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Aim. To identify and systematize the criteria influencing the location of healthcare facilities in small and hard-to-reach areas.Material and methods. Within the study, regulatory legal acts of the Russian Federation and methodological guidelines on territorial planning were analyzed. Content analysis and statistical methods were used.Results. The following criteria for a comprehensive assessment of the location of healthcare facilities should be used: 1. Age structure of the population. 2. Distance to a similar medical organization. 3. Population size within the working radius of the organization. 4. Availability of public roads (criteria and categories of roads). 5. Availability of public transport. 6. Climatic. 7. Availability of medical workers residing in the locality. 8. Availability of mobile medical teams. 9. Dilapidation and breakdown of buildings. Taking into account various criteria affecting the accessibility of primary health care to a patient, it is possible to develop and implement management decisions on the rational placement of healthcare facilities at the regional level with detail for each locality.Conclusion. The use of criteria in territorial planning for a comprehensive assessment of the location of healthcare facilities makes it possible to take into account regional climatic, geographic, infrastructural, social and other features of the Russian constituent entities. This contributes to the implementation of development targets for primary health care in small and hard-to-reach areas.

Aim. To review the current progress in the use of remote health monitoring (RHM) technologies for chronic noncommunicable diseases (CNCD).To search for data, we used Web of Science, Scopus, Russian Science Citation Index, Academic Search Complete (EBSCO), Cochrain, and PubMed databases. The date range was 5–10 years. The importance of development of RHM technologies and their further study was shown to confirm the evidence of effect of certain RHM systems.New approaches to the integration of the medical community into the international telemedicine strategy are considered. It was established that RHM can potentially decrease treatment costs and reduce the burden on medical organizations. The review analyzes the experience in using RHM in patients with cardiovascular diseases, as well as respiratory and endocrine disorders. The review also summarizes and systematizes the findings of studies on assessing the effectiveness of RHM technologies in clinical practice, including their use in the COVID-19 pandemic.It is noted that despite high interest of the scientific community in the study of RHM technologies, unambiguous results demonstrating the effectiveness of such developments in clinical practice have not been presented.

Aim. To summarize the experience of organizing and evaluating the efficiency of the Medical Center for Remote Monitoring of patients with COVID-19 and community-acquired pneumonia in Tomsk.Materials and methods. The project of the Medical Center for Remote Monitoring was developed on the basis of data from theoretical and empirical analyses of the current state of the healthcare system in the Tomsk region and the epidemiological situation with regard to COVID-19. The Center efficiency was assessed based on the analysis of quantitative and time indicators of the load on the emergency medical service and outpatient service. Statistical processing of the results was carried out using the Statistica 12.0 software package.Results. On October 20, 2020, in Tomsk, on the premises of the “Emergency medical unit”, a Medical Center for Remote Monitoring was established. It was aimed at providing remote consultations for patients with COVID-19 and community-acquired pneumonia. According to its algorithm, operators of the Center assessed a patient’s condition on a point scale using standardized speech modules to make a decision on the tactics of their support. During the second wave of COVID-19, when the Center operated, a statistically significant decrease in the load on the ambulance service (average number of calls per day, average waiting time for all calls and coronavirusrelated calls) as well as on the outpatient service (average number of house calls per day, including calls for acute respiratory diseases) was registered.Conclusion. The work of the Medical Center for Remote Monitoring based on the described model is associated with a decrease in the load on the healthcare system in an unfavorable epidemiological situation due to high COVID-19 incidence. This experience can be spread to other regions of Russia and adapted for other categories of citizens.

Aim. To determine the prevalence and structure of risk factors (RF) for chronic noncommunicable diseases (CNCD) medical specialists in the Tomsk Region depending on labor parameters, gender, residence and specialty.Material and methods. As part of the study, specialists filled out questionnaires that included questions related to their labor activity, as well as a questionnaire made up on basis of methodological recommendations “Monitoring of risk factors for chronic noncommunicable diseases in practical healthcare”. The questionnaire was submitted in electronic form and posted on the website http://www.golosaonline.ru/medto.Results. Medical specialists in the Tomsk region revealed a high prevalence of such RFs of CNCD as improper feeding and sedentary lifestyle, as well as overweight. We recorded that these RFs are most common among surgical specialties.Conclusion. The study showed that there is a need for practical recommendations for medical specialists on leveling the individual RFs of CNCD.

