[Stroke in children: experience of the Center for the Treatment of Cerebrovascular Diseases in Children and Adolescents in Moscow]. / Insul't u detei: opyt raboty Tsentra po lecheniyu tserebrovaskulyarnykh zabolevanii u detei i podrostkov Moskvy.

OBJECTIVE: To analyze the work of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents, operating on the basis of the Morozov Children's City Clinical Hospital of the Moscow Health Department for the period 2018-2021 and to assess the peculiarities of organizing the provision of specialized care to children and adolescents with acute cerebrovascular accident (ACA). MATERIAL AND METHODS: Annual reports of the Center for the period 2018-2021; included children and adolescents aged 1 month to 17 years 11 months 29 days, with new onset ischemic stroke (IS) and hemorrhagic stroke (HS), cerebral venous thrombosis (sinus thrombosis), confirmed clinically and radiologically. RESULTS: Statistical data on stroke and organization of care for children with this pathology in Moscow are presented. The incidence of IS in Moscow for the period 2018-2021 ranged from 1.6 to 2.5 per 100.000 children, HI - from 2.35 to 3.3 per 100.000, sinus thrombosis from 0.5 to 1.38 per 100.000. When assessing the main etiological factors of stroke in The Center for International Pediatric Stroke Research categories, we noted a prevalence of chronic head and neck diseases (20-37%) and chronic systemic conditions (conditions or diseases with known changes in coagulation or vascular structure, including connective tissue dysplasia, genetic, hematological, inflammatory or diseases of the immune system) (15-20%). In addition, data on reperfusion therapy carried out at the Center are presented. From 2018 (first thrombolysis was performed) to 2021, 7.3-14.7% of all patients with IS underwent thrombolysis. CONCLUSION: The experience of functioning of the Center for the Treatment of Cerebrovascular Pathology in Children and Adolescents has shown that the creation of such centers in the regions of the Russian Federation is relevant, but requires taking into account the characteristics of the pediatric population when organizing their work.

[Vaginal leiomyosarcoma in pregnancy]. / Leiomiosarkoma vlagalishcha u beremennoi.

The article presents a rare clinical observation of a vaginal tumor detected during pregnancy, which prevented delivery through the natural birth canal and caused a cesarean section at full term. According to the primary biopsy at 34 weeks, neurofibroma was diagnosed. In the postpartum period, due to profuse bloody discharge, the patient was admitted to the Moscow Regional Research Institute of Obstetrics and Gynecology for surgical treatment, where, according to the results of a morphological study of the removed tumor, vaginal leiomyosarcoma was diagnosed.

[History of congresses of surgeons in Russia (1900-2022)]. / Istoriya s"ezdov khirurgov Rossii (1900­2022).

The authors describe a history of surgical congresses in the Russian Empire, the USSR and the Russian Federation from the I Congress of Russian Surgeons held on December 28-30, 1900 in Moscow in the building of the Moscow Meeting of Doctors to the XLVIII (XIV) Congress of Surgeons of Russia held on November 25-27, 2022 in Moscow in the hotel «Cosmos¼. The time and place of congresses, as well as chairmen are named. The main issues are listed. Scientific issues of congresses between 1900 and 1986 are summarized in tables. The authors present a brief history of Russian surgical societies including the current Russian Society of Surgeons. Surgical forums of the 21st century are considered in detail (Congresses of Surgeons of Russia, National Surgical Congresses, All-Russian Surgical Forums). Finally, the authors came to conclusion that 55 surgical forums have been held in Russia for more than 120 years. Surgeons presented all aspects of surgery in Russia. Their issues are essentially the history of Russian surgery, and their works are sources for analysis of the past and present of Russian surgery.

[The influence of gender, age and length of service on educational preferences of general practitioners in Russia].

