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Relevance. There are large regional disparities in prevalence of non-communicable disease risk factors, as well as in the cardiovascular disease (CVD) incidence and mortality rates in Russian Federation (RF). Aim. To demonstrate the disparities in prevalence of CVD risk factors between Vologda Oblast districts. Materials and methods. Databases created in 2009 at the State-financed health institution of the Vologda Oblast «Vologda Regional Center for Medical Prevention», based on the results of a survey conducted within the framework of the World Health Organization CINDI program. CINDI questionnaire; cross-sectional study; the data was processed using R programming language and the Statistica software package 12. Results. The most common behavioral CVD risk factors in different Vologda Oblast districts included inadequate fruits and vegetables consumption (30–90%) and alcohol abuse (40–80%); hypertension (40–60%), overweight and obesity (30–55%) were the most frequent biological CVD risk factors; the most prevalent socio-economic risk factors included low education level (75–90%) and unemployment (20–40%). Participants residing in rural municipalities differed from urban okrugs (cities) dwellers in a higher prevalence of smoking (p < 0.01), alcohol abuse (p < 0.001), inadequate fruits and vegetables consumption (p < 0.0001), overweight and obesity (p < 0.05), unemployment (p < 0.0001), low education level (p < 0.0001), as well as a low overall assessment of their health (p < 0.05). Conclusions. We detected disparities in CVD risk factors prevalence between Vologda Oblast districts in 2009. Both behavioral and biological CVD risk factors were more common in participants from rural municipalities. The CVD risk factors distribution between the RF subjects’ districts requires further scientific research.

Considers an example of organizing and conducting practice-oriented classes on providing emergency medical care for injuries with medical personnel of the military level, garrison and base military hospitals in the Western military district. In large garrisons of the military district in 2019, we conducted four rounds of field training on the organization of emergency medical care for major life-threatening conditions. The format of classes included master classes and blitz lectures on various topics: cardiopulmonary resuscitation, stopping ongoing external bleeding, eliminating asphyxia and pneumothorax, transport immobilization, and features of the use of modern means of emergency medical care. An important practical part of the training was training with surgeons of military and hospital units on living biological objects. At the beginning and end of the course, primary and control tests of the level of knowledge were conducted. During the initial testing, the percentage of correct answers in the groups averaged: surgeons (n=20) 53,9%, doctors of other specialties (n=25) 56,5%, average medical staff (n=34) 52,8%, health instructors (n=52) 52,6%. During the control testing, the following results were obtained: 71,5; 83,5; 84,3 and 83,9% respectively. The format of classes reliably (p˂0,05) showed their high efficiency in all groups. Thus, the need to actively introduce a practice-oriented form of training in the form of demonstration classes, including the use of biological models and simulators, into the combat and special training of military medical personnel is obvious and beyond doubt.

In recent years, significant progress has been made in the treatment of severe injuries and traumas. In critical situations, for the heaviest category of wounded, the outcome is largely determined in the next few minutes after admission to the hospital. The only possible tactic that gives a chance to save the lives of such victims is the tactics of multi-stage surgical treatment (damage control). The low effectiveness of traditional methods of training surgeons in the basics and techniques of this tactic makes it necessary to develop new forms of training. One of the most progressive and sought-after is training on biological material (large animals or cadaver material), but the methodology for conducting such studies has not been worked out before. For the first time in Russia in November 2018, a unique training and practical course «SMART» (Modern Methods and Algorithms for the Treatment of Wounds and Traumas) was conducted, combining training in both living tissues and cadavers. Participants were given the opportunity to see and independently work out the basic combinations of typical surgical techniques and maneuvers aimed at eliminating the life-threatening consequences of injuries and traumas.

The article presents the experience of using an improved model of the trauma registry. The model allows you to register all the injuries to the victim in accordance with the International Classification of Diseases ICD-10 and the Abbreviated Injury Scale severity index. The results of monitoring the structure of multiple and combined injuries in 548 patients are presented.

