Forty years have passed since one of the world’s largest man-made disasters — the accident at the Chernobyl Nuclear Power Plant. To provide high-quality and accessible medical care to the population affected by the Chernobyl accident, the State Institution «Republican Research Center for Radiation Medicine and Human Ecology» (RRCRM&HE) was established in 2002. It remains a leader in the development of new medical technologies and scientific advances in radiation medicine. This article presents the main achievements of the RRCRM&HE in providing medical care to the population affected by the Chernobyl accident, including its interactions with the Gomel regional healthcare system and Gomel State Medical University, the activities of the State Registry of Persons Affected by the Consequences of the Chernobyl Disaster, participation in the implementation of Union State events, and the diagnostic and therapeutic activities of its outpatient clinic and inpatient department. Information on the implementation of new methods, educational, scientific and practical activities and the international cooperation of the RRCRM&HE is provided.

The analysis of the results of the authors’ research in 1991-2026 aimed at studying the patterns of formation of doses of internal radiation to the population exposed to radiation as a result of the Chernobyl nuclear power plant accident is carried out. The main achievements in this area of research, problems and actual tasks that need to be solved at the present time are presented. Currently, the threat of radiological accidents as a result of military operations and acts of terrorism has increased significantly. The most important task is to ensure emergency response readiness, including the development of scientific and methodological support for situational crisis centers. This includes sorting out citizens with possible thyroid disorders. The accident at the Chernobyl nuclear power plant showed a catastrophic shortage of specialized monitoring tools for 131I in the thyroid gland. The Republican Research Center for Radiation Medicine and Human Ecology develops methods that make it possible to quickly calibrate and use widespread non-specialized equipment (wearable spectrometers and dosimeters) for mass screening of the population, which is especially important in conditions of time and resource constraints.

A study was conducted to investigate the effects of ⁹⁰Sr on the genome of the pond snail (Lymnaea stagnalis L.) and the morphology of its hemolymph cells. Genome status was assessed based on the frequencies of cells with micronuclei, hemocyte remnants, multinucleated hemocytes, karyorrhexis, and apoptotic bodies. An analysis of the biogeochemical behavior of 90Sr in aquatic ecosystems of the Chernobyl exclusion zone was performed based on sampling of surface water, bottom sediments, and mollusks. A correlation was found between the content of this radionuclide in the «bottom sediment-water-shell» system. The results of the study indicate the possibility of substantiating and selecting pond snail individuals as a marker biota for assessing radiation exposure and the characteristics of ⁹⁰Sr migration at the level of regional ecosystems.

The incidence of malignant neoplasms in the population is one of the most important medical and social problems. Compared to higher doses, the risks of low doses of radiation will obviously be lower and significantly larger epidemiological studies are required to quantify the risk with an acceptable degree of accuracy. During the study, from 1989 to 2024, the oncological morbidity of 1838 employees of the Polesie State Radiation-Ecological Reserve was studied. Based on the data, 160 cases of malignant neoplasms were identified, with an expected value of 176,51 (SIR=0,9 (0,77-1,06)), which is 10% lower than the population level (p>0,05).

This article examines the key parameters of vaginal microecology in cervical dysplasia and cervical cancer. The vaginal microbiota, host endocrine system, vaginal anatomy, and local immunity collectively constitute the vaginal microecology. The physiological interaction of vaginal microecological factors maintains the balance of the vaginal microenvironment and ensures a woman›s reproductive health. A balanced vaginal microenvironment improves the barrier function of the mucous membranes and immune function, facilitating the prevention and elimination of human papillomavirus (HPV). Conversely, disruptions in the vaginal microecology weaken these protective mechanisms, increasing susceptibility to HPV infection. Studying the vaginal microecology and its role in the development and progression of precancerous pathology and cervical cancer is essential for the prevention, diagnosis, and treatment of these diseases. In recent years, this topic has received considerable research attention.

