CONTENTS 2025_4
HYGIENE
1. Features of hygienic identification of production factors for occupational risk assessmen
Meltzer A.V., Erastova N.V., Volochkova A.I.
2. Assessment of the provision of harmless working conditions for disabled people in need of vocational rehabilitation and employment measures in the russian federation
Ishutina I.S., Meltzer A.V., Chernyakina T.S.
3. Prospect of including a multicomponent cryotechnology product in the diet of arctic workers
Rakhmanov R.S., Narutdinov D.A., Bogomolova E.S., Razgulin S.A., Nepryakhin D.V.
4. Scientific basis for monitoring premature aging caused by exposure to occupational hazards
Savchenko O. A., Novikova I. I.
5. Hygienic assessment of the functional state and psychoemotional indicators of reduced working capacity of military university cadets
Kertanov H.A., Bokarev M.A., Kiselyova N.V.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
1. Atopic dermatitis and obesity. Is there a single genetic failure?
Novikova V.P., Al-Nawaiseh Khaled Zakaria Hussein, Zaslavsky D.V., Zavyalova A.N., Markovskaya I.N., Buntovskaya A.S., Trandina A.E., Glushakov R.I.
2. Health status and provision of some essential microelements in school-aged children with undifferentiated connective tissue dysplasia
Bogomolova I.K., Plotnikova M.I.
3. Comprehensive clinical and epidemiological analysis of the incidence of infection caused by clostridium difficile among the population of moscow for the period 2019-2024
Kobzeva Yu.V., Zadorozhny A.V., Wheat N.Yu.
4. To the question of improving epidemiological monitoring of iaimd in resuscitation units
Darina M. G., Zakhvatova A. S., Ivanova T. G., Vasilyev K. D., Molchanovskaya M. A., Aslanov B. I.
5. Features of epidemiology and laboratory diagnostics of tick-borne infections in saint-petersburg during 2019-2024
Bogdanova M.O., Grigorieva T.D., Stalevskaya A.V.
6. Results of surgical treatment for patients with chronic post-traumatic instability of the acromioclavicular joint
Khominets V.V., Averkiev D.V., Vo K.T.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
1. On the formats of professional development of management staff in healthcare and education fields: research results
Bezrukova E.V., Buchek A.A., Modestova T.V., Modestov S.Yu.
HYGIENE
FEATURES OF HYGIENIC IDENTIFICATION OF PRODUCTION FACTORS FOR OCCUPATIONAL RISK ASSESSMENT
A.V. Meltzer, N.V. Erastova, A.I. Volochkova, I.V. Semenova
North-West State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41
Abstract
Introduction. Working conditions should not have a harmful eff ect on humans. Failure to comply with this imperative leads to the formation of risks for the development of occupational and occupational-related general somatic pathology, which in turn requires correct hazard identifi cation for risk assessment and hygienic justifi cation of measures to minimize harm to health. Aim of the study was to assess working conditions and identify the features of hygienic identifi cation of production factors for subsequent a priori assessment of occupational risk.
Results and discussion. The results of an objective and subjective assessment of working conditions indicate the existing risk of workers' health problems as a result of the combined eff ects of harmful factors of the working environment and the labor process, among which noise, heavy work, a heating microclimate, and local vibration have the greatest impact. As well as there are cases of occupational diseases. At the same time, from a hygienic point of view, it is important to pay attention to the problem of ensuring the quality, completeness and reliability of information on the impact of environmental factors and the labor process on the working population heath. Firstly, the results of the special assessment of working conditions often do not refl ect the present situation of the hygienic parameters of working conditions. In addition, the situation may worsen as a result of not carrying out, or not fully carrying out, production control of working conditions. The absence or limitation of objective information on factors of the production environment and the labor process, on the one hand, leads to a low detection rate of occupational diseases, on the other hand, negatively aff ects the results of occupational risk assessment.
Conclusion. The above highlights the necessity to use not only the data from the special assessment of working conditions, but also the results of industrial control over working conditions when assessing a priori occupational risks, in order to objectify the assessment of factors of the production environment and the labor process, and, accordingly, the fi nal conclusions and management decisions. Given the imbalance in the identifi cation of infl uencing factors, the results of a subjective assessment by employees of the impact of environmental factors and the labor process on health play a crucial role and may be considered as the earliest marker of a potential threat to the development of the disease.
Keywords: workers' health, working conditions, occupational hygiene, hygienic assessment, factors of the production environment and the labor process, workplace health, corporate health programs, occupational risk, special assessment of working conditions, special assessment of working conditions.
ASSESSMENT OF THE PROVISION OF HARMLESS WORKING CONDITIONS FOR DISABLED PEOPLE IN NEED OF VOCATIONAL REHABILITATION AND EMPLOYMENT MEASURES IN THE RUSSIAN FEDERATION
I.S. Ishutina1, A.V. Meltzer2, T.S. Chernyakina1, 2
1Albreсht Federal Scientific and Educational Centre of Mediсal and Social Expertise and Rehabilitation, Russia, 195067, Saint-Petersburg, Bestuzhevskaya street, 50.
2North-West State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41.
Abstract
Introduction. The issue of realizing the labor potential of disabled individuals and engaging this category of citizens in the workforce through the open labor market, as well as improving the effectiveness of social protection measures for disabled individuals in labor and employment, is a pressing state objective.
Aim of the study was to assess the provision of safe working conditions for disabled individuals requiring vocational rehabilitation, employment, and on-the-job adaptation.
Materials and Methods. The study involved federal statistical survey data, including recommendations on vocational rehabilitation and employment of disabled individuals, information on employed disabled individuals, and information on disabled individuals ' assessments of working conditions in their workplaces. The observation period was 2018-2023. Descriptive statistics and comparative analysis were used.
Results and Discussion. Between 2018 and 2023, the number of working-age people increased by 13.3%, while the number of employed disabled people decreased by 2.6%. The share of disabled people who received recommendations on equipping a special workplace for employment increased by 79.9%, the number of equipped workplaces for employment of disabled people increased by 66.0%, the number of disabled people who found work decreased by 35.8%, and employed individuals under quotas - by 53.8%. Disabled people aged 15 years and older rated their main job as very hard - 1.8%, as difficult - 15.5%, and as moderate - 54.2%. They constantly experienced at their main job: nervous tension, stress - 14.5%, exposure to harmful production factors - 13.1%, other inconveniences (cold, dampness, etc.) - 6.9%.
Conclusion. The reduction in the number of employed and working disabled individuals in 2023 compared to 2018, including under quotas, indicates the low effectiveness of legal mechanism for setting job quotas for disabled individuals. The majority of employed disabled people assess their primary work as difficult or moderately difficult, as well as the fact that some report nervous tension, stress, exposure to harmful production factors, and microclimate (cold, dampness, etc.) indicate the inadequacy or absence of systematic dynamic monitoring of working conditions and personalized medical, social, and psychological support. This may lead to poor adaptation in the workplace and the termination of employment for disabled individuals.
Keywords: disabled individuals of working age, recommendations for vocational rehabilitation, special workplaces, employment, self-assessment of working conditions and the severity of work.
PROSPECT OF INCLUDING A MULTICOMPONENT CRYOTECHNOLOGY PRODUCT IN THE DIET OF ARCTIC WORKERS
R.S. Rakhmanov1, D.A. Narutdinov2, E.S. Bogomolova1, S.A. Razgulin1,
D.V. Nepryakhin1
1Privolzhsky Research Medical University, Russia, 603950, Nizhny Novgorod, Minin and Pozharsky square, 10/1
2Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Russia, 660022, Krasnoyarsk, Partizana Zheleznyaka, street 1
Abstract
Introduction. Extreme living and working conditions in the Far North have a negative impact on the immunological reactivity of the body, forming a secondary ecologically dependent immunodeficiencies.
Aim of the study was to assess the prospects of including a multicomponent product developed using critically low-temperature technology in the diet of workers in the Arctic.