In conditions of active development of medical and pharmaceutical sciences and dynamically changing work environment the education of physician is to be both continuous and personalized. Purpose of the study. To investigate effect of gender, age and work experience on educational needs and on preferences of forms and methods of training in the system of continuing medical education of Russian general practitioners. The research bases were Chairs occupied with issues of personnel training for general medical practice in Moscow, Belgorod and Kemerovo. The sociological, statistical and analytical research methodologies were applied. The overall analysis covered 402 questionnaires for general practitioners. The sampling of respondents included 19.1% of men, 80.9% of women; 52.4% were aged 36-55 (60) years, 29.3% - 24-35 years and 18.3% - 56 (61) years and older; 45.0% had experience in general medical practice up to 2 years, 16.3% - 3-4 years, 27.0% - 5-6 years, 11.7% - 7 or more years. The results of comparative analysis of opinions of physicians of both genders and various age with different time of experience concerning level of significance for practice of various areas of competence within the framework of specialty and their preferences regarding organizational forms, training methods and its duration are presented. It is established that gender, age and length of service had no significant effect on the studied parameters. However, certain characteristics associated with these factors are identified. The further study of possible influence of other internal and external factors can contribute in the future into formulation of scientifically grounded approach to choosing personalized trajectory of education of general practitioner.

[The optimization of routing of patients with atherosclerosis of brachiocephalic arteries as exemplified by preventive examination in "Healthy Moscow" pavilions].

The article presents analysis of the program of preventive examinations of Moscow residents in the "Healthy Moscow" pavilions and the routing of patients with established atherosclerosis of brachiocephalic arteries. In 2022, within the framework of preventive examinations (check-ups) of Moscow residents in the "Healthy Moscow" pavilions, the pilot project of organization of surgical treatment of patients with established pathology of pre-cerebral arteries. The project included additional ultrasound examination of brachiocephalic arteries of males aged 45-72 years and females aged 54-72 years. the brachiocephalic artery stenosis was detected in 14 688 out of 370 416 people (4.0% of those passed the check-up). The stenosis was diagnosed in more than 50% - 1 369 people, 9.3% of all stenoses or 0.4% of those passed the check-up). At diagnosis of stenosis, more that 70% of patients were offered to undergo screening ultrasound examination at the "N. V. Sklifosovsky Research Institute of Emergency Care of the Moscow Health Department". The consultation was received by 117 patients out of 254 people. Out of them 22 patients were referred for additional examination, 70 patients for outpatient treatment, 25 patients for surgical treatment. The preventive examination of population organized in the "Healthy Moscow" pavilions permitted to identify sufficient number of patients requiring additional examination with following outpatient and/or surgical treatment of brachiocephalic artery stenosis who timely received necessary care. This result was facilitated by a number of organizational methodological measures implemented jointly with the Moscow Health Department".

[Intranasal vaccine against COVID-19 based on a recombinant variant of the Sendai virus (Paramyxoviridae: Respirovirus) strain Moscow].

INTRODUCTION: Intranasal vaccination using live vector vaccines based on non-pathogenic or slightly pathogenic viruses is the one of the most convenient, safe and effective ways to prevent respiratory infections, including COVID-19. Sendai virus is the best suited for this purpose, since it is respiratory virus and is capable of limited replication in human bronchial epithelial cells without causing disease. The aim of the work is to design and study the vaccine properties of recombinant Sendai virus, Moscow strain, expressing secreted receptor-binding domain of SARS-CoV-2 Delta strain S protein (RBDdelta) during a single intranasal immunization. MATERIALS AND METHODS: Recombinant Sendai virus carrying insertion of RBDdelta transgene between P and M genes was constructed using reverse genetics and synthetic biology methods. Expression of RBDdelta was analyzed by Western blot. Vaccine properties were studied in two models: Syrian hamsters and BALB/c mice. Immunogenicity was evaluated by ELISA and virus-neutralization assays. Protectiveness was assessed by quantitation of SARS-CoV-2 RNA in RT-PCR and histological analysis of the lungs. RESULTS: Based on Sendai virus Moscow strain, a recombinant Sen-RBDdelta(M) was constructed that expressed a secreted RBDdelta immunologically identical to natural SARS-CoV-2 protein. A single intranasal administration of Sen-RBDdelta(M) to hamsters and mice significantly, by 15 and 107 times, respectively, reduced replicative activity of SARS-CoV-2 in lungs of animals, preventing the development of pneumonia. An effective induction of virus-neutralizing antibodies has also been demonstrated in mice. CONCLUSION: Sen-RBDdelta(M) is a promising vaccine construct against SARS-CoV-2 infection and has a protective properties even after a single intranasal introduction.

