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In this section you can check out Belarusian author’s publications in foreign periodicals which are accessible in RSML. To order a full text, use Electronic medical library or the Electronic document delivery service.
| Возможности и ограничения вторичной профилактики хронических неинфекционных заболеваний в первичном звене здравоохранения России и стран СНГ / М. Н. Мамедов, Б. У. Марданов, В. А. Куценко, О. М. Драпкина, Л. А. Балыкова, И. В. Друк, М. С. Григорович, Е. В. Ефремова, С. Г. Канорский, М. М. Петрова, Т. М. Попонина, И. А. Золотовская, О. А. Рубаненко, Л. А. Хаишева, Н. В. Дроботя, Б. Г. Искендеров, В. А. Невзорова, М. А. Уметов, А. А. Кузнецов, В. С. Никифоров, В. В. Тыренко, А. В. Бурсиков, Е. А. Манюгина, Г. Г. Арабидзе, С. Х. Мехдиев, Ж. А. Кауызбай, И. Т. Муркамилов, Л. В. Кежун (Гродно), Л. В. Якубова (Гродно), Б. К. Жолдин, Т. З. Сейсембеков // Профилактическая медицина [Москва]. – 2024. – Т. 27, № 11. – С. 54–62.
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Objective. To analyze the possibilities and limitations of implementation of secondary prevention of chronic non-communicable diseases (CNCDs) in primary care in cities in the Russian Federation and 4 CIS countries based on a survey of doctors. Material and methods. The study involved doctors of outpatient-polyclinic facilities from 16 cities in the Russian Federation and 6 major cities in 4 CIS countries (Kyrgyz Republic, Republic of Belarus, Republic of Kazakhstan, Republic of Azerbaijan). The survey was organized on a questionnaire prepared by «National Medical Research Center for Therapy and Preventive Medicine», which included 11 blocks of questions. Multiple choice for each question is provided. Results. Men aged 50—59 years prevailed among patients, who were observed in outpatient clinics of five countries. Men aged over 65 years made up 30 and 40% respectively in the samples from the Russian Federation and the Republic of Azerbaijan, and only one fifth — in the samples from the other three countries. Men aged 40—50 years were ranked second for frequency of uptake in the samples from Republic of Kazakhstan and Republic of Belarus. The frequency of uptake among women was comparable in the age ranges of 50—59 years, as well as 60—65 years and older in samples from the Russian Federation, Republic of Belarus and Republic of Azerbaijan. Chronic forms of ischemic heart disease ranked first among CNCDs in terms of uptake (56% on average), the second place is occupied by the type 2 diabetes mellitus (27% on average). At least partial coverage by preferential drugs was provided according to the doctors in most of the considered samples from CIS countries; 100% coverage supplied the needs up to 40% in three CIS countries, this indicator was 2 times less in other countries. In the Kyrgyz Republic and Republic of Azerbaijan, 50% of the target level was reached. The situation was slightly better in the other three countries, with doctors reporting 75% of the target level reaching for the main risk factors. In all countries, about 30% of the cases were without problems with hospitalization, partial difficulties prevailed in the rest of the cases. An incomplete coverage by doctors in the staffing list in the analyzed countries has been noted, and there has been a significant shortage of doctors in the Russian Federation and Republic of Kazakhstan. The similar picture has been observed regarding the nursing staff. Conclusion. Systematic screening and regular medical check-up of adults are necessary, especially in the age group of 40—49 years for men and 50—59 years for women with regard to the significant role of chronic non-communicable diseases in the development of complications and mortality in CIS countries. Measures to increase adherence to the treatment, that affects the achievement of target levels of major risk factors, should be taken. The increase of preferential provision of pharmaceutical products and the organization of health-promoting schools for patients with chronic non-communicable diseases are important measures. In most CIS countries, the increase of the staffing list coverage by doctors and nursing staff can improve the implementation of secondary prevention of chronic non-communicable diseases. |
| Трансплантация печени при нерезектабельной опухоли Клацкина: опыт двух центров, первые отдаленные результаты / Д. А. Гранов, О. О. Руммо (Минск), И. И. Тилеубергенов, А. Е. Щерба (Минск), И. О. Руткин, В. Н. Жуйков, И. П. Штурич (Минск), А. А. Поликарпов, С. В. Коротков (Минск), А. Р. Шералиев, Л. В. Кирковский (Минск), Т. М. Чернышов (Минск), А. В. Моисеенко // Анналы хирургической гепатологии [Москва]. – 2024. – Т. 29, № 3. – С. 70–80.
