CONTENTS
MEDICOSANITARY PROVISION OF WORKERS OF INDUSTRIAL ENTERPRISES IN KAZANThe state of medicosanitary care to workers in Kazan from 1958 to 2004 is analyzed. Indices of occupational diseases significantly decreased mostly due to elimination of corporation principle of medicosanitary provision of workers. About 70% of patients are workers of three aircraft industry factories still performing medical examinations in the same medical organizations. Low occupational pathologic alert of periodic medical examinations in most of medical institutions but the diagnostic center of the Aviastroitelnii district, the polyclinic ¹ 11 and the hospital ¹11 is noted. PECULIARITIES OF ÐRÎFESSIONAL ACTIVITY AND FUNCTIONAL STATE OF ORGANISM OF MANAGERS IN CURRENT SOCIAL AND ECONOMIC SITUATIONThe results of complex hygienic and medicosocial estimation of professional activity and health of managers of different levels are analyzed. The results of study of duration and content of working day, neuropsychic stress of labour, functional state of nervous and cardiovascular system, correlation of sociometric, professional graphic indices of professional activity and parameters of the functional state of organism of managers of different levels are given. CHANGES OF ACTIVITY OF CARDIOVASCULAR SYSTEM IN WORKERS OF ELECTRIC POWER OBJECTS IN KAZANOccupational conditions and activity of cardiovascular system of workers of electric power substations in Kazan are studied. It is established that effect of electric fields of 50 Hz is one of risk factors in formation and development of cardiovascular diseases in staff of electric power objects. "Dose-effect" correlation of electric fields in 50 Hz is revealed. Necessity to define safety of fields of 50 Hz and continuation of studies on estimation of effects of this factor on health of workers of electric power substations are justified. EPIDEMIOLOGIC STUDY OF THE EFFECT OF WORK WITH THE SOURCES OF ELECTROMAGNETIC FIELDS OF EXTREMELY LOW FREQUENCY ON DEVELOPMENT OF CARDIOVASCULAR DISEASESCross-sectional study of the incidence of cardiovascular diseases using electronic data base of medical examinations of workers of different works in Kazan and Tatarstan Rep[ublic (7587 persons) is carried out. Risk of development of specific diseases in groups with high probability of occupational expositions to electromagnetic fields of extremely low frequency versus low expositions is studied. Reliable risk is revealed for arterial hypertension: odds ratio 1,14 (95% confidence interval 1,06-1,23), etiologic fraction 12,38%. For ischemic heart disease odds ratio is 1,3 (95% confidence interval 1,06-1,60), etiologic fraction 23,1%, for stenocardia - 1,44 (95% confidence interval 1,03-2,02), etiologic fraction 30,6%. On ischemic disease as a whole (120-125) odds ratio is 1,23 (95% confidence interval 1,03-1,47), etiologic fraction 18,7%. Estimation of blood pressure in the model for ischemic heart disease made it possible to obtain higher values of risk: 1,48 against 1,23, etiologic fraction increased up to 32,4%. SCIENTIFIC JUSTIFICATION OF THE CRITERIA OF DEVELOPMENT OF DISORDERS OF REPRODUCTIVE HEALTH UNDER THE INFLUENCE OF INDUSTRIAL ECOLOGY FACTORSScientific justification of the criteria of development the indices of reproductive health disorders taking into account industrial and extraindustrial risk factors is given. The main factors on areas affected by industrial ecology are revealed. The necessity of wider use of mathematical simulation in estimation and prediction of reproductive health state is underlined. MEDICAL AND HYGIENIC PRINCIPLES OF THE DECREASE OF RISK FACTORS AND HEALTH PROTECTION OF POPULATION OF KAZANResults of prolonged studies of the effect of ecologic factors including occupational ones on health of adults and their children are presented. Data on risk factors common for the most often noninfectious diseases in children are given. Main direction of studies of the role of urban environment in the origin of ecopathology of population, its prevention and correction are discussed. The basic condition of rehabilitational care of population is the decrease of environmental pollution for prevention of negative influence of side effects of technical transformation