Saint Petersburg State Pediatric Medical Academy
Saint Petersburg, Russia

Saint Petersburg State Pediatric Medical University , formerly known as St. Petersburg State Pediatric Medical Academy is the first in the world and the only medical school in Russia providing higher medical education with a specialization in Pediatrics.The University is located in Saint Petersburg, which is a unique city with beautiful European architecture and rich history.SPbSPMA has a state license and accreditation to provide training in medicine according to the state standards.In June 2005, under the support of Government of Russia, State Duma, Federation Council of Russia, Russian Rector's Union, the prize-winners of Golden Medal: European Quality competition in the nomination of Top 100 of Russian Universities were awarded. Saint Petersburg State Pediatric Medical Academy was honored with a golden medal. Rector of the academy Vladimir Levanovich was named The Best Rector of The Year 2004.There are four programs in the academy, leading to the Doctor of Medicine with a specialization in Pediatrics, Doctor of Medicine, Doctor of Dental Medicine, and Master in Clinical Psychology degrees. Postgraduate training, providing the opportunity to get a PhD, is also available. Wikipedia.

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Kostik M.M.,Saint Petersburg State Pediatric Medical Academy | Klyushina A.A.,Heart Genetics | Moskalenko M.V.,Russian Institute of Hematology and Transfusiology | Larionova V.I.,Saint Petersburg State Pediatric Medical Academy
Pediatric Rheumatology | Year: 2011

Background: The glucocorticoid receptor gene (NR3C1) has been suggested as a candidate gene affecting juvenile idiopathic arthritis (JIA) course and prognosis. The purpose of this study is to investigate the glucocorticoid receptor gene BclI polymorphism (rs41423247) in JIA patients, the gene's role in susceptibility to juvenile idiopathic arthritis, and its associations with JIA activity, course and bone mineralization.Methods: One hundred twenty-two Caucasian children with JIA and 143 healthy ethnically matched controls were studied. We checked markers of clinical and laboratory activity: morning stiffness, Ritchie Articular Index (RAI), swollen joint count (SJC), tender joint count (TJC), physician's visual analog scale (VAS), hemoglobin level (Hb), leukocyte count (L), platelet count (Pl), Westergren erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), albumin, DAS and DAS28. Bone mineralization was measured by dual-energy X-ray absorptiometry (DXA) of lumbar spine L1-L4. Assessments of bone metabolism included osteocalcin, C-terminal telopeptide (CTT), parathyroid hormone (PTH), total and ionized calcium, inorganic phosphate and total alkaline phosphatase (TAP). BclI polymorphism was genotyped by polymerase chain reaction restriction fragment length polymorphism.Results: No association was observed between glucocorticoid receptor gene polymorphism and the presence or absence of JIA. In girls with JIA, the presence of the G allele was associated with an unfavorable arthritis course, a younger age of onset of arthritis (p = 0.0017), and higher inflammatory activity. The higher inflammatory activity was demonstrated by the following: increased time of morning stiffness (p = 0.02), VAS (p = 0.014), RAI (p = 0.048), DAS (p = 0.035), DAS28 (p = 0.05), Pl (p = 0.003), L (p = 0.046), CRP (p = 0.01). In addition, these patients had bone metabolism disturbances as follows: decreased BA (p = 0.0001), BMC (p = 0.00007), BMD (0.005) and Z score (p = 0.002); and higher levels of osteocalcin (p = 0.03), CTT (p = 0.036), TAP activity (p = 0.01) and ionized calcium (p = 0.017). In boys with JIA, no significant differences were observed related to the polymorphic alleles or genotypes.Conclusions: We suggest that G allele and the GG genotype of the glucocorticoid receptor gene BclI polymorphism contribute to an unfavorable course and low bone mineral density in girls with JIA. © 2011 Kostik et al; licensee BioMed Central Ltd.

Droblenkov A.V.,Saint Petersburg State Pediatric Medical Academy
Neuroscience and Behavioral Physiology | Year: 2011

