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Contents 2018-2


  1. Health and well-being at work: presenteeism and absenteeism issues.

A.V. Meltser, V.P. Chashchin, B. Lahgajn, N.V. Erastova, A.S. Kopylkova                                    5

  1. .Method of okadiс acid quantitative determination as indicator of seafood safety

 P.V. Kudan, I.E. Sokolov, A.D. Evstratova, O.V. Bagryantseva, S.A. Khotimchenko                     16

  1. Rrevalence of overweight and obesity in school-aged children of Saint-Petersburg.

N.B. Kuprienko, N.N. Smirnova                                                                                                         23

  1. Monitoring of the microbiocenosis in newborns with in intensive care units

T.A. Kondratenko, A.V. Sheozheva                                                                                                    31

  1. Health and mortality risk as an assessment criteria of public health.

O.P. Lomov                                                                                                                                          35

  1. Сomparability of methods for short-term and long-term indoor air sampling on ammonium concentration.

N.O. Barnova, A.V. Mel'tser, I.Sh. Iakubova, Y.V. Dadaly, M.A. Andreyeva, M.P. Gorshkova          41

  1. Blastocystis spp. infection in Saint-Petersburg. Еpidemiological survey for 2015-2017. D.V. Azarov, A.E. Goncharov, E.V. Sousova, F.I. Mezhazakis, E.V. Rahmanova, U.A. Dmitrieva, S.G. Belov, V.O. Tarskih                                                                                                                              49



  1. The analysis of the results of surgical treatment of renal cell carcinoma with tumor invasion in the renal and inferior vena cava.

B.K. Komyakov, S.A. Zamyatin, A.I. Archangelskiy, V.A. Zubarev, A.T. Salsanov                  56

  1. Еxperience with surgical treatment of pylorodudodenal stenosis in aged patients with high surgical and anesthesiological risk.

N.I. Glushkov, T.L. Gorshenin, S.K. Dulaeva                                 62

  1.  Mechanism of apoptosis induction in chronic alcohol intoxication (review).

A.A. Vershinin, I.E. Sviridov, V.V. Shilov                69

  1.  Restorative potential of complex rehabilitation in the primary health care provision for patients with degenerative disc diseases.

Yu.A. Kreneva, V.P. Panov, M.V. Avdeeva, K.A. Bogomolova            76

  1. Mesenteric panniculitis in abdominal surgeon practice.

V.P. Zemlyanoy, B.V. Sigua, D.S. Semin, D.V. Gurzhii, R.M. Abdulaeva, V.E. Kvarku                 83




A.V. Meltser 1, V.P. Chashchin 1, B. Lahgajn 1.2, N.V. Erastova 1, A.S. Kopylkova1
1 North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg
2Bielefeld University, Bielefeld

The World Health Organization and the International Labor Organization point out worldwide changes in labor socialization, a more stressful working life, which, in their turn, require adaptation of employees to the changing conditions, negatively affecting their health and well-being at work. In view of the future challenges in most developed countries, the issues of a healthier workforce and ability to work become more important. The paradigm changes, as well, from diseases treatment to prevention, to creating health protective behaviors and health potentials (comprehensiveness).
Currently presenteeism and absenteeism are of great importance, their management being able to considerably affect the employees’ health and working efficiency. Goal-oriented efforts focusing on decreasing presenteeism and absenteeism, search for methods of their integration into the strategy of professional risk management, revision of priorities in prevention measures with an emphasis on individual health management. International experience shows success of this approach to improving labor conditions and life quality of the employees in the framework of Health Management programs.
Key words: health and well-being at work, stress at work, working efficiency, presenteeism, absenteeism, occupational health promotion. 

