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[Russia-Halle interrelations in medicine of the 18th century. II. Halle medical delegations in Czar Peter's Russia and later].

In the 18th century for the purpose of amelioration of the medical care by the authorities responsible for the medicinal organization in Russia aimed methods of delegation were brought about. Requests of such kind were sent to the medical faculties of renowned universities. In such requests the University of Halle played a significant role. For the 18th century more than 40 candidates for a Halle doctorate can be authenticated who took Russian services for a certain time or for ever and there obtained important positions during their stay.

Germany

[Russia-Halle reciprocity in medicine of the 18th century. V. Halle graduates employed in Russia and their medical fields].

In the 18th century about 40 medical men of non-Russian descent graduated in Halle temporarily or permanently entered the Tsarist services. Their activities are to be proved in nearly all fields of medicine. They occupied positions as court-physicians and military surgeons, worked in hospitals or as free practitioners. Some of them occupied important positions in research and education at the Academy of Petersburg and the University of Moscow.

Germany

Immunity to diphtheria in northern Norway and northwestern Russia.

A case of diphtheria, which has not been seen in Norway for 30 years, was reported in 1992 in the northern part of the country bordering Russia. An increasing number of cases of diphtheria has been reported in the former USSR, including the northwestern part of Russia. In order to elucidate the potential of an epidemic spread across the Norwegian-Russian border, a seroepidemiological study was performed. A total of 470 sera, 243 from Finnmark, Norway, and 227 from Arkhangelsk, Russia, were examined for antibodies against diphtheria toxin, using an in vitro toxin neutralisation method. No statistically significant difference in the presence of diphtheria antitoxin between the Norwegian and the Russian populations was found. The presence of neutralising antibodies decreased by age, and this decrease was most pronounced among the Russians. Individuals aged 40 to 70 years, and Norwegian women in particular, seem to have an increased risk for diphtheria as judged by the diphtheria antitoxin levels.

Adolescent

A comparison of the treatment of acute myocardial infarction between St. Petersburg, Russia and Seattle, Washington.

This study compared the baseline demographics, time to treatment and types of treatment of patients presenting with acute myocardial infarction in St. Petersburg, Russia and Seattle, WA. The study included 63 consecutive patients admitted to City Hospital #1 in St. Petersburg in July 1993. Comparative data for Seattle patients was obtained from the multi-year Myocardial Infarction Triage and Intervention project, a registry of all acute myocardial infarction patients hospitalized in the Seattle area. The results show a significantly prolonged time from symptom onset to presentation in Russia (51.8 h vs. 8.0 h; P < 0.001). Aspirin was used slightly more often in Seattle (78.9% vs. 74.6%; P = 0.40) while thrombolysis was used much more often in Seattle (22.5% vs. 6.3%; P = 0.002). There was also much less use of percutaneous transluminal coronary angioplasty (0% vs. 26.9%; P < 0.001), heparin (12.7% vs. 79.1%; P < 0.001), or cardiac catheterization (4.8% vs. 64.3%; P < 0.001). Also, the length of hospitalization was longer in St. Petersburg (23.8 +/- 10.8 vs. 7.5 +/- 5.1 days; P < 0.001). The findings in this study are an impetus for us all in understanding the magnitude of differences currently existing and the challenges for improving health care delivery in Russia.

Aged

Cholera diffusion in Russia, 1823-1923.

All six cholera pandemics of the 19th and early 20th centuries struck Russia, causing millions of deaths. Cholera entered Russia from the south, with the Volga river system being a common and efficient route into the heart of the country. Diffusion was predominantly linear, along the navigable rivers and later, along the railroads. In contrast to Pyle's findings for the U.S.A., urban hierarchical diffusion was of only local significance in Russia.

Cholera

Psychosocial care for HIV-infected individuals in Russia.

The relatively small number of people known to be infected with HIV in Russia together with the absence of large numbers of affected people does not help to increase awareness of HIV infection as a social problem. This results in almost non-existent organized care systems for psychosocial support. Characteristics of psychosocial stress in HIV-infected individuals in Russia were studied over 3 years and ways to overcome it were examined. One-hundred-and-eighty-nine patients (120 men and 69 women) were studied. Our patients found support in attending health workers and from one another. Some characteristic features of the lifestyle of HIV-infected people in Russia are described. These include a search for non-traditional treatment methods; creating families (nine couples) or support networks between the infected; participating in public meetings in order to support those infected and pursue educational work, and meetings on for religious reasons. Social support may decrease the stress experienced by these people.

Adaptation, Psychological

Japan-Russia Pediatric Society.

In March 1990, medical interchange between Japan and the Soviet Union began with a letter from the local health bureau of Khabarovsk. We visited Khabarovsk three times and Kamchatka once, and saw many hospitals and patients. Russian doctors of pediatrics visited Japan. Medical information was exchanged and discussed. The Japan-Russia Pediatric Society was established to perform interchange of medical information, technology and staff such as doctors, nurses and technicians between Japan and Russia, especially the Far East district of Russia. The Society meeting has been held three times: Tokyo (1991), Khabarovsk (1992) and Niigata (1993). It is necessary to continue the interchange between the two countries.

