[Prevalence of cognitive impairment in older adults in the Russian Federation]. / Rasprostranennost' kognitivnykh rasstroistv u patsientov starshego vozrasta v Rossiiskoi Federatsii.

Dementia is one of the main challenges to modern society. According to estimated data, as of 2019, there were 1.949.811 people living In Russia with dementia of various etiology. At the same time, there have been no large epidemiological studies of dementia in the Russian Federation. The article provides an overview of the available data on the epidemiology of cognitive impairment (CI) In Russia given from various sources. Not only estimated, but also available clinical data were analyzed. In general, the obtained prevalence values for CI are comparable to global values. Thus, in an epidemiological study of people over 60 years of age in a separate district of Moscow, the prevalence of dementia was 10.4%, Alzheimer's disease 4.5%. A study of outpatients aged 60 years and older showed a high prevalence of both dementia and non-dementia CI at general medical appointments (incidence of dementia 7.8%, MCI 49.6%). It has been shown that the problem of non-dementia CI is already relevant in people of pre-retirement age (the prevalence of non-dementia CI in patients 55-64 years old is 36.8-44.8%). Unique data obtained in a population of institutionalized centenarians (prevalence of dementia 69%), as well as data on the relationship of CI with both somatic and demographic factors are presented.

[From the history of domestic dentistry: Moscow Dental School of the Privat-docent of Moscow University, MD Gilyariy Ivanovich Vilga]. / Iz istorii otechestvennoi stomatologii: Moskovskaya zubovrachebnaya shkola privat-dotsenta Moskovskogo universiteta doktora meditsiny Gilyariya Ivanovicha Vil'ga.

Based on archival data, the authors describe the Moscow School of Dentistry with dental courses for doctors, dentists, and dentists of the Moscow University, Privat-docent Dr. Gilyari Ivanovich Vilga, examine the background to its formation, provide unique archival data on the location of the school, as well as its internal organization and equipment. The authors review in detail the program of courses, as well as their duration, cost, and form of student accountability. During its existence (1909-1918), more than two thousand dentists were educated at G.I. Vilg's school, among them Alexander Ivanovich Evdokimov, a future corresponding member of the USSR Academy of Medical Sciences, director of the State Institute of Dentistry (GIZ) and the State Institute of Dentistry and Odontology (GIZO). The authors of the article also focus on analyzing the differences in the approaches to the organization of several dental schools, viz: The First Moscow I.M. Kovarsky School of Dentistry and the Second G.I. Vilga School of Dentistry. In his efforts, I.M. Kovarskij's aspirations to establish the best dental school in Russia were crowned with success: a specially constructed and equipped building meeting the state-of-the-art requirements (the building even boasted an X-ray machine), and the best professors and instructors of the University of Moscow of that time were hired. In contrast, G.I. Vilga rented premises for his school, the equipment was in short supply, and he himself was the only eminent professor. Nevertheless, his fierce desire to unite the entire dental community and organize the best dental care for the entire population of Russia allowed his brainchild to enter the top five schools of the time.

[The gender aspects of changes in mortality during COVID-19 pandemic as exemplified by Moscow].

The mortality is a major component of damage caused by COVID-19. The comparative analysis of changes in mortality was carried out on the basis of the ROSSTAT data over 2012-2020 to determine differences in losses of male and female population caused by pandemic in Moscow. It is demonstrated that at close trends in mortality of males and females before pandemic, in 2020 their mortality changed differently. At equal increase of male and female mortality, main contribution into excess mortality (excluding contribution of COVID-19) was made approximately equally by diseases of nervous system and circulatory system in males and diseases of nervous system in females. The male mortality from COVID-19 is 1.9 times higher than female mortality. As a result of younger average age of death the amount of economic losses in terms of years of potential life lost (PYLL) due to premature death of males because of COVID-19 exceeds economic losses due to premature death of females up to 2 times. Although the average age of death of females from all causes decreased by smaller amount, their values of PYLL increased more, mainly due to higher rate of female mortality from disease of nervous system and from mortality related to drug addiction. In Moscow, the highest increase of PYLL is conditioned by dearth related to drug addiction and alcohol consumption. In the structure of this indicator in males they are ranked fourth and fifth. In females, alcohol-related deaths are ranked as sixth and drug-related deaths as eighth. The pandemic, contributing into increase in economic losses, didn't change their leading causes: diseases of circulatory system, external causes and neoplasms in males; neoplasms, diseases of circulatory system and external causes in females. The value of PYLL due to death from COVID-19 takes sixth place in males and fourth place in females.