Material and methods. The main group took 10.0 g of the product for 21 days (n=30). Initially, on days 22 and 32, blood samples were analyzed: erythrocytes and hemoglobin, platelets, leukocytes (non-specific adaptive reactions of the body were determined by lymphocytes, the intensity of adaptation was determined by leukogram); serum immunoglobulins A, M, G.
Results. Blood counts, with the exception of neutrophilic leukocytes (Me 0.4; Q1 - 0.2, Q3 - 0.8 at a rate of 1-6%), were within the normal range. Non-specific adaptive reactions of the body were assessed as "training" - "calm activation". The inclusion of a multicomponent product in the diet led to an increase in erythrocytes (by 4.7%, p = 0.001), hemoglobin (by 2.0%, p = 0.001) and platelets (2.4%, p = 0.007); an increase in the proportion of band neutrophils (by 31.3%, p=0.004) and segmented neutrophils (by 11.2%, p=0.001), eosinophils (by 20.3%, p=0.006), lymphocytes (by 40.6%, p=0.001) and monocytes (12.1%, p=0.014). Stimulation of cellular immunity is confirmed by the state of non-specific adaptive reactions of the body: lymphocytes in a state of increased activation (Me 39.65; Q1 - 37.0, Q3 - 40.0, p=0.001); stimulation of nonspecific resistance - an increase in IgA by 6.6% (p=0.001). The intake of the product contributed to the normalization of the physiological state of the body; in the comparison group, at the observation stages, a pre-nosological state was determined in 57.1-61.5%.
Conclusion. The prospects of optimizing the nutrition of employees with a multicomponent product have been established. It is necessary to determine the optimal dose and period for repeated prevention courses according to the seasons of the year.
Key words: Arctic; multi-component product; macronutrients, micronutrients, blood parameters, non-specific adaptive responses.
SCIENTIFIC BASIS FOR MONITORING PREMATURE AGING CAUSED BY EXPOSURE TO OCCUPATIONAL HAZARDS
O.A. Savchenko, I.I. Novikova
Novosibirsk Research Institute of Hygiene,Russia, 630108, Novosibirsk, Parkhomenko street, 7
Abstract
Introduction. Modern hygiene is facing a challenge of occupationally induced aging (OIA) – the accelerated development of systemic signs of aging under the influence of chronic isolated, combined, and compound exposure to physicochemical factors in the occupational environment (at a level of 1.5 MAC/MPL). The existing paradigm of hygiene regulation, focused on controlling isolated factors, fails to take into account the synergistic effects of their joint effects, leading to an underestimation of long-term risks.
Aim of the study was to substantiate the scientific basis for monitoring premature aging caused by exposure to occupational hazards.
Materials and Methods. This study presents the results of a 180-day chronic experiment studying the effects of physicochemical factors in the occupational environment (1.5 MAC/MPL) on health indicators in 6 groups of Wistar rats (n=190), an analysis of the data obtained, and a review of the current literature. Hygienic, toxicological, physiological, behavioral, clinical, biochemical, histological, genetic, and theoretical research methods were used: formalization, generalization, comparison, and systems analysis.
Results. The experimental results demonstrate the need to shift from a traditional model to a risk-based one that takes into account the complex interaction of factors, the cumulative effect, and pre-nosological changes. An integral pathogenetic model of OIA is proposed, the central element of which is oxidative stress-induced telomere shortening as the "molecular clock" of aging.
Conclusion. Conceptual foundations for prevention have been formulated, including: a pre-nosological system based on multilevel biomarkers; a differentiated approach taking into account the type of exposure and gender-specific response; targeted pathogenetic interventions; and scientific and methodological support. The implementation of the proposed concept aims to shift the occupational safety paradigm from reactive to predictive and preventive, thereby preserving the professional longevity of workers.
Keywords: occupationally induced aging, isolated, combined, and compound exposures, synergism, oxidative stress, telomeres, biomarkers, pre-nosological diagnostics, and hygienic prevention.
HYGIENIC ASSESSMENT OF THE FUNCTIONAL STATE AND PSYCHOEMOTIONAL INDICATORS OF REDUCED WORKING CAPACITY OF MILITARY UNIVERSITY CADETS
Kh.A. Kertanov, M.A. Bokarev, N.V. Kiselyova
Federal State Budgetary Military Educational Institution of Higher Education «Kirov Military Medical Academy» of the Ministry of Defence of the Russian Federation. Russia, 194044, Saint Petersburg, Akademika Lebedeva Street, 6
Abstract
Introduction. Training in military educational institutions is accompanied by high physical and psychoemotional stress, which affects the functional state and performance of cadets. Under conditions of prolonged and intensive educational process, there is a risk of reducing the adaptive reserves of the body and increasing the level of psychoemotional stress, which determines the relevance of timely assessment of the health status of future officers.
The aim of the study. The aim is to assess the functional state and psychoemotional performance indicators of cadets at a military medical educational organization during the dynamics of the educational process.
Materials and methods. A cross-sectional study of 353 cadets (171 men, 182 girls) of 1-6 courses was conducted. The functional state was assessed according to the functional change index (modified by B.A. Adamovich, R.M. Bayevsky, A.P. Berseneva, 1990). The assessment of working capacity was carried out using a questionnaire according to the methodology of A.B. Leonova, S.B. Velichkovskaya "Differentiated diagnosis of a state of reduced working capacity" (2002). Nonparametric Kruskal-Wallis, Mann-Whitney and Spearman correlation analysis criteria were used.
Results. It was found that the dynamics of the functional change index is nonlinear, with critical points at the first Me = 2.35 [2.22-2.53] and the sixth courses Me = 2.31 [2.18-2.47]. Tension of adaptation mechanisms was revealed in 5.9% of students (≥ 2.6). The gender differences were revealed by the index of functional changes, which were higher in male cadets (p < 0.001). Psychoemotional indicators showed multidirectional dynamics: fatigue and mental satiety increased by the senior years, stress showed a U-shape with peaks in the first and sixth years, while indicators of monotony showed no significant inter-course differences. Correlation analysis revealed a moderate positive association of the functional change index with stress (p = 0.43; p < 0.001) and weak correlations with fatigue (p = 0.24; p < 0.001) and mental satiety (p = 0.21; p < 0.001).
Conclusion. The obtained results indicate the presence of critical adaptation stages during the educational process, with the formation of risk subgroups among cadets. The established correlations confirm the interconnection between physiological and psychoemotional manifestations of adaptive stress, which should be considered when organizing preventive measures and developing health-preserving technologies in a military educational institution.
Key words: cadets, students, performance, functional changes index, functional state, health, adaptation, fatigue, stress, mental satiation, monotony.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
ATOPIC DERMATITIS AND OBESITY. IS THERE A SINGLE GENETIC FAILURE?
V.P. Novikova¹, Al-Nawaiseh Khaled Zakaria Hussein¹, D.V. Zaslavsky¹, A.N. Zavyalova¹, I.N. Markovskaya¹, A.S. Buntovskaya², A.E. Trandina²,
R.I. Glushakov¹,².
¹Saint Petersburg State Pediatric Medical University, Russia, 194100, Saint Petersburg, Litovskaya street, 2
²S.M. Kirov Military Medical Academy, Russia, 194044, Russia, Saint Petersburg, Akademika Lebedeva street, 6
Abstract.
Introduction. The physical development and nutritional status of children with atopic dermatitis changes with maturation. Polymorphism of genes involved in fatty acid metabolism and energy metabolism in children with dermatitis and different nutritional status has not been studied.
Aim of the study was to analyze the polymorphism of the genes FADS1 rs174544, FADS1 rs174583; APOE rs769452, APOA1 rs1799837; FTO rs9939609; LIPC rs2070895 and their impact on the nutritional status in children with atopic dermatitis.
Materials and methods. The single-center, cross-sectional cohort study included 35 children aged 6 to 17 years (13.14 + 5.5). All children underwent physical development assessment Antro Plus WHO, SCORAD, and bioimpedancemetry (MEDASS). The genetic profile included a set of single nucleotide polymorphisms in the FADS1 (rs174544), FADS1 (rs174583), APOE (rs769452), APOA1 (rs1799837), FTO (rs9939609), and LIPC (rs2070895) genes. The study was approved by the Ethics Committee 8.11.2023, №32/01. Statistical analysis StatTech v. 3.1.8.
