Oxidative stress is a ubiquitous cellular process that results in damage to various biological  molecules and it is involved in the etiopathogenesis of many diseases. The sulfhydryl-containing tripeptide glutathione (GSH), which is synthesized and maintained in high concentrations  in all cells, is a component of one of the defense mechanisms. N-acetylcysteine, a synthetic  derivative of the endogenous amino acid L-cysteine and a precursor of GSH, has been used for  several decades as a mucolytic and antidote for acetaminophen (paracetamol) poisoning. As a  mucolytic, N-acetylcysteine breaks the disulfide bonds of highly cross-linked mucins, thereby  reducing the viscosity of the mucus. As an antidote for acetaminophen poisoning, N-acetylcysteine restores the hepatic GSH pool depleted during drug detoxification. More recently,  enhance knowledge of N-acetylcysteine’s mechanisms of action has expanded its clinical use.  This publication presents an overview of the most relevant and recent data on the clinical use of  N-acetylcysteine in transplantology, neurology and ophthalmology.

The effect of repeated low dose irradiation of the thoracic region of laboratory mice of the C57Bl/6 line on the general condition of laboratory animals and the condition of their lungs was studied. It has been shown that repeated local irradiation of the thoracic region of mice at a dose of 150 mGy (the total radiation dose was 1050 mGy) does not cause significant changes in the general condition of the animals, morphofunctional changes in the lungs of mice, but at the same time the level of apoptotic cells in the mixed population of lung cells increases to an aver -age of 6,7%, and also increases the level of pro-inflammatory cytokines IL-1 and TNFα in lung tissue homogenates, compared to the control, which indicates activation of innate immunity in irradiated tissue in response to repeated low-dose irradiation.

Hereditary angioedema (HAE) is an orphan genetically determined disorder with recurrent episodes of swelling in various localization. HAE is divided into two groups: HAE with C1-inhibitor deficiency and without C1-inhibitor deficiency. The main diagnostic tests are: meas urements of levels and function of C1-inhibitor, and levels of C4. These tests are not useful in all cases, for example, in HAE without C1-inhibitor deficiency. The detection of cleaved high-molecular-weight kininogen (cHK), which, even in remission, is expected to be elevated both in patients with HAE due to C1-inhibitor deficiency and in HAE with normal C1-inhibitor is a promising biomarker. The aim of this study was to determine the clinical efficiency of the cHK detection in the diagnosis of HAE. According to the results of the measurements of cHK, the patients were divided into two groups. Group №1 (100% of cHK): 27 patients, of which 19 in the study regions had variants associated with HAE, 8 didn’t have. Group №2 (not 100% of cHK): 13 patients, of which one patient had a variant associated with HAE, 12 didn’t have. The obtained data demonstrate acceptable results of using the measurement of cleaved high-molecular-weight kininogen in laboratory practice in the diagnosis of HAE.

Transplantation  of  adipose-derived  mesenchymal  stem  cells  (ADMSCs)  is  currently considered as one of the treatment methods of peripheral neuropathic pain. The analgesic effect of ADMSCs has been proven, and one of the potential options for its enhancement and prolongation could be the activation of type 2 cannabinoid receptors (CB₂ receptors). The antinociceptive and reparative effects of ADMSCs were analyzed after type 2 cannabinoid receptors (CB₂) pharmacological stimulation by the selective agonist AM1241 on the ADMSC’s membranes and in the tissues of the area of sciatic nerve traumatic injury in rats. It was found that  pharmacological  stimulation  of  CB2  receptors  on  ADMSC’s  membranes  accelerated the  recovery  of  nociceptive  sensitivity  to  mechanical  and  thermal  stimuli  compared  with transplantation of ADMSCs alone. Early (before transplantation of ADMSCs) activation of CB₂ receptors in tissues surrounding the sciatic nerve more effectively attenuated nociceptive responses to thermal stimuli in the long-term period of the experiment. Stimulation of CB₂ receptors did not significantly affect the rate of recovery of gait parameters in rats after ADMSCs transplantation, but led to the structure recovery of the sciatic nerve distal segment of rats. The latter was expressed in increased proliferation of Schwann cells and a decrease in the number of damaged nerve fibers.

