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The study is devoted to the consideration of the existence of mortality in the works of contemporary Russian-speaking Tatar writers (Salavat Yuzeev, Rustem Sabirov, Shamil Idiatullin, Albina Nurislamova, Guzel Yakhina), on the one hand, influencing the macropoetics of works, contributing to the complication of compositional structures, on the other hand, reflected in micropoetics (complexes of motives that actualize the thanatological code, lexical units expressing anti-vital reflection, the living-dead dichotomy). The mortal dimension is associated with the poetics and aesthetics of magical realism, the features and symptoms of which are found in the works of these authors. Particular emphasis in the article is placed on the interpretation of death in the works of the German art critic Franz Roh, who substantiated the category of anti-vitality as fundamental to magical realism. The poetics of death is associated with the existential orientation of the works. Conclusions are drawn that mortality is one of the main artistic constants in the works of these authors, which contributes to the consideration of the traditions of magical realism in their work.

Enterotoxemia, accompanied by diarrhea and bloating, is still a matter of pressing concern to the rabbit farming. Clostridia bacteria are often isolated from the internal organs of rabbits that have died of an anaerobic infection. Clostridial infection, manifested in various forms, is a major problem for veterinarians. The following drivers contribute to the emergence of the infectious disease: malnutrition (insufficient fiber intake); non-compliance with hygiene requirements for animal handling; unsustainable use of antibacterial drugs; gastrointestinal congestion. All these drivers can disrupt healthy caecum microflora due to changes in the gastrointestinal environment. Low-fiber diets result in slow cecum motility, thus, delaying transit of the intestinal contents and eventually changing the microflora. Use of antibiotics together with stress make Clostridia accumulate in the gastrointestinal tract, at the same time, reducing the number of microorganisms of other groups. The first signs of toxicoinfection are observed when rabbit kits are weaned from does. Clinical manifestation begins with bloating, weakness, inappetence, which ultimately lead to death. Observations have shown that the risk group includes rabbit kits weaned from the 35–77-day old does. Mortality was less reported in breeding stock and among replacement young animals. Autopsy revealed signs of enterotoxemia: serous-catarrhal gastritis, serous-hemorrhagic lymphonodulitis, degenerated kidneys, liver and heart muscle; passive congestion of lungs and pulmonary edema. Microbiological diagnosis revealed Clostridium histolyticum and Clostridium perfringens species known for their pronounced toxigenic profile, most often bacteria were found in the stomach, intestines and heart.

The aim of the study was to assess the territorial patterns in cancer incidence and mortality among the population of the Far Eastern Federal District in the period 2013–2022. Material and Methods. Data from official reports of cancer services (form No 35, No. 7) processed using standard cancer statistics programs were presented. Results. In the east of the country, 31,822 new cancer cases were registered in 2022, which was 1.3 % more than in 2021. The average cancer incidence rate in males was 294.06 ± 5.05 per 100,000 (2020: 296.94 ± 4.66), with a decrease rate of 3.0 %. In females, the equivalent rate increased to 240.96 ± 5.73 per 100,000 (2020: 237.92 ± 6.26 per 100,000) with a rise of 6.3 %. Skin cancer was the most common malignancy (11.6 %) followed by trachea, bronchi, lung (11.5 %), breast (11.3 %) and colon (6.3 %) cancers. The percent of actively detected patients increased to 23.2 % (2013: 14.0 %) as did the index of accumulation of contingents – 7.3 (2013: 5.3). The number of patients with stage I–II cancer increased to 57.0 % (2013: 47.5 %), while the number of stage III-IV cancers decreased to 20.8 % (2013: 24.7 %). The number of morphologic studies (94.1 %) was lower than the average for RF (95.8 %). The proportion of patients registered for five or more years decreased to 57.2 % (RF: 58.2 %). The average cancer mortality rate in men was 174.99 ± 3.10 per 100,000 (2020: 181.76 ± 2.51 per 100,000). The average cancer mortality rate in women was lower than in men, being 91.34 ± 1.20 per 100,000 (2020: 93.71 ± 0.80о per 100,000). Cancers of trachea, bronchi and lung (20.0 %), stomach (8.9 %), colon (7.0 %) and breast (6.6 %) were the leading causes of mortality. Conclusion. The low level of active cancer detection did not significantly change the incidence rates during the study period. A greater volume of preventive measures with improvement of their quality will enable the primary health care system to detect cancer at early stages, form groups being at high risk for cancer development and, consequently, to reduce mortality rates. A prerequisite for improving medical care for cancer patients is the continuous training of professional staff and the use of modern diagnostic and treatment technologies.

The presented research covers a significant part of the period of the COVID-19 pandemic and studies the role of environmental factors in formation of population mortality from main causes. The main causes of mortality among the population of Odesa Region during the studied period include diseases of circulatory system, COVID-19, neoplasms, external causes, diseases of digestive organs and diseases of respiratory organs. The aforesaid causes constitute 94-95% of all causes of mortality in Odesa Region. However, out of these six classes of diseases, only diseases of circulatory system, COVID-19 and diseases of respiratory organs and some of their nosological forms have simultaneous peaks in mortality, during which mortality of the Odesa Region population from all causes almost doubles. Over time, there is a certain redistribution of frequency of the causes of mortality among the six main causing diseases of the population`s mortality in the region. But this does not explain occurrence of simultaneous peaks in mortality from diseases of circulatory system, COVID-19, and diseases of respiratory organs. Formation of simultaneous peaks in mortality from non-infectious and infectious diseases cannot be explained by the influence of social or anthropogenic factors. This indicates the need to address a number of environmental factors of natural origin – meteorological, biometeorological and heliocosmic. The study shows the possibility of an existing linear statistical connection between these environmental factors and the mortality of the Odesa Region population from such classes of diseases as diseases of circulatory system, COVID-19 and diseases of respiratory organs, as well as the relevant nosological forms. The results of the correlation analysis between mortality rates from major diseases and the environmental factors studied showed weak correlations between them. It is fully consistent with the World Health Organization's view of the role of environmental conditions in shaping public health.

The SARS-CoV‑2 coronavirus has become a major global health concern. Infection with SARS-CoV‑2 has caused millions of deaths worldwide, and the case fatality rate has been found to be largely related to pre-existing clinical conditions. The main clinical manifestation of COVID‑19 is the presence of respiratory symptoms. Severe complications of COVID‑19 are most often observed in people with significant medical histories. The SARS-CoV‑2 virus primarily attacks the respiratory system, causing pneumonia and acute respiratory distress syndrome, which can lead to severe systemic inflammation, multiple organ dysfunction, and death, especially in patients with pre-existing comorbidities. A number of meta-analyses strongly suggest that comorbid respiratory diseases, including chronic obstructive pulmonary disease and interstitial lung diseases, are factors in the development of severe forms of COVID‑19, worsening patient outcomes and survival rates. Studies have shown an association between adverse outcomes of COVID‑19 and the expression level of the angiotensin-­converting enzyme 2 (ACE2) in these patients. Regarding other respiratory system pathologies, such as bronchial asthma and cystic fibrosis, it is known that the main unfavorable factor is long-term immunosuppressive pharmacotherapy preceding infection. In this article, we highlight the main respiratory comorbidities to better understand the pathogenesis of COVID‑19.

Background. Over the past 10–15 years, there has been a clear trend towards improving the diagnosis and treatment of acute pancreatitis. However, even at the current stage of technology development, a number of difficulties arise in making an accurate diagnosis, in determining the volume and timing of surgical intervention, in organizing measures to prevent complications, treatment and further recovery of patients after acute pancreatitis. Aim. To analyze the structure of morbidity and treatment outcomes of patients with acute pancreatitis in an emergency surgical hospital. Materials and methods. We analyzed the structure of pathology and incidence of acute pancreatitis in patients of the 5th and 6th surgical departments. The sample consisted of 2033 patients diagnosed with acute pancreatitis. Of these, 973 people are patients of the 5th surgical department, 1060 people are patients of the 6th surgical department. The work used standard mathematical and statistical methods of data processing. Results. The results indicate that in the structure of surgical pathology, the predominant diagnoses are acute pancreatitis, unspecified, and other acute pancreatitis. At the same time, these are also those forms of the disease that are characterized by high mortality. On average, 1 patient takes 9–10 bed days, which indicates the high medical and social significance of these forms of pathology. All the data obtained confirm the fact that many patients require emergency surgical care, even at a stage when the diagnosis has not yet been definitively confirmed. As a rule, indications for emergency surgical intervention appear already at the first stages of diagnosis, according to the main ultrasound criteria. The mortality rate averages 3–4%. Conclusion. The data obtained are approximately comparable with data obtained by other authors. In general, the literature notes that among all patients with pancreatitis, the acute form of the disease predominates. However, in terms of mortality, the results we obtained were slightly lower compared to the results for the country as a whole.

Background. The incidence of female reproductive system cancer, including breast, cervical, ovarian and uterine cancers, is steadily increasing, and therefore it is advisable to conduct an epidemiological analysis and assess the quality of medical care. The purpose of the study was to analyze the epidemiological characteristics of reproductive system cancer in females of the Tyva Republic. Material and Methods. The reporting forms № 7 “Cancer incidence in the Tyva Republic” for 2013–2022 were used. Age-standardized incidence rates were calculated using the “Oncostat” program, and cancer care quality was assessed using “Cancer Care Indicators” program. Results. Reproductive system cancer in the Tyva Republic accounted for 46.3 % of all malignant neoplasms in females during 2013–2022. In 2022, breast cancer was the most common cancer (16.2 %) followed by cervical cancer (13.7 %), ovarian cancer (6.7 %), and uterine cancer (4.0 %). During the study period, none of these cancers showed a statistically significant increase in agestandardized incidence rates (AS R). In 2022, age-standardized incidence rates in the Tyva Republic were higher than those in the Siberian Federal District for cervical cancer (27.5 ± 3.7 vs 16.3 ± 0.4 0/0000) and for ovarian cancer (14.1 ± 2.8 vs 12.7 ± 0.3 0/0000), but lower for breast cancer (32.4 ± 4.1 vs 58.7 ± 0.6 0/0000) and uterine cancer (8.6 ± 2.2 vs 19.7 ± 0.4 0/0000). Overall, cancer care quality indicators for reproductive system cancers had improved. Active detection increased from 22.0 to 29.8 %, p=0.039 (in the Siberian Federal District: from 27.6 to 37.2 %, p=0.001). The detection rate at I–II stages increased from 53.7 to 75.2 %, p=0.004 (in the Siberian Federal District: from 63.0 to 71.3 %, p=0.001). The percentage of advanced stages decreased from 37.4 % to 15.5 %, p=0.001 (from 27.4 % to 23.1 % in the Siberian Federal District, p=0.013). The oneyear mortality rates also decreased from 19.0 to 5.4 %, p=0.013 (in the Siberian Federal District: from 11.8 to 8.5 %, р