Results. SCORAD=54.86 [44.3; 71.8] which is typical for a severe course. Children with obesity are characterized by the following alleles: CA allele of the FADS1 rs174544, CT allele of the FADS1 rs174583; CC allele of the APOA1 rs1799837; AA allele of the FTO rs9939609; alleles of the LIPC rs2070895 G/A and G/G. APOE rs769452 was only homozygous Leu/Leu.
Conclusion. Changes in nutritional status with accumulation of fat mass and development of obesity among patients with severe atopic dermatitis, having different roots, can be regulated by the same genes. Knowing the genotype responsible for controlling satiety could allow children to be provided with targeted therapy for dermatitis and obesity.
Key words: atopic dermatitis; children; FADS1rs174544; APOA1rs1799837; FTOrs9939609; LIPCrs2070895; FADS1rs174583.
HEALTH STATUS AND PROVISION OF SOME ESSENTIAL MICROELEMENTS IN SCHOOL-AGED CHILDREN WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA
I.K. Bogomolova, M.I. Plotnikova
Federal State Budgetary Educational Institution of Higher Education Chita State Medical Academy of the Ministry of Health of the Russian Federation. 672010, Russia, Transbaikal Territory, Chita, Gorky Street, 39A.
Abstract
Connective tissue dysplasia (CTD) is a pressing pediatric problem, affecting 20% to 80% of children worldwide. The disease typically onsets in early school age (ages 7-11), as this is the period when children experience the most significant physical stress at school. Certain essential micronutrients, such as iodine and selenium, are thought to be involved in the pathogenesis of CTD. A study aimed to assess the health status and iodine and selenium status of primary school-aged children with undifferentiated connective tissue dysplasia (UCTD) revealed a high prevalence of pathological lesions, with diseases of the circulatory, nervous, and digestive systems, musculoskeletal, and ocular and adnexal systems predominating. In our study, the multiple combinations of clinical syndromes accompanying the clinical manifestations of CTD reached up to 7-8 in one child. Among these, the most common combinations of syndromes included visual pathologies, neurological disorders, asthenic and valvular syndromes, and gastrointestinal or urinary pathologies. Foot pathologies were recorded in half of the cases in children with UCTD, along with iodine deficiency and general selenium deficiency. Laboratory diagnostics revealed elevated levels of sulfated glycosaminoglycans in daily urine, mild iodine deficiency, and severe selenium deficiency in the group of children with UCTD, compared with normal iodine levels and moderate selenium deficiency in the control group. Thus, the study concluded that the presence of connective tissue dysplasia in primary school-aged children is associated with mild iodine deficiency and severe selenium deficiency, along with high glycosaminoglycan excretion, accompanied by high pathological lesions.
Key words: connective tissue dysplasia, undifferentiated connective tissue dysplasia (UCTD), school-age children, iodine, selenium, glycosaminoglycans.
COMPREHENSIVE CLINICAL AND EPIDEMIOLOGICAL ANALYSIS OF THE INCIDENCE OF INFECTION CAUSED BY CLOSTRIDIUM DIFFICILE AMONG THE POPULATION OF MOSCOW FOR THE PERIOD 2019-2024
Yu.V. Kobzeva1,3, A.V. Zadorozhny1,4, N.Yu. Wheat2,3,4
1Moscow Office of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, 129626, Grafskiy per., 4, bldg. 2, 3, 4, Moscow;
2Federal Budgetary Scientific Institution "Central Research Institute of Epidemiology" of Rospotrebnadzor, 111123, Russia, Moscow, Novogireevskaya st., 3a;
3Federal State Budgetary Educational Institution of Continuous Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Health of the Russian Federation (FGBOU DPO RMANPO of the Ministry of Health of the Russian Federation) Russia, 125993, Moscow, Barrikadnaya st., 2/1с1;
4Institute of Disinfection of the Federal Budgetary Scientific Institution of Science "Federal Scientific Center of Hygiene named after F.F. Erisman" Rospotrebnadzor, 117246, Russia, Moscow, Nauchny proezd, 18.
Abstract.
Introduction. C. Difficile-associated infection remains a serious problem for healthcare systems worldwide, requiring strict epidemiological surveillance to reduce its impact. The relevance of studying this issue is supported by global data, with approximately 500,000 C. difficile infections reported annually in the United States, and incidence rates ranging from 4.1 to 16.8 cases per 10,000 patient-days in EU countries. The problem is particularly significant in the context of healthcare-associated infections (HAIs), which account for up to 40% of all infections and have a mortality rate of up to 15-20% among elderly patients [4].
Purpose: Clinical and epidemiological analysis of the incidence of C. difficile-associated infection in Moscow (2019–2024) with an assessment of its significance for the preventive healthcare system in medical facilities.
Materials and methods: A retrospective clinical and epidemiological analysis was conducted on 2,948 cases of C. difficile-associated infection registered in Moscow from 2019 to 2024.
Results: An analysis of data for 2020-2025 revealed a significant increase in the incidence of C. difficile-associated infection among the population of Moscow, which increased by 4.65 times, from 1.39 to 6.47 0/0000. The highest proportion was observed among patients over 60 years of age (55.7%), but the proportion of children under 1 year of age increased (7.2%). Severe forms predominate in adults aged 36–59 (54.5%) and the elderly (40.9%), while children are more likely to have mild cases.
Conclusion: The results obtained highlight the need to optimize the system of epidemiological surveillance of C. difficile-associated infection (including as part of the prevention of nosocomial infections) and antibiotic therapy.
Keywords: C. difficile, epidemiological analysis, nosocomial infections, morbidity.
TO THE QUESTION OF IMPROVING EPIDEMIOLOGICAL MONITORING OF IAIMD IN RESUSCITATION UNITS
M. G. Darina1, 2, A. S. Zakhvatova1, 2, T. G. Ivanova1, K. D. Vasilyev1,
M. A. Molchanovskaya1, B. I. Aslanov1
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, St. Petersburg, Kirochnaya St., 41
2 St. Petersburg State Budgetary Healthcare Institution "Medical Information and Analytical Center" of the Healthcare Committee of St. Petersburg, Russia, 198095, St. Petersburg, Shkapina St., 28, Bldg. 30, Litera A
Аbstract
Introduction. Intensive care unit patients undergoing various medical procedures and prolonged use of invasive devices during treatment and diagnostics are at risk of developing various forms of infectious pathology associated with invasive medical procedures.
Aim of the study was to assess the level of the use of medical information systems in St. Petersburg hospitals for epidemiological surveillance of nosocomial infections in intensive care units among patients at risk of developing purulent-septic infections.
Materials and Methods.A retrospective analysis of the incidence of leading forms of infections associated with invasive medical procedures was conducted among patients in intensive care units of 49 hospitals in St. Petersburg. Methods for collecting data on risk factors for infectious complications and patient treatment outcomes in accordance with existing regulations, including the use of information technology, were examined.
Results. The analysis revealed discrepancies between official data from St. Petersburg hospitals on the incidence of healthcare-associated infections and expert opinion, indicating a lack of unified approaches to organizing and conducting epidemiological surveillance of intensive care unit (ICU) patient treatment outcomes across the city's institutions, including the use of the city's hospital information systems.
Conclusions. Using the capabilities of local and regional medical information technologies to conduct active epidemiological surveillance of invasive medical interventions in ICUs will allow hospital epidemiologists to calculate the average incidence rate of specific forms of nosocomial purulent-septic infections, identify predictors of epidemiological problems in high-risk units, implement targeted preventive and anti-epidemic measures, and evaluate the effectiveness of these measures.
Keywords: infections associated with invasive medical procedures, risk factors for the development of septic conditions, nosocomial purulent-septic infections, infections associated with the provision of medical care, epidemiological surveillance, medical information system.
