CONTENTS 2025_2
HYGIENE
Shtina I.E., Valina S.L.
Aleksandrova E.S., Alikbaeva L.A., Yakubova I.Sh., Zaritskaya E.V., Khurtsilava O.G., Stefanovich D.O., Ryzhkov A.L., Fomin M.V.,. Moschev A.N
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
Grishin O.V., Saiganov S.A., Miroshnichenko A.G., Makhnovsky A.I., Aslanov B.I., Eremeev S.N., Kitsishin V.P., Bozhko V.O., Bulach T.P.
M.V. Novoselova, E.B. Brusina
Khominets V.V., Averkiev D.V., Vo K.T.
Bushueva E.V., Dianova T.I., Ivanova O.N., Kichigin V.A., Smirnova E.I.
Petrov I.V., Patyashina M.A., Sokolova N.G., Petrova F.S., Almukhametov A.A.
Savgachev V.V., Shubin L.B.
Rydnova L.V., Zenina M.N., Styuf I.Yu., Bessmeltsev S.S., Kozlov A.V.
Zhigalova E.V., Aslanov B.I., Fedorova A.I., Tsypurdeeva A.A.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
Kalashnikova M.R., Dulaev A.K., Klyukovkin K. S., Shirshova N.Y., Nakonechny D.G., Kutianov D.I.
CLINICAL LABORATORY DIAGNOSTICS
Gromova A.V., Skachkova T.S., Gorshkova T.G., Goloveshkina E.N., Lazareva A.V., Novikova I.E., Akimkin V.G.
HYGIENE
TRENDS IN THE INDICATORS OF PHYSICAL DEVELOPMENT OF ADOLESCENTS OF THE PERM REGION DURING 2015-2024
I.E. Shtina1,2, S.L. Valina1
1Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Russian Federation, 614000, Perm, Monastyrskaya street, 82
2Perm State Medical University named after Academician E.A. Wagner, Russian Federation, 614000,Perm, Petropavlovskaya street,26
Abstract.
Introduction. Physical development is a complex of dynamically changing morphofunctional properties of the body, reflecting health status. Knowledge about the trends in the dynamics of indicators of physical development among children and adolescents is necessary for forming priority socio-hygienic and medical preventive measures.
Aim of the study was to assess trends in changes of physical development indicators among adolescents living in the Perm Region during 2015-2024.
Materials and methods. The study included 783 adolescents aged 15-17 years living in the Perm Region, comprising 381 (48.7%) boys and 402 (51.3%) girls (p=0.47),with an average age of 15.9±0.8 and 15.8±0.8 years, respectively (p=0.142). They were divided into three subgroups according to study periods (2015-2018, 2019-2021, 2022-2024), body weight, height, and BMI were measured using a standard methods followed by interpretation of HAZ (Height-For-Age Z-Score) and BMI Z-score.The results were analyzed using standard statistical methods.
Results. The growth rates of adolescents of both sexes remained stable during the study period (p=0.193-0.216). During 2019-2021, BMI and Z-score in girls were significantly higher than in other time periods (21.8±1.06 and 0.17±0.12, respectively). In boys, BMI values and BMI Z-score significantly increased during the entire study period, with a calculated regression coefficient value of +0.64 units +0.06, respectively (p=0.008-0.019).
Conclusion. Physical development of adolescents in the Perm Region is characterized by sexual dimorphism and no decrease in the proportion of disharmonious development. The trend in changes in physical development shows a positive trend in boys due to an increase in BMI and BMI Z-score.
Key words: physical development, z-score, regional features, adolescents, Perm Region
TOXICOLOGICAL AND HYGIENIC ASSESSMENT OF DE-ICING LIQUIDS FOR AIR TRANSPORT TREATMENT
E.S. Aleksandrova1, L.A. Alikbaeva1, I.Sh. Yakubova1, E.V. Zaritskaya2, O.G. Khurtsilava1, D.O. Stefanovich1, A.L. Ryzhkov1, M.V. Fomin1,
A.N. Moschev1
1North-West State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41
2North-West Scientific Centre of Hygiene and Public Health, Russia, 191036, Saint Petersburg, 2-Sovetskaya street, 4
Abstract
Introduction. Ensuring flight safety is a top priority for any airline, and the de–icing of aircraft is a crucial measure to protect them from ground icing. De-icing fluid is typically composed of ethylene glycol or propylene glycol, which helps to remove snow and ice from aircraft surfaces. However, the specific climate conditions in the Russian Federation require a minimum concentration of glycol in de-icing solutions of 30%. This can lead to the migration of excess glycol into water bodies and soil, exceeding the maximum allowable concentration, and potentially harming workers' health during the de-icing process.
The aim of the study to give a toxicological and hygienic assessment of the properties of working solutions of de-icing liquids based on ethylene glycol and propylene glycol.
Materials and methods. Toxicological and hygienic assessment of de-icing liquid PROFLIGHT EG1 (TU ST TOO 221140002027-001-2024) and EG4 (TU ST TOO 221140002027-002-2024) – based on ethylene glycol, and PROFLIGHT PG4 (TU ST TOO 221140002027-003-2024) - based on propylene glycol was carried out on laboratory animals (mice, rats, guinea pigs, rabbits). The parameters of acute toxicity, local irritant, skin-resorptive and sensitizing effects were determined.
Results. The conducted toxicological assessment made it possible to classify the working solutions of de–icing liquid based on ethylene glycol and propylene glycol as low-hazard compounds - hazard class 4. It was found that the working solutions have no skin-resorptive effect, allergenic activity is not expressed. However, de-icing liquids based on ethylene glycol and propylene glycol can have a mild irritating effect on the skin and mucous membranes of the eyes.
Conclusion. To ensure safe de-icing treatment, employees need personal protective equipment for their skin and eye mucosa to protect aircraft from ground icing.
Keywords. De-icing liquids, de-icing treatment, aircraft, ground icing, ethylene glycol, propylene glycol, toxic and hygienic assessment.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
EPIDEMIOLOGICAL ASPECTS OF APPLICATIONS FOR EMERGENCY MEDICAL CARE IN CONNECTION WITH ARTERIAL HYPERTENSION IN ST. PETERSBURG
O.V. Grishin1, 6, S.A. Sayganov1, A.G. Miroshnichenko1,3, A.I. Makhnovsky1,3,4, B.I. Aslanov1, S.N. Eremeev6, V.P. Kitsyshin5, V.O. Bozhko1,6, T.P. Bulach1
1Federal State Budgetary Educational Institution of Higher Education "North-West State Medical University named after I.I. Mechnikov" of the Ministry of Health of the Russian Federation;
2Federal State Budgetary Educational Institution of Higher Education "First Saint Petersburg State Medical University named after Academician I.P. Pavlov" of the Ministry of Health of the Russian Federation;
3State Budgetary Institution "Saint Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze";
4Federal State Budgetary Scientific Institution "Institute of Experimental Medicine";
5Federal State Budgetary Military Educational Institution of Higher Education "Military Medical Academy named after S.V. Kirov", Ministry of Defense of the Russian Federation;
6State Budgetary Healthcare Institution "City Polyclinic No. 17", Saint Petersburg, Russia
Abstract
The aim of the study: to assess the descriptive epidemiological characteristics of patient requests for emergency medical care due to high blood pressure among residents of St. Petersburg.
