Bulletin of Semashko National Research Institute of Public Health
Semashko National Research Institute of Public Health publishes the Scientific Journal «Bulletin of Semashko National Research Institute of Public Health»
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Effectiveness of clinical and economic aspects of remote monitoring in patients with diabetes mellitus
Aim: to conduct an assessment of cost-effectiveness of remote monitoring (RM) compared to routine practice (control) in adult patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) on non-insulin therapy, and T2DM on a basal-bolus insulin therapy, based on the results of a multicenter clinical trial (CT) conducted in 2023—2024 in 7 regions of the Russian Federation. Materials and methods: the study consisted of a cost-utility analysis, which included an effectiveness analysis aimed at identifying the effectiveness criterion, the number of years of quality life, as well as an analysis of costs that reflect the current practice of providing medical care to patients with diabetes. Results: according to the results of the cost-effectiveness analysis, which was based on data from a multicenter CT, the cost of an additional year of life adjusted for quality (incremental cost-utility ratio) in adult patients with diabetes mellitus was -96,990,771.23 rubles for RM compared to control with T1DM, and 15,229,158.30 rubles for T2DM on non-insulin therapy. The cost of an added year of life adjusted for quality when using RM in adult patients with T2DM on a basal-bolus insulin regimen was 688,092.98 rubles, which is below the willingness-to-pay threshold (3,530,062.10 rubles in 2024). Conclusion: the results of the clinical and economic evaluation demonstrate the economic feasibility of using RM in patients with T2DM on a basal-bolus insulin regimen.
Copyright (c) 1970 ФГБНУ Национальный НИИ Общественного здоровья имени Н.А. Семашко https://creativecommons.org/licenses/by-nc-nd/4.0
International Classifiers of Medical Interventions and the Formation of a National Classification System in the Healthcare of the Kyrgyz Republic
In modern healthcare, the effective collection, systematization, and analysis of medical data depend on the quality-of-service standardization and classification. International and national healthcare initiatives aim to create a universal «language» for global data compatibility and to support management decisions. The creation of a national classifier for medical services in the Kyrgyz Republic became critical due to the need for a flexible healthcare financing system. The existing classifier for surgical interventions, in use since 1997, was outdated, and no such system existed for therapeutic services, which complicated accurate accounting and funding. This study used a comprehensive approach, including documentary, normative-comparative, and content analysis of international classifiers and national regulatory documents. The Kyrgyz Republic's Healthcare Services Classifier, approved in 2021, is the first unified national tool, covering 3363 surgical (sections A, B, C) and 1996 non-surgical (sections P, D, L, T, R) medical service codes. The classifier is based on a nosological principle, using a 6-digit alphanumeric code with a three-level hierarchy, balancing detail with ease of application. A key advantage is its adaptation to the country's legal, organizational, and economic realities, including cost reimbursement. Its implementation has filled significant gaps in healthcare accounting, providing a reliable basis for fair tariff setting, flexible financing, effective planning, and the further development of digital healthcare.
Characteristics of the dynamics of primary disability in the working-age population in the Arkhangelsk region from 2019–2023
The article presents a comprehensive analysis of primary disability rates among the working-age population of the Arkhangelsk Region. All cases of primary disability were analyzed from the database of the Federal State Institution Medico-social expertise center for the Arkhangelsk Region and the Nenets Autonomous Okrug of the Ministry of Labor of the Russian Federation. It was found that during the study period, there was no trend towards a decrease or increase in disability rates among the working-age population of the Region, and the average rate decreased by 0.7%. In the structure of primary disability, the most numerous group was made up of persons with the third disability group (least severe), accounting for up to 52.3%; men accounted for 65.9% of all persons initially recognized as disabled. Men also have a higher incidence of the first disability group (most severe) than women. The distribution of disability by group did not change significantly during the period under review. Cancer (31.1%) and circulatory system diseases (21.6%) are the leading causes of disability among the working-age population. There is also an increase in the proportion of diseases of the musculoskeletal system and connective tissue (by 4.0% over 5 years). The analysis of the information obtained allows us to clarify the scope of preventive measures, early diagnosis of diseases, and comprehensive rehabilitation programs aimed at improving the quality of life for people with disabilities and preserving their labor potential. The results of this study can serve as a basis for improving regional health policies and the medical and social examination system.
