CONTENTS 2026_1
HYGIENE
Kiselev A.V., Meltzer A.V., Erastova N.V., Serebritskiy I.A.
Mazhaeva T.V., Gurvich V.B., Trifonova Yu.V., Chernova Yu.S., Dubenko S.E.
Savchenko O.A., Novikova I.I., Kulikova O.M.
Koroleva A.A., Yanushanets O.I., Baltrukova T.B.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
Yakimenko A.V., Lebedeva I.B., Troshkov I.A., Kan S.l., Grigorev E.V., Brusina E.B.
Shomina E.A., Guriev V.V., Pogorelov K.O., Yarygin N.V.
Khominets V.V., Le V.S., Fedorov R.A., Grankin A.S.
Petrov I.V., Patjashina M.A., Alekseev A.P., Cyplenkova R.R., Chestnova R.V., Al'muhametov A.A., Jusupova N.Z., Seksimushkina E.S.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
Krylov V.V.
Berezhnoy A.V., Repeshov S.M., Krassa E.A., Aleshko O.V.
Kirilkin G.E., Unguryanu T.N.
Kreneva Yu.A., Avdeeva M.V., Shastin A.S., Filatov V.N., Marinicheva G.N., Gogoleva M.N.
HYGIENE
PREDICTING THE PROBABILITY OF ODOR DETECTION IN HYGIENIC STUDIES OF ATMOSPHERIC AIR POLLUTION
A.V. Kiselev1, A.V. Meltser1, N.V. Erastova1, I.A. Serebritskiy2,3
1 Federal State Budgetary Educational Institution of Higher Education "I.I. Mechnikov Northwestern State Medical University" of the Ministry of Health of the Russian Federation, 41 Kirochnaya St., 191015, Saint Petersburg, Russia
2 committee for Nature Management, Environmental Protection and Environmental Safety of the Government of St. Petersburg, Russia, 191123, St. Petersburg, Tchaikovsky St., 20, lit.V.
3 St. Petersburg State University, Department of Geology, 7-9 Universitetskaya nab., Saint Petersburg, 199034, Russia
Abstract.
Introduction. The guarantee of sanitary and epidemiological well-being of the population plays a key role in the implementation of constitutional rights to health protection and a favorable environment, including atmospheric air, the quality of which should not create unacceptable health risks and cause negative olfactory reflex reactions in the population. The development of effective methods to control atmospheric air, including its odor pollution, is one of the urgent tasks that have not been fully solved to date. The method of determining the probability threshold of odor is the basis for odourometric studies of odorous substances. A correct hygienic assessment of the atmospheric air requires a correct determination of the averaging period for the exposure concentration.
Aim of the study is to develop and provide hygienic justification for an approach to assessing the probability of odor detection in case of atmospheric air pollution with odorous substances, taking into account the correct period of concentration averaging during olfactory (odorometric) studies.
Results and discussion. As the results of the study showed, the developed model of calculating (extrapolating) the maximum single concentration over a 15-second averaging period is more sensitive than the 20-minute averaging used in practice, and therefore it could be recommended for use in olfactory (odorometric) studies to obtain adequate information about the likelihood of public complaints related to atmospheric air pollution by smelling chemicals. In addition, a classification of the probability of detecting a non-specific and intrusive odor is proposed, which can be used to provide a basis for justifying management decisions that allow developing and hygienically justifying of urgent and promising air quality management measures in areas where sources of pollution with olfactory effects are located, in order to prevent negative olfactory-reflex reactions in the population.
Conclusion. In the hygienic assessment of atmospheric air pollution by odorous substances, in order to determine the probability of detecting the odor caused by them, it is recommended to recalculate the maximum single 20-minute concentration by a 15-second averaging. The proposed technique can be applied using the results of both field studies and calculations of the dispersion of harmful impurities in case of atmospheric pollution or the lack of a sufficient number of instrumental measurement samples.
Keywords: atmospheric air, probabilistic odor threshold, atmospheric air hygiene, atmospheric air pollution, atmospheric air quality control, odorometric studies, health risk assessment, social and hygienic monitoring, risk management, clean air, environmental monitoring.
APPROACHES TO DEVELOPING NUTRITION PLANS FOR INDUSTRIAL EMPLOYEES BASED ON PHENOTYPING AND NUTRIENT PROFILING
T.V. Mazhaeva 1,2., V.B. Gurvich 1, Yu.V. Trifonova 1,
Yu.S. Chernova 1, S.E. Dubenko 1
1 Federal Budgetary Institution of Science "Yekaterinburg Medical and Scientific Center for Prevention and Protection of Industrial Workers" of Rospotrebnadzor, Yekaterinburg, Russian Federation, 620014, Sverdlovsk Region, Yekaterinburg, Popova Street, Building 30
2 Federal State Budgetary Educational Institution of Higher Education "Ural State Medical University of the Ministry of Health of the Russian Federation", Yekaterinburg, Russian Federation, 620028, Sverdlovsk Region, Yekaterinburg, Repina Street, Building 3
Abstract
Introduction.The development of approaches that integrate the assessment of phenotypic traits and nutritional support based on group and individual needs is a relevant area of preventive medicine.
Study Objective: To develop and test a methodology for nutritional prevention for industrial workers based on phenotyping and nutrient profiling.
Materials and Methods: A cross-sectional study involved 81 workers at metallurgical enterprises in the Sverdlovsk region, employed in hazardous and dangerous working conditions. A method for nutritional prevention of industrial worker morbidity based on phenotyping was used (Patent No. 2851069, November 18, 2025). The method included eight key characteristics (working conditions, exposure to toxicants, nutritional quality index, anthropometric, biochemical, and nutritional markers); six phenotypes were identified. For each phenotype, group and individual nutrition programs were developed based on phenotyping and nutrient profiling principles.
Results: Using one phenotype as an example, the effectiveness of a preventive approach using nutritional support was demonstrated. In workers with phenotype 4 (lead exposure, overweight, dyslipidemia), the introduction of a personalized diet resulted in a significant reduction in BMI by an average of 4.8 kg/m² (p=0.049) and body weight by 5.5 kg, as well as an improvement in the lipid profile and a decrease in blood lead levels by an average of 10 times (p=0.000). Gut microbiota monitoring revealed positive dynamics: an increase in the proportion of workers with normal levels of Bifidobacterium spp. (3-fold), Eubacterium spp. (10-fold), and Propionibacterium freudenreichii (3-fold).
Conclusion: The proposed methodology, combining phenotyping and nutrient profiling, is an effective tool for developing targeted therapeutic and preventive nutrition programs. It not only corrects nutrition-related health problems but also enhances the body's adaptive capacity to industrial toxicants, thereby contributing to the prevention of occupational and general morbidity.
Keywords: personalized nutrition, industrial workers, harmful working conditions, phenotyping, nutrient profiling, therapeutic and prophylactic nutrition, intestinal microbiota, toxic metals.
ASSESSMENT OF THE CHRONIC EFFECT OF PHYSICAL AND CHEMICAL FACTORS OF THE INDUSTRIAL ENVIRONMENT AT A LEVEL OF 1.5 MAC/MEL ON THE BIOCHEMICAL PARAMETERS OF THE BLOOD OF LABORATORY RATS (EXTENDED STATISTICAL ANALYSIS OF THE RESULTS OF THE EXPERIMENTAL RESEARCH)
O.A. Savchenko, I.I. Novikova, O.M. Kulikova
Novosibirsk Research Institute of Hygiene, Russia, 630108, Novosibirsk, Parkhomenko street,7
Abstract
Introduction.The existing system of hygienic rationing, focused on the control of isolated factors, may not take into account the effects of their combined action, updating the study of the phenomenon of occupational aging.
Aim of the study was to conduct an extended statistical analysis of the dynamics of biochemical parameters in the blood of laboratory rats under chronic isolated, combined, and combined-action exposure to physical and chemical factors of the industrial environment at a level of 1.5 MAC/MEL.
