ПРОФИЛАКТИЧЕСКАЯ И КЛИНИЧЕСКАЯ МЕДИЦИНА

 

 [ Main ]  [ Contacts ]  [ E-mail ]

 

Contents 2021-1
MEDICAL SCIENCE
 
PREVENTIVE MEDICINE

  1. Characteristics of the health status of teachers of educational institutions of higher and secondary medical education
  2. O.G. Khurtsilava, E.A. Baimakov, I.Sh. Iakubova, I.A. Mishkich, T.S. Volkova       4

  3. Аpriori occupational health risk of oil refining workers from noise production impact
  4.  A.V Meltser., N.V. Erastova, A.V. Kiselev, А.I. Кropot     12

  5. Formation of new economic principles of government power for quality assurance of healthcare services
  6. L.A. Gabueva, A.D. Shcherbakova, P.V. Sorokoletov, A.V. Emanuel, I.O. Churekova      20

  7. The prevalence of persons with professional diseases
  8. A.V. Guryev, A.R. Tukov        30

CLINICAL MEDICINE

  1. Peculiarities of personal and adaptive potential in young and middle-aged women with acute myocardial infarction
  2. N.S. Tretyakova, I.A. Leonova, S.A. Boldueva, S.L. Solovieva       38

  3. To the question of natural course of asymptomaticcal cifiс aortic stenosis
  4. Y.S. Samedov, V.A. Krivopalov, N.N. Shikhverdiev, D.I. Ushakov         46

  5. Ophthalmological examination of premature children in Saint-Petersburg: results and prospects
  6. E.I. Saidasheva, S.V. Buynovskaya, Y.A. Alekseev, N.A. Malinovskaya, A.V. Morozova, V.I. Shilina, C.V. Bilichenko, V.M. Panchishena, V.A. Makarova    53

  7. Сlimatic metamorphosis of the 21st century and allergic respiratory diseases (review)
  8. Z.V. Nesterenko      58

  9. The medical rehabilitation of different age groups of patients with chronic pain syndrome: evaluation of biopsychosocial model
  10. V.A. Ishinova, A.A. Povorinsky, I.A. Leonova, S.A. Boldueva     66

  11.  Daily monitoring of nutrition and nutritional status of young children hospitalized in a multidisciplinary pediatric hospital
  12. Ju.V. Peshekhonova, A.I. Sinyugina, K.M. Grigorieva, M.N.Yakovleva, M.O. Revnova      74

СLINICAL LABORATORY DIAGNOSTICS

  1. Hematological markers for prognosis of surgical site infection in hip arthroplasty
  2. L.B. Gaikovaya, N.L. Afanasieva, A.N. Tkachenko, A.I. Ermakov, A.A. Vorokov, B.G. Aliev       82

  3. Cytokine storm in COVID-19 (review)
  4. A.Yu. Anisenkova, D.A. Vologzhanin, A.S. Golota, T.A. Kamilova, S.V. Makarenko, S.V. Mosenko, S.G. Sherbak      89

  5. Laboratory assessment of the effectiveness and safety of the redox-modulating action of omega-3 polyunsaturated fatty acidscontaining preparations used for correction of psoriasis
  6. N.V. Тyunina, L.B. Gaykovaya, A.T. Burbello, R.N. Pavlova, A.I. Ermakov, Y.A. Vlasova, А.А. Murzina, L.A. Karyakina   96

 

