Vol 67, No 4 (2023)

Introduction. The morbidity is one of the key indicators used to assess the level of public health and demonstrating the level of accessibility of medical care to the population and the effectiveness of primary health care.

The aim was to analyze the trend in the morbidity of the population in the Russian Federation, considering factors affecting the availability of general medical services, in the context of the subjects of the Russian Federation.

Material and methods. The study based on information from the federal static observation form No. 12 “Information on the number of diseases registered in patients living in the service area of a medical organization” for 2018–2021.

Results. In the Russian Federation from 2018 to 2021, general morbidity increased by 2.6%, while newly identified morbidity increased by 9.4%. The Ivanovo region had the largest rate of rise in general morbidity (24.9%), Stavropol Krai — the highest newly identified morbidity (34.7%). When assessing the influence of various factors on the level of morbidity using the method of stable regression, the level of provision of the population with doctors was revealed to have the greatest influence, which is confirmed by the presence of a strong direct dependence.

Limitations. The data from the federal static observation form No. 12 “Information on the number of diseases registered in patients living in the service area of a medical mamnagement” for 2018–2021 for 85 subjects of the Russian Federation were examined to determine the morbidity of the population of the Russian Federation that is able-bodied and over the working age.

Conclusion. The morbidity rate in the Russian Federation during the period under review tends to increase. It is an integral indicator of the availability of medical care and the detection of diseases, which influenced by a variety of factors, including the availability of primary care doctors, the strength of the medical managemorganization, the degree of hospitalization, the average number of visits to doctors.

Compliance with ethical standards: the study does not require the submission of the conclusion of the biomedical ethics committee or other documents.

Contribution of the authors:
Chigrina V.P. — collection and processing of material, writing the text, compilation of the list of literature, responsible for the integrity of all parts of the manuscript;
Khodakova O.V. – research concept and design, editing of the article;
Tyufilin D.S. — research concept and design, editing of the article, approval of the manuscript final version;
Artamonov G.A. — processing of material;
Medvedev V.A. — processing of material;
Kobyakova O.S. — editing of the article, approval of the manuscript final version;
Deev I.A. — editing of the article, approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

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

Received: December 30, 2022
Accepted: April 12, 2023
Published: August 30, 2023 

Modern management literature describes various approaches to measuring the effectiveness of managing organizational structures. As a result, many interpretations and definitions of efficiency, methods and measures for their measurement have appeared.

Objective. This article is a description of the experience of Brazilian scientists from the Federal University of Santa Catarina (UFSC) in developing a technology for evaluating the performance of hospitals in Brazil.

Material and methods. There were applied DEA (Data Envelopment Analysis) method, multi-stage quantitative and qualitative analysis, which can be useful in Russia.

Results. The result of the study was the development of specific positive scenarios for the enhancement of the managing structures of the hospitals participating in the study. The work is practice-oriented, in terms of quantitative indicators being clearly ranked. Russian colleagues participated in the study at the stage of discussion of the results. The conclusions reached by the working group of Brazilian and Russian researchers are also significant for Russian medical institutions.

Research limitation. The materials are limited to the results of scientific research of the Federal University of Santa Catarina, Brazil, and represent a sufficient reference sample obtained in 2017–2019.

Conclusion. The use of DEA is an effective instrument to reflect the operational efficiency of medical institutions. Based on the results of performance evaluations, hospital managers can monitor their actions, as well as compare their own management system with other participants in the healthcare market. As a powerful management tool, DEA allows evaluating and comparing the managing units in a medical institution, transforming the information into a single index, being used as a measure of relative global performance.

Compliance with ethical standards. Sources of information are reliable, relevant and do not have ethical and socio-cultural prohibitions. The outcomes of the study was approved by the program of the academic university UFSC and complies with the ethical standards of management training in Brazil.

Contribution:
Azevedo B.M. — research concept, design, conducting research, compilation of the list of literature, statistical data processing;
Stoian Ya.A. — discussing the results of the research, writing the text, editing;
Baturina L.I. — discussing the results of the research, writing the text, editing, organization of international cooperation, corresponding author;
Campos F.L.S. — collection and processing of material, statistical data.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

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

Received: October 29, 2022
Accepted: December 15, 2022
Published: August 30, 2023

Despite the active development of measures for the prevention and treatment of cardiovascular diseases (CVD), today the mortality rate remains high. In this regard, in recent decades, there has been a pronounced progress in the field of methods of treating patients with coronary heart disease (CHD). Undoubtedly, an important role is assigned to the improvement of methods of surgical myocardial revascularization. To reduce mortality rates it is necessary to work in various directions, including the improvement of surgical techniques, active work on the early detection of CVD. It is worth to aim at delivery a system of information support for the population on the issues of maintaining and promoting health, a healthy lifestyle, and effective drug treatment for CVD. It is actual to study factors that can influence on the course of the disease after surgery.

