Features of the spinal-pelvic relationships characterizing trunk balance in patients with true spondylolisthesis before and after corrective spinal surgery
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya Street, 41
Abstract Introduction. The worsening of epidemic situation in regard to COVID-19 requires the measures development to prevent the spread of disease in dormitories. Aim of the study was to evaluate the effectiveness of preventive and counter-epidemic measures in the self-isolation facility placed in the hotel-type dormitory. Materials and methods: A self-isolation facility has been organized in one of the buildings of a hotel-type dormitory of the North-Western State Medical University named after I.I. Mechnikov (NWSMU) to isolate and provide medical observation of mild cases patients having contact with COVID-19 patients and recovered COVID-19 patients discharged from hospitals. The contact person was defined as a person who had a direct contact (face to face) with a COVID-19 patient within 1-meter distance and for more than 15 minutes. Epidemiological, anamnestic and clinical data on patients transferred to the self-isolation facility from April 21 to June 21, 2020 were analyzed. Results: During the period of observation there were 26 people with test positive to COVID-19 in the facility: 11 (42,3%) of them were admitted with a positive test for SARS-CoV-2, 15 (57,7%) were diagnosed during the period of stay in the self-isolation facility. Among thepatients having contacts and admitted to the observatory without signs of infection, COVID-19 was diagnosed in 15 out of 48 patients (31.3%) during their stay. High morbidity (50%) was found among those who had contact with COVID-19 patients at their working place in health care facilities, compared with those who had contact at their place of residence - 8.3% (RR=6.0 [95% CI 2.11-17.07; p=0.0001]). Conclusion: In case of coronavirus infection, effective therapeutic, preventive and counter-epidemic measures in the self-isolation facility are:
1. Measures aimed at preventing droplet transmission, i.e. isolation only of those who had close contact with the infected individuals.
2. The organization of round-the-clock medical observation of patients with mild forms of COVID-19.
3. The risk group is medical workers who have been in contact withCOVID-19 patients.
4. Rapidity and complexity of implementation of treatment and preventive, counter-epidemic and administrative control measures. Key words: New coronavirus infection, quarantine, contact person, self-isolation facility, dormitory, medical supervision
HYGIENIC JUSTIFICATION OF QUANTITATIVE ASSESSMENT MODELS OF A PRIORI OCCUPATIONAL HEALTH RISK
Meltser A.V. 1, ErastovaN.V. 1, Kiselev A.V. 1
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnayastreet, 41
Abstract Introduction. Various models of professional health risk assessment have been developed over the past decade. Unfortunately, these models do not provide objective assessments and do not sufficiently applicable in practice. Aim of the studywas to provide a hygienic justification of quantitative assessment modelsof a priori occupational health risk from the impact of various production factors. Results.It was designed and tested quantitative assessment models of a priori professional health risk. The development of these models is based on the systematization of many-years’ experience in applying various approaches to professional health risk assessment. Conclusion.The advantage of the proposed quantitative assessment modelsof a priori occupational health risk is the assessment and forecasting of occupational health risks using existing hygienic criteria for classification of working conditions. Key words: working conditions, health, professional health risks, working efficiency, occupational health promotion.
PATHOLOGY FEATURES OF MUSCULOSKELETAL SYSTEM IN CHILDREN OF INNOVATIVE EDUCATIONAL INSTITUTION
1Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Russia, 614045, Perm, Monastirskaya street, 82
2 Perm State National Research University, Russia, 614990, Perm, Bukireva street, 15
Abstract Introduction. Many researchers noted a progressive deterioration in the health status of schoolchildren, an increase in the incidence of diseases caught in school, where only 25% of schoolchildren were found to be practically healthy. Innovative educational institutions, aimed both at successful experiencing of general educational programs and preserving and strengthening the health of the younger generation, are of a great interest. Aim of the study was to analyze the pathology features of the musculoskeletal system in children of an innovative educational institution. Materials and methods. It was evaluated the data of an in-depth medical examination of 156 boys aged 10-14 years studying in institutions of various educational forms. To assess violations of musculoskeletal system were performed ultrasonic densitometry, automated contactless computer optical topography and computer plantography. Results. In 66.7-79.5% of students, the pathology of the musculoskeletal system was identified, violation of posture and flat feet prevailed. Optical topograph study revealed some or other spinal disorders in almost all examined schoolchildren, while scoliosis was 2.5 times more common in boys of a comprehensive school. The presence of an inverse relationship between the possibility of postural disorders development in the frontal plane and chest deformity with a decrease in bone mineral density was established. It was revealed that the relative risk of flat-footedness formation in cadet school boys was 1.9 times higher.
