New possibilities for laboratory diagnostics of partial age androgen deficiency
Drygina L.B. 111
TO AUTHORS ATTENTION
HYGIENE
DEVELOPMENT OF SOCIAL AND HYGIENIC MONITORING WITHIN THE IMPLEMENTATION OF TARGETS OF STATE AND NATIONAL PROJECTS AT THE REGIONAL LEVEL
A.V. Meltser2, I.A. Kuznetsova 1, N.V. Chezhina 1, N.V. Erastova 2, L.Sh. Petrova1 , A.I. Kropot 2, T.Yu. Pilkova 2,A.V.Kiselev2 1Regional office of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in Vologda region. Russia, 160012, Yashin street, 1a 2North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 Abstract Introduction.The achievement of the key socially significant results determined by state policy, including an increase in healthy life expectancy, a decrease in mortality among the able-bodied population, favorable environmental conditions, requires the further development of social and hygienic monitoring at the regional level. The aim of the study was to perform a hygienic substantiation of priority measures to ensure the sanitary and epidemiological well-being of the population of the Vologda region within the implementation of the targets of the Federal projects, taking into account regional characteristics and previously achieved results according to data analysis of social and hygienic monitoring. Materials and methods. The analysis of indicators, charactering the state of the environment, general and primary morbidity of population and management decisions making based on the results of social and hygienic monitoring, was performed. Results. The information-analytical system of social and hygienic monitoring of the Vologda region integrates all available databases in the region. The results of social and hygienic monitoring are used for the development, justification and updating of management decisions to reduce negative environmental impact on health. It is carried out a set of measures aimed at informing and motivating target population to maintain a healthy lifestyle and at the development of special nutrition education programs. The ongoing project, ensuring a reduction of negative health impacts, allow to predict positive trends in the dynamics of the incidence rates and meets the objectives of the Concept of the Social and Hygienic Monitoring Development, which is considered as the basis of the state system for assessing ,managing, monitoring and informing about risks to public health. Conclusion. Set of hygiene measures is being implemented in the Vologda region, as well as the realization of measures aimed at minimizing exposures of the most toxic substances causing a risk to health of the population of Cherepovets; strengthening drinking-water surveillance; informing the population about health risks. It is necessary to improve the priority directions of work in the field of the formation of a healthy lifestyle, to intensify the work in the organization of informing of employees about improving workplace environment. Key words: Rospotrebnadzor, social and hygienic monitoring, population health, health risk assessment, healthy lifestyle, healthy nutrition, healthcare risk management, safe water, fresh air.
HYGIENIC ASSESSMENT OF DEVICES REDUCING THE RISK OF THE INFECTIONS SPREAD BY AIRBORNE MECHANISM (ON THE EXAMPLE OF FACE MASKS)
1First Moscow State Medical University. Russia, 119991, Moscow, Trubetskaya street, 8
2Limited liability Company Respiratorniy Kompleks. Russia, 188679, Lenindrad region, Vsevolozhsk district, Chekalova str., 592-3
Abstract Introduction. The use of devices that reduce the risk of infections spreading by aerogenic mechanism is quite effective among non-specific prevention measures. A large number of the devices (respirators, face masks and face shields) with different parameters manufactured in different countries are used in Russia during the coronovirus infection pandemic. Their effectiveness and safety for health depend on many factors. Purpose of the study is development of principles for an hygienic assessment of devices reducing the risk of the infections spread by airborne mechanism, and its testing on the example of face masks. Material and research methods. We analysed the results of our previously published studies about the use of respiratory protection devices by transport workers during the coronovirus infection pandemic.
The study included the types of face masks most commonly used by the population: disposable medical non-woven three-layer (from spunbond and meltblown); reusable non-medical cotton two-layer; reusable non-medical neoprene single layer.
