Экономический ущерб от болезней органов дыхания и хронической обструктивной болезни легких в Российской Федерации в 2016 году

The aim of this study was to evaluate economic burden of respiratory diseases and chronic obstructive pulmonary disease (COPD) in Russian Federation (RF) in 2016 including direct costs and economic losses caused by decreased labor efficiency. Methods. The analysis included direct cost, such as healthcare expenses and disablement payout, and economic losses due to decreased labor efficiency by the reason of morbidity and premature mortality. Data of Federal State Statistics Service, annual State Statistical Reports, the State Guarantee Program of Free Medical Care for Citizens of Russian Federation, and statistical data on respiratory diseases and COPD were used. Costs of medical care (ambulatory, hospital, and emergency care) were calculated based on compulsory health insurance tariffs. The amount of disability benefits payments was calculated based on number of disabled persons in each group and the size of the disability benefit. Indirect costs (or economic losses) included losses from non-produced products due to premature mortality and disability of working-aged adults. Results. In 2016, there were 623,000 years of potential life lost (YPLL) due to respiratory diseases, mainly in males. Of this, 35% of deaths and 22% of YPLL were related to COPD. Healthcare costs for COPD treatment included hospital care costs (83.9%), ambulatory care costs (11.1%) and emergency care costs (5%). In 2016, the economic burden of COPD in Russian Federation reached 170.3 billion ₽, or 18.8% of all losses and expenditures from respiratory diseases. This is 0.2% of the gross domestic product (GDP) in the same year. Conclusion. The economic burden of COPD in Russia in 2016 was 170.3 billion ₽, or 0.2% of GDP. The burden of COPD predominantly consisted of economic losses caused by premature mortality of working-aged subjects. These data suggest that priority should be given to measures aimed at preventing the occurrence and slowing down the progression of this disease, probably by increase the investment in the prevention and treatment of COPD. Such measures could reduce clinical and economic consequences of COPD.Целью данного исследования явилась оценка экономического ущерба от болезней органов дыхания (БОД) и хронической обструктивной болезни легких (ХОБЛ) в Российской Федерации (2016), включая прямые затраты системы здравоохранения и непрямые потери в экономике, обусловленные снижением производительности труда. Материалы и методы. В анализ включены данные о прямых затратах (системы здравоохранения и выплаты по инвалидности) и потерях в экономике вследствие снижения производительности труда, обусловленного заболеваемостью и преждевременной смертью. В работе проанализированы показатели Федеральной службы государственной статистики, данные годовых форм федерального статистического наблюдения (формы 14, 141, 12 и 16-ВН), Программы государственных гарантий бесплатного оказания гражданам медицинской помощи (МП), статистические данные по БОД и ХОБЛ. Затраты на оказание всех видов МП (амбулаторной, стационарной, скорой МП – СМП) рассчитывались на основании тарифов обязательного медицинского страхования. Объем выплат пособий по инвалидности рассчитывался по числу инвалидов каждой группы и величине пособия по инвалидности. Непрямые затраты (экономические потери) включали потери от непроизведенной продукции вследствие преждевременной смерти и инвалидности в экономически активном возрасте. Результаты. Число потерянных лет потенциальной жизни (ПГПЖ) вследствие БОД в экономически активном возрасте (2016) составило 623 тыс., преимущественно за счет мужчин, при этом 35 % смертей и 22 % ПГПЖ обусловлены ХОБЛ. В структуре прямых медицинских затрат здравоохранения на лечение ХОБЛ преобладают затраты на стационарную МП (83,9 %), на амбулаторно-поликлиническое обслуживание приходится 11,1 %, на СМП – 5 %. Экономическое бремя ХОБЛ в Российской Федерации (2016) составило 170,3 млрд руб. (18,8 % всех потерь и затрат от БОД), что эквивалентно 0,2 % валового внутреннего продукта (ВВП) за этот год. Заключение. Экономический ущерб от ХОБЛ в Российской Федерации (2016) составил 170,3 млрд руб. (0,2 % ВВП). В структуре основного ущерба превалируют непрямые потери в экономике, обусловленные преждевременной смертью лиц экономически активного возраста. Эти данные свидетельствуют о том, что первоочередное внимание должно быть уделено мерам, направленным на предотвращение развития заболевания и замедление его прогрессирования с целью облегчения клинических и экономических последствий ХОБЛ путем увеличения инвестиций в профилактику и лечение