More than ⅔ boys aged 10-14 have musculoskeletal system pathology, whereas every fourth student in a secondary school have scoliosis due to a decrease in bone mineral density. An increased load on the feet during drill and military sports training may result in the formation of flat feet in 73.3% of students in the cadet school. Carrying out hardware diagnostics increases up to 25% the frequency of detecting violations of posture and flat feet in the examined children. Key words: pathology of the musculoskeletal system, posture disorders, scoliosis, flat feet, cadets, schoolchildren
CHARACTERISTIC OF FUNCTIONAL BODY STATE OF “GIFTED” TEENAGERS LEARNING IN INNOVATIVE EDUCATIONAL INSTITUTIONS
A.G. Setko, E.V. Bulycheva, О.М. Zhdanova
Orenburg state medical university, Russia,460000, Orenburg, Sovetskaya street, 6
Abstract Introduction. A necessary condition for the development of the intellectual potential of the younger generation is the preservation and strengthening of the health level of “gifted” students. The aim of the studyis to assess the functional body state of the“gifted” teenagers studying in innovative general educational organizations. Materials and methods. In 400 “gifted” students and schoolchildren aged 15-16, the functional state of the central nervous system was studied by variational chronoreflexometry; respiratory system by using spirography; cardiovascular system by variationalpulsometry on the hardware-software complex ORTO-expert; Results.It was established that against the background of harmonious development of the respiratory system, the optimal state of autonomic regulation systems in “gifted” students, compared with schoolchildren, high values of operational indicators of the functional state of the central nervous system, such as the stability of the nervous reaction and the level of functional capabilities of the nervous system, were revealed, that probably due to the training of nervous processes as a result of intense cognitive activity. At the same time, every third “gifted” teenager showed a decrease in functional capabilities, 43.6% and 19.5% of “gifted” students showed adaptation stress and a breakdown in biological adaptation, respectively. Conclusion.The decrease in functional reserves and adaptive capabilities of “gifted” adolescents in conditions of high intellectual stress is a risk factor for the development of diseases and requires the development of a set of measures aimed at correcting the revealed deviations and increasing the adaptive potential of the student’s body. Keywords: “Gifted” students, functional state of the central nervous system, respiratory system, cardiovascular system
STUDY RESULTS OF SOME ASPECTS OF HEALTH LITERACY OF PEOPLE FROM NORTH CAUCASIAN FEDERAL DISTRICT
K. R. Amlaev, Kh.T. Dakhkilgova, A.A. Khripunova
Stavropol State Medical University, Russia,355017, Stavropol, Mira street,310
Abstract Introduction. The problem of health literacy among population is becoming increasingly relevant. Currently, despite the importance of this issue, there are virtually no studies on health literacy. The aim of the study was to analyze the level of functional, interactive and critical literacy in relation to the public health on the example of the North Caucasian Federal District of the Russian Federation. Materials and methods: Sociological study was conducted (a survey of 2141 residents from 7 subjects of the North Caucasus Federal District). Statistical data processing was performed using the SPSSv24.0 software package. Qualitative data were presented in fractions (%),95% confidence interval (95% CI) was calculated by the Wilson method. Results. An assessment of health literacylevel demonstrated a low level of functional, interactive and critical literacy. Conclusion. One of the key aspects of the state’s social policy is the improvement of the population’s health literacy. It is necessary to develop measures to increase health literacy both at the political level and at the level of primary medical care. Key words: health literacy, North Caucasus Federal District
TOBACCO AND ANTI-TOBACCO MARKETING ORIENTED TO TEENAGERS IN THE KYRGYZ REPUBLIC (GYTS 2019)
1 National Center of Cardiology and Internal Medicine Named After Academician Mirrakhimov M.M., Kyrgyz Republic 720040, Bishkek,TogolokMoldostreet, 3
2 Kyrgyz-Russian Slavic University,Kyrgyz Republic, 720065,Bishkek, Kiev street, 44
3 World Health Organization Country Office in Kyrgyzstan, Kyrgyz Republic, 720040, Bishkek,Orozbekovastreet, 52-54
4Department of Disease Prevention and State sanitary and epidemiological surveillance of the Ministry of Health of the Kyrgyz Republic, Kyrgyz Republic, 720033, Bishkek, Frunze street, 535
