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The aim: to develop a modern certification program "Global Health" for the continuous professional development of public health professionals. Materials and methods. The study employed bibliosemantic, informational-analytical, medical-statistical, sociological methods, and content analysis method. The research program included an analysis of the main competencies of public health professionals, as defined by the Association of Schools of Public Health in the European Region (ASPHER) and the higher education standard for specialty 229 "Public Health" for the second (master's) level of higher education; analysis of existing certification programs on global health; conducting sociological surveys of public health professionals regarding priority topics and preferred learning methods. The research was based on normative documents, electronic resources, and the results of sociological research. Statistical processing and mathematical analysis of materials were conducted using statistical analysis methods. Results. It was established that global health issues are significant in shaping the professional competencies of public health professionals, considering the requirements of the higher education standard for specialty 229 "Public Health" for the second (master's) level of higher education and those, defined by the European List of Core Competencies for Public Health Professionals ASPHER. The study of these issues was identified as important for continuous professional development based on sociological surveys of disease control and prevention center employees (38.4 out of 100 respondents). Among various forms of education, webinars (62.2±3.8 out of 100 respondents) and online learning (60.4±3.8) are most in demand. Analysis of the obtained data led to the justification of the "Global Health" certification program. In the developed "Global Health" certification program, 26.7% of the workload corresponds to lectures, 33.3% to practical classes, and 40% to preparatory work. Structurally, it covers 2 modules and 8 topics on current issues of the impact of globalization on health and analysis of global health indicators. Conclusions. The "Global Health" certification program meets the requirements of normative documents, considers contemporary challenges and consequences of globalization on health, highlights global health trends, and its topics are in demand among disease control and prevention center professionals.

Introduction. The interest in Global Health (HG) as an academic discipline has increased in the last decade. The Rouen School of Medicine is one of the first to offer a GH curriculum in France. The objective was to identify the characteristics and profile of students involved in a GH curriculum. Material and methods. In 2016 and 2017, a cross-sectional study was conducted, including enrolled in the GH course: 3rd and 4th year in medicine, midwifes studies and pharmacy. Based on self-questionnaire, data collected were motivations for health studies, investment in humanitarian associations, opinions about the GH topics. Results. A total of 422 students were included; 122 students attended to GH cursus (GH+) and 300 in control group (GH-). The students of the GH+ group were more likely to get involved in a humanitarian association (22.3% versus 6.7%, p

With the outbreak of the Coronavirus disease (COVID-19) pandemic, the international community is forced to face the global health crisis again. Even though, throughout the course of history, the human race has seldom succeeded in getting rid of infectious diseases and global health inequalities completely. Faced with this tragic situation and extreme inequality, some philosophers have put forward some exciting plans, and it is undoubtedly regrettable that Rawls, one of the most outstanding contemporary political philosophers and ethicists, has not addressed this issue in his The Law of Peoples. However, if Rawls wants its philosophical blueprint for the future world – the law of peoples as a “realistic utopia” to be feasible, he has to face the challenges of global health and make a reasonable response. Otherwise, the magnificent building of this “realistic utopia” will collapse. Therefore, the author tries to develop Rawls’ international justice theory by introducing the idea of the right to health into the law of peoples, so as to hopefully provide a feasible philosophical plan to solve the global health problems.

As an analysis of foreign literature on donation has shown, the global market for therapy with drugs from human plasma is growing, which leads to the need for large volumes. With significant geographic imbalances in the global plasma supply and the dependence of most countries on plasma supplies from the United States, the most vulnerable are low- and middle-income countries, where the challenge of meeting the demand for plasma products requires improvements to regional plasma donation systems. An effective tool for the development of plasma collection services is compliance with the standards of plasma donation services, the development of voluntary free plasma donation, and the optimization of donor recruitment and retention processes.

The article considers draft of new edition of the International Health Regulations. The possible risks associated with changing of the document are evaluated from perspective of member countries, in whose territories occur or supposedly occur emergency situations in field of public health having international importance.

