Introduction. Since 2011, Moscow has been implementing a three-level model for prevention of noncommunicable diseases. At the first (population) level, as part of interagency interaction, health authorities are developing measures to promote population’s commitment to a healthy lifestyle. Aims. To provide rationale for management decision on creation of the Center for Public Health and Medical Prevention of Moscow in State Budgetary Institution “Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department”. The goal of the Center is to develop new urban policy in improving public health based on interdepartmental interaction by providing scientific, methodological and organizational support to promote population’s commitment to a healthy lifestyle. Materials and methods. Authors analyzed and assessed development issues of primary prevention at the population level using open data on the Internet, statistical databases of Rosstat and Mosgorstat. Content, statistical and documentary analyses were also used. Results. Currently, Moscow puts an emphasis on prevention, and for this purpose implemented a three-tier model for prevention of non-communicable diseases. At the population level, as part of interdepartmental interaction, it is required to develop measures aimed at improving healthcare, creating a health-preserving environment in the city, and forming a commitment to a healthy lifestyle among the population. Implementation gaps to a decree have been narrowed; and health authorities have created an institution that works towards the goal of strengthening public health in Moscow, covering the entire population of Moscow, and that interacts in the interests of healthcare with government bodies, departments, media and civil society. The current situation, including challenges due to COVID-19 pandemic, required wider participation of authorities and departments, leadership of administrative districts in strengthening public health, coordination and monitoring of all business processes to improve public health. Conclusion. It has been substantiated that public participation in preventive measures is not enough. To solve the issues one should develop and implement large-scale programs and projects to improve public health with more active involvement of authorities and departments of administrative districts, consultative and methodological support, taking into account the existing territorial characteristics of administrative and municipal districts of Moscow, including improving health quality of workers.

Introduction. Children with various forms of vascular malformations of the tongue are an extremely complex patient population for a number of reasons: the quality of life of the child is significantly reduced – in addition to cosmetic problems, occur functional disorders, characterized by impaired breathing, act of swallowing, chewing food, speech, the appearance of pain syndrome, the child’s social adaptation worsens; the uniqueness of each clinical case, which requires an individual approach to the treatment of a particular child; frequent combination of malformation (malformation of all types of vessels – arterial, venous, lymphatic); the absence of a clear algorithm for the diagnosis and treatment of this group of patients in the domestic and foreign literature. In this regard, the full rehabilitation of such children requires a search for optimal treatment methods, the purpose of which is to achieve a stable good functional and cosmetic result. Materials and methods. 37 children aged 1 to 17 years with lymphatic, lymphovenous, lymphoarteriovenous and venous malformations of the tongue were treated. The average age of the children was 4.7 years. In addition to general clinical data, the mandatory examination methods were – ultrasonography of pathological tissues of the head and neck, study of the blood coagulation system (thromboelastography, thrombodynamics, coagulogram), Doppler ultrasonography of the head and neck vessels, transcranial Doppler, fibrolaryngoscopy, MRI (magnetic resonance imaging) and CT (computed tomography) of the head and neck with intravenous contrast agent. All children underwent surgical treatment; 6 – puncture-sclerosing method with 3 % solution of aethoxysklerol (with venous malformation of the
tongue); 9 – curly resection of the tongue and its subsequent plastic surgery with local tissues (with macroglossia in children with lymphatic, lymphovenous and lymphoarteriovenous malformations of the tongue); 31 – laser treatment (with a superficial
form of lymphatic, lymphovenous and lymphoarteriovenous malformations of the tongue). It is worth noting that 9 children out of 31 who underwent laser treatment, the first stage was performed curly resection of the tongue and its subsequent plastic surgery with local tissues. Thus, 46 operations were performed on 37 children. To carry out laser treatment was used a laser apparatus LSP-»IRE-Polyus» (ЛСП-«ИРЭ-Полюс»), which allows working with two wavelengths (0.97 μm and 1.55 μm) in two modes (pulse and pulse-periodic). All operations were performed under general anaesthesia. Results. A diagnostic algorithm has been created, new methods for treating children with various forms of vascular malformations of the tongue have been developed and introduced into practice. A good result was achieved in 37 children (100 %). There were no complications. A patent for invention No. 2676832 was obtained for the method of laser treatment. The maximum observation period is 3.5 years. Conclusions. When managing patients with vascular malformations of the tongue, it is necessary to adhere to a clear diagnostic algorithm. Treatment of patients should take place in a multidisciplinary hospital and be interdisciplinary in nature. Treatment should be started immediately when complaints appear; expectant tactics are not warranted. After the treatment and the achievement of a good clinical result, dynamic monitoring of the patient is necessary.

