[Clinical/epidemiological characteristics of ischemic stroke in Dagestan]. / Kliniko-épidemiologicheskie kharakteristiki ishemicheskogo insul'ta v Respublike Dagestan.

OBJETIVE: To analyze risk factors and course of acute ischemic stroke (IS) based on hospital register data. MATERIAL AND METHODS: Ninety-seven patients (38 women and 59 men, mean age 65.4±12.8 and 61.2±18.8 years, respectively) with acute IS admitted in 2016 to the Clinical hospital of Makhachkala were examined. Medical history and severity of neurological deficit (the British Medical Council Scale, The Glasgow Coma Scale, MMSE) were assessed. RESULTS: The severity of neurological deficit was comparable in men and women though cognitive impairment was more frequent in women (p<0.05). At admission, symptoms of inflammation and hyper coagulation were more frequently identified in women (p<0.05). The high prevalence of chronic cerebral ischemia preceding IS, insufficient efficacy of preventive treatment and late hospitalization were noted. CONCLUSION: The results should be confirmed in a large-scale long-term study. They can be used to improve quality of medical care of patients with IS.

[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).

[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.

[The dynamics of the morbidity rate of stroke in the Dagestan Republic].

Results of the first epidemiologic survey of cerebral stroke in the Dagestan Republic (DR) carried out in 2009--2010 are presented. Using a population register, we evaluated the dynamics of the morbidity rate of stroke and effectiveness of primary and secondary prevention of stroke. There were 7533 cases of stroke, including 4116 in 2009 and 3413 in 2010. The morbidity rate per 1000 people was 2.76 in 2009 and 2.29 in 2010. The diagnoses were distributed as follows: ischemic stroke 3029 (73.6%) in 2009 and 2457 (72%) in 2010; hemorrhagic stroke -- 760 (18.5%) in 2009 and 692 (20.3%) in 2010; undifferentiated -- 327 (7.9%) in 2009 and 264 (7.7%) in 2010. Mean age at disease onset was 65.41±11.4 in 2009 and 66.43+12.6 in 2010. The measures for primary and secondary prevention of stroke performed in DR led to the reduction of stroke cases by 17% in 2010 compared to 2009.

[10-years caries incidence and intensity dynamics in pregnant women of Derbent city].

Caries incidence was assessed in pregnant women in 1998, 2003 an 2008 showing the values to be stable. DMF was almost the same in 1998 and 2003, but in 2008 the rate of "F" (filled) element was significantly higher thus confirming growth in motivation for dental treatment after introduction of private dental practices.

[The results of the clinical and epidemiological study of epilepsy in urban and rural areas of the Dagestan Republic].

The results of the clinical and epidemiological study of epilepsy in the Soviet region of Makhachkala city and the Khasavurt region of the Dagestan Republic are presented. The sample size was 139.115 in the Soviet region and 101.278 in the Khasavurt region, The samples included 344 and 338 patients with epilepsy, respectively. The age- and sex- standardized prevalence of epilepsy was 2.06 (CI95% 1.80-2.32) cases per 1000 population in the Soviet region and 2.98 (CI95% 2.60-3.35) cases per 1000 population in the Khasavurt region (p=0.05). The prevalence of epilepsy was higher in men. Focal (location-related) forms of epilepsy were most frequent, with the highest frequency of partial seizures with secondary generalization. Cranial-brain injury, intra- and perinatal pathology and cerebral vascular diseases were the main causes of the development of focal epilepsies. Seizure frequency greater than 12 per year was noted in more than a half of patients. The study of social aspects showed that only small portion of patients worked, most of patients received disability pensions. Differences in the education level were identified as well.

[The development of specialized hospital care to children of early age].

