Vol 8, No 1 (2017)

Articles
Proteomic Profile of Tears for the Diagnosis of Uveitis Associated with Juvenile Idiopathic Arthritis: Setting Targets to Achieve Results
Chasnyk V.G., Gaidar E.V., Kononov A.V., Ammosova T., Hynes A., Dubko M.F., Kostik M.M., Nikitina T.N., Serogodskaia E.D., Kalashnikova O.V., Masalova V.V., Snegireva L.S., Keltsev V.A., Grebenkina L.I., Obukhov Y., Lin X., Nekhai S.
Abstract

The paper presents epidemiologic and pathophysiological aspects of the problem statement for early recognition of Uveitis (Uv) associated with Juvenile Idiopathic Arthritis (JIA) in terms of the proteomic profile of tears as well as the results of an attempt to solve this problem by means of the Tandem Mass-Spectrometry (TMS). The solution of this problem is of the highest relevance due to revolutionary changes in treatment strategies after introducing highly effective biologics. Content analysis of literature reviews reveals the following: 1. the incidence of JIA-Uv in the Northwest Federal District of Russian Federation averages 0.5-0.7 per 100 000 of children with the prevalence being ten-fold higher than incidence, 2. without Methotrexate treatment 4-7 years after the diagnosis of JIA-Uv cataract is revealed in 35-40% of children and in 5% – glaucoma as well, 3. even with Methotrexate in 28-40% of children the complications of JIA-Uv inevitably will be revealed with blurred vision in 10-36% of children, 4. timely diagnosis of JIA-Uv and adequate treatment reduce the risk of complications by 4% per year, 5. current medical care system reveals in one third of children already the complications of JIA-Uv. Revelation in tears of the motif mode for protein interaction network, triggering mobilization/inhibition of cells which moderate Uv would contradict the traditional point of view on existing natural anatomic and physiologic barriers, isolating the intraocular space, but however seems to be possible since JIA is a systemic disease and Uv leads to damage of the blood-retinal barriers. To reveal protein biomarkers of JIA-Uv tears of 31 children aged 2-17 years were studied: 17 – chronic JIA-Uv, 4 – JIA without Uv, 4 – idiopathic Uv, 3 – systemic vasculitis, 3 – healthy children. We used the current clinical guidelines and standards to diagnose the pathology and TMS with hierarchical clustering methodology for protein identification: nano C18 column attached to Shimadzu nano LC coupled in-line to LTQ Orbitrap XL tandem mass spectrometer, data-dependent 4-event scan method, a survey FT-MS parent scan followed by sequential data dependent FT-MS/MS scans on the three most abundant peptide ions. Proteins were identified from the mass spectra results with Proteome Discoverer 1.2 software for protein database search using the International Protein Index (IPI) and Human Protein Database. Quantification was conducted using SIEVE 2.0 after normalization to albumin keeping in mind the validity of proportional change of its concentration after stimulation of lacri-mation. Data from SIEVE were exported to IPA (Ingenuity Pathway Analysis) for filtering. The extracellular proteins selected in Ingenuity were further analyzed for disease relation and networks formation. TMS revealed more than 3000 proteins in tears and 300 of them have been considered to be the first row candidates to be biomarkers of JIA-Uv. The top two proteins, lactoferrin and lipocalin were upregulated over ten-fold in children with Uv. Pathway analysis placed these proteins into the inflammation-related IL-1 and TNF-α related networks which also included proteins involved in the development of endothelial dysfunction, inflammation and retinopathy. In addition, IL-23, which was previously linked to Uveitis, was found to be upregulated. Taken together, our proof-of-principle study presents a novel and yet untested approach for detection of early biomarkers of Uveitis and identified several candidate proteins.

