The problem of undifferentiated inflammatory bowel disease: from world views to own experience of artificial neural networks application
M.I. Skalinskaya, E.V. Skazyvaeva, I.G. Bakulin, G.A. Mashevsky, N.M. Shelyakina, M.S. Zhuravleva, I.A. Rasmagina, K.N. Ivanova, M.A. Formozova
TO AUTHORS ATTENTION
PREVENTIVE MEDICINE FEATURES OF PHYSICAL DEVELOPMENT IN CHILDREN WITH ALLERGIC DISEASES IN AEROGENIC EXPOSURE TO CHEMICALS OF ANTHROPOGENIC ORIGIN
О.А. Maklakova 1,2, O.Yu.Ustinova 1,2, A.J. Vandysheva 1, O.G. Tolmacheva 1 1 Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Russia, 614045, Perm city, Monastyrskaya str., 82 2 Perm State National Research University”, Russia, 614990, Perm, Bukireva str.,15 Abstract Introduction.The majority of the researchers noted the high prevalence of allergic diseases among children living in anthropogenic air pollution areas, as well as deviations in physical development in children with allergic pathology. The aim of the study was to analyze the features of the physical development of preschool children with allergic pathology exposed to chronic exposure to chemicals of anthropogenic origin. Materials and methods.The study included 153 children aged 5-7 years with allergic pathology, who were carried out anthropometric measurements. Results. In the children’s blood comprising study group was found out formaldehyde and nickel by 1.3-3.4 times higher than the regional level. It was revealed that children with allergic pathology in aerogenic exposure to chemicals of anthropogenic origin have a decline of physical development: 2,1 times higher a risk of weight gain, 1,8 times higher a risk of disorders of harmonious physical development due to phenol and nickel in blood. It was revealed that in preschool children with allergic pathology in chronic aerogenic exposure to technogenic chemicals the risk of decrease in hypoxia resistance was 1.95. Conclusion. The assessment of physical development considering calculated indices revealed the process of gracialization of children with allergic diseases. Key words: physical development, preschool children, allergic pathology, formaldehyde, nickel, phenol.
INFORMATIVE VALUE OF BEHAVIORAL FACTORS AND MEDICAL ACTIVITY OF PARENTS IN ASTHMA DEVELOPMENT IN PREMATURE BABIES
N.M. Agarkov, A.V. Poshibailova Southwest state University, 305040, Russia, Kursk, 50 years of October street,94 Abstract Introduction: Development of childhood asthma depends on various parental risk factors. However, the prevalence and informativeness of behavioral factors and medical activity of parents in childhood asthma development is unstudied. The aimof the study was to assess the impact of lifestyle and medical activity of parents on the asthma development in premature babies. Material and methods: lifestyle and medical activity of parents were studied in 156 premature babies with asthma (main group) and 145 children without asthma (control group). Information on these risk factors for asthma was obtained by interviewing parents and copying out from medical records. The informativeness of risk factors was determined using Bayes—Wald—Gubler method. Results: Informative risk factors for asthma development in premature babies among the negative factors of lifestyle and medical activity of parents are: the sleep duration of a pregnant woman less than 7 hours, smoking more than 10 cigarettes a day after the birth of the child by mother, smoking more than 20 cigarettes a day after the birth of the child by father, stay of a pregnant woman in the fresh air less than 1 hour per day, irregular visits to the maternity welfare center in the second half of pregnancy, failure to comply with the majority of obstetrician-gynecologist prescriptions , registration in the maternity welfare center after 10 weeks of pregnancy and non-attendance of the maternity welfare centers for preventive purposes. Key words: asthma, children, lifestyle, medical activity, premature babies
JUSTIFICATION OF A SHORT-TERM INDOOR AIR SAMPLING FOR AMMONIA IN EXPERIMENT
¹North-Western State Medical University named afterI.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 ²Saint-Petersburg Institute of Pharmacy, Russia, 188663, Leningradskaya oblast’, Vsevolozhskiy district, settlement Kuzmolovskiy 245 ³Hygiene and Epidemiology Center in Saint-Petersburg, Russia, 191023, Saint-Petersburg, Malaya Sadovaya Street, 1 Abstract Introduction. The mass character of housebuilding and the constructed buildings commissioning implies a conduction of a significant number of air research of confined spaces for ammonia. Existing sampling methods are difficult and expensive, so it is reasonable using the experiment to assess the possibility of improving the air sampling program in confined spaces for ammonia during numerous research. Aim of the study was to assess the comparability of the tests on short-term and long-term indoor air sampling for ammonia in experiment for a wide range of concentrations. Material and methods. Tests on short-term and long-term air sampling for ammonia were carried out in the premises of a new apartment building. The evaluation of the deviations significance of analysis results was carried out in accordance with Recommendations of the Interstate Standardization 61-2003 and 61-2010. Result. It was carried out model tests of air sampling for ammonia by short- and long-term sampling methods and obtained the significantly comparable results of ammonium levels in the indoor air. Key words:methods of air sampling, indoor air, indoors, ammonium, model tests, the comparability of measurement results.
