Standardization of early intervention operations (review).
E.M. Starobina, S.G. Krivenkov 20
Working conditions as a risk factor of tooth diseases development in working age (review)
A.Sh. Galikeeva, N.I. Simonova, N.H Sharafutdinova, E.G. Stepanov, T.K. Larionova 27
5. Medical support of pupils in comprehensive schools implementing innovative educational technologies. A.V. Suvorova, I.Sh. Iakubova 34
CLINICAL MEDICINE
Сoronary computed tomography angiography as a diagnostic method of coronary artery bifurcation lesion in patients with stable ischemic heasrt disease to plan coronary interventions. G.G. Khubulava, D.A. Starchik, A.N. Shishkevich, O.O. Volikov, I.F. Menkov, L.A. Bobrovskaya, E.E. Bobrovskaya 42
Risk factors for cognitive impairement in patients after carotid endarterectomy.
N.I. Glushkov, M.A. Ivanov, A.S. Artemova, V. Belokazantseva 50
Urine proteomic profiles and quality of self-control in pediatric type 1 diabetes mellitus Gabbasova N.V. 58
Prognostic polymorphism significance of A1166C gene AGTR1 and AGT gene M235T and interleykin-10 in the development of carbohydrate metabolism disorder in patients with arterial hypertension
The puberty of girls in the Republic of Khakassia: ethnic and somatometric aspects.
V.S. Gladkaya, V.L. Gritsinskaya 70
Provision of Vitamin D for adolescents with connective tissue dysplasia.
O.V Danilenko, N.N. Smirnova 76
Infantile colic: the basic principles of treatment and possibility of diet therapy (review).
N.M.Bogdanova 84
PREVENTIVE MEDICINE
HYGIENIC CHARACTERISTIC OF WORKING CONDITIONS AND DERMATOLOGICAL AND SUBCUTANEOUS TISSUE WORK-RELATED DISORDERS IN WORKERS OF SEWAGE PUMPING STATIONS
L.A. Alikbaeva, I.Sh.Iakubova, T.Z. Alikbaev, A. L. Ryzhkov, N.N. Krutikova North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 Abstract: Introduction. Sewagepumping stations are the major water disposal systems where could be the direct exposure of bacterial-mold contamination of the work area on dermatological status. It defines the necessity and importance of activities aimed at the reduction of negative impacts of working environment on employees’ health. Aim of the study was to assess the working conditions and risks of dermatological and subcutaneous tissue work-related disorders in workers of sewage pumping stations.
Materials and methods. The working conditions assessment was carried out in SUE «Vodokanal of St. Petersburg» by microclimate parameters, noise levels, general vibration, artificial light, determination of chemicals, biological factor, as well as the severity and intensity of the working process. It was performed the estimation of the incidence and pathological prevalence of dermatological and subcutaneous tissue disorders in workers of SUE "Vodokanal of St. Petersburg" by results of periodic medical examinations. It was evaluated the effectiveness of devices "Biozones", "Gasconvertor Test" and "Experimental site of air gas purification of working premises" by odor measurement, the impact on atmospheric chemical composition and sanitary-microbiological indicators.
