Time trends in anxiety disorders incidence across the BRICS: an age-period-cohort analysis for the GBD 2021.

Background: Anxiety disorders are a significant global mental health concern, contributing to substantial disability-adjusted life years (DALYs) and imposing considerable social and economic burdens. Understanding the epidemiology of anxiety disorders within the BRICS nations (Brazil, Russian Federation, India, China, and South Africa) is essential due to their unique socio-economic landscapes and ongoing transformations. Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 database to evaluate anxiety disorder incidence trends in BRICS countries from 1992 to 2021. The Age-Period-Cohort (APC) model with an intrinsic estimator (IE) algorithm was employed to disentangle the effects of age, period, and cohort on incidence rates. Data were categorized into 5-year age groups, and 95% uncertainty intervals (UIs) were calculated to account for data variability. Results: From 1992 to 2021, the global number of anxiety disorders cases increased by 73.44%, with age-standardized incidence rates rising by 21.17%. Among BRICS nations, India experienced the largest increase in cases (113.30%), while China had the smallest increase (2.79%). Globally, young (15-49 years) and oldest (80-94 years) age groups showed predominantly positive local drift values, indicating rising incidence rates. Brazil and India mirrored this trend, while China and South Africa mostly exhibited negative local drift values. Russia Federation had mixed trends with younger groups showing negative and older groups positive local drift values. The incidence of anxiety disorders exhibited an "M-shaped" age pattern with peaks at 10-14 and 35-39 years. Period effects were stable globally but varied in BRICS countries, with Brazil showing a decline and India an increase. Cohort effects were stable globally but showed increasing trends in Brazil and India post-1955-1959 cohort. Conclusion: This study highlights a significant increase in anxiety disorders incidence globally and within BRICS nations over the past three decades, with marked variations across countries. The distinct trends observed in age, period, and cohort effects call for age-specific and gender-sensitive mental health policies. Continuous monitoring, research, and tailored public health strategies are essential to address the rising burden of anxiety disorders and improve mental health outcomes in these rapidly evolving regions.

[An interdisciplinary approach to assessing the risk of cerebrovascular accidents. Resolution of the Expert Council of the Russian Scientific Medical Society of Therapists]. / Mezhdistsiplinarnyi podkhod k otsenke riska vozniknoveniya narushenii mozgovogo krovoobrashcheniya. Rezolyutsiya Ekspertnogo soveta Rossiiskogo nauchnogo meditsinskogo obshchestva terapevtov.

An interdisciplinary approach to assessing the risk of cerebrovascular accidents. Resolution of the Expert Council of the Russian Scientific Medical Society of Therapists.

[Prevalence of dental anomalies and need for orthodontic treatment among adults in the Arctic part of the Arkhangelsk region]. / Rasprostranennost' zubochelyustnykh anomalii i nuzhdaemost' v ortodonticheskom lechenii u vzroslogo naseleniya Arkticheskoi zony Arkhangel'skoi oblasti.

OBJECTIVE: The aim of the study is to study the prevalence of dental anomalies (DA) and assess the need for orthodontic treatment (NOT) among adults in the Arctic part of the Arkhangelsk region. MATERIALS AND METHODS: In total, 1068 adult residents of Arkhangelsk and Primorski rural district aged 35-90 years took part in a cross-sectional study. The Dental Aesthetic Index (DAI) was used to assess the prevalence of DA and NOT in the study population. The prevalence is presented as percentage with 95% confidence intervals (CI) calculated using Wilson's method. RESULTS: The overall prevalence of DA was 55.2% (95% CI: 52.2-58.1). It was found that 58.2% (95% CI: 53.5-62.8) of men and 53.1% (95% CI: 49.2-56.9) of women required orthodontic treatment. The highest prevalence of malocclusion and the need for orthodontic treatment was identified in the age group of 60-74 years in both men and women. This high rate is due to removed teeth, periodontaland somatic diseases so that ortodontical treatment should be used to improve quality of life. CONCLUSIONS: The prevalence of dental anomalies and the need for orthodontic treatment in the adult population of the Arctic zone of the Arkhangelsk region is at a high level. Improving dental literacy and developing strategies directed at early prevention of dental diseases starting from childhood, particularly in remote areas, is warranted.

