Hygienic characteristics of chemical pollution in the zone of influence of highways port cities in sakhalin region
L.A. Alikbaeva, A.V. Kim............24
The optimal model of the process approach to organizing the preventive work of Health s on the primary prevention of the most important non-communicable diseases
Bronchopulmonary pathology among nickel industry workers: development, diagnostics and clinical manifestations
V.V. Shilov, S.A. Syurin.......................50
The stromal fibroblasts features and their relationship with the invasiveness and epithelial-mesenchymal transition of the main histological types of gastric cancer
I.V. Vasilenko, R. B. Kondratiuk, K.V. Poliakov, E.M. Bakurova..........57
Forecast and prevention of local infections complications for a hip and knee arthroplasty (the scientific review)
EVALUATION OF VITAMIN AND MINERAL STATUS OF MILITARY MEN SERVING IN THE FAR NORTH AND IN ST . PETERSBURG MILITARY MEDICAL ACADEMY, ST . PETERSBURG A.L. Smetanin, A.I. Andrianov, E.S. Belozerov, N.A. Shchukina, Y.V. Ivchenko, N.N. Kirichenko, A.V. Krivtsov, T.I. Subbotina, I.A. Konovalova Military Medical Academy named after S.M. Kirov, St. Petersburg, Russia
Abstract Purpose of the study. Comparative rating of vitamin and mineral status of servicemen in the Far North and St. Petersburg. Materials and methods. The blood of soldiers serving in the Far North and in St. Petersburg was investigated on the content of vitamins and minerals. The study was done in the spring. Determination of fat-soluble vitamins A, D, E, and watersoluble vitamins B1 and B2 were performed on the analyzer body fluids “Fluorat-ABLF-02-T” – luminescent-photometric; determination of ascorbic acid in the serum – titrimetric method Til’mans paint. Blood test for the content of trace elements of selenium, copper, zinc and manganese were performed by atomic absorption spectrophotometer MGA-915. The article presents an assessment of the quantitative content of vitamins and minerals in the blood of the military personnel of the far North and St. Petersburg with fluorescent-photometric and atomic absorption spectrophotometry. Results. Analysis of the obtained data showed that the content of vitamins A and B1 in the blood of military men from the Far North was higher, and vitamin E was less, compared to the same contents – from St. Petersburg. According to the content of vitamins D, B2 and C among the same groups statistically significant differences were not found. Almost all examined military men identified the deficiency of vitamins B2 and E. In the group from the Far North revealed lower levels of selenium and higher – copper and manganese. Conclusion. An Identified imbalance of micronutrients in the body soldiers is the basis for control and correction of the content of vitamins and minerals in food. Was proposed a comprehensive approach to correction of vitamin and mineral status of military personnel serving in the far North, including the use of vitamin-mineral complexes, improvement of water treatment technologies (the application of systems of mineralization), as well as correction of the content of vitamins, macro – and micronutrients in the diet. Key words: vitamins, minerals, military men, nutrition, vitamins and minerals complexes
ZINC DEFICIENCY CONDITION AMONG THE INHABITNTS OF SAINT-PETERSB URG I.I. Shantyr’, M.V. Yakovleva, M.A. Vlasenko The Federal State Budget Institution «The Nikiforov Russian of Emergency and Radiation Medicine», Abstract Purpose: To carry out laboratory diagnostics of body zinc sufficiency among certain categories of adult population of St. Petersburg taking into account age and gender differences for exposing the spread area of zinc deficiency condition and proposing the corresponding corrective measures. Materials and methods: In the course of work was carried out the outpatient examination of 2457 adults. Zinc content in the internal environment of the body was assessed with a help of analysis of the chemical composition of various biological media (hair, blood serum and gastric content) via mass spectrometry with inductively coupled plasma. Results reflect the topicality of resolving the problem of zinc deficiency condition among different categories of Saint Petersburg population that should be considered while developing preventive and individual treatment programs of rehabilitation. Key words: zinc, macrominerals, microminerals, bioelemental status, mass spectrometry with inductively coupled plasma.