Objective: to study the histological structure of lung cancer, as well as molecular-genetic, gender, demographic and anamnestic characteristics of patients with non-small cell lung cancer in Khanty-Mansiysk Autonomous district – Ugra. Material and Methods. Material for the study consisted of 6725 cases of lung cancer for the period 2001–2020 and 266 cases diagnosed with non-small cell lung cancer for the period 2020–2023. Nonparametric Fisher’s criterion and χ2 test were used to analyze statistical factors. The relative risk of an event in the main group compared to the control group was calculated. Results. Squamous cell carcinoma remained the most common histological form among lung cancers detected for the periods 2001–2010 and 2011–2020 (40.2 and 38.3 %, respectively). During the second decade of the study period, the proportion of lung adenocarcinoma increased by 9.6%, approaching the rates of squamous cell lung carcinoma. It should be noted that in the structure of all histologic subtypes of non-small cell lung cancer, genetic aberrations occurred more frequently in adenocarcinoma than in other histologic forms of lung cancer (33 vs 6 %, respectively). The results of the analysis showed that the relative risk of developing genetic aberrations in EGFR, KRAS, ALK oncogenes was respectively 21.08; 9.04 and 10.84 times higher in lung adenocarcinoma and 15.87; 2.18 and 10.2 times higher among never smokers than in the control groups. The incidence of mutations in the EGFR gene was statistically more frequent in women (p

Aim. To study the long-term prognosis of patients’ life who have suffered cerebrovascular accident (CVA), and to determine the role of diabetes mellitus (DM) as a possible negative prognostic factor, according to the outpatient follow-up stage in the REGION-M registry.Material and methods. The outpatient part of the REGION-M registry included 684 patients assigned to the Moscow City Polyclinic No. 64, discharged from the hospital in the period from 01.01.2012 to 30.04.2017 with a confirmed diagnosis of CVA, of which 122 patients (17.8%) were diagnosed with DM. The polyclinic stage included three observation points: 2017, 2020, and 2022. Data on the life status of all patients were obtained by telephone survey, if it was impossible to establish contact with the patient or his relatives, a unified medical information and analytical system was used to determine the life status of patients. The study patients were observed on an outpatient basis for more than 5 years (ME 1958 (751; 2555) days), the primary endpoint was death from any cause.Results. Information about the life status was obtained for all 684 patients. By the end of the observation, 415 cohort members had died, and 269 were alive. The average age of patients with DM was significantly higher than that of patients without DM: 71.5±10.9 years vs 68.0±14.7 years (p

Background. The COVID-19 pandemic, which swept the world in 2020–2021, had a significant impact on the epidemiological picture of hematological malignancies. Aim. To study the dynamics of epidemiological indicators of five chronic hemoblastoses in Moscow over a 12-year period, and also to assess the impact of the COVID-19 pandemic on these indicators. Materials and methods. A population-based study was conducted for five types of oncohematological diseases: multiple myeloma, Hodgkin's lymphoma, follicular lymphoma, chronic lymphocytic leukemia, chronic myeloid leukemia. The annual rates of morbidity, mortality, prevalence of these nosologies, overall survival, and expected overall survival were calculated. Gender and age characteristics for each disease were determined. Results and discussion. The present study showed a uniform increase in the incidence and prevalence of five hematological malignancies between 2012 and 2019. Convincing evidence of an increase in mortality and a decrease in the number of diagnosed cases in comparison with the expected figures for these hematological malignancies in 2020–2021 was presented. A greater reduction was shown for cases diagnosed at early stages compared to later ones. During the pandemic, a significant increase in mortality was recorded among patients with chronic lymphocytic leukemia and multiple myeloma, while in cohorts of patients with chronic myeloid leukemia and Hodgkin lymphoma it increased slightly. The return of morbidity, mortality and prevalence rates to the original dynamics in 2022–2023 has been demonstrated. Conclusion. This study demonstrated the features of the regional pattern of incidence, mortality, prevalence and gender-age characteristics of five hematological malignancies and provided the changes in the indicators dynamics of different hematological malignancies during the COVID-19 pandemic.

Currently, the prognosis for systemic lupus erythematosus (SLE) has improved significantly, but the relative risk of death in these patients is stillhigher than in the general population. Thrombotic complications are one of the leading causes of death in SLE. Objective: to analyze the survival rate and structure of lethal outcomes in Orenburg population of patients with SLE, including deaths due to thrombotic complications. Material and methods. A two-stage study of SLE progression and patient survival was conducted from 2007 to 2022. Clinical signs of the diseasewere analyzed in all patients at baseline (n = 68) and in survivors (n = 50) after 15 years. The median age at the time of enrolment in the study was 35 [29; 45] years, the disease duration – 7.5 [3; 13.5] years. During the second stage, the characteristics of the course of the disease in the survived patients and the causes of death in those who died over 15-year period were determined. Results and discussion. The 10-, 15- and 20-year survival rates in Orenburg population of patients with SLE reached 98.5, 95.5 and 86.3%, respectively. During this period, 18 (26.5 %) deaths were registered, the median age of the deceased was 48.5 [39; 57] years, and the duration of the disease was 22 [16; 30] years. The most common causes of death were thrombotic complications (n = 14, 78 %) due to antiphospholipid syndrome, lupus nephritis, and arterial hypertension. Less frequently, infectious complications were the cause of death (n = 4, 22 %). Patients with thrombotic complications had a 20-year survival rate of 80.2% that was significantly lower than in the SLE group without thrombosis. Conclusion. The results obtained allow to consider the presence of thrombotic complications in patients with SLE in Orenburg population as an unfavorable prognostic factor.

Objective. To determine the influence of the urgency of performing surgical decompression of the spinal cord (SC) on the course of acute and early periods of complicated injury of the lower cervical spine. Material and Methods. The results of treatment of 75 patients with acute complicated injury of the lower cervical spine with ASIA A and ASIA B severity of spinal cord injuries were retrospectively analyzed. Two groups were formed, depending on the timing of surgical decompression of the spinal cord after injury. Group I included 33 patients in whom the SC decompression was performed within the first eight hours after the injury, and Group II included 42 patients in whom the SC decompression was performed in more than eight hours after the injury. Results. The mean age of patients in Group I was 29 [25; 39] years, in Group II – 35 [30; 42] years (p = 0.129). There were 31 (94.0 %) male patients in Group I and 38 (90.5 %; p > 0.999) in Group II. The time from the moment of injury to decompression of the spinal cord was 6.1 [5.0; 7.5] hours in Group I and 16.9 [11.8; 39.6] hours in Group II (p < 0.001). Pneumonia developed in 55 % [38 %; 70 %] of patients in Group I and in 86 % [72 %; 93 %] of patients in Group II (p = 0.004). The duration of pneumonia in Group I was 18 [8; 20] days, and in Group II – 28 [20; 39] days (p < 0.001). It was shown that the risk ratio for developing pneumonia in patients with delayed decompression of the spinal cord was 2.08 [1.17; 3.67] times higher (p = 0.01). The duration of mechanical ventilation in Group I was 12 [7; 17] days versus 19 [11; 26] days in Group II (p = 0.001). Maintaining the target blood pressure levels ≥ 85 mm Hg was required in 73 (97.3 %) patients with a duration of hemodynamic support of 6 [3; 10] days in Group I versus 10 [5; 15] days in Group II (p = 0.019). It was shown that SC decompression within the first eight hours after injury reduced the proportion of patients with a SOFA score of 4 points or more by 20 % in the acute period and by 42 % by the fifth day of the early period of injury. Positive dynamic in neurological status was recorded in 30.0 % [17.0 %; 47.0 %] of patients in Group I and only in 2.0 % [0.0 %; 12.0 %] of patients in Group II (p < 0.001). The duration of treatment in the ICU was 20 [16; 25] days in Group I and 29 [23.5; 41.75] days in Group II (p = 0.001). The total length of hospital stay was 38 [27; 46] days in Group I versus 57 [45.75; 67.50] days in Group II (p < 0.001). Mortality was recorded only in Group II and amounted to 5.3 %. Conclusion. Decompression and stabilization surgery within the first eight hours after the injury, together with a complex of intensive care measures for acute complicated injury of the lower cervical spine have a significant positive effect on the course of the acute and early periods of traumatic SC disease.

Relevance. The high primary incidence of peptic ulcer in people of working age and frequent relapses with a complicated course are accompanied by temporary but quite long-term loss of ability to work, a decrease in labor productivity and quality of life of patients, as well as disability and mortality, which determines the important medical, social and economic status of this disease. In addition, a significantly increasing contribution of primary morbidity to the overall morbidity is made by pediatric patients, and the morbidity of elderly and senile people is growing. In the Russian Federation in 2019, 1,188,551 cases of peptic ulcer disease were registered, 101,680 (8.5 %) of which were diagnosed for the first time in life. According to recent studies, the lifetime prevalence of peptic ulcer disease in the general population of the Russian Federation is 5–10 %, and the annual incidence is 0.1–0.3 %.In the Russian Federation, the incidence of ulcer in children in the last decade is 1100–1500 cases per 100,000 children. In 81–87 % of children, the localization of a newly detected ulcerative defect is determined in the duodenal zone, in 11–13 % — in the stomach wall, and in 4–6 % of children, a combination of ulcer localization in the stomach wall and duodenal zone is noted. The number of complications in the form of bleeding is recorded with an annual frequency of 19 to 57 per 100,000 people. (from 0.02 to 0.06 %). The number of complications in the form of perforation ranges from 4 to 14 cases per 100,000 people. (from 0.004 to 0.014 %). Mortality from complications of peptic ulcer and erosive and ulcerative lesions of the stomach and duodenum is 7.7 % of all deaths caused by diseases of the digestive system. Conclusion. Peptic ulcer disease currently remains one of the diseases of the human digestive system that requires studying the accumulated experience of domestic and foreign medicine and further multidisciplinary research to improve treatment results for this category of patients, and the epidemiology of gastric and duodenal ulcers continues to be of interest, both scientifically and from a practical point of view.