The search for materials was carried out by analyzing open sources of English and Russian reports in the electronic databases PubMed, MEDLINE, Scopus, eLibrary, CyberLeninka, Web of Science, RSCI. A review of the literature on works aimed at identifying the most significant predictors of poor long-term prognosis after coronary artery bypass grafting (CABG) is presented. The main predictors of an unfavourable long-term prognosis after surgical myocardial revascularization include age at the time of surgery over 60–65 years, diabetes mellitus (DM), chronic kidney disease (CKD), multivessel coronary atherosclerosis, multifocal atherosclerosis (MFA), reduced fraction ejection (EF) of the left ventricle (LV) (< 50%), index coronary bypass surgery for acute coronary syndrome (ACS), a history of acute cerebrovascular accident (ACV), and myocardial infarction (MI), LV plasty.

Contribution:
Serebryakova V.N. — research concept and design, writing the text;
Kuzmichkina M.A. — writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

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

Received: August 19, 2021
Accepted: January 20, 2022
Published: August 30, 2023 

Introduction. The work is devoted to evaluating the results of own studies on the possibility of using autostrains of lactobacilli isolated from wastewater and the intestinal biotope of patients, based on their antagonistic properties to prevent of nosocomial diarrhea associated with toxigenic Clostridioides difficile. There are presented results of studies on an animal model of antibiotic-associated diarrhea to determine the effectiveness of lactobacilli when eliminating toxigenic C. difficile.

Materials and methods. Studies were conducted on the antagonistic activity of clinical cultures of lactobacilli isolated from wastewater and intestinal biotope of patients against toxigenic strains of C. difficile isolated from patients with nosocomial diarrhea. Preclinical tests of the efficacy of the selected highly antagonistically active strain of Lactobacillus paracasei CTR079 in vivo were carried out in an animal model of C. difficile-associated infection in mice of the C57BL line.

Results. As a result of the studies, lactobacilli with high, medium, and without antagonistic activity were isolated. Antagonistically inactive strains were unable to inhibit the growth of C. difficile, unlike highly active strains. A strain of Lactobacillus paracasei CTR079 was selected to study the possibility of its use as a probiotic strain for the prevention and treatment of C. difficile associated infection in an in vivo experiment. Various changes in the intestinal epithelium as a result of the development of C. difficile-associated infection.

Limitations of the study. As part of the study, all isolated strains of lactobacilli were identified and stored for the study of biological, genetic properties, and production of bacteriocins.

Conclusion. As a result of the studies, the use of highly active strains of lactobacilli was established to be a promising direction for the prevention and treatment of nosocomial diarrhea, which will reduce the spread of C. difficile among patients and in the environment of medical institutions.

Compliance with ethical standards: conducting research on animals is approved by the local Ethical Committee on Bioethics of the Federal Scientific Center “All-Russian Research Institute of Experimental Veterinary named after K.I. Scriabin and Y.R. Kovalenko” of the Russian Academy of Sciences, the study was conducted in accordance with the European Convention for the Protection of Vertebrates Used for Experiments or Other Scientific Purposes (ETS N 123), Directive of the European Parliament and the Council of the European Union 2010/63/EC dated 22.09.2010 on the protection of animals used for scientific purposes (Protocol No. 2 of 16.07.2020).

Contribution of the authors:
Sukhina M.A. — research concept and design, data collection and processing, statistical processing, text writing, editing;
Yudin S.M. — editing;
Zagaynova A.V. — research concept and design, statistical processing.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgment. The study was carried out as part of the research work of the state task «Study of the prevalence, pathogenicity factors and mechanisms of antibacterial resistance of Clostridioides difficile» State Registration N АААА-А21-121012100073-8, «The effectiveness of the use of lactobacteria bacteriocins to combat multiresistant microorganisms associated with inflammatory diseases of the colon» State registration number АААА-А18-118122900073-2; state task No. 388-00099-23-02 within the framework of the implementation of applied research work on the topic: “Creation of a method for the treatment of antibiotic-associated diarrhea using autotransplantation of microaerophilic and obligate anaerobic bacteria of the large intestine” (code: “Autotransplantation”) and state contract «Development of unified methods, including sampling, for the determination of microbiological and parasitological pollution of wastewater» (code «Wastewater») N. 145.001.21.6 dated 12.11.2021.

