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There demonstrated information on reducing the prevalence and incidence of peptic ulcer in the past 10 years in Moscow, as well as the authors' observations about the possible factors underlying the development trend in reducing the incidence and morbidity of peptic disease.

The influence of weather factors (atmospheric pressure and temperature) and the geomagnetic activity on the development of severe cardiological pathologies has been studied using the daily data from two Moscow clinics, accumulated over a period of 12 and 7 years. It was shown that the most biotropic factors are variations of atmospheric temperature. The relative contribution of the geomagnetic activity to the development of diseases is only 20%; however, its action is combined with the effect of ordinary weather because both these factors affect the vascular tonus of humans.

The primary objective of prophylactic medical examination of oncological patients is reduction of mortality and improvement of the quality of life. Activities of the Department of Head and Neck Tumours of No 1 Oncological Clinical Dispensary are focused on dynamic follow-up of treated patients for early identification of continued tumour growth, diagnosis of relapses and metastases. Compliance with the schedule of control examination in the post-treatment period facilitates early identification of continued tumour growth, diagnosis of relapses and metastases. It is maintained that irregular examination is a cause of progression of latent relapses and metastasis in oncological patients. Actions and duties of district otorhinolaryngologists and ENT specialists of the Department of Head and Neck Tumours, No 1 Oncological Clinical Dispensary are outlined for the periods of prophylactic medical examination and follow up studies at the pre-hospital stage and in the course of dynamic post-treatment observations. Continuity of patients' care provided by oncologists and otorhinolaryngologists is supposed to contribute to the reduction of time spent during pre-treatment studies, early diagnosis of relapses and metastases, and improvement of the quality of life in the patients with incurable and recurring tumours.

Aim: To estimate the prevalence and clinical significance of leukopenia and neutropenia in patients with chronic hepatits C, to analyze the impact of different regimens of antiviral therapy by standart or induction doses of pegylated interferon alpha-2a (PegIFNalpha-2a) to optimize curative measures., Materials and Methods: 24 patients with genotype 1 HCV and different therapeutic regimens of PegIFNalpha-2a were investigated with analysis of kinetics and prevalence of leukopenia and neutropenia., Results: On an average 66,7% patients meet neutropenia during antiviral therapy, and 37,5% and 16,7% among them was the moderate and severe grade accordingly. The major prevalence of leukopenia and neutropenia was evidenced between 12 and 24 weeks of antiviral therapy, the marked severity of neutropenia was noted., Conclusions: It was no correlation between the prevalence of leukopenia and neutropenia and the induction treatment regimens of PegIFNalpha-2a; the tendency for more severity in patients with advanced fibrosis and cirrhosis was detected. It was no infection complications during the therapy observed so it may be provided with full doses of PegIFNalpha-2a in case of mild and moderate grades of leukopenia and neutropenia.

The carcinogenic risk to the Moscow population exposed to ambient air pollutants, such as benzene and formaldehyde, discharged by motor transport has been assessed. The ways of lowering the negative impact of motor transport on the urban environment are considered.

Problems in the delivery of antituberculosis care to the pediatric population of Moscow are analyzed. Databases are set up by the statutory forms available in the city's tuberculosis dispensaries and by additional analytical tables from pediatric therapeutic-and-prophylactic institutions, such as children's local polyclinics. In Moscow, there was a reduction in the vaccination coverage of healthy neonatal infants at their discharge from maternity hospitals and departments over a number of years (88.0% in 2008 and 90.3% in 2005). The proportion of non-vaccinated neonates due to their parents' refusal was as high as 3.2% of the annual cohort to be vaccinated at maternal hospital discharge. A more alarming situation is established in children's polyclinics where the share of parents' refusal of tuberculosis vaccination was 60.5% (44.5% in 2005) of all the children who were registered in the children's polyclinics and remained unvaccinated at the end of the year. The low number of contacts per bacteria-excreting person registered in the Moscow dispensaries (2.7% in.2008, 2.5% in 2007, and 2.0% in 2004) suggests that phthisiatricians and epidemiologists did inadequately active work in the foci of tuberculosis infection. Migrants with tuberculosis and socially disadapted persons living in the megapolis are an uncontrolled reservoir of infection. In 2008, there was a surge in the number of tuberculosis children who had been non-vaccinated with BCG vaccine for various reasons--the annual growth rate was +2.96. The possible ways out of the established situation are considered. The authors propose to actively involve not only general practitioners and local pediatricians, but also public organizations into prophylactic work with children. Major attention and resources should be directed to work in the foci of tuberculosis infection; it is necessary to differentiate the use of preventive chemotherapy in children, by taking into account the results of evidence-based medicine to identify the most likely risk factors for the development of the disease.