Relevance. To investigate the prognostic value of the Charlson Comorbidity Index (CCI) and its components in assessing outcomes related to in-hospital and 18‑month mortality and to determine additional prognostic value when incorporating them into the GRACE score among patients with acute myocardial infarction (MI). Material and methods. A prospective study enrolled 712 patients diagnosed with acute MI who underwent coronary angiography within 24 hours of hospitalization. Results and Discussion. Of the patients, 61 % were male, median age 65 (interquartile range [IQR] 56–74years). In-hospital and 18‑month mortality rates were 5.1 % (n = 36) and 12.1 % (n = 86), respectively. Median GRACE, CCI scores were 117 (IQR: 98–141), and 4 (IQR: 3–6) respectively. Common comorbidities within the CCI components included previous MI (21.8 %), diabetes mellitus (21.1 %), chronic pulmonary disease (16.2 %), dementia (9.2 %), peptic ulcer disease (9.1 %), renal failure (8.6 %). Factors associated with in-hospital and 18‑month mortality included chronic lung disease (odds ratio [OR] = 4.21 and 2.04, respectively) and renal failure (OR = 3.51 and 1.99, respectively) after adjusting for GRACE score. Dementia (OR 2.10; 95 % confidence interval [CI] 1.11–3.97) was a significant risk factor for 18‑month mortality. CCI was associated with in-hospital and 18‑month mortality (GRACE-adjusted OR 1.29, 95 % CI:1.07–1.57, p = 0.001 and 1.37, 95 % CI (1.20–1.57, p = 0.001, respectively). CCI demonstrated good predictive ability for in-hospital mortality (area under the ROC Curve [AUC]: 0.826) and modest performance for 18‑month mortality (AUC: 0.797). Adding chronic lung disease, renal failure in the GRACE score significantly improved the predictive efficacy for in-hospital mortality, with an AUC of 0.932 (95 % CI: 0.905–0.959, p = 0.001). Including CCI in the GRACE score enhanced the prediction efficiency for 18‑month mortality (AUC 0.819, 95 % CI: 0.768–0.871, p = 0.001). Conclusion. The CCI demonstrated moderate prognostic value in assessing in-hospital mortality among patients with acute MI and good predictive ability for long-term mortality. The CCI and its components (chronic lung disease, renal failure) added prognostic significance in addition to the GRACE score for predicting both short-term and long-term adverse outcomes.

The aim of the work is to analyze the incidence and mortality of pancreatic cancer (PC) in Ukraine and the Zaporizhzhia region to highlight and compare the organization of oncological care, the benefits of prevention, and early diagnosis of this disease. Materials and methods. The analysis of the data of the National Cancer Registry of Ukraine for 2014–2022 was carried out. The information used in the research was reviewed and approved by the Commission on Bioethics of Zaporizhzhia State Medical and Pharmaceutical University, an extract from protocol No. 10 dated 12/21/2023. The data analysis was carried out using Microsoft Excel spreadsheets and the applied statistical program Statistica® for Windows 13.0 (StatSoft Inc., USA, license No. JPZ804I382130ARCN10-J). Results. According to GLOBOCAN data (2022), RP ranks 14th in the world and 12th in Ukraine in morbidity and is one of the leading causes of mortality. Every year there is an increase in cases of this pathology. Morbidity and mortality rates are significantly higher in countries with a high level of development, while the survival rate does not reveal such a dependence. Mortality from PC in Ukraine is 76.9–82.3 %, in the Zaporizhzhia region 86.2–99.5 % with positive dynamics. Detection of early stages of PC in Ukraine and the Zaporizhzhia region is at the level of 26.0–36.4 %, 30.7–43.6 %, respectively, diagnosis of advanced stages is at the level of 43.8–56.3 % across Ukraine, in the Zaporizhzhia region – 58.6–63.2 %. In Ukraine, 25.3–31.9 % of primary patients are covered by special treatment, the regional indicator is 17.9–26.6 % with positive dynamics. The effectiveness of primary prevention of PC in Ukraine reaches 3.3 %, the regional indicator does not exceed 3.0 %. Conclusions. Improvement of preventive measures, selection of groups at risk of development of PC, modification of lifestyle are factors for improvement of prognosis and survival of patients with PC.

Demographic indicators have an important place in the system of indicators determining the quality of life. The issues of improving the demographic indicators of the quality of life of the population are especially important for the Greater Caucasus province, which plays an important role in the socio-economic and geopolitical development of the Republic of Azerbaijan and has a high demographic and labour potential. The main purpose of the research work, which is of practical importance, is to study the trends in demographic processes in the Greater Caucasus province and their impact on the quality of life of the population. On the basis of statistical materials, the demographic indicators of the population living in the region were studied, the current state of modern demographic processes and how they affect the quality of life were researched. According to the results of the research, the role of demographic factors in the quality of life of the population living in the region has been significant in recent years. It revealed that the natality and natural increase in the region decreased over the analyzed period. The mortality rate has increased over the past 2 years. [ABSTRACT FROM AUTHOR]

Relevance. Surveillance of new genetic variants and manifestations of the epidemic process in SARS-CoV-2 is relevant for predicting the epidemiological situation and timely introduction of anti-epidemic measures. Aim. To evaluate changes in the intensity of the epidemic process during the long circulation of the «omicron» variant and its daughter genovariants. Materials and methods. The analysis of the computer database of the WHO National Center for morbidity, hospitalization and deaths from COVID-19 of the population as a whole and by age groups of 54 cities of the Russian Federation was carried out. Results. Since the appearance of COVID-19 in Russia in 2020, the maximum intensity was the V (winter–spring) wave of 2022. The intensity of the VI (autumn) and VII (winter–spring) waves was lower. In the VI wave, the incidence and mortality from COVID-19 of the population of the RF as a whole decreased by 2.5 and 6.5 times, St. Petersburg – by 2.6 and 29.7 times, and Moscow by 1.6 and 26.6 times. In the VII wave, compared with the VI wave, the decrease in morbidity was less. By age groups, the incidence decreased more among children aged 7–14 years (4.3 times in the VI wave) and less among children 0 –2 and people over 65 years (2.0 times), there was a tendency to increase the proportion of people over 65 years from 18% to 27%. The incidence rates of COVID-19 in the population as a whole and in age groups were higher in 4 FD (North-West, Far East, Siberia and the Center). In 2022, an interepidemic period was revealed for the first time in Russia, the duration of which was in megacities for 9 and FD – from 11 to 13 weeks. In the interepidemic period, the incidence was less than in the minimum VII (winter-spring) wave in the RF as a whole – by 4.6 times, in St. Petersburg – by 7.1 times and in Moscow – by 15 times. There were no deaths among children in the observed cities, and an increase in the total coefficient of mortality rate is associated with mortality among people over 65 years of age. Conclusion. The decrease in the intensity of the epidemicprocess in the VI and VII waves is caused by the prolonged circulation of omicron and its daughter genovarians.

Background. Despite the clear trend towards infant mortality decrease in our country, there are significant differences in values in some federal districts and regions of Russian Federation. Thus, the assessment of infant mortality rates and health indicators is crucial topic of scientific analysis. Objective. The aim of the study is to investigate selected child health indicators and infant mortality rates in the Chechen Republic. Methods. We have conducted the retrospective cross-sectional study of infant mortality rates, prematurity incidence, infant and newborn morbidity, and mortality of children born sick or got sick. The study was based on the data from official statistics and from the extraction of statistical reporting forms No. 12 and No. 32. Results. The Chechen Republic belongs to the regions with high infant mortality rate, however, it has decreased by 11.6% from 6.9 to 6.1‰ in 2018–2022. The major diseases causing lethal outcomes in infants in this region, and in Russia as a whole, were certain conditions that occur in the perinatal period, and congenital disorders. Meanwhile, mortality from respiratory diseases and some infectious and parasitic diseases exceeded the national average. Prematurity incidence in the republic was 1.5 times lower than the national average, newborns morbidity was 1.7 times lower, infants morbidity was 4.0 times lower. Trend analysis has revealed that prematurity incidence and newborns morbidity have slightly changed over 5 years (+2.2% and –1.0%), while infants morbidity had significant trend (–40.2%). All morbidity rates of children who died at the age under 1 year were significantly lower than the national average for all classes of diseases that are the most common for infants mortality. The mortality rates among children born sick or got sick were on average 5.4 times higher than similar indicators in Russia. The highest mortality rate was observed among children who died from perinatal conditions, congenital disorders, external causes, and some infectious and parasitic diseases. The level of the maternal and child health service performance was 0.44 on average over the 5-year interval, that corresponds to the average level of efficacy. Conclusion. This study has allowed to reveal that there is an urge to improve the organization of medical care for infants in the Chechen Republic.

Despite significant progress in the field of prevention, early diagnosis and antibacterial therapy, community-acquired pneumonia still retains the status of not only the most common among acute infectious diseases, but is also a frequent source of sepsis, which greatly increases the likelihood of death in this group of patients. The purpose of the study was to perform a comparative analysis of clinical and laboratory parameters and assess the nature of their changes in the first 48 hours from the moment of verification of sepsis that developed against the background of pneumonia in patients of the therapeutic department, depending on the outcome of hospitalization.Clinical groups and research methods. A retrospective comparative study was carried out, which included, using a continuous sampling method, patients with sepsis that developed against the background of pneumonia in patients hospitalized in therapeutic clinics of the Federal State Budgetary Educational Institution of Higher Education Siberian State Medical University of the Ministry of Health of Russia in the period from 01/01/2019 to 04/30/2023. In total, the study included 40 patients of both gender, followed by division into two comparison groups depending on the outcome of hospitalization (discharge from hospital or death) for the dynamic assessment of clinical, anamnestic and laboratory parameters in the early stages of the development of a septic condition (the first 48 hours) in order to determine their relationship with the outcome of hospitalization.Results. All patients were divided into 2 groups. The first group (n=17, 42.5 %) consisted of patients with a favorable outcome of hospitalization (recovery), the second group (n=23, 57.5 %) consisted of patients with a fatal outcome. At the time of verification of sepsis, patients with a favorable outcome had a significantly lower SOFA score (3 (2; 6) points) than patients with a fatal outcome (6 (5; 7) points), p = 0.037. The change in urea concentration in the first 48 hours from the moment of verification of sepsis, which in the group of survivors was -1.3 (-4.4; 1.99) mmol/l, and in the group of deceased 5.5 (-1.5; 12. 2) mmol/l, p=0.020. In the group of deceased patients, 8 people (34 %) at the time of verification of sepsis had a combination of hypotension (5 mmol/l. In the survivor group, hypotension was observed in only 2 people (11 %), and lactate levels in these patients were in the range of 4.5- 4.6 mmol/l. At point 1, the indicators of immature granulocytes were not statistically significantly different between surviving and deceased patients (1.2 (0.7; 2.1)% vs 0.8 (0.6; 1.5)%, respectively, p>0. 05). After 48 hours, the level of immature granulocytes increased in surviving patients to 1.5 (1; 3.2)% and, conversely, decreased to 0.65 (0.45; 1.45)% in the group of deceased patients, and the difference in these indicators between groups became statistically significant, p