Results. It was observed the high levels of air contamination of the working area by opportunistic microorganisms and mold micromycetes. The workers of sewage pumping stations have a risk of the development of dermatological and subcutaneous tissue work-related disorders. The studies indicating the presence of odor concentration decrease of chemical concentration and microbicides action against biological aerosol in the working zone area while working with the studied devices. Conclusions. At the enterprises with air microbiological contamination of a working zone working is a risk of the development of dermatological and subcutaneous tissue disorders. The workers aged 41-50 and 51-60 have an increased risk of the development of dermatological and subcutaneous tissue disorders. Key words:working conditions, mould and bacterial contamination, sewage pumping stations, dermatological and subcutaneous tissue disorders, professional risk, odor measurement
INCIDENCE OF INFLUENZA AMONG PREGNANT WOMEN IN ST.PETERSBURG. EFFECT OF INFLUENZA OF PREGNANT WOMEN ON NEWBORN HEALTH
Z.P. Kalinina1,2, M.A. Molchanovskaya1, M.D. Zlokasov1, I.G. Petrova2, V.V. Nechaev1,N.T. Gonchar1 1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41. 2S.P. Botkin Clinical Infectious Diseases Hospital, Russia, 191167, St. Petersburg, Mirgorodskaya street, 3. Abstract. Introduction. Pregnant women are in a high-risk group of exposure to influenza: during 2015-2016 the number of pregnant women hospitalized with influenza was 8.6% of those who was hospitalized with influenza aged 18, in the 2016-2017 the percentage of hospitalization of pregnant women increased up to 23.4%. Aim of the study was to compare the incidence of influenza in pregnant women in the epidemic seasons of 2015-2016 and 2016-2017 and to evaluate the neonatal risk associated with severe influenza. Materials and methods. Retrospective analytical cohort study was conducted in maternity hospitals of St. Petersburg and included 306 pregnant women. The effect of influenza on the newborn health was studied in 102 women (main cohort) of different weeks of pregnancy. The study materials were data from the official reporting documentation. Statistical analysis was carried out using computer software Statistica and WinPepi, as well as relative risk (RR) was calculated. Results. According to the results of the analytical study it was found that in main cohort (women who have had influenza А (H1N1) pdm09) the risk of neonatal pathology development (congenital malformations and intrauterine growth retardation) 5.8 times higher than in women without influenza during pregnancy (RR = 5.8; CI 29.6 -1.2; p< 0.05). Conclusion. It was revealed that women who have had influenza a(H1N1) pdm09, the relative risk of neonatal pathology is higher than in women who did not have influenza during pregnancy (RR = 5,8). Key words: pregnancy, influenza, congenital malformation, intrauterine growth retardation, comorbidities, vaccinations.
STANDARDIZATION OF EARLY INTERVENTION OPERATIONS
E.M. Starobina, S.G. Krivenkov Federal Scientific of Rehabilitation of the Disabled named after G.A. Albrecht , Russia, 195067 Saint -Petersburg, Bestugevskaya st., 50 Abstract Aim of the study was to analyze the normative and legal regulation in the field of early intervention operations in Russia and abroad. Results. It is provided the basic principles and requirements for the development and organizations of early intervention operations containing in foreign standards. The "early intervention operational standards» of Massachusetts (USA) was considered, as well as the history of standards development of early intervention operations in Russia along with the standardization current state. Conclusion. The settings of norms, requirements, realizations rules of early intervention operations in relevant standards will ensure the unity of measurements and comparability of the results, increase of provided services, assessment possibility and development of statistical tools. Key words: early intervention operations, early intervention, standardization, system of complex rehabilitation and habilitation of disabled people.
WORKING CONDITIONS AS A RISK FACTOR OF TOOTH DISEASES DEVELOPMENT IN WORKING AGE (REVIEW)
A.Sh. Galikeeva1, N.I. Simonova2, N.H. Sharafutdinova1, E.G. Stepanov3,4, T.K. Larionova5 1 Bashkirian State Medical University, Russia, 450000, Ufa, Teatralnaya Street, 2a, 2 Clinical Institute of Occupational Safety and Working Conditions, Russia, 141607, Moscow region, Klin , Dzerzhinskogo street, 6 3 Department of Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in the Republic of Bashkortostan, Russia, 450054, Ufa, R,Zorge street 56 4Ufa State Petroleum Technological University, Russia, 450062, Ufa, Kosmonavtov street, 1 5Ufa Research Institute of Occupational Health and Human Ecology, Russia, 450106, Ufa, Kuvykin street, 94 Abstract:
Nowadays, dentistry in Russia has been accumulated the considerable experience in studying of prevalence and intensity of major tooth diseases in employees of various economic sectors. The hypothesis of the etiopathogenic correlation between working conditions and oral health is confirmed by significant increase of intensity and severity of tooth diseases in employees of various economic sectors, including plants manufacturing mineral fertilizers, phosphorus, synthetic monomers, synthetic rubber, tire and paper. Additionally, there are studies on conservation and promotion of oral health in employees of ferrous metallurgy of non-ferrous metals industry; machine building, industrial boiler room, candy manufactures and etc. The present article presents the publications analysis on high prevalence of tooth diseases in employees of various industries. The major authors agree that the prevalence of tooth diseases in industrial workers exposure to harmful working conditions is higher than in intact population (comparison group). The employees of hazardous industries have sever pathologies and increasing level of tooth diseases correlated with the length of service in comparison with control groups.