The aim of the present work was to identify normal levels of pathologically altered neurons and the intensity of neuron-glial interactions in interconnected parts of the mesoaccumbocingulate dopaminergic system (MDS) of the brain in adult intact female Wistar rats (n=6) and healthy humans aged 24-45 years (n=5). The proportions of unaltered, hypochromic, pyknomorphic, and ghost neurons were identified in the anteromedial segment of the paranigral nucleus of the ventral tegmental area (VTA) and the compact zone of the substantia nigra, in the central medial part of the nucleus accumbens (NA) close to the anterior commissure of the brain, and the central part of layer III of the pregenual part of field 24b (Cg3 in rats). Controls consisted of brain formations which are not part of the MDS, i.e., layers III and V of field 1. Our data provide evidence of significant changes in MDS neurons in healthy people as compared with the level of changes in intact rats. The number of pathologically altered MDS neurons in humans decreased with increases in the distance from the catecholaminergic nuclei of the reticular formation, as did the number of fibers in the medial forebrain bundle, reaching a minimum in the non-dopaminoceptive and low-noradrenalinoceptive layer V of field 1. In the VTA, more than 25% of neurons were ghost cells. More than 30% of NA neurons were hypochromic and ghosted. About 25% of neurons in field 24b were ghost cells, hypochromic, and pyknomorphic. The intensities of neuron-glial interactions in the dopaminergic nuclei in humans and intact rats were significantly greater than in the projection areas of the MDS and the non-MDS layers of field 1. Local changes in human MDS neurons and the high intensity of neuron-glial interactions in the dopaminergic nuclei reflect blurring of the boundaries between normal conditions and pathology and the lower durability of this system as compared with cortical fields distant from the origin of catecholaminergic fibers. © 2011 Springer Science+Business Media, Inc.

Background. Trisomy of chromosome 21 (T21; Down syndrome, DS) is the most common aneuploidy in live births. Though its etiology has been intensively studied for a half of century, there are surprisingly many problems awaiting their elucidation. Some of the open questions are related directly to germ line mosaicism for T21, other problems include the prevalence of males with non-mosaic trisomy over females (skewed sex ratio, SR), the genetic predisposition to non-disjunction, etc. Studies in families of gonadal mosaicism (GM) carriers might help resolving some of these problems. Results. 80 families of carriers of GM, in which the sex of the offspring had been specified, were identified in the literature and in logbooks of two local genetic units. Mothers in these families were relatively young: only 8% of mothers were 35 years old and older at the time of delivery of their first affected offspring while the proportion of grandmothers on the GM carrier's side aged 35 years old and older was significantly higher (39%). Postzygotic rescue of T21 due to error in the meiosis I had been proposed as a mechanism of parental GM formation in 78% of the families with known origin of the T21. For the other 22%, rescue of errors in the meiosis II or postzygotic mitotic non-disjunction was assumed. Mosaicism for T21 in successive generations was reported in at least 12 families. The proportion of mosaics among affected female offspring (14%) is significantly higher compared to that among affected male offspring (0%). Male preponderance (SR = 1.5) is found in non mosaic liveborn offspring with either maternally- or paternally transmitted T21. Among unaffected offspring of male carriers of GM there is a notable excess of females (SR = 0.27). Conclusion. Both direct (results of cytogenetic and molecular study of the origin of trisomic line) and indirect (advanced grandmaternal age on the side of GM carrier) evidences allow to assume that significant proportion of the mosaic parents had been conceived as trisomics. Female-specific trisomy rescue and genetic predisposition to postzygotic non-disjunction has been suggested as mechanisms of formation of both GM and somatic mosaicism. Typical male preponderance in affected non mosaic offspring with either maternally- or paternally transmitted trisomy 21, indicates than meiotic events are not responsible for the skewed sex ratio in DS. However a female excess among unaffected offspring of male carriers of GM might be the result of meiotic non homologous co-orientation of chromosomes 21 and X in spermatogenesis. © 2010 Kovaleva; licensee BioMed Central Ltd.

Gorbunova V.N.,Saint Petersburg State Pediatric Medical Academy
Russian Journal of Genetics: Applied Research | Year: 2011

Genetic components are involved in the etiology of the overwhelming majority of the most common complex human diseases. Three methodological approaches have been used successfully for the identification of genetic factors predisposed to common human diseases: linkage analysis, candidate gene association studies (GASs), and genome-wide association scans (GWASs). The structural features of many genes make a small but significant contribution to the overall risk of common diseases. Syntropy of related diseases is determined by the participation in their pathogenesis of the functional polymorphisms of genes controlling the same metabolic pathways. Nonrandom combination of different diseases in the same patients is determined by common epigenetic mechanisms in expression control of different "gene nets." © 2011 Pleiades Publishing, Ltd.