A clinical stomatological and social research of 432 young people at the age of 16-25 years was wade in establishments for higher and specialized secondary education in Moscow. It was found out that unbalanced food dominated by soft carbohydrates, frequent eating of sweets as well as low medical culture, lack of sanitary and hygienic knowledge and skills, negligence of preventive control contribute greatly to progression of caries and paradontal diseases. Bad habits and unheavy somatic affections do not have time early in life to exhibit their bad influence on teeth but they can violate the paradont.

As a result of clinical epidemiological survey of 432 Moscow students and of evaluation of medical records of annual dental examination, the high-level of various pathologies of dentitions and low efficiency of annual examination were found out in 232 students. It was traced back that main faults of dental examination of students were: poor coverage by medical examinations; occasional nature of examinations; incomplete revelation of pathologies; lack of remedial measures and educative activities.

Aim: to study the prevalence of various risk factors (RF) for venous thromboembolic events (VTEE) and their association with D-dimer levels., Subjects and Methods: The clinical, demographic, anthropometric, anamnestic, and laboratory data were analyzed in 106 patients (73 men and 33 women) aged 18 to 78 years admitted to hospital with the first or recurrent episode of VTEE., Results: RF and VTEE-associated diseases were identified in all patients. Over 90% of the patients had more 2 RFs. The most common RFs were the age above 40 years (85%) and overweight (82%), including obesity (42%). There was a preponderance of cardiovascular diseases in the pattern of VTEE-associated diseases. The direct causes (precipitating factors) of thrombosis were revealed in 57% of cases; the thrombotic episode was classified as idiopathic in 43%. Elevated D-dimer levels were found in 74% of the patients. Higher D-dimer content was seen in women, non-smokers, patients operated on for thrombosis, those who had 2 precipitating factors or more, and those who had a less than 30-day history of thrombosis. There was an inverse correlation between the elevated level of D-dimer and the duration of thrombosis by the moment of its identification (thrombus age)., Conclusion: All patients who have experienced a venous thrombotic episode have various RFs for VTEE The content of D-dimer exceeds the normal value in most patients with VTEE. Among the RFs studied, thrombus age is the most important factor associated with elevated D-dimer levels in patients with VTEE

The Russian federation has been undergoing a concentrated epidemic of HIV-1 with high rates of infection among injecting drug users. Less is known about the relative risk and contribution to the country's HIV epidemic by other at-risk populations including sex workers and men who have sex with men. The goals of this project were to explore demographic characteristics, substance use patterns, and estimate the prevalence of sexually transmitted infections (STIs) and high-risk behaviors among male sex workers (MSW) in Moscow and to assess the feasibility of prospective cohort recruitment and retention among this population. Research design was a longitudinal study of 50 men with a six-month follow-up period. Participants were recruited through venue-based and snowball sampling methods. Results revealed an HIV prevalence at baseline of 16%; one MSW seroconverted during the follow-up period, yielding an incidence estimate of 4.8/100PY (95%CI 0.0-11.2). Twenty-four percentage were diagnosed with at least one STI: 12% had syphilis; 8% had Human Papilloma Virus (HPV); and 4% had Herpes Simplex Virus (HSV)-2. Three (6%) of the study participants had evidence of previous Hepatitis C Virus (HCV) exposure at baseline. Retention rates were poor with higher retention significantly associated with older men (OR: 13.1, 95% CI 3.3-52.5). This was the first study to evaluate baseline demographics, substance use patterns, and prevalence of infectious disease among MSW in Moscow. Identification and recruitment of this population appears to be feasible, but retention a challenge. While the sample size in the current study was small, the results also suggested that this is a population at considerable high risk for HIV. MSW in Moscow may be an important at-risk population in the Russian HIV epidemic and further research is urgently required to address their needs and explore prevention strategies.

The immune status of Moscow dwellers was studied. The findings indicate the criterion significance of immunological and allergological parameters in the estimation of a risk of allergic diseases under the influence of poor environmental factors influence. Hyperactivity in individuals with high immunoglobulin class E levels to environmental factors is suggested by the elevated concentrations of serum specific IgE to intrahouse factors that in combination with the increased levels of anti-inflammatory cytokines (interferon-gamma, tumor necrosis factor-alpha) and the suppressed production interleukin-4 are criteria for the early manifestations of allergy.

Analysis of medical appealability of adult subjects in outpatient clinics of Moscow during the last 5 years (2003-2008) has demonstrated a tendency toward the increased incidence of ear diseases and mastoid process lesions as well as the concomitant decrease of the incidence and prevalence of chronic purulent otitis media (CPOM). Accordingly, the surgical activity in specialized otorhinolaryngological facilities has grown up to 8.9%. Treatment of chronic purulent otitis media accounts for 47.5% of this value. 26.4% of the patients presenting with CPOM undergo hearing-saving operation on the middle ear and sometimes classical radical surgery. Patients with CPOM account for 41.1% of their total number in surdological departments. Treatment by hearing-preserving surgery on the middle ear is given in surdological departments to only 13% of the patients presenting with CPOM. In the departments for urgent otorhinolaryngological aid, patients with chronic purulent otitis media constitute 4.4% of the total and 45% of them undergo sanitizing hearing-preserving surgery on the middle ear (including extensive interventions in the cases developing complications).

