[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.

[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 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.

[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.

[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]

[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.

[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.

[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.

[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.

[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%.

[The epidemiological features of concomitance of diabetes mellitus and pulmonary tuberculosis].

The study was undertaken to reveal the clinical and epidemiological features of development diabetes mellitus (DM) and pulmonary tuberculosis (PT) in comorbidity. The material of the study was 143 case histories and outpatient cards of patients with DM and PT who were registered in 2001-2006. A total of 11,702 cases of tuberculosis were notified in 1999-2005. The significance ofa difference between the extensive indices was assessed by Student's test preceded by the Fisher angular transformation. Thus, the specific features of development of DM and PT are: 1) type 1 DM frequently occurs in youth while type 2 DM does at mature age; 2) tuberculosis in DM patients occurs at mature and old ages; 3) there is a male preponderance among patients with type 1 DM and a female predominance among those with type 2 DM; 4) comorbidity is more common in town-dwellers; 5) severe PT was prevalent in type 1 DM; mild PT is rarely observed in type 2 DM; 6) in comorbidity, fibro-cavernous, cirrhotic tuberculosis, caseous pneumonia, and tuberculoma are encountered by several times more frequently and focal tuberculosis and tuberculous pleurisy are less frequently in patients without DM.

[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.

Overview of genetic-epidemiological studies in ethnically and demographically diverse isolates of Dagestan, Northern Caucasus, Russia.

AIM: To assess genetic diversity and genetic distances among isolated populations from Dagestan. METHODS: A cross-population genetic epidemiology design was applied in ethnically and demographically diverse isolates from Dagestan, some with more than 200 and some with less than 100 generations of demographical history since their founding. RESULTS: The analysis of genetic diversity showed that Dagestan ethnic populations are clearly close to European ethnic populations. The genetic data support the view of them as ancient, highly isolated populations 85%-97% the rate of the endogamy and inbreeding coefficient F=0.010-0.015. Many Dagestan populations have very high prevalence of certain complex diseases such as cardiovascular illnesses, cancer, schizophrenia, mental retardation, and progressive muscular dystrophy. Lifetime morbid risk for schizophrenia in the isolates varied from 0 to 5%. Among the relatives, the number of men with chronic schizophrenia was at least twice as high as women. The average age of onset of schizophrenia was 21.2 years for offspring of consanguineous marriages and 17.4 years for offspring of non-consanguineous marriages (P=0.033). CONCLUSION: The results support the hypothesis that cross-population design provides unique opportunities for observing reliable ancestral haplotypes with disease predisposing loci, as well as population-specific linked loci.

[Impact of the area burden of agrochemicals on tuberculosis morbidity and mortality].

The rate of use of pesticides and mineral fertilizers in the Republic of Daghestan was high in the USSR and Russia and was many times greater than the critical burden (3/93 kg/ha) and ranged from 3.5-4.2 kg/ha in the highlands to 17.0-21.7 kg/ha in the plain. Two-factor analysis indicated that out of the mineral fertilizers, pesticides and phosphate fertilizers had the most adverse effect on the incidence of tuberculosis whereas potash fertilizers exerted a less effect. Phosphate fertilizers and copper-containing pesticides were secondary risk factors of death from tuberculosis. The correlation coefficient was 0.53 for phosphate fertilizers, 0.59 upon total exposure to organochlorine compounds, and 0.68 upon total exposure to copper-containing pesticides.

[Recurrence of echinococcosis: pathogenesis, prophylaxis, early diagnosis and treatment].

Complex of measures for prophylaxis of echinococcosis recurrence was developed basing on experimental and clinical studies. Results of surgical treatment of echinococcosis of different location in 983 patients were analyzed. Complex approach to the treatment reduced the rate of recurrences to 0.6% (p=0,0002). Criteria of recovery and algorithm of early diagnosis of echinococcosis recurrence are presented.

[Drug addiction morbidity in Republic of Dagestan].

In Republic of Dagestan, analysis of drug addiction morbidity rate for last ten years refers to that its level in urban population is four times higher than in rural areas. Portion of opiate addicts detected for the first time consists 46.8% in urban areas and 22.1% in rural areas. In the morbidity structure of age-specific drug addiction highest level is in the age group of 20-39 years and 40-59 years. In rural areas, as compared with urban areas, drug addiction cases among women were detected for the first time only in 2004. In rural areas and towns of Republic, there are territories with higher rates of drug addiction morbidity.

[Genetic and epidemiological studies in Dagestan highland isolates]. / Genetiko-épidemiologicheskie issledovaniia v gornykh izoliatakh Dagestana.

Interpopulation differences in the epidemiology and age of onset of complex diseases, as well as expression of some vital parameters, have been found. The relationship between these interpopulation differences and the genetic processes that have been occurring in the populations throughout their history has been demonstrated. The Daghestan genetic isolates studied are characterized by aggregation of certain complex diseases. In each genetic isolate, almost all affected subjects with homogeneous clinical phenotypes belong to the same large pedigree with a limited number of founders. There is evidence for a large variance of the population risk of schizophrenia (morbid risk) in Daghestan isolates (this parameter varies from 0 to 5%). Examination of 211 cases of schizophrenia earlier diagnosed in Daghestan psychiatric hospitals has shown that only 139 of them meet the DSM-IV criteria for schizophrenia. The remaining 72 subjects have, according to DSM-IV criteria, various schizoaffective and affective disorders; all of these subjects are close relatives of the schizophrenic patients. The age of onset of schizophrenia in the isolates studied varies from 14 to 40 years (20.84 +/- 0.568 years). Offspring of consanguineous marriages exhibit later age at onset and a higher risk of schizophrenia than offspring of exogamous marriages. The results of multivariate genetic analysis indicate that different gene complexes are involved in the pathogeneses of early-onset and late-onset forms of schizophrenia. An association of schizophrenia incidence, its age dependence, and reproductive parameters with polymorphisms of some microsatellite loci have been demonstrated.