[The comparative analysis of dynamics of indicators of morbidity of adolescents in the regions of the Northern-Caucasus Federal Okrug].

The purpose of the study is to establish main trends in morbidity of adolescents (15-17 years old) in the regions of the Northern-Caucasus Federal Okrug in 2011-2020. The study is based on data of statistical reports on primary and general morbidity of population aged 15-17 years for 2011-2020. The results. The epidemiological situation concerning morbidity of adolescents in the Russian Federation and the Northern-Caucasus Federal Okrug is characterized by positive trend over the analyzed period. The deterioration of epidemiological situation is observed in the Karachay-Cherkessia Republic (KChR) where absolute increase in overall morbidity of adolescents comprised 105.3% and primary morbidity 49.0% and in the Stavropol Territory (ST) - 23.0% and 27.5% correspondingly. The decrease of morbidity of adolescents is observed in the Republic of Ingushetia (RI) (by 56.9% and 51.7%) and in the Chechen Republic (ChR) (by 34.6% and 45.0%). In the Republic of Dagestan (RD), an increase of overall morbidity (by 114.0%) is accompanied by decreasing of primary morbidity (by 13.2%) and in the Republic of North Ossetia-Alania (RNOA) (absolute increase in overall morbidity by 7.8% and decrease of primary morbidity by 7.0%). In the Kabardino-Balkaria Republic (KBR), there is absolute decreasing of overall morbidity (by 1.7%) with simultaneous increase of primary morbidity of adolescents (by 24.2%). However, there are features inherent in most of analyzed regions of the Northern-Caucasus Federal Okrug. The increase of overall morbidity of eye diseases in adolescents is registered in six out of seven regions with exception of the RI, the increase of primary morbidity occurred in four of them (KChR, RD, KBR, ST). The increase of general and primary morbidity of ear diseases is registered in five regions (KChR, RD, RI, KBR, RNOA). The increasing of morbidity of neoplasms registered as common for five regions (the KChR, RD, RI, KBR, the ST) and as primary one in four of them (with the exception of the ST). The conclusions. In the regions of the Northern-Caucasus Federal Okrug multi-directional dynamics of indicators of general and primary morbidity among adolescents was established with predominance of particular classes of diseases. This result testifies absence of unified policy in the field of public health targeted to maintaining healthy life-style in adolescents.

New data on the fauna of pyraloid moths (Lepidoptera: Pyraloidea) of Dagestan (Russia).

58 species of pyraloid moths are reported for the East Caucasian region of Russia and the Republic of Dagestan for the first time. Among them, 13 species are new for the fauna of Russia. Additionally, we report first-time records of several pyraloid species from Kazakhstan and also from different regions of Russia: Astrakhan, Volgograd, Voronezh and Orenburg Provinces. Imagoes of four notable species are illustrated.

Metagenomic Analysis of Ampelographic Collections of Dagestan Revealed the Presence of Two Novel Grapevine Viruses.

In this study, we analyzed the virome of 73 grape samples from two Dagestan ampelographic collections in Russia using high-throughput sequencing of total RNAs. Fourteen viruses and four viroids were identified, with one to eleven of them detected in each plant. For the first time in Russia, we identified grapevine leafroll-associated virus 7 and grapevine Kizil Sapak virus. A total of 206 genomes of viruses and viroids were obtained, and their phylogenetic analysis was carried out. The de novo assembly and tblastx analysis allowed us to obtain contigs of a novel (+) ssRNA genome of a plant virus from the genus Umbravirus, which was tentatively named grapevine umbra-like virus (GULV), as well as contigs of a novel dsDNA pararetrovirus from the genus Caulimovirus, which was tentatively named grapevine pararetrovirus (GPRV). Complete genomes of these viruses were obtained and used for Sequence Demarcation Tool (SDT) analysis and phylogeny studies. GULV and GPRV were detected in 16 and 33 germplasm samples from the Dagestan collections, respectively.

[The comprehensive rehabilitation and abilitation of the disabled: the examples of evaluation of regional system].