There is an increase in the prevalence of chronic, noncommunicable diseases, including allergic and autoimmune diseases in developed countries. In this regard, the study of factors modifying the population’s immune response is very important.According to the “old friends” hypothesis , insufficiency of infectious stimulation and decrease in prevalence of helminthiasis are associated with development of noncommunicable diseases. Studies revealed that intestinal parasites modulate the host immune response and alter susceptibility to immunological diseases. It is suggested that one of the pathogenetic mechanisms of immune response modulation by parasites is an increase in the content of gastrointestinal bacteria with anti-inflammatory effect. Advanced technologies of microorganism identification provide a deep insight into the microbiota in different pathologies. The study of changes in the intestine and bile microbiota of the host in helminthiases provides new possibilities for prevention, diagnosis and control of such conditions as chronic inflammatory bowel diseases and allergic diseases. The purpose of this review is to analyze current experimental and clinical data on intestinal microbiota in helminth infections and possible association with development of chronic noncommunicable diseases.

One of the most significant and urgent targets of modern healthcare is an effective control of chronic non-communicable diseases. These diseases lead not only to premature death, but also to permanent incapacitation and worsening of life quality. Prophylactic measures have proven to be the most effective method for control of chronic non-communicable diseases. However, in addition to well-known prevention tactics: population, high-risk and secondary prevention strategies, there are currently other approaches. The presented review provides a brief comparison of two “classical” prevention strategies. We analyzed the contribution of each of them to world healthcare, and justified the need for a complex approach to prevention. We studied possible transformation of present strategies and considered other promising approaches developed by some authors. Particular attention is paid to assessing the possibilities and feasibility of genetic information using to define the disease risks and personalize medical prevention.

The Declaration on Patient-Oriented Healthcare of theTomsk Region was accepted by the medical and patient communities on August 24, 2018. It was the first document of its kind in Russia. It was created based on several elements: modern international experience in the field of protection of patients’ and medical workers’ rights, particular qualities of Russian legislation, principles of humanistic medicine, and broad analysis of specific complaints from patients of regional public health institutions in the Tomsk region. The reason to create the Declaration was the necessity to build a healthcare system in which both medical staff and patients comply with such principles as mutual respect, choice and responsibility, involvement, accessibility, and openness. The document explains the need for constant adherence to these principles for the effectiveness of treatment, the protection of the individual, professional dignity, and equality.

Objectives. Allergic rhinitis (AR) is highly prevalent all around the world. It adversely affects the quality of life of patients and leads to the development of bronchial asthma, which determines its high socioeconomic burden. International and Russian authorities establish control of the disease as a primary efficacy end point of allergic rhinitis treatment. Nevertheless, there is no international, standardized, validated tool to assess control of allergic rhinitis. In this regard, this review aims to analyze research on the development of such tools and to provide their comparative analysis. Review methods. Using PubMed, Web of science and Russian Citation Index database, we searched from 1991 to 2019 with logical combinations of the following key words: “allergic rhinitis control”, “AR control”, “AR questionnaire”. A total of 96 publications were included in the study. Results. All studies were arranged in chronological order and their main results were described. Questionnaires on the quality of life, tools offered by the clinical guidelines, visual analogue scales, and specialized questionnaires for measuring the control of allergic rhinitis were considered separately. The advantages and disadvantages of these instruments are described. Conclusion. The evidence based on the quality of the tool to support the use of specialized questionnaires was shown. Many disease control scales have been validated, but have some practical disadvantages asprimary efficacy criteria in clinical practice.

Due to increasing needs in new domestic medical drugs and devices, it's becoming very topical to train complex design specialists of clinical trials and medical devices tests. Because of it in this research we surveyed main skills and required competence for such specialists by questioning potential companies-employers. All data we obtained allowed us to make a list of professional activity tasks and/or job functions for «medical writers» that correlates with the needs of companies-employers.

