For more than a year and a half, the entire world has been experiencing the COVID-19 pandemic. Only the development of safe and effective vaccines may make the most significant changes in the fight against this infection. The World Health Organization (WHO) and its partners are contributing to accelerated development of vaccines because it is the vaccination along with social distancing and the use of personal protective equipment that is an effective way to prevent the coronavirus disease. This review covers general characteristics of vaccines registered or approved by at least one national regulator, the risks and side effects of the vaccines, as well as approaches to assess the effectiveness of COVID-19 vaccination.

This review is devoted to a number of important innovations and their role in modern medical practice of a family practitioner. We have discussed benefits, restrictions and controversies related to their use. We have also reviewed the evidence base on the practical implementation of these innovations. This review is devoted to a number of important innovations and their role in modern medical practice of a family practitioner. We have discussed benefits, restrictions and controversies related to their use. We have also reviewed the evidence base on the practical implementation of these innovations.

This review presents basic principles and methods of next-generation sequencing (NGS) and discusses a number of the latest papers on the possibilities, principles and stages of NGS, as well as the application of NGS in medical research, particularly, clinical microbiology and infectious diseases, epidemiology. The development of NGS technologies will allow improving the results of diagnostics, treatment and prevention of infectious diseases and opens up new prospects for personalized medicine.

Objective. To assess the susceptibility of K.pneumoniae and A.baumanii strains isolated from hospitalized COVID-19 patients to antibiotics and their combinations.

Materials and methods. The minimum inhibitory concentrations (MICs) of meropenem and colistin were determined for 47 A.baumannii and 51K.pneumoniaestrains isolated from the hospitalized COVID-19 patients by the broth microdilution method. The susceptibility to 11 antibiotic combinations was assessed using the method of multiple combination bactericidal testing.

Results. Colistin resistance was detected in 31.9 % of A.baumannii strains (MIC₅₀ — 0.5 mg/l, MIC₉₀ — 16 mg/l) and in 80.4 % of K.pneumoniaestrains (MIC₅₀ — 16 mg/l, MIC₉₀ — 256 mg/l). It has been shown that double antibiotic combinations with the inclusion of colistin exhibit bactericidal or bacteriostatic activity against 76.6–87.2 % of A.baumannii strains. Combinations with the addition of meropenem, colistin and macrolides exhibited bactericidal activity against 78.4–80.4 % of K.pneumoniae strains. Combinations of two carbapenems were not active, the combination of meropenem-colistin had a bactericidal effect only in 13.7 % of K.pneumoniae strains.

Conclusion. Widespread colistin resistance was found in carbapenem-resistant K.pneumoniae and A.baumannii strains isolated from the hospitalized COVID-19 patients. The combinations of antibiotics that have a synergistic antibacterial effect in their pharmacokinetic/pharmacodynamic concentrations have been determined.

Objective. To determine the levels of matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in the plasma of patients with 5D stage chronic kidney disease (CKD) and in patients with anterior abdominal wall hernias.

Materials and methods. Patients with end-stage chronic kidney disease and patients with anterior abdominal wall hernias were included into the study. MMP-1 and TIMP-1 plasma concentrations were determined by enzyme-linked immunosorbent assay.

Results. The analysis of the plasma of the patients with end-stage CKD and with anterior abdominal wall hernias shows a statistically significant increase in the level of MMP-1 when compared to that of the patients of the comparison group: 7.98 ng / ml and 8.35 ng / ml, respectively (p ˂ 0. 0001). The plasma level of TIMP-1 (158.85 ng / ml) was statistically significantly higher in the patients with 5D CKD than in the patients with anterior abdominal wall hernias — 33.16 ng / ml and in the comparison group — 73.46 ng / ml (p ˂ 0.001). At the same time, the TIMP-1 level was determined statistically significantly higher in the comparison group than in the patients with anterior abdominal wall hernias (p ˂ 0.001).

Conclusion. The obtained patterns may indicate an increased breakdown of type I collagen and interstitial substance in patients in the end-stage of CKD and in patients with anterior abdominal wall hernias.

