[The Constituent and Second Sessions of the General Meeting of the USSR Academy of Medical Sciences (1944-1945) and tasks of the Soviet medicine in post-war period].

The article presents the materials of the 1st and 2nd sessions of the General Meeting of the USSR Academy of Medical Sciences (1944 and 1945). The comparative analysis of main tasks set at these sessions for the Soviet medical science and practical public health is implemented. It is demonstrated that if the 1st session of the USSR Academy of Medical Sciences (December 20-22, 1944) was devoted, in addition to organizational tasks, to formulation of main directions in development of fundamental (morphology, physiology, biochemistry, etc.), and practical (surgery, therapy, obstetrics, etc.) medicine, then at the 2nd session (October 28 - November 2, 1945) scientists and medical workers of the USSR were tasked to eliminate sanitary consequences of the Great Patriotic War (1941-1945) and to restore health of population of the country.

On the classification of cerebral tumors: A tribute to Leonid Smirnov.

The corresponding member of the Academy of Medical Sciences of the USSR Professor Leonid Iosifovich Smirnov (1889 - 1955) authored several dozen publications on neuropathology of infections, schizophrenia, cerebral injuries, and brain tumors. Based on his study of pathology of gunshot head injuries during World War II he suggested a doctrine of traumatic on traumatic brain disease. He was the author of the first Russian classification of cerebral tumors and had an impact on the development of neurooncology in the former USSR. The aim of this paper is to show the early development of modern neuropathology at the example of a leading Soviet neuropathologist in the first half of the 20th century and his relevance for modern classification of CNS tumors.

Genetic Variation and Cardiovascular Risk Factors: A Cohort Study on Migrants from the Former Soviet Union and a Native German Population.

Resettlers are a large migrant group of more than 2 million people in Germany who migrated mainly from the former Soviet Union to Germany after 1989. We sought to compare the distribution of the major risk factors for cardiovascular disease (CVD) and to investigate the overall genetic differences in a study population which consisted of resettlers and native (autochthone) Germans. This was a joint analysis of two cohort studies which were performed in the region of Augsburg, Bavaria, Germany, with 3363 native Germans and 363 resettlers. Data from questionnaires and physical examinations were used to compare the risk factors for cardiovascular diseases between the resettlers and native Germans. A population-based genome-wide association analysis was performed in order to identify the genetic differences between the two groups. The distribution of the major risk factors for CVD differed between the two groups. The resettlers lead a less active lifestyle. While female resettlers smoked less than their German counterparts, the men showed similar smoking behavior. SNPs from three genes (BTNL2, DGKB, TGFBR3) indicated a difference in the two populations. In other studies, these genes have been shown to be associated with CVD, rheumatoid arthritis and osteoporosis, respectively.

Findings of Russian literature on the clinical application of Eleutherococcus senticosus (Rupr. & Maxim.): A narrative review.

ETHNOPHARMACOLOGICAL RELEVANCE: Eleutherococcus senticosus (Rupr. et Maxim.) Maxim (ES) (syn. Acanthopanax senticosus (Rupr. & Maxim.) Harms) is a medicinal plant used in traditional medicine of Russian Far East and East Asia and known as an adaptogen - a category of herbal medicinal products which have non-specific inter-system anti-stress effects throughout the human body. ES was first established as a medicinal plant officially in the pharmacopeia of the Union of Soviet Socialist Republics (USSR) in 1962, and is currently recommended by the European Medicines Agency (EMA) to be prescribed to treat symptoms of asthenia such as fatigue and weakness. AIM OF THE REVIEW: During the time of the USSR, a distinct research directive was undertaken on ES to examine substances which improve stamina and endurance, with over 1000 studies published. Due to security measures within the former USSR these papers were not accessible to the public and were never translated into English. This is the first study to make findings of the USSR studies on ES available to the international research and scientific community. METHODS: This study was an archival retrieval. References for studies were sought from printed journal and conference preceding's publications, then located within library catalogues of three libraries in St Petersburg Russia. Eligibility criteria included human clinical trials examining the efficacy of ES in any condition, published in the Russian language in the Soviet Union. RESULTS: A total of 46 studies published between 1962 and 1986 in the USSR were sourced. Of the retrieved articles, 29 were reported as placebo-controlled trials, 11 were reported as controlled trials and six studies did not report the study design. Trends in studies were those reporting on healthy volunteers (n=21) at a dose of 2 ml extract/day (n=14) examining outcomes such as physical and mental stamina under varying conditions, normal work conditions, high temperatures and high altitudes, incidence or prophylaxis of colds and influenza (n=5), effects on color perception and vision (n=2), work capacity (n=1), cognitive effects (n=1), prophylaxis of hearing loss (n=3), effects on blood cell counts (n=2) and sensitivity to UV radiation (n=1). CONCLUSIONS: ES appears to exhibit benefits for cognitive function and physical and mental endurance and its effect as a respiratory system infection prophylaxis treatment are promising. This study is the first to publish the findings of clinical trials on ES from the USSR, which supports the traditional use and offers a valuable contribution to the body of evidence on medicinal uses of ES when the data is applied within the context of its limitations.