Materials and methods.The 180-day experiment included 190 Wistar rats were used, divided into 6 groups (n=30): intact control; exposure to isolated general vibration, noise, a chemical mixture of hydrocarbons; combined exposure (vibration+noise); combined exposure (vibration+noise+toxic substances), and one additional group for background control. The exposure was administered for 0.5 hours per day, 5 days per week. The dynamics of changes in the biochemical parameters of rat blood (11 parameters) were evaluated on days 0, 60, 120, and 180. The nonparametric Kruskal–Wallis criterion with post-hoc analysis and the Wilcoxon criterion for intra-group dynamics were used. Effect size was assessed using Cohen’s d.
Results.The control group demonstrated the stability of most indicators and the expected age-related changes. Statistically significant differences from the control (p<0,001) were detected from day 60. The most pronounced effects in the groups of combined and concomitant exposure were hypercholesterolemia (up to +61%), hyperbilirubinemia (up to +131%), increased creatinine (up to +66%), and a persistent decrease in ALT activity (up to -37%). For isolated chemical exposure, the increase in alkaline phosphatase (+48%) was specific. Effect size analysis confirmed synergism: for creatinine on day 180, d = 5,50-5,57 versus 1,08-3,48 for isolated effects.
Conclusion.Chronic 180-day exposure to physicochemical factors of the industrial environment at a level of 1,5 MAC/MEL causes specific changes in the biochemical blood profile of laboratory rats, which are statistically significantly different from the natural age-related dynamics. The most pronounced effects were observed in the combined (vibration + noise) and combined (vibration + noise + toxic substances) exposures groups: hypercholesterolemia up to +61%, hyperbilirubinemia up to +131%, increased creatinine up to +66%, decreased ALT activity by −37%. Analysis of effect size (Cohen's d up to 5,57) and calculation of the synergy index (SI=1,6) confirmed the synergistic nature of the interaction between factors. The obtained data indicate the development of pre-nosological disorders of lipid and pigment metabolism, as well as liver and kidney functions under combined exposures, confirm the necessity to take into account the synergism of factors in hygienic regulation, and justify the advisability of transitioning to a risk-oriented model for assessing occupational exposure.
Key words: physicochemical factors, synergy, laboratory rats, biochemical blood parameters, statistical analysis, phenomenon of occupationally induced aging
HYGIENIC ASSESSMENT OF VARIOUS FORMS OF MULTIMEDIA CONTENT IN THE EDUCATIONAL PROCESS: BARRIERS AND WAYS OF OPTIMIZATION
A.A. Koroleva, O.I. Yanushanets, T.B. Baltrukova
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya Street, 41
Abstract
Introduction. The intensive digitalization of education emphasizes the problem of hygienic safety of multimedia content widely used in the educational process. There is a contradiction between its didactic potential and the insufficient study of the impact of specific characteristics of various forms of content on students’ health.
Aim of the study was to carry out a comprehensive hygienic and socio-pedagogical assessment of various forms of multimedia content for high school students and identify barriers preventing the creation of a health-saving environment when using it.
Materials and methods. The study included a hygienic examination of more than 1,500 pieces of content (presentations, interactive exercises, online platform materials, tests) according to developed scoring protocols and a survey of 400 teachers to identify professional difficulties when using multimedia content in the educational process.
Results. The examination revealed systemic hygiene violations in all types of content intended for use in various types of educational activities. The most critical violations of the principles of hygienic rationality were found in the basic parameters of visual design: color (up to 80%) and font (up to 70%) design. The survey of teachers revealed that the main barriers to the use of hygienically rational content are lack of time, lack of available hygienically rational resources and lack of methodological support.
Conclusion. The data obtained indicate a deep gap between sanitary requirements and the real digital educational environment. Systematic measures are needed for optimization: the creation of a database of verified resources, the development of specialized hygiene recommendations for various types of educational activities, and the integration of digital ergonomics principles into teacher training programs.
Keywords: high school students, multimedia educational content, hygiene assessment, type of educational activity, visual design, digital educational platform, health care.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
HEALTHCARE -ASSOCIATED INFECTIONS IN INTENSIVE CARE UNITS: RESULTS OF AN EPIDEMIOLOGICAL
REGIONAL MULTICENTER
A. V. Yakimenko1, I. B. Lebedeva1, I. A. Troshkov ², S L. Kan1, E.V. Grigorev1,3, E. B. Brusina1
1 Kemerovo State Medical University, Russia, 650056, Saint-Petersburg, Vorshilov Street, 22a
2 KuzbassRegionalClinicalHospitalnamedafterS.V.Belyaev, Russia, 650056, Kemerovo,Oktyabrsky Avenue, 22
3 Research Institute of Complex Problems of Cardiovascular Diseases, Russia, 650002, Kemerovo, L.S. Barbarash Boulevard, 6
Abstract
Introduction. Healthcare-associated infections (HAIs) remain an urgent problem worldwide. The inclusion of periodic prevalence studies in HAIs monitoring programs allow to assess changes in incidence and improve diagnostic efficiency.
Aim of the study was to assess the activity of the HAIs epidemic process during the provision of medical care in intensive care units.
Materials and methods. A four-stage (2024-2025) one-day regional multicenter epidemiological study of HAIs in intensive care units (ICUs) was conducted. Forty-six ICUs from 30 medical organizations in the region (681 patients) involved in the study.
Results. The prevalence of the moment of HAIs in the ICU is 21.73%. The he incidence rate of ventilator-associated pneumonia was 25.44 per 1,000 days of mechanical ventilation, catheter-associated bloodstream infections ‒ 2.65 per 1,000 days of central vein catheterization, and catheter-associated urinary tract infections − 17.06 per 1,000 days of bladder catheterization.The probability of developing HAIs in the intensive care unit increases in patients with impaired consciousness by 5.23 times, with overweight - 3.95 times, with hemotransfusion - 3.83 times, with a nasogastric tube - 3.63 times, over 45 years old - 3.02 times, who underwent surgery - 2.48 times, with multiple organ failure syndrome - 2.16 times, receiving parenteral nutrition - 2.12 times, having drainage systems - 1.92 times. Klebsiella pneumoniae was identified as the predominant pathogen causing HAIs, with an isolation rate of 35.04 per 100 samples. Extensively drug resistance was demonstrated by 60.98% of strains isolated from patients with HAI.
Conclusion. The epidemiological process of healthcare-associated infections (HAIs) in intensive care units (ICUs) is characterized by high intensity and activity of manifestations, which is comparable to the indicators observed in ICUs across the Russian Federation.
Keywords: healthcare-associated infections, intensive care units, prevalence, incidence density, risk of developing HAIs.
MODERN VIEW ON THE PATHOGENESIS OF OSTEOARTHRITIS OF LARGE JOINTS OF THE LOWER EXTREMITIES
E.A. Shomina, V.V. Guriev, K.O. Pogorelov, N.V. Yarygin
Russian University of Medicine, Russia, 127006, Moscow, Dolgorukovskaya Street, 4
Abstract
Introduction. According to the Global Burden of Disease 2020 Study, the number of patients worldwide diagnosed with OA ranged from 550-600 million,indicating a more than twofold increase compared to the situation thirty years ago Due to forecasts, by 2050 this will be 1 billion cases: the most pronounced increase is expected in terms of damage to large joints: knee (by 74.9%), hip (by 78.6%), as well as other joints (up to 95.1%). The prevalence of the disease demonstrates a steady upward trend due to the aging of the population and the global epidemic of obesity, which together forms a significant social burden and poses a serious medical and social problem.
Aim of the study was to systematize contemporary understanding of the pathogenesis of osteoarthritis in large joints of lower extremities.
