Hygienic and epidemiological aspects of the formation of competencies within the framework of an increased group of specialties and areas of training 32.00.00 Health sciences and preventive medicine
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
Analysis of the production load of medical equipment used in medical rehabilitation departments for the rehabilitation of patients with degenerative disc diseases
Kreneva Yu.A., Avdeeva M.V., Panov V.P. 63
Timekeeping of working time as a means of evaluating the effectiveness of the labor activity of nurses providing assistance in the PHC system
Pchelina N.V., Pozdeeva T.V. 73
General analysis of the results of sociological studies on the prevalence of risk factors for the development of chronic non-infectious diseases in students of the Voronezh state medical university named after N.N. Burdenko. for the academic year (september 2022- may 2023)
Kochetkova I.V., Fursova E.A., Zolotareva Y.A. 80
CLINICAL LABORATORY DIAGNOSTICS
Сalculated indicators of neutrophil/ platelet/ basophil/ eosinophil-to-lymphocyte ratios as biomarkers of immune inflammation (review)
Mikryukova N.V., Kalinina N.M. 86
Anticoagulant activity of rivaroxaban and apixaban in traumatological patients
Gaikovaya L.B., Zamyatina K.N. 92
Characteristics of erythrocyte indices in pre-school children of the Republic of Sakha (Yakutia)
Stepanova L.A., Marinova L.G., Roeva D.E 98
TO AUTHORS ATTENTION
HYGIENE
HYGIENIC AND EPIDEMIOLOGICAL ASPECTS OF THE FORMATION OF COMPETENCIES WITHIN THE FRAMEWORK OF AN INCREASED GROUP OF SPECIALTIES AND AREAS OF TRAINING 32.00.00 HEALTH SCIENCES AND PREVENTIVE MEDICINE
A.V. Meltser1, А.А. Pronina2,3, N.V. Erastova 1, Т.I. Aristova2, A.N. Pavlova1, Т.Yu. Pilkova1 1 North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 2 Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing. Russia 127944, Moscow, Vadkovsky lane, 18, buildings 5 and 7 3 Russian Medical Academy of Continuous Professional Education. Russia 125993, Moscow, Barrikadnaya street, 2/1, building 1
Abstract Introduction. The federal educational and methodological association for enlarged groups of specialties and areas of training 32.00.00 Health Sciences and Preventive Medicine in 2023 it were developed drafts of federal state educational standards for higher education of the new generation in the specialty 32.05.01 Preventive medicine care and areas of training 32.04.01 Public health. Materials and Methods. It was analyzed federal state educational standards of higher education: specialty in the areas of training 32.05.01 Рreventive medicine care, 31.05.01 General medicine and 31.05.02 Pediatrics, master's degree in the areas of training 32.04.01 Public health. Scientific literature, organizational and regulatory documents on the activities of preventive medicine doctors were analyzed. Results. The novel drafts of federal state educational standards of higher education for the specialty program in the field of training 32.05.01 Рreventive medicine care and master's degrees in the field of training 32.04.01 Public health are based on the current federal state educational standards of higher education, updated taking into account current documentation and requirements of contemporary labor market. Within the drafts of federal state educational standards professional competencies are not provided. Taking this into account, the federal educational and methodological association for enlarged groups of specialties and areas of training 32.00.00 Health Sciences and Preventive Medicine has developed and proposed professional competencies recommended for the implementation of basic professional educational programs. Conclusion. It seems appropriate to return mandatory unified professional competencies to educational programs aimed at training medical personnel and healthcare system specialists. Key words: preventive medicine care; public health; training of medical specialists; competencies; professional competencies; federal state sanitary and epidemiological supervision; Rospotrebnadzor; sanitary and epidemiological well-being; health promotion (improve health).