[The use of artificial intelligence in modern dentistry in the Russian Federation]. / Ispol'zovanie iskusstvennogo intellekta v sovremennoi stomatologii v Rossiiskoi Federatsii.

OBJECTIVE: The aim of the study is to identify the prospects and possibilities of using artificial intelligence (AI) and domestic software in the provision of organization dental care in the Russian Federation. MATERIALS AND METHODS: An analysis of the actual situation on the use of domestic computer programs using AI for the provision of medical care in the Russian Federation was carried out based on information presented on the official websites of software developers, in scientific sources of information and analytical systems of the Higher Attestation Commission, eLibrary, PubMed, Scopus, Google Scholar. Content analysis and analytical method were used, followed by interpretation of the data and conclusions obtained. RESULTS: To date, information technologies and domestic software aimed at automation, improving safety and quality of medical care are being actively introduced. The requirements for AI-based programs are justified, namely: safety, accessibility for medical professionals and patients, as well as high competitiveness among developers. AI helps to process large amounts of medical data, contributes to the creation of a personalized approach to patient treatment, automates and optimizes administrative processes in healthcare, increases the accuracy of diagnosis, identification of early signs of the disease, predicts the outcome of treatment, neural networks accelerate the development of remote healthcare and telemedicine. However, it is the doctor who should be responsible for the decisions made based on the "tips" and recommendations of artificial intelligence. CONCLUSION: The use of computer programs using artificial intelligence in dentistry opens up significant prospects for improving the quality of medical care, interaction with patients and improving the level of education of doctors. The most popular programs will be in therapeutic and pediatric dentistry, aimed, among other things, at the prevention of dental diseases.

Warming reduces trophic diversity in high-latitude food webs.

The physical effects of climate warming have been well documented, but the biological responses are far less well known, especially at the ecosystem level and at large (intercontinental) scales. Global warming over the next century is generally predicted to reduce food web complexity, but this is rarely tested empirically due to the dearth of studies isolating the effects of temperature on complex natural food webs. To overcome this obstacle, we used 'natural experiments' across 14 streams in Iceland and Russia, with natural warming of up to 20°C above the coldest stream in each high-latitude region, where anthropogenic warming is predicted to be especially rapid. Using biomass-weighted stable isotope data, we found that community isotopic divergence (a universal, taxon-free measure of trophic diversity) was consistently lower in warmer streams. We also found a clear shift towards greater assimilation of autochthonous carbon, which was driven by increasing dominance of herbivores but without a concomitant increase in algal stocks. Overall, our results support the prediction that higher temperatures will simplify high-latitude freshwater ecosystems and provide the first mechanistic glimpses of how warming alters energy transfer through food webs at intercontinental scales.

The Population Typology of Conspiracy Beliefs About Sars-Cov-2 Origin in Russia Based on Predictive Modelling of COMET-G Study Data: Incoherent Attitude Indicator as a Predisposing Factor for Developing Mental Disturbances.

BACKGROUND: We examined the prevalence and spread of conspiracy beliefs about the origins of the COVID-19 pandemic among representatives of the Russian population. Our study aimed to identify belief clusters and develop predictive models to understand the factors that influence conspiracy beliefs, particularly in the context of how they might evolve in response to socio-political events and cause mental disturbances, thus in relation to specific pathways of the infodemic and psychodemic waves that spread among vulnerable population groups. METHODS: Data respondents to the international COMET-G study living in Russia during pandemic period (n=7,777) were analyzed using descriptive statistics, K-means clustering, and various machine learning models, including gradient boosting. We identified distinct populations depending on predominant beliefs about COVID-19 pandemic origins, and applied game theory (Shapely additive explanations) to determine the most influential variables in predicting cluster membership. RESULTS: Four distinct belief clusters emerged, which we designate as Naturalists, Conspiracists, COVID-Sceptics, and the Incoherent Attitude groups. The Incoherent Attitude cluster constituted 20.8% of the sample, and was particularly associated with mental health signs such as sleep disturbances and the use of psychotropic medications. Internet use and mental health-related factors, as well as the respondents' education level, were key predictors of mental disturbances with mediating effects of the conspiracy views across all clusters. Conspiracy beliefs about COVID-19 origin were highly fluid/variable, often being shaped by external sociopolitical factors rather than objective health data. CONCLUSIONS: The cluster with Incoherent Attitude regarding COVID-pandemic origins, which had an association with psychoticism, showed a greater predisposition for mental health problems, than did the Conspiracist, Naturalist and Sceptic clusters. We suppose that underlying psychoticism bears a relation to their sleep problems and resorting to use of psychotropic medications. These results emphasizes the global health need for implementing target-focused and selective strategies that address public misinformation and promote the adoption of critical thinking skills to mitigate the impact of conspiracy theories, considering the factors of education level and pre-existing mental disorders.