The main reason of tooth diseases in industrial workers, besides direct exposure to harmful factors, is a lack of priority in dental care for workers, despite the higher necessity. Key words: dental status of employees, hazardous and dangerous working conditions, peculiarities of the clinical course of tooth diseases.
MEDICAL SUPPORT OF PUPILS IN COMPREHENSIVE SCHOOLS IMPLEMENTING INNOVATIVE EDUCATIONAL TECHNOLOGIES
A.V. Suvorova, I.Sh. Iakubova North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41. Abstract Introduction: Medical support of pupils in comprehensive schools is a topical issue due to implementation of the innovative educational technologies against constant health deterioration of pupils and teenagers. Aim of the study was to substantiate the measures for medical support of pupils in comprehensive schools implementing innovative educational technologies. Material and methods: It was analyzed the official statistical data on pupils' health of Saint-Petersburg, educational process organization and medical services. The study included 581 pupils from 5 schools examining the learning environment, educational process organization, and health status and day regimen. The health risks for pupils from daily regimen and educational process were assessed. The study included generally accepted social, hygienic and statistical methods. Results and conclusions. The study results revealed the poor health state in pupils of Saint-Petersburg, the majority of them had high academic load and disturbance of the daily regime. The high school students had health risk factors associated with irrational educational process and daily regimen factors. The algorithm to provide medical support of pupils in comprehensive schools was developed to dynamically monitor the pupils' health and daily regimen. Keywords: pupils, educational process, innovative educational technologies, health status, daily regimen, medical support of pupils.
CLINICAL MEDICINE
CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY AS A DIAGNOSTIC METHOD OF CORONARY ARTERY BIFURCATION LESION IN PATIENTS WITH STABLE ISCHEMIC HEASRT DISEASE TO PLAN CORONARY INTERVENTIONS
G.G. Khubulava1, D.A. Starchik2, A.N. Shishkevich1, O.O. Volikov1, I.A. Menkov1, L.A.Bobrovskaya3, E.E. Bobrovskaya1 1 Military Medical Academy named after S.M.Kirov, Russia, 194044, Saint- Petersburg, Akademika Lebedeva street, 6. 2First Pavlov State Medical University of St. Petersburg, Russia, 197022, St. Petersburg, Leo Tolstoy street, 6-8. 3Altai State Medical University, Russia, 656000, Altai Territory, Barnaul, Lenin prospect, 40. Abstract Introduction: Currently, the coronary computed tomography angiography (CCTA) is insufficiently used in the planning of coronary artery disease interventions. Although being the only one non-invasive method for visualizing of lumen, walls of the coronary arteries, lateral artery angle and degree of lumen stenosis. In this regard, the comparison of CCTA diagnostic capabilities with selective coronary angiography for planning coronary interventions is of a high interest. Materials and methods: The study included 69 patients divided into two groups: Group 1-34 patients (27 male and 7 female aged 61.21 ± 10.22) after CCTA; Group 2 -35 patients (29 male and 6 female aged 61.77 ± 10.33) after selective coronary angiography (p = 0.11). The groups were comparable due to sex, age and comorbidities, while the statistical data processing was conducted by t-test. Results: The conducted study revealed that CCTA could be successfully used for planning the coronary interventions, thereby allowing to choose the necessary equipment, stents, strategy of bifurcation stenting, correspondingly, to decrease the length of stay in the X-ray operating room, radiation dose and financial costs. Conclusions: The CCTA method may be recommended for the wider use in clinical practice as an alternative invasive method of determining the level of coronary artery stenosis, distribution of atherosclerotic plaque with respect to bifurcation of the coronary arteries, lateral artery angle, thereby it may be used for planning of coronary interventions, particularly, for coronary artery bifurcation stenting. Key words: coronary artery stenting, bifurcation lesion, computed tomography, computed tomography of coronary arteries, coronary computed tomographic angiography, noninvasive assessment of coronary arteries, atherosclerosis, and degree of lumen stenosis.