ASSESSMENT OF BLOOD LIPID SPECTRUM AND DYSLIPIDAEMIAS IN WORKERS WITH DIFFERENT LENGTH OF STAY IN RUSSIA'S ARCTIC ZONE
R.S. Rakhmanov1, D.A. Narutdinov2, E.S. Bogomolova1, S.A. Razgulin1, A.V. Istomin3, N.N. Potekhina1 1Privolzhsky Research Medical University. Russia, 603950, Nizhny Novgorod, Minin and Pozharsky square, 10/1 2 Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky. Russia, 660022, Krasnoyarsk, Partizana Zheleznyaka street, 1 3Federal Scientific Center of Hygiene named after.F.F.Erisman. Russia, 141000, Mytishchi, Semashko street, 2
Abstract Introduction. Adaptation to the conditions of the North leads to dyslipidemia. The aim of the study was to assess the blood lipid spectrum and the type of dyslipidemia in men with different length of work in the Arctic region. Material and methods. It was analyzed lipid profiles of men working in the Arctic and Subarctic regions up to 5 (nn= 18 and 28) and up to 10 (nn= 30 and 26) years, aged 35.7±0.6 and 34.2±0.9 years (p=0.156). As well as living and working conditions were studied. Results. In the Arctic region, life and food was organized; in the Subarctic region, life and food was homemade; work is hard (3.3) and intense (3.2), as well as acceptable (2) and intense (3.2). In the Arctic region, lipids in mmol/l: triglycerides 1.81±0.05 and 1.67±0.04 (p=0.04), total cholesterol - 6.53±0.17 and 6.34±0.12 (p=0.33), lipoproteins: low 4.2±0.16 and 4.31±0.11 (p=0.056) and high 1.65±0.08 and 1.22±0.05 (p=0.001) density.
The atherogenicity index 2 was 3.07±0.14 and 4.37±0.21 (p=0.001).In the Subarctic region, triglycerides were 1.33±0.1 and 1.72±0.3 (p=0.216), total cholesterol 5.04±0.19 and 5.42±0.18 (p=0.152), lipoproteins: low 4.13±0.12 and 3.64±0.03 (p=0.007) and high (1.11±0.04 and 1.09±0.04 (p=0.758) density. Atherogenic coefficient 3.7±0.17 and 4.32±0.2 (p=0.035).
In the subgroup under 5 years of work experience in the Arctic region, hypercholesterolemia and mixed dyslipidemia were detected in 95.5% (77.3% - compensated); in the Subarctic region, mixed hypercholesterolemia was detected in 66.8% (compensated in 33.3%, decompensated in 33.4%), atherogenic dyslipidemia in 16.6% and decreased HDL in 8.3%.
In the subgroup under 10 years of work experience in the Arctic region, hypercholesterolemia and mixed dyslipidemia were found in 100.0% (compensated in 39.0%, decompensated in 6.7%), in the Subarctic region hypercholesterolemia, mixed in 83.3% (compensated in 33.3%, decompensated – in 16.7%) and atherogenic dyslipidemia in 16.7%. Conclusion. The adaptive capacity of the organism in the Subarctic region was lower. Lipids assessment in workers of the Arctic zone is necessary during each medical examination. Key words: Arctic, Subarctic, dyslipidemia and types, length of work.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
Combination of radiotherapy and chemoradiotherapy with immunotherapy for locally advanced and metastatic non-small cell lung cancer (REVIEW)
A.I. Arseniev1,2, S.N. Novikov1, A.O. Nefedov3, E.A. Arseniev1, S.A. Tarkov1, Yu.S. Melnik1, R.V. Novikov1, A.Yu. Zozulya1, F.E. Antipov1, K.E. Gagua1 1National Medical Research Center of Oncology named after N.N. Petrov. Russia, 197758, Saint-Petersburg, Pesochny settelement, Leningradskaya street, 68 2 North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint-Petersburg, Kirochnaya street, 41 3 Saint-Petersburg State Research Institute of Phthisiopulmonology. Russia, 191036, Saint Petersburg, Ligovsky avenue, 2-4
Abstract