[XXI Moscow scientific and practical conference "Otorhinolaryngology: traditions and modernity", dedicated to the 100th anniversary of the birth of Professor Nina Petrovna Konstantinova]. / XXI Moskovskaya nauchno-prakticheskaya konferentsiya «Otorinolaringologiya: traditsii i sovremennost'¼, posvyashchennaya 100-letiyu so dnya rozhdeniya professora Niny Petrovny Konstantinovoi.

XXI Moscow scientific and practical conference "Otorhinolaryngology: traditions and modernity", dedicated to the 100th anniversary of the birth of Professor Nina Petrovna Konstantinova.

[Forensic medical characteristic of prevalence and structure of sudden juveniles' death in Moscow Region and St. Petersburg]. / Sudebno-meditsinskaya kharakteristika rasprostranennosti i struktury vnezapnoi smerti lits molodogo vozrasta v Moskovskoi oblasti i Sankt-Peterburge.

THE AIM OF THE STUDY: Was to compare the prevalence and structure of sudden death from cardiovascular diseases (CVD) in the structure of nonviolent death in Moscow Region as a representative of the large region and St. Petersburg as a city of federal importance. Frequency and structure of this parameter, as well as its dynamics were analyzed. The comparison of obtained results with data of Federal State Statistics Service was done. Nonparametric analysis of the initial data has been conducted. Clustering and visualization, based on the following parameters of initial sample, have been done: «death rate from CVD in the structure of nonviolent death¼, «morbidity rate¼, «incomes¼ and «unemployment rate¼. Correlation dependences between death rate from CVD according to the Form №42 and mentioned parameters of medical and social state of the subject have been determined. Dependences between sudden death rate from CDV and a number of medical and social parameters have been established.

[Establishment and initial stage of forensic anthropology's development at Moscow University]. / Stanovlenie i nachal'nyi etap razvitiya sudebno-meditsinskoi antropologii v Moskovskom universitete.

A historical and medical study of preconditions and circumstances of the forensic anthropology establishment is presented. Official demographic statistics and P.A. Minakov's scientific publication on anthropology and forensic medicine were used. The circumstances of forensic anthropology occurrence (a new scientific direction in forensic medicine) were studied. The precondition of its appearance was a strong migration process, with a prevalent concentration of population in large industrial cities. The fact that studied occurrence took place in Moscow can be explained by the high level of development of the anthropological school at Moscow University, and by the fact that one of its leaders, P.A. Minakov, simultaneously headed the university's department of forensic medicine. The idea of anthropology scientific integration into forensic medicine, which was successfully implemented at the Forensic Medicine Department of the Moscow University, belonged to him.

HIV and Hepatitis C Risk among Tajik Migrant Workers Who Inject Drugs in Moscow.

The human immunodeficiency virus (HIV) epidemic in Eastern Europe and Central Asia continues to grow with most infections occurring in high-risk groups including people who inject drugs and their sexual partners. Labor migrants from this region who inject drugs while in Russia are at especially high HIV risk. Male Tajik migrant workers who inject drugs in Moscow (N = 420) were interviewed prior to a randomized trial of the Migrants' Approached Self-Learning Intervention in HIV/AIDS (MASLIHAT) peer-education HIV-prevention intervention. Participants were interviewed about their sex and drug use behavior and tested for HIV and hepatitis C (HCV) prior to the intervention. Only 17% had ever been tested for HIV. Over half of the men reported injecting with a previously used syringe in the past month, and substantial proportions reported risky sexual behavior. Prevalence rates of HIV (6.8%) and HCV (2.9%) were elevated, although lower than expected when compared to estimates of prevalence among people who inject drugs at the national level in Tajikistan. Risk behavior in diaspora varied across the men's regional area of origin in Tajikistan and occupation in Moscow, with HIV prevalence rates highest among those working at the bazaars. Evidence-based prevention approaches and messaging that specifically address the drug- and sex-related risk behavior of migrants with varying backgrounds are needed.