International Cooperation

Comparative HLA Alleles and Haplotypes of Bone Marrow Volunteers Recruiting in the Asian and European Parts of Russia.

HLA typing of 9126 haematopoietic stem cell donors living in the Asian and European parts of Russia and identifying themselves as Russians was performed using NGS technology in 2-field resolution at the HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 loci. The study of donors in the Asian part of Russia disclosed 77 alleles at the HLA-A locus, 111 at the HLA-B locus, 58 at the HLA-C locus, 54 at the HLA-DRB1 locus, and 26 at the HLA-DQB1 locus. Donors of the European part of Russia are characterised by the following allelic diversity: 87 alleles at the HLA-A locus, 136 at the HLA-B locus, 72 at the HLA-C locus, 67 at the HLA-DRB1 locus, and 37 at the HLA-DQB1 locus. The most common five-locus haplotype in both populations is HLA-A*01:01&#x2009;~&#x2009;HLA-C*07:01&#x2009;~&#x2009;HLA-B*08:01&#x2009;~&#x2009;HLA-DRB1*03:01&#x2009;~&#x2009;HLA-DQB1*02:01. Throughout the study, 26 new alleles were revealed.

Humans

Heterogeneity of diphtheria toxin gene, tox, and its regulatory element, dtxR, in Corynebacterium diphtheriae strains causing epidemic diphtheria in Russia and Ukraine.

Diphtheria toxin (tox) and its regulatory element (dtxR) from 72 Corynebacterium diphtheriae strains isolated in Russia and Ukraine before and during the current diphtheria epidemic were studied by PCR-single-strand conformation polymorphism analysis (PCR-SSCP). Twelve sets of primers were constructed (eight for tox and four for dtxR), and three regions within tox and all four regions of dtxR showed significant variations in the number and/or sizes of the amplicons. Two to four different SSCP patterns were identified in each of the variable regions; subsequently, tox and dtxR could be classified into 6 and 12 different types, respectively. The great majority of epidemic strains from both Russia and Ukraine had tox types 3 and 4, and only in a single preepidemic strain isolated in Russia were all eight tox regions identical to those of C. diphtheriae Park-Williams No. 8 (tox type 1). Epidemic strains from Ukraine can easily be identified by dtxR type 5, while the majority of the Russian epidemic strains have dtxR of types 2 and 8. No differences in the tox regions between mitis and gravis biotype strains were observed. However, dtxR types 2, 5, and 8 were identified only in the gravis biotype, and dtxR type 1 was characteristic for the mitis biotype strains. PCR-SSCP is a simple and rapid method for the identification of variable tox and dtxR regions that allows for the clear association of tox and dtxR types with strains of distinct temporal and/or geographic origins.

Bacterial Proteins

Addressing the epidemiologic transition in the former Soviet Union: strategies for health system and public health reform in Russia.

OBJECTIVES: This paper reviews Russia's health crisis, financing, and organization and public health reform needs. METHODS: The structure, policy, supply of services, and health status indicators of Russia's health system are examined. RESULTS: Longevity is declining; mortality rates from cardiovascular diseases and trauma are high and rising; maternal and infant mortality are high. Vaccine-preventable diseases have reappeared in epidemic form. Nutrition status is problematic. CONCLUSIONS: The crisis relates to Russia's economic transition, but it also goes deep into the former Soviet health system. The epidemiologic transition from a predominance of infectious to noninfectious diseases was addressed by increasing the quantity of services. The health system lacked mechanisms for epidemiologic or economic analysis and accountability to the public. Policy and funding favored hospitals over ambulatory care and individual routine checkups over community-oriented preventive approaches. Reform since 1991 has centered on national health insurance and decentralized management of services. A national health strategy to address fundamental public health problems is recommended.

Health Care Reform

Resistance gene mutations and phylogenetic relationships in Candidozyma auris isolates from Russia.

INTRODUCTION: Candidozyma auris is an emerging healthcare-associated fungal pathogen with a high propensity for nosocomial transmission and development of antifungal resistance. This study aimed to identify resistance-associated genomic variants and characterize the phylogenetic structure of clinical C. auris isolates circulating in Russia. METHODS: We analyzed 82 isolates collected between 2017 and 2023 from 18 hospitals in the Northwestern and Central Federal Districts of the Russian Federation. Antifungal susceptibility testing was combined with whole-genome sequencing, targeted FCY2 sequencing, and comparative phylogenomic analysis using publicly available international genomes. RESULTS: All isolates analyzed in this study belonged to clade I and showed a highly conserved profile of elevated azole MICs. The consistent detection of ERG11 (K143R), TAC1B (A640V), and CDR1 (V704L) suggests that reduced azole susceptibility in this population is associated with both target-gene alteration and efflux-mediated mechanisms. All isolates remained susceptible to echinocandins in vitro, and no resistance-conferring mutations were detected in FKS1, consistent with the absence of an echinocandin-resistant phenotype. Decreased susceptibility to flucytosine was mainly associated with the FCY2 (L383*) nonsense mutation, which was confirmed by targeted Sanger sequencing in additional isolates. Phylogenomic reconstruction showed that the Russian isolates represented a restricted segment of global clade I diversity and revealed two major geographically structured lineages corresponding to two large metropolitan areas in European Russia. DISCUSSION: The distribution of closely related isolates across hospitals supports local persistence and inter-hospital dissemination of genetically related strains. These findings provide important insights into the molecular epidemiology, antifungal resistance mechanisms, and transmission dynamics of C. auris in Russia.