The literature review analyzes the possibility, efficacy and safety of combining radiation and chemoradiotherapy with immunotherapy for locally advanced non-small cell lung cancer. It has been shown that radioimmunotherapy results in an undoubted increase in survival rates, which has been proven by a number of prospective randomized studies and meta-analyses. In some patients, who have stopped responding to immunotherapy, radiation could provide a repeatable efficiency. The optimal modes of radioimmunotherapy and the mechanisms of their aditive and superadditive effects require further study. It was revealed that the combined use of immunotherapy and stereotactic irradiation of individual foci in metastatic non-small cell lung cancer significantly increases the frequency of objective responses without increasing toxicity. The areas of active randomized studies are dose-per-fraction intensification, adaptive irradiation with correction of radiation plans during treatment, the use of stereotactic boosts after the end of chemoradiotherapy and optimization of a combination of radiation and systemic treatment, including radioimmunotherapy. The results of radiation therapy could be improved by using modern high-tech equipment, planning systems upgrading, methods of summing up radiation doses, fractionation mode and optimization of combination with systemic treatment, including immunotherapy. Keywords: non-small cell lung cancer; radiation therapy, chemoradiotherapy, immunotherapy, radioimmunotherapy.
DIAGNOSIS AND SURGICAL TREATMENT OF PRIMARY MULTIPLE SYNCHRONOUS NEOPLASMS OF THE BREAST AND ABDOMEN
1Military Medical Academy named after SM Kirov. Russia, 194044, Saint-Petersburg, Akademika Lebedeva Street, 6, Lit. J 2 North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint-Petersburg, Kirochnaya street, 41
Abstract Introduction. Synchronous tumors of the chest and abdomen organs remain a serious clinical problem. With such tumor’slocalization, there is a high probability of misdiagnosis and the choice of the wrong therapeutic tactics. The aim of the study was to analyze the possibilities of diagnosis and surgical treatment of patients with primary multiple neoplasms of the chest and abdomen. Materials and methods. During 2002-2017, 79 patients with synchronous primary multiple neoplasms of the chest and abdomen were under supervision. The study included 72 men (91%) and 7 women (9%), the average age of patients was 59±5.7 years. Results. All patients were operated. Simultaneous operations to remove breast and abdominal tumors were performed in 44 patients (55%), two–stage sequential operations were performed in 35 (45%). According to the results of histological examination of the removed tumors, true polyneoplasia with lesions of the chest and abdomen was established in 40 cases, in 39 cases one of the tumors were metastatic in nature. The frequency of complications after simultaneous (11%) and consecutive (10%) operations did not differ significantly, and there were no differences in this indicator in primary multiple cancers and tumors with distant metastasis. The 5-year survival rates for primary multiple breast and abdominal cancers in the early stages did not significantly differ from those for isolated tumors of the same localization. Conclusions. Active surgical tactics are the key to reliable diagnosis of true polyneoplasias and tumors with distant metastasis. Surgical treatment of patients with primary multiple breast and abdominal cancers in the early stages allows to achieve favorable long-term results. Simultaneous operations for primary multiple tumors of the breast and abdomen are more preferable, since they shorten the length of stay of patients in the hospital and do not lead to an increase in the number of postoperative complications. Keywords:primary multiple cancer, oligometastatic disease, simultaneous surgery, survival.