The data were divided into 3 blocks of indicators: 1st – the results of the subjective assessment of masks by users; 2nd – laboratory studies of unworn masks; 3rd – laboratory studies of masks after wearing. Results and its discussion. The hygienic assessment of the face mask was based on the its each indicator scores, taking into account the multiplying factor. A multiplying factor of 2 was used for the second bloc of indicators, since the results of laboratory studies are unbiased. However, this bloc do not take into account changes in the mask properties during wearing, so for the third block of indicators we used a multiplier of 3. Conclusion. The hygienic assessment is based on indicators characterizing the comfort and subjective adverse reactions of the user when wearing face masks, as well as data from laboratory studies of the properties of devices before and after their use. All studied types of face masks are comparable to each other and can be used by the population and non-medical specialties workers to protect against infections spread by an aerogenic mechanism. A non-woven face mask made of spunbond and meltblown is the most effective and safest for the user. Key wards: facemask, coronovirus infection, non-specific prevention, hygienic assessment, airborne mechanism, respiratory protection devices.
OVERWEIGHT AS A RISK FACTOR FOR THE HEALTH OF PEOPLE WORKING IN UNFAVORABLE WORKING CONDITIONS
R.S. Rakhmanov 1, E.S. Bogomolova 1, S.A. Razgulin1, D.A. Narutdinov2, N.N. Potekhina1, S.A. Spirin3 1Volga Research Medical University.Russia, 603950, Nizhny Novgorod, Minin and Pozharsky square, 10/1 2Medical service of military unit 73633. Russia, 660017, Krasnoyarsk, Dzerzhinsky street, 186 3Center of Sanitary and Epidemiological Surveillance of military unit 10283. Russia, 683009, Petropavlovsk-Kamchatsky, Kosmichesky proezd, 7A Abstract Introduction. The increase in body weight potentially reduces the body's resistance to adverse environmental conditions. The aim of the study was to determinewhether the overweight is a risk factor to the workers' health. Materials and methods.The study included healthy men with normal (No. 1, n=14) and excess (No. 2 - n=13) body weight, working by a shift method within hazardous working conditions. Before and after 2 months of work, anthropometric and physiometric examinations were carried out; physical development indices of the functional state were calculated. The index of functional changes was defined. Results. Initially, differences were determined in body weight (No. 1 - 74.1 ± 1.1, No. 2 - 91.8 ± 2.7 kg, p = 0.001) and heart rate (60.0 ± 2.3 and 73.1 ±2.0 w/min, p=0.001). Before working in hazardous conditions, according to endurance coefficient, Robinson index and circulatory efficiency, the cardiovascular system in group 1 was more resistant to stress; as well as higher levels of body adaptation and the prevalence of anabolic processes, which were confirmed by the vegetative Kerdo index and functional changes. After work, the endurance coefficient increased, respectively, in 42.8% and 69.2%, the Robinson index was estimated below the average in 35.7% and 76.9%, the circulatory efficiency was above the norm in 68.6% and 76.9%. The average values of the functional changes index in each group were assessed as a "state of functional stress": according to individual data in group 1 in 100%, in group 2 - in 92.3% (poor adaptation in 7.1%). Conclusion: Unfavorable working conditions affect the health of workers. Functional changes were more pronounced in the group with excess body weight. Thus, the overweight should be considered as a risk factor for the deterioration of the functional state of the body. Key words: body weight, working conditions, shift work, physical development, body functions.
PROBLEM ISSUES OF FORMING HEALTHY FOOD HABITS IN SCHOOL AGE CHILDREN
I.Sh. Iakubova¹, A.V. Suvorova¹, A.V. Meltser¹, O.G. Khurtsilava1, E.M. Bakalkina¹,² 1North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 2St. Petersburg State Budgetary Institution of Health Care "City Hospital of the Holy Martyr Elizabeth". Russia, 195257, Saint-Petersburg, st. Vavilovykh, 14, letter A Abstract Introduction. One of the most problematic issues is the formation of healthy eating habits in children. Purpose of the study: to assess the formation of healthy eating habits in school-age children in St. Petersburg in the course of a pilot study, as well as the nutritional diversity of school meals in a sample study in 10 cities. Material and methods: a pilot study was conducted in which a special questionnaire was used. To assess individual actual nutrition, the food diversity index was used, which makes it possible to identify 5 levels of food intake diversity for a given population. In total, the study included 532 children and adolescents 7-17 years old (mean age 13.9±2.4 years), including 254 boys and 278 girls who studied in 6 general education institutions in St. Petersburg. A sample assessment of school meal rations from 10 cities was carried out. Results: An analysis of the frequency of food consumption, indicating "healthy" eating habits of schoolchildren, taking into account age and gender differences, showed that as they grow older (12-17 years old), the proportion of children and adolescents with an orientation towards healthy eating habits becomes larger, compared with children 7-11 years old.
