pathogen. In all 34 patients, non-spore-forming anaerobes were found in the purulent contents taken directly from the abscess in the phase of its formation in quantities of 2×107—7×109 per 1 ml. Aerobic bacteria (pneumococci) were detected in 8 out of 34 patients in unreliably small diagnostic quantities. The information obtained about anaerobic etiology provided the basis for clarifying the pathogenesis of APDL.

Conclusion. The ratio of different clinical forms of APDL was determined. Pathogenetic factors have been identified, according to which variants of the clinical course for each clinical form have been identified. It has been established that APDLs arise under the influence of non-spore-forming anaerobes. The mechanism of interdependence of etiological and pathogenetic factors in the development of acute nonspecific inflammatory processes in the lungs has been clarified.

Objective. Detection of voluminous formation of soft tissues in the right axillary region in a patient with an aggravated hereditary anamnesis (having a mother diagnosed with breast cancer).

Materials and methods. The authors present their own observation of a rare pathology detected with the help of instrumental methods of research. The current literature data on the prevalence, peculiarities of clinical and histomorphological manifestations of myxoid neurofibroma are presented.

Results. Instrumental research methods have established the exact localization of the tumor, its topographic location in relation to the surrounding tissues, which made it possible to perform surgical removal of the lump in full. However, the final diagnosis: myxoid neurofibroma is based on the results of histological examination.

Conclusion. Differential diagnosis of myxoid neurofibroma using instrumental research methods has limitations. The exact diagnosis is based on the data of histological verification of the tumor and molecular genetic testing.

A clinical and statistical analysis of orbital injuries showed that among the patients who admitted, 97.8 % were of working age. The main mechanism of damage to the orbit was contusion with a blunt solid object — 93.2 %. In the early stages after injury, 35 % of patients admitted for specialized medical care, 65 % of patients admitted in the delayed and late periods, the reason for the appeal was the presence of persistent functional disorders and aesthetic defects. The introduction of the developed technology of surgical treatment of patients with traumatic defects and orbital deformities contributed to an increase in the number of patients seeking specialized care from 29.2 ± 4.2 cases per year to 105.7 ± 12.5 cases per year, an increase in the number of reconstructive operations on the orbit in medical institutions of the Republic of Belarus from 5.0 ± 1.4 per year to 29.7 ± 5.9 per year.

Fracture of the bones in the area of the lower wall of the orbit, the most common injury of the orbit, which leads to a hernia of the orbital tissue, enophthalmos, hypophthalmos and other functional disorders of the orbital organ complex. Combined (inferomedial) and combined (damage to the orbit, bones of the facial, cerebral parts of the skull) fractures lead to pronounced changes in the anatomical and topographic relationships of the orbit. The severity of enophthalmos and hypophthalmos depends on the type of orbital fracture, and the durability of its preservation on the timing of patients seeking specialized medical care, and in the postoperative period on the type of implant used. The use of an individual implant eliminated enophthalmos in all (100 %) patients with isolated and combined fractures, as well as in 81 % of patients in the group with combined damage to the orbital wall due to the corretion of the posteromedial part of the inferior wall of the orbit, which is impossible to achieve using standart implants also contributed to the elimination of hypophthalmos in all patients with isolated and combined fractures and in 95 % of patients in the main group with combined damage to the orbit.

The purpose of this publication is a systematic presentation of the theoretical and methodological aspects of the preventive focus of protecting public health. The content of the concepts “disease prevention” and “preventive orientation of public health protection” is considered. The characteristics of the types of prevention are given. The levels, main stages and technologies of preventive measures are disclosed and described.

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

The article describes some features of the medical history of A. Chekhov. Strange as it may seem, doctors are more likely than others to fall into two possible extremes. They either overestimate their painful sensations and symptoms, attributing to themselves all the most unfavorable things that they know from books or practice about their disease, or, on the contrary, underestimate what they have, brushing aside the most convincing symptoms, trying to justify their attitude with medical arguments and considerations. Both were the case with the patient A. Chekhov, who had been suffering from pulmonary tuberculosis for 20 (!) years. And not only did he suffer, but first of all, he lived intensely creatively and worked fruitfully, becoming a great Russian writer.