[The burden of COVID-19 in a heterogeneous population of immunocompromised patients - realities of the postpandemic].

On July 3, 2023, an interdisciplinary Council of Experts "The burden of COVID-19 in a heterogeneous population of immunocompromised patients - post-pandemic realities" was held in Moscow with leading experts in pulmonology, rheumatology, hematology, oncology, nephrology, allergology-immunology, transplantation, and infectious diseases. The aim of the meeting was to discuss the current clinical and epidemiologic situation related to COVID-19, the relevance of disease prevention strategies for high-risk patients. The experts addressed the following issues: 1) the disease burden of COVID-19 in 2023 for patients with immunodeficiency in different therapeutic areas; 2) the place of passive immunization with monoclonal antibodies as a method of COVID-19 prophylaxis among immunocompromised patients; 3) prerequisites for the inclusion of passive immunization of immunocompromised patients into routine clinical practice.

[The methodology of prognostication of severe exacerbation of bronchial asthma and asthmatic status].

The modes of predicting chronic non-infectious diseases in clinical practice remain actual issues for general practitioner. The methodology of predicting severe exacerbation of bronchial asthma and asthmatic status during therapeutic care rendering in out-patient conditions is proposed. The methodology comprises sequential assessment in patient availability of predictors of severe exacerbation of bronchial asthma and asthmatic status with further calculation of indices of information values of each of them separately and as well as accumulated information value to evaluate their cumulative effect.

[Alcohol-associated mortality in Russia (based on the materials for the period from 2011 till 2016)]. / Alkogol'-assotsiirovannaia smertnost' v Rossii (po materialam 2011-2016 gg.).

The objective of the present study was to evaluate the frequency of alcoholic drunkenness documented during forensic medical expertises (investigations) of the corpses carried out in this country throughout the period from 2011 till 2016. The investigations were conducted with the use of medical statistics methods by calculating the fractional difference, dynamics, and rates of detection of the cases of alcoholic intoxication depending on the cause of death. The study has demonstrated the high frequency of the cases of alcoholic drunkenness revealed during forensic medical expertises (investigations) of the corpses that amounted to 30.5% [15, 16]. The total number of the corpses examined in 2016 was 8.6% higher than in 2011. The frequency of the documented cases of alcoholic drunkenness during the same period decreased by 19.7%. The frequency of the documented cases of alcoholic drunkenness in the cases of violent death was 2.8 times that in the cases of death from various diseases (52.8 and 19.0% respectively). The enhanced frequency of alcoholic drunkenness in relation to the number of the conducted forensic medical expertises was documented in the cases of death by drowning and from hypothermia whereas the lowest frequency of alcoholic intoxication was recorded for the corpses of the people who had died from malignant tumours and diseases of the nervous system. Various regions of Russia differed in terms of the frequency of alcoholic drunkenness recorded among the recently deceased people.

[The program for the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise' as a component of the integral educational space]. / Programma ordinatury po spetsial'nosti 31.08.10 Sudebno-meditsinskaia ékspertiza - sostavliaiushchaia edinogo obrazovatel'nogo prostranstva.

The objective of the present study was the development and implementation of the educational program for the training of the highly qualified specialists within the framework the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise' aimed at the adherence to and the maintenance of the systemic approach to the training in compliance with the upgraded regulatory documents at the medical institutions of the Russian Federation authorized to carry out post-graduate educational activities. The residency program for the training of the highly qualified specialists in the speciality 31.08.10 'forensic medical expertise' has been developed and implemented based at the Russian Federal Centre of Forensic Medical Expertise with the extension of the elective part of the working residency program in order to provide the delivery of the lectures and holding seminars on the selected issues of forensic medicine and criminalistics. The ongoing modernization of the healthcare system in this country taking into consideration the public needs and the challenges for practical medicine, the necessity of formation of the integral educational medium, the development of the unique systemic approach to the effective training of the highly qualified specialists in forensic medical expertise, and further optimization of the educational process are intended to propel forensic medical education and the training of the forensic medical experts to the qualitatively new level.

[Professional competence of the graduates of the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise']. / Professional'nye kompetentsii vypusknika ordinatury po spetsial'nosti 31.08.10 Sudebno-meditsinskaia ékspertiza.