A multidisciplinary approach to diagnosing reproductive system tumors as a basis for preventing losses of society's reproductive potential: current state and prospects
The treatment of malignant neoplasms is a leading issue in global medicine. Early detection of malignant neoplasms and precancerous conditions, ensured through timely and comprehensive screening and preventive examinations, is the key to successful treatment. An analysis of the existing regulatory framework in the Russian Federation revealed inconsistencies and contradictions in certain provisions related to the lack of standardization and disparate locations for conducting necessary examinations in various regulatory acts governing preventive, screening, and routine examinations of women aimed at the prevention and early detection of malignant neoplasms of the female reproductive system, which hinders the proper implementation of these examinations. This problem can be overcome by standardizing the proposed treatment and diagnostic solutions across all existing regulatory acts, as well as revising organizational approaches in favor of conducting comprehensive diagnostic examinations aimed at the early detection and prevention of malignant neoplasms in women within a single, geographically designated structural unit of a medical organization with all the necessary logistical and personnel resources. Implementing the approach of concentrating all necessary examinations in a single location will clearly improve the accessibility of medical care, increase patient adherence to prevention and treatment, and enhance the likelihood of early detection and treatment success. This will undoubtedly improve the quality of treatment and preventive measures and lead to the preservation of women's reproductive health. Improving the organization of medical care and legal support for the prevention of gynecological oncological diseases is of high social significance, due to their inclusion among the key medical causes of reproductive health losses.
Possibilities of telemedicine application in otorhinolaryngology. Expert interview
Telemedicine in outpatient otorhinolaryngology is actively developing; however, its boundaries of application remain insufficiently defined. Criteria for patient selection, the safety of remote monitoring, and the role of telemedicine in initial consultations are still underexplored. The aim of this study was to examine the opinions of practicing otorhinolaryngologists regarding the use of telemedicine in their work and to compare these opinions with current literature data. Between January and March 2025, interviews were conducted with ten outpatient otorhinolaryngologists (experience 12—30 years; inclusion criteria — at least 10 years of professional practice and practical familiarity with telemedicine). The interview recordings were transcribed and subjected to thematic analysis. It was found that 8 out of 10 experts had used telemedicine during the COVID-19 pandemic, and five continue to use it today. All respondents considered remote consultations appropriate for follow-up visits and chronic patient monitoring; 7 out of 10 recognized its usefulness for early postoperative follow-up, whereas for initial diagnostics, 6 experts admitted only the format of tele-triage, while 4 insisted on the necessity of in-person examination. The main advantages identified were improved accessibility of care and time savings, while the key barriers included the impossibility of full physical examination, technical failures, and legal restrictions. The findings confirm that telemedicine is a valuable supplement to in-person consultations in outpatient ENT practice; however, its implementation requires regulatory adjustments, technical support, and participant training.
On the issue of modern characteristics of life expectancy dynamics in international health care
The article presents the results of analysis of dynamics of indicators of life expectancy and healthy life expectancy according key causes. In various world regions there is general trend of increasing life expectancy of population. The general characteristics and specific differences of indicator increasing related to national socio-economic and organizational characteristics of health care of different countries.
Assesment of health care system development in the Amur region from the perspective of human capital preservation
In this study, the author attempts to analyze the state of the healthcare system at the regional and municipal levels in the Amur Region. An analysis of the resource provision of the Amur Region's healthcare system for the period 2004—2024 reveals systemic challenges threatening the preservation of human capital. A decline in resources and human resources has led to disparities in access to medical care: the availability of doctors in rural areas is half that of urban areas, and variation coefficients exceed 40%, indicating an uneven distribution of resources. The identified shortages in certain medical specialties contradict the goals of the Russian Federation Healthcare Development Strategy to 2025.
University clinics in China: organizational models and role in the healthcare system
The article presents a comprehensive analysis of the organizational models of university clinics in the People's Republic of China based on a study of eight leading medical centers for the period 2020—2025. The key characteristics of the integration of medical education, scientific research and clinical practice are investigated. Financing systems, publication activity, and the role in the national health system are considered. Four main organizational models have been identified: full integration with the university, an autonomous model with elements of public-private partnership, a network model of distributed integration, and a specialized military medical model. Special attention is paid to advances in transplantation, gene therapy and digital transformation. The prospects of adapting the Chinese experience for the development of academic medical clusters in the Russian Federation are determined.
