Epidemiological features and infection control in covid-19 in dental practice(review)
A.V. Silin, L.P. Zueva, E.A. Satygo, M.A. Molchanovskaya 5
Hygienic assessment of working conditions in intermittent effect of occupational factors on the example of selective refining of mineral oils with phenol
T.B. Baltrukova, O.I. Ivanova 11
Epidemiology and prevention of coronavirus infection (review)
Current tendencies in diagnostics and surgical treatment of distal radius fracture (review) V.V. Khominets, M.V. Tkachenko, V.S. Ivanov, M.A. Zhogina, S.V. Lisin, I.A. Myshkin 34
Possibilities of detecting the hidden pathology of the cardiovascular system and preventing sudden cardiac death with the use of external event recorders
EPIDEMIOLOGICAL FEATURES AND INFECTION CONTROL IN COVID-19 IN DENTAL PRACTICE (REVIEW)
A.V. Silin, L. P. Zueva, E. A. Satygo, M. A. Molchanovskaya North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya Street, 41 Abstract Introduction. Coronavirus COVID-19 pandemic announced by World Health Organization (WHO) on 11 March 2020has significantly affected dentistry. Materials and methods. This article analyzes scientific publications on the features of epidemiology and prevention of infections caused by coronaviruses, including in dental practice. Results. Data on possible transmission route of COVID-19 in dentistry, such as airborne transmission, spread through contacts and contaminated surfaces were analyzed. Conclusion. Practical strategies for preventing transmission of the virus during dental diagnosis and treatment are provided from scientific sources, including patient assessment, hand hygiene, personal protective measures for dental specialists, pre-dental preparation, cofferdam isolation, disinfection of clinic premises, and medical waste management. Keyword: COVID-19, coronavirus, dentistry, epidemiology, infection control, prevention.
Hygienic assessment of working conditions IN intermittent EFFECT of occupational factors on the example of selective REFINING of mineral oils with phenol
T.B. Baltrukova, О.I. Ivanova North-Western State Medical University named after I.I. Mechnikov, Russia,191015,Saint-Petersburg, Kirochnaya str., 41 Abstract Introduction. Current production of oil refining with phenol, despite the significant mechanization and automation of production processes remains harmful and dangerous. The intermittent action of harmful chemical and physical factors may contribute to the deterioration of the workers’ health invarious fields. However, the intermittent nature of harmful factors is not considered when assessing working conditions. The aim of the study was to conduct a hygienic assessment of conditions and job characteristics of workers of installations of selective refining of mineral oils with phenol inintermittent action of occupational factors. Materials and methods. It was used the methods of hygienic assessment of the production environment and labor processfactors. Results. The study on the working conditions of workers of selective refining oil with phenol revealed that the effect of harmful factors on workers was intermittent, the most significant are high concentrations of harmful substances, noise level, unfavorable microclimate, as well as high nervous and emotional stress. Conclusion. When working in conditions of intermittent effect of harmful factors, the indicators of the labor process should be evaluated considering the duration of work within closed spaceand open areas, as well as the duration of various operations performance. Keywords: working conditions, hygienic assessment of working environment factors and labor process, intermittent nature, selective refining of oils with phenol
EPIDEMIOLOGY AND PREVENTION OF CORONAVIRUS INFECTION (REVIEW)
A.V. Liubimova1, B.I. Aslanov1, A.E.Goncharov1,2, V.S. Vysotckii1, M.A. Molchanovskaya1, T.G. Ivanova1, K.D. Vasilev1 1North-Western State Medical University named after I. I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya Street, 41. 2Institute of experimental medicine, Russia, 197376, Saint-Petersburg, Academician Pavlov Street, 12 Abstract
The situation caused by the new coronavirus COVID-19 is alarming. On 30 January, 2020, the World Health Organization has declared that the new coronavirus COVID-19 outbreak is a public health emergency of international concern.
The aim of the article is to summarize the latest data on the epidemiology and prevention of infections caused by coronaviruses, including COVID-19.
SARS-CoV, MERS-CoV and 2019-nCoV outbreaks convincingly show the ability of coronaviruses to cross the inter-species barrier. However, while SARS-CoV and MERS-CoV had no wide free transmission of the viruses from person to person, this phenomenon is distinctive for COVID-19.
New coronavirus infection has been severe for 14% and critical for 5% of patients. COVID-19 case fatality rate was 2.3%. The risk groups are the elderly people and male. COVID-19 can be transmitted from person to person by airborne droplets and by contact. It is of concern that the virus has been detected in individuals without or with minimal clinical symptoms.
Currently, no data on infection caused by the new coronavirus can be exhaustive and final, as well as recommendations for their prevention. There is an obvious need for virological investigations of bat populations as an element of emergent infections surveillance. Key words: COVID-19, coronavirus, severe acute respiratory syndrome, prevention, medical masks.
