An analytical review of literature data on modern methods of treatment of pregnant patients with severe iron deficiency anemia (IDA) was carried out. The authors present their own data on the results of treatment of severe IDA in two pregnant patients who were in the Department of Pregnancy Pathology of the Gomel City Clinical Hospital №3 in October – November 2022. Literature data on the high effectiveness of treatment of pregnant patients with severe IDA by intravenous infusion of iron carboxymaltosate in a dose of 1000 mg . The absence of immediate adverse side effects and complications of pregnancy makes it reasonable to use this drug in the 2nd and 3rd trimesters in the complex treatment of IDA.

Objective. To identify clinical and psychological features that contribute to the formation of therapeutic remission in patients with alcohol dependence (PAD).
Materials and methods. A comprehensive (clinical, experimental, psychological, statistical) comparative study was conducted of 79 PAD at the stage of therapeutic remission (icnluding 39 people in high-quality remission and 40 in low-quality remission) and 42 practically healthy individuals aged 27 to 55 (40.18 ± 10.2) years.
Results. It was found that the condition of patients with high-quality PAD in remission differed from the condition of patients with the threat of relapse and healthy individuals with significantly fewer health complaints (p < 0.05), higher indicators of psychological functioning (p < 0.01) and a high level of activation of the nonspecific adaptive reaction of the body (NARB) (p < 0.001).
It was found that the state of PAD in high remission differed from that of patients at risk of relapse and healthy individuals by a significantly lower number of health complaints (p < 0.05), higher indicators of psychological functioning (p < 0.01) and a high level of activation of nonspecific adaptive response of the body (NARB) (p < 0.001).
Conclusion. The formation of qualitative and long-term therapeutic remission in PAD requires not only specific changes with a weakening of the manifestations of the disease, but also a high level of NARB, which provides energy support for the process of recovery with integration into a healthy society.

Materials and methods. To analyze the volumes of administered and removed fluid, fluid balance, cumulative fluid balance during 5 days and its relationship with mortality in 143 patients after abdominal surgical interventions who were treated in the department of anesthesiology and intensive care. Two groups of patients were identified: 1st (n = 86) - without sepsis, 2nd (n = 57) - with the presence of sepsis. There were no deaths in group 1, 11 patients (19.3%) died in group 2.
Results. The patients of the 2nd group had a positive fluid balance in the volume of 1.55 (1.2; 2.4) liters on the first day, which was significantly greater than in the patients of the 1st group - 1.1 (0.4; 1.8) liters (p = 0.0016). At the subsequent stages, the fluid balance in patients in the studied groups did not differ. The optimal limits for maintaining the cumulative fluid balance during 5 days in patients of the 2nd group in the postoperative period of surgical interventions were established: less than 5.6 liters or less than 8 % of the patient’s body weight. Exceeding the 5-day cumulative fluid balance above 5.6 liters or more than 8 % of body weight resulted in a significant increase in the risk of mortality among patients in group 2: odds ratio (OR) - 1.39 (p < 0.01) and 1.24 (p < 0.01), respectively.
Conclusion. The features of fluid balance in patients with sepsis in the postoperative period of abdominal surgical interventions are highlighted.

Objective. To perform a comparative analysis of three methods for assessing blood loss (gravimetric, hemoglobin dilution, hemoglobin balance) in patients with heart surgery under cardiopulmonary bypass (CB).
Materials and methods. The study involved 35 patients over the age of 18 who underwent heart surgery under CB. The volume of blood loss was assessed by the gravimetric method and compared with the blood loss volume calculated by hemoglobin dilution and hemoglobin balance methods.
Results. After the patient was admitted from the operating room to the intensive care unit, the blood loss calculated by the hemoglobin dilution method did not differ from the blood loss measured by the gravimetric method. After 12-18 hrs after surgery, the blood loss calculated by hemoglobin dilution and hemoglobin balance methods did not differ from the blood loss measured gravimetrically. After 36-42 hrs after surgery, blood loss calculated by hemoglobin dilution and hemoglobin balance formulas was statistically significantly different from that measured by gravimetric method.
Conclusion. The blood loss calculated by the hemoglobin dilution method corresponds to the blood loss measured by gravimetric method at the stages “admission from the operating room” and “12-18 hours after surgery”. The volume of blood calculated by the method of hemoglobin balance at the stage “12-18 hours after surgery” corresponds to the volume of blood measured by gravimetric method. All of the above calculation methods at the stage of the study “36-42 hours after surgery” cannot be recommended for calculating the volume of blood loss after heart surgery with cardiopulmonary bypass.

