Volume 36, Nº 11 (2025)

Objective. To review the features of postpartum rehabilitation in patients who underwent fertility-sparing treatment for gynecological cancers.

Materials and methods. Literature review and clinical observations regarding postpartum recovery in this category of women were analyzed.

Results. Key risks and complications were identified, including pelvic floor dysfunction, lymphedema, and psychoemotional disorders.

Conclusion. Development of specialized monitoring protocols and comprehensive rehabilitation programs for patients after organ-preserving treatment for gynecological cancer is required.

The article presents a comprehensive analysis of the use of biofeedback methods (BFB) in the rehabilitation of patients after hip arthroplasty. Based on a systematic review of the literature for the period 2019–2024, modern approaches to the use of various types of BFB, including electromyographic, ultrasound and inertial feedback, are studied. Pathogenetic mechanisms of the postoperative period are considered and the effectiveness of BFB technologies at different stages of rehabilitation is substantiated. The results of clinical studies demonstrating the benefits of using BFB in restoring motor function and forming correct motor stereotypes are analyzed. Practical recommendations for the use of BFB methods are developed, taking into account the time stages of rehabilitation and individual characteristics of patients.

This article discusses the development of specialized mathematical software, which is a set of mathematical methods, models and algorithms, as well as software tools for assessing leading indicators of patients' health using digital twin technologies. We will discuss the necessary mathematical approaches, ways to integrate them into clinical practice, and the potential for further research in this area.

Purpose. To establish the prevalence, clinical and medical-social aspects of syphilis in pregnant women and congenital syphilis, to determine the effectiveness of measures to eliminate congenital syphilis in Belarus.

Material and methods. Archival materials from the institutions of the dermatovenerological service of the Republic of Belarus were studied and summarized, including 127 reports of investigations into cases of congenital syphilis, as well as outpatient cards and medical histories of pregnant women diagnosed with syphilis for the period from 1994 to 2023.

Results. From 1996 to 2023, 5,338 cases of syphilis were detected among pregnant women in Belarus, which is 8.43% of the total number of registered cases of the disease in women. The dynamics of the incidence of syphilis among pregnant women is considered, including an analysis of the structure of diagnoses, timing of detection of infection during pregnancy and associated reproductive losses, in particular, cases of induced termination of pregnancy. Particular attention is paid to the problem of congenital syphilis: during the study period, 127 cases of mother-to-child transmission of the infection were recorded. The results of the study formed the basis for the developed improved approaches to the treatment and prevention of both congenital syphilis and syphilitic infection in pregnant women, which is important for the protection of maternal and child health. The World Health Organization validation process for the elimination of vertical mother-to-child transmission of syphilis in Belarus (2016) is described, as well as the country’s actions to meet the requirements of the Global Validation Committee to maintain the validation status to date.

Conclusion. The implemented diagnostic algorithms and treatment regimens make it possible to effectively identify and treat the disease in pregnant women, preventing its transmission to the fetus.

Purpose. To study the opinion of practicing dentists on the prospects and possibilities of introducing telemedicine technologies into dental practice at the level of a separate region – Donetsk.

Materials and methods. Based on the developed questionnaire, a sociological survey of practicing dentists in Donetsk (n=118) with experience in the specialty from 3 to 25 years was conducted. The attitude of respondents to telemedicine technologies was analyzed, taking into account their gender, age, experience in the specialty and specialization.

Results. Dentists noted the undoubted relevance of using teledentistry in their professional activities. It is necessary to note the absence of reliable differences in the analysis of the possibilities and prospects for the introduction of telemedicine technologies in dentistry among male and female respondents, as well as the absence of reliable differences in the readiness to introduce teledentistry depending on the age of doctors.

Conclusion. The use of teledentistry can contribute to a significant reduction in the number of inappropriate referrals, a decrease in the workload of a specialist while increasing the coverage of the population with dental care. At the same time, the limited use of teledentistry in Donetsk was revealed along with the recognition by dentists of the relevance of the active implementation of teledentistry services.

Arterial hypertension (AH) remains a key factor in the progression of chronic kidney disease (CKD) and cardiovascular risk. Modern recommendations emphasize the need for early prescription of renin-angiotensin system blockers in the form of rational fixed combinations to achieve target blood pressure (BP) levels and nephroprotection.

Purpose. To evaluate the efficacy and safety of the fixed combination of azilsartan/chlorothalidone (Edarbi^®Clo) in patients with AH and CKD in real clinical practice.

Materials and methods. A retrospective analysis of 502 outpatient records from the MONIKI database was conducted; inclusion criteria: over 18 years old, essential AH, prescription of Edarbi^®Clo 40/12.5 or 40/25 mg once a day, glomerular filtration rate (GFR) >30 ml/min/1.73m², single-dose microalbuminuria (MAU) >30 mg/l; excluded: secondary AH, combined therapy with a second angiotensin receptor blocker, GFR <30 ml/min/1.73m², type 1 diabetes, hyperkalemia. The parameters were assessed at 3 visits up to 24 weeks.