[On becoming of nephrology in the USSR: The role of Moscow therapists M. I. Vihert and E. M. Tareev].

The article considers stages of becoming of Soviet nephrology as independent scientific educational clinical discipline. The role of M. I. Vikhert in becoming of nephrology as independent clinical direction within the framework of the clinic of internal diseases is demonstrated. Also the role of E. M. Tareev as the founder of nephrology in the USSR as institutionalized clinical discipline is revealed.

[The outstanding Russian ophthalmologist Alexey Nikolaevich Maklakov]. / Vydayushchiisya russkii oftal'molog Aleksei Nikolaevich Maklakov.

The conducted archival research and analysis of literary publications allowed us to supplement the biography and creative path in science, clinical and social activities of the outstanding Russian ophthalmologist A.N. Maklakov. This article emphasizes the urgency of the problem of teaching in medical universities, and gives special attention to the thoughts of the scientist about providing clarity in the process of teaching students. The article notes his role in the arrangement and equipment of the new eye clinic of the Moscow University, and presents fragments of memoirs of his student and mentee, another famous Russian ophthalmologist S.S. Golovin. A remark is made about the need to clarify the terms traditionally accepted in the history of medicine in relation to surgery and ophthalmology. An assessment is given on the contribution of A.N. Maklakov to the establishment of the Moscow Ophthalmological Circle, his efforts to unite doctors, and the development of the statutory documents of the All-Russian Society of Eye Doctors.

Metagenomic insights into the wastewater resistome before and after purification at large­scale wastewater treatment plants in the Moscow city.

Wastewater treatment plants (WWTPs) are considered to be hotspots for the spread of antibiotic resistance genes (ARGs). We performed a metagenomic analysis of the raw wastewater, activated sludge and treated wastewater from two large WWTPs responsible for the treatment of urban wastewater in Moscow, Russia. In untreated wastewater, several hundred ARGs that could confer resistance to most commonly used classes of antibiotics were found. WWTPs employed a nitrification/denitrification or an anaerobic/anoxic/oxic process and enabled efficient removal of organic matter, nitrogen and phosphorus, as well as fecal microbiota. The resistome constituted about 0.05% of the whole metagenome, and after water treatment its share decreased by 3-4 times. The resistomes were dominated by ARGs encoding resistance to beta-lactams, macrolides, aminoglycosides, tetracyclines, quaternary ammonium compounds, and sulfonamides. ARGs for macrolides and tetracyclines were removed more efficiently than beta-lactamases, especially ampC, the most abundant ARG in the treated effluent. The removal efficiency of particular ARGs was impacted by the treatment technology. Metagenome-assembled genomes of multidrug-resistant strains were assembled both for the influent and the treated effluent. Ccomparison of resistomes from WWTPs in Moscow and around the world suggested that the abundance and content of ARGs depend on social, economic, medical, and environmental factors.

[Touches to the portrait of I.M. Kovarsky]. / Shtrikhi k portretu I.M. Kovarskogo.

Ilya Matveyevich Kovarsky (1856-1933) - the founder and permanent head of the First Moscow Dentistry School, organizer and honorary member of the Moscow Dentistry Society, editor and publisher of one of the first Russian dental journals «Odontological Revue¼ - was deprived of his personal pension and suffrage in 1930 as a former owner of a private capitalist enterprise; his name was actually erased from the national dentistry. The portrait of Ilya Matveyevich Kovarsky - a remarkable doctor, teacher and worthy man - is reconstructed by the documents preserved in the Kovarsky family archive (on the basis of which this article was written) and the memories of his eldest daughter (published for the first time).

