The pathology of extracranial arteries takes a significant place in the structure of diseases, causing insufficiency of cerebral blood circulation. This article describes the effect of carotid arteries tortuosity on cerebral blood circulation, options of the course of vascular insufficiency and its clinical implications, the role of tool research methods in the diagnosis of this pathology and definition of the indications for surgery. Also, the article throws light upon the possible ways of expeditious treatment and possible complications in the postoperative period.

The stage-to-stage care after an AF patient can adequately assess the severity of the patient`s state, to assess the possible risk of cardioembolic stroke, to restore sinus rhythm or to obtain control of ventricular rate in the permanent form of persistent AF. Warfarin under the control of INR (2.0-3.0) is a drug to prevent cardiovascular stroke according to the scales CHADS2 and CHA2DS2-VASc in AF treatment.

Virchow-Roben spaces (EPVS) are canals that surround intracerebral blood vessels. They are formed at the early stages of embryogenesis due to ingrowth into the nervous tissue of blood vessels that draw in the vascular folium of soft brain tunic. In the present scientific articles there are a lot of contradictions about localization of these spaces around capillaries, venules and veins, about their histological structure in the different areas of central nervous system. EPVSs are known to play a big role in the circulation of cerebral spinal fluid, in immune regulation, and are a compound part of the hematologic encephalitic barrier, which become wider in various pathologic processes. The study of the localization and structure of these spaces with the use of up-to-date methods of research will help to understand their function and clinical significance.

The review of literature analyzes the publications which cover the peculiar features of the schoolchildren’s lifestyle in Gomel and studies the incidence rate of the main classes of diseases among them.

The article deals with application of active forms and methods of self-study of junior medical students. The development of new forms of students’ teaching was introduced for studying of general chemistry in order to improve the methods of teaching of natural scientific subjects at a medical university.

The article describes the clinical features, diagnosis, treatment and chemoprophylaxis of tuberculosis in HIV-infected patients. The knowledge of the clinical peculiar features of tuberculosis depending on a stage of HIV infection will help various medical specialists to diagnose timely this pathology and direct patients to specialized medical institutions.

Purpose: define diagnostic significance of nucleo-cytoplasmic ratio value at histological evaluating iliolumbar dystrophic changes intensity. Materials and methods. Iliolumbar ligaments (n = 36) from 18 corpses (at the age from 25 till 83 years): 11 men (middle age 61,8 ± 9,7 years) and 7 women (middle age 66,7 ± 9,1 years). Results: There were defined moderate correlation between nucleo-cytoplasmic ratio value and results of evaluation by Bonar scale (r = 0,66; р = 0,0028) in mixed group. And besides the correlation coefficient in group of women were higher (r = -0,88; p = 0,009). Conclusion. It was concluded that it is possible to use nucleo-cytoplasmic ratio value for approximate evaluating iliolumbar dystrophic changes intensity.

Pain syndrome is one of the main clinical manifestations of degenerative disease of the lumbar spine. The severity of pain depends on the degree of compression of spinal roots of the intervertebral disc herniation, osteophytes or hypertrophied yellow ligament. The article presents the comparison of the evaluation results of radicular pain when using different scales of pain.

Objective: to compare the long-term results of operations on the nasal septum in different conditions of anesthesia. Materials and мethods. 155 people were interviewed, of them, 102 were operated under local anesthesia (LA group), 53 patients were operated under general anesthesia (group GA). The patients were divided into two groups - with a satisfactory and unsatisfactory level of anasthesia. We used the nonparametric Mann-Whitney test to compare the groups. Results. After surgery under regional anesthesia, 62 % patients reported the presence of pain, 35 % patients expressed a wish to get such surgery under general anesthesia in future. The patients from the LA and GA groups, satisfied with anesthesia, showed no significant differences in the assessment of the surgery results ( p = 0.80). The patients with worse conditions of the operation assessed the results of the surgery as worse compared with the patients who had had the painless surgery: for the LA group (3.4 ± 0.7 and 4.2 ± 0.7, respectively, p < 0.001) for the group GA (3.8 ± 0.8 and 4.2 ± 0.7, respectively, p < 0.045). Conclusion. ENT operations under general anesthesia were substantiated in the patients with low tolerance of acute pain.

