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Aim: To study relationship between anemia and health-related quality of life (HRQOL) of chronic kidney disease stage 5 patients (CKD) undergoing renal replacement therapy by programmed hemodialysis., Materials and Methods: The study was conducted on the basis of dialysis centers/departments in Moscow. The Russian-language version of the KDQOL-SF TM questionnaire, validated in Russia, was used to assess the HRQOL of patients on hemodialysis. A total of 723 patients were interviewed. Hemoglobin (Hb) levels were assessed in 442 patients based on outpatient records. To identify the relationship between Hb level and HRQOL scales, a correlation analysis was performed, as well as a HRQOL analysis in the three groups differing in hemoglobin levels (<100; 100-120 and >120 g/l). Statistical data processing was carried by SPSS.22 and using parametric and nonparametric statistical methods., Results: Correlation relationship was revealed between Hb and HRQOL of patients on hemodialysis on the scales "symptoms/problems", "pain", "vital activity, energy" and "total physical component of health". According to the scales "symptoms/problems" and "vital activity, energy", higher rates were noted among patients with Hb higher than the target level, which confirms the recommendations concerning the possibility of achieving higher Hb among individual patients who have not serious concomitant diseases and cardiovascular complications in order to improve their quality of life., Conclusion: HRQOL assessment is important tool for planning and evaluating the effectiveness of anemia drug therapy among patients with CKD on hemodialysis.

Objective: The aim of the study is determination of the effectiveness of technologies for predicting the progressive course of dental caries in pregnant women., Material and Metods: We examined 511 pregnant women aged 18-40 years with dental caries (304 were included in a main group, 207 were enrolled in controls), who were assessed the DMFT index sequentially in the 1st, 2nd and 3rd trimesters of pregnancy. The prognosis of recurrence of dental caries was determined by the method of two-stage clinical and laboratory prognosis., Results: The prevalence of dental caries in the main group was 89.1% (271 out of 304 patients), in the control group - 87.9% (182 out of 207 patients). In the third trimester of pregnancy 36.2% of women in the main group had a recurrence of caries (vs 43.0% in the control group). Early examination of patients in the 1st trimester of pregnancy, followed by monitoring of the state of the organs and tissues of the mouth, made it possible to achieve timely treatment of dental caries and prevent its recurrence. In the third trimester of pregnancy, the DMFT-index in the dispensary group, in contrast to the control group, was statistically significantly ( p <0.05) lower by 12.3%, which indicated the effective use of the proposed monitoring., Conclusion: The use of a system for providing dental treatment and preventive care in the form of screening, dynamic forecasting and assessment of the risk of recurrence of caries in pregnant women with dental caries and a high risk of its progression makes it possible to stop the development of this process and ensure the preservation of dental health.

The personality of N. A. Semashko presents incontestable interest as health care official and ideologist of the Soviet health care system who contributed significantly into development of health care. Great number of studies are devoted to analysis of activities of N. A. Semashko in the Soviet period holding position of the First People's Commissar of health care of the RSFSR, initiator and head of the chair of Social hygiene of the Medical Faculty of the First Moscow State University. The studies related to pre-revolutionary period of life of N. A. Semashko are presented in less degree. The article describes, on the basis of publications and archive sources (documents from the Central State Archive of the Samara Oblast, the foundations of the Russian State Library and also the family archive of E. G. Farobina, grand-daughter of N. A. Semashko) the period of life and and activity of N. A. Semashko in the Samara Gubernia after graduating the medical faculty of the Imperial Kazan University. In 1901-1902, after short training in bacteriological laboratory of the Samara Gubernia Zemstvo Hospital and appointment to the post of sanitary and epidemiological doctor of the Zemstvo, N. A. Semashko was directly involved in elimination of epidemics of diphtheria in Orlov Guy village and of anthrax in Alexandria village of the Novouzensky Uezd. The dangerous epidemics were eliminated owing to outstanding medical knowledge, courage and organizational skills of young doctor.