Self-Harm Behavior and Suicidality Among Adolescents in Samara Region.

INTRODUCTION: Self-harm behavior is a significant global concern, with Russia among the countries with high prevalence rates. Adolescents and young adults (15-29 years old) are particularly vulnerable, with suicide being the fourth leading cause of death in this age group. Our objective was to present statistics on suicidality and non-suicidal self-harm behavior (NSSH) among adolescents in the Samara region and to identify psychosocial differences between patients hospitalized for the first time and those hospitalized repeatedly. SUBJECTS AND METHODS: This study is a retrospective chart analysis of adolescents hospitalized due to suicidal ideation or attempts in 2023. Data were collected from hospital records, comprising a diverse sample of adolescents. RESULTS: The sample included 76 adolescents, with a significant gender imbalance, as 84.2% were female. Chronic family conflicts presumably were the most influential factor, rather than family composition. Data on hereditary predisposition were subjective and presumably did not correlate with the number of hospitalizations. Fetal hypoxia was the only notable perinatal pathology. Self-harm behavior was more common in readmissions, while suicidal thoughts were present in similar proportions in both initial and repeat hospitalizations. The main reasons for self-harm behavior were the desire to gain control over life or to relieve emotional pain. Only 2.6% of cases were directly aimed at suicide. CONCLUSIONS: Identified risk factors for suicidal behavior among adolescents included female gender, an unfavorable family environment, and NSSH, which, although not directly suicidal, increased the risk of future suicidal behavior. These factors should be considered in the diagnosis and prevention of suicidal behavior.

Visual Snow Syndrome Prevalence Among Young Adults in the Russian Federation: a Research Perspective.

BACKGROUND: Visual snow syndrome (VSS) is a poorly understood neurological condition of unclear etiology, characterized by visual and non-visual symptoms that reduce quality of life. The objective of our study was to estimate the prevalence of young adults with visual snow in Russia. MATERIALS AND METHODS: We conducted an online survey among 1,177 respondents over the age of 18 residing in Russia. The questionnaire was based on MIDAS, HIT-6, ICHD-3, GAD-7, CES-D. RESULTS: A total of 1085 individuals, divided into three groups: 48 participants with Visual Snow Syndrome (VSS), 36 participants with visual snow symptoms (VS), and 1001 participants without visual snow (control group). Tinnitus (p<0.001) and paresthesia (p<0.001) were more common in participants with VSS compared to the control group. VSS group also reported mood disorders more frequently than those in the other groups (29.2% VSS, 13.9% VS, 7.0% control, p<0.001). Additionally, VSS group exhibited more elevated anxiety levels on the GAD-7 scale compared to the other groups (p=0.005), suggesting a weak association between anxiety and VSS. CONCLUSIONS: Diagnosed migraine, tinnitus, concentration problems, paresthesia, and verified psychiatric conditions were significantly more prevalent in the VSS group in our study. Tinnitus was significantly more frequent in the VS group. Diagnosed conditions across all ICD-10 classes were more frequently identified in the VSS group, with the strongest associations (moderate) found with ICD-10 codes: F80-F89 and F60-F69. Additionally ICD-10 codes F30-F39 were more frequently found in the VS group compared to the control group. Our study revealed that nearly all individuals with VSS in our sample (89.6%) had experienced symptoms for as long as they can remember. The prevalence of VS symptoms in Russia is 7.7% (6.2-9.3%) and VSS is 4.4% (3.2-5.7%).

