Medicni perspektivi, 2018;23(3 part 1)
2018 Vol. XXIII N 3 part 1
Basanets A.V., Bulavko M.M. Labor conditions and peculiarities of the clinical course of deforming arthrosis in workers of mining industry
Key words: deforming arthrosis, miner, preservation of health
Abstract. Labor conditions and peculiarities of the clinical course of deforming arthrosis in workers of mining industry. Basanets A.V., Bulavko M.M. Pathology of the musculoskeletal system occupies one of the leading places in the structure of occupational morbidity in Ukraine. A total of 40 miners were surveyed, 29 of them are mining workers of breakage face (MWBF) and 11 machinists of shearer mining machines (МSMM), suffering from deforming arthrosis (DA) at the age of 44.45 ± 0.95 years. Working conditions of the miners of these specialties were beyond the normative ones, approved in Ukraine in terms of severity and tension. The most common symptoms of DA in the miners of both groups are: constant pain; pain aggravating at exertion; crunch; limitation of movement and changed contours of the knee joints. While comparing the clinical symptoms of DA between the professional groups, there were no significant difference in their frequency, except for the change in the contours of the knee symptoms, which is 2.40 times more frequent in the MWBF than in the MSMM. The majority of biochemical indexes do not exceed the physiological norm in the subjects. Significant differences are observed in the values of C-reactive protein, ASLO, glucose and calcium between patients of both occupational groups (p<0.05).
Basanets A.V., Ostapenko T.A., Zhurakhivska N.V. The role of «proteolysis-antiproteolysis» system genes in occupational COPD development
Key words: chronic obstructive pulmonary disease (COPD), genetic predisposition, polymorphism
Abstract. The role of «proteolysis-antiproteolysis» system genes in occupational COPD development. Basanets A.V., Ostapenko T.A., Zhurakhivska N.V. COPD is multifactorial disease, in which hereditary predisposition and environmental factors (including work conditions) play an important role. Among the genes associated with possible predisposition to COPD development a group of genes with the expression impacting the activity of “proteolysis-antiproteolysis – MMP2, MM9, TIMP2, A2M, ELN is considered. The main group of 72 underground coal miners with COPD (mean age 53,7±5,8 years, mean work experience – 21,8±4,8 years), and control group of 79 healthy miners (mean age – 48,2±5,6 years, mean work experience – 20,2±4,5 years) were examined. Polymorphism of genes with out bronchopulmonary pathology MMP9, α2M was revealed using PCR with electroforetic detection in agarosegel. Polymorphism of genes TIMP2, MMP2, ELN was revealed using PCR with fluorescent detection (RealTime PCR). By the data of molecular-genetic research among miners with COPD of occupational etiology (main group) and miners without it (control group) there was estabkished a reliable difference for the genotypes:
MMP9*СС,MMP2*CC,TIMP2*G/G,α2M*IIe/IIe,ELN*Gly/Gly; MMP9*СС,MMP2*CТ,TIMP2*G/G,α2M*IIe/Val,ELN*Gly/Gly; MMP9*СС,MMP2*CС,TIMP2*G/G,α2M*IIe/Val,ELN*Ser/Se; MMP9*СТ,MMP2*CC,TIMP2*G/G,α2M*IIe/IIe,ELN*Gly/Ser.
These genotypes are associated with resistance for COPD development in underground coal miners of Ukraine. The obtained results testify to the participation of genes encoding protein synthesis of the system "proteolysantiproteolysis": MMP2, MMP9, TIMP2, A2M, ELN in the formation of genetic predisposition and resistance to the development of COPD of professional etiology in miners, which reveals new opportunities in the prevention of this disease in workers subject to the high concentrations of coal-rock dust.