CHANGES IN PATIENTS' CONDITION AS A BASIS FOR ASSESSING THE QUALITY OF GERIATRIC NURSING
C. Konson, E.V. Frolova North-Western State Medical University named after I.I. Mechnikov,Russia, 191015,Saint Petersburg, Kirochnaya Street, 41 Abstract Introduction. The quality indicators characterizing geriatric nursing care outcomes should include indicators that determine the impact of nursing care on the elderly patients' quality of life: first of all, the ability to service themselves independently and to feel safe. The aim of the study was to analyze the dependence of clinical statistical indicators of elderly patients’ condition on adherence to nursing care principles based on the developed standard operating procedures. Materials and methods. Study included 209 patients of a long-term care institution being observed during 2017-2018. Standardized geriatric scales were used to assess patients' level of possible condition violations in points. Results. Standard procedures of nursing practice were developed at the institution and after a year of applying, the study of patients condition revealed statistically significant deteriorations of only 10.3% (95% CI: 2.1% - 22.5%, p <0.05) in functional and only 12% (95% CI: 0.29% - 22.81%, p <0.05) in cognitive status of patients. At the same time, the risks of developing pressure ulcers did not significantly change, and the risks of falls decreased by 15% (95% CI: 7.2% - 23.0%, p <0.05). Actual cases of falls during the year of observation amounted to 8.3%, cases of pressure ulcers with impaired skin integrity - 0.5%. Conclusion. Clinical statistical indicators of elderly patients' condition over a certain period of time, such as changes in functional and cognitive status, changes in status to safety characteristics - risks of falls and pressure ulcers, as well as the percentage of actual cases of falls and pressure ulcers, can serve as criteria for assessing the quality of nursing care. Key words: geriatric patient, nursing care quality, standard operating procedure, functional status, cognitive status, pressure ulcers, falls.
CLINICAL MEDICINE
PLEIOTROPIC EFFECTS OF ERYTHROPOIETIN (REVIEW)
V.P. Novikova1, O.V.Varlamovа1, O.D.Chervyakovskaya2 1Saint-Petersburg State Pediatric Medical University, Russia, 197022, Saint-Petersburg, LitovskayaStreet, 2 2Pavlov First St.Petersburg State Medical University, Russia, 197022, Saint-Petersburg, LeoTolstoy Street, 6-8 Abstract
The present review showed that erythropoietin is not only a regulator of erythropoiesis, but also has a pleotropic effects. The results of numerous clinical and experimental studies revealed the impact of erythropoietin on the functional state of the cardiovascular system, nervous system, affective status, hemostasis system, immune status, reproductive system and kidneys.
Erythropoietin receptors were found on cells of the nervous tissue, ovaries and testicles, uterus, vascular smooth muscle cells, cardiomyocytes, endothelial cells, lung epithelium and renal tubules. Thus, erythropoietin is a hormone regulating a number of body functions. Keywords: erythropoietin, hormone, pleotropiceffects.
CURRENT TENDENCIES IN DIAGNOSTICS AND SURGICAL TREATMENT OF DISTAL RADIUS FRACTURE (REVIEW)
V.V. Khominets1, M.V. Tkachenko1, V.S. Ivanov1, M.A. Zhogina1, S.V. Lisin1, I.A. Myshkin2 1S.M. Kirov Military Medical Academy, Russia, 194044, Saint-Petersburg, Akademika Lebedeva Street, 6 2Military unit 51087, Russian, 108811, Moscow, v. Kartmazovo Abstract Introduction. Distal radius fracturesin a “typical place” are the most common type of injury in adults, comprising about 16-20% of all skeletal fractures, being the first in structure of injuries. Injuries to young people are usually caused by high-energy injuries, while, at the age of 60 years and older, the most common reason is a fall from a height of one's own height growth. The aim of the study is to provide the current trends in the diagnosis and surgical treatment of fractures based on the analysis of medical literature, considering the peculiarities of the applied anatomy of the distal radius. Material and methods. The study included 87 publications on the problem of diagnosis and surgical treatment of the distal radius fractures during 2010 - 2019, obtained from scientific electronic databases: PubMed, Cochrane Library, eLIBRARY. Results. For the successful implementation of the anatomical reposition of intraarticular elements in the preoperative period, a comprehensive assessment of the radiological parameters of the fracture, as well as computed tomography, are required. Currently, there are a number of methods of surgical treatment: external fixation using various frames, internal fixation using volar and dorsal plates, fragment-specific and intramedullary structures, as well as, the use of arthroscopic assistants. The choice of fixation method in each clinical case depends on the nature of the fracture, the experience of the surgeon and the technical equipment of the hospital.