Objective. To evaluate the features of the cardiovascular system in children after surgical correction of congenital heart defects revealed by functional diagnostic studies.
Materials and methods. A functional diagnostic examination of the cardiovascular system (CVS) was performed in 43 children aged 5 to 17 years with the main clinical diagnosis: “Congenital heart disease” (CHD), of which 33 children of the main group (MG) had corrected CHD, in 10 children of the comparison group (CG) CHD correction was not performed due to the presence of certain contraindications. Patients were on a routine examination and treatment for CHD in the cardio-rheumatology department of the institution “Gomel Regional Children’s Clinical Hospital” in the period 2020-2022.
Results. Based on the statistical processing of the results of the study, which included an assessment of clinical and anamnestic data and indicators of functional diagnostic methods for examining the CVS in children with CHD, the need for a comprehensive cardiological examination in children with this pathology was established, regardless of the method of performed surgical intervention. It was found that the majority of children with corrected CHD on the ECG had rhythm and conduction disturbances, as well as combined arrhythmias, and one third of the patients had cardiac complaints. According to the Holter monitoring (HM) and bicycle ergometry (BEM) tests, the children showed signs of electrical instability of the myocardium and a decrease in the adaptive reserves of the cardiovascular system.
Conclusion. Children with corrected CHD require a comprehensive functional and diagnostic examination, which makes it possible to identify an “arrhythmogenic substrate” and establish signs of myocardial electrical instability, thereby optimizing the tactics of treatment and rehabilitation of this group of patients.

Objective. To evaluate the effectiveness of profundoplasty in patients with atherosclerotic lesions of the arteries of the lower extremities, depending on the state of the distal bed.
Materials and methods. A retrospective analysis of 50 medical records and a survey of patients were carried out. The patients were divided into two groups: the first group (n=32) — patients with a satisfactory distal bed (without occlusion of the popliteal artery (PCA) and the presence of at least one tibial artery), the second group (n=18) — patients with occlusion of the PCA and / or tibial arteries. The results of the study were processed using applied statistics methods using MS Excel and the software package for statistical analysis “Statistica v. 8.0”. Differences were considered statistically significant at p < 0.05.
Results. The vast majority of patients who underwent profundoplasty were patients with critical lower extremities’ ischemia (F = 0.026; p<0.05). Among patients with occlusion of the popliteal segment, the lower limb was saved during the first year in 44 % of cases. Among patients with a satisfactory distal bed during the year, the limb was saved in 84 % of cases.
Conclusion. The state of the distal bed has a significant impact on the result of profundoplasty in the late postoperative period (p=0.008). Patients with peripheral arterial disease in the postoperative period have low compliance with ongoing conservative therapy and modification of risk factors (p>0.05).

Objective. Based on the analysis of the data presented in the literature and own clinical observation, to develop an understanding of the frequency of occurrence and clinical signs of a fairly rare pathology – stylohyoid syndrome. Consider the peculiarities of the pathological process and give recommendations for working with patients of this category.
Materials and methods. The material for the analysis was the data of studies by domestic and foreign authors concerning etiology, pathogenesis, diagnosis, differential diagnosis and treatment of stylohyoid syndrome published over the last 40 years. A descriptive method was used in the study. The article presents our own clinical observation and uses data from the medical record of an inpatient with verified “stylohyoid syndrome”.
Results. The stylohyoid syndrome occurs in 4.0-10.3% of people who report constant pain in the pharynx, oral cavity, face and neck, dysphagia, hearing loss, limited mobility of the head, vegetative disorders. It has been determined that a set of clinical and radiation data is required for the diagnosis of the stylohyoid syndrome, the most significant of which are: abnormal length of the stylod process, a significant angle of its deviation, which leads to pain due to the pressure of the latter on the surrounding anatomical formations. The main method of treatment is surgical.
Conclusion. The results of the study have an applied component: they indicate the necessity to perform radial examination, to consult related specialists for differential diagnostics in persons with suspected stylohyoid syndrome and contain an organizational and tactical element: they determine surgical treatment as the main method of specialized care for this category of patients.