Materials and Methods. An analytical review and thematic classification of 77 scientific publications (2000-2024) was conducted, including large-scale epidemiological studies, genome-wide association studies (GWAS), experimental model-based research, and clinical observations.
Results. Analysis of 73 scientific publications (2000–2024) demonstrates that OA development is the result of a dynamic violation of the homeostasis of the entire bone and cartilage complex. A key role is played by the interaction of genetic predisposition that creates a vulnerable joint phenotype, chronic mechanical stress, and systemic metabolic imbalance (obesity). It is established that the basis of the pathological process is the persistent activation of innate immunity, triggered by danger-associated molecular patterns (DAMPs) and leading to chronic synovitis and alternative forms of chondrocyte death (pyroptosis, ferroptosis).
Conclusion. This literature review descibes the specific features of the pathogenesis of osteoarthritis in large joints of lower extremities. Existing reviews and published studies are analyzed. The article presents conclusions and generalizations derived from the conducted theoretical research.
Keywords: osteoarthritis, pathogenesis, pathophysiology, clinical manifestations, risk factors, chondrocytes, cytokines, central sensitization, synovial lymphatic system, pyroptosis.
AUTOGRAFT SELECTION IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION. WHAT IS CURRENTLY IN TRENDS?
V.V. Khominets, V.S. Le, R.A. Fedorov, A.S. Grankin
S.M. Kirov Military Medical Academy, Russia, 194044, Saint-Petersburg, Akademika Lebedeva Street, 6
Abstract
Anterior cruciate ligament reconstruction (ACL) is one of the most common orthopedic procedures in knee arthroscopy. Over the past decade, there was a significant progress in studying the anatomy and biomechanics of the knee joint, graft characteristics, resulted in refinement of surgical techniques. One of the factors influencing clinical outcomes is the choice of graft. Autografts are currently preferred particularly in young, active patients, military personnel, and athletes. However, the use of autologous tissues competes with the functional needs of patients, which becomes the goal of scientific discussions.
Keywords: anterior cruciate ligament reconstruction; revision ACL reconstruction; autograft; bone-patellar tendon-bone; hamstring tendon; quadriceps tendon; peroneus longus tendon.
ASSESSMENT OF INCIDENCE OF MYCOBACTERIAL DISEASES IN THE TATARSTAN REPUBLIC
I.V. Petrov1,2, M.A. Patjashina1,3, A.P. Alekseev4, R.R. Cyplenkova1,4, R.V. Chestnova4, A.A. Al'muhametov1,5, N.Z. Jusupova1, E.S. Seksimushkina4
1Kazan State Medical Academy - branch of the Federal State Budgetary Educational Institution of Continuing Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Health of the Russian Federation, Russia, 420012, Republic of Tatarstan, Kazan, Mushtari St., 11
2Mari State University of the Ministry of Education and Science of the Russian Federation, Russia, 424000, Republic of Mari El, Yoshkar-Ola, Lenin Square, 1
3Office of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in the Republic of Tatarstan, Russia, 420111, Kazan, Bolshaya Krasnaya St., 30
4Republican Clinical Anti-Tuberculosis Dispensary of the Ministry of Health of the Republic of Tatarstan, Russia, Kazan, Pobedy Avenue, 69B
5Kazan State Medical University of the Ministry of Health of the Russian Federation, Russia, 420012, Republic of Tatarstan, Kazan, Butlerova St., 49
Abstract
Mycobacteriosis is a group of infectious diseases caused by non-tuberculous mycobacteria and characterized by the formation of granulomatous inflammation in the affected organs and tissues.
The aim is to assess the incidence of mycobacteriosis of the lungs in the Republic of Tatarstan for 2018-2024.
Materials and methods. The data of the Republican Clinical Tuberculosis Dispensary of the Republic of Tatarstan were used. The study uses methods of retrospective epidemiological analysis. The statistical analysis was performed using the StatTech v. 4.8.11 software (developed by Stattech LLC, Russia).
Results. During the studied period, the incidence of MD in the general population increased 2.4 times (2018 – 0.18; 2024 – 0.42 per 100,000 population). The predominance of women (58.3%, 95% CI 48.5 – 67.7; n = 63) and urban residents (77.8%, 95% CI 68.8 – 85.2; n = 84) was revealed in the gender structure. Among both urban and rural residents, there was a 2.5-fold increase in morbidity (2018– 0.17; 2024– 0.42 per 100,000 of the corresponding population) and 2–fold (2018: 0.22; 2024: 0.43 per 100,000 of the corresponding population), respectively. In the group of men and women, the growth rate was also 2.5 (2018: 0.17; 2024: 0.43 per 100,000 of the corresponding population) and 2.2 (2018: 0.19; 2024: 0.42 per 100,000 of the corresponding population) times, respectively. The analysis of patients with MD revealed the predominance of the age groups 60-69 (n = 28; 25.9%, 95% CI 18.0 – 35.2) and 70-79 years (n = 27; 25.0%, 95% CI 17.2 – 34.3).
Conclusion. The data obtained allowed us to identify the characteristics of mycobacteriosis at the regional level, which can contribute to understanding the epidemiology of this disease.
Keywords: mycobacteriosis, non-tuberculous mycobacteria, morbidity, epidemiological analysis
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
ANALYSIS OF THE NEED FOR CARDIAC SURGERY IN THE POPULATION OF THE MOSCOW REGION
V.V. Krylov
State Budgetary Institution of Healthcare of the Moscow Region "Moscow Regional Research Clinical Institute named after M.F. Vladimirsky", Russia, 129110, Moscow, Shchepkina St., 61/2
Abstract
Introduction. Against the backdrop of the increasing prevalence of cardiovascular diseases and the development of modern cardiac surgery, the issue of calculating the current population need for high-tech cardiac surgery and forecasting this need is becoming increasingly important for the Moscow Region.
Study Objective: To analyze the need for high-tech cardiac surgery in the Moscow Region and forecast this need to 2030, analyze existing challenges in organizing the provision of high-tech cardiac surgery in the region, and develop a strategy aimed at ensuring the necessary accessibility of cardiac surgery for this category of patients.
Materials and Methods: A multi-stage study, including an analysis of statistical indicators for the Moscow Region for the period from 2015 to 2024 and forecasting the values of the studied indicators to 2030; Identifying a list of conditions requiring cardiac surgery, calculating the required volumes of high-tech cardiac surgery for the study period based on this list and official statistics, comparing the obtained values with actual volumes of cardiac surgery provided, and forecasting the required volumes through 2030; analyzing existing organizational problems in the system of high-tech cardiac surgery for the adult population of the Moscow Region and developing a regional healthcare development strategy to mitigate the identified problems.
Results. Based on a comprehensive analysis of the obtained data, the need for changes is substantiated and critical factors are identified. Addressing these factors will effectively increase the availability of high-tech cardiac surgery for the adult population of the Moscow Region.
Conclusion. The proposed strategy for ensuring the necessary accessibility of high-tech cardiac surgery for the adult population of the Moscow Region will significantly improve treatment outcomes for patients with cardiovascular pathology and preserve the population's labor force, which will ultimately contribute to improving the region's economic potential.
Key words: cardiac surgery, cardiac surgery service, cardiovascular diseases, Moscow region, high-tech medical care, organization of medical care
EVALUATION OF THE EFFECTIVENESS OF A CORPORATE HEALTH PROMOTION PROGRAM USING THE CASE STUDY OF A CITY POLYCLINIC
A.V. Berezhnoy1, S.M. Repeshov1,2, E.A. Krassa3, O.V. Aleshko4
1 City Center for Public Health and Medical Prevention, Russia, 191023, Saint Petersburg, Italianskaya Street, 25
2 North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg,Kirochnaya Street,41
3 City Psychiatric Hospital No. 6, Burnout Prevention Center,Russia,191167, Saint Petersburg, Obvodny Canal Embankment, 9A
4 City Polyclinic No. 76, Russia, 194021, Saint-Petersburg, Khlopina Street, 11
Abstract
Introduction. Based on a survey that identified the prevalence of key risk factors for chronic non-communicable diseases development, the staff of City Polyclinic No. 76 designed and approved a staff health improvement program in September 2024. The program's activities implemented throughout the year and were aimed at reducing the psychoemotional stress of the staff.
