Вестник Санкт-Петербургского университета. Медицина 2022-05-04T21:46:16+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> Features of lymphocyte differentiation in ANCA-associated and virus-associated glomerulonephritis in children 2022-05-04T21:46:14+03:00 Ольга Гурина Елена Дементьева Арина Степанова Александр Блинов Ольга Варламова <p>Glomerulonephritis is a heterogeneous group of immuno-inflammatory diseases. The purpose of the study: to analyze the subpopulation composition of lymphocytes in children with various types of glomerulonephritis. 50 children aged 1 to 16 years were examined: 1 group — 17 children aged 1 to 16 years with ANCA-associated glomerulonephritis; 2 group — 33 patients aged 2 to 16 years with virus-associated glomerulonephritis. Diagnostics of the subpopulation composition of lymphocytes was performed by flow cytometry using non-flushing technology using a three-color combination of monoclonal antibodies. It was found that the development of ANCA-associated glomerulonephritis is accompanied by signs of immunodeficiency against the background of a relative increase in the content of T-lymphocyte subpopulations. Differentiation of lymphocytes in children with virus-associated glomerulonephritis is ambiguous: the process goes either along the path of activation of antiviral protection, or along the path of development of insufficient antiviral activity of immunocytes. In children with virus-associated glomerulonephritis, a decrease in the level of B-lymphocytes was found, correlating with hypoimmunoglobulinemia A, which is an additional factor in reducing resistance on the mucous membranes. The study of lymphocyte differentiation in the development of glomerulonephritis is important for identifying the main immunological mechanisms involved in the pathogenesis of these diseases.</p> 2022-02-28T00:00:00+03:00 Copyright (c) 2021 Ольга Гурина, Елена Дементьева, Арина Степанова, Александр Блинов, Ольга Варламова Evaluation of the cytokine profile and vascular elasticity in middle-aged men with essential hypertension and combined pathology 2022-05-04T21:46:14+03:00 Ирина Лебедева Евгений Крюков Василий Цыган Александр Парцерняк Гурам Маградзе Виталий Устюжанинов Белла Айвазян Сергей Парцерняк <p>The diagnosis and management of patients with polymorbid cardiovascular pathology is a significant challenge. The pathogenesis of many cardiovascular diseases, such as arterial hypertension, coronary heart disease, angina pectoris, as well as diabetes mellitus, obesity and dyslipidemia are associated with systemic inflammation. The inflammatory process, both at the systemic and local levels, can make a significant contribution to the progression of atherosclerosis and endothelial dysfunction, and provoke the destabilization of blood pressure. Therefore, it is important to develop new approaches to the identification of patients with polymorbid pathology and chronic inflammatory processes in the body. It is known that the<br>presence of the oral cavity inflammation increases the risk of cardiovascular disease. Periodontal pathology, leading to an increased expression of pro-inflammatory cytokines, affects the initiation of atherosclerosis, endothelial dysfunction, vasospasm, and blood pressure dysregulation. It can be assumed that the oral cavity inflammatory processes against the arterial hypertension increase the probability of early vascular aging, the overall cardiovascular risk, and also increase the chance of other diseases of the cardiological profile The research subject was to determine the vascular elasticity parameters and the dynamics of blood pressure daily profile, as well as the level of pro-inflammatory and anti-inflammatory cytokines in persons with arterial hypertension, considering the presence of inflammatory processes in the oral cavity. The structure of comorbidity and a number of laboratory and instrumental data of middle-aged men with arterial hypertension in combination with periodontitis were analyzed in comparison with patients with arterial hypertension without periodontitis and healthy volunteers of the same age. A correlation was shown between the periodontal inflammation level in men with arterial hypertension and the polymorbid cardiovascular pathology presence (diabetes mellitus, dyslipidemia, anxiety and depressive disorders, coronary heart disease, signs of left ventricular hypertrophy by ECG, high ankle-brachial index as a marker of peripheral atherosclerosis), significant variability in blood pressure, an altered cytokine profile with a<br>predominance of pro-inflammatory cytokines, an increase in “vascular age” on the ASCORE scale, and increased vascular stiffness, assessed by 24-hour blood pressure monitoring using the “VasotensOffice” program.