Wide use of interventional radiology methods is one of the promising trends in the improvement of the treatment of patients with severe pancreatitis. The minimally invasive interferences carried out under beam rider guidance, such as percutaneous punctures and percutaneous drainage, endovascular hemostasis and endovascular catheterization of celiac trunk, are effective at all stages of the course of severe pancreatitis, and make it possible to avoid open operational interference in 40-90 % cases and to decrease mortality up to 8-9 %. The article presents the review of national and foreign publications dealing with controversial questions of surgical tactics in sharp liquid formations of the pancreas and omental bursa, effectiveness of the use of percutaneous draining operational interference in infected pancreatic necrosis and parapancreatitis. The world experience of endovascular stoppage of major haemorrhagic complications in patients with acute and chronic inflammatory diseases of the pancreas has been summarized. Questions of the selective intra-arterial infusion of medicines in severe pancreatitis have been studied.

The decoding of Mycobacterium tuberculosis genome opened new possibilities for the development of new diagnostic methods based on detection of antigen-specific immune response. New methods detecting the immune response to proteins which are mostly produced by actively propogating pathogenic microbacteriummake it possible to assess the risk for development of active tuberculosis in patients with latent tuberculosis as well as to prescribe preventive treatment. Their results may be used as a criterion for complex assessment of active tuberculosis and efficiency of anti-tuberculosis therapy.

Aim : to determine the clinical and microbiological features of bacterial vaginosis on the basis of the microbiological examination, assessment of the cytokine status in female patients. Material and methods . The article presents the results of the complex clinical and microbiological examination of 86 female patients of the fertile age. 30 (34.88 ± 5.14 %) patients were diagnosed bacterial vaginosis on the basis of revelation and identification of DNA of Gardnerella vaginalis, Atopobium vaginae, Lactobacillus spp. and the total number of bacteria. The control group consisted of 56 (65.12 ± 5.14 %) patients without bacterial vaginosis. The work also presents the results of the microbiological analysis of the material obtained from the cervical canal and endometrium. All the patients underwent blood tests for detection of the inflammatory reaction - interleukins IL-1, IL-2, tumor necrosis factor (TNF-α), interferon (γ-IFN). Results . The prevalence of bacterial vaginosis among the patients of the reproductive age was 34.8 %. The pathology of the reproductive function was found with equal frequency in the patients of both the groups. Disorders of the immune status in favor of pro-inflammatory cytokines were not diagnosed. The clinical and laboratory criteria made it possible to diagnose bacterial vaginosis in 3.49 % of the patients, the use of PCR diagnosis - in 34.88 %. The concentration of lactobacillus spp. is reliably lower in the patients with bacterial vaginosis, than in the control group (p = 0.0085). As for the concentrations of Gardnerella vaginalis and Atopobium vaginae the groups do not significantly differ. Only 4 (13.33 ± 6.21 %) patients (χ = 5.51, p = 0.02) in the main group detected sexually transmitted infections, which should be taken into account while performing the diagnostic activities. Conclusion. The identification of DNA of certain kinds of microorganisms give an opportunity to assess the state of vaginal microcenosis and the degree of its malfunction even in the absence of clinical and other laboratory signs of bacterial vaginosis. The malfunction of the biocenosis of the genital tract is not associated with disorders of the reproductive function and does not lead to a change in the cytokine status. Patients with bacterial vaginosis are in the risk group for development of sexually transmitted infections, which should be taken into account while performing the diagnostic activities.

Objective: to reveal significant clinical and demographic risk factors and pathomorphological features of the placenta in women with antenatal fetal death. Material and methods. The study included the retrospective analysis of 177 case histories of female patients who were delivered at the medical institutions of the city of Gomel within 2012-2016. The main group consisted of 87 women with antenatal fetal death at various gestational age. The comparison group included 90 women with a favorable pregnancy outcome. Results. The study has revealed pregravid risk factors of antenatal fetal death and the specific features of the course of pregnancy in women with antenatal fetal death: threat of abortion, chronic placental insufficiency, low placenta, polyhydramnios, fetal development delay syndrome, inflammatory diseases of the genitourinary system, anemia, hypertensive disorders, pathomorphological features of the placenta (chronic placental insufficiency, placental hypoplasia, pathologically immature placenta, signs of ascending and hematogenic pathways of infection of the feto-placental system). Conclusion. Multiple factors of antenatal fetal death require a detailed analysis of each case of this pathology with the development of actual models of prevention and prognosis.