FEATURES OF EPIDEMIOLOGY AND LABORATORY DIAGNOSTICS OF TICK-BORNE INFECTIONS IN SAINT-PETERSBURG DURING 2019-2024
M.O. Bogdanova1, 2, T.D. Grigorieva1, A.V. Stalevskaya1
1. S.P. Botkin Clinical Infectious Diseases Hospital, Russia,191167, Saint Petersburg, Mirgorodskaya street,3
2.North-West State Medical University named after I.I. Mechnikov, Russia,191015, Saint Petersburg, Kirochnaya street,41
Abstract
Introduction. Tick-borne infections pose a significant challenge for the healthcare system as they lead to significant socio-economic losses associated with temporary disability of patients. Various nosological forms of natural focal diseases are registered annually in Saint-Petersburg, among which infections transmitted by ixodes ticks, such as viral tick-borne encephalitis and ixodes tick-borne borreliosis, predominate.
Aim of the study was to analyze the epidemiological profile of tick-borne diseases in Saint-Petersburg during a six-year monitoring period during 2019-2024.
Materials and methods. The medical records of 15708 patients (N=15,708) applied for medical care in S.P. Botkin Clinical Infectious Diseases Hospital during 2019-2024 were analyzed, along with data from studies on 60881 ticks (N=60,881) removed from bite victims using ELISA method and the VectoVKE antigen system manufactured by JSC Vector-Best, and polymerase chain reaction (PCR) analysis of the RNA of virus causing tick-borne encephalitis (TBEV) using the AmpliSens® TBEV test system. Additionally, the Rospotrebnadzor State Report on the sanitary and epidemiological situation for 2019-2024 was analyzed.
Results. The majority of tick bite victims in the city was observed in the Kurortny District (48.2%), with significantly lower rates in Primorsky (18.9%) and Pushkinsky districts (17.7%). Most residents of the city experienced tick bites within the Leningrad region, accounting for 81.6% of all cases. Cases of tick bites outside of Saint-Petersburg and the Leningrad region have been reported during visits to regions endemic for tick-borne infections, accounting for 15.2% of total cases. Seasonal tick activity was observed from April to October, with a higher rate of medical attention during the spring and summer months. During the study period, there were 243 reported cases of tick-borne encephalitis (representing 1.5% of referrals) and 699 cases of tick-borne borreliosis (4.5%). The average annual incidence rate was 1.35 ± 0.27 cases per 10,000 applicants. The diseases were identified in all age groups between 15 and 89 years old, with the highest proportion of cases among adults over 60 years, accounting for 32.9% of tick-borne encephalitis cases and 55.1% of tick-borne borreliosis cases. During 2019 -2024, a total of 103 patients presenting with clinical manifestations of tick-borne diseases were admitted to the S.P. Botkin Clinical Infectious Diseases Hospital, for whom the etiology of their illness could not be determined. Upon examination of ticks removed from these patients, a positive test result was obtained in 90.8% of cases. Additionally, during the same period, five cases of co-infection with tick-borne encephalitis and tick-borne borreliosis were identified.
Conclusion. A persistently high prevalence of tick-borne pathogen infection has been identified, indicating a significant risk of transmission through tick bites. In order to confirm the etiology of these infections, it is essential to expand the capacity of modern laboratory testing and develop methods for the early detection of mixed infections with tick-borne encephalitis and borreliosis, allowing for the rational use of targeted therapy.
Keywords: tick-borne infections, ixodes ticks, tick-borne encephalitis, tick-borne borreliosis, natural focal infections, laboratory diagnosis
RESULTS OF SURGICAL TREATMENT FOR PATIENTS WITH CHRONIC POST-TRAUMATIC INSTABILITY OF THE ACROMIOCLAVICULAR JOINT
V.V. Khominets, D.V. Averkiev, K.T. Vo
S.M. Kirov Military Medical Academy, Russia, 194044, Saint-Petersburg, Akademika Lebedeva street, 6
Abstract
Introduction. Chronic post-traumatic instability of the acromioclavicular joint (ACJ) develops in 13-40% of cases due to neglected acromial end of the clavicle dislocation, manifesting as persistent pain syndrome, impaired function of the shoulder girdle, and requiring reconstructive surgery.
The aim of the study was to evaluate the long-term results of surgical treatment of patients with chronic post-traumatic ACJ instability using the technique of coracoclavicular ligament reconstruction with an augmented tendon autograft, looped around the coracoid process and the acromial end of the clavicle, with temporary fixation using a hook plate.
Materials and methods. A retrospective study was conducted on 26 male patients with chronic ACJ instability (mean time from injury to surgery 9,7±5,4 months). Coracoclavicular ligament reconstruction was performed using an autograft of the palmaris longus tendon augmented with a synthetic tape. The graft was positioned as a loop encompassing the coracoid process and the acromial end of the clavicle. The ACJ was fixed with a hook plate, which was removed after 7-8 months. The mean follow-up period was 7,8±4,3 years. Evaluation was conducted using the Constant Score (CS), American Shoulder and Elbow Surgeons (ASES) score, Visual Analog Scale (VAS), and bilateral radiographic stress test with a 5 kg traction load on the upper extremities.
Results. Functional outcomes demonstrated high treatment efficacy. The mean CS score was 90,7±3,8 points, and the mean ASES score was 93,4±3,0 points. Excellent results (CS ≥ 90) were achieved in 69,2% of patients. The mean VAS score was 0,9±0,7. The radiographic stress test confirmed the restoration of ACJ stability almost to the level of the intact joint: the mean differences in the acromioclavicular and coracoclavicular distances between the operated and intact sides were statistically non-significant.
Conclusion. Reconstruction of the coracoclavicular ligament with an augmented tendon graft looped around the coracoid process and the acromial end of the clavicle, with temporary fixation using a hook plate, is an effective method for treating patients with chronic post-traumatic instability of the acromioclavicular joint. Long-term follow-up confirmed the reliability of the obtained results in terms of restored stability and high functional outcomes.
Keywords: acromioclavicular joint, chronic instability, coracoclavicular ligament reconstruction, tendon autograft
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
ON THE FORMATS OF PROFESSIONAL DEVELOPMENT OF MANAGEMENT STAFF IN HEALTHCARE AND EDUCATION FIELDS: RESEARCH RESULTS
E.V. Bezrukova1, A.A. Buchek2, T.V. Modestova3,2, S.Yu. Modestov1
1North-West State Medical University named after I.I. Mechnikov,Russia, 191015, Saint-Petersburg, Kirochnaya streeet, 41
2State University of Education, Russia, 105005, Moscow, inner territory of the city, Basmanny municipal district, Radio street , 10A, bldg. 2
3Information and Methodological Center of the Petrogradsky District of Saint- Petersburg,Russia, 197198, Saint-Petersburg, Nesterova lane, bldg. 9A, room 1-N
Abstract
Introduction. Working with management remains a key task in modern management. This article presents comparative results from a study of management personnel in educational and healthcare organizations in the Russian Federation and their attitudes toward 22 professional development formats. Current professional development formats of the studied management audiences are examined, and methodological recommendations for their use in postgraduate education are provided.
Aim of the study was to identify and compare current professional development formats for management personnel in healthcare and education fields.
Materials and Methods. The research methodology used was a previously tested questionnaire [5] aimed at identifying the significance of professional development formats for respondents in terms of their impact on their professional development: low, medium, and high effectiveness, according to respondents. The authors of the study [5] define professional development formats as a diverse and organized space for interaction aimed at developing professional skills and increasing competence.
Results. School principals are more focused on professional development formats aimed at further developing their management competencies, while healthcare principals are more focused on formats for professional development of practicing physicians and physician researchers.
Conclusion. The study results may be useful for methodological support of effective professional development formats in the continuous education system for healthcare and education management. This research was supported by the Russian Ministry of Education and Science on the topic "The Impact of Professional Development on School Principals' Motivation" (EGISU NIOKTR registration number 125071608546-5).
Keywords: management personnel, professional development, professional development formats.