Children’s exposure to television advertising of unhealthy foods and beverages across four countries of WHO European Region

Abstract Objective: To compare the frequency and healthfulness of foods being advertised to children and adolescents in four countries of WHO European region. Design: Cross-sectional quantitative study, guided by an adapted version of the WHO protocol. All recorded food advertisements were categorised by categories and as either ‘permitted’ or ‘not permitted’ for advertising to children in accordance with WHO Regional Office for Europe Nutrient Profile Model. Settings: Four countries: Russia, Turkey, Kazakhstan and Kyrgyzstan Participants: TV channels most popular among children and adolescents Results: Analysis included 70 d of TV broadcasting for all channels, during which time there were 28 399 advertisements. The mean number of advertisements per hour varied from eleven in Turkey and Kazakhstan to eight and two in Russia and Kyrgyzstan. In all countries, the majority of the food and beverages advertised should not be permitted for advertising to children according to the WHO Nutrient Profile Model. The mean number of non-permitted food and beverage advertisements per hour was high in Turkey and Kazakhstan (8·8 and 8·5 ads) compared with Russia (5·1) and Kyrgyzstan (1·9). Turkey was the only country where nutritional information was fully available, and no values were missing that prevented coding for some product categories. Conclusions: Results revealed that children and adolescents in four countries are exposed to a considerable volume of food and beverage advertisements, including sugary products on broadcast television. As such, policymakers should consider protecting youth by developing regulations to restrict these marketing activities within media popular with children

Children’s exposure to television advertising of unhealthy foods and beverages across four countries of WHO European Region

Abstract Objective: To compare the frequency and healthfulness of foods being advertised to children and adolescents in four countries of WHO European region. Design: Cross-sectional quantitative study, guided by an adapted version of the WHO protocol. All recorded food advertisements were categorised by categories and as either ‘permitted’ or ‘not permitted’ for advertising to children in accordance with WHO Regional Office for Europe Nutrient Profile Model. Settings: Four countries: Russia, Turkey, Kazakhstan and Kyrgyzstan Participants: TV channels most popular among children and adolescents Results: Analysis included 70 d of TV broadcasting for all channels, during which time there were 28 399 advertisements. The mean number of advertisements per hour varied from eleven in Turkey and Kazakhstan to eight and two in Russia and Kyrgyzstan. In all countries, the majority of the food and beverages advertised should not be permitted for advertising to children according to the WHO Nutrient Profile Model. The mean number of non-permitted food and beverage advertisements per hour was high in Turkey and Kazakhstan (8·8 and 8·5 ads) compared with Russia (5·1) and Kyrgyzstan (1·9). Turkey was the only country where nutritional information was fully available, and no values were missing that prevented coding for some product categories. Conclusions: Results revealed that children and adolescents in four countries are exposed to a considerable volume of food and beverage advertisements, including sugary products on broadcast television. As such, policymakers should consider protecting youth by developing regulations to restrict these marketing activities within media popular with children. </jats:sec

Identification of Novel Candidate Markers of Type 2 Diabetes and Obesity in Russia by Exome Sequencing with a Limited Sample Size

Type 2 diabetes (T2D) and obesity are common chronic disorders with multifactorial etiology. In our study, we performed an exome sequencing analysis of 110 patients of Russian ethnicity together with a multi-perspective approach based on biologically meaningful filtering criteria to detect novel candidate variants and loci for T2D and obesity. We have identified several known single nucleotide polymorphisms (SNPs) as markers for obesity (rs11960429), T2D (rs9379084, rs1126930), and body mass index (BMI) (rs11553746, rs1956549 and rs7195386) (p &lt; 0.05). We show that a method based on scoring of case-specific variants together with selection of protein-altering variants can allow for the interrogation of novel and known candidate markers of T2D and obesity in small samples. Using this method, we identified rs328 in LPL (p = 0.023), rs11863726 in HBQ1 (p = 8 &times; 10&minus;5), rs112984085 in VAV3 (p = 4.8 &times; 10&minus;4) for T2D and obesity, rs6271 in DBH (p = 0.043), rs62618693 in QSER1 (p = 0.021), rs61758785 in RAD51B (p = 1.7 &times; 10&minus;4), rs34042554 in PCDHA1 (p = 1 &times; 10&minus;4), and rs144183813 in PLEKHA5 (p = 1.7 &times; 10&minus;4) for obesity; and rs9379084 in RREB1 (p = 0.042), rs2233984 in C6orf15 (p = 0.030), rs61737764 in ITGB6 (p = 0.035), rs17801742 in COL2A1 (p = 8.5 &times; 10&minus;5), and rs685523 in ADAMTS13 (p = 1 &times; 10&minus;6) for T2D as important susceptibility loci in Russian population. Our results demonstrate the effectiveness of whole exome sequencing (WES) technologies for searching for novel markers of multifactorial diseases in cohorts of limited size in poorly studied populations