Objective: to study the levels of depression, quality of life, personal and reactive anxiety in patients with chronic heart failure with hypertension and coronary heart disease. Material and methods. We examined 105 patients with coronary artery disease and hypertension with the manifestation of I-IV heart failure of functional classes according to the classification of the New York Heart Association. The level of depression was determined by the Beck Depression Inventory, the level of life quality was studied using the NAIF questionnaire (New Assessment and Information form to Measure Quality of life by P. Y. Hugenholtz and R. A. Erdman, 1995), personal and reactive anxiety was evaluated using Spielberg Hanina scale. The statistical analysis was performed using nonparametric tests: T-criteria of Mann-Whitney test, Spearman's rank correlation method, the data were processed with the program «Statistica», 6.0. Results. 39 patients (37.2 %) observed no depressive symptoms, 66 patients (62.8 %) detected depression of various degrees. 25 patients (41 %) observed mild depression, 26 (34.5 %) - moderate, 11 (18 %) - expressed, 4 people (6.5 %) - severe. Patients who had hypertension II-III and angina of the functional classes II and III more often suffered from depression, as well as patients with a combination of coronary heart disease and hypertension. The integral component of life quality was significantly reduced in patients with CHF FC I (73.8 ± 3.5 %), moderately reduced in patients with class II (62 ± 3.6%), significantly reduced in patients with FC III (44.2 ± 3.8%) and dramatically reduced in patients with IV FC (23.4 ± 3.8%). According to the nosological reasons, the integral indicator of life quality was lower in the patients who suffered hypertension II-III, angina FC II-III, as well as in those with a combination of hypertension and coronary heart disease. The level of reactive anxiety in all the groups of the patients did not exceed 45 points, that is, remained moderate and the reactive anxiety FC did not depend on chronic heart failure, angina and severity of arterial hypertension. At the same time we noticed a high rate of personal anxiety in the patients with FC II and CHF III in the patients with angina FC II-III, hypertension II-III and combination of angina and hypertension. Conclusion. 62.8 % patients with chronic heart failure revealed depressive disorders; cognitive-affective symptoms were prevalent in the patients with classes I and II of heart failure, somatic manifestations of depression - in the patients with FC III and IV of heart failure. Depressive disorders were associated with female sex (68 % women and 32 % men), age over 50 and the severity of somatic illness. The level of life quality decreases with increasing severity of CHF FC and somatic illness. The level of reactive anxiety in all the groups of the patients with chronic heart failure is moderate, the level of personal anxiety is high and is associated with the severity of heart failure and somatic illness, possibly because of the individual characteristics of a person and the influence of their medical condition.

The use of the modern classification of myelodysplastic syndrome makes it possible to standardize the approaches to diagnosis and treatment of patients with this pathology. An approach to MDS treatment should be individualized and based on the definition of risk groups, age and somatic status. Among treatment strategies, epigenetic therapy with decitabine is given advantage in terms of quality of life. The decitabine therapy is clinically effective, demonstrating a high level of response to therapy in patients with myelodysplastic syndrome.

The article presents the clinical analysis of 181 patients with depressive and anxiety disorders associated with pathologic bodily sensations under consultative supervision. It covers the structure of sensopathy, its pathogenetic features, singles out the phenomelogical variants for diagnostical optimization. The conceptual notion about the vital nature of pathologic bodily sensations and its relation to somatopsychic disorders is being specified.

We have performed the retrospective comparison of the parameters of physical development (circumference of head and chest, body weight and length), dynamics of laboratory tests, death rate in 103 HIV-positive and 77 HIV-exposed children. The majority of the studied parameters were within the normal range. The differences between the groups revealed in the follow up might be used for HIV status prognosis.

The quality of lighting in surgery is the main factor of operative success. The prospects of the application of diod lightning devices in the surgery of lumbar spine dystrophic lesions were developed and analyzed.

