Nowadays a lot of attention is drawn to the study of clinical and practical aspects of the effect of energy deficiency on the organism during physical exercise, especially because of the negative consequences of energy balance disorders on sportsmen`s health. This review of literature deals with the present-day notions about the functional disorders associated with inadequate energy supply during intense physical exercise in sportsmen.

Endocrine ophthalmopathy (EOP) is an autoimmune progressing pathology, which in most cases is associated with Graves’ disease (GD), but also occurs in patients with autoimmune thyroiditis and euthyroidism without symptoms of thyroid disease. Despite the existence of the proven interconnection between thyroid pathology and EOP, the mechanisms of its pathogenesis have not been studied completely. The article covers the modern theories of etiology and pathogenesis, genetic predisposition to the development of EOP, the risk factors, features of the clinical course and major complications of this pathology. EOP may cause significant loss of visual acuity and lead to disability, so only the multidisciplinary approach, timely diagnosis and treatment may prevent the complications and preserve the quality of life of patients.

Objective: to assess and describe the characteristics of the changes in the cervix uteri according to the data of transvaginal ultrasound conducted in lying and standing body positions in women with the physiological course of pregnancy. Material and methods. Dynamic transvaginal ultrasound of the cervix uteri was performed in two body positions (lying and standing) in 30 women with the physiological course of pregnancy and subsequent urgent labor. Results. The changes in the length of the isthmic and cervical region occur due to different anatomical segments, at different time and at different velocity. The changes in the utero-cervical angle related to the changes of body positions at the term of 28 weeks of gestation are associated with the formation of the lower segment and redistribution of pressure on it by the presenting part of the fetus. Shortly before birth, the cervix uteri is centralized. The changes in body positions of patients does not lead to significant changes in the frequency of occurrence of T- and Y-shaped internal os. Conclusion . The reference values of the parameters of the cervix uteri found by transvaginal ultrasound in the standing position were revealed and described in the women with the physiological course of pregnancy.

Objective: to evaluate the dynamics of the markers of oxidative stress in patients with chronic obstructive pulmonary disease (COPD) during the application of atorvastatin. Material and methods. The study included 52 COPD patients with concomitant hyperlipidemia. The main group (n = 30) were given atorvastatin at a dosage of 20 mg per day in addition to the standard COPD treatment. The comparison group (n = 22) only underwent the standard COPD treatment. The patients were monitored for 24 weeks. The levels of superoxide dismutase, catalase and malondialdehyde were evaluated for the assessment of oxidative stress. Results. In the group of the patients taking atorvastatin, the level of superoxide dismutase decreased from 949 [608; 1042] units/ml initially to 406 [319; 478] u/ml after 24 weeks (p = 0.035). The levels of catalase and malondialdehyde did not change significantly both in the experimental and comparison groups. Conclusion. The intake of atorvastatin decreases the level of superoxide dismutase, which may indicate a decrease in the level of oxidative stress in COPD patients.

Objective : to study the phenomenology of postaddictive hypochondria on new clinical cases. Material and methods . 4 patients of the Borderline Personality Disorders Ward suffering from lingering non-delusional hypochondria were included into the study. The methods of the study - psychosomatic, anamnestic, dynamic. Results . The study has found the leading link of the constitutional anomaly in the form of somatonia as a disturbance of drives with the subsequent formation of postaddictive hypochondria in association with the accentuations of psychotypes. Conclusion. The study has proved that postaddictive hypochondria is on the register of personal psychopathologies.