The objective of the present study was the definition of the basic professional competences of the graduates of the clinical residency and internship in the speciality 31.08.10 'forensic medical expertise'. The program for the acquirement of the basic knowledge, skills, and professional competences needed to be trained in the speciality 31.08.10 'forensic medical expertise' has been elaborated in the framework of the more extensive program for the clinical residency and internship intended for the training of the highly qualified specialists in this discipline. The preliminary list of basic professional competences of a graduate from the clinical residency and internship has been formulated in accordance with the program for the training of a competitive and highly qualified forensic medical experts. The practical professional activities are considered to be an indispensable component of the training and educational process for a future forensic medical expert. It is believed that the strengthening of this training component will greatly contribute to the improvement of the quality of training of such specialists.

[Therapeutic possibilities hepatoprotectors in alcoholic liver cirrhosis].

UNLABELLED: The aim of the study was to investigate the therapeutic opportunities of S-adenosylmethionine and polyunsaturated lecithin in Child class A patients with alcoholic liver cirrhosis using transient elastography. MATERIALS: The 38 males Child class A alcoholic liver cirrhosis were investigated. RESULTS: The use of S-adenosylmethionine or polyunsaturated lecithin in patients with alcoholic liver cirrhosis is reasonable cause of their possibility to reduce the fibrogenesis in liver tissue and of their possibility to improve the function of remained intact hepatocytes. Thus use of this remedies prevents progression of cirrhotic transformation of the liver and gives a patient an opportunity to get the stable clinical status.

[The algorithm of quality of medical care examination for gastroenterologists in cases of chronic calculouse cholecystitis].

THE AIM: development of quality and consequences of medical care evaluation test at chronic calculouse cholecystitis by the expert--gastroenterologist. Defined defects, that statistically significantly determined negative outcomes, had fixed distribution within groups by frequency of these defects. Analysis resulted in calculation of the cumulative information value score of each case separately for diagnosis and treatment processes with assessment of probabilistic limits by binary logistic regression method with determination of limits of appropriate and inadequate medical care provision to chronic calculouse cholecystitis patients provide the algorithm for gastroenterologist.

[Methodological approaches to the expert appraisal of therapeutic care quality in chronic cholecystitis].

AIM: to develop a technology for assessing the quality and consequences of medical care in chronic noncalculous cholecystitis by an expert--a therapist, a gastroenterologist. MATERIALS AND METHODS: One hundred and ninety-three cases of expert appraisal of medical care quality in chronic noncalculous cholecystitis were analysed. The expert appraisal of the quality of medical care was carried out by comparing with that of the reference - the standard for the diagnosis and treatment of chronic noncalculous cholecystitis. To detect the defects correlated with the negative consequences of medical care, the authors calculated statistical criteria for assessing an association between the indices of accumulated informative value and the consequences of rendered medical care. RESULTS: According to the assessed quality of medical care, the patients were divided into two groups: (1) 163 patients with negative consequences of delivered medical care; (2) 30 patients with its positive consequences (a control group). The identifed drawbacks that significantly determined negative outcomes had a certain distribution in the groups by their frequency. The analysis provided calculations of the accumulated informative value index for each case individually for the processes of diagnosis and treatment, by drawing up the boundaries of proper and improper medical care delivered to patients with chronic noncalculous cholecystitis. CONCLUSION: The formulated criteria of positive consequences of medical care are oriented to the differential diagnosis of biliary tract pathology, to differentiated approaches to treatment analysis, and to the likely outcomes of exposure to medical and diagnostic actions on the pathological process, which allows an expert to predict its further dynamics and consequences of rendered medical care. The algorithmized expert appraisal of cases of medical care delivery makes it possible to objectivize the opinion and conclusions of an expert.

[Examination of health care quality in chronic viral hepatitis].

On a basis of consultant's investigation of medical aid for patients with chronic viral hepatitis were proposed the criteria for determine of medical aid quality and algorithm for consultant's investigation.

[Objectivization of expert evaluation of the quality and efficiency of medical care for patients with gastric and duodenal ulcer with the help of a standard algorithm].

Criteria for the efficiency of medical care being provided to patients with gastric and duodenal ulcer are discussed. The method and the algorithm are proposed for expert evaluation of the reliability and quality of medical attendance.

[Antibiotic-associated diarrheas in phthisiatric care: standardization of their diagnosis, treatment, prevention, examination of health care quality].

The authors propose a phthisiological care-adjusted standard of the diagnosis, treatment, prevention of antibiotic-associated diarrhea. They have developed a standard-driven algorithm of expert assessment of the quality of medical aid to this group of patients.