An analysis of food addictions to such products as salty cookies, chips, nuts, lemonade, cola, fanta, hamburgers, "fast food" showed that their consumption significantly decreases with age, and products: sausage or ham, sweets, pies, cookies – increases and reaches 50-40%. Of the 10 school meals considered, only 5 can be considered optimal in terms of nutritional diversity. Conclusion: food habits are formed at the age of 7-11 years, and already in the age groups of 12-14 years and 15-17 years they are characterized by relative stability, which is confirmed by the addiction to both "healthy" and "unhealthy" food. Key words: schoolchildren, foodstuffs, consumption frequency, eating habits, school food rations.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
COLLECTIVE IMMUNITY TO SARS-COV-2 AMONG EMPLOYEES OF A DENTAL ORGANIZATION DURING COVID-19 PANDEMIC
I.V. Feldblyum1, T.M. Repin1, M.YU. Devyatkov1, N.B. Vol'dshmidt, T.V. Shutova2, M.A. Gileva3, A.A. Kovtun3. 1Perm State Medical University named after Academician E. A. Wagner. Russia, 614990, Perm, Petropavlovskaya street, 26 2Office of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the Perm Region. Russia, 614016, Perm, Kuibyshev street, 50 3Regional Clinical Dental Polyclinic. Russia, 614036, Perm, Brothers Ignatov street,4 Abstract Introduction. Epidemiological well-being during coronavirus disease 19 is determined, in priority, by the state of population (collective) immunity to the SARS-CoV-2. Dentists have a higher risk among healthcare workers of contracting Coronavirus disease 19. The aim of the study was to assess the state of herd immunity to SARS-CoV-2 among employees of dental organizations. Materials and methods. An assessment of the state of collective immunity was carried out during the circulation of the SARS-CoV-2 strain (B.1.617.2 Delta) based on the results of a one-stage continuous screening study of employees of a medical organization. A total of 175 blood samples were taken. Collective immunity was assessed by the level of seroprevalence and the intensity of humoral immunity, which were determined by the presence or content of immunoglobulin’s G to SARS-CoV-2 in the blood serum. The level of seroprevalence among the general population was assessed based on the serological monitoring results of the population of the Russian Federation for Coronavirus disease 19. Results. Herd immunity in the dental clinic was characterized by a high seroprevalence of 92% (95% CI 87.9-96.1), exceeding the seroprevalence of the general population by 23%. The median serum level of immunoglobulin G to the SARS-CoV-2 surface protein S in employees was 608 (BAU/ml). A higher content of virus-neutralizing antibodies was observed in individuals who received a basic course of immunization. The highest content of virus-neutralizing antibodies was found in vaccinated persons - 1113 (BAU/ml), against 362.2 and 196.45 (BAU/ml) in recovered patients and persons with inapparent seroconversion, respectively. Conclusion. The collective immunity of dental clinic employees to SARS-CoV-2 was determined by those who had been ill, vaccinated, and persons with inapparent seroconversion and was characterized by high rates of seroprevalence and intensity of humoral immunity. Key words. herd immunity, Coronavirus disease 19, healthcare workers, dental clinic.
