Vol 33, No 11 (2022)

The state of public health is determined by the health status of the totality of all members of society, whereas the self-rating of health is its indirect measure.

Objective. To analyze the self-rated health status among the population of Russia in 2019–2021.

Material and methods. The data from a Russian Federal State Statistics Service survey (coverage of 60,000 households) on the self-rated health status in the entire population over the age of 15 years in 2019–2021 and 2020–2021 were considered by 5-year age groups and Russia’s regions. The average regional estimates of health indicators (2020–2021) were determined. Com-parison was made using the nonparametric Wilcoxon test.

Results. The majority (83%) of the population rated their health status as good and satis-factory. In the considered period (2019–2021), the proportion of respondents who rated their health status as very good (>9% in the entire sample; the maximum proportion [19%] was observed among those aged 15–19 years in 2021; the minimum proportion [0.2%] was among those over the age of 85 years), exceeded that of respondents who rated their health as very poor (0.7%; the max-imum proportion [8%] was among the respondents over the age of 85 years in 2020; the minimum proportion [0.1%] was in the age groups under the age of 40 years). A significant regional variabil-ity was found in health status self-ratings. The average regional proportion of those who rated their health as good and very good was 49.4% in 2020 and 49.3% in 2021 (p=0.9), moreover, >60% of these respondents were registered in 8 regions (Moscow, Saint Petersburg, the Astrakhan Region, the Chukotka Autonomous District, the Chechen Republic, the Republic of Tyva, Dagestan, and Ingushetia). The proportion of those who rated their health as poor and very poor exceeded 10% in 38 regions in 2020 and in 28 regions in 2021 (the average regional proportion was 9.4% and 8.6% in 2020 and 2021, respectively, (p=0.001).

Conclusion. There were no substantial changes in the self-ratings of health status in Russia over a 3-year period (including those during the COVID-19 pandemic) (the differences were <1%); however, considerable interregional differences in the self-ratings of health status call for additional investigations.

Reducing cancer incidence and increasing early diagnosis in cases of cancer diseases is possible only with a sufficient level of public awareness of the causes of cancer, measures and methods of their prevention and early diagnosis. All this is ensured by effective cancer education of the population, which is the main tool for implementation scientifically based and effective measures and methods for the prevention of cancer diseases into practical health care.

Purpose of the study is to assess the availability to understanding and effectiveness of the information brochure "How not to get cancer", as one of the types of cancer education of the population.

Material and methods. In the N.N. Blokhin National Medical Research Center of Oncology the information brochure "How not to get cancer" was prepared and printed, which intended for distribution among the adult population. The brochure in a language accessible to a wide range of readers provides scientific and reliable information on the cancer prevalence, on the main causes and risk factors for the development of cancer diseases and proven effective measures and methods of cancer prevention. To assess the information brochure availability and effectiveness in improving knowledge about cancer and motivation to implement cancer prevention measures, out of a total of 257 persons who confirmed reading of the brochure, a targeted random sample survey of 73 persons aged 18-79 was conducted. The survey in the form of a telephone interview was conducted according to a standardized, structured questionnaire that included 10 main questions regarding the clarity and personal informativeness of information brochure, its usefulness and the possibility of applying the information contained in it for yourself and in your lifestyle.

Results. In the survey, a large majority of 77% (95%CI 68% to 86%) of respondents rated the brochure information as "interesting". And none of those surveyed rated the brochure as "not interesting". Almost all the respondents, 92% (95% ДИ 86% -98%), replied that they understood everything in the content and text of the brochure. Furthermore 71% (95% CI 61%-81%) of them expressed a desire to take some preventive measure to eliminate or limit the action of 1 or more known cancer risk factors from their lifestyle.

Conclusion. The results of the study confirm the effectiveness of the information brochure "How not to get cancer" for the understanding of scientifically based knowledge about cancer and it’s prevention and for motivation for behavior to exclude cancer risk factors for from lifestyle.