During the analysis of international requirements for designing of clinical trials we found that principal documents are provided by ICH. The main standard in Russian Federation is the National State Standard “Good Clinical Practice”, that is similar to ICH GCP. Thorough industrial standards are issued by global regulators: FDA and EMA. Currently there is absence of local regulatory documents on designing clinical trials in Russia, thus there might be a distinct need in development of national regulatory documents and its harmonization with international standards for pharmaceutical industry.

The definition of safety, tolerability and efficacy of drugs is largely related with the results of clinical trials (CTs). Currently, phase I studies, pharmacokinetics and bioequivalence, conducted with the participation of healthy volunteers, are one of the main ways to registering drugs in our country and in the world. Despite this, the question of perception by the subjects of these types of studies remains open to this day. The purpose of this work was to analyze the formation and priorities of the motivational determinant by evaluating the experience of participation of healthy volunteers in CTs. During the study, the factors influencing the decision to participate in bioequivalence studies were analyzed.

Aim. To determine the frequency and structure of risk factors (RF) for chronic noncommunicable diseases (CNCDs) among physicians in the Tomsk Region.Material and methods. The questionnaire was compiled based on the methodological guidelines “Monitoring of risk factors for chronic noncommunicable diseases in practical healthcare”. The questionnaire was provided in electronic format and posted on the site http://www. golosaonline.ru/medto.Results. Doctors of the Tomsk region revealed a high frequency of such RF for CNCDs as chronic as hypodynamia (45,7%), improper feeding (67,6%) and overweight (34,7%).Conclusion. The study showed that the frequency of RF for CNCDs in a Tomsk region was lower than the same one in general population. However, there is a need to develop practical guidelines for healthcare workers.

Development of the undifferentiated connective tissue dysplasia (UCTD) is influenced by various adverse factors to the fetus during intrauterine growth. There is not a clear linkage to the contribution of the separate factors to the development of the UCTD.Aims of the study are to determine the risk factors associated with the development of the UCTD of the adolescents and to appreciate the predictive value of the examined factors related to UCTD to form the dispensary groups of the children with UCTD.Materials and methods. During the first stage of the study there was an examination of 110 adolescents at the age of 10–14 years old, the UCTD presence was established according to the scale proposed by T.I. Kadurina and V.N. Gorbunova (2009). During the second stage the data of the prenatal casework and maternity hospital records attached to the out-patient medical records were examined to detect the specialties of the antenatal life course. During the third stage 2 groups were formed: with the presence of UCTD (n = 81) and without UCTD (n = 29). The mother groups were formed accordingly with the adolescents groups.Results. The pregnancy of the mothers of the adolescents with UCTD proceeded against the anemia, threatening miscarriage, chronic fetal hypoxia, chronic fetoplacental insufficiency, toxicosis, gestosis, and concomitant chronic conditions (thyroid, kidneys, digestive apparatus, aspiration pathology) more common than the pregnancy of the mothers of the adolescents without UCTD. The binary logistic regression method allowed the predictors of the UCTD’s formation to be determined, there were: toxicosis during the gestation course (OR = 10.9; CI 95% 2.94–40.49), anemia of pregnancy (OR = 8.6; CI 95%: 2.42–30.81), gestosis (OR = 6.53; CI 95%: 1.27–33.71), chronic fetal hypoxia (OR = 4.4; CI 95%: 1.09–17.83) and pre-existing chronic conditions of the mothers (OR = 3.6; CI 95%: 0.86–15.48). Different factor combination enhances the likelihood of the delivery of a child with UCTD more than 6.5-fold: chronic conditions of the mothers and chronic fetal hypoxia (OR = 6.8; CI 95%: 1.95–48.57); anemia of pregnancy and chronic fetal hypoxia (OR = 7.2; CI 95%: 1.01–50.99), and toxicosis (OR = 10.4; CI 95%: 1.48–72.82).Conclusion. The risk factors associated to the development of UCTD in adolescents are: toxicosis during the gestation course, anemia of pregnancy, gestosis, chronic fetal hypoxia and pre-existing chronic conditions of the mothers. The use of the equation of the binary logistic regression allows the prediction of the possibility of the development of UCTD in adolescents at the level of 80.9% and to form the dispensary groups of children in order to prevent the development of dysplastic-dependent pathology