THE STRUCTURE OF DYSPHAGIA IN A PEDIATRIC PATIENT AND ITS IMPACT ON NUTRITIONAL STATUS
A. N. Zavyalova Saint Petersburg State Pediatric Medical University. Russia, 194100, Saint Petersburg, Litovskaya street, 2 Abstract. Introduction. Dysphagia is a rare occurrence in pediatric practice, affecting the nutritional status of the patient. The aim of the study was to assess the degree of malnutrition in children with dysphagia, depending on its causes. Materials and methods. The nutritional status of children with dysphagia was assessed over 8 years of study. Diagnostics was carried out by an interdisciplinary team of neurologists, otorhinolaryngologists, gastroenterologists and a speech therapist. It was excluded 1328 children with limited mobility with and cerebral palsy, described earlier. This study included 173 children with dysphagia due to other causes. The material was analyzed using SPSS Statictics 26. Results. It was observed a prevalence ofneurological pathology. Among 77 /44.5% of children with organic pathology of nervous system, 65 (84.4%) were diagnosed with oropharyngeal dysphagia, 12 (15.6%) had a mixed form with esophageal dysphagia; with genetic pathology n=37 /21.5% in 97.3% of cases had oropharyngeal dysphagia, and in 1 patient was observed a mixed variant. A group of 22 / 21.5% patients with laryngomalacia (12) and laryngeal stenosis (10) consisting of 18 children with oropharyngeal dysphagia, 3 children had a mixed form. Esophageal dysphagia was diagnosed in children with esophageal burns (n-10/5.7%) and congenital esophageal atresia (n-12/7%). The rest of the patients with the oropharyngeal dysphagia form had a primary neurological lesion. Conclusion. Severe malnutrition was noted in every fifth patient with dysphagia, mild and moderate malnutrition in every fourth patient among children with neurological pathology. Excess body weight was noted in 6.3% of children with organic pathology of nervous system. When divided into groups of pathologies, children with laryngopharyngeal pathology and organic lesions of the central nervous system more often demonstrated severe malnutrition (p<0.05), unlike other groups. The timing of the diagnosis of dysphagia, its severity and the timely setting of a gastrostomy allow to avoid severe malnutrition. Key words: children; dysphagia; malnutrition; nutritional status.
DIAGNOSIS OF INSULIN RESISTANCE IN ADOLESCENTS USING THE CHEST CIRCUMFERENCE TO HEIGTH RATIO
A.G. Kedrinskaya1, N.B. Kuprienko1, G.I. Obraztsova2, I.A. Leonova1,2 1Pavlov First Saint Petersburg State Medical Universiy. Russia, 197022, Saint Petersburg, L'va Tolstogo street, 6-8 2Almazov National Medical Research Centre. Russia, 197341, Saint Petersburg, Akkuratova street, 2a Abstract Introduction. The prevalence of insulin resistance in children and adolescents is growing along with the tendency to increase the percentage of overweight and obese children, but its detection in large-scale studies is difficult. The aim of the study is to determine anthropometric parameters associated with insulin resistance, and to create a mathematical and statistical model based on them to predict the presence of insulin resistance. Materials and methods. The one-stage study included 106 adolescents (56.6% – boys) aged 13-17 years. Fasting glucose, basal insulin, anthropometric parameters were determined according to the standard methods. Insulin resistance was diagnosed at HOMA-IR levels more than 3.2. Binary logistic analysis and ROC data analysis were applied to create a model for predicting the presence of insulin resistance and studying its diagnostic value. The model was tested in groups of children with normal body weight, overweight and obesity. Results. The highest coefficient of logistic regression of the presence/absence of insulin resistance was in chest circumference to height ratio (p=0.000). The area under the ROC curve is 0.82 (95% CI 73-0.90), p=0.000; n=106. A mathematical and statistical model for calculating the probability of insulin resistance:
p=1/(1 + 2,718-(20,12*chest circumference to height ratio - 11,40)).
