Autoimmune thyroiditis: organizational and medical measures for early detection in the Republic of Belarus

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.

Onco-epidemiological features of head and neck tumors within the competence of the otorhinolaryngological service across the regions of the Republic of Belarus

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.

To the 100th anniversary of the Medical Faculty of Belarusian State University (1921–2021)

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.

Rationale for the use of photocatalysis for natural and drinking water purification from pollutants of biological origin

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.

Systemic lupus erythematosus: challenges of early detection

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.

Assessment of the microbial status of internal environment objects in second cleanliness class health care facilities

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.

Integrative parameter of platelet aggregation in intensive care of COVID-19 patients

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.

Susceptibility to antibiotic combinations of Klebsiella pneumoniae and Acinetobacter baumannii strains isolated from COVID-19 patients

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.

Epidemiological analysis of the malignant tumors of the larynx in Belarus over 2000–2019

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

Extrapulmonary tuberculosis: risk factors

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.