[The comparative analysis of dynamics of indicators of morbidity of adolescents in the regions of the Northern-Caucasus Federal Okrug].

The purpose of the study is to establish main trends in morbidity of adolescents (15-17 years old) in the regions of the Northern-Caucasus Federal Okrug in 2011-2020. The study is based on data of statistical reports on primary and general morbidity of population aged 15-17 years for 2011-2020. The results. The epidemiological situation concerning morbidity of adolescents in the Russian Federation and the Northern-Caucasus Federal Okrug is characterized by positive trend over the analyzed period. The deterioration of epidemiological situation is observed in the Karachay-Cherkessia Republic (KChR) where absolute increase in overall morbidity of adolescents comprised 105.3% and primary morbidity 49.0% and in the Stavropol Territory (ST) - 23.0% and 27.5% correspondingly. The decrease of morbidity of adolescents is observed in the Republic of Ingushetia (RI) (by 56.9% and 51.7%) and in the Chechen Republic (ChR) (by 34.6% and 45.0%). In the Republic of Dagestan (RD), an increase of overall morbidity (by 114.0%) is accompanied by decreasing of primary morbidity (by 13.2%) and in the Republic of North Ossetia-Alania (RNOA) (absolute increase in overall morbidity by 7.8% and decrease of primary morbidity by 7.0%). In the Kabardino-Balkaria Republic (KBR), there is absolute decreasing of overall morbidity (by 1.7%) with simultaneous increase of primary morbidity of adolescents (by 24.2%). However, there are features inherent in most of analyzed regions of the Northern-Caucasus Federal Okrug. The increase of overall morbidity of eye diseases in adolescents is registered in six out of seven regions with exception of the RI, the increase of primary morbidity occurred in four of them (KChR, RD, KBR, ST). The increase of general and primary morbidity of ear diseases is registered in five regions (KChR, RD, RI, KBR, RNOA). The increasing of morbidity of neoplasms registered as common for five regions (the KChR, RD, RI, KBR, the ST) and as primary one in four of them (with the exception of the ST). The conclusions. In the regions of the Northern-Caucasus Federal Okrug multi-directional dynamics of indicators of general and primary morbidity among adolescents was established with predominance of particular classes of diseases. This result testifies absence of unified policy in the field of public health targeted to maintaining healthy life-style in adolescents.

Plant Community of Pine Forests (Pinus kochiana, Pinaceae) of Dagestan.

The plant community of Dagestan pine forests, comprising 590 vascular plants species, was examined based on materials from field studies performed from 2012 to 2019. Taxonomic, biomorphological, florocoenotic, and geographical characteristics of the plant community showed its boreal and Mediterranean nature. Mesotrophic and eutrophic plants predominated in terms of soil fertility and mesophytes and mesoxerophytes, in terms of soil water availability. Species of different altitudinal belts, including forest, meadow, and mountain-steppe belts, were observed in the plant community of pine forests. The plant community included 22 species listed in the Red Books of the Russian Federation and the Republic of Dagestan, 82 relict species, and 76 endemics.

[The comprehensive rehabilitation and abilitation of the disabled: the examples of evaluation of regional system].

In the Russian Federation, comprehensive rehabilitation and abilitation of the disabled is actively developing effected by the UN Convention on the Rights of the Disabled. In 2018-2019, the quantitative indicators of comprehensive rehabilitation and abilitation were studied in 85 regions of Russia. In 36 regions (42/4%) formation of system of comprehensive rehabilitation and abilitation was necessary. The remaining 49 regions required improving their systems of comprehensive rehabilitation and abilitation (57.6%, respectively). The study results demonstrated that significant increase in rehabilitation organizations (from 12.0% in 2018 to 100.0% in 2021) to be included in regional system of comprehensive rehabilitation and abilitation is expected. In the Republic of Dagestan, the final rating of comprehensive rehabilitation and abilitation system was from 6.5 to 7.6 points that indicates the need to organize and to improve comprehensive rehabilitation and abilitation system in the region. The experience of the Sverdlovsk Oblast and the Perm Krai where pilot project on comprehensive rehabilitation and abilitation system was carried out proved that one of the effective mechanisms of organizing comprehensive rehabilitation and abilitation system is development of state regional program by the authorities with involvement of all interested players and public organizations.

[IMPROVING THE ORGANIZATION OF LABOR AND THE QUALITY OF MEDICAL CARE AT PARAMEDIC AND OBSTETRIC STATIONS].