Life quality (LQ) is an integrated parameter of the health, applied for integral characterization of population health, and as the parameter of healthcare interventions effectiveness. Aim. To assess LQ in Russian population at the age 25-64 y. o. in general and in various socio-economical groups using EQ-5D, by the results of ESSE-RF (2012-2013) study. Material and methods. LQ was assessed on representative selections of inhabitants of 13 Russian Federation regions, aged 25-64 (males 8327, females 13497) with response 80%. LQ was assessed via international questionnaire EUROQOL — EQ-5D: 1) no decline; 2) mild decline; 3) significant decline; scoring also performed with visualanalogue scale (VAS). Integral LQ by EUROQOL performed with Shaw JW et al. method (ranging from 0,0 (death) to 1,0 (perfect health)). Result. EQ-5D index of Russian population was 0,87 with no gender difference. By the increase of the age LQ declines. Educational gradient of LQ was significant only in VAS (p

Aim. To assess rate of familiarity and specifics of treatment with statins among the citizens of economically active age with various cardiovascular risk by the data from epidemiological study ESSE-RF (Epidemiology of Cardiovascular Diseases in Different Russian Federation Regions). Material and methods. In the work the data from ESSE-RF study was used, of representative selection of non-organized male and female inhabitants aged 25-64 y.o. from 13 regions, investigated during 2012-2014. Responded ~80%. The study included questionning by standard scale that included data on the anamnesis, etc. Lipid profile, including total cholesterol (TC), cholesterol of lipoproteids low and high density were measured at SSRCPM and RSPCC. Results. Analysis of the whole selection showed that 20% of men and 32% of women knew their TC, and 13,6% and 18,2% were even familiar having increased level of TC. Part of those with high and very high risk was 31,3%, incl. men — 42,2%, women — 30,9%. Statins took ~7,0% of patients from this risk category. Effectiveness of treatment (target levels reached of low density cholesterol) in these groups of men and women was 14,4% and 4,8%, respectively. Conclusion. The data obtained in populational study points on insufficient knowledge and low rate of statin treatment of the persons with high and very high cardiovascular risk in RF, which confirms the anxiety provoking data of registries and other studies. The data dictates necessity of development and implementation of specific educational programs for citizens, of physician improvement and availability of cheap but effective lipid-lowering medications.

Aim. To study results of registration, calculation and evaluation of quality of arterial hypertension (HT) control (HT Register) in Vologda Region (VR). Material and methods . HT Register system is developed and legislatively introduced in the VR. Blood pressure registration in every visitor of out-patient clinics is the basic principle of HT Register. The algorithm of HT diagnosis in primary medical care of rural public health services was developed. Analysis of results of HT Register implementation in VR during 2004-2007 is presented. Results. Patients with HT stage 1 seek medical help more often in cities while patients with HT stage 3 seek medical help more often in villages. Patients with HT in villages take antihypertensive drugs more often, but they have more risk factors and associate conditions. Conclusion. Improvement of HT pharmacotherapy was observed in urban and rural districts of VR. At the same time non pharmacologic HT control has to be developed.

Aim. To study social and economic gradients — educational and occupational statuses, wealth level, behavioral risk factors (FR) in Russian population by the ESSE-RF data. Material and methods. The data for the analysis consisted of representative selections of 13 regions of RF (n=22906) participants of the study, incl. men (n=8353) and women (n=13553) of 25-64 y.o., with response 80%. We calculated the odds ratios for the presence of behavioral FR: smoking, excessive alcohol consumption, insufficient physical activity (IPA), nonrational food consumption, anxiety and depressive disorders, — in persons from different social and economic groups by education level, type of inhabitation, professional status, wealth level. Results. Higher education was associated with better FR profile, except IPA (negative association) and alcohol consumption (absence of association). "White in general had less FR probability than Blue, excl. IPA and psychoemotional deviations (in men). As for the wealth association with the FR there is backward gradient, i.e. lesser the income, higher the risk of FR presence, excl. IPA and excessive alcohol intake in women. For example, in very wealthy men the odds ratio for depressive states was 3,09 [95% CI 2,08-4,57] comparing to the persons with low income. The type of territory of inhabitance was associated with less behavioral FR in Russian population, as significant associations are found only for depression and excessive salt consumption in both genders and IPA in men. Conclusion. The significant social and economic gradients of behavioral FR prevalence are found, the direction of those is not necessary the same as in European countries. The analysis of association with social and economic parameters would help to develop the directed preventive interventions.

