Risk factors for hospital-acquired pneumonia in patients after cardiac surgery
Sadovnikov E.E. 67
Modern etiological features of bacterial purulent-inflammatory lesions of the pharyngotonsillar zone in patients with acute respiratory viral infections
Significant laboratory findings in cases of reinfection with sars-cov-2 virus variants (review) Pobozhaja I.A., Kalinina N.M. 97
TO AUTHORS ATTENTION 102
HYGIENE
EMPLOYEE'S HEALTH AS A SOCIO-ECONOMIC RESOURCE
Vlasova E.M.1, Gorbushina O.Yu.1, Luzheckij K.P.1, Cinker M.Yu.1, Belyakov A.V.2, Shlyapnikova Yu.A.2 1Federal Scientific Center for Medical and Preventive Health Risk Management Technologies. Russia, 614045, Perm, Monastyrskaya street, 82 2PAO «URALKALIJ»., 83 Pyatiletki St, Berezniki Permskij kraj, 618426, Russian Federation
Abstract Introduction. Employee health is a socio-economic component of national security. Challenges and threats to economic security include insufficient labor resources. The aim of the study is to analyze the health status of industrial enterprises workers as a socio-economic category. Materials and methods. Monitoring of the health status of employees in the main key industries of the region was conducted for the period from 2013 to 2023. Questionnaires were used; anthropometric, clinical, laboratory data, and functional research results were evaluated. The relative risk of developing somatic diseases hindering continued professional activity was assessed over time. Results and discussion. The main causes of death among the working-age population are diseases of the circulatory system 740.5 per 100,000 people (19016). The leading non-occupational risk factors for arterial hypertension and hearing loss in the initial period included smoking (AH- RR=1.7, 95%CI=1.0-2.7; χ2=4.7 p=0.03; HCT- RR=2.7, 95%CI=1.4-5.3; χ2=11.6, p<0.001), physiological factors such as excess body weight or obesity (AH- RR=3.6, 95%CI=2.1-6.6; χ2=21.9 p<0.001; HCT- RR=2.8, 95%CI=1.4-5.9; χ2=8.0 p=0.005), hypercholesterolemia (AH- RR=5.8, 95%CI=2.9-11.2; χ2=38.3, p<0.001; HCT- RR=3.0, 95%CI=1.2-7.5; χ2=5.3 p=0.02;), environmental factors like socio-cultural factors (AG- RR=2.2, 95%CI=1.1-4.2; χ2=4.9, p=0.03; HST- RR=3.0, 95%CI=1.2-7.5; χ2=6.5 p=0.01) and workplace risks (AG- RR=2.1, 95%CI=1.5-3.1; χ2=15.5 p<0.001; HST- RR=6.2, 95%CI=3.5-10.7; χ2=68.6 p<0.001). Employees only begin to recognize the leading role of individual responsibility for health when facing job loss. The survey results revealed that the health deterioration index (id) of employees for the period from 2013 to 2023 was <1, indicating a trend towards normalized behavior >1, overall suggesting the effectiveness of the implemented measures. Conclusions. The main reason for the shortage of qualified personnel is diseases of the circulatory system. Timely correction of modifiable risk factors, early detection of predictors allows to increase the of active work period. Keywords: worker's health, industrial production, harmful production factors, circulatory system diseases, arterial hypertension, sensorineural hearing loss, correction of risk factors, labor productivity.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
Hypofractionated and hyperfractionated radiation therapy for locally advanced non-small cell lung cancer (REVIEW)
A.I. Arseniev 1,2, S.N. Novikov 1, A.O. Nefedov 3, E.A. Arseniev1, S.A. Tarkov1, R.V. Novikov 1, A.Yu. Zozulya1, F.E. Antipov1, A.A. Barchuk1, N.Yu. Aristidov2 1N.N. Petrov National Medical 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 State Research Institute of Phthisiopulmonology. Russia, 191036, Saint Petersburg, Ligovsky avenue, 2-4
Abstract
In the scientific review, an analysis of literature data related to current issues of oncology, was conducted to determine the role of unconventional radiotherapy in the treatment of non-small cell lung cancer. In the treatment of locally advanced lung cancer, three main approaches to the fractionation regime are used: classical, hypofractionation, hyperfractionation and their combinations. Various fractionation and dosing options correlate with the radiobiological effects of radiation exposure, immediate and long-term results.