Liver transplantation for unresectable Klatskin tumor: experience of two centers, first distant results |
Aim. Evaluation of the first distant results of the combined experience of liver transplantation for unresectable portal cholangiocarcinoma from two large specialized clinical centers. Materials and methods. In total, 23 attempts at liver transplantation for unresectable Klatskin tumor were undertaken. Out of them, 10 were conducted at the A.M. Granov Russian Research Center for Radiology and Surgical Technologies (Granov Center), and 13 were conducted at the Minsk Scientific and Practical Center for Surgery, Transplantology, and Hematology (Minsk Center). The maximum tumor size was 5 and 3 cm in patients operated at the Granov and Minsk Centers, respectively. In the Granov Center, neoadjuvant therapy included a combination of endobiliary photodynamic therapy, regional and systemic chemotherapy. Patients were included in the waiting list only in cases of decreased tumor marker levels and in the absence of disease progression and acute cholangitis. In the Minsk Center, stereotactic radiotherapy was used for neoadjuvant treatment in the absence of active cholangitis; the first 3 patients underwent liver transplantation without prior neoadjuvant treatment. Results. Due to disease progression, six patients were excluded. In three patients at the Mink Center, the diagnosis was not morphologically confirmed after liver transplantation. A total of 14 liver transplantations were performed for unresectable hilar cholangiocarcinoma. After neoadjuvant treatment at the Granov Center, normalization of the CA19-9 marker was observed in four patients, its decrease by 3–4 times was observed in two patients. Liver transplantation was performed in six patients. The average time from the onset of treatment to transplantation was 9.1 months (6–14). Out of the six patients, one was alive for 34 months, with the median overall survival being 22.2 months. Progression was the cause of death in only one patient. Out of the three patients without neoadjuvant treatment at the Minsk Center, two were alive at 16 and 134 months without progression. One patient died after transplantation from disease progression at 24 months. Stereotactic radiotherapy achieved normalization of CA19-9 in four patients; its twofold reduction was observed in one patient. The average time from the onset of treatment to transplantation was six months (3–12). The average CA19-9 tumor marker level by the time of transplantation was 11.3 IU/mL. At 20–26 months, three patients were alive without evidence of disease progression; two patients died of progression after 9 and 59 months. Conclusion. Liver transplantation for unresectable portal cholangiocarcinoma after neoadjuvant treatment regardless of the methods used is highly promising in carefully selected recipients. |
| Гиндюк, Л. Л. Оценка удовлетворенности медицинских работников организацией социально-гигиенического мониторинга пациентов с бронхиальной астмой / Л. Л. Гиндюк (Минск), И. Н. Мороз (Минск) // Бюллетень Национального научно-исследовательского института общественного здоровья им. Н. А. Семашко [Москва]. – 2024. – № 4. – С. 19–24.
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The article presents the assessment of satisfaction of medical workers with the organization of socio-hygienic monitoring of health status of patients at risk of bronchial asthma and patients with bronchial asthma. The most important activities of the organization of socio-hygienic monitoring that affect the quality of life of patients with bronchial asthma and the formation of the need for medical care are identified. |
| Кирей-Ситникова, Я. Доступность гендерно-аффирмативного и общего здравоохранения для трансгендерных людей в Республике Беларусь / Я. Кирей-Ситникова, А. Кумец (Минск) // Бюллетень Национального научно-исследовательского института общественного здоровья им. Н. А. Семашко [Москва]. – 2024. – № 4. – С. 71–79.
