CONTENTS 2024_3
HYGIENE
Kalyuzhny E.A., Rakhmanov R.S., Bogomolova E.S., Mukhina I. V., Sheyykhova S. Sh.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
Arseniev A.I., Gagua K.E., Novikov S.N., Barchuk A.A., Tyurina E.S., Arseniev E.A., Nefedov А.O., Tarkov S.A., Novikov R.V., Aristidov N.Y.
Podorova L.A., Evdokimova N.V.
Fursova E.A., Kochetkova I.V., Gurov V.R., Abramova Yu.A.
Arseniev A.I., Gagua K.E., Novikov S.N., Barchuk A.A., Tyurina E.S., Arseniev E.A., Nefedov А.O., Tarkov S.A., Novikov R.V., Aristidov N.Y.
Orlov O.A., Alyeva M.Kh., Kaufman E.A., Dzhumaklychev B., Khorinko A.V., Gorelikova E.V., Golodnova S.O.
Davtyan N.R., Klur M.V., Aslanov B.I., Pogromskaya M.N., Goncharov A.E.
Shtina I.E., Ustinova O.Yu., Ermakova O.V., Shtina A.D.
Suraeva N.A., Zakharchenko O.O., Terentyeva D.S.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
Ponomarenko G.N., Kozhushko L.A., Rokhmanova M.V.
Sokolovskaya T.A., Armashevskaya O.V.
REVIEW OF THE MONOGRAPHY
Meltser A.V.
TO AUTHORS ATTENTION
HYGIENE
MORPHOFUNCTIONAL ORGANISM STATUS OF MEDICAL UNIVERSITY STUDENTS
E.A. Kalyuzhny, R.S. Rakhmanov, E.S. Bogomolova,
I. V. Mukhina, S. Sh. Sheyykhova
Volga Research Medical University, Russia, 603950, Nizhny Novgorod, Minin and Pozharsky square,10/1
Abstract
Introduction. The study of the growth and development characteristics of students is one of the priority tasks in preventive medicine.
The aim of the study was to assess the gender characteristics of sexual dimorphism, harmony of morphofunctional development and somatotype of medical university students.
Materials and methods. The study included students aged 19.5±0.4 years (45 males and 132 females). The nutritional status (Kettle2 index), physical development by sigma and parametric methods, tempo somatotype, harmony of morphofunctional development were evaluated.
Results. Males were characterized by statistically significant greater values in height, body weight, chest circumference by 10.8 cm, 15.5 kg and 10.2 cm, lung capacity (by 44.3%), strength of the right (by 61.5%) and left (by 49.8%) hands. The upper values of diastolic pressure and heart rate exceeded reference limits. Systolic blood pressure in males was significantly higher by 6.2%, diastolic – by 7.7%. Body weight was assessed as normal. Individuals with microsomatic somatotype prevailed in the groups. Two-thirds of both males and females were harmoniously developed, while the rest were disharmonious. The trend of intra-group ontogenetic patterns of the physiological status of students was confirmed. Gender characteristics in males included an increase in height with a decrease in body weight and a divergent shift of the chest circumference, while in females was an increase in height with a decrease in body weight and chest circumference. This indicated a gracialization of the students' bodies, which is more pronounced in gemales. This micro-population differed from the regional standard by the predominance of extreme sigma and centile intervals. The limitations of the study included healthy female and male students studying in different faculties at the medical university.
Conclusion. A slowed pace of physical development among students was revealed. Evidence of the tension of the body's adaptation mechanisms is indicated by elevated pulse rates and diastolic pressure, more pronounced in young men.
Keywords: students; gender groups; morphofunctional indicators; sexual dimorphism; tempo somatotype; harmonious development.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
THE USE OF HIGH-DOSE ENDOBRONCHIAL BRACHYTHERAPY IN CENTRALLY LOCATED ADVANCED AND METASTATIC NON-SMALL CELL LUNG CANCER
A.I. Arseniev 1,2, K.E. Gagua 1, S.N. Novikov 1, A.A. Barchuk 1,4, E.S. Tyurina 4, E.A. Arseniev 1, А.O. Nefedov 3, , S.A. Tarkov 1, R.V. Novikov 1, N.Y. Aristidov1,2
1 National Medical Research Center of Oncology named after N.N. Petrov, Russia,197758, Saint Petersburg, Pesochny, Leningradskaya street, 68
2North-Western State Medical University named after I.I. Mechnikov, Russia,191015, Saint-Petersburg, Kirochnaya street, 41
3Saint-Petersburg State Research Institute of Phthisiopulmonology, Russia, 191036, Saint Petersburg, Ligovsky avenue, 2-4.
4European University at St. Petersburg. Institute for Interdisciplinary Health Research,Russia, 191187, Saint-Petersburg, Gagarinskaya street, 6/1A
Abstract
Introduction. Lung cancer was the most commonly diagnosed malignancy with the highest mortality rate among all oncological disease in 2022.
The aim of the study was to conduct multifactorial analysis of the effectiveness of high-dose endobronchial brachytherapy.
Materials and methods. The treatment results of 570 patients with centrally located advanced and metastatic non-small cell lung cancer (1998-2022) were analyzed using the "MatchIt" model. The main group was represented by patients receiving brachytherapy (19.5%; n=111). Patients with stage III accounted for 71.9%, and with stage IV – 28.1%. The fractionation mode of 7 Gy for 1-4 fractions was used with a 7-day interval, with a total dose ranging from 7 to 28 Gy (on average 18.4 Gy).
Results. Brachytherapy increase the frequency of objective response from 35.1% to 73.9%, achieve an endoscopic response in 91.9%, and improve the X-ray findings in 95.1% (p<0.001). The method provides cumulative symptoms relief in 95.4% of patients, effectively controlling symptoms such as hemoptysis - 97.5%, shortness of breath - 95.9%, cough - 94.0%, pain - 95.6%. In the brachytherapy group, survival benefits were demonstrated: for 2-year-olds - 36.8% vs. 10.0%, p<0.001, median survival – 19 vs. 10 months: HR=0.39; p<0.001. Statistically significant factors influencing survival rates included: status T4 - HR=0.1, p=0.01; N3 - HR=2.26, p=0.006; M1 - HR=3.76, p<0.001; IIIC and IV stages - HR=17.1, p=0.007 / HR=11.3, p=0.002; additional chemotherapy - HR=1.4, p=0.0005; subsequent distant irradiation – HR=9.3, p=0.003. Survival rates in the brachytherapy group were significantly higher in patients with a complete objective response HR=1.6, p=0.0004, and effective symptom control significantly correlated with higher survival rates - HR=1.9, p=0.00032.
Conclusion. High-dose endobronchial brachytherapy is an effective method to increase the life expectancy of patients and improve its quality.
Key words: non-small cell lung cancer; central lung cancer; endoscopic recanalization; endobronchial high-dose brachytherapy.
FEATURES OF DYSLIPIDEMIA IN OBESITY IN CHILDREN (SCIENTIFIC REVIEW)
L.A. Podorova, N.V. Evdokimova
Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, 194100, Litovskaya Street, 2, Russia.