Materials and methods. A retrospective analysis of requests for emergency medical care among residents of St. Petersburg in 2018–2022 was conducted. A total of 541,274 patients were included in the study, who sought emergency medical care 868,736 times during this period.
Results of the study. It was shown that the number of requests for emergency medical care due to high blood pressure in 2018–2022 sharply decreased during the COVID-19 pandemic, followed by an increase in 2022 by 9% and will continue to increase, then, as shown by neural network programming, the incidence of complications will also continue to grow in subsequent years. In the structure of requests for emergency medical care due to high blood pressure in St. Petersburg, uncontrolled arterial hypertension accounted for 91.8%. 2/3 of emergency medical care calls for high blood pressure were made to women, of which 71.2% of patients were elderly, senile and long-livers. The five-year survival rate of patients who sought emergency medical care for high blood pressure, even taking into account the past pandemic of 2020-2021, was 98.5%, and as predictive modeling using neural networks showed, the number of emergency medical care calls for high blood pressure in the period 2023-2025 will remain high and will directly depend on the number of male and female patients in older age groups (elderly, senile and long-livers).
Conclusion. The structure of calls due to high blood pressure has been clarified, their dynamics and distribution of patients by age and gender have been determined. The most common emergency conditions associated with high blood pressure have been identified. The forecast of changes in patients' appeals for emergency medical care due to increased blood pressure was made and the five-year survival rate of patients was estimated taking into account the period of the COVID-19 pandemic.
Keywords: increased blood pressure, neuroprognostic modeling, older patients.
RISK FACTORS FOR ENTEROVIRUS (NON-POLIO) INFECTIONS
M.V. Novoselova, E.B. Brusina
Kemerovo State Medical University, Russian Federation, 650056б, Kemerovo, Voroshilova Street,22a.
Abstract
Introduction. Risk-oriented approach to infection prevention demonstrates high efficiency. Currently. system of epidemiological surveillance of enterovirus (non-polio) infection is insufficiently sensitive, which requires pre-epidemic diagnostics based on monitoring the properties of pathogens and risk factors.
Aim of the study was to identify risk factors for activation of the epidemic process of enterovirus (non-polio) infection.
Materials and methods. Factor and cluster analysis was carried out using data from 477 epidemiological survey cards of the enterovirus (non-polio) infection outbreak.
Results. General risk factors for enterovirus (non-polio) infection in children and adults in the observed area include: staying in and swimming in water bodies and swimming pools in other regions, abroad in the Russian Federation, as well as eating fresh vegetables and fruits. Additional risk factors in children include living in a household with decentralized sewerage systems, contact with individuals infected with enterovirus (non-polio) infection, drinking water from non-centralized water supply sources, and swimming in the region’s reservoirs.
Conclusion. The identified risk factors could be taken into account in the prevention system of enterovirus (non-polio) infection. The determination of specific clusters makes it possible to identify target groups for preventive and anti-epidemic measures.
Key words: enterovirus (non-polio) infection, pre-epidemic diagnosis, spread, risk factors, components, factor analysis, cluster analysis, dendrogram.
SURGICAL TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC INSTABILITY OF THE ACROMIOCLAVIC JOINT
(SCIENTIFIC REVIEW)
V.V. Khominets, D.V. Averkiev, K.T. Vo
S.M. Kirov Military Medical Academy. Russia, 194044, Saint-Petersburg, Akademika Lebedeva Street, 6
Abstract
Dislocation of the acromial end of the clavicle is a common injury in physically active young people, especially athletes in contact sports. The objective of surgical treatment in the acute period of injury is the reduction and stabilization of the acromial end of the clavicle for the period necessary for ligament fusion. In chronic dislocations, chronic instability of the acromioclavicular joint is formed in 20-40% in the vertical and horizontal planes with persistent pain syndrome, scapular dyskinesis, and weakness of the shoulder girdle muscles. A feature of chronic injuries is the absence of reparative potential of degeneratively altered damaged ligaments, therefore, the use of only methods of reduction and fixation of the acromial end of the clavicle is ineffective. In chronic instability, ligament and muscle transposition and ligament reconstruction using synthetic materials or tendon grafts are used. In most cases, surgical intervention is supplemented by acromioclavicular or coracoclavicular stabilization. All known methods of surgical treatment have their advantages and disadvantages. The best functional treatment results were achieved by combining methods of tendon ligament reconstruction and fixation of the acromioclavicular joint. In biomechanical experiments, the maximum restoration of vertical and horizontal stability was obtained using complex anatomical multi-bundle methods of combined reconstruction of the acromioclavicular and coracoclavicular ligament complexes. At the same time, the functional results of treatment using combined methods did not show obvious advantages compared to isolated reconstruction of the coracoclavicular ligaments.
Keywords: acromioclavicular joint, chronic instability, chronic dislocation, surgical treatment
THE ROLE OF CONTROLLED INCREASED BLOOD PRESSURE RISK FACTORS IN HEALTHY ADOLESCENTS: A COHORT STUDY
E.V. Bushueva, T.I. Dianova, O.N. Ivanova, V.A. Kichigin, E.I. Smirnova
Abstract
Introduction. Arterial hypertension is one of the leading risk factors for the development of cardiovascular catastrophe at any age, and its prevalence among the child population tends to increase. The increase in arterial pressure is influenced by a complex set of neurohumoral, hemodynamic and metabolic mechanisms that are affected by controllable factors.
Aim of the study was toevaluate the influence of controlled factors on the risk of increased arterial pressure in healthy adolescents.
Materials and methods. A cohort study was conducted. In hospital conditions, medical data were analyzed and controlled factors of 133 adolescents aged 15-18 years of the II health group were evaluated. The main II group consisted of 67 children who had episodes of high blood pressure, but arterial hypertension was excluded. The comparison group I included 66 children without an increased blood pressure. The study was conducted during 2021-2023.
Results. The risk of high blood pressure in adolescents increased with a sleep time of less than 420 minutes in boys (HR) = 2.968) and less than 390 minutes in girls (HR= 3.694), if sports activities were less than 40 minutes per day (HR=2.5), additional training sessions of more than 2.85 hours per day (HR = 2), using phones and computers for more than 3 hours per day (HR = 2.57), outdoor walks for less than 1.5 hours for boys (HR = 5.9), and less than 30 minutes for girls (HR = 4.6).
Conclusion. The influence of controlled high blood pressure risk factors has been confirmed and established, with the establishment of critical time points for the action of factors at which the relative risk of their realization in a pathological state increases several times.
Keywords: risk factors, children, adolescents, blood pressure, hypertension, prevention.
A RETROSPECTIVE OBSERVATIONAL STUDY OF A GROUP OF
PATIENTS WITH RESPIRATORY MYCOBACTERIOSIS
I.V. Petrov 1, M.A. Patyashina 2, N.G. Sokolova 3,
F.S. Petrova1,3, A.A. Almukhametov 2,4
1 Mari State University,Russian Federation, 424000, Yoshkar-Ola, Lenina square,1
2 Kazan State Medical Academy – Branch Campus of Russian Medical Academy of Continuous Professional Education,Russian Federation , 420012, Kazan, Mushtari street,11
3Republican Tuberculosis Dispensary, Russian Federation, 424037, Yoshkar-Ola, Bolnichnaya street, 22
4 Kazan State Medical University, Russian Federation, 420012, Kazan, Butlerova street, 49
Abstract
Introduction. There is a global increase is the isolation of non-tuberculosis mycobacteria from patients, as well as an increase in the incidence and prevalence of mycobacteriosis.