P.V.Kudan1, I.E.Sokolov1, A.D. Evstratova1, O.V. Bagryantseva1,2, S.A. Khotimchenko1,2
1 Federal Research Centre «Fundamentals of Biotechnology, Russia, Moscow, 109240, Ustinskiy proezd 2/14;
2 I.M. Sechenov First Moscow State Medical University, Russia,Moscow, 119992, Trubetskaya Str. 8c2
Introduction: Phycotoxins okadaic acid is the contaminant obligatory to be monitored in seafood.  The approved detecting method of okadaic acid MR 01.016-07 (express detection of okadic acid in mollusc using «DSP-Check» test system)   is screening, which is not sufficient to detect the concentration of okadaic acid thus the manufacture of these test systems is stopped.
The aim of the study is to develop a highly effective precision and selective method for okadaic acid detection and quantitate determination in seafood.
Materials and methods: It was used the highly effective liquid chromatography along with mass spectrometry.
Results: It was developed the okadaic acid quantitative determination in seafood by LC-MS/MS based on liquid chromatograph Agilent 1200 HPLC System and high-resolution mass spectrometer Thermo Scientific Orbitrap Elite. Sample preparation included product homogenization, okadaic acid extraction, centrifugation, supernatant selection. The analysis of the supernatant was conducted using highly effective liquid chromatography along with mass spectrometry dividing on C18  Columns in gradient mode with water-and methanol-based eluents plus 0.1%formic acid and okadaic acid mass spectrometric detection with ionization using electrospray in positive ion mode [MH-H2O]+or [MH-2H2O]+or [MH-3H2O]+. The lower limit of the okadaic acid quantitative determination using the proposed method is from 5 to 20 ug/kg, depending on the used ion with measurement inaccuracy up to 15%.
Conclusions: This method provides limits of okadaic acid quantitative determination, sufficient for the expertise purposes and state supervision on the seafood safety (the maximum permissible level of okadaic acid in seafood – up to 160 mg/kg).
Keywords: okadaic acid, marine biotoxins, chromatographic analysis, mass spectrometry analysis, calibration curve.

N.B. Kuprienko, N.N. Smirnova
Pavlov First Saint Petersburg State Medical University, Russia, 197022, St. Petersburg, Leo Tolstoy str., 6-8.
Introduction. Obesity and its associated health problems have significant social, economic and medical consequences, for that reason it is necessary to monitor trends in the obesity prevalence since childhood to develop preventive measures.
Methods. The electronic protocols data of regular preventive medical examinations were collected on 4618 children (7-17 years, 47.8 % boys) for the period from 2009 to 2013. Participants were classified as normal weight, overweight and obese by the cut-off points of the body mass index using two childhood obesity definitions.
Results. In school-aged children, the overweight prevalence was 18.2%, obesity was found in 6.2% of children according to the World Health Organization body mass index classification criteria. By the cut-off points of the body mass index by Russian recommendations on the diagnosis, treatment and prevention of hypertension in children and adolescents, the overweight prevalence was 13.7%; obesity was 3.6% (boys 15.6 / 4.4, girls 12.0 / 2.9). The maximum overweight prevalence  was observed at 11 years in boys (20.1%), at 8 years in girls (20%), and the minimum at age of 15 years (11% and 4.7%). The maximum obesity prevalence was registered in boys at 11 years of age (6.6%), and in girls at 9 years (4.3%) and at 12 years (4.8%). The minimum obesity prevalence among boys was 16 years (2, 3%), girls at 8 years (2.2%) and 15 years (2.3%).
Conclusions. The prevalence of overweight and obesity in school-aged children in Saint- Petersburg remains at a high level and corresponds to global trends.
Kеy words: overweight, obesity, prevalence, school-aged children


T. A. Kondratenko1, A. V. Sheozhevа1,2
1 Rostov State Medical University. Russia, 344022, Rostov-on-Don, Nakhichevansky Lane, 29
2 Adygei Children's Republican Clinical Hospital , Russia, 385000, Republic of Adygea, Maykop, Gagarin St., 6
            Introduction. Due to the dysmaturity of the neonate's immune system, especially of premature babies, a larger number of manipulations, the intensive care units (ICU) are the risk zones for the development of healthcare-associated infections. The level of intrahospital infections in these very units is 10 times higher, than in general units.
            The aim of the study was to investigate the circulating microbiota and its sensitivity to antibiotics in newborns during development care in ICU.
Materials and methods. In neonatal intensive care units of
Maykop  perinatal during 2015-2016 were conducted laboratory studies carried out in institution’s bacteriological laboratories.  Microbiological examination of newborns was performed on the admission and discharge of the ICU. The obtained results were analyzed using WONET programme (v.5.6), statistical analysis was performed using SPSS programme (v.22).
Results. By the research results on the infant microflora colonization during the first days after birth it was observed the scanty microflora and only in 7,8% out of 260 cases  was founded the coccal flora (St. haemoliticus). During the admission the microbiology of biotypes was formed on newborn (25 days Me = 25,00; Р 23,00–26,00), so while investigating the pharynx contamination was observed the high-level colonization by gram-negative bacteria of Pseudomonas aeruginosa (4,1%) and Enterobacteriaceae (E. cloacae – 4,6%, E. agglomerans-of 6,1%, E. aerogenes of-2,6%) being pathogens of nosocomial pneumonia,  genitourinary tract lesions  and bacteremia. Gram-positive facultative aerobes was prevailed in nose, eyes and navel (S. aureus of-3,9%, S. haemoliticus of-29,1%). Pathogens of a wide range had a resistance to first-line antibiotics.
At originators of a wide range resistance to the antibiotics applied as starting therapy became perceptible.
Conclusion. Against the immunodeficiency, low body weight and intrauterine infection it is observed the more dynamic contamination by pathogen and opportunistic pathogens; high level of microorganisms detection may be considered as a result of hospital microflora demanding the development of evidence-based, economically effective methods of prevention.
Keywords: monitoring, microbiocenosis, newborns, microorganism, antibiotic resistance.