ANALYSIS OF THE FUNCTIONAL STATE OF EMPLOYEES EXTRACTED OIL BY THERMAL-MINING METHOD
E.M. Vlasova, O.Yu. Ustinova, A.E. Nosov Federal Scientific Center for Medical and Preventive Health Risk Management Technologies” of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Russia, 614045, Perm city, Monastyrskaya str., 82 Abstract: Introduction. According to Federal State Statistics Service, the proportion of employees working in hazardous working conditions in oil extraction ranged from 25% to 33% in 2015-2017. An urgent issue in modern economic conditions is to increase the effective career longevity. Thus it is necessary to study the basic mechanisms of diseases to justify medical and preventive technologies. The aim of the study was to justify the programs of medical and preventive technologies aimed at increasing the career longevity of workers extracted oil by thermal-mining method.
Materials and methods. The study group included 21 operator of blowing the well-out aged 31.6±5.2 years; having an average underground experience of 6.5±2.7 years. The control group included 1- 15 employees of mine management, having underground experience of 31.2±4.5 years and average ground experience of 6.4±3.1 years; the control group 2 included 24 office workers aged 34.3±4.6 years (p>0.05), having an average working experience of 6.5±3.4 years (p>0.05), (class of working conditions – 2). It was conducted the working conditions analysis, clinical examination, statistical data processing, calculation of odds ratio, relative risk and etiological part. Results. About 82% of the working places in oil mining facilities are classified as places with harmful working conditions (class 3.1-3.3) corresponding to a high professional risk. In the drilling gallery WBGT (Wet Body Global Temperature) is up to 29.20 ° C (norm <24); working conditions class 4. When extracting oil by thermal-mining method employees have to stay underground at high temperatures. The risk of hypertension development by 55 years is 1.0 (realized risk) for employees with an underground experience. Conclusions. The professional activity of employees’ extracted oil by thermal-mining method leads to vegetative disorders increasing the risk of hypertension development. Usage of the prevention techniques increasing the recovery efficiency of functional state of organism aimed at increasing the career longevity is of a high importance. Key words: vegetative disorders, high temperatures, thermal mining oil extraction
Comprehensive hygienic characteristics of technical detergents used for road maintenance
L.A. Alikbaeva1, S.P. Kolodii1, I. Sh. Iakubova, А.V. Bek1,2, N.N. Krutikova1
1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya st., 41. 2Hygiene and Epidemiology Centre in Saint-Petersburg, Russia, 192102 Saint-Petersburg, Volkovsky pr., 77. Abstract: Introduction. The direct and indirect negative impact on public health may occur while using technical detergents for road pavement. The aim of the study was to conduct a hygienic assessment of technical detergents used to maintain city roads. Materials and methods. The study objects were technical detergents «Bionord», «Bionord-aviashampoo» and «Road pavement cleaner». A comprehensive hygienic assessment was carried out by stages: studies on the toxicity parameters evaluation; experimental studies on the migration to adjacent environments. Results. 1. According to GOST 12.1007-76 «Bionord», «Bionord-aviashampoo» and «Road pavement cleaner» belong to the 4th hazard class, have a slight irritating effect on the skin and do not irritate the eye mucous. They do not have a skin-resorptive and allergenic reaction.
2. The toxic effect of all the studied detergents during tests on hydrobionts, had a toxic effect in their natural form and in dilutions up to 1000. The cytotoxic effect of «Bionord», «Road pavement cleaner» had in dilutions from 1 to 100, whereas «Bionord-aviashampoo» did not have a cytotoxic effect.
3. Technical detergents do not have a toxic effect on soil microflora.
4. The toxic effect of «Bionord», «Bionord-aviashampoo» and «Road pavement cleaner» on higher plants resulted in growth inhibition of the seedlings roots.
5. Substances comprising the technical detergents migrate to filtrated waters in concentrations not exceeding their maximum permitted concentration in water.
