Вестник Санкт-Петербургского университета. Медицина 2021-10-04T19:58:02+03:00 Яблонский Петр Казимирович Open Journal Systems <p>«Вестник Санкт-Петербургского университета. Медицина» — рецензируемый междисциплинарный научный журнал, публикующий работы российских ученых из различных медицинских организаций, университетов, научных институтов, а также результаты исследований авторов из зарубежных медицинских организаций и университетов стран ближнего и дальнего зарубежья, которые охватывают основные области фундаментальной и прикладной медицины.</p> Renal oncocytoma in a female patient with rheumatoid arthritis and secondary Sjögren’s syndrome: Non-coincidental link to autoimmunity?* 2021-09-09T08:50:11+03:00 Леонид Чурилов Жозелио Фрейре де Карвалью <p>The objective of the article was to describe a female patient with rheumatoid arthritis (RA) and secondary Sjögren’s syndrome (SS) who developed a renal oncocytoma and was cured by percutaneous cryoablation therapy. A 72-year-old female patient with a long-term history of polyarthritis involving her hands, shoulders, knees, and ankles associated with morning stiffness and rheumatoid factor of 107 U/mL (nr: &lt;29 U/mL) and anti-CCP of 121 U/mL (nr:&lt;5 U/mL). A diagnosis of RA was determined 10 years ago, and prednisone with methotrexate were initiated, later changed for leflunomide 20mg/day. In 2014 a diagnosis of secondary SS was determined. In April 2014, during a routine abdominal ultrasound, a tumor was found in her left kidney. A magnetic resonance imaging confirmed a solid nodule with hypervascularization on the left kidney. She was submitted to a percutaneous cryoablation procedure without any intercurrence, and it had success. The histopathological analysis demonstrated a renal oncocytoma limited to the left kidney. No chemotherapy or radiotherapy was needed. After surgery, a flare of RA was noted and was resistant to methotrexate and sulfasalazine. Rituximab was then started, and she had an excellent progressive response. Minor thyroid changes were registered by ultrasound monitoring and signs of hyperparathyroidism manifested. This observation illustrates the first ever described case of a patient with RA and secondary SS who developed several years after the RA onset, a renal oncocytoma, and was successfully treated with cryoablation therapy. The possible links between oncocytic cell metaplasia/neoplasia and autoimmunity are discussed.</p> 2021-06-16T00:00:00+03:00 Copyright (c) 2021 Леонид Чурилов, Жозелио Фрейре де Карвалью Automatic scoliosis angle measurement using deep learning methods, how far we are from clinical application: A narrative review 2021-09-09T08:50:11+03:00 Дима Кассаб Ирина Камышанская Андрей Першин <p>In recent years, automatic measurement of scoliosis angle using deep learning (DL) techniques is being studied extensively. The objective of this study is to review and assess the clinical applicability of these new methods. A wide search for English and Russian literature was conducted, 13 studies were included. Although the results of many of the reviewed DL methods in measuring the angle of scoliosis are promising, their clinical implication is by far not possible. There is absence of consensus in many issues regarding these new methods (differences in architecture of the ANN, data set, principle of angle measurement and nature of the reported results). In order to successfully introduce these new methods into clinical practice, more comparative and prospective studies are needed. Also, a multidisciplinary team including technical and medical workers is needed.</p> <p>&nbsp;</p> 2021-06-16T00:00:00+03:00 Copyright (c) 2021 Дима Кассаб, Ирина Камышанская, Андрей Першин Telemedicine in psychiatric care in the community and its satisfaction by outpatients during the COVID-19 outbreak in St. Petersburg, Russia 2021-09-09T08:50:12+03:00 Егор Чумаков Лариса Азарова Олег Лиманкин <p>The process of reorganizing psychiatric day clinics to telecommunication services during the COVID-19 pandemic in St. Petersburg, Russia, is described in this article. This study aims to provide a brief assessment of outpatient psychiatric care in the community users feedback about the technical availability and satisfaction of new telemedicine services provided. 151 patients with mental disorders filled out a short structured questionnaire. All the patients surveyed received outpatient psychiatric treatment at day centers in the first two weeks of May 2020. This study demonstrated a high degree of satisfaction in telemedicine services among users of psychiatric care. It was found that majority of patients were technically ready to switch to telepsychiatry care, and had a positive feedback about the use of the service. Based on the<br>authors of the article experience, telepsychiatry proved to be the accessible mean of providing outpatient psychiatric care during the current COVID-19 pandemic.</p> 2021-06-16T00:00:00+03:00 Copyright (c) 2021 Егор Чумаков, Лариса Азарова, Олег Лиманкин Коморбидные расстройства у молодых лиц с вертеброгенной патологией и диспластическим фенотипом 2021-10-04T19:58:02+03:00 Людмила Тибекина Екатерина Спиричева Ольга Субботина <p>Pathological changes in the spine are often accompanied by pain syndrome at a young age. However, the significance of comorbid disorders in the formation and course of vertebrogenic pain syndrome has not been studied enough.The objective of the article to clarify the role of comorbid disorders in young adults with unclassified dysplastic phenotype in the formation of vertebrogenic pain syndrome. 