Colorectal Cancer among Resettlers from the Former Soviet Union and in the General German Population: Clinical and Pathological Characteristics and Trends.

This study examined time trends and clinical and pathological characteristics of colorectal cancer (CRC) among ethnic German migrants from the Former Soviet Union (resettlers) and the general German population. Incidence data from two population-based cancer registries were used to analyze CRC as age-standardized rates (ASRs) over time. The respective general populations and resettler cohorts were used to calculate standardized incidence ratios (SIRs) by time-period (before and after the introduction of screening colonoscopy in 2002), tumor location, histologic type, grade, and stage at diagnosis. Additionally, SIRs were modeled with Poisson regression to depict time trends. During the study period from 1990 to 2013, the general populations showed a yearly increase of ASR, but for age above 55, truncated ASR started to decline after 2002. Among resettlers, 229 CRC cases were observed, resulting in a lowered incidence for all clinical and pathological characteristics compared to the general population (overall SIR: 0.78, 95% CI 0.68-0.89). Regression analysis revealed an increasing SIR trend after 2002. Population-wide CRC incidence decreases after the introduction of screening colonoscopy. In contrast the lowered CRC incidence among resettlers is attenuating to the general population after 2002, suggesting that resettlers do not benefit equally from screening colonoscopy.

Comparison of breast cancer and cervical cancer stage distributions in ten newly independent states of the former Soviet Union: a population-based study.

BACKGROUND: Screening for breast cancer and cervical cancer in the newly independent states of the former Soviet Union is largely opportunistic, and countries in the region have among the highest cervical cancer incidence in the WHO European Region. We aimed to compare the stage-specific distributions and changes over time in breast cancer and cervical cancer incidence in the newly independent states of the former Soviet Union. METHODS: We collected breast cancer and cervical cancer incidence data from official statistics from Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Republic of Moldova, Russian Federation, Ukraine, and Uzbekistan for the years 2008-17 by tumour, node, metastasis (TNM) stage, and by age where population-based cancer registry data were available. We used log-linear regression to quantify the changes over time in age-standardised rates. FINDINGS: During the period 2013-17, more than 50% of breast cancer cases across the analysed countries, and more than 75% of breast cancer cases in Belarus, Kazakhstan, and Ukraine, were registered at stages I-II. The proportion of stage I breast cancer cases was highest in the screening age group (50-69 years) compared with other ages in Moldova and the Russian registries, but was highest in those aged 15-49 years in Georgia and Ukraine. Breast cancer stage-specific incidence rates increased over time, most prominently for stage I cancers. For cervical cancer, the proportions of cancers diagnosed at a late stage (stages III and IV) were high, particularly in Moldova and Armenia (>50%). The proportion of stage I cervical cancer cases decreased with age in all countries, whereas the proportions of late stage cancers increased with age. Stage-specific incidence rates of cervical cancer generally increased over the period 2008-17. INTERPRETATION: Our results suggest modest progress in early detection of breast cancer in the newly independent states of the former Soviet Union. The high proportions of early-stage disease in the absence of mammography screening (eg, in Belarus) provide a benchmark for what is achievable with rapid diagnosis. For cervical cancer, there is a need to tackle the high burden and unfavourable stage-specific changes over time in the region. A radical shift in national policies away from opportunistic screening toward organised, population-based, quality-assured human papillomavirus vaccination and screening programmes is urgently needed. FUNDING: Union for International Cancer Control, WHO Regional Office for Europe, and Ministry of Health of Ukraine.