of manufacture and chemicalization of environment on health and evolution of human society. CONTENTS OF VITAMINS B1, B2 AND C IN FOOD-STUFFS PRODUCED IN REGIONS WITH VARIOUS TYPE OF SOILThe level of vitamins in food-stuffs made in the studied region is estimated and the amount of vitamins in day ration of children, calculated using reference tables and based on data on content of vitamins in food-stuff is compared. Significant discrepancy between true content of vitamins in food-stuffs and data of reference tables is revealed. True amount of thiamine and ascorbic acid in day ration of children is lower on 10 - 23% than calculated using reference tables, true content of riboflavin is higher on 10 - 20%. STUDY OF KNOWLEDGE OF PUPILS ON PROBLEMS OF RATIONAL FEEDINGThe level of knowledge of pupils in high school of Kazan and Zelenodolsk on rational feeding by questionnaire with subsequent interviewing of 519 pupils is studied. Statistical analysis using Kramer criteria, ?2, Fisher angular transformation, calculation of indices of fraction and its error are carried out. Distribution of answers of interviewed pupils shows lack of knowledge on problems of rational feeding. REPRODUCTIVE POTENTIAL OF GIRLS-TEENAGERS IN KAZANReproductive and demographic process in Kazan characterized by negative phenomena (low level of birth rate, negative natural increase, impairment of health of population) on the one hand, and by positive tendencies (pronounced decrease of level of reproductive loss, growth of the amount of women of childbearing age and teenagers) on the other hand is studied. Social and behavioural irregularity of schoolgirls, various degree and specificity of the effect of hygienic factors on reproductive health are revealed. General laws in health state of girls in Kazan including indices of morphofunctional development, which are considered as negative prognostic signs with regard to realization of reproductive function, are determined. ANALYSIS OF HYGIENIC AND ERGONOMIC INDICES ON WORKING PLACES OF WOMEN POLISHERS FOR OPTIMIZATION OF LABOUR PROCESSMeasurements of temperaturå, relative humidity, air motion velocity, sound pressure intensity in octave zones of average geometric frequencies and equivalent values of sound, levels of local vibration, concenration of aerosols largely of fibrogenic action taking into account actual and control dust loads are carried out to estimate labour conditions on 55 working places of polishers. Analysis of the obtained results according to requirements of sanitary and hygienic documents on some hazardeus industrial factors showed that their labour falls to unhealthy labour conditions - to the 3 d class of the 2nd degree. Preventive measures are suggested to inprove labour conditions. EFFECT OF COMPUTER STUDIES ON HEALTH STATE OF PUPILS IN KAZANRelative risk of appearance of subjective complaints as well as deviations in physical development and physical fitness of pupils of middle forms depending on the use of computers in education and training is determined. The results show the presence of increased risk of complaints on health among children using computer for studies. GENDER AND AGE DIFFERENCES IN STYLE OF LIFE OF GYMNASIA PUPILS IN KAZANStyle of life and behaviour peculiarities of teenagers of different sex and age in educational institutions of new type in different age groups are studied. School achievements, physical and mental health are predictors of crime and require increased attention, being a measure of their prevention in adults. Analysis of health state in pupils by questionnaire showed that the most vulnerable part of observed persons are girls aged 13-15, for what reason they should be defined as risk group. HIGH-DOSE IMMUNOSUPPRESSIVE THERAPY WITH AUTOLOGOUS TRANSPLANTATION OF STEM HEMOPOETIC CELLS IN RHEUMATOID ARTHRITISAutologous transplantation of stem hemopoetic cells was performed in 3 patients with rheumatoid arthritis from 2000 to 2003 in Samara region hospital. Clinical case of the patient with unfavourable prognostic signs is given. After autologous transplantation of stem hemopoetic cells remission of the disease was achieved. JUSTIFICATION OF PREVENTIVE CORRECTION OF HEPATIC CIRCULATION DURING SURGICAL TREATMENT OF