In this study, we evaluated the proliferative capacity of mesenchymal stem cells (MSCs) from the bone marrow of patients with drug-resistant tuberculosis (DR-TB) and selected the optimal conditions for obtaining autologous MSCs transplant. The results of the expansion of MSCs from 42 patients with DR-TB in medium with 10% FBS demonstrated low proliferative potential for of these cells compared with MSCs from 47 donors. MSCs content in 1 ml of bone marrow of patients was also lower. A relationship was found between the amount of MSCs in the primary culture and in the finished product, and with a small number of cells in the primary culture, we used 5% platelet lysate instead of 10% FTS, which made it possible to obtain a high dose of MSCs in the transplant.

An article contents the results of investigation of natural uranium isotopes content in the certain types of foodstuffs sampled in the kitchen gardens located in Leningrad region and bought in the trade network of Saint-Petersburg. More suitable and simple for realization than existing method is given for uranium isotopes (²³⁸U, ²³⁴U, ²³⁵U) content investigation in the foodstuffs from a sample with not more than 1,0 kg weight with minimal detectable activity not more than 0,02 Bq. Radiochemical investigations were carried out in 2018-2020. Estimation of potential average annual population internal exposure dose (E_int) have been carried out due to ²³⁸U and ²³⁴U content in the bread foodstuffs, black leaf tea, spicy herbs and salad greenery consumed by the local population. It is demonstrated that population internal exposure dose from uranium isotopes in the investigated types of foodstuffs could be about 0,0000022 mSv/ year. Estimated dose value is only small part of population internal exposure dose from uranium and even more so from total composition of natural radionuclides in the foodstuffs. At the same time toxic effect from soluble uranium as a chemical element prevails over its radiation effect.

A method is proposed for estimating the density of soil contamination with gamma-emitting radionuclides (Bc·m^-2) in situ (in the field without sampling). The method allows to take into account the peculiarities of the distribution of radionuclides along the soil profile at a given site by the ratio of scattered and non-scattered photon fluxes. The scope of application has been expanded and the uncertainty of the previously developed method used for radiological examination of agricultural lands contaminated with ¹³⁷Cs without sampling has been reduced. The proposed method of remote assessment of the pollution density practically does not introduce an additional error in comparison with the traditional method, which includes soil sampling and subsequent analysis in laboratory conditions. The duration of the spectrum set and its automatic processing at a ¹³⁷Cs contamination density of more than 100 kBq·m^-2 does not exceed 1 min.

According to the World Health Organization, infectious and parasitic diseases account for about a quarter of all deaths in the world. In Belarus, 2,0-2,5 million cases of infectious diseases are registered annually. An analysis of the levels and trends of mortality from infectious and parasitic diseases is important for improving the practice of anti-epidemic work.

Aims: Conduct an analysis of mortality from infectious and parasitic diseases in the Gomel region for the period 2009-2019.

For the study, official data of the National Statistical Committee of the Republic of Belarus on the number of deceased persons and estimated data (mortality rates) of the «Gomel Regional Clinical Hospital» organizational and methodological department on infectious and parasitic diseases for 2009-2019 were used. The mortality rates of the Gomel region population from infectious and parasitic diseases were analyzed. We used epidemiological and statistical methods of information processing. To assess the statistical significance of differences, Student’s t-test was used.

During the analyzed period in the Gomel region, there was a statistically significant trend towards a decrease in the mortality rate of the population from infectious and parasitic dis -eases, both among urban and rural residents. A statistically significant downward trend in mortality rates was also noted among people of working age. In the dynamics of the analyzed years in the period from 2009 to 2015, there was a statistically significant decrease in the mortality rate of the population older than working age, from 2016 to 2019 a statistically significant increase was established.

In order to further reduce mortality from infectious and parasitic diseases, the main emphasis should be placed on two aspects: the formation of the population’s commitment to preventive measures and the improvement of the quality of medical care for the population.

Acute gastroenteritis (AG) can be caused by a wide range of viral pathogens. Detection of dominant pathogens (noro-, rota-, adeno-, enteroviruses) makes it possible to establish the etiology of 40-60% of AG cases. To increase the proportion of their etiological interpretation, it is advisable to conduct research on minor intestinal viruses. This article presents the method of multiplex polymerase chain reaction for the diagnosis of unspecified viral intestinal infection. It allows detecting the genetic material of astro-, sapo-, parecho-, boka-, picobirna- and aichi viruses in biological material (faeces). The approbation of the method made it possible to detect the presence of these pathogens in 4,89% of patients with AG, in whose biological material were no dominant intestinal viruses.

