[Migraine in the real-life clinical practice: results of the observational study of diagnosis and treatment patterns in the urban population of the Russian Federation]. / Migren' v real'noi klinicheskoi praktike: rezul'taty nablyudatel'nogo issledovaniya patternov diagnostiki i lecheniya sredi gorodskogo naseleniya Rossiiskoi Federatsii.

OBJECTIVE: Analysis of real-life clinical practice data regarding the patterns of diagnosis and treatment of migraine in the Russian Federation. MATERIAL AND METHODS: An observational real-world cohort study was conducted from January 2013 to December 2018 (over a 5-year period) to analyze the electronic database of 5 large private clinic chains in Moscow and St. Petersburg. RESULTS: Among 1.15 million people who sought medical care, «G43 Migraine¼ diagnosis was established in 6.650 people, which accounted for 0.6%. A total of 54% of patients were diagnosed by a neurologist, while 35% by a GP. In roughly half the cases, to diagnose migraine, the doctors had to resort to additional methods of examination. While 53% of patients had indications for preventive treatment, it was prescribed only to 12% of those. Of these, the treatment strategy chosen for 29% of patients was changed: either the intragroup/intergroup switching of the medicinal product took place, or the combined treatment was prescribed. CONCLUSION: In the real-life outpatient clinical practice, the level of diagnosis of migraine is extremely low. Additional methods of examination are excessively used for the diagnosis of migraine. The insufficient use of preventive medication and common use of therapies with unsubstantiated efficacy in migraine result in frequent changes in the treatment strategy.

[Rubella virus genetic determinant of attenuation].

Vaccination is the most effective and available way to prevent Rubella. Presently, 9 vaccine strains were registered. Nevertheless, the molecular mechanisms of the attenuation were poorly elucidated for the rubella virus. However, the study of these mechanisms identifying genotypic and phenotypic markers of attenuation, which together with sequence analysis could be used for the genetic stability control of vaccine strains, is still of current interest. Common trends of genetic changes in the process of adaptation to cold were found due to comparison of nucleic acid and amino acid sequences of the Russian strain C-77 with corresponding positions of the known rubella virus strains and its wild type progenitors, if available.

[Studying of molecular mechanisms of rubella virus attenuation evidence from Russian strain C-77].

Live attenuated rubella vaccine is used for vaccination. Temperature-sensitive (ts) phenotype was proved for almost all rubella vaccine strains, and the acquisition of the ts phenotype during cold adaptation was strongly correlated with the attenuation of the wild-type viruses. Nevertheless, the molecular mechanisms of the attenuation have been insufficiently understood for rubella virus. Study ofthese mechanisms, identifying genotypic markers of attenuation, which together with the sequence analyses could be used for genetic stability control of vaccine strains, is still of current interest. In this work, we determined nearly complete genome sequences of attenuated (ca) and the wildtype progenitor (wt) of the rubella virus strain C-77 isolated in Russia. Possible genetic determinants of attenuation were detected. Thus, 13 nucleotide differences leading to 6 amino acid substitutions were found. Four amino acid substitutions were found to be almost unique. Special consideration should be given to Tyr1042Cys substitution in the protease domain of C-77 strain, because it most probably plays the crucial role in acquisition of ts-phenotype.