PREVENTIVE MEDICINE

CHARACTERISTICS OF THE HEALTH STATUS OF TEACHERS OF EDUCATIONAL INSTITUTIONS OF HIGHER AND SECONDARY MEDICAL EDUCATION

O.G. Khurtsilava, E.A. Baimakov, I.Sh. Iakubova, I.A. Mishkich, T.S. Volkova
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41
Abstract
Introduction. Changes in the modern system of medical education make high demands on the professionalism of teaching staff of higher and secondary medical education, as well as on their health due to the increased intensity of emotional, sensory, and intellectual loads.
Aim of the study wasto assess the health status of the teachers of medical university and college based on the results of medical examinations and a questionnaire survey.
Materials and methods. The assessment of the health status of teaching staff is based on the analysis of the results of a medical examination and data from a questionnaire screening.
Results and discussion. The results of the questionnaire screening revealed that the majority of teachers do not consider themselves healthy (73.3%). There is a high prevalence of health complaints, caused by a critical attitude to their health and professional knowledge. Analysis results of the medical examination showed that diseases were observed in 85.7% of teachers (95% CI 80.3-89.8). The indicator of pathological disease incidence was 279.4 cases per 100 examined patients. The structure of pathological lesions was dominated by the circulatory system diseases, diseases of the eye and its appendage, the endocrine system diseases, eating disorders and metabolic disorders, diseases of the musculoskeletal system and connective tissue. When calculating the cardiovascular risk, it was found that more than half (64.3%) of teachers over 40 years have an individual high and very high absolute cardiovascular risk.
Conclusion. Health complaints based on the results of questionnaire screening are characterized mainly by burnout syndrome. The prevalence of the underlying diseases in teachers increases with age, apart from the diseases of the eye and its appendage. Target groups of teachers aged 40-64 years were inclusively identified to reduce the degree of cardiovascular risk.
Keywords: teachers of educational institutions of higher and secondary medical education, health status, cardiovascular risk.

A PRIORI OCCUPATIONAL HEALTH RISK OF OIL REFINING WORKERS FROM NOISE PRODUCTION IMPACT

A.V. Meltser, N.V. Erastova, A.V. Kiselev ,А.I. Кropot
North-Western State Medical University named after I.I.  Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41.
Abstract
Introduction. Currentlaw and regulations establish the necessity to assess the occupational health risk of workers in case the noise level at the workplace is more than 80 dBA. However, a special assessment is to be assumed to carry out a risk assessment. Determination of occupational risk is performed to confirm risk acceptability to health, to predict the probability of health disorders development, to justify preventive measures aimed at minimizing risk.
Aim of the study was to analyze the dynamics of a priori occupational health risk of workers of the oil refinery LLC "KINEF" from the noise production impact to justify medical and preventive measures.
Materials and methods. The assessment of a priori occupational health risk was based on the principles of R 2.2.1766-03 «Guidelines on occupational risk assessment for workers health. Organizational and methodological aspects, principles and evaluation criteria" and R 2.2.2006-05«Guidelines on hygienic assessment of the factors of the working environment and the work load». The assessment model of a priori occupational risk was used considering the work experience dose.
Results. The assessment results of a priori occupational risk caused by production noise impact allow to determine both the priority workplaces and work experience load according to the development of nonspecific and occupational diseases. Comparative results analysis of risk assessment based on the noise levels measurements in 2015 and 2020 indicates a decrease in a priori occupational risk at the majority of work places and the effectiveness of the implemented management decisions.
Conclusion. The use of the above approach makes allow to identify workplaces and the most vulnerable groups of workers taking into account the length of work experience, probable health consequences caused by adverse noise impact, which is of a high importance not only for determining the priorities and measures targeting to improve working conditions, but also for evaluating their effectiveness to advance periodic medical examinations.
Key words: workers' health, occupational health, working conditions, production noise, occupational risk, risk assessment, a priori risk.

FORMATION OF NEW ECONOMIC PRINCIPLES OF GOVERNMENT POWER FOR QUALITY ASSURANCE OF HEALTHCARE SERVICES

L.A. Gabueva1, A.D. Shcherbakova2, P.V. Sorokoletov1, A.V. Emanuel3,
 I.O. Churekova3
1 Russian Presidential Academy of National Economy and Public Administration, Russia,119571, Moscow, Vernadskogo prospect, 82
2 Territorial Compulsory Medical Insurance Fund of the Magadan, Russia,6685000, Magadan, Pushkina street, 6
3 Tikhvin Interdistrict Hospital named after A. F. Kalmykov, Russia, 187553, Tikhvin, Karla Marxa street, 68
Abstract
Introduction. Within the annual refinement of the budgeting parameters (federal and regional) for health care, it is crucial to ensure the stability of the implementation of national priorities and state guarantees. The article is addressed to scientific and pedagogical specialists and practitioners –health care organizers making decisions in the formation of territorial programs of state guarantees for the provision of free medical care to the population of Russia.
Aim of the study was to analyze the medical and demographic characteristics and financial support of regional health care.
Materials and Methods. It was used statistical method, factor analysis and mathematical modeling.
Results. In order to eliminate the financial deficit to ensure state guarantees for free medical care to residents of the constituent entities of the Russian Federation with a low population density, living in remote areas, as well as for territories located in the Far North and equivalent areas, it was established that budget mechanisms distribution of the Federal Compulsory Medical Insurance Fund could be improved within the existing regulatory framework.
Conclusion. The current methodology for the formation of the volumes of public obligations in the field of health care and the peculiarities of their financial support in accordance with the current legislation in certain regions of the Far North do not always allow solving urgent economic problems to ensure the quality and availability of medical care for the territorial population, which is confirmed both by regional practice and the Accounts Chamber of the Russian Federation.
Keywords: national priorities in the field of healthcare, regional economy of state guarantees, availability of healthcare services, insurance principles of payment for medical care.