RISK FACTORS FOR COGNITIVE IMPAIREMENT IN PATIENTS AFTER CAROTID ENDARTERECTOMY N.I. Glushkov, M.A. Ivanov, A.S. Artemova, V. Belokazantseva North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya st. 41 Abstract Introduction: Cerebrovascular diseases are among the most important medical issues due to the high level of disability and mortality. Aim of the study was to determine the risk factors for cognitive impairment in patients after carotid endarterectomy (CEA). Materials and methods. It was collected and analyzed the treatment results of 50 patients after carotid endarterectomy. Patients were divided into three clinical groups regarding the study results of cognitive impairment by MOCA scale : Group I - over 26 points -5 patients; Group II – range between 16 - 25 points - 39 patients; III group - less than 16 points - 6 patients. Results. The lipid profile was correlated with the severity of cognitive impairment (p <0.05). The relationship between body mass index (BMI) and cognitive impairment (p <0.05), as well as the relation between increased systolic blood pressure and cognitive impairment was revealed (p <0.05). Conclusions. The manifestation of metabolic changes affects the significance of cognitive impairment after carotid endarterectomy. Key words: cognitive impairment, carotid endarterectomy.
URINE PROTEOMIC PROFILES AND QUALITY OF SELF-CONTROL IN PEDIATRIC TYPE 1 DIABETES MELLITUS
N.V. Gabbasova
Voronezh State Medical University named after N.N. Burdenko, Russia, 394036, Voronezh, Studencheskaya str., 10 Abstract.
Introduction. Numerous clinical studies have demonstrated that the improvement of glycemic control causes a significant reduction of the risk of micro- and macrovascular complications of diabetes mellitus, particularly the development of diabetic nephropathy.
Aim of the study was to investigate the effect of the quality of self-control in pediatric type 1 diabetes mellitus on the functional state of the nephron, determined by the urine proteomic profile.
Methods. It were examined 308 patients with type 1 diabetes mellitus dividing into four groups depending on the quality of self-control (regularity of insulin administration, glycemic control, compliance with diet and exercise regimen): from dissatisfaction to the excellent quality of self-control. Uroproteinograms were studied using automated electrophoresis method in gradient polyacrylamide gel (8-25%). Results and conclusion. The favorable effect of good self-control on diabetes was confirmed: an inverse correlation was established between self-control and the level of glycemia, lipidemia, mean blood pressure, the presence of proteinuria in common urine analysis and etc. At the same time, analysis of the uroproteinogram in patients with type 1 diabetes mellitus didn’t reveal any differences in the protein profile of urine, depending on the level of control. The performed investigation of the nephron state confirms the possibility of the development of diabetic nephropathy even with excellent self-control. Key words:diabetic nephropathy, urine proteomic profiles, self-control.