The main randomized studies and meta-analyses have not yet shown significant advantages of other radiation fractionation methods over conventional ones. Nevertheless, the search for alternative solutions continues. It is known that tumor cells demonstrate accelerated repopulation during radiotherapy, therefore, shortening the duration of treatment could increase its effectiveness.
Basically, non-conventional radiation is used for palliative irradiation and when it is impossible to carry out standard synchronous chemoradiotherapy. Hypofractionated radiation saves resources, reduces treatment costs, and optimizes logistics. According to the majority of studies, it improves or does not reduce survival rate, does not increase toxicity and reduces the risk of the immune system suppression. Accordingly, the method is promising when combined with radiation and immunotherapy. Hypofractionation is the method of choice in infectious pandemics to accelerate the duration of treatment. The introduction of new technologies allows to looking towards wider use of modified fractionation regimes and increase their effectiveness in lung cancer.
However, so far the most reputable professional communities do not consider unconventional radiation therapy as an alternative to the classical fractionation regimen. It is argued that the available data are not convincing enough for final conclusions and further randomized trials are required. Key words: review; non-small cell lung cancer; hypofractionation, hyperfractionation.
LAPAROSCOPIC SURGERY IN TREATMENT OF COMPLICATED COLON CANCER IN ELDERLY AND SENILE PATIENTS (REVIEW)
1North-Western State Medical University named after I.I. Mechnikov. Russia, 195067, Saint-Petersburg, Kirochnaya street, 41 2Hospital for War Veterans. Russia, 193079, Saint Petersburg, Narodnaya street, 21, room 2
Abstract
One of the well-known and widespread ways of surgical techniques development is the widespread introduction of laparoscopic technologies. The present review is devoted to determining the possibilities and feasibility of implementing laparoscopy in the surgical treatment of malignant neoplasms of the colon. Special attention is paid to cases with a complicated course and patients of older age groups. Keywords: colon cancer, laparoscopy, endovideosurgery, acute intestinal obstruction, geriatrics, review.
LABORATORY MARKERS OF SARCOPENIA IN CHILDREN WITH CEREBRAL PALSY
A.N. Zavyalova¹, M.N. Yakovleva¹, V.P. Novikova¹, M.D. Prudnikova¹, I.A. Lisitsa¹, Y.V. Kuznetsova¹, D.A. Kuznetsova², A.N. Moshnikova², S.V. Lapin², S.A. Krylova¹
¹ Saint Petersburg State Pediatric Medical University, Russia, 194100, Saint Petersburg, Litovskaya street, 2
² Pavlov First St.Petersburg State Medical University, Russia, 197022, St. Petersburg, Lev Tolstoy street, 6-8
Abstract Introduction. Nutritional deficiency in children with cerebral palsy occurs with a frequency of 7-73%. The visceral protein level in children with prolonged weight deficit rarely deviates from the norm. Searching for laboratory markers of nutritional deficiency among routine parameters could facilitate early diagnosis of sarcopenia in children with cerebral palsy. Aim of the studywas to identify the most significant laboratory markers of sarcopenia in children with cerebral palsy. Materials and methods. Levels of retinol binding protein and prealbumin, albumin, C-reactive protein and body composition were studied in 40 children with cerebral palsy and different nutritional status. Results. Low levels of retinol binding protein and prealbumin were detected in children over 9 years, even in the group with normal nutritional status. Correlations between prealbumin levels and malnutrition were identified in 43% of children and with severe malnutrition in 33% of children. Changes in body composition, such as accumulation of the proportion of fat mass more than 18% are associated with a decrease retinol binding protein (p = 0.016) and prealbumin (p = 0.005). In all children over 9 years, a low level of prealbumin was observed with a predominance of % fat mass over % active cell mass. Conclusions. Among the studied laboratory parameters, the most promising for diagnosing sarcopenia is the prealbumin level. A diagnostic marker of sarcopenia in children is a prealbumin levels less than 0.15 g/l. The value of retinol binding protein and visceral protein pool for the diagnosis of sarcopenia requires further clarification. Keywords: malnutrition, children, laboratory markers, retinol-binding protein, prealbumin, sarcopenia.