Conclusion. At present, it is necessary to continue comparative studies on treatment results of distal radius fractures depending on the type of surgical intervention, individual characteristics of patients, which allow developing an algorithm that significantly improves both the anatomical and functional results of treatment. Keywords: distal radius fractures, intraarticular distal radius fractures, surgical treatment of distal radius fractures, complications of surgical treatment of distal radius fractures.
POSSIBILITIES OF DETECTING THE HIDDEN PATHOLOGY OF THE CARDIOVASCULAR SYSTEM AND PREVENTING SUDDEN CARDIAC DEATH WITH THE USE OF EXTERNAL EVENT RECORDERS
V.A. Kachnov1, V.V. Tyrenko1, I.V. Rudchenko2, E.S. Bratilova1, S.G. Bologov1, A.N. Bogdanov1 1Military medical academy of S.M. Kirov, Russia, 194044, Saint-Petersburg, Akademika Lebedeva str., 6. 2Military Innovation Technopolis «Era» ,Russia, 353456, Krasnodar Region, Anapa, prospect. Pionersky 28 Abstract Introduction. Hidden pathology of the cardiovascular system could result in the development of sudden cardiac death. In this regard, early detection of predictors of life-threatening arrhythmias and risk factors for the development of the circulatory system diseasesis extremely relevant. One of the ways to detect hidden pathology is the use of external event recorders. The aim of the studywas to test the electrocardiograph «CardioQVARK» and evaluate its capabilities in detecting hidden cardiovascular pathology. Materials and methods. It was examined 116 healthy controls, an electrocardiogram was registered, blood pressure was measured, and risk factors were assessed. Results. Total screening revealed 12 people with an increased risk of life-threatening arrhythmias and sudden cardiac death. Тhe percentage of detection of hidden pathology of the cardiovascular system was 10.3 %. During repeated electrocardiogram registration, 9 people with hidden pathology were additionally identified (the total percentage of detection of hidden pathology of the cardiovascular system was 18.1 %). Conclusion. It is advisable to use the "CardioQVARK" electrocardiograph to detect pathology of the cardiovascular system at the earliest stages in healthy controls. Keywords: hidden pathology of the cardiovascular system, electrocardiograph «CardioQVARK», sudden cardiac death, external event recorder, screening.
MODERN POSSIBILITIES OF SEVERE OSTEOPOROSIS TREATMENT
E.S. Zhugrova, V.I. Mazurov North-Western State Medical University named after I.I. Mechnikov. Russia , 191015, Saint Petersburg, KirochnayaStreet, 41 Abstract Introduction. Osteoporosis is still one of the urgent issues for healthcare due to its high prevalence and early disability. The aim of the study was to analyze the effect of Teriparatide therapy on the spineBMD, proximal femur and bone turnover in patients with severe postmenopausal osteoporosisduring a year, as well as to evaluate the incidence of new fracture. Materials and methods. The study included 30 women aged 60±6.0 years with a disease duration of 10.0±5.0 years. All patients had severe postmenopausal osteoporosis complicated by multiple vertebral and nonvertebral fractures. FRAX was more than 30% on the axial skeleton in all patients. Results. The study results showed an increase in BMD after 12 months of Teriparatide therapy, accompanying by the activation of bone formation processes. Almost up to the 3rd month of therapy it was observed a statistically significant back pain relief and improved quality of life in patients according to the SF-36 questionnaire. Conclusion.The increase in BMD resulted in the reduction of the number of new repeated fractures in patients with severe osteoporosis. Keywords: osteoporosis, quality of life, back pain, teriparatide.
BURNINJURY: IMMUNOLOGICAL ASPECTS (REVIEW)
P.A. Selivanov1.3, N.V. Bychkova1.2, N.M.Kalinina1.2 1Nikiforov Russian Center for Emergency and Radiation Medicine (EMERCOM of Russia) , Russia, 194044, Saint-Petersburg, AcademicLebedevstreet, 4/2 2Pavlov First St.Petersburg State Medical University, Russia, 197022, Saint-Petersburg, Lev Tolstoy Street,6-8 33rd Military hospital of the national guard of the Russian Federation, Russia, 192171, Saint- Petersburg, Tsymbalina street,36 Abstract
Burn injury is considered as one of the most severe types of injuries with high mortalityrate even in patients with burns affecting a small area. Patients with severe burns observed with a significant suppression of the cellular immunity, resulted in the development of both local and general complications, up to a fatal outcome. Changes occur not only in the effectors of cellular and humoral immunity, but also in the regulatory link, also due to a change in the cytokines balance. The present literature review summarizes the available data in scientific publications on the features of the immune response to burn injury. Key words: immune system, cytokines, cellular immunity, burn injury.