 

THE PREVALENCE OF PERSONS WITH PROFESSIONAL DISEASES

A.V. Gurev, A.R. Tukov

Russian State Research Center − Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Russia, 123098, Moscow, Marshal Novikova street, 23
Abstract
Introduction. In the scientific literature, the impact of harmful production factors on the workers’ health is thoroughly analyzed. However, the insufficient attention is paid to the problem of the general morbidity of persons, who already have occupational diseases.
Aim of the study was toidentify the features of the general morbidity of persons with occupational diseases caused by chemical and physical harmful production factors at enterprises and organizations served by medical institutions of the Federal Medical- Biological Agency.
Materials and methods. The database includes health indicators of 777 persons with occupational diseases caused by chemical hazardous production factors, aged 72.9 ± 0.6 years (372 men - 72.4 ± 0.9, 405 women - 73.3 ± 0.9) and physical factors - 262 patients, aged 67.8 ± 1.0 years (239 men - 67.2 ± 1.0 years and 23 women - 74.7 ± 4.2 years) during the study.  It was used the general morbidity prevalence indicator per 1000 patients with occupational diseases and with an error of the intensive indicator and the proportion of pathology in the structure of diseases of general pathology.
Results. The article describes the features of the general morbidity and its structure in individuals with occupational diseases, considering a wide range of harmful production factors, caused occupational diseases. The prevalence of circulatory system diseases in persons with occupational diseases caused by chemical harmful production factors is 1369.3 ± 42.4, pathologies of the digestive system - 474.4 ± 18.1, of the musculoskeletal system - 438.9 ± 17 ,9. In the morbidity structure, these diseases amounted to 47.1%, 16.3% and 15.1%, respectively.
In persons whose occupational diseases were caused by physical harmful production factors, the prevalence of diseases of the circulatory system was 457.3 ± 29.1, of the musculoskeletal system - 372.0 ± 28.2, of the respiratory system - 276.5 ± 26.1. In the morbidity structure, these diseases amounted to 31.2%, 25.3% and 18.8%, respectively.
Conclusion. When analyzing the general morbidity in individuals with occupational diseases caused by chemical and physical harmful production factors, differences in the level and morbidity structure of the circulatory system of digestive, respiratory and musculoskeletal systems diseases were observed and should be taken into account in the development of targeted social and medical rehabilitation of this groups of persons.
Key words: chemical hazardous production factors, physical hazardous production factors, prevalence, structure of diseases, diseases of the circulatory system, diseases of the musculoskeletal system, diseases of the digestive system, diseases of the respiratory system, the Industry register of persons with occupational diseases.

CLINICAL MEDICINE

PECULIARITIES OF PERSONAL AND ADAPTIVE POTENTIAL IN YOUNG AND MIDDLE-AGED WOMEN WITH ACUTE MYOCARDIAL
 INFARCTION

 N.S. Tretyakova, I.A. Leonova, S.A. Boldueva, S.L. Solovieva
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya str., 41
Abstract
Introduction. Stress of any etiology is one of the reasons for the development of acute coronary syndrome, but also an unfavorable course of the disease.
Aim of the study was to analyze the personal and adaptive potential in young and middle-aged women with myocardial infarction (MI).
Materials and methods. The study of the personal and adaptive potential was carried out in young and middle-aged women: 60 patients with myocardial infarction and 38 female patients in the control group without coronary heart disease.
Results. It weren’t found any significant changes in the level of "vitality" and its components in patients with MI. The need of psychological protection with the tension of adaptation mechanisms is more obvious in women with MI. Psychological defenses mechanisms "denial" and "substitution" are associated with the duration of the pain syndrome and with the time of applying for medical assistance and the development of ventricular arrhythmias. There were no significant differences in the use of coping-mechanisms.
Conclusion: The revealed adaptation resources features could facilitate not only the assessment of the prognosis of the dynamics of the disease, but also the preparation of rehabilitation and correction programs for young and middle-aged women with MI.
Key words: myocardial infarction, young and middle-aged women, vitality, coping strategies, mechanisms of psychological defense