Objective. To assess the vitamin D availability of newborn babies, nursing mothers and children of the first year of life living in various regions of Belarus.
Materials and methods. 114 children were examined. Group I included 31 newborns from Gomel, group II — 40 newborns living in Minsk, group III — 43 children — were infants (1–12 months) from Gomel. Mothers of group I children (31 women) were also additionally examined. To assess vitamin D availability, we determined the level of 25 (OH) D - the main metabolite of vitamin D.
Results. In newborns of group I a low vitamin D content was found. Normal vitamin D content was not detected in any child. The average content level is 25(OH)D in the blood serum of mothers of newborns was significantly higher than in their children. The absolute majority of mothers had vitamin D insufficiency or deficiency, regardless of taking preventive doses of vitamin D. In newborn children of group II, the average content level is 25(OH)D was higher than in group I. In children of group II, 25(OH)D deficiency was statistically more common. In group III, the normal vitamin D content was detected only in 62,8 % of children.
Conclusion. A high prevalence of vitamin D deficiency has been established in newborn children and their mothers both in Gomel and Minsk. The administration of vitamin D in the first year of a child’s life in a preventive dose does not allow in 37.2% of cases to ensure its optimal level in the blood serum. Taking vitamin D by pregnant women for prophylactic purposes does not allow to ensure an optimal level of 25 (OH)D more than 30 ng/ml in a newborn baby. It is necessary to carry out comprehensive diagnostic, preventive and corrective measures to eliminate vitamin D insufficiency and deficiency.

Objective. Analyze the etiological structure of infectious complications in patients with acute leukemia and determine the sensitivity to antibacterial drugs of the main pathogens.
Materials and methods. The results of bacteriological cultures and antibiograms of 177 patients with acute leukemia and infectious complications for the period 2019–2021 were retrospectively studied.
Results. In 2019, the frequency of isolation of Gr+ flora was 45.28% and Gr- was 54.72%; in 2020 the percentage of Gr+ bacteria was 34.62%, Gr− was characterized by 65.38%; in 2021 it was 41.3% and 58.7% respectively, (x2=0.20, p=0.66). In 2019, one of the main pathogens was Klebsiella pneumoniae (21%), which retained its positions by 2021 (13%; x2=0.05, p=0.82). The causative agent showed polyresistance to many antibiotics, except for imipenem (100%) and fosfоmycin (100%). In the period 2020–2021 Klebsiella pneumoniae began to compete with Stenotrophomonas maltophilia, which showed an increase in the detection rate from 11% to 17% (x2=29.46, p=0.0001). Having polyresistance, the pathogen showed 100% sensitivity only to ticarcillin/clavulanate and co-trimoxazole.
Conclusion. In the absence of changes between the frequency of isolation of Gram-positive and Gram-negative microorganisms, the increase in the number of strains of Gram− microorganisms (K. pneumoniae and S. maltophilia) with multiple antibiotic resistance among the causative agents of infectious complications in patients with acute leukemia necessitates continuous microbiological monitoring to improve the tactics of antibacterial drugs.