Event rates and incidence of post-COVID-19 condition in hospitalised SARS-CoV-2 positive children and young people and controls across different pandemic waves: exposure-stratified prospective cohort study in Moscow (StopCOVID).

BACKGROUND: Long-term health outcomes in children and young people (CYP) after COVID-19 infection are not well understood and studies with control groups exposed to other infections are lacking. This study aimed to investigate the incidence of post-COVID-19 condition (PCC) and incomplete recovery in CYP after hospital discharge and compare outcomes between different SARS-CoV-2 variants and non-SARS-CoV-2 infections. METHODS: A prospective exposure-stratified cohort study of individuals under 18 years old in Moscow, Russia. Exposed cohorts were paediatric patients admitted with laboratory-confirmed COVID-19 infection between April 2 and December 11, 2020 (Wuhan variant cohort) and between January 12 and February 19, 2022 (Omicron variant cohort). CYP admitted with respiratory and intestinal infections, but negative lateral flow rapid diagnostic test and PCR-test results for SARS-CoV-2, between January 12 and February 19, 2022, served as unexposed reference cohort. Comparison between the 'exposed cohorts' and 'reference cohort' was conducted using 1:1 matching by age and sex. Follow-up data were collected via telephone interviews with parents, utilising the long COVID paediatric protocol and survey developed by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). The WHO case definition was used to categorise PCC. RESULTS: Of 2595 CYP with confirmed COVID-19, 1707 (65.7%) participated in follow-up interviews, with 1183/1707 (69%) included in the final 'matched' analysis. The median follow-up time post-discharge was 6.7 months. The incidence of PCC was significantly higher in the Wuhan variant cohort (89.7 cases per 1000 person-months, 95% CI 64.3-120.3) compared to post-infection sequalae in the reference cohort (12.2 cases per 1000 person-months, 95% CI 4.9-21.9), whereas the difference with the Omicron variant cohort and reference cohort was not significant. The Wuhan cohort had higher incidence rates of dermatological, fatigue, gastrointestinal, sensory, and sleep manifestations, as well as behavioural and emotional problems than the reference cohort. The only significant difference between Omicron variant cohort and reference cohort was decreased school attendance. When comparing the Wuhan and Omicron variant cohorts, higher incidence of PCC and event rates of fatigue, decreased physical activity, and deterioration of relationships was observed. The rate of incomplete recovery was also significantly higher in the Wuhan variant cohort than in both the reference and the Omicron variant cohorts. CONCLUSIONS: Wuhan variant exhibited a propensity for inducing a broad spectrum of physical symptoms and emotional behavioural changes, suggesting a pronounced impact on long-term health outcomes. Conversely, the Omicron variant resulted in fewer post-infection effects no different from common seasonal viral illnesses. This may mean that the Omicron variant and subsequent variants might not lead to the same level of long-term health consequences as earlier variants.

HIV knowledge, self-perception of HIV risk, and sexual risk behaviors among male Tajik labor migrants who inject drugs in Moscow.

BACKGROUND: The interplay of human immunodeficiency virus (HIV) knowledge and self-perception of risk for HIV among people who inject drugs is complex and understudied, especially among temporary migrant workers who inject drugs (MWID) while in a host country. In Russia, Tajik migrants make up the largest proportion of Moscow's foreign labor. Yet, HIV knowledge and self-perceived risk in association with sexual risk behavior among male Tajik MWID in Moscow remains unknown. OBJECTIVE: This research examines knowledge about HIV transmission, self-perception of HIV risk, and key psychosocial factors that possibly contribute to sexual risk behaviors among male Tajik labor MWID living in Moscow. METHODS: Structured interviews were conducted with 420 male Tajik labor MWID. Modified Poisson regression models investigated possible associations between major risk factors and HIV sexual risk behavior. RESULTS: Of the 420 MWID, 255 men (61%) reported sexual activity in the last 30 days. Level of HIV knowledge was not associated in either direction with condom use or risky sexual partnering, as measured by sex with multiple partners or female sex workers (FSW). Lower self-perceived HIV risk was associated with a greater likelihood of sex with multiple partners (aPR: 1.79, 95% CI: 1.34, 2.40) and FSW (aPR: 1.28, 95% CI: 1.04, 1.59), but was not associated with condom use. Police-enacted stigma was associated with sex with multiple partners (aPR: 1.22, 95% CI: 1.01, 1.49) and FSW (aPR: 1.32, 95% CI: 1.13, 1.54). While depression and lower levels of loneliness were associated with condomless sex (aPR: 1.14, 95% CI: 1.05, 1.24; aPR: 0.79, 95% CI: 0.68, 0.92, respectively), only depression was associated with condomless sex with FSW (aPR: 1.26, 95% CI: 1.03, 1.54). CONCLUSIONS: HIV prevention programing for male Tajik MWID must go beyond solely educating about factors associated with HIV transmission to include increased awareness of personal risk based on engaging in these behaviors. Additionally, psychological services to counter depression and police-enacted stigma are needed.

