Vol 65, No 1 (2021)

Introduction. During the expanding epidemic of the new coronavirus infection COVID-19 in our country, medical workers were one of the groups at the increased risk of infection. Simultaneously, certain information about the number of cases and duration of this disease in medical workers is not available in official sources. However, this information is necessary to develop effective preventive measures, assess economic damage from a temporary disability, and the planning of medical personnel in emergency epidemic conditions.

Purpose of study. To investigate the incidence of the temporary disability of employees of a medical institution with a new coronavirus infection connected with the performance of their occupational duties to assess the health risks for medical workers, develop appropriate measures to improve the safety system of their work.

Material and methods. The study was conducted by a continuous process based on the country’s largest repurposed infectious diseases hospital to treat COVID-19 patients using the classical method of analyzing morbidity rates with the temporary disability.

Results. The dynamics of the main indices of the morbidity with the temporary disability since the beginning of the COVID-19 epidemic was revealed. Features of the morbidity by groups of personnel working in the ”red“ and ”green“ zones of the infectious hospital are established. The incidence of medical personnel providing medical care to patients with COVID-19 was proved to be associated with the implementation of professional activities, but not in all cases. This type of personnel is also subject to risks of infection outside the medical institution. 

Conclusion. For effective prevention, it is necessary to consider that working in the “red” zone significantly increases the risk of COVID-19, regardless of the category of medical personnel.

Introduction. The rapid aging of the world and Russian population and the associated medical, demographic, and socioeconomic problems determine the increased interest in the issue of aging. 

Aim and objectives. to study the features and causes of changes in age-related mortality, life expectancy (LE), and aging in Russia in the second half of the XX century compared to other countries. 

Material and methods. We used the Human Mortality Database survival tables to estimate the expected and maximum life expectancy. The aging rate was calculated using the Gompertz–Makeham formula and the increment of total mortality. Graphs were built using Microsoft Office Excel’s standard tools and the computer program Aging of Populations developed by us. 

Results. Until the middle of the XX century, significant aging rate changes did not accompany a sharp increase in Le. Later with a relatively small increase in LE, it decreases sharply. Deceleration of aging was observed for all studied countries (from 12 to 36 for different available historical periods) for all studied parameters and progresses to the end of the studied period. For Russia, the decline in the aging rate that began simultaneously 7 with other countries in 1960–1970's slows down and is restored only by 2000. 

Discussion. Improvements in living conditions and health outcomes lead to an increase in the proportion of the elderly population structure. However, these same processes reduce the rate of individual aging. Improving medical and social care for retired people reduces their mortality rate. Still, it produces a phenomenon of delayed mortality in later ages (the phenomenon of inversion of centenarians’ total mortality – from reduced to increased). Nevertheless, the use of the mortality rate increment indicator shows that the decline in the aging rate for centenarians persists. 

Conclusion. The identified trends in mortality are useful for developing areas of preventive and socio-medical impact on the population’s health.

Purpose. Description and illustration of the most common alternative causes of shortness of breath, cough, and acute chest pain in pandemic COVID-19 conditions. 

Material and methods. Authors evaluated results of the retrospective single-center study and instrumental data of 67 patients with complaints of sudden chest pain, cough and shortness of breath. For patients admitted to the hospital between March, 27 and June, 30, 2020, the first stage of diagnosis was made with the performed multispiral computed tomography (MSCT) of the chest, confirming the presence of pulmonary manifestations of COVID-19. The study did not include patients with pneumothorax identified at the pre - and hospital stages. We describe early radiographic changes in the chest organs, main vessels, and coronary bed in patients with CT-confirmed COVID-19 admitted to O.M. Filatov Municipal Clinical Hospital No. 15, Moscow for sudden chest pain, cough, and shortness of breath.

Results. In CT of the chest organs, combinations of COVID-19 and pulmonary artery thromboembolism, central/peripheral lung cancer, and acute aortic syndrome manifestations were most common. Combinations of radiation techniques in pandemic settings are COVID-19 required by patients with the acute coronary syndrome. However, it will be possible to analyze all cases of a combination of acute chest pain and sudden shortness of breath in patients with COVID-19 only after processing an extensive array of data.