TO THE QUESTION OF NATURAL COURSE
OF ASYMPTOMATICCAL CIFIС AORTIC STENOSIS

Y.S. Samedov2, V.A. Krivopalov1, N.N. Shikhverdiev1, D.I. Ushakov1
1S. M. Kirov Military Medical Academy, Russia, 194044, Saint-Petersburg, AkademikaLebedevast., 6
2Main Military Clinical Burdenko Hospital, Russia, 115229, Saint-Petersburg,Gospital'naya square, 3
Abstract
Introduction. The diagnostic complexity and high mortality rate after the clinical symptoms manifestations of the defect caused the relevance of studying the natural course of asymptomatic calcified aortic stenosis.
Aim of the study.  wasto evaluate the character, degree and consequences of pathological changes in the heartchambers and intracardiac hemodynamics in the natural course of asymptomatic aortic stenosis.
Materials and methods. The features of the natural course of isolated calcific aortic stenosis in 21 patients: 14 male and 7 female patients with an average age of 70, 5 years, were analyzed. 5 - and 10-year survival rates, freedom from surgery, the appearance of the disease symptoms and the development of left ventricular systolic dysfunction, as well as the dynamics of changes in the heart chambers and intracardiac hemodynamics were evaluated based on echocardiography.
Results. The study showed a reduction in compensatory mechanisms of the left ventricle in the clinical symptomsmanifistation of defect in 43% of patients in the 5-year period, 77% - in 10-year period. 5-year survival was in 90% of patients, and 10-year survival was in 71%; 5 - and 10-year freedom from surgery comprised95% and 84%, respectively. 5-year freedom from systolic dysfunction was 90%, 10-year-76%. During the observation period revealed the following statistically significant echocardiographic changes: the increase in the thickness of the interventricular septum by 2,37 mm, posterior wall of the left ventricle by 1,8 mm, decrease of ejection fraction by 8%, increase in the velocity of the transaortic flow of 0,9 m/s, mean gradient pressure of 10,8 mm Hg.
Conclusion. The natural course of calcified aortic stenosis is characterized by a long asymptomatic period with decompensation of the defect, usually in the elderly; high mortality rates in the conservative treatment of severe aortic stenosis; a low frequency of systolic dysfunction; and increasing changes in the echocardiographic parameters of the heart in response to a gradual narrowing of the aortic opening.
Key words: calcified aortic stenosis, asymptomatic course, myocardial hypertrophy, systolic dysfunction.

