Сomparative analysis of indicators of population provision with doctors and medical staff in health care institutions in particular regions of the NorthWestern Federal district providing primary and specialized health care.
Justification of medical and organizational activities on prevention improvement and probabilityestimation of surgical site infection in patients with bone fractures.
Modern approach to enteral and parenteral nutrition of infants with extremely low birth weight (review).
A.S. Simakhodskij, E.S. Uliynicheva, S.K. Gorelik
Infectious morbidity among fans, tourists and servicemen hospitalized to clinical infectious disease hospital named after S.P. Botkin during 2018 FIFA World cup in Saint-Petersburg. A.V. Stalevskaya, D.V. Ruksin, I.A. Chmir
Thyroid status in children and adolescents with atopy (review).
A.P Listopadova, Z.M. Golovach
ANNIVERSARY DATE
ANDREY STANISLAVOVICH RADILOV (dedicated to the 60th anniversary of birth)
TO AUTHORS ATTENTION
PREVENTIVEMEDICINE
PREVALENCE OF PSYCHOACTIVE SUBSTANCE USE AMONG SCHOOL-AGED CHILDREN AND MULTIVARIATE ANALYSIS OF CAUSES OF ALCOHOL AND TOBACCO CONSUMPTION
L.L.Lipanova1, G.М. Nasybullina1, V.S. Kazantsev2
1Ural State Medical University, Russia, 620028, Ekaterinburg, Repin street, 3 2Ural scientific and practical left of medical, social and economic problems of health care, Russia, 620075, Ekaterinburg, Karl Liebknecht street, 8-Б Abstract Introduction.Adolescence is associated with an increased risk for substance use, including psychoactive drugs. The aim of the study was to analyze the prevalence of psychoactive substance useamong school-aged children and to identify the factors determining the probability of alcohol and tobacco consumption. Materials and methods. The study group included 6858 students from secondary school grades 7-11 in Ekaterinburg. It was used the method of anonymous survey, when for evaluation of correlation between psychoactive substance and studied risk factors it was calculated the odd ratio (OR) with the 95 % confidence interval, as well as a multivariate discriminant analysis was carried out. Results. The frequency of tobacco users among school-aged children was 21.3 %, alcohol users – 43.4 %, substances users – 2.1 %. The most significant factors determining the probability of alcohol and tobacco consumption were the lifestyle, mental wellbeing of school-aged children, academic motivation, and level of hygiene awareness, medical and preventive activities. Conclusion. The risk factors of initiation of psychoactive drugs consumption should be taken into consideration during preventive activities with the school-aged children. Key words: school-aged children, psychoactive substance, risky behavior.
DEVELOPMENT OF QUALITY CRITERIA FOR THE PAEDIATRIC MEDICAL REHABILITATION
I. G. Samoilova 1, O.G.Khurtsilava 2, I. N.Lesnaya1 1Pediatric Research and Clinical left for Infectious Diseases, Russia,197022, Saint-Petersburg, Professora Popova 9 2North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street,41
Abstract Introduction.Constant monitoring of the quality of rehabilitation process is the effective tool of the provision of the quality rehabilitation. Theaim of the study was to develop quality control criteria for the medical rehabilitation of children with nervous system diseases. Materials and methods.It was studied 223 medical records of the in-patients and 699 expert opinions were received and processed. Each expert opinion was compiled by the physician, head of the department and expert-physician. Results.The evaluation of the quality of the medical rehabilitation of childrenwith nervous system diseases, including infectious one, allowed revealing some drawbacks in diagnostic & rehabilitation, as well as in documentation management and to find the solutions to eliminate them. Conclusions.Efficacy evaluation of the rehabilitation may be concluded as the assessment of the patient status dynamics undergoing rehabilitation and also the assessment of the outcomes in its clinical and functional means. In medical institutions it is more effectively to use quality control criteria for the medical rehabilitation not only as a final measure of efficacy, but also during the rehabilitation process to achieve the support for the medical opinion. Continual monitoring of the rehabilitation process quality is the working tool of the healthcare quality services. Keywords: healthcare quality, rehabilitation, children.