Objective : to study the bone mineral density in patients with diabetes type 2. Material and methods . The study included patients with diabetes type 2 aged over 45. The duration of the disease, type of the therapy and anthropometric measures were taken into account. The laboratory investigation included determination of the level of glycated hemoglobin using the biochemical analyzer «Architect c8000». The bone mineral density in the lumbar spine and proximal femur was measured by dual energy absorptiometry with the «PRODIGY LUNAR». Results. 30 per cent of the patients with diabetes type 2 in the studied group recorded reduced BMD indices, of them 22 % patients diagnosed osteopenic syndrome and 8 % - osteoporosis. The densitometry parameters of the lumbar spine in the patients receiving insulin therapy were significantly lower (p < 0.05) than in the patients taking oral hypoglycemic drugs. The bone mineral density indices in the studied areas were not significantly different in the groups of the patients with different levels of glycated hemoglobin. It was found that the T-score of the lumbar spine in the patients with diabetes 2 with longer duration of the illness was significantly lower than in the comparison group. Conclusion. The patients with long-term (over 12 years) duration of diabetes type 2 showed statistically significant (p = 0.039) lower values of T-score of the lumbar spine (-0.28, 95 % CI -1.04, -0.48) than the group of the patients with diabetes experience less than 12 years (0.29, 95 % CI -0.29, -0.87) with no significant differences in the age and anthropometric values.

Purpose: to assess left ventricular filling pressure (LVFP) in patients with aortic stenosis (AS) and ischemic heart disease (IHD) using methods of tissue Doppler imaging (figure E/Em) and impedance plethysmography (IP). Materials and methods . The study included three groups of patients: 40 with AS, 40 with IHD (constrictive coronarosclerosis) and 10 healthy people. In addition to the standard protocol echocardiography all the patients were examined using two survey methods for assessment of LVFP: tissue Doppler and IP. The statistical analysis of the material was performed using «Statistica», 6.0 for Windows. Results . The group with the AS was characterized by concentric hypertrophy of the left ventricular. The group with IHD was characterized by the mixed type of hypertrophy of the left ventricular and less significant growth of LVFP. Conclusion . In the AS group, the LVFP growth was determined according to the data of the two methods. In the IHD group, the LVFP growth was defined only by IP method which differentiates the two methods. The groups revealed the relation of LVFP (E/Em) with preload and the relation of LVFP (IP) with preload, afterload and left ventricular hypertrophy.

Objective: to study the features of lipid spectrum of blood serum in patients with hypothyroidysm and thyrotoxicosis depending on age, degree of compensation, duration of the illness and body mass index (BMI). Materials and methods . 70 patients with thyroid dysfunctions with various degree of compensation were included in the study. They were divided into 3 groups: the first group with primary subcompensated and decompensated hypothyroidysm; the second group with primary subcompensated and decompensated thyrotoxicosis, and the third group as a comparison group included patients in the state of medicamental compensation. The laboratory research was aimed at the definition of the indices of cholesterol (chol), triglycerides (TG), high density lipoproteins (HDLP), low density lipoproteins (LDLP), very low density lipoproteins (VLDLP) and quotient aterogenesity (QA) on the biochemical machine «Architect с8000» (ABBOOT, USA). Results. The analysis of the lipid spectrum depending on age in patients under 40 and over 50 revealed higher indices of chol and TG in the first group, than in the third one. The patients of the second group under 49 and over 60 had the same indices lower than in the patients of the third group. The patients of the first group who were in the state of decompensation observed the maximum indices of chol, TG, LDLP, VLDLP and QA. The patients of the second group in the state of decompensation had minimum deflection of the same indices of lipid spectrum. The patients of the first group observed increased indices of chol and TG in augmentation of the illness experience and the patients of the second group had the same indices decreased. The comparison of the data revealed minimum chol indices in the patients of the second group, and maximum TG indices in the first group in normal, boundary and increased BMI. Conclusion. The state of lipid spectrum in the patients with thyroid dysfunctions depended on the age of the patients, the experience of the illness, and BMI and compensation degree of thyroid functions which was confirmed by authentic correlation communications between the indices of free thyroxin and chol, TG and LDLP, and also between the thyroid stimulated hormone level and chol, TG, QA, LDLP and VLDLP indices.

Objective: analysis of the state of vessels of myocardium microcircular channel of rats, exposed to hypokinesia, incorporation of¹³⁷Сs radionuclides. Material and methods. Myocardium of pedigreeless white rats was studied by means of histologic, electro-microscopic and dosimetric methods of analysis. Results. The study revealed considerable structural functional changes at tissue, cellular and subcellular levels in the vessels of the microcircular channel of the rats` myocardium. Conclusion. The degree of the appearing disorders depends on the type and duration of stress impact. The structural change of the vessels of the microcircular channel are mostly evident at the early stages of the experiment. Compensation mechanisms are realized in long-term hypokinesia, which partially stabilizes myocardium. The characteristic feature of radiation impact is dose-independent effect of the lesions. The processes of intercellular regeneration do not eliminate radioinduced subcellular disorders. The gradual decline in the functional potential of the vascular system of myocardium can serve as a precondition for development of heart pathology.