CHILD FEEDING DURING THE FIRST YEAR OF LIFE LIVING IN THE BELGOROD REGION
M.M. Gurova 1,2,3, E.A. Procenko 4, E.A. Balakireva 1, T.A. Romanova 1, E.V. Podsvirova 1, A.I. Kirienko 5 1Belgorod State National Research University. Russia, 308015, Belgorod, Pobedy street,85 2Sаint-Petersburg State Pediatric University. Russia, 194100, Sаint-Petersburg, Litovskaya street, 2 3Clinical and Diagnostic Center for Children. Russia, 192289, Sаint-Petersburg, Oleko Dundicha street, 36, building 2 4Belgorod Regional Clinical Hospital of St. Joasaph. Russia, 308007, Belgorod, Nekrasova street, 8/9 5Children's Regional Clinical Hospital, Children's polyclinic 1. Russia, 308009, Belgorod, Popova street, 24A
Abstract Introduction. The article presents data characterizing the nutritional patterns of children during the first year of life living in the Belgorod region. The aim of the study was to analyze the compliance of the accepted practice of feeding children during the first year of life in the Belgorod region with the existing recommendations of the Union of Pediatricians of Russia. Materials and methods. It was conducted interviews with 348 women having children of the first two years of life born at 38-41 weeks of gestation; with an Apgar score of at least 8 points. It was developed a questionnaire allowing to provide a retrospective assessment of a woman’s nutritional habits during pregnancy, the duration of breastfeeding and the timing of the introduction of complementary foods. Results. It was revealed that only 48.3% of respondents during pregnancy adhered to the antenatal doctors’ recommendations for a balanced diet. The nutrition of children of the first year of life revealed the following features: cessation of breastfeeding before the child reaches the age of 3 months. - in 29.8% of cases, violation of the timing and rules of introducing complementary foods - in 22% and 52.7% of children, respectively, and the range of selected products. The source of information about complementary foods for most parents was recommendations from doctors and other medical experts - in 60% of cases, advice from relatives, friends and acquaintances - in 16.0%, and in 18.0% - advice from Internet. Conclusions. The study results indicate the necessity to increase awareness and further implementation of the recommendations of the “National Program for Optimizing Feeding of Children in the First Year of Life”, aimed at supporting breastfeeding, implementing rules for the introduction and selection of a range of food products. Key words: nutrition of pregnant women, young children, breastfeeding, artificial feeding, complementary feeding.
PEDIATRIC MASKS OF INFECTIOUS DISEASES. TOXOCAROSIS (CLINICAL CASE)
S.P. Kaplina1,2, I.Y. Melnikova1, E.G. Shapovalov1, V.Y. Chistyakova1 1North-Western State Medical University named after I.I. Mechnikov. Russia, 191015, Saint- Petersburg, Kirochnaya street, 41 2Research Institute of Children's Infections of the Federal Medical and Biological Agency. Russia, 197022, Saint- Petersburg, Professor Popov street, 9
Abstract
The pediatric problems have specific characteristics, since a number of factors contribute to the occurrence of acute and chronic diseases at an early age, where respiratory and gastrointestinal pathologies occupy a significant place. In pediatric practice, a cough is one of the most common reasons for visiting a doctor. The pulmonary syndrome, which is characterized by a prolonged asthmatic-type cough, could develop in a child with severe forms of helminthiasis. The main cause of tissue helminthiasis is nematodes of the Tohosaga genus. The impact of helminths on the health of children may vary. They cause dysfunction of the gastrointestinal tract (abdominal pain, unstable stools, flatulence, nausea), chronic intoxication (prolonged low-grade fever, headache, loss of appetite, irritability, fatigue, sleep disturbance). The article presents a description of two clinical cases of late diagnosis of childhood toxocariasis with clinical symptoms, diagnostic criteria and drug treatment options. Key words: toxocarosis, eosinophilia, obstructive syndrome, differential diagnosis, children.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE ANALYSIS OF THE PRODUCTION LOAD OF MEDICAL EQUIPMENT USED IN MEDICAL REHABILITATION DEPARTMENTS FOR THE REHABILITATION OF PATIENTS WITH DEGENERATIVE DISC DISEASES