Aim of the study was to characterize patients with mycobacterial deseases.
Materials and methods. The authors analyzed the medical records of patients (n = 87) diagnosed with Mycobacteriosis of the lungs. Methods of bacteriological and radiation diagnostics were used. The statistical analysis was performed using the StatTech v program. 4.7.1 (developed by Stattech LLC, Russia).
Results. The average age at the time of diagnosis was 65 years. The predominance of women was established; most patients lived in urban conditions, in apartment buildings, and were unemployed pensioners. In most cases, mycobacteriosis was caused by slow-growing species of non-tuberculous mycobacteria (M. intracellulare, M. avium). The majority of patients (56/87, 64.4%) had concomitant respiratory diseases or had been treated for them earlier, 33.9% (19/56) had two or more diseases. The largest number of people with mycobacteriosis of the lungs and other respiratory diseases has contracted tuberculosis of the lungs and COVID-19. The majority of patients (64 people, 73.6%, 95%CI 63.0 – 82.4) was referred to a phthisiologist by a therapist, a narrow specialist (being observed under dispensary monitoring for another diagnosis) and underwent a medical examination during a planned hospitalization. The remaining patients (23 people, 26.4%, 95%CI 17.6 – 37.0) were referred to a phthisiologist based on the results of medical examinations, preliminary and periodic medical examinations. Analysis of clinical manifestations showed that 74.7% of patients (65 out of 87, 95%CI 64.3 – 83.4) had complaints, the leading manifestation was cough with sputum.
Conclusion. The study made it possible to determine the regional features of mycobacteriosis of the respiratory system.
Key words: mycobacteriosis, non-tuberculous mycobacteria, mycobacterial infections
GENES PPARG, IL17A, IL6, PAI-1: PROGNOSTIC SIGNIFICANCE
FOR PURULENT COMPLICATIONS AFTER TREATMENT OF LOWER
LIMB BONE INJURIES
V.V. Savgachev , L.B. Shubin
Yaroslavl State Medical University, Russian Federation, Yaroslavl region, 150000, Yaroslavl, Revolutsionnaya street, 5.
Abstract
Introduction. Research on post-treatment purulent complications (PTPC) in traumatology and orthopedics shows a connection to heredity, emphasizing the importance of genetics. Methods such as inheritance analysis, gene expression, and genetic variation are applied. This allows developing individualized treatment approaches and improving rehabilitation effectiveness. Special attention is given to immune response genes (IL-17A, IL-6) and those controlling metabolism and blood clotting (PPARG, PAI-1), which contribute to risk prediction and improved treatment outcomes.
Aim of the study was to analyze the interaction of the genes PPARG, IL17A, IL6, and PAI-1 and their effect on the course of purulent complications after treatment of lower limb bone injuries.
Materials and Methods. A prospective cohort study on genetic polymorphisms (PPARG, IL17A, IL6, PAI-1) was conducted in 208 patients with purulent complications after treatment of lower limb injuries. The allele-specific polymerase chain reaction method was used. The patients were divided into two groups: with and without recurrence of the complication within 1 year after treatment. The analysis was performed using the MDR (Multifactor Dimensionality Reduction) method to identify intergenic interactions.
Results and discussion. Firstly, linkage disequilibrium (LD) between four SNPs (SNP1 – PPARG/C 1431 T; SNP2 – IL 17 A/G – 197 A; SNP3 – IL 6 / C174G; SNP4 – PAI-1 / -675) was analyzed to identify haplotypes associated with the risk of complication recurrence. The most common haplotype was "C-G-G-5G" (18.49%). Haplotype frequencies differed between groups with and without recurrences, suggesting possible links to complication relapse.
Genetic analysis of polymorphisms and haplotypes may enhance diagnostics and treatment of lower limb injuries by reducing recurrence risks. Linkage between PPARG (C1431T) and IL17A (G-197A) was found, highlighting its predictive value.
Conclusion. The use of genetic data in traumatology helps to create personalized approaches to treatment and complications prediction. The analysis of haplotypes of polymorphisms of the PPARG, IL6, IL17A, PAI-1 genes and their connections with age, gender, and concomitant diseases demonstrates the prospects of applying genetics in clinical practice.
Keywords: complications, lower limb injuries, genes, PPARG, IL6, IL17A, PAI-1.
PROBLEMS OF DETERMINING PROTEIN IN URINE IN PATIENTS WITH MULTIPLE MYELOMA
L.V. Rydnova1, M.N. Zenina1,2, I.Yu. Styuf1, S.S. Bessmeltsev1,2, A.V. Kozlov1
1North-West State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41
2Russian Research Institute of Hematology and Transfusiology, Russia, 191024, Saint Petersburg, 2-ya Sovetskaya street, 16.
Abstract.
Introduction. The leading symptom of kidney damage in multiple myeloma is persistent proteinuria. Test strips are insensitive to Bence-Jones protein, delaying the diagnosis of multiple myeloma.
Aim of the study was to choose the optimal approach for determining protein in the urine of patients with multiple myeloma.
Materials and methods. The study included conditionally healthy individuals (n = 20) aged 31 to 87 years, 13 men and 7 women (Group 1) and patients with a newly diagnosed form of multiple myeloma (n = 20) aged 33 to 86 years, 11 men and 9 women (Group 2). The biomaterial was the first morning urine sample; the protein concentration was determined by test strips and quantitative methods – pyrogallol red and biuret examination.
Results. In Group 1, there was one case where the test strip result was "1+" and quantitative methods exceeded the discriminatory level. In the remaining 19 cases, test strip results were negative; 4 results were false negative (21%), since the protein concentration determined by quantitative methods exceeded the discriminatory level.
In Group 2, two patients – one with solitary plasmacytoma and one with non-secreting myeloma- had negative test strip results while quantitative methods showed normal values.
In the urine of 9 out of 20 (45%) patients with multiple myeloma, test strips showed false negative result, while protein concentrations determined by quantitative methods exceeded the discriminatory level.
Conclusions. In laboratories, a positive result of a protein test strip should be confirmed by a quantitative method with subsequent conduction of differential diagnosis of proteinuria. Negative protein test strip result may mask proteinuria due to the presence of a monoclonal immunoglobulin in urine. The clinician, taking into account clinical and laboratory data, prescribes protein quantification to prove proteinuria.
Key words: proteinuria, test strips, quantitative methods of protein determination in urine, multiple myeloma
CLINICAL AND EPIDEMIOLOGICAL FEATURES OF CHRONIC PAIN SYNDROME IN GENITAL ENDOMETRIOSIS: PSYCHOSEXUAL ASPECTS
E.V. Zhigalova1, B.I. Aslanov1, A.I. Fedorova1, A.A. Tsypurdeeva2
1 Federal State Budgetary Educational Institution of Higher Education "North-West State Medical University named after I.I. Mechnikov" of the Ministry of Health of the Russian Federation. Russia, 191015,
Saint Petersburg, Kirochnaya St., 41.
