[The trends of dynamics and characteristics of structure of population ovary cancer disability in the Chechen Republic].

The article presents the results of analysis of issue of disability because of ovarian cancer in female population of the Chechen Republic. The object of study was total number of women, for the first time and repeatedly recognized as disabled ones. The analysis was applied to three age groups (the young, the middle aged and the elderly) in 2014-2020. It is established that dynamics of disability was characterized by negative trends of increasing of number of the disabled. The clear-cut age differentiation was revealed:the elderly disabled predominated. The study established that the disabled suffer of persistent malfunction of blood circulation system and of immune system that resulted in such life activity limitations as moving, self-service and work functions. The characteristics of structure of ovarian cancer disability according its severity were established. The disabled with second group of disability prevailed in all age groups. At that, percentage of women with first group of disability was higher in the middle-aged disabled. The results of the study testify actuality of optimization of onco-gynecological screening of female population for the purpose of early detection of risk factors and diagnosis of malignant process at initial stages of development. This is rational way to organ-preserving treatment and medical and social prevention of primary ovarian cancer disability. The results of the study can consider as scientific practical base for both targeted routing of preventive and therapeutic and rehabilitation measures.

[Regional aspects of disability due to malignant neoplasms in the Russian Federation.]

The increase in the number of older people (elderly and senile) among the population around the world is associated with a significant impact on the increase in the incidence of malignant neoplasms (MN). The federal project «Fight against oncological diseases for 2018-2024¼ has been launched in Russia within the framework of the national project «Healthcare¼. The article presents the results of a study of the general disability (primary and repeated) of the adult population due to MN in the Chechen Republic (2010-2020). The main trends in the dynamics of general disability (age differentiation, severity, level) in the Chechen Republic and in the North Caucasus Federal District as a whole are compared. Older people with disabilities prevail in the structure of both primary and repeated disability due to MN in the Chechen Republic. This corresponds to the indicators for the North Caucasus Federal District and correspond to the data for the Russian Federation as a whole. The level of disability in the Chechen Republic is lower compared to the indicators for the North Caucasus Federal District. The proportion of disabled people with severe group II and group I disabilities is higher in the republic compared to extensive indicators for the district. The formed structure of disability and the identified trends in its dynamics are a scientific and practical basis that is advisable to use when developing an integrated approach to the medical and social rehabilitation of disabled people and the prevention of health disorders due to MN, taking into account the identified features of disability of the population in the territorial subject of the Russian Federation.

[The repeated disability because of thyroid cancer in adult population].

The article presents the results of analysis of repeated disability because of thyroid cancer in adult population of Moscow in 2015-2019. The study established negative dynamics of increasing of the number of individuals with repeated disability because of thyroid cancer in all essential age contingents (young, middle and elderly age) of adult population. The similar trend was revealed in gender contingents of individuals with repeated disability because of thyroid cancer (in males, increase was made up to 112.5% and in females up to 196.3%). In the gender and age structure of repeated disability because of thyroid cancer, predominated females and the elderly. The study established dynamics of decreasing of percentage of individuals with repeated disability because of thyroid cancer of the disability groups I and III and corresponding increasing in disability group II. The percentage of individuals with repeated disability because of thyroid cancer in disability groups I and II was higher in males as compared with females. Most individuals with disabilities because of thyroid cancer don't work. The study results make available spectrum of disorders of main functions of organism, their degree and types and intensity of limitations in vital activity of individuals with repeated disability because of thyroid cancer. The organized database of characteristics of repeated disability because of thyroid cancer in adult population can be used in implementation of personalized approach to medical social rehabilitation of increasing number of disabled individuals with malignant damage of the most important organ of endocrine system.

[Age-related aspects and gender differentiation of primary disability due to thyroid cancer in the adults population of Moscow.]

The results of the analysis of primary disability due to thyroid cancer of the adult population of Moscow in the period 2015-2019 are presented. An increase in the number of peaple newly recognized as disabled (PNRD) due to this pathology was revealed. In the age structure of primary disability elderly people was dominated. The predominant gender contingent of the PNRD were women. It was found that the predominant number of PNRD had a moderate impairment (II degree) of the basic functions of the body. At the same time, gender differentiation in the severity of persistent impairment of the body functions among disabled was revealed. In the contingent of disabled men the proportion of persons with severe (III degree) and complete (IV degree) impairment of the function of the blood system and the immune system and with a severe impairment of the function of the endocrine system and metabolism was higher compared to the contingent of disabled women. It was determined that the main types of capacity limitations were self-care, work, moving and communicate limitations (the first degree of difficulties in life areas prevailed (p<0,05). Thyroid cancer, due to the rapid growth of morbidity and disability, is an important public health concern. The study of disability indicators of the population is necessary for the development of rational measures of medical and social rehabilitation of patients suffering from thyroid cancer, and for the implementation of medical and social prevention of disability.