This article presents a review of current literature on the use of shear wave sonoelastography for assessing the stiffness of peripheral nerves in the lower limbs of patients with diabetic polyneuropathy (DPN). The global prevalence of diabetes mellitus (DM) continues to rise, exceeding even the most conservative predictions of researchers. Diabetic polyneuropathy is one of the most common and serious complications of diabetes, significantly impairing patients’ quality of life, imposing substantial economic burden, and ultimately leading to disability. Given the prolonged asymptomatic phase – often referred to as subclinical DPN – the development and validation of new methods for early diagnosis of diabetic neuropathy remain a pressing challenge both globally and in the Republic of Belarus.

Based on partial sequencing data of the S gene from 2 066 clinical samples, the spectrum of SARS-CoV-2 variants was determined and the characteristics of their spread in the Republic of Belarus in 2020–2021 were established. At the beginning of 2020, predominantly early «Wuhan» variants were identified: A.1 in Minsk and B.1 in the Vitebsk Region. In the 2nd–3rd quarters, all analyzed sequences belonged to variant B.1, which remained the leader in the 4th quarter (90,6%). Rare B.1 sublineages collectively accounted for 9,4%, among which variant B.1.1.374 predominated. Regional differences during this period were not significant (p>0,05). The Alpha variant displaced the early variants (including B.1.1.374) in the first quarter of 2021, becoming dominant. The Delta variant, represented predominantly by AY.4, began to active spread from May 2021 and by summer completely replaced Alpha. Regional differences in 2020–2021 were not significant (p>0,05).

Modern intraocular lens calculation methods do not always achieve ideal refraction due to the influence of additional anatomical factors. This retrospective cohort study evaluated the effect of the optic disc–macula distance, measured by optical coherence tomography, on refractive outcomes after phacoemulsification with IOL implantation in cataract patients. The distance was measured on OCT images, followed by correlation, regression, and ROC analyses with subsequent validation on a control sample. It was established that the studied anatomical parameter is an independent predictor of refractive error. A threshold value was determined that allows for high-sensitivity prediction of the risk of a clinically significant deviation from the target refraction. The nature of the distance’s influence varies depending on the baseline refraction: in hyperopic eyes with a short axis, a pronounced inverse correlation with residual hyperopia was revealed, whereas in myopia, the effect is mediated by the axial length of the eye. These findings substantiate the feasibility of preoperative measurement of the optic disc–macula distance for personalized IOL calculation, especially in patients with hyperopia, which will minimize the risk of unexpected refractive errors and increase patient’s satisfaction.

This article presents a literature review on the etiology, clinical manifestations, and diagnosis of partial optic nerve atrophy secondary to intracranial neoplasm. A clinical case of a tension cyst in the chiasmal-sellar region discovered during examination of a patient with glaucoma is presented.

Anesthesia for extremely preterm infants is the «new» modern problem in anesthesiology and demands special preparation for anesthesiologists, equipment and medicines. These little patients have usually bronchopulmonary dysplasia, intraventricular hemorrhages, periventricular leukomalakia, metabolic disorders, hypoglycemia; it is extremely important to ensure safety of respiratory tract during general anesthesia with endotracheal intubation. Hyperoxia should be avoided (development of retinopathy, lipid peroxidation).
Hemodynamic stability must be maintained (prevention of IVH, cerebral ischemia, development of periventricular infiltration, disorders of autoregulation of cerebral circulation);
Prevention of hypothermia, hypoglycemia during the surgery is extremely important.
Due to the risk of apnea development, surveillance should be ensured.
The incidence of apnea is higher when used opioids, sedatives, hypoglycemia, hypothermia, anemia (timely correction is needed).
It should be remembered that premature babies feel pain more than full–term newborns and infants. In this category of patients, assessment of the effect and dosage of opioids is difficult, their duration of action is variable, and especially careful monitoring is required after surgery. A minimum of 12 hours of observation after surgery is required. In children under one year of age, the risk of anesthetic complications is higher than in other age groups.
Opioids have a narrower therapeutic window (from analgesia to respiratory depression) in preterm infants compared to term infants.
Retinopathy of prematurity (ROP) develops in 30% of all premature infants weighing less than 1500 grams at birth, leading in some cases to retrolental fibroplasia; fibrovascular strands leading to retinal detachment (traction), this is important until approximately 34 weeks of gestation; fluctuations in SpO2 are significant for ROP formation.