Coronavirus infection caused by a new strain of SARS-CoV-2 virus contributed to an increase in the number of infectious patients. The Ministry of Health of the Russian Federation and Rospotrebnadzor took over the organization of work to combat the pandemic. In Moscow, medical and preventive events were organized by the Government of the capital and the Department of Health of the city. As soon as possible, it was decided to reassign medical institutions to infectious hospitals for the treatment of patients with COVID-19 or with suspicion of it. “Maternity hospital No. 8” – the branch of State Clinical Hospital named after V. P. Demikhov was redesigned as a hospital on March 13, 2020. The decision was due to the presence of isolated boxes and an intensive care unit in the institution. The task was solved in one day: the first patients with coronavirus infection were admitted to the hospital for medical care at 17:00 on March 13, 2020.

Introduction. Transmissible coronavirus SARS-CoV-2I is the seventh known coronavirus that causes an acute infectious disease predominantly affecting the lungs (Corona Virus Disease 2019, COVID-19). The COVID-19 pandemic exposed serious gaps in health systems preparedness. The epidemic urgently required priority organizational measures to contain and reduce the spread of COVID-19. Public health authorities had to make decisions in a challenging situation where there was a lack of knowledge, experience, and great confidence, and the number of infected was steadily increasing. Purpose. The purpose of this article is to present the unique experience of Moscow in organizing a large-scale laboratory examination of the population of a metropolis with about 12.6 million inhabitants to meet the needs of the capital in testing for SARS-CoV-2 virus and combating
its circulation in conditions of the COVID-19 pandemic. Materials and Methods. The decisions made and the measures taken by the Government of Moscow, the Moscow Operational Staff, the DZM and the DZM Laboratory Service to slow the growth of the COVID-19 epidemic among the population of the capital are listed step-by-step. Results. In the course of organizational activities, sufficient capacity to maintain the public health infrastructure in terms of laboratory diagnosis of the new coronavirus infection was ensured by the joint efforts. Safe laboratory diagnostics for detecting, treating, and isolating COVID-19 cases and contacts have been established in the capital city. Thanks to the successful implementation of timely decisions, the spread of infection in the city of Moscow has been slowed. The Moscow government has reported a steady decline in cases of the new coronavirus disease and most hospitals have switched to a safe treatment regimen for patients requiring hospitalization. Centralized laboratories with readiness to perform screening and referral studies for COVID-19 outbreaks have been established within the structure of the DZM.

Objective. To substantiate the role of teaching technologies in popularizing training for graduates of medical universities for training and further employment in the capital health system. Methods. The analysis of educational
technologies aimed at quick adaptation and immersion of young specialists is carried out. The effectiveness of new approaches to training medical personnel was assessed. Results. The system of organizational measures aimed at training young specialists to work in the Moscow health care system allows for the adaptation of new personnel as soon as possible.