The present work showed negative effect of acute immobilization stress on the morphology of the rats` testis. The study was conducted in 22 sexually mature male albino rats (per 11 animals in the experimental and control groups). The rats of the experimental group were subjected to three-hour acute immobilization stress. The animals of the experimental group had degenerative changes in the epithelium of the seminiferous tubules until the development of focal necrosis. Also, the rats, exposed to stress, revealed a statistically significant reduction in the diameter of the seminiferous tubules and germinal layer thickness.

The article presents the results of the assessment of potential ability of metalworking fluids in experiments in vitro on various strains of Salmonella typhimurium , Escherichia coli by means of the test DNA of l phage. It was shown that the studied metalworking fluids did not display mutagen and genotoxic properties on the specified test objects.

Objective: to investigate the expression of marker genes by hepatocyte-like cells differentiated from mesenchymal stem cells (MSCs). Materials and methods. Wistar white rats, bone marrow MSCs, isolated hepatocytes of the rats were obtained by enzymatic perfusion of liver; differentiation of MSCs in hepatocyte direction; light microscopy; investigation of expression of genes by polymerase chain reaction (PCR). Results. The observed changes in the gene expression profile during the stages of differentiation indicate the presence of the cells differentiated into hepatocytic direction in MSCs culture. The expression of Carbox, Krt18, Krt19 Cyt1A1 genes depends on the composition of the medium and is not permanent and inducible in nature. It is important to go on searching for the molecular markers of MSCs differentiation in the hepatocytic direction. These results demonstrate the necessity to systematize the available data on the changes in the levels of gene expression during MSCs differentiation into hepatocytes to unify the conditions of assessment of the gene expression profiling.

Purpose: to study the characteristics of friction of wattled surgical threads made from traditional sutural material. Materials and methods . The friction of dry and wet threads was studied on the apparatus «ComTen 94C» by the original developed technique. We fixed a cylindrical mandrel with a diameter of 40 mm, wrapped up with a rag of suede skin 18 cm long between the captures in horizontal position. After fixing the end of the thread in a mobile capture of the test car we made one turn round the mandrel and suspended weight of 50 g to the second end of the thread. The speed of the mobile capture movements made up 100 mm/min. Results. The experimental tests revealed the best sample in the group - the surgical thread of Ethibond firm covered with polibutilate. The polymeric covering of the surgical threads «Supramid Ergon sutramed» makes it possible to achieve the optimum indicators of friction in the group of the threads made from caprone. The best sample among the surgical threads made from silk is a thread by Silkam B/Braun firm with a covering made from wax and silicone. Conclusion. The modification of surgical threads by drawing a covering makes it possible to achieve optimum indicators of friction, to improve the handling qualities and gives threads the quality of autraumatics.

Objective: to study the effect of long-term preliminary application of probiotics on the state of the rats` colon microflora in experimental chronic heart failure (CHF). Materials and methods. The experiments were performed on male rats (n = 38). CHF was modeled by double subcutaneous administration of isoprenaline hydrochloride (Sigma) at a dose of 80 mg/kg with 24-hour intervals. The composition of the intestinal microflora was determined on selective nutrient media with further incubation and subsequent evaluation of the results. Results. It has been found that the administration of drugs «Dialakt» and «Bifidumbacterin» decrease E.coli pool in normal conditions (p < 0.05) by 34.0 and 31.3 %, respectively. The CHF development leads to an increase of colibacillus titre by 46 % and decrease in the number of milk bacteria by 14.7 % and decrease of the antagonistic activity by 30 %. The prophylactic application of «Dialakt» and subsequent CHF modeling revealed that the number of E.coli was lower by 15.2% if to compare animals with CHF, the pool of Lactobacillus spp. was 28 % higher, and the pH value of the culture medium of bifidobacteria was lower than 4.5. The application of «Bifidumbacterin» leads to the same trend in the change of the analyzed parameters, which, however, does not reach the values of the background group. Conclusion. The preliminary use of «Dialakt» is conducive to maintain the balance of the intestinal microflora in chronic heart failure in rats and corresponds to the related indicators of the background group.