In the provision of primary health care to the rural population, the role of paramedic and obstetric stations (FAP) is great. The purpose of the study is to develop a system of measures aimed at improving the quality of medical care provided at paramedic and obstetric stations. The study was conducted in 2019-2020 on the basis of 26 FAP of 12 central district hospitals (CRH) of the Republic of Dagestan. The organization of labor of 26 paramedics and 26 midwives during 1740 hours was studied by the method of time-lapse observation. The content of 16511 visits by the FAP population was analyzed. The expert evaluation method studied the quality of medical care to 445 patients on 7 FAP. The main work of FAP paramedics accounts for 74.5%, and for midwives - 76.3% of all labor costs. A significant share in the cost structure is occupied by preventive (22.9% for paramedics and 27.8% for midwives) and diagnostic and therapeutic activities (17% and 15.6%). There are high costs for transitions and relocations (17.3% and 14.1%) and for working with documentation (13.7% and 14.5%). In the structure of visits by the population of paramedics and midwives of FAP, for reasons of the greatest proportion are visits with therapeutic and diagnostic purposes (37%), followed by visits for medical appointments (32.8%) and preventive (23.9%). The quality of medical care provided by paramedics to patients with therapeutic diseases was inadequate in 23.8% of cases. Every third (35.7%) patient was treated with FAP unreasonably. Out of the total number of patients who were treated unreasonably on FAP, according to experts, 62.5% had to be treated in the CRH, 34.8% - in the district hospital (outpatient clinic).

[Features of demographic trends and infant mortality in the Republic of Dagestan].

The article analyzes the regional characteristics of the demographic development of the Republic of Dagestan, presents the results of the analysis of infant mortality rates in the republic, gives a structure of the causes of infant mortality, identifies the main indicators of natural growth and population decline. The results of the study showed that in Dagestan infant mortality is one of the highest among the subjects of Russia in 2018 - 8.3 ‰ per 1000 live births (national average - 5.1 ‰, North-Western Federal District - 6.8 ‰); the main cause of death in infants under 1 year of age in Dagestan are individual conditions that occur during the perinatal period.

[The regional characteristics of indices of mortality of adult population and life expectancy].

The article analyzes the demographic situation in the Republic of Dagestan and presents analysis of indices of population mortality and life expectancy. It is established that number of deaths per 1000 people of the Republic of Dagestan is one of the lowest not only in the Northern Caucasus, but in the country at large. At the same time, high mortality indices are determined in elder age groups both in Dagestan and on average in Russia. The main causes of death in the Republic of Dagestan are diseases of circulatory system and respiratory system, neoplasms, accidents, poisoning and traumas, which account almost three quarters of all cases of deaths. However, mortality indices in Dagestan from diseases of circulatory system, neoplasms, digestive system diseases, infectious and parasitic diseases are significantly lower as compared to the national average level. In Dagestan, one of the highest indices of life expectancy is observed as compared with other subjects of the Russian Federation (2nd place in the Russian Federation) - on 6 years exceeding the national average level (in males, difference in values ​​of indicator amounted to 7.5 years). In Dagestan, during analyzed period, life expectancy at birth increased more than on 5 years.

[The medical ethical aspects of organization of medical rehabilitation].

The article considers such aspects of organization of medical rehabilitation care of population as accessibility, quality, social efficiency from perspective of medical ethics. The quality of diagnostic, prevention and treatment of diseases is affected by qualification of medical personnel that is applied both to areas of clinical medicine and health care management. The specialists are to apply common principles and standards of health care. Among them are support of valuable quality of medical care under optimal application of available resources and observance of medical ethics standards. The Republic of Dagestan is anagrarian region where 55% of population resides in rural area and most of health care resources are cumulated in urban area. The indices of health of population residing in rural area are in many parameters worse than in urban population and provision of medical institutions with medical personnel is low. The specialized medical care support including medical rehabilitation, of rural population, is provided without additional managerial decisions and is much more difficult as compared with patients residing in urban area. Hence in conditions of necessity of optimization of resource support of health care system functioning no extensive development of possibilities of medical rehabilitation is possible in rural residents of Dagestan.

[The characteristics of medical demographic development of the Republic of Dagestan].

The issues of assessing medical and demographic processes and improving public health are very actual in Russia. The article analyzes the current state and regional characteristics of medical and demographic development using the example of the Republic of Dagestan. The positive tendency of the main fertility indicators was determined, including the analysis of the age structure of the population and population size alterations.

[The evaluation of the impact of quality and microelement composition of drinking water on the incidence of urolithiasis in various regions of Dagestan].