Resume A retrospective analysis of the screening results was carried out (970 subjects of the cohort underwent an in-depth (4-fold) examination (at each visit: ultrasound examination of the thyroid gland, determination of the levels of thyroid-stimulating hormone (TSH) in the blood serum and antibodies to thyroid peroxidase (TPOAb), examination by an endocrinologist) for thyroid diseases. Medical examinations (visits) were carried out every 2 years.

It was noted that within the cohort subjects, the most common clinical and laboratory variant of AIT was subclinical with preserved size and function of the thyroid gland or its transient decrease. The frequency of occurrence of the atrophic form of AIT is minimal (only 2/71 patients had a thyroid volume less than 6 ml) as well as the hypertrophic form (in 5/71 cases of AIT the thyroid volume exceeded 24 ml).

Analysis of the combination of laboratory and instrumental criteria showed the dependence of the diagnosis of AIT on one of two examinations: Ultrasound (decreased echogenicity) or increased TPOAb. The proportion of each criterion was almost equal (echogenicity was decreased in 10 cases – 14,1%; TPOAb was increased in 16 cases – 22,5%). In most cases (43 cases – 60,6%) there was a combination of two criteria (decreased echogenicity and increased TPOAb). In one case (1,4%), against the background of an increased ratio of antibodies to thyroid peroxidase, an increased level of TSH was noted; ultrasonographic signs were normal. In the second case, against the background of decreased echogenicity of the thyroid gland and low TSH levels, ratio of antibodies to thyroid peroxidase is increased. In all cases, the patients did not report any clinical symptoms, i.e. it manifested as a subclinical form. The TSH level (in 70/71 cases) was within the normal range (0,3-4,0 mIU/l), but its level was significantly higher in patients with AIT (2,4±0,12 mIU/l) than in healthy individuals (TPOAb – normal and thyroid echogenicity – normal) 1,6±0,02 mIU/l; p<0,001.

The simultaneous presence of high concentrations of TPOAb in the blood serum and sono -graphic criteria of AIT, including decreased echogenicity of the thyroid gland, increases after 2 years the risk of primary hypothyroidism (PHT) by 12,8 (5,19-31,61) times (p<0,001), in the case of TPOAb content in the blood serum – 29,9 IU/ml and higher, 9,4 (3,86-23,11) times – when the concentration of these autoantibodies TPOAb is more than 60 IU/ml.

Maternal obesity is becoming more common, occurring in one third of pregnant women, and is associated with increased morbidity and mortality in both mothers and children. The article presents data from a study of the course of pregnancy and childbirth in women with abdominal obesity. It was found that a third of women with abdominal obesity had signs of placental insufficiency on Doppler ultrasound (OR=2,9; 95% CI 1,2; 6,6, p<0,05), chronic placental insufficiency was more often recorded (20 (22,2%); TCP=0,03, p<0,05) and gestational diabetes mellitus  (14  (15,6%),  TCP=0,005,  p<0,05).  Childbirth  in  women  with  abdominal  obesity was complicated by the development of decompensated placental insufficiency (15 (16,7%), p<0,05), and weakness of labor activity (13 (14,4%), p<0,05).

Purpose: Clinical and neuropsychiatric assessment of the state of the cognitive functions of clean up workers of the accident at the Chernobyl nuclear power plant.

Comparative examination of the cognitive functions of a group of clean up workers of the consequences of the Chernobyl accident, suffering from non-psychotic psychoorganic syndrome and patients with of cerebrovascular brain damage, using clinical, clinical-metric and neuropsychological methods. Psychopathological and neuropsychological assessment of their condition, correlation of neuropsychological and clinical-psychopathological manifestations of the identified disorders.

The study revealed a wide range of cognitive impairments; at the remote stages, they dem onstrate an increase in cognitive impairment with the inclusion in the neuropsychological profile of predementia signs of the «Alzheimer’s» type. The predominance of violations of the regulatory mechanisms of cognitive functions over operational, predominantly neurodynamic, was noted. An increase in psycho-organic symptoms occurring against the background of somatic disorders can provoke previously unmanifested signs of neurodegenerative processes. Conative (motivational) disorders are also characteristic of the DS subgroup and are associated with altered affective mechanisms that are available for recovery as affective disorders are reduced. The structure of the clinical state of patients with LPA gravitates towards the psycho-pathological and neuropsychological profile of the CDS subgroup and is determined by the inclusion of deep structural mechanisms of cognitive impairment. The loss or decline in cognitive capabilities is acutely and painfully experienced in the LPA group; perhaps, there is not a true loss of skills, but some overvalued processing of the existing decline in professional level and household self-service abilities.

