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PREVENTIVE MEDICINE
HEALTH CARE-ASSOCIATED INFECTIONS RISK MANAGEMENT - THE CASE OF MOSCOW E.E. Andreeva Moscow Department of Federal Service for Supervision of Consumer Rights Protection and Human Welfare. Russia, 129626, Moscow, Grafsky lane, 4/9, Abstract
The problem of infections prevention when delivering health care against the background of health care modernization is of particular relevance. The increased use of limited material resources of health care leads to the emergence of new epidemiological risks. Health care-associated infections risk management should reduce the likelihood of health damage to patients and staff and minimize the economic costs of infections prevention when delivering health care. Risk reduction must be achieved by eliminating the conditions for the implementation of risk scenarios, including the optimization of medical care and also the system carrying out sanitary and anti-epidemic (preventive) measures. Key words: risk management, medical care safety, health care-associated infections.
CHILD AND ADOLESCENT OBESITY PREVALENCE IN ST. PETERSBURG T.M. Chirkina, B.I. Aslanov, TA. Dushenkova, S.V. Rischuk Federal State budget institution of higher education "Northwest State Medical University named after I.I. Mechnikov" of the Russian Federation Ministry of Health, Russia, 191015, St. Petersburg, ul. Kirochnaya, d. 41. Abstract Introduction. Obesity in children and adolescents is one of the important issues of modern pediatric healthcare. Complications of obesity and concomitant diseases affect the functional state of the body's systems. The study of epidemiology of children obesity is important for the prevention of diseases and complications arising in the future as a result of obesity. Objectives. This study aimed to evaluate the prevalence and gender features of excess weight and obesity in adolescents in St. Petersburg. Materials and methods. The study included 1030 children at the age of 0-17 years (512 boys and 518 girls). Anthropometric examination was performed by standard methods with detection of the body mass index (BMI). Medical examinations data obtained in 2012 were compared with the data collected in 2015. Results. Average values of prevalence of obesity in preschoolers and schoolchildren amount to 36,9% in boys and 37,5% in girls. The prevalence is highest in 10-14-year-old boys in 2012 and 2015 (46,6% and 46,0% respectively), and in girls of 5-9-year-old in 2012 and 5-9 and 10-14-year-old in 2015 (65,1%, 37,7% and 37,8% respectively). Conclusions. Obesity is fairly common among children and adolescents, it depends on the age and gender. Obesity can be detected in young children. It leads to necessity of timely preventing and treating obesity, starting from early childhood. In the absence of early diagnosis and correction, the developing complications of obesity persist later in adult age and lead to early invalidation and decrease in life expectancy. Key words: overweight, obesity, children, adolescents.
SOCIAL - HYGIENIC CHARACTERISTIC OF HEALTH- SAVING BEHAVIOR OF CHILDREN AND ADOLESCENTS
A.V. Suvorova, I.Sh. Iakubova Federal state budget institution of higher education «North - Western State Medical University named after I.I. Mechnikov» of the Ministry of Public Health of the Russian Federation, Russia, 191015, Saint-Petersburg, Kirochnaya ul. 41. Phone: 8(812) 303-50-00, Abstract Purpose: assessment of the principles of formation of health – saving behavior in children and adolescents to search for the means directed on formation of motivation of a healthy lifestyle. Material and methods: The study included 638 children and adolescents of 9 – 18 years (average age was 13,9±2,4 years) from 6 schools in St. Petersburg. Was used a specially designed questionnaire, proposed by Professor Mr. H.P. Brandl-Bredenbek of Sport University of Cologne, in which each pupil answered 109 questions on various aspects of his lifestyle. Questions in the questionnaire grouped into 6 main sections: questions about physical education and sports, family and home, about nutrition, about the TV, computer and game consoles, school marks for the last year and «assess yourself». The study was conducted in accordance with international recommendations HBSC «Health Behaviour in School-Aged Children». Results and conclusions. The study established some positive elements of the health - saving behavior of children and adolescents. However, elementary hygiene skills, suitable for each age group, were not secured by more than half of the pupils: execution of daily regime, walks in the open air, a skill to alternate a mental and physical load, adequate physical activity, regular and rational nutrition. It was found that the quality of the application of these skills decreases as children get older. Keywords: children, adolescents, health - saving behavior, healthy lifestyle, self-concept, needs, motivation, prevention; actions for the conservation of health.