Abstract
The prevalence of obesity in children and adolescents leads to an increased incidence of secondary dyslipidemia, leading to the development of complications in adulthood. The aim of our review is to investigate the features of dyslipidemia in pediatric obesity based on published contemporary data published from 2017 to 2024. The mechanism of dyslipidemia development is increased fatty acid entry into the liver due to increased caloric intake, insulin resistance and de novo synthesis of free fatty acids in the liver, as a consequence, triglycerides, very low density lipoproteins and apolipoprotein B100 levels are increased, causing increased ester exchange via transport protein between high, low and very low density lipoproteins. Liver lipase hydrolyzes low and high density lipoprotein triglycerides, which forms small dense low density lipoprotein particles, due to which the total low density lipoprotein level in the blood is increased, and small high density lipoprotein particles, which can be excreted with the kidneys, resulting in a decrease in high density lipoprotein levels. Most children with dyslipidemia have no clinical manifestations of the disease. The first symptoms with which a child seeks medical help may be manifestations of arterial hypertension. The diagnosis of "dyslipidemia" is established in the presence of 2 or more "high" and/or "low" indicators: cholesterol ≥5.2 mmol/L, triglycerides >1.3 (for children under 10 years); 1.7 (for children over 10 years) mmol/L, high-density lipoproteins ≤ 0.9 (boys) and ≤ 1.03 (girls) mmol/L, low-density lipoproteins ≥3.0 mmol/L. The basis of treatment and prevention of dyslipidemia on the background of obesity is normalization of body weight through diet therapy and exercise. If they are ineffective, statins, cholesterol absorption inhibitors or fibrates are used.
Key words: children, obesity, dyslipidemia.
COMPARATIVE EVALUATION OF THE EFFICACY AND SAFETY OF COMBINATION THERAPY WITH SYSTEMIC AND LOCAL ANTI-INFLAMMATORY DRUGS IN PATIENTS WITH KNEE OSTEOARTHRITIS
E.A. Fursova, I.V. Kochetkova, V.R. Gurov, Yu.A. Abramova
Voronezh State Medical University named after N. N. Burdenko, Russia,394036, Voronezh, Studentskaya street,10
Abstract
Introduction. Osteoarthritis is the most common musculoskeletal disorder and a leading cause of disability worldwide [1,8]. Osteoarthritis (OA) occurs in every third patient aged 40 to 70 years.
Currently, OA is known as a chronic inflammatory process associated with aging. Low-intensity inflammation and an increase in the synthesis of proinflammatory cytokines lead to the predominance of catabolic processes in cartilage tissue, structural changes and the formation of pain syndrome [2,7].
In everyday clinical practice, physicians face the problem of choosing the safest and most effective combinations of medicines [3,6].
The aim of the study was to evaluate the clinical efficacy and safety of combined anti-inflammatory therapy in patients with knee osteoarthritis using systemic and local medicines - in the form of aceclofenac 1.5% cream / diclofenac 1% emulgel / ketoprofen 5% cream.
Materials and methods. The use of combined anti-inflammatory therapy for knee osteoarthritis: meloxicam orally with one of the local NSAIDs: aceclofenac / diclofenac / ketoprofen for 14 days resulted in significant decrease in pain syndrome indicators, severity of functional impairment, total WOMAC index score and VAS levels, as well as complete or partial reduction of synovitis.
Results. It was found that the combination of NSAIDs (meloxicam + aceclofenac 1.5% cream) resulted in fewer side effects from the gastrointestinal tract (GI tract) and cardiovascular system (CVS) compared to the combinations: meloxicam+diclofenac 1% emulgel and meloxicam+ ketoprofen 5% cream.
Conclusions. Anti-inflammatory therapy with three drug combinations was characterized by positive tolerability and safety. Side effects occurred relatively rarely and were mild, allowing the use of these therapy options in patients with knee OA, taking into account gastrointestinal and cardiovascular risks.
Key words: knee osteoarthritis, NSAIDs, local anti-inflammatory therapy, efficacy and safety.
ENDOSCOPIC BRONCHIAL RECANALIZATION IN THE COMBINED TREATMENT OF CENTRAL LUNG CANCER
A.I. Arseniev 1,2, K.E. Gagua 1, S.N. Novikov 1, A.A. Barchuk 1,4, E.S. Tyurina 4, E.A. Arseniev 1, А.O. Nefedov 3, S.A. Tarkov 1, R.V. Novikov 1, N.Y. Aristidov1,2
1National Medical Research Center of Oncology named after N.N.Petrov, Russia, 197758, Saint Petersburg, Pesochny, Leningradskaya street, 68
2 North-Western State Medical University named after I.I. Mechniko, Russia,191015, Saint-Petersburg, Kirochnaya street, 41
3 Saint-Petersburg State Research Institute of Phthisiopulmonology, Russia,191036, Saint Petersburg, Ligovsky avenue, 2-4.
4 European University at St. Petersburg,Institute for Interdisciplinary Health Research,Russia,191187, Saint-Petersburg, Gagarinskaya street, 6/1A
Abstract
Introduction. Among malignant neoplasms, lung cancer ranked first in 2022 for the highest mortality rate.
The aim of the study was to evaluate the effectiveness and safety of endoscopic recanalization of the airways as a part of combined treatment of patients with central non-small cell lung cancer (NSCLC).
Materials and methods. The results of treatment of 163 patients with stage III-IV central non-small cell lung cancer with obstructive tumor stenosis of the bronchi, who underwent endoscopic recanalization (1998-2022) under fibrobronchoscopy (36.8%) or rigid bronchoscopy (63.2%), were analyzed. Argonoplasmic coagulation (95.7%) and laser vaporization (4.3%) were used as a technology for direct impact on the tumor.
Results. In the presence of tumor stenoses of the respiratory tract performing recanalizations allowed for restoration of bronchial lumen in 95.7% of patients: completely in 31.9% and partially in 63.8% (p<0.001). Complete restoration of the lumen with rigid bronchoscopy was achieved in 41.8%, and with fibrobronchoscopy in 15.0% (p<0.001). Respiratory failure was eliminated or transferred to a compensated form in 94.8% of patients, while lung vital capacity improved in 94.6% of patients, bronchial patency in 93.8%. Non–fatal complications were noted in 19% of patients: temporary increase in respiratory failure - 10.4%, bleeding from bronchial arteries – 3.7% and bronchial perforation - 4.9%. The rate of complications was higher with rigid bronchoscopy (25.2% vs. 8.3%; p=0.00798), although this was justified by the superior effectiveness of the access method. Recanalization did not impact long-term outcomes (HR=1 [0.8-1.3], p=0.9896), however, it allowed to improve the functional status of patients and to carry out subsequent antitumor treatment.
Conclusion. Endoscopic recanalization in central NSCLC with obstructive tumor stenosis is an effective and safe method that optimizes functional parameters, improving quality of life and ensuring the implementation of comprehensive specialized treatment.
Key words: non-small cell lung cancer, central lung cancer, endoscopic recanalization, combined treatment, endobronchial brachytherapy.
EPIDEMIOLOGICAL FEATURES OF INCIDENCE AND MORTALITY FROM NON-HODGKIN LYMPHOMAS IN PERM REGION
O.A. Orlov1,2, M.Kh. Alyeva1, E.A. Kaufman1, B. Dzhumaklychev2, A.V. Khorinko2, E.V. Gorelikova1, S.O. Golodnova1
1Perm State Medical University named after Academician E.A. Wagner, Russia,614000, Perm, Petropavlovskaya street, 26
2Perm Regional Oncology Dispensary, Russia, 614066, Perm, Bauman street, 15
Abstract
Introduction. Non-Hodgkin lymphomas represent a heterogeneous group of neoplastic diseases originating from cells of the lymphatic system. Although they rank 11th in the structure of the incidence of all forms of cancer, non-Hodgkin lymphomas have significant medical and social importance due to its clinical and epidemiological features.
The aim of the study was to investigate the epidemiological features of morbidity and mortality from non-Hodgkin lymphomas in Perm region for the period from 2007 to 2022.