Objective. To identify the main demographic and clinical risk factors for the development of extrapulmonary tuberculosis (EPTB).

Materials and methods. A retrospective study of tuberculosis cases registered from 2016 to 2020 in the Gomel region was conducted (330 patients with EPTB and 2,505 patients with pulmonary tuberculosis). The odds ratios were calculated to assess the risk factors for the development of EPTB.

Results. The prevalence of EPTB was studied over the course of five years. The most significant risk factors for the development of tuberculosis in extrapulmonary localizations have been identified.

Conclusion. The risk factors for the development of EPTB are age (EPTB often develops in children and older persons), females, and in those who have had an episode of tuberculosis previously. Awareness of the predisposing factors may help physicians maintain a high index of suspicion regarding the development of EPTB.

Objective. To study the features of psychosomatic pathology in patients with morphea.

Materials and methods. We used the Symptom Check List-90 Revised (SCL-90-R) to assess patterns of phychological signs in 95 patients suffering from morphea. The control group included 30 respondents without the skin pathology.

Results. The patients with morphea revealed higher values in the Global Severity Index (GSI), Positive Symptom Distress Index (PSDI), Positive Symptoms Total (PST). The group of the patients with morphea showed higher distress levels according to the somatization, obsessive and compulsive disorders, depression, anxiety scales.

Conclusion. Patients with morphea have a wider range of psychosomatic symptoms. The prevalent characteristics of psychosomatic changes are somatization, obsessive and compulsive disorders, depression, anxiety.  

Objective. To study the effectiveness of liquid cytological diagnosis of bladder cancer and its local relapses using the Cellprep Plus technology as an example.

Materials and methods. We analyzed outpatient records of patients with urothelial pathology (n = 806) who underwent a urine cytology exam by the methods of liquid (n = 383) and conventional (n = 423) cytology.

Results. The diagnostic sensitivity and specificity of the cytological examination method for diagnosing urothelial carcinoma using the method of liquid cytology have been found to be 93.4 % and 95.4 % respectively, which significantly exceeds the similar indices in the use of the method of conventional cytology – 42.4 % and 93.6 % respectively. The use of the method of liquid cytology considerably increases the accuracy of the cytological examination of bladder pathology and allows obtaining conclusions that coincide with the histological conclusion in 94.0 % of cases. In the use of the method of conventional cytology, the coincidence with histological findings is only 44.6 % (χ² = 25.08, p < 0.001).

Conclusion. The Cellprep Plus liquid technology standardizes the pre-analytical stage and increases the efficiency of the cytological method in the primary diagnosis and monitoring of patients with urothelial pathology. A promising direction of using the method of liquid cytology in the diagnosis of urothelial carcinoma is the development and implementation of the cytological criteria of differential diagnosis between reactive cell atypia and atypia characteristic of a malignant tumor.

Objective. To identify the predictors of the development of hepatorenal syndrome in patients with liver cirrhosis.

Materials and methods. We analyzed the medical records of 79 patients diagnosed with liver cirrhosis. The laboratory research included general and biochemical blood tests. The general blood test measured erythrocyte and leukocyte counts. The biochemical blood test measured the content of ALT (U/L), AST (E/L), total bilirubin (μmol/L), direct bilirubin (μmol/L), indirect bilirubin (μmol/L), alkaline phosphatase (U/L), albumin (g/L), urea (mmol/L), creatinine (mmol/L), cholesterol (mmol/L).Viral hepatitis markers were determined for all the patients.

Results. The predictors of the development of hepatorenal syndrome were identified: increased leukocyte count, increased total and indirect bilirubin levels, urea level and decreased erythrocyte count and albumin level. The most specific predictors were the amount of indirect bilirubin (98 %) and the content of albumin in the serum (89.8 %), and the most sensitive predictors were AST (96.7 %) and the content of red blood cells and creatinine (73.3 %).

Conclusion. The most significant predictors of the development obtained will contribute to the diagnosis of the development of hepatorenal syndrome in patients with liver cirrhosis.  