Aim of the study was to assess the dynamics of changes in the prevalence of risk factors for the development of chronic non-communicable diseases under the influence of the health promotion program among the staff of City Polyclinic No. 76.
Materials and Methods. Based on a repeated sociological survey, the overall dynamics of the Program indicators were statistically assessed.
Results. Statistically significant positive dynamics were identified in the stress level among the staff, demonstrating the effectiveness of the applied methods and measures. Statistically significant positive results were also observed for adherence to antihypertensive therapy, smoking cessation intentions, and some other indicators.
Conclusion. The implementation of the corporate health promotion program had a positive effect on the prevalence of risk factors for chronic non-communicable diseases among the staff of
City Polyclinic No. 76.
Keywords: corporate programs, employee health promotion, workplace health, risk factors, chronic non-communicable diseases (CNCDs), public health.
MORBIDITY OF CONGENITAL MAXILLOFACIAL MALFORMATIONS AMONG CHILDREN IN ARKHANGELSK REGION CITIES
G.E. Kirilkin, T.N. Unguryanu
Northern State Medical University , Russia, 163000, North-Western Federal District, Arkhangelsk region, Arkhangelsk, Troitskiy avenue, 51.
Abstract
Introduction. Congenital malformations of the maxillofacial region (CMMR) represent a significant medical and social problem adversely affecting the quality of life of patients. Morbidity rates of CMMR vary significantly in regions with different levels of anthropogenic environmental pollution and socio-economic factors.
Consequently, at is of particular importance to study the regional characteristics of the primary incidence of CMMR in children.
Aim of the study was to perform a retrospective epidemiological analysis of primary morbidity due to congenital anomalies of the maxillofacial region among children residing in the cities of the Arkhangelsk Region.
Materials and Methods. A retrospective epidemiological analysis was conducted to assess the primary morbidity of congenital maxillofacial anomalies in urban areas of the Arkhangelsk Region between 2014 and 2023. The study relied on primary diagnostic data extracted from the registry of the Arkhangelsk Region Medical Insurance Fund. It was calculated key epidemiological parameters, including morbidity rates, nosological structure, long-term temporal dynamics, and the age of initial diagnosis of CCMR.
Results. The highest primary morbidity rate of CMMR in children aged 0-17 years was recorded in Severodvinsk (1.19 per 1000 children). In Koryazhma and Novodvinsk, the average long-term morbidity rate of CMMR was 0.49 per 1000 population. In Severodvinsk, the long-term dynamics were accompanied by a pronounced increasing trend (growth rate [GR] = 7.3%, R2 = 0.95). A moderate increasing trend in morbidity was observed in Arkhangelsk (GR=25.7%, R2=0.86), Koryazhma (GR=55.9%, R2=0.80), and Kotlas (GR=30.9%, R2=0.56). A decrease in the primary morbidity of CMMR was observed in Novodvinsk (decrease rate=-16.6%, R2=0.89). The Q38 code group (other congenital malformations of the tongue, mouth, and pharynx) predominates in the structure of nosological entities (40–85%).
Conclusion. Congenital malformations are an important medical and social problem in the Arkhangelsk Region. The highest primary morbidity rate was recorded in Severodvinsk, with a predominance of the Q38 code group. Further research will help identify the leading risk factors for the development of this pathology in the Arctic zone of the Russian Federation.
Key words: congenital malformations, maxillofacial region, primary morbidity, Arkhangelsk region, congenital cleft, ankyloglossia, Arctic zone of the Russian Federation
MUSCULOSKELETAL AND DEFORMING DORSOPATHIES MORBIDITY TRENDS AMONG WORKING-AGE ADULTS IN RUSSIA, NORTHWESTERN FEDERAL DISTRICT AND SAINT PETERSBURG
Yu.A. Kreneva 1, M.V. Avdeeva1,2, A.S. Shastin 3, V.N. Filatov1, G.N. Marinicheva1, M.N. Gogoleva1
1North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia, 191015, Kirochnaya street, 41
2Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia, 194100,Saint- Petersburg, Litovskaya street, 2.
3EkaterinburgMedicalResearchCenterforPreventionandHealthPromotionofIndustrialWorkers, Russia, 620014,Ekaterenburg, Popov street, 30
Abstract
Introduction. The increasing incidence of musculoskeletal system and connective tissue pathologies is creating a vicious cycle of social challenges: the exponential growth in the need for expensive high-tech treatments is compounded by the need to expand social support programs against a rapid decline in the quality of life for patients. The economic burden of musculoskeletal system diseases is influenced by two main cost groups: direct medical costs (diagnosis, long-term therapy, rehabilitation) and indirect losses associated with funding disability programs and social transfers. Analysis of disease dynamics serves as the foundation for strategic planning in healthcare: it allows not only to predict the economic burden and optimize patient management, but also to determine the direction of preventive measures for at-risk groups.
Aim of the study was to identify and characterize the main trends in the incidence of diseases of the musculoskeletal system and connective tissue in the working-age population at the regional and federal levels.
Materials and methods. This study was based on official statistical data from Russian Research Institute of Health for 2011–2023. These data were used to calculate the incidence rates (overall and primary) of musculoskeletal system and connective tissue diseases, including deforming dorsopathies, for three administrative-territorial units: the Russian Federation as a whole, the North-Western Federal District, and Saint-Petersburg, in the working-age population group. Regression analysis was used to develop predictive models and identify trends in the incidence of musculoskeletal system and connective tissue diseases (including deforming dorsopathies), assessing the quality of the approximation of the resulting models using the determination coefficient (R²).
Results. Saint-Petersburg demonstrated the highest overall incidence growth rate among the compared territories: in 2011-2023, the rate increased by 26.19%, 1.5 times higher than in the North-Western Federal District (+17.53%) and 3.5 times higher than the national average rate (+7.37%). Notably, that against the background of a national trend toward a decline in primary incidence (-7.61%) and a similar dynamics in the North-Western Federal District (-5.88%), Saint-Petersburg demonstrated a reversal trend: here, the rate increased by 11.63%, reaching 2,310.9 cases per 100,000 working-age population. The revealed heterogeneity of the epidemiological situation is most strikingly evident in Saint-Petersburg, where, along with the steady growth of all analyzed indicators, the dynamics of deforming dorsopathies require special attention: their increase in the city significantly outpaces the values for both the North-Western Federal District and the Russian Federation as a whole.
Discussion. The conducted analysis revealed significant regional differences in the dynamics of morbidity with diseases of the musculoskeletal system and connective tissue, as well as deforming dorsopathies among the working-age population. The most alarming trends are observed in Saint-Petersburg, where a significant increase in both general and primary morbidity was noted during 2011–2023. The significant increase in the rates of primary and general morbidity with deforming dorsopathies, which significantly exceed the average Russian values and rates in the North-Western Federal District is of a particular concern.
Conclusion. The study's results provide an analytical basis for strategic decision-making by federal and regional health authorities: from prioritizing musculoskeletal system disease prevention to the development and implementation of targeted programs aimed at maintaining public health.
Keywords: musculoskeletal and connective tissue diseases, incidence of musculoskeletal and connective tissue diseases, deforming dorsopathies, osteochondrosis, degenerative spinal diseases
CONTENTS 2026_1
HYGIENE
Kiselev A.V., Meltzer A.V., Erastova N.V., Serebritskiy I.A.
Mazhaeva T.V., Gurvich V.B., Trifonova Yu.V., Chernova Yu.S., Dubenko S.E.