Interpersonal Psychotherapy in Russia: Remembering Past Losses of the Heart, Keeping Mindful of the Culture of Melancholy, and Reconnecting with a Supportive Social Environment.

BACKGROUND: The dissolution of the Soviet Union brought economic instability and variety of social changes, resulting in fluctuating suicide rates and highlighting the national phenomenon of a melancholy cultural trait across the general population. The socio-political changes in Russia post-1991 led to increased rates of depressive and stress-related disorders, as well as opening avenues for integrating foreign psychotherapeutic methods, including Interpersonal Psychotherapy (Klerman-Weissman IPT), into the treatment of mental disorders. This narrative review explores the adaptation and efficacy of IPT in Russia, particularly for depressive and stress-related disorders. MATERIAL AND METHODS: We assembled key PhD theses related to the topic of IPT use in Russia. One such study involved 120 female patients aged 23-45 years with adjustment disorders, treated at the Omsk Rehabilitation Treatment Hospital. Participants were divided into an IPT group (n=80) and a control group (n=40) receiving treatment as usual (TAU). The IPT group underwent 12-16 individual sessions, each lasting 60 minutes, held twice a week. The main study group was further divided into four sub-groups based on specific interpersonal problems: loss of loved ones, interpersonal conflicts, social role changes, and social isolation. RESULTS: Both groups showed improvement in anxiety, dyssomnia, and motor retardation, with the IPT group demonstrating more sustained improvement. At the 8-week endpoint, full recovery from depression was observed in 50% of the IPT group, compared to only 20% in the TAU group. The IPT group also showed significant improvements in coping strategies, with a notable decrease in avoidance behaviors and an increase in problem-solving strategies, also targeting melancholy national phenomenon via training acceptance skills and practicing an active life position to aware the self-responisbility and achieve a of well-being state of emotional balance. The group IPT method was also experimentally combined with the person-oriented (reconstructive) psychotherapy, which has a long and successful history of within the group format, and has enabled shortening of the standard course of person-oriented reconstructive treatment. CONCLUSIONS: IPT method has proven efficacy in treating depressive and stress-related disorders in Russia, by addressing deeper pathogenetic levels of mental and behavioral formations. The Russian Society of Psychiatrists and Russian Psychotherapy Association have recommended its broader implementation in Russian mental health institutions, and has included IPT in the Russian National Guidelines for Psychiatry.

In Search of Optimal Criteria for Iron Deficiency in CHF Patients. Post-hoc Analysis of the Study "Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (ID-CHF-RF)".

AIM: Comparative analysis of clinical, anamnestic, and laboratory and instrumental data of patients with chronic heart failure (CHF) and iron deficiency (ID) diagnosed according to the AHA/ESC/RSC criteria, and CHF patients diagnosed with ID based on decreased transferrin saturation (TSAT) ≤19.8% or serum iron (Fe) ≤13 µmol/l. MATERIAL AND METHODS: An additional analysis of the ID-CHF-RF study was performed. The analyzed population included 498 patients (198 women) with CHF. In addition to the ID criteria provided by the protocol (AHA/ESC/RSC criteria: ferritin <100 µg/l or ferritin from 100 to 299 µg/l and TSAT<20%), concentrations of ID biomarkers were assessed, which showed high sensitivity and specificity for the diagnosis of ID compared to the morphological picture of the bone marrow (TSAT<19.8% or Fe ≤13 µmol/l). Subgroups of patients with ID determined only by the AHA/ESC/RSC criteria, only by the TSAT≤19.8% and Fe ≤13 µmol/l criteria, and by both were analyzed. RESULTS: ID diagnosed by the AHA/ESC/RSC criteria was found in 83.1% of patients. The TSAT ≤19.8% and Fe ≤13 µmol/l criteria revealed ID in 74.5% of patients. In 341 patients (76.8%), ID was diagnosed using both criteria. Patients with ID diagnosed by the TSAT≤19.8% and Fe≤13 µmol/l criteria, compared with patients with ID diagnosed by the AHA/ESC/RKO criteria, had a 50% lower Fe (9.8 µmol/l vs. 19.4 µmol/l) and a higher incidence of anemia (43.3% vs. 23.3%) and diabetes mellitus (DM) (36.7% and 24.7%). Also, these patients had higher values of body mass index (BMI) and NT-proBNP concentration (2317 [1305;9092] vs. 1691 [709;3856] pg/ml), and lower LV EF values (41.5 [29.0;54.5]% vs. 45.0 [34.0;54.0]%), respectively. The most severe course of CHF and the greatest changes in laboratory tests associated with ID and anemia were observed in patients with ID determined by two criteria. Patients in this group were older, with a higher BMI, more frequent presence of atrial fibrillation, and higher NT-proBNP (4182 [1854;9341] pg/ml). CONCLUSION: Patients with isolated low ferritin are characterized by less severe clinical and functional impairment compared to patients with low TSAT or Fe. At the same time, patients with ferritin higher than 300 µg/l and low TSAT and/or Fe were characterized by very severe CHF and a low functional status, although this may not be related with ID. Thus, the use of the ferritin-based criteria of ID may lead to overdiagnosis of ID in some patients and, at the same time, miss some of the most "severe" patients who likely require the ID correction. Patients with ID who show a decrease in all three parameters are likely to benefit most from Fe supplementation. It is advisable to perform additional studies on the effect of Fe supplements on the course and prognosis of the disease in this cohort of patients.