[Urban stress of a megalopolis resident: stress factors and correctioN].

Residents of a megalopolis are constantly exposed to urban stress - the combined effects of a number of different extreme factors and living conditions of the urban environment. Urban stress of a megalopolis resident has an extreme complex multifactorial effect on his body and psyche. The features of the existing subspecies of urban stress (ecological, psychological, social, informational, professional, related to the pandemic), as well as the main stress factors causing them, are considered. The medical and social features of urban stress are described. The consequences of exposure to urban stress, directly related to human health disorders, include the so-called «urban stress diseases¼ or «diseases of civilization¼, primarily psychosomatic diseases. It is determined that urban stress is a multifactorial complex of stress factors affecting the physical and mental health of megalopolis residents. Due to the fact that an increasing number of megalopolis residents are experiencing the negative impact of an aggressive urban environment, it is necessary both to formalize stress factors in order to possibly correct them to improve the quality of life of citizens, and to develop appropriate optimizing medical and social recommendations. Modern organizational and medical and social measures aimed at reducing the negative impact of urban stress on the health of megalopolis residents are considered. It is proposed to minimize the negative impact of extreme urban stress factors on the physical and mental health of megalopolis residents by using therapeutic and preventive strategies to increase their stress resistance. There are a number of different organizations and departments in Moscow that provide psychological and psychotherapeutic support. Also, in order to determine the level of the body's reserves and stress resistance, it is possible to undergo a comprehensive examination both in the nearest polyclinic and in the nearest park within the framework of the Healthy Moscow program.

[performance evaluation of the programs aimed at myocardial infraction prevention by relevant mortality rates].

BACKGROUND: Despite implemented measures and general favourable trend, number of patients with myocardial infarction remains high, younger people are increasingly becoming ill and dying. The study purpose: to estimate age-sex mortality dynamics from acute and recurrent myocardial infarction in adults in Moscow compared to Russia's average in 2007-2021 to reveal patterns of mortality change within the implementation period of state prevention programs. MATERIAL AND METHODS: Standardized adult mortality rates for Moscow and Russia, mean expected age at death within interval 20-85 years and gain in life expectancy when eliminating this cause calculated and analyzed. RESULTS: Moscow morbidity rates for acute and recurrent myocardial infarction are twice lower than Russia's, there are higher reduction rates for both diseases - by 16% and 58% respectively. During study period, mortality from myocardial infarction in men was by 45% higher than in women. In 2007 Moscow male-female difference estimated 3% and in 15 years it became 32% due to faster female mortality reduction. Whereas Russia's average age of death from myocardial infarction in 2021 returned to 2010-2011 levels, then in Moscow during 2020-2021 female rates returned to 2008's and male rates fall out the study period. CONCLUSIONS: Since implementation of the first programs on reducing mortality from chronic non-infectious diseases during the 15 years period morbidity and mortality rates from myocardial infarction reduced in Russia and Moscow in all ages. Acute and recurrent myocardial infarction have rejuvenated both in men and women as a negative effect of the pandemic.

[Readiness for intersectoral cooperation to preserve health of megalopolis population].