СИМПТОМ «БУС» У ПАЦИЕНТКИ С ВАЗОРЕНАЛЬНОЙ ГИПЕРТЕНЗИЕЙ (КЛИНИЧЕСКИЙ СЛУЧАЙ)

HighlightsFibromuscular dysplasia (FMD) is an idiopathic, non-atherosclerotic muscular layer artery lesion predominantly affecting the carotid and renal arteries. This pathology is quite rare in the general population and is most often diagnosed in women. In this article, on the example of a clinical case, up-to-date information is presented regarding the features of the clinical picture, diagnostic and therapeutic algorithms in patients with FMD, which may be useful for physicians of different specialties. AbstractArterial hypertension in young people is most common cause of another disease. The task of the physician who encounters such a patient is to make up a specific plan for further action.Despite the low fibromuscular dysplasia incidence in the population, this disease is relevant for differential diagnosis in young patients with arterial hypertension. The presented clinical case clearly shows that a timely diagnosis and timely treatment can help to prevent the development of complications and improve the patient's quality of life.Основные положенияФиброзно-мышечная дисплазия – идиопатическое неатеросклеротическое заболевание мышечного аппарата артериальной стенки, поражающее преимущественно сонные и почечные артерии. Данная патология в общей популяции встречается редко и чаще диагностируется у женщин. В представленном клиническом случае описаны особенности клинической картины, диагностического и лечебного алгоритмов у пациентов с ФМД, что может представлять интерес для врачей разных специальностей. РезюмеАртериальная гипертензия у молодых людей чаще всего носит вторичный характер. В задачи врача, который сталкивается с такими пациентами, входит составление четкого плана дальнейших действий. Несмотря на невысокую частоту встречаемости фиброзно-мышечной дисплазии в популяции, данное заболевание актуально при проведении дифференциальной диагностики у молодых больных артериальной гипертензией. Представленный клинический случай наглядно показывает, что вовремя поставленный диагноз и своевременно начатое лечение могут предотвратить развитие осложнений и улучшить качество жизни пациентов

Вопросник для первичной самооценки здоровья пациентов, перенесших новую коронавирусную инфекцию: Рекомендации Междисциплинарного совета экспертов по проведению скрининга симптомов постковидного периода при углубленной диспансеризации

The post-COVID symptom complex is wide enough and requires special vigilance during clinical examination of patients after the novel coronavirus infection. The aim of the Multidisciplinary Expert Board study was to develop a standardized questionnaire for initial self-assessment by patients who had had COVID-19 before the expanded medical check-up.Methods. The existing validated international and national questionnaires and scales were analyzed to assess their relevance, convenience, and ease of filling out. Results of the analysis were used to set up a screening for post-COVID symptoms.Results. The work of the Multidisciplinary Expert Board in June-August 2021 resulted in a new screening questionnaire for the initial assessment of the health status of patients who have COVID-19. The questionnaire is intended for self-filling before the further clinical examination.Conclusion. A new standardized patient questionnaire to screen for post-COVID symptoms may significantly optimize the doctor’s working time, increase the efficiency of diagnosis, improve the principles of selection and formation of risk groups of patients during an expanded medical check-up.Симптомокомплекс нарушений постковидного периода достаточно широк и требует специальной настороженности врача при проведении диспансеризации пациентов, перенесших новую коронавирусную инфекцию.Целью работы Междисциплинарного Совета экспертов явилась разработка унифицированного вопросника для самостоятельного заполнения пациентом при подготовке к углубленной диспансеризации после перенесенного COVID-19.Материалы и методы. Проведен анализ существующих международных и отечественных анкет и шкал с целью оценки их релевантности, удобства и простоты заполнения для возможного скрининга расстройств постковидного периода. Результаты. Итогом работы Междисциплинарного Совета Экспертов в июне-августе 2021 г. явилось создание нового скрининг-вопросника по первичной оценке состояния здоровья пациентов, перенесших COVID-19, предназначенного для самостоятельного заполнения ими при подготовке к углубленной диспансеризации.Заключение. Создание унифицированного вопросника пациента при скрининге постковидных нарушений позволит существенно оптимизировать рабочее время врача, повысить эффективность диагностики заболеваний, совершенствовать принципы отбора и формирования групп риска пациентов при углубленной диспансеризации