Background: The expansion of the Baby-Friendly Hospital Initiative to neonatal wards, known as the Neo-BFHI, provides recommendations to support breastfeeding, as outlined in the Three Guiding Principles, the expanded Ten Steps, and the International Code for Marketing of Breast-Milk Substitutes. In 2017, Russia participated in an international survey about compliance with the Neo-BFHI., Research Aim: To assess breastfeeding support policies and practices in Russian neonatal wards at the country and federal district level in accordance with the Neo-BFHI recommendations., Methods: This study was a prospective cross-sectional survey. We used the Neo-BFHI Self-Assessment questionnaire to collect data from neonatal wards that had all levels of care. A total of N = 60 Russian neonatal wards in hospitals that have ever been designated Baby-Friendly or planned to do so participated in the survey., Results: Compliance scores at the federal district and country level ranging from 0-100 were used to summarize results. The median country overall score was 90 ( IQR = 83 - 93). Respect for mothers, continuity of care, having a breastfeeding policy, and rooming-in had the highest median scores. Family-centered care, antenatal informing, skin-to-skin contact, and human milk use had the lowest median scores. Neonatal wards in the hospitals that were ever designated as Baby-Friendly had significantly higher scores than those that were never designated. Most respondents ( n = 48, 80%) expressed a desire to obtain Neo-BFHI designation in their neonatal wards., Conclusion: Neo-BFHI recommendations can be successfully implemented in Russian neonatal wards at hospitals designated Baby-Friendly or planning to be designated.

Nowadays, the breast-feeding, despite the approved advantages, is not a standard in many communities. The multi-factorial determinants determining its prevalence need to be supported at various levels - from legal and legislative one to views and values of society, conditions of women's labor and also health care system that can develop a favorable environment for breast-feeding. The breast-feeding effects positively on health, economic development and ecology and therefor it is a benefit for children, women and whole society in short-term and long-term perspective. The defense, propaganda and support of breast-feeding need a political will, and financial investments to implement its advantages.

Objective: The objective was to evaluate implementation of the WHO/UNICEF "Ten Steps to Successful Breastfeeding" as defined by the Baby-Friendly Hospital Initiative in eight maternity hospitals in the Moscow region. Four maternity hospitals had been certified Baby- Friendly Hospitals (BFHs), the experimental group; and four maternity hospitals Not-as-Yet Baby Friendly, the control group (NBFHs)., Methods: Maternal interviews and infant breastfeeding rates were the primary outcomes of the study. In total, 741 healthy postpartum women from the experimental and control group were interviewed: 383 and 358, respectively. Interviews were conducted over 5 months, from May to July 2004. In addition, an assessment of levels and trends in breastfeeding for the period of 1998 to 2003 was made for the area served by the BFHs and the NBFHs., Findings: Analyses of the questionnaires completed by the mothers found a positive effect of BFH practice on a number of parameters, such as an increased rate of in-hospital exclusive breastfeeding, mothers' decisions concerning planned duration of breastfeeding, mothers' and babies' health, and maternal knowledge about the necessary measures in BFHs. Mothers appreciated baby-friendly changes, such as rooming-in, breastfeeding on baby's demand, and taking care of their babies by themselves. The successful initiation of breastfeeding in the BFHs was shown to favor the promotion of breastfeeding among 1-year-old babies in the experimental areas. However, there were some shortcomings in the BFHs: frequent use of labor anesthesia; insufficient placing of newborns on the mother's abdomen, rooming-in, and initiating breastfeeding immediately; and a short length of "skin-to-skin" contact (<30 minutes). The women in BFHs also observed the use of feeding bottles and dummies, and experienced some problems with breast health., Conclusions: BFH practices can increase breastfeeding rates as well as maternal satisfaction. However, shortcomings in the training and support for mothers, and limited help of the medical personnel were noted. It is recommended that BFHs pay attention to maintaining adherence to the criteria of the 10 steps of the Baby-Friendly Hospital Initiative. Since 2003 to control the implementation of the Baby Friendly Initiative principles and sustain the progress in the hospitals designated as Baby Friendly reassessment of maternity hospitals is held in Russia in conformity with the requirements of WHO and UNICEF.