DYNAMICS OF PHYSICAL DEVELOPMENT OF CHILDREN IN THE FIRST YEAR OF LIFE FROM MOTHERS WITH OBESITY
N.E. Prokopyeva, V.L. Gritsinskaya, D.O. Ivanov, Yu.V. Petrenko, V.P. Novikova Saint Petersburg State Pediatric Medical University/ Russia, 194100, Saint Petersburg, Litovskaya street, 2. Abstract Introduction. The problem of maternal obesity is associated with both obstetric, gynecological and perinatal risks, as well as with long-term effects on the offspring’s health. It has been proven that excess body weight before pregnancy is a significant risk factor for the development of obesity and metabolic syndrome in the offspring. The article presents data from an analysis of physical development in children in the first year of life born to mothers with obesity. The aim of the study was to analyse the dynamics of physical development in children during the first year of life born to obese mothers. Materials and methods. The prospective study included 90 children: Group 1 - 54 children born to mothers with obesity (mother's body mass index before pregnancy ≥ 30 kg/m2; Group 2 - 36 children born to mothers with normal body mass index (18.5 - 24.9 kg/m2 All children underwent monthly anthropometry with subsequent assessment of body length, body weight and weight-height index in accordance with gender and age according to World Health Organization criteria using the WHO Anthro program. Statistical processing was carried out using the IBM SPSS Statictics 26. Results. In the group of children born to obese mothers, integral indicators of physical development were higher at birth. Also, in this group, there is a tendency towards accelerated rates of increase in body weight and body length, starting from 3 months of life, thereby demonstrating statically significant differences in the disharmony of physical development at the age of 12 months due to excess body weight. Conclusion. The results of the analysis of physical development prove the influence of maternal obesity on anthropometric indicators in the offspring and indicate the risks of developing obesity and metabolic syndrome at an early age. Key words: physical development, children, maternal obesity, overweight.
FEATURES OF BODY COMPOSITION AND ITS DYNAMICS IN CHILDREN WITH NEWLY IDENTIFIED DIABETES MELLITUS
D.P. Turun¹, F.Z. Tsoraeva², P.A. Pankratova¹, A.N. Zavyalova¹. ¹St. Petersburg State Pediatric Medical University, Russia, 194100, Saint Petersburg, Litovskaya street, 2 ²Children’s municipal multi-specialty clinical center of high medical technology named after K.A. Rauhfus, Russia, 190961, Saint Petersburg, Ligovsky avenue
Abstract Introduction.The body composition of children with insulin-dependent diabetes mellitus does not differ from that of healthy children. But at the onset of the disease, it depends on complications. Aim of the study was to evaluate the dynamics of body composition in children with newly diagnosed diabetes mellitus receiving insulin therapy depending on the variants of its onset. Materials and method. Continuous prospective single-center hospital study from June 15,2023 to December 29,2023 was conducted. Anthropometry in dynamics was evaluated with subsequent bioimpedance analysis using «MEDASS». The study included the assessment of active cell mass, its proportion, fat mass and its % proportion, lean body mass and skeletal muscle mass. Statistical analysis was performed using SPSS Statistics 26. Results and conclusions: The study involved 78 patients: 34(43.6%) - girls, 44 (56.4%) boys from 4 to 18 years old, average age - 10 years. Hospitalization time ranged from 6 to 26 days, average – 15.5 days. The patients were divided into 2 groups: 1 - without ketoacidosis (n = 49; 61.6%), 2 - with ketoacidosis at the onset of diabetes (n = 29; 37.2%). Patients with ketoacidosis had a more pronounced loss of body weight (p=0.039) due to fat (p=0.007) and active cell mass (p=0.017) and their proportions, especially the proportion of active cell mass (p<0.001) Most children gained weight; however, weight recovery was not achieved in 12 (15%) patients.
