The article presents scientific data of overseas and national researchers engaged in the study of cerebral circulation disorders. Growing incidence rate of the disease and severity of outcomes indicate that currently this pathology is not only a medical and social, but also an economic problem.

The article describes pathogenetic factors of metabolic syndrome and skin diseases that are most often associated with it, gives data on treatment of metabolic syndrome.

Objective: to assess the etiological structure of bacteremia in various pathological conditions. Material and methods. To check blood sterility, we analyzed results of 4548 blood tests of patients with lower respiratory tract infections, urinary tract infections, endocarditis, burns, cancer, fever of unknown etiology, sepsis. Cultural blood analysis was performed by means of the traditional bacteriological method or using an automated hemocultivator. Results. We isolated 477 clinically significant blood cultures. Gram-positive microorganisms prevailed over gram-negative in terms of the isolation rate, and fungemia was observed considerably most rarely (4.4%). Microbial inoculation found by the automated method was 1.5 times as high as that found by the traditional two-phase medium (14.7 and 9.5%, respectively). The etiological structure of microorganisms isolated as blood cultures in various nosological forms was assessed. Conclusion. We have revealed the prevalence of coagulase-negative staphylococci in patients with fever of unknown etiology (53.7 %), lower respiratory tract infections (39.5 %), endocarditis (31.4 %), burns (30.5 %) compared to other nosological forms. Enterobacteria were isolated with higher frequency in bacteremia in patients with malignant tumors (30.0 %) and urinary system infections (29.4 %), and gram-negative non-fermenting bacteria - with the highest specific weight in the isolated hemoculture associated with burn disease (31.6 %) and urinary system infections (29.4 %), enterococci - with greater frequency in bacteremia in patients with endocarditis (23.5 %).

Objective. To determine the size of the area under the back long sacroiliac ligament that is critical for occurrence of the lower back pain syndrome. Material and methods. The area under the posterior long sacroiliac ligament was determined in 50 patients without clinical manifestations of the lower back pain syndrome (the age range was 18-58 years). Results. It has been found that the area under the posterior long sacroiliac ligament in patients without the lower back pain syndrome corresponded to a level of 0.89 or more (0.68; 1.0) cm², in patients with palpable pain - 0.62 (0.5; 0,7) cm², p < 0.0034. Conclusion. The risk of occurrence of the lower back pain syndrome will be the highest when the area under the posterior long sacroiliac ligament is less than 0.6 cm².

Objective: to identify microorganisms present in the biopsy material of the endometrium using the method of 16s rRNA gene fragment sequencing. Material and methods . Using the method of 16s rRNA gene fragment sequencing, we identified the microorganisms present in the endometrial biopsy material in 56 patients. Additionally, identification of mixed bacterial cultures obtained during subculturing of the endometrial biopsy material was carried out. Results. The sequencing method was used to determine the type of microorganisms in mixed cell culture in 18 (32.1 %) patients and in the endometrial tissue in 30 (53.6 %) patients. The predominant microorganisms in the biopsy material of the endometrium are Lactobacillus spp. , detected in 10 (33.3 %) patients and Staphylococcus spp. , revealed in 9 (30 %) patients. Based on the immunohistochemical examination, chronic endometritis was diagnosed in 26 (86.7 %) patients with positive sequencing results in the endometrial tissue. Gr+cocci dominate in patients with chronic endometritis (c² = 3.98; p = 0.05), Lactobacilli - in patients without chronic endometritis (c² = 6.35; p =0.01). The species composition of microorganisms in the cervical canal and endometrium were not identical in 17 (56.7%) cases. Conclusion. Determination of the type of microorganisms by means of the method of 16s rRNA gene fragment sequencing in the endometrial tissue is a highly informative diagnostic method and it is expedient to use it to detect inflammatory diseases of the endometrium in cases of reproductive malfunction.