In the Russian Federation, comprehensive rehabilitation and abilitation of the disabled is actively developing effected by the UN Convention on the Rights of the Disabled. In 2018-2019, the quantitative indicators of comprehensive rehabilitation and abilitation were studied in 85 regions of Russia. In 36 regions (42/4%) formation of system of comprehensive rehabilitation and abilitation was necessary. The remaining 49 regions required improving their systems of comprehensive rehabilitation and abilitation (57.6%, respectively). The study results demonstrated that significant increase in rehabilitation organizations (from 12.0% in 2018 to 100.0% in 2021) to be included in regional system of comprehensive rehabilitation and abilitation is expected. In the Republic of Dagestan, the final rating of comprehensive rehabilitation and abilitation system was from 6.5 to 7.6 points that indicates the need to organize and to improve comprehensive rehabilitation and abilitation system in the region. The experience of the Sverdlovsk Oblast and the Perm Krai where pilot project on comprehensive rehabilitation and abilitation system was carried out proved that one of the effective mechanisms of organizing comprehensive rehabilitation and abilitation system is development of state regional program by the authorities with involvement of all interested players and public organizations.

[IMPROVING THE ORGANIZATION OF LABOR AND THE QUALITY OF MEDICAL CARE AT PARAMEDIC AND OBSTETRIC STATIONS].

In the provision of primary health care to the rural population, the role of paramedic and obstetric stations (FAP) is great. The purpose of the study is to develop a system of measures aimed at improving the quality of medical care provided at paramedic and obstetric stations. The study was conducted in 2019-2020 on the basis of 26 FAP of 12 central district hospitals (CRH) of the Republic of Dagestan. The organization of labor of 26 paramedics and 26 midwives during 1740 hours was studied by the method of time-lapse observation. The content of 16511 visits by the FAP population was analyzed. The expert evaluation method studied the quality of medical care to 445 patients on 7 FAP. The main work of FAP paramedics accounts for 74.5%, and for midwives - 76.3% of all labor costs. A significant share in the cost structure is occupied by preventive (22.9% for paramedics and 27.8% for midwives) and diagnostic and therapeutic activities (17% and 15.6%). There are high costs for transitions and relocations (17.3% and 14.1%) and for working with documentation (13.7% and 14.5%). In the structure of visits by the population of paramedics and midwives of FAP, for reasons of the greatest proportion are visits with therapeutic and diagnostic purposes (37%), followed by visits for medical appointments (32.8%) and preventive (23.9%). The quality of medical care provided by paramedics to patients with therapeutic diseases was inadequate in 23.8% of cases. Every third (35.7%) patient was treated with FAP unreasonably. Out of the total number of patients who were treated unreasonably on FAP, according to experts, 62.5% had to be treated in the CRH, 34.8% - in the district hospital (outpatient clinic).

Plant Community of Pine Forests (Pinus kochiana, Pinaceae) of Dagestan.

The plant community of Dagestan pine forests, comprising 590 vascular plants species, was examined based on materials from field studies performed from 2012 to 2019. Taxonomic, biomorphological, florocoenotic, and geographical characteristics of the plant community showed its boreal and Mediterranean nature. Mesotrophic and eutrophic plants predominated in terms of soil fertility and mesophytes and mesoxerophytes, in terms of soil water availability. Species of different altitudinal belts, including forest, meadow, and mountain-steppe belts, were observed in the plant community of pine forests. The plant community included 22 species listed in the Red Books of the Russian Federation and the Republic of Dagestan, 82 relict species, and 76 endemics.

Enchytraeidae (Annelida: Oligochaeta) from Eastern Dagestan, Russia, with the description of a new species.

The first ever list of terrestrial enchytraeids of Eastern Dagestan includes 12 species belonging to five genera. Several species from studied localities may be assigned as undescribed, therefore additional comprehensive research of enchytraeid fauna from Eastern Dagestan is required. A new enchytraeid species of the genus Fridericia Michaelsen, 1889, Fridericia samurai sp. nov., is described from Eastern Dagestan, Russia. It clearly differs from other species of the genus by short and simple oesophageal appendages, not subdivided spermathecal diverticula, and the absence of spermathecal ectal glands and clitellum on ventral side.

Preliminary faunistic study on the rove beetles (Coleoptera: Staphylinidae) of Republic of Dagestan, with some additional information from northern Caucasus.

