Quality of life in adolescents with obesity and concomitant diseases
V.A. Kalashnikova, V.P. Novikova, N.N. Smirnova, I.S. Volkova
3. Тhrombin generation assay in patients with coronary artery disease having indications for coronary stenting V.Yudina, O. Melnichnikova, S.Chernyh, E. Vorobeychikov, M. Кarpenko, T. Vavilovа
4. Laboratory markers of surgical site infection prediction after transpedicular screw fixation of the spine. L.B. Gajkovaya, A.N. Tkachenko, A.I. Ermakov, E.M. Fadeev, V.V. Usikov, V.M. Hajdarov, D.Sh. Mansurov
5. Gender differences of peripheral atherosclerosis: role of metabolic changes N.I. Glushkov, M.A. Ivanov, P.B. Bondarenko, M.Y. Yermina, A.S. Artemova, M.S. Chvostova, P.D. Pusdriak
Аssessment of degree of disability in patients with radically treated breast cancer
A.Z. Dovgalyuk, V.S. Spiridonova, I.A. Pazuhina, M.M .Suleymanov
7. Surgery for esophageal cancer: past, present and future (scientific review) K.V. Arutyunyan, K.S. Il'in, I. M. Kuznetsov, M.D. Ter-Ovanesov, K.G. Shostka, L.D. Roman
Еvaluation of the effectiveness of rehabilitation measures using computer optical topography in outpatients with lower back pain
J.A. Kreneva, V.P. Panov, M.V. Avdeeva
REVENTIVE MEDICINE
MODERN VIEW ON DENTAL STATUS IN SMOKERS ACCORDING TO PREVENTIVE MEDICINE
A.V. Silin, A.S. Nechoroshev, N.B. Danilova, E.I. Morozova,E.Y. Lubskaya North-Western State Medical University named after I. I. Mechnikov, Russia, Saint-Petersburg Abstract.
The problem of smoking in the Russian Federation is still urgent, hereat it is regulated on the state level by the development and enchantment of laws and regulations to control smoking. Dental status in smokers as the most reliable working population health indicator is worth noticing for further investigation to develop the preventive measures aimed at health improvement. Key words: Preventive medicine, smoking, laws and regulations, dental status, prevention.
COMPARATIVE ASSESSMENT OF DRINKING -WATER QUALITY IN THE ARKHANGELSK REGION AND ITS IMPACT ON POPULATION HEALTH
E.V.Baydakova1,2, T.N. Unguryanu1,2 1 Federal Supervision Agency for Customer Protection and Human Welfare Federation, Arkhangelsk Branch, Russia
2Northern State Medical University, Arkhangelsk, Russia
Abstract Introduction: Microbiological and parasitic markers in drinking-water directly indicate its epidemiological insecurity regarding the risk of infectious diseases. Aim of the study was to conduct a comparative analysis of the drinking water quality in the areas with different types of water consumption and to assess its impact on the infectious morbidity of the population. Materials and methods: It was performed the hygienic assessment of microbiological quality of the drinking-water supply network in the towns and districts of the Arkhangelsk region with various types of water sources. Results: The microbiological quality of the drinking-water in the areas with surface water sources is lower than in the areas with underground water sources. A correlation between the incidence of ascariasis and the content of thermotolerant coliform bacteria in piped water was established (rs = 0.78, p = 0.012). Conclusions: the quality of drinking-water supply in areas with surface water sources is lower than in the areas with underground water sources. Low quality of drinking-water supply could influence the intensity of the incidence of acute intestinal infections of unknown etiology and parasitic diseases. Key words: surface and underground water sources, drinking-water, infectious and parasitic diseases.