A comparative analysis of the regulatory framework for telemedicine technologies in the Russian Federation
This article provides a comparative analysis of two regulations governing the use of telemedicine technologies in Russia: Order No. 965n of the Russian Ministry of Health dated November 30, 2017, and the new Order No. 193n dated April 11, 2025, which entered into force on September 1, 2025. The aim of the study is to identify the key changes introduced by the new regulation and analyze the potential impact of these changes on the accessibility, quality, and effectiveness of medical care. The study includes an assessment of continuity and innovation in approaches to patient identification, forms of interaction between healthcare professionals and patients, and information security requirements for the use of telemedicine technologies. Based on the analysis, practical recommendations have been formulated aimed at optimizing the implementation of the new legal framework and increasing the effectiveness of telemedicine services in the healthcare system.
Major changes in polyclinic work standards: implementation problems
The Russian Ministry of Health's Order No. 202n of April 14, 2025, which substantially reforms labor regulation for medical personnel, requires scientific scrutiny of its consequences and implementation issues. The article conducts a comparative analysis of the new staffing standards with prior regulations and sector-specific standards of care.
Problems of providing medical care to patients with malignant neoplasms at the regional level (based on a sociological survey)
This article presents the results of a sociological survey of patients diagnosed with malignant neoplasms to examine access to medical care for them in the Saratov Region. The following methods were used: sociological, content analysis of literary data, and analytical. To examine priority issues of access to medical care for patients with malignant neoplasms in urban and rural areas, an original questionnaire was developed. It included general and specific sections, comprising a total of 29 questions. Its validity was determined using Cronbach's α coefficient, an indicator of the internal consistency or reliability of a set of questions. Literary data confirming the challenges of patient routing for cancer patients in rural areas were analyzed. A statistically significant relationship was found between patients' place of residence and the conditions of cancer diagnosis, the location of examinations at diagnosis, and wait times for medical care. The study identified issues with patient routing when diagnosing malignant neoplasms, leading to increased delays in treatment and diagnostic procedures, and also revealed low access to medical care for rural patients. This study revealed low access to medical care for residents of rural areas of the Saratov Region based on an analysis of a survey of patients receiving specialized treatment for cancer. The study identified challenges in scheduling appointments and obtaining outpatient diagnostic tests, as well as insufficient coverage of routine medical examinations to enable timely detection of cancer. Combating the damage caused by cancer in the population requires a comprehensive approach to detecting malignant neoplasms.
The study of the influence of individual demographic factors on the lifestyle and attitude towards health-saving behavior of foreign medical students
This article examines the lifestyle and attitude of foreign medical students towards health-saving behavior. The study reveals the level of awareness, the prevalence of healthy and harmful habits, as well as the factors influencing the formation of these attitudes in this group of students. The results indicate significant differences in students' behavior related to adaptation to a new cultural environment and stress levels, confirming the need to develop specialized prevention programs. The presented data contribute to a deep understanding of the needs of international students in the field of health and maintaining a healthy lifestyle while studying abroad.
Functional gastrointestinal disorders in generation Z: prevalence patterns and risk factors
This study was conducted to characterize functional gastrointestinal disorders (FGIDs) among Generation Z representatives in terms of their prevalence patterns and risk factors. According to foreign studies, the prevalence of such disorders affects more than 40% of the global population, which allows classifying them as global medico-social problems. FGIDs are widespread among youth, accounting for nearly half of visits to gastroenterologists. Based on the results of 14 studies conducted in Europe, North and Latin America, the global prevalence of FGIDs among adolescents is 23%, meaning that every fourth representative of this generation exhibits corresponding clinical manifestations. The main forms of FGIDs are functional constipation (12%), followed by functional dyspepsia (5%) and irritable bowel syndrome (3%). Recent studies indicate that patients with FGIDs are characterized by a high degree of comorbid psychological and psychiatric disorders. Modern scientific literature identifies the main risk factors for FGIDs in Generation Z as unbalanced nutrition, unhealthy eating habits, insufficient water intake, uncontrolled use of drugs promoted as «digestive improvers,» as well as anxiety, insomnia, impaired intestinal barrier regulation, suboptimal body mass index (BMI), low physical activity, and living in dormitories or boarding schools.