HYGIENIC ASSESSMENT OF DIET OF SAINT -PETERSBURG CITIZENS V.A. Docenko, I.A. Kononenko, L.V. Mosiychuk, S.A. Dolotov, V.V. Zakrevskijj North-Western state medical University named after I. I. Metchnikov, Saint-Petersburg, Russia
Abstract Purpose. To study and evaluate the diet of St. Petersburg citizens in comparison with the basics of a healthy diet and to justify organizational and methodological improvements. The method of questioning was used to interview 1,200 residents of St. Petersburg. Analytical analysis of the data was produced using the software system STATISTICA. Results. One third of St. Petersburg citizens (33%) does not comply with recommendations for optimal diet. Many individuals in socially active adulthood adhere to eat two meals a day (27.8 percent). About a third of respondents violate the regularity of food intake in the morning, one of four does not have a specific time for lunch (26.2%) and dinner (25%). More than a third of the population (34,2%) has late dinner or before bedtime. Conclusion. A significant portion of the population disrupts a proper diet, which can lead to adverse shifts in metabolic processes, increasing the risk of alimentary-dependent diseases, decreased performance, reduced life expectancy. This raises the feasibility of establishing a healthy nutrition-based s or clinics. Key words: diet, the residents of St. Petersburg, health s.
HYGIENIC CHARACTERISTICS OF CHEMICAL POLLUTION IN THE ZONE OF INFLUENCE OF HIGHWAYS PORT CITIES IN SAKHALIN REGION L.A. Alikbaeva, A.V. Kim North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia
Abstract Purpose: hygienic assessment of atmospheric air and soil pollution in cities of Sakhalin Region in the area of influence of the highway. Methods. The assessment of car emissions was conducted in accordance with the “Methodology for determining of vehicles emission for summary calculations of air pollution of cities”. Determination of metals in soil was carried out by stripping voltammetry. Results. The results of modeling of emissions dispersion according to annual average concentrations of Kholmsk and Korsakov showed that exceeding for any of the chemicals is not expected. The city’s location in the coastal areas in the monsoon climate zone causes the circulation of air masses and migration of chemical substances released into the air. In the soil of the cities was formed an antropotechnogenic geochemical anomaly of focal type with the positive dynamics of soil pollution increase, which in all investigated areas at a rate of heavy metal contamination is characterized as a acceptable level. Conclusion:.The positive dynamics of accumulation of heavy metals in the soil of Kholmsk and Korsakov due to total index of soil pollution indicates the existence of the problem of soil contamination in the future. Key words: environment pollution, air, soil, urban areas, motor vehicles, health risk assessment, heavy metals.
THE OPTIMAL MODEL OF THE PROCESS APPROACH TO ORGANIZING THE PREVENTIVE WORK OF HEALTH S ON THE PRIMARY PREVENTION OF THE MOST IMPORTАNT NON-COMMUNICABLE DISEASES M.V. Avdeeva 1, Yu.V. Lobzin 1, 2, V.S. Luchkevich 1 1 North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia 2 Science Research Institute of Children Infections, Saint-Petersburg, Russia
Abstract Introduction. After a period of formation of organization and prophylactic work of Health s it is necessary to analyze the effectiveness of their work, assess the preliminary results and plan the directions for further development. Methods. the study examined the reporting and accounting documents, the actual content of work of health care professionals and the structure of risk factors of 2007 visitors of Health . The study revealed 4 sub processes in the work of Health . Optimal model of preventive activity of Health was constructed with the help of SADT technology. The model provides a timely identification of risk factors of most important non-communicable diseases among th population. Results: Health activity was complemented with new functions: marketing activity to enhance interaction with the priority consumers of primary prevention; quantitative account of medical and biological risk factors; change theorder of formation of primary reporting and accounting documentation; assessment of prenosological states; use a special methodology for assessing the effectiveness of preventive work. Using the new process approach has allowed a 40% increase in the timely identification of risk factors of diseases among the population. Conclusion. For the interpolation the developed model of the Health in clinical practice required legislative change in the principles of the right control of medical-prophylactic activity of the population, correction of a number of by-laws. This will allow creating a federal system of quality management and effectiveness of the organization and prophylactic activity of Health s on the primary prevention of the most important non-communicable diseases. Key words: non-communicable diseases, primary prevention, Health , risk management, public health care, process management, controlling management.