PATIENTS WITH ABDOMINAL CAVITY ORGANS' DISEASESDisorders of local hepatic circulation in surgical traumas are established on the basis of experimental studies. The method of correction of hepatic circulation, with proven efficiency based on portal pressure data and morphologic histochemical data, is suggested. STATE OF HEMOSTASIS IN VIRAL HEPATITIS BComplex study of the clinico-hemostasiologic status of patients with viral hepatitis B in dynamics of infectious process is carried out. The results characterizing the disseminated intravascular coagulation syndrome in its different phases are obtained: in acute viral hepatitis B - hyper- or hypocoagulative changes depending on severity of the disease. The more severe is infectious process in acute period the more pronounced is hypocoagulation state. In chronic viral hepatitis B hemostasis indices show most hypocoagulative changes depending on level of viraemia. ULTRASOUND CRITERIA OF CHRONIC PYELONEPHRITISUltrasound method in the diagnosis of chronic pyelonephritis with possible sonohemodynamic correlations is estimated. Ultrasound examination of kidneys in B-regime was performed in 65 patients with chronic pyelonephritis with transitory, persistant and critical degree of nephrogenic hypertension. Ultrasound examination with color Doppler mapping of vessels was performed in 35 patients. Kidney function was normal in all patients. Renal sinus volume and renoparenchymal index changed, blood circulation decreased in cortical and then in medullar layers of kidney along with severity of nephrogenic hypertension. PREVENTION AND TREATMENT OF POSTOPERATIVE COMPLICATIONS IN PATIENTS AFTER CYSTECTOMY WITH ENTEROCYSTOPLASTYImmediate results of cystectomy with different variants of enterocystoplasty are studied. The most frequent complications are paralytic postoperative ileus, peritonitis and pyelonephritis. In postoperative period in case of persistant dynamic ileus paranephralgic or lumbar bilateral novocaine blockade is recommended under ultrasound control. Relaparotomy and unloading enterostoma are recommended in peritonitis during 3-4 days. Percutaneous nephrostomy is indicated in acute obturational pyelonephritis, in urinary back flows and peritonitis. COMPARATIVE ESTIMATION OF THE RESULTS OF LOW-FLOOR MAGNETO-RESONANCE TOMOGRAPHY AND ARTHROSCOPY IN THE DIAGNOSIS OF PATHOLOGY OF THE KNEE JOINT IN CHILDRENResults of magnetoresonance tomography of the knee joint in 65 children aged 6 to 17 are analyzed. Iniury of meniscus is diagnosed in 31 patients, isolated injury - in 13 patients, in combination with injuries of other interual structures of the joint - in 18 patients. Inflammatory and degenerative changes as wellas injuries of capsular-ligamentous structures of the knee joint are diagnosed in 18 from 34 children. Comparison of the results of magnetoresonance tomography and arthroscopy and operative intervention showed that sensitivity of magneto-resonance tomography in pathology of the knee joint in children is 95,4%, accuracy is 95,2%. DYNAMICS OF REACTIVE REORGANIZATION OF MICROCIRCULATORY MODULES OF DIFFERENT TYPES OF SKELETAL MUSCLES AFTER BULLET DAMAGE IN EXPERIMENTDynamics of reorganization of components of microcirculatory modules in white and red skeletal muscles of rabbits 5,15 and 30 days after bullet damage is studied. Diameters of all components of the microcirculatory modules and muscular fibers on preparations after injection of blood vessels in combination with histologic staining are measured. Dynamics of reorganization of the intraorgan microcirculatory structure and restitution of vascular supply are predetermined by initial differences of the level of muscle metabolism, special organization of all components of microcirculatory modules and their diameters. QUALITY OF HOSPITAL PEDIATRIC CARE AND WAYS OF ITS IMPROVEMENT IN TATARSTAN REPUBLICThe state of hospital pediatric care to children in Tatarstan Republic during 1991-2003 is analyzed. Basic indices of activity of beds, hospitalized morbidity, quality of treatment and diagnostic process in various hospitals are studied. Suggestions on improvement of quality îîf hospital care for children are developed and justified, their medical and economic efficiency is estimated. |