In children who did not regain their weight before illness, a decrease in weight due to far mass was observed (p<0.001). During hospitalization, 21 (27.69%) patients did not regain their lean mass (p<0.001), decrease in active cell mass in 20 (26.15%) children (p<0.001) and in 24 (30.77%) skeletal muscle mass (p<0.001). Key words: сhildren, insulin-dependent diabetes mellitus, ketoacidosis, body composition.
ANTIBIOTIC RESISTANCE OF PATHOGENS ISOLATED FROM PATIENTS IN CHILDREN'S HOSPITALS AND MATERNITY HOSPITALS DURING HOSPITAL ADMISSION
1North-Western State Medical University named after I.I. Mechnikov. Russia, 195015, Saint-Petersburg, Kirochnaya street, 41 2Medical Information and Analytical Center of the Health Committee of Saint Petersburg. Russia,198095, Saint Petersburg, Shkapina street, 30 3Saint Petersburg State Pediatric Medical University. Russia, 195015, Saint-Petersburg, Litovskaya str., 2 4Pavlov First Saint Petersburg State Medical University. Russia, 197022, Saint -Petersburg, L'va Tolstogo str. 6-8
Abstract Introduction. Antibiotic resistance is one of the most urgent problems worldwide. Monitoring the sensitivity to antibiotics of community-acquired pathogens is essential for the development and adjustment of empirical antibiotic therapy. Aim of the study was to analyze antibiotic resistance of pathogens isolated from clinical samples of patients of children's hospitals and maternity hospitals during hospital admission. Materials and methods. A retrospective analysis of etiology and antibiotic resistance of S.aureus, Enterococcus spp., E.coli, K.pneumoniae, P.aeruginosa, Acinetobacter spp. isolated from patients of 7 children's hospitals and 8 maternity hospitals upon admission during 2017-2021 was carried out. Results and discussion. In pediatric hospitals, S.aureus was the predominant pathogen. Over the study period, the proportion of antibiotic-resistant strains of S.aureus remained stable, with rates of 5.4% to gentamicin, 5.4% to cefoxitin, 29.3% to erythromycin, 8.1% to clindamycin, and 5.4% to ciprofloxacin. In 2021, there was an increase in antibiotic resistance of P.aeruginosa and Acinetobacter spp. to all studied antibiotics. In maternity facilities, the leading microorganisms were E.coli and Enterococcus spp. with low resistance to aminoglycosides. Resistance to all tested antibiotics was as foloows: 0.3% for S.aureus, Enterococcus spp. 1.8%, E.coli 0.6%, K.pneumoniae 2.2%, P.aeruginosa 3.7%, Acinetobacter spp. 8.7%. Newborn units are at risk of carbapenem-resistant microorganisms, which requires the introduction of carrier screening for these microorganisms upon admission for timely identification of infection sources and implementation of isolation measures.
Сonclusion: The increase in antibiotic resistance of S.aureus, Enterococcus spp., E.coli, K.pneumoniae wasn’t observed. However, a decrease in resistance was noted in P.aeruginosa and Acinetobacter spp. in 2020 followed by an increase in 2021. Keywords: etiology, antibiotic resistance, children’s hospitals, maternity hospitals, S.aureus.
