Risk factors for dyshormonal benign hyperplasia and breast cancer

Risk factors for the occurrence of benign diseases and breast cancer were studied in a comparative analysis of the survey data of 321 women who were operated on the mammary gland, had an established histological diagnosis and were registered in the oncology offices of the Kursk polyclinics (main group), and 150 women who did not have any clinical , no objective manifestations of breast pathology (comparison group). To study the frequency of dyshormonal hyperplasias of the mammary glands and risk factors in girls, an in-depth preventive examination of 390 schoolgirls aged 13-17 years was carried out.

Seroconversion rate and socioeconomic and ethnic risk factors for SARS-CoV-2 infection in children in a population-based cohort

Introduction: Socioeconomic and ethnic background have been discussed as possible risk factors for SARS-CoV-2 infections in children. Improved knowledge could lead way to tailored prevention strategies and help to improve infection control. Methods: Observational population-based cohort study in children (6mo. - 18 ys.) scheduled for legally required preventive examination and their parents in a metropolitan region in Germany. Primary endpoint was the SARS-CoV-2 seroconversion rate during study period. Risk factors assessed included age, pre-existing medical conditions, socioeconomic factors, and ethnicity. Results: 2124 children and their parents were included. Seroconversion rates among children in all age groups increased by 3-4-fold from 06/2020 to 02/2021. Only 41% of seropositive children were symptomatic. In 51% of infected children at least one parent was also SARS-CoV-2 positive. Low level of parental education (OR 3.13 (0.72-13.69)) significantly increased the risk of infection. Of the total cohort, 38.5% had a migration background. Specifically, 9% were of Turkish and 5% of Middle Eastern origin. These children had the highest risk for SARS-CoV-2 infections (OR 6.24 (1.38-28.12) and 6.44 (1.14-36.45) after adjustment for other risk factors. Discussion: Seroprevalence of SARS-CoV-2 infections in children increased by 3-4-fold within the study period. Frequently, more than one family member was infected. Children from families with lower socioeconomic status were at higher risk. The highest risk for SARS- CoV-2 infection was identified in families with Turkish or Middle Eastern background. Culture sensitive approaches are essential to improve infection control and serve as a blueprint for vaccination strategies in this population.

GENDER-DEPENDENT HEMOSTASIS PROFILE IN APPARENTLY HEALTHY YOUNG PEOPLE

The objective of the study is to reveal the parameters of red blood cells, rheology, endothelin level, Willebrand factor, tPA-PAI-1 complex, antithrombin III, procoagulantive mechanisms of the hemostatic system and fibrinogen in medical students in the process of learning, taking into account gender differences. Materials and Methods. We examined 100 relatively healthy people (50 men and 50 women who did not have any complaints, were not under regular medical check-up, and did not have any proven diagnoses). The absence of diseases was confirmed by medical documentation, since all study participants underwent an annual preventive examination for admission to study. The volunteers were 18–30 years old. Results. Women had a higher endothelin level if compared with healthy men, which led to less powerful vasoconstriction and increased procoagulant blood activity. At the same time, higher levels of both procoagulant, anticoagulant and fibrinolytic blood activity were recorded. A significantly lower concentration of the tPA-PAI-1 complex and a change in the vWF index were also noted. In addition, relatively healthy women showed greater activity of VIIIa factor, higher resistance of Va factor to active protein C, and significantly higher fibrin content if compared with healthy men. Key words: sex differences, rheology, endothelin level, Willebrand factor, tPA-PAI-1 complex, AT III, procoagulantive mechanisms of the hemostatic system and fibrinogen. Цель. Выявить особенности показателей красной крови, реологии, уровня эндотелина, фактора Виллебранда, комплекса tPA-PAI-1, антитромбина III, прокоагулянтных механизмов системы гемостаза и фибриногена у студентов медицинских вузов с учетом половых различий в процессе обучения. Материалы и методы. Было обследовано 100 относительно здоровых (не предъявлявших жалоб, не состоявших на диспансерном учете и не имевших установленных диагнозов) человек (50 мужчин и 50 женщин). Отсутствие заболеваний подтверждалось медицинской документацией, так как все участники исследования проходили ежегодный профилактический осмотр для допуска к учебе. Возраст добровольцев составлял от 18 лет до 30 лет. Результаты. У женщин отмечался более высокий уровень эндотелина по сравнению со здоровыми мужчинами, что приводило к менее мощной вазоконстрикции и усилению прокоагулянтной активности крови. При этом были зарегистрированы более высокие значения как прокоагулянтной, так и противосвертывающей и фибринолитической активности крови. Одновременно с этим отмечена достоверно более низкая концентрация комплекса tPA-PAI-1, изменение показателя vWF. Кроме того, у относительно здоровых женщин была зафиксирована большая активность фактора VIIIа, более высокая резистентность фактора Vа к активному протеину С, а также достоверно более высокое содержание фибрина по сравнению со здоровыми мужчинами. Ключевые слова: половые различия, реология, уровень эндотелина, фактор Виллебранда, комплекс tPA-PAI-1, АТ III, прокоагулянтные механизмы системы гемостаза и фибриногена.