Yu.A. Kreneva1,2, M.V. Avdeeva1,3, V.P. Panov1,2 1North-Western State Medical University named after I.I. Mechnikov. Russia, 195067, Saint-Petersburg, Piskarevsky prospect, 47 2City Polyclinic No. 14. Russia, 194021, Saint-Petersburg, 2nd Murinsky prospect, 35 3Saint-Petersburg State Pediatric Medical University. Russia, 194100, Saint-Petersburg, Litovskaya street, 2
Abstract Introduction. One of the criteria for lean manufacturing in healthcare is the efficiency of the medical equipment use in the provision of primary health care. The aim of the study was to conduct a comprehensive analysis of the effectiveness of the medical equipment use in the medical rehabilitation department of a typical city clinic, used for the rehabilitation of patients with degenerative disc diseases. Materials and methods. The production load of the equipment of the medical rehabilitation department used during the rehabilitation of patients with degenerative disc diseases complicated by spondylogenic pain syndrome was analyzed within the framework of the Territorial program of state guarantees of free medical care for citizens. Results. The analysis results revealed the insufficient effectiveness of the medical equipment use in medical rehabilitation departments. The production load of the equipment used for the rehabilitation of patients with degenerative disc diseases complicated by spondylogenic pain syndrome averaged 65.2±5.2%. The reasons are: space shortage, lack of nursing staff, forced downtime during COVID-19, lack of demand for certain types of equipment due to its technological backwardness, rare referral of patients with degenerative disc diseases for rehabilitation to the medical rehabilitation department. In addition, there are regulatory problems associated with the medical rehabilitation organization for degenerative disc diseases. Conclusion. The identified problems make it possible to implement organizational measures to ensure increased efficiency of the medical equipment use in medical rehabilitation departments of outpatient clinics, to improve the availability and quality of medical care to the population. Key words: medical rehabilitation, lean manufacturing, lean technologies, efficiency of use of medical equipment, degenerative disc diseases.
TIMEKEEPING OF WORKING HOURS AS A MEANS OF EVALUATING THE EFFECTIVENESS OF THE WORK OF NURSES PROVIDING ASSISTANCE IN THE PRIMARY HEALTH CARE SYSTEM
N.V. Pchelina 1, T.V. Pozdeyeva 2 1Arzamas Medical College. Russia, 607220, Arzamas, Sobornaya Square, 7 2Volga Research Medical University. Russia, 603950, Nizhny Novgorod, Minin and Pozharsky Square, 10/1 Abstract Introduction. The main indicator of the effective organization of the working day of nursing staff is the structure of time spent by type of professional activity, therefore, timing is a prerequisite for evaluating the effectiveness of nurses. The aim of the study was to assess the effectiveness of the use of the working time and identification of defects in the organization of professional activities of nurses working within the primary healthcare system. Materials and methods. A time-lapse study of the time spent by nursing staff by types of professional activity was conducted. The study included 52 nurses of Arzamas healthcare institutions: City Hospital No. 1, Children's polyclinic and polyclinic No. 3 «Central Hospital of Arzamas», among them were 11 procedural nurses and 41 district nurses. Results. The analysis of the initial level of the distribution of the working time by types of nurses' activities revealed an unsatisfactory structure of the working day: the district nurse's interaction with the patient occupied only 28.0% of the total amount of working time, while 62.4% of the time budget was spent on processing medical documentation; the procedural nurse's 19.4% of the total amount of working time was occupied by communication with the patients, and 41.6% was spent on registration of medical documents.
The second stage of the study, conducted after the integration of a set of measures to optimize nursing work, revealed positive changes in the structure of the working time spent by the nurses: the share of time allocated for interaction with patients increased by an average of 1.5 times for district nurses in all medical organizations, and twice for procedural nurses. Conclusion. Conducting an audit of work time expenditure is a determining mechanism for obtaining a reliable picture of the working day of a medical specialist.
Key words: nurses, primary health care, timekeeping, optimization of production processes.