Pediatrician (St. Petersburg). 2017;8(1):5-26
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Main pediatric urology Saint Petersburg, professor Igor Borisovich Osipov (70th anniversary)
Lebedev D.A., Sosnin E.V., Osipov A.I., Lifanova M.V., Sarychev S.A., Krasilnikov D.E., Alekseeva L.A.
Abstract
It has become 70 years since birth and 40 years of medical, scientific, pedagogical and social activity of Professor Igor B. Osipov, ScD, chief of urology chair of Federal State Budget Educational Institution of High Education Saint Petersburg State Pediatric Medical University and not established chief pediatric urologist of Saint Petersburg. Igor B. Osipov graduated from Crimea State Medical Institute. Since 1973 till 1977 he had worked as an urologist at Pediatric Hospital No 2 named after N. Krupskaya and later he became one of the best followers of Professor G.A. Bairov, corresponding member of USSR Academy of Science, and E.A. Ostropolskaya. In 1996 he brilliantly got the degree of ScD on the subject of surgical treatment of children with bladder extrophy and in 1997 he became professor of pediatric surgery chair. Igor B. Osipov is always finding time for every side of his polyhedral talent. He actively performs scientific work, pedagogical practice and newer gives short of his attention to any colleague, follower or a parent of sick child. Professor Osipov is an author of 280 scientific works and 11 patents. For many years he has been not established chief pediatric urologist-andrologist of Saint Petersburg applying all his forcers and abilities on improvement of management of pediatric urology service. For long years Professor Igor Osipov has been board member of Russian Urology Society. Since 1999 to 2010 he had been scientific work pro-rector of Pediatric University, successfully uniting leadership at scientific activity of University and urology chair. His human characteristics as kindness, philanthropy, tenderness, insistence and diligence, his working achievements lay at the base of his success and huge scientific, medical and organizer authority in Russia and abroad.
Pediatrician (St. Petersburg). 2017;8(1):27-32
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Results of routine medical examinations of the children’s population of the russian federation in 2014
Baranov A.A., Namazova-Baranova L.S., Terletskaya R.N., Antonova E.V., Ustinova N.V., Baibarina E.N., Chumakova O.V.
Abstract

The relevance of this research was determined by the need for enhancement and increase in the efficiency of routine medical examinations of minors in the Russian Federation. The information and statistical materials of medical examination of the children’s population in 2014 in terms of the health of various age groups in a section of federal districts and subjects were studied. The following indicators were studied: coverage of the children’s population by routine medical examination; level and structure of the revealed general and primary morbidity; frequency of dispensary registration; need for additional consultations; and researches and treatment in an outpatient clinic, a day hospital, a hospital with round-the-clock services, and sanatorium organizations as well as coverage by these medical services. A high level of coverage of minors by routine medical examinations was registered. More than one-third of the healthy children’s population passed the medical examination. The revealed general and primary morbidity of the children’s population in more than one-third of subjects is above mean Russian levels. Diseases of the respiratory organs, bone, and muscular and nervous systems are the most common among children, whereas diseases of the bone and muscular system, eyes, and respiratory organs are common among teenagers. Despite the high prevalence of chronic diseases among the children’s population, recommendations for treatment and rehabilitation were given insufficiently during routine medical examinations. Regional characteristics of the medical examination results, which allowed for the identification of the most disadvantaged areas and defects in its organization and the lack of continuity between medical institutions providing this type of service, have been established.