The study was carried out in 2009-2010 on the basis of the Republican children clinical hospital of the Republic of Dagestan. The structure of hospitalized children aged 0-3 years was analyzed using the data from of medical records of hospital patients. The sampling consisted of 17 368 cases. The morbidity of children of the first year of life and morbidity of newborns in maternity hospitals was analyzed. It is established that the morbidity of children of the first year of life made 2258.6 to 1 000 children of corresponding age. The morbidity of newborns in maternity hospitals made 290 to 1 000 newborns. Thy indicator is slightly higher in urban area (295) than in rural area (272.3). In the structure of classes of diseases of hospitalized children of early age the first position is for particular states of perinatal period (40.4%), second position for respiratory diseases (18.1%), third position for inherited malformations (15.3%) and forth position for neoplasms (6.8%). The analysis of hospital lethality demonstrated that the major percentage of deceased (88.9%) go to the first year of life.

[The input of graduates of Russian military medical academies into fight against acute infectious diseases in pre-revolutionary Dagestan].

The population study permitted to establish the role of Russian military physicians in organization of medical business in Dagestan. The prevalence of acute epidemiologic diseases in pre-revolutionary Dagestan is examined. It is derived that mass propagation of infections was supported by cultural and economic backwardness, non-sanitary conditions in cities, lifestyle of mountain dwellers. The tradition to visit ill fellow villager resulted into mass morbidity and even in death collapse of entire population of mountain settlements (auls). The positive conditions to develop medical business developed after Dagestan joined Russia. The activities of Russian military physicians in the Caucasus coincided with the full swing of various infection epidemics among soldiers and residents. The measures undertaken by Russian military physicians permitted to liquidate the epidemics.

[The analysis of risk factors for acute stroke in Dagestan].

Results of the first epidemiologic survey of cerebral stroke in Dagestan carried out in 2009 using a method of population register are presented. Arterial hypertension was on the first place (98.5%) among risk factors. Other risk factors were determined as follows: cardiac diseases (24.2%), cardiac fibrillation (14.5%), lipid profile dysfunction (10.6%), smoking (8.7%), diabetes mellitus (8.6%), stress (7.5%), history of myocardial infarction (3.6%).

[The diseases of circulatory system and the characteristics of organization of curative preventive care in the Republic of Dagestan].

The analysis of the circulatory system diseases morbidity and its mortality in the Republic of Dagestan is presented. The recommendations on the reformation of medical care in the Republic are presented.

[Atopic dermatitis concurrent with toxoplasmosis in the Republic of Dagestan: epidemiological aspects].

[By using a group of patients with atopic dermatitis who live in Dagestan as an example, the authors show the high prevalence of toxoplasmosis among them. This requires new approaches to diagnosing and treating atopic dermatitis to be introduced in this region]

Short communication: Molecular epidemiology of HIV type 1 in the Republic of Dagestan, Russian Federation: virtually uniform circulation of subtype A, former Soviet Union variant, with predominance of the V77I(PR) subvariant.

We examine the distribution of viral genetic forms and the presence of antiretroviral drug resistance mutations in HIV-1 infections in the Republic of Dagestan, in the North Caucasus area of Russia, where a recent large increase in HIV-1 infections has been documented. Samples were collected from 41 HIV-1-infected individuals from Dagestan, most of them from the cities of Derbent (n = 21) and Mahachkala (n = 18). Thirty six were injecting drug users and five were infected by heterosexual contact. None was on antiretroviral drug treatment. HIV-1 protease and a segment of reverse transcriptase were amplified by RT-PCR from plasma RNA and sequenced, and phylogenetic trees were constructed via maximum likelihood. Forty (97.6%) of 41 samples were of subtype A, former Soviet Union variant (A(FSU)), of which 27 (67.5%) clustered with the subvariant containing the V77I substitution in protease (V77I(PR)). Within this cluster, 13 viruses formed a local subcluster, 10 of which were from Derbent. Four viruses clustered with the A(SP2) subcluster, recently identified in St. Petersburg, two with a virus from Georgia and one with a virus from Azerbaijan. No mutations associated with antiretroviral drug resistance were detected. The results, therefore, show the relationship of the HIV-1 epidemic in Dagestan with that of other areas of Russia and of neighboring countries, and reveal the spread of the A(FSU) V77I(PR) variant in the North Caucasus area.