Health care in general and medicine in particular play an important role in the geopolitical landscape and the political positioning of the state in the modern world. The health of the citizens of the country is the most important resource of national security. This article, based on a SWOT-analysis, highlights the strengths and weaknesses of the foreign and national resort industry as a part of medical diplomacy, with decomposition to its individual participants. The undoubted advantage of our country in terms of humanitarian policy, on the world stage is shown, specifically in the context of national key success factors, including the technological capabilities of domestic medical science and practice, regarding the availability of trained staff, specialized variable climatic sanatorium and resort institutions network with unique technologies and natural healing resources, coupled with international experience in humanitarian cooperation, developed healthcare system and sanitary and epidemiological supervision of the country. Medical diplomacy and national resort medicine as an active participant of the branch, are strategically important areas in public diplomacy, having the ability to play an important role in achieving national goals in geopolitics.

For the World Kidney Day Steering Committee Kidney disease is a global public health problem that affects more than 750 million persons worldwide. The burden of kidney disease varies substantially across the world, as does its detection and treatment. Although the magnitude and impact of kidney disease is better defined in developed countries, emerging evidence suggests that developing countries have a similar or even greater kidney disease burden. In many settings, rates of kidney disease and the provision of its care are defined by socioeconomic, cultural, and political factors, leading to significant disparities in disease burden, even in developed countries. These disparities exist across the spectrum of kidney disease - from preventive efforts to curb development of acute kidney injury or chronic kidney disease, to screening for kidney disease among persons at high risk, to access to subspecialty care and treatment of kidney failure with renal replacement therapy. World Kidney Day 2019 offers an opportunity to raise awareness of kidney disease and highlight disparities in its burden and current state of global capacity for prevention and management. In this editorial, we highlight these disparities and emphasize the role of public policies and organizational structures in addressing them. We outline opportunities to improve our understanding of disparities in kidney disease, the best ways for them to be addressed, and how to streamline efforts toward achieving kidney health equity across the globe.

Over 6% of the world's population lives with disabling hearing loss which can adversely affect their development, education and overall health. Unless action is taken, it is expected that by 2050 the prevalence of hearing loss could grow to nearly 10%. Many of the causes responsible for this growth, such as noise, ototoxicity and ear infections are preventable through public health measures. In those who develop hearing loss: appropriate, timely and cost effective interventions can reduce its adverse impact. However, most people do not have access to the required ear and hearing care services. Strong government-led action, is required to address this issue. Such action must focus on raising awareness in all sections of society and providing services to address hearing loss. Professional groups and civil society has to support governments in developing and implementing evidence-based policies that can ensure accessible ear and hearing care for all.

World Bank and Russian Federal State Statistics Service data were used to analyze cross-country correlations between life expectancy (LE) and per capita gross domestic product (pcGDP). The resulting world trend (Preston curve) as of 2015 was compared with the trend revealed by plotting regional LE vs. pcGDP related to the major administrative areas of the Russian Federation (RF). Besides that, correlations between the same parameters related to different years, from 1960 to 2015, were examined in each of several selected countries representing the upper and lower extremes of pcGDP and LE. The same has been done with per capita health care expenditures (pcHCE) vs. LE. In all cases, the points related to RF are found significantly lower the respective regression lines (Preston curves) built based on all points. The LE vs. pcGDP and LE vs. pcHCE plots and their extrapolations built based on data related to different years in the same country run markedly lower in the case of RF compared with other countries, including Tajikistan and the Republic of Congo. At the same time, the proportion between pcGDP and pcHCE has been shown to be the same throughout all years and all countries. Taken together, these observations suggest that the effectiveness of investing the available resources into LE, that is in human life quality, is markedly lower in Russia compared not only with Finland and Japan, where pcGDP and pcHCE are several times greater than in RF, but also with Congo and Tajikistan, where these parameters are several fold smaller, than in RF. This means that by merely increasing pcGDP and pcHCE it is impossible to increase LE in Russia above 80 years declared a national priority. Identifying the factors responsible for the above disproportions is beyond the scope of the present paper. However, the mere awareness of their existence is essential as an incentive to take special efforts aimed at the identification and neutralization of these factors.

The Global Technical Strategy for Malaria 2016-2030, which was approved by the World Health Assembly in 2015, over the next 15 years suggests that the number of patients with malaria will decline by 90%, that it will be eliminated in 35 countries where this infection remained endemic in 2015, and that the resurgence of malaria will be prevented in the previously eliminated areas. Taking into account the existing features of antimalarial programs in the endemic countries at both national and subnational levels, this strategy can and must serve as a basis for the development and formulation of really implementable national malaria control and elimination programs.