PROGNOSTIC POLYMORPHISM SIGNIFICANCE OF A1166C GENE AGTR1 AND AGT GENE M235T AND INTERLEYKIN-10 IN THE DEVELOPMENT OF CARBOHYDRATE METABOLISM DISORDER IN PATIENTS WITH ARTERIAL HYPERTENSION
L.V. Zhuravlyova, Т.V. Ashcheulova, М.V. Kulikova Kharkiv National Medical University, Ukraine, 61022, Kharkiv, Nauki avenue, 4 Abstract Introduction. The combined arterial hypertension and diabetes mellitus type 2 is the most common comorbid condition resulted in disability and requires to be timely and individually treated for the prevention of severe complications. Aim of the study was to investigate the polymorphic variants of Angiotensin II type 1 receptor A1166C gene, M235T angiotensinogen gene, carbohydrate metabolism indices and plasma activity of interleukin-10 with further development of diagnostic algorithm for predicting the development of carbohydrate metabolism disorders in patients with arterial hypertension (AH). Material and methods. The study included 129 patients with AH that were divided into 3 groups regarding presence/absence of concomitant carbohydrate metabolism disorders: Group 1- patients with AH (n = 60), Group 2 -patients with AH and prediabetes (n = 39) and Group 3 (n=30) - patients with AH and diabetes mellitus type 2, the control group consisted of 10 healthy controls. The following indicators were examined to assess the state of carbohydrate metabolism: fasting blood sugar level and during challenge test, insulin level, glycosylated hemoglobin (HbA1c).
Polymerase chain reaction (PCR) was used to determine Angiotensin II type 1 receptor A1166C gene polymorphism, M235T angiotensinogen gene, whereas the plasma levels of IL-10 was determined by enzyme-linked immunosorbent assay (ELISA). Results. While investigating the distribution of the genotypes of the studied genes, a significant prevalence of the TT genotype of the AGTM235T polymorphism in the angiotensinogen gene was revealed in patients with AH and prediabetes, diabetes mellitus type 2. Additionally, increased IL-10 production in patients with hypertension and prediabetes, compared with the control group, can be considered as an early marker of the carbohydrate metabolism disorders development. During discriminant analysis, the main indicators affecting the development and prediction of carbohydrate metabolism disorders development were defined: body mass index (BMI), heart rate, IL-10 levels, glucose challenge test, HbA1c, C allele in AGTR1 A1166C gene polymorphism and T allele in angiotensinogen (AGT) M235T gene polymorphism. Conclusions. Based on the study results, it was developed a mathematical model allowing to individually predict the development of carbohydrate metabolism disorders (prediabetes, diabetes mellitus type 2) in patients with AH at earlier stages regarding anthropometric evaluation, carbohydrate metabolism, IL-10 and AGTR1 A1166C gene polymorphism and (AGT) M235T gene polymorphism. Key words: arterial hypertension, prediabetes, diabetes mellitus type 2, Angiotensin II type 1 receptor A1166C gene, M235T angiotensinogen gene, interleukin-10.
The PUBERTY of girls in the Republic of Khakassia: Ethnic and somatometric aspects
V. S. Gladkaya1, V. L. Gritsinskaya2 1Katanov State University of Khakassia, Russia, 655017, Abakan, Shetinkina. 61 2 Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Russia, 197341, Saint-Petersburg,2 Akkuratova Street Abstract: Introduction: Among factors reducing the possibility of reproductive function in mature age, the major ones are gynecological diseases; disharmonious growth and puberty in pre and pubertal age determine unfavorable socio-hygienic living conditions in regions with adverse environmental and social conditions. The Republic of Khakassia is a habitat of the indigenous population of Siberia – Khakass, but there is a lack of data on puberty of Indigenous girls and newcomers. Aim of the studywas to determine the ethnic characteristics of the puberty of the girls of Khakassia. Material and methods. The study involved indigenous girls (Mongoloids, Khakass females – 1056) and the newcomers of the Republic (Caucasians – 867) aged 11 to 18 years. The survey included interviewing, somatometry and an evaluation of the stages of sexual development by J. Tanner. Results. It was revealed that in the indigenous girls, the length and weight of the body, the circumference of the buttocks and the pelvic bone is smaller than in newcomers’ peers. The pubertal growth in Khakass females is observed at 13 years; in Caucasians girls at 12 years. The development of secondary sexual characteristics (telarche – 11,8 years, pubarche: 12,0 years, menarche – 12,8 years) occurs earlier than in Khakass females (12,1; 12,2 and 12,9 years, respectively). A significant part of the surveyed schoolgirls noted a delay in the formation of B5 and P5; up to 18 years of irregular menstrual cycle have 1,3% of Khakass-females and 2,4% of Caucasians girls. Conclusion. The revealed regional and ethnic peculiarities of puberty predetermine the search for the causes negatively affected the realization of the reproductive potential in the younger generation. Key words: physical development, puberty, indigenous population of Siberia.
