A web application has been developed to calculate radiation doses accumulated from 1986 to 2056. The web application is available on the website of the Republican Scientific and Practical Center for Radiation Medicine and Human Ecology at https://www.rcrm.by. A link to the application is available on the website of the Republican Scientific and Practical Center for Radiation Medicine and Human Ecology at https://www.rcrm.by in the «Scientific Activities » section (https://www.rcrm.by/science/dose-forecast/). Accumulated individualized doses of internal and external radiation are calculated for individuals permanently residing in areas contaminated with radionuclides that were exposed to radioactive contamination as a result of the Chernobyl accident. It is conservatively assumed that the patient belongs to the 10% most exposed group among individuals of a given age and occupation in a given locality. By combining fragments of calculation results for various input data, such as residence in different localities or different occupations, it is possible to calculate individualized doses of internal and external radiation accumulated since the Chernobyl accident, taking into account changes in residence and occupation. The calculated individualized cumulative radiation doses since the accident enable radiation epidemiological studies to establish the dose-response relationship and assess the risks of long-term effects of radiation exposure. Taking into account the individualized cumulative radiation doses, epidemiological studies are being conducted on the development of radiation-related diseases in individuals exposed to radiation as a result of the Chernobyl accident. Furthermore, using the developed web application, individuals living or who have lived in radioactively contaminated areas can quickly and easily assess their cumulative radiation dose levels and the associated health risks, as well as the advisability of seeking additional social protection measures.

An analysis of radiation exposure and Chernobyl-related fatal cancer risk predictions in the Gomel region, conducted 40 years after the accident compared to 30 years earlier, showed that the expected increase in Chernobyl-related cancer fatalities could be the same as the one predicted 10 years after the accident — 1% of the spontaneous level, which is in fact undetectable. Reducing radiation doses to 1 mSv/year through a set of radiation countermeasures allows for a 10% reduction in the collective dose, which would reduce the number of cancer cases to 3 per year, or 0,1% of the expected fatal cancer cases in the Gomel region. This raises the question of whether radiation countermeasures aimed at reducing radiation doses are necessary if the risk associated with a radiation dose is already negligible.

The article presents the results of a study of the levels of T-lymphocyte receptor DNA recombination products (TREC) and B-lymphocyte receptor DNA recombination products (KREC) in children with severe infectious diseases complicated by a fatal outcome. Data from 18 children who died from infections associated with immune mechanism disorders were analyzed. TREC and KREC levels were successfully determined in 11 children from neonatal screening records using real-time PCR. Significant variability in marker levels was established: the TREC copy number ranged from 250,0 to 29 988,0, and KREC – from 1 759,0 to 33 214,0 copies per 106 leukocytes. Cases of both reduced marker levels and marker levels within the normal range were identified. The lowest TREC levels were observed in children with thymic hypoplasia and sepsis (250,0 and 746,0 copies per 106 leukocytes, respectively). These data suggest the need for a differentiated approach to interpreting TREC and KREC levels in critically ill newborns, taking into account the multiple factors affecting immune status

The article is devoted to the study of the functional state of the brain in patients with post- COVID-19 conditions using magnetic resonance tractography. The study involved 27 patients with varying degrees of post-COVID-19 syndrome. The analysis showed a change in the functional status of the brain, characterized by a decrease in the sum of diffusions in the right cingulate gyrus, regardless of the severity of the post-COVID-19 condition. The identified changes were associated with increased levels of pro-inflammatory cytokines interleukin 8 and interleukin 6, and were accompanied by impaired performance on the proof-reading test and lower scores on the express assessment of cognitive status.

