Vol 22, No 3 (2015)

Realization and introduction of social economic and medical measures, which are aimed at protection and promotion of health of indigenous and small-numbered peoples of North-Eastern Russia do not provide efficient conditions for improvement of health quality. Demographic processes, increased morbidity and changes in its structure require a different approach to establishment of a system of monitoring and development of medical social infrastructure for northern ethnic groups. Development and organization of medical measures should be realized in association with specific characteristics of gene- and phenotype-caused mechanisms of adaptation, that have been formed during many thousands of years in indigenous and small-numbered peoples.

A comparative study of metabolic and hormonal changes in the indigenous population of the Republic of Tyva (continental Siberia), males and females aged 19-21 years, during spring and autumn periods of the annual cycle, has shown some differences in the annual cycle of metabolic parameters compared to those of the high latitudes residents. There has been found a seasonal pattern of the need of metabolic processes' transition to the type of protein-fat metabolism in autumn and winter. Effectiveness of processes of activation of a protein-lipid exchange in autumn is closely connected with an increased stress response, characterized by amplification of stress hormone cortisol production and increased mental and emotional stress.

Pneumonia is one of the main contributors to infant mortality in Kazakhstan. In 2010, Kazakhstan became the first former Soviet republic introduced pneumococcal vaccine into the national immunization scheme. Mangistau region was one of the two first regions where the vaccination became routine from 1 December 2010 using a WHO certified PCV-13 vaccine. The aims of this study were: 1) to assess the number of hospitalizations of children aged 0-5 years for pneumonia in the region before and after introduction of vaccination programme; 2) to compare duration of hospital stay of children with pneumonia before and after introduction of vaccination programme and 3) to compare time between the first visit to medical services and hospitalization of children with pneumonia before and after introduction of vaccination programme. Data to answer these three research questions were analyzed using multivariable negative binomial regression, multiple linear regression and multivariable logistic regression, respectively. All coefficients and odds ratios (OR) are presented with 95 % confidence intervals (CI). We observed a significant reduction of the number of cases of pneumonia by 22 (95 % CI: 6-38) % in 2011 and by 33 (95 % CI: 16-49) % in 2012 compared to 2009. No changes in the duration of hospital stay (β = 0.28; 95 % CI: -0.06; 0.64) or the number of days (0-6 vs. 7 days or more) between the first contact with the healthcare system (OR = 1.0; 95 % ДИ: 0.8-1.2) and hospitalization were found. Our results suggest that the introduction of vaccination against pneumococcal infection contributed to the overall reduction of the number of cases of pneumonia among children aged 0-5 years in Mangistau region, Kazakhstan.

The Peptic Ulcer (PU) social epidemic comprises one tenth of adult population of the globe. The PU polygenic nature required development of the synergetic bio-psycho-socio-spiritual conception that allowed to specify three prenosological fractals: predisposition - ulcerogenic family, latent - ulcerogenic diathesis, initial - a preulcerous state, and three nosological fractals: a full-scale clinical picture, chronization and an outcome. There have been proposed criteria of a social PU epidemic, a destructive social epidemic and a pandemy. The multidisciplinary program of preventive-correctional and medical-rehabilitation aid has been grounded.

The number of therapeutic beds amounted to 20.3 % of the total bed capacity of the hospital base in the time of its maximal load. In the structure of general internal diseases, the lung and pleura diseases prevailed - 39.3 %, as well as metabolic diseases (nutritional dystrophy and hypovitaminosis) - 24.7 %, the cardiovascular system diseases - 9.2 %. The percentage of tuberculosis patients over 90% (among the lung and pleura diseases) seems to be overestimated because of the diagnostic limitations in the wartime. Drug provision of the Therapeutic Service was poor, that was the reason of treatment prolongation. 46.5 % of officers and soldiers recovered and stepped back to service, 21.9 % were recognized as disabled persons. The hospital mortality was 2.94 %.