Phylogeny

[Russia and Halle reciprocity in medicine of the 18th century. Correspondence, scientific communication and reception].

In the history of the interrelations of Halle and Russia in medicine during the 18th century Francke's Foundations, the Faculty of Medicine and the Academia Naturae Curiosorum are important institutions. The correspondence of these three institutions with the partners in Russia became remarkable for the scientific communication and reception. The activities of the working teams which were embedded in these authoritative bodies were scarcely inferior in importance to the centres of enlightenment of that time working in other towns (for instance in Leipzig). In the field of medicine Halle occupied a leading position for the early knowledge about Russia.

Germany

[Study results and the unresolved problems in the epidemiology and prevention of parenteral viral hepatitis in Russia].

Great differences in the activity of the epidemic process of hepatitis B (HB), the occurrence of HBsAg among the population of different regions of Russia (in the central and northwestern regions among 1.8-2.4% of the population, in Tuva among 9.8% of the population, in Yakutia among 11.6% of the population) and considerable differences in the occurrence of HBeAg among HBsAg carriers in these regions (antibodies to delta virus have been detected in 1.3-5.5% of carriers of this antigen in the European part of Russia and in 21.0% of carriers in Tuva) are shown. The structure of the transmission routes of HB virus, the proportion of the artificial and natural routes of its transmission are analyzed. The data on the frequency of cases of perinatal and intrafamily HB virus infection in regions with different activity of the epidemic process, as well as the data on effectiveness of measures for the prevention of posttransfusion HB and parenteral infection during therapeutic and diagnostic interventions, are given. The results of the use of Engerix B vaccine among 2,500 persons belonging to groups of risk are presented. The proportion of hepatitis C (HC) cases among patients with different kinds of acute and chronic viral hepatitis among the population of different regions and the occurrence of anti-HC antibodies among the population of different regions of Russia (in Moscow and St. Petersburg among 1.1-1.2% of the population, in North Caucasia among 4.5% of the population), as well as in high risk groups (3.1% among medical personnel, 19.4% among drug addicts, 25% among patients of hemodialysis wards, ets), are considered. The structure of transmission routes of HC virus is analyzed, the possible measures for the prophylaxis of HC virus infection are considered.

Adolescent

Pin care using the Ilizarov apparatus: recommended treatment plan in Kurgan, Russia.

Differences in the care of the pins used in association with the Ilizarov apparatus and technique are found in various countries and institutions. During a recent visit to the Ilizarov Institute in Russia, the methods of caring for the Ilizarov pins were extensively investigated and documented. The U.S. infection rate at pin sites has been reported to be nearly 10%. No specific infection rate has been reported from Russia. What constitutes an infection at the Ilizarov Center in Kurgan was investigated, as were methods of treatment. Our conclusion is that pin care in Russia is conducted under a more vigorous and stringent regimen, but less often, than in the United States. Soviet record keeping is different, and therefore the infection rates cannot be compared. In Kurgan, specific diligence is exercised in addressing the problems at each pin site. Treatment is directed toward alleviating these problems.

Anti-Bacterial Agents

Behavior therapy in Russia.

The development of behavior therapy in Russia is discussed within the context of the evolution of Russian psychology. The pre-revolutionary contributions of Sechenov, Grot, Pavlov, and Bekhterev to the conceptual foundation of behaviorism in Russia are examined. This is followed by a discussion of the marked impact of social and political influences on the development of therapeutic methods from 1917 onward. Major milestones in the development of behavior therapy are examined. Finally, it is noted that the current period of openness provides an expanded opportunity to teach behavior therapy which has so far been limited to major Russian cities.

Behavior Therapy

Environmental pollution around nickel smelters in the Kola Peninsula (Russia).

Air pollution along the border between Norway and Russia has been recorded since 1974 in Sør-Varanger county (Norway) and since 1985 in Murmansk county (Russia). A more extensive collaboration on the environmental pollution problems in the border region was started in 1988 with the establishment of a joint pollution commission. Sulphur dioxide seems to be the most important pollutant causing both environmental damage and adverse health effects. The recommended highest 6-month mean acceptable value for Norway of 40-60 micrograms/m3 was exceeded for two Russian and one Norwegian station during the winter of 1990/91. About 5% of hourly means exceeded 350 micrograms/m3 at the most polluted Norwegian station. The highest value recorded at the nearest populated area in Norway was 2500 micrograms/m3 (The Norwegian Institute for Air Research). Standardized mortality data suggest an increase in deaths from cancer and cardiovascular disease in two cities with nickel refineries, compared to a control city. Further analysis is required to confirm this.

Air Pollutants