Mitiushkina N.V.,Nn Petrov Institute Of Oncology | Iyevleva A.G.,Saint Petersburg State Pediatric Medical Academy | Poltoratskiy A.N.,Ip Pavlov Medical University | Ivantsov A.O.,Nn Petrov Institute Of Oncology | And 6 more authors.
Cancer Cytopathology | Year: 2013

BACKGROUND: Although the molecular analysis of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) in archived lung cancer tissues is relatively well established, the genetic testing of cytological material has not yet become a routine. METHODS: The current study used cell samples that were obtained by bronchial brushing, transthoracic needle aspiration, or biopsy imprint preparation between 1993 and 2008. Islets of malignant cells were visually located on the archived cytological slides, lysed in situ by a drop of sodium dodecyl sulfate-containing buffer, and subjected to the standard DNA and RNA extraction. Examination of paraffin-embedded tissue blocks (resection specimens or biopsy material) from the same patients was performed in parallel. RESULTS: A total of 75 cytological/histological lung adenocarcinoma sample pairs underwent polymerase chain reaction analysis for the EGFR mutation. Two cytological samples and 1 morphological sample failed to produce DNA. Concordance for the wild-type and mutation status was observed in 54 of 72 and 14 of 72 informative pairs, respectively; 3 pairs and 1 pair, respectively, had mutation only in the cytological or histological material. The discrepancies could be explained by the failure to ensure a high percentage of lung cancer cells in the analyzed samples or, alternatively, by the genuine intratumoral molecular heterogeneity of some neoplasms. RNA extraction followed by reverse transcriptase-polymerase chain reaction analysis for the EML4-ALK translocation was performed for 44 EGFR mutation-negative sample pairs; failures were observed for 2 cytological and 6 histological specimens. All informative pairs were concordant either for the norm (32 of 36 pairs) or for the presence of EML4-ALK gene fusion (4 of 36 pairs). CONCLUSIONS: Archived cytological slides appear to be well suited both for EGFR and ALK analysis. Cancer (Cancer Cytopathol) 2013;121:370-6. © 2013 American Cancer Society.

Shiryajev Y.N.,Saint Petersburg State Pediatric Medical Academy
European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery | Year: 2013

Oesophageal replacement in patients following distal gastrectomy (DGE) remains a surgical challenge, and the standard option is the colonic or jejunal transplant. However, in some cases, it is possible (or mandatory) to utilize the remnant stomach for oesophagoplasty (EP). This method preserves some advantages of the gastric EP in comparison with the bowel EP. During recent years, several papers have been published in English regarding remnant stomach EP, and different aspects of this procedure have been discussed. However, there is still no comprehensive literature review analysing the possible EP approaches using the remnant stomach. A multilingual literature search (database and manual) to collect and classify the currently available data regarding remnant stomach EP following DGE and its subsequent analysis was carried out. There are a number of principally different methods of a remnant stomach EP: (1) mobilization of the remnant stomach with the spleen and tail of the pancreas with its transposition into the left hemithorax; (2) mobilization of the remnant stomach after splenectomy; (3) implementation of a reversed gastric tube, tailored from the major curve; (4) the use of a transplant fed from the right gastric and right gastroepiploic arteries; (5) the use of a transplant fed from the left gastric and short gastric arteries; (6) complete mobilization of the remnant stomach; (7) direct revascularization of the gastric stump conduit. The excellent plastic potential and rich vascularization of the stomach justify its use for EP, even after prior DGE. The majority of the methods of gastric stump EP are less well developed but should be investigated further.

Stolyarova M.V.,Saint Petersburg State Pediatric Medical Academy
Tsitologiya | Year: 2011

Epithelium of the hepatic region of the intestine in Saccoglossus mereschkowskii, a representative of enteropneusts (Enteropneusta, Hemichordata) standing at the base of Chordata, has been investigated using electron microscope. The ultrastructure of ciliated and granular epithelial cells, elements of the intraepithelial nerve layer, and intercellular junctions have been characterized. The data concerning details of the organization of the ciliary apparatus and rootlets system are presented. It is justified the presence of complicated supporting construction of cilia which performs a mechanical stabilizing function and possibly also provide synchronization of ciliary movements. The presence of cilia with two centrioles is considered as an adaptation to high functional load on ciliary apparatus. Well developed bundles of myofilaments are found in the cytoplasm of the basal portions of ciliary cells that characterizes these cells as myoepithelial. The features indicating the role of ciliary cells in absorption are described. The capability of these cells to balloon-like secretion is considered. Data on the accumulation of food reserves in the form of lipid droplets and glycogen in the cell cytoplasm are presented. Ciliated cells are characterized by their function as ciliated secretory-absorptive myoepithelial cells. Based on the location of secretory granules both in the apical and basal portions of granular cells, an exocrine-endocrøine function of these cells has been suggested. Typical endocrine cells in the intestinal epithelium of S. mereschkowskii are absent. Several types of granules in the nerve fibers cytoplasm are described. Junctions between the nerve fibers and basal portions of ciliary and granular epithelial cells are found. Nerve regulation of contractile and secretory functions of epithelial cells is supposed. The presence of the regulatory nerve-endocrine system that includes receptor cells of open type, secretory endocrine-like cells and nerve elements of nerve layer is supposed in the intestinal epithelium of enteropneusts.

