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The article presents results of cohort epidemiological studies conducted in the period from 2001 to 2010 among the indigenous population residing in Chukotka (ChAO) and Nenets (NAO) autonomous districts. The aim was to document temporal changes in blood concentrations of persistent contaminants that caused the serious health concern from the first Arctic Monitoring and Assessment Program (AMAP) survey in 2001 “Persistent toxic substances, food security and indigenous peoples of the Russian North”. In monitored indigenous cohorts there have been measured blood concentrations of persistent contaminants including polychlorinated biphenyls (28/31; 52; 99; 101; 105; 118; 128; 138; 153; 156; 170; 180; 183 and 187); hexachlorocyclohexane (α, β, γ - isomers of HCH); oxychlordane (trans chlordane, cis-chlordane); DDT (2,4 DDE; 4,4 DDE; 2,4 DDD; 4,4 DDD; 2,4 DDT; 4,4 DDT); hexachlorobenzene (HCB); heptachlor; dieldrin; mirex; toxaphene (Par 26, the Par 50, the Par 62); PBDEs (28; 47; 100; 99; 153; 154; 183); metals (Cd, Pb, Hg). During 2003-2004 there was implemented a set of measures for the disposal and detoxification of local sources of persistent pollutants and reduction of the risk of associated health effects that had been recommended by the international AMAP expert panel. As a result of 2010 study a significant reduction in the average serum concentrations of DDT and DDE 4.4, as well as blood concentrations of lead was found to occur, they were observed only in men living in NAO. Changes in concentrations of a number of other persistent toxic substances (PTS) although show a tendency to decrease, but these changes failed to reach the level of statistical significance. The mean annual incidence rates of diseases associated with harmful impact of PTS, in particular, cancer, endocrine system diseases, congenital malformations, and immunodeficiency, unlike most of the other classes of diseases in the population showed a clear trend towards to the increase in the period of observation. Conclusion. The results obtained did not allow to confirm the sufficient effectiveness of implemented measures for the rehabilitation of residential areas both in Chukotka and NAO. The period of re-measuring blood concentrations of PTS was assumed not be appropriate due to longer half-life of many PTS studied. The health importance of long-range transboundary transport of PTS is likely to be also underestimated especially due to the observed high contamination of migrating of commercial species of wild birds, fish and marine animals that make up a significant part of the traditional diet of indigenous peoples of the North. There is need for the improvement of national biomonitoring as well as information systems for appropriate assessment, prediction and management of health risks associated with long-range biotransportation of PTS into the arctic food chains.

By means of transformations based on the scientific and educational basis of the two higher education institutions with more than 100 years of history, pursues the policy of best traditions of the outstanding medical schools. In the I.I. Mechnikov North-Western State Medical University the special attention is paid to the training of qualified personnel for a wide range of health care organizations and the health care system of state sanitary and epidemiological surveillance, which is reflected in the university’s Mission. In the I.I. Mechnikov North-Western State Medical University there was developed a complex of innovative technologies, which seem for the first time in Russia to implement a systematic approach to the practice-oriented training in modern molecular techniques in medical microbiology and epidemiology. For the first time in world practice, there was developed and introduced in the training simulator training in microbiology based on software complex automated laboratory. At the beginning of the 21st century I.I. Mechnikov North-Western State Medical University determines its future strategy on the formation of doctors, along with professional competences, motivation to health-saving lifestyle that will ultimately contribute to the improvement of the quality of life of the all population