The Incidence of Intestinal Gastric Cancer among Resettlers in Germany-Do Resettlers Remain at an Elevated Risk in Comparison to the General Population?

OBJECTIVE: Previous studies have shown that the incidence of gastric cancer (GC), and particularly intestinal GC, is higher among resettlers from the former Soviet Union (FSU) than in the general German population. Our aim was to investigate if the higher risk remains over time. METHODS: GC cases between 1994 and 2013, in a cohort of 32,972 resettlers, were identified by the respective federal cancer registry. Age-standardized rates (ASRs) and standardized incidence ratios (SIRs) were analyzed in comparison to the general population for GC subtypes according to the Laurén classification. Additionally, the cohort was pooled with data from a second resettler cohort from Saarland to investigate time trends using negative binomial regression. RESULTS: The incidence of intestinal GC was elevated among resettlers in comparison to the general population (SIR (men) 1.64, 95% CI: 1.09-2.37; SIR (women) 1.91, 95% CI: 1.15-2.98). The analysis with the pooled data confirmed an elevated SIR, which was stable over time. CONCLUSION: Resettlers' higher risk of developing intestinal GC does not attenuate towards the incidence in the general German population. Dietary and lifestyle patterns might amplify the risk of GC, and we believe that further investigation of risk behaviors is needed to better understand the development of disease pattern among migrants.

History of the E.I. Martsinovsky Institute of Medical Parasitology and Tropical Medicine: research on malaria and leishmaniasis / História do Instituto E.I. Martsinovsky de Parasitologia Médica e Medicina Tropical: pesquisa sobre malária e leishmaniose

Abstract This review presents the 100-year history of the Martsinovsky Institute of Medical Parasitology and Tropical Medicine in Moscow, Russia, starting with its foundation and early activities, and also describes the impact of its leading scientists, some of whom became internationally known. The institute headed a network of nine tropical institutes in the various Soviet republics from the 1920s to 1990. The extensive body of literature on the history and research accomplishments of this institute has mainly been published in Russian; our goal here is to introduce these achievements and this expertise to the international scientific and medical community, focusing on malaria and leishmaniasis and the development of measures to control and monitor these diseases in the USSR.

Resumo O artigo analisa a história centenária do Instituto Martsinovsky de Parasitologia Médica e Medicina Tropical em Moscou, Rússia, desde sua fundação e primeiras atividades, e descreve a influência de seus principais cientistas, alguns dos quais viriam a conquistar renome internacional. O instituto liderou uma rede de nove institutos tropicais em diversas repúblicas soviéticas entre as décadas de 1920 e 1990. A vasta literatura sobre o trabalho de história e pesquisa desse instituto foi publicada sobretudo em russo; nosso objetivo aqui é apresentar esse trabalho e conhecimento à comunidade médica e científica internacional, concentrando-se na malária e na leishmaniose e no avanço de medidas de controle e monitoramento dessas doenças na URSS.

Transmission of HIV and HCV within Former Soviet Union Countries.