A technology for the toxicological monitoring of chemical poisoning cases in Moscow is described. Its results over 2002-2006 are presented. The distribution of poisonings by causes, gender, and age, pattern, and occurrence circumstances is analyzed. A number of difficulties arising from the filling toxicological monitoring record form No. 58-1/y are discussed. The problems facing the participants of monitoring are given.

Environmental pollution has a negative impact on the health status of the population, on that of children in particular. In-depth developments of primary morbidity of childhood diseases of respiratory organs as a system that is mostly exposed to ambient air pollution have indicated that respiratory diseases, including their chronic forms, are more frequently notified in the children residing in the areas characterized by high levels of air pollution. Formaldehyde and nitric dioxide, i.e. the chemical compounds the concentrations of which exceed the hygienic normal values, make the greatest contribution to risk formation. In-depth analysis of morbidity rates in the children living in the areas along which the heavy-traffic motorways pass has demonstrated that chronic respiratory diseases are more frequently registered in these children than in those residing in the areas remote from the motorways. A role of social factors influencing the increase of the so-called alimentary-dependent diseases is shown.

Herd immunity against poliomyelitis was studied in 1391 children and adolescents from 10 towns of the Moscow Region. It was ascertained that the values of herd immunity against poliomyelitis virus type 1 were high everywhere and those of herd immunity against poliomyelitis virus type 2 were high and very high in 9 towns and below the WHO minimum levels (80%). The values of herd immunity against poliomyelitis virus type 3; they were lower than the required minimum in 2 towns and very low in 2 other towns arouse alarm. The study of strain-specific antibodies to vaccine-derived and wild polioviruses has demonstrated that wild poliomyelitis viruses have not circulated in the areas of the examinees in the past decade.

The ambient atmosphere of Moscow is appraised as unbeneficial to the health of the population, that of children and adolescents in particular. Motor transport is a powerful source of the ambient air pollution of Moscow. The average annual level of atmospheric pollution in 2008 is considered to be moderate. Scientific-and-practical studies using the risk assessment methodology also suggest that the ambient air in Moscow is the leading habitat posing a carcinogenic and non-carcinogenic risk to Muscovites' health.

Retrospective analysis of the prevalence of iodine-deficiency states among the adult population in the Moscow Central Administrative District in 2001 to 2004 revealed an upward trend in the incidence of the major nosological entities of diffuse and multinodular goiter. The age distribution of iodine-deficiency diseases in the district is characteristic of the whole city. The prevalence of endocrine diseases, among which thyroid pathology is about 60%, among the adolescents of the district is greater than the background values (in Moscow). A questionnaire was used to examine 2 groups of apparently healthy (an organized collective body--Group A) and apparently ill (endocrinological patients--Group B) subjects. Nutrition rating ascertained that both groups insufficiently consumed iodine-containing products. At the same time, under the conditions of iodine deficiency, the relative risk of thyroid disease in Group A is much higher (OR = 11.63) than in Group B (OR = 2.5). In the alternative (high and low morbidity) areas, the data on the sales of iodinated salt sale were analyzed and the buyers were questioned about its domestic use in two large supermarkets. This established that the district's population consumed iodinated salt little and showed a low awareness of its domestic use.

In the past 2 years, the malaria epidemiological situation has drastically improved in Moscow: only sporadic cases of local transmission of tertian (Plasmodium vivax) malaria have been notified, which sets a task to eradicate malaria in the megalopolis in 2010. In this connection, the surveillance of the malaria vectors Anopheles mosquitoes is assuming prime importance. The results of entomological monitoring have shown its efficiency on the territory of the megalopolis. Main efforts have been directed to the application of safe controlling methods against the mosquitoes and to hydraulic engineering actions to reduce "area susceptibility". Entomological observations have demonstrated benefits from the correctly chosen and constantly performed hydraulic engineering measures that guarantee a long-term and positive impact on the malaria situation.

