Vol 65, No 3 (2021)

Introduction. In the context of the growing epidemic of the new coronavirus infection COVID-19, the Russian health system, for the first time in recent history, faced the need for large-scale mobilization and conversion of many existing hospitals into infectious diseases hospitals. At the same time, the composition of hospitalized patients has not been studied, and the availability of data on it is crucial for the organization and planning of medical care.

Purpose of study. To study the composition of hospitalized patients with a new coronavirus infection COVID-19 from the point of view of their age, gender, the severity of the condition, the presence of pneumonia and concomitant diseases to optimize the planning and objectification of the assessment of the need for medical care in a hospital setting.

Material and methods. The data was studied, and the analysis of hospitalizations of 1037 patients in the country’s largest repurposed infectious hospital for the treatment of patients with the new coronavirus infection COVID-19 was carried out.

Results. For the first time analyzed the main regularities of the formation of hospitalized patients, which characterize features of the disease and have a high prognostic value both from the point of view of organization of specialized medical care in stationary conditions and assess the need for diagnostic and diagnostic and treatment activities and their resource provision. It is established that adult patients of almost all age groups receive medical care in a hospital setting, but as the age increases, the need for hospitalization tends to increase. 

Conclusions. The severity of hospitalized patients with COVID-19 is determined by their age and the presence of concomitant pathology, which is of important prognostic value from the point of view of optimal planning of this type of medical care.

Contribution of the authors:

Kitsul I.S. — writing the text, editing;

Vechorko V.I. — research concept and design, writing the text, editing;

Kats D.V. — collection and processing of material, statistical data processing;

Sychev D.A. — research concept and design, editing;

Approval of the final version of the article, responsibility for the integrity of all parts of the article — all co-authors.

Acknowledgments. The study had no sponsorship. 

Conflict of interest. The authors declare no conflict of interest.

The mortality rate and life expectancy are the most important characteristics of public health, depending on the country’s socio-economic development, living conditions, and the quality of the living environment. At the state level, excess mortality at the working-age is recognized as an important reason for the low life expectancy of Russians. 

The objective of the study is to analyze the trend in the mortality rate and life expectancy of the employable age population of the Kemerovo region during 2011–2018. 

Material and methods. To estimate the mortality rate, the general and age-specific mortality rates, mortality rates by significant classes and individual causes of death were used. The life expectancy of the employable age population was calculated using temporary mortality tables based on age-specific mortality rates. A graphic analysis of the dynamics of age-specific mortality rates and the life expectancy in men and women of employable age in urban settlements, rural areas and the entire population of the Kemerovo region was carried out over five-year age intervals for 2011–2018. Statistical data obtained on the website of Rosstat.

Results. In 2018, in the Kemerovo region, the mortality rate of 40–44 year men in urban settlements, 35–44 years old in rural areas, and women 35–44 years old in urban settlements and rural areas exceeded the level of 2011, which negatively affected the dynamics of life expectancy. In rural areas, due to these age groups, the life expectancy in men decreased by 0.57, women – by 0.41 years. Losses in urban settlements were minor.

Conclusion. When developing regional socio-demographic programs, it is necessary to consider the identified features of mortality of the employable age population. An increase in life expectancy is impossible without overcoming the socio-economic crisis, improving health care financing, and increasing the availability and quality of medical care. A person should be interested in improving his health, saving his life. It is necessary to raise the level of culture, education, change the mentality. 

Contribution of the authors:

Baran O.I. — the concept and design of the study, the collection and processing of the material, statistical analysis, writing a text, editing;

Zhilina N.M. — the concept and design of the study, writing a text, editing;

Ryabov V.A. — the collection and processing of the material, writing a text.

All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgements. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Introduction. The organization of medical assistance for employees of remote industrial facilities is a highly pressing task, and the role of medical evacuation in the health care system can hardly be overestimated. There is currently no unified medical evacuation system. There is no data on the structure of the reasons for evacuations and economic justification for the required amount of funding for this area in Russia. 

Purpose. The assessment of the structure of the reasons for medical evacuations of the personnel from remote industrial facilities and their possible relationship to seasonality, the profile of the enterprises, and the age of workers.

Material and methods. Considering that men constitute most industrial facilities’ personnel, the analysis of 1,823 evacuations among male personnel (1,159 planned and 664 emergencies) was carried out. The structure of the reasons for evacuations was studied depending on the age, season, and industrial enterprise profile. The χ² Pearson criterion (significance level p <0.05) was used to assess the significance of differences between analyzed indices.