</p> 2022-02-28T00:00:00+03:00 Copyright (c) 2021 Ирина Лебедева, Евгений Крюков, Василий Цыган, Александр Парцерняк, Гурам Маградзе , Виталий Устюжанинов , Белла Айвазян , Сергей Парцерняк Possibility of using of international classification of functioning in rehabilitation of patients with cataract 2022-05-04T21:46:15+03:00 Елена Клюшникова <p>The problem of rehabilitation of patients with cataract, analysis of effectiveness of surgical treatment, restoration of professional activity and obtaining a high quality of life after cataract surgery is of great medical and social importance. The basic principles of modern medicine are patient orientation, personalized and multidisciplinary approach. Attention is focused not on an individual disease and its symptoms, but on the patient as a whole person with all life’s concerns and problems. The study of the quality of life (QOL) of the patients with cataract allows us to assess the influence of cataract and surgical treatment on the psychological, emotional state of the patient, his functioning in the social environment. However, cataract surgery is a rehabilitation treatment aimed at restoring functions lost due to cataract. International classification of functioning (ICF), limitation of vital activity and health is a generally accepted classification in rehabilitation medicine. In accordance with new trends, the possibility of using ICF for the study of visual impairments and limitation of vital activity in patients with cataract before and after surgical treatment is becoming relevant.</p> 2022-02-28T00:00:00+03:00 Copyright (c) 2021 Елена Клюшкова Current knowledge of genetics of COVID-19 2022-05-04T21:46:15+03:00 Александр Голота Дмитрий Вологжанин Татьяна Камилова Станислав Макаренко Сергей Щербак <p>The ongoing COVID-19 pandemic, caused by coronavirus SARS-CoV-2, is responsible for a reported 456,797,217 cases of COVID-19, and 6,043,094 deaths worldwide as of 12.03.2022. Following infection with SARS-CoV-2, COVID-19 clinical presentation ranges from asymptomatic or mild (~80 % of infections), to severe disease that typically requires hospitalization and assisted respiration. Innate immune responses to viral infection are also a critical determinant of disease outcome. Genetic risk factors for COVID-19 are in the early stages of study. A number of mutations and polymorphisms have been identified that affect the structure and stability of proteins — factors of susceptibility to SARS-COV-2 infection, a predisposition to the development of respiratory failure, and the need for intensive care. Most of the identified genetic factors are related to the function of the immune system. On the other hand, the genetic polymorphism of the virus itself affects the spread and severity of the course of COVID-19. The genome of the virus accumulates mutations and evolves towards increasing contagiousness, replicative ability, and evasion from the host’s immune system. Genetic determinants of infection are potential therapeutic targets. Studying them will provide information for the development of drugs and vaccines to combat the pandemic.</p> 2022-02-28T00:00:00+03:00 Copyright (c) 2021 Александр Голота, Дмитрий Вологжанин, Татьяна Камилова, Станислав Макаренко, Сергей Щербак Альтернативное мультимодальное лечение мигрени эффективно и безопасно 2022-05-04T21:46:15+03:00 Леонид Чурилов Jozélio de Carvalho Aaron Lerner Natalia Marques <p>The objective of the article was to evaluate an alternative approach for migraine. The patients received an alternative multimodal approach (AMA) involving nutraceuticals, melatonin, and dietary changes. Six patients were included in the study. Comorbidities were observed in all patients and included hypertension, depression, anxiety, diabetes, asthma, silicone breast implants, and allergic rhinitis. Sleep disorders were observed in 67 % of the patients. Interestingly, after applying AMA, there was a remarkable improvement in all participants. Vitamin D levels surged significantly, and sleep improved in all patients with sleep disturbances. The number of days with migraine was reduced significantly. An improvement of VAS well-being was observed after AMA, and a reduction of the VAS migraine pain was noted. All migraineurs, except one, suspended the conventional preventive drugs for migraine. An AMA is effective and safe, without any side effects for migraine prevention and therapy.