If the values above the cut-off point (0.534, sensitivity 75.5%, specificity 83.0%), the teenager should be classified as a risk group for insulin resistance. Testing of the model in groups of children with normal body weight, overweight and obesity revealed a coincidence in the presence of insulin resistance in obese children and in the absence of insulin resistance in children with normal body weight. Conclusion. This model of insulin resistance diagnosis, when being compared with the reference method, showed significant specificity, sensitivity, general predictive ability and could be used to form a risk group for the presence of insulin resistance during clinical examination of adolescents. Key words: diagnostics, insulin resistance, anthropometric markers, children, adolescents, overweight, obesity.
NON-TARGETED ABSCOPAL EFFECT IN RADIOBIOLOGY OF RADIATION THERAPY (REVIEW)
A.I. Arseniev 1,2, S.N. Novikov 1, S.V. Kanaev 1, S.A. Tarkov 1, E.A. Arseniev1, Yu.S. Melnik 1, A.O. Nefedov 3, R.V. Novikov 1, F.E. Antipov 1, A.Yu. Zozulya1 1N.N. Petrov National Medicine Research Center of oncology. Russia, 197758, Saint Petersburg, Pesochny, Leningradskaya street, 68 2 North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 3 Saint-Petersburg Research Institute of Phthisiopulmonology. Russia, 191036, Saint Petersburg, Ligovsky avenue, 2-4 Abstract
The biological response to ionizing radiation is realized through several mechanisms: direct damage to the genetic apparatus; vascular endothelial apoptosis; immune cell death and the realization of non-targeted effects. The contribution to the cumulative response of each of these mechanisms varies depending on the irradiation regime, and primarily on the dose per fraction. With high single doses of radiation, indirect (vascular, immune and non-targeted) death of tumor cells comes to the fore. Non-targeted radiobiological effects developing in cells and tissues that have not been directly exposed to ionizing radiation are the subject of intense interest and remain insufficiently studied and little predictable. They are one of the reasons for the paradigm shift of modern radiobiology and could be adequately described only at the junction of three main models of radiobiology: linear-quadratic, vascular and immune. One of the manifestations of non-targeted effects is the abscopal effect and its particular manifestation - the "bystander effect" - consisting in the transmission of radiation signals (primarily apoptosis) from irradiated cells to non-irradiated ones by at least two mechanisms: intercellular contacts and secretion of mediators as a result of intensive stimulation of the immune system with massive expression of tumor antigens. Non-targeted effects could have both a positive (radioprotective) and, more often, a negative (radiosensitizing) effect. The low frequency of abscopal effects is partly due to the suppressive effect of the tumor microenvironment. Understanding the mechanisms of realization of radiobiological phenomena allows to actively explore and implement various combinations of radiation with immunotherapy and chemotherapy to achieve a synergistic effect. Key words: review; radiobiology; high-dose radiation; stereotactic radiation therapy; abscopic effect; vascular, immune and non-targeted radiation models; bystander effect, immunotherapy.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
STATE SUPPORT FOR FAMILIES WITH CHILDREN IN SAINT -PETERSBURG AS A POWERFUL FACTOR SHAPING HEALTH
A.S. Simakhodsky1, A.I. Panchenko3, I.V. Sidorova1, O.A. Simakhodsky4, I.A. Leonova1,2, L.D. Sevostyanova5, L.Yu. Maslentseva6 1 Pavlov First Saint Petersburg State Medical University. Russia, 197022, Saint-Petersburg, Leo Tolstoy street, 6–8. 2 Almazov National Medical Research Centre. Russia, 197341, Saint-Petersburg, Akkuratova street, 2. 