[The Psychological Status of the Disabled due to ischemic heart disease].

The article analyzes psychological state of the disabled due to ischemic heart disease. It is established that depressive mood prevailing among the disabled decreases their quality of life and impedes effective medical and social rehabilitation that requires implementation of measures restoring psychological status of the disabled through rehabilitation program.

[The gender and age characteristics of morbidity of thyroid cancer].

The thyroid cancer is the most prevalent oncologic disease of endocrine organs, characterized by multi factorial risk of development. The purpose of the study was to analyze dynamics of indices of thyroid cancer morbidity of population of the Russian Federation, considering gender and age differences in 2008-2018. The increase of "rough" indicator of thyroid cancer morbidity of male population made up to 56.6%, and of female population - 48.3%. The dynamics of standardized indicator in gender contingents was characterized by increasing up to 48.7% in males and up to 43.9% in females. There is an increasing of thyroid cancer morbidity with age and prevalence of the morbidity in females as compared with males in all age categories. The highest morbidity was established in male population aged 65-69 years (8.3 per 100,000 population) and in females aged 55-64 years (27.3 per 100,000 population). In the territories of the Russian Federation, in the gender aspect, variations in thyroid cancer morbidity were established. both in male and female populations, maximal thyroid cancer morbidity was established in the North Western and Siberian Federal Okrugs, and morbidity below national level was registered in the Privolzhskiy and North Caucasian Federal Okrugs. It is necessary to take into account differentiation of the territories of the Russian Federation in terms of the thyroid cancer morbidity in different gender and age groups for development of rational measures of early identification of risk factors, diagnosis and treatment of patients.

[Disability due to arterial hypertension and alimentary factors, determining cardiovascular risk].

The problem of disability is associated with the problem of socially significant diseases, the main feature and at the same time the key characteristic of which is mass character. The epidemic nature of the spread and the medical and social burden of arterial hypertension (AH) leads to the assignment of this pathology to the number of socially significant diseases. The aim of the study was to analyze primary disability due to AH in Moscow and clinical and pathogenetic parallels between the level of arterial pressure and alimentary factors determining cardiovascular risk (CVR). Material and methods. The object of study was the data on the primary disability of the population of Moscow during the period 2011-2017 according to the form of state statistical observation #7-sobes and data of the Ministry of Health of Russia. The study was retrospective. The subject of a selective study was an analysis of the nosological spectrum of causes of disability, the nature of functional impairment and the degree of disability of elderly people who underwent inpatient treatment at the hospital for war veterans of the Rostov region in 2018-2019. The analysis of the spectrum of factors that determine the CVR. Results and discussion. The total number of newly recognized disabled (NRD) due to hypertension amounted to 11,069 people. The growth of the share of NRD of young age (6.8-11.7%), a decrease in the proportion of NRD of middle age (45.3-41.7%) and elderly in 2015-2016 (39.1-39.9%), but the growth of this indicator in this contingent in 2017 to 46.6% were noted. The proportion of NRD group III increased (to 69.1%), NRD group II decreased (to 20.3%) with a negative trend of growth in the proportion of VPI of the most severe group I. Selective survey data among people with disabilities undergoing inpatient treatment at the hospital for war veterans of the Rostov Region (2018-2019) indicated that they had a wide range of factors determining the CVR. Conclusion. The persistence of patients with hypertension triggers, supporting its further progression, is the cause of the low effectiveness of therapy and exacerbates the prognosis. It is advisable to have a unified approach to improving the efficiency of dietary use at the stages of complex treatment, prophylactic and rehabilitation programs with the goal of primary and secondary prevention of hypertension and disability due to this socially significant pathology.

[The Medical Social Aspects of Repeated Disability of Adult Population Due to Malignant Neoplasms in the Russian Federation].