</p> 2022-02-28T00:00:00+03:00 Copyright (c) 2021 Леонид Чурилов, Jozélio de Carvalho, Aaron Lerner, Natalia Marques Methodological aspects of programs’ updating for advanced training of doctors 2022-05-04T21:46:16+03:00 Алексей Трегубов Валерия Шурыгина Никита Перепеч <p>An important component of improving the healthcare system is providing medical institutions with highly qualified personnel. In the era of evidence-based medicine, clinical guidelines developed by the expert community and approved by regulatory authorities are the cornerstone of maintaining the knowledge and skills of medical personnel at a high level. In modern medicine, new data are accumulating very quickly, which requires regular changes in the algorithms for managing specialized patients. Frequent updating of clinical guidelines and their increasing importance as a document regulating the provision of medical care to patients with various diseases necessitate the intensification of additional professional education of doctors. Doctors’ awareness of the current provisions of clinical guidelines and readiness to implement them in everyday practice is an important condition for the compliance of real medical care with modern requirements. Under the conditions of the system of continuous medical education, the programs for improving the skills of doctors should be constantly improved. The article discusses the methodology for updating educational programs based on the analysis of the results of an anonymous survey of doctors on the main aspects of the current clinical guidelines. Identification of questions, the answers to which turn out to be incorrect more often than others, and quantitative analysis of the distribution of incorrect answers allow to correct programs in order to achieve a higher level of knowledge of trainees in the most difficult sections of clinical guidelines. Information about the changes that were made to the advanced training programs for doctors in the diagnosis and treatment of cardiovascular diseases on the basis of the data obtained during the questionnaire is presented. It is expected that the discussed methodology for updating the advanced training programs for doctors will help to improve the provision of the needs of modern healthcare for highly qualified personnel.</p> 2022-02-28T00:00:00+03:00 Copyright (c) 2021 Алексей Трегубов, Валерия Шурыгина, Никита Перепеч Life support training: Looking for target audience (a pilot study) 2022-05-04T21:46:16+03:00 Ирина Аршукова Татьяна Дудина Игорь Акулин Елена Добрецова <p>There are many different emergency cases (besides road traffic incidents) in which the outcome for the affected person depends on the timing of the relevant first aid. One of the possibilities to improve the situation is to train a certain population of first aid skills. Identify the audience which is more appropriate to teach first aid skills to be able early to recognize a medical emergency and provide first aid correctly. First aid knowledge and skills of the participants were detected by a questionnaire in 2020. Data were analyzed using SPSS Version 22, p &lt; 0.05. Four hundred and thirty loyal citizens of Krasnoyarsk, Russia, participated in classes. The training led to the significant improvement in the first aid knowledge and skills of the participants (before-and-after study). The citizens who have already witnessed an emergency case realize the opportunity of the emergency situation and their responsibility for the outcome better than the others. The regular first aid classes conducted by the medical community members for people of 30–45 years old with a higher educational level can significantly influence the number of favorable outcomes of emergency out-of-hospital cases.</p> 2022-05-04T20:55:33+03:00 Copyright (c) 2021 Ирина Аршукова, Татьяна Дудина, Игорь Акулин, Елена Добрецова Dutch cultural heritage of Fredrik Ruijsch and Herman Boerhaave in the Military Medical Academy named after S. M. Kirov 2022-05-04T21:46:16+03:00 Inge Hendriks Fredrik Boer Вячеслав Кравцов Иван Гайворонский Pancras Hogendoorn <p>During historical research into the Russian physician Nikolay Ivanovich Pirogov (1810–1881) and his relation to Dutch scientists in shaping Russian medical science, access was allowed to the first author of this manuscript to the fundamental library of the Military Medical Academy named S. M. Kirov. The library is one of the oldest libraries in Russia and was founded by Pavel Zakharyevich Condoidi, a pupil of the Dutch scientist Herman Boerhaave. Condoidi succeeded the oldest nephew of Herman Boerhaave, Herman Kaau-Boerhaave after his death as director of the Russian Meditsinskaya Kantselyariya (Ministry of Healthcare). At this site, the extensive library and personal notes of Hermann Boerhaave and his nephews are kept. Later on, it appeared that the same Academy also had a collection of artefacts that are attributed to the famous<br>anatomist Frederik Ruijsch. These artefacts were acquired during the first visit of Peter the Great to the Netherlands. To understand how these artefacts and archive of Boerhaave had become part of the Academy’s collection, we delved into the common medical history of Russia and the Netherlands. In this manuscript, we will lift a tip of the veil regarding the archives of Herman Boerhaave and the “small” anatomical and zoological collections of Fredrik Ruijsch.</p> 2022-02-28T00:00:00+03:00 Copyright (c) 2021 Inge Hendriks , Fredrik Boer, Вячеслав Кравцов, Иван Гайворонский, Pancras C. W. Hogendoorn — MD, PhD; Hogendoorn