Biletska E.M., Onul N.M., Nikonenko V.I. Metallurgical enterprises as a source of atmospheric air pollution and a risk factor for deteriorating of population health
Key words: metallurgical enterprise, air pollution, emission of harmful substances, risk, prevention
Abstract. Metallurgical enterprises as a source of atmospheric air pollution and a risk factor for deteriorating population health. Biletska E.M., Onul N.M., Nikonenko V.I. The article is devoted to modern aspects of technogenic pollution of atmospheric air of industrial city in connection with the activity of the largest metallurgical enterprise in Ukraine - Dneprovsky metallurgical combine. The peculiarity of this scientific research is the use of a comprehensive and systemic ecological and hygienic approach: by-ingredient and summary hygienic assessment of technogenic pollution of the atmospheric air layer in the city, its spatial and temporal characteristics in the dynamics of a 30-years’ period with an emphasis on the last five years, considering quantitative relationship with the volumes of gross industrial atmospheric emissions and their distribution on the territory of the city was performed, as well as mathematical calculations and hygienic assessment of risk to the health of the city population were made.
Key words: carpal tunnel syndrome, overstrain syndrome, occupational diseases, ergonomics
Abstract. Computer mouse, keyboard and carpal tunnel syndrome. Berezutsky V.I. The article aims to analyze scientific publications of recent years on the problem of carpal tunnel syndrome in computer users. To achieve the aim, the search was carried out in the science-based databases Scopus, WebOfScience and PubMed for 2015-2018. The results suggest that repeated movements of the wrist lead to overstrain of the ligaments of the wrist and neuropathy of the median nerve in almost 15% of professional users of computers and gamers. Early diagnosis is possible with ultrasound examination of the carpal tunnel and electrophysiological examination of the median nerve in occupational risk groups. In severe carpal tunnel syndrome, only surgical treatment is effective, and physiotherapy methods for moderate and light forms. The most effective prevention strategy is to improve the ergonomics of the workplace for professional computer users, short breaks in work to relax the muscles of the hand, and various physical exercises to improve the circulation of blood and lymph in the carpal tunnel. The popularization of the latest advances in the diagnosis, treatment and prevention of carpal tunnel syndrome among practitioners will help to increase the effectiveness of medical care in this disease.
Varyvonchyk D.V., Kopach K.D. Complex analysis of occupation-related morbidity in the workers of dental service
Key words: medical workers, incidence, occupational factors, prevention
Abstract. Complex analysis of occupation related morbidity in the workers of dental service. Varyvonchyk D.V., Kopach K.D. Purpose – to establish the current state and role of occupational factors of determination of morbidity among dental service employees of Ukraine for the following scientific substantiation of the risk-prevention measures. The research was carried out with the help of the developed medico-sociological questionnaire among 1000 workers of dental service in Kyiv, Odessa, Chernivtsi. Working conditions, morbidity with temporary disability (MTD) and prevalence of pathology among workers (in the context of classes and nosologies ICD-10) were studied. There was compared the prevalence of pathology among workers with the general population of Ukraine and Europe (as of 2016), using a Standardized Incidence Ratio (SIR). With the use of non-parametric Spearman correlation analysis statistical links between the prevalence of classes of diseases in the workers were investigated. Using discriminant analysis (Wilks-test) determining role in the formation of MTD, prevalence of pathology among the employees of the dental service, the following factors: gender, age, occupational group, speciality, working conditions was determined. The employees of the dental service have сomorbidity of pathology with simultaneous diseases of the organs of the system: digestion, bone-muscular, skin, blood circulation, nervous and respiratory. On average, one worker has diseases from 2.2 classes of diseases (ICD-10). All pathological states have multifactoral etiology, in which both biological (age-related changes) and professional risk factors are combined. Taking into account the significant effect of the complex of harmful occupational factors on the levels of prevalence and progression of pathological conditions, it is highly probable to say that the category "Occupational diseases" relatively employees of the dental service include: infectious diseases (HIV infection, hepatitis B/C, tuberculosis), mental disorders and behaviors (including depression); diseases of respiratory organs (bronchitis, bronchial asthma); skin diseases (dermatosis); diseases of the nervous system (radiculopathy) and musculoskeletal system (arthritis, osteoarthritis). Prevention programs should be developed and implemented among dental workers.