SURGICAL SITE INFECTIONS IN PEDIATRIC SURGERY AND ANTIMICROBIAL PROPHYLAXIS
A.A. Malashenko1,2, B.I.Aslanov1, V.Y.Detkov2 1State budget institution of higher education “North-Western State Medical University named after I.I Mechnikov” under the Ministry of Public Health of the Russian Federation. Russia, 191015, Saint-Petersburg, Kirochnaya st., 41 2State budget institution of Public Health Rauhfus Children's City Hospital № 19, , Russia, 193036, Saint-Petersburg,Ligovsky Prospekt, 8 Abstract. Purpose. The present study aimed to evaluate the occurrence of surgical site infections (SSI) in pediatric surgery and efficacy of antibiotic prophylaxis (AP) in pediatric patients. Methods.The study was conducted in Saint-Petersburg Children's hospital №19 during the period from December 2011 to December 2013 and included retrospective data on 5239 surgical procedures. The data were collected by means of medical records review and different survey questionnaires. We used CDC standard definitions to evaluate the incidence of SSI, the fact and the quality (regimen) of the AP was also evaluated. The efficacy of AP was estimated in case-control study with 312 cases and 1064 controls. Results. During the study we revealed 218 cases of superficial incisional SSI (3.8 per 100 surgeries). No deep incisional SSI or organ/space SSI were registered during the study period. In the case-control study 53 patients in the "cases" group and 514 patients in the “controls” group received AP. The odds ratio was 0.22 (95% CI= 0,16-0,30), which demonstrated high effectiveness of the AP. Conclusion. The study revealed that the SSI incidence 3.8% in pediatric surgery is much higher than the official data. It requires implementation of high-quality epidemiological surveillance of SSI and effective prevention measures. The results of the study demonstrate that AP is an effective method of prevention of SSI in pediatric surgery. Key words: surgical site infection, pediatric surgery, antibiotic prophylaxis.
FEATURES OF PSYCHOPHYSIOLOGICAL ADAPTATION OF STUDENTS
V. I. Nikolaev, O. S. Bulgakova, E. A. Belogurova, I. V. Budnikova, M. D. Denysenko, N. P. Denisenko North-Western state medical University by I. I. Mechnikov (Russia, 195067, Saint-Petersburg, Piskarevsky prospect, 47 Abstract The aim of the research: The article deals with the social and information prevention of maladaptation of today's youth. Materials and methods: In the group of students of 18 people was used an innovative method of teaching "active". Results: It is shown that as a result of students decreases anxiety in public performance; increasing the motivation to obtain information; increased interest, activity and attention in class; the formation of healthy competition among the students of the group; increase self-esteem, understanding of their problems, as a subject of activity. Applying the method of "active intellectual game" is a measure to prevent the breakdown of adaptive defense mechanisms among students, mediated by the voltage of the external social and information environment. Keywords: students, stress management, social exclusion, information exclusion, active learning methods.
EPIDEMIOLOGICAL SITUATION OF HYDATID ECHINOCOCCOSIS IN KARACHAY-CHERKESSIA
K. Kh. Bolatchiev1, L.A. Ermakova2, N.Y. Pshenichnaya2,3, В.A. Khapaev1, T.I. Tverdochlebova2 1Federal state budget institution of higher education “North-Caucasian State Humanitarian and Technological Academy”. Russia, 369000, Cherkessk, Stavropolskaya st., 36. 2Federal State Scientific Institution “Rostov-on-Don Research Institute of Microbiology and Parasitology of the Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing”. Russia, 344000, Rostov-on-Don, Gazetny str., 119. 3Federal state budget institution of higher education “Rostov State Medical University” of the Ministry of Health of the Russian Federation. Russia, Rostov-on-Don.