OPHTHALMOLOGICAL EXAMINATION OF PREMATURE CHILDREN IN SAINT-PETERSBURG: RESULTS AND PROSPECTS

E.I. Saidasheva 1,2, S.V. Buynovskaya 2, Y.A. Alekseev 1, N.A. Malinovskaya 1,
 A.V Morozova2, V.I.Shilina 2, C.V.Bilichenko 2, V.M. Panchishena 3, V.A. Makarova 3
1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint- Petersburg, Kirochnayast., 41
2Children's City Multidisciplinary Clinical Specialized Center for High Medical Technologies, Russia, 198205, Saint-Petersburg, Avangardnayast., 14
3Diagnostic Centre No.7 (ophthalmological), Russia, 191028, Saint Petersburg, Mokhovayast., 38
Abstract
Introduction. In Russia, as in the world, the survival rate of deeply premature newborns is increasing, but this group of children subsequently represents a group of high risk in terms of visual impairments development. The article presents the experience of organization of inpatient ophthalmological observation as a stage in the system of providing medical care to premature children in Saint-Petersburg and the prospects for its development.
Aim of the study was to analysis the effectiveness of the organizational model of inpatient ophthalmological observation of premature children in Saint-Petersburg.
Materials and methods. The research material was the reporting forms of the activities of inter-district ophthalmological cabinets; reporting forms of medical and social expertise from Rosstat No.7D.
Results. In 2010, it was organized a system of specialized ophthalmological inpatient care for premature children in Saint-Petersburg (screening and laser treatment of active ROP using telemedicine technologies; surgical treatment of late stages of the disease). In 2018, for the subsequent inpatient observation of premature children up to 3 years, 6 inter-district ophthalmological cabinets of medical history were organized. A developed routing scheme for children at risk and children with active and cicatricial ROP in Saint-Petersburg and preliminary results of ROP incidence presented. It is also provided data on the frequency of visual impairments, except for ROP in premature children.
Conclusion. 1. Inter-district cabinets of medical in the compulsory medical history within insurance system are a modern form of inpatient ophthalmological observation of premature children of risk groups or with ROP in a megalopolis, which could be recommend for widespread implementation in practical health care.
2. These cabinets could serve as the outpatient-polyclinic stage of medical rehabilitation of premature children.
Keywords: premature children, retinopathy of prematurity, vision impairment, prevention, follow-up.

CLIMATIC METAMORPHOSIS OF THE 21st CENTURY AND ALLERGIC RESPIRATORY DISEASES (REVIEW)

Z.V. Nesterenko
Saint-Petersburg State Pediatric Medical University, Russia, 194100, Saint-Petersburg, Litovskaya str., 2
Abstract
The article provides an overview of the literature data and materials of the EAACI Congress 2020, devoted to the study of the relationship between climate change and the state of the respiratory system in patients with allergic diseases. Rates of allergic respiratory diseases prevalence have increased dramatically up to an epidemic worldwide. The polyetiological nature of diseases such as asthma, allergic rhinitis is widely discussed by specialists. Global climate change on Earth, anthropogenic activities are considered as cumulative reasons for these increasing rates. Numerous studies confirm the relationship of exacerbations of allergic diseases with an increase in the level of pollutants. The role of climatic factors in environmental pollution, in the development of allergic diseases, is actively studied and became the topic of discussion at symposia of the European Academy of Allergy and Clinical Immunology (EAACI) Digital Congress, held in June 2020, where leading experts presented the results of their research in this field.  The strong need for the research on the aggregate impact of climate parameters (weather hardness, pathogenicity of meteorological factors) and environmental pollutants on human health was identified there allowing to outline new strategies for the treatment and prevention of allergic diseases.
Key words: climate, environment, allergic diseases, respiratory system, anthropogenic pollutants.

THE MEDICAL REHABILITATION OF DIFFERENT AGE GROUPS OF PATIENTS WITH CHRONIC PAIN SYNDROME: EVALUATION OF
BIOPSYCHOSOCIAL MODEL

V.A. Ishinova 1, A.A. Povorinsky 1, I.A. Leonova 2,
S.A. Boldueva 2
1 Federal Scientific Center of Rehabilitation of the Disabled named after G.A. Albrecht, Russia, 195067, Saint-Petersburg, Bestuzhevskaya street, 50
2 North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41
Abstract
Introduction. The investigation of biopsychosocial model of chronic pain enables not only to determine the peculiarities of their mutual influence, but also to reveal the target of their impact.
The aim of the study is to determine the significance coefficient of biological, psychological and social components of biopsychosocial model and to define the therapeutic target for restorative treatment of adolescent, middle age, elderly and old age patients suffering from chronic pain.
Materials and methods. The study included 153 patients of different age groups suffering from chronic pain. Psychological testing of patients was carried out at the beginning and at the end of the treatment course.
Results. At the beginning of the treatment course, the disorders were registered in every biopsychosocial model component in all patients. At this, the psychogenic component in all groups was the most susceptible to the impacts of diseases accompanied by chronic pain. At the end of the treatment course, the improvement of all biopsychosocial model components’ indices was observed.
Conclusion. In accordance with the obtained data, the elderly patients were in the risk group.  Most likely, it was associated with the changes of their self-perception, self-esteem in case of illness and also the possible changes of their economic and social status after retirement.  The research results could be useful not only for medical psychologists, psychiatrist, psychotherapists, but also for specialists of various medical fields.
Key words: biopsychosocial model, chronic pain, significance coefficient, the target of impact, age groups.