CONTENTS 2025_4
HYGIENE
1. Features of hygienic identification of production factors for occupational risk assessmen
Meltzer A.V., Erastova N.V., Volochkova A.I.
2. Assessment of the provision of harmless working conditions for disabled people in need of vocational rehabilitation and employment measures in the russian federation
Ishutina I.S., Meltzer A.V., Chernyakina T.S.
3. Prospect of including a multicomponent cryotechnology product in the diet of arctic workers
Rakhmanov R.S., Narutdinov D.A., Bogomolova E.S., Razgulin S.A., Nepryakhin D.V.
4. Scientific basis for monitoring premature aging caused by exposure to occupational hazards
Savchenko O. A., Novikova I. I.
5. Hygienic assessment of the functional state and psychoemotional indicators of reduced working capacity of military university cadets
Kertanov H.A., Bokarev M.A., Kiselyova N.V.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
1. Atopic dermatitis and obesity. Is there a single genetic failure?
Novikova V.P., Al-Nawaiseh Khaled Zakaria Hussein, Zaslavsky D.V., Zavyalova A.N., Markovskaya I.N., Buntovskaya A.S., Trandina A.E., Glushakov R.I.
2. Health status and provision of some essential microelements in school-aged children with undifferentiated connective tissue dysplasia
Bogomolova I.K., Plotnikova M.I.
3. Comprehensive clinical and epidemiological analysis of the incidence of infection caused by clostridium difficile among the population of moscow for the period 2019-2024
Kobzeva Yu.V., Zadorozhny A.V., Wheat N.Yu.
4. To the question of improving epidemiological monitoring of iaimd in resuscitation units
Darina M. G., Zakhvatova A. S., Ivanova T. G., Vasilyev K. D., Molchanovskaya M. A., Aslanov B. I.
5. Features of epidemiology and laboratory diagnostics of tick-borne infections in saint-petersburg during 2019-2024
Bogdanova M.O., Grigorieva T.D., Stalevskaya A.V.
6. Results of surgical treatment for patients with chronic post-traumatic instability of the acromioclavicular joint
Khominets V.V., Averkiev D.V., Vo K.T.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
1. On the formats of professional development of management staff in healthcare and education fields: research results
Bezrukova E.V., Buchek A.A., Modestova T.V., Modestov S.Yu.
HYGIENE
FEATURES OF HYGIENIC IDENTIFICATION OF PRODUCTION FACTORS FOR OCCUPATIONAL RISK ASSESSMENT
A.V. Meltzer, N.V. Erastova, A.I. Volochkova, I.V. Semenova
North-West State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya street, 41
Abstract
Introduction. Working conditions should not have a harmful eff ect on humans. Failure to comply with this imperative leads to the formation of risks for the development of occupational and occupational-related general somatic pathology, which in turn requires correct hazard identifi cation for risk assessment and hygienic justifi cation of measures to minimize harm to health. Aim of the study was to assess working conditions and identify the features of hygienic identifi cation of production factors for subsequent a priori assessment of occupational risk.
Results and discussion. The results of an objective and subjective assessment of working conditions indicate the existing risk of workers' health problems as a result of the combined eff ects of harmful factors of the working environment and the labor process, among which noise, heavy work, a heating microclimate, and local vibration have the greatest impact. As well as there are cases of occupational diseases. At the same time, from a hygienic point of view, it is important to pay attention to the problem of ensuring the quality, completeness and reliability of information on the impact of environmental factors and the labor process on the working population heath. Firstly, the results of the special assessment of working conditions often do not refl ect the present situation of the hygienic parameters of working conditions. In addition, the situation may worsen as a result of not carrying out, or not fully carrying out, production control of working conditions. The absence or limitation of objective information on factors of the production environment and the labor process, on the one hand, leads to a low detection rate of occupational diseases, on the other hand, negatively aff ects the results of occupational risk assessment.
Conclusion. The above highlights the necessity to use not only the data from the special assessment of working conditions, but also the results of industrial control over working conditions when assessing a priori occupational risks, in order to objectify the assessment of factors of the production environment and the labor process, and, accordingly, the fi nal conclusions and management decisions. Given the imbalance in the identifi cation of infl uencing factors, the results of a subjective assessment by employees of the impact of environmental factors and the labor process on health play a crucial role and may be considered as the earliest marker of a potential threat to the development of the disease.
Keywords: workers' health, working conditions, occupational hygiene, hygienic assessment, factors of the production environment and the labor process, workplace health, corporate health programs, occupational risk, special assessment of working conditions, special assessment of working conditions.
ASSESSMENT OF THE PROVISION OF HARMLESS WORKING CONDITIONS FOR DISABLED PEOPLE IN NEED OF VOCATIONAL REHABILITATION AND EMPLOYMENT MEASURES IN THE RUSSIAN FEDERATION
I.S. Ishutina1, A.V. Meltzer2, T.S. Chernyakina1, 2
1Albreсht Federal Scientific and Educational Centre of Mediсal and Social Expertise and Rehabilitation, Russia, 195067, Saint-Petersburg, Bestuzhevskaya street, 50.
2North-West State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg, Kirochnaya street, 41.
Abstract
Introduction. The issue of realizing the labor potential of disabled individuals and engaging this category of citizens in the workforce through the open labor market, as well as improving the effectiveness of social protection measures for disabled individuals in labor and employment, is a pressing state objective.
Aim of the study was to assess the provision of safe working conditions for disabled individuals requiring vocational rehabilitation, employment, and on-the-job adaptation.
Materials and Methods. The study involved federal statistical survey data, including recommendations on vocational rehabilitation and employment of disabled individuals, information on employed disabled individuals, and information on disabled individuals ' assessments of working conditions in their workplaces. The observation period was 2018-2023. Descriptive statistics and comparative analysis were used.
Results and Discussion. Between 2018 and 2023, the number of working-age people increased by 13.3%, while the number of employed disabled people decreased by 2.6%. The share of disabled people who received recommendations on equipping a special workplace for employment increased by 79.9%, the number of equipped workplaces for employment of disabled people increased by 66.0%, the number of disabled people who found work decreased by 35.8%, and employed individuals under quotas - by 53.8%. Disabled people aged 15 years and older rated their main job as very hard - 1.8%, as difficult - 15.5%, and as moderate - 54.2%. They constantly experienced at their main job: nervous tension, stress - 14.5%, exposure to harmful production factors - 13.1%, other inconveniences (cold, dampness, etc.) - 6.9%.
Conclusion. The reduction in the number of employed and working disabled individuals in 2023 compared to 2018, including under quotas, indicates the low effectiveness of legal mechanism for setting job quotas for disabled individuals. The majority of employed disabled people assess their primary work as difficult or moderately difficult, as well as the fact that some report nervous tension, stress, exposure to harmful production factors, and microclimate (cold, dampness, etc.) indicate the inadequacy or absence of systematic dynamic monitoring of working conditions and personalized medical, social, and psychological support. This may lead to poor adaptation in the workplace and the termination of employment for disabled individuals.
Keywords: disabled individuals of working age, recommendations for vocational rehabilitation, special workplaces, employment, self-assessment of working conditions and the severity of work.
PROSPECT OF INCLUDING A MULTICOMPONENT CRYOTECHNOLOGY PRODUCT IN THE DIET OF ARCTIC WORKERS
R.S. Rakhmanov1, D.A. Narutdinov2, E.S. Bogomolova1, S.A. Razgulin1,
D.V. Nepryakhin1
1Privolzhsky Research Medical University, Russia, 603950, Nizhny Novgorod, Minin and Pozharsky square, 10/1
2Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Russia, 660022, Krasnoyarsk, Partizana Zheleznyaka, street 1
Abstract
Introduction. Extreme living and working conditions in the Far North have a negative impact on the immunological reactivity of the body, forming a secondary ecologically dependent immunodeficiencies.
Aim of the study was to assess the prospects of including a multicomponent product developed using critically low-temperature technology in the diet of workers in the Arctic.