Abstract Purpose. This study aimed to evaluate epidemiological situation of hydatid echinococcosis in Karachay-Cherkessia Republic (KChR) in order to improve the epidemiological surveillance for this disease. Methods. Over the period from 2000 to 2014, echinococcosis incidence in KChR was evaluated. We analyzed 286 records of epidemiological investigation of echinococcosis. 120 medical records of hospitalized patients with echinococcosis. 130 dog fecal samples were analyzed. Results. The persistence of synanthropic foci of hydatid echinococcosis existing on the territory of KChR provided by climatic features of the region and a number of socio-economic factors, as well as national traditions of the local population. Multilevel analysis carried out in the study of archival materials of Rospotrebnadzor institutions, veterinary services, primary medical records, official statistics for the period of fifteen years has allowed estimate priority features of epidemic process of echinococcosis in the territory and to determine the main factors contributing to the spread of the disease among the population. Conclusion. Stratification of KChR by type of epidemic threat was conducted with applying the average long-term morbidity on the map of the echinococcosis foci; it allowed to confirm the migration of echinococcosis outside the rural areas. Due to the improvement and introduction of preventive measures, the incidence of hydatid echinococcosis in the human population of KChR in 2015 decreased to 2.1 per 100 000 population compared to 5.4 in 2006. Keywords: hydatid echinococcosis, synanthropic foci, stratification of territory.
PREVALENCE OF ANTIMICROBIAL RESISTANCE IN K.PNEUMONIAE AND E.COLI
Y.S.Svetlichnaya1,3, S.A. Egorova2, M.А. Makarova2, L.A. Kornoukhova5, M.G.Daryina1,2, E.N.Kolosovskaya1,4L.A.Kaftireva1,2. 1Federal State budget institution of higher education "Northwest State Medical University named after I.I. Mechnikov" of the Russian Federation Ministry of Health, Russia, 191015, St. Petersburg, ul. Kirochnaya, d. 41. 2Federal Budget Institution of Science "St. Petersburg Research Institute of Epidemiology and Microbiology. Pasteur "Federal Service for Supervision of Consumer Rights Protection and Human Welfare. Russia, 197101, St. Petersburg, ul. Mira. 14. 3State budget health care institution "Medical Information and Analytical ", Russia, 198095, St. Petersburg, ul. Shkapina, d. 30 4Federal State Educational Institution of Higher Military Education, "Military Medical Academy named after SM Kirov »Russian Federation Ministry of Defense. Russia, 194044, St. Petersburg, ul. Akademika Lebedeva, d. 6 References. J. 5Closed Joint Stock Company "North-West of evidence-based medicine", Russia, 197046, St. Petersburg, Peter nab., D. 4, office. 3 Abstract Relevance. The most important problem of public health is the steady increasing in the number of infections caused by resistant pathogens. Purpose. This study aimed to evaluate the prevalence of antimicrobial resistance in K.pneumoniae and E.coli isolated in Intensive Care Unit of the multidepartment hospital. Materials and methods. Bacteriological methods were used to study the resistance phenotypes and resistance mechanisms in Enterobacteriacae. Results. Strains isolated as “nosocomial pathogens” and community acquired strains characterized by multiple antimicrobial resistance, identical resistance phenotypes and common beta-lactam resistance mechanisms. Conclusion. Emergence of resistance and selection of resistant clones are due to the common mechanisms inherent in a certain species of microorganisms. Key words: nosocomial infection, resistance profiles, resistance mechanisms
CLINICAL MEDICINE
EXAMINATION OF PROTEIN ACTIVITY REGULATING APOPTOSIS IN CHILDREN WITH HEREDITARY AND ACQUIRED DISEASES OF THE NERVOUS SYSTEM