Spectrum of COVID-19 cases in Arkhangelsk, Northwest Russia: Findings from a population-based study linking serosurvey, registry data, and self-reports of symptoms.

INTRODUCTION: The spectrum of COVID-19 manifestations makes it challenging to estimate the exact proportion of people who had the infection in a population, with the proportion of asymptomatic cases likely being underestimated. We aimed to assess and describe the spectrum of COVID-19 cases in a sample of adult population aged 40-74 years in Arkhangelsk, Northwest Russia, a year after the start of the pandemic. MATERIALS AND METHODS: A population-based survey conducted between February 24, 2021 and June 30, 2021 with an unvaccinated sample aged 40-74 years (N = 1089) combined a serological survey data, national COVID-19 case registry, and self-reported data on COVID-19 experience and symptoms. Based on the agreement between these sources, we classified the study participants as non-infected and previously infected (asymptomatic, non-hospitalized and hospitalized symptomatic) cases, and compared these groups regarding demographics, lifestyle and health characteristics. RESULTS: After a year of the pandemic in Arkhangelsk, 59.7% 95% confidence intervals (CI) (56.7; 62.6) of the surveyed population had had COVID-19. Among those who had been infected, symptomatic cases comprised 47.1% 95% CI (43.2; 51.0), with 8.6% 95% CI (6.6; 11.1) of them having been hospitalized. Of the asymptomatic cases, 96.2% were not captured by the healthcare system. Older age was positively associated, while smoking showed a negative association with symptomatic COVID-19. Individuals older than 65 years, and those with poor self-rated health were more likely to be hospitalized. CONCLUSION: More than half of the infected individuals were not captured by the healthcare-based registry, mainly those with asymptomatic infections. COVID-19 severity was positively associated with older age and poor self-rated health, and inversely associated with smoking. Combining different sources of surveillance data could reduce the number of unidentified asymptomatic cases and enhance surveillance for emerging infections.

[Medicine of the future: the role of artificial intelligence in optimizing nutrition for the health of the Russian population].

One of the most pressing medical, social and government tasks is to ensure health saving, improve the quality of life and increase the life expectancy of the Russian population. The most important lever to ensure the solution of these issues is the optimization of nutrition and the use of methods of artificial intelligence (AI) and new information technologies to support decision-making in this area. The purpose of the study was to familiarize specialists with the Scientific Instrument for Nutrition Analysis (SINA), created on the basis of AI technologies to optimize nutrition and prevent alimentary diseases in order to preserve the health of the population of the Russian Federation. Results. A patent was created and received for a scientific web tool (SINA) based on AI technologies for actual nutrition analyzing with subs equent assessment of health status and generation of recommendations, including a personalized diet, which is formed based on individual human needs for energy, nutrients and bioactive compounds, taking into account genome, gender characteristics, age, food preferences, profession, diseases, medication treatment, clinical blood parameters, individual morphological and constitutional characteristics, his physical activity, etc. Conclusion. The results of using SINA can reduce the labor costs of doctors; personalize diets as much as possible taking into account many factors; increase patient adherence to the prescribed diet and recommendations; increase public awareness of nutrition issues, reduce morbidity rates and improve public health. The high-tech approach using AI is advanced and is capable of solving many key challenges in the field of health care, prevention and medicine in general, and improve the quality of life of the population.