Results. In the structure of all evacuations of the personnel of remote industrial facilities, diseases of the circulatory system are the leading reason for evacuations, followed by injuries and poisoning, diseases of the digestive system and respiratory diseases. The main reason for emergency evacuations is injuries and poisoning. In the group of workers under 39 years old, injuries and poisoning, diseases of the digestive system and diseases of the circulatory system take the first three positions. In the more senior age groups, diseases of the circulatory system prevail, injuries and poisoning take second place, and digestive diseases take third place.

Conclusion. The main directions in improving the health care system and maintaining the health of the personnel of remote industrial facilities include the development of the legal framework for activities in the field of remote health care, the organization of the unified state system of medical evacuations, the development and the implementation of telemedicine technologies, the organization of educational courses and training programs for medical professionals in the field of remote health care.

Contribution of the authors:

Karpov A.B. — the concept and the design of the study, writing a text, editing; 

Antipov S.A. — the concept and the design of the study, editing;

Badmaeva E.R. — the collection and processing of the material, collecting and analyzing literature data, writing a text;

Skobelsky A.V. — the collection and processing of the material, editing;

Mazurov R.G. — the collection and processing of the material;

Shibalkov I.P. — the collection and processing of the material, statistical analysis.

All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgments. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest. 

The problem of inherited pathology remains relevant, gaining in recent decades and medical and biological and acute socio-economic importance. 

Purpose. To analyse statistical data on prevention and diagnosis of congenital malformations in Primorsky Krai. 

Material and methods. As a material of the study, the data of medical-genetic consultation and medical-genetic assistance were used. Information Federal State Statistics Service for the Primorsky Territory on the birth rate. The data were processed using descriptive statistics. 

Results. According to the study, during 2015–2017, within the framework of the budget 5561 (2015), 5537 (2016), and 5418 (2018), patients visited reception for the medical and genetic consultation and received the corresponding assistance. Most congenital malformation of compulsory registration was recorded in large urban districts (34.1–5.7%), and the remaining municipalities accounted for 0.2–3%. Diseases of the circulatory system, deformations of the musculoskeletal system, diseases of the urogenital system (frequency of occurrence 36.5%, 13.8%, 11.3%, respectively) dominated the structure of congenital malformations. The most common congenital malformations of mandatory registration identified during the prenatal screening – hypospadias and Down syndrome were identified. The most common congenital malformations identified during mass neonatal screening included hypothyroidism, phenylketonuria, cystic fibrosis. 

Conclusion. Possible reasons for the high level of congenital malformations in some areas of Primorsky Krai are lack of public awareness of the problem, environmental conditions, distance from the regional medical and genetic centre, lack of qualified specialists and modern equipment for research in municipal hospitals. However, proper medical and genetic counselling, prenatal diagnosis and monitoring play a critical role in the prevention of congenital malformations.

Contribution of the authors:

Astrakhantseva M.A. — data collection and statistical processing, work with literature, writing а text, responsibility for the integrity of all parts of the article;

Kiku P.F. — the concept and design of the study, writing а text, approval of the final version of the article, responsibility for the integrity of all parts of the article;

Voronin S.V. — the concept and design of the study, writing а text, editing;

Sukhova A.V. — work with literature, editing.

Acknowledgments. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest. 

Introduction. Breast cancer (BC) is one of the most common malignancies within female incidence and mortality patterns in the RF. 

Study objective. To analyze BC incidence in females exposed to occupational ionizing radiation over prolonged periods. 

Materials and methods. The study cohort included 5689 females who had been occupationally exposed to ionizing radiation throughout 1948–1982 and followed up until 31.12.2018. 

Results. BC was on the top of the list among females of the study cohort (11.9%). BC prevalence rate in the female cohort understudy was 28.3% as of 31.12.2018. The standardized BrCa incidence rate was 0.88 ± 0.07 per 1000 person-years of the follow-up. The absolute BrCa case increase in the females was 1.29, with the rise of 232.48% by the end of the follow-up due to the rise in age categories of females and the elevating risk of the disease occurrence.

Discussion. The study cohort of females demonstrated standardized BrCa incidence rates consistent with the corresponding estimates for the general female population of the RF. Meanwhile, the observed rates were lower than those estimated for the female population of the Chelyabinsk region. The increasing trend of the standardized BC incidence rate by the end of the follow-up period (31.12.2018) was consistent with WHO statistics. The extended follow-up for an updated assessment of ionizing radiation effect on BC incidence is required to develop new cancer prevention strategies.