Purpose: to define the thickness of the long dorsal sacroiliac ligament in patients without clinical manifestation of low back pain syndrome. Material and methods . The thickness of the long dorsal sacroliliac ligament has been measured in 105 patients (38 males and 67 females aged from 19 to 86) without clinical manifestation of low back pain syndrome. Sonography and MSCT were used as methods of visualization. Results . We have defined a range of values of the thickness of the long dorsal sacroiliac ligament in patients without clinical manifestation of low back pain syndrome on Me (Q₂₅-Q₇₅): on the middle one-third part - 1.3 (1.1-1.5) mm; on the proximal one-third part (near the enthesis) - 2.4 (2.0-3.1) mm; some symptomless difference in the thickness of contrlateral ligaments within 8-14 % was found in certain patients. Conclusion. The obtained data make it possible to distinguish the normal and pathological changes in cases of increased thickness of the long dorsal sacroiliac ligament.

Purpose: to define the thickness of the great sacrosciatic ligament in patients without clinical manifestation of low back pain syndrome. Material and methods. The thickness of the great sacrosciatic ligament has been measured in 60 patients (35 males and 25 females aged 20-73) without clinical manifestation of low back pain syndrome. Results . We have defined a range of values of the thickness of the middle one-third part of the great sacrosciatic ligament (2.1-3.9 mm) in patients without clinical manifestation of low back pain syndrome and have found some symptomless difference in the thickness of contrlateral ligaments within 3-19 % in certain patients. Conclusion . The obtained data make it possible to distinguish the normal and pathological changes in cases of increased thickness of the great sacrosciatic ligament.

Objective: to study the dynamics of the detection of resistance to antibiotics of the infectious agents of the ENT organs in 2011 and 2016. Material and methods. The study of the sensitivity of microflora to antibiotics was performed by the diffusion method in agar (standard disk method) in accordance with the Order of the Ministry of Health of Ukraine No. 167 dated 05.04.2007. Results. The study has found growth of the resistance of the bacterial flora isolated from the ENT organs to some fluoroquinolones (norfloxacin, ciprofloxacin, levofloxacin), aminopenicillins (ampicillin, amoxicillin), macrolides (azithromycin) maintaining its sensitivity to meropenem, tygecycline and cephalosporins, especially to cephoperazone, ceftriaxone, and cephepime. Conclusion. Active antibiotic therapy over the past five years has led to a sharp decrease in the sensitivity of the pathogens of ENT infectious diseases to traditional drugs used for empirical therapy. It is necessary to monitor the sensitivity of microorganisms to antibiotics in each region in order to determine the tendency of resistance of the leading etiological agents to antibiotics.

The paper presents the results of application of ozone-oxygen mixture in the comprehensive treatment of 68 elderly patients with ischemic heart disease with stable I-II functional class angina. Ozone synthesis was carried out on the ozone therapeutic installation UOTA-60-01 «Medozon», Moscow. The therapy was carried out in the form of intravenous infusion of ozonized physiological solution with ozone concentration of 2-4 mg/l, 3 times per week, in the amount of 7 procedures in patients receiving nitrates, or beta blockers, or inhibitors of angiotensin converting enzyme. The results of the study indicate a high clinical efficacy of the method of ozone therapy, which is a qualitatively new approach in restorative treatment of elderly patients with ischemic heart disease.

Aim: to assess the blood serum level of vitamin D in patients with juvenile rheumatoid arthritis living in Grodno region in comparison with that of healthy ones and to establish its association with the activity of the inflammatory process. Material and methods. 123 patients were examined and among them there were: 42 patients with juvenile rheumatoid arthritis, 40 children with arthritis, without autoimmune diseases and the group of comparison consisting of 41 patients. Vitamin D [25(OH)D total] serum level was evaluated by ELISA test. Results. The average blood serum level of 25(OH)D in patients with juvenile rheumatoid arthritis was 19.0 (12.9-24.3) ng/mL. The significant negative correlation between ESR, CRP, seromucoid and blood serum level of 25(OH)D have been determined. Conclusion. The revealed associations are indicative of the association of vitamin D deficiency and course, progression of juvenile rheumatoid arthritis in children.

Aim of research: to carry out comparative assessment of monthly gains of length, body mass, head circumference, and chest circumference in healthy full-term infants during their first year of life receiving different types of feeding. Material and methods of research. We have analyzed monthly gains of the basic parameters of physical development of 200 full-term infants by the results of the retrospective survey of histories of infant development performed at Branch No. 3 of state health institution «Gomel City Central Children`s Out-Patient Clinic». Results. We have revealed accelerated gains of body mass, head circumference, and chest circumference in the first quarter and some lag of these parameters in other periods (as compared to the parameters recommended by the WHO). At the same time, the gain of body length practically did not differ from the standard one. On the whole, the average gains of body mass and body length, head circumference, and chest circumference in most the infants by 12 months did not differ from the standard ones. Only the girls receiving artificial feeding noted an inadequate gain of body length in comparison with the standard one (22.34 and 25 см correspondingly; -10.6 %), and those who were receiving natural feeding detected a decrease of the average gain of chest circumference by 10.4 %. Conclusion. We have found uneven rates of gains of the basic parameters of physical development in contemporary infants during their first year of life which do not depend on the type of feeding.