INTRODUCTION: For a better understanding of issues related to health-preserving activities for the benefit of city population, theoretical knowledge about the attitude and readiness of all interested parties for intersectoral cooperation is needed. The purpose of the study is to analyze readiness of the participants of health-preserving activities for intersectoral cooperation in Moscow. MATERIAL AND METHODS: In 2023, a one-time, one-time study of intersectoral responsibility, commitment and awareness, as well as satisfaction with individual health care (original test cards) was conducted among different participants in the health care of the population of the city of Moscow (n = 1007). From among them, participants were identified -workers of «medical¼ infrastructure facilities of urban space, participants-workers of other facilities (sports, culture, industry, waste disposal, transport, food, trade, education and others) and the population as a participant in intersectoral health saving. RESULTS: The research based on the original integrated assessment methodology shows insufficient readiness for intersectoral cooperation to implement health-saving activities for the benefit of Moscow population. Immature intersectoral responsibility, literacy, motivation for teamwork noted among the participants of the unified health-preserving city space determines the lack of internal conviction that it is necessary to deal with both own health, and health of other members of the urban community. CONCLUSION: The data obtained can form basis for new methodological approaches to prioritize control measures to improve intersectoral cooperation between the participants of health-preserving activities in the metropolis.

[Public health risk threats associated with coronavirus infection in Moscow and the need to counteract].

PURPOSE OF THE STUDY: to determine the main threats to the health of the population of Moscow based on the analysis of the medical and demographic situation in Moscow and the Russian Federation in the context of the COVID-19 pandemic, in order to develop management decisions at the regional level. MATERIAL AND METHODS: Materials of the Federal State Statistics Service (Rosstat), as well as statistical collections of the Russian Research Institute of Health of the Ministry of Health of Russia for 2013-2022 were used. RESULTS: Coronavirus infection has changed the morbidity and mortality rates of the population of the Russian Federation and its constituent entities. In the Russian Federation mortality in 2019-2021 increased from 12.3 to 13.6‰, while in Moscow the increase in the indicator is significant - from 9.5 to 16.7‰. The incidence of COVID-19 in Moscow in 2020-2021 (over the two COVID years) increased from 6191.0 to 8976.0‰oo. The noted decrease in incidence rates across almost all classes of diseases during the COVID period (2019-2020) was associated with the lower medical check-ups and preventive activities, while during 2019-2021 there was an increase in disease incidence of the following classes: mental disorders, behavior disorders; diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, etc., indicating the need for rehabilitation of this group of patients. CONCLUSIONS: The need to counter the threats to the health of the population of Moscow caused by the coronavirus infection requires the development of management decisions aimed at strengthening preventive activities and rehabilitation of patients in the post-COVID period.

[Management solutions using digital technologies in the Healthy Moscow pavilions].

The digital transformation of healthcare is an integral part of the priorities in modern healthcare. A striking example of the practical implementation of compliance with the basic principles of digital healthcare is the Healthy Moscow project, which has been implemented since 2021, which has become a real breakthrough in Russia in ensuring accessibility and convenience in providing medical care to the population. The aim of the project is the early prevention of chronic non-communicable diseases, the formation of a healthy lifestyle and the improvement of the well-being of Moscow residents, as well as the development of a conscious attitude to taking care of their health. Pavilions in the park areas of Moscow are an integral part of the modern medical infrastructure, providing convenient conditions for obtaining medical advice and information. The article provides information on the types of digital technologies and basic equipment that the pavilions (large and small) are equipped with as part of the Healthy Moscow project, it is shown that the introduction of digital healthcare technologies is one of the key tasks of the national strategy of Russia, which contributes significantly contribution to the successful implementation of the Healthy Moscow project.

[ANALYSIS OF THE MAIN PERFORMANCE INDICATORS OF DAY HOSPITALS IN MOSCOW IN 2017-2022].