PROVISION OF VITAMIN D FOR ADOLESCENTS WITH CONNECTIVE TISSUE DYSPLASIA
O.V. Danilenko, N.N. Smirnova First Pavlov State Medical University of St. Petersburg, Russia,197022, Saint Petersburg,Leo Tolstoy street, 6-8. Abstract Introduction. The major clinical signs of connective tissue dysplasia coincide with the clinical manifestations of vitamin D deficient states, whereas the causes of the 25 (OH) vitamin D levels decrease in individuals with connective tissue dysplasia and, especially, in adolescents, are not specified. Aim of the study was to determine the provision and formation of 25 (OH) vitamin D deficiencies in adolescents with dysplasia in comparison with peers without this constitutional disease. Materials and methods. The transport form of 25 (OH) vitamin D by enzyme-linked immunosorbent assay was determined in blood plasma of 142 somatically healthy adolescents aged 14-20 years old (n = 87 with and without n = 55 without connective tissue dysplasia), living in the territory of St . Petersburg (34%) and Leningrad Region (66%) regarding the influence of various environmental on 25 (OH) D levels. Results. The mean annual serum 25 (OH) vitamin D level and its seasonal fluctuations in the adolescents with connective tissue dysplasia is considerably lower, while the specific gravity of the inadequate 25 (OH) vitamin D provision is higher, than the same findings in adolescents without connective tissue dysplasia (x2 =7.81, p <0.05). Under the same conditions, a strong correlation was found between the dysplasia and the values of 25 (OH) vitamin D deficiency (rs=0.76), and only the average correlation between the absence of dysplasia and the values of 25 (OH) D deficiency was revealed (rs=0.42). Conclusion. Dysplasia of connective tissue, conventionally predisposed to a low concentration of 25 (OH) vitamin D. The common triggers of hypovitaminosis D within such conditions undoubtedly aggravate the situation, but not being the main reason for the formation of 25 (OH) vitamin D lower levels in comparison with peers without connective tissue dysplasia. Key words: adolescents, connective tissue dysplasia, vitamin D
INFANTILE COLIC: THE BASIC PRINCIPLES OF TREATMENT AND POSSIBILITY OF DIET THERAPY
N.M. Bogdanova Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics, Russia, 197341, Saint-Petersburg,2 Akkuratova Street Abstract.
The article considers the general concept and social importance of infantile colic; modern diagnostic criteria presented in Rome IV (revision 2016), and general treatment principles. The treatment basis of infantile colic is a trusting relation between parents and pediatrician, compliance with postural therapy requirement and care, as well as minimal use of drugs (defoamers and probiotics). It is presented the main pathogenetic mechanism of action and simethicone pharmacokinetic and biological significance of L. reuteri in pain relief. Mostly the article dedicated to diet therapy depending on the feeding type. While breastfeeding the recommendations are aimed at correction of mother's diet, while artificial feeding - at choosing of a proper milk mixture of "comfort class". Due to the specially selected components, the product may have a complex effect on the causes of colic. The control of feeing technique and moderate nutrition regime for babies with colic is of a high importance. Key words: infantile colic, Rome criteria, pre-, probiotics, diet therapy, milk mixture, milk formula, merocrine and goloсrine secretion
(с) 2020 North-Western State Medical University named after I.I.Mechnikov