Material and methods. The main group took 10.0 g of the product for 21 days (n=30). Initially, on days 22 and 32, blood samples were analyzed: erythrocytes and hemoglobin, platelets, leukocytes (non-specific adaptive reactions of the body were determined by lymphocytes, the intensity of adaptation was determined by leukogram); serum immunoglobulins A, M, G.
Results. Blood counts, with the exception of neutrophilic leukocytes (Me 0.4; Q1 - 0.2, Q3 - 0.8 at a rate of 1-6%), were within the normal range. Non-specific adaptive reactions of the body were assessed as "training" - "calm activation". The inclusion of a multicomponent product in the diet led to an increase in erythrocytes (by 4.7%, p = 0.001), hemoglobin (by 2.0%, p = 0.001) and platelets (2.4%, p = 0.007); an increase in the proportion of band neutrophils (by 31.3%, p=0.004) and segmented neutrophils (by 11.2%, p=0.001), eosinophils (by 20.3%, p=0.006), lymphocytes (by 40.6%, p=0.001) and monocytes (12.1%, p=0.014). Stimulation of cellular immunity is confirmed by the state of non-specific adaptive reactions of the body: lymphocytes in a state of increased activation (Me 39.65; Q1 - 37.0, Q3 - 40.0, p=0.001); stimulation of nonspecific resistance - an increase in IgA by 6.6% (p=0.001). The intake of the product contributed to the normalization of the physiological state of the body; in the comparison group, at the observation stages, a pre-nosological state was determined in 57.1-61.5%.
Conclusion. The prospects of optimizing the nutrition of employees with a multicomponent product have been established. It is necessary to determine the optimal dose and period for repeated prevention courses according to the seasons of the year.
Key words: Arctic; multi-component product; macronutrients, micronutrients, blood parameters, non-specific adaptive responses.
SCIENTIFIC BASIS FOR MONITORING PREMATURE AGING CAUSED BY EXPOSURE TO OCCUPATIONAL HAZARDS
O.A. Savchenko, I.I. Novikova
Novosibirsk Research Institute of Hygiene,Russia, 630108, Novosibirsk, Parkhomenko street, 7
Abstract
Introduction. Modern hygiene is facing a challenge of occupationally induced aging (OIA) – the accelerated development of systemic signs of aging under the influence of chronic isolated, combined, and compound exposure to physicochemical factors in the occupational environment (at a level of 1.5 MAC/MPL). The existing paradigm of hygiene regulation, focused on controlling isolated factors, fails to take into account the synergistic effects of their joint effects, leading to an underestimation of long-term risks.
Aim of the study was to substantiate the scientific basis for monitoring premature aging caused by exposure to occupational hazards.
Materials and Methods. This study presents the results of a 180-day chronic experiment studying the effects of physicochemical factors in the occupational environment (1.5 MAC/MPL) on health indicators in 6 groups of Wistar rats (n=190), an analysis of the data obtained, and a review of the current literature. Hygienic, toxicological, physiological, behavioral, clinical, biochemical, histological, genetic, and theoretical research methods were used: formalization, generalization, comparison, and systems analysis.
Results. The experimental results demonstrate the need to shift from a traditional model to a risk-based one that takes into account the complex interaction of factors, the cumulative effect, and pre-nosological changes. An integral pathogenetic model of OIA is proposed, the central element of which is oxidative stress-induced telomere shortening as the "molecular clock" of aging.
Conclusion. Conceptual foundations for prevention have been formulated, including: a pre-nosological system based on multilevel biomarkers; a differentiated approach taking into account the type of exposure and gender-specific response; targeted pathogenetic interventions; and scientific and methodological support. The implementation of the proposed concept aims to shift the occupational safety paradigm from reactive to predictive and preventive, thereby preserving the professional longevity of workers.
Keywords: occupationally induced aging, isolated, combined, and compound exposures, synergism, oxidative stress, telomeres, biomarkers, pre-nosological diagnostics, and hygienic prevention.
HYGIENIC ASSESSMENT OF THE FUNCTIONAL STATE AND PSYCHOEMOTIONAL INDICATORS OF REDUCED WORKING CAPACITY OF MILITARY UNIVERSITY CADETS
Kh.A. Kertanov, M.A. Bokarev, N.V. Kiselyova
Federal State Budgetary Military Educational Institution of Higher Education «Kirov Military Medical Academy» of the Ministry of Defence of the Russian Federation. Russia, 194044, Saint Petersburg, Akademika Lebedeva Street, 6
Abstract
Introduction. Training in military educational institutions is accompanied by high physical and psychoemotional stress, which affects the functional state and performance of cadets. Under conditions of prolonged and intensive educational process, there is a risk of reducing the adaptive reserves of the body and increasing the level of psychoemotional stress, which determines the relevance of timely assessment of the health status of future officers.
The aim of the study. The aim is to assess the functional state and psychoemotional performance indicators of cadets at a military medical educational organization during the dynamics of the educational process.
Materials and methods. A cross-sectional study of 353 cadets (171 men, 182 girls) of 1-6 courses was conducted. The functional state was assessed according to the functional change index (modified by B.A. Adamovich, R.M. Bayevsky, A.P. Berseneva, 1990). The assessment of working capacity was carried out using a questionnaire according to the methodology of A.B. Leonova, S.B. Velichkovskaya "Differentiated diagnosis of a state of reduced working capacity" (2002). Nonparametric Kruskal-Wallis, Mann-Whitney and Spearman correlation analysis criteria were used.
Results. It was found that the dynamics of the functional change index is nonlinear, with critical points at the first Me = 2.35 [2.22-2.53] and the sixth courses Me = 2.31 [2.18-2.47]. Tension of adaptation mechanisms was revealed in 5.9% of students (≥ 2.6). The gender differences were revealed by the index of functional changes, which were higher in male cadets (p < 0.001). Psychoemotional indicators showed multidirectional dynamics: fatigue and mental satiety increased by the senior years, stress showed a U-shape with peaks in the first and sixth years, while indicators of monotony showed no significant inter-course differences. Correlation analysis revealed a moderate positive association of the functional change index with stress (p = 0.43; p < 0.001) and weak correlations with fatigue (p = 0.24; p < 0.001) and mental satiety (p = 0.21; p < 0.001).
Conclusion. The obtained results indicate the presence of critical adaptation stages during the educational process, with the formation of risk subgroups among cadets. The established correlations confirm the interconnection between physiological and psychoemotional manifestations of adaptive stress, which should be considered when organizing preventive measures and developing health-preserving technologies in a military educational institution.
Key words: cadets, students, performance, functional changes index, functional state, health, adaptation, fatigue, stress, mental satiation, monotony.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
ATOPIC DERMATITIS AND OBESITY. IS THERE A SINGLE GENETIC FAILURE?
V.P. Novikova¹, Al-Nawaiseh Khaled Zakaria Hussein¹, D.V. Zaslavsky¹, A.N. Zavyalova¹, I.N. Markovskaya¹, A.S. Buntovskaya², A.E. Trandina²,
R.I. Glushakov¹,².
¹Saint Petersburg State Pediatric Medical University, Russia, 194100, Saint Petersburg, Litovskaya street, 2
²S.M. Kirov Military Medical Academy, Russia, 194044, Russia, Saint Petersburg, Akademika Lebedeva street, 6
Abstract.
Introduction. The physical development and nutritional status of children with atopic dermatitis changes with maturation. Polymorphism of genes involved in fatty acid metabolism and energy metabolism in children with dermatitis and different nutritional status has not been studied.
Aim of the study was to analyze the polymorphism of the genes FADS1 rs174544, FADS1 rs174583; APOE rs769452, APOA1 rs1799837; FTO rs9939609; LIPC rs2070895 and their impact on the nutritional status in children with atopic dermatitis.
Materials and methods. The single-center, cross-sectional cohort study included 35 children aged 6 to 17 years (13.14 + 5.5). All children underwent physical development assessment Antro Plus WHO, SCORAD, and bioimpedancemetry (MEDASS). The genetic profile included a set of single nucleotide polymorphisms in the FADS1 (rs174544), FADS1 (rs174583), APOE (rs769452), APOA1 (rs1799837), FTO (rs9939609), and LIPC (rs2070895) genes. The study was approved by the Ethics Committee 8.11.2023, №32/01. Statistical analysis StatTech v. 3.1.8.