The paper deals with lung dysplasia in preterm newborns. It gives epidemiological data on congenital lung malformations and the main features of pathohistogenesis of the respiratory system. The authors consider the clinical and morphological types of lung dysplasia, its critical periods and risk factors for embryonic lung pathology, and the peculiarities of fetal lung fluid metabolism. They characterize and provide evidence for the clinical role of oligohydramnios in the presence of perinatal maladaptation in a fetus and the development of lung dysplasia in preterm newborns. The paper describes the significance of morphopathological factors in the pathogenesis of premature rupture of the membranes. It discusses diagnostic methods, a medical algorithm, and the features of prenatal prevention of intrauterine anomalies. The perinatal outcomes of lung dysplasia are considered in preterm newborns.

Severe acute respiratory syndrome induced by SARS-CoV-2 (COVID-19) has caused its substantial morbidity and mortality in the world’s population. Long-term global practice shows that one of the most effective and dominant ways to prevent COVID-19 is to immunize the population with vaccines. The results of a coronavirus vaccination program published in different countries of the world demonstrate its high significance in the fight against the COVID-19 pandemic. There are now a number of registered coronavirus vaccines that have put through Phase III clinical trials and have shown their efficacy in combating this virus. Our literature review describes in detail most of the currently available COVID-19 vaccines, their design companies, design stages, the composition of vaccines, the results of clinical trials, the proven successful use of vaccines, as well as the inferred and identified side effects due to their use (both local and systemic reactions, as well as cases of more formidable and severe complications and their incidence). There is evidence that there is a need for large-scale coronavirus vaccination of the population. The attitude of the population in different countries to an active vaccination campaign and its satisfaction with currently available vaccines are detailed. Since the efficacy of COVID-19 vaccines attenuates over time, timely revaccination should also be considered. Vaccination is necessary, since the main value is a person’s health and life, so it is necessary to take measures for their preservation and the prevention of diseases.

The use of modern imaging techniques in clinical practice is accompanied by a steady increase in the detection of pancreatic cystic neoplasms, many of which are an accidental finding due to asymptomatic course. At the same time, the absence of early clinical manifestations in conjunction with the different malignant potential of cystic neoplasia of the pancreas, the difficulties of differential diagnosis, determine the extreme relevance of this clinical problem.

Purpose of the study. To evaluate the possibilities and advantages of magnetic resonance imaging (MRI) in the differential diagnosis of pancreatic cystic neoplasms.

Materials and methods. The analysis of clinical and radiographic data of 75 patients with cystic neoplasms of the pancreas was carried out. All patients underwent MRI, in the amount or combination of the MR-protocol, magnetic resonance diffusion, magnetic resonance cholangiopancreatography, dynamic contrast enhancement. Computed tomography (n=7), endosonography (n=45) were also performed.

Results and conclusions. Tissue contrast, the use of various modalities of magnetic resonance imaging provides a number of advantages in the visualization of cystic neoplasms of the pancreas and the assessment of relationships with the ductal system, which allows us to consider it as the most effective method in the algorithm for radiological diagnosis of cystic neoplasms of the pancreas. During the study, the sensitivity of MRI in the diagnosis of cystic neoplasms was 96%, the specificity was 90%. The most frequent cystic neoplasms were intraductal papillary mucinous neoplasm type II – 34.5%. Serous cystic neoplasm (16%), mucinous cystic neoplasm (12%), and intraductal papillary mucinous neoplasm type I (10.5%) were also identified. Timely use of MRI at the stages of primary and differential diagnosis of cystic neoplasms of the pancreas will allow not only the necessary surgical treatment, but also to avoid unreasonable intervention. MRI is the method of choice for non-invasive differential diagnosis of pancreatic cystic neoplasms and the method of their dynamic monitoring.

A novel coronavirus infection in medical workers can be considered as an occupational disease if the infection occurred while they were performing their official duties. One of the most important complications of the novel coronavirus infection (COVID-19) is damage to the nervous system.

From the point of view of pathogenesis, neurological disorders in COVID-19 can be caused by a "cytokine storm", hypoxemia, homeostasis disorders (encephalopathy of critical conditions), neurotropy and neurovirulence of SARS-CoV-2 (isolated cranial nerve damage, focal and diffuse CNS lesions), as well as mixed effects of these factors. COVID-19 also affects the course of chronic neurological diseases.

