Vol 33, No 1 (2022)

Studies of morbidity with temporary disability (MTD) at the regional and interregional levels, along with the investigations of other morbidity types in the population, are an important element in the sociohygienic monitoring system. Objective. To investigate the regional features of MTD in the subjects of the Central Federal District (CFD) over the period of 2005-2020. Material and methods. A descriptive epidemiological study was conducted on the basis of the MTD rates available in the Unified Interdepartmental Statistical Information System in 2005-2020. The mean (M) annual values of indicators, standard deviation (a), and coefficient of variation (CV) were calculated. The Shapiro-Wilk W test was used to check the normalcy of distribution. The Mann-Whitney U test was applied to assess differences between the indicators. Results. In all CFD subjects, the MTD rates decreased in 2005 and 2019 and increased in 2020. A statistically significant difference was established between the analyzed rates in 2005-2014 and 2015-2019. Conclusion. The CFD subjects show considerable differences in relative MTD rates with formally insignificant deviations from the mean value for a whole district. The decrease in MTD rates in 2015-2019 is associated with the entry into force of Russian Federal State Statistics Service (Rosstat) Order dated December 25, 2014 under No. 723 «On the Approval of Statistical Tools for the Ministry of Health of the Russian Federation to Organize a Federal Statistical Observation in the Health Sector.» Under the current procedure for the federal statistical observation, the intensive indicators at the municipal and regional levels do not reflect the real morbidity in the working population by the subjects of the Russian Federation, inter alia due to internal labor migration. Amendments to Rosstat Order No. 723 are required to increase the completeness and reliability of the data on MTD.

The review of information on the effect of the trace element selenium (Se) on reproductive health, pregnancy and lactation was carried out. The article presents research data showing that an increased need for Se is noted during pregnancy and lactation, and selenium deficiency leads to disorders of the reproductive system, complications of pregnancy and childbirth, and the development of disorders in the fetus. It has been shown that the use of SELENBIO for women dietary supplement containing selenium, zinc, vitamins C and E can be a way to prevent Se deficiency.

Health care workers are increased risk group of SARS-CoV-2 infection when providing medical care. The novel coronavirus infection (NCI) in healthcare workers can be considered an occupational disease if the infection occurs when they fulfil their professional duties. Damage to the cardiovascular system is one of the most important complications of NCI. The paper describes a clinical case of a serious NCI complication that develops in the presence of chronic autoimmune disease - severe myocarditis with pulmonary embolism, which leads to inflammatory cardiomyopathy with congestive heart failure in a healthcare worker. The paper presents the principles and results of a medical examination made to establish a causal relationship between the disease and professional activities.

The use of autologous platelet-rich plasma (aPRP) is one of the modern methods to model tissue regeneration, which promotes acceleration of scar formation, activation of collagenization and angiogenesis, and maturation of connective tissue. Objective. To evaluate the therapeutic efficiency of intraoperative aPRP use for intensifying the mechanism of reparative wound regeneration after cesarean section (CS). Subjects and methods. Fifty pregnant women who had undergone surgical delivery participated in the investigation. During the latter, the patients were randomized into 2 groups according to the type of surgery: 1) standard CS; 2) CS using aPRP. Clinical, laboratory, and instrumental studies were applied. Results. The incorporation of aPRP during CS has been shown to be an easy-to-use method that does not increase the duration of surgical therapy and significantly reduces blood loss by 26.3% (p>0.05). The use of aPRP in the early stages of CS is accompanied by a decrease in peripheral vascular resistance and by an improvement in blood flow, which leads to the stimulation of wound regenerative processes, to the intensification of angiogenesis, to the acceleration of tissue remodeling, to a reduction in the phase of wound healing, and, as a result, to a lower incidence of pyoseptic complications. Conclusion. aPRP can be used during CS to reduce the risk of pyoseptic complications and to create an optimal and adequate uterine scar.