Savchenko O.A., Novikova I.I., Kulikova O.M.
Koroleva A.A., Yanushanets O.I., Baltrukova T.B.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
Yakimenko A.V., Lebedeva I.B., Troshkov I.A., Kan S.l., Grigorev E.V., Brusina E.B.
Shomina E.A., Guriev V.V., Pogorelov K.O., Yarygin N.V.
Khominets V.V., Le V.S., Fedorov R.A., Grankin A.S.
Petrov I.V., Patjashina M.A., Alekseev A.P., Cyplenkova R.R., Chestnova R.V., Al'muhametov A.A., Jusupova N.Z., Seksimushkina E.S.
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
Krylov V.V.
Berezhnoy A.V., Repeshov S.M., Krassa E.A., Aleshko O.V.
Kirilkin G.E., Unguryanu T.N.
Kreneva Yu.A., Avdeeva M.V., Shastin A.S., Filatov V.N., Marinicheva G.N., Gogoleva M.N.
HYGIENE
PREDICTING THE PROBABILITY OF ODOR DETECTION IN HYGIENIC STUDIES OF ATMOSPHERIC AIR POLLUTION
A.V. Kiselev1, A.V. Meltser1, N.V. Erastova1, I.A. Serebritskiy2,3
1 Federal State Budgetary Educational Institution of Higher Education "I.I. Mechnikov Northwestern State Medical University" of the Ministry of Health of the Russian Federation, 41 Kirochnaya St., 191015, Saint Petersburg, Russia
2 committee for Nature Management, Environmental Protection and Environmental Safety of the Government of St. Petersburg, Russia, 191123, St. Petersburg, Tchaikovsky St., 20, lit.V.
3 St. Petersburg State University, Department of Geology, 7-9 Universitetskaya nab., Saint Petersburg, 199034, Russia
Abstract.
Introduction. The guarantee of sanitary and epidemiological well-being of the population plays a key role in the implementation of constitutional rights to health protection and a favorable environment, including atmospheric air, the quality of which should not create unacceptable health risks and cause negative olfactory reflex reactions in the population. The development of effective methods to control atmospheric air, including its odor pollution, is one of the urgent tasks that have not been fully solved to date. The method of determining the probability threshold of odor is the basis for odourometric studies of odorous substances. A correct hygienic assessment of the atmospheric air requires a correct determination of the averaging period for the exposure concentration.
Aim of the study is to develop and provide hygienic justification for an approach to assessing the probability of odor detection in case of atmospheric air pollution with odorous substances, taking into account the correct period of concentration averaging during olfactory (odorometric) studies.
Results and discussion. As the results of the study showed, the developed model of calculating (extrapolating) the maximum single concentration over a 15-second averaging period is more sensitive than the 20-minute averaging used in practice, and therefore it could be recommended for use in olfactory (odorometric) studies to obtain adequate information about the likelihood of public complaints related to atmospheric air pollution by smelling chemicals. In addition, a classification of the probability of detecting a non-specific and intrusive odor is proposed, which can be used to provide a basis for justifying management decisions that allow developing and hygienically justifying of urgent and promising air quality management measures in areas where sources of pollution with olfactory effects are located, in order to prevent negative olfactory-reflex reactions in the population.
Conclusion. In the hygienic assessment of atmospheric air pollution by odorous substances, in order to determine the probability of detecting the odor caused by them, it is recommended to recalculate the maximum single 20-minute concentration by a 15-second averaging. The proposed technique can be applied using the results of both field studies and calculations of the dispersion of harmful impurities in case of atmospheric pollution or the lack of a sufficient number of instrumental measurement samples.
Keywords: atmospheric air, probabilistic odor threshold, atmospheric air hygiene, atmospheric air pollution, atmospheric air quality control, odorometric studies, health risk assessment, social and hygienic monitoring, risk management, clean air, environmental monitoring.
APPROACHES TO DEVELOPING NUTRITION PLANS FOR INDUSTRIAL EMPLOYEES BASED ON PHENOTYPING AND NUTRIENT PROFILING
T.V. Mazhaeva 1,2., V.B. Gurvich 1, Yu.V. Trifonova 1,
Yu.S. Chernova 1, S.E. Dubenko 1
1 Federal Budgetary Institution of Science "Yekaterinburg Medical and Scientific Center for Prevention and Protection of Industrial Workers" of Rospotrebnadzor, Yekaterinburg, Russian Federation, 620014, Sverdlovsk Region, Yekaterinburg, Popova Street, Building 30
2 Federal State Budgetary Educational Institution of Higher Education "Ural State Medical University of the Ministry of Health of the Russian Federation", Yekaterinburg, Russian Federation, 620028, Sverdlovsk Region, Yekaterinburg, Repina Street, Building 3
Abstract
Introduction.The development of approaches that integrate the assessment of phenotypic traits and nutritional support based on group and individual needs is a relevant area of preventive medicine.
Study Objective: To develop and test a methodology for nutritional prevention for industrial workers based on phenotyping and nutrient profiling.
Materials and Methods: A cross-sectional study involved 81 workers at metallurgical enterprises in the Sverdlovsk region, employed in hazardous and dangerous working conditions. A method for nutritional prevention of industrial worker morbidity based on phenotyping was used (Patent No. 2851069, November 18, 2025). The method included eight key characteristics (working conditions, exposure to toxicants, nutritional quality index, anthropometric, biochemical, and nutritional markers); six phenotypes were identified. For each phenotype, group and individual nutrition programs were developed based on phenotyping and nutrient profiling principles.
Results: Using one phenotype as an example, the effectiveness of a preventive approach using nutritional support was demonstrated. In workers with phenotype 4 (lead exposure, overweight, dyslipidemia), the introduction of a personalized diet resulted in a significant reduction in BMI by an average of 4.8 kg/m² (p=0.049) and body weight by 5.5 kg, as well as an improvement in the lipid profile and a decrease in blood lead levels by an average of 10 times (p=0.000). Gut microbiota monitoring revealed positive dynamics: an increase in the proportion of workers with normal levels of Bifidobacterium spp. (3-fold), Eubacterium spp. (10-fold), and Propionibacterium freudenreichii (3-fold).
Conclusion: The proposed methodology, combining phenotyping and nutrient profiling, is an effective tool for developing targeted therapeutic and preventive nutrition programs. It not only corrects nutrition-related health problems but also enhances the body's adaptive capacity to industrial toxicants, thereby contributing to the prevention of occupational and general morbidity.
Keywords: personalized nutrition, industrial workers, harmful working conditions, phenotyping, nutrient profiling, therapeutic and prophylactic nutrition, intestinal microbiota, toxic metals.
ASSESSMENT OF THE CHRONIC EFFECT OF PHYSICAL AND CHEMICAL FACTORS OF THE INDUSTRIAL ENVIRONMENT AT A LEVEL OF 1.5 MAC/MEL ON THE BIOCHEMICAL PARAMETERS OF THE BLOOD OF LABORATORY RATS (EXTENDED STATISTICAL ANALYSIS OF THE RESULTS OF THE EXPERIMENTAL RESEARCH)
O.A. Savchenko, I.I. Novikova, O.M. Kulikova
Novosibirsk Research Institute of Hygiene, Russia, 630108, Novosibirsk, Parkhomenko street,7
Abstract
Introduction.The existing system of hygienic rationing, focused on the control of isolated factors, may not take into account the effects of their combined action, updating the study of the phenomenon of occupational aging.
Aim of the study was to conduct an extended statistical analysis of the dynamics of biochemical parameters in the blood of laboratory rats under chronic isolated, combined, and combined-action exposure to physical and chemical factors of the industrial environment at a level of 1.5 MAC/MEL.