2Federal State Budgetary Educational Institution of Higher Education "Saint Petersburg State University". Russia, 199034, Saint Petersburg, Universitetskaya Nab., 7–9.
Abstract
Introduction. The relevance of studying the clinical and epidemiological profile of patients with chronic pain syndrome (CPS) in genital endometriosis (GE) is due to the high prevalence and negative impact of GE on the quality of life of women. In order to select the tactics of CP therapy in GE, the article analyzes psychosexual factors influencing the development and chronization of CP in GE from the standpoint of a biopsychosocial approach.
Objective. Identification of clinical and epidemiological features of chronic pain syndrome in genital endometriosis in terms of psychosexual aspects with an assessment of the predictive significance of the identified factors for CP.
Materials and methods. The study included 400 patients of reproductive age from 18 to 45 years with painful and painless forms of GE and a comparison group of women without GE and without CP. The study was based on epidemiological, clinical-anamnestic, clinical, clinical-psychopathological, clinical-sexological, psychometric and statistical research methods. To predict the factors influencing the development of BS and its chronicity, a binary logistic regression model was built using the tidymodels package in R (Vienna, Austria), which included clinically significant predictors.
Results. As a result of a comprehensive study of patients with BS in GE and subsequent statistical processing of the obtained data, a significantly higher level of psychosexual developmental disorders, sexual dysfunctions and marital disharmony, as well as psychoemotional disorders, psychopathological syndromes that do not reach the psychopathic level were revealed.
Conclusion. The obtained results indicate the statistical significance of the influence of psychosexual factors on the development and chronicity of BS in GE, which justifies the need to create and implement in medical practice an integrative algorithm for the diagnosis, treatment and prevention of BS in women with GE, including a comprehensive assessment and therapy of psychoemotional disorders, sexual dysfunctions and partner (marital) disharmony.
Key words: clinical and epidemiological profile, genital endometriosis, chronic pelvic pain, psychosexual factors, sexual dysfunctions.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
ANALYSIS OF THE ORGANISATION OF OUTPATIENT CARE FOR PATIENTS WITH HAND DISEASES IN STATE BUDGETARY INSTITUTION OF HEALTH CARE
M.R Kalashnikova1,2, A.K. Dulaev1, K. S. Klyukovkin1, N.Y. Shirshova3, D.G. Nakonechny1,2,4, D.I.Kutianov 1
1 Pavlov First Saint Petersburg State Medical University, Russia, 197022, Saint-Petersburg,Leo Tolstoy street, 6-8
2 Ltd. "Scandinavia" & "AVA-PETER" clinics Russia, 191014, Saint-Petersburg, Liteyny prospect, 55a
3 City Polyclinic No. 32,Russia,197022, Saint-Petersburg, Vyazemsky lane,3А
4 LLC «My Medical Center. Clinic of High Technologies », Russia,188651, Saint-Petersburg, Vsevolozhsk District , Yukki urban settlement,1
Abstract
Introduction. In the Russian Federation, there is no regulatory recognition of hand surgery as an independent specialty, which is particularly evident at the level of outpatient care. General practitioners and surgeons are generally insufficiently prepared to manage such patients, and the routing system remains unclear.
Aim of the study was to perform a comprehensive assessment of the organization of primary health care for patients with hand diseases, including routing, specialization of care and the level of training of doctors, in order to identify systemic limitations and formulate proposals for their elimination.
Materials and methods. A retrospective analysis of 857 outpatient records of patients with common hand diseases (carpal tunnel syndrome, tenosynovitis, Dupuytren's disease, etc.) who visited St. Petersburg outpatient clinics during 2017–2021 was conducted. A survey of 115 primary care physicians was conducted regarding their awareness and level of training in this area.
Results. It was found that primary care for patients with hand pathology is provided by general practitioners, surgeons, neurologists and traumatologists-orthopedists. Referrals to specialized specialists are often delayed and are irregular. Only 20% of doctors assess their training as sufficient, and less than 5% have undergone specialized training.
Conclusion. Significant organizational and qualification deficit in outpatient care for hand pathology have been identified. It is necessary to create a specialized city center, improve the qualifications of doctors and develop clinical recommendations or guidelines for the management of such patients.
Key words: hand surgery, hand diseases, outpatient surgery center, carpal tunnel syndrome, trigger finger, tenosynovitis of the styloid process of the radius (De Quervain's syndrome), ganglion, Dupuytren's contracture.
CLINICAL LABORATORY DIAGNOSTICS
TESTING AN ALGORITHM FOR QUANTITATIVE DETERMINATION OF UROPATOGENS AND MAIN DETERMINANTS OF ANTIBIOTIC RESISTANCE USING PCR IN URINE WITH BACTERIURIA FROM PATIENTS OF THE PEDIATRIC UROLOGY DEPARTMENT IN 2021-2023
A.V. Gromova 1, T.S. Skachkova 1, T.G. Gorshkova 1, E.N. Goloveshkina 1,
A.V. Lazareva 2, I.E. Novikova 2, V.G. Akimkin 1
1Federal Budget Institution of Science "Central Research Institute of Epidemiology" of The Federal Service on Customers' Rights Protection and Human Well-being Surveillance.
Novogireevskaya Str., 3A, Moscow, Russia, 111123
2National Medical Research Center for Children's Health Federal State Autonomous Institution of the Ministry of Health of the Russian Federation
Lomonosovsky Prospekt, 2, building 1, Moscow, Russia, 119991
Abstract
Introduction. Urinary tract infection is one of the most common bacterial infections in children. The most important component for the institution of rational antibiotic therapy is the species identification and determination of the pathogen resistance.
The aim of the study was to testing of the PCR research algorithm for quantitative assessment of bacteriuria with species identification and further detection of the main genetic determinants of antibiotic resistance.
Materials and methods. 1821 urine samples from pediatric patients were tested. The results of molecular biological and bacteriological methods for identifying uropathogens in bacteriuria were compared.
Results. The sensitivity of the PCR method for quantitative species identification of uropathogens in comparison with the reference method was 81-100%, specificity - 81-99.5%. Most common bacteria were bacteria of the order Enterobacteriales – 65%, including E. coli - 37%, K. pneumoniae - 16%, Proteus spp. - 6%. Some other pathogens were identified: Enterococcus - 16%, P. aeruginosa - 14%, Staphylococcus spp. - 5%, Streptococcus spp. - 1%, Streptococcus agalactiae - 0.5%. Optimal threshold values for each target DNA were determined: for bacteria of the order Enterobacterales, E. coli and Streptococcus spp. – about 104 GE/ml; for Proteus spp., K.pneumoniae, P.aeruginosa, Enterococcus spp., Staphylococcus spp. and S. agalactiae – about 103 GE/ml; for the Bacteria domain – about 105 GE/ml.
Conclusion. The introduction of PCR studies into laboratory diagnostics will reduce the time for identifying pathogenic biological agents to 5 hours. In addition, PCR research does not require manipulation of bacterial cultures and allows working with biological material only. Molecular genetic determination of antibiotic resistance genes in biological material can be used to prescribe therapy before pure culture isolation of bacteria.
Keywords: PCR, urinary tract infection, antibiotic resistance, bacteriuria, molecular biological methods
CONTENTS 2025_2
HYGIENE
Shtina I.E., Valina S.L.