A prospective randomized observational study was conducted in cohorts of vaccinated and unvaccinated patients hospitalized in one of the Moscow hospitals and diagnozed with COVID-19 in the period from 06.23.2021 to 01.05.2022.The purpose of the study was to identify the epidemiological features of COVID-19 in vaccinated people and to present scientifically based data on the need for vaccination and its importance in stopping the epidemic process.Materials and Methods. The samples were studied in comparison for a number of indicators: age, clinical condition at admission, the presence and number of concomitant systemic chronic diseases as well as disease outcomes.Results. It was proven that the risk of COVID-19 morbidity in vaccinated people decreased by 1.5 times, mortality by 1.5 times, and hospitalization due to the severity of the condition by 3.1 times. The mortality risk among vaccinated patients shifted to older age (76.9 years), while among unvaccinated patients, the mortality risk was higher for older people (73.7 years), which indicates an increase in life expectancy of vaccinated people.

Background. Infections associated with socially significant diseases considerably contribute to a decrease in the quality of public health. Tuberculosis, though declining in Russia, is still recognized as a pressing public health problem. Meanwhile, an assessment of the burden of tuberculosis on society, using such comprehensive methods as measuring disability-adjusted life years, is yet to be investigated in Russia. Objective. To estimate the tuberculosis burden by calculating the index of disability adjusted life years in a high-density region.Methods. The retrospective cohort study involved data on newly-diagnosed and died of tuberculosis cases that corresponded to the annual reporting form of federal statistical surveillance No. 8 “Information on active tuberculosis cases” for the Republic of North Ossetia-Alania; information on patients who died of tuberculosis or tuberculosis combined with infection caused by human immunodeficiency virus, was obtained from the Department of Civil Status Records of the Republic of North Ossetia-Alania and verified with data from the Federal State Statistics Service; data on tuberculosis-associated disability was received from Main Bureau of Medical and Social Expertise in the Republic of North Ossetia-Alania of the Ministry of Labor and Social Protection of the Russian Federation for 2018 and 2022. Following the analytic dataset, 691 people with newly-diagnosed tuberculosis, who received TB-associated disability and died from TB in 2018 (318 people) and 2022 (373 people) were identified. The study involved calculation of gender and age standardized TB morbidity and mortality rates as well as DALY index with its components: Years of Life Lost due to tuberculosis and Years Lost due to Disability. The study involved comparing data between 2018 and 2022 and gender/age-specific indicators within the same year. Mathematical data processing was performed using Microsoft Excel 2017 (Microsoft Corporation, USA) and SPSS 26.0 (SPSS Inc., USA). Differences between the compared indicators were evaluated by Chi-square criterion with variations, the initial data were grouped in a contingency table, the significance of differences was expressed by p-value.Results. The burden of tuberculosis in the Republic of North Ossetia-Alania refers predominantly to the male population: with a gender difference in the decrease in the disability-adjusted life years in 2018 and 2022 by 4.4 and 9.0 times (p < 0.05), respectively; 2.8 times among males, 5.5 times among females (p < 0.05). The burden of tuberculosis is mainly associated with premature mortality due to tuberculosis among males aged 35–54 years and among females aged 35–44 years with a pronounced decrease in Years of Life Lost. Years of Life Lost among males aged 20–34 in 2022 appears two times higher than the cohort average. The increase in Years of Life Lost among males aged 60–64 accounted for 1.7 times, in Years Lost Due to Disability — 11.2 times (p < 0.05). Years Lost Due to Disability among females aged 20–44 years appeared to be the highest, exceeding the cohort average by more than two times in 2018.Conclusion. The burden of tuberculosis is predominantly due to tuberculosis-related premature mortality among the male population. According to the disturbing conclusion, Years of Life Lost among young males aged 20–34 years and tuberculosis-related premature mortality shift towards the male population of pre-retirement age (60–64 years) with an increase in Years Lost Due to Disability among them. Notably, the study reveals high rates of Years Lost Due to Disability among females aged 20–44. The results obtained should be taken into account when developing regional tuberculosis programs with their targeted use in “vulnerable” age and gender groups of the population.

The aim of the study: to evaluate the 1- and 3-year survival of patients operated for complicated forms of colon cancer (СC) in general surgical hospital. Materials and methods. The study group included 71 (100 %) patients with complicated forms of СС. Acute intestinal obstruction was detected in 49 (69.1 %) patients, tumor perforation – in 13 (18.3 %), acute colonic bleeding – in 3 (4.2 %) patients, a combination of acute intestinal obstruction with tumor perforation – in 4 (5.6 %) and intestinal obstruction with bleeding – in 2 (2.8 %) operated patients. Radical operations were performed in 48 (67.6 %) patients, palliative operations – in 18 (25.4 %), symptomatic operations – in 5 (7.0 %) patients. II stage of the disease was diagnosed in 15 (21.1 %), III stage – in 32 (45.1 %), IV stage – in 24 (33.8 %) operated patients. 19 (30.2 %) patients underwent specific chemotherapy after surgery. Results. Among patients with the II stage of the oncological process 1-year survival was 76.9 ± 11.7 %, 3-year – 53.8 ± 13.8 %; with stage III, 1-year survival was 65.6 ± 8.4 %, 3-year – 50.0 ± 8.8 %; in persons with IV stage of СC – 29.2 ± 9.3 % and 8.3 ± 2.6 % respectively (χ2 = 21.8, p = 0.0001). Among male patients, 1-year survival was 51.4 ± 8.5 %, 3-year – 31.4 ± 7.9 %; women – 61.1 ± 8.1 % and 44.4 ± 8.3 %, respectively (χ2 = 2.3, p = 0.1302). Better indicators were found in the case of cancer of the left sections of the large intestine than the right sections – the 1-year survival rate was 60.4 ± 7.1 % and 43.5 ± 10.3 % respectively; 3-year – 39.6 ± 7.1 % and 30.4 ± 9.6 % (χ2 = 0.74, p = 0.3906). Conclusions. The conducted analysis indicates a clear dependence of the survival results on the stage of the disease, gender and localization of the tumor process.

Relevance. Demyelinating diseases of the central nervous system and multiple sclerosis, in particular, make their debut at a young age and can lead to profound disability and death within a few years. In the last decade, there has been an increase in the number of cases of demyelinating diseases in Russia and in the world, which necessitates an in-depth study of these pathologies. Goal. To study the dynamics and features of the formation of morbidity, prevalence and mortality from demyelinating diseases of the central nervous system, including multiple sclerosis in various population groups in the Russian Federation. Materials and methods. The study design is a descriptive retrospective epidemiological study (continuous). The data was sampled from the forms of the federal state statistical observation on the distribution of the deceased by gender, age groups and causes of death of Rosstat (FSN S-51), as well as from the statistical collections of the Federal State Budgetary Institution "Central Research Institute of the Ministry of Health of the Russian Federation "Morbidity of the population" from 2009 to 2021. Results. The analysis of the data showed that in 2009-2021 in Russia there was an increase in idiopathic inflammatory demyelinating diseases (IDD) and multiple sclerosis (MS) among the adult population and adolescents aged 15 to 17 years. There is no tendency to increase or decrease the incidence among children under 14 years of age. The highest average long–term incidence rates of IDD and MS among adults are observed in the Ufa region (7.13 ± 0.27 and 5.31 ± 0.23 per 100 thousand adults, respectively), among children under 14 - IDD in the Central Federal District (1.88 ± 0.18 per 100 thousand contingent) and MS in the Central Federal District and Volga Federal District (0.22 ± 0.07 per 100 thousand contingent). Among children from 15 to 17 years of age, the highest incidence of IDD is noted in the Northwestern Federal District (4.41 ± 1.10 per 100 thousand contingent) and the Ural Federal District (4.40 ± 1.09 per 100 thousand contingent), RS – in the Central Federal District (2.67 ± 0.51 per 100 thousand contingent). IDD and MS are the least common among all age groups in the Far Eastern Federal District. Over the period from 2000 to 2020, there has been a decrease in MS mortality in the Russian Federation by 34%, from 0.72 to 0.48 per 100,000 population. The average annual mortality rate from MS among men was 0.4 ± 0.021 cases per 100 thousand of the contingent, among women 0.5 ± 0.023 cases per 100 thousand of the contingent. Conclusion. The increase in the incidence of demyelinating diseases and MS, in particular, is an important medical and social problem. These pathologies significantly reduce the quality of life and shorten the duration of work, due to the development of persistent disability in the young population. The study showed the uneven distribution of the disease across the territories of the Russian Federation, which in the future will improve the logistics of drug delivery and the provision of medical personnel, which confirms the relevance of constant and in-depth study of the epidemiology of idiopathic inflammatory demyelinating diseases in Russia.

Relevance. As is known, the presence of some concomitant diseases may be directly related to the severe course of Coronavirus infection and high mortality among the sick. However, the question of the possible impact of bronchial asthma and COPD on outcomes and survival rates in patients with COVID-19 remains relevant. Aim. To evaluate, according to the literature, the prevalence of bronchial asthma and COPD in the general population and among COVID-19 patients in the Russian Federation and in the world, and to determine the degree of their influence on outcomes. Materials and methods. The results of 1080 previously conducted domestic and foreign studies were studied, from which 46 papers were selected that meet the inclusion criteria. Based on the data presented in the studies on the prevalence of bronchial asthma and COPD, the analysis of survival rates, mortality and severity of the consequences of COVID-19 in patients with these pathologies was carried out. Results and discussions. Patients with COPD often had a more severe course of COVID-19, as well as high mortality rates due to the rapid progression of the pulmonary process. Earlier it was reported that patients with bronchial asthma did not notice a negative effect of COVID-19, but the results of recent studies prove the opposite, and therefore further observations are required in this cohort of patients. Conclusion. The presence of COPD has a significant impact on the severity of the course and outcomes of the disease in patients with COVID-19. Timely diagnosis of an infectious disease, qualitative examination, appointment of effective therapy and subsequent rehabilitation with supervision by a specialist have a great importance for patients with COPD. According to the latest data, the presence of bronchial asthma in a number of patients may contribute to a more severe course of COVID-19, but this issue requires further research. At the same time, all patients with chronic lung diseases, without exception, must comply with the basic measures for the prevention of COVID-19 infection and carry out vaccination on time.