O.P. Lomov
North-Western State Medical University named after I.I. Mechnikov, Russia, Saint-Petersburg
            Introduction. The major risk factors posed threat to the national security of Russia is the health deterioration of the population. The development of objective assessment criteria is essential for ensuring sanitary and epidemiological welfare of the population.
The aim of the research is to develop and approve methodological approach to hygienic assessment of health, based on the probability of morbidity and mortality.
           Materials and methods. It was used the official data on morbidity and mortality rates in Saint-Petersburg during 1996-2007, presented in the publications of Medical Information and Analytical (MIAC Saint-Petersburg, 2004, 2009) and from data base represented by male healthy controls aged from 25 to 55 (for the period from 2003-2013).
The possibility of the development of n-class diseases was determined by the correlation of the number of registered n-class patients to the total number of patients with all classes of diseases. The death probability was calculated due to the relation of the mortality rate for the n-class of diseases within the total mortality rate. The risk of damage to health (Ro) was assessed on the sum of possibility of primary incidence rate (Po) and mortality (GCM).
            Results. It was found out that the state of public health is mainly determined by disease rate:
cardiovascular diseases (wn=85,4-88,37%),  injuries and poisonings (wn=3,5-5,7%) and neoplasms (wn=3.2-3,4%). The main individual lifelong mortality risk associates with cardiovascular diseases (extremely high, more than 10-1), injuries and poisonings, neoplasms, respiratory and gastrointestinal diseases (high-10-3-10-1).The mortality risk of the population in 2007 was similar to the assessment levels in 2003. It was observed the significant changes of certain indexes: central nervous system diseases and sense organs (class 6), injuries and poisonings (class 14) became less significant
due to the reduction of mortality and morbidity.
In the group of organized contingents of population the disease rate is mainly determined by cardiovascular diseases, injures and poisonings (medium level). In 2013 the class “neoplasms” was added to medium risk diseases with increase values from 6,2-10'5 to 1-104.
The risk of health loss among organized contingents in 2003 was 1, 38x10-4 which is considered to be very high. In 2013 this number decreased to 9x10-4, which is socially admissible (staff).
            Conclusion. The health risk of population and organized contingent in Saint-Petersburg should be considered as criteria of environment hygiene assessment. The analysis of environment adverse effect to population health according to summarized risk of its loss provides the possibility to detect the greatest threat to public health.
            Key words: health, risks, safety, threats, mortality rate, disease rate.


N.O. Barnova1, A.V. Meltser1, I.Sh. Iakubova1, Y.V. Dadaly1,2 , M.A. Andreyeva3, M.P. Gorshkova3
¹ North-Western State Medical University named after I.I. Mechnikov, Russia, 191015,Saint-Petersburg, Kirochnaya Street, 41.
² Saint-Petersburg Institute of Pharmacy, Russia,188663, Leningradskaya oblast’, Vsevolozhskiy district , settlement Kuzmolovskiy 245.
³Hygiene and Epidemiology of Saint-Petersburg, Russia, 191023, Saint-Petersburg,Malaya Sadovaya Street, 1.
Introduction.The smell of ammonia in new buildings is a cause for numerous citizens' appeals, whereas the detected high concentrations of ammonia, exceeding ten or hundred times the maximum permissible concentrations, make the residences inappropriate for living. Herewith, there is no algorithm for the experts of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) to plan the research programmes for the selection of minimum number of control points for indoor air sampling.
Aimof the study was to assess the comparability of short-term and long-term indoor air sampling on ammonium concentration for monitoring programmes substantiation.
Material and methods. The air sampling on ammonium concentration was carried in
multicompartment buildings by short- and long term methods according to State Standards and RD 52.04.186-89. The evaluation of deviations in analysis results was performed in accordance with State Standards R ISO 5725-6-2002and Recommendations on Interstate Standardization RMG - 61-2003.
Results.It was carried out the air sampling on ammonium concentration by short- and long term sampling methods and obtained the significantly comparable results of ammonium concentration in the indoor air.
Conclusion.The method of long-termsampling may be replaced by the short-term one under the certain conditions in accordance with State StandardsR 57256-2016 which resulted in optimization for monitoring purposes and manufacturing control.
Key words:methods of air sampling, indoors, indoor  air, ammonium, the comparability of measurement results

