COVID-19 in Russia: Evolution of Views on the Pandemic. Report II

Over the two years of the novel coronavirus infection (COVID-19) pandemic, there has been an evolution of views in various fields of medicine, which has led to a powerful development of scientific research in the field of epidemiology, clinic, diagnosis and therapy of COVID-19. This article discusses the evolution of views and approaches to the study of the clinic and therapy of COVID-19. The symptoms and aggravation of the course of cardiovascular diseases with COVID-19 have been established. The main strategy for organizing surgical care for patients with COVID-19 is indicated. The main criteria for the treatment of COVID-19, the need to prescribe SGCS on an individual basis, and the need to search for new methods of anti-inflammatory therapy for COVID-19, one of which may be the use of alkylating drugs in ultra-low doses, are described. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.

COVID-19 in Russia: Evolution of Views on the Pandemic. Report I

Over the two years of the novel coronavirus infection (COVID-19) pandemic, there has been an evolution of views in various fields of medicine, which has led to a powerful development of scientific research in the field of epidemiology, clinic, diagnosis and therapy of COVID-19. The article highlights the evolution of views and approaches to the study of the epidemiology and radiology of COVID-19. The data of molecular genetic studies are shown, which are the most important component of epidemiological surveillance. The study of the manifestations of the COVID-19 epidemic process made it possible to distinguish two stages in the development of the epidemiological situation in the Russian Federation. At the first stage of the epidemic, two rises in the incidence rate of the population were recorded, regulated by social and natural factors. The second stage of the epidemic was due to a change in the biological properties of the SARS-CoV-2 virus, followed by a change in the prevailing genovariants (Alpha, Delta and Omicron). At the second stage of the epidemic, three rises in the incidence of the population were recorded. The general principles for the use of radiodiagnosis methods, which are used primarily to detect lung damage in COVID-19, are given. With the accumulation of experience, a natural change in ideas about the algorithms for the use of visualization technologies has occurred. Copyright © 2022 Izdatel'stvo Meditsina. All rights reserved.

Regulatory information: The principles and prospects of development at the stage of creating a single digital contour in health care

Aim. The aim of the study was to consolidate the principles and rules for building a regulatory and reference space based on the analysis of previous phases of implementation to prioritize the development and to create a single digital contour in health care. Information sources. Data were obtained from the Regulatory Service at the Federal Registry of Regulatory and Reference Information (RRI), regulations of the Russian Ministry of Health in the field of information technology development, and the methodical and conceptual documents of the federal project “Creation of the integrated digital contour in healthcare based on the uniform state health information system”. Results. The stages of creating a single system of regulatory and reference information in the health sector over the past decade were analyzed taking into account the continuity of goals and objectives consistently presented in the conceptual and strategic documents that define the process of creating unique state health information system, as well as the experience of their solution. The analysis allowed to formulate the basic principles of development, namely: central management, structural unity, functional unity, information unity, and prioritization of tasks. Consolidation of principles and rules provided the basis for a scientific and methodical approach to further development of a single RRI system at the stage of creating a single digital contour in health care and shaping priorities of the development. Conclusion. At the stage of creating a single digital contour in health care, which has been approached by many countries, including Russia, the importance of a ubiquitous language of communication increases dramatically and, as the events associated with the COVID-19 pandemic have shown, the readiness of information systems directly determines the readiness of society to meet challenges and to protect the population. © 2020 Tomsk State University. All right reserved.

Trends in Morbidity and Hospital Lethality from Neoplasms before and during the New Coronavirus Infection COVID-19

Background. Taking into account the special medical and social significance of oncological diseases, as well as taking into account that patients suffering from neoplasms are a special risk group for developing complications of coronavirus infection, it seems relevant to study the impact of the COVID-19 pandemic on the level of morbidity and hospital lethality of patients with neoplasms. Aims ' to study the trends of morbidity and hospital lethality due to neoplasms in the Russian Federation before and during the pandemic of the new coronavirus infection COVID-19. Methods. The indicators of primary and general morbidity, hospital lethality from neoplasms of the adult population were calculated on the basis of federal statistical observation data contained in reporting forms No. 12 and No. 14 of all subjects of the Russian Federation for 2015-2020. Results. During the period from 2015 to 2019, an increase in the general (by 14.8%) and primary (by 4.8%) incidence of neoplasms was noted in the Russian Federation. In 2020, compared with 2019, on the contrary, the indicators of general (by 5.0%) and primary (by 17.4%) incidence of neoplasms decreased. Hospital lethality due to neoplasms also increased during 2015-2019, in total it increased by 19.2%, in one year (2020) hospital lethality increased by 6.6%. A similar situation has developed in all federal districts and most regions of the country. Conclusions. The decline in the incidence of neoplasms in 2020, with their previous continuous growth, reflects the difficult situation that has developed during the pandemic of a new coronavirus infection in the healthcare of the Russian Federation. The increase in hospital lethality from neoplasms indicates a more severe course of coronavirus infection in adult patients with malignant neoplasms and a more frequent development of fatal complications in them. © 2021 Izdatel'stvo Meditsina. All rights reserved.