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Background. Feedback from patients is an important source of information for improving healthcare. This study aims to investigate accessibility of gender-affirming and general healthcare for transgender people in the Republic of Belarus. Materials and methods. Thematic analysis of 16 oral interviews using the socio-ecological model. Results. Social factors complicating access to gender-affirming healthcare include: the lack of legal possibility to initiate hormone therapy before changing the gender marker; inaccessibility of medical transition for individuals under 18; psychopathologization of transgenderism; inability to change the identification number, which encodes gender; inability to enter marriage for individuals with the same legal gender. Institutional factors: centralization of gender-affirming healthcare in Minsk, which leads to geographic barriers and the system’s instability; the need to pay for hormonal drugs out of pocket; long evaluation time and unpredictability; unnecessary evaluations; low quality of surgeries; the lack of connection between specialists; the lack of gender-neutral toilets; sex-based separation of specialists (gynecologist/urologist). Interpersonal factors: misgendering and deadnaming; the lack of properly defined diagnostic criteria; gender stereotypes of specialists; denial of service; breach of confidentiality. Intrapersonal factors: low awareness; psychophobia; the lack of self-confidence; concerns about the reactions of people around. Conclusions. Gender-affirming healthcare is free for patients in Belarus, which is its major advantage. The disadvantages include: centralization, unclear diagnostic criteria, and the lack of competence/politeness on behalf of medical professionals. |
| Транслокация кишечной микрофлоры у умерших органных доноров / О. В. Петкевич (Гомель), В. М. Мицура (Гомель), В. Н. Мартинков (Гомель), Д. Л. Дугин (Гомель), З. А. Дунаров (Гомель) // Вестник трансплантологии и искусственных органов [Москва]. – 2024. – Т. 26, № 4. – С. 178–183.
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Objective: to ascertain the prevalence and risk factors for bacterial translocation (BT) in brain-dead donors (BDDs) during organ and tissue retrieval in health care facilities. Materials and methods. The study included 62 BDDs, featuring 44 males (71%) and 18 females (29%), aged 17 to 64 years. Organ was retrieved in healthcare institutions located in Gomel Oblast in 2019–2022. Bacteriological examination of biopsy material taken from different parts of the intestine, mesenteric lymph nodes (MLNs) and spleen was carried out. The presence of BT was validated when bacterial growth was obtained from homogenized MLNs and(or) spleen by isolating an identical strain from the intestinal lumen. The anthropometric сharacteristics of BDDs, hematologic, biochemical parameters, and the length of stay in the intensive care unit (ICU) were assessed. Results. Evidence of bacterial translocation was detected in 22 BDDs (35.5%, 95% CI 24.7–48.0). Growth in MLNs and in spleen biopsies was noted in 21 (95.5%) and 7 (31.8%) patients, respectively. The BDDs were categorized into two groups depending on the presence of BT, and the main characteristics were compared. ROC analysis was used to determine the prognostic significance of the main parameters. Risk factors for BT were serum sodium level >144 mmol/L (AUC = 0.759) at the time of retrieval, weight >89 kg (AUC = 0.756), BMI >27.5 (AUC = 0.709), decreased hemoglobin <126 g/L (AUC = 0.665), and ICU stay >2 days (AUC = 0.656). Conclusion. Bacterial translocation is found in 35.5% of BDD cases, and it is accompanied by penetration of bacteria and yeast-like fungi into the MLNs and spleen. Bacterial translocation is linked to excess body weight, hypernatremia, prolonged ICU stay, and decreased hemoglobin levels at the time of retrieval. These factors should be taken into account in the medical management of brain-dead donors (organ donor conditioning). |
| Успешная коррекция аортолевожелудочкового туннеля / Е. Н. Жук (Минск), М. М. Швед (Минск), А. В. Горустович (Минск), С. В. Китикова (Минск), В. В. Дроздовская (Минск), Ю. И. Линник (Минск), К. В. Дроздовский (Минск) // Детские болезни сердца и сосудов [Москва]. – 2024. – Т. 21, № 1. – С. 60–65.