Conclusion. In pandemic conditions, COVID-19 performing standard imaging methods should be not lost about the most frequent causes of chest pain and sudden shortness of breath, complementing native MSCT with contrasting enhancement in suspected pathology of the main arteries, and small circulation in high-risk patients.

Introduction. Despite the increase in the specific weight of bronchopulmonary dysplasia among children, its true incidence is unknown. The ratio of the incidence of bronchopulmonary dysplasia and associated prematurity remains unexplored.

The aim of the study was to analyze the ratio of the incidence of bronchopulmonary dysplasia and prematurity and to predict their dynamics.

Material and methods. According to official data, 469 cases of bronchopulmonary dysplasia and the frequency of prematurity in 2012–2017 were studied with the use of a continuous retrospective method. The Brown method’s calculation of the absolute growth, growth rate, growth rate, and forecasting was carried out.

The results of the study. An increase in the incidence of bronchopulmonary dysplasia in children occurs simultaneously with an increase in the frequency of prematurity. However, the indices of the growth rate and growth rate of prematurity outstrip those of the incidence of bronchopulmonary dysplasia and the absolute increase in bronchopulmonary dysplasia is significantly higher than for the frequency of prematurity. Short-term prognosis indicates an increase in the incidence of bronchopulmonary dysplasia and the frequency of prematurity.

Conclusion. Indices of the dynamics and prognostic estimates of the incidence of children with bronchopulmonary dysplasia and prematurity should be taken into account when managing specialized medical care.

Introduction. Iodine deficiency diseases (IDD) are currently one of the most common pathologies of the endocrine system. The development of these diseases in the Primorsky region depends on the sufficient intake of iodine and various factors of exogenous and endogenous nature. The identification and establishment of the contribution of social and hygienic nature factors in the comprehensive impact to the occurrence and development of thyroid diseases, including IDD, is an important area of research.

The aim of the study is to obtain information about the social and hygienic factors that influence the occurrence and development of thyroid pathology, including iodine deficiency diseases.

Material and methods. Based on statistical data the dynamics in the population prevalence of diseases of the endocrine system in the Primorsky region was analyzed. To identify social and hygienic factors, a survey of 222 patients of the Center of Endocrinology Regional Clinical Hospital No. 2 (Vladivostok) was performed. Statistical processing of the results of the sociological survey was carried out using the Terentyev correlation pleiades method.

Results. The development of thyroid pathology, including IDD, is influenced by unfavorable environmental conditions, physical inactivity and stressful situations in the workplace, unfavorable occupational factors including an exposure to noise, dust, radiation from a personal computer, lifestyle factors due to low physical activity, non-compliance with the waking and sleeping regime. More often, thyroid diseases develop in women and people over 50 years of age. The development of IDD is influenced by the observance of the principles of rational nutrition and the presence of certain foods in the diet. The contribution of these factors in the conditions of their combined impact on the human body is established.

Conclusion. The identified complex of social and hygienic factors that are important for the occurrence and development of thyroid diseases can be further used to create targeted programs for the prevention of these diseases in the population of the Primorsky region.

Introduction. Entering the body in various ways, pesticides, being biologically highly active compounds, can pose a real danger to public health, causing changes in non-specific biochemical reactions of metabolism occurring in all living cells. The antioxidant system, represented as a balance of lipid peroxidation and antioxidant protection (POL – AOZ), is one of the metabolic regulatory mechanisms of these responses.

The aim of the study was to study the effect of a technical product (ТР), a derivative of triazoles, on the acti-vity of antioxidant enzymes in the rat body, under its repeated oral intake in a chronic 12-month experiment.

Material and methods. A chronic (12 months) experiment was performed on male rats with a bodyweight of 200–210 g at the beginning of the study. Tested doses: 5.0, 16.0 and 55.0 mg/kg of body weight (1 control and 3 experimental groups, 20 individuals each). In the dynamics of the experiment, after 1, 3, 6 and 12 months, the state and behavior of animals, water and food consumption were observed. Changes in the enzymatic indices of the body’s antioxidant defense system (superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase) were registered.