Aim: To study pathogenic characteristics of B. pertussis strains isolated from patients during different periods of pertussis infection epidemic process., Materials and Methods: Strains of B. pertussis isolated in Moscow during 1967 - 1971, 1980 - 1985, and 2001 - 2005 were studied. Nutrient media: Bordet-Gengou blood agar, casein-charcoal agar., Animals: mice - F1 hybrids (CBA x C57BL6). Pathogenic characteristics of strains were studied by assessment of virulence (LD50), leukocytosis-stimulating (LS units) and histamine-sensitizing (HSD50) activities of cultures. Genotyping was performed using standard equipment and reagents for DNA isolation, amplification, sequencing and detection of results., Results: On the sample of 164 strains, pathogenic and genotypic characteristics of B. pertussis populations circulated during 1967 - 1971, 1980 - 1985, and 2001 - 2005. Majority of B. pertussis strains isolated in 1967 - 1971 and strains circulated during current phase of epidemic process were virulent (80.75% and 81.8% respectively) and had significant leukocytosis-stimulating and histamine-sensitizing activity, whereas strains isolated from patients with pertussis in 1980 - 1985 characterized by lower virulence and toxicity. Genotyping showed strains carrying "non-vaccine" allele ptxA1, which emerged in the middle of 1970s, totally displaced strains with "vaccine" alleles ptxA2 and ptxA4., Conclusion: Adaptive changes of B. pertussis driven by increased vaccination coverage involve both ptxA gene and pathogenic characteristics of infectious agent in the range of genotypically homogenous population with domination of strains, which have high levels of virulence and toxicity.

Aim: To study etiologic role of microorganisms during wound infection and elucidation of their populations interaction in patientswith burns., Materials and Methods: 2137 patients with wound infection treated in burn center were studied. 3179 samples of wound exudates and 6501 strains of microorganisms were studied. Assessment of microorganism's etiologic role was carried out using results of calculation of various statistic indexes, including indexes of ecological similarities of microorganisms in the wound (indexes of contamination, prevalence or persistence, incidence). Ecological similarity of wounds' microflora was determined by calculation of the coefficient Kj., Results: It was established that Staphylococcus aureus is the most common cause of mono- and mixed wound infections. It was determined that Kj value for common agents points to antagonism or associative interaction. During particular time periods of the study values of Kj significantly differed and depended from species. Specifically, for Pseudomonas aeruginosa the values of Kj were equal or exceeded 30% during several years. It was the first time when correlation between persistence and ecological similarity indexes was studied in agents of wound infections., Conclusion: In order to reveal factors influencing on microbial etiology of mixed wound infections it is reasonable to consider the nature of interspecies interactions of causative agents.

In accordance with the normative and methodical documents [3-5, 7-9], a complex of organizational, sanitary, and antiepidemic actions is performed to protect soil from causative agents of parasitic diseases in Moscow. About 2000 soil samples are annually taken from the playgrounds of children's educational establishments and apartment houses and tested. The soil contamination averages 3.2%. It has been established that there are no sanitary-and-epidemiological opinions as to the parasitic safety of sand or lids on the sand-boxes on the playgrounds from which the soil or sand samples show causative agents of parasitic diseases (most commonly toxocariasis) and which are accessible to stray and domestic dogs. In 2005, DESINBAC super having bactericidal, fungicidal, sporocidal, and virocidal activities and ovicidal properties was approved for soil disinfection in the Russian Federation. The prevention of toxocariasis is a state problem. Executive bodies, housing-and-communal services, veterinary stations, and health care services with the participation of sanitary-and-epidemiological facilities and their control must take part in solving this problem.

In Moscow, 7 species of helminths and 5 species of protozoa were found in domestic dogs and 6 species of helminths and 6 species of protozoa were detected in domestic cats. Such a great variety in pararistic diseases is distinguished for a low, but steady-state extensity of invasion. The change in socioeconomic relations accompanied by a gradual rise in the number of domestic and stray dogs in the megalopolis may create prerequisites for not only the spread, but also occurrence of parasitic diseases that have not been earlier notified in the city.

Aim: To study genetic diversity of Pseudomonas aeruginosa strains circulating in intensive care unit (ICU), to determine the source of these strains and duration of circulation of epidemically-significant clone in the hospital., Materials and Methods: Genotyping of 106 P. aeruginosa strains isolated from patients, clinical specimens and fomites was performed by random amplified polymorphic DNA analysis with oligonucleotide primer Sh1 of 10 bp long., Results: Out of 106 P. aeruginosa isolates, 72.6% belonged to the same genotype, which was dominated in ICU during whole study period. It was established that 58.3% of examined patients were colonized by identical strains belonged to prevalent genotype that indicates the intrahospital transmission of epidemic strain., Conclusion: Obtained data show that during the period of observation (15 months) one clone of P. aeruginosa dominated in ICU, which was characterized by multiple resistance to antibiotics and caused nosocomial infection in 58.3% of patients. This confirms the need of continuous molecular-microbiological monitoring of hospital microflora in order to early detect potentially dangerous epidemic hospital strains, which are able to cause nosocomial infections.