DAILY MONITORING OF NUTRITION AND NUTRITIONAL STATUS OF YOUNG CHILDREN HOSPITALIZED IN A MULTIDISCIPLINARY PEDIATRIC HOSPITAL

Ju.V. Peshekhonova, A.I. Sinyugina, K.M. Grigorieva, M.N. Yakovleva,
M.O. Revnova
Saint-Petersburg State Pediatric Medical University, Russia, 194100, Saint-Petersburg, Litovskaya street, 2
Abstract
Introduction. A complete and balanced diet is important for a sick child.  Therefore, the nature of baby feeding, the timing of the introduction of complementary foods, the choice of the correct assortment of products of the nursing mother or the correct food substrate for the artificially fed one, allow to «work on mistakes» after child birth.
The aim of the study was to assess the nutritional status and physical development of hospitalized children aged 0-18 months.
Materials and methods. The study included 44 children from 2 to 18 months hospitalized at the Clinic of Pediatric University.  The patients' parents signed informed consent to participate in the study and were questioned.  Height, body weight, head circumference, chest, middle third of the shoulder, wrist, abdomen and hips were measured for all children.  Daily monitoring of nutrition was performed for 3 days.  Physical development was assessed using the Anthro program and the values ​​of centile tables.
Results. Upon admission to the clinic, it turned out that the proportion of artificially fed children increased to 68.2% in comparison with the period after their mothers were discharged from the hospital.  Natural feeding was preserved only in 18.2%, and 13.6% of children remained on mixed feeding.  Allergy to cow's milk protein was almost equally frequently detected in breastfed and bottle-fed children.  It was revealed that the parents did not comply with the recommendations on the management of complementary foods.  The nutritional status of the patients was determined.
Conclusion. A decrease in the proportion of breastfed hospitalized children up to 18.2% was revealed.  Hospitalized children in 50% of cases demonstrated nutritional deficiency.  Adequate nutrition was determined in 10% of children.  Violation of the timing of the introduction of complementary foods and the distortion of biorhythmological adequacy were found in 50% of children.  Research is ongoing.
Key words: young children;  nutritional status;  nutrition;  malnutrition.

СLINICAL LABORATORY DIAGNOSTICS

HEMATOLOGICAL MARKERS FOR PROGNOSIS OF SURGICAL SITE INFECTION IN HIP ARTHROPLASTY

L.B. Gaikovaya1, N.L. Afanasieva1, A.N. Tkachenko1, A.I. Ermakov1.2, A.A. Vorokov1, B.G. Aliev1
1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnayast., 41
2Almazov National Medical Research Centre, Russia, 197341, Saint-Petersburg, Akkuratovast. 2
Abstract
Introduction. The emergence of infectious complications in the field of surgical intervention during the arthroplasty aim to developsimple and accessible laboratory tests to predict early postoperative complications.
Materials and methods. The study included 42 patients admitted to traumatology and orthopedics clinic of the NWSMU named after  I.I. Mechnikov for elective hip arthroplasty, and 28 donors who underwent blood tests using an automatic hematology analyzer DxH800 (Beckman Coulter, USA) and an FC-500 flow cytometer (Beckman Coulter, USA) using the CytoDiff reagent (Beckman Coulter, USA).
Results. Patients wereexamined before surgery. Retrospectively, patients were divided into 2 groups: group 1 without infectious complications in the surgical site (31 patients) and group 2 - with infectious complications (11 patients). Before surgery patients had no changes in hematological parameters compared to donors and reference values. In patients with infectious complications, an initial decrease in B-lymphocytes was established in comparison with patients without infectious complications. Studying the relationship of B-lymphocytes with hematological calculated blood parameters, a relationship with the volume distribution of monocytes (SD-MO) was established.
Conclusion. Thus, it is recommended to include the assessment of the content of B-lymphocytes in the blood in the structure of the prognostic coefficients when calculating the development indices of an infectious complication in traumatological patients. For the prediction of the risks of complications, use the indicator obtained from the hematological analyzer - the width of the distribution of monocytes by volume.
Key words: arthroplasty, hip joint, surgical site infection, markers, CytoDiff reagent, flow cytometry, hematology analyzer, standard deviation of monocyte volume.