Aleksandrova E.S., Alikbaeva L.A., Yakubova I.Sh., Zaritskaya E.V., Khurtsilava O.G., Stefanovich D.O., Ryzhkov A.L., Fomin M.V.,. Moschev A.N
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
Grishin O.V., Saiganov S.A., Miroshnichenko A.G., Makhnovsky A.I., Aslanov B.I., Eremeev S.N., Kitsishin V.P., Bozhko V.O., Bulach T.P.
M.V. Novoselova, E.B. Brusina
Khominets V.V., Averkiev D.V., Vo K.T.
Bushueva E.V., Dianova T.I., Ivanova O.N., Kichigin V.A., Smirnova E.I.
Petrov I.V., Patyashina M.A., Sokolova N.G., Petrova F.S., Almukhametov A.A.
Savgachev V.V., Shubin L.B.
Rydnova L.V., Zenina M.N., Styuf I.Yu., Bessmeltsev S.S., Kozlov A.V.
Zhigalova E.V., Aslanov B.I., Fedorova A.I., Tsypurdeeva A.A.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
Kalashnikova M.R., Dulaev A.K., Klyukovkin K. S., Shirshova N.Y., Nakonechny D.G., Kutianov D.I.
CLINICAL LABORATORY DIAGNOSTICS
Gromova A.V., Skachkova T.S., Gorshkova T.G., Goloveshkina E.N., Lazareva A.V., Novikova I.E., Akimkin V.G.
HYGIENE
TRENDS IN THE INDICATORS OF PHYSICAL DEVELOPMENT OF ADOLESCENTS OF THE PERM REGION DURING 2015-2024
I.E. Shtina1,2, S.L. Valina1
1Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Russian Federation, 614000, Perm, Monastyrskaya street, 82
2Perm State Medical University named after Academician E.A. Wagner, Russian Federation, 614000,Perm, Petropavlovskaya street,26
Abstract.
Introduction. Physical development is a complex of dynamically changing morphofunctional properties of the body, reflecting health status. Knowledge about the trends in the dynamics of indicators of physical development among children and adolescents is necessary for forming priority socio-hygienic and medical preventive measures.
Aim of the study was to assess trends in changes of physical development indicators among adolescents living in the Perm Region during 2015-2024.
Materials and methods. The study included 783 adolescents aged 15-17 years living in the Perm Region, comprising 381 (48.7%) boys and 402 (51.3%) girls (p=0.47),with an average age of 15.9±0.8 and 15.8±0.8 years, respectively (p=0.142). They were divided into three subgroups according to study periods (2015-2018, 2019-2021, 2022-2024), body weight, height, and BMI were measured using a standard methods followed by interpretation of HAZ (Height-For-Age Z-Score) and BMI Z-score.The results were analyzed using standard statistical methods.
Results. The growth rates of adolescents of both sexes remained stable during the study period (p=0.193-0.216). During 2019-2021, BMI and Z-score in girls were significantly higher than in other time periods (21.8±1.06 and 0.17±0.12, respectively). In boys, BMI values and BMI Z-score significantly increased during the entire study period, with a calculated regression coefficient value of +0.64 units +0.06, respectively (p=0.008-0.019).
Conclusion. Physical development of adolescents in the Perm Region is characterized by sexual dimorphism and no decrease in the proportion of disharmonious development. The trend in changes in physical development shows a positive trend in boys due to an increase in BMI and BMI Z-score.
Key words: physical development, z-score, regional features, adolescents, Perm Region
TOXICOLOGICAL AND HYGIENIC ASSESSMENT OF DE-ICING LIQUIDS FOR AIR TRANSPORT TREATMENT
E.S. Aleksandrova1, L.A. Alikbaeva1, I.Sh. Yakubova1, E.V. Zaritskaya2, O.G. Khurtsilava1, D.O. Stefanovich1, A.L. Ryzhkov1, M.V. Fomin1,
A.N. Moschev1
1North-West State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41
2North-West Scientific Centre of Hygiene and Public Health, Russia, 191036, Saint Petersburg, 2-Sovetskaya street, 4
Abstract
Introduction. Ensuring flight safety is a top priority for any airline, and the de–icing of aircraft is a crucial measure to protect them from ground icing. De-icing fluid is typically composed of ethylene glycol or propylene glycol, which helps to remove snow and ice from aircraft surfaces. However, the specific climate conditions in the Russian Federation require a minimum concentration of glycol in de-icing solutions of 30%. This can lead to the migration of excess glycol into water bodies and soil, exceeding the maximum allowable concentration, and potentially harming workers' health during the de-icing process.
The aim of the study to give a toxicological and hygienic assessment of the properties of working solutions of de-icing liquids based on ethylene glycol and propylene glycol.
Materials and methods. Toxicological and hygienic assessment of de-icing liquid PROFLIGHT EG1 (TU ST TOO 221140002027-001-2024) and EG4 (TU ST TOO 221140002027-002-2024) – based on ethylene glycol, and PROFLIGHT PG4 (TU ST TOO 221140002027-003-2024) - based on propylene glycol was carried out on laboratory animals (mice, rats, guinea pigs, rabbits). The parameters of acute toxicity, local irritant, skin-resorptive and sensitizing effects were determined.
Results. The conducted toxicological assessment made it possible to classify the working solutions of de–icing liquid based on ethylene glycol and propylene glycol as low-hazard compounds - hazard class 4. It was found that the working solutions have no skin-resorptive effect, allergenic activity is not expressed. However, de-icing liquids based on ethylene glycol and propylene glycol can have a mild irritating effect on the skin and mucous membranes of the eyes.
Conclusion. To ensure safe de-icing treatment, employees need personal protective equipment for their skin and eye mucosa to protect aircraft from ground icing.
Keywords. De-icing liquids, de-icing treatment, aircraft, ground icing, ethylene glycol, propylene glycol, toxic and hygienic assessment.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
EPIDEMIOLOGICAL ASPECTS OF APPLICATIONS FOR EMERGENCY MEDICAL CARE IN CONNECTION WITH ARTERIAL HYPERTENSION IN ST. PETERSBURG
O.V. Grishin1, 6, S.A. Sayganov1, A.G. Miroshnichenko1,3, A.I. Makhnovsky1,3,4, B.I. Aslanov1, S.N. Eremeev6, V.P. Kitsyshin5, V.O. Bozhko1,6, T.P. Bulach1
1Federal State Budgetary Educational Institution of Higher Education "North-West State Medical University named after I.I. Mechnikov" of the Ministry of Health of the Russian Federation;
2Federal State Budgetary Educational Institution of Higher Education "First Saint Petersburg State Medical University named after Academician I.P. Pavlov" of the Ministry of Health of the Russian Federation;
3State Budgetary Institution "Saint Petersburg Research Institute of Emergency Care named after I.I. Dzhanelidze";
4Federal State Budgetary Scientific Institution "Institute of Experimental Medicine";
5Federal State Budgetary Military Educational Institution of Higher Education "Military Medical Academy named after S.V. Kirov", Ministry of Defense of the Russian Federation;
6State Budgetary Healthcare Institution "City Polyclinic No. 17", Saint Petersburg, Russia
Abstract
The aim of the study: to assess the descriptive epidemiological characteristics of patient requests for emergency medical care due to high blood pressure among residents of St. Petersburg.