GENERAL ANALYSIS OF THE RESULTS OF SOCIOLOGICAL STUDIES ON THE PREVALENCE OF RISK FACTORS FOR THE DEVELOPMENT OF CHRONIC NON-INFECTIOUS DISEASES IN STUDENTS OF THE VORONEZH STATE MEDICAL UNIVERSITY NAMED AFTER N.N. BURDENKO. FOR THE ACADEMIC YEAR (SEPTEMBER 2022- MAY 2023)
I.V. Kochetkova, E.A. Fursova, Y.A. Zolotareva Voronezh State Medical University named after N. N. Burdenko. Russia, 394036, Voronezh, Studentskaya Street., 10 Abstract Introduction. Despite the achievements of medicine in the field of prevention and treatment of chronic non-infectious diseases, the mortality rate of the population still remains high. The aim of the study was to analyze the prevalence of risk factors for the development of chronic non-infectious diseases among students of the Voronezh State Medical University named after N.N. Burdenko for the implementation of recommendations for strengthening and preserving health among young people. Materials and methods. It was conducted a sociological study on the prevalence of risk factors for the development of chronic non - infectious diseases among students of Voronezh State Medical University named after N.N. Burdenko for the academic year from September 2022 to May 2023. During the academic year 2058 people took part in the sociological survey. Results. The interviewed students are characterized by a high prevalence of modifiable risk factors and their combinations, which increases the likelihood of chronic non- infectious diseases.
Of the 2058 students surveyed, 8% drink alcohol, 7.96% smoke, 4.2% use (or have tried) drugs, 24% are overweight, and 32% lead an inactive lifestyle (low physical activity). , eat improperly – 27.3%; some students had high blood pressure – 15.6%; have elevated cholesterol levels – 7% and high blood glucose levels – 2.5%. Conclusions. Alcohol, smoking, drugs, poor nutrition, low physical activity, stress, behavioral characteristics are risk factors for the occurrence of chronic non–communicable diseases in students. According to the results of a sociological study, the most common risk factors included in the survey were alcohol consumption and poor nutrition. Key words: chronic non- infectious diseases, risk factors, alcohol, narcotic substances, overweight, low physical activity, stress, smoking.
CLINICAL LABORATORY DIAGNOSTICS
CALCULATED INDICATORS OF NEUTROPHIL/ PLATELET/ BASOPHIL/ EOSINOPHIL-TO-LYMPHOCYTE RATIOS AS BIOMARKERS OF IMMUNE INFLAMMATION (REVIEW)
N.V. Mikryukova1, N.M. Kalinina1,2 1Nikiforov’s All-Russian Center for Emergency and Radiation Medicine. Russia, 194044, Saint-Petersburg, Academica Lebedeva street,4/2 2 Pavlov First Saint Petersburg State Medical University. Russia, 197022, Saint-Petersburg, Leo Tolstoy street, 6- 8 Abstract
Over the past 20 years, the use of calculated indicators of neutrophils (NLR), platelets (PLR), basophils (BLR), eosinophils (ELR) to lymphocytes in clinical blood tests as diagnostically important biomarkers of various pathological conditions have been used widespread in biomedical research. In 90s there were published the first publications on the use of calculated indicators in the prognosis of cancer. Calculated indicators are determined by dividing the absolute number of neutrophils, eosinophils, basophils, platelets by the absolute number of lymphocytes determined in a clinical blood test.
The analysis of domestic and foreign scientific literature on the effectiveness of using calculated indicators and the pathophysiological mechanisms underlying them was performed Key words: neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, eosinophil- to-lymphocyte ratio, basophil-to-lymphocyte ratio, serum biomarkers, substance P, chronic urticaria.