Promising measures to reduce the mortality in Russia: an analytical review

The purpose of the study was to identify promising measures to reduce mortality in Russia. Methods used included analysis of systematic reviews from PubMed, Web of Science, Scopus, and Google Scholar. Results. Promising measures for reducing mortality in Russia include promoting healthy behaviour (tobacco control, alcohol control, support for healthy diet, physical activity) and preventing death due to external causes. It is necessary to increase the effectiveness of disease management, including arterial hypertension, hypercholesterolemia, diabetes mellitus, cardiovascular accidents, hepatitis C, HIV. This could require intensifying digital transformation of health care, implementing modern teamwork approaches to the patient’s treatment and follow-up with greater involvement of nurses and other personnel. In terms of screening, it is essential to expand coverage and introduce modern, effective screening methods for colorectal cancer, cervical cancer, and neonatal screening. It is necessary to expand vaccination against COVID-19, vaccination of the elderly from Pneumococcus, and teenagers from HPV. Prevention of mortality from external causes should include sets of measures targeted at the prevention of suicides, traffic accidents, fires, drownings, etc., in addition to alcohol control measures. Finally, increasing health care financing, including medication provision, can bring additional years of life. Conclusions. Russia has significant potential to implement new measures to reduce the mortality. © AUTHORS, 2021.

Associated pathology in case of death from circulatory circulatory diseases according to the analysis of multiple causes

Background. Comorbidity of diseases deteriorates health and often increases the risk of death. Identification of comorbidities with diseases of the circulatory system (DCS) will help find additional measures to increase life expectancy. Aims - to identify causes associated with death from DCS and to analyze their interrelation based on the multiple cause analysis. Materials and methods. Data on DCS deaths of the Death registration in the Moscow Unified Medical Information and Analytical System (RFS-EMIAS) in 2019 (46 000 deaths) and from April to May 2020 (11 000 deaths) excluding perinatal mortality were analyzed. The association analysis was carried out across groups of the ICD-10 DCS blocks by calculating the corresponding frequency. Effect of SARS-CoV-2 was analyzed in the infected deceased and those free from infection. Comparison was carried out by the Chi-square test. Results. The following Diseases of the circulatory system are associated with Diabetes mellitus: Hypertension, Coronary heart disease, Cerebrovascular diseases, and Diseases of arteries, arterioles and capillaries. A synergetic effect has been identified in comorbidity with the diseases characterized by high blood pressure and Chronic rheumatic heart diseases, "other forms of heart disease"(I30-I52), Cerebrovascular diseases and Diseases of arteries, arterioles and capillaries;the latter and Coronary heart disease and Cerebrovascular diseases;"other forms of heart disease" and Mental disorders due to psychoactive substance use;Diseases of veins, lymphatic vessels and lymph nodes and Pulmonary circulation disorders. Effect of the increased risk of death in non-symmetric associations of causes has been detected for comorbidity of Diseases of veins, lymph vessels and lymph nodes and Chronic viral hepatitis;Coronary heart disease and "other forms of heart disease";Hypertension and Coronary heart disease;in males - comorbidity of Obesity and Hypertension, and Diseases of arteries, arterioles and capillaries and Hypertension. Associations between DCS and their complications have been identified in females: Diseases of veins, lymph vessels and lymph nodes and Phlegmon, and Cerebrovascular diseases and Decubital ulcers. Conclusion. SARS-CoV-2 increases mortality from Chronic coronary heart disease, ICD-10 I67.8 code for Other specified cerebrovascular diseases and Hypertension in females 1.5-fold. The infection rate in females died from DCS is significantly lower compared to the one in males.

Telemedicine technologies: prospects and limitations

In the context of rapid technological progress, the outlines of the prospects for the development of telemedicine technologies are becoming more and more clear. At the same time, changes in the organizational, legal and economic spheres often do not keep up with technological changes. This was especially evident in the conditions of the spread of the COVID-19 coronavirus.The article contains an analysis of the features of telemedicine technologies application in modern conditions, prospects and obstacles that arise in this area. В условиях быстрого технологического прогресса очертания перспектив развития телемедицинских технологий становятся все более явственными. При этом изменения в организационной, правовой и экономической сфере зачастую не поспевают за технологическими изменениями. Особенно наглядно это проявилось в условиях распространения коронавирусом COVID-19.В статье содержится анализ особенностей применения телемедицинских технологий в современных условиях, перспективы и возникающие в этой сфере препятствия.

E-MAIL: CHILILOV@MAIL.RU

The aim of the research is to study the economic aspects of telemedicine technologies application, taking into account the experience of other countries;to develop methodological approaches to evaluating the effectiveness of telemedicine technologies;to analyze the features of evaluating the effectiveness of telemedicine technologies in the conditions of COVID-19 coronavirus spread. Methodological approaches to evaluating the effectiveness of telemedicine technologies are proposed.The additional costs and benefits of using telemedicine technologies are analyzed in the context of the main participants: the state, medical organizations, doctors, and patients. The additional costs of introducing telemedicine technologies are estimated in terms of their belonging to the so-called “necessary costs” or investments that have different economic content.The proposals developed by the authors allow us to more correctly assess the effectiveness of investments in the provision of telemedicine services and, thus, choose the most optimal options. Целью исследования является изучение экономических аспектов применения телемедицинских технологий с учетом опыта других стран;выработка методологических подходов к оценке эффективности применения телемедицинских технологий;анализ особенностей оценки эффективности применения телемедицинских технологий в условиях распространения коронавируса COVID-19. Предложены методологические подходы к оценке эффективности применения телемедицинских технологий. Дополнительные расходы и выгоды от применения телемедицинских технологий анализируются в разрезе основных участников: государство, медицинские организации, врачи, пациенты. Затраты на введение телемедицинских технологий оцениваются с точки зрения их принадлежности к так называемым «необходимым затратам» или инвестициям, имеющим различную экономическую природу.Выработанные авторами предложения позволяют более корректно оценивать эффективность вложений в оказание телемедицинских услуг и, тем самым, выбрать наиболее оптимальные варианты их применения.