Abstract Introduction.Bad habits more often begin to form in the teenage period due to the presence of a number of factors - smoking of parents and friends, lack of certain life goals and exposure to advertising. Aim of the study was to evaluate the marketing of tobacco products, as well as the effectiveness of anti-tobacco measures among 13-15 teenagers in the Kyrgyz Republic. Material and methods.Two-stage cluster sample design was used to create a representative selection ofmiddle school students (7–9 grades). At the first stage, schoolchildren were selected with a probability of choice proportional to the number of students in this school of the proper age; the second stage was systematic selection with equal probability (with a random start) of classes from each school selected in the first stage. The survey includes 73 questions from the Standard Questionnaire and additionally selected questions with multiple answer options. Statistical processing was performed using the SUDAAN software package, and a 95% confidence interval was calculated to assess objective prevalence estimates and standard errors estimates. Results.About 16.5% of schoolchildren see any kind of tobacco advertising or promotion campaigns at points of sale; 51.1% noticed scenes of tobacco consumption on television, video or films. 20.3% of surveyed students are susceptible to tobacco marketing and had an increased risk of its consumption in the future. 49.7% have seen or heard any anti-tobacco messages in the media over the past 30 days; 21.9% of schoolchildren noticed anti-smoking messages at sports or social events. Over the past 30 days, 73.1% of current smokers noticed warnings about the dangers of smoking on cigarettes packs and 25.2% thought about quitting smoking because of warnings about the dangers of smoking on cigarettes packs. Conclusion. Despite the existing tobacco advertising laws ban, marketing of tobacco products continues, especially at points of saleresulted in a high susceptibility of students to tobacco products. It should be noted the extremely low efficiency of the anti-tobacco measures carried out by the media (media). Keywords: smoking, teenagers 13-15 years old, tobacco marketing,
tobacco control measures
CLINICAL MEDICINE
FEATURES OF THE SPINAL-PELVIC RELATIONSHIPS CHARACTERIZING TRUNK BALANCE IN PATIENTS WITH TRUE SPONDYLOLISTHESIS BEFORE AND AFTER CORRECTIVE SPINAL SURGERY
1S.M. Kirov Military Medical Academy, Russia, 194044, Saint-Petersburg, Akademika Lebedeva street, 6 2442 Military Clinical Hospital, Russia, 191124, Saint-Petersburg, Suvorovsky prospect, 63 3Saratov State University, Russia, 410012, Saratov region, Saratov, Astrakhanskaya street, 83
Abstract Introduction. The relevance of the work is due to the current tendency in orthopedics towards a harmonious correction of the musculoskeletal system pathology with maintaining or restoring the normal balance of the body. The body position in space determines the biomechanics of the musculoskeletal system and the functional status of the person. Therefore, the normalization of the spinal-pelvic relationship, as an important part of the overall balance of the trunk, is the key factor to successful treatment in corrective spinal surgery. The aim of the study was to analyze the effect of the trunk balance on the long-term results of surgical treatment of patients with true spondylolisthesis and to develop a geometric planning method of surgical interventions. Materials and methods: The results of surgical treatment of 40 patients with grade I and II spondylolisthesis were evaluated. Using the original specialized mobile application "SpinoMeter", an assessment of the body balance performed with the calculation of the spinal-pelvic relationships based on the data of spondylography, spinal telegraphy (full body X-ray) and computed tomography performed before and after surgical treatment. A geometric planning method and evaluation of the trunk balance in the treatment of patients with true spondylolisthesis has been developed. Results: To assess the body balance, a necessary study is full-body tele-radiography, which allows you to evaluate the necessary parameters of the spinal-pelvic relationship. A technique for geometric planning of their optimal correction is developed. The use of a specialized mobile application "SpinoMeter", which allows measuring sagittal vertebral-pelvic parameters, simplifies the process of full-fledged preoperative geometric planning of surgical correction in patients of this category. Conclusion: As a result of the study, the dependence of the long-term results of surgical treatment of patients with true spondylolisthesis of a low degree of gradation on the characteristics of the trunk sagittal balance was revealed. The influence of the magnitude of the lower arch of lumbar lordosis (LA), specified during surgery, on the values of the Barrey index and compensatory mechanisms of the trunk balance is demonstrated. The main vertebral-pelvic parameters are determined, the use of which is advisable in the preoperative planning of corrective operations on the spine with true spondylolisthesis of I and II degree. Keywords: spondylolisthesis, body balance, posture, geometric planning
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY AS TREATMENT CHOICE OF SEVERE NEUROGENIC OROPHARYNGEAL DYSPHAGIA AFTER STROKE
K.V.Golubev1,2, E.E. Topuzov2, V.V. Oleynik1,K.V.Golikov1, I.P. Mavidi1, S.V. Gorchakov1
1 City Multidisciplinary Hospital No. 2, Russia, 194354, Saint-Petersburg, Uchebny pereulok, 5 2 North-West State Medical University named after I. I. Mechnikov, Russia, 195067, Saint- Petersburg, Piskarevsky prospect, 47.