AIM: to study the influence of qualitative and microelement composition of drinking water on the incidence of urolithiasis in different regions of the Republic of Dagestan. MATERIALS AND METHODS: The statistical data of the Ministry of Health of the Republic of Dagestan for 2000-2016 yy. were used. A total of 12123 outpatient and inpatient charts of patients with urinary stone disease were analyzed. The annual average quality of drinking water, as well as the contents of microelements in different climatic and geographical areas of the region were assessed. THE RESULTS: The high morbidity among the residents of the flat territory was established which was associated with the highest water hardness, high content of microelements and salts of heavy metals that exceeded the acceptable concentrations. The number of patients with urinary stone disease living in mountainous areas is much less (11.8%) than in the flat area (83.08%). A relationship between quality of water, microelement composition and urinary stone disease in this area was found. The stone disease was more common in women (66.3%) than in men (33.7%). CONCLUSION: Our results can be used for the prevention of urinary stone disease given that the Republic of Dagestan is an endemic region.

[The Development of Technology of Functioning of District Physicians During Out-Patient Reception].

To develop recommendations and proposals related to amelioration of technology of of functioning of district physicians and general practitioners during out-patient reception in 2015-2016 a specialized study was carried out in three municipal polyclinics of Makhachkala of the Republic of Dagestan. The technology of functioning of 16 district physicians and general physicians during out-patient reception according information on 2685 visits in established conditions and in experiment. It is established that district physicians are insufficiently able to handle methodological issues of technology of out-patient reception. The implementation, in conditions of experiment, of enhanced medical technology at out-patient reception ameliorated quality of performance of conversation, check-up and examination of patients by district physicians. It resulted in more full-blown and targeted collection of anamnesis, in-depth physical check-up and examination, more complete giving of recommendations to every patient concerning one's treatment, diet and examination.

[On the evaluation of hospital care of persons of elderly and senile age].

The study was carried out in 2012-2014 on the of the hospital of veterans "The Republican medical center" with purpose of optimizing hospital care of population of elderly and senile age. The special record of hospitalized patient containing 16 questions was developed for sampling primary data. On the basis of received results the directions of development of hospital care to patients of elderly and senile age were determined.

Coevolution of genes and languages and high levels of population structure among the highland populations of Daghestan.

As a result of the combination of great linguistic and cultural diversity, the highland populations of Daghestan present an excellent opportunity to test the hypothesis of language-gene coevolution at a fine geographic scale. However, previous genetic studies generally have been restricted to uniparental markers and have not included many of the key populations of the region. To improve our understanding of the genetic structure of Daghestani populations and to investigate possible correlations between genetic and linguistic variation, we analyzed ~550,000 autosomal single nucleotide polymorphisms, phylogenetically informative Y chromosome markers and mtDNA haplotypes in 21 ethnic Daghestani groups. We found high levels of population structure in Daghestan consistent with the hypothesis of long-term isolation among populations of the highland Caucasus. Highland Daghestani populations exhibit extremely high levels of between-population diversity for all genetic systems tested, leading to some of the highest FST values observed for any region of the world. In addition, we find a significant positive correlation between gene and language diversity, suggesting that these two aspects of human diversity have coevolved as a result of historical patterns of social interaction among highland farmers at the community level. Finally, our data are consistent with the hypothesis that most Daghestanian-speaking groups descend from a common ancestral population (~6000-6500 years ago) that spread to the Caucasus by demic diffusion followed by population fragmentation and low levels of gene flow.

[Prevalence of various urination disorders in residents of the Republic of Dagestan].

PURPOSE: to evaluate the prevalence of various urination disorders in residents of the Republic of Dagestan, and, thus, to improve their diagnosis and treatment. MATERIALS AND METHODS: 584 residents (264 men and 320 women) from different regions of the Republic of Dagestan took part in an anonymous questionnaire survey: 165 residents of Makhachkala, including 92 men and 73 women; 86 residents of Derbent and villages of Southern Dagestan, including 30 men and 56 women; 73 residents of Khasavyurt and Kizilyurt, including 34 men and 39 women; 53 residents of Buynaksk, including 19 men and 34 women; 42 residents of Izberbash, including 19 men and 23 women; 58 residents of the Kaspiysk, 29 men and 29 women; 42 residents of Kayakent, 4 men and 38 women; 65 residents of other regions of the Republic of Dagestan (Karabudakhkent, Gumbet, Gunibsk, Shamil, Khunzakh, Botlikh, Kazbek, Levashin, Tlyaratin, and Tsumadin regions), 37 men and 28 women. RESULTS: According to the survey of the residents of the Republic of Dagestan, a significant prevalence of various urinary disorders (63.5%) was found among both men (61.7%) and women (65.0%). Unfortunately, not all patients seek medical advice with complaints of dysuria (55.5%). The fact that 18.8% of patients do not know that they can get help, and 24.1% believe that they do not have a good doctor in their region can be considered as the most an unfavorable moment in terms of the reasons for the refusal of visiting a doctor.. CONCLUSIONS: All this findings suggest the need for educational programs both for physicians and the population (educative activities).