Background: Following the collapse of the Union of Soviet Socialist Republic (USSR) in 1991, trans-border mobility increased within the former Soviet Union (FSU) countries. In addition, drug-trafficking and injection drug use began to rise, leading to the propagation and transmission of blood-borne infections within and across the FSU countries. To examine the transmission of blood-borne infections within this region, we analyzed the phylogenetic relationship of publically available sequences of two blood-borne viruses, hepatitis C virus (HCV) and human immunodeficiency virus (HIV), from FSU countries. Methods: We analysed 614 and 295 NS5B sequences from HCV genotypes 1b and 3a, respectively, from 9 FSU countries. From 13 FSU countries, we analysed 347 HIV gag and 1282 HIV env sequences. To examine transmission networks and the origins of infection, respectively, phylogenetic and Bayesian analyses were performed. Results: Our analysis shows intermixing of HCV and HIV sequences, suggesting transmission of these viruses both within and across FSU countries. We show involvement of three major populations in transmission: injection drug user, heterosexual, and trans-border migrants. Conclusion: This study highlights the need to focus harm reduction efforts toward controlling transmission of blood-borne infections among the abovementioned high-risk populations in the FSU countries.

Determinants of Bone Mineral Screening Behavior among Three Ethno-Cultural Groups of Women in Israel.

Bone mineral density (BMD) screening is one of the main means to detect and treat osteoporosis. Yet, the manner in which ethno-cultural background is associated with BMD health cognitions and screening behavior remains limited. Several ethno-cultural groups (n = 100 in each group)-Israeli-born Jews, Israeli-born Bedouin-Muslims, and Jewish immigrants from the Former Soviet Union (FSU), mean age 70 (SD = 7.1)-participated in face-to-face interviews in a cross-sectional survey, using valid and reliable questionnaires on BMD screening behavior, knowledge about osteoporosis, and theory of planned behavior (TPB) components. FSU immigrants reported the lowest BMD screening behavior. The multivariate analysis showed that higher knowledge level, positive attitudes, supportive subjective norms, and greater intentions increase the probability of BMD screening behavior. The TPB attitude component had a more pronounced effect on the probability of undergoing BMD screening among Israeli-born Bedouin-Muslims compared to Israeli-born Jews. Our findings contribute to the TPB by deepening our understanding of the associations between TPB components and BMD screening behaviors, from an ethno-cultural perspective. To assure sufficient BMD screening behavior among all ethno-cultural groups, intervention programs-suited to address the unique characteristics of each ethno-cultural group-are required.

[MELANOMA INCIDENCE, IMMIGRATION AND ORIGIN].

BACKGROUND: Melanoma is a malignant tumor of melanocytes, whose prevalence has been increasing in recent decades. Early diagnosis allows removal of the tumor prior to the metastatic stage and may lead to a complete recovery. OBJECTIVES: To compare melanoma incidence among different epidemiological groups in northern Israel, and to assess the impact of migration on the increase in incidence of the disease. METHODS: A retrospective review was conducted of the medical records of all patients diagnosed with melanoma and treated in the Plastic Surgery Department at the Rambam Health Care Campus in 2016. Demographic data of 130 patients and tumor characteristics were collected and analyzed. RESULTS: European and American immigrants were found to carry an increased risk for melanoma compared to African and Asian immigrants. Increased melanoma risk was also found among a large subset of European immigrants from the former Soviet Union. This sub-group accounted for 32% of study group patients, while they only comprise 9% of the population (p <0.05). Most melanoma tumors in this sub-group were found in upper and lower extremities (60%). Disease was diagnosed at a younger age compared to the other European immigrants (p <0.05), with a trend towards a more advanced disease than the rest of the patients. CONCLUSIONS: Study findings imply an increased melanoma risk in immigrants from the former Soviet Union. Raising awareness of this population to preventative measures and the importance of early diagnosis may reduce morbidity and mortality caused by the disease. Further research is needed to determine whether routine screening tests should be applied to this population.

Breast cancer incidence and mammography screening among resettlers in Germany.