Hemodynamic determinants in the structure of the digital phenotype of aging: results of a cross-sectional study
In the context of the global initiative of the World Health Organization «Decade of Healthy Aging» (2021—2030), the development of objective methods for assessing the rate of aging is becoming a priority task of modern medicine. Digital phenotyping of aging (DFS) is a promising interdisciplinary approach that makes it possible to quantify aging processes through the analysis of complex digital biomarkers. The purpose of this cross-sectional study was to structure and evaluate the significance of hemodynamic parameters of systemic hemodynamics (SRS) as key components of the aging phenotype. The study included a cohort of 905 patients aged 1 to 89 years. For a comprehensive assessment of hemodynamics, the method of noninvasive compression oscillometry was used with the registration of twenty-two parameters of the SRS. The calculated biological age (BV), determined automatically based on an algorithm that takes into account the circulatory index and the peripheral vascular resistance index, was used as an integral marker of the aging rate. As a result of the analysis, a set of statistically significant correlations was established between the negative trend of BV (excess of BV over the calendar age) and a number of hemodynamic disorders in people over 45 years of age. These included increased values of systolic, pulse, mean and lateral blood pressure, as well as high rates of cardiac energy expenditure and total peripheral vascular resistance. Separately, a U-shaped relationship between the cardiac index and the rate of aging was revealed, in which the risk of accelerated aging is associated with both hyper- and hypokinetic types of blood circulation. The data obtained expand the arsenal of predictive tools of the CFS and open up new opportunities for the formation of personalized preventive scenarios aimed at slowing the rate of aging and preventing age-associated pathology.
Circle of good Foundation: are all diseases rare?
In accordance with Decree No. 16 of the President of the Russian Federation dated January 5, 2021, the Circle of Good Foundation (hereinafter referred to as the Foundation) was established to support children with severe life-threatening and chronic diseases, including rare (orphan) diseases. The Foundation's goal is to implement an additional mechanism for organizing and financially supporting medical care for children, providing them with medications and medical devices, including those not registered in the Russian Federation, as well as technical rehabilitation equipment. This article analyzes the diseases for which the organization of medical care is carried out for children under the care of the Circle of Good Foundation, identifies the diseases that are considered to be rare and the discrepancies between the List of Rare (Orphan) Diseases of the Ministry of Health and the List of Severe Life-Threatening and Chronic Diseases Including Rare (Orphan) Diseases of the Foundation.
Results of assessing the readiness of primary healthcare organizations in the Moscow Region public health system for global challenges based on surveys of healthcare professionals and department heads
In the context of persistent risks of biological, man-made, and geopolitical emergencies that increase the vulnerability of primary healthcare, there is a particular urgency for a standardized assessment of its preparedness. Such an assessment must allow for the benchmarking of results and their translation into specific management decisions. The aim of this cross-sectional analytical study was to evaluate the preparedness of the Moscow Region state primary healthcare organizations for global challenges, based on surveys of healthcare professionals and department heads. Data from 147 department heads and 486 healthcare workers were analyzed. Methodological approaches included psychometric validation of the research instruments (Cronbach's alpha, factor analysis), non-parametric and robust inferential analysis, IRT modeling (Rasch model), latent class analysis (LCA), territorial clustering assessment, and ROC/AUC verification. The average preparedness index was 0.812±0.167 for department heads and 0.709±0.277 for healthcare professionals, revealing a pronounced polarization of profiles. The most deficient areas were resource-intensive and organizationally complex components: human resource reserves and staff rotation, prevention of psycho-emotional burnout, laboratory capacity redundancy, stable communication channels, and regular interagency drills. A significant gap was identified between the existence of formal regulations and the practical application of skills. The findings substantiate the necessity of transitioning from documentary to verifiable preparedness, prioritizing measurable reserves, scenario-based exercises, and targeted measures to mitigate inter-territorial heterogeneity.