Frequencies of polymorphisms in genes affecting the pharmacokinetics of warfarin in the Zaporizhzhia region

The aim of the study: to establish the frequencies of polymorphisms in VKORC1, CYP2C9 and CYP4F2 genes among residents of the Zaporizhzhia region. Materials and methods. A total of 150 persons (62 male, 88 female) with a median age of 46 years (26; 58) undergoing preventive examination at the Medical Educational and Scientific Center “University Clinic” of Zaporizhzhia State Medical University (ZSMU). The CYP2C9, CYP4F2, VKORC1 genes polymorphisms in atrial fibrillation patients were determined in the Department of Molecular Genetic Studies of the ZSMU Medical Laboratory Center. Amplification of DNA fragments containing polymorphic regions was performed using multiplex real time polymerase chain reaction with Warfarin Pharmacogenetics kits (LLC NPO DNA Technology) in a CFX-96 thermocycler (BioRad) with a fluorescence detection scheme. Results. It was determined that among Zaporizhzhia region residents, the frequencies of CYP2C9*2 genotypes were: C/C – 77.3 %, C/T – 22.7 %, T/T – 0; CYP2C9*3 genotypes: A/A – 88.7 %, A/C – 10.7 %, C/C – 0.6 %; CYP4F2 genotypes: C/C – 56.0 %, C/T – 35.3 %, T/T – 8.7 %; VKORC1 genotypes: G/G – 38.0 %, G/A – 50.0 %, A/A – 12.0 %. There were no statistically significant differences in the distribution of genotype frequencies between males and females and between different age groups. The frequencies of CYP2C9, CYP4F2, VKORC1 genotypes in different populations were compared. Their variability in different geographic regions was established. Conclusions. CYP4F2 and VKORC1 genes polymorphisms are more common in the Zaporizhzhia region, while the prevalence of CYP2C9*2 and CYP2C9*3 genes polymorphisms is much lower. It is necessary to take into account the prevalence of genes polymorphisms that affect warfarin metabolism for each individual population to select its dose by pharmacogenetic testing.

THE PREVALENCE OF DENTAL CARIES IN CHILDREN AND THE IMPLEMENTATION OF AN EDUCATIONAL PREVENTION PROGRAM AMONG PRESCHOOLERS AND PRIMARY SCHOOL STUDENTS