BACKGROUND: European studies showed that women with a migration background are less likely to participate in mammography screenings than autochthonous women. However, the participation in the German mammography screening programme (MSP) among ethnic German migrants from countries of the former Soviet Union (called resettlers) is unclear so far. The aim of this study was to identify possible differences regarding MSP participation between resettlers from the FSU and the general German population. METHODS: Data from two independent, complementary studies from North Rhine-Westphalia, Germany (a retrospective cohort study 1994-2013; a cross-sectional study 2013/14) were used for comparisons between resettlers and the general population: Odds Ratios (ORs) for MSP participation utilizing the cross-sectional data and time trends of breast cancer incidence rates as well as Chi-Square tests for breast cancer stages utilizing the cohort data. RESULTS: Resettlers showed higher Odds to participate in the MSP than the general population (OR 2.42, 95% CI 1.08-5.42). Among resettlers, a large increase in incidence rates was observed during the MSP implementation (2005-2009), resulting in stable and comparable incidence rates after the implementation. Furthermore, pre-MSP implementation, the proportion of advanced breast cancer stages was higher among resettlers than in the German population, post-MSP implementation the proportion was comparable. CONCLUSIONS: MSP participating seems surprisingly high among resettlers. An explanation for the increased willingness to participate might be the structured invitation procedure of the MSP. However, the exact reasons remain unclear and future research is needed to confirm this hypothesis and rule out the possibility of selection bias in the cross-sectional study.

Differences in caesarean delivery and neonatal outcomes among women of migrant origin in Finland: A population-based study.

BACKGROUND: In Finland, limited information is available on neonatal disparities among women of migrant origin. OBJECTIVE: This study investigated differences in caesarean delivery and neonatal outcomes between women of migrant origin and Finnish women in Finland. METHODS: The study was based on nationwide data from the Medical Birth Register of Finland. Our study included information on the most recent singleton birth of women delivering between January 2004 and December 2014 (N = 382 233). Women were classified into nine regional categories based on their country of origin. Generalized linear models were used to describe associations between country of origin and pregnancy outcomes adjusted for maternal age, socio-economic status, pre-pregnancy body mass index, parity, marital status, smoking during pregnancy, and delivery year. Finnish women were the reference group. RESULTS: Among the study population, almost 92% of women were of Finnish origin; the remaining 8% were of migrant origin. Among the migrant women, those of Russian/former USSR origin were the largest group (n = 11 994); the smallest group was women of Latin American/Caribbean origin (n = 739). Compared with Finnish women, women of sub-Saharan African, South Asian, and East Asian origin were at greater risk of emergency caesarean delivery, preterm birth, low birthweight, and lower five-minute Apgar scores for newborns. Latin American/Caribbean-origin women were at increased risk of both elective and emergency caesarean delivery and lower five-minute Apgar scores compared with Finnish women. Women of Russian/former USSR origin overall had a lower risk of caesarean delivery and poor neonatal outcomes compared with Finnish women. CONCLUSIONS: We identified sub-Saharan African, South Asian, and East Asian women as higher-risk groups, and women from Russia/former USSR as a lower-risk group, for emergency caesarean delivery and poor neonatal outcome compared with Finnish women. More research is needed to identify the reasons for these differences by country of origin in Finland.

Plutonium production and particles incorporation into the human body.

Plutonium is one of the most toxic radioactive substances known. The isotope 239Pu gained attention when it had become known as a potential explosive material for atomic bombs. This paper describes the main problems encountered during the early years of operation of the first plutonium production plant in the former Soviet Union, the Mayak Production Association (Mayak PA). Mayak PA caused severe radioactive contamination of the environment and exposure personnel and population living in the vicinity areas to high radiation doses. The authors focus on key findings of large-scale studies on the internal dosimetry of workers for use in assessment of radiological risks from exposure to plutonium. This work presents an overview of the important issues for inhalation dose assessments such as generation of plutonium particles, plutonium intake, dissolution of plutonium particles, distribution of plutonium in humans, related exposures and health effects. Understanding the relationship between health effects, radiation dose and route of exposure helps quantify the health risks associated with occupational exposure in the nuclear industry and validate the radiation protection standards used in the Russian Federation and worldwide.