MEDICO-SOCIAL AND LEGAL ASPECTS OF REHABILITATION AND HABILITATION OF PERSONS WITH DISABILITIES IN THE RUSSIAN FEDERATION A.A. Svintsov, V.I. Raduto, G. I. Chernova Saint-Petersburg Scientific and Practical of Medical and Social Expertise, Prosthetics and Rehabilitation of the Disabled Persons under the Ministry of Labour and Social Protection of the Russian Federation , Saint-Petersburg Abstract Purpose: analysis of the legislative and regulatory framework of the Russian Federation for the state guarantees the rights of persons with disabilities to rehabilitation and habilitation. Materials and methods. The methodological basis of the research were scientific methods: statistical, analytical, systematic and structural, as well as special techniques: formal-legal, comparative legal, historical and legal. The study used methods of interpretation of law (grammatical, logical, systematic, historical, theological, functional) Results. Was carried out the analysis of federal legislation, regulations of the Government of the Russian Federation, regulatory documents to ensure the rights of persons with disabilities to rehabilitation and habilitation. Were specified state measures taken to implement the obligations of the Russian Federation under article 26 “habilitation and Rehabilitation” of the UN Convention on the rights of persons with disabilities. The main directions for state guarantees the rights of persons with disabilities to rehabilitation and habilitation were presented. It is shown that in accordance with the Federal Law of 01.12.2014 № 419-FZ “About Amendments to Certain Legislative Acts of the Russian Federation on the issues of social protection of disabled persons in connection with the ratification of the Convention on the Rights of Persons with Disabilities” made amendments to the Federal Law of 24 November 1995 № 181-FZ “On social protection of disabled persons in the Russian Federation.” The new law for the first time introduced the concept of “Habilitation”. Federal law should create additional safeguards to ensure, protect and promote social and economic rights of persons with disabilities as well as serve as a guideline for further improvement of legal regulation and practice in the field of social protection of disabled persons. Conclusion. The analyzed actions taken to implement the obligations of the Russian Federation under Article 26 “Rehabilitation and habilitation” UN Convention on the Rights of Persons with Disabilities and the analysis of materials of federal legislation, regulations of the Government of the Russian Federation, regulatory documents to ensure that the state guarantees the rights of persons with disabilities to rehabilitation and habilitation indicate that they are designated government measures to guarantee the rights of persons with disabilities to rehabilitation and habilitation established by the legislation of the Russian Federation. Key words: people with disabilities, rehabilitation, habilitation, rehabilitation equipment, rehabilitation institutions
CLINICAL MEDICINE
THE CONDITION OF COLON IN CASE OF OBESITY (THE SCIENTIFIC REVIEW) V.P. Novikovа 1, E.I. Aleshina 1, M.Y. Komissarova 2 1 Northwest Federal Medical Research named after V.A. Almazov, Saint-Petersburg, Russia 2 Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia
Abstract Purpose. To assess thecondition and pathology of the colon in adults and children with obesity. Materials and methods. analysis of scientific data to assess various aspects of the condition of colon in case of obesity. Results. An increase of abdominal pain frequency and diarrhea in patients with obesity were detected. Electromyography revealed discoordination of gastro-duodenal motility, as well as of ileum and large intestine function in children with obesity. Experimental work with high-calorie fat diet implementation, showed the development of intestinal barrier dysfunction and endotoxemia. The points for discussion include the role of microbiota, bacterial products and the role of Toll-like receptors-4 in the regulation of motility, intestinal permeability and inflammation of the gastrointestinal tract in obese patients. Conclusion. The majority of scientific works demonstrates the increased rate of transit in the proximal intestine, the increase of the intestinal wall contractility with the reduced transit in the distal intestine in case of obesity as well as the increased intestinal wall permeability and its inflammation. The material being accumulated proves the role of obesity in the development of IBS, IBD, polyposis and colorectal cancer. Key words: obesity, motility, bowel disease, colon, children.