Materials and methods. A retrospective analysis of requests for emergency medical care among residents of St. Petersburg in 2018–2022 was conducted. A total of 541,274 patients were included in the study, who sought emergency medical care 868,736 times during this period.
Results of the study. It was shown that the number of requests for emergency medical care due to high blood pressure in 2018–2022 sharply decreased during the COVID-19 pandemic, followed by an increase in 2022 by 9% and will continue to increase, then, as shown by neural network programming, the incidence of complications will also continue to grow in subsequent years. In the structure of requests for emergency medical care due to high blood pressure in St. Petersburg, uncontrolled arterial hypertension accounted for 91.8%. 2/3 of emergency medical care calls for high blood pressure were made to women, of which 71.2% of patients were elderly, senile and long-livers. The five-year survival rate of patients who sought emergency medical care for high blood pressure, even taking into account the past pandemic of 2020-2021, was 98.5%, and as predictive modeling using neural networks showed, the number of emergency medical care calls for high blood pressure in the period 2023-2025 will remain high and will directly depend on the number of male and female patients in older age groups (elderly, senile and long-livers).
Conclusion. The structure of calls due to high blood pressure has been clarified, their dynamics and distribution of patients by age and gender have been determined. The most common emergency conditions associated with high blood pressure have been identified. The forecast of changes in patients' appeals for emergency medical care due to increased blood pressure was made and the five-year survival rate of patients was estimated taking into account the period of the COVID-19 pandemic.
Keywords: increased blood pressure, neuroprognostic modeling, older patients.
RISK FACTORS FOR ENTEROVIRUS (NON-POLIO) INFECTIONS
M.V. Novoselova, E.B. Brusina
Kemerovo State Medical University, Russian Federation, 650056б, Kemerovo, Voroshilova Street,22a.
Abstract
Introduction. Risk-oriented approach to infection prevention demonstrates high efficiency. Currently. system of epidemiological surveillance of enterovirus (non-polio) infection is insufficiently sensitive, which requires pre-epidemic diagnostics based on monitoring the properties of pathogens and risk factors.
Aim of the study was to identify risk factors for activation of the epidemic process of enterovirus (non-polio) infection.
Materials and methods. Factor and cluster analysis was carried out using data from 477 epidemiological survey cards of the enterovirus (non-polio) infection outbreak.
Results. General risk factors for enterovirus (non-polio) infection in children and adults in the observed area include: staying in and swimming in water bodies and swimming pools in other regions, abroad in the Russian Federation, as well as eating fresh vegetables and fruits. Additional risk factors in children include living in a household with decentralized sewerage systems, contact with individuals infected with enterovirus (non-polio) infection, drinking water from non-centralized water supply sources, and swimming in the region’s reservoirs.
Conclusion. The identified risk factors could be taken into account in the prevention system of enterovirus (non-polio) infection. The determination of specific clusters makes it possible to identify target groups for preventive and anti-epidemic measures.
Key words: enterovirus (non-polio) infection, pre-epidemic diagnosis, spread, risk factors, components, factor analysis, cluster analysis, dendrogram.
SURGICAL TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC INSTABILITY OF THE ACROMIOCLAVIC JOINT
(SCIENTIFIC REVIEW)
V.V. Khominets, D.V. Averkiev, K.T. Vo
S.M. Kirov Military Medical Academy. Russia, 194044, Saint-Petersburg, Akademika Lebedeva Street, 6
Abstract
Dislocation of the acromial end of the clavicle is a common injury in physically active young people, especially athletes in contact sports. The objective of surgical treatment in the acute period of injury is the reduction and stabilization of the acromial end of the clavicle for the period necessary for ligament fusion. In chronic dislocations, chronic instability of the acromioclavicular joint is formed in 20-40% in the vertical and horizontal planes with persistent pain syndrome, scapular dyskinesis, and weakness of the shoulder girdle muscles. A feature of chronic injuries is the absence of reparative potential of degeneratively altered damaged ligaments, therefore, the use of only methods of reduction and fixation of the acromial end of the clavicle is ineffective. In chronic instability, ligament and muscle transposition and ligament reconstruction using synthetic materials or tendon grafts are used. In most cases, surgical intervention is supplemented by acromioclavicular or coracoclavicular stabilization. All known methods of surgical treatment have their advantages and disadvantages. The best functional treatment results were achieved by combining methods of tendon ligament reconstruction and fixation of the acromioclavicular joint. In biomechanical experiments, the maximum restoration of vertical and horizontal stability was obtained using complex anatomical multi-bundle methods of combined reconstruction of the acromioclavicular and coracoclavicular ligament complexes. At the same time, the functional results of treatment using combined methods did not show obvious advantages compared to isolated reconstruction of the coracoclavicular ligaments.
Keywords: acromioclavicular joint, chronic instability, chronic dislocation, surgical treatment
THE ROLE OF CONTROLLED INCREASED BLOOD PRESSURE RISK FACTORS IN HEALTHY ADOLESCENTS: A COHORT STUDY
E.V. Bushueva, T.I. Dianova, O.N. Ivanova, V.A. Kichigin, E.I. Smirnova
Abstract
Introduction. Arterial hypertension is one of the leading risk factors for the development of cardiovascular catastrophe at any age, and its prevalence among the child population tends to increase. The increase in arterial pressure is influenced by a complex set of neurohumoral, hemodynamic and metabolic mechanisms that are affected by controllable factors.
Aim of the study was toevaluate the influence of controlled factors on the risk of increased arterial pressure in healthy adolescents.
Materials and methods. A cohort study was conducted. In hospital conditions, medical data were analyzed and controlled factors of 133 adolescents aged 15-18 years of the II health group were evaluated. The main II group consisted of 67 children who had episodes of high blood pressure, but arterial hypertension was excluded. The comparison group I included 66 children without an increased blood pressure. The study was conducted during 2021-2023.
Results. The risk of high blood pressure in adolescents increased with a sleep time of less than 420 minutes in boys (HR) = 2.968) and less than 390 minutes in girls (HR= 3.694), if sports activities were less than 40 minutes per day (HR=2.5), additional training sessions of more than 2.85 hours per day (HR = 2), using phones and computers for more than 3 hours per day (HR = 2.57), outdoor walks for less than 1.5 hours for boys (HR = 5.9), and less than 30 minutes for girls (HR = 4.6).
Conclusion. The influence of controlled high blood pressure risk factors has been confirmed and established, with the establishment of critical time points for the action of factors at which the relative risk of their realization in a pathological state increases several times.
Keywords: risk factors, children, adolescents, blood pressure, hypertension, prevention.
A RETROSPECTIVE OBSERVATIONAL STUDY OF A GROUP OF
PATIENTS WITH RESPIRATORY MYCOBACTERIOSIS
I.V. Petrov 1, M.A. Patyashina 2, N.G. Sokolova 3,
F.S. Petrova1,3, A.A. Almukhametov 2,4
1 Mari State University,Russian Federation, 424000, Yoshkar-Ola, Lenina square,1
2 Kazan State Medical Academy – Branch Campus of Russian Medical Academy of Continuous Professional Education,Russian Federation , 420012, Kazan, Mushtari street,11
3Republican Tuberculosis Dispensary, Russian Federation, 424037, Yoshkar-Ola, Bolnichnaya street, 22
4 Kazan State Medical University, Russian Federation, 420012, Kazan, Butlerova street, 49
Abstract
Introduction. There is a global increase is the isolation of non-tuberculosis mycobacteria from patients, as well as an increase in the incidence and prevalence of mycobacteriosis.