Objective. To develop a diagnostic algorithm, a rational method of treatment, and principles of preconception care in women with herpes-associated recurrent vulvovaginal candidiasis (RVVC).

Materials and methods. We examined 68 patients with herpes-associated RVVC and 20 gynecologically healthy women.

Results. It has been found that in RVVC it is necessary to study vaginal swab culture with the determination of the microorganism and its biofilm-forming ability in combination with viral DNA detection by the polymerase chain reaction (PCR) in vaginal secretion, determination of the IgG titer to the herpes simplex virus (HSV), the avidity index to HSV I and II. In the presence of laboratory-confirmed RVVC and HSV infection, it is necessary to assume the presence of an atypical course of HSV infection followed by complex antiviral and antimycotic therapy.

Conclusion. The use of the developed algorithm of diagnostic and treatment interventions as preconception care makes it possible to address symptoms, reduce relapse rates and extend a non-relapse interval, prepare women with the mixed-infection for favorable pregnancy outcomes.  

Objective. To analyze basic medico-statistical indices of the morbidity rates of the malignant tumors of the larynx in the Republic of Belarus.

Materials and methods. Data of the Belarusian Cancer Register on all detected cases of the malignant tumors of the larynx in the Republic of Belarus over 2000-2019 served as the material of the study. The following rates were studied: age standardized morbidity, gross intensive morbidity, morbidity separately in the general population and working age population, in urban and rural population, males and females. All epidemiological indices for the periods 2000-2005 and 2015-2019 in the country and across the regions of the Republic of Belarus were compared.

Results. The age standardized morbidity rate in Belarus increased from 4.2 cases/year per 100,000 population in 2000 to 5.8 in 2019. The gross intensive morbidity rate increased from 5.5 to 7.3, respectively. An increase in the morbidity rate from 4.0 in 2000 to 4.3 in 2019 was noted in the working age population. The gross intensive morbidity rates in males were on average 33.9 times higher than in females, and in the urban population – 1.7 times lower than those in the rural population. The maximal increase in the morbidity rate was registered in the working age population of rural areas – by 60.3% during the monitored period. A statistically significant increase in the morbidity rate was noted in the city of Minsk. The morbidity rates registered in Minsk were statistically significantly lower than those in the republic. In other regions, there was no significant difference in the morbidity rates and growth dynamics from the indices in Belarus as a whole.

Conclusion. Malignant tumors of the larynx are characterized by a slow increase of the morbidity rate for the last 20 years in Belarus. The observed epidemiological trends deter

Objective. To assess internal environment objects ofsecond cleanliness class health care facilities according to microbiological standards.

Materials and methods. The methods of swabbing, direct seeding, membrane filtration and instrumental aspiration were used for sampling. The microbial status was analyzed by cultural and biochemical methods on nutrient, differential and diagnostic media with species identification using the microbiological analyzer. The phenotypic features were studied in vitro by the standard biochemical and microbiological methods in accordance with the principles of good laboratory practice.

Results. The microbiological testing of indoor air and internal environment objects of second cleanliness class health care facilities (dental offices) was done to determine the qualitative and quantitative composition of the microbiota. As a result of the taxonomic identification, it has been found that the most common representatives of the air microbiota are Staphylococcus, Micrococcus and Kocuria bacteria, which are true residents of the human dermis.

Conclusion. The obtained data provide material for the study of the phenomenon of the modification of phenotypic properties and its use at the stages of hazard detection and profiling and for the minimization of uncertainty within the concept of microbial risk analysis.

Objective. To conduct a comparative analysis of changes in platelet aggregation parameters in COVID-19 patients which are related to anticoagulant therapy and to determine the effectiveness of the integrative parameter of platelet aggregation.

Materials and methods. 34 patients with confirmed COVID-19 (group 1) were included into the study. To compare the obtained results, healthy females were included into group 2 (n = 30). The following parameters of aggregation were determined: degree, time, rate and area of aggregation (until its maximum degree).