[Molecular epidemiological analysis of SARS-CoV-2 genovariants in Moscow and Moscow region].

INTRODUCTION: SARS-CoV-2, a severe acute respiratory illness virus that emerged in China in late 2019, continues to spread rapidly around the world, accumulating mutations and thus causing serious concern. Five virus variants of concern are currently known: Alpha (lineage B.1.1.7), Beta (lineage B.1.351), Gamma (lineage P.1), Delta (lineage B.1.617.2), and Omicron (lineage B.1.1.529). In this study, we conducted a molecular epidemiological analysis of the most prevalent genovariants in Moscow and the region. The aim of the study is to estimate the distribution of various variants of SARS-CoV-2 in Moscow city and the Moscow Region. MATERIALS AND METHODS: 227 SARS-CoV-2 sequences were used for analysis. Isolation of the SARS-CoV-2 virus was performed on Vero E6 cell culture. Sequencing was performed by the Sanger method. Bioinformatic analysis was carried out using software packages: MAFFT, IQ-TREE v1.6.12, jModelTest 2.1.7, Nextstrain, Auspice v2.34. RESULTS: As a result of phylogenetic analysis, we have identified the main variants of the virus circulating in Russia that have been of concern throughout the existence of the pandemic, namely: variant B.1.1.7, which accounted for 30% (9/30), AY.122, which accounted for 16.7% (5/30), BA.1.1 with 20% (6/30) and B.1.1 with 33.3% (10/30). When examining Moscow samples for the presence of mutations in SARS-CoV-2 structural proteins of different genovariants, a significant percentage of the most common substitutions was recorded: S protein D614G (86.7%), P681H/R (63.3%), E protein T9I (20.0%); M protein I82T (30.0%), D3G (20.0%), Q19E (20.0%) and finally N protein R203K/M (90.0%), G204R/P (73.3 %). CONCLUSION: The study of the frequency and impact of mutations, as well as the analysis of the predominant variants of the virus are important for the development and improvement of vaccines for the prevention of COVID-19. Therefore, ongoing molecular epidemiological studies are needed, as these data provide important information about changes in the genome of circulating SARS-CoV-2 variants.

[Circulation of bovine herpesvirus (Herpesviridae: Varicellovirus) and bovine viral diarrhea virus (Flaviviridae: Pestivirus) among wild artiodactyls of the Moscow region].

INTRODUCTION: Pestiviruses and viruses of the Herpesviridae family are widely distributed among different species of ungulates, but the main information about these pathogens is related to their effect on farm animals. Data on detection of bovine viral diarrhea virus (BVDV) and bovine herpes virus (BoHV) in wild ungulates reported from different countries in recent years raises the question of the role of wild animals in the epidemiology of cattle diseases. AIM OF WORK: To study the prevalence of herpesviruses and pestiviruses in the population of wild artiodactyls of the Moscow region. MATERIALS AND METHODS: Samples of parenchymal organs and mucosal swabs from 124 wild deer (moose and roe deer) shot during hunting seasons 20192022 in Moscow Region were examined by PCR, virological and serological methods for the presence of genetic material and antibodies to bovine infectious rhinotracheitis and viral diarrhea. RESULTS: BVDV RNA was found in a sample from one moose, BoHV DNA was detected in samples from three roe deer and two moose shot in the Moscow region. Seropositive animals were of different sex and age, the total BoHVs and BVDV seroprevalence rates in wild artiodactyls were 46 and 29%, respectively. CONCLUSION: Wild ruminant artiodactyls of the Moscow Region can be a natural reservoir of BoHV-1, and this must be taken into account when planning and organizing measures to control the infectious bovine rhinotracheitis. Cases of BVDV infection in wild artiodactyls are less common, so more research is needed to definitively establish their role in the epidemiology of this disease in cattle.

Identification of growing tuberculosis incidence clusters in a region with a decrease in tuberculosis prevalence in Moscow (2000-2019).

