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Objetive: To analyze risk factors and course of acute ischemic stroke (IS) based on hospital register data., Material and Methods: Ninety-seven patients (38 women and 59 men, mean age 65.4±12.8 and 61.2±18.8 years, respectively) with acute IS admitted in 2016 to the Clinical hospital of Makhachkala were examined. Medical history and severity of neurological deficit (the British Medical Council Scale, The Glasgow Coma Scale, MMSE) were assessed., Results: The severity of neurological deficit was comparable in men and women though cognitive impairment was more frequent in women (p<0.05). At admission, symptoms of inflammation and hyper coagulation were more frequently identified in women (p<0.05). The high prevalence of chronic cerebral ischemia preceding IS, insufficient efficacy of preventive treatment and late hospitalization were noted., Conclusion: The results should be confirmed in a large-scale long-term study. They can be used to improve quality of medical care of patients with IS.

Purpose: to evaluate the prevalence of various urination disorders in residents of the Republic of Dagestan, and, thus, to improve their diagnosis and treatment., Materials and Methods: 584 residents (264 men and 320 women) from different regions of the Republic of Dagestan took part in an anonymous questionnaire survey: 165 residents of Makhachkala, including 92 men and 73 women; 86 residents of Derbent and villages of Southern Dagestan, including 30 men and 56 women; 73 residents of Khasavyurt and Kizilyurt, including 34 men and 39 women; 53 residents of Buynaksk, including 19 men and 34 women; 42 residents of Izberbash, including 19 men and 23 women; 58 residents of the Kaspiysk, 29 men and 29 women; 42 residents of Kayakent, 4 men and 38 women; 65 residents of other regions of the Republic of Dagestan (Karabudakhkent, Gumbet, Gunibsk, Shamil, Khunzakh, Botlikh, Kazbek, Levashin, Tlyaratin, and Tsumadin regions), 37 men and 28 women., Results: According to the survey of the residents of the Republic of Dagestan, a significant prevalence of various urinary disorders (63.5%) was found among both men (61.7%) and women (65.0%). Unfortunately, not all patients seek medical advice with complaints of dysuria (55.5%). The fact that 18.8% of patients do not know that they can get help, and 24.1% believe that they do not have a good doctor in their region can be considered as the most an unfavorable moment in terms of the reasons for the refusal of visiting a doctor.., Conclusions: All this findings suggest the need for educational programs both for physicians and the population (educative activities).

Aim: To comparatively study the clinical manifestations, sexual and HLA-B51 associations in patients with Behçet's disease (BD) in two ethnic groups., Subjects and Methods: The authors examined 143 patients with the valid diagnosis of BED who were divided into 2 groups: 1) 85 patients, the dwellers of Dagestan (a multiethnic cohort), 63 men and 22 women (mean age 29 +/- 7.4 years); 2) 58 Russian men and women (mean age 33 +/- 11.7 years)., Results: Two major criteria for BD, such as aphthous stomatitis and external genital ulcers, were found with the same frequency. Panuveitis and angiitis of the retina were diagnosed more frequently in the Dagestani population with BD than in the Russians. Out of the minor criteria for BD, the incidence of lower limb deep venous thrombosis was 23% for the Dagestanis versus 3% for the Russians. Arterial thromboses and pulmonary artery aneurysms became causes of death in 4 in 5 men aged 19-23 years from their Dagestani ancestry. HLA B51 (B marker) was found in the dwellers of Dagestan: in 70% of the men and 40% of the women who had BD., Conclusion: BD runs a more severe course in male patients and is characterized by severe eye diseases and the systematic pattern of the process at young age. Gender-specific and genetic aspects call for further comparative investigations on large ethnic patient cohorts of other ancestries.