Practical application of regulatory documents in the field of laboratory diagnostics of infectious diseases in medical organizations of the state healthcare system in the Far North
Objective. To analyze how national regulatory requirements for laboratory diagnostics of infectious diseases are implemented in the Arctic region, using the Yamalo-Nenets Autonomous Okrug (YNAO) as a case study. Materials and Methods. The study combined a review of federal regulations and scientific literature, a survey of laboratory managers (11 out of 13 facilities, 84.6%), a SWOT analysis of the regional laboratory network, and an assessment of practical measures introduced at Novy Urengoy Central City Hospital, particularly the implementation of standardized turnaround times (TAT) for laboratory testing. Results. Although federal regulations have been formally adopted, their practical enforcement remains inconsistent. Only 54.5% of laboratories reported defined turnaround times, while integration between laboratory information systems (LIS) and medical information systems (MIS) was incomplete; manual data entry persisted in 72.7% of cases. SWOT analysis highlighted strengths (adequate funding, modern equipment), weaknesses (staff shortages, lack of unified standards), opportunities (digitalization, professional training), and threats (logistical barriers, epidemic surges). The experience of Novy Urengoy Hospital demonstrated that prioritization of urgent versus routine tests, introduction of target TAT benchmarks, and staff training improved the timeliness of results and enhanced communication with clinical departments. Conclusion. These findings may guide the development of tailored management models for laboratory diagnostics in remote northern regions.
Evaluation of social effects from the implementation of various innovative methods of diagnostics and treatment in the profiles of «cardiovascular surgery» and «neurosurgery» in a multidisciplinary medical organization at the regional level
Aim. To evaluate the social effects of the implementation of various innovative diagnostic and treatment methods in the fields of cardiovascular surgery and neurosurgery in a regional multidisciplinary medical organization. Methods. This study is based on an organizational experiment, the purpose of which was to test and evaluate the effectiveness of a proprietary set of organizational and management technologies designed to optimize the implementation of innovative diagnostic and treatment methods in a multidisciplinary hospital. The main group (n=125) included patients who received medical care using the innovative diagnostic and treatment methods introduced as part of the experiment. The comparison group (n=68) included patients who received treatment using standard («routine») diagnostic and treatment methods for similar nosologies, comparable in clinical complexity and patient age. The total sample for the sociological study consisted of 193 people. Results. Patients' opinions on the quality of care provided varied significantly depending on the innovative method used (p=0.0031, Kruskal-Wallis test). The highest average scores were assigned to minimally invasive endovascular interventions: endovascular embolization of vessels and balloon angioplasty (5.00 points each on a 5-point scale). Cryoballoon ablation of the pulmonary vein orifices demonstrated a comparably high result (4.91 points). The integrated indicator of overall satisfaction, assessed on a 10-point scale (Figure 3), demonstrated the most pronounced and highly reliable differences between the groups (p=0.00001, Kruskal-Wallis test). The undisputed leaders were endovascular embolization of vessels (10.00 points) and balloon angioplasty (9.94 points). Patients who underwent endovascular laser coagulation (9.11 points) and radiofrequency thermal ablation (8.78 points) also expressed high satisfaction. Cryoballoon ablation, which demonstrated the best results in terms of quality of life, achieved a more moderate, but still high, score (7.30) in this parameter. Conclusion. Planning for the implementation of innovative technologies should consider not only clinical and economic benefits but also the predicted socio-psychological effectiveness, which varies significantly between different methods. For technologies with delayed clinical and functional results (for example, in spinal surgery), it is necessary to develop and integrate structured patient information programs and support during the rehabilitation period into the treatment process to enhance the positive social impact.