PREVALENCE OF HYPERTENSIONIN SCHOOL-AGE CHILDREN WITH OVERWEIGHT AND OBESITY
N.B. Kuprienko1,2, N.N. Smirnova1,2
1Pavlov First St.Petersburg State Medical University, Russia, 197022, Saint-Petersburg, Leo Tolstoy street, 6-8
2Almazov National Medical Research Center, Russia, 197341,Saint-Petersburg, Akkuratovastreet, 2 Abstract Introduction. High prevalence of obesity and hypertension in children increases the risk of cardiovascular disease development in adults. The aim of the study wasto determine the proportion of children with different high blood pressure percentilein children with normal weight, overweight and obesity. Materials and methods. The study includes data from electronic protocols of clinical examination of 4,618 children aged 7 -17 years (boys – 47.8%). Results. In the group of children with normal body weight, prehypertension is observed in 9.1% (95% CI: 8.2-10.6) of children, stage 1 hypertension was in 6.2% (95% CI: 5.5-7.0) of children, and stage 2 hypertension was in 0.6% (95% CI: 0.4-0.8) of children. In the group of overweight children, the corresponding proportions were 16.9 % (95% CI: 14.2-20.1), 16.3 % (95% CI: 13.6-19.4), 2.1% (95% CI: 1.2-3.5). In children with obesity it were 11.9% (95% CI: 7.8-17.7), 38.7% (95% CI: 31.7-46.2), 6,5% (95% CI: 3.7-11.4). The coefficients of the proportion of children with normal, overweight and obesity were 1.00/2.71/6.65. Conclusion. The prevalence of hypertension is directly related to a higher body mass index in children. Keywords: hypertension, overweight, pediatric obesity, children, prevalence.
INTERLEUKIN 4: BIOLOGICAL FUNCTIONS AND CLINICAL IMPORTANCE IN ALLERGIES DEVELOPMENT (REVIEW)
E.A.Boytsova1,G.O. Azimurodova2, T.V.Kosenkova1
1Almazov National Medical Research Centre, Russia, 197341,Saint-Petersburg, Akkuratova street,2 2Pavlov First St.Petersburg State Medical University, Russia,197022, Saint-Petersburg,Leo Tolstoy street,6-8 Abstract:
The article provides an analysis of modern literature on the study of the structure, biological functions and role of interleukin-4in the pathogenesis of allergic diseases and describes the relationship of IL-4 with other cytokines in various immune responses. Key words: Interleukin 4, allergy, bronchial asthma, atopy, atopic dermatitis.
ASSESSMENT OF CELLULAR IMMUNITY PARAMETERS IN PATIENTS WITH BURN INJURIES
N.V. Bychkova1,2, P.A. Selivanov1,3, N.M. Kalinina1,2, A.V. Semiglazov4, E.V. Zinoviev4, P.K. Krylov4, O.V. Orlova4 1Nikiforov Russian Center for Emergency and Radiation Medicine (EMERCOM of Russia), Russia, 194044, Saint-Petersburg, AcademicLebedevstreet, 4/2 2Pavlov First St.Petersburg State Medical University, Russia, 197022, Saint-Petersburg, Leo Tolstoy Street,6-8 33rd Military hospital of the national guard of the Russian Federation, Russia, 192171, Saint- Petersburg, Tsymbalina street,36 4Saint- Petersburg research Institute of emergency medicine named after I. I. Dzhanelidze», Russia, Saint-Petersburg, 192242, Budapest street,3 A
Abstract Introduction. One of the most significant medical and social problems is burns. A key reason of the skin flap transplantation failure for the burn injuries is the lack of objectiveassessment methods of the patient's condition before free autodermoplasty. Determination of the patient cellular immunity parameters is not included in the algorithm of examination and monitoring of the state of patients with burn injuries. The aim of the study was to analyze thecellular immunity parametrs for expanding the algorithm of laboratory examination to prepare patients for further free autodermoplasty. Materials and Methods. Flow cytometry was used to study the subpopulation of lymphocytes including T-regulatory cells in 50 patients with burn injuries compared to healthy controls. Results. A number of parameters affectingthe mortality of patientswith burn injuries and the outcome of free autodermoplasty have been identified. The time frame for the appointment of an immunological examination has been specified. Adverse indicators are high leukocytosis with a significant absolute and relative lymphopenia, an imbalance in the major populations of lymphocytes, an increase in the number of T-regulatory cells and activated T-lymphocytes expressing HLA DR. Conclusion. Expanding the algorithm for laboratory examination for patients with burns by determining the main subpopulations of lymphocytes, as well as T-regulatory cells and activated T-lymphocytes allow to optimize the treatment of patients with burn injuries. Keywords: burns, autodermoplasty, flow cytometry, cellular immunity.
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