Results of the first epidemiologic survey of cerebral stroke in the Dagestan Republic (DR) carried out in 2009--2010 are presented. Using a population register, we evaluated the dynamics of the morbidity rate of stroke and effectiveness of primary and secondary prevention of stroke. There were 7533 cases of stroke, including 4116 in 2009 and 3413 in 2010. The morbidity rate per 1000 people was 2.76 in 2009 and 2.29 in 2010. The diagnoses were distributed as follows: ischemic stroke 3029 (73.6%) in 2009 and 2457 (72%) in 2010; hemorrhagic stroke -- 760 (18.5%) in 2009 and 692 (20.3%) in 2010; undifferentiated -- 327 (7.9%) in 2009 and 264 (7.7%) in 2010. Mean age at disease onset was 65.41±11.4 in 2009 and 66.43+12.6 in 2010. The measures for primary and secondary prevention of stroke performed in DR led to the reduction of stroke cases by 17% in 2010 compared to 2009.

The study was carried out in 2009-2010 on the basis of the Republican children clinical hospital of the Republic of Dagestan. The structure of hospitalized children aged 0-3 years was analyzed using the data from of medical records of hospital patients. The sampling consisted of 17 368 cases. The morbidity of children of the first year of life and morbidity of newborns in maternity hospitals was analyzed. It is established that the morbidity of children of the first year of life made 2258.6 to 1 000 children of corresponding age. The morbidity of newborns in maternity hospitals made 290 to 1 000 newborns. Thy indicator is slightly higher in urban area (295) than in rural area (272.3). In the structure of classes of diseases of hospitalized children of early age the first position is for particular states of perinatal period (40.4%), second position for respiratory diseases (18.1%), third position for inherited malformations (15.3%) and forth position for neoplasms (6.8%). The analysis of hospital lethality demonstrated that the major percentage of deceased (88.9%) go to the first year of life.

Caries incidence was assessed in pregnant women in 1998, 2003 an 2008 showing the values to be stable. DMF was almost the same in 1998 and 2003, but in 2008 the rate of "F" (filled) element was significantly higher thus confirming growth in motivation for dental treatment after introduction of private dental practices.

The results of the clinical and epidemiological study of epilepsy in the Soviet region of Makhachkala city and the Khasavurt region of the Dagestan Republic are presented. The sample size was 139.115 in the Soviet region and 101.278 in the Khasavurt region, The samples included 344 and 338 patients with epilepsy, respectively. The age- and sex- standardized prevalence of epilepsy was 2.06 (CI95% 1.80-2.32) cases per 1000 population in the Soviet region and 2.98 (CI95% 2.60-3.35) cases per 1000 population in the Khasavurt region (p=0.05). The prevalence of epilepsy was higher in men. Focal (location-related) forms of epilepsy were most frequent, with the highest frequency of partial seizures with secondary generalization. Cranial-brain injury, intra- and perinatal pathology and cerebral vascular diseases were the main causes of the development of focal epilepsies. Seizure frequency greater than 12 per year was noted in more than a half of patients. The study of social aspects showed that only small portion of patients worked, most of patients received disability pensions. Differences in the education level were identified as well.

The population study permitted to establish the role of Russian military physicians in organization of medical business in Dagestan. The prevalence of acute epidemiologic diseases in pre-revolutionary Dagestan is examined. It is derived that mass propagation of infections was supported by cultural and economic backwardness, non-sanitary conditions in cities, lifestyle of mountain dwellers. The tradition to visit ill fellow villager resulted into mass morbidity and even in death collapse of entire population of mountain settlements (auls). The positive conditions to develop medical business developed after Dagestan joined Russia. The activities of Russian military physicians in the Caucasus coincided with the full swing of various infection epidemics among soldiers and residents. The measures undertaken by Russian military physicians permitted to liquidate the epidemics.

Results of the first epidemiologic survey of cerebral stroke in Dagestan carried out in 2009 using a method of population register are presented. Arterial hypertension was on the first place (98.5%) among risk factors. Other risk factors were determined as follows: cardiac diseases (24.2%), cardiac fibrillation (14.5%), lipid profile dysfunction (10.6%), smoking (8.7%), diabetes mellitus (8.6%), stress (7.5%), history of myocardial infarction (3.6%).

The use of nutriceutics (hexavit (multivitamin) or the natural concentrated product (NCP) Atlant from the raw plant material) and the parapharmaceutic lyophilized bifidumbacterin to enhance natural resistance in the subjects of an organized collective body in skin and subcutaneous fat infections (SSFI) (furuncul, abscess, phlegmons, pyodermas) showed the increasing bactericidal activity of the skin, normalized composition of colonic microflora, decreases in primary morbidity from appealability rates and in SSFI morbidity. When the NCP was taken, prophylactic efficiency was higher, which was likely associated with its increased concentrations of antioxidant vitamins (A, E, and C) and minor components.