[Nutrition value of wild-growing fruits from mountain Dagestan and its safety after fast freezing and cold storage].

Results of research of mineral composition, content of vitamin C and P, titrable acids, pectinaceous and phenol substances in fresh, fast-frozen (t=-30 °C), and also stored within 3 and 9 months (t=-18 °C) fruits of wild-growing blackberry, cornel, medlar and sea-buckthorn are presented in article. Determination of mineral composition was carried out by flame atomic absorption photometry, vitamin C and pectinaceous substances -by titirimetric methods, phenolic substances and vitamin P - by colorimetric methods. Vitamin C content was minimal in fresh fruits of cornel (6.9±0.3 mg%), amounted to 21.7-32.0 mg% in the fruits of blackberries and medlar and reached 180.1±7.2 mg% in the fruit of sea-buckthorn. Vitamin P concentration ranged from 34.9 (sea-buckthorn) to 180.0 mg% (cornel). Berries of a cornel contained also the greatest number of titrable acids (33.2±1.3 g/dm3), phenolic compounds (243.0±4.8 mg%) and pectinaceous substances (2.91±0.08%). The most significant content of potassium (521±15.6 mg%), calcium (133.2±5.2 mg%), magnesium (62.4±2.5 mg%) and iron (2.81±0.05 mg%) was revealed in medlar fruits. Consumption of 100 g of the studied fruits provides daily requirements of a human body, depending on a species of wild plants: in calcium -for 2-13.3%, potassium - for 7.0-20.8%, magnesium - for 8.1-15.6%, iron - for 5.9-19.2% and in vitamin C - from 5.8-24.6 to 145.7% in the case of sea buckthorn. The applied processing method of conservation - fast freezing (t=-30 °Ð¡) of fruits and their long storage (t=-18 °Ð¡) is the effective way ensuring high safety of nutrients in them. In the studied berries after 9-months cold storage the safety of vitamin C varied ranging from 55.7 (blackberry) to 76.1% (cornel), and vitamin P - from 81.9 (sea-buckthorn) to 92.8% (cornel). Stability of titrable acids, except for medlar fruits, varied from 84.2% (blackberry) to 94.0% (sea-buckthorn). The safety of phenolic and pectinaceous compounds by the end of 9 months of storage, has averaged 90.6 and 95.6% respectively in comparison with their initial quantity in fresh fruits. The mineral composition was the stablest. After completion of experiment the safety of mineral substances in fruits of wild plants fluctuated from 94.6 to 98.5%. Distinctions in change of biochemical complexes of berries of blackberry, cornel, medlar and sea-buckthorn at fast freezing (t=-30 °Ð¡) and storage (t=-18 °Ð¡), apparently, are caused by specific features, content of free and bound water, thickness of cellular walls, durability of a thin skin of fruits, as well as by concentration of the components that inhibit the destructive processes occurring at the cellular and molecular level.

[Micronutrient composition of grape growing in Dagestan].

Micronutrient content in Pearl Zala, Pearl Saba, Creamy, and Amber Muscat varieties of grape has been determined. The ultimate analysis has been made by the atomic-absorption flame photometry; ascorbic acid has been determined by the titrometric analysis; rutin, niacin, and carotene have been studied by the colorimetric method. It has been found that the content of potassium (2673.8 mg/kg), calcium (349.0 mg/kg), iron (35.9 mg/kg), silicon (611.3 mg/kg), manganese (0.89 mg/kg) and vitamin C (5.3 mg/dm3) was the highest in Pearl Zala grapes, while the content of zinc (0.31 mg/kg), nicotinic acid (10.9 mg/dm3) and carotene (0,33 mg/dm3) was the highest in Pearls Saba. Amber Muscat grape has been found to have the highest concentration of sodium (151.4 mg/kg), phosphorus (466.8 mg/kg), magnesium (221.6 mg/kg), aluminum (68.5 mg/kg), cobalt (0.120 mg/kg) and copper (1.91 mg/kg) in comparison with other grape varieties. It has been found that the content of ascorbic acid and rutin differ 1.5-1.6 fold, of magnesium, iron, silicon and potassium--1.7-1.8 fold, of calcium and phosphorus--2.2-2.5 fold, carotene--4.1 times, aluminum, sodium and nicotinic acid--4.7-5.5 fold, cobalt and copper--8.6-8.7 fold, zinc and manganese--10.3-22.2 fold.