6. It is recommended to conduct all preparatory activities for the use of «Bionord», «Bionord-aviashampoo» and «Road pavement cleaner» coming from the manufactures on the territory with hard surface using personal protective equipment. Key words: technical detergents, parameters of acute toxicity, skin-resorptive effect, irritant effect, allergic reaction.
CLINICAL MEDICINE
SHEAR WAVE ELASTOGRAPHY IN LIVER FIBROSIS EVALUATION
1 Medical center «MedElit», LLC «MedElitConsulting», Russia, 121170, Moscow, Ploshchad’ Pobedy street, 2 korp. 2 2North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41
3 Saint-Petersburg state pediatric medical university, Russia,194100, Saint-Petersburg, Litovskaya street, 2
Abstract Introduction.The liver fibrosis is one of the most significant factors in choosing treatment strategy, predicting the effectiveness of antiviral therapy and determining the expected rate of disease progression and it's outcome in patients with chronic hepatitis C. Shear wave elastography is a new and highly informative non-invasive method for liver fibrosis. Aim of this study is to study shear wave elastography efficiency in liver fibrosis evaluation. Materials and Methods. Patients with chronic hepatitis C underwent the shear wave elastography and percutaneous liver biopsy followed by fibrosis staging according to METAVIR score (F0 – no fibrosis, F1 – stellate enlargement of portal tracts but without septa formation, F2 – enlargement of portal tracts with rare septa formation, F3 – numerous septa formation, F4 – cirrhosis); and activity grading according to METAVIR score (A0 – no activity; A1 – mild activity; A2 – moderate activity; A3 – severe activity). Statistical analysis used ROC analysis with standard AUROCs. Results.The study included 99 patients. The main characteristics of the cohort: 59,6% males with mean age 37 years (21-63); fibrosis prevalence: F0 – 21 (21,2%), F1 – 45 (45,5%), F2 – 12 (12,1%), F3 – 12 (12,1%), F4 – 9 (9,1%); significant necroinflammatory activity (А2 – А3) – 36 (36,4%). AUROC of the shear wave elastography was 0,660 at the point of differentiation between “absence of fibrosis” and “fibrosis” (F0 vs. F1 through F4); 0,904 between “mild and absence of fibrosis” and “moderate, advanced fibrosis and cirrhosis” (F0-F1 vs. F2 through F4); 0,924 between “moderate, mild and absence of fibrosis” and “significant fibrosis and cirrhosis” (F0 through F2 vs. F3-F4); 0,978 between “significant, moderate, mild and absence of fibrosis” and “cirrhosis” (F0 through F3 vs. F4). Conclusion. Shear wave elastography by Aixplorer was effective in detecting moderate fibrosis (F2), significant fibrosis (F3) and cirrhosis (F4). That allows considering this technique as a possible expert method for confirming significant fibrosis (F3) and cirrhosis (F4). Key words: shear wave elastography, liver fibrosis, chronic hepatitis C.
CLINICAL, FUNCTIONAL AND CYTOLOGICAL FEATURES IN COMORBIDITY OF OCCUPATIONAL CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND PNEUMOCONIOSIS
L.A. Shpagina, O.S. Kotova, I.S. Shpagin, G.V. Kuznetsova Novosibirsk State Medical University, Russia, 630091, Novosibirsk, Krasnyj Prospect, 52
Abstract Introduction. Pathomorphosis in comorbidity of occupational chronic obstructive pulmonary disease and pneumoconiosis is still unknown. The aim of the study was to determine clinical, functional and cytological features in comorbidity of occupational chronic obstructive pulmonary disease and pneumoconiosis. Materials and methods. It was conducted a prospective cohort study of patients with comorbid chronic obstructive pulmonary disease and pneumoconiosis (n=67). Comparison groups - pneumoconiosis (n=43) and occupational chronic obstructive pulmonary disease (n=55). Сhronic obstructive pulmonary disease was diagnosed according to GOLD 2018 criteria, pneumoconiosis was diagnosed due to federal clinical guidelines. Statistical analysis included analysis of covariance, chi square test, linear regression. Results. Patients with comorbidity of chronic obstructive pulmonary disease and pneumoconiosis were exposed to silica dust which concentration was 1,5 - 5,5 times higher than occupational exposure limit, but less than in control groups. Work experience was above 18 years. Comorbidity was characterized by severe dyspnea (4,5±2,01 score by Borg scale), low DLCO (46,5±5,48%), pulmonary hypertension in 61% of patients, hypoxemia, high prevalence of epithelial cell metaplasia - in 34,3% of patients. Results. Comorbidity of chronic obstructive pulmonary disease and pneumoconiosis differs from chronic obstructive pulmonary disease as well as from pneumoconiosis by symptoms severity and lung function, thus it has to be taken into consideration during treatment. Key words. Occupational chronic obstructive pulmonary disease, pneumoconiosis, comorbidity.