Pediatrician (St. Petersburg). 2017;8(1):33-39
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Neuropsychiatric development of children in the first 6 months of life born with fetus growth delay
Ivanov D.O., Kozlova L.V., Derevtsov V.V.
Abstract
Features of the neurological status and neuropsychiatric development (NPD) in children at the age of 6 month of life born with fetus growth delay (G 1) in comparison with children born without fetus growth delay (G 2) are revealed in the article. Attention group was composed of 13 (22.41%) of children G 1. NPD delay was reported in 15.69% of children in G 1 and in 20.51% of children in G 2 at the age of 3 month of life. Thus, 13.73% of G 1 children (17.59% of G 2 children) were included in the attention group while 1.96% of G 1 children (2.56% of G 2 children) composed the control group. By the end of the first six months of life proper NPD was observed in the same percentage of cases (33.33% in G 1). Lower harmonious development dominated in all cases, but non-harmonious NRD was observed in children of G 2 born with fetus growth delay. Attention group was composed of 58.82% of G 1 children, risk group – of 5.88% and dispensary group – of 1.96%. Changes in the following lines of development were registered: general movement, active speech, skills and social behavior.
Pediatrician (St. Petersburg). 2017;8(1):40-49
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Effective of antiviral therapy of HIV infection and intercurrent diseases in children
Timchenko V.N., Yastrebova E.B., Bulina O.V.
Abstract
The study included 366 HIV-infected children (under-23) and 350 children with perinatal contact with HIV infection (R-75), consisting on the dispensary account in the Department of motherhood and childhood of the Saint Petersburg city AIDS center. The vast majority of children with perinatal HIV receive HAART (95.0%) with high efficacy (undetectable viral load, normalization of CD4 lymphocytes, the absence of clinical manifestations). In the structure of opportunistic viral infections (herpes, respiratory infections) 40.0%, bacterial (bronchitis, tonsillitis, pyoderma, pulmonary tuberculosis) - 28.6%, fungal infections (candidiasis mucous membranes of the oral cavity) and Pneumocystis pneumonia - 31.4%. Complex therapy (etiotropic, pathogenetic, symptomatic) acute respiratory viral infections in children with B-23 and R-75, allows us to achieve in the early stages (6 days treatment) of the regression of the main symptoms of acute respiratory diseases.
Pediatrician (St. Petersburg). 2017;8(1):50-54
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Features of morphological changes of the liver’s tissue in cases of sudden cardiac death because of alcoholic cardiomyopathy
Sokolova O.V., Nasyrov R.A.
Abstract
A retrospective analysis of acts of forensic autopsies from the archives of St Petersburg GBOOSE BSME and histological examination of liver tissue in an amount of 152 cases (78 women and 74 men) with a statistical processing of the results for studying and evaluating the morphological changes of liver’s tissue in cases of sudden cardiac death from alcohol cardiomyopathy. Identified in the course of the study morphological changes in the endothelial lining of the microvasculature showed that in addition to direct cytotoxic effects of ethanol and its metabolites in the basis of damage to the endothelial lining of the microvasculature are the cellular responses associated with exposure to mediators, the release of which is due to irritation of reactive cells, which entails a swelling deformation and increased activity endothelial cell membranes with the expansion of intercellular spaces. The development of increased permeability of the endothelial lining of transport contributes to a violation of electrolytes and nutrients to the changes of the liver’s tissue trophism, which is a substrate for the occurrence of degenerative processes and necrobiotic major structural components of the body. In turn, a direct toxic effect of ethanol and its metabolites on the wall microvascular contributes to ischemia and necrosis of the hepatocytes with the development of severe inflammatory reactions in the surrounding liver tissue, which in turn is the direct cause of the disturbances regeneration nature and excessive proliferation connective tissue with the subsequent restructuring of the vascular bed. Identified and described the morphological criteria of changes in liver’s tissue in cases of death from alcoholic cardiomyopathy should be considered in conjunction with other visceral manifestations, being a reflection of the alcohol intoxication in chronic alcoholism.
Pediatrician (St. Petersburg). 2017;8(1):55-60
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Serological level of transforming growth factor-β as a predictive biomarker of aortic enlargement in patients with Marfan syndrome
Rudoy A.S., Uryvaev A.M.
Abstract
Marfan syndrome - an inherited, autosomal dominant disease with an expected rate of 3-5/10 000 or fraction of 20-25% of new mutations, accompanied by violation of the connective tissue that occurs as a result of gene mutations FBN1, coding for the synthesis of fibrillin-1, performing the most important role in the modulation physiological bioavailability TGF-β (transforming growth factor-β). Prediction of aortic rupture is based on the identification of risk factors: family history, the absolute size of the aortic root, the rate of expansion of the aorta, which are based on the results of the history and techniques of imaging ultrasound, CT, MRI. At the same time there is a chance of developing aortic rupture under normal aortic root size and the absence of any risk factors, as well as after the prophylactic prosthetic aortic root. This makes it necessary to search for alternative prognostic markers, threatening bundle and rupture of the aorta. Article verified the predictive role of TGF-β as a serological biomarker for assessing the extension of the aortic root in patients with Marfan syndrome (n = 23, F : M / 7 : 16; 33 ± 9.3 years). The article describes the patterns between TGF-β and the size and the reconstruction of the aneurysm of the thoracic aorta. It was found that elevated levels of serum TGF-β1 (49.1 ng/ml Vs 29.15 ng/ml in the control, p < 0.05) in patients with MS diagnosed with an extension of the aortic root (Z > 1.96) can serve as a serological marker to poor prognosis, accompanied by an increase in the size of the aortic root. In patients with normal-sized aorta, and after aortic reconstruction serum TGFβ1 not elevated. Serum TGFβ may be a promising target for therapeutic, diagnostic and prognostic tactics which are not based on imaging techniques.
Pediatrician (St. Petersburg). 2017;8(1):61-66
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Mechanism of neurodevelopment of children with hearing deprivation
Yuryeva D.S., Palchik A.B., Yuldashev Z.M., Mashevskiy G.A., Ulyanova A.V., Sablina Y.V.
Abstract
100 children with sensorineural hearing loss, who had confirmed hearing impairment, were examined by routine somatoneurological and surdological survey, as well as standard psychomotor development scales (Alberta Infant Motor Scale (AIMS), Denver Developmental Screening Test (DDST), Griffiths Mental Development Scales (GMDS, GMDS-ER) in the city rehabilitation center for children with hearing and speech pathology. Criterion for inclusion in the study were the following: post-conceptual age of the child had to be not more than 36 months at the time of observation; bilateral or unilateral chronic sensorineural hearing loss or deafness and/or the presence of auditory neuropathy, confirmed by objective methods with modern audiological examinations for the core group; the absence of hearing loss, set by the modern objective methods of audiological examination for the comparison group; assessment of psychomotor and speech development of a child with at least two scales from the selection below. The survey results were analyzed using nonparametric statistical methods. Next Bayesian networks were used as efficient, compact, and intuitive way to represent knowledge related to uncertainty. Patterns of mental development, motor skills, speech and social functions in children with hearing impairment were obtained. The technique, which, depending on the factors affecting the trait under study, can help to predict with certainty the likelihood of various normal and deviant development of the child.
Pediatrician (St. Petersburg). 2017;8(1):67-73
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The Analysis of Effectiveness of the Optimized Intensive Care Consultative System of Urgent Medical Care to Children in the Territory of Rostov Region
Piskunova S.G., Sharshov F.G., Prometnoy D.V., Prometnaya G.A., Eryomenko V.P.
Abstract