Environmental changes and nutritional quality affect metabolic processes, which is accompanied by metabolic and endocrine diseases, especially in the child population. Objective. To substantiate the diagnostic examination and etiotropic therapy schemes that can reduce the influence of disease-producing factors on metabolism in male adolescents with alimentary obesity in environmental risk areas. Subjects and methods. Forty-five boys were examined: Group 1 consisted of 25 boys who lived in a technologically polluted area; Group 2 included 20 ones who lived in an ecologically clean area of the city. Group 3 comprised 10 healthy schoolchildren who had normal weight and lived in an ecologically clean area (a control group). Anthropometric indices, body mass index (BMI), Tanner stage of puberty, insulin resistance index, and complete blood count were determined. The urinary concentrations of lead (Pb), vanadium (V), chromium (Cr), copper (Cu), zinc (Zn), and selenium (Se) were measured by an atomic absorption method on a Kvant-Z analyzer (OOO «Kortek», Russia). The blood levels of glucose, lipid fractions, and malondialdehyde were estimated. The immune status was established by the level of the main classes of serum immunoglobulins by a radial immunodiffusion technique in gel. Adiponectin, leptin, cortisol, total testosterone, and insulin were detected by enzyme immunoassay on an Alisei Radium analyzer (Italy). The results were processed by statistical variation methods. Results. The most negative immune hormonal changes in the presence of microelementosis were found in boys from the environmental risk group. There was an inversely proportional relationship between adiponectin level and BMI. High leptin levels and lower urinary concentrations of Se, Cr, and Vcorresponded to increased BMI in children with hyperinsulinemic phenomena. No signs of microelementosis were observed in adolescents with slightly higher body weight. Conclusion. The findings suggest that mitosis plays an etiological role in neuroexchange disorders of homeostasis and provide evidence for the modification of a diagnostic examination and etiotropic therapy in male adolescents from environmental risk groups with alimentary obesity.

Familial Mediterranean fever (FMF; periodic disease) is an autosomal recessive disease, the features of which are recurrent inflammatory episodes, abdominal pain, fever, and arthritis. FMF is divided into two phenotypes. The most accurate diagnostic method is molecular genetic testing that includes a single-gene study, utilization of a multigene panel, and more whole- genome testing. The main therapy for the disease includes colchicine; its acute episodes are treated with nonsteroidal anti-inflammatory drugs and infusion therapy. Drugs, such as anakinra, rilonacept, and canakinumab, are used to treat colchicine-resistant FMF patients. The article describes the clinical case of a female patient with FMF.

The effectiveness of combating the pandemic of a new coronavirus infection (COVID-19) is based on a detailed analysis of the pathogenetic features of the course of SARS-CoV-2 infection, including an assessment of the state of the microbiota and intestinal permeability during the treatment of COVID-19 patients. Purpose: To study the dynamics of intestinal permeability, qualitative and quantitative composition of microbiota in the treatment of COVID-19 patients. Material and methods. The study was performed in 80 patients with COVID-19, whose average age was 45years, 19 of them had mild and 61 had moderate severity of the disease. The scope of the examination included traditional clinical, clinical and laboratory, biochemical, instrumental and radiation studies, as well as original methods for studying intestinal permeability and microbiota. Rebamipid was used as an element of complex pathogenetic therapy in the treatment of 41 patients (51.3%). Results and conclusions: The clinical, laboratory and radiation semiotics of COVID-19 were studied, the interdependence of manifestations of systemic inflammation, changes in the intestinal microbiome in patients with mild and moderate severity was revealed. The characteristic dynamics of the concentration levels of proinflammatory cytokines, insulin, fecal calprotectin and zonulin, reflecting the peculiarities of changes in intestinal permeability during COVID-19 treatment, has been established. The necessity of correction of intestinal permeability in the treatment of COVID-19 patients has been proved, the effectiveness of rebamipid when used at the inpatient stage of treatment and with further use in the process of outpatient rehabilitation has been confirmed.