D.V. Azarov1,2, A.E. Goncharov1,  E.V. Sousova1, F.I. Mezhazakis1,
E.V. Rahmanova2, U.A. Dmitrieva2, S.G. Belov1, V.O.Tarskih1
1 North-Western State Medical University named after I.I Mechnikov,Russia,191015, Saint-Petersburg, Kirochnayastreet, 41.
2 Saint-Petersburg City for Hygiene and Epidemiology,Russia,191023,Saint-Petersburg, Malaya Sadovayastreet, 1.

Introduction. Blastocystis infection is a quite widespread, but still poorly known parasitic invasion.
Aim of the study was to identify the prevalence ofblastocystis infection in St. Petersburg, to determine the seasonality, groups and risk areas.
Materials and methods. It was conducted the retrospective epidemiological analysis of blastocyst infection incidence in St. Petersburg in 2015-2017 according to the study results of more than 11 thousands samples of clinical materials.
Results. The blastocystis infection was found in 10 out of 100 patients in Saint-Petersburg. Annual dynamics is irregular characterized by increases and decreases, but without significant manifestation of seasonality. The incidence of blastocystis infection increases in relation to the patients’ age, but irrespective of sex with at least 58 days of infection carriage. The blastocystis infection is relatively equally disturbed by the regions of Saint-Petersburg.
Conclusions. According to the studyresults, it may be assumed that the epidemic process of blastocystis infection is chronic, mainly with household transmission.
Key words: blastocystis infection, blastocystis, retrospective epidemiological analysis, parasitology, protozoan invasions


B.K Komyakov, S.A Zamyatin, A.I. Archangelskiy, V.A Zubarev, A.T.Salsanov
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnayast., 41
Introduction: Renal cell carcinoma accounts for approximately 90% of kidneys tumors. Despite the improvement of methods for early diagnosis distant metastasis is revealed in 20-30% of patients with primary renal cell carcinoma. The extension of renal cell carcinoma into the renal vein and inferior vena cava observed in about 4-15% of patients, 1% of cases - into the right atrium.
The aim of the study was to expand the possibilities and to improve the results of surgical treatment of patients with intraluminal tumor invasion into the renal and inferior vena cava.
Materials and Methods:The study was based on the examination of 220 patients with kidney cancer complicated by intraluminal tumor invasion. The results after treatment were assessed depending on the prevalence of tumor venous thrombosis, the condition of regional lymph nodes, the type of the performed surgical intervention, the histological type and the grade of tumor differentiation.
Results:About 117 patients (53.2%) were diagnosed with renal vein tumor thrombosis and 103 patients (46.8%) with the tumor ivasion into the lumen of the inferior vena cava. In 37 patients, the tumor thrombus was located at or above the level of hepatic veins. Depending on the type of surgical intervention, the patients were distributed as follows:1. 104 patients (51.5%) – nephrectomy and inferior vena cava marginal clamping with the removal of the renal vein; 2. 78 (38.6%) – nephrectomy and inferior vena cava clamping with the removal of the renal vein and thrombus; 3. 1 (0.5%) – right-sided nephrectomy with the removal of the abdominal part of inferior vena cava; 4. 13 (6.4%) – nephrectomy and thrombectomy with inferior vena cava clamping above the diaphragm; 5. 3 (1.5%) – nephrectomy with thrombectomy under cardiopulmonary bypass; 6. 3 (1.5%) – vena cavography and thrombo-extraction followed by nephrectomy and transverse inferior vena cava clamping from hepatic to iliac veins, venacavatomy, marginal vein resection with the removal of thrombus.
Conclusion: Kidney cancer complicated by thrombosis of the renal and inferior vena cava is potentially treatable. The completeness of thrombus removal, tumor growth into paranephric fiber, regional lymph node involvement and distant metastases are prognostically significant factors for survival. Nephrectomy with thrombectomy is considered the only radical method for treating tumor thrombi in kidney cancer.
Key words: kidney cancer, tumor venous thrombosis.