BRONCHOPULMONARY PATHOLOGY AMONG NIKEL INDUSTRY WORKERS:
DEVELOPMENT, DIAGNOSTICS AND CLINICAL MANIFESTATIONS V.V. Shilov, S.A. Syurin Northwest Public Health Research , Saint-Petersburg, Russia
Abstract Introduction. The working conditions at the nickel industry enterprises create an increased risk of chronic bronchopulmonary diseases (CBPD). The purpose of the study was to examine risk factors, features of development, clinical and functional manifestations of CBPD of 1718 nickel industry employees. Results. It was found that almost a fifth of those surveyed have clinically formed CBPD, and still another fifth of workers is at risk of forming CBPD. It is important that the development of CBPD in nickel industry workers is caused by hazardous working conditions (chronic bronchitis, toxic pulmonary fibrosis) as well as by smoking (chronic bronchitis, chronic obstructive pulmonary disease). The most prevalent CBPD are chronic bronchitis (10.6%) and toxic pulmonary fibrosis (4.7%) while chronic obstructive pulmonary disease and asthma have the poorest prognosis. Conclusion. It is concluded that despite objectively existing difficulties, there are sufficient opportunities for the diagnosis of early forms of CBPD followed by timely implementation of preventive and rehabilitative measures. Key words: chronic bronchopulmonary diseases, diagnosis, prevention, nickel industry workers.
THE STROMAL FIBROBLASTS FEATURES AND THEIR RELATIONSHIP WITH THE INVASIVENESS AND EPITHELIAL-MESENCHYMAL TRANSITION OF THE MAIN HISTOLOGICAL TYPES OF GASTRIC CANCER I.V. Vasilenko, R. B. Kondratiuk, K.V. Poliakov, E.M. Bakurova Donetsk National Medical University named after M. Gorky, Donetsk, Ukraine
Abstract Purpose: to evaluate the relationship between the frequency and fullness of epithelial-mesenchymal transition (EMT), tumor invasion and features of stromal component in tumors of different gastric cancer types. Materials and methods: The research of individual tumor properties were examined by means immunohistochemical method in 69 cases of different gastric cancer types by the epithelial markers (AE1/AE3, CK18, HMW), a connective tissue marker (vimentin), smooth muscle (αSMA) and desmin. The tissue sections staining was used by hematoxylin and eosin, by Van Gieson, by Alcian blue at pH 2.5 and at pH 1.0. The tumor-promoting abilities were compared with changes of two distinct carcinoma-associated fibroblast subtypes ratio. The subtype I of cancer-associated fibroblasts (CAF) was detected by alcianophilia registration at pH 2.5. The CAF II subtype was determined by the expression of both vimentin and αSMA. Results: the analysis of vascular invasion frequency in the group with different ratios of CAF I and CAF II in diffuse gastric cancer showed the increase of invasiveness along with the increase of CAF II (from the group with a predominance of CAF I – 75% to the group with equal quantity – 87,5% to the group with a predominance of CAF II – 100%). In the mixed type gastric cancer in the groups with a predominance of one of the CAF type a 100% vascular invasion was noted. However, we demonstrated that in predominance CAF II in the group in the mixed type tumors and in the tumors of intestinal type the full EMT was indicated. Conclusion: the subtypes of stromal fibroblasts can determinate the features of EMT and vascular invasion in the main histological types of gastric cancer. Key words: gastric cancer, epithelial-mesenchymal transition, fibroblasts.
FORECAST AND PREVENTION OF LOCAL INFECTIONS COMPLICATIONS
FOR A HIP AND KNEE ARTHROPLASTY (THE SCIENTIFIC REVIEW) A.N.Tkachenko, L.A.Matveev, Yu.L.Dorofeev, A.V. Alkaz North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia
Abstract
At the any hospital a risk of developing of infectious complications on the area of surgical intervention after hip and knee arthroplasty remains. Despite the implementation of strict aseptic and antiseptic rules as well as the existence of modern operating theatres, it is practically impossible to avoid bacterial contamination of the area of surgical intervention during arthroplasty. Thus forecast and prevention of this kind of complication is on agenda for medical science and practice. In recent years, mathematical modeling systems of course and outcomes of therapeutic profile diseases as well as surgical pathology have become a part of everyday life. Significance of creation of such system for forecast and prevention of postoperative complications in hip and knee arthroplasty is great. Presented literature overview allows navigating in the today’s state of the problem. Key words: hip replacement, knee replacement, suppuration, forecast, prevention.