Materials and methods.The 180-day experiment included 190 Wistar rats were used, divided into 6 groups (n=30): intact control; exposure to isolated general vibration, noise, a chemical mixture of hydrocarbons; combined exposure (vibration+noise); combined exposure (vibration+noise+toxic substances), and one additional group for background control. The exposure was administered for 0.5 hours per day, 5 days per week. The dynamics of changes in the biochemical parameters of rat blood (11 parameters) were evaluated on days 0, 60, 120, and 180. The nonparametric Kruskal–Wallis criterion with post-hoc analysis and the Wilcoxon criterion for intra-group dynamics were used. Effect size was assessed using Cohen’s d.
Results.The control group demonstrated the stability of most indicators and the expected age-related changes. Statistically significant differences from the control (p<0,001) were detected from day 60. The most pronounced effects in the groups of combined and concomitant exposure were hypercholesterolemia (up to +61%), hyperbilirubinemia (up to +131%), increased creatinine (up to +66%), and a persistent decrease in ALT activity (up to -37%). For isolated chemical exposure, the increase in alkaline phosphatase (+48%) was specific. Effect size analysis confirmed synergism: for creatinine on day 180, d = 5,50-5,57 versus 1,08-3,48 for isolated effects.
Conclusion.Chronic 180-day exposure to physicochemical factors of the industrial environment at a level of 1,5 MAC/MEL causes specific changes in the biochemical blood profile of laboratory rats, which are statistically significantly different from the natural age-related dynamics. The most pronounced effects were observed in the combined (vibration + noise) and combined (vibration + noise + toxic substances) exposures groups: hypercholesterolemia up to +61%, hyperbilirubinemia up to +131%, increased creatinine up to +66%, decreased ALT activity by −37%. Analysis of effect size (Cohen's d up to 5,57) and calculation of the synergy index (SI=1,6) confirmed the synergistic nature of the interaction between factors. The obtained data indicate the development of pre-nosological disorders of lipid and pigment metabolism, as well as liver and kidney functions under combined exposures, confirm the necessity to take into account the synergism of factors in hygienic regulation, and justify the advisability of transitioning to a risk-oriented model for assessing occupational exposure.
Key words: physicochemical factors, synergy, laboratory rats, biochemical blood parameters, statistical analysis, phenomenon of occupationally induced aging
HYGIENIC ASSESSMENT OF VARIOUS FORMS OF MULTIMEDIA CONTENT IN THE EDUCATIONAL PROCESS: BARRIERS AND WAYS OF OPTIMIZATION
A.A. Koroleva, O.I. Yanushanets, T.B. Baltrukova
North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint Petersburg, Kirochnaya Street, 41
Abstract
Introduction. The intensive digitalization of education emphasizes the problem of hygienic safety of multimedia content widely used in the educational process. There is a contradiction between its didactic potential and the insufficient study of the impact of specific characteristics of various forms of content on students’ health.
Aim of the study was to carry out a comprehensive hygienic and socio-pedagogical assessment of various forms of multimedia content for high school students and identify barriers preventing the creation of a health-saving environment when using it.
Materials and methods. The study included a hygienic examination of more than 1,500 pieces of content (presentations, interactive exercises, online platform materials, tests) according to developed scoring protocols and a survey of 400 teachers to identify professional difficulties when using multimedia content in the educational process.
Results. The examination revealed systemic hygiene violations in all types of content intended for use in various types of educational activities. The most critical violations of the principles of hygienic rationality were found in the basic parameters of visual design: color (up to 80%) and font (up to 70%) design. The survey of teachers revealed that the main barriers to the use of hygienically rational content are lack of time, lack of available hygienically rational resources and lack of methodological support.
Conclusion. The data obtained indicate a deep gap between sanitary requirements and the real digital educational environment. Systematic measures are needed for optimization: the creation of a database of verified resources, the development of specialized hygiene recommendations for various types of educational activities, and the integration of digital ergonomics principles into teacher training programs.
Keywords: high school students, multimedia educational content, hygiene assessment, type of educational activity, visual design, digital educational platform, health care.
DIAGNOSIS, TREATMENT, EPIDEMIOLOGY, PREVENTION OF DISEASES
HEALTHCARE -ASSOCIATED INFECTIONS IN INTENSIVE CARE UNITS: RESULTS OF AN EPIDEMIOLOGICAL
REGIONAL MULTICENTER
A. V. Yakimenko1, I. B. Lebedeva1, I. A. Troshkov ², S L. Kan1, E.V. Grigorev1,3, E. B. Brusina1
1 Kemerovo State Medical University, Russia, 650056, Saint-Petersburg, Vorshilov Street, 22a
2 KuzbassRegionalClinicalHospitalnamedafterS.V.Belyaev, Russia, 650056, Kemerovo,Oktyabrsky Avenue, 22
3 Research Institute of Complex Problems of Cardiovascular Diseases, Russia, 650002, Kemerovo, L.S. Barbarash Boulevard, 6
Abstract
Introduction. Healthcare-associated infections (HAIs) remain an urgent problem worldwide. The inclusion of periodic prevalence studies in HAIs monitoring programs allow to assess changes in incidence and improve diagnostic efficiency.
Aim of the study was to assess the activity of the HAIs epidemic process during the provision of medical care in intensive care units.
Materials and methods. A four-stage (2024-2025) one-day regional multicenter epidemiological study of HAIs in intensive care units (ICUs) was conducted. Forty-six ICUs from 30 medical organizations in the region (681 patients) involved in the study.
Results. The prevalence of the moment of HAIs in the ICU is 21.73%. The he incidence rate of ventilator-associated pneumonia was 25.44 per 1,000 days of mechanical ventilation, catheter-associated bloodstream infections ‒ 2.65 per 1,000 days of central vein catheterization, and catheter-associated urinary tract infections − 17.06 per 1,000 days of bladder catheterization.The probability of developing HAIs in the intensive care unit increases in patients with impaired consciousness by 5.23 times, with overweight - 3.95 times, with hemotransfusion - 3.83 times, with a nasogastric tube - 3.63 times, over 45 years old - 3.02 times, who underwent surgery - 2.48 times, with multiple organ failure syndrome - 2.16 times, receiving parenteral nutrition - 2.12 times, having drainage systems - 1.92 times. Klebsiella pneumoniae was identified as the predominant pathogen causing HAIs, with an isolation rate of 35.04 per 100 samples. Extensively drug resistance was demonstrated by 60.98% of strains isolated from patients with HAI.
Conclusion. The epidemiological process of healthcare-associated infections (HAIs) in intensive care units (ICUs) is characterized by high intensity and activity of manifestations, which is comparable to the indicators observed in ICUs across the Russian Federation.
Keywords: healthcare-associated infections, intensive care units, prevalence, incidence density, risk of developing HAIs.
MODERN VIEW ON THE PATHOGENESIS OF OSTEOARTHRITIS OF LARGE JOINTS OF THE LOWER EXTREMITIES
E.A. Shomina, V.V. Guriev, K.O. Pogorelov, N.V. Yarygin
Russian University of Medicine, Russia, 127006, Moscow, Dolgorukovskaya Street, 4
Abstract
Introduction. According to the Global Burden of Disease 2020 Study, the number of patients worldwide diagnosed with OA ranged from 550-600 million,indicating a more than twofold increase compared to the situation thirty years ago Due to forecasts, by 2050 this will be 1 billion cases: the most pronounced increase is expected in terms of damage to large joints: knee (by 74.9%), hip (by 78.6%), as well as other joints (up to 95.1%). The prevalence of the disease demonstrates a steady upward trend due to the aging of the population and the global epidemic of obesity, which together forms a significant social burden and poses a serious medical and social problem.
Aim of the study was to systematize contemporary understanding of the pathogenesis of osteoarthritis in large joints of lower extremities.