The study examines the features of state policy in the field of demography and health care, special attention is paid to the analysis of the main indicators of the quality of life of the population, as well as the results already achieved within the framework of the national projects “Demography” and “Health Care”. The problems of low life expectancy of the population and a decrease in the birth rate have been identified. Based on the results of monitoring of the national projects “Demography” and “Health Care”, it was concluded that they are interconnected and it is possible to achieve the targets only through the successful implementation of both national projects. Based on this, the research suggests measures aimed at improving state policy in the field of demography and health, including the need to strengthen measures aimed at combating neoplasms, including malignant ones, which in turn will have a positive impact on the quality of life of the country’s population.

Background. Community-acquired pneumonia remains one of the most common and life-threatening forms of pathology among respiratory diseases.The aim of the study. To identify the features of the epidemiology of communityacquired pneumonia in the conditions of mass immunization against pneumococcal infection in the Irkutsk region.Materials and methods. We conducted a descriptive epidemiological retrospective study. We studied the incidence of community-acquired pneumonia (including community-acquired pneumonia of bacterial and viral etiology) and mortality from this disease in the Irkutsk region for 2011–2022 according to statistical reporting forms No. 2, No. 5, No. 6, C51.Results. The incidence of community-acquired pneumonia during the observation period remained at a high level: the long-term annual average rate among the total population was 627.3 [467.8÷786.8]. At the same time, there was a persistent decrease in the incidence of community-acquired pneumonia of bacterial etiology (Tdecrease = 6.8 %). Incidence rates of community-acquired pneumonia of bacterial etiology were distributed unevenly over the years and the compared population groups. The highest levels were recorded in children in 2018–2019 – 12.3 [10.8÷13.8] and 19.3 [17.8÷20.8], respectively. A decrease in the mortality rate from community-acquired pneumonia among children, adults and in the general population in 2020 was shown, with a subsequent increase in the rate among adults and the general population by 2.5 times. Against the background of ongoing immunization of the population against pneumococcal infection, there is a statistically significant decrease in the incidence of community-acquired pneumonia, including communityacquired bacterial pneumonia, and mortality from community-acquired pneumonia among different population groups.Conclusion. Despite the high incidence of community-acquired pneumonia, a statistically significant decrease in the incidence of community-acquired pneumonia of bacterial etiology has been shown among children and adults. The decrease in mortality from community-acquired pneumonia has continued since the introduction of immunization against pneumococcal infection. The results of the study can be used to optimize epidemiological surveillance and epidemiological control of community-acquired pneumonia at the regional level.

Aim. To assess total, ageand sex-specific survival rate after discharge of patients with heart failure (HF) using real-world electronic health data.Material and methods. This retrospective analysis of data from the St. Petersburg Chronic Heart Failure Registry was performed. Hospitalizations of patients aged 18 years with a diagnosis code I50.x (International Classification of Diseases, 10th revision) were included in the period from January 1, 2019 to December 31, 2023. Cases with acute myocardial infarction, cerebrovascular accident, coronavirus disease 2019, hospitalization duration of >30 days, and death during the current hospitalization were not included.Results. The study included 73450 patients aged 18 to 99 years (mean age, 73±12 years; women, 59,1%). During a median follow-up of 388 days, 16212 (22,1%) patients died. The cumulative death probability within one and five years after discharge was 16,3% and 48,9%. At each time period, the rate was higher in men when stratified by age and as age increased.The mortality rate was 15,3 (95% confidence interval 15,1 to 15,6) per 100 patientyears. For all subgroups, the highest value was recorded in the first month after discharge (50,1 per 100 patient-years), reaching a maximum in the subgroup of elderly and senile patients (60,7 per 100 patient-years).Conclusion. Within 1 year and 5 years after hospital discharge, 16,3% and 48,9% of patients with HF die, respectively. The highest death risk is typical in the first month after discharge, especially for elderly and senile patients.

Aim. To assess the risks of all-cause and cardiovascular mortality in smokers with hypertension (HTN) based on the results of a 34-year prospective observation of a Tomsk population.Material and methods. The study included 630 men and 916 women aged 2059 years who underwent primary screening in 1988-1991. HTN was established with blood pressure (BP) ³140/90 mm Hg and

Complicated forms of colon cancer occupy a significant share of emergency operations in general surgical departments with high rates of mortality and complications. Assessment of possible complications and mortality before surgery is an important aspect in choosing treatment tactics for this group of patients. The aim of the study. To analyze the risks of complications and mortality in the perioperative period in patients with complicated forms of colorectal cancer using the prognostic CR-POSSUM scoring system and to determine the critical levels of the CR-POSSUM score using ROC analysis. Materials and methods. The data of 71 (100 %) patients who were treated for complicated forms of colorectal cancer were analyzed. The studied group included 36 (50.71 %) men and 35 (49.29 %) women aged 67.97 ± 12.71 years. In the postoperative period, complications were found in 32 (45.07 %) patients, there were 8 (11.27 %) deaths. Results. The mortality risk at the time of hospitalization was 6.40 (3.50; 19.10) %. The actual mortality rate in the studied group was 8 (11.27 %) patients, which corresponded to the CR-POSSUM theoretically calculated mortality risk, U = 234.0, p = 0.739. Conclusions. Increased level of complications was noted at the critical score ˃20 points, AUC = 0.744, p ˂ 0.001 (sensitivity – 71.0 %, specificity – 67.5 %) and the critical score of increasing the mortality rate was ˃22 points, AUC = 0.781, p = 0.005 (sensitivity – 75.0 %, specificity – 74.6 %) as defined by CR-POSSUM. According to the ROC analysis, the increase in mortality in the studied group did not depend on the character and complexity of surgical interventions (p = 0.159), but on the general patient condition at the time of hospital admission (р ˂ 0.001). At the same time, the increased level of complications in the group depended on both the character and complexity of the surgical intervention (p = 0.028) and on the general patient health at the time of hospitalization to the general surgical department (р ˂ 0.001).

In the years that preceded the World War I, the inhabitants of the rural areas of the west of Serbia, in Valjevo and Užice regions, died of natural causes, because of various accidents and wide range of non-epidemic diseases, but mostly of the consequences of local epidemic of different infectious diseases, primarily of pertussis, and then of scarlet fever and dysentery, as well as diphtheria, stomach typhus and measles, and during Balkan War II, in 1913, of cholera. At the beginning of the World War I, the situation did not change a lot, but diphtheria became primary cause of the death. Besides, it was expected to notice murdering the soldiers at the front, but, also, two widespread epidemics on the territories appeared: three kinds of typhus epidemics, stomach, spotted fever and a reversible type during 1915 and Spanish fever during 1918. On the basis of the death registers, it is noticed that in 34 villages of the analysed rural area, where 21483 peasants lived, the death was registered among 4852 of them, i. e. 22.59% of the inhabitants registered before the war, from January of 1914 to December of 1918. It is also noticed that 8.77% died of typhus and Spanish fever (5.27% of typhus, and 3.50% of the Spanish fever), 4.42% of other infectious diseases, and 9.40% of all other possible causes. If we exclude from the analysis two great epidemics, 13.81% of the inhabitants died, during five year war period, of all causes including local epidemics, while in the pre-war five year period, that was 12.95%. Regarding the fact that the results of the population census from 1910 and 1921, indicates that analysed territory had bigger demographic loss from the average for Serbia (18.47%:11.98%), it can be assumed Serbia lost about one fifth of the inhabitants during war years, from August of 1914 to November of 1918.

BACKGROUND. Theoretical data convincingly support the use of extracorporeal hemocorrection (ECHC) methods in the treatment of sepsis. However, a large number of researchers have still not been able to convincingly prove the advantage of ECHC methods; there is no unanimity of opinion. We tried to analyze our own experience in using ECHC methods in the treatment of abdominal sepsis over the past 3 years. AIM OF STUDY. To analyze the use of ECHC methods in the early stages of treatment of abdominal sepsis, to determine whether their use had an advantage for survival. STUDY DESIGN. Prospective cohort. DESCRIPTION OF THE METHOD. In 50 cases (group 1), ECHC was performed early after surgery. The median time from admission to the intensive care unit after surgery to the start of ECHC was 25.3 (17.7; 36.5) hours. When determining the ECHC modality, we were guided by the individual approach and clinical experience of the ECHC specialist. Apheresis methods alone were performed in 8 % of patients (4/50), a combination of apheresis methods and renal replacement therapy was performed in 40 % (20/50), renal replacement therapy (RRT) methods were performed in 98 % (46/50), plasmapheresis/plasma exchange/selective plasma filtration were performed in 30 % (15/50), selective hemosorption of cytokines was performed in 4 % (2/50), selective hemosorption lipopolysaccharides was performed in 24 % (12/50). We analyzed outcomes, assessments of the severity of functional disorders and sepsis-associated organ dysfunction according to the APACHE scales II and SOFA and their dynamics, probabilities of outcomes depending on the scores on the indices (logistic regression); life times, cumulative survival rate (Kaplan-Meier method). SAMPLE CHARACTERISTICS. There were 113 patients after emergency laparotomy due to widespread peritonitis, abdominal sepsis, aged from 23 to 90 years. 67 men, 46 women. In 50 cases of observation (group 1), ECHC was performed in the early stages ; in 63 cases, methods of active hemocorrection were not used (group 2). In group 1 there were 35 patients with septic shock and 15 patients with stable hemodynamics (subgroup 1/shock and subgroup 1/sepsis). In group 2 there were 20 patients with shock and 43 with stable hemodynamics (subgroup 2/shock and subgroup 2/sepsis). RESEARCH RESULTS ECHC. Methods allowed survival of patients with more severe APACHE scores II and SOFA: in survivors in subgroup 1/shock Me 29 (24; 31) versus 23 (14; 26) in the subgroup 2/shock and 8 (4; 10) versus 4 (2; 6) points, p=0.048 and p = 0.010; with stable hemodynamics in survivors in subgroup 1/sepsis Me 20 (17; 22) versus 15 (11; 19) in subgroup 2/sepsis, p=0.016. ECHC changed the survival threshold in favor of more severe patients from 29 to 33 points; reduced the likelihood of an unfavorable outcome 1.2-fold for each point on the APACHE scale II and 1,276 times over the entire range of estimates; prolonged survival time in hemodynamically unstable patients at a significance level of p = 0.083, shifting the first quartile of survival from 1 to 12 days, the median from 12 to 20, the third quartile from 27 to 45 days. When performing ECHC, the cumulative survival rate was higher throughout the entire hospital observation period: 0.886 (95 % CI 0.780–0.939) in 2 days versus 0.700 (95 % CI 0.499–0.802); 0.800 (95 % CI 0.667–0.868) in 10 days versus 0.545 (95 % CI 0.325–0.658); 0.653 (95 % CI 0.494–0.734) in 14 days versus 0.416 (95 % CI 1.185–0.533). Overall mortality from all causes was 35.4 % (40/113), 67.3 (37/55) with shock, 5.2 % (3/58) with stable hemodynamics. The maximum risk of an unfavorable outcome occurred in the early stages: 30 % (12/40) of all deaths occurred in the first 4 days after surgery, 20 % (8/40) in the first 24 hours. In shock patients, 10-day mortality was lower when performing ECHC: 20.0 % (7/35) versus 45.0 % (9/20), p = 0.050, 1st stage. Fisher’s test, P = 0.38 insufficient. Hospital mortality in the shock subgroups was equal, all the advantages of ECHC achieved in the early stages were lost; although in most late outcomes the peritonitis was relieved; which was confirmed during the section. CONCLUSIONS. The power of the study was sufficient to identify statistically significant advantages of extracorporeal hemocorrection in the treatment of abdominal sepsis based on APACHE index estimates II and SOFA. For the Kaplan–Meier method, differences were obtained for shock patients at a significance level of 0.083; the number of observations must be doubled to detect statistically significant differences. The final results of hospital mortality require additional in-depth analysis, since in the later stages many deaths were not associated with abdominal sepsis and occurred with already resolved peritonitis. It is necessary to understand to what extent they were associated with experienced sepsis, and to what extent with comorbid pathology; whether there was an association with methods of extracorporeal hemocorrection.