Objective. To evaluate the role of obstructive sleep apnea-hypopnea syndrome (OSAHS) in stratification of the cardiovascular risk (CVR) by the PROCAM scale in patients with non-valvular atrial fibrillation (AF) associated with ischemic heart disease (IHD) and/or arterial hypertension (AH). Material and methods. 158 patients aged 55.8 ± 8.01 (69.62 % males) with non-valvular AF associated with IHD and/or AH were included into the study. Based on the results of clinical and instrumental data, the study subjects were divided into 4 groups according to presence of OSAHS and the degree of its severity. The total CVR score was calculated by the PROCAM scale in all the patients. Results. In the study subpopulation of the patients with non-valvular AF associated with IHD and/or AH, the frequency rate of OSAHS was 72.78 %. The higher total PROCAM number was more characteristic for the second group of the patients compared to those of the first group (47 (39; 53) vs. 39 (33; 50) respectively; p < 0.01). Occurrence of AH, IHD, chronic heart failure (CHF), diabetes mellitus (DM) and dyslipidemia was higher in moderate and severe OSAHS patients than in non-OSAHS patients (p < 0.01). The strongest positive correlation links were found between the risk values by the PROCAM scale and indices of the apnea/hypopnea and hypoxemia parameters in the patients of the sample group (r = 0.341 and r = 0.289 respectively; р < 0.01). Conclusion. High prevalence of OSAHS in patients with non-valvular AF associated with IHD and/or AH has been revealed. The presence of OSAHS itself and growing severity of the course of this syndrome lead to higher CVR by the evaluation PROCAM scale in patients with non-valvular AF associated with IHD and/or AH. The performed study has confirmed the necessity to introduce the methods of OSAHS verification into practice in AF patients for the purpose of more accurate diagnosis of the present risk and prognosis in patients under examination.

Objective: to define interrelation of alexithymia and affective and personal properties in persons dependent on alcohol. Material and methods. 41 patients with alcohol dependence syndrome were under observation. The method of complex medical rehabilitation was applied during work with patients with alcohol dependence syndrome and disturbance of mood. The following techniques were used: the Toronto Alexithymia Scale (TAS-20); the Hospital scale of anxiety and a depression (HADS); the Beck Hopelessness Scale; the Existence Scale by A. Längle; the Level of Subjective Control (LSC); the Scale of diagnostics of frustration of a bipolar range (BSDS). Results. Alexithymia in patients with alcohol dependence syndrome is directly interconnected with anxiety as per the Difficulties in Emotion Regulation Scale, with the Beck Hopelessness Scale (R = 0.55; p = 0.02), which shows growing self-dissociation in alcohol dependent persons, reveals interrelations of all the alexithymia scales with the subscales of the Existence Scale technique, indicates a direct link of the Beck Hopelessness Scale with the subscales of the Difficulties in Emotion Regulation Scale (R = 0.56; p = 0.022) and “externally focused thinking” (R = 0.57; p = 0.02). Thus, expressed negative attitude of dependent persons to their own future is directly connected with inability to identify their own feelings. Conclusion. Alcohol dependent persons reveal a high rate of alexithymia, which has interrelations with anxiety, depression, existential sensibleness, level of subjective control. Application of complex medical rehabilitation is effective in respect of decreasing the alexithymia rate and affective disorders, increasing consciousness and self-expression of feelings in persons dependent on alcohol.

Objective : to reveal distinctive features of the structure of the mucosal folds of each part of the duodenum in newborns and adults. Material and methods . We have performed a comparative anatomic and morphometric study of the folds of the duodenal mucosa of 40 newborns and 93 adults aged 31-75. Results . We have obtained new data on general signs and distinctive features of the structure of the folds of the duodenal mucosa in newborns and adults. Conclusion . Complicated relief of the mucous membrane in each part of the duodenum expressed in changes of qualitative and quantitative characteristics of its folds should be considered as a morphological manifestation of adaptation to the type of food having changed in the conditions of extrauterine life. General signs of the macroscopical structure of the folds of the duodenal mucosa of newborns and adults are reflexion of the general plan of the structure of the relief of the human duodenal mucosa.