M.G. Sokolova1, S.V. Lobzin1, I.V. Litvinenko2, M.V. Rezvantsev2 1Federal state budget institution of higher education “North-Western State Medical University named after I.I Mechnikov” under the Ministry of Public Health of the Russian Federation, 191015, St. Petersburg, Kirochnaya street, 41. 2 Federal state budget military institution of higher education Military Medical Academy named after S.M. Kirov under the Ministry of Defence of the Russian Federation, Russia, 194044, St. Petersburg, Academiсian Lebedev Street, 6. Abstract Purpose: Determination of the activity of proteins regulating apoptosis: Bcl-2 and p53 in children with hereditary and acquired diseases of the nervous system, comparison of the results with data of the clinical and neurological and neurophysiological researches. Materials and methods: Was conducted clinical, neurophysiological (ENMG or EEG) and laboratory examination of 85 children with hereditary and acquired disorders of the nervous system. Determination of Bcl2 and p53 protein levels was performed by an immunoenzyme method in serum. Statistical analysis was performed using STATISTICA 8.0 package (StatSoft®, Inc., USA). Results. Conducted clinical and laboratory examination of 85 children with hereditary and acquired disorders of the nervous system has revealed that there are statistically significant differences in the concentration of p53 and Bcl2 proteins in comparison with the control group. No specificity was revealed in the content of p53 and Bcl2 proteins in serum by type, severity, and the genesis of the CNS lesions. However, it was found out that p53 and Bcl2 protein concentration was significantly (p < 0.001) higher in patients with the pathological neuronal excitability according to neurophysiological studies result (EEG, ENMG). Epileptiform EEG changes in children from the 1st group and pathological potentials (fibrillation, acute waves) identified by electroneuromyography examinations in children from the 2nd group were associated with high concentrations of p53 and Bcl2 proteins. Conclusion. The above data shows a high activity of apoptotic protein p53 and anti-apoptotic protein Bcl2 in children with severe diseases of the nervous system. Thus, it is possible to use the concentration of p53 and Bcl2 proteins in the blood serum of children with lesions of the nervous system as markers of a pathological process which is accompanied by a change in the functional activity of the central nervous system. Further research of these proteins will allow using them for the selection of pathogenic personalized treatment for children with severe cerebral palsy and hereditary diseases of the nervous system. Кey words: children with cerebral palsy, neurodegenerative diseases in children, blood serum, protein Bcl-2, protein р53, immunoenzyme method.
RISK CIRCUMSTANCES OF HEMODYNAMIC INSTABILITY AMONG PATIENTS WITH GENERALIZED ATHEROSCLEROSIS DURING THE PERIOPERATIVE PERIOD.
N.I. Glushkov, M.A. Ivanov, A.V. Kebriakov, N.S. Kopliarova, M.A. Strizhonok, P.B. Bondarenko State budget institution of higher education “North-Western State Medical University named after I.I Mechnikov” under the Ministry of Public health of the Russian federation. Russia, 191015, Saint-Petersburg, Kirochnaya str., 41.
Abstract Introduction. Study of predictors of hemodynamic instability and ways of its assessment is significant for preventing complications in the postoperative period. Materials and methods. On the first day after the surgery on magistral arteries 130 patients were divided into 2 groups. Patients with corrected hemodynamics made up the main group (n=69). In the control group (n=61) no medical correction required. Changes of blood pressure were assessed according to the systolic blood pressure variability. Result. Type 2 diabetes mellitus with duration of more than 3 years turned out to be a risk factor for blood pressure abnormalities, leveling the gender difference (p<0,05). Components of metabolic syndrome impair the cardiac rhythm (p<0,05). In case of systolic blood pressure variability of 20 mm Hg and more, in 76% blood pressure correction is applied (p=0,05). 86,4% of complications (17 in total) and 72,7% of fatal cases (12 in total) occurred with systolic blood pressure variability more than 20 mm Hg (p<0,05). Conclusions. Type 2 diabetes mellitus and metabolic syndrome should be referred to the risk circumstances of hemodynamic instability. High level of systolic blood pressure variability enhances risk of developing adverse cardiovascular events. Key words: adverse cardiovascular events, hemodynamic instability, perioperative period, generalized atherosclerosis, systolic blood pressure variability, metabolic syndrome.