In the frame of Multicenter observational study ECVD-RF (Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation) by the unique protocol the investigation of representative selections of adult population at the age of 25-64 y.o. of 11 regions RF (n=18305, including males, n=6919 and females n=11386): Volgograd, Vologda, Voronezh, Ivanovo, Kemerovo, Orenburg, Samara, Tomsk, Tyumen, Saint-Petersburg and Northern Osetia-Alania. The prevalence of the following risk factors (RF) of cardiovascular diseases is evaluated: high blood pressure — 33,8%, obesity — 29,7%, high total cholesterol — 57,6%, high glucose level or diabetes — 4,6%, smoking (tobacco consumption) — 25,7%, insufficient (low) level of physical activity — 38,8%, excessive salt consumption — 49,9% and insufficient vegetables and fruits consumption — 41,9%. Gender differences and an increase with the age of the parameters mentioned are described.The absence of a epidemiologic monitoring system at the Federal level leads to an impossibility of clear conclusions on the RF dynamics in Russian population. While comparing the ECVD-RF study with previous epidemiological studies we can just cautiously suppose the existence in 21st age of negative dynamics of one RF (obesity, dyslipidemia) and positive dynamics of the others (smoking).

The work analyzes participation of the serotoninergic system in correction of adverse effects of benthic deposits contaminated with industrial wastes on the level of lipid peroxidation (LPO) in the fry of the sturgeon Acipenser guldenstadti persicus. In the first series of the study, two intramuscular injections to the sturgeon fry of serotonin-modulated anticonsolidation protein (SMAP) that is in the direct correlation with the serotonin level led to pronounced normalization in the animal tissues of the LPO level whose increase was due to keeping the sturgeons in the fresh water contaminated with benthic deposits. In the second series of the study, administration to the animals of polyclonal anti-SMAP antibodies led to a significant increase of the LPO level in the tissues, similar to effects of the benthic deposits. It is concluded that adverse factors can produce their negative pro-oxidative effects on the organism tissues through a decrease of activity of the serotoninergic system, whereas an artificial increase of the serotoninergic system activity promotes correction of the oxidative stress.

The work presents data on studies of effect of a decrease in the serotoninergic system activity on the level of mutagenic changes (the micronuclear test) in the goby Neogobius fluviatilis and the fry of sturgeon Acipenser guldenstadti persicus. It has been shown that the long exposure of the animals to conditions of industrial and oil pollution leads to a significant decrease in their liver of the level of serotonin-modulated anticonsolidation protein (SMAP) correlating directly with the serotonin level as well as to a sharp rise of the level of micronuclear in erythrocytes. The intramuscular administration of anti-SMAP polyclonal antibodies to the sturgeon fry produces a significant increase of the amount of micronuclear as compared with that in the animals injected with non-immune γ-globulin. The obtained results allow concluding that the decrease of activity of the serotoninergic system is the mechanism that is triggered with adverse environmental factors and realizes mutagenic damages in the modified genetic apparatus.

Aim. To study the prevalence of ischemic heart disease as one of the most common cardiovascular disorders, together with arterial hypertension (AH), diabetes mellitus (DM) and liver diseases (LD) in adult (25-64 y.o.) population of selected RF regions, the variance of those with gender and age, and association of cardiovascular risk factors (FR). Material and methods. Into analysis we included the results of representative selections studies from 13 RF regions, studied according to the program of multicenter study ESSE-RF during the years 2012­2014; totally 21923 patients studied. Investigation included standard questioning, including anamnesis. For statistics we used applied software SAS. Results. In men the prevalence of IHD is associated with the growth of comorbidity from 0 in the age group 25-34 y. to 77% in the age 55-64 y., almost duplicating every decade. For women there is analogic tendency, less prominent. In men there are significant associations only with AH, which increases the risk of IHD 2,5 times, though in women together with AH the associations are significant for LD. Comorbidities with DM do not influence the prevalence of IHD in men and women. At the same time, any association with two diseases increases the risk of IHD >304 times. The most negative is the association of all three diseases, with which IHD is 8,7 times more prevalent, than in their absence. Using multidimensional logistic regression after correction for the age and comorbidity in the patients with IHD of both genders, there are associations revealed of high density cholesterol lipoproteids (HDL) in blood and abdominal obesity. In men there are also positive associations with smoking and negative — with increased cholesterol. Conclusion. Comorbidities of IHD with AH, DM and LD in adult population are common, are associated with the general FR, are increasing with the age. Taking modern tendencies of population ageing, it is plausible to expect an increase of the prevalence of comorbidities, that requires a necessity of the healthcare services to these changes.