The Mediterranean diet is considered one of the healthiest diets. In Italy the progressive abandonment of this diet coincides with the increase in overweight and obesity. The authors through the KIDMED Index have identified a low adherence to the Mediterranean diet in 16 % of the students in a high school. The low adhesion is significantly related to lack of physical activity, low academic performance, low cultural and social level of their families. It follows, therefore, the need for cultural interventions to understand that the traditional Mediterranean diet should not be abandoned in favor of other nutritional patterns and even the need to promote the spread of eating habits in line with this diet if we want to maintain the high levels of health and longevity that distinguish the Italian population. The school and the family must support children in the development of responsible and proactive behavior in the field of nutrition.

Neonatal hyperbilirubinemia is one of the most common pathologic neonatal states. At present, there are no normative documents, regulating organization of rehabilitation activities for premature babies who had hyperbilirubinemia in the neonatal period in the Republic of Belarus. The follow-up for such children is realized depending on their pathology at the moment of admission to a children`s polyclinic. As a result of the carried out research, new clinical organization approaches have been developed for the follow-up on the premature babies at the out-patient stage of rendering medical aid.

The differences in understanding of the causes of the lack of time among healthy teachers and students and those with health problems have been established. The reasons for the lack of time can not be reduced only to the problems of the organization of activity, they may be based on a number of psychological problems that yet need to be identified and solved. The reasons for the lack of time in the healthy teachers and students and those with health problems, preserving the ability to work, reveal a decrease in the intensity of the motivational component of activity.

The article presents assessment of the dose of gonad irradiation accumulated in adult men and women after Chernobyl Disaster. It was established, that the doses of external irradiation of the gonads were approximately equal to the accumulated dose of external irradiation of body in whole, and the doses of internal irradiation were considerably lower in comparison with the accumulated dose of external irradiation of body in whole. The inclusion of the values of the accumulated doses of gonad irradiation into the data base of the National Register of people affected by radiation after Chernobyl Disaster considerably expands its informativity and makes it possible for scientific workers and physicians to make more substantiated conclusions about health state of population, residing in radioactively polluted territories. In general, the doses of the gonads are considerably lower than those that cause noticeable genetic effects.

The article describes 3 cases of negative perinatal outcomes due to intrauterine listeriosis, analyzes the literature data and gives recommendations for the diagnosis and treatment of listeriosis in pregnant women.

Couvelaire uterus is a rare complication of premature placental abruption. The article presents a brief literature review and describes a case of organ-preserving surgery in this complication. A pregnant patient in her thirty week was admitted to a maternity hospital with placental abruption and prenatally dead fetus. Cesarean section was performed and Couvelaire uterus was diagnosed during the operation. Taking into account the condition of the patient, her young age (20), absence of children, we performed organ-preserving surgery. The uterus was compressed with B-Lynch hemostatic suture. The patient was discharged from hospital on the eighth postoperative day without any complications. Menstrual function recovered after 3 months.

On the clinical case the article presents our first experience of the use of Ex-Press shunt in combination with hemostatic sponge in obstinate (resistant) glaucoma surgery, which requires a special approach to the choice of means and methods of treatment because of the low efficiency of conventional methods. The technology of the surgery distinguishes with its minimal invasiveness, absence of necessity in scleroticectomy or iridectomy, provides reliable and consistent normalization of intraocular pressure. Good conditions for the formation of a consistent filtering bleb are created in combination with the use of gelatinous hemostatic sponge, because the processes of formation of conjunctival and scleral as well as scleral adherences in the area of surgical interference are prevented. The use of a sponge reduces the possibility of haemorrhagic intraoperative and postoperative complications, and significantly reduces the period of post-operative ocular hypotony.

Objective: to assess the reproducibility of sonographic and histologic determination of the severity of dystrophic changes in iliolumbar ligament in different age periods. Materials and methods. Iliolumbar ligaments from 31 corpses (at the age from 25 till 90): of them, 20 men (middle age 60.2 ± 9.6) and 11 women (middle age 66 ± 9.4). Results. The criteria making it possible to differentiate moderate and expressed dystrophic changes have been sorted out and the reproducible technique has been defined. Conclusion. The proposed method of sonographic and histologic assessment of severity of the dystrophic changes of iliolumbar ligament has a good reproducibility and can be recommended to be used in practical work.