При проведении профилактических осмотров по стоматологической заболеваемостиу детей г. Шымкента были выявлены влияния факторов, как недостаточность знаний и навыков по чистке полости рта и профилактике у большинства из них. Проведение массовых стоматологических осмотров имеет своей целью получение данных, характеризующих пораженность обследованных контингентов основными стоматологическими заболеваниями. Нет необходимости в организации сплошного обследования, так как это требует значительных затрат времени и средств. Поэтому выбран метод гнездного обследования наиболее типичных по структуре населения массивов, внутри которых проводится сплошное обследование. Что является достаточно репрезентативным и дают материалы наиболее точные, соответствующие по изучаемой проблеме.Основные вопросы, включенные в программу стоматологических осмотров, отражали уровень распространения кариеса зубов и интенсивность поражения, включая временных и постоянных зубов, число лиц, нуждающихся в профилактическом обследовании, составление специальных образовательных программ по комплексной профилактики стоматологических заболеваний у детей.Выводы: Таким образом, разработанные и обоснованные программы, позволяют добиться улучшения гигиенического состояния полости рта и улучшить кариесологический статус обследованных When conducting preventive examinations for dental morbidity in children of Shymkent, the influence of factors such as lack of knowledge and skills in cleaning the oral cavity and prevention in most of them was revealed. The purpose of conducting mass dental examinations is to obtain data describing the prevalence of the examined patients with the main dental diseases. There is no need to organize a continuous survey, as this requires significant time and money. Therefore, the method of nesting survey of the most typical massifs in terms of population structure, within which a continuous survey is carried out, was chosen. Which is suffciently representative and provides the most accurate materials relevant to the problem under study.Results and conclusions: The main issues included in the program of dental examinations reflected the level of spread of dental caries and the intensity of the lesion, including temporary and permanent teeth, the number of persons in need of preventive examination, the preparation of special educational programs for the comprehensive prevention of dental diseases in children.

CHOROID PLEXUS TUMORS IN CHILDREN: ANALYSIS OF CLINICAL DATA

Choroid plexus tumors (CPT) are rare neoplasms accounting for 2–5% of all brain tumours in children, and are most commonly under 2 years of age. Most of these tumors present with symptoms of intracranial hypertension. Survival directly depends on the histological variant of the CPT. Objective of the study: to analyze the current and outcome characteristics of patients with CPT depending on the morphological variant. This study is a multicenter, retrospective, open, uncontrolled, non-comparative, non-randomized, longitudinal study. Materials and methods of research: 152 children with CPT according to the WHO classification of CNS tumors (2007, 2016), aged 0 to 18 years, who received treatment and observed from 2009 to 2019 were included in this study. Results: 83 (54,6%) of 152 children with CPT had choroid plexus papillomas (CPPs), 37 (24,3%) – atypical choroid plexus papillomas (APPs), 32 (21,1%) – choroid plexus carcinomas (CPCs). The median age for CPP was 21 months, for APP – 6 months, for CPC – 30 months. CPTs occurred at the age of less than 24 months in 53,3% of cases. In 70,4% of cases CPT were localized in the lateral ventricles. In most children disease manifested by intracranial hypertension, and this symptomatology in children with CPC was statistically significantly more frequent than in children with CPP (p=0,0042). In 28,9% of patients with CPP, 24,3% with APP and 9,4% with CPC the disease was asymptomatic, and all these patients were diagnosed during routine preventive examination. Five-year event-free survival (EFS) and overall survival (OS) for CPP, APP and CPC were 96%±2% and 99%±1%, 81%±7% and 97%±3%, 44%±10% and 66%±10%, respectively (p<0,0001). Conclusion: for the first time in the national literature the results of a retrospective analysis of clinical characteristics and survival of children suffering from a rare group of diseases such as CPT are collected and presented.

SOCIOLOGICAL ASSESMENT OF THE INFLUENCE OF ELECTRONIC DEVICES ON HUMAN HEALTH

Background. In this article we have studied the results of a sociological survey of young people living in Omsk, users of modern electronic devices and their impact on the organs and systems of the human body. Objectives ― to study the frequency of using electronic devices in various spheres of life of Omsk residents; to assess the influence of electromagnetic radiation of a personal computer on the human body; establish the frequency of visits to the dentist for the purpose of a preventive examination. Methods. An electronic survey (Google Form) of 318 people was conducted in order to study issues related to electronic devices, general and dental health. The questionnaire consists of 25 questions, conventionally divided into 4 thematic groups. Results. Out of 318 people 80% of survey participants work on a personal computer every day for 2-3 hours without a break. 95% of respondents are aware of the negative effects of electromagnetic radiation from electronic devices. 52.5% of the respondents do not comply with the recommendations regulated by the Russian Federation when working on a PC; 11% have no information about their existence. 80.8% of respondents visit a dentist 1-2 times a year for a preventive examination. Conclusions. According to the results of a sociological survey in the format of a questionnaire, the majority of respondents work on a personal computer every day, not observing hygiene recommendations. It has been proven that a long stay at a personal computer is unsafe for human organs and systems. It is necessary to develop dental recommendations for the prevention of the negative impact of electromagnetic radiation from a personal computer on the state of the oral cavity.