Aim. To assess the features of the clinical picture of coronary artery disease (CAD) and the prognosis of patients with myocardial infarction with depressive disorder (DD). Materials and methods. We examined 101 patients with stable CAD who had myocardial infarction more than six months ago: 67 CAD patients with depression (Group 1) and 34 CAD patients without depression (Group 2). The clinical picture of CAD was assessed by complaints, angina self-monitoring diaries, and exercise tests. The presence and severity of DD was determined using psychometric scales: BDI (Beck Depression Scale), HADS (Hospital Anxiety and Depression Scale) and the opinion of a psychiatrist. Five-year survival information was obtained through telephone interviews with patients and their relatives. Results. In patients with CAD and DD in comparison with patients without DD self-monitoring diaries revealed more frequent angina attacks: 9 [6; 12] vs 6 [4; 7] per week (p=0.0001), the greater need for sublingual nitrates: 2 [0; 9] pills vs 0 [0; 4] pills (p=0.0001). DD significantly reduced exercise tolerance: 370 [250; 450] meters vs 435 [350; 500] meters using the six-minute walk test (p=0.04), according to the results of bicycle ergometry – 50 [25; 75] W vs 75 [50; 75] W (p=0.03). After 5 years of follow-up patients with comorbidities (CAD and DD) had a greater number of deaths: 13 (19.4%) vs 2 (5.9%), respectively, survived – 54 (80.6%) vs 32 (94.1%) (Gehan–Wilcoxon test, p=0.04). Conclusion. The comorbidity CAD and DD leads to a worsening of the clinical course of CAD and prognosis, which actualizes the need for verification of the diagnosis of DD and timely prescription of antidepressant therapy.

Purpose of the study. To analyze the immediate outcomes following surgical treatment of locally advanced malignant non-organ retroperitoneal tumors (NRT).Materials and methods. Surgical interventions for malignant NRTs were performed in 114 patients at Abdominal Oncology Department № 1, National Medical Research Centre for Oncology.There were 48 males and 66 females among them. According to the histological structure, liposarcoma was commonly detected in 64 (56.1 %) cases.Results. Intraoperative revision revealed the spread of the tumor to adjacent anatomical structures in 67 (58.8 %) cases. Resection surgical interventions were performed in 109 patients, of which 106 (97.2 %) patients had operations performed in an amount of R0. Combined surgical interventions for NRTs were performed in 62 (54.4 %) patients, and multiorgan happened to be in 45 (72.6 %) patients out of those. Resection of the inferior vena cava was performed in 12 patients. Resection of the superior mesenteric vein was performed in 2 patients and the iliac-colonic vein in 2 patients. In 1 observation the left renal vein was resected with suturing of the lateral defect of the vessel wall. Complications during surgery and in the early postoperative period were noted in 14 (12.3 %) patients. In total, 2 patients died after operations, the mortality rate was 1.8 %.Conclusions. Tumor invasion of big main blood vessels is not a contraindication for surgical treatment of locally spread malignant non-organ retroperitoneal tumors.

The aim of the study. To investigate certain aspects of the state of health of the male population of Ukraine in the period 2014-2021; justify the value of a separate analysis of men's health; to determine the need for personalized accounting of the health status of persons who took part in military operations, in particular men. Materials and methods. The research materials were official statistical data from the reports of the State Statistics Service, the Center for Medical Statistics of the Central Health Service of the Ministry of Health of Ukraine for 2014–2021, the National Cancer Registry of Ukraine, the Institute of Health Metrics and Evaluation (IHME, USA) on the global burden of diseases, data individual sociological studies. The female population of Ukraine served as a comparison group. Results. The dynamics of the state of health of the male population by individual indicators (mortality, average life expectancy, morbidity, disease burden) in recent years compared to the female population were analyzed. It was established that the health of the male population has negative trends and is inferior to the vast majority of the relevant indicators of the health of the female population. In addition, the severe consequences of military operations, men's lack of attention to their own health, particularly reproductive health, and an unhealthy lifestyle significantly worsen the health of the male population. An in-depth study of the health of the male population is needed to understand its specific needs in health care services, to develop prevention, treatment and rehabilitation programs. Conclusions. Against the background of the deterioration of the health of the male population, especially during the war, it is necessary to provide him with all kinds of support, to improve the quality and availability of various types of medical care, to introduce personalized records of the health of combatants (military and civilians), as well as children of war.

The applicability of the left ventricular global function index (LVGFI) and its deriva­tive, determined by echocardiography, to distinguish clinical phenotypes in a cohort of patients with heart failure with preserved ejection fraction (HFpEF) is unknown.Aim. To evaluate the differential diagnostic potential of LVGFI and its derivative when phenotyping outpatients aged ≥60 years with HFpEF.Material and methods. A total of 140 outpatients (men, 43%) aged 73 (67-78) years with functional class II-IV HFpEF were included in the study. The follow-up period was 34 (22-36) months.Results. LVGFI was 22,4 (19,4-24,6)%, while derivative index of LVGFI — 283,9 (248,9-332,2) ml. There were 18 (12,9%) deaths. The threshold value for predicting death for LVGFI was ≤21,4%, for derivative index of LVGFI — ≥303,6 ml. Based on cluster membership and mortality analysis, two following risk groups for death of patients with HFpEF were identified: a relatively low-risk (group 1) and moderate (group 2) risk group (mortality within 34 months ~25%). Group 1 was represented by patients, predominantly male, with class II HFpEF, coronary artery disease (CAD) and prior myocardial infarction (MI), concentric hypertrophy, a significant LV mass increase, a high frequency of bendopnea, lower LVGFI and higher derivative index of LVGFI. Group 2 was represented by patients, predominantly female, with class II HF, a history of CAD and myocardial infarction, concentric hypertrophy and concentric remodeling, a moderate LV mass increase, a relatively low frequency of bendopnea, higher LVGFI and lower derivative index of LVGFI. Based on the data obtained, an algorithm was developed to determine the risk of death in patients with HFpEF.Conclusion. LVGFI and its derivative index can be used in phenotyping patients with HFpEF. The developed algorithm for determining the death risk makes it possible to identify outpatients with HFpEF who need intensified therapy and observation by a general practitioner and cardiologist in order to reduce the risk of an unfavorable prognosis.

Aim. To present clinical characteristics and assess serious adverse outcomes (death, acute cardiovascular events) in outpatients with atrial fibrillation (AF) in one of the Yaroslavl clinics for 10 years.Material and methods. A total of 212 patients with AF aged from 23 to 94 years were included in the REQUAZA AF registrу — Yaroslavl at the first visit to the clinic in 2013. Their health status was monitored over 10,5 years through in-person visits, phone contacts with patients, their relatives, and treating physicians. Recorded data included the AF type, comorbid conditions, extent and quality of examinations and treatments, development of serious adverse events, and mortality. Statistical processing was carried out using the Microsoft Office 365 application software package.Results. Most patients (66,5%) were diagnosed with persistent AF. Paroxysmal, persistent, and newly detected forms were observed in 26,4%, 3,8%, and 3,3% of patients, respectively. Most AF patients had concomitant cardiovascular diseases, most frequently hypertension (96,7%), heart failure (91,6%), and coronary artery disease (91,2%). A total of 54 patients (25,5%) had prior stroke or transient ischemic attack. Complete information was obtained for 203 patients (95,8%), of which 164 (78,5%) passed away during the follow-up period. The leading death cause was cardiovascular disease, particularly cerebrovascular events (n=111; 67,7%). The highest mortality was recorded within the first two years of follow-up, during which more than a quarter (25,1%) of the registered patients had died. The COVID-19 pandemic did not significantly affect the mortality rates. The most common AF complications were stroke and transient ischemic attack, with a total of 74 episodes in the history and follow-up period, including 7 recurrences.Conclusion. Ambulatory AF patients represent a group with a high frequency of cardiovascular events and fatal outcomes. In the observed group of ambulatory AF patients, annual mortality exceeded 10%, and over 3/4 of patients died within 10 years. The leading death cause was cardiovascular disease, primarily cerebrovascular events.