The severity of the disease is the main factor for further treatment. Bronchoobstructive syndrome of children is widespread. Early detection of the disease severity and correct treatment eliminate the clinical manifestation of the syndrome and improve the quality of patients life. Criteria of severity, as a rule, serve a certain set of clinical and paraclinical parameters used for different nosological forms. In particular, the decrease in parameters of the function of external respiration is the “gold standard” for assessing the severity. Lung function tests for preschoolers are limited. Clinical respiratory scales may be useful in the evaluation of preschooler. Alternative assessment respiratory function is sometimes used as clinical scale. Numerous studies devoted to the objective assessment of bronchial obstruction syndrome severity. A scientific literature review is dedicated to the analysis to the assessment of the bronchoobstructive syndrome severity degree and the effectiveness of therapy at preschool-aged children.

In the review, the results provided of clinical and epidemiological trials confirming high prevalence of the risk factors of chronic noncommunicable diseases among medical workers, common comorbidity and hence adverse influence on the health. Analysis of literature data underscores the necessity of further long term populational studies of epidemiology, age range, relation to occupation positions, for the main risk factors. Organization of various preventive events is required, that obviously will impact not only health state and life quality, but furthermore, will increase medical care in general.

Patients’ evaluation of medical care is becoming more and more important due to expanding patient-centered care. For this purpose a complex index of patient satisfaction with healthcare is used. This parameter reflects the correspondence of actual healthcare services to patient’s expectations that were formed under the influence of cultural, social, economic factors, and personal experience of each patient. Satisfaction is a subjective parameter, thus, a grade of satisfaction is barely connected with quality of healthcare services itself. Moreover, medical organizations should always take into account specific features of each patient, since they can have an influence on customer attitude to medical services.This article comprises the review of publications studying determinants of patient satisfaction. In the course of the study, we analyzed data received by research teams from different countries.According to the review, we made some conclusions. First, determinants of patient satisfaction with healthcare can be divided in two groups. The first group of factors includes patients’ characteristics such as age, gender, ethnical and cultural features. However, researches from different countries revealed that there is a difference in the importance of factors belonging to this group and their influence on satisfaction of certain patient cohorts. The second group includes factors that belong to the process of healthcare services delivery and its organization. Moreover, it was found that patient satisfaction level is changing in a waveform. Thus, medical organization should not only try to increase patient satisfaction level but also maintain it. AS a result, it necessary to monitor patient satisfaction with healthcare services. That is why there is a distinct need for the development of a new tool or adaptation of existing instrument of satisfaction measurement, which would be unitized for all medical organizations in the Russian Federation

Background. Improving nursing methods of newborns with birth weight less than 2500 g resulted in an increase in the proportion of children at risk for the development of severe disabling conditions. Objective: Our aim was to investigate the risk factors of the mother, associated with the birth of a child with a birth weight less than 2500 g. Methods. In a retrospective cohort study included 572 children born to 566 mothers in 5 perinatal centers. Risk assessment was carried out taking into account birth weight (in groups of children with normal, low, very low and extremely low birth weight). Results. Sample of mothers (n = 489), whose children had birth weight 2500 g, characterized by a mean age of 31 (26; 35) years, the growth of 164 (159; 168) cm, weighing when registering for pregnancy 62 (53; 74) and 70 kg (60; 80) kg just before birth. Among the independent predictors of birth weight infants were allocated as follows: maternal education (higher/more), mother occupation (housewife/other), presence of chronic diseases, anemia during pregnancy, the threat of premature births, growth and weight of the mother’s body before birth, weight gain body during pregnancy, body mass index (BMI) when registering for antenatal care in pregnancy and before delivery. Conclusion. Identified risk factors for maternal birth weight infants, which can be used to stratify pregnant women at risk.