Objective: to study the effect of alcohol on formation of a hostile position in patients suffering from schizophrenia. Material and methods. A comparative, cross-sectional, one-stage study of persons suffering from schizophrenia up to 5 years over 2015-2017 has been performed. The following evaluation methods were used: hostile attributive style - the AIHQ scale (D. R. Combs et аl., 2007), screening for alcohol use - the ASSIST scale (R. Humeniuk et al., 2008), severity of psychopathological symptoms - the PANSS scale (S. Kay, L. Opler, 1986). Results. The group with a low «risk level» of problematic alcohol use revealed the lowest indices by the PANSS «Paranoid Militancy» and «PANSS-Hostility» subscales. The comparison of psychometric parameters by the AIHQ Scale among persons suffering from schizophrenia has revealed that an increase in the amount and frequency of alcohol consumption leads to an increase of indices of anger and accusations in deliberate situations. Conclusion. The obtained data make it possible to assume presence of the modifying effect of quantitative parameters of alcohol use on formation of a hostile position in persons suffering from schizophrenia.

Objective : to study antibacterial properties of Hypogymnia physodes extract and its combinations with antibiotics against vancomycin-sensitive and vancomycin-resistant strains of enterococci. Material and methods. Minimum inhibitory concentrations (MICs) of the acetone extract of H. physodes for reference and clinical isolates of Enterococcus faecalis were determined by the serial broth dilution method. Evaluation of efficiency of the combined effect of the H. physodes extract in combination with antibiotics was carried out using the modified disc-diffusion method and «chessboard» method. Results. We have revealed marked antibacterial activity (MIC 32-64 mcg/ml) of the acetone extract of H. physodes against vancomycin-sensitive and vancomycin-resistant strains of enterococci and found a synergistic effect (ΣFIC from 0.125 to 0.375) of the combination of the H. physodes extract and aminoglycosides against E. faecalis , including vancomycin-resistant strains. Conclusion. H. physodes is a promising source of compounds with antibacterial activity, further research is required to identify and isolate a secondary metabolite having synergistic activity in combination with aminoglycosides from the lichen extract.

Objective: to study changes in the morphologic and morphometric parameters of the liver tissue in male Wistar rats under chronic Ortiz stress. Material and methods. The study was conducted on 50 male Vistor rats. The experimental group of the animals was subjected to 10-day chronic stress by Ortiz. The morphologic and morphometric parameters of the liver tissue of the animals exposed to chronic stress were studied. Results. The morphologic changes in the liver of the animals which had sustained chronic stress were characterized by impaired blood circulation and degenerative changes of hepatocytes. At the same time, a statistically significant increase in the percentage of binuclear hepatocytes (p = 0.046) and functional cariocellular index (p = 0.03) was found. Conclusion. The effect of chronic stress leads to a change in the morphologic and morphometric parameters of the liver tissue with activation of reparative processes.

Objective: assess effectiveness of the tactics and methods developed by the authors for surgical treatment of instability of the long biceps head tendon. Material and methods. The results of the treatment of 66 patients with instability of the long head of biceps tendon over 2004-2017 have been studied. Depending on the diagnosed type of instability of the long head of biceps tendon, the subjects were divided into 5 groups by Bennet classification (2003). Patients with type 1 and type 2 of damage were prescribed a course of conservative therapy, patients with type 3-5 were recommended surgical treatment using arthroscopy and the methods developed by the authors. Results and discussion. According to the OSS, 66 patients, who had undergone treatment, revealed 38 (57.6 %) excellent, 13 (19.7 %) good, 14 (21.2 %) satisfactory and 1 (1.5 %) unsatisfactory treatment outcomes. The result of the assessment is presented in the form of Me [Q25; Q75] and made up 56 points before the treatment [46; 56], and 14 [12; 32] after it. The tactics and methods of surgical treatment developed by the authors aimed at eliminating damage to the rotator-bicipital complex have confirmed their effectiveness. Conclusion. The tactical approaches aimed at correcting damage to the rotator-bicipital complex is a promising way to improve the clinical results of the treatment.