Materials and method. A descriptive-evaluative retrospective epidemiological study was performed according to official data: reporting forms No. 7 «Information on inflammatory malignant neoplasms», No. 35 «Information on patients with malignant neoplasms» and No. 35 «Information on patients with malignant neoplasms» and No. «Distribution of deaths by gender, age groups and causes of death» for the period from 2007 to 2022. In long-term dynamics, the structure of incidence by gender and age was studied. The average annual growth (decrease) rate and trends determination in morbidity of cancer was calculated using a first-order parabola (y = a + bx).
Results. It was revealed that the incidence of non-Hodgkin lymphoma in the Perm region increased by 1.8 times, in Russia - by 1.2 times. The mortality rate remains stable throughout the 15-year observation period both in Perm region and Russian Federation. Risk groups included persons over 65 years of age; with morbidity in male population being 1.5 times higher than in female population.
Conclusion. Non-Hodgkin lymphomas remain one of the priority areas for the prevention of malignant neoplasms in Perm region due to a moderate tendency towards increasing morbidity. The obtained data on the epidemiological features of this nosology in the region serve as a basis for further in-depth study aimed at identifying regional risk factors.
Key words: non-Hodgkin lymphoma, incidence, mortality, epidemiology, risk groups.
ANALYSIS OF THE MICROBIAL SPECTRUM OF THE OROPHARYNX IN YOUNG PATIENTS WITH CHRONIC APHTHOSIC STOMATITIS ON THE BACKGROUND OF ACUTE RESPIRATORY VIRAL INFECTION
Davtyan N.R., Klur M.V., Aslanov B.I., Pogromskaya M.N., Goncharov A.E.
1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya Street, 41
2 Clinical Infectious Diseases Hospital named after S.P. Botkin, Russia, 191167, Saint-Petersburg, Mirgorodskaya, 3
Abstract
Aim of the study was to analyze the spectral composition of the microbiota isolated from the surface of the tonsils and the posterior pharyngeal wall in young patients without a complicated medical history and concomitant ENT pathology, experiencing recurrence of chronic aphthous stomatitis against the background of acute respiratory viral infection.
Materials and methods. Retrospective examination was conducted on 210 medical records of patients with chronic aphthous stomatitis, whose manifestations were recorded at the time of hospitalization at the Clinical Infectious Disease Hospital named after S.P. Botkin with the primary diagnosis of "acute respiratory viral infection." As a complication, acute tonsillitis was registered. The results of bacteriological cultures from the surface of the tonsils and the posterior pharyngeal wall for anaerobic and facultative anaerobic microorganisms were analyzed, along with antibiotic sensitivity testing.
Results. In most cases (90,0%, n=189) chronic aphthous stomatitis was characterized by single lesions; in 6,2%9 (n=13) the lesions were widespread, accompanied by significant pain syndrome and sleep disturbances; while in 3.8% (n=8) of patients, severe cases with extensive, long-lasting non-healing ulcerative defects of the oral mucosa were registered. The microbiotic spectrum was characterized by low species diversity and was predominantly represented by Streptococcus viridans (93.3%, n=196) and non-pathogenic Neisseria (58.6%, n=123). Moreover, the species composition of microorganisms did not correlate with the severity of chronic aphthous stomatitis.
Conclusion. The obtained data indicate the absence of visible disturbances in the microbial spectrum of the oral cavity in young patients (25±1.6 years) hospitalized with acute respiratory viral infection and relapse of chronic aphthous stomatitis at the time of hospitalization. The vast majority of isolated microorganisms are representatives of normal microflora.
CORRELATIONS OF PARAMETERS OF PULSE OSCILLOMETRY PARAMETERS WITH ANTHROPOMETRIC DATE, AGE AND SEX IN CHILDREN
I.E. Shtina1,2, O.Yu. Ustinova1, O.V. Ermakova 1, A.D. Shtina1
1 Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Russia, 614045, Perm, Monastyrskaya street, 82
2 Perm State Medical University named after Academician E.A. Wagner, Russia, 614000, Perm
Petropavlovskaya street,26
Abstract
Introduction. Impulse oscillometry is a method for assessing external respiratory function in children, as it does not require a forced expiration maneuver.
The aim of the study was to analyze the correlations of impulse oscillometry parameters with anthropometric date, age and gender in children.
Materials and methods. The study involved 240 children aged 4–14 years:130 boys (54.2%) and 110 girls (45.8%) (p=0.220), mean age 9±2.49 and 9±2.56 years, respectively (p=0.653). All children underwent anthropometric study, impulse oscillometry (IOS) determing the relative value of the total respiratory resistance at an oscillation frequency of 5 Hz, resistive resistance at an oscillation frequency of 5 and 20 Hz, reactance at an oscillation frequency of 5 Hz, frequency dependence of resistance and resonant frequency. Mathematical and statistical analysis of the results was performed.
Results. Data analysis revealed a statistically significant weak negative correlation between respiratory impedance and gender (r = -0.14 – (-0.13)), resistive resistance (5 Hz) with growth (r = -0.13), and a negative correlation between resistive resistance ( 20 Hz) – with gender, a positive connection – with age and height (r = 0.25–0.26), a negative connection of reactance (5 Hz) – with gender and height (r = -0.15 – (-0, 13)). Established moderate correlations between resonant frequency and frequency dependence with age and gender (r = -0.46 – (-0.36)), allowed for the calculation of regression coefficients.
Conclusion. The obtained results indicate the importance of considering gender, height and age when interpreting the results of impulse oscillometry for assessing external respiratory function.
Key words: impulse oscillometry; children; external respiration function; height; gender; sex; respiratory resistance.
DETECTION OF MALIGNANT NEOPLASMS DURING DISPENSARY EXAMINATION OF ADULT POPULATION IN THE NORTH-WESTERN FEDERAL DISTRICT DURING 2018-2023
N.A. Suraeva1, Zakharchenko O.O.2, Terenteva D.S.2
1 National Medical Research Center of Oncology named after N.N.Petrov, Russia, 197758, Saint Petersburg, Pesochny, Leningradskaya Street, 68
2Central Research Institute of Health Care Organization and Informatisation, Russia, 127254, Moscow, Dobroliubova Street, 11
Abstract
Introduction. Currently, one of the main tasks facing the state is to preserve the health of the nation, increase life expectancy, and reduce mortality. Experience shows that the leading technology for ensuring the effectiveness of preventive health care is dispensary examination of the adult population. For the early detection of malignant neoplasms, a number of screening measures and research methods are provided during the dispensary.
The aim of the study was to estimate the detection rate of malignant neoplasms during the dispensary examination of the adult population in the Russian Federation, the North-West Federal District and its subjects.
Materials and methods. Data from the industry statistical reporting form No. 131/o "Information on the dispensary examination of certain groups of the adult population" during 2018-2023 were used, as well as regulatory legal documentation regulating the conduct of dispensary examinations. Descriptive statistics methods, content analysis, and retrospective comparative analysis were applied in the study.
Results. The frequency of detected cases of malignant neoplasms during dispensary examinations in Russia and the Northwestern Federal District from 2018 to 2020 averaged 1.4 and 1.5 per 1,000 examined citizens, respectively, while in 2021–2023 it was 1.3 and 1.4. The share of first-time diagnosed malignant neoplasms and in situ neoplasms from the total number of newly diagnosed chronic non-communicable diseases in Russia and the Northwestern Federal District in 2018-2020 was 1.1% and 1.6%, respectively; in 2021–2023 it was 1.6% and 1.7%. The share of first-time detected cases of malignant neoplasms at stages 1-2 from the number of newly diagnosed malignant neoplasms and neoplasms in situ in Russia and the Northwestern Federal District in 2018-2020 averaged 52.4 and 54.5%; and in 2021-2023, 1.6 and 62.9%, respectively. - 57.9 and 62.9%.