TRENDS OF REGIONAL INDICATORS OF PHYSICAL DEVELOPMENT OF SCHOOL CHILDREN IN SAINT-PETERSBURG
V.L. Gritsinskaya, V.P. Novikova Saint-Petersburg state pediatric medical university, Russia, 194100, St. Petersburg, Litovskaya, 2 Abstract: Introduction: Monitoring of physical development of younger generation is one of indicators of social and economic prosperity. From the beginning and till 80s it was observed the increase of physical development of children called acceleration. In the 90s it was marked the decrease of absolute somatometric indicators among children in the majority of the countries. The aimof the study was to estimate the dynamics of the somatometric indicators of school children in Saint- Petersburg within 30 years. Materials and methods. It was examined 6207 schoolchildren aged 7-17 years in Saint- Petersburg. The comparative assessment of the somatometric indicators of modern school students with regional standards of children physical development from 1991 is carried out. Results. Modern school children have indicators of weight and length of a body higher, than at their peers in the late 80s; the most significant difference is observed in the pubertal period. Chest circumference indicators in modern schoolgirls are lower in all age groups; indicators in schoolboys are also lower except age group from 13 to 16 years old. Conclusion. Comparative analysis of the somatometric indicators of school children allowed revealing trends of physical development of children in Saint-Petersburg. Keywords: physical development, dynamics, school children, children, teenagers
TOXICOLOGICAL-HYGIENIC ASSESSMENT OF SOLID CHEMICAL DE-ICING MATERIALS
А.А. Zolotareva1, L.A. Alikbaeva1, А.V. Bek1,2 , A.L. Ryzhkov1
1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya Street, 41. 2Hygiene and Epidemiology left in the city of St. Petersburg, Russia, 192102 Saint-Petersburg,Volkovsky pr., 77. Abstract: Introduction. Use of chemical de-icing materialsto ensure the safety of traffic and the population movement may resulted in the pollution of air , soil adjacent to roads, surface and ground water having a negative ecology-hygienic impact on natural environments and population health. The aim of the study was to carry out the toxicological-hygienic assessment of solid chemical de-icing materials «MDM», «Multicomponent de-icing material solid» composition 1 and composition 2, «Bionord», «MR solid» composition 1 and composition 2, «CCS solid», «CCSM». Materials and methods. Experimental studies were performed on white outbred male rats, mice and guinea pigs. The studies were carried out in accordance with the current methodological documents. Results and conclusions.Assessment of toxicity allowed to associate "MPM", "Multicomponent de-icing material solid" composition 1 and composition 2, "Bionord", "MRT" composition 1 and composition 2, "HCNtv" with the hazard class IV (low hazard) (GOST 12.1.007-76). De-icing materials "MPM", "MPM solid" composition 1 and 2 has a low-irritating effect on the skin. De-icing materials "MRT" composition 1 and 2, "Bionord", "Hcnt", "HKLM" do not provoke the irritation on skin after single exposure, after repeated exposure observed low irritation, the single exposure of these chemical de-icing materials causes irritation on the eye mucus. The studied de-icing materials do not have a skin resorptive effect,as well as allergenic action. During the work with these de-icing materials it is necessary to use personal protective equipment for the skin and eyes. Key words:de-icing materials, parameters of acute toxicity, skin-resorptive effect, resorptive effect, allergenic effect.
COMPARATIVE ANALYSIS OF INDICATORS OF POPULATION PROVISION WITH DOCTORS AND MEDICAL STAFF IN HEALTH CARE INSTITUTIONS IN PARTICULAR REGIONS OF THE NORTHWESTERN FEDERAL DISTRICT PROVIDING PRIMARY AND SPECIALIZED HEALTH CARE
A.V. Meltser, N.V.Erastova, E.A. Abumuslimova, T.V. Samsonova, N.T.Gonchar North-Western State Medical University named after I. I. Mechnikov, Russia, 191015, Saint-Petersburg,Kirochnaya Street, 41. Abstract Introduction: The problem of the shortage of medical personnel remains among one of the burning issues for the health care institutions in the Russian Federation. There is a marked disproportion in provision with doctors in health care system of various regions. The problem is particularly acute for the staff shortage in primary health care with the lack of doctors specialized in particular fields, disproportion in human resources. The article presents a comparative analysis of indicators characterizing the provision of the population of the Pskov, Vologda, Kaliningrad regions and the Republic of Karelia with medical staff, it was evaluated the level of human resources in regional medical institutions providing medical care both outpatiently and inpatiently. The aim of the study was to conduct a comparativeanalysis of the indicators of population provision with doctors and medical staff of various specializations in medical institutions in Vologda, Pskov, Kaliningrad and the Republic of Karelia providing medical care both outpatiently and inpatiently. Materials and methods. The analysis of indicators of provision of medical staff was carried out on the basis of official statistics presented in form №30 « Information on medical institution» from 2017 using the guidelines on the health care procedures approved by the Ministry of Health of the Russian Federation and descriptive and analytical methods of statistical analysis.