BARRETT’S ESOPHAGUS DIAGNOSTICS AND TREATMENT AS A METHOD TO PREVENT ESOPHAGUS ADENOCARCINOMA (SCIENTIFIC REVIEW) K.V. Arutyunyan 1, M.D. Ter-Ovanesov 2, K.G. Shostka 1, L.D. Roman1 1 State Budgetary Healthcare Institution "Leningrad Regional Oncological Dispensary", Russia, 191014, St.-Petersburg, Liteyny Prospect, 37
2 Federal State Institution Russian National Research Medical University named after N.I. Pirogov, Deputy chief Surgeon and Oncologist of the medical unit City clinical oncological hospital №40, chief scientific officer of Dmitry Rogachev Federal Research of Pediatric Hematology, Oncology and Immunology, Russia, 129301, Moscow, Kasatkina Str., 7 Abstract.
Treating patients with esophageal cancer remains one of the challenges for clinical oncology. Squamous cell carcinoma has long been considered as the most common morphological structure of esophageal cancer. However over the last decades there has been a dramatic increase in the incidence of esophagus adenocarcinoma and of esophagogastric junction in particular. It determines the necessity to define etio-pathogenetic factors of suchlike epidemiological changes and to study prognostic and predictive factors in combined and complex therapy of such patients. Barrett's esophagus is a precancerous background of esophagus adenocarcinoma and is considered by some scientists as an obligate precancer. This article is devoted to the modern methods of diagnostics, screening and treatment of Barrett's esophagus to prevent the development of esophageal adenocarcinoma. Key words: esophagus adenocarcinoma, Barrett's esophagus, Barrett’s esophagus diagnostics, Barrett’s esophagus treatment, lower third esophagus cancer.
THE ASSOCIATION OF LIPID SPECTRUM WITH THE ESR1 GENE POLYMORPHISM IN POSTMENOPAUSAL WOMEN WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS
1 Kharkiv National Medical University. Ukraine, 61022, Kharkiv, Nauky ave, 4 2 Kharkiv Specialized of Medical Genetics. Ukraine, 61058, Kharkiv, Pravdy ave, 13
Abstract. The purpose of the research was to determine the relationship between the level of serum lipids and polymorphism of the estrogen alpha receptor gene (ESR1) in postmenopausal women with hypertension and type 2 diabetes mellitus. Materials and methods. A total of 137 caucasian women residing in the territory of Kharkiv city and Kharkiv region were examined. Women were receiving an inpatient treatment at endocrinology and cardiology units of "Regional Clinical Hospital - for emergency medical care and disaster medicine" in Kharkiv. Patients were divided into the following groups: 1st - patients with type 2 diabetes mellitus (n = 30), 2nd - patients with arterial hypertension, grade 2-3 (n = 34), 3rd – comorbid hypertension of grade 2-3 and type 2 diabetes (n=42). The control group included 31 women in early natural menopause, which had normal blood pressure, glycated hemoglobin (HbA1c) level below 6% and absent endocrine diseases. The age of examined patients varied between 45 and 60 years.
The following indexes were measured to study the lipid profile: triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C). Using polymerase chain reaction (PCR) was determined ESR1 gene T397C polymorphism in DNA samples. Identification of polymorphisms led to three types of conclusions: normal homozygotes (TT), heterozygotes (TC) and homozygous mutation (CC). Results. Our research has shown that the presence of diabetes might contribute to the worsening of the blood lipid profile in postmenopausal patients.The changes of blood lipid profile were associated with predominance of heterozygous TC genotypes of ESR1 gene in postmenopausal patients. Postmenopausal women either with hypertension alone or with comorbid course of hypertension and type 2 diabetes are characterized by significant predominance of heterozygous TC polymorphism T397C of ESR1 gene. Also, these patients have more pronounced changes of the lipid profile. Conclusions. According to the results of our study, we proposed a marker for targeted prevention of cardiovascular disease in postmenopausal women, which is the identification of heterozygous TC genotype T397C polymorphism of ESR1 gene against the background of marked lipid profile changes. Key words: gene polymorphism, lipid profile, diabetes mellitus, arterial hypertension, postmenopause.
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