A checklist of rove beetles recorded from the Republic of Dagestan (221 species) is given, with 47 new records from this region. The genus Oedichirus Erichson, 1839 (Oedichirus rubronotatus Pic, 1903) and species Stenus turk Puthz, 1972 are new additions to the fauna of Russia. Two new synonyms are established: Xantholinus dagestanicus Bordoni, 2011 syn. nov. and X. circassicus Bordoni, 2011 syn. nov. (both =Xantholinus variabilis Hochhuth, 1851).

[The regional characteristics of indices of mortality of adult population and life expectancy].

The article analyzes the demographic situation in the Republic of Dagestan and presents analysis of indices of population mortality and life expectancy. It is established that number of deaths per 1000 people of the Republic of Dagestan is one of the lowest not only in the Northern Caucasus, but in the country at large. At the same time, high mortality indices are determined in elder age groups both in Dagestan and on average in Russia. The main causes of death in the Republic of Dagestan are diseases of circulatory system and respiratory system, neoplasms, accidents, poisoning and traumas, which account almost three quarters of all cases of deaths. However, mortality indices in Dagestan from diseases of circulatory system, neoplasms, digestive system diseases, infectious and parasitic diseases are significantly lower as compared to the national average level. In Dagestan, one of the highest indices of life expectancy is observed as compared with other subjects of the Russian Federation (2nd place in the Russian Federation) - on 6 years exceeding the national average level (in males, difference in values ​​of indicator amounted to 7.5 years). In Dagestan, during analyzed period, life expectancy at birth increased more than on 5 years.

[Features of demographic trends and infant mortality in the Republic of Dagestan].

The article analyzes the regional characteristics of the demographic development of the Republic of Dagestan, presents the results of the analysis of infant mortality rates in the republic, gives a structure of the causes of infant mortality, identifies the main indicators of natural growth and population decline. The results of the study showed that in Dagestan infant mortality is one of the highest among the subjects of Russia in 2018 - 8.3 ‰ per 1000 live births (national average - 5.1 ‰, North-Western Federal District - 6.8 ‰); the main cause of death in infants under 1 year of age in Dagestan are individual conditions that occur during the perinatal period.

[Spastic ataxia of Charlevoix-Saguenay: the first Russian case report and literature review]. / Spasticheskaia ataksiia Sharlevua-Sagené: pervoe rossiiskoe nabliudenie i obzor literatury.

Spastic ataxia of Charlevoix-Saguenay (ARSACS) is a rare autosomal recessive neurodegenerative disease related to SACS gene and characterized by cerebellar, pyramidal and some other signs. The disease was delineated in Quebec, where it cumulates due to founder effect and has similar phenotype with very early onset. ARSACS in other populations is more variable. The first Russian case of ARSACS in a 37-year-old woman, an only patient in a Lak (one of Dagestan ethnicities) family, is presented. Along with main typical features, she had atypical late disease onset (in 32 years) and moderate cognitive decline. MPS-panel 'hereditary paraplegias' detected an earlier reported homo- or hemizygous mutation c.72276C>T (p.Arg2426Stop) in SACS exon 10.

[The characteristics of medical demographic development of the Republic of Dagestan].

The issues of assessing medical and demographic processes and improving public health are very actual in Russia. The article analyzes the current state and regional characteristics of medical and demographic development using the example of the Republic of Dagestan. The positive tendency of the main fertility indicators was determined, including the analysis of the age structure of the population and population size alterations.

Recent autochthonous cases of leishmaniasis in residents of the Republic of Dagestan, Russian Federation.

Eighty years after the last published record of human leishmaniasis from Dagestan, Russian Federation, we report two recent cases which were most probably acquired locally: one case of visceral leishmaniasis in a 2-year old child, and one cutaneous leishmaniasis case in a 39-year-old man co-infected with HIV, both resident in Dagestan.

[The medical ethical aspects of organization of medical rehabilitation].