The purpose of this study is to evaluate the ability of systemic glucocorticosteroids administered during the exacerbation of the disease to have a modifying effect on the qualitative and quantitative composition of the oropharyngeal microbiota.Material and methods. The study included 88 patients with COPD and 50 patients with stable asthma. The patients have had a history of observation for twelve months or more; they are characterized by the absence of exacerbations and systemic antibiotic therapy for four weeks or more prior to inclusion in the study. Also, all patients participating in the study were taken samples of oropharyngeal microbiota for isolating bacterial DNA and sequencing 16S rRNA gene sequences followed by the analysis of the taxonomic composition of the microbiota. Generalized linear model implemented in the R programming language version 3.1.0, glm2 package was used to identify the relationship between taxonomic composition of metagenomes and metadata.Results. The study suggests that the use of systemic glucocorticosteroids administered during the exacerbation of asthma and COPD modifies the composition of the respiratory microbiome in the period of stability increasing the oropharyngeal representation of non-pathogenic bacteria such as Bacteroidetes (including members of the genus Prevotella) and reducing bacterial contamination of oropharyngeal swabs by proteobacteria especially Streptococcus, and Haemophilus, which includes pathogens.

The purpose of this paper is to perform the pilot review of the official medical statistics on reported Opisthorchis felineus (O. felineus) infection and liver and intrahepatic bile duct cancer in Russian Federation, covering the period 2011–2013.Materials and methods. Statistical data collected from 81 regions of Russia, reflecting the incidence of opisthorchiasis over a period from the 1st of January 2011 to the 31st of December 2013 was analyzed. The analysis of official health statistics of malignant hepatic lesions and intrahepatic bile duct was conducted in 82 regions of Russia over the same period. The data was obtained from the annual reports of the Russian center of information technologies and epidemiological studies in the field of oncology.Results. The average annual incidence of O. felineus was 24,7 ± 9,0 cases per 100,000 population. The highest incidence was observed in Khanty-Mansiysk Autonomous Okrug, Yamalo-Nenets Autonomous Okrug, Tyumen Oblast, Tomsk Oblast, Omsk Oblast and Novosibirsk Oblast. We did not observe any significant change in O. felineus infection rates within last 20 years. However, we found that infection incidence had increased in some geographical units of Western Siberia. The incidence of liver and intrahepatic bile duct cancers was 4,8 ± 0,2 cases per 100,000 population; the highest rate was reported in Far East regions, Siberia and Volgograd Oblast. This study documents the importance of opisthorchiasis in certain endemic areas and presents the best available data on associations between O. felineus infection and liver/intrahepatic bile duct cancers in endemic areas of Russian Federation.

Analysis of features of physical and neuro-psychological development of children with low, very low and extremely low birth weight in different age periods is carried out according to cohort studies of newborns with different gestational age and birth weight, presented in electronic databases PubMed and Medscape. It is revealed that the overwhelming number of children with low, very low and extremely low birth weight, gain physical and neuro- psychological development impairments, hearing and vision disorders of varying severity, violation of motor function, intelligence and cognitive skills infringement in an older age. In this regard, it is actual not only to develop new neonatal reanimation and intensive care technologies, but also to ensure adequate prevention of preterm birth in the group of women with a high degree of perinatal risk. All this will further allow preventing increase in children with disabling conditions number among premature infants.