Objective: to perform the prospective assessment of the endoscopic picture of the gastric mucous membrane (MM) after the performed eradication therapy among patients with rheumatoid arthritis (RA) who have been taking nonsteroidal anti-inflammatory drugs (NSAIDs) for a long time. Material and methods. The study included 116 RA patients who had been taking NSAIDs for a long time and were infected with Helicobacter pylori . The re-examination aimed at the identification of gastropathy induced by the intake of NSAIDs (NSAIDs-gastropathy) after the treatment was performed in 45 patients who had undergone the eradication therapy and in 16 patients from the comparison group after 0.5 (0.25; 0.91) year. Results. During the assessment of the results of the endoscopic examination of the gastric MM, no statistically significant difference was found in the incidence rates of NSAID gastropathy between the group with the successful eradication of Helicobacter pylori and the comparison group (χ²=0.03; р=0.863; 1.63; 95% CI: 0.30-8.89). Conclusion. The successful eradication of the Helicobacter pylori microorganisms, which was performed against the background of the long-term intake of NSAIDs in the RA patients who continued to take them did not affect the frequency of occurrence of gastroduodenal erosions and ulcers.

Objective: to evaluate the clinical features of infertile female patients and to determine the immunohistochemical parameters of the endometrium using local immunity markers. Material and methods . The clinical and anamnestic features, FoxP3 and CD56 expression in the endometrium have been studied in infertile patients. Endometrial biopsy was performed depending on the duration of the menstrual cycle on 7-9 days after ovulation using the ProfiCombi aspiration curette (Simurg, Belarus). Results. 55 female patients of the reproductive age altogether were examined. 40 (72.73 %) infertile patients were included in the main group, and the control group consisted of 15 (27.27%) patients with no reproductive malfunction who had undergone preconception checkup. The infertile patients had a high rate of intrauterine manipulation - 22.50 (c² = 4.04;p = 0.05), the patients of the comparison group had not undergone these surgical operations. During the immunohistological investigation, chronic endometritis was diagnosed in 37 (92.50 %) infertile patients and in 2 (13.33 %) patients of the control group (c² = 33.14; p < 0.001). The expression of CD56 in the endometrium was 15.30 (12.60; 18.60) in the infertile patients and 4.90 (4.00; 5.60) in the patients of the control group (z = 4.96, p < 0.001). FoxP3 expression was 3.00 (2.30; 3.70) in the main group, FoxP3 was not expressed in any patients of the control group (p < 0.001). Conclusion. The prevalence of chronic endometritis in the infertile patients was 7 times (p < 0.001) as high as that in the women in the comparison group. The women of the main group revealed higher values (p < 0.001) of local CD56 and FoxP3 immunity in the endometrium. Evidently, high FoxP3 and CD56 expression in the endometrium of infertile patients causes local disorders of the immune response, which worsens the prognosis of impregnation and carrying of pregnancy. Frequent intrauterine manipulations are a risk factor for chronic endometritis, which should be taken into account during the selection of methods of examination of infertile patients.

Objective : to analyze the risk factors, as well as the features of abnormal uterine bleedings in adolescent girls of Gomel region. Material and methods : The retrospective analysis of 143 records of in-patients of the Gynecological Ward of Gomel Regional Clinical Hospital over 2014-2017 has been carried out. The statistical analysis determining the proportion and standard error of the proportion - P ± sp%, the median and quartiles, OR (95 % CI), has been performed. Results and discussion. 31 (21.7 ± 3.5 %) patients with juvenile uterine bleedings (JUB) were diagnosed with low nutrition, 63 (44.1 ± 4.2 %) of the examined patients revealed anemia. The anamnesis of the girls was burdened with somatoform vegetative dysfunction of the nervous system (18.2 ± 3.2 %) and thyroid pathology (35.7 ± 4.0 %), as well as chronic tonsillitis (2.8 ± 1.4 %) and chronic pyelonephritis (4.9 ± 1.8%). Conclusion . The anamnesis of JUB patients is burdened with somatoform vegetative dysfunction of the nervous system, thyroid pathology inflammatory infectious ENT and kidney disorders. A long-term JUB episode leads to the development of anemia in adolescent girls. In autumn the risk for the development of the above pathology is higher.