Background: The control of tuberculosis (TB) may benefit from a prospective identification of areas where the incidence may increase in addition to the traditionally identified foci of high incidence. We aimed to identify residential areas with growing tuberculosis incidence rates and assess their significance and stability. Methods: We analysed the changes in TB incidence rates using case data georeferenced with spatial granularity to apartment buildings in the territory of Moscow from 2000 to 2019. We identified sparsely distributed areas with significant increases in the incidence rate inside residential areas. We tested the stability of found growth areas to case underreporting via stochastic modelling. Results: For 21 350 cases with smear- or culture-positive pulmonary TB among residents from 2000 to 2019, we identified 52 small-scale clusters of growing incidence rate responsible for 1% of all registered cases. We tested clusters of disease growth for underreporting and found them to be relatively unstable to resampling with case drop-out, but their spatial displacement was small. Territories with a stable increase in TB incidence rate were identified and compared to the rest of the city, which is characterised by a significant decrease in incidence. Conclusions: Identified areas with a tendency for an increase in the TB incidence rate may be important targets for disease control services.

[Residency is a fundamental stage of professional training of an otorhinolaryngologist]. / Ordinatura ­ osnovopolagayushchii etap professional'noi podgotovki otorinolaringologa.

Systematic analysis of various indicators of the educational process becomes important to assess the effectiveness of the training of residents. One of the most common tools for monitoring the effectiveness of the educational process is a questionnaire of students. OBJECTIVE: To analyze the results of the assessment of the quality of training in the residency of the Sverzhevky Research Clinical Institute of Otorhinolaryngology according to the survey of residents. MATERIAL AND METHODS: The study includes the results of an anonymous questionnaire survey of a sample group of residents of the residency of the Sverzhevky Research Clinical Institute of Otorhinolaryngology of the second year of study. RESULTS: The data obtained allow us to judge the satisfaction with the quality of training of the absolute majority of the interviewed residents, their active use of specialized electronic search engines, a high assessment of the level of lectures, the desire to improve their surgical training. The importance for the professional development of residents of participation in weekly scientific and clinical conferences of the Sverzhevky Research Clinical Institute of Otorhinolaryngology, meetings of the Moscow Scientific Society of Otorhinolaryngologists, traditional annual scientific and practical conferences of otorhinolaryngologists of Moscow, as well as in the activities of the Youth Council of the Institute is noted. CONCLUSION: The results of the survey create prerequisites for improving the educational process, the formation of professional competencies and readiness for independent work among residents.

[Abstracts of the National Congress with International Participation "Heart Failure 2022" Moscow, 09.12.2022 - 10.12.2022].

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[Activity of N.A. Semashko during the evacuation of the 1st Moscow Order of Lenin Medical Institute to Ufa (1941-1942)].

An attempt is made to systematize the main directions of N.A. Semashko's activity during the evacuation of the 1st Moscow Order of Lenin Medical Institute (MOLMI) during the Great Patriotic War to Ufa (October 1941 - March 1942) is undertaken. The significance of its results for the Bashkir State Medical Institute (now Bashkir State Medical University) is evaluated. It is shown that the joint work of N.A. Semashko with the teaching staff of the 1st MOLMI and Bashkir medical institute improved the pedagogical and scientific qualification of teachers at Bashkir medical institute, improved the existing forms of teaching, scientific and educational work during the period of war and created new ones. Professor N.A. Semashko actively worked in several directions during complicated conditions of evacuation. Besides pedagogical and scientific activities, he was occupied with the training of scientific-pedagogical personnel, took part in advanced training of physicians and medical workers, organized educational work with the population, delivered brilliant lectures to the crowded halls. In addition, as the first People's Commissar of Health of the RSFSR, he helped the People's Commissariat of Health of the Bashkir ASSR in organizing the work of evacuation hospitals and rendering assistance to health care institutions located on the territory of the Bashkir ASSR.

[Pre-exposure prophylaxis of new COVID-19 coronavirus infection with tixagevimab/cilgavimab in adult Moscow patients with primary immunodeficiencies].

