Purpose of the study: to study changes in the structure of causes of death among those who died aged 18 years and older according to medical death certificates (MDC) and to discuss the problems of assessing the contribution of certain groups of diseases and conditions to the mortality of the population. Materials and methods. The source of information was the electronic database of the Main Directorate of the Civil Registry Office (USR registry office of the Moscow Region) of the MSS for those who died at the age of 18 and older for 2019, 2021 and 2022. one of the subjects of the Russian Federation. Results: All 3 years 99 % of deaths occur in 12 classes of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10); 3 classes (diseases of the circulatory system – DCS, nervous system – DNS and neoplasms) accounted for 70 % of deaths in 2019, 58 % in 2021 and 62 % in 2022 (the share decreased due to COVID-19). The share of DCS was 40 %, 32 % and 37.7 %; neoplasms – 15.3 % 10.9 % and 13.5 %. The greatest decrease in mortality was noted in the class of mental and behavioural disorders (MBD; 8 times: 58.4 in 2019 and 7.4 per 100 thousand in 2022). The proportion of male deaths over all 3 years was higher in the classes of injury and poisoning (IP), infectious diseases (ID), diseases of the respiratory system (DRS) and digestive system diseases (DDS). The highest age of the deceased was registered according to the classes of DNS and diseases of the genitourinary system (DGS); the youngest age in ID and IP classes. For all 3 years, more than 60 % of deaths in a hospital are registered in the classes of ID and DDS, and in 2021 and 2022 from COVID-19. Deaths at home predominate in the class of DNS and ill-defined conditions (class R). For individual codes in the classes of DCS, DNS, MBD, DGS, representing non-prohibited but unspecified causes of death, significant changes (hundreds and thousands of cases) were revealed in dynamics, which is probably due to a change in approaches to coding primary cause of death and affects the structure of mortality by classes and individual reasons. Conclusions. Significant annual changes in the number of deaths from individual causes, differences in demographic characteristics by ICD classes require clarification of the criteria for using individual 4-digit codes and subsequent analysis of mortality for clinically related groups of diseases.

In order to implement the Federal Project “Development of a Network of National Medical Research Centers and Implementation of Innovative Medical Technologies”, the National Medical Research Center (NMRC) on the “Anesthesiology and Intensive Care (for adults)” was established in 2021 on the basis of the Sechenov First Moscow State Medical University (Sechenov University), designed to perform organizational and methodological management of specialized units of medical organizations of regions of the Russian Federation. Aim. Evaluate the contribution of Sechenov University to the implementation of the federal project “Development of a network of medical research centers and the introduction of innovative medical technologies” using the unique experience of the NMRC as an example.. Materials and methods. Analysis of the results of NMRC visits to the regions of the Russian Federation. Reports review of medical organizations of the regions of the Russian Federation. The involvement of medical personnel of the regions in the system of continuous medical education, including scientific and practical events carried out by NMRC, and the demand for the use of telemedical consultations were assessed. Results. During 17 months of the NMRC work 15 of on-site inspections in the regions of Russian Federation were carried out in order to analyze the level of anesthesiology and intensive care services in the regions of Russian Federation, 2577 telemedical consultations were provided, and 15 interactive educational modules for the portal of continuous medical and pharmaceutical education of Ministry of Health of Russia were prepared. Conclusion. The main forms of NMRC’s interaction with the regions of the Russian Federation are organizational and methodological, scientific and educational support of the representatives of healthcare practitioners and regional healthcare authorities. The NMRC activities are aimed at improving the quality of medical care in the field of anesthesiology and intensive care in the regions of the Russian Federation and the formation of a value-oriented approach in modern health care.

Socially significant diseases are in the focus of world health care, because they affect a significant proportion of the able-bodied population and are the main causes of disability and death. The aim of the study was to carry out statistical analysis of the dynamics of morbidity of some socially significant diseases of the population of the Saratov region and comparative analysis of these data with similar indicators in the Russian Federation. Materials and methods. The statistical data published on the official site of the Federal State Statistics Service and the Russian Research Institute of Health of the Ministry of Health of Russia for the period from 2011 to 2021 were used. We built variation series and assessed the reliability of differences in relative indicators using Student’s t-criterion (p < 0.05 and t > 2). Results. Negative trends in the dynamics of primary and general morbidity of diseases characterized by high blood pressure, type 1 and 2 diabetes mellitus, and malignant neoplasms were recorded both in the region and in the Russian Federation. Conclusion. The obtained data regulate the necessity to conduct an in-depth study of the availability and quality of medical care for patients with socially significant diseases, as well as to develop measures to improve the provision of medical care for them.

To analyze the primary incidence of mental disorders and behavioral disorders associated with the use of psychoactive substances in subjects with cities with a population of over a million and in subjects where there are no such cities, using the example of the Volga and North-Western federal districts. Material and methods. The study compared the detection rates for these disorders obtained from the forms of federal statistical observation №11 «Information on diseases with narcological disorders» for 2020 in all subjects that are part of the Volga and North-Western federal districts. Results. When assessing the detectability of narcological disorders between the North-Western and Volga federal districts, significant differences were found in the detectability of alcoholism, harmful use of alcohol and harmful use of narcotic substances. In all cases, the detection of such disorders was higher in the Volga Federal District. At the same time, when assessing the detection of drug addiction, no differences were found. It was established that the primary incidence of drug addiction, the harmful use of alcohol and drugs was significantly higher in the cities with a population of one million in the Volga Federal District. And in the Northwestern Federal District, the opposite situation was observed. It draws attention to the fact that the detection of alcoholism, the harmful use of alcohol and the harmful use of drugs is significantly less in St. Petersburg, compared with other subjects of the district. Conclusion. The incidence of narcological disorders depends on many factors, including economic, social, as well as the territorial location of the subject. In addition, the identified differences both between the compared federal districts and between regions with cities with a population of over a million and regions without such cities indicate different approaches to organizing drug treatment services for the population, in particular preventive and diagnostic measures.

The article considers a modern approach to the organization of career guidance and pre-university training with schoolchildren conducted at a medical university, which allows to promote professional self-determination of high school students at the stage of choosing a profession, the formation of personal and professional competencies that contribute to admission to medical and pharmaceutical education programs. The purpose of the work is to present the experience of implementing and implementing the model of career guidance work “School – Pre–University – University” on the example of the Pre-University of VSMU named after N.N. Burdenko for the formation of a career-oriented and high-quality contingent of students. Materials and methods: in the course of the research, an analytical method was used, including the analysis of experience and systematization of published scientific and methodological literature on the implementation of professional orientation of schoolchildren. The results of the study. Career guidance work at the higher medical school should be systematic and dynamic, taking into account the factors of personal growth, motivation of schoolchildren. Only in this case, career guidance will be comprehensive and will ensure a continuous process of professionalization at the pre-university stage of medical education. Conclusion: at the pre-university stage of education, an important role is assigned to Pre-universities. Professional orientation and training of students of the medical Pre-University provides the highest quality preparation of specialized training and the formation of the motivational potential of the student for the future profession.