Objective: to study the predictors of prolonged second stage of labor. Material and methods. The study of labors complicated by prolonged second stage has been performed (n = 120). The analysis of the obtained data was carried out in comparison with those of the control group which included primiparas with physiological delivery (n = 30). Results. The labors complicated by prolonged second stage more often started with induction (p = 0.001), more often there was a necessity for oxytocin in delivery (58 % vs 36.6 % in the control group; p = 0.034), the duration of the first stage was longer (435 (295; 520) min vs 305 (255; 470) min; p = 0.035), as well as a higher frequency rate of occiput posterior presentation was noted (14.8% versus 3.3% in the control group; p < 0.001)). Conclusion. The application of labor induction, the necessity for the use of oxytocin, as well as occipital posterior presentation are the predictors for prolonged second period of labor.

Objective: to determine the prognostic significance of MELF patterns, the depth of tumor invasion and number of tumor emboli in order to predict the survival rate of patients with endometrioid adenocarcinoma. Mаteriаl аnd methods. The study included 60 female patients. The presence/absence of MELF patterns, the depth of invasions and number of tumor emboli in stromal vessels were assessed. The groups were compared using the Mann-Whitney test. The threshold values were determined using the ROC-analysis. The survival rate was analyzed using the Log-rank test. Results. Statistically significant differences in the above parameters were found in the groups with different disease outcomes. The values of the threshold indicators reflecting the negative disease outcome, as well as the differences in the survival rate of the patients based on the threshold values were determined. Conclusion. The presence of MELF patterns (p = 0.0018), the depth of tumor invasion into the myometrium > 54.1 % (p < 0.001), the number of tumor emboli more than 6.7 to 1 mm² (p < 0.001) more often are indicative of a low overall survival rate.

Objective: to determine the prevalence of arterial hypertension (AH), as well as the influence of the risk factors on the AH incidence rate in the organized population of the personnel of the plant «Polimir», OJSC «Naftan». Material and methods. Over 200-2014 a clinical and epidemiological examination of the personnel of the plant «Polimir», OJSC «Naftan, was performed and included 1,431 subjects, 460 of whom did not work in an adverse working environment and 971 did. Results. The organized population revealed a rather high prevalence rate of AH, which apart from age and sex is associated with heredity (p < 0.05), alcohol abuse (p < 0.001), low physical activity (p < 0.01), body mass index (p < 0.01), salt taste threshold value (p < 0.05), heart rate (p < 0.001), the amount of ECG peaks S_V1 + R_V5-V6 (p < 0.001), total cholesterol level (p < 0.001), LDL (p < 0.05), values of triglycerides (p < 0.01), glucose (p < 0.01), GFR (p < 0.01), absence of higher education (p < 0.01), factors of working conditions (p < 0.05), smoking (p < 0.01), HDL (p < 0.001). Conclusion. The study has found the high incidence rate of AH, which in addition to traditional risk factors is associated with the amount of ECG peaks S_V1 + R_V5-V6 and in 10-years` time with the factors of working conditions.

Objective: to study the microscopic and ultrastructural changes in the liver of rats exposed to AZT. Material and methods. The histological and electron microscopic examination of the liver samples with mitochondrial morphometry has been performed. Results . The 7-day administration of AZT does not cause any significant structural changes in the liver. The exposure to the drug for 21 days leads to the development of moderate inflammatory and degenerative processes in the liver, including changes in the structure of hepatocyte mitochondria. Conclusion. One of the pathogenetic mechanisms of the hepatotoxic effect of AZT is its impact on the structural and functional properties of hepatocyte mitochondria.

Objective: to study the features of the formation of antibacterial resistance of the causative agents of pyo-inflammatory lung diseases. Material and methods. The microbiological landscape of 59 patients with severe forms of pneumonia, the ability of the isolates to form biofilms, and the presence of the resistance genes to carbapenems and cephalosporins have been studied. Results. 73 isolates were isolated by the microbiological method. K. pneumoniae was the most common (64.4%). The microflora was not detected in 5 cases. The use of the PCR diagnostics made it possible to identify the associations of microorganisms in all the cases. P. aeruginosa was the one which formed the biofilm most intensively. The most common resistance genes were OXA-48 (63.1 %), CTX-M (35.9 %), and NDM (25 %). Conclusion. K. pneumoniae having the OXA-48 resistance gene was the most common pathogen in the patients with severe forms of pneumonia in the Resuscitation and Intensive Care Ward of Vitebsk Regional Clinical Hospital. The majority of the isolates possessed a moderate or high ability to form the biofilm with its maximum weight in P. aeruginosa 136.5 [23; 75.1] µg/well. The detection of antibiotic resistance genes by the method of the PCR diagnostics will make it possible to adjust the choice of drugs.