DIAGNOSIS AND SURGICAL TREATMENT OF DUODENUM AORTO-MESENTERIC COMPRESSION V.P. Zemlyanoy, B.V. Sigua, N.V. Semenov, A.V. Nikiforenko, P.A. Kotkov, D.V. Gurzhiy North-Western State Medical University named after I.I. Mechnikov», Saint-Petersburg, Russia
Abstract Introduction: the superior mesenteric artery syndrome is an uncommon pathological condition, characterized by compression of the horizontal part of the duodenum between the abdominal part of aorta and superior mesenteric artery. Usually, the syndrome is accompanied by the development of organic changes in the duodenum, whereby the surgical treatment of the disease most often means the exclusion of duodenum from the chyme passage. Purpose: to evaluate possibilities of the surgical treatment of superior mesenteric artery syndrome. Materials and methods: a retrospective analysis of clinical case of the superior mesenteric artery syndrome. Results: a described clinical case was a result of visceroptosis as a consequence of rapid weight loss. Robinson operation was elected as the best anatomic option for surgical treatment of superior mesenteric artery syndrome. Conclusion: Early diagnosis and treatment in the absence of severe organic changes from the upper gastrointestinal tract allow to get good results in these group of patients. Key words: aorto-mesenteric compression, superior mesenteric artery syndrome.
THE CAPABILITIES OF COMPUTED TOMOGRAPHY IN PATIENTS WITH COPD IN CASE OF THEIR FIRST VISIT TO A PULMONOLOGIST N.V. Bagisheva 1, E.R. Idrisov 1, A.V. Mordyk 1, D.A. Sulim 2, ZH.Z. Ilchenko 3, O.V. Koroleva 3 1 Omsk State Medical University, Ministry of Health of the Russian Federation, Omsk, Russia 2Emergency Hospital № 1, Omsk, Russia 3City polyclinic № 2, Omsk, Russia Abstract Scientific relevance: chronic obstructive pulmonary disease (COPD) with the increase in the number of primary incidence and prevalence is a topical problem of modern health care. Purpose: To provide a quantitative and qualitative characteristic of the changes in lung MSCT in patients with chronic obstructive pulmonary disease for determining its capabilities and its role in the differential diagnosis. Materials and methods: analysis of clinical and radiological pattern of 105 patients with COPD, in case of their first visit to a pulmonologist. The average age is 62 ± 7,8 years, men – 84,7%, women – 15.3% active smokers – 94.3%. Results: in the course of follow-up examination mild COPD was diagnosed in 10% of patients, medium one – in 30%, severe – in 46%, extremely severe – in 14% of patients. Whith the application of MSCT WGC emphysematous changes in lung tissue were detected in 52.3% of cases, changes of the bronchial tree of the type of chronic bronchitis – in 76.2%, bronchiectasis – in 10.5%. General pathology in the form of single and multiple focal shadows was detected in 60%, cavitary lesion – in 3.81% of patients, mass leison – in 1.9% and intrathoracic lymphadenopathy – in 9.5% of patients. Conclusion: in the presence of high prevalence of tuberculosis and cancer pathology in patients with COPD MSCT WGC should be performed to exclude alternative pathology and determination of the disease phenotype. Key words: chronic obstructive pulmonary disease, multispiral computed tomography, focal leison, tuberculosis.