Results. It was observed the disproportion of medical staff both between regions and within one region in medical institutions, providing medical care both outpatiently and inpatientlyagainst a sufficient general level of human resources. The high coefficient of spare-time work was revealed, especially in medical institutions providing specialized health care. There is a shortage of special -fields’ doctors in outpatient medical organizations.
Conclusion: The most significant issues in the field of human resourcing of medical institutions are: distribution of medical staff between regions without taking into account compliance with standards for the population provision with doctors; imbalance in the human resourcing of medical institutions providing primary and specialized health care; extremely high coefficient of spare-time work of doctors of different specialties. Key words: provision and staffing of medical personnel, primary health care, outpatient facilities, inpatient, oncologists, physicians, gastroenterologists, pulmonologists, cardiologists.
Picture 2 – The coefficient of spare-time work of doctors in outpatient and inpatient facilities in 2017
JUSTIFICATION OF MEDICAL AND ORGANIZATIONAL ACTIVITIES ON PREVENTION IMPROVEMENT AND PROBABILITY ESTIMATION OF SURGICAL SITE INFECTION IN PATIENTS WITH BONE FRACTURES
D.Sh. Mansurov1, V.S. Luchkevich1, A.V. Tarasov2 , A.A. Korneenkov3, A.N. Tkachenko1 1 North-Western State Medical University named after I.I. Mechnikov, 191015, Russia, Saint- Petersburg, Kirochnaya street, 41 2 State budgetary institution of health care of the Republic of Crimea "Simferopol Clinical Emergency Hospital No. 6",295026, Russia Republic of Crimea, Simferopol, street Gagarin, 15, 3. S.M. Kirov Military Medical Academy, 194044, Russia, St. Petersburg, Ak. Lebedeva stree,t 6 Abstract: Introduction: Injury remains a worldwide problem due to increased road and industrial accidents, as well as natural disasters. Treatment results of injuries are not always positive, whereas the most often injured group is the working-age population. The frequency of surgical site infections during operations performed in connection with bone fractures does not tend to decrease. Existing prognostic and prevention methods of purulent complications designated only for particular fractures. In this regard, the study of the organizational aspects of predicting the development and prevention of surgical site infections during operations performed in connection with bone fractures is relevant for medical science and practice.
.Materials and methods. A retrospective analysis of data on 487 patients operated in connection with bone fractures was carried out. Information on patients underwent surgical intervention without local infectious complications (421 cases - 86.4%) was compared with the data of injured, who were diagnosed with local infectious complications -89 (18.3%) patients. Multivariate logistic regression model was used to screen for independent risk factors for the purulent complications development. The revealed risk factors were estimated prospectively in 984 patients underwent surgery for bone fractures within treatment-and-prophylactic institutions of the Republic of Crimea in 2016-2017. Preventive organizational measures were applied to risk group patients. Surgical site infections were observed in 105 (10.7%) patients a year after surgery. Results. When studying the information on a retrospective group of patients was formed the data base being the basis for the development of logistic regression models. Five criteria for predicting the development of infectious complications in the surgical site are identified: gender, age, presence of concomitant pathology, the risk for anesthesia by ASA and the interaction of individual factors. Organizational measures were developed that resulted in the decrease of surgical site infections during trauma surgeries from 18.3% to 10.7%. Key words: fracture, surgical site infection, prognosis, prevention.