Purpose of the study. To evaluate the effectiveness of the prevention programs aimed at the prevention of the spread of socially important infections on example of HIV infection, as well to express it in units permitting the comparison with other fields of health care and to compare with to expenses for the prevention and treatment of sequelae of infection. Materials and methods. Results of the panel study, executed in 2006-2013 in 10 regions of the Russian Federation in HIV infection risk groups (4 waves). The total number of participants is 9891. Study protocol included detailed survey of risk behavior, involvement in prevention programs and HIV testing. Obtained data were used for the assessment of the change of the morbidity rate as a result of prevention and calibration of the dynamic (Markov) model of the effect of the prevention on the length of quality-adjusted life and treatment cost. Expenses for the prevention were estimated from field reports of prevention projects. Results. Programs for the comprehensive prevention of socially important infections, first of all HIV-infections, among injecting drug users result in the significant decrease in HIV incidence. The assessment of the effect of the prevention within framework of the multivariable model shows odds ratio to be of 0.56 (95% CI=0.40-0.78). This relative reduction corresponds to the decline of the absolute incidence from 3.98 per 100 person per year in the group of persons who was not involved in prevention programs (95% CI=3.37-4.69) to 2.22 per 100 person per year (95% CI=1.89-2.62) among participants. Such effect of the prevention leads to the increase in quality-adjusted life-years per each person (QALY=0.23, 95% CI=0.10-0.37), and the saving of budget cost by 226 thousand rubles (95% CI=209,6 - 822,2 thousand rubles). With the use of more pessimistic assumptions in relation to expenses for the prevention and treatment, the cost per quality-adjusted life per year failed to surpass the threshold of society’s willingness to pay for health technology, with demonstrating high cost-effectiveness of investing in the prevention. Conclusion. Programs of the comprehensive prevention of socially important infections in the Russian Federation have significant effectiveness and under most plausible assumptions are cost-saving. For the solution the problem of financing preventive measures it is necessary to apply the same principles of health technology assessment as it is done is the area of drug coverage.

The existing classifier of qualifications appears to be replaced by professional standards (PS) for specialists of preventive medicine, approved by the order of the Ministry of labor of RF № 399n from 25.06.2015. This is a multifunctional regulatory document setting requirements for the content, quality and conditions of the work, qualifications and competencies, professional education and training for skills required to meet this qualification, as well as a description of the ethical standards that are obligatory for the acceptance and respect of all members of the professional community. The standard includes the main type of professional activity of specialists of preventive medicine direction - ensuring sanitary and epidemiological welfare of the population and protection of consumers, identifies summarized working functions and corresponding qualification levels for the specialist, as well as requirements for education and practical activities which are necessary for their implementation. For the each working function included into the standard there are identified required knowledge and skills. The Federal educational-methodical Association in the field of the science of health and preventive medicine prepared a new educational standard in which the professional tasks and competences of the future specialist were both harmonized with the labor functions described in the standard and aligned with the major employer of graduates - Federal Service on Surveillance for Consumer rights protection and human well-being. Conclusion. The implementation of the professional standard provides a number of advantages for specialists of preventive medicine, its employers and professors of universities. Continuous updating of professional standards will allow to assess the quality and level of employee competencies, mainstream vocational training programs at all levels, aimed at creating and improving the professionalism of preventive medicine direction.

The article presents the first Russian experience in a facial composite tissue allograft transplantation. An algorithm for the interaction of government agencies such as the Ministry of Healthcare and the The Ministry of Defence of the Russian Federation was being reviewed . The basic aspects of the preparation and conduct of the operation, followed by immunosuppressive therapy were being presented.

This article represents a brief review of the development of the doctor’s and the patient’s attitudes towards each other. Where does the estrangement stage start, when a patient turns from an individual into an interesting medical case? What unites and distinguishes these images? How does the image of the doctor change from healer shaman into a specialist wearing the medical uniform? What unites and distinguishes these two images?

The investigation included 56 patients with MI of lower localization and acute left ventricle failure (ALVF). Group A included 33 patients with primary coronary balloon angioplasty (PCBAP), in group B there were 23 patients with MI and ALVF without revascularization. Group A was divided into 2 subgroups--A1 (patients with history of IM) and A2 (patients without previous MI). On the first and on the 14th days echocardiographic investigation was performed in all the patients. Ejection fraction (EF) of the LV in dynamics by the 14th day of the disease increased in group A from 32.8 +/- 1.8% to 36.1 +/- 1.6% (p0.05) at the expense of subgroup A2 (32.1 +/- 2.6% on the first day and 37.5% +/- 1.9 on the 14th day, p0.05), while in subgroup A1 there were no substantial changes of EF. In group B, on the contrary, there was decreased EF of the LV. Most of the group A patients had many injuries of the coronary bed vessels. After PCBAP of the right coronary artery (RCA) the increase of EF was followed by an improvement of the local contractility of the LV myocardium not only in the infarction zone, but also in the segments with ischemic dysfunction in which blood flows from the infarction-independent artery with its collateral filling from RCA.