Optimization of patient flow routing as a basis for improving organizational efficiency of outpatient care (experience of the Tomsk region)

Introduction. The problem of access to medical care remains extremely relevant in many countries in the world nowadays. In this context, it is advisable to optimize patients’ flow, that is, primary and repeated admissions and appointments for preventive and medical care purposes, and information. The document titled “The Standard for Organizing Outpatient Care in the Tomsk Region” was developed to solve this problem in the region. The document regulates the organizational features of providing medical care to the residents in state polyclinics. The document addresses the following: service parameters, issues of routing patient flows, and the procedures for organizing workplaces and specialists’ behavior.Objective. To evaluate the effectiveness of the solutions proposed in “the Standard for Organizing Outpatient Care in the Tomsk Region” for routing patient flows in outpatient clinics.Material and Methods. The effectiveness of measures was evaluated for 35 medical organizations with outpatient departments based on the temporal changes in eight indicators in 2018–2019.Results and discussion. Except for the percentage of children who passed preventive examination out of the number of children subject to preventive examination, positive dynamics were observed for all study parameters. First of all, this observation suggests the adequacy of proposed solutions from the perspective of the health care system, and secondly, it indicates their acceptance by the patient community. However, the extent of growth/decline is extremely uneven depending on the medical organization, which requires further research.Conclusion. Standardization of patient flow routing within the state regional health system through the issuance of appropriate orders and further monitoring of their implementation is an effective way to increase the medical care availability.

ORGANIZATION OF WORK OF NUCLEAR MEDICINE DEPARTMENT AFTER COVID-19

The purpose of work was to develop and implement an algorithm for organizing the work of the nuclear medi-cine department in time of covid-19 epidemy. As a result of the spread of a new coronavirus infection, special requirements are imposed on medical institutions to ensure the safety of patients and medical staff. In ac-cordance with the recommendations of the European association of nuclear medicine, work was carried out on the introduction of preventive examination of per-sonnel, optimization of documentation flow and minimi-zation of direct contact between medical personnel and patients. Patient routing has been adapted, taking into epidemiological standards. The work carried out made it possible to prevent infection of medical staff and pa-tients. The time of contact with patients was reduced to the necessary minimum without any decrease the quality of treatment. Routing deficiencies were identified and eliminated, which significantly extended the time spent by patients in a medical facility. In addition, the load on the medical staff was optimized, which made it possible to improve the quality of medical care provided.

Cervical cancer prevention in Pernambuco: improvements for whom? Inequity scenario in the state of the Northeast Region

Objectives: to analyze the access to cervical cancer preventive examination in Pernambuco between 2002 and 2015 by cytopathological exam coverage. Methods: public data from SUS Computer Department were used, then processed by Tabnet and Excel and calculated the slope of the over time coefficient trend by simple regression techniques. Afterwards, they were plotted in thematic maps covering cytopathological exams on Terraview app 4.2.2. Results: Pernambuco State presented an increase of exam coverage trend in all the health regions until 2010. Since that year it started to have stabilization and decreased the tendency. Comparing the coverage of the two first years, in 2002, 42.7% of the cities coverage was below 0.2 and in 2015 the scenario changed, 41.1% of the cities coverage was above 0.6. We emphasize that even in that same year 13.5% of the cities still had a low or too low coverage (less than 0.4). The over time trends in increase and decline were strongly meaningful. Conclusions: this study revealed that all health regions presented a coverage lower than recommended, in some period or in all of them, even with the State growth tendency it demonstrated an unequal and heterogeneous characteristic.