Modern content and improvement of high cardiovascular risk strategy in reducing mortality from cardiovascular diseases

The article describes the modern content of the high-risk strategy, which, along with the population strategy, forms the basis of a set of measures to reduce mortality from cardiovascular diseases. The high cardiovascular risk strategy is carried out at the individual level in outpatient structures as a part of primary and secondary prevention of cardiovascular diseases, and is also implemented in hospitals when performing elective surgical procedures, including high-tech interventions. Improving this strategy within the framework of primary health care involves the development of a system of high-risk offices, telemedicine consulting, remote monitoring of physiological parameters on the basis of a regional medical information system, and in the future, on the basis of a uniform vertically integrated medical information system. The development of the high-risk strategy as a part of inpatient practice occurs through the further replication of high technologies and the implementation of new types of them

Gender, Age, Family and Territorial Features of Dietary and Physical Activity Patterns in Russian Youths

Objective: Identifying dietary and physical activity (PA) patterns in Russian youths and examining their dependence on gender, age, family characteristics and area of residence features. The research involved 783 school students 10&ndash;17 years of age and their parents living in the cities of Moscow and Murmansk. Using the principal component analysis, four integral indices were identified that characterized the habits and dietary patterns, PA and lifestyle. Boys, compared with girls, were more likely to consume unhealthy foods but less likely to practice malnutrition. Within the age ranges of 13&ndash;15 years old and 16&ndash;17 years old, the proportions of school students with a poor sleep pattern and low PA were higher than in children 10&ndash;12 years of age. In smoking families, children were less likely to consume healthy foods and more likely to eat unhealthy foods. In Murmansk school students, compared with their Moscow peers, a reduction in both sleep time and PA was observed less often. Our study demonstrated that the most significant factors of a balanced and healthy diet, rational daily routine and lifestyle in school students were their gender and age characteristics, as well as some contextual factors

Regional Living Conditions and Individual Dietary Characteristics of the Russian Population

The goal of our study was to examine the effects of the regional characteristics of the living environment on individual a priori and a posteriori dietary patterns of the Russian population. For the analysis, we used cross-sectional data from the Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation study from 2013–2014. The sample included 18,054 men and women 25–64 years of age from 12 regions. Based on the frequency of consumption of basic foods, four a posteriori empirical dietary patterns (EDPs), along with an a priori cardioprotective dietary pattern (CPDP), were identified. To describe the regional living environment, five regional indices were used. Adherence to the meat-based EDP was directly associated with deterioration of social living conditions and a more northerly location for the region of residence. The probability of a CPDP increased with greater deterioration of social living conditions, aggravation of demographic crises, and higher industrial development in the region, as well as with declines in the economic development of the region, income, and economic inequality among the population. We detected several gender-dependent differences in the associations established. The patterns revealed reflect the national dietary preferences of Russians, and the regional indices characterize the effect of the living environment

Expert council resolution on regional program of early T2D detection, prevention and treatment in Russian Federation

Type 2 diabetes prevalence is growing in Russia and worldwide. To date disease is considered as the leading cause ofmortality in many countries. To date, there is a need to develop integrated program of type 2 diabetes and prediabetes early detection and care. Within Advisory council experts developed recommendations regarding program plan including activities on type 2 diabetes early screening, prevention and care. The Public Screening Program for Adult Population is currently being implemented in Russia and should be considered as a background for activities on type 2 diabetes early prevention