The aim of the study was to assess the primary incidence of immunoglobulin A nephropathy (IgAN) based on population data, analyzing the frequency of its various phenotypic variants. For the first time in the Republic of Belarus, a study was conducted using a kidney biopsy registry from Minsk for the period from 2010 to 2020. An increase in the incidence of IgAN was observed, rising from 1,6 per 100 000 in 2010 to 2,0 per 100 000 of the adult population in 2020. The more frequent clinical phenotype was asymptomatic, occurring in 67,4% of cases, while the adverse clinical course manifested as acute kidney injury or chronic kidney disease, which over a 10-year observation period led to the initiation of kidney replacement therapy in 33,3% and 50,0% of cases, respectively.

This study aimed to evaluate the ultrasound findings in skeletal muscle lymphoma, and investigate the correlations between ultrasound findings and histopathological characteristics.
Ultrasonographic images with skeletal muscle lymphoma obtained between June 2014 and June 2024 were retrospectively reviewed. The ultrasonographic examinations comprised grayscale (n = 35), color-Doppler (n = 35), contrast-enhanced (n = 5), and elastography imaging (n = 5). Biopsy samples underwent histopathological analysis to identify the histopathologic basis of the typical ultrasound features. Kappa statistics were used to assess the consistency between ultrasound findings and histopathological features.
The study comprised 35 patients (mean age, 63 years ±15 [standard deviation], 17 men). In gray-scale sonography, 35 lesions (100%) appeared as hypoechoic areas in the muscle with poorly defined margins. Residual myofiber-like echoes were observed in 25 (71,4%) lesions, and a «cobblestone» appearance was noted in 18 (51,4%). In color-Doppler sonography, ten (28,6%) patients had intact transverse vessels perpendicular to the long axis of the muscle. In contrast-enhanced sonography, four out of five (80%) lesions showed synchronous high enhancement. Four out of five (80%) lesions exhibited high stiffness on elastography imaging. Myofiber-like echoes (p<0,001) and the «cobblestone» appearance (p<0,017) are consistent with myofibers in pathology. Skeletal muscle lymphoma demonstrates specific features on multimodal ultrasound.

There are two types of pathology in which the clinical picture and magnetic resonance semiotics are similar in the early stages of the disease, but it is important to distinguish them. Aseptic, also known as avascular necrosis, is a severe degenerative-dystrophic disease that eventually leads to osteoarthritis and disability. Transient osteoporosis is an independent temporary clinical condition of unknown etiology, which is usually resolved by conservative therapy. In the early stages, avascular necrosis is diagnosed using a modern imaging method — magnetic resonance imaging (MRI), in the later stages radiography and computed tomography (CT) are used, whereas transient osteoporosis is usually diagnosed only using MRI, radiography and osteodensitometry can sometimes be informative in the later stages. A correct diagnosis affects the prognosis of the disease, as well as the choice of treatment tactics.

The article presents information about Evans syndrome (ES), which is a rare disease with a combination of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP), occurring in both children and adults. More than 70% of pediatric patients with ES have a predisposing immune defect, which requires a number of laboratory and instrumental studies, as well as molecular genetic tests to clarify the nature of the disease. Literature data on modern approaches to the diagnosis and treatment of this pathology are presented. Two cases of ES manifested in childhood from the authors’ clinical practice are presented. Both patients were consecutively diagnosed with AIHA and then ITP, concomitant diseases allowed us to assume, and subsequently reliably confirm, the presence of primary immunodeficiency in these patients. The effectiveness of treatment with glucocorticosteroids, intravenous immunoglobulin, mycophenolate mofetil is discussed.