Conclusion. The low proportion of malignant neoplasms detected during dispensary examinations may indicate insufficient attention to the problem of early detection of neoplasms, including malignant neoplasms during dispensary examinations of the adult population.
Keywords: dispensary examination of the adult population, malignant neoplasms, in situ neoplasms, detection of malignant neoplasms, screening, oncological component of health examination, statistical accounting during health examinations.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
RETROSPECTIVE OBSERVATIONAL STUDY OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
A.L. Ershov1, A.A. Boykov2, L.E. Elchinskaya2,
A.Yu.Shchurov2, T.A. Kolomoitseva3
1North-Western State Medical University named after I.I. Mechnikov,Russia, 191015, Saint-Petersburg, Kirochnaya street, 41
2 City Emergency Medical Care Station,Russia, 191023, Saint-Petersburg, Malaya Sadovaya street, 1/25
3City outpatient clinic №52, Department of Emergency Medical Care, Russia,194354, Saint- Petersburg, Lunacharsky avenue, 60
Abstract
Introduction. Chronic obstructive pulmonary disease (COPD) is a widespread disease that significantly impacts disability and mortality among population. The number of patients with COPD is steadily increasing, and as the clinical manifestations become pronounced, they being seek emergency medical care (EMS). However, there are currently no treatment protocols for COPD patients, making it challenging for EMA services.
Aim of the study was to provide a medical-demographic characteristic of a group of patients with COPD who applied for EMS.
Results. A retrospective study was conducted of the results of 951 emergency medical services calls to patients with COPD, as the main or concomitant disease. These data accounted for 0.2% of the total number of EMS calls over a12 month period. The average age of patients in this group was 65.7±14.79 years. In 60.4% of cases, the diagnosis of COPD was primary, in the other cases it was a competing or concomitant diagnosis. Comorbidity was present in 75.8% of patients; cardiovascular pathology predominated among concomitant diseases. In 67.3% of patients, the general condition was assessed as moderate, in 23.5% - as severe. Patients in these groups experienced acute respiratory failure (ARF) of grades 2-3. Among COPD patients who south EMS, 78,3% were admitted to the hospital. The highest number of requests for EMS from patients with COPD was observed from October to January.
Conclusion. Patients diagnosed with COPD are distinguished by: seasonal variations in the use of EMS; elderly age; high level of comorbidity; severity of general condition; presence of acute respiratory failure, high need for inpatient treatment. Providing medical care to patients with COPD is complicated by the lack of clinical recommendations (treatment protocols) prepared for use in the specific conditions of the EMS service.
Keywords: chronic obstructive pulmonary disease, epidemiology, emergency medical care
ASSISTED LIVING AS A NEW TECHNOLOGY IN COMPLEX REHABILITATION OF DISABLED PEOPLE
G.N. Ponomarenko1, 2, L.A. Kozhushko1, M.V. Rokhmanova1
1Albrecht Federal Scientific and Educational Centre of Mediсal and Social Expertise and Rehabilitation, Russia, 195067, Saint Petersburg, Bestuzhevskaya Street, 50
2North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41
Abstract
Introduction. The process of rehabilitation and habilitation of disabled people involves not only providing them with medical care, but also includes a wide range of measures aimed at their social adaptation and integration into the society. These measures are particularly crucial for disabled people who are unable to lead independent life and reside in institutional care.
In this regard, the task of preparing disabled people for life outside intuitional settings becomes relevant, through the organization of assisted living and training aimed at developing their independence and communication skills.
Since 2019, the state has been co-funding activities to train people with disabilities and their family members in caregiving skills, selection and use of assistive technologies, as well as rehabilitation skills, as a part of the implementation of the state program “Accessible Environment” to develop regional programs for comprehensive rehabilitation and habilitation of disabled people, which indicates the social significance of this direction.
The aim of the study was to assess the level and dynamics of development of the development
of the assisted living as a new technology in the comprehensive rehabilitation of disabled people in the Russian Federation.
Materials and methods.The materials provide data from annual monitoring studies of the development of assisted living of disabled people, collected using a classification table designed within this study. The table demonstrates all categories (and subcategories) for subsequent substantive assessment of the identified indicators provided by the executive authorities of 85 constituent entities of the Russian Federation.
The study involves general scientific methods (analysis, synthesis, grouping), logical generalization, comparative and statistical analyses to achieve its aim.
Results. There is a positive trend in the development of assisted living for disabled people: in 2022 compared to 2018, the number of entities implementing these technologies and participated in their financing increased by 1.9 times (from 39 to 75 entities), the number of disabled people who underwent training for assisted living and received a range of necessary medical, social and rehabilitation services at home increased by 2.3 times (from 1291 people to 4245 people).
According to forecasts, by 2026, the number of disabled people who have undergone training for assisted living will increase by 40.0reaching over 6,000 thousand people, as indicated an ascending trend line (R2 is approaching one). However, as of January 1, 2022, the was a need for this form of living arrangements among 9,828 people, revealing that only 43.2% of those in need had undergone training.
The development of knowledge, skills and abilities among disabled people in the field of social and everyday adaptation, social and environmental orientation and communication activities is an important condition on their path to independent or assisted living.
Conclusion.Further development of assisted living technologies will enable disabled people to live at home, receive a range of social and rehabilitation services, be more independent and feel like equal members of our society.
Key words: assisted living; comprehensive rehabilitation; rehabilitation services; disability; training apartment
POPULATION AWARENESS OF SEXUALLY TRANSMITTED INFECTIONS AND THEIR IMPORTANCE FOR MAINTAINING REPRODUCTIVE HEALTH
T.A. Sokolovskaya, O.V. Armashevskaya
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russia, 127254, Moscow, Dobrolubov street, 11
Abstract
Introduction. Sexually transmitted infections (STIs) are not only socially significant diseases, but also negatively affect the reproductive health of the population. This in turn contributes to the formation of developmental delays and congenital anomalies in the fetus. At the same time, preventive measures aimed at strengthening and preserving reproductive health cover the female population to a greater extent, paying insufficient attention to men and their problems. However, the success of preventive measures is largely determined by the compliance of medical workers, educators, families and future parents.
Aim of the study was to analyze the levels of knowledge of the population about sexually transmitted infections as the basis for maintaining reproductive health at the regional level.
Material and methods. The study involved 390 respondents (134 men and 256 women) aged 18 years and older, which corresponds to a representative sample with a confidence level of 95%. Descriptive statistics were used to describe the characteristics (M – mean, SD – standard deviation, SE – standard error, ±95% CI – confidence interval); and to identify differences and connections between characteristics: Mann-Whitney U test (U empirical ≤ U critical at p≤0.05) and correlation analysis (at p≤0.05).
Results. According to the study, it was revealed that the majority of respondents were aware of STIs and their negative impact on the health of the unborn child (M - 82.0%; n = 110; F - 92.6%; n = 237 and 73.9% - 83, 2%). At the same time, only 56.7% (M; n = 76) and 60.5% (F; n = 155) of respondents use barrier methods of contraception to prevent STIs, despite the fact that 10.0% of women and 7.8 % of men prefer chance meetings. Parents has a priority role in the formation of sexual culture and intimate hygiene skills (72.8±9.1% and 45.8±11.7%). It is the sufficient level of knowledge on intimate hygiene and the presence of conversations with parents about sexual relations and family planning that allow respondents to understand the role of STIs in disrupting reproductive health and the health of future children (r = 0.60; r = 0.37; r = 0.52 and r = 0.43; at p≤0.05).
Conclusion. The analysis showed that despite high awareness of the negative consequences of STIs, the concept of contraception, and recognition of the role of the family, as the main educational resource, respondents have a lack of knowledge on this issue and they have problems in implementing preventive strategies.
Key words: sexually transmitted infections, reproductive health, population, prevention.