The analysis of the circulatory system diseases morbidity and its mortality in the Republic of Dagestan is presented. The recommendations on the reformation of medical care in the Republic are presented.

We examine the distribution of viral genetic forms and the presence of antiretroviral drug resistance mutations in HIV-1 infections in the Republic of Dagestan, in the North Caucasus area of Russia, where a recent large increase in HIV-1 infections has been documented. Samples were collected from 41 HIV-1-infected individuals from Dagestan, most of them from the cities of Derbent (n = 21) and Mahachkala (n = 18). Thirty six were injecting drug users and five were infected by heterosexual contact. None was on antiretroviral drug treatment. HIV-1 protease and a segment of reverse transcriptase were amplified by RT-PCR from plasma RNA and sequenced, and phylogenetic trees were constructed via maximum likelihood. Forty (97.6%) of 41 samples were of subtype A, former Soviet Union variant (A(FSU)), of which 27 (67.5%) clustered with the subvariant containing the V77I substitution in protease (V77I(PR)). Within this cluster, 13 viruses formed a local subcluster, 10 of which were from Derbent. Four viruses clustered with the A(SP2) subcluster, recently identified in St. Petersburg, two with a virus from Georgia and one with a virus from Azerbaijan. No mutations associated with antiretroviral drug resistance were detected. The results, therefore, show the relationship of the HIV-1 epidemic in Dagestan with that of other areas of Russia and of neighboring countries, and reveal the spread of the A(FSU) V77I(PR) variant in the North Caucasus area.

[By using a group of patients with atopic dermatitis who live in Dagestan as an example, the authors show the high prevalence of toxoplasmosis among them. This requires new approaches to diagnosing and treating atopic dermatitis to be introduced in this region]

The results of the study of quality of pulmonological medical care are presented. Overall, 366 out-patient case histories with the most commonly encountered diseases of respiratory system were submitted to expert assessment. The raw material was collected in 2005-2006 in 3 cities of the Republic of Dagestan. The expertise revealed that about a quarter of patients were examined timely and more than two third of them not timely. The discrepancy of diagnoses made by physicians and experts took place in 16.1% of cases. The expertise of treatment quality revealed that in 10.1% of cases the prescribed treatment was inopportune, in 24.9% it was inadequate and in 7.8% it was redundant. The research data was used to develop the guidelines and proposals regarding the enhancement of quality and effectiveness of pulmonological medical care of population.

One of common urological problems in middle-aged and old male population is urination disorders and erectile dysfunction. We studied these problems in male population of Dagestan. We found that erectile dysfunction occurs in 38%, moderate and severe urination disorders in 22% males in Dagestan. Each 8-9th man in Dagestan suffers from combination of these disorders.

Incidence of androgenic deficiency in Dagestan males was studied using AMS questionnaire. Assessment of the results was made by standard criteria. The obtained statistics on 780 responders over 30 years of age demonstrate that symptoms of androgenic deficiency exist in 51.15% males in Dagestan. They are primarily caused by sexual problems.

Two hundreds and eighty-seven patients, aged from 46 to 78 years, mean age 60.2 +/- 9.4 years, with confirmed diagnosis of ischemic stroke have been studied. The correlations between glycemia and severity of neurological deficit in the 1st (r = -0.433; p < 0.001) and the 21st days (r = -0.289; p < 0.05) of hospitalization were found. The glucose concentration in the venous blood plasma on an empty stomach was significantly higher in the fatal cases compared to the survived patients in the 1 (9.8 +/- 0.6 mmol/l and 5.7 +/- 0.4 mmol/l; p < 0.01), 3rd (9.1 +/- 0.4 mmol/l and 5.6 +/- 0.4 mmol/l; p < 0.05) and 5th days of stroke (9.3 +/- 0.4 mmol/l and 5.5 +/- 0.5 mmol/l; p < 0.01). The level of glycemia on an empty stomach was significantly correlated with the fatal outcome (r = 0.367; p < 0.01). The correlation between the development of lacunar infarction and the presence of previously developed diabetes mellitus type 2 (r = .0.756; p < 0.01) was also noted. The results obtained suggest a significant effect of diabetes mellitus type 2 on the course of ischemic stroke and the necessity of correction of glycemia in these patients.