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

Received: August 28, 2022
Accepted: January 19, 2023
Published: August 30, 2023   

Relevance. Widespread among adolescents bullying usually shows as traditional bullying (TB) and cyberbullying (CB). The public health relevance of bullying is that it can lead to emotional distress, social maladjustment and suicidal behavior.

Aim. To analyze the prevalence of traditional bullying and cyberbullying among adolescents, to assess the social roles of participants and methods of intimidation with regard to gender differences.

Materials and methods. Data collection was carried out in 2015–2017 within EACMHS. With the continuous method there were examined six hundred ninety two students of secondary schools in Krasnoyarsk (364 girls) aged 11–17 years (average age is 14.6 ± 1.3). A questionnaire including two sets of questions related to bullying and cyberbullying developed by the EACMHS was used.

Results. The TB prevalence is 28.7% (26.5% — boys, 30.8% — girls), the СB prevalence is 25.7% (33.5% — boys, 18.9% — girls). TB and CB can occur both independently and in combination, increasing the prevalence of bullying as a whole up to 43.1% (where only TB — 17.2%, only CB — 14.3%, both types — 11.6 %). Boys are more likely to be the aggressors. The most common methods of bullying are name calling (17.5% for TB, 15.3% for CB). Girls are more often bullied because of their appearance (19.5%), boys are more often by dangers (14.3%) and threats (13.4%).

Limitations. Adolescents living in one city were examined. One source of information was used.

Conclusions. The high involvement of adolescents in bullying requires the development of preventive measures.

Compliance with ethical standards. Approval for the study was received from the Ethics Committee of the Research Institute of Physiology and Fundamental Medicine (Minutes of the meeting No. 3 of 03/25/2015). The study was conducted by the method of anonymous questioning. After answering the questions, each teenager independently sealed their questionnaire in their own envelope. Subsequently, the experimenter sealed all the envelopes received in each class in one common envelope.

Gratitude. The author thanks Professor Andre Sourander for kindly providing the questionnaire, as well as colleagues who took part in the collection of material and the formation of the statistical base — L.V. Lapteva, T.O. Rippinen, and T.V. Osipova.

Acknowledgment. The work was carried out within the framework of the State Budget Project “Somatic and psychological aspects of the adaptation of children and adolescents in Central Siberia in the context of the widespread use of new computer technologies, the intensification of the educational process and the socio-cultural transformation of indigenous ethnic groups” (No. EGISU 121022600087-7).

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

Received: December 02, 2021
Accepted: January 20, 2022
Published: August 30, 2023 

The problems of introducing mandatory vaccination against various infections exist both in foreign countries and in Russia. The World is searching for optimal legal incentives for the activity of the population in the immunoprophylaxis of diseases to ensure public health and infectious safety of the population.

The purpose of the study. To assess the implementation of mechanisms for the introduction of mandatory vaccination in foreign countries and Russia, to identify problems and ways to solve them.

Materials and methods. Normative legal acts, scientific literature, court decisions. The study used dialectical and logical methods, which created the basis for a comprehensive study of the optimal mechanisms of vaccination. There was applied the system-structural method allowed investigating the problem of non-vaccination in its relationship with the constitutional guarantee of public health protection in the Russian Federation, the comparative legal method that allowed analyzing regulations in different countries of the world.

Results. There are analyzed modern legal mechanisms of mandatory vaccination in foreign countries and in Russia. The existing threats of non-vaccination for public health are identified. The main forms of legal responsibility for non-compliance with vaccination requirements by Russian citizens are established.

Limitations. The implementation of the vaccination process in the Russian Federation is carried out on the basis of federal legislation, which ensures the legality, unity of the requirements of its management throughout the country and reliability of the study.

Conclusion. The preservation of public health is a constitutional duty of public authorities, therefore, in the conditions of epidemics and pandemics. It is possible to establish mandatory vaccination and restrictions on the rights of citizens, which must be justified and temporary.

Compliance with ethical standards. The study does not require the submission of the conclusion of the Biomedical ethics committee or other documents.

Contribution of the authors:
Basova A.V. — concept and design, writing of the article, design, approval of the final version of the article;
Komkova G.N. — concept and design, writing of the article, editing, approval of the final version of the article.