Results. The area of aggregation is the best among all the parameters of platelet aggregation to diagnose COVID-19 in patients according to the Hosmer-Lemeshow test: with an ADP inducer — 0.3 μg/ml (Chi-square = 9.481, p = 0.303); ADP — 1.25 μg/ml (Chi square = 12.577, p = 0.127); ADP — 2.5 μg/ml (Chi-square = 6.226, p = 0.622); adrenaline — 2.5 μM (Chi-square = 7.367, p = 0.498); adrenaline — 5 μM (Chi-square = 6.824, p = 0.556).

Conclusion. The area of aggregation is an informative integrative parameter that allows to quantify the degree of aggregation in the treatment of hypercoagulation syndrome in COVID-19 patients.

Objective. To estimate the in vitro effect of ethanol on the function of oxygen transport in the blood of patients in a state of alcohol deprivation and in healthy donors.

Materials and methods. We analyzed blood samples from 13 male patients aged 22–56 in a state of alcohol deprivation and 11 males aged 20-45 in whom this diagnosis was excluded. The blood was incubated with ethanol solution at a final concentration of 50 μmol/L. The parameters of the function of oxygen transport (р50, рО₂, рСО₂, рН, АВЕ, НСО₃^-, ТСО₂,SВЕ, SBC) of the blood taken from the cubital vein using an ABL-330 “Radiometr” microgas analyzer were determined.

Results. The patients in a state of alcohol deprivation reveal increased affinity of hemoglobin for oxygen, and their acid-base status of the blood becomes alkaline. When ethanol is added in vitro to the blood of patients, the affinity of hemoglobin for oxygen decreases.

Conclusion. Decreased affinity of hemoglobin for oxygen upon the in vitro addition of ethanol in the examined patients indicates compensatory and adaptive changes in the oxygen transport of the blood in response to chronic ethanol consumption.

Objective. To study the effect of thermal skin burns in experimental animals (rats) on the state of the system “mother-fetus” in a late gestation period.

Materials and methods. An experimental study was carried out on 18 female outbred white rats weighing 300–350 g (per 9 rats in the control and experimental groups), which were exposed to third-degree thermal burns with an area of 12 cм² in a late gestation period. The oxygen transport function and the main blood biochemical markers were studied. The effect of thermal injury on the course of pregnancy was studied.

Results. The thermal skin burn in the rats in the late gestation period leads to the development of hypoxia, a decrease in the affinity of hemoglobin for oxygen and metabolic acidosis in the mother’s body. Changes in the blood biochemical markers indicate the presence of endogenous intoxication. In the experimental animal group, a decrease in fetal weight was observed, an increase in the post-implantation fetal death rate was noted.

Conclusion. Impaired oxygen homeostasis and endogenous intoxication in skin burns in rats in late gestation periods lead to fetal malnutrition and a qualitative increase in the post-implantation fetal death rate.

Objective. To study the specificity of the functioning of inpatient healthcare facilities in the Gomel region in the spread of the coronavirus disease COVID-19.

Materials and methods. A survey among 78 physicians of the inpatient healthcare facilities was conducted, which provided an opportunity to analyze the specificity of the work in the spread of the coronavirus disease COVID-19 and related difficulties.

Results. According to the respondents, in the situation of the COVID-19 pandemic, there has been a considerable growth in working hours and intensity of the work of the physicians in the inpatient healthcare facilities. In the vast majority of the cases (74.7 %), the physicians in the inpatient healthcare facilities underwent training on prevention, diagnostics, adoption of anti-epidemic measures in the detection and treatment of COVID-19 patients. Nevertheless, only 25.6 % of the respondents considered their professional competence level with regard to their work with COVID-19 patients to be high. Moreover, the physicians` satisfaction rate for the existing strategies for rendering medical care to COVID-19 patientswas 6.87 ± 2.06 outof 10.

Conclusion. To a large extent, the physicians of inpatient healthcare facilities of the Gomel region during their work with patients are concerned about such circumstances as longer working hours and increased working intensity, complexity of making balanced and optimal decisions regarding the organization of the work of inpatient healthcare facilities during the pandemic, as well as issues related to contact with patients (worrying about getting infected and infecting family, organization of childcare due to the closure of schools and preschool institutions during quarantine and others).