N. I. Glushkov, T.L. Gorshenin, S.K. Dulaeva
North-Western State Medical University named after I.I. Mechnikov, Russia, Saint-Petersburg
Introduction. Video-assisted surgery technique provides maximum safety for the patient, accompanied by a reduction of the complications and a rapid postoperative rehabilitation period.
Aim of the study was to improve the results of pyloroduodenal stenosis treatment in aged patients within polymorbidity due to the optimal preoperative preparation and modern high-tech methods of surgical treatment.
Materials and methods. It was carried out a comparative analysis of the treatment results of 80 patients with pyloroduodenal stenosis. The control group comprises 40 patients undergoing traditional laparotomy surgery; the main group comprises 40 patients undergoing video-assisted gastroenteroanastomosis.
Results. According to the analysis results, 100 of postoperative complications and mortality after traditional gastroenterostomy are significantly higher than after endovideosurgical interventions in patients with pyloroduodenal stenosis.
Conclusion. The use of enteral nutritional support before surgery and during the postoperative period in aged patients with pyloroduodenal stenosis improves the parameters of the trophic status, allows accelerating the periods of independent activation, contributes to the better functioning of gastroenteroanastomosis in the postoperative period. The use of endovideosurgical techniques in the formation of gastroenteroanastomosis can significantly reduce the operating time, traumatism, the number of postoperative complications.
Keywords: pyloroduodenal stenosis, gastroenteroanastomosis, surgical treatment, aged patients.

A.A. Vershinin1, I.E. Sviridov1, V.V. Shilov1,2
1 North-Western State Medical University named after I. I. Mechnikov,Russia,191015, Saint-Petersburg, Kirochnaya street, 41
2 North-Western Scientific for Hygiene and Public Health, Russia,191036, Saint-Petersburg, 2ndSovetskayastreet, 4
Until recently, the toxic effect of alcohol was considered only as the membranotropic and conformational action of ethanol leading to the irreversible cell changes and its further death by necrosis. The present article concerns the analysis and summary of modern studies determining the alcohol as the inductor of apoptosis caused by several mechanisms: firstly, some ethanol metabolite could act as reactive oxygen species and ethanol itself contribute to the increase of reactive oxygen species generation. Secondly, the alcohol inhibitsthe antioxidant system and intensifies iron absorption thus increasing the number of free radicals and triggering the programmed cell death.
Keywords: apoptosis, alcoholism, ethanol, reactive oxygen species, free radicals, antioxidant system.

Y.A. Kreneva2, V.P. Panov1,2, M.V. Avdeeva1,K.A. Bogomolova1
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

Introduction. The treatment effectiveness of chronic back pain is a current problem as the absence of clinical effect from various treatment methods resulted in significant social and economic consequences due to the disability, decline in the quality of life in patients and increased expenditures on medical and social services.
Material and methods. It were examined 200 outpatients aged 18 to 75 with degenerative disc diseases (DDD) and pain syndrome. The treatment effectiveness was assessed according to the severity of pain syndrome and computer optical topography data determined before and after rehabilitation.
Results. The determinants of effective treatment of pain syndromein patients with DDD were the use ofamplipulse therapy, in positive scores estimated by pain scales (visual analog scale (VAS), MPQ questionnaire,Roland Morris Disability Questionnaire) (p<0,05). The pronounced analgetic effect from rehabilitation was observed after the combination of various therapeutic factors on the spine (b=0,38; p<0,05). The determinants of spinal functional state improvement were physical therapy, mud therapy and massage (p<0,05). The most pronounced analgesic effect from rehabilitation was observed after combination of various therapeutic factors on the spine. The improvement of spinal functional state was enhanced due to the combination of various rehabilitation measures.
Conclusion. The use of restorative potential of hospital-replacing technologies promotes medical, social and economic efficiency through the improvement of the quality of life and reduction of the necessity in primary health care.
Keywords: degenerative disk disease, effectiveness of rehabilitation treatment, primary health care.

V.P. Zemlyanoy, B.V. Sigua, D.S. Semin,
D.V. Gurzhii, R.M. Abdulaeva, V.E. Kvarku
North-Western State Medical University named after I.I.Mechnikov, Russia, 191015, Saint- Petersburg, Kirochnay street, 41.
Introduction. Mesenteric panniculitis is a rare disorder characterized chronic nonspecific inflammation of the mesentery adipose tissue, omentum, pre- and retroperitoneal soft tissue, including pararectal cellular tissue.
The aim of the study was to examine clinical and laboratory findings of mesenteric panniculitis and to develop treatment guidelines.
Materials and methods. It was analyzed the scientific literature and confirmed by own clinical case of mesenteric panniculitis representing the complications of this nosology diagnostics.
Results. For many years the mesenteric panniculitis was considered as chronic pancreatitis, but after examination it was collectively diagnosed as mesenteric panniculitis, that was successfully treated.
Conclusion. Timely diagnosis and treatment resulted in the positive outcome of the disorder.
Keywords. Mesenteric panniculitis, clinical case, diagnosis, treatment.



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