Objective: to identify changes of indicators of tetrapolar rheohepathography (RHG) in patients with mechanical jaundice, liver cirrhosis, and multiple organ dysfunction syndrome (MODS) taking into account the comparative assessment of their clinical and laboratory indicators. Material and methods . The clinical and laboratory parameters and results of RHG were analyzed in 73 patients undergoing treatment from December 2015 to June 2017. Four groups were singled out: 1-st (control) - 27 patients with limb fractures, somatically practically healthy; 2-nd - 11 patients with mechanical jaundice; 3-rd - 14 patients with liver cirrhosis; 4-th - 21 patients with MODS. Results. It has been established that the parameters of RHG come back to normal within the first 24 hours after the surgical intervention to eliminate mechanical jaundice, despite the presence of an increased level of general bilirubin and cytolysis syndrome. The greatest degradation of the RHG parameters was diagnosed in the patients of the groups with liver cirrhosis and MODS. Conclusion. The parameters of RHG in patients with mechanical jaundice, liver cirrhosis, and MODS differ, which indicates different pathogenesis of the development of hepatic hemodynamics disorders in these conditions.

Intensive allergenic activity of the protein-antigenic substances of wool dust and their ability to induce allergic reactions under the inhalation influence in concentrations equal to or below the current MPC in the air of a working area has been determined experimentally. The results of the study give a basis to attribute the working conditions of workers who contact with wool aerosols to the high level allergenic hazard with the associated high potential risk of development of occupational allergic and industry-related immune dependent diseases.

Objective: to assess the features of initial vegetative tone and vegetative reactivity in sportsmen during their endurance training and speed-power physical exercises. Material and methods. We examined 50 sportsmen (22 athletes и 28 rowers) and 29 young men of the control group. The parameters of heart rate variability were evaluated by the results of ECG registration during conduction of the orthostatic test (complex «Polyspectr»). Results . The initial vegetative tone in speed-power sportsmen is characterized by more expressed activity of autonomic regulation of heart rhythm, and vegetative reactivity is characterized by higher degree of humoral-metabolic regulation mechanisms than in sportsmen specializing in endurance training. Conclusion. The features of the parameters of heart rate variability during the orthostatic test have been determined in dependence on the direction of the training process.

Objective: to assess the efficiency of the use of specialized mobile applications for self-controlled treatment of patients with chronic non-infectious diseases. Material and methods. Using the key phrases we have studied the databases of PubMed, Embase, Springer in order to find the studies which evaluated the efficiency of mobile applications in the treatment of diabetes, cardiovascular diseases, and chronic lung diseases. Subsequently, a systematic review and analysis of the data were performed. Results. All the analyzed studies proved the impact of the use of mobile applications on the control of disease-specific symptoms. Conclusion. The use of mobile applications as a part of the mobile healthcare system (mHealth) makes it possible to improve the clinical outcomes of the treatment in the patients with chronic diseases and to promote the quality of symptom control.

Aim : to assess the quality of life, level of anxiety and suicidal risk in patients with chronic liver diseases. Material and methods. 220 people aged 16-84 took part in the study. The main group consisted of 100 patients suffering from chronic viral hepatitis C (CVHC). Other groups included 60 patients with liver cirrhosis (LC) and 60 practically healthy people. The quality of life was assessed using the SF-36 questionnaire. To assess the level of anxiety, we used the scale developed by Zung in 1971. As an additional method of assessment of suicidal risk The Sad Persons Scale was used. Results . The parameters of 5 out of 8 scales of the SF-36 questionnaire in the patients with CVHC appeared to be statistically considerably lower in comparison with the parameters of quality of life in practically healthy people. The parameter of physical activity was lower and the parameter of social activity was higher in the patients with liver cirrhosis than in the patients with CVHC. The general level of anxiety in the patients with CVHC was low - 36.4 ± 0.53 points, in practically healthy people - 30.8 ± 0.85 (p < 0.01). The level of anxiety in the patients with liver cirrhosis was 45.0 ± 1.7 points, which corresponded to the average level of anxiety. The average value of suicidal risk (SR) in the control group was 1.76 ± 0.15 points. The average value of SR in the group of the patients with CVHC was 2.71 ± 0.11 points, which indicates a low level of SR. The average value of SR in the group of the patients with LC was 3.39 ± 0.09 points, which corresponded to the average level of SR. Conclusion. Patients with chronic liver diseases observe dramatically decreasing physical and social activity, emotional status, subjective assessment of emotional state, mood and, on the whole, general state of health. The average level of anxiety in the patients with liver cirrhosis corresponded to the average level of anxiety. The patients with liver cirrhosis revealed average level of suicidal risk, which was low in the patients with chronic viral hepatitis C.