The objective of the study was to investigate the characteristics of immunological indicators in the peripheral blood of patients with primary immunoglobulin A nephropathy (IgAN) compared to those with immune-mediated glomerulopathies. The immunophenotypic characterization of cellular and humoral immunity in patients with IgAN showed that, alongside similar changes in the immunological indicators of peripheral blood that are characteristic of various immune-mediated glomerulopathies—specifically, a decrease in the level of CD3+CD4+ T-helper cells and an increase in CD3+CD8+ T-cells and CD3+CD4-CD8- T-cells. Patients with IgAN also exhibited an increase in the number of CD56+ NK cells, CD3+CD56+ TNK cells, and γδ T-lymphocytes expressing a cytotoxic phenotype. This represents a functional distinction compared to similar indicators in groups of patients with chronic glomerulonephritis, including focal segmental glomerulosclerosis and minimal change disease, lupus nephritis, and immunoglobulin A vasculitis.

This study reports the frequency and prognostic significance of NUP98 rearrangements in a homogeneous cohort of pediatric and young adult patients with myeloid neoplasms treated according successive versions of AML-MM protocol. The frequency of NUP98 aberrations was 2,7% (4 of 147) in primary acute myeloid leukemia (AML) and 12,5% (1 of 8) in MDSassociated AML. In the primary AML cohort, NUP98 rearrangements were associated with a significantly higher cumulative incidence of relapse compared to both the overall NUP98- negative AML group (p < 0,0001) and prognostically unfavorable AML subtypes, including KMT2A rearrangements (p < 0,01) and FLT3-ITD mutations (p < 0,05). Furthermore, we demonstrate the potential efficacy of natural killer cell-based therapy prior to hemopoietic stem cell transplantation in a patient harboring a NUP98 rearrangement.

This article presents the results of a retrospective study of the prevalence of nontoxigenic and toxigenic C. difficile strains in hematological oncology patients. The detection rate of C. difficile in hematological oncology patients was 22,5%, of which toxigenic strains accounted for 38,5%. Toxigenic C. difficile strains were most often detected in patients with acute leukemia (46,7%). More than half of the detected toxigenic C. difficile strains (53,3%) were found in patients over 65 years of age. Among patients in whom toxigenic strains of C. difficile were detected, men accounted for 46.7%, women – 53,3%. 64,1% of patients had a history of multiple hospitalizations (from 2 to 15). The median length of hospitalization was 30,5 [18,5; 41,5] bed-days. Combination antibacterial therapy (two or more antibiotics) was used in 79,5% of patients, chemotherapy in 71,8%, and proton pump inhibitor therapy in 69,2%. Secondary immunodeficiency was diagnosed in 87,2% of patients with oncohematological diseases.

The article presents the results of studying the taxonomic structure of lactobacilli in cervical intraepithelial neoplasia. Species identification was performed using modern methods of clinical microbiology: mass spectrometry and molecular genetic methods. Based on the results of the studies, the features of the taxonomic characteristics of lactobacilli in cervical dysplasia were determined. The studies revealed a predominance of L. crispatus in women without pathological changes in the cervix, while L. iners was the leading species in cervical dysplasia.

Hemophilia A is caused by pathogenic variants in the F8 gene, with large deletions and duplications accounting for approximately 6% of severe cases and 1,4% of mild/moderate forms. Standard molecular diagnostic approaches typically include screening for introns 22 and 1 inversions, followed by sequencing of coding exons and flanking splice sites of the F8 gene. However, these methods frequently fail to detect large structural rearrangements, such as deletions and duplications, as the underlying genetic cause. This study is the first in Belarus to assess the utility of multiplex ligation-dependent probe amplification (MLPA) for identifying large structural alterations in the F8 gene. The study included 6 male patients with hemophilia A from 5 unrelated families and 3 female blood relatives (mothers or sisters), assessed for carrier status and mode of inheritance. MLPA identified hemizygous large CNV in all patients: deletions of exon 6 and exons 2–6, and duplications of exon 13 and exons 2–7. The same structural alterations were detected in heterozygous state in the female relatives examined. These findings demonstrate the high sensitivity and clinical value of MLPA in the genetic diagnosis of hemophilia A. The method provides a robust foundation for precise medical genetic counseling in families with a positive history, accurate risk assessment for disease transmission, and prevention of therapy-related complications.