Introduction. Currently, clinical trials (CT) remain the only technology, which provides proof of efficacy and safety of new drugs and their subsequent release to the market. Medical researcher and informed consent (IC) are the main (and often the only) source of information for the patient about the upcoming clinical trials, and thus have a direct impact on the perception of clinical trials, and on the patient’s decision about participation. However, the degree of influence of these factors on the clinical trials participants still remains unclear.Materials and methods. A multicenter cross-sectional study was conducted in different cities of the Russian Federation. Patients who had previous experience in CTs (or were enrolled in a CT at the time of this study) were asked to complete a questionnaire.Results. To assess the impact of researcher, all respondents were divided into 2 groups: patients that acquainted with IC in collaboration with the researcher, and the other group, which reviewed IC form independently. We evaluated the importance of the factors influencing the decision-making process on participation in clinical trials. According to our data, the most important factors were professional monitoring services (3,72 ± 1,00), regular condition monitoring (3,66 ± 0,98), and better medical care (3,62 ± 1,00). These factors were evaluated at significantly lower score by group of patients that acquainted with IC together with the researcher (3,55 ±0,94, vs 4,01 ± 0,90, p = 0,002; 3,52 ± 1,01 vs 3,87 ± 0,90, p = 0,040; 3,49 ± 0,94, vs 3,83 ± 1,06, p = 0,020 respectively). In assessing the factors that had negative impact on the interest in participating in a clinical trial, the most significant were risk of side effects (3,01 ± 1,27), study of new medication (2,68 ± 1,21), and the risk of getting into the placebo group (2,64 ± 1,34) (so-called “objective” risk factors). At the same time, risk of side effects and risk of getting into the placebo group were also assessed at significantly lower score by group of patients that acquainted with IC together with the researcher (2,87 ± 1,28, vs 3,33 ± 1,17, p = 0,024; 2,51 ±1,25, vs 3,03 ± 1,34, p = 0,022 respectively). Furthermore, it was found that in the case of the researcher’s assistance acquaintance time with IC reduced threefold. We also evaluated the effect of the complexity of IC text on the decision-making process on participation in clinical trials. The group of respondents, who rated the IC as easy, appeared to be more interested in the final results of the study.Conclusion. Thus, when assessing the impact of the researcher on the review process of informed consent with the decision to participate in clinical trials, we found that in the case of assistance of the researcher, the acquaintance time with IC is reduced three times. In addition, this group of patients during the conversation with the researcher shows better and more clear understanding of the nature and general methodology of clinical trials, resulting in an adequate assessment “objective” risk factors for participation in clinical trials. Thus, this group of patients is more informed, compared with an “independent” group. According to the study “Face to Face”, we can recommend mandatory participation of a researcher during review process of the IC.

The article is dedicated to the analysis of features of somatic pathology in children with low, very low and extremely low body weight at birth at different ages of life, according to foreign cohort studies of newborns with different gestational age and weight into electronic databases PubMed, Medscape. The results of the study demonstrated the fact that the vast majority of children in the study population are have impaired the physical and neuropsychological development, and associated with prematurity, respiratory, cardiovascular and hematopoietic diseases in older age. In this connection, currently there is a need not only use latest technology of nursing of newborns with a gestational age less than 37 weeks, which increases the survival of low-birth-weight cohort of patients, but also provide full preventive care in women with high perinatal risk and threat of preterm labor, that will prevent in the future the development and progression of disabling diseases in the population of premature infants.

ABSTRACT Aim of the study is to develop the diagnostic checklist based on the incidence and significance analysis of the external features of the dysplasia of the connective tissue (DCT) for its screening and assessment of its prevalence in the adolescents’ population.Materials and methods.110 adolescents (aged from 10 to 14 years) were examined, 81 of them had the dysplasia of the connective tissue (the first group). The second group was presented by 29 adolescents without DCT. The presence and degree of manifestation of DCT were established according to the criterions of Kadurina T. I., Gorbunova V.N. (2009), Т. Milkovska–Dimitrova (1987). There were the physical, laboratory and instrumental examination. Statistical processing of the results was carried out using Statistica 6.0 program and IBM SPSS Statistics 20.0. The diagnostic efficiency of the developed checklist was appreciated by means of the receiver operating characteristic curve (ROC curve). Results. The frequent occurrence of the DCT’s external features in adolescents was identified. The diagnostic checklist was developed. It was consisted of 12 items with illustrations, allowing readily identification of the dysplastic phenotype presence with diagnostic sensitivity 81.5% and specificity 79.3%. This checklist can be recommended as for the population studies, as for screening about DCT in adolescents during the primary outpatient pediatrician attendance. In the positive result of the screening it is necessary the further checkup to detect the organ changes and diagnosis updating.