Objective. To analyze the onco-epidemiological features of head and neck tumors within the competence of the otorhinolaryngological service across the regions of the Republic of Belarus.

Materials and methods. The material for the study was data on 21,533 cases of malignant neoplasms of the head and neck (including laryngeal tumors) registered in the Belarusian Cancer Registry from 2009 to 2018.

Results. Significant changes have occurred in the structure of the incidence of head and neck malignant neoplasms over the past decade. The leading positions are occupied by such tumors of visual localization as cancer of the oropharynx (14.9 %), the floor of the oral cavity (12.4 %), tonsils (11.4 %) and tongue (excluding the root of the tongue) (11.4 %), which are available for diagnosis during routine clinical examination.

Conclusion. The analysis of newly diagnosed cases of malignant neoplasms depending on the localization has showed that regardless of the availability of otorhinolaryngologists and staffing levels, patients with primary manifestations of the tumor process are not timely referred to the health experts for morphological verification, which requires further organizational decisions on patient referral at different levels of health care and defining the role and scope of responsibility of subject-matter primary care specialists.  

Objective. To study the process of formation of the Medical Faculty of Belarusian State University in the early 1920s.

Materials and methods. Archival, periodical and narrative sources processed by general scientific and special historical research methods.

Results. The emergency of a higher medical education in Belarus became possible only after the solid establishment of Soviet power in its territory. Political and ideological components played a significant role in the processes of the selection of future doctors and their education, but at the same time, democratic elements of self-government were implemented along with the formation of the Medical Faculty.

Conclusion. Despite the successful experience of organizing the Medical Faculty of Belarusian State University, a small number of graduates in the 1920s and the general lack of doctors in the BSSR predetermined the need for its reorganization into an self-administered academic institution– Minsk Medical Institute.  

Objective. To evaluate the effectiveness of photocatalytic methods of oxidation of organic substances for the preparation of drinking water. To show the expediency of the use of the described method for the design of wastewater treatment facilities.

Materials and methods. The oxidation degrees of 58 organic substances of various hazard classes were studied. The sampling frame was based on two characteristics: origin (biological and artificial) and the oxidation state stated in different sources.

Results. A high efficiency of photocatalysis for the destruction of organic substances in wastewater from various industries has been shown: the degrees of oxidation range from 70 to 100 %.

Conclusion. Photocatalysis can be used to design wastewater treatment facilities with a view to reducing the probability of biological pollution of natural waters intended for drinking water production.

Objective. To evaluate the effectiveness of conducted organizational and medical measures for early detection and medical examination of patients with autoimmune thyroiditis (AIT) in the regions of the Republic of Belarus and to develop measures to enhance them.

Materials and methods. Data on the incidence rates of AIT and primary hypothyroidism (PGT) in the Republic of Belarus from 1997 to 2017 were analyzed, data of a sociological study were presented and patients` records were analyzed. Epidemiological and sociological methods were used.

Results. In the Republic of Belarus, two organizational and medical approaches to early diagnosis of AIT have been developed. The study has found a low competence level among therapists (general practitioners) of the Brest and Gomel regions and showed the absence of patients with AIT at Gomel Regional Endocrinological Dispensary even if there is a pathognomonic ultrasound picture and a high level of AT-TPO titer, which indicates that the incidence is undercounted.

Conclusion. As a result of the performed study, the algorithm for organizational and medical measures has been developed and implemented for early detection and clinical examination of AIT patients aimed at PGT prevention.

The article presents a clinical case of such difficult for detection disease assystemic lupus erythematosus (SLE), which is characterized by atypical debut options, rapid development of complications, inadequate response to therapy. It is emphasized that the first clinical manifestations of the disease are the most important for its timely diagnosis, beginning of treatment and prevention of complications. The study concludes that mistakes in the diagnosis, late beginning of treatment may be related to the absence of SLE awareness among physicians.