Increase of effectiveness of intensive care consultative providing of children is an actual problem.

Purpose: the analysis of effectiveness of the optimized system of intensive care consultative providing of the emergency medical care to children in the Rostov region.

Methods: the retrospective cohort study, including patients of the of intensive care consultative center (ICCC) is conducted. Databases and log-books of patients of ICCC were analyzed. Research period: 2012-I half of 2016. The studied groups: the 1st – 2012-2014 (before optimization, n = 1124), the 2nd – 2015-2016 (after optimization, n = 1432). Effectiveness was estimated on dynamics of a lethality in intensive care unit (ICU), it is padding – dynamics of number of distant consultations, departures and evacuations.

Results: Ninety-seven percent of patients of ICCC are evacuated in the ICU. The lethality decreased from 5,1% – in 2012 to 3% in the I half-year 2016. Increased: the number of distant (telephone) consultations for 119,6% from 572 to 1363 in 2015 in comparison with 2014; consultations near the patients for 37,6% with 237 to 326; a share of departures with the subsequent evacuation from 54,8% (338 of 617) in group 1 to 60,8% (270 of 444; p = 0,050) in group 2; indexes “the number of departures evacuations to departures consultations” to 1,8 in the I half-year 2016 in comparison with 1,2 in 2012 and “number of primary consultations to repeated consultations” to 3,1 in comparison with 2,2. Significant strong negative correlation between an index of a lethality, the relation of number of departures evacuations to departures to consultations (р = 0,028) and the relation of primary distant consultations to repeated is revealed (р = 0,026).

Conclusion: optimization of reanimation providing advice allowed to lower a lethality in ICU at increase in a flow of the evacuated patients.

Pediatrician (St. Petersburg). 2017;8(1):74-81
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The importance of immunohistochemical examinations for patients with failed IVF-methods
Abramova V.N., Gajdukov S.N., Tajc A.N.
Abstract

Infertility is one of the most acute problems in modern reproductive studies. The theme of research is poorly conceptualized in modern medical literature, and this fact is an additional confirmation of the relevance and scientific significance of this research. With the use of assisted reproductive technology (ART), pregnancy in an infertile marriage became possible. In this article, the authors pay significant attention to the role of the endometrium in the implantation process. To better assess the status of the endometrium, they performed hysteroscopy and endometrial biopsy and conducted morphological study of biopsy material and immunohistochemistry analysis. The features, competitive advantages, or disadvantages of every method of research and treatment have also been included in the discussion. Analysis of the results of the immunohistochemical studies revealed the presence of autoimmune chronic endometritis and chronic endometritis without an autoimmune component. Comprehensive examination and treatment resulted in successful pregnancy in 90% of women with failed IVF attempts in anamnesis. At the same time, in 60% of cases the pregnancy resulted in childbirth between 36 and 40 weeks of gestation. During such pregnancies, there are only a few specific features: high risk of miscarriage, fetal defects, and extragenital pathology. Thus, reproductology is in constant search for new methods that are able to further improve the positive results of IVF.