3LLC "Timurovskoye". Russia, 195266, Saint-Petersburg, Timurovskaya street, 4, building 1 4LLC «Tenderfood». Russia, 192007, Saint-Petersburg, Obvodny Canal Embankment, 64, building 1 5Saint-Petersburg Polyclinic № 37. Russia, 191186, Saint-Petersburg, Gorokhovaya street, 6 6 Saint-Petersburg Children's Polyclinic № 73. Russia, 192177, Saint-Petersburg, Karavaevskaya street, 30 Abstract Introduction: In the 1990, the chain store «Diettorg» and dairy kitchens were liquidated. Their function was delegated to polyclinics. Currently, the legal basis for cashless payments has been developed and a chain store has been organized to provide children with the necessary products. Aim of the study was to evaluate the effectiveness of a new methodology for providing children with baby food according to the dynamics of the level of alimentary-dependent diseases, deviations in physical development and the frequency of breastfeeding in children from 0 to 4 years. Materials and methods. It was analyzedthe legislative framework of Saint-Petersburg: «On compensation payments to residents of St. Petersburg for childbirth and caring for him» since 2000 ; analysis of alimentary-dependent diseases according to statistical forms of Rosstat: № 31, № 12, № 30, № 030- PO/o-12, No. 030-PO/o-17. Results. The procedures of the formation of legal and regulatory framework of standard system of social assistance to families and children was studied. Cashless financial assistance increases breastfeeding rates, improve the prevention of alimentary-dependent diseases in children from 0 to 4 years due to parents’ conscious choice in terms of products, care items, clothes, children's furniture, educational games and books having an impact on the neuropsychic development of children. Conclusion. The effectiveness of the system of social support for families with young children developed in Saint- Petersburg represents the significant role of the executive and legislative authorities of the subjects in protecting and shaping the health of children. Keywords: state support for families, children, health, nutrition.
ANALYSIS OF MORBIDITY OF THE POPULATION OLDER THAN WORKING AGE IN THE REPUBLIC OF BASHKORTOSTAN IN 2016-2020
J.E. Kondratyeva1,2, L.A. Karasaeva1, V.S. Luchkevich3, I.F. Timerbulatov2, D.L. Logunov4 1St. Petersburg Institute of advanced training of doctors-experts. Russia, 194044, Saint- Petersburg, Bolshoy Sampsoniyevskiy prospect, 11/12 2Bashkir State Medical University. Russia, 450008, Ufa, Lenina street, 3 3North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint Petersburg, Kirochnaya street, 41 4City polyclinic No. 78. Russia, 192239, Saint Petersburg, Budapestskaya street, 63, building 2 Abstract Introduction. The study of the process of population aging is one of the burning issues in health care being necessary for the provision of high-quality medical and social care to the elderly and senile population. Aim of the study was to analyze the structure and dynamics of morbidity of the population older than working age in the Republic of Bashkortostan. Materials and methods.The statistical reports of the Medical Information and Analytical Center (MIAC) of the Republic of Bashkortostan, annual reports of the federal statistical observation form No. 12 «Information on the number of diseases registered in patients living in the service area of a medical organization residing in the service area» of the Republic Bashkortostan during 2016-2020 were used to analyze the level and structure of morbidity. It was revealed medical and social features and current trends in medical and demographic processes in the formation and medical care of residents at geriatric risk. Results.In the Republic of Bashkortostan in dynamics for 2016-2020 the number of people over working age increased from 927473 to 1019047 people (by 9.9%). The share of this demographic group in the population age structure in 2020 was 25.4%. Circulatory system disease, respiratory system diseases, musculoskeletal disorders and injuries, poisoning and some other consequences of external causes prevailed in the structure of morbidity in people older than working age. According to the available data on the use of medical care by the population older than the working age, over the five-year period, the indicators of general morbidity increased by 11.2% (R2= 0.865), common - by 25.6% (R2= 0.983). The increase in primary morbidity occurred mainly due to respiratory diseases (by 94.3%), while the number of requests for pneumonia increased by 7.1 times. Conclusion.In dynamics for 2016-2020 primary and general morbidity among individualsabove working age in the Republic of Bashkortostan increased, the largest increase in requests was due to respiratory diseases, a decrease in the proportion of injuries, poisoning and some other consequences of external causes was noted. Kew words: primary morbidity; general morbidity; population above working age.