Results. It was found that TP at a dose of 5.0 mg/kg of body weight does not cause significant changes in the activity of antioxidant enzymes, doses of 16.0 and 55.0 mg/kg of body weight cause an increase in the activity of superoxide dismutase (SOD) and a decrease in the activity of catalase in the body of experimental animals compared to control animals.

Discussion. In the conducted chronic experiment, it was found that the studied TP at a dose of 5.0 mg/kg of body weight does not cause significant changes in the activity of the studied antioxidant enzymes in the body of rats. The introduction of TP at doses of 16.0 and 55.0 mg/kg of body weight causes a significant change in the activity of such antioxidant enzymes as SOD and catalase. Our results are consistent with the literature data, according to which the cell quickly reacts to oxidative stress by increasing the activity of SOD, and SOD is considered even as a stress protein synthesized in response to oxidative stress.

Conclusions. The conducted research shows the feasibility of studying antioxidant enzymes’ activity in the mammalian body in sanitary and toxicological studies to increase the reliability of the developed hygienic standards of xenobiotics in environmental objects and food products.

Introduction. During oil production, drillers are exposed to harmful occupation production factors: noise, vibration, the severity and intensity of work, microclimatic conditions, oil, and components.

The purpose of the study was to conduct comprehensive investigations of working conditions and health status, to assess the occupational risk of drillers at an oil production enterprise. 

Material and methods. The work was carried out within the framework of the special assessment of working conditions carried out according to the plan. The influence of occupational factors of the production environment on workers’ health was assessed by indices of occupational morbidity and the results of periodic medical examinations of drillers servicing the drilling rig for oil production driller 5000.320 ERO for the period 2013–2018.

Results. Analysis of the measured parameters of harmful occupation factors indicates noise, vibration, and psychophysiological indices to be the leading indices of working conditions that affect the employees’ health. The general assessment of employees’ working conditions corresponds to the class– 3.3 (harmful), the category of occupational risk – high (unbearable). The source of harmful effects on workers is the equipment of the drilling rig 5000.320 ERO. Analysis of medical documents drillers over 5 years revealed a link between working conditions and the development of occupational diseases (vibration disease, sensorineural hearing loss); between operating conditions and the development of career-related diseases: musculoskeletal system (arthrosis, arthritis, osteochondrosis, etc.); the peripheral nervous system (radiculitis, plexitis, polyneuritis, etc.); diseases of the respiratory system (bronchitis, pneumonia, asthma, and respiratory diseases, etc.).

Conclusion. To prevent the negative impact of harmful production factors at the enterprise it is necessary to provide many preventive measures: automation, mechanization, sealing of equipment, employees have to be equipped with personal protective equipment, improving the quality of preliminary and periodic medical examinations.

The article describes the main problems of managing medical care for industrial enterprises’ staff, including remote industrial sites (RIS), and the options for health care for this category of the employed population. The search for publications was conducted on all available bibliographic and abstract databases (The Russian Science Citation Index, Scopus, Web of Science, CyberLeninka, eLibrary, PubMed) containing the Russian publications.

The data of industrial injuries and the country’s working population’s occupational morbidity in recent years are given. As a result, the authors point out the need to transition to risk management in the workplace. The disadvantages of the assessment system of the health status of employees during routine medical examinations are identified. The main problems of creating a medical support system for RIS workers were analyzed, and the relevance of creating a remote industrial healthcare system in the Russian Federation is substantiated. The paper presents the existing disadvantages in the current legislative framework. In particular, it is established that today in Russia, there is no standard for the provision of medical care for RIS workers, no algorithm for the actions of medical staff, no sanitary rules for managing health posts at RIS. The characteristics of the problems in medical evacuation and the ways of their solution are presented. The necessity of the introduction of telemedicine technologies and conditions for ensuring this process nationwide is substantiated. The spectrum of factors negatively affecting the health of RIS workers is characterized. The need to take these factors into account when creating a health care system for this category of the working population is substantiated.