RISK FACTORS FOR HOSPITAL-ACQUIRED PNEUMONIA IN PATIENTS AFTER CARDIAC SURGERY
E. Sadovnikov Kemerovo State Medical University, Russia, Kemerovo, 650056, Kemerovo, Voroshilova street, 22a
Abstract Introduction. Cardiovascular surgery patients are at high risk of healthcare-associated infections. Despite continuous advancements in medical technologies, pneumonia remains a serious postoperative complication. Recently, a risk-based approach to infection prevention has become widespread in clinical practice. Identification of risk factors of hospital-acquired pneumonia could reduce its prevalence. Aim of the studywasto assess the risk of hospital-acquired pneumonia in patients after cardiac surgery. Material and methods. A “case-control” study was conducted on surgery outcomes in 5340 adults and 839 children. In accordance with the standard epidemiological definitions of hospital-acquired pneumonia, the study included 159 cases of pneumonia in adults and 42 in children. All analyzed risk factors were divided into three groups. Statistical processing of the data was carried out using the Statistica and the GraphPad Prism software. Results. It was revealed that out of 32 studied risk factors, 11 had no impact on the development of pneumonia. Significant patient-related risk factors included: age of children, smoking status, chronic kidney disease, chronic obstructive pulmonary disease, impaired cerebral circulation, heart failure functional class, pre- and post-anesthesia evaluation of the patient, surgical risk score in children, degree of obesity, receiving antibiotics and hospitalization in the previous three months. Epidemiologically significant risk factors associated with the medical procedures were the following: duration of ventilation, bronchoscopy, extracorporeal membrane oxygenation, repeat operation, duration of surgery and cardiopulmonary bypass. The length of stay in the intensive care unit was classified as healthcare-related risk factors. Conclusion. The data on the identified risk factors could be used for development of a risk calculator and a patient-oriented approach to pneumonia prevention. Keywords: pneumonia, cardiac surgery, hospital-acquired pneumonia, risk factors.
MODERN ETIOLOGICAL FEATURES OF BACTERIAL PURULENT-INFLAMMATORY LESIONS OF THE PHARYNGOTONSILLAR ZONE IN PATIENTS WITH ACUTE RESPIRATORY VIRAL INFECTIONS N.R. Davtyan1, M.V. Klur2, B.E. Aslanov1, S.A. Gordeeva2, M.N. Рogromskaya2, А.Е. Goncharov1 1 North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 2Clinical Infectious Diseases Hospital named after. S.P. Botkin, Russia
Abstract
The aim of the study was to analyze the microbial composition isolated from the surface of palatine tonsils and the posterior pharyngeal wall in patients with inflammatory/purulent-inflammatory lesions of the pharyngotonsillar zone against the background of various acute respiratory viral infections.
Materials and methods. A retrospective study of the medical record of 306 patients hospitalized in the Clinical Infectious Diseases Hospital named after. S.P. Botkin was performed. These patients had inflammatory/purulent-inflammatory lesions of the pharyngotonsillar zone against the background of acute respiratory viral infections in the first quarter of 2024. The analysis included bacteriological examination results of swabs taken from the surface of the palatine tonsils and the posterior pharyngeal wall for anaerobic and facultative anaerobic microorganisms with antibiotic sensitivity testing.
Results. In the vast majority of patients, the condition was assessed as moderate. Among the lesions of the pharyngotonsillar zone, the following were recorded: acute tonsillitis (J03), acute pharyngitis (J02), acute tonsillopharyngitis (J03/J02), lacunar tonsillitis (J02), acute tonsillitis and paratonsillitis (J03), acute tonsillitis and paratonsillar abscess (J36). Streptococcus viridans was detected in 95.0% of cases, while 67.8% showed an association of Streptococcus Viridans with other microorganisms, including non-pathogenic Neisseria, Rothia mucilaginosa, and Candida albicans. The presence of Staphylococcus aureus, Streptococcus pyogenes and other pyogenic microorganisms was insignificant.