CYTOKINE STORM IN COVID-19 (REVIEW)

A.Yu. Anisenkova1,2, D.A. Vologzhanin1,2, A.S. Golota1,
T.A. Kamilova1, S.V. Makarenko1,2, S.V. Mosenko1, S.G.Sherbak1,2
1 City Hospital № 40 of Kurortny District,Russia, 197706, Saint-Petersburg,
Sestroretsk, Borisova street, 9.
2 Saint Petersburg State University, Russia, 199034, Saint-Peterburg, Universitetskaya Embankment ,7/9

Abstract.
Since its first detection, coronavirus disease (COVID-19) caused by coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection has spread rapidly around the world and become a pandemic. Although, SARS-CoV-2 primarily attacks the respiratory system, complications in other organ systems (cardiovascular, neurological, liver and kidney) increase the mortality risk. Currently, clinical experience indicates a wide range of COVID-19clinical manifestations from asymptomatic to severe forms with low survival rates, associated with an aggressive inflammatory response. Overactivation of the immune system during COVID-19 leads to a sharp increase of levels of circulating proinflammatory cytokines – a cytokine storm, characterized by systemic inflammation, hyperferritinemia, acute respiratory distress syndrome and systemic inflammatory response syndrome, hemodynamic impairment, thrombosis and disseminated intravascular coagulation, damage to the lungs and other organs, multiple organ dysfunction  and unvaforableprognosis.
Keywords: COVID-19, coronavirus, SARS-CoV-2, immunity, cytokine storm, hyperinflammation, hypercoagulation, multiorgan damage.

LABORATORY ASSESSMENT OF THE EFFECTIVENESS AND SAFETY OF THE REDOX-MODULATING ACTION OF OMEGA-3 CONTAINING PREPARATIONS USED FOR CORRECTION OF PSORIASIS

N.V. Tyunina, L.B. Gaykovaya, A.T. Burbello, R.N. Pavlova,
A.I. Ermakov, Y.A. Vlasova, A.A.Murzina, L.A. Karyakina
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint- Petersburg, Kirochnayast., 41
Abstract
Introduction. Psoriasis is a recurrent immune-dependent disease, accompanied by inhibition of the intensity of free radical oxidation and a high level of antioxidant protection, which can be corrected by omega-3 polyunsaturated fatty acids having a redox-modulating effect.
Aim of the study was to justify the choice of laboratory methods for evaluating the effectiveness and safety of the redox-modulating effect of omega-3 polyunsaturated fatty acids and to determine the timing of their implementation.
Materials and methods. The study included 75 patients with vulgar psoriasis and 14 individuals (control group). Patients who received omega-3 polyunsaturated fatty acids for a month were randomized into 3 groups depending on the dose and the frequency of taking "Omega-3, 35%": 1-1150 mg 3 times a day; 2 - 3450 mg/day once; 3-2640 mg/day once. The effect of the action was evaluated by the PASI index, catalase activity, superoxide dismutase, their ratio, the concentration of total NS groups, interleukins, malondialdehyde, and lymphocyte apoptosis before treatment, after 14 and 28 days.
Results and discussion. In patients with psoriasis, an increase in the thiol groups of plasma proteins, catalase activity and the ratio of catalase to superoxide dismutase was found. During therapy with the addition of "omega-3, 35%" dose 2640 mg/day once revealed the most pronounced redox modulatory action: to 14 day increase 1.4 times of malondialdehyde, interleukin-8 to 17,58 PG/ml and lymphocytes in the stage of late apoptosis; at day 28, the reduction of these parameters to baseline or reference values, as well as clinical improvement and reduction in PASI. The correlation analysis showed the comparability of the results obtained by scientific research and unified methods.
Conclusion. To assess the effectiveness of the redox-modulating action of "Omega-3, 35%" ( 2640 mg/day once for a month) in patients with psoriasis, it is advisable to determine interleukin-8 on day 14, for safety assessment – interleukin-8 on day 28 and interleukin-10 on day 14 and 28 by enzyme immunoassay.
Key word: psoriasis, AOS, apoptosis, interleukin status, redox-modulating effects of omega-3 containing drugs, methods for evaluating the effectiveness and safety of the drug, PASI index.

 

 

(с) 2020 North-Western State Medical University named after I.I.Mechnikov