[Assessment of the radiation risk to health caused by the intake of Cs-137 and Sr-90 radionuclides from food in the able-bodied population of the Samara region].

Monitoring of the content of technogenic radionuclides (Cs-137 and Sr-90) in foods is one of the key areas in ensuring radiation safety of the population, taking into account the current radiation situation. The greatest risk to health is food produced or imported from the territories that have been subjected to man-made radiation accidents. The purpose of the research was to assess the radiation risk caused by oral intake of radionuclides based on the study of the actual nutrition of the adult population and contamination of food with Cs-137 and Sr-90 radionuclides. Material and methods. The specific activity of Cs-137 and Sr-90 radionuclides (median and 90 percentile) was assessed by gamma spectrometric method in 1235 samples of food produced in the Samara region and imported from outside. Data on the actual nutrition of 894 respondents aged 18 to 68 years (in the autumn-winter period) were obtained by the 24-hour dietary recall using the automated software package Nutri-prof (version 2.9). Based on the data obtained, effective annual doses of internal radiation were calculated, information was obtained on the risks of malignant neoplasms, including in the long-term period under various scenarios of internal radiation. Results. Radiometric studies of food samples did not reveal deviations from hygienic standards. The highest median values of Cs-137 specific activity were observed in samples of forest mushrooms (1.23 Bq/kg), wild berries (0.97 Bq/kg), fish and fish products (0.96 Bq/kg). The highest median values of Sr-90 specific activity were also observed in samples of forest mushrooms (3.86 Bq/kg), fish and fish products (2.71 Bq/kg). The radiation risk under various scenarios of Cs-137 intake was regarded as «negligible¼, while the risk was regarded as «small¼ when consuming food contaminated with Sr-90. The number of additional cases of malignant neoplasms at the admission of Cs-137 in the median values of specific activity is 0.38 per year, at maximum values - 0.57 per year, at the admission of Sr-90 - 2.04 per year and 3.30 cases per year, respectively. Conclusion. The implementation of radiation monitoring of food, especially those imported from areas of high radiation risk, is a necessary condition for ensuring radiation safety of the population. It is also necessary to take into account the stochastic effect of the influence of small doses of internal exposure on the organism when consuming food, which make a significant contribution to the formation of the dose of internal radiation.

[Vitamin D and childhood disability: diseases of the musculoskeletal system and connective tissue in the Khanty-Mansi Autonomous Okrug - Ugra].

Vitamin D deficiency is more prevalent among children with musculoskeletal and connective tissue disorders (MSCTD), which plays a significant role in childhood disability, which ranks sixth in the structure of childhood disability in the Russian Federation. The aim of the research was to study of the relationship between the incidence of childhood disability associated with MSCTD and the state of vitamin D status of the population living in the territory of the Khanty-Mansiysk Autonomous Okrug - Ugra. Material and methods. A correlation analysis was carried out between the level of childhood disability (that arose in connection with MSCTD in children aged 0-17 years in the Khanty-Mansi Autonomous Okrug - Ugra in 2021) and the prevalence of severe vitamin D deficit [serum 25(OH)D <10 ng/ml] among the population (12 city and 5 district municipalities), using the INVITRO-Ural LLC database (31 595 anonymized measurements of vitamin D level in Ugra residents). In addition, a correlation analysis was conducted between the total incidence of certain types of MSCTD in the constituent entities of the Russian Federation and the geographical latitude of the administrative center of the subjects of the Federation. Results. In the Khanty-Mansi Autonomous Okrug - Ugra, the frequency of childhood disability resulting from MSCTD is associated with a statistically stable (p=0.01) directly proportional relationship with the prevalence of severe vitamin D deficit in the residents of the municipality territory. In the Russian Federation, the dependence of the general morbidity of MSCTD in children (arthropathy, juvenile arthritis, and damage to the tendon synovial membranes) is very stable (p<0.0001) directly proportional associated with the geographical latitude of the territory. This indicates the impact of reduced levels of ultraviolet radiation and, accordingly, the average blood level of vitamin D in the population high in latitudes, along with other reasons, on human health. Conclusion. Low levels of vitamin D have a negative impact on the activity of MSCTD in children and the associated disability. To justify the recommended daily dose and duration of vitamin D intake, which in some cases can reduce the activity of MSCTD, it is necessary to measure its initial level in the blood serum of patients at risk.