CHARACTERISTICS OF CURRENT NUTRITION OF CHILDREN IN THE GENERAL EDUCATIONAL ORGANIZATIONS OF YUZHNO SAKHALINSK AND WAYS OF ITS OPTIMIZATION
N.A. Samarskay 1, I.Sh. Iakubova 2 1Yuzhno-Sakhalinsk Children's City Policlinic, Russia, Yuzhno-Sakhalinsk, 2 North-Western State Medical University named after I.I. Mechnikov, Russia, Saint-Petersburg, Abstract Introduction. The municipal program for education improvement for 2015-2020 was approved in Yuzhno-Sakhalinsk, which provides the implementation of the subprogram «Healthy Nutrition. The program for studying the paediatric nutrition of Yuzhno-Sakhalinsk allows to obtain the general characteristics and to determine the regional peculiarities caused by the climate, economic factors, eating habits, knowledge and children's eating attitudes toward healthy nutrition. Aim of the study was to optimize the organization of school catering on the basis of hygienic assessment of current nutrition and social and hygienic examination of children and their parents, Material and methods. The study was conducted on base of 23 general education organizations of Yuzhno-Sakhalinsk. It was analyzed the 3-year period of activity of the general education organizations on school catering organization. The social and hygienic examination on healthy nutrition included 5885 parents from 14 general education organizations and 6026 pupils from 12 general education organizations. The analysis of child and teenagers morbidity was conducted in Yuzhno-Sakhalinsk Children's City Policlinic according to the data on morbidity statistic reports, incidence of outpatient visits and preventive examinations. Results and conclusions. While studying the current nutrition and child morbidity in Yuzhno-Sakhalinsk was determined the tendency to increase of teenagers incidence rate (15-17 years) from 1636,13 per 1000 people in 2013 to 1834,53 per 1000 people in 2015.
From among receiving hot meals the majority of pupils (82%) were provided with the breakfast,11,6% of pupils were provided with the lunch,14% of pupils with breakfast and lunch (two meals per day),19,2 of pupils with other forms of meal (afternoon snacks, buffet food). Assessment of sanitary and technical conditions of school catering revealed the problems in each general education organizations. The results analysis of social and hygienic examination of pupils confirmed the lack of knowledge of healthy eating habits, nutrition regime, products quality in pupils. Keywords: pupils, general education organizations, current nutrition, state of health, sanitary and technical conditions of schools catering, food intake, social and hygienic examination, eating habits, healthy food.
COMPREHENSIVE ASSESSMENT OF THE STUDENTS ' HEALTH STATUS
S.V. Mikhaylova Lobachevsky State University of Nizhni Novgorod, Russia, Arzamas Abstract Introduction:the comprehensive assessment of health status based on various approaches allow to receive detailed information on body functioning. The aim of the study was to analyze health indicators obtained from the results of comprehensive medical examinations in Health . Methods: the study included1302 students (453 male and 849 female) aged 18-25 undergoing questioning, anthropometry, bioimpedanceometry, cardiointervalography, determination of biological age, cholesterol and glucose level, vascular screening. Results: Self-assessment of health among students has high rates, they are interested in methods and ways of health promotion and protection, maintain the healthy life style. The study of the indicators of the biological age characterizing the functional state of the body revealed its correspondence to the passport age, but 19,3% had delayed body aging. According to IARS 45% of students had green zone health that is the optimal or moderate exertion of regulatory systems, total or sufficient body balance to the environment. In the majority of students (more than 80%) the biochemical parameters (blood sugar and glucose level) as well as the ankle brachial index are normal. The analysis of calorie intake corresponded to the nutritional norm in the half of the students, most of the female students kept to a low-calorie diet in comparison with male students keeping high-calorie diet. The comparative analysis of the bioimpedance parameters among students with various ageing rates showed the differences of the body composition in students being in good health and in students with delayed body aging, characterized by lower mean body fat percentage and higher indexes of body cell mass. Conclusion: The analyzed rates in the majority of students corresponded to the normal values, and the revealed deviations allow to timely prevent and treat the diseases, thus confirming the importance of the preventive function of the Health s. Key words: students, Health , biological age, IARS, BMI, ankle-brachial index, physical health, body composition, calorie intake
CLINICAL MEDICINE
OUR EXPERIENCE OF USING THE ABSORB BIORESORBABLE VASCULAR SCAFFOLD TO TREAT CORONARY ARTERY BIFURCATION LESION
G.G. Khubulava 1, K.L. Kozlov 2, A.N. Shishkevich 1, Z.M. Abdullaev 1, V.N. Kravchuk 1, S.S. Mikhailov 1, A.I. Lubimov 1, O.O. Volikov1, E.E. Bobrovskay 1 1 Military Medical Academy named after S.M.Kirov, Russia, Saint- Petersburg 2 Saint- Petersburg Institute of Bioregulationand Gerontology of the North-Western Branch of the Russian Academy of Medical Sciences, Russia, Saint- Petersburg Abstract Introduction: The article presents the data on our experience of using the absorb bioresorbable vascular scaffold at the X-ray endovascular treatment in aged patients with acute coronary artery calcification. The description of the absorb bioresorbable vascular scaffold and the stages of its in-vessel biodegradation was considered. Materials and methods: On the basis of our experience in performing the correction of the coronary artery bifurcation lesion using Absorb (Abbott Vasc., the USA) in 42 patients aged 63 to 90 was performed the comparison with the stenting of a bifurcation lesion using BMS and DES. Results: Performing the procedure it was observed the 50% stenosis at the side branch ostium in 20 cases after implantation, thus demanding to perform the balloon post-dilatation at the side branch ostium. After dilatation the residual stenosis at the side branch was no more than 30%. An adequate angiographic result with the restoration of coronary blood flow (TIMI III) was achieved in all patients. Against the double antiaggregant therapy it was not observed any complication of excessive and non- excessive bleedings, as well as signs of an early stent thrombosis. Conclusions: Our experience of using of the absorb bioresorbable vascular scaffold by the T-stenting technique showed the good results in the early and late postoperative period with positive angiographic and clinical outcomes. Keywords: absorb biodegraded vascular scaffold; bifurcation lesion; coronary stenting.