Breast cancer is the most common malignancy in the female population. Early detection of breast cancer is crucial for reducing mortality from the disease. Late detection of breast cancer may have an unfavorable prognosis. Study Objective – To evaluate the awareness of the female population of the Gomel region concerning prevention and early diagnostics of breast cancer. The participants were 317 women, all of them were of full age, gave their consent to participate in the present study, and filled in a specially designed questionnaire.

Absolute majority of respondents know that effectiveness of treatment of breast cancer depends on the stage of its detection, almost all respondents know who the doctor-mammologistis. According to respondents the main reasons of breast cancer development are genetic predisposition, bad ecology, breast trauma and smoking. Only 24,29% of respondents pointed out the correct frequency of mammography examinations at the age of over 50 years – once in 2 years. The fact that 77,6% of the respondents, in one form or another, received information about cancer prevention in the outpatient clinic seems extremely favorable. More than a half of the respondents are not aware of the breast cancer screening program in the Republic of Belarus. The absolute majority of the respondents would prefer to get information about prevention of malignant neoplasms from their doctor, mass media and the Internet.

According to the data of the study, the majority of respondents have basic information about breast cancer and risk factors for its development. All participants also received information about mammography and its benefits in early detection of cancer. However, the level of public awareness is insufficient on a number of questions concerning the timing and frequency of examinations, screening, and early detection of cancer.

Decreased bone mineral mass is one of the significant somatic problems for adolescents with Turner syndrome. The results of our own study, which estimates the state of bone mineral density in children with Turner syndrome depending on age, karyotype variant, spontaneous or stimulated onset of sexual development are present in the publication. A high frequency of bone mineral density deficiency in patients with Turner syndrome was established, regardless of the presence of puberty. Changes in bone density in girls with spontaneous puberty are less common. The difference in bone mineral density between patients with Turner syndrome and the control group from the age of 11 years was shown. Positive effect of replacement estrogen therapy on bone tissue condition in Turner syndrome is shown.

Psychophysiological examination was carried out on two patients, former border guards, who suffered on October 05, 1982 as a result of accidental contact with a source of gamma radiation (¹³⁷Cs) while on duty while serving on the Iranian-Azerbaijani border in the ranks of the Soviet army. They suffered ARS of the 1st degree with extremely uneven gamma irradiation in the form of local radiation injuries of the hands of varying severity. The assessment of the aver -age dose for the whole body according to the frequency of dicentrics in cultures of peripheral blood lymphocytes in patient No. 1 and patient No. 2 is the same and is 0,26 Gy. Psychophysiological research was carried out in dynamics in 2001-2013 using the automated software and methodological complex «Expert». According to the MMPI data, both victims have a hyperthymic type of psychophysiological adaptation with varying degrees of severity. Patient No.  2 is a chronically hyperthymic personality with a significant increase in the profile on the 9th scale and with its gradual increase in dynamics, which reflects the persistence of hyperthymic personality traits and causes an overstrain of mental adaptation, with an increase in the dynamics of the tendency to explain their difficulties and problems by somatic distress (1Hs).  

Patient No. 1 has a hyperthymic personality type with a moderate increase in profile dynamics on the ninth scale. A personality trait is indicated by a high, growing in dynamics, indicator on the K scale, which determines behavior depending on social approval and concern for one’s social status. The appearance in dynamics (2013) of a peak on scales 1 (preoccupation with the state of health) and 4 (emotional tension in direct behavior) determines the insufficient ability to internalize the social norm, i.e. insufficient ability to perceive this norm as part of one’s own settings (a combination of profile peaks on scales 4 and 9). The presence of profile peaks on the 7th scale and the scales of the neurotic triad reflect the tendency to various options for the implementation of antisocial attitudes in a socially acceptable way, the desire to appear in a favorable light (scale L). Sufficiently high intelligence and demonstrative behavior determine good adaptation to the environment with self-confidence, high social adaptability, and resilience in overcoming difficulties.