Results. In the cohort with a full set of visits receiving azilsartan/chlortalidone (n=153), the average mean systolic BP decreased from 147.5±11.8 to 125.1±7.9 mmHg; diastolic BP – from 90.1±8.2 to 77.2±6.1 mmHg. By the 24^th week, 93% reached BP <140/90 and 71% – <130/80 mmHg. GFR increased (from 50.1±4.1 to 55.9±3.1 ml/min/1.73m²), MAU decreased (from 198.7±9.2 to 99.4±7.8 mg/l). Potassium and glucose did not change significantly. 3.3% of patients required therapy adjustment.

Conclusion. The use of Edarbi^®Clo in patients with AH and CKD provided a targeted antihypertensive effect with parallel nephroprotection (increased GFR, decreased MAU) and stable potassium levels; it demonstrated a favorable safety profile in real clinical conditions. The obtained results are consistent with the data from randomized studies of azilsartan/chlorthalidone and the current recommendations of ESH and KDIGO.

Objective. To evaluate the mechanical strength, biodegradability, and functional response of human fibroblasts to a collagen hydrogel modified with lactate and citric acid salts.

Materials and methods. Denatured type I collagen (First Alive Collagen, Russia) and 80 mM sodium lactate and sodium citrate solutions were used in the study. The mechanical properties of the samples were analyzed using a TX-700 texture analyzer (Lamy Rheology Instruments, France). The biological properties of the materials were assessed according to the standards set forth in GOST ISO 10993-5-2011. The cellular response of human fibroblasts to the biomaterials was assessed using light and fluorescence microscopy. Cell viability was assessed using the CCK-8 reagent kit (WST-8). The amount of collagen and fibronectin was assessed using ELISA kits (Cloud-Clone Corp.).

Results. Modifying collagen hydrogel with tricarboxylic acid salts resulted in hydrogel biomaterials with enhanced strength and resistance to biodegradation. The resulting modified hydrogels exhibited high biocompatibility and the ability to support fibroblast growth and proliferative activity. The ability of a hydrogel modified with a citric acid salt to stimulate fibroblast production of extracellular matrix proteins was demonstrated.

Conclusion. Thus, these results complement the literature and demonstrate that lactic or citric acid salts increase the resistance of collagen hydrogel to biodegradation while maintaining the hydrogel's high biocompatibility. Furthermore, the use of sodium citrate was found to regulate the cellular functional response, specifically the production of extracellular matrix proteins – type I collagen and fibronectin – by fibroblasts. Controlling excessive fibroblast activation and unregulated deposition of extracellular matrix proteins is of interest both in developing an effective strategy for addressing excessive connective tissue growth and fibrosis, and for inhibiting fibrous encapsulation of implanted biomaterials.

Purpose. To compare the results of using different types of abdominoplasty in patients with mas-sive weight loss, taking into account the type of anterior abdominal wall deformity (AWD).

Material and methods. An analysis of the clinical material of 226 patients with massive weight loss was carried out, in whom different methods of abdominoplasty were used to correct the deformity of the hip joint. Depending on the method of surgical intervention, 2 groups were divided: 1st (compari-son group; n = 109) – standard abdominoplasty methods were used; 2nd (main group; n = 117) – an ap-proach to abdominoplasty developed by the authors was used, taking into account the type of deformity.

Result. The use of a standard method for correcting deformities of the hip joint turned out to be ineffective: the frequency of complications in the early and late postoperative period in the comparison group exceeded those in the main group by 18.9–25.7 and 23.5–29.8% (p = 0.01), respectively. The use of the developed approach to abdominoplasty, taking into account the type of hip joint deformities, is characterized by better intraoperative indicators, a lower incidence of early complications, and higher favorable long-term outcomes compared to standard methods.

Conclusion. The choice of abdominoplasty method for correction of hip joint deformities must be carried out taking into account the type of deformation.

Objective. To assess the prognostic value of circulating microRNA-29a expression levels in relation to cardiac arrhythmias detected by 24-hour (Holter) ECG monitoring in patients with hypertrophic cardiomyopathy (HCM).

Materials and methods. The study included 41 patients with a verified diagnosis of HCM (21 men, 20 women), with a mean age of 57.2±14.2 years. All patients underwent 24-hour ECG monitoring. The expression level of microRNA-29a in plasma was measured using RT-qPCR. The Mann–Whitney U test was used for statistical analysis (p < 0.05).

Results. In patients with arrhythmias, the level of microRNA-29a was significantly lower compared to those without arrhythmias (0.206 vs. 0.433; p = 0.0015). No statistically significant associations were found between miR-29a expression and conduction disturbances.

Conclusion. Reduced expression of microRNA-29a may be associated with an increased risk of arrhythmias in patients with HCM. This epigenetic marker could serve as a valuable addition to existing risk stratification tools and warrants further investigation in larger patient cohorts.

The article provides an overview of the literature on the study of the functional capabilities and limitations of digital solutions in cardiac rehabilitation, identifies the main barriers to implementation, and formulates recommendations.