Data on Eimeria (Sporozoa: Coccidia) parasitizing cattle in different regions of the Republic of Dagestan are given. Eight species of the genus were found. Eimeria zuernii, E. subspherica, and E. bovis appeared to be the dominate species. Total infestation rate in the republic is 67.7%, while in mountain regions of Dagestan in is 83%.

The study was undertaken to reveal the clinical and epidemiological features of development diabetes mellitus (DM) and pulmonary tuberculosis (PT) in comorbidity. The material of the study was 143 case histories and outpatient cards of patients with DM and PT who were registered in 2001-2006. A total of 11,702 cases of tuberculosis were notified in 1999-2005. The significance ofa difference between the extensive indices was assessed by Student's test preceded by the Fisher angular transformation. Thus, the specific features of development of DM and PT are: 1) type 1 DM frequently occurs in youth while type 2 DM does at mature age; 2) tuberculosis in DM patients occurs at mature and old ages; 3) there is a male preponderance among patients with type 1 DM and a female predominance among those with type 2 DM; 4) comorbidity is more common in town-dwellers; 5) severe PT was prevalent in type 1 DM; mild PT is rarely observed in type 2 DM; 6) in comorbidity, fibro-cavernous, cirrhotic tuberculosis, caseous pneumonia, and tuberculoma are encountered by several times more frequently and focal tuberculosis and tuberculous pleurisy are less frequently in patients without DM.

Aim: To assess genetic diversity and genetic distances among isolated populations from Dagestan., Methods: A cross-population genetic epidemiology design was applied in ethnically and demographically diverse isolates from Dagestan, some with more than 200 and some with less than 100 generations of demographical history since their founding., Results: The analysis of genetic diversity showed that Dagestan ethnic populations are clearly close to European ethnic populations. The genetic data support the view of them as ancient, highly isolated populations 85%-97% the rate of the endogamy and inbreeding coefficient F=0.010-0.015. Many Dagestan populations have very high prevalence of certain complex diseases such as cardiovascular illnesses, cancer, schizophrenia, mental retardation, and progressive muscular dystrophy. Lifetime morbid risk for schizophrenia in the isolates varied from 0 to 5%. Among the relatives, the number of men with chronic schizophrenia was at least twice as high as women. The average age of onset of schizophrenia was 21.2 years for offspring of consanguineous marriages and 17.4 years for offspring of non-consanguineous marriages (P=0.033)., Conclusion: The results support the hypothesis that cross-population design provides unique opportunities for observing reliable ancestral haplotypes with disease predisposing loci, as well as population-specific linked loci.

Complex of measures for prophylaxis of echinococcosis recurrence was developed basing on experimental and clinical studies. Results of surgical treatment of echinococcosis of different location in 983 patients were analyzed. Complex approach to the treatment reduced the rate of recurrences to 0.6% (p=0,0002). Criteria of recovery and algorithm of early diagnosis of echinococcosis recurrence are presented.

The rate of use of pesticides and mineral fertilizers in the Republic of Daghestan was high in the USSR and Russia and was many times greater than the critical burden (3/93 kg/ha) and ranged from 3.5-4.2 kg/ha in the highlands to 17.0-21.7 kg/ha in the plain. Two-factor analysis indicated that out of the mineral fertilizers, pesticides and phosphate fertilizers had the most adverse effect on the incidence of tuberculosis whereas potash fertilizers exerted a less effect. Phosphate fertilizers and copper-containing pesticides were secondary risk factors of death from tuberculosis. The correlation coefficient was 0.53 for phosphate fertilizers, 0.59 upon total exposure to organochlorine compounds, and 0.68 upon total exposure to copper-containing pesticides.