LIFE QUALITY IN ADOLESCENTS WITH OBESITY AND CONCOMITANT DISEASES
V.A. Kalashnikova1,2, V.P. Novikova2,3, N.N. Smirnova2,3 I.S.Volkova3 1 Children's regional hospital, Saint-Petersburg, Russia 2 Pavlov First Saint-Petersburg State Medical University, Russia, St-Petersburg 3 Federal State Budgetary Establishment Federal Almasov Nord-West Medical Research Centre, Russia. St. Petersburg Abstract: Introduction: Obese children have more concomitant diseases than children with normal somatotypes; they have worse quality of life and eating disorders in comparison with the peers with normal BMI. Meanwhile the correlation between certain quality of life indicators with metabolic status and concomitant diseases is not studied. Material and methods: Questionnaire SF-36 (Healthy Status Survey) was used to evaluate the main quality of life indicators associated with obesity and concomitant diseases. Answers to 36 questions revealed the physical and emotional state of patient, his/her physical activity and social communication. The study included 42 obese adolescents (BMI 30.1-42.87) and 32 adolescents with normal physical parameters (BMI 30.1-42.87) with mean age 14,25 (±1,2). The data on anamnesis, clinical, instrumental and biochemical examination was compared with survey findings by the Questionnaire SF-36. Results and conclusions: It was found out that obese adolescents have worse quality of life in comparison with healthy ones and decrease depending on the duration and disease progression. Family obesity disimproves the psychological component of quality of life in adolescents, thus requiring family therapy. Concomitant diseases and metabolic complications in obese adolescents make their quality of life worse. Key words: obesity, children, quality of life, liver steatosis, metabolic syndrome.
THROMBIN GENERATION ASSAY IN PATIENTS WITH CORONARY ARTERY DISEASE HAVING INDICATIONS FOR CORONARY STENTING
V.A.Yudina1, O.S.Melnichnikova1, S.G.Chernyh1, E.V. Vorobeychikov2, M.A. Karpenko 1, T.V. Vavilova1 1Almazov National Medical Research Centre, Russia, , Saint-Petersburg 2 Limited Liability Company "Polypharm", Russia, Saint- Petersburg Abstract Introduction: the thrombin generation assay (TGA) and its modification with thrombomodulin (TM) is used to evaluate the hemostatic system and the activity of the protein C. Significance of TGA in patients with stable coronary artery disease (CAD) is not definitively determined, and the available data is contradictory. The aim of the study was to determine the reliability of differences of the TGA parameters and its modification with TM in patients with CAD and in the control group. Objective: The study included 75 patients with stable CAD (60 male and 15 female aged 40-75,) and 23 healthy controls (non-smokers, the same age and gender). Thrombin generation assay were measured by Thrombinoscope (Netherlands) in duplicate before procedures. Results are presented as Lag Time (min), Endogen Thrombin Potential (ETP, nmol/min), Peak thr. (nmol) and ttPeak (min). Results: A significant difference (p <0.05) was found in the mean values for ETP, Peak, and ttPeak and modifications with and without TM in both groups. The mean values of the TGA parameters with TM revealed a significant (p <0.05) decrease in ETP, Peak, sensitivity to TM and elongation of ttPeak, which indicates an inadequate activity of the protein C in patients with CAD. Conclusion: Patients with chronic coronary artery disease have a decrease in the activity of the anticoagulant protein C determining during TGA with TM. Key words: thrombin generation assay, coronary artery disease, coronary stenting.