Conclusion. The study demonstrated that BC incidence rates in the study cohort varied by age and calendar period of the follow-up. The increasing trend of the standardized rates of BC incidence was observed by the end of the follow-up.

Contribution of the authors:

Rumyantseva A.V. — the concept and design of the study, the collection and processing of the material, writing a text, editing;

Azizova T.V. — the concept and design of the study, writing a text, editing;

Zubkova O.V. — collection and processing of the study data;

Bannikova M.V. — statistical analyses of the data.

All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgments. The reported study was performed under the government contract no. 11.307.19.2 as of 16.08.2019 with the Federal Medical Biological Agency «Assessment of the nuclear security provisions aimed to identify current and long-term radiological implications for health of citizens exposed to ionizing radiation» (code name «Provisions»).

Conflict of interest. The authors declare no conflict of interest. 

There has been an active discussion on estimating the need for public funding of the domestic health system. An analysis of international experience can be helpful to determine methodological approaches to estimate the market for government spending on the Russian health system.

Aim. To systemize and summarize approaches and methods used in international practice to estimate the need for health financing; to highlight the most important factors dictating the need for additional funding.

Material and methods. A systematic search with the developed protocol for publications, a comprehensive analysis and systematization of the obtained information. The protocol included databases of peer-reviewed publications, search terms, and search restrictions. The search for publications was carried out in the databases of Embase, Pubmed, Medline, Global Health, etc., on the websites of international organizations (World Health Organization (WHO), Organization for Economic Cooperation and Development (OECD), etc.). The search strategy included a combination of the terms “free text” and “Medical subject heading”, which refer to the definition of the need for health financing. The main limitations of the search were the language of publications (English and Russian) and the date of publication (not earlier than 2000).

Results. Of the two used in international practice approaches to estimate the need for health financing, a system based on the use of the current level of funding and its forecasting under several factors is used in developed countries. Forecasting health expenditures is one of the most effective tools to identify critical factors affecting needs for sector financing. Despite the variety of indicators and methods used, most studies agree that non-demographic factors, such as GDP growth and technology development, influence health spending growth to the greatest extent. Demographic factors per se, including population ageing, affect health spending growth to a lesser extent. 

Conclusion. Conducting scenario forecasts contributes to a better understanding of what can happen in the future if the government does not act. This also contributes to a more clear determining of the main spheres for government interventions in the health sector.

Acknowledgments.  The study was conducted within the framework of the Basic Research Program of the National Research University, Higher School of Economics. 

Conflict of interest. The author declares no conflict of interest. 

Introduction. Attempts to assess the prevalence of antibodies (seroprevalence) to the Epstein–Barr virus have been made several times. Still, a complete understanding of this issue has not been reached due to the small samples of the surveyed. The goal is to evaluate seroprevalence in different age groups in Europe and Asia using a systematic review and meta-analysis.

Material and methods. The search for publications was carried out on PubMed, Cochrane Reviews/CochraneLibrary, eLibrary, Cyberleninka, Researchgate from May 6 to 30, 2020. A total of 2,364 articles were found, 12 of which were included in the study. Seroprevalence to Epstein–Barr virus was determined in 67,561 individuals aged 0 to 80 years. The research results were distributed by age groups, continents (Europe and Asia), and their implementation (2000–2012 and 2013–2019) and subjected to meta-analysis.

Results. Minimal seroprevalence was detected among children under 1 and 1–2 years of age (53.3 and 50.9%). With increasing age, it grew, and people over 18 years of age were more than 90%. In 2013–2019, the index value (68.9%) was significantly higher than in 2000–2012 (89.6%). In Asian countries in 2000–2019, seroprevalence (86.7%) was considerably higher than in Europe (76.3%). The highest growth rate was observed in 7–14 years. In 2000-2012, the maximum growth rate of seroprevalence occurred in 15–17 years and 2013–2019 – 3–6 years. For all age groups, the growth rate was higher in Europe than in Asia and 2013–2019 compared to 2000–2012.

Conclusion. The meta-analysis revealed differences in seroprevalence depending on age and territory of residence and the growth of indices in the trend.

Contribution of the authors:

Solomay T.V. — concept and design of research, collection and processing of material, statistical processing, text writing;

Semenenko T.A. — concept and design of research, collection and processing of material, editing;

Blokh A.I. — collection and processing of material, statistical processing, text writing.

All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgements. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.