THE FEATURES OF HEMORRHAGIC SYNDROME AND INDICATORS OF THROMBOELASTOGRAPHY AMONG PATIENTS WITH CHRONIC MYELOID LEUKEMIA O.V. Efremova, A.N. Mamaev, V.A. Elykomov, D.E. Belozerov The Altay Regional Clinical Hospital, Barnaul, Russia Abstract Introduction. Certainly any hemorrhages are able to form a lot of problems for any patients. The hemorrhagic syndrome in patients with chronic myeloid leukemia (CML) is discussed in the research work. The purpose of the research study – determination of frequency, prevalence, localization of hemorrhagic syndrome in patients with CML and to detect any thromboelastogramm changes in the patients. Methods. We examined 99 patients with CML. All patients with CML were treated with the tyrosine-kinase inhibitors. We used thromboelastography (TEG) to detect any hemostasis disturbances in the patients. Results. The number of patients who had any hemorrhages was 56%. We discovered the number of patients with hemorrhagic tendency was higher than frequency of thrombocytopenia in the group. Using TEG we revealed the blood coagulation defects
in the patients. The blood coagulation defects were characterized the changes of MCF and CFT. Conclusion: The hemorrhagic syndrome accompanies patients with CML who treated tyrosine-kinase inhibitors. Thrombocytopenia is not always the only reason of a hemorrhagic syndrome in patients with CML who were treated tyrosinekinase inhibitors. TEG is able to reveal coagulation defects (MCF, CFT) in patients with CML who were treated with the tyrosine-kinase inhibitors Kеy words: chronic myeloid leukemia, tyrosine-kinase inhibitors, hemorrhages, hemostasis, thromboelastography.
THE FUNCTIONAL ACTIVITY OF ENERGY PRODUCING SYSTEM OF MYOCARDIUM AFTER GENERAL VIBRATION EXPOSURE V.V. Vorobieva 1, P.D. Shabanov 2 1 North-western State Medical University named after I.I.Mechnikov, St.Petersburg, Russia 2 Military Medical Academy, St.Petersburg, Russia
Abstract
The purpose of the paper was to study the activity of energy producing system of the rabbit myocardium after exposure of different regimens of general vibration. The energy dependent reactions of native mitochondria was investigated in rabbits by means of polarographic method using Clark’s closed membrane electrode. The changes in functional activity of mitochondria depended on the regimens of general vibration (frequency and duration) and manifestated with imbalance between functional activity of FAD- and NAD-depended chains of cell breath. The increase of frequency and duration of vibration was accompanied with disfunction of energy producing system of myocardium like low energetic shift with activation of succinate oxidation and inhibition of NAD-depended chain of mitochondria breath. Therefore, the general vibration can be used as a model both for studying vibration phenomena on the level of energy producing systems of tissues and organs and for assessment of vibroprotective properties of drugs. Key words: vibration, mitochondria, energy metabolism of myocardium, low energetic shift.
FEBRILE SEIZURES AMONG CHILDREN: THEORETICAL AND PRACTICAL ASPECTS (THE SCIENTIFIC REVIEW) Sh.B. Kurbanova, G.K. Sadikova, Sh.A. Kudratov Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
Abstract
The article reviewed the literature data on the subject of febrile seizures. We have thoroughly analyzed the causes of development, peculiarities of clinical manifestations, diagnosis and therapy of febrile seizures. Despite extensive study of this problem still remain many controversial issues regarding the treatment of febrile seizures. Thus, the solution of these issues is a priority. Key words: febrile seizures, afebrile seizures, electroencephalography, anticonvulsant therapy.
CENTRAL AORTIC PRESSURE AND VASCULAR STIFFNESS: GENDER FEATURES RELATIONSHIP WITH CARDIOVASCULAR RISK FACTORS A.G. Polupanov 1, 2, Zh.A. Mamasaidov 1, Ju.N. Geleskhanova 2, D.B. Alimbekova 2, T.A. Romanova 2 1 Kyrgyz-Russian Slavic University named after B.N. Yeltsin, Bishkek, Kyrgyz Republic 2 National of Cardiology and Therapy named after academician M. Mirrahimov, Bishkek, Kyrgyz Republic Abstract Purpose: the study of gender-specific relationship between cardiovascular risk factors and the parameters of arterial system stiffness in patients with essential hypertension (EH). Material and Methods: the study involved 155 patients with EH aged 30-70 years. A physical examination, determination of glucose, creatinine, and lipid (lipid levels low and high density, triglycerides), duplex scanning of carotid arterial stiffness by the means of the pulse wave contour analysis. Results: women reflection index value was significantly higher than in men. At the same time in women only central blood pressure correlated with the level of peripheral blood pressure and BMI. Significant correlations augmentation index with cardiovascular risk factors in this group were not observed. On the contrary, in men with hypertension with cardiovascular risk factors, mainly the value of augmentation index correlated. Key words: essential hypertension, risk factors, vascular stiffness, augmentation index.
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