LABORATORY MARKERS OF SURGICAL SITE INFECTION PREDICTION AFTER TRANSPEDICULAR SCREW FIXATION OF THE SPINE
L.B. Gajkovaya, A.N. Tkachenko, A.I. Ermakov, E.M. Fadeev, V.V. Usikov, V.M. Hajdarov, D.Sh. Mansurov North-Western State Medical University named after I.I Mechnikov, St. Petersburg, Russia Abstract Introduction. The infection risk development in the surgical site after the spine operation remains within any patient facilities. Despite strict antisepsis, use of antiseptics, modern operation units it is nearly impossible to avoid bacterial contamination of the surgical area during transpedicular screw fixation of the spine. In this case the prediction and prevention of these very complications is essential for medical science and practice. Methods. The blood levels in patients were determined by flow cytometry using reagents as “CytoDiff”® (Beckman Coulter, USA) to reveal laboratory markers for the prediction of local suppurative complications. Results. It was found that the decrease of B-lymphocytes and increase of eosinophils allows to early predicting of the infectious complications in patients after transpedicular screw fixation. Key words: infectious complications in the surgical site, prediction, laboratory markers, transpedicular screw fixation, flow cytometry.
GENDER DIFFERENCES OF PERIPHERAL ATHEROSCLEROSIS: ROLE OF METABOLIC CHANGES
N.I. Glushkov, M.A. Ivanov, P.B. Bondarenko, M.Y. Yermina, A.S. Artemova, M.S. Chvostova, P.D. Pusdriak North-Western State Medical Universitynamed after I.I. Mechnikov, Saint-Petersburg, Russia
Abstract Introduction. Peculiarities of peripheral atherosclerosis, as well as the severity of metabolic changesin patients with peripheral arterial disease (PAD), have an impact both on the results of surgical intervention and the quality of life of patients after revascularization. The aim of the study was to identify the relationship between the characteristics of peripheral arterial lesions and metabolic changes in female and male patients. Materials and methods: The study included 128 patients, who underwent surgery on the main arteries to treat of peripheral atherosclerosis: 41 women in the treatment group and 87 men in the control group. Carbohydrate and lipid abnormalities, systemic hemodynamics, peculiarities of atherosclerotic lesion of peripheral arteries, patients’ physical activity were evaluated. Results: Women with atherosclerotic lesions of the lower limbs arteries had more frequently the lesion of the other arterial basins vessels. The female patients oftener had the arteries calcification, dyslipidemia, obesity and violations of carbohydrate metabolism (p <0.05). The probability of critical ischemia was higher in women with severe metabolic disorders (p <0.05). Conclusion: Patients with PAD in the perioperative period need careful correction of metabolic changes as a prophylaxis of dangerous complications development. Keywords: peripheral atherosclerosis, metabolic changes, sex differences
Assessment of degree of disability in patients with radically treated breast cancer
A.Z. Dovgalyuk1, V.S. Spiridonova1, I.A. Pazuhina2, M.M. Suleymanov1 1Saint-Petersburg Postgraduate Institute of Medical experts, St. Petersburg, Russia 2Main Bureau of Medical-Social Expertise of St. Petersburg, St.-Petersburg, Russia
Absract.