Aim of the study was to characterize patients with mycobacterial deseases.
Materials and methods. The authors analyzed the medical records of patients (n = 87) diagnosed with Mycobacteriosis of the lungs. Methods of bacteriological and radiation diagnostics were used. The statistical analysis was performed using the StatTech v program. 4.7.1 (developed by Stattech LLC, Russia).
Results. The average age at the time of diagnosis was 65 years. The predominance of women was established; most patients lived in urban conditions, in apartment buildings, and were unemployed pensioners. In most cases, mycobacteriosis was caused by slow-growing species of non-tuberculous mycobacteria (M. intracellulare, M. avium). The majority of patients (56/87, 64.4%) had concomitant respiratory diseases or had been treated for them earlier, 33.9% (19/56) had two or more diseases. The largest number of people with mycobacteriosis of the lungs and other respiratory diseases has contracted tuberculosis of the lungs and COVID-19. The majority of patients (64 people, 73.6%, 95%CI 63.0 – 82.4) was referred to a phthisiologist by a therapist, a narrow specialist (being observed under dispensary monitoring for another diagnosis) and underwent a medical examination during a planned hospitalization. The remaining patients (23 people, 26.4%, 95%CI 17.6 – 37.0) were referred to a phthisiologist based on the results of medical examinations, preliminary and periodic medical examinations. Analysis of clinical manifestations showed that 74.7% of patients (65 out of 87, 95%CI 64.3 – 83.4) had complaints, the leading manifestation was cough with sputum.
Conclusion. The study made it possible to determine the regional features of mycobacteriosis of the respiratory system.
Key words: mycobacteriosis, non-tuberculous mycobacteria, mycobacterial infections
GENES PPARG, IL17A, IL6, PAI-1: PROGNOSTIC SIGNIFICANCE
FOR PURULENT COMPLICATIONS AFTER TREATMENT OF LOWER
LIMB BONE INJURIES
V.V. Savgachev , L.B. Shubin
Yaroslavl State Medical University, Russian Federation, Yaroslavl region, 150000, Yaroslavl, Revolutsionnaya street, 5.
Abstract
Introduction. Research on post-treatment purulent complications (PTPC) in traumatology and orthopedics shows a connection to heredity, emphasizing the importance of genetics. Methods such as inheritance analysis, gene expression, and genetic variation are applied. This allows developing individualized treatment approaches and improving rehabilitation effectiveness. Special attention is given to immune response genes (IL-17A, IL-6) and those controlling metabolism and blood clotting (PPARG, PAI-1), which contribute to risk prediction and improved treatment outcomes.
Aim of the study was to analyze the interaction of the genes PPARG, IL17A, IL6, and PAI-1 and their effect on the course of purulent complications after treatment of lower limb bone injuries.
Materials and Methods. A prospective cohort study on genetic polymorphisms (PPARG, IL17A, IL6, PAI-1) was conducted in 208 patients with purulent complications after treatment of lower limb injuries. The allele-specific polymerase chain reaction method was used. The patients were divided into two groups: with and without recurrence of the complication within 1 year after treatment. The analysis was performed using the MDR (Multifactor Dimensionality Reduction) method to identify intergenic interactions.
Results and discussion. Firstly, linkage disequilibrium (LD) between four SNPs (SNP1 – PPARG/C 1431 T; SNP2 – IL 17 A/G – 197 A; SNP3 – IL 6 / C174G; SNP4 – PAI-1 / -675) was analyzed to identify haplotypes associated with the risk of complication recurrence. The most common haplotype was "C-G-G-5G" (18.49%). Haplotype frequencies differed between groups with and without recurrences, suggesting possible links to complication relapse.
Genetic analysis of polymorphisms and haplotypes may enhance diagnostics and treatment of lower limb injuries by reducing recurrence risks. Linkage between PPARG (C1431T) and IL17A (G-197A) was found, highlighting its predictive value.
Conclusion. The use of genetic data in traumatology helps to create personalized approaches to treatment and complications prediction. The analysis of haplotypes of polymorphisms of the PPARG, IL6, IL17A, PAI-1 genes and their connections with age, gender, and concomitant diseases demonstrates the prospects of applying genetics in clinical practice.
Keywords: complications, lower limb injuries, genes, PPARG, IL6, IL17A, PAI-1.
PROBLEMS OF DETERMINING PROTEIN IN URINE IN PATIENTS WITH MULTIPLE MYELOMA
L.V. Rydnova1, M.N. Zenina1,2, I.Yu. Styuf1, S.S. Bessmeltsev1,2, A.V. Kozlov1
1North-West State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41
2Russian Research Institute of Hematology and Transfusiology, Russia, 191024, Saint Petersburg, 2-ya Sovetskaya street, 16.
Abstract.
Introduction. The leading symptom of kidney damage in multiple myeloma is persistent proteinuria. Test strips are insensitive to Bence-Jones protein, delaying the diagnosis of multiple myeloma.
Aim of the study was to choose the optimal approach for determining protein in the urine of patients with multiple myeloma.
Materials and methods. The study included conditionally healthy individuals (n = 20) aged 31 to 87 years, 13 men and 7 women (Group 1) and patients with a newly diagnosed form of multiple myeloma (n = 20) aged 33 to 86 years, 11 men and 9 women (Group 2). The biomaterial was the first morning urine sample; the protein concentration was determined by test strips and quantitative methods – pyrogallol red and biuret examination.
Results. In Group 1, there was one case where the test strip result was "1+" and quantitative methods exceeded the discriminatory level. In the remaining 19 cases, test strip results were negative; 4 results were false negative (21%), since the protein concentration determined by quantitative methods exceeded the discriminatory level.
In Group 2, two patients – one with solitary plasmacytoma and one with non-secreting myeloma- had negative test strip results while quantitative methods showed normal values.
In the urine of 9 out of 20 (45%) patients with multiple myeloma, test strips showed false negative result, while protein concentrations determined by quantitative methods exceeded the discriminatory level.
Conclusions. In laboratories, a positive result of a protein test strip should be confirmed by a quantitative method with subsequent conduction of differential diagnosis of proteinuria. Negative protein test strip result may mask proteinuria due to the presence of a monoclonal immunoglobulin in urine. The clinician, taking into account clinical and laboratory data, prescribes protein quantification to prove proteinuria.
Key words: proteinuria, test strips, quantitative methods of protein determination in urine, multiple myeloma
CLINICAL AND EPIDEMIOLOGICAL FEATURES OF CHRONIC PAIN SYNDROME IN GENITAL ENDOMETRIOSIS: PSYCHOSEXUAL ASPECTS
E.V. Zhigalova1, B.I. Aslanov1, A.I. Fedorova1, A.A. Tsypurdeeva2
1 Federal State Budgetary Educational Institution of Higher Education "North-West State Medical University named after I.I. Mechnikov" of the Ministry of Health of the Russian Federation. Russia, 191015,
Saint Petersburg, Kirochnaya St., 41.
