The history of the F. Erisman Institute of Public Health and its directions of activity during the COVID-19 pandemic

In 2020, exactly 90 years have passed since the first sanitary faculty in the history of medical education (F. ErismannInstitute of Public Health, nowadays) was found in the 1st Moscow Medical Institute (Sechenov University, nowadays).The history of the faculty unites the names of prominent scientists in the field of preventive medicine: F. Erismann, N.A. Semashko, A.V. Molkov, A.N. Sysin, E.M. Tareev and many, many others. New challenges to public health continueto appear in our time. The direction of “preventive medicine” has become more important than ever in the context of a pandemic of infection caused by the novel coronavirus (COronaVIrus Disease-19, COVID-19). The issues of epidemiologyand hygiene have become extremely relevant for doctors of any profile, not only for preventive ones (epidemiologists and hygienists). The strategic task today is to increase the “preventive medicine” specialty’s authority. It is also important to preserve and enhance the domestic experience of studying the disciplines of preventive medicine, harmonizing the content of educational programs with the world community. Research work at the Institute is carried out in 4 main areas of preventive medicine and public health: epidemiology, public health, microbiology, and hygiene.This review presents the main historical milestones in the development of teaching the specialty “preventive medicine” at the Sechenov University, the current state, and prospects for further development.

Organizational aspects of vaccination against a new coronavirus infection

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Historical aspects of the medical education system transformation

The history of medical and pharmaceutical education development is part of the social history. The quality of medical personnel training determines the efficiency of the entire health care system and has been a priority area of development throughout the history of the Russian state. The paper reflects the main stages of the medical education system development in the period from the 17th century to the present. The training of medical personnel in Russia began in the second half of the 17th century, when, under the Pharmaceutical Order, a medical school was established in 1654to train doctors for the needs of the army.The need to provide qualified medical personnel remains relevant, both in wartime and in peacetime. The reforms of medical education that have been taking place over the centuries make it possible to diversify educational programs, as well as the to introduce new educational technologies, considering modern requirements and global trends. The study of the historical aspects of domestic medicine determines a more competent approach to the development of the health care system and medical education.

Features of hospitalization of patients in the trauma and orthopedic center in the context of the second wave of the COVID-19 pandemic

The algorithm for examining patients for SARS-CoV-2 during admission to non-infectious hospitals, a unified route scheme for patients taking into account the potential infectious hazard is not regulated.The aim of the study is to identify the features of the diagnosis of SARS-CoV-2 during planned hospitalization in the field of “traumatology and orthopedics”; to present schemes for examining patients for SARS-CoV-2 during hospitalization and patient routing in the clinic.Materials and methods. The route and procedure of examination to exclude the nosocomial spread of COVID-19 in patients hospitalized for three months is described. 3366 survey results were analyzed.Results. Positive PCR tests for COVID-19 before hospitalization were obtained in 4.5 % of patients. High titers of IgM are found in 7.8 % of cases. At the level of the Pass Office, 10.5 % of arrivals were denied hospitalization. The CT scan of the chest organs, which was then carried out, revealed among the examined 9.1 % of asymptomatic pneumonia, of which 93.5 % – with radiological signs of COVID-19, 2/3 of “covid” pneumonia – with a CT-0 degree. Another part of hospitalizations was postponed due to somatic contraindications during clinical examination. After all the selection stages, 73.2 % of planned hospitalizations ended up. In the hospital, 12 cases of COVID-19 were detected in the postoperative period, more often on the 4th day after the operation. A total of 2,328 patients were discharged during the study period – 69.2 % of planned hospitalizations, a third of patients received a medical withdrawal from hospitalization due to COVID-19.Conclusions. The peculiarities of admitting patients to planned hospitalization in the traumatology and orthopedics profile is the difficulty of reliably detecting COVID-19 in a limited time. In some cases of asymptomatic course, the disease is detected only with the help of CT diagnostics. In 0.5 % of cases, COVID-19 is detected in the postoperative period. The described patient routing scheme, multistage diagnostics to exclude COVID-19 are able to ensure maximum infectious safety of patients and staff in the clinic.

Medical education in Russia: vectors of reboot in pandemic conditions

The pandemic of the new coronavirus infection, determined, the need for accelerated transformations in the fi of national health, as well as a change in the usual principles and approaches in the system of higher medical education. The article, using the example of the Sechenov University case as the flagship of higher medical education in the country, analyzes the experience of operational restructuring of the organization of the university’s activities and highlights the key vectors of the educational process reorganization and training of medical personnel in the context of the spread of COVID-19.Sechenov University, based on the existing digital content modified the lecture materials into a digital format, adapted individual distance learning algorithms to the educational process of a medical university. The result is the preservation of the quality of education, the adaptation of educational programs, taking into account new formats and technologies for the delivery of knowledge, a flexible response to the demands of consumers of educational services of the University.