Objective: to develop and justify the application of a new experimental method of the simulation of liver cirrhosis in laboratory animals. Material and methods. The simulation of liver cirrhosis was performed on 11 eugamic white Wistar male rats with the body weight of 203.5 ± 22.2 g (experimental group). The control group consisted of 12 healthy laboratory animals. Acute toxic liver injury resulting in cirrhosis was caused by means of the intraperitoneal administration of 50 % solution of carbon tetrachloride (CCl4) in olive oil on the first day of the experiment at a dosage of 0.1 ml of CCl4 + 0.4 ml of olive oil per 100 g of the body weight of the animals, on the second day of the experiment - 0.3 ml of CCl4 + 0.2 ml of olive oil per 100 g of the body weight of the animals. For synergism and potentiation of the hepatotoxic effect of CCl4, the animals daily had free access to 10% ethanol solution. The duration of the experiment was 65 days. The clinical and laboratory parameters were evaluated, the histological assessment of the preparations was carried out. The obtained data were compared with the same parameters of the control group of the animals. Results. The reproducibility of the model was 81.8% (9 animals). The values of the biochemical blood analysis indicated statistically significant increases in the levels of total bilirubin, serum transaminases (AST, ALT), creatinine, a decrease in the glucose level in the animals of the experimental group. The complex morphological confirmation of liver cirrhosis in progress was obtained. Conclusion. The proposed method of the liver cirrhosis modeling correlate with the values of the biochemical blood analysis, pathological changes in the tissue of the liver and internal organs of liver cirrhosis in humans. With the help of the original model, it is possible to investigate the pathogenesis and effects of various groups of pharmacological drugs on liver cirrhosis and its complications (acute blood loss associated with the syndrome of portal hypertension).

Objective: to assess the influence of medical and social factors on the reproductive health of male population. Material and methods. The agenda of the study of the medical and social aspects of men`s reproductive health was developed aimed at the fulfilment of the stated objective. The object of the study was a group of men aged 18-75 living in Gomel (n = 200). The study included a survey according to the WHO short questionnaire for the assessment of the quality of life (WHOQOL-BREF). The men`s awareness and attitude to their health, as well as reproductive mindset were studied, the sources of their formation were determined. Results and discussion. As a result of the survey, it has been ascertained that social status affects not only the quality of life but also the satisfaction level with personal health. Thus, the majority of entrepreneurs gave high rating of both the quality of their life and their health status - 87.5 and 75 %, respectively. However, it was found that students revealed the highest level of satisfaction with their health (92 %) and one of the lowest levels of satisfaction with the quality of their life (6 %). The survey results confirm a direct correlation between the age and presence of acute or chronic diseases and pathological conditions of the genitourinary system in men. Conclusion. Social status affects not only the quality of life but also satisfaction with the personal health status. Infertility and prostate disorders show the most significant growth among men`s reproductive health disorders in Gomel.

The article analyses the organization and results of the activities of the Vascular Surgery of Pre-Stroke Disorders and Emergency Neurosurgical Care Ward, founded at Gomel Regional Clinical Hospital of the Disabled of World War II in 2015, to provide medical care to patients with vascular pathology. It gives the data on the bed fund, staffing and personnel potential of the ward, facilities for complex and high tech surgery, lists modern methods applied in the treatment of patients with vascular disorders. The article summarizes the prospects of the treatment and rehabilitation of this category of patients at the new ward taking into account the experience which has been accumulated for the past three years of its existence.