[Determination of carbohydrate content in soft drinks. Methodological aspects and results of research using various methods].

An important component of the programs to prevent type 2 diabetes mellitus, obesity, and other chronic noncommunicable diseases is limiting the intake of added sugars. Information about the composition of the product and its nutritional value contained in the labeling contributes to the informed choice of consumers when forming a diet. On July 1, 2023, new provisions of the Tax Code of the Russian Federation came into force, providing for the imposition of an excise tax on "sugar-containing drinks" - soft drinks made with added sugar and containing carbohydrates in quantities of more than 5 g/100 ml. The stated goal of the new excise regulation is to reduce sugar consumption by the population. Currently, information on the carbohydrate content in soft drinks is provided by manufacturers based on calculated values according to the recipe, which makes it possible to take into account as much as possible all the carbohydrate components of the product. There is no standardized method for analytically assessing the carbohydrate content of soft drinks (including "sugar-sweetened beverages" for excise tax purposes). The purpose of the work was the comparative analysis of existing analytical methods for determining the content of sugars and carbohydrates in general in foods, including beverages; and determination of the most correct analytical approach to assessing the content of carbohydrates in soft drinks. Material and methods. The existing methods for determining sugars and carbohydrates in foods, including beverages, have been analyzed. The objects of research were samples of model aqueous solutions with different sugar concentrations (30 samples) and 17 samples of industrially produced soft drinks (including tonic and tonic energy drinks) made using sugar or sugars (glucose-fructose syrup), sweeteners, and a mixture of sugar and sweeteners. The total content of sugars/carbohydrates in beverages was determined: in accordance with MU 10-05031531-372-93 as the difference between the total dry matter content and the dry matter from acids; by the Bertrand method; by the Bertrand-Schorl method. The obtained values were compared with the calculated data specified in the labeling of consumer packaging of the products. Results. The determination of sugars in model solutions showed sufficient accuracy of the Bertrand-Schorl method: deviations of the obtained values from the amount of sugars added to the model solution were observed only at their high concentration (over 10 g/100 ml) and amounted to ±0.1 g/100 ml. The carbohydrate content in industrial soft drinks estimated by various methods differed slightly from that indicated in the labeling (obtained by calculation). The differences were at the level from - 0.2 to +0.4 g/100 ml when using the method from MU 10-05031531-372-93, at the level from -2.6 to +0.8 g/100 ml when using the Bertrand method and at the level from -2.7 to +0.1 g/100 ml when using the Bertrand-Schorl method. The greatest differences were observed for tonic drinks (including energy drinks) - from -2.7 to +0.3 g /100 ml, depending on the method. Conclusion. The research data showed that the Bertrand-Schorl method can be used as a basis for developing a state standard for determining the total sugar content in soft drinks and for assessing their carbohydrate content in general. At the same time, the method needs to be refined for tonic drinks. At present, the most acceptable method is to assess the carbohydrate content using the analytical method given in MU 10-05031531-372-93, but it should be taken into account that deviations from the carbohydrate content values determined by this method from the values obtained by calculation can be up to +10%. At the same time, the calculation method for determining the carbohydrate content in drinks remains a priority, including for the purposes of excise regulation.

[The prevalence of mutations underlying development of Helicobacter pylori resistance to antibiotics in Kazan].