Objective. To study the frequency of polymorphic loci rs1042713 and rs1042714 of the β2-adrenoreceptor gene in healthy Caucasians of the Gomel region.
Materials and methods. A one-step study of 143 healthy volunteers living in Gomel region was conducted. This group included 86 (60,14%) men and 57 (39,86%) women. The average age was 36.0±10.20 years. Two single nucleotide polymorphisms (SNPs) rs1042713 and rs1042714 were genotyped in blood samples of patients by polymerase chain reaction (PCR).
Results. Among the genotypes of the rs1042713 polymorphic locus, the most common was the AG genotype (45.4%). The GG (44.1%) and AA (10.5%) genotypes were less common. The rs1042714 polymorphic locus was characterized by a more frequent presence of the CG genotype (48.9%). The CC (25.9%) and GG (25.2%) genotypes were detected less frequently. Among the alleles of polymorphic locus rs1042713, allele G was the most common (66.8%). Of the alleles of the polymorphic locus rs1042714, the C allele was more frequent (50.4%). The ADRB2 gene was more frequently represented by the AG/CG and GG/CG haplotypes (32.9% and 39.9%, respectively). AA/GG, AG/GG, and GG/ GG haplotypes were not detected among the volunteers examined.
Conclusion. AG and CG genotypes, haplotypes AG/CG and GG/CG for the polymorphic locus rs1042713 and rs1042714, respectively, were more common among Caucasians living in the Gomel region. The G allele for the polymorphic locus rs1042713 and the C allele for rs1042714 turned out to be the most common among the alleles.

Objective. To determine the relationship between violent acts and personality characteristics in alcohol dependent individuals.
Materials and methods. The study was conducted in the penitentiary system. It involved 295 men with alcohol dependence syndrome (F10.2) aged from 21 to 60 years, with an average age of 40.7 ± 8.9 years and an average alcohol intake of 13.5 years. During the study, patients with alcohol dependence syndrome were divided into three groups. The following psychodiagnostic methods were used: the technique “Types of aggressiveness” developed by L. G. Pochebut (2012), the questionnaire “Style of self-regulation of behavior” (SSP-98), the test-questionnaire “Study of volitional self-regulation”, the questionnaire for the study of stages of psychotherapy “URICA” and others. Statistical analysis was carried out using the program SPSS 19.0. Spearman’s R-criterion and Mann-Whitney U-criterion were used.
Results. The revealed high level of the final HCR-20 score in all three groups under study indicates a significant risk of committing violent acts, low adaptive capabilities and reduced stress tolerance of alcohol-dependent persons. The revealed average level of tolerance showed that personality traits, attitudes and beliefs of alcohol-dependent persons to a great extent determine their ambivalent attitude to the surrounding world with a combination of both tolerant and intolerant traits.
The existing dual causal relationship between alcohol intake and stress manifestation shows that excessive stress increases the risk of alcohol-related problems, alcohol abuse in turn causes significant alcohol distress.
Conclusions. The risk of violent acts in persons with alcohol dependence syndrome depends on the severity of such personality characteristics as aggressiveness and emotional excitability, low stress resistance, intolerance, and decreased ability to volitional self-regulation.

Objective. To study the effect of total γ-irradiation of the organism of rats at a dose of 1 Gy on the adenylate- and guanylate cyclase systems and their relationship with Ca2+ levels in the platelet cytoplasm.
Materials and methods. The studies were carried out on outbred white male rats of mature age (6-7 months) weighing 250±30 g. Animals were irradiated (once and evenly) on the IGUR unit with 137Сs γ-quanta at a dose of 1 Gy (dose rate 0.62 Gy/min, for 1.61 min). Animals of the corresponding age served as controls. To determine the content of cyclic nucleotides, RIO cAMP/cGMP-iodine125-M-IBOX reagent kits were used. The amount of calcium in platelets was determined using a Fura-2/AM fluorescent probe using spectrofluorimeter SM 2203 “SOLAR” (Minsk, Belarus).
Results. In the short period after irradiation, an increase in the activity of the adenylate cyclase system is observed. The cAMP level rises 1.8-1.5 times during 3-30 days of the post-radiation period. However, the increase in [Ca2+]cyt on the 3rd day after irradiation leads to its predominance by 1.8 times in relation to cAMP, which explains the appearance of an increased aggregation activity of the blood platelets in the immediate post-radiation period. An increase in the activity of the guanylate cyclase system and an increase in the intracellular content of cGMP are observed on the 90th day, which leads to a decrease in the Ca2+/cGMP ratio by 1.83 times and corresponds to a reduced platelet aggregation activity and the probability of bleeding in the long term of the rehabilitation period.
Conclusion. The effects of radiation on the platelets of rats irradiated at a dose of 1 Gy are due to systemic disorders of the main intracellular regulatory mechanisms: Ca2+, cAMP, cGMP. Based on the data obtained, it can be concluded that pharmacological correction in the short-term after irradiation should be aimed at inhibiting the effects of [Ca2+]cyt and adenylate cyclase system activity, and in the long-term, at inhibition of guanylate cyclase system activity.