CLINICAL MEDICINE
SURGICAL TREATMENT RESULTS OF COLON CANCER COMPLICATED WITH BLEEDING IN ELDERLY PATIENTS
N.I. Glushkov1,2 , T.L. Gorshenin1,2 , M.B. Kvetny 2, I.V. Merkulov2, C.K. Dulaeva1,2 1North-Western State Medical University named after I.I. Mechnikov, Russia ,191015, Saint-Petersburg, Kirochnaya st. 41, 2Saint-Petersburg State Healthcare Institution "Hospital for War Veterans", Russia, 193079, Saint- Petersburg, Narodnaya st., 21, building
Abstract. Introduction. Usually, rectalbleeding is not accompanied by a high level of blood loss; often it is recurrent and occurs against iron deficiency anemia. The high risk of bleeding recurrence is an absolute surgical indicator. The aim of the study was to evaluate the surgical treatment results in elderly patients with rectal bleeding according to the method of surgery. Materials and methods. The surgical treatment results of 545 elderly with colon cancer were analyzed during 2008-2016. Among them, 30 patients were operated for bleeding from the tumor: 21 (70%) traditional type of surgery, 9 (30%) – surgery using endovideosurgical techniques. Results. It was revealed that the surgery using endovideosurgical techniques with the formation of primary anastomosis is more advantageous in treating this type of colorectal cancer complication, it is accompanied by a lower postoperative mortality rate, minimal blood loss, thereby ensuring higher levels of patient safety and early rehabilitation in the postoperative period. Conclusion. Modern hemostatic conservative therapy allows to prepare patients for surgical treatment, whereas the use of endovideosurgical techniques in this group of patients allows to improve the surgical treatment results, herewith reducing the number of postoperative complications, mortality, average postoperative stay. Keywords: colon cancer, bleeding, elderly and old age.
MODERN APPROACH TO ENTERAL AND PARENTERAL NUTRITION OF INFANTS WITH EXTREMELY LOW BIRTH WEIGHT (REVIEW)
A.S. Simakhodskij, E.S. Uliynicheva, S.K.Gorelik Рavlov First Saint Petersburg State Medical University, Ministry of Healthcare of the Russian Federation, Saint Petersburg, Russia, Leo Tolstoy st , d. 6-8.
Abstract
In the Russian Federation and in Saint-Petersburg, the reduction of child mortality is also ensured by adequate parenteral and enteral nutrition of premature infants with a gestation period of 23-26 weeks and a birth weight of 500 – 1000 gr. Even small amounts of enteral nutrients in infants with extremely low birth weight have a positive effect on the functional maturation of the gastrointestinal tract, without increasing the risk of ulcerative-necrotic colitis, as well as reduce the duration of full parenteral nutrition, improve tolerance to food load during the neonatal period.
Complete parenteral nutrition in infants with extremely low birth weight should be combined with minimal enteral nutrition. Key words: parenteral nutrition, enteral nutrition, extremely low body weight, gastrointestinal tract, ulcerative- necrotizing enterocolitis.
INFECTIOUS MORBIDITY AMONG FANS, TOURISTS AND SERVICEMEN HOSPITALIZED TO CLINICAL INFECTIOUS DISEASE HOSPITAL NAMED AFTER S.P. BOTKIN DURING 2018 FIFA WORLD CUP IN SAINT-PETERSBURG
Introduction. The 2018 World Cup is a worldwide football event with the tourist increase to the hosting city up to 70-80% according to the international experience. About 5 million tourists (including 2.9 million foreigners) visited the host cities.
The aim of the study was to analyze and summarize the data on infectious morbidity among tourists and fans visited Saint-Petersburg.
Material and methods. During the research it was performed the analysis of hospitalized patients to Clinical Infectious Disease Hospital named after S.P. Botkin with the signs of infectious diseases.The data on laboratory research of patients material are summarized.
Results. The collected data shows a high risk of the incidence and infection imported by fans arriving from all over the world. Thus, the informing and predicting of epidemiological risks are of a high importance.
THYROID STATUS IN CHILDREN AND ADOLESCENTS WITH ATOPY (REVIEW) A.P. Listopadova 1, Z. M. Golovach 2
1Saint- Petersburg State Pediatric Medical University, 194100, Russia, Saint-Petersburg, Litovskaya st., 2 2Pavlov First St.Petersburg State Medical University,197022, Russia, Saint-Petersburg, L'va Tolstogo str. 6-8.
Abstract:
The article presents a modern literature review on correlation between thyroid dysfunction and paediatric atopy. It was revealed the regulations in tendencies of thyroid gland functional changes in bronchial asthma, depending on its severity, duration and age. Moreover, it was analyzed the correlation between thyroid diseases and atopic dermatitis, chronic urticaria, atopic keratoconjunctivitis. Studies show changes in the course of the underlying disease against thyroid dysfunctions. Whereas the pathogenetic mechanisms are currently not fully understood. There is a necessity in further researchers on common pathogenetic mechanisms in thyroid dysfunction along with atopic diseases in order to optimize therapy. Key words: thyroid dysfunction, thyroid autoimmunity, atopy, children
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