Evidências sociais, políticas e econômicas do surgimento do direito universal à saúde na URSS / Social, political and economic evidence of the development of the universal right to health in the USSR

Resumo O artigo sintetiza um estudo que visou demonstrar as bases legais e socioeconômicas do surgimento do direito universal à saúde na URSS. Utilizando pesquisa bibliográfica, são analisados três trabalhos que apresentam cenários sobre a criação e implantação do sistema de saúde soviético, escritos entre 1933 e 1937. Para a análise dos trabalhos, utilizou-se materialismo histórico dialético, baseado em Marx e Engels, utilizando as categorias de forças produtivas, relações de produção, revolução social e política, mercadorias e salários. Identificaram-se, na análise dos trabalhos, evidências materiais que apontam o surgimento do direito universal à saúde no contexto revolucionário, concluindo que a saúde livre e universal, como nova qualidade de serviço voltado ao atendimento das necessidades de reprodução social foi consequência da transição entre modos de produção, observada na revolução russa.

Abstract This article summarizes a study aimed at demonstrating the legal and socioeconomic basis of the emergence of the universal right to health in the USSR. Using a bibliographic research, three works are presented that show scenarios about the creation and implantation of the Soviet health system, written between 1933 and 1937. For the analysis, it was used dialectical historical materialism, based on Marx and Engels, using the categories of productive forces, relations of production, social and political revolution, commodities and wages. It was identified, in the analysis, material evidence that point to the emergence of the universal right to health in the revolutionary context, concluding that free and universal health, as a new quality of service aimed at meeting the needs of social reproduction, was a consequence of the transition between modes of production observed in the Russian revolution.

A cross-national perspective of migration and cancer: incidence of five major cancer types among resettlers from the former Soviet Union in Germany and ethnic Germans in Russia.

BACKGROUND: Few studies compared cancer incidence among migrants both to their host countries and to their population of origin. We aimed to compare cancer incidence of ethnic Germans who migrated from the former Soviet Union to Germany (resettlers) to those living in Russia as well as to the German and the Russian general populations. METHODS: The cancer registry of North Rhine-Westphalia identified incident cases of stomach, colorectal, lung, breast and prostate cancer in resettlers and the general population of the administrative district of Münster (Germany) between 2004 and 2013. The Tomsk cancer registry collected the same data in ethnic Germans and the general population of the Tomsk region (Russia). We used standardised incidence rate ratios (SIRs) to compare rates of resettlers and ethnic Germans with the respective general populations. RESULTS: The total number of person-years under risk was 83,289 for ethnic Germans, 8,006,775 for the population of Tomsk, 219,604 for resettlers, and 20,516,782 for the population of Münster. Incidence of the five investigated cancer types among ethnic Germans did not differ from incidence of the general population of Tomsk. Compared to the general population of Tomsk, incidence among resettlers was higher for colorectal cancer in both sexes (females: SIR 1.45 [95% CI 1.14-1.83], males: SIR 1.56 [95% CI 1.23-1.97]), breast cancer in females (SIR 1.65 [95% CI 1.40-1.95]), and prostate cancer (SIR 1.64 [95% CI 1.34-2.01]). Incidence rates of these cancer types among resettlers were more similar to rates of the general population of Münster. Incidence of stomach and lung cancer did not differ between resettlers and the general population of Tomsk. CONCLUSIONS: After an average stay of 15 years, we observed that incidence of colorectal, breast and prostate cancer among resettlers converged to levels of the general population of Münster. Resettler's incidence of stomach and lung cancer, however, was comparable to incidence in their population of origin. Causes must be investigated in subsequent analytical studies.

Primary care behind the former "Iron Curtain": changes and development of primary healthcare provision in the Eastern part of the European Union.

BACKGROUND: The Alma-Ata Declaration was a big step in the development of primary care, defining the main tasks and populations' expectation. Celebrating the 40th year's anniversary is a good opportunity to make an analysis. Development of primary care was not parallel in the Eastern and Western part of Europe. AIM: To provide an overview on the societal and economic situation, structural and financial changes of healthcare systems in the former 'Soviet bloc' countries, to present an analysis of the primary healthcare (PHC) provision and to find relationships between economic development and epidemiological changes of the respective countries. METHOD: Epidemiological data, healthcare expenditures and structure, and financing schemes were compared; systematic literature search was performed. RESULTS: Visible improvements in population health, in the national economic condition, structural changes in healthcare and more focus to primary care were experienced everywhere. Higher life expectancies with high inter-country variation were observed in the former 'Soviet bloc' countries, although it could not be clearly linked to the development of healthcare system. PHC provision improved while structural changes were rarely initiated, often only as a project or model initiation. Single-handed practices are yet predominant. The gate-keeping system is usually weak; there were no effective initiatives to improve the education of nurses and to widen their competences. Migrations of workforce to Western countries become a real threat for the Central-East European countries. CONCLUSION: Lack of coordination between practices and interdisciplinary cooperation were recognized as the main barriers for further improvement in the structure.