Conclusion. The obtained results do not confirm the findings of most researchers, who indicate Staphylococcus and group A Streptococcus (Streptococcus pyogenes) as the main cause of purulent-inflammatory lesions in the pharyngotonsillar zone. According to the study, other microorganisms and their associations, some of which belong to representatives of normal oral flora, play a dominant role. Essay Purpose of the study. To analyze the species composition of microorganisms sown from the surface of the palatine tonsils and the posterior wall of the pharynx in patients with inflammatory/purulent-inflammatory lesions of the pharyngotonsillar zone against the background of various acute respiratory viral infections. Materials and methods. A retrospective study was conducted of clinical case histories of 306 patients who were hospitalized at the St. Petersburg State Budgetary Institution "Clinical Infectious Diseases Hospital named after. S.P. Botkin" with inflammatory/purulent-inflammatory lesions of the pharyngotonsillar zone against the background of acute respiratory viral infections in the first quarter of 2024. The results of bacteriological studies of smears taken from the surface of the palatine tonsils and the posterior wall of the pharynx for anaerobic and facultative anaerobic microorganisms with determination of sensitivity to antibiotics were analyzed. Results. In the vast majority of patients, the condition was assessed as moderate. Among the lesions of the pharyngotonsillar zone, the following were recorded: acute tonsillitis (J03), acute pharyngitis (J02), acute tonsillopharyngitis (J03/J02), lacunar tonsillitis (J02), acute tonsillitis and paratonsillitis (J03), acute tonsillitis and paratonsillar abscess (J36). In 95.0% of cases, Streptococcus viridans was found in cultures, in 67.8% - Streptococcus Viridans in association with other microorganisms, of which non-pathogenic Neisseria, Rothia mucilaginosa, and Candida albicans were most often found. The percentage of seeding of Staphylococcus aureus, Streptococcus pyogenes and other pyogenic microorganisms turned out to be insignificant. Conclusion. The results obtained do not confirm the data of most researchers pointing to staphylococcus and beta-hemolytic streptococcus of group A (Streptococcus pyogenes) as the main cause of purulent-inflammatory lesions of the pharyngotonsillar zone. The dominant role is played by other microorganisms and their associations, some of which are representatives of the normal microflora of the oral cavity.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
CURRENT PROBLEMS AND DIRECTIONS FOR IMPROVING STATE POLICY TO COMBAT ANTIMICROBIAL RESISTANCE AMONG THE POPULATION (REVIEW)
M.V. Avdeeva 1,2, K.O. Kirilovskaya 1, A.A. Rukavichnikova 1 1North-Western State Medical University named after I.I. Mechnikov, Russia, 195067, Saint-Petersburg, Piskarevsky prospect, 47 2St. Petersburg State Pediatric Medical University, Russia, 194100, Saint-Petersburg, Litovskaya street, 2 Abstract Introduction. Antimicrobial resistance is considered by WHO as one of the most critical threats to public health in the twenty-first century. The aim of the study was to conduct a content analysis of modern literary sources and regulatory documents on the issue of antimicrobial resistance and develop recommendations for its reduction. Materials and methods. A content analysis of modern domestic and foreign literature on the problem of antibiotic resistance was performed. A total of 27 literary sources and 5 regulatory documents regulating the organization of measures to combat antimicrobial resistance among the population were analyzed. Results. The main reasons for the development of antimicrobial resistance among the population are: a lack of resources for producing new antibiotics, inefficacy of created antibiotics, low level of public awareness about the importance of adherence to treatment, irrational use of antimicrobial drugs in healthcare, agriculture, including livestock farming, crop production, and aquaculture. , as well as in the food industry; insufficient availability of diagnostic tools for drug resistance of microorganisms in practical healthcare; violation of the qualitative and quantitative composition of the normal human and animal microbiota; environmental pollution and the emergence of new biological threats associated with the use of genetically engineered microorganisms and plant pests; lack of mechanisms for interdepartmental interaction to prevent the spread of antimicrobial resistance and other types of resistance, including monitoring the spread of antimicrobial resistance and other types of resistance. Conclusion. The accelerated rate of development of microbial resistance does not allow timely creation of new antimicrobial drugs and modification of existing forms. To solve this issue, it is necessary not only to understand the nature of the development of antibiotic resistance, but also to fully convey information to the population about the rational use of antibacterial drugs and highlight the possible consequences of the uncontrolled use of drugs. Key words: antibiotic resistance, antibiotic, microorganisms, resistance to microorganisms, antimicrobial resistance.