In Republic of Dagestan, analysis of drug addiction morbidity rate for last ten years refers to that its level in urban population is four times higher than in rural areas. Portion of opiate addicts detected for the first time consists 46.8% in urban areas and 22.1% in rural areas. In the morbidity structure of age-specific drug addiction highest level is in the age group of 20-39 years and 40-59 years. In rural areas, as compared with urban areas, drug addiction cases among women were detected for the first time only in 2004. In rural areas and towns of Republic, there are territories with higher rates of drug addiction morbidity.

The morbidity of rheumatic heart diseases (RHD) was studied, for the purpose of designing a set of measures to prevent them, among the teenagers in the Republic of Dagestan. The studies were based on the medical aid appealability, hospitalization data and clinical-and-epidemiological research made, with respect to climatic-and-geographic zones, in 3 rural areas and in the city of Makhachkala. A total of 1142 teenagers were questioned; laboratory-instrumental examinations were made for 234 teenagers. According to the data analysis, RHD and acute rheumatic fever (ARF) have been recently on the rise in the Republic, where the average morbidity figures are 4.5-fold higher versus those registered in whole Russia. The morbidity rate of RHD went up 1.8-fold, and that of ARF--1.5-fold, in Dagestan during 2000-2002. According to clinical-and-epidemiological examinations, RHD prevail among rural youth residing primarily in plains and, to a less extent, in highlands. Finally, measures are suggested, on the basis of research, for the prevention of RHD among youth.

The data on the sanitary and epidemiological situation in the Republic of Daghestan during the period of high flood in 2002. The scope of sanitary, hygienic and prophylactic measures carried out during this period with a view to prevent the appearance of the outbreaks of acute enteric infections and viral hepatitis A in the Republic of Daghestan is shown.

The Republic of Daghestan is at present one of the most unsafe territories in the Russian Federation with respect to brucellosis morbidity among humans. The figures of human morbidity in brucellosis grew from 3.4 per 100,000 of the population in 1999 to 10.5 per 100,000 of the population in 2002, thus exceeding the figures for the whole of Russia 15- to 20-fold. The analysis of human morbidity in the Kizlyar region (where the interregional regrouping of the cattle was made) after the natural calamity, as well a in other regions where live-stock was evacuated, indicated that by the end of 2002 an essential deterioration of the epidemiological situation took place in these regions. In view of grave epizootological situation and the absence of epidemiological safety in brucellosis in the Republic of Daghestan the sanitary, epidemiological and veterinary services should, together with other priority tasks in their work aimed at the liquidation of the emergency situation, pay greater attention to measures for the prevention of the spread of brucellosis.

Materials characterizing the sanitary and epidemiological situation in the Republic of Daghestan which arose as the consequence of the emergency situation caused by the high flood and inundation in summer 2002 are presented. The work of the sanitary and epidemiological service, carried out in cooperation with the relevant departments, on the organization and realization of measures aimed at preventing the deterioration of the epidemiological situation on the territories of the republic, affected by the natural calamity, is described. As shown in the presented materials, all these measures made it possible to ensure the effective control on the sanitary, hygienic and epidemiological situation in the republic and to prevent the appearance and spread of the outbreaks of infectious diseases.

Interpopulation differences in the epidemiology and age of onset of complex diseases, as well as expression of some vital parameters, have been found. The relationship between these interpopulation differences and the genetic processes that have been occurring in the populations throughout their history has been demonstrated. The Daghestan genetic isolates studied are characterized by aggregation of certain complex diseases. In each genetic isolate, almost all affected subjects with homogeneous clinical phenotypes belong to the same large pedigree with a limited number of founders. There is evidence for a large variance of the population risk of schizophrenia (morbid risk) in Daghestan isolates (this parameter varies from 0 to 5%). Examination of 211 cases of schizophrenia earlier diagnosed in Daghestan psychiatric hospitals has shown that only 139 of them meet the DSM-IV criteria for schizophrenia. The remaining 72 subjects have, according to DSM-IV criteria, various schizoaffective and affective disorders; all of these subjects are close relatives of the schizophrenic patients. The age of onset of schizophrenia in the isolates studied varies from 14 to 40 years (20.84 +/- 0.568 years). Offspring of consanguineous marriages exhibit later age at onset and a higher risk of schizophrenia than offspring of exogamous marriages. The results of multivariate genetic analysis indicate that different gene complexes are involved in the pathogeneses of early-onset and late-onset forms of schizophrenia. An association of schizophrenia incidence, its age dependence, and reproductive parameters with polymorphisms of some microsatellite loci have been demonstrated.