The article presents performance indicators of the capital day hospitals for the period from 2017 to 2022. The analysis has identified a high demand for this type of medical services in Moscow. A separate analysis focused on indicators of day hospitals subordinate to the Moscow Healthcare Department deployed at outpatient (polyclinic) medical facilities, as well as institutions providing inpatient care. The bed capacity structure and number of treated diseases by pediatric and adult population have been analyzed in detail. The study has identified main trends in dynamics in a number of indicators characterizing the development of hospital-replacing forms of care delivery in Moscow in recent years. The study is based on of the Federal statistical observation form # 14 - DS «Information on day hospital performance in medical organizations¼.

[Questionnaire survey of patients of medical dental organizations in different regions of the Russian Federation on the issues of individual and professional oral hygiene]. / Anketirovanie patsientov meditsinskikh stomatologicheskikh organizatsii razlichnykh regionov RF po voprosam individual'noi i professional'noi gigieny rta.

To analyze the respondents' attitudes to oral hygiene and to assess the need for professional oral hygiene in different regions of the Russian Federation based on the data of questionnaire analysis. OBJECTIVE: To obtain comparative data on the issues of individual and professional oral hygiene of patients of medical dental organizations in a number of Russian cities. MATERIAL AND METHODS: We conducted an anonymous questionnaire survey of 624 patients (18 to 70 years old) who applied to medical dental organizations of different forms of ownership in five regions of the Russian Federation (Moscow, Omsk, Ryazan, Samara, Tambov). Patients were interviewed using a specially designed questionnaire. RESULTS: The study involved patients of medical dental organizations from 5 regions of the Russian Federation, 57.2% of them were women and 42.8% men. In all cities more than 50% of the surveyed patients received care under the MHI program. More than 50% of the surveyed patients said that they tried to brush their teeth twice a day, the rest of the respondents said that they brushed their teeth only twice a day. Up to 27% of patients are not willing to comply with individualized dental care recommendations for various reasons. CONCLUSIONS: Highly motivated patients to high-quality dental hygiene behavior are in minority; according to the results of the study, it can be stated that there is a high need for professional oral hygiene among the surveyed respondents. It is necessary to work with patients to improve hygienic knowledge, skills and motivation for quality oral hygiene.

[Resolution of the XV Congress. All-Russian public organization "Russian Society of Surgeons named after Academician V.S. Saveliev" 26 October 2023 Moscow, Russia]. / Rezolyutsiya XV S"ezda. Obshcherossiiskoi obshchestvennoi organizatsii «Rossiiskoe obshchestvo khirurgov im. akademika V.S. Savel'eva¼ 26 oktyabrya 2023 g. g. Moskva.

Resolution of the XV Congress. All-Russian public organization "Russian Society of Surgeons named after Academician V.S. Saveliev" 26 October 2023 Moscow, Russia.

[Moscow scientific schools on the field of internal medicine in the second half of the XIX - early XX centuries: comparative characteristics].

Peculiarities and comparative characteristics of three main Moscow schools on the field of internal medicine of the second half of the XIX - early XX centuries are discussed: schools of Grigory Zakharyin, Alexey Ostroumov and Vassily Shervinsky - Leonid Golubinin; the legitimacy to acknowledge scientific clinical schools of Mikhail Cherinov and Nikolay Golubov is disputed. The arguments are provided that of the Moscow therapeutic schools, it was the Shervinsky-Golubinin school, and not the Zakharyin or Ostroumov school, that played the most significant role in the formation of the internal medicine in the USSR, in passing the accumulated knowledge and ideas to therapeutic elites in the USSR.

[Development of clinical medicine in Russia at the turn of the XIX-XX centuries: choice of the path. Once again about the founders of scientific internal medicine. Sergey Botkin and Grigory Zakharyin].

On the basis of a critical analysis of numerous literary and archival sources, the authors confirm the idea of the decisive role of the Botkin's direction in the development of the European science-based internal medicine in Russia and revise the canonical position about the three founders of this medicine: according to the authors, the founders of the scientific internal medicine in Russia were Sergey Botkin (Petersburg), Grigory Zakharyin, Alexey Ostroumov (Moscow) and Vassily Obraztsov (Kyiv). The topic is covered in two articles; this article is devoted to S. Botkin and G. Zakharyin.