COMPARATIVE ASSESSMENT OF THE NEUROPSYCHIC STATE OF FIRST-YEAR AND SENIOR STUDENTS OF A MEDICAL UNIVERSITY
O.V. Lisovskii, V. L. Gritsinskaya, L.V. Kolotilov, I.A. Lisitsa,
M.A. Gospodarets, T.Yu. Makarova
St. Petersburg State Pediatric Medical University, Ministry of Healthcare of the Russian Federation. Russia, 194100, St. Petersburg, Litovskaya st., 2 Abstract Introduction. Physical and mental well-being of medical students significantly determine their academic performance and positive formation of a physician’s personality, as well as the quality of life in general. The way students react to stressful factors in the educational environment, caused by high academic workload and lifestyle changes, contributes to the development of anxiety and depressive states. There are large differences in the results of researches on this problem among students of different categories of universities, regions of our country and other countries. This motivates to study psychological comfort among medical students and to develop preventive measures within the university settings, The aim of the study was to conduct a comparative assessment of the frequency and severity of anxiety and depressive disorders in the first-, fourth- and sixth year students of pediatric department. Materials and methods. A comparative sociological study of 1st, 4th and 6th year students using the Hospital Anxiety and Depression Scale (HADS) was conducted at the Department of General Medical Practice of St. Petersburg State Pediatric Medical University. In each subject the scores corresponding to normal or anxious-depressive characteristics were summarized.
The study included 1587 students formed in groups: group 1 (1st year) 570 students, group 2 (4th year) 758 students, and group 3 (6th year) 259 students. According to the scores of the HADS scale in each group, subgroups 1, 2 and 3 were identified (group 1 - normal - from 0 to 7 points; group 2 - subclinical - 8 to 10 points and group 3 - clinical - more than 11 points). Results. Average levels of anxiety and depression among students from the studied courses varied. Clinical manifestations of anxiety were noted in 28.2% of sixth-year students, higher than in first-year (21.1%) and fourth-year students (13.7%). The average score for clinically significant anxiety was higher in females compared to males. Graduates had a higher frequency of clinical manifestations of depression compared to first-year (7.2%) and fourth-year students (4.9%). There was no statistically significant difference in the average depression score between females and males. There were no convincing data found regarding the influence of chronic illnesses and vocational education on the levels of anxiety and depression among students. Conclusions. The number of 4th year students with subclinical and clinical manifestations of anxiety and depression is decreasing, but the number of such manifestations is increasing among sixth year students, which determines the need to form adaptation resources in students and to adjust work programs taking into account the form of certification and preparation for accreditation. Key words: anxiety; depression; quality of life; mental health; medical students; hospital anxiety and depression scale (HADS); accreditation; medical education.
CLINICAL LABORATORY DIAGNOSTICS
SIGNIFICANT LABORATORY FINDINGS IN CASES OF REINFECTION WITH SARS-COV-2 VIRUS VARIANTS (REVIEW)
I.A. Pobozhaja¹, N.M. Kalinina² ¹ City Hospital No. 40. Russia, 197706, Saint-Petersburg, Sestroretsk, Borisova street, 9 ² All-Russian Center for Emergency and Radiation Medicine named after A.M. Nikiforova. Russia, 194044, Saint Petersburg, Academician Lebedev street, 4/2, lit. A, 1N
Abstract
Estimates suggests that more than half a billion people worldwide have been infected with SARS-CoV-2 at least once. After more than two years of the COVID-19 pandemic, reinfection still remains a matter of consensus. Re-infection with SARS-CoV-2 means that a person was infected, recovered, and became reinfected more than 90 days after the last infection, as confirmed by laboratory diagnostic methods. The frequency of recurrent episodes, as well as the severity compared to initial infections, changes in laboratory parameters in cases of primary and recurrent infections are important information for understanding the pathogenesis of recurrent infections. Keywords: SARS-CoV-2, COVID-19, reinfection, reinfection, laboratory parameters.
(с) 2024 North-Western State Medical University named after I.I.Mechnikov