[The constituent session of the USSR Academy of Medical Sciences. The first day (December 20, 1944)].

The article describes and analyzes the first day of the Constituent Session of the USSR Academy of Medical Sciences held on December 20, 1944. During this meeting the People's Commissar of Health of the USSR, G. A. Miterev, academicians A. I. Abrikosov and L. A. Orbeli, the full member of the USSR Academy of Medical Sciences S. S. Yudin made their speeches devoted to organizational tasks facing the USSR Academy of Medical Sciences during the war and post-war time, as well as to questions of morphology and physiology that require priority attention. The Yudin's report was emotional, patriotic and reflected the achievements of Soviet surgery in the mid-twentieth century. Analysis of the reports demonstrated that they contained many provisions that influenced the further development of medicine and public health in the USSR.

Postinjection abscesses and granulomas in children adopted from Russia.

Up to 1.3 million children from the former Soviet Union (fSU) and Eastern Europe have been placed in institutional care worldwide. With the hope of ensuring the child's health in the immediate post-adoption period, these children are known to receive many injections of vaccines, vitamins, and medications, many unnecessary and often administered with unsafe technique. This practice can lead to formation of suppurative granulomas in these children. Though rare, dermatologists should be aware of these conditions in adoptees from Eastern Europe.

[Bleedings after reconstructive operations on the aorta, its branches, and peripheral arteries (on materials of the Department of Vascular Surgery A.N. Bakulev ICVS of the Academy of Medical Sciences of the USSR, 1961-1983)]. / Krovotecheniia posle rekonstruktivnykh operatsii na aorte, ee vetviakh i perifericheskikh arteriiakh (po materialam otdeleniia khirurgii sosudov ISSKh im. A.N. Bakuleva AMN SSSR, 1961-1983 gg.).

The authors retrospectively analysed episodes of bleeding after reconstructive operations on the aorta, its branches, and peripheral arteries. The sources of information were the archival medical records of the Department of Vascular Surgery of formerly the Institute of Cardiovascular Surgery named after A.N. Bakulev under the USSR Academy of Medical Sciences (now known as the National Medical Research Centre of Cardiovascular Surgery named after A.N. Bakulev) over the period from 1961 to 1983. A total of 3,787 operations on the aorta and arteries had been performed over that time period. Bleedings were observed in 170 cases (4.5% of all interventions), with the mortality rate amounting to 25.3%. Of these, 72 bleedings (42.3%) were primary, to have developed from anastomoses or sutures of the artery, with 38 (22.3%) being secondary (arrosive) and 10 (5.9%) related to hypocoagulation. In the remaining 50 (29.4%) episodes, the blood had leaked from tissues (en masse). Of these, no source of bleeding had been identified in 8 (4.7%) cases. The subjects of investigation were the terms of bleeding onset, localization, causes, dependence from suture material. The authors suggested a tentative classification of postoperative bleeding. It was determined that 50.6% of these events had developed within the first 24 postoperative hours. Primary bleedings were found to have more often occurred from sutures of the thoracic aorta (58.3%) and arrosive ones from the femoral artery (60%). The causes of primary bleedings were determined to be as follows: cuts of the vascular wall by suture material (66.7%) or needle entry holes (15%), defects between sutures of an anastomosis (14%), defects of an autovein in the area of an anastomosis (2.8%), separation of fibers of the graft in the area of an anastomosis (1.4%). Also analysed are the methods of final arrest of haemorrhage. The authors believe that this historical experience may be used to improve qualification of vascular surgeons.