TRENDS IN THE ABORTIONS DYNAMICS ON THE BACKGROUND OF THE IMPLEMENTED STATE POLICY TO INCREASE THE FERTILITY IN THE RUSSIAN FEDERATION
M.V. Avdeeva 1,2, O.G. Khurtsilava 1, А.А. Kuznetsova 1 1North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 2St. Petersburg State Pediatric Medical University. Russia; 194100, Saint-Petersburg, Litovskaya street, 2 Abstract Introduction. The abortion dynamics is directly related to population size, as well as to the retention of human capital. In this regard, an analysis of the current situation regarding the state of the abortion issues in Russia is of a great strategic importance for the improvement of the state demographic policy. The aim of the study was to determine current trends in the abortions dynamics among women of different age on the background of the state policy being implemented in Russia to increase the birth rate. Materials and methods. The study materials were the statistical data of the demographic yearbook of Russia, published by the Federal State Statistics Service. The demographic yearbook contains statistics on the implementation of abortions for a certain period (from 2000 to 2020). Information about abortions in these years was collected and presented in the form of graphs for subsequent change analysis. Results. Between 2000 and 2020 there was a favorable statistical trend in the form of a reduction in the total number of abortions by 3.9 times (from 2138.8 to 553.5 thousand), a decrease in the number of abortions among primigravida by 3.7 times (from 161.1 to 43.0 thousand), and also reducing the number of terminated pregnancies in women of reproductive age (15-17 years and 18-45 years). Positive dynamics was noted after the adoption of new regulatory legal acts aimed at improving the quality of life of mothers and children (increase in maternity capital, lower interest rates on loans, payment of state benefits). At the same time, there was an increase in the number of abortions among women over 45, due to the influence of the age factor and health problems. The results of the regression analysis demonstrate a high probability of continued positive dynamics in the reduction in the number of abortions in Russia in the short-term period among women of childbearing age (R2=0.96; p<0.05). Over the past decades, the legislative and regulatory framework has changed significantly in our country, this has created more favorable conditions for stimulating the birth rate. Conclusion. During the analyzed period of time, a favorable situation resulted in a reduction of abortions in the Russian Federation. In each age group of women, the abortion statistics are influenced by a combination of individual medical and social factors. The reduction in the number of abortions among women of childbearing age was observed against the backdrop of a significant improvement in Russian regulatory framework in the direction of improving the social protection of families with children. Key words: abortion, demographics, reproductive losses, termination of pregnancy.
CLINICAL LABORATORY DIAGNOSTICS
NEW POSSIBILITIES FOR LABORATORY DIAGNOSTICS OF PARTIAL AGE ANDROGEN DEFICIENCY
L.B. Drygina The Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia. Russia, 194044, Saint-Petersburg, Academica Lebedeva Str., 4/2 Abstract Introduction. A decrease in circulating testosterone may be observed in middle-aged men. This condition is referred to by the term partial age-related androgen deficiency. The work compares and analyzes various methods for determining testosterone levels in serum. Purpose. The objective is to compare androgenic status parameters in patients with partial androgenic deficiency using direct extract-free immunoassay methods and calculated using a testosterone fraction calculator. Materials and methods. The aim of the work is to compare androgen status parameters in patients with partial androgen deficiency using direct immunoassay methods and then, using a testosterone fraction calculator, determine the concentration of free testosterone and bioavailable testosterone. The study included men aged 45 to 70 years (57,0±2,5), in 34 people erectile dysfunction was combined with metabolic syndrome, and in 32 - with osteopenic syndrome. All patients examined were divided into three age subgroups: 45-50, 51-60, 61-70 years. Results and conclusion. Significant differences are shown in the determination of free testosterone by direct and calculation method. To diagnose partial androgen deficiency, it is recommended to determine total testosterone and globulin binding sex hormones in the blood by immunoassay, and then, using a testosterone fraction calculator, determine the concentration of free testosterone and bioavailable testosterone. Based on the results obtained, in the future, it is necessary to decide on the feasibility of prescribing hormone replacement therapy. Key words: partial age-related androgen deficiency, laboratory diagnostics, testosterone, free testosterone, bioavailable testosterone, testosterone fraction calculator.
(с) 2020 North-Western State Medical University named after I.I.Mechnikov