On the basis of the analysis of the approaches to the organization of medical care to patients after ocular prosthetics existing in the Republic of Belarus and the study of the level of awareness of ophthalmologists about the problem of anophthalmos, organizational and clinical recommendations about delivery of health care to this category of patients have been offered. The model of the organization of such care has been developed and comprises a multidisciplinary approach and an algorithm of examination and dispensary observation of patients with anophthalmos for the ophthalmologist in out-patient conditions.

Objective: to study social and psychological factors determining welfare and life values of a modern family (by the example of families in Gomel region). Material and methods. The methodical basis of the study was selective single observation. 1100 respondents aged 18-60 and older (342 men, 758 women) took part in a sociological survey. To obtain scientifically proved results, the received data were subjected to the statistical analysis. Results. The study has revealed that every fifth family is incomplete. Almost half of the families have their own accommodation. More than half of the interviewed families have a median income level. In spite of the fact that almost all the families (86.6%) experience occasional conflict situations, most of them (60.1 %) observe a positive family atmosphere, which is most characteristic for spouses aged 32-45. More than half of the families (52.4 %) face marital discords and this problem is especially urgent for the age range of 46-59, which is characterized by growing contradictions, disagreements and conflicts. The main causes of the conflicts are household chores, running the house and solving financial problems. In most families (42.8 %) both the parents take part in up-bringing of children, whereas in every third family the mother and other relatives take the key role in this process. With age there are more fathers giving more attention to up-bringing of their children (from 1.4 % to 81.2 %). Among the dominant family values, health of family members takes the first place in the hierarchy, academic progress of children occupies the second place, diligence and discipline - the third place. Conclusion. The article describes the factors determining psychological welfare and health of a modern family.

Objective: to study dynamics of the attitude of students of Gomel State Medical University to HIV-positive people. Material and methods. The study was conducted by the method of a sociological survey in which six year students of the Faculty of General Medicine of Gomel State Medical University took part: 145 in 2012 and 137 in 2018. Results. A tolerant attitude towards HIV-positive people is noted among the students of the medical university, 73.8 % (95 % CI 61.9-85.8 %) of the respondents in 2012 and 82.4 % (95 % CI 75.4-89.4 %) in 2018 are ready to communicate and have social contacts with HIV-positive people. While there is a relatively high level of tolerance in the answers to questions related to general situations and social interactions, some tension was revealed if situations affect the respondent personally, which can be a prerequisite for discrimination in personal situations. Conclusion. It is necessary to pay attention to matters of HIV discrimination during work with students and young doctors in order to prevent stigmatization of HIV-positive patients by health care workers.

This article describes a case of late debut of sepsis caused by Streptococcus agalactiae in an infant at the age 7 weeks and gives an example of early diagnosis, timely hospitalization and successful treatment.

The developed molecular and genetic method for analysis of the carcinogenic potential of Helicobacter pylori based on determining the degree of phosphorylation of the cytotoxin-associated protein of the bacterium (CagA) has been presented. The degree of phosphorylation of CagA protein of Helicobacter pylori is estimated by determining the number and type of so-called EPIYA (Glu-Pro-Ile-Tyr-Ala) motifs at the carboxyl end of the CagA protein region using PCR (polymerase chain reaction) and sequencing of the CagA gene locus. The proposed method can be used to form groups of patients who need additional examination and follow-up observation for the purpose of early prediction of pathological conditions associated with the infectious process caused by Helicobacter pylori strains dominating in the Republic of Belarus. The determination of the number and type of EPIYA motifs can be used as an additional criterion for detection of risk groups for gastrointestinal diseases.