BACKGROUND: Primary immunodeficiencies (PIDs), now known as inborn errors of immunity, are a group of inherited diseases caused by defects in the genes that control the immune response. Patients with PIDs have risks of developing a severe course and/or death in COVID-19. Passive immunization with long-acting monoclonal antibodies (MABs) to SARS-CoV-2 should be considered as pre-exposure prophylaxis in patients with PIDs. Tixagevimab/cilgavimab is a combination of MABs that bind to the SARS-CoV-2 spike protein. AIM: To evaluate the efficacy and safety of pre-exposure prophylaxis of new SARS-CoV-2 infection in PIDs with the combination of tixagevimab/cilgavimab. MATERIALS AND METHODS: Forty eight patients diagnosed with PIDs were included in the study. Median follow-up after drug administration was 174 days. The total number of confirmed coronavirus infections in patients with PIDs as well as 6 months before and after administration of MAT were assessed. RESULTS: In the analyzed cohort, the overall incidence of COVID-19 from pandemic onset to MABs administration was 75% (36/48), with 31% (11/36) of over-infected patients having had the infection more than once. The incidence of COVID-19 immediately 6 months before the introduction of tixagevimab/cilgavimab was 40%. All patients who had COVID-19 after pre-exposure prophylaxis had a mild infection. The incidence of COVID-19 6 months after tixagevimab/cilgavimab administration significantly decreased compared to the incidence 6 months before administration (7 and 40%, respectively; p<0.001). CONCLUSION: The use of tixagevimab/cilgavimab in patients with PIDs is effective as pre-exposure prophylaxis and reduces the risk of severe COVID-19.

[THE EVOLUTION OF PROACTIVE DISPENSARY MONITORING IN THE MOSCOW HEALTHCARE SYSTEM].

Economic and social losses due to epidemics of non-communicable diseases have put prevention and control of them on the first line in the field of sustainable development of the United Nations. The tasks of combating NCDs and risk factors within the framework of the Sustainable Development Goals require targeted actions on the part of States in the field of policy and legislation and provision of health systems with appropriate resources. In the Russian Federation, such work is being implemented within the framework of the national project "Healthcare", federal programs to combat oncological and cardiovascular diseases. Each subject takes into account the peculiarities of economic development, staffing, implementation of informatization processes, etc. The rapid pace of transformation of Moscow healthcare, its unique institutional structure allowed to form the basis for the effective development of a system of proactive dispensary monitoring of patients suffering from chronic diseases. The authors describe the process of formation of preventive work and organization of dynamic dispensary observation in Moscow. The paper presents in detail the organizational, administrative and technological resources used to create a unique system of dynamic dispensary observation. In addition, the article illustrates the personalized subsystem of dynamic dispensary observation in EMIAS and the institute of "physician assistant". The introduction of a proactive dispensary monitoring system will reduce premature mortality and disability among residents of the city. Moscow through an individual monitoring program and motivation for the responsible attitude of metropolitan patients to their health.

[Adrian Aleksandrovich Kryukov (1849-1908)]. / Adrian Aleksandrovich Kryukov (1849­1908).

This article presents a creative biography of professor A.A. Kryukov - a prominent Russian ophthalmologist, compiled on the basis of previously unpublished archival information and analysis of literary sources. The work notes constant attention and trust of his teacher M.M. Voinov, associate professor of the Medical Faculty of Moscow University; describes the main directions of scientific research of A.A. Kryukov, emphasizes the social significance of his work, the long-lasting high demand for his «Textbook of Eye Diseases¼. A.A. Kryukov prioritized development and implementation of iridectomy through a scleral incision in the ophthalmic practice. He was interested in developing ties with European colleagues, constantly assisted with dissemination of scientific information, cooperated with domestic and foreign mass media. He had an initiative role in the establishment and development of the Moscow Ophthalmological Circle. The article also amends the mistake of modern researchers who present A.A. Kryukov as a pioneer of local anesthesia in ophthalmology.

On the Paper by Leonid A. Gavrilov and Natalia S. Gavrilova entitled "Trends in Human Species-Specific Lifespan and Actuarial Aging Rate" Published in Biochemistry (Moscow), Vol. 87, Nos. 12-13, pp. 1622-1633 (2022).

The methodology used for analyzing the survival process should keep in mind heterogeneity in empirical data. Cross-sectional data are more heterogeneous in comparison with birth-cohort data.