Micro test systems for the biochemical identification of comma bacilli (MTS-V) and for a rapid determination of their groups according Heiberg (MTS-H) were designed and commissioned into medical practice. The micro test systems showed their advantages before the control media of Hiss and Bacterium Incubation Media at studying the museum-kept and freely-obtained vibrio strains as well as at studying the concomitant microflora and clinical materials taken from ill people and vibrio-carriers during the 1994 outbreak of cholera in Daghestan.

The paper assesses the epidemiology of retarded intrauterine development (RIUD) of a fetus by the ecological areas of the Republic of Daghestan. There is a positive and significant correlation of fetal RIUD with regional load an assortmental index of pesticides in the foothill and low areas and an inverse significant correlation with the standards of living in the mountainous districts of the Republic of Daghestan.

When Mycobacteria tuberculosis isolated from the sputums of patients with pulmonary tuberculosis in Daghestan were typed, the proportion of the bovine type mycobacteria was found to 20.5% in 1977-1978; that was 8.9% after long-term health-promoting measures in 1989 and 24.8%; after a decade of decreased measures in 1997-1998. The epidemiology and epizooty of tuberculosis in the region were closely interrelated and intensified each other. The proportion of bovine mycobacteria isolated from patients with tuberculosis is one of the sensitive indices of the epidemic situation in the region. Tuberculosis control measures in cattle-breeding regions should be implemented in a close contact and interaction of health care and veterinary facilities.

The results of the analysis of sanitary and epidemiological situation in the Republic of Daghestan are presented. The tendency towards the deterioration of epidemiological situation in a number of infections is noted. This unsatisfactory sanitary and epidemiological situation is caused by the low level of the sanitary and hygienic security of the population as the consequence of failures in the accomplishment of the planned works and measures, regulated and approved by the Republican Government, due to insufficient financing.

In Daghestan in the focus of the flood-plain swamp type 64 persons fell ill with tularemia in 1999. During the epizootological survey 8 Francisella tularensis strains were isolated from vectors and carriers and in 7 samples taken from open water reservoirs, as well as in 1 sample obtained from Ixodes ticks, tularemia antigen was detected. Humans were infected mainly by the transmissive route, as found in 71.8% of patients. 28% of patients were infected through contacts. The disease took mainly a mild course, registered in 95.6% of patients. The disease affected those persons who had not been immunized against tularemia.

The results of the determination of the amount and location of ticks Hyalomma marginatum in Daghestan at the period of the appearance of cases of Crimean haemorrhagic fever (CHF) are presented. The domination and abundance indices of these ticks in different landscape areas, on the territories of some plain and foothill regions of the Republic of Daghestan are given. The advantages of the effective method for the collection of ticks "on the observer" have been substantiated. The data thus obtained are of importance for the epidemiological surveillance and prophylaxis of CHF.

The authors have summarized organizational experience of surgical work of garrison military hospital strengthened with specialized brigades during the period of armed conflict in Republic of Dagestan (August-September, 1999). From the start of active actions in order to render assistance specialized surgical teams from district military hospital equipped with special kits (at the rate of 7 operations/day during a week) were sent to garrison hospital. In this armed conflict there are features characterising both mine-and-explosive war in Afghanistan and sniper war in Chechen Republic resulting in increase in the number of seriously wounded (up to 46.7%) casualties during Botlikhskiĭ operation constituted 1:4, Novolakskiĭ (Kadarskiĭ)--1:5. Bullet injuries were fatal in 49.4% of the cases, fragmentation (including MET)--50.6%. During 1.5 month of hospital work there were performed 303 surgical interventions. 22.7% of slightly wounded from local garrisons were treated in garrison hospitals. Treatment results--postoperative lethality in gunshot trauma at the given stage constituted 1.1%.

The epidemiological features of tuberculosis among rural males in Daghestan were studied. Its mortality in males was found to greatly vary by climatic and geographic areas by the east-west and north-south axes. 1990 to 1997 were marked by a rise in tuberculosis morbidity by both ecological and administrative areas. The data are given in the paper.