Introduction. The division of nursing staff into procedural, post and dressing personnel has long been fixed in the system of medical positions. Their work dictates the execution of highly specialized manipulations. Such a system of job responsibilities is transparent and understandable for medical personnel and patients. But in recent years, there has been a tendency to generalize labor functions and consolidate nursing specializations. In this regard, a special role is played by studies related to the identification of the attitude of medical personnel to this reform. Purpose of the study. Identification of the attitude of medical personnel to the idea of introducing the position of “clinical nurse“. Methodology. Sociological research using the quantitative method (mass questionnaire survey of nurses and doctors of medical organizations). Results. Based on the systematization of the information obtained by the authors in the course of the study, the main positive and negative aspects of the introduction of a new position in the health care system are identified. Discussion. Subject to the introduction of the new position of “clinical nurse“, its functionality should be fixed in educational programs along with the new functionality of nurses. And not only when training nurses, but also their colleagues, doctors. In practice, the interaction of medical specialists should be built accordingly. Conclusion. The collected and systematized opinions of the respondents interviewed in the course of the study are valuable material for formulating recommendations for implementing the idea of creating a “clinical nurse“ position.

Background. The quality of care is assessed by set of indicators, including quality of life indicators. Dozens of countries have approved the EQ-5D quality of life questionnaires and have developed national / regional evaluation systems. We carefully hypothesize that the broader usage of EQ-5D in real clinical practice of local Moscow health system could be incentivized and improved through the development of direct region-specific standard EQ-5D «values sets» for population of Russian capital. Purpose. Reviewing the results of the studies on values sets for EQ-5D as well as summarizing the parallel valuations of EQ-5D-3L and -5L by time trade-off based on two examples. Materials and methods. The study was carried out using open external databases. We analyzed the research works which employed the standard valuation methods for EQ-5D, including time trade-off and math modelling. Results. To obtain direct regional values for EQ-5D, standard international protocols (EQ-VT) are used with the inclusion of such tools as: time trade-off, visual analogue scale and experiments with discrete choice. In particular, the application of the time trade-off method allows the generation of direct region-specific values set for EQ-5D. Moreover, the EQ-5D-5L questionnaire was superior to EQ-5D-3L in many aspects. Conclusion. The best results in health assessments could be obtained by applying a variety of methods adapted to the specific highly urbanized region. The many issues behind the standardization of EQ-5D (particularly EQ-5D-5L) value sets in accordance with the cultural/societal preferences of Moscow city population as well as entire Russian population remain unresolved.

In this article provides an overview of publications by foreign authors of the novel coronavirus (SARS-CoV-2) and introduce a modified treatment method for COVID-19-associated pneumonia. X-ray therapy was used to treat pneumonia during the first half of the 20th century. Fifteen studies report that approximately 700 cases of bacterial (lobar and bronchopneumonia), sulfanilamide non-responsive, interstitial, and atypical pneumonia were effectively treated by low doses of X-rays, leading to disease resolution, based on clinical symptoms, objective disease biomarkers, and mortality incidence. The capacity of the X-ray treatment to reduce
mortality was similar to serum therapy and sulfonamide treatment during the same time period. The mechanism by which the X-ray treatment acts upon pneumonia involves the induction of an anti-inflammatory phenotype that leads to a rapid reversal of clinical symptoms. The capacity of low doses of X-rays to suppress inflammatory responses is a significant new concept for treatment COVID-19 pneumonitis. Low dose whole lung irradiation may be a potential solution in the present time. International research organization and the International Geriatric Radiotherapy Group (http://www.igrg.org) proposed a simple and practical protocol for Low dose whole lung irradiation to allow participation of all countries in the world regardless of their resources and made available to the whole world community for treatment COVID-19 pneumonitis.

In 2021, the sociological service of State Budgetary Institution «Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department» celebrates its 5th anniversary; this article partly reflects on the experience gained during its operation. The article examines the current challenges for medical sociology in healthcare management, among which are the need to change present work culture with feedback, poor skills in medical and sociological research (problems of sampling, creating tools, collecting data, determining reference values) and weak practice-orientation in research. The article outlines important directions for development of medical sociology.