Results. SCORAD=54.86 [44.3; 71.8] which is typical for a severe course. Children with obesity are characterized by the following alleles: CA allele of the FADS1 rs174544, CT allele of the FADS1 rs174583; CC allele of the APOA1 rs1799837; AA allele of the FTO rs9939609; alleles of the LIPC rs2070895 G/A and G/G. APOE rs769452 was only homozygous Leu/Leu.
Conclusion. Changes in nutritional status with accumulation of fat mass and development of obesity among patients with severe atopic dermatitis, having different roots, can be regulated by the same genes. Knowing the genotype responsible for controlling satiety could allow children to be provided with targeted therapy for dermatitis and obesity.
Key words: atopic dermatitis; children; FADS1rs174544; APOA1rs1799837; FTOrs9939609; LIPCrs2070895; FADS1rs174583.
HEALTH STATUS AND PROVISION OF SOME ESSENTIAL MICROELEMENTS IN SCHOOL-AGED CHILDREN WITH UNDIFFERENTIATED CONNECTIVE TISSUE DYSPLASIA
I.K. Bogomolova, M.I. Plotnikova
Federal State Budgetary Educational Institution of Higher Education Chita State Medical Academy of the Ministry of Health of the Russian Federation. 672010, Russia, Transbaikal Territory, Chita, Gorky Street, 39A.
Abstract
Connective tissue dysplasia (CTD) is a pressing pediatric problem, affecting 20% to 80% of children worldwide. The disease typically onsets in early school age (ages 7-11), as this is the period when children experience the most significant physical stress at school. Certain essential micronutrients, such as iodine and selenium, are thought to be involved in the pathogenesis of CTD. A study aimed to assess the health status and iodine and selenium status of primary school-aged children with undifferentiated connective tissue dysplasia (UCTD) revealed a high prevalence of pathological lesions, with diseases of the circulatory, nervous, and digestive systems, musculoskeletal, and ocular and adnexal systems predominating. In our study, the multiple combinations of clinical syndromes accompanying the clinical manifestations of CTD reached up to 7-8 in one child. Among these, the most common combinations of syndromes included visual pathologies, neurological disorders, asthenic and valvular syndromes, and gastrointestinal or urinary pathologies. Foot pathologies were recorded in half of the cases in children with UCTD, along with iodine deficiency and general selenium deficiency. Laboratory diagnostics revealed elevated levels of sulfated glycosaminoglycans in daily urine, mild iodine deficiency, and severe selenium deficiency in the group of children with UCTD, compared with normal iodine levels and moderate selenium deficiency in the control group. Thus, the study concluded that the presence of connective tissue dysplasia in primary school-aged children is associated with mild iodine deficiency and severe selenium deficiency, along with high glycosaminoglycan excretion, accompanied by high pathological lesions.
Key words: connective tissue dysplasia, undifferentiated connective tissue dysplasia (UCTD), school-age children, iodine, selenium, glycosaminoglycans.
COMPREHENSIVE CLINICAL AND EPIDEMIOLOGICAL ANALYSIS OF THE INCIDENCE OF INFECTION CAUSED BY CLOSTRIDIUM DIFFICILE AMONG THE POPULATION OF MOSCOW FOR THE PERIOD 2019-2024
Yu.V. Kobzeva1,3, A.V. Zadorozhny1,4, N.Yu. Wheat2,3,4
1Moscow Office of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, 129626, Grafskiy per., 4, bldg. 2, 3, 4, Moscow;
2Federal Budgetary Scientific Institution "Central Research Institute of Epidemiology" of Rospotrebnadzor, 111123, Russia, Moscow, Novogireevskaya st., 3a;
3Federal State Budgetary Educational Institution of Continuous Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Health of the Russian Federation (FGBOU DPO RMANPO of the Ministry of Health of the Russian Federation) Russia, 125993, Moscow, Barrikadnaya st., 2/1с1;
4Institute of Disinfection of the Federal Budgetary Scientific Institution of Science "Federal Scientific Center of Hygiene named after F.F. Erisman" Rospotrebnadzor, 117246, Russia, Moscow, Nauchny proezd, 18.
Abstract.
Introduction. C. Difficile-associated infection remains a serious problem for healthcare systems worldwide, requiring strict epidemiological surveillance to reduce its impact. The relevance of studying this issue is supported by global data, with approximately 500,000 C. difficile infections reported annually in the United States, and incidence rates ranging from 4.1 to 16.8 cases per 10,000 patient-days in EU countries. The problem is particularly significant in the context of healthcare-associated infections (HAIs), which account for up to 40% of all infections and have a mortality rate of up to 15-20% among elderly patients [4].
Purpose: Clinical and epidemiological analysis of the incidence of C. difficile-associated infection in Moscow (2019–2024) with an assessment of its significance for the preventive healthcare system in medical facilities.
Materials and methods: A retrospective clinical and epidemiological analysis was conducted on 2,948 cases of C. difficile-associated infection registered in Moscow from 2019 to 2024.
Results: An analysis of data for 2020-2025 revealed a significant increase in the incidence of C. difficile-associated infection among the population of Moscow, which increased by 4.65 times, from 1.39 to 6.47 0/0000. The highest proportion was observed among patients over 60 years of age (55.7%), but the proportion of children under 1 year of age increased (7.2%). Severe forms predominate in adults aged 36–59 (54.5%) and the elderly (40.9%), while children are more likely to have mild cases.
Conclusion: The results obtained highlight the need to optimize the system of epidemiological surveillance of C. difficile-associated infection (including as part of the prevention of nosocomial infections) and antibiotic therapy.
Keywords: C. difficile, epidemiological analysis, nosocomial infections, morbidity.
TO THE QUESTION OF IMPROVING EPIDEMIOLOGICAL MONITORING OF IAIMD IN RESUSCITATION UNITS
M. G. Darina1, 2, A. S. Zakhvatova1, 2, T. G. Ivanova1, K. D. Vasilyev1,
M. A. Molchanovskaya1, B. I. Aslanov1
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, St. Petersburg, Kirochnaya St., 41
2 St. Petersburg State Budgetary Healthcare Institution "Medical Information and Analytical Center" of the Healthcare Committee of St. Petersburg, Russia, 198095, St. Petersburg, Shkapina St., 28, Bldg. 30, Litera A
Аbstract
Introduction. Intensive care unit patients undergoing various medical procedures and prolonged use of invasive devices during treatment and diagnostics are at risk of developing various forms of infectious pathology associated with invasive medical procedures.
Aim of the study was to assess the level of the use of medical information systems in St. Petersburg hospitals for epidemiological surveillance of nosocomial infections in intensive care units among patients at risk of developing purulent-septic infections.
Materials and Methods.A retrospective analysis of the incidence of leading forms of infections associated with invasive medical procedures was conducted among patients in intensive care units of 49 hospitals in St. Petersburg. Methods for collecting data on risk factors for infectious complications and patient treatment outcomes in accordance with existing regulations, including the use of information technology, were examined.
Results. The analysis revealed discrepancies between official data from St. Petersburg hospitals on the incidence of healthcare-associated infections and expert opinion, indicating a lack of unified approaches to organizing and conducting epidemiological surveillance of intensive care unit (ICU) patient treatment outcomes across the city's institutions, including the use of the city's hospital information systems.
Conclusions. Using the capabilities of local and regional medical information technologies to conduct active epidemiological surveillance of invasive medical interventions in ICUs will allow hospital epidemiologists to calculate the average incidence rate of specific forms of nosocomial purulent-septic infections, identify predictors of epidemiological problems in high-risk units, implement targeted preventive and anti-epidemic measures, and evaluate the effectiveness of these measures.
Keywords: infections associated with invasive medical procedures, risk factors for the development of septic conditions, nosocomial purulent-septic infections, infections associated with the provision of medical care, epidemiological surveillance, medical information system.