BACKGROUND: One of the reasons for the decrease of Helicobacter pylori eradication effectiveness is its resistance to antibiotics. AIM: To examine the prevalence of H. pylori point mutations responsible for clarithromycin and levofloxacin resistance among the patients with upper gastrointestinal (GI) tract disorders in Kazan. MATERIALS AND METHODS: The study included 203 patients with symptoms of dyspepsia who underwent upper GI endoscopy at the University Hospital of Kazan Federal University (Kazan, Russia) in 2019-2021. DNA isolation from gastric antrum mucosal biopsies was performed using PureLink Genomic DNA Mini Kits (Thermo Fisher Scientific, USA). Polymerase chain reaction was performed using primers specific for the V-region of the 23S gene and the A subunit DNA gyrase encoding gyrA gene region. The sequencing of obtained DNA fragments was performed on 3730 DNA Analyzer. The sequences were searched for point mutations responsible for H. pylori resistance to clarithromycin (A2143G, A2142G and A2142C193 mutations) and levofloxacin (mutations of the gyrA gene). RESULTS: H. pylori was detected in 47.78% of biopsy specimens using polymerase chain reaction. The proportion of H. pylori strains with mutations leading to clarithromycin resistance was 17.53%. Amino acid substitutions in the gyrA gene were found in 12.37% of samples. In case of two H. pylori strains (2.06%), dual resistance to clarithromycin and levofloxacin was found. CONCLUSION: So high incidence of mutations underlying the development of H. pylori resistance to clarithromycin and levofloxacin was observed among examined patients in Kazan.

[Detection of anticoagulant medication errors by triggers].

BACKGROUND: Medication errors can cause preventable adverse events. For example, inappropriate use of anticoagulants (AC) can result in bleeding and thromboembolic complications. Detection and analysis of AC medication errors allow to reveal deficiencies in the safety systems in healthcare organizations. AIM: The study was aimed to develop a method of systematic detection of anticoagulant medication errors for consequent audit, analysis and development of medication safety improvement measures. MATERIALS AND METHODS: The study was conducted in the multidisciplinary hospital and included 4924 patients admitted from January 2019 to December 2021 who received AC. Three laboratory triggers (international normalized ratio ≥4, serum creatinine ≥133 µmol/l, and glomerulofiltration rate <30 ml/min/1.73 m2) helped to reveal 4304 cases. Their matching with patient's data helped to develop combined triggers. Two clinical pharmacologists reviewed all cases identified by combined triggers for checking medication errors. The trigger was considered positive when anticoagulant medication error was detected in the history selected by combined trigger. RESULTS: Of the 4924 patients 253 (5.3%) were selected by combined triggers. Combined trigger allowed to reduce the amount of medical health records audit by 97.3%. Medication errors were detected in 137 patients. Positive predictive value of selected combined triggers varied from 0 to 63.9%. Aggregated positive predictive value of all combined triggers amounted to 54.2%. AC medication errors were detected in 2.8% patients. CONCLUSION: Method of systematic detection of AC medication errors using combined triggers in all hospitalized patients receiving AC allowed to reveal typical medication errors for consequent analysis and elaboration of measures to reduce preventable patient harm in healthcare settings.

[Prevalence of gastroesophageal reflux disease in Russia: a meta-analysis of population-based studies].

AIM: To systematize data on the prevalence of gastroesophageal reflux disease (GERD) in the adult population of Russia. MATERIALS AND METHODS: The search for studies was conducted in the electronic databases MEDLINE/PubMed, EMBASE, and RSCI (Russian Science Citation Index) from January 2000 to December 2022. The review included relevant publications in peer-reviewed periodicals in English or Russian, publications with data from cross-sectional epidemiological studies assessing the prevalence of GERD in the Russian population, studies on adult patients with GERD, and publications with detailed descriptive statistics that allow using the data in the meta-analysis. RESULTS: The final analysis included 6 studies involving 34,192 subjects. The overall prevalence of GERD (prevalence of heartburn ± regurgitation once a week or more frequently) in the analyzed studies was 25.605% (95% confidence interval [CI] 17.913-34.147). The analysis used a random effect model, as there was significant heterogeneity between the results in both groups (I2=99.63%; p<0.0001). The overall mean age of GERD patients in the study population was 48.14 (95% CI 32.25-4.03) years. The prevalence of GERD in the male population was 23.653% (95% CI 13.351-35.832) and 25.457% (95% CI 17.094-34.849) in females. CONCLUSION: This meta-analysis demonstrated that GERD is a common esophageal disease in the Russian population, affecting approximately one in four country residents.