Causes of death in patients with tuberculosis and human immunodeficiency virus co-infection

Objectives. The aim of the study was to investigate the cause of death of tuberculosis patients infected with the human immunodeficiency virus (HIV). Many researchers and experts note the urgency of the problem of tuberculosis combined with HIV infection in the world and in Russia. One of the main criteria for assessing the effectiveness of medical care for tuberculosis patients infected with the human immunodeficiency virus is the mortality rate.Materials and methods. For a detailed study of the causes of death of patients with tuberculosis in combination with HIV infection, we analyzed the causes of death of this contingent of patients in 5 regions of the Russian Federation.Results. The social characteristics of patients, the forms and course of the disease, the main and immediate causes of death of 223 patients with co-infection with HIV and tuberculosis were studied.Conclusion. Half of the deaths of tuberculosis patients infected with human im­munodeficiency virus were not associated with tuberculosis. Among these cases, there was either the presence of several infections at the same time, equally leading to death, or separate opportunistic infections (candidiasis, Pneumocystis pneumonia, toxoplasmosis), or cancer. In addition, the lifestyle of patients often became the cause of deaths, namely: drug poisoning and accidents, or cirrhosis of the liver, which develops as a result of alcoholism or hepatitis C infection which occurred during intravenous administration of drugs.

COVID-19 pandemic in Russia: medical and social problems of the digital educational environment

In connection with the epidemic of a novel coronavirus infection, all schools in the Russian Federation in the spring of 2020 were forced to switch to remote work.Aim. To analyze key publications on: the organization of the educational process in the context of distance learning; life and well-being of participants in the educational process in conditions of lockdown; medical and social approaches to reduce the negative consequences of lockdown for children and adolescents during distance learning. Materials and methods. The analysis of domestic and international scientific publications and recommendations found using the search engines Scopus, Pubmed, the Russian Science Citation Index and by manual search on the resources of WHO, UNICEF, UNESCO and CDC (Centers for Disease Control and Prevention).Results. The closure of educational institutions is a risk of reducing the quality of education. In 2020, with the closure of Russian schools, the educational process was not stopped due to distance learning using digital technologies. The article examines the history of the emergence of online distance learning, presents the results of research carried out by scientific organizations and universities in order to study the features of the organization of the educational process in conditions of distance learning, the life of participants in the educational process in schools, and their well-being in lockdown. To reduce the negative consequences of lockdown on children and adolescents and distance learning, medical and social approaches have been analyzed and substantiated.Conclusion. The solution of problems related to distance education can be realized in the course of scientific and methodological support and examination of the experiment on the implementation in 14 constituent entities of the Russian Federation of the target model of the digital educational environment in the field of general and secondary vocational education, planned in Russia in 2020–2022. For this, the Russian Academy of Sciences, represented by the Department of Medical Sciences and the Section of Preventive Medicine, the Ministry of Health of Russia, and Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) have to be participants.

Methods and problems of the nosological analysis of mortality in the period of COVID-19 pandemic

The article discusses different approaches to assessing mortality during the COVID-19 pandemic. The analysis of inter­national data shows that different countries use different approaches to assessing mortality from COVID-19 and the increase in mortality from all causes. The most probable reasons for the variability of the increase in mortality rates are the rate of spread of infection, the quality of isolation and quarantine measures, the commitment of the population to their implementation, the resource capacity of the healthcare system and the quality of medical care (both for the treatment of COVID-19 and other diseases), features of living conditions, socio-economic and political processes that are difficult to formalize (and therefore assess the contribution by methods of mathematical statistics). For a correct comparison of excess mortality rates, it will be necessary to calculate standardized indicators and compare data in five-year age groups.In 2021, serious problems should be expected with the comparison of mortality rates in different countries from individual causes. The methodology for recording deaths from COVID-19 and other causes is not uniform at the global level, prob­lems are associated with differences in approaches to determining the primary cause of death, difficulties in determining the cause of death if a patient has multimorbid pathology (especially without postmortem examination). A full-fledged analysis is possible only with transdisciplinary cooperation under the auspices of the WHO of doctors, mathematicians, economists, and information technology specialists.