[Efficiency of the use of nutriceutics and parapharmaceutics for the prevention of skin and subcutaneous fat infections].

The use of nutriceutics (hexavit (multivitamin) or the natural concentrated product (NCP) Atlant from the raw plant material) and the parapharmaceutic lyophilized bifidumbacterin to enhance natural resistance in the subjects of an organized collective body in skin and subcutaneous fat infections (SSFI) (furuncul, abscess, phlegmons, pyodermas) showed the increasing bactericidal activity of the skin, normalized composition of colonic microflora, decreases in primary morbidity from appealability rates and in SSFI morbidity. When the NCP was taken, prophylactic efficiency was higher, which was likely associated with its increased concentrations of antioxidant vitamins (A, E, and C) and minor components.

[The organizational aspects of the pulmonological medical care provision to urban population].

The results of the study of quality of pulmonological medical care are presented. Overall, 366 out-patient case histories with the most commonly encountered diseases of respiratory system were submitted to expert assessment. The raw material was collected in 2005-2006 in 3 cities of the Republic of Dagestan. The expertise revealed that about a quarter of patients were examined timely and more than two third of them not timely. The discrepancy of diagnoses made by physicians and experts took place in 16.1% of cases. The expertise of treatment quality revealed that in 10.1% of cases the prescribed treatment was inopportune, in 24.9% it was inadequate and in 7.8% it was redundant. The research data was used to develop the guidelines and proposals regarding the enhancement of quality and effectiveness of pulmonological medical care of population.

[Correlation between erectile function and urination disorders in male population of Dagestan].

One of common urological problems in middle-aged and old male population is urination disorders and erectile dysfunction. We studied these problems in male population of Dagestan. We found that erectile dysfunction occurs in 38%, moderate and severe urination disorders in 22% males in Dagestan. Each 8-9th man in Dagestan suffers from combination of these disorders.

[Prevalence of androgenic deficiency in male population of Dagestan].

Incidence of androgenic deficiency in Dagestan males was studied using AMS questionnaire. Assessment of the results was made by standard criteria. The obtained statistics on 780 responders over 30 years of age demonstrate that symptoms of androgenic deficiency exist in 51.15% males in Dagestan. They are primarily caused by sexual problems.

[Peculiarities of the course of ischemic stroke in patients with diabetes mellitus type 2].

Two hundreds and eighty-seven patients, aged from 46 to 78 years, mean age 60.2 +/- 9.4 years, with confirmed diagnosis of ischemic stroke have been studied. The correlations between glycemia and severity of neurological deficit in the 1st (r = -0.433; p < 0.001) and the 21st days (r = -0.289; p < 0.05) of hospitalization were found. The glucose concentration in the venous blood plasma on an empty stomach was significantly higher in the fatal cases compared to the survived patients in the 1 (9.8 +/- 0.6 mmol/l and 5.7 +/- 0.4 mmol/l; p < 0.01), 3rd (9.1 +/- 0.4 mmol/l and 5.6 +/- 0.4 mmol/l; p < 0.05) and 5th days of stroke (9.3 +/- 0.4 mmol/l and 5.5 +/- 0.5 mmol/l; p < 0.01). The level of glycemia on an empty stomach was significantly correlated with the fatal outcome (r = 0.367; p < 0.01). The correlation between the development of lacunar infarction and the presence of previously developed diabetes mellitus type 2 (r = .0.756; p < 0.01) was also noted. The results obtained suggest a significant effect of diabetes mellitus type 2 on the course of ischemic stroke and the necessity of correction of glycemia in these patients.

[Eimeria of cattle in the Republic of Dagestan].

Data on Eimeria (Sporozoa: Coccidia) parasitizing cattle in different regions of the Republic of Dagestan are given. Eight species of the genus were found. Eimeria zuernii, E. subspherica, and E. bovis appeared to be the dominate species. Total infestation rate in the republic is 67.7%, while in mountain regions of Dagestan in is 83%.