The review focuses on the results of epidemiological and clinical trials, which witness high prevalence of risk factors for chronic noncommunicable diseases in student population, their common combination and potentiating negative impact on the health and academic success of students. The results of literature data analysis underlies an aim for further long-term population epidemiologic studies, trends and age tracking of the main risk factors for chronic noncommunicable diseases in student population, with properly organized interinstitutional system of medical-social follow-up of the studying and research for differentiated prevention technologies.

Despite modern achievements in child allergology, the question of evaluating tolerance formation and defining the safest time for expanding the child’s ration after an eliminatory diet remains open. This article contains the results of the authors’ own investigation concerning the practical meaning of specific immunoglobulins (sIg) class G4 as tolerance formation markers at food allergies in children. Thus, it has been found that high levels of sIgG4 are not only a favourable prognostic factor for light manifestations of food allergy, but also an index of a tolerance formation. The prevalence of high food allergy sIgG4 was statistically significantly higher in early age children from the comparison group than in patients with food allergy. Thus the authors suggest that the production of sIgG4 is a normal physiological process which hinders the development of hypersensitivity, while high levels of sIgG4 are evidence for the child’s immune system “contacting” this or that product. Clinical tolerance formation predictors define lighter clinical manifestations of food allergies, a non IgE-mediated form of food allergy and the retention of breastfeeding.

The DALY indicator (Disability Adjusted Life Years) is widely used for the assessment of a contribution of various diseases to losses of the population health and of the analysis of activity efficiency of health care systems. Background: Research objective was to evaluate dynamics of the DALY indicator as a result of premature mortality of the child population of Tomsk region during 2008-2012. Patients and methods: DALY calculation as a result of premature mortality of the child population of the region during the period from 2008 to 2012 is made. While calculating the data of Territorial body of Federal service of state statistics for the Tomsk Region (Rosstat) which included a sex of the dead, day, month and year of death, place of residence, cause of death, day, month and year of birth of the dead was used. The number and gender and age structure of the population of the Tomsk Region according to Rosstat data were also considered. Results: The DALY decrease by 16,5% in child population at the age of 0–17 years is observed in the Tomsk region during the period from 2008 to 2012. Following the results of 2012, DALY in studied population made 833.1 (82.3 ± 5.4) years for 10 thousand of corresponding population that is 1,1 times lower than totally in the Russian Federation, and 3.4 times lower than the universal indicator of 2010. Conclusion: The received result reflects the activity of health care system of the region, directed on integration of synthesis of theoretical and practical knowledge. Decrease in DALY among the child population in the territory of the region is promoted by a number of factors: continuous quality improvement of the medical care rendered to children, target programs on motherhood and childhood health protection realized in the territory of the region, and also functioning of the federal scientific and educational institutions promoting introduction of modern techniques of medical care delivery in practical health care.Key words: demography, DALY, health assessment of the child population.

Study of sensitization spread is crucial to the understanding of formation mechanisms of allergic diseases symptoms and development of prevention programs. However, this parameter has been studied very insufficiently in Russia. The aim of this trial is to study spread of sensitization to allergens and skin sensitivity to histamine in the populations of urban and rural schoolchildren using the method of skin prick test. Methods: the authors examined 2,290 urban and rural schoolchildren (1-11 grades). Mixed allergens of house dust mites, cockroach, fish, birch pollen, mixed weeds and cat hair were used for the allergy test. Results: the authors revealed spread of sensitization to various allergens in various age-sex groups of urban and rural schoolchildren in Tomsk Region. Conclusion: the trial revealed that sensitization spread and skin sensitivity to histamine was higher in urban schoolchildren than in their rural peers (p

Primary prevention of allergy is an attractive aim due to high social, economic burden and increasing prevalence of allergic diseases. The up-to-date data strongly support the use of partially hydrolyzed whey formula for primary prevention of atopic dermatitis. This approach is effective and cost-saving both from societal and governmental health service perspectives. Pediatricians as well as parents of high risk children should be strictly aware of these data. Because of cost-saving effect of partially hydrolyzed whey formula governmental health service administrations should develop programs for primary prevention of atopic dermatitis with free supply of high risk children with this nutrition for first months of life.