The spectrum of neurological disorders in COVID-19 is wide: from cranial mononeuropathies, clinically manifested by anosmia, ageusia/dysgeusia to acute inflammatory polyneuropathy of Guillain–Barre and severe lesions of the brain and spinal cord in the form of acute hemorrhagic necrotizing encephalopathy and myelopathy.

The presented clinical case describes one of the possible serious complications of COVID-19 – encephalopathy. The article presents the principles and results of a medical examination conducted in order to establish a causal relationship of the disease with professional activity. The need for a multidisciplinary approach to the diagnosis of manifestations, treatment of COVID 19 and its complications with the mandatory participation of a neurologist is emphasized.

It is obvious that the COVID-19 pandemic will have significant consequences in the context of immediate and long-term neurological complications.

Twenty-nine patients with osteoarthritis (OA) were examined to identify the relationship between the level of vitamin D and the characteristics of the course of OA in patients residing in the Arctic Region. Vitamin D deficiency or insufficiency was detected in 82.8% of the examinees. In addition, a more obvious radiographic stage of OA, pain syndrome, signs of depression and anxiety, as well as greater dependence on outside help in everyday life were more commonly diagnosed in patients with OA and vitamin D deficiency/insufficiency..

Almost all eyeball and optic nerve structures are secondarily involved in the pathological process in syphilitic infection. Ophthalmic syphilis is manifested by uveitis, panuveitis, retinal angiopathy, neuritis, optic nerve demyelination and atrophy, necrotizing scleritis, and keratitis.

Objective. To study the forms of damage to the organ of vision in syphilis and the results of their specific treatment.

Subjects and methods. The investigation enrolled 158 patients with latent syphilis. The patients were divided into 4 groups according to the approaches to therapy. Enzyme immunoassay, passive hemagglutination assay, and a set of serological tests were used to estimate the serum levels of anti-Treponema pallidum antibodies in all the patients. To examine the organ of vision, the patients underwent ophthalmoscopy, biomicroscopy, color (red, white, and green) perimetry tests, optical coherence tomography, and critical flicker fusion frequency measurements.

Results and conclusion. The organ of vision is involved in the infectious process in syphilis, which is manifested by the development of uveitis, scleritis, neuritis, optic nerve atrophy, and anterior ischemic neuropathy. Specific penicillin therapy used in the treatment of neurosyphilis has been shown to be effective for organ of vision pathology associated with early latent syphilis. Eye analyzer lesion can be the manifestation of the latent forms of syphilis, which may be recommended as a screening criterion for selection of the patients to be examined for anti-Treponema pallidum antibodies. For effective therapy, ophthalmic syphilis must be detected in the first 2 years of infection, as there are irreversible eye analyzer lesions in the long-term persistence of Treponema pallidum in the macroorganism.

Aim: to study the literature data reflecting the antioxidant effect of selenium (Se) and the possibility of using selenium-containing preparations in clinical practice.

Material and methods. The analysis of 33 foreign and Russian publications reflecting antioxidant action of Se and possibility of application of selenium-containing preparations in clinical practice was performed.

Results. The problem of Se deficiency in nature is very topical. Se had antioxidant action, participated in improvement of immune functions, metabolic homeostasis. Increased Se concentration was associated with decreased serum total cholesterol and triglycerides. Optimal Se intake is important for normal reproductive function in men and women. The risk of Se deficiency increased in proportion to age. Decreased levels of certain selenoproteins could be associated with an increased likelihood of Parkinson's disease, Alzheimer's disease, and epilepsy.

Conclusions. Plants were the main dietary source of Se for populations in most countries. They were able to metabolize and accumulate organic Se in edible parts for consumption. Russian SELENBIO for women selenium-containing complex could be useful to compensate for Se deficiency in elderly patients. This allowed to prevent the growth of oxidative stress – one of the leading mechanisms of aging.

The paper gives the results of studying the impact of Mildronate therapy on the endothelial function of peripheral arteries and on the indicators of silent myocardial ischemia in women with hypertension and estradiol deficiency.

Relying on the study, it may be concluded that Mildronate is well tolerated by patients and is an effective treatment: the patients report a positive effect of the drug on endothelium-dependent vascular relaxation, as well as cardiometabolic and anti-ischemic effects due to the normalization of cardiomyocyte metabolism.