The paper presents the results of the first isolation of the new influenza virus in Moscow and the Russian Federation, which was similar to the swine A/IIV-Moscow/01/2009(H1N1)swl strain isolated on May 24, 2009 from a Russian arrived in Moscow from the USA on May 19, 2009. The antigenic, biological, and molecular genetic properties of this virus were studied. The virus was isolated on MDCK and chick embryos, the hemagglutination titers being 1:8-1:16 AE; the infectious titers being 6.51g of the tissue cytopathogenic infective dose (TCID50) and 7.01g of the common infective dose (CID50). The virus was sensitive to arbidol, ribavirin, oseltamivir, and resistant to rimantadine. The complete virus genome was sequenced; the data were accepted to the Gen Bank on May 28, 2009 under GQ219584-GQ219590 and GQ202724. The significant gene substitution of neuraminidase Asp for Gly in position 451, which has been undetectable in any other strain published in the Gen Bank by the present time is unique only to A/IIV-Moscow/01/2009 (H1N1)swl. The virus has been deposited in the State Collection of Viruses, D. I. Ivanovsky Institute of Virology, Russian Academy of Medical Sciences, under No. 2452 dated May 24, 2009.

One of the aims in the strategy of Moscow health service is perfection of early diagnosis of urological diseases. Examination of about 1.500000 males over 50 years was conducted in 2002-2007. The number of PSA tests rose 5-fold for 5 years. The number of ultrasonographies and transrectal ultrasonic investigations of the prostate rose from 21650 (2002) to 128890 (2007), the number of polyfocal biopsies--from 2165 (2002) to 12219 (2007). The rate of detection of prostatic diseases increased from 1146 cases per 100000 adult male population (1999) to 2097 (2007). Chronic prostatitis was registered in 17.8%, prostatic adenoma in 29.6% examinees, new cases of prostatic cancer were detected in 0.86% examinees. Standard prostatic cancer morbidity rose from 30.4 to 47.0 per 100000 male population. Percentage of early detected prostatic cancer increased from 42.9% in 2000 to 62% in 2007, detection of prostatic cancer stage III-IV reduced from 27.3% in 2000 to 16.6% in 2007. Thus, new prophylactic measures improved efficacy of outpatient urological service, raised rate of detection of chronic prostatitis, prostatic adenoma, prostatic cancer

Background: Prior research has revealed large differences in health and mortality across countries, socioeconomic groups, and individuals. Russia experiences one of the world's highest levels of all-cause and cardiovascular mortality, great mortality differences within the population, and a heavy burden of ill health. Psychological stress has been suggested as a likely explanation of health loss and premature death in Russia and Eastern Europe. However, physiological mechanisms connecting stress with health in Russia remain unclear since existing epidemiological data are scarce and limited to conventional risk factors., Method and Design: The survey on Stress Aging and Health in Russia (SAHR) is addressing this knowledge gap by collecting an unusually rich database that includes a wide range of reported information, physical and cognitive health outcomes, and biomarkers in a sample of Muscovite men and women aged 55 and older. The total planned sample size is 2,000 individuals. The sample was randomly selected from epidemiological cohorts formed in Moscow between the mid-1970s and the 1990s and from medical population registers. The baseline data collection was carried out from December 2006 to June 2009. Interviews and medical tests were administered at hospital or at home according to standardized protocol. Questionnaire information includes health, socio-demographic characteristics, economic well-being, cognitive functioning, and batteries on stress and depression. Biomarkers include anthropometry, grip strength, resting ECG, conventional cardiovascular factors of risk such as lipid profile and blood pressure, and other biochemical parameters such as those related to inflammation, glucose and insulin resistance, coagulation, fibrinolysis, and stress hormones. In addition to these measurements, SAHR includes dynamic biomarkers provided by 24-hour ECG (Holter) monitoring. This method continuously registers the beat-to-beat heart rate in naturalistic conditions without restrictions on normal daily activities. It provides information about heart functioning, including heart rate variability and ischemic and arrhythmic events.Re-examination of the study subjects will be conducted in 2009-2011 and will focus on health, functional status, economic conditions, behaviors, and attitudes towards aging. The subjects are also followed up for mortality and non-fatal health events., Discussion: The SAHR will produce a valuable set of established and novel biomarkers combined with self-reported data for the international research community and will provide important insights into factors and biological mechanisms of mortality and health losses in Russia.

Background: Despite a high prevalence of smoking for decades, recent research has documented an increase in the rates of both male and female smoking in post-Soviet Russia. As yet, however, little research has taken place on smoking at the subnational level. The current study addresses this deficit by examining smoking in Moscow -- the city that has been at the forefront of the entry into the Russian market of transnational tobacco corporations (TTCs) in the transition period., Methods: Data were obtained from the Moscow Health Survey 2004 -- a stratified random sample of 1190 people representative of Moscow's larger population. Information was obtained about subjects' smoking habits and age of smoking initiation., Results: The prevalence of smoking was high among both men (55.5%) and women (26.9%), with significantly higher rates in the younger age groups. There was also a high prevalence of smoking initiation before age 15 years, especially in the youngest women (18-30 years). Logistic regression analysis showed that respondents' age, binge drinking, locus of control and economic situation were important determinants of smoking., Conclusions: Although lifestyle factors seem to underpin the generally high levels of smoking, other things, such as its high prevalence in the younger generations and the factors associated with smoking (locus of control), nevertheless suggest that the TTCs may have played an important role in the spread of smoking in transitional Russia's changing social environment.