The effectiveness of microsurgical revascularization performed according to indications ranges from 85.3% within the first three years of observation and up to 65.5 % during a five-year follow-up. These data are significant evidence of the necessity to rationalize both the indications for this kind of surgery and the surgical techniques. Five revascularization operations were performed using the Virag II and Michal II technique in the Sharlip modification with a satisfactory result. Two-stage combined revascularization, including angioplasty and stent placement in the common iliac artery as the first stage and open penile revascularization surgery as the second stage was performed in one patient. In all the cases, the lower epigastric artery (epigastrica inferior) was used as a donor artery for bypass epigastric-penile anastomosis. The article discusses issues of the mobilization of the above artery for its use as a donor shunt, as well as methods of prevention and diagnosis of arterial thrombosis in it in the postoperative period with the use of duplex ultrasound and angiography.

Objective: to develop a new method of quantified evaluation of the quality of remission in patients with alcohol dependence. Material and methods. A comparative study of a representative sample of patients with alcoholism (F 10.202) in remission of high (I group, n = 88) and low (II group, n = 44) quality has been performed. Results. It has been found that comprehensive examination of patients using the standardized clinical questionnaire with a high degree of significance (sensitivity 80 %, specificity 77.17 %) allows to diagnose a threat of relapse in alcohol dependence. Conclusion. The proposed new method for measuring the quality of remission in alcohol-dependent persons with can be used to assess the effectiveness of treatment and to prevent relapses.

Objective: to compare the methylation rates of nine genes in prostate cancer and breast cancer and to identify a single panel of genes that is promising for its use as an additional marker in the diagnosis of these types of cancer. Material and methods. The methylation analysis of promoter areas of 9 genes ( RARβ , HIN1 , DAPK , RASSF1A , GSTP1 , CCND2 , p16 , APC and hMLH1 ) was performed by means of methylspecific polymerase chain reaction with electrophoretic detection. Results. We have identified and compared the methylation rates of the 9 genes in the biopsy material of 68 patients with prostate cancer, 39 patients with benign prostatic hyperplasia / prostatic intraepithelial neoplasia (BPH/PIN), surgical material from 104 female patients with breast cancer and 38 patients with benign tumors of the mammary gland (fibroadenoma, nodal mastopathy). Conclusion. It has been found that methylation of five genes ( RARβ , HIN1 , CCND2 , APC and GSTP1 ) out of the nine analyzed genes is statistically significantly more common in samples of malignant tumor tissue compared to that in samples with benign pathology both among patients with prostate diseases and among patients with breast pathology. The methylation rate of each of these five genes is significantly higher in the tumor tissue of patients with prostate cancer compared to those with breast cancer. Methylation of two or more genes out of five in prostate cancer was detected in 89.7 % of cases, in BPH / PIN - in 23.1 %, which is 3.9 times as little, OR - 29.1 (95 % CI [9.9-85, 6]), p < 0.001. The diagnostic sensitivity of the method was 89.7 % with specificity of 76.9 % and accuracy of 85.0 %. Methylation of one or more genes out of five in the group of patients with breast cancer was detected in 80.8 % cases, with benign tumors of the mammary gland in 13.2 % cases, which is 6.1 times as little, OR - 27.7 (95 % CI [9.6-80.0]), p < 0.001. Accordingly, the sensitivity of the method was equal to 80.8 %, specificity - 86.8 %, and accuracy - 82.4 %.

Objective: to formulate the main points of the diagnostic algorithm in the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments based on the limits and potential of visualization methods. Material. Data of X-ray, multispiral computer tomography (MSCT), magnetic resonance imaging (MRI) and sonography of 184 patients aged 19-79 with clinical manifestations of the lower back pain syndrome caused by pathology of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments were analyzed. Results. The potential of the visualization methods in the assessment of structural changes of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments has been identified. The main points of the algorithm which makes it possible to diagnose the lower back pain syndrome, caused by pathology of ilio-lumbar, posterior long sacroiliac and sacrotuberal ligaments have been formulated. Conclusion. The choice of the visualization method in the lower back pain syndrome, caused by ligamentosis of the ilio-lumbar, posterior long sacroiliac, and sacrotuberal ligaments must be made taking into account the limits and potential of MSCT, MRI and sonography, which will shorten the time of diagnostic search and reduce the risk of diagnostic errors.