The article considers changes in mass physician consciousness approaches to diagnostic and treatment of diseases occurred in the end of XIX-first half of XX centuries. It was the result of gaining a foothold in medicine of new view on organism as a procedural system and concepts of diseases as a complex feedback reaction of this system to unfavorable effect of environmental factors. It is demonstrated that the major change in diagnostic became refusal of traditional for XIX century orientation of diagnostic search exclusively on “clinical prediction of pathological picture" in favor of complex evaluation of state of ill person. The scale transformations in medical business affecting clinic of internal diseases and surgery disciplines resulted in that for the first time symptomatic therapy was replaced by comparatively effective ethiotropic and pathogenic treatment.

The rapid aging of the population and the steady increase in life expectancy around the world is one of the greatest social, economic and political transformations of our time. The on-going demographic changes are accompanied by a significant increase in the prevalence of non-communicable diseases and disabled people. There is still no adequate medical care, as well as access to essential medicines and technologies for treatment and prevention of NCDs, what leads to disability, loss of productivity and reduction of national income in many regions of the world. These trends underline the necessity of developing effective measures to promote prosperous aging, which implies, first of all, legislative, administrative and other measures, as well as the development of a socio-economic strategy and action plan, which will protect interests of elderly population.

The article provides an overview of domestic and foreign works on the impact of the replaceable labor on the efficiency, general state of health, the health and the dream of workers. Many hours shifts and overtime work were found to disturb likely familiar rhythms (sleep, wakefulness, performance), change the metabolic and hormonal metabolisms, reducing the recovery period between duties, contribute to more rapid development of fatigue. The consequence of circadian dyschrony may be the development of diseases of the cardiovascular system and cancer incidence. Studies have shown that sleep disorders are associated with metabolic changes, and particularly, obesity. In persons working in shifts, there are more often registered as individual features of the metabolic syndrome and the whole syndrome. It is noted that persons forming this group are at higher risk of developing diseases of the gastrointestinal tract. Thus, the problem of shift work is presented to be very important. Knowledge of ways and mechanisms that explain the impact of shift work on health is necessary to evaluate the professional risk. In the system of health measures the attention should be given to the rationalization of work and rest regimens, prevention of fatigue, struggle with sleep disorders and obesity.

According to the papers thyroid nodules are quite rare in the first two decades of life. However, there are some exceptions, relating to areas with an iodine deficiency or affected by radioactive fallout, where the risk of nodules and carcinomas is increased. Therefore, it is a great challenge for the physician to distinguish between benign and malignant lesions preoperatively, and not only in these areas of greater risk. The authors analyzed current works, which are devoted to diagnostics and treatment of adenomas of thyroid gland in children. This literature review is based on works dedicated to epidemiology, histotypes study, and methods of diagnostics, surgical treatment, prognosis and complications of this pathology. The current tendencies in surgical approaches, intraoperative monitoring of recurrent laryngeal nerve are also discussed. The actuality of this problem is connected with last decade increase of adenomas in structure of thyroid gland nodules, increase of number of patients with multiple adenomas and with polypathias: adenomas with nodular goiter, autoimmune thyroiditis and cancer in children. The difficulties of diagnostic of adenomas are related to the similar clinical symptoms, cytogenetic characteristics of growth of benign and malignant lesions of thyroid gland. Additionally there is no systematic review about thyroid adenomas in children recent years.

Hypertension is the leading risk-factor for cardiovascular disease and death from them. Traditionally, the problem of isolated systolic hypertension is associated with old age in mind the natural dynamics of systolic and diastolic blood pressure throughout life. Isolated systolic hypertension is the most common type of hypertension in elderly men as well as young adults. The pathophysiology of this condition in different age periods have fundamental differences. The adverse prognostic significance of isolated systolic hypertension in the elderly, and the need for its non-drug and drug treatment are well documented. Accumulating epidemiological evidence on the adverse prognostic significance of isolated systolic hypertension. People young and middle-aged isolated systolic hypertension heterogeneous and may be a consequence of excessive pulse pressure amplification from the aorta to the peripheral arteries and the manifestation of an accelerated aging. Evaluation of central blood pressure and arterial stiffness in young may help identify premature vascular aging.