EXPERIMENTAL PATHOMORPHOLOGICAL STUDY OF HEMOSTASIS AFTER LIVER INJURIES
D.S. Savitsky1, A.N. Tkachenko2 1.SOGAZ International Medical Center, LLC, Russia, 191186, Saint Petersburg, Cheboksarsky Lane, Building A, 1/6 2. North-Western State Medical University named after I.I Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya str.,41
Abstract Introduction. The problem of hemostasis after liver injuries is urgent in case of natural disasters or in battlefield conditions, when the vital necessity of surgery is evident, the time for healthcare delivery is limited and surgeries are carried out by specialists without sufficient experience. The existing intraoperative hemostatic methods are not always effective. Thus, the development and experimental study of new medications allowing to conduct the reliable hemostasis in case of parenchymal organs injuries, that are also important for the medical science and practice. Material and methods. The experimental study included 116 male and female Wistar rats weighing 230±25 g and 30 male and female Chinchilla rabbits weighing from 2.5 to 3.5 kg. The bleeding time after a simulated liver injury without hemostatic agents and with the use of Alufer and Viscostat was evaluated in experiments in vivo. A morphological study of the regeneration process in the liver was carried out on the 1st – 14th day after the injury. Biopsy material was fixed in 10% neutral-buffered formalin. The histological sections were stained both by hematoxylin and eosin and Prussian blue (Max Perls method) in order to detect the presence of iron compounds in tissues. Results. It was found out the hemostasis using Alufer is accompanied by decrease in circulatory disturbances (edemas, hemorrhages); hemostasis is characterized by more apparent development of the connective tissue in the field of application of the medication, that partially remains in the application site (considering study time interval). Key words: experimental liver injury, hemorrhage, hemostasis, Alufer.
IMPORTANCE OF INSULIN RESISTANCE IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE AND DIASTOLIC DYSFUNCTION OF THE HEART
S.N. Jadhav, V.G. Radchenko, P.V. Seliverstov, S.I.Sitkin North-Western State Medical University named after I. I. Mechnikov, Russia, 191015, Saint-Petersburg,Kirochnaya Street, 41. Abstract: Introduction.Non-alcoholic fatty liver disease is the most common cause of chronic liver disease in Western countries and Russia. It affects around one-third of adults, which means about 1 billion individuals worldwide. According to the multiple-hit hypothesis insulin resistance is one of the key factors in the development of steatosis/non alcoholic statohepatitis and results in increased hepatic de novo lipogenesis, impaired inhibition of adipose tissue lipolysis and with consequently accumulation of triglycerides in the liver. Nonalcoholic statohepatitis increases risk of death compared to the general population, the causes of death being cardiovascular, malignancy and liver-related complication. Aim:To evaluate the role of insulin resistance in the development of left ventricular diastolic dysfunction in patients with nonalcoholic fatty liver disease.
Methods: We conducted a cohort mono-center study in which 140 patients enrolled. The inclusion criteria were age (18-65yrs) and non-alcoholic fatty liver disease. All patients underwent a primary physical examination, biochemical blood testing, ultrasound of the abdomen, and echocardiography. Results: According to echocardiography data, 60% of patients with non-alcoholic fatty liver disease had diastolic dysfunction of the left ventricle. In patients with diastolic dysfunction of left ventricle and insulin resistant level >5, the level of serum total cholesterol, low density lipoprotein, very low density lipoprotein, triglyceride, alanine aminotransferase, alkaline phosphatase, gamma-glutamyltransferase, uric acid were more severe than compare to other subgroups. Conclusion: Insulin resistance in patients with non-alcoholic fatty liver disease contribute to the development of systemic inflammation, metabolic disorders and activation of liver enzymes, which leads to the development of left ventricular diastolic dysfunction. Key words: non-alcoholic fatty liver disease (NAFLD), uric acid, diastolic dysfunction, hyperglycemia, dylipidemia, HOMA-IR, insulin resistance.