Abstract Introduction: Oropharyngeal dysphagia affects the majority of stroke patients. For the aspiration pneumonia prevention patients with severe neurogenic dysphagia are fed through a nasogastric tube. The use of a nasogastric tube with long-lasting severe dysphagia, in turn, causes the development of complications - aspiration pneumonia, gastroesophageal reflux, and sinusitis. The determination of optimal timing of the percutaneous endoscopic gastrostomy formation in this group of patients remains unsolved, as well as the possibility of ensuring prevention and reducing the frequency of the above complications. The aim of the study was to improve the treatment results of stroke patients with severe neurogenic dysphagia by determining the optimal timing for percutaneous endoscopic gastrostomy the formation; to provide complications prevention (pneumonia, sinusitis, etc.), as well as reducing the duration of inpatient treatment. Materials and methods: During the study, it was analyzed 140 medical records of in-patients after stroke, who were fed by a nasogastric tube. According to the timing of the endoscopic gastrostomy formation, patients were divided into two groups: first group-from the 14th to the 21st day from the onset of a stroke, second group- after the 21st day. Results: During the study, it was obtained the data on the difference in the post-stroke complications development (pneumonia, sinusitis, etc.) depending on the treatment tactics used for the endoscopic gastrostomy formation (in patients with and without tracheostomy); optimal terms for the gastrostomy formation are determined. The advantages of an endoscopic gastrostomy over a nasogastric tube are proved in relation to the complication’s prevention and the reduction of the in-patient treatment time. Conclusion: Endoscopic gastrostomy formation in the interval from the 14th to the 21st day in patients with acute severe neurogenic dysphagia without tracheostomy allow to reduce the number of complications (pneumonia, sinusitis, etc.) and the duration of inpatient treatment. Key words: stroke, neurogenic oropharyngeal dysphagia, percutaneous endoscopic gastrostomy.
OPTIMAL TERMS OF REVASCULARIZATION IN PATIENTS WITH PERIPHERAL ATHEROSCLEROSIS
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41
Abstract Introduction. Unnecessary and delayed surgical treatment of peripheral atherosclerosis may result in negative consequences. The aim of this study was to compare the results of the lower limb revascularization according to the ischemia stage. Materials and methods. The study includes 88 patients with peripheral arterial disease, whereas 44 patients underwent surgical intervention in claudication stage of ischemic disease and another 44 patients underwent surgery at critical limb ischemia stage. During the first 30 days were studied the adverse effects of the revascularization in the analyzed groups. Results. Quarter of patients operated at the critical limb ischemia stage showed no improvements (a number of patients with dysbasiawereseven times lower). Every second patient with critical limb ischemia had complications after surgery (in every tenth patient in the second group). Infectious complications were especially common inpatients with critical limb ischemia. Conclusions. Reconstructive interventions at the claudication stage are characterized by a low frequency of postoperative complications development, which is an argument in favor of revascularization in patients with rapidly progressive claudication. Key words: peripheral atherosclerosis; claudication; critical limb ischemia.