CONTENTS 2024_3
HYGIENE
Kalyuzhny E.A., Rakhmanov R.S., Bogomolova E.S., Mukhina I. V., Sheyykhova S. Sh.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
Arseniev A.I., Gagua K.E., Novikov S.N., Barchuk A.A., Tyurina E.S., Arseniev E.A., Nefedov А.O., Tarkov S.A., Novikov R.V., Aristidov N.Y.
Podorova L.A., Evdokimova N.V.
Fursova E.A., Kochetkova I.V., Gurov V.R., Abramova Yu.A.
Arseniev A.I., Gagua K.E., Novikov S.N., Barchuk A.A., Tyurina E.S., Arseniev E.A., Nefedov А.O., Tarkov S.A., Novikov R.V., Aristidov N.Y.
Orlov O.A., Alyeva M.Kh., Kaufman E.A., Dzhumaklychev B., Khorinko A.V., Gorelikova E.V., Golodnova S.O.
Davtyan N.R., Klur M.V., Aslanov B.I., Pogromskaya M.N., Goncharov A.E.
Shtina I.E., Ustinova O.Yu., Ermakova O.V., Shtina A.D.
Suraeva N.A., Zakharchenko O.O., Terentyeva D.S.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
Ponomarenko G.N., Kozhushko L.A., Rokhmanova M.V.
Sokolovskaya T.A., Armashevskaya O.V.
REVIEW OF THE MONOGRAPHY
Meltser A.V.
TO AUTHORS ATTENTION
HYGIENE
MORPHOFUNCTIONAL ORGANISM STATUS OF MEDICAL UNIVERSITY STUDENTS
E.A. Kalyuzhny, R.S. Rakhmanov, E.S. Bogomolova,
I. V. Mukhina, S. Sh. Sheyykhova
Volga Research Medical University, Russia, 603950, Nizhny Novgorod, Minin and Pozharsky square,10/1
Abstract
Introduction. The study of the growth and development characteristics of students is one of the priority tasks in preventive medicine.
The aim of the study was to assess the gender characteristics of sexual dimorphism, harmony of morphofunctional development and somatotype of medical university students.
Materials and methods. The study included students aged 19.5±0.4 years (45 males and 132 females). The nutritional status (Kettle2 index), physical development by sigma and parametric methods, tempo somatotype, harmony of morphofunctional development were evaluated.
Results. Males were characterized by statistically significant greater values in height, body weight, chest circumference by 10.8 cm, 15.5 kg and 10.2 cm, lung capacity (by 44.3%), strength of the right (by 61.5%) and left (by 49.8%) hands. The upper values of diastolic pressure and heart rate exceeded reference limits. Systolic blood pressure in males was significantly higher by 6.2%, diastolic – by 7.7%. Body weight was assessed as normal. Individuals with microsomatic somatotype prevailed in the groups. Two-thirds of both males and females were harmoniously developed, while the rest were disharmonious. The trend of intra-group ontogenetic patterns of the physiological status of students was confirmed. Gender characteristics in males included an increase in height with a decrease in body weight and a divergent shift of the chest circumference, while in females was an increase in height with a decrease in body weight and chest circumference. This indicated a gracialization of the students' bodies, which is more pronounced in gemales. This micro-population differed from the regional standard by the predominance of extreme sigma and centile intervals. The limitations of the study included healthy female and male students studying in different faculties at the medical university.
Conclusion. A slowed pace of physical development among students was revealed. Evidence of the tension of the body's adaptation mechanisms is indicated by elevated pulse rates and diastolic pressure, more pronounced in young men.
Keywords: students; gender groups; morphofunctional indicators; sexual dimorphism; tempo somatotype; harmonious development.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
THE USE OF HIGH-DOSE ENDOBRONCHIAL BRACHYTHERAPY IN CENTRALLY LOCATED ADVANCED AND METASTATIC NON-SMALL CELL LUNG CANCER
A.I. Arseniev 1,2, K.E. Gagua 1, S.N. Novikov 1, A.A. Barchuk 1,4, E.S. Tyurina 4, E.A. Arseniev 1, А.O. Nefedov 3, , S.A. Tarkov 1, R.V. Novikov 1, N.Y. Aristidov1,2
1 National Medical Research Center of Oncology named after N.N. Petrov, Russia,197758, Saint Petersburg, Pesochny, Leningradskaya street, 68
2North-Western State Medical University named after I.I. Mechnikov, Russia,191015, Saint-Petersburg, Kirochnaya street, 41
3Saint-Petersburg State Research Institute of Phthisiopulmonology, Russia, 191036, Saint Petersburg, Ligovsky avenue, 2-4.
4European University at St. Petersburg. Institute for Interdisciplinary Health Research,Russia, 191187, Saint-Petersburg, Gagarinskaya street, 6/1A
Abstract
Introduction. Lung cancer was the most commonly diagnosed malignancy with the highest mortality rate among all oncological disease in 2022.
The aim of the study was to conduct multifactorial analysis of the effectiveness of high-dose endobronchial brachytherapy.
Materials and methods. The treatment results of 570 patients with centrally located advanced and metastatic non-small cell lung cancer (1998-2022) were analyzed using the "MatchIt" model. The main group was represented by patients receiving brachytherapy (19.5%; n=111). Patients with stage III accounted for 71.9%, and with stage IV – 28.1%. The fractionation mode of 7 Gy for 1-4 fractions was used with a 7-day interval, with a total dose ranging from 7 to 28 Gy (on average 18.4 Gy).
Results. Brachytherapy increase the frequency of objective response from 35.1% to 73.9%, achieve an endoscopic response in 91.9%, and improve the X-ray findings in 95.1% (p<0.001). The method provides cumulative symptoms relief in 95.4% of patients, effectively controlling symptoms such as hemoptysis - 97.5%, shortness of breath - 95.9%, cough - 94.0%, pain - 95.6%. In the brachytherapy group, survival benefits were demonstrated: for 2-year-olds - 36.8% vs. 10.0%, p<0.001, median survival – 19 vs. 10 months: HR=0.39; p<0.001. Statistically significant factors influencing survival rates included: status T4 - HR=0.1, p=0.01; N3 - HR=2.26, p=0.006; M1 - HR=3.76, p<0.001; IIIC and IV stages - HR=17.1, p=0.007 / HR=11.3, p=0.002; additional chemotherapy - HR=1.4, p=0.0005; subsequent distant irradiation – HR=9.3, p=0.003. Survival rates in the brachytherapy group were significantly higher in patients with a complete objective response HR=1.6, p=0.0004, and effective symptom control significantly correlated with higher survival rates - HR=1.9, p=0.00032.
Conclusion. High-dose endobronchial brachytherapy is an effective method to increase the life expectancy of patients and improve its quality.
Key words: non-small cell lung cancer; central lung cancer; endoscopic recanalization; endobronchial high-dose brachytherapy.
FEATURES OF DYSLIPIDEMIA IN OBESITY IN CHILDREN (SCIENTIFIC REVIEW)
L.A. Podorova, N.V. Evdokimova
Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, 194100, Litovskaya Street, 2, Russia.