Background. Breast cancer is the main cause of morbidity and mortality of the female population among economically developed countries, including in Russia. Despite the continued increase in morbidity, mortality is decreasing, which is confirmed by a decrease in the index of accuracy (the ratio of the number of deaths to the sick). Calculations of survival at the population level (the most important criterion for evaluating the activities of the oncological service) in Russia are carried out only on the basis of databases of the population cancer registry of the North-Western Federal District. The accumulated 1.5 million primary cases of malignant tumors allowed for the in-depth development of data on rare tumor localities, including breast cancer among the male population.Aim. To study the impact of the coronavirus pandemic on the dynamics of the process of detection, mortality and survival of breast cancer patients in Russia and in the North-Western Federal District of the Russian Federation.Materials and methods. The material of the study is the reference books of the P. Hertzen Moscow Oncology Research Institute – branch of the National Medical Research Radiology Center, Ministry of Health of Russia, and the N.N. Petrov National Medical Research Oncology Center, Ministry of Health of Russia, and the database of the population cancer registry of the North-Western Federal District, clinical materials of the surgical department of breast tumors of theN.N. Petrov National Medical Research Oncology Center. More than 110 thousand primary cases of breast cancer were selected. Data processing was carried out by standard methods of oncology statistics recommended by the International Association of Cancer Registries (Eurocare program).Results. A significant impact of the coronavirus pandemic on the primary registration of breast cancer in Russia from 2019 to 2020 has been established, with some weakening of its impact in the subsequent period. The pandemic has had a significant impact on the quality of primary registration of patients. The value of the index of accuracy has been set back five years, but there is a sign of its improvement in 2021. The positive dynamics of one-year and five-year survival of patients with breast cancer is shown. The quality of registration of patients with breast cancer by detailed localization and histological structures of breast cancer was investigated. A significant decrease in the mortality of patients was noted when studying the patterns of dynamics in annual mortality over three follow-up periods.Conclusion. A steady increase in the incidence of breast cancer among women has been established, and the negative impact of the coronavirus pandemic has been noted. The mortality rate of the Russian population from breast cancer continues to decrease. The localization and histological structure of the incidence of breast cancer in women remains unchanged. The one-year and five-year survival rate of breast cancer patients continues to grow.

A review of domestic and foreign literature was carried out. Statistical analysis of the available literature showed that at present, despite the improvement of screening programs around the world, there is a steady increase in the incidence and mortality of cervical cancer in women of reproductive age with a high percentage of patients with advanced forms, whose proportion is 32 %. The percentage of deaths during the year since the verification of the disease in 2020 was 12.6 %.In the structure of mortality in the Russian population, malignant diseases occupy the second ranking place, accounting for 13.6 % after diseases of the cardiovascular system – 43.9 %. Diseases of the female reproductive system account for 18.2 %. At the same time, cervical cancer in the overall structure of oncological morbidity occupies the 4th ranking place, and among the organs of the reproductive system – the 2nd place – 13.3 %, yielding to breast cancer (47.8 %). These figures reflect the lack of implemented programs aimed at reducing the incidence of cervical cancer.

The pandemic of a new corona virus infection (NCVI) has worsened the already unfavorable demographic situation in the Russian Federation. Aim of the study was to assess the changes in the demographic situation in the country and the Siberian Federal District and the causes contributing to them. Material and methods. Statistical data of the Ministry of Health of the Russian Federation, Rosstat, regional ministries of health of subjects belonging to the Siberian Federal District, and literature on the problems of demography were used. The following methods were used: analytical, historical, statistical, including statistical observation, summary and grouping of materials, absolute and relative statistical values, sampling. Results and discussion. The pandemic period of the new coronavirus infection in RF and SFD is characterized by a substantial increase in the mortality rate, which became the maximum in the newest history of Russia, i.e. since 1991. The structure of the main causes of death has changed. Diseases of the circulatory system, neoplasms, diseases of the digestive organs and external causes, accounted for 76.6 % of all causes in 2019, in 2021 they accounted for only 60.1 %, with NCVI taking second place among causes of death (19.1 %). The birth rate remains at a low level, and in 2021 was 9.6 per 1000 population, which is 16.5 % lower than in 2017, due to which the natural decline in population has significantly increased (to –6.3 in Russia and to –7.0 per 1000 population in SFD) and the average life expectancy has decreased. Conclusions. All of the foregoing points to the ineffectiveness of measures to prevent and forestall the adverse effects of the pandemic, which is practically inevitable in the case of new, poorly studied infectious diseases. The measures taken to organize medical care to the population in the conditions of the pandemic have not been adequate. This is evidenced by the higher rates of total mortality of the population, compared to the probable ones (caused by the increase in mortality from NCVI), a significant increase in natural population decline and a reduction in life expectancy.

Morbidity and mortality caused by malignant neoplasms (MNs) is a priority challenge for health care. We analyzed some rough and standardized levels (oncological morbidity and mortality) over 2009–2018 based on official statistics. We ranked the RF regions as per the standardized morbidity level and established that the Irkutsk region took the 1st rank place among 85 RF regions as per it; it took the 16th rank place as per the ‘rough’ level. Morbidity and mortality levels that were higher in the Irkutsk region than the national average were established for such localizations as trachea, bronchi and lung cancer; prostate cancer; cervical cancer. The mortality to morbidity ratios were on average equal to 0.45 in the Irkutsk region and 0.49 in the RF as a whole; we identified a certain decrease in them, by 19.3 % and 20.0 % accordingly. We provided evidence of unacceptable individual carcinogenic chemical risk for people in cities with developed chemical industry and non-ferrous metallurgy. High carcinogenic radiation risks were caused by natural radon levels in soils. We calculated some prognostic morbidity and mortality levels: in 2021, the standardized morbidity level would be between 270.9 and 329.8 cases per 100 thousand people; the ‘rough’ level, between 372.7 and 532.4. The ‘rough’ mortality level would be between 220 and 230 cases per 100 thousand people. We determined some priority tasks for future research aimed at identifying adverse effects produced by environmental factors and lifestyle-related factors as well as some tasks related to developing relevant targeted activities aimed at eliminating and mitigating cancer-inducing exposures.

Aim. To assess the relationship between plasma chitotiosidase (CHIT) level and mortality in hospitalized patients with COVID-19. Materials and methods. 347 hospitalized patients with COVID-19 were enrolled in our single-center cohort prospective observational study. On the first day of hospitalization the patients were assessed by the level of CHIT in the venosus blood to addition to default laboratory examinations. The primary endpoint was all-cause death. The survival after hospital discharge were assessed via phone calls on 90 and 180 days since inclusion to the study (NCT04752085). Results. Our study included 347 patients. The first symptoms appeared in 7 days [5; 7] before hospitalization; 283 (84.3%) patients had less than 50% of the involvement of the lung tissue to the inflammation process (CT 02); 36 (10.4%) patients had died since the start of our investigation; 30 (83.3%) of them died during hospitalization, others -no later than 60 days; 68 (19%) people didnt answer during phone call. The survivor's activity of the enzyme in the deceased was significantly lower in compare to deceased patients (90.5 [40.2; 178.0] nmol/h/mL vs 180.0 [77.2; 393.2] nmol/h/mL; p=0.001). Survivor of the patients with a higher level of the activity of the CHIT (more than 171 nmol/h/mL) was statically significantly lower. Conclusion. Rising of the CHIT's activity more than 171 nmol/h/mL might be an early independent predictor of the bad prognosis of the patients, who were hospitalized with COVID-19 infection.

Background. Constant assessment of the dynamics of the main characteristics of the epidemic process is the basic function of epidemiological surveillance of infectious diseases. The search for factors that determine changes in the characteristics of the epidemic process makes it possible to develop timely management decisions and reduce the risk of an increase in the scale of the pandemic. Moscow is the main centre of attraction for the population of other Russian regions with the most complex structure of social links and the highest population density. The purpose of the study is to identify factors that potentially determine the trends of observed changes using a molecular epidemiological analysis of the main characteristics of the epidemic process of a new coronavirus infection (COVID-19). Materials and methods. For the analysis, the data of Russian national genome sequence database of SARS-CoV-2 virus (VGARus) were combined with information on morbidity and mortality presented at the official internet resources стопкоронавирус.рф and Yandex DataLens, the dynamics of vaccination, COVID-19 disease incidence and hospitalization from the portal Gogov.ru. A multicentre retrospective observational epidemiological study was conducted to examine the sex and age structure of hospitalised patients. Anonymized case histories of patients with COVID-19 collected at different follow-up periods in the institutions of Moscow (41,561 cases) served as a source of data for the sex and age structure analysis. Results. We identified 11 periods with significantly different complex epidemiological characteristics. A decrease in the incidence among young people of working age during the period of restrictive measures was revealed. In 3 out of 11 worsening of the epidemic situation coincided with the beginning of the circulation of a new genetic variant of the pathogen COVID-19 (variants Wuhan, Delta, Omicron). A decrease in the incidence in the summer period was noted, regardless of the circulating genetic variants. Conclusion. A significant part of the observed dynamics of the characteristics of the epidemic process in Moscow can be explained by the properties of the pathogen, seasonality and dynamics of magnitude of the herd immunity. The influence of the dynamics of the herd immunity indicators on the course of the epidemic process is to be studied further.

Glucocorticoids (GCs) are one of the most commonly used drugs for the treatment of rheumatoid arthritis (RA), the effectiveness of which is beyond doubt. The review considers current literature data on the safety of GCs use, as well as the most common adverse events associated with such therapy. Most authors point to an increased risk of complications with an increase in the daily dose and/or duration of GCs treatment. At the same time, a safe dose of GCs has not been determined. Probably, the optimal tactic is the selection of an individual dose of GCs in each individual case, taking into account the activity of RA and the spectrum of comorbid conditions. In this case, the minimum effective doses and short courses of GCs should be used, regular monitoring of clinical and laboratory parameters should be carried out in order to detect adverse events early.

The article is dedicated to the review of some hazardous and extremely hazardous emergent viral infections of the beginning of the XXI century – severe acute respiratory syndrome (SARS), Middle­East respiratory syndrome (MERS), Lujo hemorrhagic fever (LHF) and severe fever with thrombocytopenia syndrome (SFTS). Special attention is paid to the time of reveal and identification of infectious agents, their taxonomic belonging, genome organization, possible ways of the appearance of strains, virulent for human beings, to endemic regions, probable ways of infection, reservoirs and transmitters of infection, morbidity and mortality. These infections should be of particular concern because of the severity of illnesses, caused by the above mentioned viruses, the absence of characteristic clinical signs that makes diagnostics more difficult, especially in non­endemic areas, the absence of means of specific prophylaxis and treatment and the difficulties in their identification. The analyze of this emergent viral infections reveals their potential threat for the Armed Forces and population of the Russian Federation in case of accidental or intentional delivery of causative agents of these diseases to the Russian territory.