Acknowledgment. The study had no sponsorship.

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

Received: January 20, 2022
Accepted: February 17, 2022
Published: August 30, 2023

Introduction. The process of population aging, characterized by a gain in the group of people of older working age in the age structure, has begun in Russia, and in the developed countries. The demographic policy of the state is aimed at creating a favourable age and gender structure of the population with the aim of systematic socio-economic development of the regions.

The purpose of the study is to give a comprehensive assessment of the trend in demographic aging of the population of the northern and equated territories of the Irkutsk region over 2011–2019.

Materials and methods. The selection of territories is based on the Decree of the Government of the Russian Federation of November 16, 2021 N 1946 “On approval of the list of regions of the Far North and areas equated to regions of the Far North”. Information on the absolute size of the total population, population by gender and individual age groups was obtained from the Rosstat service for the Irkutsk region. In accordance with the methodological provisions on demographic statistics, special aging coefficients were studied in the formed statistical population using the Statistica 6.0 MS Excel 2017 software packages.

Results. In the northern and equated territories of the Irkutsk region, population aging processes are taking place. The intensity of the aging process in the regions in time proceeds differently. There is a disproportion in the age-gender structure due to the feminization of aging, which leads to deformation of the age-gender pyramid. In most regions, the depth of aging is decreasing, the number of people surviving to the age group of 75–89 years is becoming smaller. There is a twofold gain in the pension burden coefficient, its trend in the regions is similar to the Irkutsk region in general, with the exception of Bratsky, Nizhneilimsky, Ust-Kutsky industrial areas.

Research limitations. The method used is applicable in the study of the trend in the population aging rate in certain territories.

Conclusion. The formation of a steady growth trend of indicators characterizing the processes of population aging in the territories determines the need to develop programs to improve demographic policy in the subject of the Federation.

Compliance with ethical standards. The study does not require the submission of the opinion of the biomedical ethics committee or other documents.

Contribution of the authors:
Gaidarov G.M. — concept and design of the study;
Alekseevskaya T.I. — concept and design of the study, editing, writing the text;
Sofronov O.Yu. — statistical processing, writing the text;
Kindrat D.O. — collection and processing of material, statistical processing, compilation of a list of references.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgment. The study had no sponsorship.

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

Received: July 07, 2022
Accepted: October 18, 2022
Published: August 30, 2023 

Many factors contributed to the improvement of the quality and safety of medical services, including the development of medical instruments and methods of their treatment and disinfection. This article summarizes a brief history of instruments for medical manipulation and the development of methods of their processing over the world and Russia.

The purpose of the study is to review and generalize the development of surgical instruments used for medical manipulations, including autopsy, their treatment, and disinfection. A comprehensive literature search was conducted for references on the topic of the article and subsequent analysis of publications. Systematic search of scientific papers was carried out using several search engines: PubMed, RSCI, Google Scholar, CyberLeninka.

The progress of forensic medical examination is largely related to the result of the development of medical instruments, methods, and modes of their processing. Surgical instruments existed at the dawn of mankind, and their evolution corresponds to the degree of development of medical science and practice. The use of disinfectants for the treatment of medical instruments dates back hundreds of years. Disinfection of sectional instruments is of paramount importance to ensure infection safety. We have accumulated some experience in using disinfectants. Success depends solely on the use of effective methods and disinfection, in recent years, the treatment and disinfection of instruments has been supplemented with modern methods. Prospects for further improvement of the results of forensic medical examination are necessarily associated with the development of tools for medical manipulation and their processing.

Contribution:
Timerzyanov M.I. — concept and design of the study;
Vasiliev D.E. — collection and processing of the material, writing the text, compiling the list of references;
Milushkina O.Yu. — editing.
All authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The work was carried out within the framework of the strategic academic leadership program of Kazan Federal University (Priority — 2030) of the Educational and Research Laboratory “New professional competencies in health saving” of the Institute of Fundamental Medicine and Biology of Kazan Federal University.

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

Received: December 28, 2022
Accepted: March 16, 2023
Published: August 30, 2023 

Мигмар Александрович Пинигин — признанный авторитет в области токсикологии и санитарной охраны атмосферного воздуха, профессор, доктор медицинских наук, заслуженный деятель науки Российской Федерации.

15 августа 2023 года на 84-м году ушёл из жизни Крятов Игорь Александрович, кандидат медицинских наук, посвятивший жизнь развитию гигиенической науки.