Materials and Methods. An analytical review and thematic classification of 77 scientific publications (2000-2024) was conducted, including large-scale epidemiological studies, genome-wide association studies (GWAS), experimental model-based research, and clinical observations.
Results. Analysis of 73 scientific publications (2000–2024) demonstrates that OA development is the result of a dynamic violation of the homeostasis of the entire bone and cartilage complex. A key role is played by the interaction of genetic predisposition that creates a vulnerable joint phenotype, chronic mechanical stress, and systemic metabolic imbalance (obesity). It is established that the basis of the pathological process is the persistent activation of innate immunity, triggered by danger-associated molecular patterns (DAMPs) and leading to chronic synovitis and alternative forms of chondrocyte death (pyroptosis, ferroptosis).
Conclusion. This literature review descibes the specific features of the pathogenesis of osteoarthritis in large joints of lower extremities. Existing reviews and published studies are analyzed. The article presents conclusions and generalizations derived from the conducted theoretical research.
Keywords: osteoarthritis, pathogenesis, pathophysiology, clinical manifestations, risk factors, chondrocytes, cytokines, central sensitization, synovial lymphatic system, pyroptosis.
AUTOGRAFT SELECTION IN ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION. WHAT IS CURRENTLY IN TRENDS?
V.V. Khominets, V.S. Le, R.A. Fedorov, A.S. Grankin
S.M. Kirov Military Medical Academy, Russia, 194044, Saint-Petersburg, Akademika Lebedeva Street, 6
Abstract
Anterior cruciate ligament reconstruction (ACL) is one of the most common orthopedic procedures in knee arthroscopy. Over the past decade, there was a significant progress in studying the anatomy and biomechanics of the knee joint, graft characteristics, resulted in refinement of surgical techniques. One of the factors influencing clinical outcomes is the choice of graft. Autografts are currently preferred particularly in young, active patients, military personnel, and athletes. However, the use of autologous tissues competes with the functional needs of patients, which becomes the goal of scientific discussions.
Keywords: anterior cruciate ligament reconstruction; revision ACL reconstruction; autograft; bone-patellar tendon-bone; hamstring tendon; quadriceps tendon; peroneus longus tendon.
ASSESSMENT OF INCIDENCE OF MYCOBACTERIAL DISEASES IN THE TATARSTAN REPUBLIC
I.V. Petrov1,2, M.A. Patjashina1,3, A.P. Alekseev4, R.R. Cyplenkova1,4, R.V. Chestnova4, A.A. Al'muhametov1,5, N.Z. Jusupova1, E.S. Seksimushkina4
1Kazan State Medical Academy - branch of the Federal State Budgetary Educational Institution of Continuing Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Health of the Russian Federation, Russia, 420012, Republic of Tatarstan, Kazan, Mushtari St., 11
2Mari State University of the Ministry of Education and Science of the Russian Federation, Russia, 424000, Republic of Mari El, Yoshkar-Ola, Lenin Square, 1
3Office of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing in the Republic of Tatarstan, Russia, 420111, Kazan, Bolshaya Krasnaya St., 30
4Republican Clinical Anti-Tuberculosis Dispensary of the Ministry of Health of the Republic of Tatarstan, Russia, Kazan, Pobedy Avenue, 69B
5Kazan State Medical University of the Ministry of Health of the Russian Federation, Russia, 420012, Republic of Tatarstan, Kazan, Butlerova St., 49
Abstract
Mycobacteriosis is a group of infectious diseases caused by non-tuberculous mycobacteria and characterized by the formation of granulomatous inflammation in the affected organs and tissues.
The aim is to assess the incidence of mycobacteriosis of the lungs in the Republic of Tatarstan for 2018-2024.
Materials and methods. The data of the Republican Clinical Tuberculosis Dispensary of the Republic of Tatarstan were used. The study uses methods of retrospective epidemiological analysis. The statistical analysis was performed using the StatTech v. 4.8.11 software (developed by Stattech LLC, Russia).
Results. During the studied period, the incidence of MD in the general population increased 2.4 times (2018 – 0.18; 2024 – 0.42 per 100,000 population). The predominance of women (58.3%, 95% CI 48.5 – 67.7; n = 63) and urban residents (77.8%, 95% CI 68.8 – 85.2; n = 84) was revealed in the gender structure. Among both urban and rural residents, there was a 2.5-fold increase in morbidity (2018– 0.17; 2024– 0.42 per 100,000 of the corresponding population) and 2–fold (2018: 0.22; 2024: 0.43 per 100,000 of the corresponding population), respectively. In the group of men and women, the growth rate was also 2.5 (2018: 0.17; 2024: 0.43 per 100,000 of the corresponding population) and 2.2 (2018: 0.19; 2024: 0.42 per 100,000 of the corresponding population) times, respectively. The analysis of patients with MD revealed the predominance of the age groups 60-69 (n = 28; 25.9%, 95% CI 18.0 – 35.2) and 70-79 years (n = 27; 25.0%, 95% CI 17.2 – 34.3).
Conclusion. The data obtained allowed us to identify the characteristics of mycobacteriosis at the regional level, which can contribute to understanding the epidemiology of this disease.
Keywords: mycobacteriosis, non-tuberculous mycobacteria, morbidity, epidemiological analysis
PUBLIC HEALTH, ORGANIZATION AND SOCIOLOGY OF HEALTH CARE
ANALYSIS OF THE NEED FOR CARDIAC SURGERY IN THE POPULATION OF THE MOSCOW REGION
V.V. Krylov
State Budgetary Institution of Healthcare of the Moscow Region "Moscow Regional Research Clinical Institute named after M.F. Vladimirsky", Russia, 129110, Moscow, Shchepkina St., 61/2
Abstract
Introduction. Against the backdrop of the increasing prevalence of cardiovascular diseases and the development of modern cardiac surgery, the issue of calculating the current population need for high-tech cardiac surgery and forecasting this need is becoming increasingly important for the Moscow Region.
Study Objective: To analyze the need for high-tech cardiac surgery in the Moscow Region and forecast this need to 2030, analyze existing challenges in organizing the provision of high-tech cardiac surgery in the region, and develop a strategy aimed at ensuring the necessary accessibility of cardiac surgery for this category of patients.
Materials and Methods: A multi-stage study, including an analysis of statistical indicators for the Moscow Region for the period from 2015 to 2024 and forecasting the values of the studied indicators to 2030; Identifying a list of conditions requiring cardiac surgery, calculating the required volumes of high-tech cardiac surgery for the study period based on this list and official statistics, comparing the obtained values with actual volumes of cardiac surgery provided, and forecasting the required volumes through 2030; analyzing existing organizational problems in the system of high-tech cardiac surgery for the adult population of the Moscow Region and developing a regional healthcare development strategy to mitigate the identified problems.
Results. Based on a comprehensive analysis of the obtained data, the need for changes is substantiated and critical factors are identified. Addressing these factors will effectively increase the availability of high-tech cardiac surgery for the adult population of the Moscow Region.
Conclusion. The proposed strategy for ensuring the necessary accessibility of high-tech cardiac surgery for the adult population of the Moscow Region will significantly improve treatment outcomes for patients with cardiovascular pathology and preserve the population's labor force, which will ultimately contribute to improving the region's economic potential.
Key words: cardiac surgery, cardiac surgery service, cardiovascular diseases, Moscow region, high-tech medical care, organization of medical care
EVALUATION OF THE EFFECTIVENESS OF A CORPORATE HEALTH PROMOTION PROGRAM USING THE CASE STUDY OF A CITY POLYCLINIC
A.V. Berezhnoy1, S.M. Repeshov1,2, E.A. Krassa3, O.V. Aleshko4
1 City Center for Public Health and Medical Prevention, Russia, 191023, Saint Petersburg, Italianskaya Street, 25
2 North-Western State Medical University named after I.I. Mechnikov, Russia, 191015, Saint-Petersburg,Kirochnaya Street,41
3 City Psychiatric Hospital No. 6, Burnout Prevention Center,Russia,191167, Saint Petersburg, Obvodny Canal Embankment, 9A
4 City Polyclinic No. 76, Russia, 194021, Saint-Petersburg, Khlopina Street, 11
Abstract
Introduction. Based on a survey that identified the prevalence of key risk factors for chronic non-communicable diseases development, the staff of City Polyclinic No. 76 designed and approved a staff health improvement program in September 2024. The program's activities implemented throughout the year and were aimed at reducing the psychoemotional stress of the staff.