Abstract
The prevalence of obesity in children and adolescents leads to an increased incidence of secondary dyslipidemia, leading to the development of complications in adulthood. The aim of our review is to investigate the features of dyslipidemia in pediatric obesity based on published contemporary data published from 2017 to 2024. The mechanism of dyslipidemia development is increased fatty acid entry into the liver due to increased caloric intake, insulin resistance and de novo synthesis of free fatty acids in the liver, as a consequence, triglycerides, very low density lipoproteins and apolipoprotein B100 levels are increased, causing increased ester exchange via transport protein between high, low and very low density lipoproteins. Liver lipase hydrolyzes low and high density lipoprotein triglycerides, which forms small dense low density lipoprotein particles, due to which the total low density lipoprotein level in the blood is increased, and small high density lipoprotein particles, which can be excreted with the kidneys, resulting in a decrease in high density lipoprotein levels. Most children with dyslipidemia have no clinical manifestations of the disease. The first symptoms with which a child seeks medical help may be manifestations of arterial hypertension. The diagnosis of "dyslipidemia" is established in the presence of 2 or more "high" and/or "low" indicators: cholesterol ≥5.2 mmol/L, triglycerides >1.3 (for children under 10 years); 1.7 (for children over 10 years) mmol/L, high-density lipoproteins ≤ 0.9 (boys) and ≤ 1.03 (girls) mmol/L, low-density lipoproteins ≥3.0 mmol/L. The basis of treatment and prevention of dyslipidemia on the background of obesity is normalization of body weight through diet therapy and exercise. If they are ineffective, statins, cholesterol absorption inhibitors or fibrates are used.
Key words: children, obesity, dyslipidemia.
COMPARATIVE EVALUATION OF THE EFFICACY AND SAFETY OF COMBINATION THERAPY WITH SYSTEMIC AND LOCAL ANTI-INFLAMMATORY DRUGS IN PATIENTS WITH KNEE OSTEOARTHRITIS
E.A. Fursova, I.V. Kochetkova, V.R. Gurov, Yu.A. Abramova
Voronezh State Medical University named after N. N. Burdenko, Russia,394036, Voronezh, Studentskaya street,10
Abstract
Introduction. Osteoarthritis is the most common musculoskeletal disorder and a leading cause of disability worldwide [1,8]. Osteoarthritis (OA) occurs in every third patient aged 40 to 70 years.
Currently, OA is known as a chronic inflammatory process associated with aging. Low-intensity inflammation and an increase in the synthesis of proinflammatory cytokines lead to the predominance of catabolic processes in cartilage tissue, structural changes and the formation of pain syndrome [2,7].
In everyday clinical practice, physicians face the problem of choosing the safest and most effective combinations of medicines [3,6].
The aim of the study was to evaluate the clinical efficacy and safety of combined anti-inflammatory therapy in patients with knee osteoarthritis using systemic and local medicines - in the form of aceclofenac 1.5% cream / diclofenac 1% emulgel / ketoprofen 5% cream.
Materials and methods. The use of combined anti-inflammatory therapy for knee osteoarthritis: meloxicam orally with one of the local NSAIDs: aceclofenac / diclofenac / ketoprofen for 14 days resulted in significant decrease in pain syndrome indicators, severity of functional impairment, total WOMAC index score and VAS levels, as well as complete or partial reduction of synovitis.
Results. It was found that the combination of NSAIDs (meloxicam + aceclofenac 1.5% cream) resulted in fewer side effects from the gastrointestinal tract (GI tract) and cardiovascular system (CVS) compared to the combinations: meloxicam+diclofenac 1% emulgel and meloxicam+ ketoprofen 5% cream.
Conclusions. Anti-inflammatory therapy with three drug combinations was characterized by positive tolerability and safety. Side effects occurred relatively rarely and were mild, allowing the use of these therapy options in patients with knee OA, taking into account gastrointestinal and cardiovascular risks.
Key words: knee osteoarthritis, NSAIDs, local anti-inflammatory therapy, efficacy and safety.
ENDOSCOPIC BRONCHIAL RECANALIZATION IN THE COMBINED TREATMENT OF CENTRAL LUNG CANCER
A.I. Arseniev 1,2, K.E. Gagua 1, S.N. Novikov 1, A.A. Barchuk 1,4, E.S. Tyurina 4, E.A. Arseniev 1, А.O. Nefedov 3, S.A. Tarkov 1, R.V. Novikov 1, N.Y. Aristidov1,2
1National Medical Research Center of Oncology named after N.N.Petrov, Russia, 197758, Saint Petersburg, Pesochny, Leningradskaya street, 68
2 North-Western State Medical University named after I.I. Mechniko, Russia,191015, Saint-Petersburg, Kirochnaya street, 41
3 Saint-Petersburg State Research Institute of Phthisiopulmonology, Russia,191036, Saint Petersburg, Ligovsky avenue, 2-4.
4 European University at St. Petersburg,Institute for Interdisciplinary Health Research,Russia,191187, Saint-Petersburg, Gagarinskaya street, 6/1A
Abstract
Introduction. Among malignant neoplasms, lung cancer ranked first in 2022 for the highest mortality rate.
The aim of the study was to evaluate the effectiveness and safety of endoscopic recanalization of the airways as a part of combined treatment of patients with central non-small cell lung cancer (NSCLC).
Materials and methods. The results of treatment of 163 patients with stage III-IV central non-small cell lung cancer with obstructive tumor stenosis of the bronchi, who underwent endoscopic recanalization (1998-2022) under fibrobronchoscopy (36.8%) or rigid bronchoscopy (63.2%), were analyzed. Argonoplasmic coagulation (95.7%) and laser vaporization (4.3%) were used as a technology for direct impact on the tumor.
Results. In the presence of tumor stenoses of the respiratory tract performing recanalizations allowed for restoration of bronchial lumen in 95.7% of patients: completely in 31.9% and partially in 63.8% (p<0.001). Complete restoration of the lumen with rigid bronchoscopy was achieved in 41.8%, and with fibrobronchoscopy in 15.0% (p<0.001). Respiratory failure was eliminated or transferred to a compensated form in 94.8% of patients, while lung vital capacity improved in 94.6% of patients, bronchial patency in 93.8%. Non–fatal complications were noted in 19% of patients: temporary increase in respiratory failure - 10.4%, bleeding from bronchial arteries – 3.7% and bronchial perforation - 4.9%. The rate of complications was higher with rigid bronchoscopy (25.2% vs. 8.3%; p=0.00798), although this was justified by the superior effectiveness of the access method. Recanalization did not impact long-term outcomes (HR=1 [0.8-1.3], p=0.9896), however, it allowed to improve the functional status of patients and to carry out subsequent antitumor treatment.
Conclusion. Endoscopic recanalization in central NSCLC with obstructive tumor stenosis is an effective and safe method that optimizes functional parameters, improving quality of life and ensuring the implementation of comprehensive specialized treatment.
Key words: non-small cell lung cancer, central lung cancer, endoscopic recanalization, combined treatment, endobronchial brachytherapy.
EPIDEMIOLOGICAL FEATURES OF INCIDENCE AND MORTALITY FROM NON-HODGKIN LYMPHOMAS IN PERM REGION
O.A. Orlov1,2, M.Kh. Alyeva1, E.A. Kaufman1, B. Dzhumaklychev2, A.V. Khorinko2, E.V. Gorelikova1, S.O. Golodnova1
1Perm State Medical University named after Academician E.A. Wagner, Russia,614000, Perm, Petropavlovskaya street, 26
2Perm Regional Oncology Dispensary, Russia, 614066, Perm, Bauman street, 15
Abstract
Introduction. Non-Hodgkin lymphomas represent a heterogeneous group of neoplastic diseases originating from cells of the lymphatic system. Although they rank 11th in the structure of the incidence of all forms of cancer, non-Hodgkin lymphomas have significant medical and social importance due to its clinical and epidemiological features.
The aim of the study was to investigate the epidemiological features of morbidity and mortality from non-Hodgkin lymphomas in Perm region for the period from 2007 to 2022.