IMMUNOPATHOGENESIS OF CHRONIC URTICARIA IN ADULTS (REVIEW)
N.V. Mikryukova1, N.M. Kalinina1.2
1 Nikiforov's All-Russian Center for Emergency and Radiation Medicine, Russia, 194044, Saint-Petersburg , Academica Lebedeva street, 4/2 2 Pavlov First St.Petersburg State Medical University, Russia, 197022, Saint- Petersburg, , Lev Tolstoy street, 6-8
Abstract
Chronic urticaria is a group of diseases characterized by the development of itchy wheals and / or angioedema lasting more than 6 weeks, divided into induced and spontaneous (without obvious triggers). There are many studies indicating that various biological systems: immune, inflammation, coagulation are involved in the pathogenesis of chronic spontaneous urticaria. Some conditions, diseases including infectious ones, coexist with chronic urticaria and are possibly associated with general pathophysiology, leading to degranulation of mast cells and basophils. It is presented a review of published research results from 2014 and discussed possible pathogenesis mechanisms of chronic spontaneous urticaria. Key words: chronic spontaneous urticaria, cytokines, pathogenesis.
Features OF VARIABILITY OF HEART RHYTHM IN RESISTANT AND ISOLATED OFFICE ARTERIAL HYPERTENSION
Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Russia, 614045, Perm, Monastirskaya street, 82
Аbstract Introduction. The level of blood pressure is controlled by the autonomic nervous system, the functioning of which can be assessed by studying the variability of the heart rhythm. Analysis of heart rate variability allows to definitely predict the likelihood of arterial hypertension development in healthy individuals, and the development of complications in individuals with arterial hypertension. The study of the dynamics of heart rate variability parameters in individuals with already formed arterial hypertension is relevant in terms of further improving the criteria for stratifying the risk of cardiovascular complications in workers in hazardous working conditions. Aim of the study was toanalyze the features of heart rate variability with resistant and isolated office arterial hypertension in order to improve the criteria for risk stratification of cardiovascular complications in workers of industries with dangerous working conditions. Materials and methods.It was examined 104 workers of the mining enterprise: 55 employees with persistent arterial hypertension, 49 employees with isolated office arterial hypertension. Variability of the heart rhythm with the analysis of short records and the assessment of the vegetative indicator, parameters of the temporal analysis, indicators and indices of variational pulsometry was studied. Results.In both groups, a decrease in heart rate variability without significant intergroup differences was recorded. In the group with resistant arterial hypertension, a hypersympathicotonic type of reaction to the load was noted 3 times more often, in comparison with employees with isolated office arterial hypertension. Conclusion. Changes in heart rate variability make it possible to consider workers with persistent arterial hypertension as a group of people with an unfavorable prognosis regarding the progression of the disease and the risk of cardiovascular complications. Isolated office arterial hypertension may be considered as a more benign condition. The initial decrease in heart rate variability in workers with isolated office arterial hypertension is the reason for their inclusion in the risk group for the development of persistent arterial hypertension. Keywords: isolated office arterial hypertension, heart rate variability, vegetative indicator, mining enterprise.
ASSESSMENT OF QUALITY OF LIFE IN BREAST CANCER PATIENTS AFTER SURGICAL TREATMENT
1 Petersburg Clinical Research and Practical Center for Specialized Types of Medical Care (Oncologic), Russia,197758, Saint Petersburg, Pesochny settlement, Leningradskaya street, 68A 2 Saint Petersburg State Pediatric Medical University, Department of Oncology, Pediatric Oncology and Radiation therapy,Russia, 194100, Saint Petersburg, Litovskaya street, 2 Abstract Introduction. Breast reconstruction is the main part of medical, social and psychological rehabilitation of female breast cancer patients allowing to avoid physical defects and psychosomatic disorders. The type of breast cancer surgery should be in favor of the best indicators of the quality of life of cancer patients. The aim of the study wastoassess the quality of life of breast cancer patients depending on the surgical volume. Materials and methods. The article is based on the results analysis of questionnaires and scales for assessing the quality of life in 457 women with breast cancer aged 29 to 83 years, who were divided into three groups depending on the surgical volume. Results. Reconstructive plastic surgery on the breast reduces the level of depression and anxiety; improves the quality of life compared to radical mastectomy. Conclusion. Simultaneous reconstructive plastic surgery is a necessary rehabilitation method of breast cancer patients. Key words: reconstructive plastic surgery, radical mastectomy, organ-preserving operations, quality of life, surgical treatment.
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