The number of patients with heart failure and atrial fibrillation is huge. Population of patients with heart failure in combination with atrial fibrillation is characterized by poor quality of life and adverse outcomes. In this review we summarized data on the guideline adherence and prevalence of long-term anticoagulant therapy in patients with atrial fibrillation and heart failure.

The article contains literature review on the problem of causes of sudden cardiac death (SCD) among young people as well as results of author's own retrospective study of deaths of persons before 39 years based on forensic autopsies performed during 10 year period. The study of structure and dynamics of causes of death, its risk factors and the role of connective tissue dysplasia in development of terminal symptomocomlexes allowed to establish that main mechanism of SCD in young people was arrhythmogenic developing as a response to provoking factors--physical effort, psychoemotional stress, consumption of light alcoholic beverages.

Clinical practice confirms high frequency of anemic syndrome. Anemia is diagnosed more often in senior patients than on the average. The most prevalent type of anemia in senior groups are iron deficiency anemia and B12-deficiency anemia, anemia of chronic diseases and anemia caused by kidney diseases. The cause of anemic syndrome in 25% of senior patients remains unclear. Anemia leads to impairment of life quality, increased morbidity and mortality in senior people except for patients with anemia of unknown origin.

Sanfilippo syndrome (mucopolysaccharidosis type III) is a lysosomal disorder caused by a defect in the catabolism of heparan sulfate. Mucopolysaccharidosis type III is the most common type of all mucopolysaccharidoses. The pathogenic basis of the disease consists of the storage of undegraded substrate in the central nervous system. Progressive cognitive decline resulting in dementia and behavioural abnormalities are the main clinical characteristics of Sanfilippo syndrome. Mucopolysaccharidosis type III may be misdiagnosed as otherforms of developmental delay, attention deficit/hyperactivity disorder and autistic spectrum disorders because of lack of somatic symptoms, presence of mild and atypical forms of the disease. Patients with Sanfilippo syndrome may have comparatively low urinary glycosaminoglycans levels resulting in false negative urinary assay. Definitive diagnosis is made by enzyme assay on leucocytes and cultured fibroblasts. There is currently no effective treatment of mucopolysaccharidosis type III, though ongoing researches of gene, substrate reduction and intrathecal enzyme replacement therapies expect getting curative method to alter devasting damage of central nervous system in near future.

Hepatitis C virus is an actual public health problem worldwide since its discovering in 1989. It is explained not only by the wide spreading and frequent adverse outcomes of disease, the lack of effective preventive vaccine, but also by the high genetic variability of the virus. The current review summarizes the results of phylodynamic and phylogeographic studies of different HCV populations that allowed to characterize epidemic processes, to analyze the divergence of HCV into genotypes and subtypes, and to determine the geographic origin of the current HCV epidemic variants.

Diarrheal infections remain the major cause of morbidity and mortality among children under 5 years of age. The rotavirus holds the leading position among principal diarrheal pathogens that include also norovirus, enteropathogenic and enterotoxigenic Escherichia coli. Rotaviruses are transmitted by the fecal-oral route and are extremely contagious and stable in the environment. This facilitates viral transmission, particularly in daycare centers and hospitals. Rotavirus infection causes acute gastroenteritis with diarrhea and dehydration of various degrees resulting primarily from destruction of intestinal villus enterocytes with subsequent impairment of the ion transport and absorption. The incidence of rotavirus infection peaks during the winter and spring in countries with temperate climate. Many children have asymptomatic infection that supports rotavirus circulation in the popula- tion. Several vaccines have been developed for specific prophylaxis of rotavirus infections and demonstrated protection from severe acute rotavirus gastroenteritis and all-cause diarrheal mortality.

Uveal melanoma is a malignant intraocular tumor associated with poor vital prognosis, process generalization, and death from metastatic disease. A number of factors are considered undesirable in the presence of a tumor. This paper provides a review of the literature on major prognostic factors for uveal melanoma development and their contribution to vital prognosis.