Introduction. During 2015 the female breast cancer incidence in Russia was 20.9 %. Over the last five years was observed the increase of malignant neoplasms of breast throughout Russia by 15.7%. Materials and methods. It was studied the medical records of 206 patients with breast cancer being made in Main Bureau of medico-social expertise of Saint-Petersburg in 2016. It was analyzed the results of surgical treatment of breast cancer by Madden and Patey radical mastectomy, typical mastectomy and organ preservation surgeries: radical sectoral breast resection followed by postoperative radiotherapy, sectoral breast resection detecting the sentinel lymph node followed by radiotherapy, subcutaneous mastectomy that are mainly used at early stages. Results. As the result of primary medical recording 14,9% of patients were considered as a disabled person of group I, 53%- disabled person of group II, 30,7% - disabled person of group III. All evaluated patients (100%) had limitation of work capability of the first degree (31%),second degree (53,8%) and third degree (15%).68% of patients had limitation of self-care mainly of the first degree, limitation of movement was observed in 7,8% of patients. Conclusions. During primary medical recording patients were considered as a disabled person of group I (14,9%), of group II (53,3%) and group III (30,7%).Comparative analysis of disability during 2000-2016 revealed the increase of the number of the disabled person of group III from 8% to 30,7% and slight decrease of the number of the disabled person of group II that could be recognized as a positive rehabilitation indicator obtained due to the treatment changing and current legislation. Key words: breast cancer, assessment of the degree of functions, disability, disability person.
SURGERY FOR ESOPHAGEAL CANCER: PAST, PRESENT AND FUTURE (SCIENTIFIC REVIEW)
K.V. Arutyunyan 1, I. M. Kuznetsov 1, I. M. Kuznetsov 2, M.D. Ter-Ovanesov 3, K.G. Shostka 1,2, L.D. Roman 1,2 1Leningrad Regional Oncologic Dispensary, Russia, Saint- Petersburg 2 Military Medical Academy named after S.M. Kirov, Russia, Saint-Petersburg 3Russian National Research Medical University named after N.I. Pirogov, Russia, Moscow
Abstract:
Surgery is still one of the main ways of treatment for patients with esophageal cancer. Modern advances in esophageal cancer treatment have been achieved due to the combination of surgical methods and chemoradiotherapy, are questionable, but for the majority of patients with esophageal cancer the surgery is still the only possible method of treatment. The history of surgery of the esophagus dates back to 1842, when scientists have only tried to find “an alternative way” to the stomach. In those days, it was hard to believe that over 100 years the intrathoracic esophagus resection with simultaneous reconstruction would be a conventional surgery for esophageal cancer. Nowadays a number of medical s worldwide perform thoracic - and laparoscopic surgeries for esophageal cancer due to low injury rate, low percentage of complications and mortality.
The first randomized trial of robotic surgery for esophageal cancer was complited in 2017, thus determining the development of new standards for esophageal cancer treatment. The present article introduces the analysis of evolution in surgical treatment of esophageal cancer: from the gastrostomy to thoracolaparotomy and robot-assisted surgeries. Key words: surgery for esophageal cancer, esophageal cancer, esophageal resection, minimally invasive surgery for esophageal cancer, robot-assisted for esophageal cancer, thoracic surgery for esophageal cancer.
EVALUATION OF THE EFFECTIVENESS OF REHABILITATION MEASURES USING COMPUTER OPTICAL TOPOGRAPHY IN OUTPATIENTS WITH LOWER BACK PAIN
J.A. Kreneva2, V.P. Panov1,2, M.V. Avdeeva1 1 North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya Street, 41 2Polyclinic №14, Russia, 194021, Saint-Petersburg,2nd Murinskii prospect, 35 Abstract. Introduction. The problem of the treatment effectiveness of chronic back pain is quite topical, as the lack of clinical effect from the various treatment methods leads to significant social and economic consequences due to the reduce of the quality of life, disability of patients and increase of costs of medical and social support. Methods. The study included 100 outpatients aged 18-75 with the lower back pain undergoing medical rehabilitation. The treatment effectiveness was assessed by the pain syndrome severity and computer optical topography data, which was collected before and after medical rehabilitation. Results. After medical rehabilitation was observed the significant back pain relief, as shown by the visual analogue scale, McGill pain questionnaire, McGill pain index and Roland Morris Disability Questionnaire (p<0,01). The treatment effectiveness was confirmed by the back lengthening due to the removal of pathological spasm of the paravertebral muscles (p<0,001); the scoliotic deformity correction (p<0,001); the pelvis skewing decrease (p<0,001); a decrease in the distortion of the pelvis (p<0,001) according to the results of computer optical topography. Conclusion. Using complex rehabilitation measures while providing primary health care in patients with lower back pain leads to the pain syndrome relief, the restoration of adequate anatomical and physiological ratio in the vertebral-motor segments and leads to the improvement of the quality of life. Key words: treatment of back pain, lower back pain, physical therapy, physical therapy effectiveness, computer optical topography
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