Aim: To study the rate of infection of ticks captured one of the Moscow park terrains with bacteria (agents of tick borreliosis and anaplasmosis)., Materials and Methods: Rates of infection of dried ticks with agents of main tick-borne bacterial infections (tick borreliosis and anaplasmosis) were determined by nested PCR., Results: In May-June 2006, 76 ticks (40 adult females, 36 adult, males) belonged to Ixodes ricinus species were captured by the method "on flag". Number of ticks on the chosen terrain was 1.77 ticks per km2. 22.4% of ticks (12 females and 5 males) were positive for the agent of tick borreliosis--spirochete Borrelia burgdorferi sensu lato which is pathogenic for humans. The main detected pathogen was Euro-Asian genovariant of B. garinii--7 female and 5 male ticks (70.6% from total number of infected ticks) were infected with it. Five female ticks were infected with genovariant of B. afzelii. One female tick (1.2%) was infected with B. valaisiana., Conclusion: Anaplasma A. phagocytophilum causing human granulocytic anaplasmosis was not detected in captured adult ticks.

Aim: The objective of this study was to assess dynamics of prevalence of hemotransmissive viral infections (HTVI) markers as mono- or mixed infections in patients admitted to Sklifosovsky Research Institute of Emergency Medicine., Materials and Methods: Two hundred thirty-five thousands and seventy patients admitted to the Institute during 1998 - 2007 were screened for the presence of laboratory markers of HTVI (antibodies to HIV, HBsAg, and anti-HCV)., Results: The long-term screening revealed 27,942 (11.9%) persons positive for laboratory markers, of which 3,099 (11.1%) were positive for >1 marker. It was established that HIV infection as well as viral hepatitis B and C have different level of similarity and ability to coexist. HIV infection was more frequently detected in association with other infections, whereas hepatitis B and C--as monoinfections., Conclusion: Attempt to consider the mutual influence of HTVI on their prevalence from the view of modern concept of microorganisms' ecology was made. Computation of Jaccard similarity coefficient showed that HIV and HCV have the greatest abilities for coexistence, whereas HIV and HBV--the smallest.

Aim: To perform advanced antigenic characterization of meningococci belonging to serogroups A and B and circulating in Moscow according to modern nomenclature of Neisseria meningitidis strains., Materials and Methods: Method of typing of "VR" fragment of FetA protein together with methods of genetic subtyping and multilocus sequence typing was used., Results: Detailed information about studied strains was inputed in Internet database--http://pubmlst.org/neisseria/. Typing of serogroup B strains did not allow to define dominating variant of "VR, fragment of FetA protein which is in accordance with subtyping data obtained previously. Serogroup A strains were notable for less variability of "VR" fragment variants: 6 variants were detected. For the majority of serogroup A strains, it was possible to trace connection between belonging of the strain to particular genetic subgroup and its revealed antigenic profile. For strains from genetic subgroup VI, antigenic profile P1.5-2, 10; F1-5 detected in 14(18%) strains was typical, whereas antigenic profile P1.5-2, 10; F3-5 was typical for genetic subgroup X and was detected in 50 (63%) strains. Antigenic profile P1.5-2, 10-67; F3-5 was detected in 5 (6%) strains, and other 10 antigenic profiles were revealed in one strain each., Conclusion: Prevalence of strains with antigenic profile P1.5-2, 10; F3-5 is explained by change of predominant genetic subgroup from subgroup VI to subgroup X in Moscow population serogroup A meningococci observed after 2003.

The study reveals that traffic traumatism continues to be a serious problem for all international community. The causes of traffic traumatism and ways of its prevention are analyzed. The results of sociological analysis of opinions of injured persons about activities and modes of preventing traffic traumatism are discussed. The system of social medical, legal and educative impacts on all participants of traffic accidents is proposed.

Urethral specimens from 172 men who attended sexually transmitted disease clinics in the Moscow Oblast were examined for Neisseria gonorrhoeae, Chlamydia trachomatis and Mycoplasma genitalium by nucleic acid amplification tests. N. gonorrhoeae was detected in the urethra of 41 (24%) of the 172 men and C. trachomatis in 57 (33%). The latter occurred in 15 (36%) of the 41 men who were infected by N. gonorrhoeae and in 42 (32%) of 131 uninfected by gonococci. Of the 42 men uninfected by gonococci but chlamydia infected, 39 (93%) had symptoms and/or signs of urethritis. M. genitalium was detected in 45 (26%) of the 172 men, in nine (22%) of the 41 men infected with N. gonorrhoeae and in 12 (21%) infected with C. trachomatis. M. genitalium was detected alone in 25 (28%) of the 89 men uninfected by either gonococci or C. trachomatis. Of these 25 men, 24 (96%) had urethral symptoms and signs of inflammation, a proportion significantly more than experienced by the 64 men uninfected by any of the microorganisms. Of the 31 men who apparently had no symptoms or signs of urethritis, only three (10%) were infected by M. genitalium. The data provide evidence for the pathogenicity and frequent occurrence of M. genitalium in men in Moscow and presumably elsewhere in Russia.