Results of a sociological study of the opinions of medical workers on the implemented organizational technology of internal patient routing in the provision of medical care using radiation therapy and diagnostic methods
The aim of this study was to conduct a sociological survey of healthcare workers' opinions on the implemented organizational technology for internal patient routing in the provision of medical care using radiation therapy and diagnostic methods. A total of 90 healthcare workers (specialist physicians and nursing staff) from a private medical organization participating in the implementation of a territorial program of state guarantees for radiation therapy and diagnostics in the provision of medical care to patients with oncological diseases took part in the sociological survey. The average length of medical experience of the surveyed healthcare workers was 9.67 years. The average length of work experience at the current place of work was 2.94 years. To assess the opinion of healthcare workers on the implemented organizational technology, a special questionnaire was developed, including six questions focused on key aspects of the routing system. Data was collected using a questionnaire survey using 5-point ordinal Likert scales. The highest average score was recorded in relation to the availability of innovative equipment (M = 4.50), which allows us to consider this aspect as the most favorable. The adequacy of standard equipment and consumables is also highly rated (M = 4.32). Overall satisfaction with working conditions in the new organizational environment is also high (M = 4.31). A Cronbach's alpha coefficient (α) assessment of the developed questionnaire yielded a reliability value of 0.870, demonstrating high internal consistency and reliability. Thus, the technology has successfully passed the implementation stage in terms of technical, organizational, and resource readiness, receiving high expert assessments in this regard from end users—healthcare workers. The identified dispersion of opinions and the relatively lower staff well-being score indicate that technological optimization has created a new configuration of workloads and requirements.
Features of family-marital behavior in old age
The article examines the features of family-marital behavior in older adults and its dependence on economic, social, and psychological factors. The study found that economic dependence and the fear of loneliness are key factors preventing elderly individuals from divorcing, with traditional marital unions dominating despite the rise of civil unions. Age significantly impacts the likelihood of being married, reducing the probability of remarriage. Financial stability lowers the risk of divorce, while difficult financial conditions increase the likelihood of divorce. The presence of children has a weak influence on divorce, but families with multiple children are less likely to break up. Education and employment have a minor impact on the marital status of the elderly. Economic dependency and social norms continue to influence decisions about divorce and remarriage. These factors should be considered in social and medical support programs for the elderly.
Adelina-Victoria Genrikhovna Skavronskaya (26.09.1922–2.07.2000)
Academician of the Russian Academy of Medical Sciences, Professor, Doctor of Medical Sciences Adelina-Victoria Genrikhovna Skavronskaya made a significant contribution to the revival and further development of genetics in our country. A student, co-author, successor and follower of the scientific views of Academician V. D. Timakov, she was the head of the Department of General Medical Microbiology at the N. F. Gamalei Scientific Research Institute of Epidemiology and Microbiology of the USSR Academy of Medical Sciences, headed the laboratory, whose developments enriched the theory and practice of medical microbiology.
Stages of Formation and Development of Dental Education in the Western Urals: On the 90th Anniversary of the Molotov Dental Institute
In September 2025, the 90th anniversary of the founding of the Molotov State Dental Institute — one of the first specialized institutions in the Urals — will be celebrated. Its history began with odontology courses at Perm University in 1923, followed by the opening of the first dental clinic. The Institute played a key role in training dental professionals and advancing scientific research in the field of dentistry, especially during the years of the Great Patriotic War. Under the guidance of prominent scholars, innovative methods for treating dental caries, maxillofacial injuries, and dentoalveolar deformities were developed. In 1953, the Institute was reorganized, and its foundation laid the basis for the Dental Faculty of Perm State Medical University named after academician E. A. Wagner, which to this day maintains a high standard of specialist training and scientific research in dentistry.
Types of regulation of apothecary activity in medieval Europe. Report 1. Emergence of professional Standards for apothecaries’ conduct
The first part of the article is devoted to decentralized types for regulating pharmaceutical activities in medieval Europe. Despite the disunity of cities in the 12–15th centuries, they introduced similar regulatory norms, going back to the Sicilian Constitutions and the Edict of Salerno of Emperor Frederick II. In the cities of central and northern Europe, the implementation of regulatory norms was based on the personal responsibility of pharmacists to the authorities. In the southern territories, corporate governance through guilds was more commonly used. This message shows the features, similarities and differences of such types of regulation as pharmacy regulations, oaths of apothecary, apothecaries’ service letters and privileges.
Women Doctors — Heads of Evacuation Hospitals in Saratov during the Great Patriotic War
The article presents the work of female doctors who were the heads of multidisciplinary and specialized evacuation hospitals in Saratov during the Great Patriotic War. It analyzes their organizational and professional activities in providing medical care to wounded and sick soldiers of the Red Army. The study of archival materials has allowed us to reconstruct the unknown facts about the lives, work, and achievements of female doctors who were the heads of evacuation hospitals in Saratov during the Great Patriotic War and in the post-war period.