BACKGROUND: Since the very first outbreak, scientists have been trying to determine the most critical pathogenetic mechanisms for the development of COVID-19 and related complications, analyze individual subpopulations of patients with chronic diseases and develop optimal tactics to combat not only the infection itself but also its acute and chronic complications.AIM: to assess the COVID-19 course among patients with Type 1 and Type 2 DM.MATERIALS AND METHODS: A retrospective cohort study of Tashkent inhabitants, who had COVID-19 from April to D ecember 2020, was performed. The data were obtained from the single electronic database of registered cases of COVID-19. All data were analyzed using a logistic regression in STATA 17.0 software. Further, the matched case-control study was performed for patients with type 2 DM and no DM based on age, gender, and BMI.RESULTS: Of the 5023 analyzed subjects, 72.63% had no diabetes mellitus (DM), 4.24% had type 1 DM, 15.19% had type 2 DM, and 7.94% was diagnosed with DM during the COVID-19 infection. DM, overweight, and obesity were associated with severe COVID-19; the most significant risk of a severe course was found in persons with type 2 DM. The risk of a lethal outcome and the need for prescription of glucocorticoids did not show a significant association with diabetes in Tashkent. The clinical features of COVID-19 were more common in patients with type 2 DM, especially for shortness of breath, chest pain, and arrhythmia. The persons receiving SU have complained of dyspnea significantly more often than matched patients without DM. Metformin and DPP4i were the groups of drugs that were not associated with significantly increased risk of hospitalization of patients because of COVID-19. The matched case-control study did not reveal statistically significant differences in the disease course severity, need for hospitalization and glucocorticoids, and death depending on the glucose-lowering therapy preceding the onset of COVID-19.CONCLUSION: Diabetes, age and overweight/obesity were associated with severe course of COVID-19 in Tashkent. There was no statistical difference in COVID-19 severity depending on initial glucose-lowering therapy.

Aim. To conduct an analysis of the incidence of breast cancer in the Krasnoyarsk Territory for 2012–2021 and calculate the medium-term forecast of indicators until 2030. Materials and methods. An analysis of the incidence of breast cancer in the Krasnoyarsk Territory was performed using the Microsoft Office Excel 2021 program. A calculation was made of “rough” indicators of oncological incidence of breast cancer, calculated per 100,000 population of the corresponding sex and age. Forecasting the incidence of breast cancer was carried out among the population of residents of Krasnoyarsk and the Krasnoyarsk Territory (excluding the city of Krasnoyarsk), of the following type: y = b + ax, where y is the predicted incidence of lung cancer; х is the serial number of the year of observation, starting from the initial reference point (2012); b is a constant; a is a coefficient reflecting the average change in y with an increase in x by one unit; and the approximation coefficients R2 were also determined. Results and conclusion. The incidence of breast cancer during the study period increased both in the regions of the Krasnoyarsk Territory and in the city of Krasnoyarsk by 21.36 % and 19.05 %, respectively. Age-specific analysis of the incidence of breast cancer in the female population showed that the incidence in Krasnoyarsk in the age group of 20–24 years showed the maximum increase, the maximum decrease in incidence was observed in the age group of 25–29 years. In the regions of the Krasnoyarsk Territory, the maximum increase in this indicator is observed in the age group of 40–44 years, and the maximum decrease in the age group of 30–34 years. The share of early detection among the working-age population is higher in the regions of the Krasnoyarsk Territory and amounts to 4.7 % over a 10-year period. The share of early detection among the working-age population is higher in the regions of the Krasnoyarsk Territory and amounts to 4.7 % over a 10-year period. The proportion of early detection among women of the disabled population is higher in Krasnoyarsk, but there is a decrease of 0.97 %. According to prognostic estimates, by 2030 the incidence of breast cancer will increase by 1.2 times in the regions of the Krasnoyarsk Territory and in the city of Krasnoyarsk. The largest increase in the incidence is predicted in the female population of the city of Krasnoyarsk – by 1.24 times compared to 2021 and by 47.8 % compared to 2012. To overcome the growth, it is necessary to introduce new technologies and methods for early diagnosis and monitoring the effectiveness of anticancer therapy.

The coronavirus pandemic has produced considerable effects on medical and demographic processes worldwide and in Russia in particular. The epidemic process involved a sequence of circulating SARS-CoV-2 virus strains with different mutations and this reflected in registered levels of incidence and mortality against spatial heterogeneity of socioeconomic factors in different RF regions. The aim of this study was to analyze spatial-dynamic heterogeneity of the COVID-19 epidemic process in the RF regions in 2020–2023. We performed retrospective analysis of incidence and mortality at the national and regional levels. The analysis relied on departmental statistical data provided by Rospotrebnadzor as well as public data that described the intensive indicators of the COVID-19 epidemic process and results obtained by sequencing of biomaterial samples to identify COVID-19 in them in 2020–2023. In 2020–2023 we identified five ‘waves’ of the COVID-19 epidemic processes that interchanged sequentially. Within these waves, RF regions reached local peaks in incidence with different speed. According to available data, the highest primary incidence among all the RF regions in 2021–2022 was established in Saint Petersburg (12,821.8 cases and 17,341.2 cases per 100 thousand people); the highest mortality in 2021 was detected in the Tver region (427 cases per 100 thousand people) and in the Arkhangelsk region in 2022 (350.9 cases per 100 thousand people).The greatest number of the RF regions where the incidence due to the disease was higher than its average annual level was established in October, November, December 2021 and February 2022 (51, 68, 51 and 82 RF regions accordingly). The established spatial-dynamic heterogeneity of the epidemic process may indicate that this process can be largely determined by differences in the initial socioeconomic, medical and demographic characteristics of the RF religions. Limitations of the study are related to the used statistical data on registered incidence and mortality as well as the concept of the epidemiological ‘wave’ accepted in it. The identified territorial differences in the COVID-19 epidemic process should be considered when developing optimal regulatory impacts including those aimed at predicting probable emergent infections.

In recent years, Russia has seen a considerable decrease in the number of consumers of alcoholic beverages. However, mortality from alcohol-related causes is still quite high. In the context of the Concept for lowering alcohol use in the Russian Federation up to 2030, it is promising to assess the risks of alcohol involvement of Muscovites as residents of a certain metropolitan region. The purpose of the study is to identify the characteristics of alcohol intake by Moscow residents, including factors and risk groups. An empirical sociological survey (CATI, randomized sample, N = 1002) was conducted in October 2022 among adult residents of Moscow. The study has showed that 78 % of Muscovites have consumed alcohol over the past year; the rate of heavy drinking is 14 % among male drinkers and 7 % among female drinkers, which is consistent with data from previous studies conducted on a nationwide sample. Also, 16 % of Muscovites note that they have consumed homemade alcohol over the past month, which means that they represent a potential risk group for poisoning. The study identified the structure of alcohol consumption, which served as the foundation for consumer classification: “bar type” (24 %), “homemade alcohol of various strengths” (21 %), “strong alcohol and homemade wine” (20 %), “wine” (18 %), "only vodka" (17 %). Alcohol abuse is uncommon among young individuals. Involvement in drinking alcohol is frequently influenced by relatives (including parents), colleagues and friends, highlighting the need to address alcoholism's social components. Respondents evaluate the current anti-alcohol measures in Moscow rather positively.

Introduction. COVID-19-related stroke is associated with a significantly higher mortality than COVID-19 or stroke alone. Mechanisms underlying the increased mortality of patients with stroke and COVID-19 should be thoroughly studied. Objective: to analyze predictors of hospital mortality associated with COVID-19-related stroke. Materials and methods. We retrospectively analyzed 1,386 cases of COVID-19-related stroke reported by an infectious diseases inpatient clinic in 2020. We studied clinical, laboratory, and instrumental parameters in patients with different outcomes. Logistic regression was used to identify independent predictors of mortality. Results. 539 (38.9%) patients died during their hospital stay, with 437 (38.0%) deaths from ischemic stroke and 102 (42.7%) deaths from hemorrhagic stroke (p = 0.0001). Independent predictors of mortality associated with COVID-19-related stroke included age, neurological deficit severity measured by NIHSS, COVID-19 severity, and laboratory parameters including white blood cell count, creatinine, glucose, and D-dimer blood levels. Discussion. The results of logistic regression analysis were able to explain only 41% of the variability in hospital deaths among patients with stroke associated with COVID-19. Conclusion. Hospital mortality in patients with COVID-19-related stroke is associated with severity of inflammatory response, impaired coagulation, age, neurological deficit severity, and somatic comorbidities.

Background. The identification of early predictors of poor outcomes of new coronavirus infection is necessary for optimizing patient management algorithms for hospitalized patients with COVID-19. Aim. To study the role of chitotriosidase activity as a marker of unfavorable outcomes in COVID-19 hospitalized patients. Materials and methods. The prospective observational single-center study included 347 patients with COVID-19 hospitalized in university clinic. In addition to the standard laboratory analysis (complete blood count, C-reactive protein, ferritin, creatinine, international normalized ratio, etc.) the blood serum chitotriosidase activity was determined at all the patients on admission. Primary endpoints were mortality from all causes and performing invasive ventilation (IV) and/or non-invasive ventilation (NIV). This study was approved by the Local Ethics Committee №12-21 (Clinical Trial Registry: NCT04752085). Results. A total of 347 patients were enrolled in this study (average age 66 years, females 182 52.5%), 30 patients (8.6%) died during the hospitalization, 39 (11.2%) performed IV or NIV. Along with age more than 65 (odds ratio OR 10.81, 95% confidence interval CI 2.6444.22) and Neutrophil-Lymphocyte Ratio higher than 7 (OR 15.89, 95% CI 3.0981.65) chitotriosidase activity higher than 170 ng/hr/ml (OR 4.23, 95% CI 1.4512.35) were independent predictors of mortality during hospitalization. Neutrophil-Lymphocyte Ratio higher than 5.6 (OR 11.22, 95% CI 2.3753,1) and сhitotriosidase activity higher than 151 ng/hr/ml (OR 3.17, 95% CI 1.317.67) have been evaluated as predictors of performing IV/NIV. Conclusion. Chitotriosidase level more than 151 nmol/h/mL could be considered as an early predictor of severity and poor prognosis in hospitalized patients with COVID-19.