Comprehensive medical examinations of 406 junior schoolchildren from 4 Moscow general educational schools during education and an investigation of the spread of poor factors caused by lifestyle and their influence on the functional status, autonomic homeostasis, and adaptive capacities of schoolchildren have established behavioral risk factors for abnormalities at junior school age. Multivariate analytical methods (137 variables) could ascertain the priority and behavioral risk factors in the formation of functional abnormalities in children during primary schooling: an increase in the incidence of abnormalities of the cardiovascular system by 3.5 times, the eye and its appendicular apparatus by 3.5 times, the musculoskeletal system by 4.2 times, and the nervous system by 4.8 times.

The paper analyzes morbidity among Moscow schoolchildren in the past 50 years on the basis of the results of in-depth studies of pupils by the researchers of the Research Institute for the Hygiene and Health Care of Children and Adolescents. There is a significant reduction in the number of absolutely healthy children, the proportion of which is 2-4%. There is a considerable increase in the prevalence of dysfunctions and chronic diseases among schoolchildren. Particularly high increment rates of morbidity were observed in the 1990s. The morbidity structure has changed in the past 50 years. Both biomedical and psychosocial factors are responsible for changes in the morbidity levels and structure of children and adolescents.

In the past 2 years, the malaria epidemiological situation in Moscow has drastically deteriorated, sporadic cases of local transmission of tertian malaria (Plasmodium vivax) have been notified, which permits one to pose a problem, namely to eliminate malaria in the megapolis by 2010. Monitoring and assessment of the entomological situation, surveillance of the malaria vectors Anopheles mosquitoes in particular, acquire vital importance. The entomological surveillance has shown its efficiency on the territory of the megapolis and a need for continuous monitoring and assessment in future in order to consolidate the achieved success and to attain malaria elimination in Moscow by 2010. The major benefit of hydraulic measures is that they are directed on fundamental radical environmental enhancement. The impact of timely and properly implanted hydraulic measures is long-term, therefore this prophylactic line has been considered to be of priority.

Analysis covered occupational background of 2680 Moscow residents disabled due to malignancies. The authors revealed differences in nosologic structure and disablement severity between groups engaged into various kinds of economic activities, gave expert evaluation of what share of disabled due to malignancies is induced by occupational carcinogenic factors.

The paper describes some experience in organizing and delivering specialized emergency health care to children who have suffered during traffic accidents in the Moscow Region, by attracting the forces and means of a disaster medicine service. In May 2004 to October 2008, examinations were made among 615 children, 552 of whom were evacuated to Moscow by intensive care cars (n = 469) and medical helicopters (n = 83). The paper shows that the two-stage medical victim medical evacuation provision system is effective and provides evidence for prospects for putting the developed model into practice of rendering a medical aid to traffic accident victims on out-of-town highways.

For the study of contribution of atrial fibrillation (AF) during acute coronary syndrome (ACS) in long-term prognosis after clinical stabilization we examined 453 patients admitted to Moscow hospitals and followed them for 2.07 +/- 0.48 years. The following events were registered: fatal and nonfatal myocardial infarction (MI), unstable angina (UA), fatal and nonfatal stroke, death of other causes. At ACS onset sinus rhythm was noted in 419 (92.5%), permanent or persistent AF-in 16 (3.5%), attack (paroxysm) of AF - in 18 (4.0%) patients. Mean length of life before end point was 884.9 +/- 23.4, 827.3 +/- 123.3 and 514.0 +/- 111.3 days in patients with sinus rhythm, permanent/persistent AF, and attack of AF during first 10 days of ACS, respectively (p<0.001). Compared with patients in sinus rhythm in patients with attack of AF relative risk (RR) of occurrence of any end point was 1.75 (95% confidence interval [CI] 1.284 to 2.873, p< 0.001), of fatal MI - 1.72 (95% CI 1.026 to 2.873, p=0.040), of UA - 2.116 (95% CI 1.249 to 3.585, p=0.005), of stroke - 2.863 (95% CI 1.300 to 6.301, p=0.009). Multifactorial analysis selected history of MI and attack of AF during first 10 days of ACS as independent predictors of unfavorable outcome. Thus paroxysmal form of AF during hospital stay because of ACS is associated with higher probability of development of unfavorable events in the next 1-2 years.