Materials and method. A descriptive-evaluative retrospective epidemiological study was performed according to official data: reporting forms No. 7 «Information on inflammatory malignant neoplasms», No. 35 «Information on patients with malignant neoplasms» and No. 35 «Information on patients with malignant neoplasms» and No. «Distribution of deaths by gender, age groups and causes of death» for the period from 2007 to 2022. In long-term dynamics, the structure of incidence by gender and age was studied. The average annual growth (decrease) rate and trends determination in morbidity of cancer was calculated using a first-order parabola (y = a + bx).
Results. It was revealed that the incidence of non-Hodgkin lymphoma in the Perm region increased by 1.8 times, in Russia - by 1.2 times. The mortality rate remains stable throughout the 15-year observation period both in Perm region and Russian Federation. Risk groups included persons over 65 years of age; with morbidity in male population being 1.5 times higher than in female population.
Conclusion. Non-Hodgkin lymphomas remain one of the priority areas for the prevention of malignant neoplasms in Perm region due to a moderate tendency towards increasing morbidity. The obtained data on the epidemiological features of this nosology in the region serve as a basis for further in-depth study aimed at identifying regional risk factors.
Key words: non-Hodgkin lymphoma, incidence, mortality, epidemiology, risk groups.
ANALYSIS OF THE MICROBIAL SPECTRUM OF THE OROPHARYNX IN YOUNG PATIENTS WITH CHRONIC APHTHOSIC STOMATITIS ON THE BACKGROUND OF ACUTE RESPIRATORY VIRAL INFECTION
Davtyan N.R., Klur M.V., Aslanov B.I., Pogromskaya M.N., Goncharov A.E.
1North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya Street, 41
2 Clinical Infectious Diseases Hospital named after S.P. Botkin, Russia, 191167, Saint-Petersburg, Mirgorodskaya, 3
Abstract
Aim of the study was to analyze the spectral composition of the microbiota isolated from the surface of the tonsils and the posterior pharyngeal wall in young patients without a complicated medical history and concomitant ENT pathology, experiencing recurrence of chronic aphthous stomatitis against the background of acute respiratory viral infection.
Materials and methods. Retrospective examination was conducted on 210 medical records of patients with chronic aphthous stomatitis, whose manifestations were recorded at the time of hospitalization at the Clinical Infectious Disease Hospital named after S.P. Botkin with the primary diagnosis of "acute respiratory viral infection." As a complication, acute tonsillitis was registered. The results of bacteriological cultures from the surface of the tonsils and the posterior pharyngeal wall for anaerobic and facultative anaerobic microorganisms were analyzed, along with antibiotic sensitivity testing.
Results. In most cases (90,0%, n=189) chronic aphthous stomatitis was characterized by single lesions; in 6,2%9 (n=13) the lesions were widespread, accompanied by significant pain syndrome and sleep disturbances; while in 3.8% (n=8) of patients, severe cases with extensive, long-lasting non-healing ulcerative defects of the oral mucosa were registered. The microbiotic spectrum was characterized by low species diversity and was predominantly represented by Streptococcus viridans (93.3%, n=196) and non-pathogenic Neisseria (58.6%, n=123). Moreover, the species composition of microorganisms did not correlate with the severity of chronic aphthous stomatitis.
Conclusion. The obtained data indicate the absence of visible disturbances in the microbial spectrum of the oral cavity in young patients (25±1.6 years) hospitalized with acute respiratory viral infection and relapse of chronic aphthous stomatitis at the time of hospitalization. The vast majority of isolated microorganisms are representatives of normal microflora.
CORRELATIONS OF PARAMETERS OF PULSE OSCILLOMETRY PARAMETERS WITH ANTHROPOMETRIC DATE, AGE AND SEX IN CHILDREN
I.E. Shtina1,2, O.Yu. Ustinova1, O.V. Ermakova 1, A.D. Shtina1
1 Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, Russia, 614045, Perm, Monastyrskaya street, 82
2 Perm State Medical University named after Academician E.A. Wagner, Russia, 614000, Perm
Petropavlovskaya street,26
Abstract
Introduction. Impulse oscillometry is a method for assessing external respiratory function in children, as it does not require a forced expiration maneuver.
The aim of the study was to analyze the correlations of impulse oscillometry parameters with anthropometric date, age and gender in children.
Materials and methods. The study involved 240 children aged 4–14 years:130 boys (54.2%) and 110 girls (45.8%) (p=0.220), mean age 9±2.49 and 9±2.56 years, respectively (p=0.653). All children underwent anthropometric study, impulse oscillometry (IOS) determing the relative value of the total respiratory resistance at an oscillation frequency of 5 Hz, resistive resistance at an oscillation frequency of 5 and 20 Hz, reactance at an oscillation frequency of 5 Hz, frequency dependence of resistance and resonant frequency. Mathematical and statistical analysis of the results was performed.
Results. Data analysis revealed a statistically significant weak negative correlation between respiratory impedance and gender (r = -0.14 – (-0.13)), resistive resistance (5 Hz) with growth (r = -0.13), and a negative correlation between resistive resistance ( 20 Hz) – with gender, a positive connection – with age and height (r = 0.25–0.26), a negative connection of reactance (5 Hz) – with gender and height (r = -0.15 – (-0, 13)). Established moderate correlations between resonant frequency and frequency dependence with age and gender (r = -0.46 – (-0.36)), allowed for the calculation of regression coefficients.
Conclusion. The obtained results indicate the importance of considering gender, height and age when interpreting the results of impulse oscillometry for assessing external respiratory function.
Key words: impulse oscillometry; children; external respiration function; height; gender; sex; respiratory resistance.
DETECTION OF MALIGNANT NEOPLASMS DURING DISPENSARY EXAMINATION OF ADULT POPULATION IN THE NORTH-WESTERN FEDERAL DISTRICT DURING 2018-2023
N.A. Suraeva1, Zakharchenko O.O.2, Terenteva D.S.2
1 National Medical Research Center of Oncology named after N.N.Petrov, Russia, 197758, Saint Petersburg, Pesochny, Leningradskaya Street, 68
2Central Research Institute of Health Care Organization and Informatisation, Russia, 127254, Moscow, Dobroliubova Street, 11
Abstract
Introduction. Currently, one of the main tasks facing the state is to preserve the health of the nation, increase life expectancy, and reduce mortality. Experience shows that the leading technology for ensuring the effectiveness of preventive health care is dispensary examination of the adult population. For the early detection of malignant neoplasms, a number of screening measures and research methods are provided during the dispensary.
The aim of the study was to estimate the detection rate of malignant neoplasms during the dispensary examination of the adult population in the Russian Federation, the North-West Federal District and its subjects.
Materials and methods. Data from the industry statistical reporting form No. 131/o "Information on the dispensary examination of certain groups of the adult population" during 2018-2023 were used, as well as regulatory legal documentation regulating the conduct of dispensary examinations. Descriptive statistics methods, content analysis, and retrospective comparative analysis were applied in the study.
Results. The frequency of detected cases of malignant neoplasms during dispensary examinations in Russia and the Northwestern Federal District from 2018 to 2020 averaged 1.4 and 1.5 per 1,000 examined citizens, respectively, while in 2021–2023 it was 1.3 and 1.4. The share of first-time diagnosed malignant neoplasms and in situ neoplasms from the total number of newly diagnosed chronic non-communicable diseases in Russia and the Northwestern Federal District in 2018-2020 was 1.1% and 1.6%, respectively; in 2021–2023 it was 1.6% and 1.7%. The share of first-time detected cases of malignant neoplasms at stages 1-2 from the number of newly diagnosed malignant neoplasms and neoplasms in situ in Russia and the Northwestern Federal District in 2018-2020 averaged 52.4 and 54.5%; and in 2021-2023, 1.6 and 62.9%, respectively. - 57.9 and 62.9%.