The article considers such aspects of organization of medical rehabilitation care of population as accessibility, quality, social efficiency from perspective of medical ethics. The quality of diagnostic, prevention and treatment of diseases is affected by qualification of medical personnel that is applied both to areas of clinical medicine and health care management. The specialists are to apply common principles and standards of health care. Among them are support of valuable quality of medical care under optimal application of available resources and observance of medical ethics standards. The Republic of Dagestan is anagrarian region where 55% of population resides in rural area and most of health care resources are cumulated in urban area. The indices of health of population residing in rural area are in many parameters worse than in urban population and provision of medical institutions with medical personnel is low. The specialized medical care support including medical rehabilitation, of rural population, is provided without additional managerial decisions and is much more difficult as compared with patients residing in urban area. Hence in conditions of necessity of optimization of resource support of health care system functioning no extensive development of possibilities of medical rehabilitation is possible in rural residents of Dagestan.

[The Development of Technology of Functioning of District Physicians During Out-Patient Reception].

To develop recommendations and proposals related to amelioration of technology of of functioning of district physicians and general practitioners during out-patient reception in 2015-2016 a specialized study was carried out in three municipal polyclinics of Makhachkala of the Republic of Dagestan. The technology of functioning of 16 district physicians and general physicians during out-patient reception according information on 2685 visits in established conditions and in experiment. It is established that district physicians are insufficiently able to handle methodological issues of technology of out-patient reception. The implementation, in conditions of experiment, of enhanced medical technology at out-patient reception ameliorated quality of performance of conversation, check-up and examination of patients by district physicians. It resulted in more full-blown and targeted collection of anamnesis, in-depth physical check-up and examination, more complete giving of recommendations to every patient concerning one's treatment, diet and examination.

[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.

[The evaluation of the impact of quality and microelement composition of drinking water on the incidence of urolithiasis in various regions of Dagestan].

AIM: to study the influence of qualitative and microelement composition of drinking water on the incidence of urolithiasis in different regions of the Republic of Dagestan. MATERIALS AND METHODS: The statistical data of the Ministry of Health of the Republic of Dagestan for 2000-2016 yy. were used. A total of 12123 outpatient and inpatient charts of patients with urinary stone disease were analyzed. The annual average quality of drinking water, as well as the contents of microelements in different climatic and geographical areas of the region were assessed. THE RESULTS: The high morbidity among the residents of the flat territory was established which was associated with the highest water hardness, high content of microelements and salts of heavy metals that exceeded the acceptable concentrations. The number of patients with urinary stone disease living in mountainous areas is much less (11.8%) than in the flat area (83.08%). A relationship between quality of water, microelement composition and urinary stone disease in this area was found. The stone disease was more common in women (66.3%) than in men (33.7%). CONCLUSION: Our results can be used for the prevention of urinary stone disease given that the Republic of Dagestan is an endemic region.

Genetic Polymorphisms of Cytochrome P450 Enzymes and Transport Proteins in a Russian Population and Three Ethnic Groups of Dagestan.

AIM: The objective of this study was to investigate the prevalence of polymorphic markers of the CYP2C19, CYP2C9, CYP2D6, SLCO1B1, and ABCB1 genes among the three ethnic groups in Dagestan and compare it with the carrier frequency of these markers among the Russian population living in Moscow. METHODS: The study involved 186 healthy, unrelated, and chronic medication-free volunteers (53 males and 133 females) of the three ethnic groups in the Dagestan Republic: 46 Laks, 90 Avars, and 50 Dargins. Genotyping was performed using real-time polymerase chain reaction-based methods. The allelic prevalences of the three Dagestan peoples were compared with ethnic Russians from the Moscow region. RESULTS: Statistically significant differences for the following gene polymorphisms: CYP2C19*17, CYP2C9*3, ABCB1 (C3435T), SLCO1B1*5 were found between the Russian population and the three ethnic groups of the Dagestan republic. CONCLUSION: The data obtained from this study will help with prioritization genotyping in the region.

[On the evaluation of hospital care of persons of elderly and senile age].

The study was carried out in 2012-2014 on the of the hospital of veterans "The Republican medical center" with purpose of optimizing hospital care of population of elderly and senile age. The special record of hospitalized patient containing 16 questions was developed for sampling primary data. On the basis of received results the directions of development of hospital care to patients of elderly and senile age were determined.