Pediatrician (St. Petersburg). 2017;8(1):82-88
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Possible ways of decline of infantile death rate are in the separate regions of Russian Federation
Telesh O.V., Petrenko Y.V., Ivanov D.O.
Abstract
This article considers the level of infant mortality - one of the most important criterion of “demographic prosperity “in the state. Here is brief historical characterization of demographic processes since the end of 20th century till the present in Russia. Nowadays, the level of infant mortality in Russia much higher than in most European countries. Information about the factors that affect the level of infant mortality and which ones can be controlled will help to understand why infant mortality levels are so different in Russia, European countries and USA for example. First factor is direct causes of infant mortality, the second one is medical care system responsible for pregnant women and children. Today causes of neonatal mortality and ways of eliminating these causes are analyzed. Countries with low level of infant mortality have a successful three-tier model of perinatal care. Russia is also undergoing modernization care system for children and pregnant women and the transition to a three-tier system of assistance. The main objective of the three-tier system is the direction of women in high-risk groups in the establishment of the level that has the capacity to provide them with necessary assistance. Three-tier system in different regions of Russia have different features so we have various coefficients of infant mortality. Some regions have high rates; some ones have similar level to the European countries. Such differences lead to the conclusion that we need to develop regional patterns of medical care which will take into account the specificities of each region.
Pediatrician (St. Petersburg). 2017;8(1):89-94
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Pathogenic Variants of Urolithiasis
Baketin P.S., Mollaev R.A., Mazurenko D.A., Grigoryev V.E., Gadzhiev N.K., Obidnyak V.M., Pisarev A.V., Tagirov N.S., Malkhasyan V.A., Petrov S.B., Popov S.V.
Abstract
The essence of Urolithiasis - one of the oldest diseases known by the mankind - is still not understood completely. For a long time the comprehension of Urolithiasis was based on matrix, colloid, ionic, inhibitory and precipitation theories. In these cases it was impossible to single out separate pathogenetic patterns. Besides, in spite of the absence of in vivo proofs the fact that new concrement nucleus forming (de novo nucleation) is only possible outside of the stone-forming metastability range should be taken into consideration for metaphilactic purposes. Fortunately, certain progress in understanding Urolithiasis started with the onset of studies devoted to detailed scrutiny of stone-forming patients’ metabolic peculiarities as well as with the introduction into clinical practice of the up-to-date digital endoscopes. Based on existing publications one may classify pathogenesis of stone-forming into 4 major groups: growth of calcium-oxalic stones on Randall’s plaques in patients with hypercalciumuria; excrescences on the of Belliny’s ducts’ “gags”; microlites forming within the internal medullar layer discharging tubules’ lumen in patients with cystineuria; stones forming in free solution. There is no doubt this classification is not the final one, neither does it exclude mixed variants, however better understanding of the aforementioned pathogenic variants would facilitate a novel view at Urolithiasis and in patients with kidney stones would increase anti-relapse measures’ effectiveness.
Pediatrician (St. Petersburg). 2017;8(1):95-105
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Experience medical rehabilitation of the patient after a comprehensive treatment of medulloblastoma of cerebellum with metastases in the shell and the substance of the spinal cord
Danilenko L.A., Belogurova M.B., Gayduk A.A.
Abstract
The article describes the experience of medical rehabilitation of patients after a complex treatment of cerebellar medulloblastoma with metastases in the spinal cord membranes and substance. Substantiates the role of medical rehabilitation funds in correcting the effects of the disease, and cancer treatment, the essence of which is determined by the damage to the structure and function of various organs and systems. The most common effects of the three-treating medulloblastoma are postoperative deficits: ataxia and paresis; radiation myelopathy, polyneuropathy chemotherapy-induced, deformations of the skeletal system, reduced functional performance and adaptation. Actualized value of interdisciplinary interaction: oncologists, pediatricians, neurologists, orthopedists, medical rehabilitation specialists; phasing and integrated use of all available methods of rehabilitation. Presented personalized rehabilitation program to study techniques of individual lessons therapeutic exercises, therapeutic swimming, gidrokinezioterapii, procedures, motor praxis, training paretic muscles of the selected feedback, massage. It is shown that multimodal rehabilitation treatment of patients at high risk of being in remission, is effective in its action in assessing both subjective: improvement of health, emotional tone, sleep, increased appetite, and objective data: normalization of body weight, improving coordination and increasing the range of motion, increase muscle strength, strength endurance muscle corset. Currently, medical rehabilitation is an essential component of cancer patients routing.
Pediatrician (St. Petersburg). 2017;8(1):106-111
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Children’s health of Saint Petersburg