The article presents an overview of the problem of varicose veins of pelvic (VVP) in elderly women. VVP is severe suffering to women, especially in the elderly, it promotes social exclusion, leads to psychoemotional disorders and occurrence of chronic pelvic pain due to pelvic varicose veins transformation. Despite the 150-year history of the disease, there is still no clear understanding of the clinical picture of the disease and, most importantly, how to treat this condition. In this regard, it is highly relevant research on timely diagnosis and appropriate treatment of VVP.

This review presents the results of a meta-analysis including data from all four studies of new oral anticoagulants for the prevention of stroke or systemic embolism in patients with non-valvular atrial fibrillation. It was found that all of the drugs had a favorable risk profile/efficiency, and provides a significant reduction in the incidence of stroke, intracranial hemorrhage and mortality. This increases the number of gastrointestinal bleeding. The relative efficacy and safety of new oral anticoagulants is consistent in patients with different clinical characteristics. These data provide a more complete picture of the new oral anticoagulants as a therapeutic method of reducing the risk of stroke in this patient population.

The author presents definition of pancreatic cancer (PC), epidemiological data on its prevalence, risk factors (chronic pancreatitis, viral hepatitis B, smoking, etc.), and clinical symptoms. Modern laboratory and instrumental differential diagnostic methods are discussed. Morphological classification and stages of the neoplastic process are considered with special reference to the methods of its surgical treatment and adjuvant therapy.

Pulmonay thromboembolism is a common difficult-to-diagnose pathology not infrequently with a lethal outcome. There are many factors leading to hypercoagulation. One of them is intake of hormonal contraceptives to which doctors sometimes do not pay due attention. This paper reports two cases of acute coagulopathy with massive pulmonary thromboembolism in young women using these agents during a long period.

Obesity is known as an independent risk factor of a number of chronic noninfectious disorders, however some investigations testify to the presence of "obesity paradox". The aim of the present review was to analyze results of investigations purposed to assess the effect of an elevated body mass index (BMI) and obesity on hospital mortality, risk of complications, and long term prognosis (mortality rate). Effect of BMI dynamics during lifespan on (cardiovascular ?) mortality was also analyzed. The results failed to demonstrate any convincing evidences that BMI 25-35 kg/m2 alone without taking into consideration metabolic changes, waist measurements, correlation between fat and muscular tissue was a risk factor of higher mortality in the long-term prospect and that its decrease improved survival. At the same time, it should be noted that these results depended on the method of sample formation and approaches to the statistical analysis.

The data on the prevalence of disease caused by Ebola virus, biological features of its pathogen, character of the epidemiological process, pathogenesis and clinical symptoms are presented. The disease is characterized by suppression of protective immunological mechanisms and systemic inflammatory reaction accounting for the lesions of vascular endothelium, hemostatic and immune systems. It eventually leads to polyorgan insufficiency and severe shock. Lethality amounts to 50%.

Bronchial asthma is the most common chronic disease in children affecting 30% of the child population. The purpose of this review was to analyze and summarize the works offoreign and Russian authors who evaluated the impact of mental disorders on the course of asthma in children. The article presents the definition of asthma as a psychosomatic disease and relevance of the study against this background. The authors adduce the results of research studies which allow us to estimate the interaction between the degree of anxiety, accentuation of the nature, severity of asthma, and the duration of the disease. The existing publications demonstrate that the researchers' opinions are polarized regarding the cause-and-effect relationship between psychological disorders and controlled asthma. The authors came to a conclusion that early detection ofpsychopathological symptoms and appropriate psychotherapeutic administration would improve the efficacy of treatment in children with bronchial asthma and the social adaptation, adjust the system offamily relations, and have a positive effect on the course of the disease.

Splenectomy is a serious operation, which includes the removal of the largest peripheral immune organ. Vast array of different pools of immunocompetent cells and immune-factors eliminate from the body as a result of this operation. Occurrence of hyposplenism in our country pediatric service is not determined--there are neither clear criteria for its diagnosis, nor approved algorithms for prevention. Data of postsplenectomy sepsis incidence in Russia are unknown. In this review article authors give contemporary literature data relating to the issue of developing hyposplenism and changes in the body after removal of spleen. Systemic effect of organ-resecting operation and the basic directions of overwhelming postsplenectomy infection and sepsis prevention are discussed.