Unlabelled: Hepatitis C virus (HCV) is a leading cause of chronic liver disease. The prevalence in blood donors in the USA and West Europe is around 0.3%. However, there are few studies performed in East Europe. We have studied the prevalence of hepatitis C virus infection and risk factors associated with it in the Russian Republic of Daghestan., Population and Methods: We included 10,682 volunteer blood donors, 267 commercial blood donors, 97 high risk patients (22 haemophiliacs, 41 in haemodialysis program and 34 parenteral drug addicts), and 87 patients with chronic liver disease (61 chronic hepatitis, 20 cirrhosis and 6 hepatocellular carcinoma). Antibodies against HCV were detected by second generation ELISA., Results: 0.93% of volunteer blood donors were found to be HCV reactive. Factors with stronger association with seropositivity were previous blood transfusion and parenteral drug addiction. 66% of seropositive blood donors had an elevated level of ALT. Alcohol use correlated with more marked deterioration in liver function tests. 7.5% of commercial blood donors were seropositive. Prevalence in high risk patients and in patients with chronic liver disease was very high (50-80% and 40-50%, respectively)., Conclusion: The Russian Republic of Daghestan has one of the lowest rates of HCV infection in East Europe. Commercial blood donors have a very high prevalence of HCV infection. The risk factors associated with HCV infection are similar to those found in other epidemiological studies.

As the result of the prospective examination of 863 pregnant women in urban and rural consultation clinics for women in Daghestan, a high proportion of them were found to be infected with toxoplasmosis (25.5%), brucellosis (1.85%) and listeriosis (12.2%). The data on the contamination of 1325 women with aggravated obstetric history were confidently higher, constituting 52.0%, 3.3% and 22.2% respectively. The results of the examination of women working on live-stock farms (226 women) and poultry farms (106 women) demonstrated a significantly high frequency of contamination with the above-mentioned zoonotic infections. The data thus obtained were indicative of the necessity of organizing epidemiological surveillance on these infections; for their diagnostics a complex of laboratory methods could be used, though the effectiveness of these methods was different in different nosological forms.

The authors report annual acute leukemia incidence through 1980 to 1995 in Dagestan in respect of implications of of environmental factors. The highest leukemia incidence rate was in the age group over 50 years. Acute leukemia incidence varied with years, sex and territory zones. Active utilization of chemical fertilizers in agriculture proved a contributing factor in the onset of acute leukemia, especially in persons older than 50 years.

The state and tendencies in the development of the epidemiological situation in cholera in the world (1961-1996) are evaluated. As revealed in this investigation, at the modern stage the development of the 7th pandemic characterized by the formation of stable and temporary endemic foci in a number of countries of Asia, Africa, Central and South America and by the import of cholera from these foci to different countries of the world, including the CIS countries and Russia. The "trigger mechanism" of epidemic manifestations in Russia is discussed, in particular the epidemic of 1994 in Dagestan used as an example. Prognostication is made on the basis of the analysis of the epidemiological situation.

Analysis of 724 case histories over many years permitted the author to distinguish the seasonal regularities in the development of various stomatological diseases, differing by the etiology and pathogenesis: furuncles on the face, mandibular fractures, and lymphadenitis of the maxillofacial area and neck. Under the climatic conditions of the town of Derbent a seasonal rise in the incidence of furuncles of the face is observed in July, August, and September, that of mandibular fractures in May, and July, and of lymphadenitis in January, February, July, and August.

The study into the causes underlying nonspecific lymphadenitis (NSL) and adenophlegmons of the maxillofacial region and the neck (AF) revealed a great variety of etiological factors and primary infectious foci in these diseases. Of 204 children admitted to hospital of the city of Derbent, odontogenic genesis of the disease was determined in 27.45% of cases; dermatogenic, stomatogenic in 23.04 and 12.74% of cases, respectively. ENT and systemic diseases were responsible for NSL and AF in 13.23 and 3.43% of cases. The cause remained unclear in 20.09% of patients. NSL and AF occurred most frequently in the coldest (January, February) and the hottest (July, August) months of the year.