Aim of the study was to assess the dynamics of changes in the prevalence of risk factors for the development of chronic non-communicable diseases under the influence of the health promotion program among the staff of City Polyclinic No. 76.
Materials and Methods. Based on a repeated sociological survey, the overall dynamics of the Program indicators were statistically assessed.
Results. Statistically significant positive dynamics were identified in the stress level among the staff, demonstrating the effectiveness of the applied methods and measures. Statistically significant positive results were also observed for adherence to antihypertensive therapy, smoking cessation intentions, and some other indicators.
Conclusion. The implementation of the corporate health promotion program had a positive effect on the prevalence of risk factors for chronic non-communicable diseases among the staff of
City Polyclinic No. 76.
Keywords: corporate programs, employee health promotion, workplace health, risk factors, chronic non-communicable diseases (CNCDs), public health.
MORBIDITY OF CONGENITAL MAXILLOFACIAL MALFORMATIONS AMONG CHILDREN IN ARKHANGELSK REGION CITIES
G.E. Kirilkin, T.N. Unguryanu
Northern State Medical University , Russia, 163000, North-Western Federal District, Arkhangelsk region, Arkhangelsk, Troitskiy avenue, 51.
Abstract
Introduction. Congenital malformations of the maxillofacial region (CMMR) represent a significant medical and social problem adversely affecting the quality of life of patients. Morbidity rates of CMMR vary significantly in regions with different levels of anthropogenic environmental pollution and socio-economic factors.
Consequently, at is of particular importance to study the regional characteristics of the primary incidence of CMMR in children.
Aim of the study was to perform a retrospective epidemiological analysis of primary morbidity due to congenital anomalies of the maxillofacial region among children residing in the cities of the Arkhangelsk Region.
Materials and Methods. A retrospective epidemiological analysis was conducted to assess the primary morbidity of congenital maxillofacial anomalies in urban areas of the Arkhangelsk Region between 2014 and 2023. The study relied on primary diagnostic data extracted from the registry of the Arkhangelsk Region Medical Insurance Fund. It was calculated key epidemiological parameters, including morbidity rates, nosological structure, long-term temporal dynamics, and the age of initial diagnosis of CCMR.
Results. The highest primary morbidity rate of CMMR in children aged 0-17 years was recorded in Severodvinsk (1.19 per 1000 children). In Koryazhma and Novodvinsk, the average long-term morbidity rate of CMMR was 0.49 per 1000 population. In Severodvinsk, the long-term dynamics were accompanied by a pronounced increasing trend (growth rate [GR] = 7.3%, R2 = 0.95). A moderate increasing trend in morbidity was observed in Arkhangelsk (GR=25.7%, R2=0.86), Koryazhma (GR=55.9%, R2=0.80), and Kotlas (GR=30.9%, R2=0.56). A decrease in the primary morbidity of CMMR was observed in Novodvinsk (decrease rate=-16.6%, R2=0.89). The Q38 code group (other congenital malformations of the tongue, mouth, and pharynx) predominates in the structure of nosological entities (40–85%).
Conclusion. Congenital malformations are an important medical and social problem in the Arkhangelsk Region. The highest primary morbidity rate was recorded in Severodvinsk, with a predominance of the Q38 code group. Further research will help identify the leading risk factors for the development of this pathology in the Arctic zone of the Russian Federation.
Key words: congenital malformations, maxillofacial region, primary morbidity, Arkhangelsk region, congenital cleft, ankyloglossia, Arctic zone of the Russian Federation
MUSCULOSKELETAL AND DEFORMING DORSOPATHIES MORBIDITY TRENDS AMONG WORKING-AGE ADULTS IN RUSSIA, NORTHWESTERN FEDERAL DISTRICT AND SAINT PETERSBURG
Yu.A. Kreneva 1, M.V. Avdeeva1,2, A.S. Shastin 3, V.N. Filatov1, G.N. Marinicheva1, M.N. Gogoleva1
1North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia, 191015, Kirochnaya street, 41
2Saint-Petersburg State Pediatric Medical University, Saint-Petersburg, Russia, 194100,Saint- Petersburg, Litovskaya street, 2.
3EkaterinburgMedicalResearchCenterforPreventionandHealthPromotionofIndustrialWorkers, Russia, 620014,Ekaterenburg, Popov street, 30
Abstract
Introduction. The increasing incidence of musculoskeletal system and connective tissue pathologies is creating a vicious cycle of social challenges: the exponential growth in the need for expensive high-tech treatments is compounded by the need to expand social support programs against a rapid decline in the quality of life for patients. The economic burden of musculoskeletal system diseases is influenced by two main cost groups: direct medical costs (diagnosis, long-term therapy, rehabilitation) and indirect losses associated with funding disability programs and social transfers. Analysis of disease dynamics serves as the foundation for strategic planning in healthcare: it allows not only to predict the economic burden and optimize patient management, but also to determine the direction of preventive measures for at-risk groups.
Aim of the study was to identify and characterize the main trends in the incidence of diseases of the musculoskeletal system and connective tissue in the working-age population at the regional and federal levels.
Materials and methods. This study was based on official statistical data from Russian Research Institute of Health for 2011–2023. These data were used to calculate the incidence rates (overall and primary) of musculoskeletal system and connective tissue diseases, including deforming dorsopathies, for three administrative-territorial units: the Russian Federation as a whole, the North-Western Federal District, and Saint-Petersburg, in the working-age population group. Regression analysis was used to develop predictive models and identify trends in the incidence of musculoskeletal system and connective tissue diseases (including deforming dorsopathies), assessing the quality of the approximation of the resulting models using the determination coefficient (R²).
Results. Saint-Petersburg demonstrated the highest overall incidence growth rate among the compared territories: in 2011-2023, the rate increased by 26.19%, 1.5 times higher than in the North-Western Federal District (+17.53%) and 3.5 times higher than the national average rate (+7.37%). Notably, that against the background of a national trend toward a decline in primary incidence (-7.61%) and a similar dynamics in the North-Western Federal District (-5.88%), Saint-Petersburg demonstrated a reversal trend: here, the rate increased by 11.63%, reaching 2,310.9 cases per 100,000 working-age population. The revealed heterogeneity of the epidemiological situation is most strikingly evident in Saint-Petersburg, where, along with the steady growth of all analyzed indicators, the dynamics of deforming dorsopathies require special attention: their increase in the city significantly outpaces the values for both the North-Western Federal District and the Russian Federation as a whole.
Discussion. The conducted analysis revealed significant regional differences in the dynamics of morbidity with diseases of the musculoskeletal system and connective tissue, as well as deforming dorsopathies among the working-age population. The most alarming trends are observed in Saint-Petersburg, where a significant increase in both general and primary morbidity was noted during 2011–2023. The significant increase in the rates of primary and general morbidity with deforming dorsopathies, which significantly exceed the average Russian values and rates in the North-Western Federal District is of a particular concern.
Conclusion. The study's results provide an analytical basis for strategic decision-making by federal and regional health authorities: from prioritizing musculoskeletal system disease prevention to the development and implementation of targeted programs aimed at maintaining public health.
Keywords: musculoskeletal and connective tissue diseases, incidence of musculoskeletal and connective tissue diseases, deforming dorsopathies, osteochondrosis, degenerative spinal diseases