Objective. To study the effect of fatty acid amides during pharmacologic blockade of GPR55 receptors on nociceptive sensitivity and gait patterns in rats in normal and experimental peripheral neuropathy.
Materials and methods. The study was carried out on male Wister rats (n=125), divided into 18 groups. The role of fatty acid amides in blockade of GPR55 receptors by administration of the antagonist O-1918 on nociceptive responses and gait parameters in healthy rats and in animals after the formation of neuropathy (NP) was studied.
Results. It was found that administration of O-1918 to healthy rats and rats with neuropathy at a dose of 1 mg/kg resulted in a statistically significant decrease in the values of nociceptive reactions and gait parameters. In healthy rats and animals after ligation of the sciatic nerve against the background of blockade of GPR55 receptors PGlyA had a pronounced antinociceptive effect, which was confirmed by a significant increase in the values of nociceptive sensitivity, as well as normalization of gait.
Conclusion. The analgesic effect after administration of PEA and SEA is probably the result of the interaction of the above FAAs with membrane orphan receptors. At the same time, the antinociceptive effect of PGlyA probably results from the activation of receptors belonging to another class, presumably vanilloid receptors of the first type.

Objective. Determination of the nature of adaptation of skeletal muscles when performing special exercises in badminton.
Materials and methods. The study involved 6 students, aged 18 - 20, of Gomel State Medical University practicing badminton. Testing of the functional state of skeletal muscles was carried out by myometrics method using myometer “MYOTON-3” and software “Myoton”.
Results. The results of the study showed that the application of special exercises during 8-week microcycles promotes the formation of skeletal muscle adaptation to the performance of special competitive exercises of high intensity, expressed in the frequency of oscillation in a relaxed state in the range of 11-15 Hz. The processes of adaptation of muscular activity have an impact on improving the trajectory of the athlete’s body links, there is a decrease in the load on the articular joints of the upper limbs, expressed in terms of the muscle decrement index of at least 0.6 c.u., and the stiffness index of at least 0.45 N/m.
Conclusions. Changes in the functional state of skeletal muscles as a result of a targeted impact contribute to an increase in strength potential, which leads to an increase in the performance of game activity.

Objective. To evaluate the effectiveness of the application of the new method in laboratory studies of water quality and to determine the optimal conditions for analysis.
Materials and methods. Generally accepted methods of analytical chemistry were used to determine the rate of the catalytic oxidation reaction and its practical yield. All measurements were subjected to standard statistical processing.
Results. The stages and results of determining the optimal conditions of photocatalytic oxidation are presented. The prospects of using photocatalysis in sanitary supervision institutions are shown.
Conclusion. The photocatalytic oxidizing system UV-nano-TiO2-K2Cr2O7 meets all the requirements for the methodology of chemical oxygen demand (COD) determination and is even more rapid, reproducible and accurate in comparison with the certified arbitration method.

Psoriasis is a chronic non-infectious autoimmune disease, dermatosis, affecting mainly the skin. Usually psoriasis is manifested by the formation of red, excessively dry, raised spots above the surface of the skin — the so-called papules, which merge with each other, forming plaques. These papules by their nature are the sites of chronic inflammation and excessive proliferation of lymphocytes, macrophages and keratinocytes of the skin, as well as excessive angiogenesis.
Psoriatic arthritis (arthopathic psoriasis) is a chronic inflammatory disease of the joints, spine and entheses, which can be observed in patients with psoriasis.
The article presents a clinical case of psoriatic arthritis. The analysis of literature sources, clinical data, and laboratory results was carried out.

Peripheral unspecified T-cell lymphoma not otherwise specified (PTCL NOS) is a malignant neoplasm that develops from mature T-lymphocytes and NK cells. PTCL NOS is a rare malignant neoplasm that occurs most often in men, predominantly over 60 years of age. This type of lymphoma accounts for about 15% of all non-Hodgkin’s lymphomas. The paper describes a clinical case of PTCL NOS , which was difficult to diagnose.