Community-acquired pneumonia in children remains one of the leading infectious causes of mortality, its etiological structure is constantly changing. A high proportion of pneumonias with an unspecified pathogen is characteristic of the Republic of Belarus that complicates the rational selection of initial therapy and contributes to the growth of antibiotic resistance.
A retrospective cohort study of 485 clinical records of children aged 0 to 17 years with confirmed community-acquired pneumonia was conducted. Bacteriological culture, polymerase chain reaction (PCR) of respiratory tract samples, and enzyme-linked immunosorbent assay (ELISA) for IgM/IgG antibodies to M. pneumoniae and C. pneumoniae were used for etiologic diagnosis.
In 64,9% of cases, the etiology was not identified. Among cases with an established etiology, respiratory viruses predominated in children under 5 years of age (60,9%), Mycoplasma pneumoniae predominated in children aged 10 years and older (78,3%), while in the 5–9 years ago group, no single pathogen showed a clear predominance (M. pneumoniae — 48,1%, respiratory viruses — 29,6%, typical bacteria and mixed infections — 11,1% respectively).
The identified age-related pattern, combined with the high proportion of cases with unidentified etiology, allows the proposal of three clinical-therapeutic strategies. In children under 5 years of age, antibiotic use should be limited in the absence of firm indications. In children aged 10–17 years, macrolides are the preferred choice for initial therapy. In the 5–9 years age group, diagnostic investigation is necessary, including mandatory assessment of inflammatory biomarkers and pathogen verification.

The article presents an experience based on five hybrid procedures performed in the acute phase of ischemic stroke, combining endovascular aspiration thrombectomy from the middle cerebral artery with open carotid endarterectomy of the extracranial segment of the internal carotid artery, with an assessment of the effectiveness of the procedures using the Thrombolysis in Cerebral Infarction scale and the modified Rankin Scale (mRS) at admission and within 90 days from disease onset. Intraoperatively, recanalization of the intracranial arteries was achieved in 100% of cases, with recovery of the neurological deficit to less than 2 points on the mRS.

The article presents an analysis of a clinical case of neurogenic urinary disorder in the postpartum period after spinal analgesia. An analytical review of the literature on modern approaches to the problem of bladder dysfunction (hypofunction) in the postpartum period, the most common clinical manifestation of which is postpartum urinary retention, has been conducted. The multifactorial pathogenesis of this complication includes neuromuscular damage, mechanical obstruction, the effect of anesthesia, and pain syndrome. Modern research makes it possible to clearly identify risk groups (instrumental labour, epidural anesthesia, prolonged labour, large fetus), which allows doctors to conduct targeted screening. The introduction of early detection protocols (ultrasound scanning, urine volume measurement) and unified treatment approaches can minimize risks and ensure a favourable long-term prognosis for patients with this complication. The literature data is illustrated by our own observation of the successful management of a patient with bladder hypofunction in the postpartum period.

This article presents a literature review on the interdisciplinary impact of hemodynamically significant internal carotid artery stenosis on visual function. The article reviews the peculiarities of the visiual function preservation in patients with hemodynamically significant internal carotid artery stenosis. The objective of the study was to analyze the factors determining the visual function preservation in hemodynamically significant internal carotid artery stenosis and to assess the possible role of collateral circulation in maintaining adequate blood supply to the visual analyzer. The presented study results clearly demonstrate the compensatory mechanisms that ensure the visual function preservation in patients with hemodynamically significant internal carotid artery stenosis. The obtained results emphasize the importance of compensatory circulatory mechanisms and the need for a comprehensive interdisciplinary approach to the examination of patients with brachiocephalic artery pathology. The work focuses on the role of collateral blood flow as one of the key factors contributing to the preservation of visual functions in hemodynamically significant stenosis of the internal carotid artery.