Objective: to study the effectiveness of psychotherapy in patients with consequences of spinal injury. Material and methods. The research included 113 people, who were divided into two groups: 1a (n = 56) - those who underwent a course of psychotherapy, 1b (n = 57) - those who did not. The Taylor Manifest Anxiety Scale, Montgomery-Åsberg Depression Rating Scale (MADRS), and Toronto Alexithymia Scale (TAS) were applied for the diagnosis. Painful sensations were evaluated by the Visual Analog Scale (VAS), Questionnaire for Neuropathic Pain (DN4 questionnaire). Results. The comparative analysis of groups 1a and 1b revealed significant differences in the input criteria of the MADRS (U = 1105.5, Z = 2.82, p = 0.005) and the Taylor (U = 1105.5, Z = 2.82, p = 0.005), which were leveled after a course of psychotherapy. Significant differences in the consistent comparison of the VAS test results were also found (1a - χ² = 7.35, p = 0.025; 1b - χ² = 3.63, p < 0.016), DN4 (1a - Z = 4.23, p = 0.00002; 1b - Z = 2.75, p = 0.006), TAS (1a - χ² = 20.51, p < 0.00004, 1b - χ² = 1.20, p < 0.55). Conclusion . The analysis of the results obtained in the group of the patients who had undergone psychotherapy, showed lower perception of pain syndrome, decreased alexithymia, anxiety and depression rates.

Objective: to develop and implement monitoring of the sustainability of the microbiota not only to antibiotics, but also to antiseptics and disinfectants. Material and methods. A total of 159 objects of the environment of the technological surroundings of kitchens were investigated. Quick and convenient methods of testing the sensitivity-sustainability of microorganisms to disinfectants were used. The basic discrete parameter set by the developed method is the value of the minimum bactericidal concentration of disinfectants (MBC). On the basis of the comparison of the MBC values of drugs for a particular culture with the lowest concentration recommended for practical disinfection over a fixed period of time, cultures are differentiated into clinically sensitive and resistant. Results. It has been established that the objects with high and medium risk levels significantly more often revealed high microbial loads on their surfaces (P < 0.01) than those with low risk levels. The significant risk factor for the microbial contamination of food and ready-to-eat meals from the environment of the technological surroundings is the unmotivated behavior of staff, which is proved by the poor results of the swabs from hands and clothing - 9 (50 ± 12.1 %) and 6 (33.3 ± 11.4 %), respectively. The main microorganisms of the environment of the technological surroundings are E. cloacae, S. aureus, S. epidermidis, E. faecalis, S. saprophyticus, K. oxytoca, E. coli, C. freundii . Among the samples of Staphylococcus spp., Enterococcus spp. and Enterobacteriaceae, along with antibiotic resistance the study revealed the resistance to the working concentrations of disinfectants. The most resistant cultures to the applied antiseptic and disinfectants are E. cloacae, K. oxytoca and С. freundii. Conclusion. Transmission of infection through eating is common in children's organized groups, which is related to the violations of food preparation techniques and the conditions of storage of ready-to-eat meals. Thus, effective microbiological control of the environment from which microorganisms can get into food is required.

Gastric cancer is one of the most common neoplasms in the world. The morbidity and mortality rates of this pathology in the Republic of Belarus are high. This is often associated with late case detection due to the absence of clinical manifestations. Recurrent thromboembolism of the pulmonary artery branches may be the only clinical manifestation in patients with malignant tumors. This necessitates cancer screening on patients with thrombosis of unknown etiology.

The article presents the description of a clinical case of myocardial infarction in combination with an acute disorder of cerebral circulation, analyzes the literary sources and clinical data, as well as gives some guidelines for the management of patients with this disease.

Objective: to assess the biological properties of a modified polypropylene endoprosthesis for hernia repair. Material and methods. The object of the study was polycaprolactone-modified mesh endoprostheses for hernia repair implanted in experimental animals. Results. During the study it was determined that the implanted modified endoprostheses caused more pronounced proliferation of fibroblasts and formation of connective tissue in comparison with the control group of implants. It should be also noted that there were more inert general biological reactions from the surrounding tissues.