The Russian Federation and Moscow also show a global tendency for dysfunctions of the locomotor apparatus (LMA) and the organ of vision (OV) to increase. Eight hundred and two adolescents from the Central Administrative District of Moscow were found to have involvements of LMA (35.4%) and OV (22.5%). There were more common abnormal posture (12.9%), spinal axis changes (11.7%), talpes (12.5%), and myopia (17.8%). The follow-ups made from 1997 to 2002 revealed an increase in the number of adolescents with functional changes (D2) with a decrease in that of apparently healthy adolescents (D1). The changes were prevalent in children born in 1986 onward. Examination of the interaction of LMA and OV as the uniform visual motor system revealed sexual dimorphism suggesting that the girls were more susceptible to these changes, which should be considered while developing a adifferential approach to teaching schoolchildren during pubertal period. Schoolchildren's health status should be systematically considered by a wide circle of specialists to estimate the maximum number of parameters in order to determine the reasons resulting in a steady-state tendency for ODA and OV dysfunctions to progress.

The authors present selected results of the analysis of medical histories of the subjects who died from complications of inflammatory aural diseases and paranasal sinus pathology in multifield city hospitals of Moscow for the period from 1993 till 2003. The character and the frequency of each intracranial complication are reported.

Retrospective analysis of the data available in the reporting form 0-89/y-[cyrillic letter: see text] and information analytical tables for Moscow tuberculosis monitoring) over 7 years on all notified new cases of tuberculosis among 15-17-year-old children has indicated that it is necessary to change the procedure for detecting tuberculosis for this age group of children in order to improve the early diagnosis of the disease. The Mantoux test is likely to be rather effective in examining adolescent schoolchildren and students from secondary specialized establishments and ineffective among unorganized young people and in migrants' families. Planned fluorography is of rather informative value in all the groups under study if there is a timely referral for examination. The authors consider whether it is worth making a tuberculosis 2 TE PPD-L in organized collective bodies (schools, colleges, etc.). Other groups of children may undergo only digital small-dose fluorography. Unorganized children above 10 years of age who lack annual Mantoux test results must be referred for digital small-dose fluorography. Refusal to undergo fluorography is justifiable only if there is no tuberculin sensitivity or evident symptoms of intoxication. In the megapolis, due to uncontrolled migration, a lawmaker must consolidate the statute on that mandatory control should be exercised over 15-17-year-old adolescents who must undergo fluorography during their each visit to a health care facility, on entering an educational establishment, or on employment. On consulting a physician, the adolescent who has undergone fluorography 6 months before must have it again.

The paper presents the results of studying the regularities and distribution pattern of natural radionuclides (potassium-40, thorium-232), as well as the representatives of the uranium family (radium-226, polonium-210) and the technogenic isotope cesium-137 in different objects of the water ecosystem in the North-Western District of Moscow (bottom sediment, hydrobiota). Some radiation parameters of these objects (the total alpha- and beta-activities of the radionuclides, their specific effective activity are given. On the basis of the experimental findings, the authors have made an assessment of the radioecological situation in the water pool of the district examined.

Aim of this study was determination of incidence and structure of sudden out of hospital cardiac death (SCD) in subjects aged 1-45 years in Moscow. We analyzed rate and structure of SD among persons who had succumbed in 2005-2007 in several districts of Moscow with population of 2,502,836. Of the total number of 19,557 autopsies 7702 (39.4% or 92/100 000/year) and 1265 (6.5%, 19.4% of autopsies in this age group, or 16.8/100000/year) in all age groups and in the age 1-45 years, respectively, were performed because of SCD. In most cases (44%) age at SCD was 41-45 years, only in 1% of cases it was less than 18 years. Eighty two percent of autopsied SD victims were men. Most frequent postmortem diagnosis was "cardiomyopathy" (69% overall, 80-96% in the age 19-35 years) established on the basis of detection of both specific and nonspecific changes in the myocardium. In 25% of SD cases in the age group before 18 years congenital heart disease was found. After 35 years rose portion of diseases of ischemic nature (22-32%). Percentages of hypertensive disease and other diseases among all diagnoses were 7 and 1, respectively. Beginning with 19 years in large percentage of cases presence of alcohol in blood was detected. This percentage was especially high in the age group 19-25 years (66.6%). SCD of most persons aged 20-45 years was registered at home, while in 50% of younger persons it occurred outside home often during physical effort. Rate of SCD, its circumstances and structure elicited in this study might serve as basis for elaboration of the system of early detection of groups of risk and prevention of SD in young age.

A clinical epidemiologic study was made among 432 Moscow students and as a part of it was found the high prevalence rate of pathologies of dentition and variety of nosologic forms. The most common cases were: caries, periodontal disease, deformity and anomalies of tooth position. These findings were necessary to estimate the need of all types of dentistry for Moscow students. It was specified that 43% of students were in need of filling and dental restoration, 35% were in need of crowns of tooth, 22% were in need of dental restoration by means of orthopedic constructions. Endodontic dentistry was necessary for 31% of students, surgical removal - for 8%, periodontal dentistry - for 37%.