Aim of the Study: On the available reports to assess the possibility of the infection with pyloric Helicobacter (H.pylori) from external sources--via contaminated food and water. BASIC CONCEPTS: H. pylori was established to be unable to multiply in dairy and other products, but under favorable conditions, can survive in the limited time. There are obtained epidemiological data about the feedback between the prevalence of H. pylori infection in the region and the availability of safe water. There was recorded ability of bacteria to survive for a short time in water in bacillary virulent form. In different water sources in different countries there was found H. pylori coccal form., Conclusion: H. pylori ability to survive in the commonly used product supports the hypothesis that contaminated food (tank-human) may serve as a conductor of infection. The literature data testify to the possibility and importance of the waterway for H. pylori infection transmission that changes the approaches to prophylaxis and the prevention of associated with it diseases.

Global efforts to eradicate dracunculiasis have continued to progress with only 542 cases reported in 2012 versus almost 1 million cases in the 1980s when the initiative was launched. The disease is still endemic, but in only four countries: South Sudan (541 cases), Chad (10 cases), Mali (4 cases), and Ethiopia (4 cases). The International Commission for the Certification of Dracunculiasis Eradication declared that 180 countries were free of the disease by 2013. Dracunculiasis was first eradicated in the former USSR in 1931 when its last case was registered due to the successful implementation of a package of appropriate measures (case detection and management, vector control, and health education, including water filtration from open water sources and behavioral changes). These approaches were actively taken into account when developing the global strategy for dracunculiasis. The World Health Organization has set a goal to eradicate the disease by 2015. However, despite the fact that the global situation looks very optimistic, the time for completing the program will be most likely postponed due to a few operational challenges remaining in the still endemic countries, in South Sudan in particular.

In 2002, it was proposed to consider functional renal disorders 3 and more months in duration under the general name chronic renal disease (CRD) bearing in mind the common mechanism behind progressive nephropathy and high cardiovascular mortality of such patients. The prevalence of CRD in Russia is unknown; it is supposed that every tenth adult in the world has CRD. Diagnostics of CRD requires at least measurement of serum creatinine, calculation of the glomerular filtration rate by CKD-EPI formula, and determination of albuminuria. A main cause of CRD is cardiovascular disorders. Complicated relationships between cardiac insufficiency and CRD account for 5 types of cardiorenal syndrome. CRD patients are at risk of terminal renal insufficiency requiring replacement therapy; moreover, CRD enhances cardiovascular morbidity and predisposes to acute renal lesion that in turn accelerates progress of CRD. Taken together these events account for the global character of the CRD problem.

The paper presents an analysis of morbidity and mortality from prostate cancer ("crude" and standardized rates), taking into account regional differences. The regularities of the dynamics of analytical rates are particularly observed.

The analysis of a problem state of chronic hepatitis C in children was conducted. Data on primary incidence of chronic hepatitis C at the children's population as on the territory of the Russian Federation, and abroad are submitted. Problems of diagnosis of a HCV infection are studied. The survey analysis of risk of contamination is carried out, possible ways of transfer are highlighted, features of a course of a HCV infection in children are shown, synchronising frequency of a process is displayed. The problem is analysed now, and further prospects in treatment of chronic viral hepatitis C in children are estimated.

Increasing prevalence of cardiovascular diseases induces an urgent need to identify and clear delineation of the most important risk factors for the development and progression of atherosclerosis. Unlike the second part of XXth century, today the World Health Organization considers particulate matter ambient pollution one of the most important predictors of cardiovascular events. However, results of similar studies conducted in the last decades, is highly fragmented. The authors' objective was to try to understand and organize this massive of accumulated information and analyze it to draw conclusions about the impact of particulate matter on the functioning of human cardiovascular system.

The literature review gives current views on the treatment of Helicobacter pylori infection. The rising antibiotic resistance of H. pylori in the first decade of the 21st century entailed the decreased efficiency of common eradication therapy (ET) regimens, by determining the higher interest in this problem. The paper summarizes data on the efficiency of current ET regimens in different regions of the world in the past 3 years. The prospects of alternative ET regimens are considered. The existing and promising ways of optimizing the current ET regimens are presented.