DIFFERENTIAL DIAGNOSTICS OF OSTEOMYELITIS AND MALIGNANT BONE TUMORS
O.F. Noor, A.N. Tkachenko North-Western State Medical University named after I.I.Mechnikov, Russia, 191015,Saint-Petersburg, Kirochnaya str.,41 Abstract Introduction. Hematogenous osteomyelitis and bone malignancies are quite common, over the last years there are a lot of scientific papers on atypical course of these diseases, thus complicating their diagnosing. Results. Despite a number of modern diagnostic methods, usually these pathological states are difficult to differentiate; even the morphological examination is not always effective. Considering the significant differences in the treatment principles of hematogenous osteomyelitis and malignant bone tumors, early diagnosis often determines the outcome of the disease. Currently, there are highly effective methods available for the treatment of osseous pathology of infectious and oncological genesis, which are constantly improved. However, late diagnosis may result in negative treatment outcomes. Thus, the search for clinical and subclinical criteria for differential diagnostics of hematogenous osteomyelitis and malignant bone tumors for early diagnosis is highly relevant for medical science and practice. The presented scientific review allows to understand the present conditions of this issue. Keywords: hematogenous osteomyelitis, malignant bone tumors, differential diagnosis.
LOCAL CHANGES IN CONNECTIVE TISSUE AND SYSTEMIC EVIDENCES OF PRIMARY OSTEOARTHRITIS IN PATIENTS WITH INCREASED RISK OF THIS DISEASE DEVELOPMENT
S.V. Belova1, E.V. Gladkova1, R.A. Zubavlenko2, N.A. Romakina1, V.Yu. Ulyanov1 1Scientific Research Institute of Traumatology Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky, Russia, 410002, Saratov, Chernyshevsky str., 148 2Saratov State Medical University named after V. I. Razumovsky, Russia, 410002, Saratov, Bolshaya Kazachya str., 112. Abstract Introduction. Osteoarthritis is the most widespread among joint diseases comprising more than 50% in this nosology structure. The aim of the study was to analyze the local changes in connective tissue and systemic evidences of primary osteoarthritis in patients with increased risk of its development. Materials and methods. It was analyzed the examination results of 34 patients with the risk of primary osteoarthritis development. Results. The increased levels of cartilage oligomeric matrix protein revealed joint cartilage tissue destruction. The increase of proinflammatory cytokines proved immunopathological reactions. Conclusion. The obtained data allow to develop a diagnostic algorithm aimed at early detection of osteoarthritis in patients with increased risk of its development. Key words: risk, osteoarthritis, knee joints.
THE PROBLEM OF UNDIFFERENTIATED INFLAMMATORY BOWEL DISEASE: FROM WORLD VIEWS TO OWN EXPERIENCE OF ARTIFICIAL NEURAL NETWORKS APPLICATION
M.I. Skalinskaya1, E.V. Skazyvaeva1, I.G. Bakulin1, G.A. Mashevsky2, N.M. Shelyakina2, M.S. Zhuravleva1, I.A. Rasmagina1, K.N. Ivanova1, M.A. Formozova1 1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 2St. Petersburg State Electrotechnical University "LETI", Russia, 197376, Saint-Petersburg, Professora Popova str., 5 Abstract Introduction. Late diagnosis of inflammatory bowel disease resulted in an increase in the number of severe forms of the disease. Difficulties arise not only in the differentiation of inflammatory bowel diseases with diseases with a similar clinical picture, but also in the distinction between ulcerative colitis and Crohn's disease. The aim of the study was: 1) to analyze the diagnostic frequency of Crohn's disease in the detection of isolated terminal ileitis, including the demonstrating the relevance of the problem of undifferentiated inflammatory bowel diseases. 2) to analyze the effectiveness of artificial neural networks in definitive differential diagnosis of ulcerative colitis and Crohn's disease. Materials and methods. The study included 99 patients diagnosed with isolated “terminal ileitis” during endoscopic examination. Further, it was conducted the analysis of the results of laboratory, histological, X-ray studies, comparison with clinical data and endoscopic picture. Application Neural Network Toolbox (Matlab) was used for the artificial neural network creation performing differential diagnosis of inflammatory bowel diseases. Results. Only 52% of patients with a macroscopic picture of "terminal ileitis" confirmed Crohn's disease. Artificial neural network was able to solve the problem of endoscopic images classification, distinguishing the norm from the pathology and differentiating ulcerative colitis and Crohn's disease. Conclusion. The absence of single standards in the diagnosis of inflammatory bowel diseases complicates the correct and timely diagnosis of this group of diseases, which in turn resulted in late diagnosis and late adequate treatment. All these necessitates the development of new methods and algorithms for the diagnosis and differential diagnosis of inflammatory bowel diseases. Key words: inflammatory bowel diseases, terminal ileitis, Crohn’s disease, ulcerative colitis artificial neuronal net.
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