[Physical development of 11-17 years old boys, residing in different ecologo-geographical zones of the Republic of Dagestan].

There was compared the physical development of adolescent boys at the puberty age of 11-17 years residing in different eco-geographical zones of the Republic of Dagestan. The physical development of adolescents in highland and lowland areas was noted to be close to the all-Russia indices. Boys from foothill areas are significantly behind in the physical development of their peers who resides in mountainous and lowland areas, their indices of physical development are below than all-Russia ones.

[Behçet's disease: clinical and demographic associations].

AIM: To comparatively study the clinical manifestations, sexual and HLA-B51 associations in patients with Behçet's disease (BD) in two ethnic groups. SUBJECTS AND METHODS: The authors examined 143 patients with the valid diagnosis of BED who were divided into 2 groups: 1) 85 patients, the dwellers of Dagestan (a multiethnic cohort), 63 men and 22 women (mean age 29 +/- 7.4 years); 2) 58 Russian men and women (mean age 33 +/- 11.7 years). RESULTS: Two major criteria for BD, such as aphthous stomatitis and external genital ulcers, were found with the same frequency. Panuveitis and angiitis of the retina were diagnosed more frequently in the Dagestani population with BD than in the Russians. Out of the minor criteria for BD, the incidence of lower limb deep venous thrombosis was 23% for the Dagestanis versus 3% for the Russians. Arterial thromboses and pulmonary artery aneurysms became causes of death in 4 in 5 men aged 19-23 years from their Dagestani ancestry. HLA B51 (B marker) was found in the dwellers of Dagestan: in 70% of the men and 40% of the women who had BD. CONCLUSION: BD runs a more severe course in male patients and is characterized by severe eye diseases and the systematic pattern of the process at young age. Gender-specific and genetic aspects call for further comparative investigations on large ethnic patient cohorts of other ancestries.

New data on the fauna of pyraloid moths (Lepidoptera: Pyraloidea) of Dagestan (Russia).

58 species of pyraloid moths are reported for the East Caucasian region of Russia and the Republic of Dagestan for the first time. Among them, 13 species are new for the fauna of Russia. Additionally, we report first-time records of several pyraloid species from Kazakhstan and also from different regions of Russia: Astrakhan, Volgograd, Voronezh and Orenburg Provinces. Imagoes of four notable species are illustrated.

McArdle disease: a novel mutation in Jewish families from the Caucasus region.

McArdle disease is caused by a myophosphorylase deficiency consequent to defects in the PYGM gene. A minority of the over-133 known mutations are associated with ethnicity, occurring mainly in patients from western Europe, the United States, and Japan. We identified a novel mutation, c.632delG, in three unrelated families of Jewish descent originating from the Caucasus region. This possibly ethnicity-associated mutation can significantly facilitate the diagnosis in Jews of the Caucasus and contribute to genetic consultations.

The dual origin of Tati-speakers from Dagestan as written in the genealogy of uniparental variants.

OBJECTIVES: Tat language is classified in an Iranian subbranch of the Indo-European family. It is spoken in the Caucasus and in the West Caspian region by populations with heterogeneous cultural traditions and religion whose ancestry is unknown. The aim of this study is to get a first insight about the genetic history of this peculiar linguistic group. METHODS: We investigated the uniparental gene pools, defined by NRY and mtDNA high-resolution markers, in two Tati-speaking communities from Dagestan: Mountain Jews or Juhur, who speak the Judeo-Tat dialect, and the Tats, who speak the Muslim-Tat dialect. The samples have been collected in monoethnic rural villages and selected on the basis of genealogical relationships. A novel approach aimed at resolving cryptic cases in the recent history of human populations, which combines the properties of uniparental genetic markers with the potential of "forward-in-time" computer simulations, is presented. RESULTS: Judeo-Tats emerged as a group with tight matrilineal genetic legacy who separated early from other Jewish communities. Tats exhibited genetic signals of a much longer in situ evolution, which appear as substantially unlinked with other Indo-Iranian enclaves in the Caucasus. CONCLUSIONS: The independent demographic histories of the two samples, with mutually reversed profiles at paternally and maternally transmitted genetic systems, suggest that geographic proximity and linguistic assimilation of Tati-speakers from Dagestan do not reflect a common ancestry.