61 male patients from 18 to 26 years old with pain syndrome in the spine were examined. Depending on the presence of signs of a dysplastic phenotype the patients were divided into two groups. The first group included 28 patients (median age 22 (21; 23) years), the second group consisted of 33 people (median age 23 (19; 24) years). All patients underwent a comprehensive examination, including neurological and somatic examination, neuroradiological, ultrasound and psychological methods of investigation, also took into account clinical and anamnestic data. Pain syndrome, the state of the autonomic nervous system and the presence of signs of a dysplastic phenotype were assessed using scales and indices. Statistical data processing was performed using the STATISTICA 10.0 program. Differences were considered statistically significant when p &lt; 0.05. According to neuroimaging data, signs of widespread dysplastic and more pronounced scoliotic and kyphoscoliotic changes of the spine, vertebral anomalies, segmental instability were authentically more frequent in patients with the unclassified connective tissue dysplasia phenotype (p&lt;0,05). They had more severe vertebrogenic pain syndrome, which was more intense and long-lasting and was on the background of a greater neurological deficit with autonomic lability and psychopathological disorders, headaches, somatic dysfunction with a prevalence of diseases of the bronchopulmonary system and ENT organs in the control group (p&lt;0.05). Research findings allow us to consider the prevalence of pathological changes in the spine, depressive disorders, somatic and cerebral burden as factors contributing to the formation of pain syndrome in patients with vertebrogenic pathology and connective tissue insufficiency.</p> 2021-06-16T00:00:00+03:00 Copyright (c) 2021 Lyudmila Tibekina, Екатерина Спиричева, Ольга Субботина Vascular dementia neurovisual markers according routine and diffusion-tensor MRI (publications’ review) 2021-09-09T08:50:12+03:00 Ирина Левашкина Светлана Серебрякова Елена Китайгородская <p>The article presents review of the most significant neurovisual biomarkers-predictors of the cognitive disfunction caused by brain vascular pathology. Also given quantitative and qualitative characteristics of this pathology including localization that can be detected using routine and diffusion-tensor MRI. Following biomarkers were noted when using standard MRI protocols: atrophy of gray matter and white matter tracts and basal nuclei; white matter hyperintensities (foci of gliosis and periventricular leukoaraiosis), micro-bleeding (large vessels, white and gray matter deposits of hemosiderin), enlarged perivascular spaces (cystic enlargement of the penetrating arteries, arterioles, veins and venules), recent small subcortical infarcts and<br>post-ischemic damages in cortex, basal nuclei and white matter tracts. The article outlines diffusion tensor MRI latest developments for cognitive deficits’ risk assessment, such as threshold coefficients (indexes) of the fraction anisotropy, received in neocortex tracts (frontal and temporal lobes; fronto-thalamic pathway).</p> 2021-06-16T00:00:00+03:00 Copyright (c) 2021 Ирина Левашкина, Светлана Серебрякова, Елена Китайгородская Hygienic assessment of phthalate migration from plastic containers for drinking water 2021-09-09T08:50:13+03:00 Ольга Копытенкова Павел Ганичев Екатерина Зарицкая <p>Packaged drinking water is one of the optimal forms of providing the population with drinking water; therefore, the achievement of guaranteed quality of this product is an urgent task. Chemical components such as phthalates in packaging can migrate into drinking water and have a negative impact on human health. The aim of our work was to assess the levels of migration of phthalates (DEHP, DiBP, DNBP) into aqueous model media at various temperature conditions (temperatures of 20 °C and 40 °C) for 30 days from PET bottles. We examined 7 samples of polymeric packaging material (unused PET bottles with a volume of 6 to 19 liters) intended for drinking water. The measurement procedure was performed using gas chromatography with mass spectrometric detection (GC-MS). The results of our research showed that packaging made of polyethylene terephthalate is a source of chemical contamination of bottled water, which is based on the processes of migration of polymer components. The highest level of migration was obtained for di (2-ethylhexyl) phthalate (DEHP). No statistically significant differences were found between the temperature of the model environment and the concentration of phthalates. The results obtained indicate the need to include di (2-ethylhexyl) phthalate in the list of monitored sanitary and hygienic safety indicators in the technical regulations on the safety of packaged drinking water, including natural mineral water with<br>established maximum permissible concentrations.</p> 2021-06-16T00:00:00+03:00 Copyright (c) 2021 Ольга Копытенкова, Павел Ганичев, Екатерина Зарицкая The The production of organic food is an urgent direction in the implementation of healthy nutrition for the population of Russia 2021-09-09T08:50:13+03:00 Виктор Вениаминович Закревский <p>The article analyzes the legislation of the European Union and Russia on the production of organic food products and the current state of the world and Russian markets for organic products. In the world, 179 countries are engaged in organic agriculture, 93 of them have their own laws in the field of production and circulation of organic products. The area of agricultural land in the Russian Federation, occupied by crops of organic crops, is the lowest percentage in comparison with the rest of Europe. Russia is actually the last developed country to adopt a law on organic products. Organic products, in comparison with traditional ones, are less contaminated with pesticides, nitrates, toxic metal compounds, mycotoxins. Organic vegetables and fruits contain more vitamins, a number of minerals and antioxidants, milk — polyunsaturated fatty acids, mainly due to the omega-3 pool. Organic beef has less cholesterol, fat, fatty<br>acids, but more α-linolenic acid, α-tocopherol, β-carotene, coenzyme Q10 and taurine than regular beef. The advantages of using organic food products in the nutrition of the population are substantiated. In conclusion, the government proposes measures to support Russian farmers interested in organic production.</p> 2021-06-16T00:00:00+03:00 Copyright (c) 2021 Виктор Вениаминович Закревский