ANTICOAGULANT ACTIVITY OF RIVAROXABAN AND APIXABAN IN TRAUMATOLOGICAL PATIENTS
L.B. Gaikovaya, K.N. Zamyatina North-Western State Medical University named after I.I. Mechnikov. Russia,191015, Saint-Petersburg, Kirochnaya street, 41 Abstract Introduction.The importance of assessing the anticoagulant activity of rivaroxaban and apixaban is associated with the risk of hemorrhagic complications in patients after hip replacement against the background of prevention of venous thromboembolism. The aim of the study was to assess the risk of hemorrhagic complications in patients after hip replacement, the concentration of rivaroxaban and apixaban was determined by chromogenic method. Materials and methods. The study included 85 planned patients of the Department of Traumatology and Orthopedics of the North-Western State Medical University named after I.I. Mechnikov, the average age was 64±10 years (46% of men; 54% of women). All patients received rivaroxaban (10 mg/1 time/day) after surgery to prevent thromboembolic complications or apixaban (2.5 mg / 2 times / day) during the entire period of stay in the clinic. Retrospectively, the patients were divided into groups: group 1 - 78 patients (36 men, 42 women) with uncomplicated postoperative period, group 2 – 7 patients (3 men, 4 women) who had verified subcutaneous hematomas. The concentration of rivaroxaban or apixaban in blood plasma was determined on an automatic coagulometer ACL TOP 500CTS (Werfen, USA) by chromogenic method with sets of reagents "HemosIL liquid Anti-Xa"; "HemosIL Rivaroxaban Calibrators" and "HemosIL Rivaroxaban Controls"; "HemosILApixaban Calibrators" and "HemosILApixaban Controls" (Werfen, USA) on the 1st day of taking the anticoagulant after surgery and on the 10th day of treatment. Results. There were no significant differences in the concentration of anticoagulant in the patients of the 1-st and 2-nd groups treated with rivaroxaban. In the 2-nd group patients with hemorrhagic complications after surgery and receiving apixaban, the concentration of apixaban was higher compared to group 1 (p<0.05) and higher than the upper limit of the reference interval. Conclusions. Exceeding the concentration of apixaban in blood plasma relative to the average preventive doses after planned surgery in traumatological patients may be one of the reasons for the development of hemorrhagic complications. Key words: hip replacement, concentration, rivaroxaban, apixaban, chromogenic method.
CHARACTERISTICS OF ERYTHROCYTE INDICES IN PRE-SCHOOL CHILDREN OF THE REPUBLIC OF SAKHA (YAKUTIA)
L.A. Stepanova, L.G. Marinova, D.E. Roeva North-Eastern Federal University named after M. K. Ammosov. Russia, 677000, Yakutsk, Belinskogo street, 58
Abstract Introduction. The Republic of Sakha (Yakutia) is located in a zone with extreme winter temperatures. Living in this territory has a certain impact on the overall health of children. The aimof this study was to identify the peculiarities of red blood cell indicators in hematological analysis in children living in the Republic of Sakha (Yakutia). Materials and methods. The study included 283 children aged 4 years of Russian and Yakut ethnic groups, living in urban and rural areas and attending preschool educational institutions. The hematological indicators of red blood cells were evaluated - hemoglobin level, red blood cell count, mean corpuscular volume, mean corpuscular hemoglobin volume, mean corpuscular hemoglobin concentration. Results. According to the obtained data, erythrocyte indicators and their indices in children living in the Republic of Sakha (Yakutia) was within the normal range for their age. Anemia of various severity levels was detected in 8.5% of all examined children. Anemia was considered to be moderate according to WHO criteria. There were differences based on gender, such as the level of erythrocyte content in hemoglobin and mean corpuscular volume. Mean corpuscular volume is higher in Yakut girls than in Yakut boys, and mean corpuscular hemoglobin content is higher in Russian girls than in Russian boys. Ethnic characteristics were found in terms of hemoglobin levels - hemoglobin levels were higher in Russian girls compared to Yakut girls. It was also revealed in the mean corpuscular hemoglobin concentration - the average hemoglobin concentration in the erythrocyte is higher in Russian girls than in Yakut girls. Conclusion. Hematological indicators in preschool-age children in the Republic of Sakha (Yakutia) are within the normal range. Erythrocyte indicators vary in children depending on their gender and ethnic background. Keywords: preschool-age children, complete blood count, erythrocyte indices, hemoglobin, erythrocytes, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin content, mean corpuscular hemoglobin concentration.
(с) 2020 North-Western State Medical University named after I.I.Mechnikov