Conclusion. The low proportion of malignant neoplasms detected during dispensary examinations may indicate insufficient attention to the problem of early detection of neoplasms, including malignant neoplasms during dispensary examinations of the adult population.
Keywords: dispensary examination of the adult population, malignant neoplasms, in situ neoplasms, detection of malignant neoplasms, screening, oncological component of health examination, statistical accounting during health examinations.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
RETROSPECTIVE OBSERVATIONAL STUDY OF PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
A.L. Ershov1, A.A. Boykov2, L.E. Elchinskaya2,
A.Yu.Shchurov2, T.A. Kolomoitseva3
1North-Western State Medical University named after I.I. Mechnikov,Russia, 191015, Saint-Petersburg, Kirochnaya street, 41
2 City Emergency Medical Care Station,Russia, 191023, Saint-Petersburg, Malaya Sadovaya street, 1/25
3City outpatient clinic №52, Department of Emergency Medical Care, Russia,194354, Saint- Petersburg, Lunacharsky avenue, 60
Abstract
Introduction. Chronic obstructive pulmonary disease (COPD) is a widespread disease that significantly impacts disability and mortality among population. The number of patients with COPD is steadily increasing, and as the clinical manifestations become pronounced, they being seek emergency medical care (EMS). However, there are currently no treatment protocols for COPD patients, making it challenging for EMA services.
Aim of the study was to provide a medical-demographic characteristic of a group of patients with COPD who applied for EMS.
Results. A retrospective study was conducted of the results of 951 emergency medical services calls to patients with COPD, as the main or concomitant disease. These data accounted for 0.2% of the total number of EMS calls over a12 month period. The average age of patients in this group was 65.7±14.79 years. In 60.4% of cases, the diagnosis of COPD was primary, in the other cases it was a competing or concomitant diagnosis. Comorbidity was present in 75.8% of patients; cardiovascular pathology predominated among concomitant diseases. In 67.3% of patients, the general condition was assessed as moderate, in 23.5% - as severe. Patients in these groups experienced acute respiratory failure (ARF) of grades 2-3. Among COPD patients who south EMS, 78,3% were admitted to the hospital. The highest number of requests for EMS from patients with COPD was observed from October to January.
Conclusion. Patients diagnosed with COPD are distinguished by: seasonal variations in the use of EMS; elderly age; high level of comorbidity; severity of general condition; presence of acute respiratory failure, high need for inpatient treatment. Providing medical care to patients with COPD is complicated by the lack of clinical recommendations (treatment protocols) prepared for use in the specific conditions of the EMS service.
Keywords: chronic obstructive pulmonary disease, epidemiology, emergency medical care
ASSISTED LIVING AS A NEW TECHNOLOGY IN COMPLEX REHABILITATION OF DISABLED PEOPLE
G.N. Ponomarenko1, 2, L.A. Kozhushko1, M.V. Rokhmanova1
1Albrecht Federal Scientific and Educational Centre of Mediсal and Social Expertise and Rehabilitation, Russia, 195067, Saint Petersburg, Bestuzhevskaya Street, 50
2North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41
Abstract
Introduction. The process of rehabilitation and habilitation of disabled people involves not only providing them with medical care, but also includes a wide range of measures aimed at their social adaptation and integration into the society. These measures are particularly crucial for disabled people who are unable to lead independent life and reside in institutional care.
In this regard, the task of preparing disabled people for life outside intuitional settings becomes relevant, through the organization of assisted living and training aimed at developing their independence and communication skills.
Since 2019, the state has been co-funding activities to train people with disabilities and their family members in caregiving skills, selection and use of assistive technologies, as well as rehabilitation skills, as a part of the implementation of the state program “Accessible Environment” to develop regional programs for comprehensive rehabilitation and habilitation of disabled people, which indicates the social significance of this direction.
The aim of the study was to assess the level and dynamics of development of the development
of the assisted living as a new technology in the comprehensive rehabilitation of disabled people in the Russian Federation.
Materials and methods.The materials provide data from annual monitoring studies of the development of assisted living of disabled people, collected using a classification table designed within this study. The table demonstrates all categories (and subcategories) for subsequent substantive assessment of the identified indicators provided by the executive authorities of 85 constituent entities of the Russian Federation.
The study involves general scientific methods (analysis, synthesis, grouping), logical generalization, comparative and statistical analyses to achieve its aim.
Results. There is a positive trend in the development of assisted living for disabled people: in 2022 compared to 2018, the number of entities implementing these technologies and participated in their financing increased by 1.9 times (from 39 to 75 entities), the number of disabled people who underwent training for assisted living and received a range of necessary medical, social and rehabilitation services at home increased by 2.3 times (from 1291 people to 4245 people).
According to forecasts, by 2026, the number of disabled people who have undergone training for assisted living will increase by 40.0reaching over 6,000 thousand people, as indicated an ascending trend line (R2 is approaching one). However, as of January 1, 2022, the was a need for this form of living arrangements among 9,828 people, revealing that only 43.2% of those in need had undergone training.
The development of knowledge, skills and abilities among disabled people in the field of social and everyday adaptation, social and environmental orientation and communication activities is an important condition on their path to independent or assisted living.
Conclusion.Further development of assisted living technologies will enable disabled people to live at home, receive a range of social and rehabilitation services, be more independent and feel like equal members of our society.
Key words: assisted living; comprehensive rehabilitation; rehabilitation services; disability; training apartment
POPULATION AWARENESS OF SEXUALLY TRANSMITTED INFECTIONS AND THEIR IMPORTANCE FOR MAINTAINING REPRODUCTIVE HEALTH
T.A. Sokolovskaya, O.V. Armashevskaya
Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russia, 127254, Moscow, Dobrolubov street, 11
Abstract
Introduction. Sexually transmitted infections (STIs) are not only socially significant diseases, but also negatively affect the reproductive health of the population. This in turn contributes to the formation of developmental delays and congenital anomalies in the fetus. At the same time, preventive measures aimed at strengthening and preserving reproductive health cover the female population to a greater extent, paying insufficient attention to men and their problems. However, the success of preventive measures is largely determined by the compliance of medical workers, educators, families and future parents.
Aim of the study was to analyze the levels of knowledge of the population about sexually transmitted infections as the basis for maintaining reproductive health at the regional level.
Material and methods. The study involved 390 respondents (134 men and 256 women) aged 18 years and older, which corresponds to a representative sample with a confidence level of 95%. Descriptive statistics were used to describe the characteristics (M – mean, SD – standard deviation, SE – standard error, ±95% CI – confidence interval); and to identify differences and connections between characteristics: Mann-Whitney U test (U empirical ≤ U critical at p≤0.05) and correlation analysis (at p≤0.05).
Results. According to the study, it was revealed that the majority of respondents were aware of STIs and their negative impact on the health of the unborn child (M - 82.0%; n = 110; F - 92.6%; n = 237 and 73.9% - 83, 2%). At the same time, only 56.7% (M; n = 76) and 60.5% (F; n = 155) of respondents use barrier methods of contraception to prevent STIs, despite the fact that 10.0% of women and 7.8 % of men prefer chance meetings. Parents has a priority role in the formation of sexual culture and intimate hygiene skills (72.8±9.1% and 45.8±11.7%). It is the sufficient level of knowledge on intimate hygiene and the presence of conversations with parents about sexual relations and family planning that allow respondents to understand the role of STIs in disrupting reproductive health and the health of future children (r = 0.60; r = 0.37; r = 0.52 and r = 0.43; at p≤0.05).
Conclusion. The analysis showed that despite high awareness of the negative consequences of STIs, the concept of contraception, and recognition of the role of the family, as the main educational resource, respondents have a lack of knowledge on this issue and they have problems in implementing preventive strategies.
Key words: sexually transmitted infections, reproductive health, population, prevention.