Kovaleva N.V.,Saint Petersburg State Pediatric Medical Academy
Russian Journal of Genetics | Year: 2013

Only relatively recently the suggestion that interchromosomal effect (ICE) may be present in man had stopped to be argued. At once it became evident that this phenomenon is inherent to a proportion of balanced chromosome rearrangement carriers, predominantly to patients with fertility problems. It is important to establish whether ICE operates in genome of fertile rearrangement carriers and to determine what kind of rearrangement and how far increases a risk of aneuploidy offspring. Using own and literature data 1) we have assessed rates of inherited non-contributing balanced rearrangements in patients with trisomy 21 (T21) and rates of both mutant and inherited non-contributing balanced rearrangements in parents of offspring with T21 and 2) we have analyzed a parental origin of T21 in affected offspring of carriers of balanced rearrangement. We have found that carriers of balanced reciprocal translocation or inversion, but not robertsonian translocation, are at increased risk of T21 offspring. However these data do not support the existence of ICE in its common sense, i. e. as an effect of rearrangement on other chromosome's segregation at the carrier's meiosis. Probably the data obtained suggest an effect of paternal rearrangements on maternal chromosomes segregation after fertilization. © 2013 Pleiades Publishing, Ltd.

Gummel K.,Karolinska Institutet | Gummel K.,Saint Petersburg State Pediatric Medical Academy | Ygge J.,Karolinska Institutet
European Journal of Ophthalmology | Year: 2013

Purpose: To study functional and anatomic characteristics of eyes of Russian children with fetal alcohol syndrome (FAS). Methods: One hundred children aged 10-16 years from Russian orphanages (St. Petersburg) were examined: 50 with verified diagnosis of FAS and 50 healthy children. All children were tested for distance visual acuity (VA) with subjective optimal correction (Sivtsev chart), skiascopy, visual inspection for FAS external ocular features, biomicroscopy, eye alignment using cover test, and indirect ophthal-moscopy. Results: All analyzed parameters were worse in children with FAS compared with controls. Children with FAS showed a higher incidence of amblyopia, hyperopia, astigmatism, and anisometropia. In children with FAS, the incidence of blepharophimosis was 34% (8% in controls), epicanthus 14% (2% in controls), telecanthus 32% (compared to 4% in controls), eyelid ptosis 9% (none in controls), and strabismus 26% (10% in controls). Ophthalmoscopy revealed a tilted optic disc in 5 children with FAS (7%) compared with none in controls. Conclusions: Russian children with FAS have a higher incidence of vision problems and eye pathology that needs to be taken into account and requires ophthalmologist monitoring. © 2013 Wichtig Editore.

Avdeeva M.V.,Saint Petersburg State Pediatric Medical Academy
Cardiovascular Therapy and Prevention (Russian Federation) | Year: 2012

Aim. To assess the potential of Health Centres in identification of individuals at higher cardiovascular risk. Material and methods. In total, 1583 individuals (mean age 51,79±14, 75 years) participated in a complex screening programme, including laboratory and instrumental examination. Results. The screening resulted in identification of individuals with high normal blood pressure (HNBP) and newly diagnosed arterial hypertension (AH) (prevalence 21%). In participants with HNBP, a combination of 2 risk factors (RFs) was the most prevalent (37, 79%), while in people with newly diagnosed AH, a combination of 3 RFs was the most common (39, 88%). The prevalence of autonomic dysfunction or "Myocardium" parameter increase, as an isolated RF, reached 8, 84% and 9, 45%, respectively. Abnormal ankle-brachial index (ABI) values were registered in 29,66% of the participants. In 18, 97%, ABI values exceeded 1, 3, while in 10, 69%, they were under 0, 9. ABI screening identified 11% of asymptomatic individuals with increased cardiovascular risk. Conclusion. A screening programme could identify individuals with preAH, primary autonomic dysfunction, functional myocardial instability, or subclinical atherosclerosis of peripheral arteries. Therefore, all subjects with increased cardiovascular risk require lifestyle modification and additional laboratory and instrumental examination, in order to assess the target organ damage and the need for pathogenetic therapy.

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