FEATURES OF EPIDEMIOLOGY AND LABORATORY DIAGNOSTICS OF TICK-BORNE INFECTIONS IN SAINT-PETERSBURG DURING 2019-2024
M.O. Bogdanova1, 2, T.D. Grigorieva1, A.V. Stalevskaya1
1. S.P. Botkin Clinical Infectious Diseases Hospital, Russia,191167, Saint Petersburg, Mirgorodskaya street,3
2.North-West State Medical University named after I.I. Mechnikov, Russia,191015, Saint Petersburg, Kirochnaya street,41
Abstract
Introduction. Tick-borne infections pose a significant challenge for the healthcare system as they lead to significant socio-economic losses associated with temporary disability of patients. Various nosological forms of natural focal diseases are registered annually in Saint-Petersburg, among which infections transmitted by ixodes ticks, such as viral tick-borne encephalitis and ixodes tick-borne borreliosis, predominate.
Aim of the study was to analyze the epidemiological profile of tick-borne diseases in Saint-Petersburg during a six-year monitoring period during 2019-2024.
Materials and methods. The medical records of 15708 patients (N=15,708) applied for medical care in S.P. Botkin Clinical Infectious Diseases Hospital during 2019-2024 were analyzed, along with data from studies on 60881 ticks (N=60,881) removed from bite victims using ELISA method and the VectoVKE antigen system manufactured by JSC Vector-Best, and polymerase chain reaction (PCR) analysis of the RNA of virus causing tick-borne encephalitis (TBEV) using the AmpliSens® TBEV test system. Additionally, the Rospotrebnadzor State Report on the sanitary and epidemiological situation for 2019-2024 was analyzed.
Results. The majority of tick bite victims in the city was observed in the Kurortny District (48.2%), with significantly lower rates in Primorsky (18.9%) and Pushkinsky districts (17.7%). Most residents of the city experienced tick bites within the Leningrad region, accounting for 81.6% of all cases. Cases of tick bites outside of Saint-Petersburg and the Leningrad region have been reported during visits to regions endemic for tick-borne infections, accounting for 15.2% of total cases. Seasonal tick activity was observed from April to October, with a higher rate of medical attention during the spring and summer months. During the study period, there were 243 reported cases of tick-borne encephalitis (representing 1.5% of referrals) and 699 cases of tick-borne borreliosis (4.5%). The average annual incidence rate was 1.35 ± 0.27 cases per 10,000 applicants. The diseases were identified in all age groups between 15 and 89 years old, with the highest proportion of cases among adults over 60 years, accounting for 32.9% of tick-borne encephalitis cases and 55.1% of tick-borne borreliosis cases. During 2019 -2024, a total of 103 patients presenting with clinical manifestations of tick-borne diseases were admitted to the S.P. Botkin Clinical Infectious Diseases Hospital, for whom the etiology of their illness could not be determined. Upon examination of ticks removed from these patients, a positive test result was obtained in 90.8% of cases. Additionally, during the same period, five cases of co-infection with tick-borne encephalitis and tick-borne borreliosis were identified.
Conclusion. A persistently high prevalence of tick-borne pathogen infection has been identified, indicating a significant risk of transmission through tick bites. In order to confirm the etiology of these infections, it is essential to expand the capacity of modern laboratory testing and develop methods for the early detection of mixed infections with tick-borne encephalitis and borreliosis, allowing for the rational use of targeted therapy.
Keywords: tick-borne infections, ixodes ticks, tick-borne encephalitis, tick-borne borreliosis, natural focal infections, laboratory diagnosis
RESULTS OF SURGICAL TREATMENT FOR PATIENTS WITH CHRONIC POST-TRAUMATIC INSTABILITY OF THE ACROMIOCLAVICULAR JOINT
V.V. Khominets, D.V. Averkiev, K.T. Vo
S.M. Kirov Military Medical Academy, Russia, 194044, Saint-Petersburg, Akademika Lebedeva street, 6
Abstract
Introduction. Chronic post-traumatic instability of the acromioclavicular joint (ACJ) develops in 13-40% of cases due to neglected acromial end of the clavicle dislocation, manifesting as persistent pain syndrome, impaired function of the shoulder girdle, and requiring reconstructive surgery.
The aim of the study was to evaluate the long-term results of surgical treatment of patients with chronic post-traumatic ACJ instability using the technique of coracoclavicular ligament reconstruction with an augmented tendon autograft, looped around the coracoid process and the acromial end of the clavicle, with temporary fixation using a hook plate.
Materials and methods. A retrospective study was conducted on 26 male patients with chronic ACJ instability (mean time from injury to surgery 9,7±5,4 months). Coracoclavicular ligament reconstruction was performed using an autograft of the palmaris longus tendon augmented with a synthetic tape. The graft was positioned as a loop encompassing the coracoid process and the acromial end of the clavicle. The ACJ was fixed with a hook plate, which was removed after 7-8 months. The mean follow-up period was 7,8±4,3 years. Evaluation was conducted using the Constant Score (CS), American Shoulder and Elbow Surgeons (ASES) score, Visual Analog Scale (VAS), and bilateral radiographic stress test with a 5 kg traction load on the upper extremities.
Results. Functional outcomes demonstrated high treatment efficacy. The mean CS score was 90,7±3,8 points, and the mean ASES score was 93,4±3,0 points. Excellent results (CS ≥ 90) were achieved in 69,2% of patients. The mean VAS score was 0,9±0,7. The radiographic stress test confirmed the restoration of ACJ stability almost to the level of the intact joint: the mean differences in the acromioclavicular and coracoclavicular distances between the operated and intact sides were statistically non-significant.
Conclusion. Reconstruction of the coracoclavicular ligament with an augmented tendon graft looped around the coracoid process and the acromial end of the clavicle, with temporary fixation using a hook plate, is an effective method for treating patients with chronic post-traumatic instability of the acromioclavicular joint. Long-term follow-up confirmed the reliability of the obtained results in terms of restored stability and high functional outcomes.
Keywords: acromioclavicular joint, chronic instability, coracoclavicular ligament reconstruction, tendon autograft
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
ON THE FORMATS OF PROFESSIONAL DEVELOPMENT OF MANAGEMENT STAFF IN HEALTHCARE AND EDUCATION FIELDS: RESEARCH RESULTS
E.V. Bezrukova1, A.A. Buchek2, T.V. Modestova3,2, S.Yu. Modestov1
1North-West State Medical University named after I.I. Mechnikov,Russia, 191015, Saint-Petersburg, Kirochnaya streeet, 41
2State University of Education, Russia, 105005, Moscow, inner territory of the city, Basmanny municipal district, Radio street , 10A, bldg. 2
3Information and Methodological Center of the Petrogradsky District of Saint- Petersburg,Russia, 197198, Saint-Petersburg, Nesterova lane, bldg. 9A, room 1-N
Abstract
Introduction. Working with management remains a key task in modern management. This article presents comparative results from a study of management personnel in educational and healthcare organizations in the Russian Federation and their attitudes toward 22 professional development formats. Current professional development formats of the studied management audiences are examined, and methodological recommendations for their use in postgraduate education are provided.
Aim of the study was to identify and compare current professional development formats for management personnel in healthcare and education fields.
Materials and Methods. The research methodology used was a previously tested questionnaire [5] aimed at identifying the significance of professional development formats for respondents in terms of their impact on their professional development: low, medium, and high effectiveness, according to respondents. The authors of the study [5] define professional development formats as a diverse and organized space for interaction aimed at developing professional skills and increasing competence.
Results. School principals are more focused on professional development formats aimed at further developing their management competencies, while healthcare principals are more focused on formats for professional development of practicing physicians and physician researchers.
Conclusion. The study results may be useful for methodological support of effective professional development formats in the continuous education system for healthcare and education management. This research was supported by the Russian Ministry of Education and Science on the topic "The Impact of Professional Development on School Principals' Motivation" (EGISU NIOKTR registration number 125071608546-5).
Keywords: management personnel, professional development, professional development formats.