Orel V.I., Sereda V.M., Kim A.V., Sharafutdinova L.L., Bezhenar S.I., Buldakova T.I., Roslova Z.A., Orel V.V., Gureva N.A.
Abstract
Now in the Russian Federation negative tendencies in the state of health of children in all age categories are observed: high incidence, growth of prevalence of chronic pathology, existence of morfo-functional deviations, deterioration in the main quality indicators of health of children. Studying of data on incidence, death rate, disability, physical development and a role of the factors determining them in separate age groupes holds a specific place in assessment of health of children. For receipt of objective assessment of the state of health of the children’s population it is necessary to analyze in interrelation statistics on different sources: database of compulsory health insurances funds, medical examinations of children, accounting and reporting documentation of the medical organizations, computer methods of inspection of the children’s population. Social and hygienic researches on this problem are of great importance for practical health care consisting in development of recommendations about decrease in indicators of incidence, disability and death rate of children, offers of new organizational forms of work of treatment and prevention facilities. We in article provided the analysis of the children of 0-17 years this about the state of health inclusive of St Petersburg for the period 2011-2015. The main demographic characteristics of the children’s population are studied, features of physical development of children of 0-17 years inclusive, incidences, including prevalence of chronic pathology and socially important diseases among the children’s contingent, disability are revealed.
Pediatrician (St. Petersburg). 2017;8(1):112-119
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Finnish Innovations in Medicine and Social Sphere
Akimova S.L.
Abstract
The article presents data collected during the tour dedicated to the medical and social institutions of Finland about new solutions and Finnish innovations in medicine and the social sphere. The article describes the principles of the Finnish health care system, including the work of maternal and child welfare clinics, as well as common European approaches in geriatrics. Thе article describes the features of geriatric services in Finland. It reflects the role of the municipal social services to provide residents of barrier-free environment in their regions. The article presents the facts from the personal experience exploring the Finnish system of medical and social support to older generation focused on the application of the latest scientific developments. The article presents innovative products for comfortable living of older people, including a traveling exhibition of technologies for older people, specialized furniture and household items available in the functional building DoMedi and others. This article describes the function of public and private Finnish services and the Finnish Centre for Elderly, including a Finnish non-profit organization Valli. The article presents the features of a private home for the elderly “Wilhelmiina” in Helsinki and scientific developments behalf Miyna Sillanpää Foundation. The article describes the innovative products, created in the Health Innovation Village at the Finnish office of GE: vacuum therapy device for the treatment of edema, a portable device for the treatment of depression, a sensor for measuring the electrical activity of muscles. The paper presents the solutions offered by the Finnish university hospitals, including personalized medicine technology for patients with cancer, developed at the Institute of Molecular Medicine, University of Helsinki. The article describes the work of one of the divisions of the institute - Biobank. The article describes the general approach to reform the health care system in Finland.
Pediatrician (St. Petersburg). 2017;8(1):120-129
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Self-conception of patients with paranoid schizophrenia in remission
Kosina N.V., Gorban L.S.
Abstract
The article presents a study of the peculiarities of self-conception of patients with paranoid schizophrenia with consideration of gender differences and the period of remission, the relationship of self-conception to other emotional and psychological factors and the peculiarities of protective and coping behavior. The results obtained indicate that, during remission of the examinees, the examined parameters of self-conception are primarily within the normal range, they use different relatively adaptive coping mechanisms most often. The examinees showed a sufficiently high level of resilience, a favorable emotional background and absence of expressed discomfort. In case of positive self-conception, regardless of the period of remission, a high level of involvement, risk taking and resilience, low values of anxiety, hostility and psychoticism are noted. For men, a high level of self-conception is associated with a high level of involvement and resilience and low levels on the scales of psychopathological symptoms. Women with a high level of self-conception are noted for a high level of resilience, willingness to take risks but at the same time they have high expression of various psychopathological symptoms. Thus, the results of the study allow to say to hold a variety of rehabilitation measures. For greater efficiency of these activities, the group can be formed regardless of the period of remission but with considering of characteristics of the self-protective and coping behavior according to gender.
Pediatrician (St. Petersburg). 2017;8(1):130-135
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