This article is devoted to V.V. Trofimov, Minister of Health of the RSFSR, an outstanding health care manager, who tried to introduce the modern methods of self-financing, automated information systems, etc., into the management of medical science during the period 1962-1983. At the initiative of V.V. Trofimov, for the first time in the country, the Main Department of research institutes and coordination of scientific research was established, the purpose of which was to ensure a scientific breakthrough in medicine through the development and implementation of innovative methods. The experience of joint work of health authorities, medical universities, and research institutions began to accumulate. It allowed solving problems of improving the quality of medical care according to united comprehensive plans. The material and technical base for public health protection was developed. During the tenth five-year plan alone, 20 large multi-specialty hospitals were built for 600-1200 beds, 88 polyclinics for 750-1200 visits per shift, 80 maternity hospitals and departments for 8849 beds were put into operation, 24 women’s consultations for 1000 visits per shift, and 13 multi-specialty children’s hospitals. The availability of medical personnel increased from 34.8 in 1975 to 40.0 in 1980 (per 10,000 population). The reform of the financing of medical institutions included the transfer of hospitals and polyclinics to economic accounting. The reform was introduced to enhance medical workers’ financial incentives to improve medical care, as savings increased doctors’ and nurses’ salaries. In essence, it was an anti-pod to the extensive, expensive way of conducting the national economy adopted in the country. As the first Editor-in-Chief of the journal “Health Care of the Russian Federation” and he prioritized innovative research in editorial policy for many years to come.

Conduction. The recognition diagnosis of helminths and protozoa invasion is one of the current and almost unresolved problems in modern parasitology. For the present, the lack of a standardized museum of parasitic pathogens in Russia and abroad complicates a parasitologist’s already hard work. The population urbanization, increased anthropogenic pressure, climate change, and natural disasters lead to the occurrence of favorable conditions for the development, long-term survival, and spread of pathogens of parasitic diseases in various environmental objects. The deterioration of the population socio-economic conditions, the emergence of interethnic conflicts in the world led to large-scale migration flows from countries near and far abroad to Russia, which led to an increase in pathogens circulating in the territory of the Russian Federation. 

The aim of our research was to improve the methodological support and create virtual slides with the image of larvae and eggs of helminths, as well as cysts and oocysts of pathogenic protozoa recorded on the territory of the Russian Federation based on digital scanner microscopes.

Material and methods. The authors used scanner microscopes with the software module “Parasitology.”

Results. An up-to-date register of photo images of more than 40 species of parasitic pathogens of medical significance and 53 species of pathogens of parasitic diseases of animals that pose a danger to human life has been delivered.

Discussion. The authors are always working on improving the technical characteristics of digital analyzers.

Conclusion. Updating the atlas, creating a new advanced gallery of helminth eggs, larvae, cysts, and oocysts of pathogenic protozoa will significantly increase parasitological studies’ effectiveness in sanitation and the analysis of intestinal microbiota.

11 февраля 2021 года – юбилей Натальи Валентиновны Полуниной – доктора медицинских наук, профессора, академика РАН, члена редколлегии журнала «Здравоохранение Российской Федерации», заведующей кафедрой общественного здоровья и здравоохранения им. академика Юрия Павловича Лисицына ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России.

Санитарно-эпидемиологическая служба Российской Федерации понесла невосполнимую утрату – 25 января 2021 года на 84-м году жизни скончался учёный, организатор отечественного здравоохранения и медицинской науки, государственный деятель, академик Российской академии медико-технических наук и Международной академии информатизации, член-корреспондент РАМН (2005 г., в настоящее время – РАН), главный государственный санитарный врач РСФСР (1990–1992 гг.), главный государственный санитарный врач Российской Федерации (1992–1996 гг.), доктор медицинских наук, профессор (1999 г.), заслуженный врач Российской Федерации (2002 г.) Евгений Николаевич Беляев.