The article presents the results of the analysis of the level and severity of repeated disability of the adult population due to malignant neoplasms in the Russian Federation. This pathology is associated with high prevalence and mortality, which makes it classify as socially significant. An effective solution to the problem of preventing the debilitating complications of malignant tumors requires the formation of a statistical database to evaluate the results of diagnostic and treatment-and-prophylactic measures and the development of optimal approaches to the medical and social rehabilitation of patients. The authors present the results of the study, which indicate that there is an age-related differentiation of adult disability due to malignant neoplasms -- elderly people predominate. In middle age, the level of recurrent disability due to this class of diseases decreases during the analyzed period (2008-2017). Among the population of young age, the tendency to change the level of recurrent disability is less stable, however, since 2014, there has been a trend for the growth rate. The structure of recurrent disability by severity is characterized by the predominance of persons with disabilities II (43.6%) and III (42.1%) disability groups with a lower proportion of persons with disabilities with I first disability group against the background of a uniform trend of increasing disability level of all three groups. The results of the ranking of subjects of the country by the level of re-disability due to malignant neoplasms among the adult population are presented. The selected subjects of the Russian Federation with a negative situation, which makes it possible to substantiate the need to strengthen measures for the prevention of primary disability and optimize the medical and social rehabilitation of patients suffering from this disabling pathology, taking into account regional features.

[Disability of elderly people due to hypertensive disease in the Russian Federation.]

The article presents the results of the analysis of the epidemiology of primary disability of the adult population in the Russian Federation for 12 years (2005-2016). During this period, 6.6 million elderly people (56,8% of the total number of people with disabilities) were recognized as invalids. The leading cause of disability in the structure of primary disability among elderly people is 68,5%. HD retains leading positions as the most important factor of disability of the population. Negative tendencies of primary disability due to this socially significant pathology are associated with the demographic situation of population aging. In the contingent of people with disabilities due to hypertension, the proportion of elderly disabled is 43,4%, while the proportion of disabled people of middle and young age is less - 29,1 and 27,4%, respectively. Medical institutions should be prepared to work with a growing contingent of the elderly population, to increase the availability and quality of medical care for patients and people with disabilities due to HD, one of the most common and prognostically unfavorable pathologies that impose a limitation on vital activity.

[Effect of anthropo-technogenic load on medico-social aspects of primary morbidity and disability of population.]

Population aging is a global social phenomenon that affects the most important health indicators of the population. The older generation is particularly vulnerable in the current conditions of urbanization and the associated environmental situation. The comprehension of indicators of disability and morbidity of the population, the study of the factors that determine the negative processes of health damage, taking into account regional features of these processes are necessary for the planning of preventive measures. In the age structure of the primary disability of the adult population in the Voronezh region elderly disabled people make up 53,3%, middle and young people with disabilities are less - 30,1 and 16,6%, respectively. These indicators are higher than the average Russian. The results of non-carcinogenic risk and primary morbidity analysis in population of Levoberezhniy district of Voronezh under permanent anthropotechnogenic load have presented. It has been established that non-carcinogenic risk coefficients were bigger that acceptable level (HQ>1) by for nitrogen dioxide, acrylonitrile, acrolein, 1,3-butadiene, copper oxide, chromium+6. Unacceptable level of non-carcinogenic risk is typical for respiratory organs pathology, pathologies of cardiovascular system and endocrine system. Analysis of the primary morbidity of these nosological forms shows their high distribution in adult population morbidity. Under rehabilitation measures in patients with respiratory organs diseases, circulatory system and endocrine system diseases it is necessary to consider anthropotechnogenic load and relationship between agents and disease development.

[CARDIOVASCULAR DISEASES: EVALUATION OF PERSISTING DISORDERS IN THE BLOOD CIRCULATION SYSTEM AND DISABILITY, CRITERIA FOR SEVERITY OF INVALIDISM].

A most important indicator of population health, its social and economic wellbeing is premature disability. 10.3 mln people had to retire from their jobs due to disability during the ten-year period from 2005 to 2014. The number of elderly subjects among them was twice that of the younger ones, with the leading cause of disability being blood circulation disorders (61,9%). At the same time, the fraction of old subjects in the group of invalids suffering from coronary heart disease and idiopathic hypertension accounted for only 58,9% and 40,9% respectively. The quantitative evaluation of persistent dysfunction of the cardiovascular system related to circulatory disturbances included in ICD class IX and to those referred to other classes is based mainly on an assessment of the following clinical and functional manifestations: pain syndrome (cardialgia or angina); hypertensive syndrome; pulmonary hypertension; arrhythmia; syncope. Other aspects of pathological process are taken into consideration, such as its form and severity, presence and frequency of exacerbations, magnitude, involvement of target organs, complications. The gerontological slant of disabling cardiovascular pathology accounts for its social significance (idiopathic hypertension, coronary heart disease, chronic heart failure) which requires the adequate solution of the problem of healthcare provisions taking account of the current demographic situation and increased life expectancy within the older population suffering from a number of chronic diseases.