2Federal State Budgetary Educational Institution of Higher Education "Saint Petersburg State University". Russia, 199034, Saint Petersburg, Universitetskaya Nab., 7–9.
Abstract
Introduction. The relevance of studying the clinical and epidemiological profile of patients with chronic pain syndrome (CPS) in genital endometriosis (GE) is due to the high prevalence and negative impact of GE on the quality of life of women. In order to select the tactics of CP therapy in GE, the article analyzes psychosexual factors influencing the development and chronization of CP in GE from the standpoint of a biopsychosocial approach.
Objective. Identification of clinical and epidemiological features of chronic pain syndrome in genital endometriosis in terms of psychosexual aspects with an assessment of the predictive significance of the identified factors for CP.
Materials and methods. The study included 400 patients of reproductive age from 18 to 45 years with painful and painless forms of GE and a comparison group of women without GE and without CP. The study was based on epidemiological, clinical-anamnestic, clinical, clinical-psychopathological, clinical-sexological, psychometric and statistical research methods. To predict the factors influencing the development of BS and its chronicity, a binary logistic regression model was built using the tidymodels package in R (Vienna, Austria), which included clinically significant predictors.
Results. As a result of a comprehensive study of patients with BS in GE and subsequent statistical processing of the obtained data, a significantly higher level of psychosexual developmental disorders, sexual dysfunctions and marital disharmony, as well as psychoemotional disorders, psychopathological syndromes that do not reach the psychopathic level were revealed.
Conclusion. The obtained results indicate the statistical significance of the influence of psychosexual factors on the development and chronicity of BS in GE, which justifies the need to create and implement in medical practice an integrative algorithm for the diagnosis, treatment and prevention of BS in women with GE, including a comprehensive assessment and therapy of psychoemotional disorders, sexual dysfunctions and partner (marital) disharmony.
Key words: clinical and epidemiological profile, genital endometriosis, chronic pelvic pain, psychosexual factors, sexual dysfunctions.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
ANALYSIS OF THE ORGANISATION OF OUTPATIENT CARE FOR PATIENTS WITH HAND DISEASES IN STATE BUDGETARY INSTITUTION OF HEALTH CARE
M.R Kalashnikova1,2, A.K. Dulaev1, K. S. Klyukovkin1, N.Y. Shirshova3, D.G. Nakonechny1,2,4, D.I.Kutianov 1
1 Pavlov First Saint Petersburg State Medical University, Russia, 197022, Saint-Petersburg,Leo Tolstoy street, 6-8
2 Ltd. "Scandinavia" & "AVA-PETER" clinics Russia, 191014, Saint-Petersburg, Liteyny prospect, 55a
3 City Polyclinic No. 32,Russia,197022, Saint-Petersburg, Vyazemsky lane,3А
4 LLC «My Medical Center. Clinic of High Technologies », Russia,188651, Saint-Petersburg, Vsevolozhsk District , Yukki urban settlement,1
Abstract
Introduction. In the Russian Federation, there is no regulatory recognition of hand surgery as an independent specialty, which is particularly evident at the level of outpatient care. General practitioners and surgeons are generally insufficiently prepared to manage such patients, and the routing system remains unclear.
Aim of the study was to perform a comprehensive assessment of the organization of primary health care for patients with hand diseases, including routing, specialization of care and the level of training of doctors, in order to identify systemic limitations and formulate proposals for their elimination.
Materials and methods. A retrospective analysis of 857 outpatient records of patients with common hand diseases (carpal tunnel syndrome, tenosynovitis, Dupuytren's disease, etc.) who visited St. Petersburg outpatient clinics during 2017–2021 was conducted. A survey of 115 primary care physicians was conducted regarding their awareness and level of training in this area.
Results. It was found that primary care for patients with hand pathology is provided by general practitioners, surgeons, neurologists and traumatologists-orthopedists. Referrals to specialized specialists are often delayed and are irregular. Only 20% of doctors assess their training as sufficient, and less than 5% have undergone specialized training.
Conclusion. Significant organizational and qualification deficit in outpatient care for hand pathology have been identified. It is necessary to create a specialized city center, improve the qualifications of doctors and develop clinical recommendations or guidelines for the management of such patients.
Key words: hand surgery, hand diseases, outpatient surgery center, carpal tunnel syndrome, trigger finger, tenosynovitis of the styloid process of the radius (De Quervain's syndrome), ganglion, Dupuytren's contracture.
CLINICAL LABORATORY DIAGNOSTICS
TESTING AN ALGORITHM FOR QUANTITATIVE DETERMINATION OF UROPATOGENS AND MAIN DETERMINANTS OF ANTIBIOTIC RESISTANCE USING PCR IN URINE WITH BACTERIURIA FROM PATIENTS OF THE PEDIATRIC UROLOGY DEPARTMENT IN 2021-2023
A.V. Gromova 1, T.S. Skachkova 1, T.G. Gorshkova 1, E.N. Goloveshkina 1,
A.V. Lazareva 2, I.E. Novikova 2, V.G. Akimkin 1
1Federal Budget Institution of Science "Central Research Institute of Epidemiology" of The Federal Service on Customers' Rights Protection and Human Well-being Surveillance.
Novogireevskaya Str., 3A, Moscow, Russia, 111123
2National Medical Research Center for Children's Health Federal State Autonomous Institution of the Ministry of Health of the Russian Federation
Lomonosovsky Prospekt, 2, building 1, Moscow, Russia, 119991
Abstract
Introduction. Urinary tract infection is one of the most common bacterial infections in children. The most important component for the institution of rational antibiotic therapy is the species identification and determination of the pathogen resistance.
The aim of the study was to testing of the PCR research algorithm for quantitative assessment of bacteriuria with species identification and further detection of the main genetic determinants of antibiotic resistance.
Materials and methods. 1821 urine samples from pediatric patients were tested. The results of molecular biological and bacteriological methods for identifying uropathogens in bacteriuria were compared.
Results. The sensitivity of the PCR method for quantitative species identification of uropathogens in comparison with the reference method was 81-100%, specificity - 81-99.5%. Most common bacteria were bacteria of the order Enterobacteriales – 65%, including E. coli - 37%, K. pneumoniae - 16%, Proteus spp. - 6%. Some other pathogens were identified: Enterococcus - 16%, P. aeruginosa - 14%, Staphylococcus spp. - 5%, Streptococcus spp. - 1%, Streptococcus agalactiae - 0.5%. Optimal threshold values for each target DNA were determined: for bacteria of the order Enterobacterales, E. coli and Streptococcus spp. – about 104 GE/ml; for Proteus spp., K.pneumoniae, P.aeruginosa, Enterococcus spp., Staphylococcus spp. and S. agalactiae – about 103 GE/ml; for the Bacteria domain – about 105 GE/ml.
Conclusion. The introduction of PCR studies into laboratory diagnostics will reduce the time for identifying pathogenic biological agents to 5 hours. In addition, PCR research does not require manipulation of bacterial cultures and allows working with biological material only. Molecular genetic determination of antibiotic resistance genes in biological material can be used to prescribe therapy before pure culture isolation of bacteria.
Keywords: PCR, urinary tract infection, antibiotic resistance, bacteriuria, molecular biological methods