The aim of the study was to analyze life quality of patients with primary hyperparathyroidism in the pre- and postoperational periods. 90 patients were examined and they were divided into 3 groups depending on the type of parathyroidectomy. The survey was done by means of the short questionnaire of life quality (SF-36) before the surgery and in the late postoperational period. The received data indicate that the parameters of life quality in the postoperational period increase in all the groups of the patients. However, the highest values were found in the patients who had underwent the mini-incision surgery.

As per the WHO data, tuberculosis is often associated with HIV-infection and remains one of the prevalent causes of death among women of the reproductive age in regions with unfavorable epidemiological situation. Due to high HIV incidence in Gomel region, the epidemiology of tuberculosis in women of the reproductive age demands to be thoroughly studied. As the conducted study has showed women aged 18-45 make 1/5 of new cases of lung tuberculosis among HIV-negative women and 1/3 among HIV-positive patients. The age peak is 25-40 regardless of the HIV-status. 27.7 % women aged 18-45 who detected tuberculosis were HIV-positive. In 10 % women of this age pregnancy and parturition preceded tuberculosis which was not associated with HIV-infection.

Objective: to evaluate the maximum possible concentrations of radionuclides in the breathing area and the expected inhaled doses of irradiation of rural residents in case when timber harvested in the area of radioactive contamination is used as fuel. Material and methods: The data of the Institute of Radiology on the contamination of the area with radionuclides were used. Mathematical modeling was applied during the study. Results. The expected annual irradiation doses of the population of settlements situated by the border of the Polessky State Radiation Ecological Reserve due to the inhalation of 90Sr and 137Cs with furnace smoke can reach up to 0.27 mSv. The main contribution (96 %) of the expected radiation dose of the population due to stove smoke is made by 90Sr (in the absence of trans-uranium elements). Conclusion. The expected annual irradiation dose from the inhalation way of radionuclide release with the fly-ash from furnace smokes is much higher than from fires in the Chernobyl exclusion zone. The absolute values of the doses from this irradiation way do not exceed the legally established exposure limit (1 mSv per year) and are comparable with the external doses from the Chernobyl fallout.

Objective : to study the pathogenesis and to illustrate clinical cases of postaddictive hypochondriasis developing after severe psychopathological panic-like attacks. Material and methods . 3 patients with borderline psychic conditions undergoing treatment in the neurosis wards were included into the study. The methods of the study were psychopathological, anamnestic, clinical, and dynamical. Results . The study has exposed a complex structure of anxious and panic-like attacks which meets the criteria of existential crisis in the personality dynamics of constitutional anomalies with the pathologic drives and development of postaddictive hypochondriasis. Conclusion . The study has showed that postaddictive hypochondriasis belongs to the cluster of personality disorders.

Objective: to demonstrate clinical cases using fragments of electrocardiograms in adolescents with repolarization disorders on the electrocardiogram. Material and methods. Clinical cases and fragments of ECG of children with repolarization disorders on the electrocardiogram have been presented. Results. Various functional tests make it possible to get important information for the differential diagnosis between the norm and pathology. Conclusion. Repolarization disorders in adolescents may be due to a number of reasons, so in-depth cardiac examination may be needed.

The article describes a clinical case of a rare disease - hereditary calcinosis of arteries, which was diagnosed in a pregnant woman and had an asymptomatic course.

The purpose of our research was to study the morphofunctional state of locomotor eye stumps of experimental animals occurring after performing eye evisceration by means of the developed method using various types of orbital implants. The conducted pathomorphological and functional studies have shown that the most significant and best results (р < 0.05) were received in the group of experimental animals where allogenic graft from the adipose cellular tissue of the sole aponeurosis was used an implant. It is integrated in the tissue of the recipient, is not rejected and well modelled, which makes it possible to create a movable locomotor eye stump of the corresponding size with the preservation of sphericity of the anterior surface of locomotor eye stump for better contact with the posterior surface of the eye prosthesis. The absence of complications, preservation of the natural topography of the stump inside the socket and well evident conjunctival fornixes make it possible to perform individual eye prosthetics within the optimal terms. Moreover, this material is widely available and does not require additional economic costs.

Objective: to substantiate the possibility and efficiency of using ultrasound elastography for noninvasive evaluation of liver cirrhosis and portal hypertension. Material and methods: Modern foreign and Russian scientific publications were analyzed, the electronic bases Medline, PubMed were used. Ultrasonic shearing wave elastography (SWE) of the liver was performed in patients with chronic liver diseases using the apparatus HITACHI / ALOKA Arietta 70. Results: The use of ultrasonic elastography in patients with chronic liver disease will make it possible to assess the rigidity of the liver, perform stratification and to identify patients with increased risk of development of clinically significant portal hypertension and patients who need additional examination using invasive methods.