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The publication presents diagnostic and surgical treatment of aorto-left ventricle tunnel in 2 years old patient. Aorto-left ventricle tunnel is a rare congenital heart defect with various clinical presentation depending on localization and size of the tunnel. Difficulties in diagnostic and surgical treatment are also described. Timing of surgery plays a significant role, because of quickly development of the heart failure. Patients with aorto-left ventricle tunnel should be full diagnosed with the aim of correct preoperative diagnosis and surgical tactics. The clinical case demonstrates method of surgical treatment of the aorto-left ventricle tunnel and successful recovery with stable postoperative period. |
| Анализ заболеваемости злокачественными опухолями кожи век в Республике Беларусь за 25 лет / Л. В. Науменко (Минск), С. А. Красный (Минск), Д. В. Овчинников (Минск), П. И. Млисеев (Минск), А. Е. Океанов (Минск), А. А. Евмененко (Минск), Е. П. Жиляева (Минск), И. Ю. Жерко (Минск) // Онкология. Журнал имени П. А. Герцена [Москва]. – 2024. – Т. 13, № 5. – C. 40–44
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To study the incidence of malignant tumors of the eyelid skin and indicators reflecting the state of diagnostics of these neoplasms in the Republic of Belarus. Material and methods. An analysis of data from the Belarusian Cancer Registry over a 25-year period (from 1998 to 2022) was carried out. The study included 10.393 cases of diseases with a cytologically and/or morphologically confirmed diagnosis: C44.1 — basal cell cancer of the skin of the eyelid, other malignant neoplasms of the skin of the eyelid, including eyelid commissure, and C43.1 — melanoma of the eyelid skin, including eyelid adhesion. Results. In the structure of the incidence of all malignant neoplasms of the skin, malignant diseases of eyelid skin in 1998 amounted to 7.1%, and in 2022 their rate was 4.8%. The decrease in the extensive proportion occurred due to a general increase in the incidence of skin cancer and melanoma of all locations, especially basal cell carcinoma. Over 25 years, there has been a more than twofold increase in the number of newly registered primary cases of eyelid skin neoplasms from 293 in 1998 to 496 in 2022. The main increase was in basal cell forms of eyelid skin cancer. Analysis of tumor prevalence according to the «T» criterion indicates a satisfactory state of early-stage diagnosis of basal and squamous cell carcinoma. Skin melanoma was detected much worse in the initial stages of the disease. Only in a quarter of patients (25.5%) the disease was detected at T1N0M0, and in 14.9% — at T2N0M0. Conclusion. A twofold increase in the incidence of eyelid skin tumors (mainly due to basal cell carcinoma) was revealed. Diagnosis of eyelid skin melanoma during medical examinations and visits from citizens requires improvement through the training of primary care doctors and the development of an examination algorithm with mandatory consultation with an ophthalmologist. |
| Особенности приема антибактериальных препаратов населением в Республике Беларусь / Н. Э. Колчанова (Гомель), Т. М. Шаршакова (Гомель), А. Ю. Брага (Гомель), В. П. Чигрина, Д. С. Тюфилин, О. С. Кобякова, И. О. Стома // Профилактическая медицина [Санкт-Петербург]. – 2024. – Т. 27, № 10. – С. 15–22.
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Resistance to antibacterial drugs has been and remains among the most critical global challenges of modern public healthcare, which affects people, animals, and the environment. Understanding the current situation with antibacterial drug intake by population is required to formulate a strategy to combat antibiotic resistance or adapt the existing measures. Objective. To identify the features of antibacterial drug intake by the population of the Republic of Belarus and compare the results with Russia’s data. Material and methods. The e-questioning was conducted in all regions of the Republic of Belarus using a questionnaire containing 28 questions in 6 blocks. The results were statistically processed using Statistica for Windows version 10.0, Stata, and R-studio software. Results. 18.7% of respondents took antibacterial drugs without a prescription; 69.5% of them started the intake independently or on the advice of familiar medical workers (29.1%), pharmacists at the pharmacy (25.5%), or family members (17.7%). The most common reasons to terminate the course of medication were the improved condition (74.9%), disagreement with the duration of taking medications (8.8%), or the onset of adverse reactions (7.9%). The parameters that increased the risk of terminating the course of antibacterial drugs were the male gender, absence of higher education, purchase of drugs without a prescription, lack of knowledge on the prohibition to sell this group of drugs without a prescription, the absence of information about the proper intake of antibacterial drugs, the non-intake of drugs that normalize intestinal microflora and the reliance on the family members’ or mates’ knowledge as the source of data on antibacterial drugs. Conclusions. The comparison of this study’s findings showed a large share of respondents taking antibacterial drugs without a prescription (32.2%) and those not completing the course of medication (21.7%) in Russia compared to the Republic of Belarus (18.7 and 132%, respectively). The reasons for terminating the course of antibacterial drugs were the same: the improved condition of the participants, disagreement with the duration of taking medications, or the onset of adverse reactions. A regular exchange of experience between the countries is needed to determine and scale the best practices and develop more efficient strategies to combat antibiotic resistance.. |