Medical Notions and Hygienic Prescriptions in the «Domostroy»
This article provides a comprehensive study of the medical and hygienic aspects reflected in the text of the «Domostroy» — an outstanding monument of Russian literature from the 16th century. Based on a detailed textological analysis, the system of sanitary norms, practices of bodily and domestic cleanliness, food safety, and disease prevention is examined. Particular attention is paid to the reconstruction of proto-medical views and their integration into the religious and moral paradigm of medieval society. The research introduces previously unsystematized data on the sanitary and hygienic regulations contained in the text, which constitutes its novelty. The entire text is divided into 64 chapters. Individual hygienic and medical aspects can be traced in no less than ten of them. The study demonstrates how religious attitudes shaped practical approaches to health preservation, creating a comprehensive system of hygienic practices relevant to the daily life of Muscovite Rus'.
The contribution of Dr. V. D. Chenykaev to the fight against famine and the organization of Russia's first rural tuberculosis dispensary in the Saratov province in the 1920s
The article provides brief information about Dr. V. D. Chenykaev's medical and social activities in the fight against famine in 1921—1922 and the establishment of Russia's first rural TB dispensary in the village of Turki, Saratov Province. It highlights his four-year medical, diagnostic, preventive, and educational work, as well as the contributions of the dispensary's medical staff, from 1923 to 1927, in combating tuberculosis among the rural population of the region.
The activities of the People's Commissariat of Health under the leadership of G. A. Miterev to prevent epidemics during the Great Patriotic War
One of the main tasks assigned to the USSR People's Commissariat of Health during the Great Patriotic War was the prevention of infections at the front and in the rear. Anti-epidemic efforts were led by People's Commissar of Health G. A. Miterev, who was appointed authorized representative of the State Defense Committee for anti-epidemic measures on February 2, 1942. Miterev considered the key sanitary and anti-epidemic measures that made it possible to prevent mass epidemics in the country during the war to include unified leadership of all anti-epidemic measures in the country, the involvement of all sanitary and anti-epidemic and medical institutions, the provision of healthcare agencies with physicians and the upgrading of their skills, extensive sanitary propaganda, the allocation of significant state funds for anti-epidemic measures, and other measures.
The role of departmental and zemstvo doctors of the Perm province in resolving forensic issues (19th — early 20th centuries): features, practice and problems
This article presents an analysis of the development of forensic medical examination practice in Perm Province in the 19th and early 20th centuries, based on a study of archival materials. It presents the organization of forensic medical activities in a large mining region, where medical care was provided within the framework of departmental and zemstvo models. The article determines the compliance of forensic medical examinations with the legal regulations governing the examination of bodies, in particular, the implementation of Article 154 of the Military Regulations of Peter the Great and the circulars of the Senate and the Ministry of Police. Key problems in forensic medical practice in the region are identified: a shortage of medical personnel, a lack of instruments and specialized literature, untimely examinations due to geographic remoteness, and systemic errors associated with the refusal of autopsies. Based on an analysis of autopsy reports, research methods are reconstructed, and the scope and quality of cause-of-death diagnosis are determined. It is established that, despite the lack of specialized expertise, Ural physicians applied a systematic approach and sought to establish cause-and-effect relationships between processes. Departmental oversight was exercised by the Medical Boards. A conclusion was reached regarding the development of a regulated practice in the Ural region, dependent on the personal qualifications of the expert, integrated into the imperial legal system and laying the foundation for the further standardization of forensic medicine.
This article commemorates the 150th anniversary of the birth of V. M. Bronner, a Bolshevik physician and one of the leading organizers of the campaign against venereal diseases and of medical personnel training in the USSR. Bronner was the initiator and first director of the State Venereological Institute, the executive editor of the journal «Venerologiya i Dermatologiya», and head of the Department of Social Diseases at the People’s Commissariat of Health (Narkomzdrav). He also headed the Department of Higher Medical Education at the People’s Commissariat of Enlightenment (Narkompros), led the Bureau of Foreign Sanitary Information under Narkomzdrav, and from 1935 served as the USSR’s representative to the Health Committee of the League of Nations.