Vasylenko A.M., Burtniak T.Z. The state of cardiorespiratory system in miners at the stages of formation and stabilization of arterial hypertension
Key words: arterial hypertension, function of external respiration, blood oxygenation, miners
Abstract. The state of cardiorespiratory system in miners at the stages of formation and stabilization of arterial hypertension. Vasylenko A.M., Burtniak T.Z. The purpose of our work is to study the functional state of the cardiorespiratory system in miners of mining industry at the stages of formation and stabilization of hypertensive disease (HD). 129 miners with normal high blood pressure were examined, 94 miners with the 1 stage of hypertonia, 52 miners with the 2 stage of hypertonia, 30 miners with the 2 stage of hypertonia combined with COPD. 305 male miners were examined. The control group consisted of 30 practically healthy miners. The examined of all groups were similar in the age and work experience. Miners with the work experience of 10 years and more were included in the research. In miners with arterial hypertension problems with function of external respiration (FER) were observed. In the early stages of hypertension, they are compensatory-adaptive in the form of hyperventilation with the increase in the respiratory volume (RV). In the late stages of hypertension, hyperventilation is characterized by the increase in the frequency of respiration (FR) and decrease in RV and vital capacity of the lungs (VCL). The maximum ventilation of lungs (MVL) decreased already at normal high pressure (systolic BP 130-139 mmHg, diastolic BP 80-89 mmHg). A significant decrease in MVL was observed in patients with stage 2 HD, especially in its combination with COPD. In patients with stage 2 HD and especially in its combination with COPD, pulmonary-cardiac ratios were significantly impaired, as evidenced by such indices as: oxygen pulse (OP), minute breathing volume (MBV) / minute blood volume (MBV), RV / stroke volume (SV), heart rate (HR) / breathing rate (BR). It is shown that at the stages of AH formation in miners, compensatory interactions of external respiration with effective hemodynamic support are observed. The conducted study showed that miners with AH develop significant changes in the apparatus of external respiration, which lead to the development of latent bronchial obstruction, hyperventilation, hypoxia, and worsening of pulmonary-cardiac relations.
Garmish I.P. Endothelial function of vessels in patients with chronic kidney disease combined with subclinical hypothyroidism under the influence of combined antihypertensive therapy
Key words: chronic kidney disease, arterial hypertension, subclinical hypothyroidism, combined antihypertensive therapy, brachial artery flow-mediated dilation
Abstract. Endothelial function of vessels in patients with chronic kidney disease combined with subclinical hypothyroidism under the influence of combined antihypertensive therapy. Garmish I.P. The aim of the study: to evaluate the endothelial function of the vessels under the influence of combined antihypertensive therapy (valsartan 160 mg / amlodipine 5 mg vs valsartan 160 mg / hydrochlorothiazide 12,5 mg) in patients with CKD and subclinical hypothyroidism. 80 patients with CKD I-II stages and AH 1 and 2 degrees were examined. According to TSH level patients were divided into 2 groups. Than patients with SH were separated into 2 subgroups: 1a – patients that received valsartan 160mg/ amlodipine 5 mg and 1b - patients that received valsartan 160mg/ hydrochlorothiazide 12,5 mg). More often violation of brachial artery flow-mediated dilation was found among the main group. The use of two-component antihypertensive therapy based on valsartan 160 mg and amlodipine 5 mg or valsartan 160 mg and hydrochlorothiazide 12,5 mg ensured the achievement of target blood pressure levels in 83,3% and 84% of patients, respectively. The more significant improvement of brachial artery flow-mediated dilation was observed in patients that received fixed combination valsartan 160 mg/amlodipine 5 mg.
Gashynova K.Yu. Chronic obstructive pulmonary disease (COPD): influence of clinic-anamnestic, anthropometric and functional characteristics on serum α-1-anitrypsin (AAT) in stable patients
Key words: COPD, exacerbation, α-1-antitrypsin
Abstract. Chronic obstructive pulmonary disease (COPD): influence of clinic-anamnestic, anthropometric and functional characteristics on serum α-1-anitrypsin (AAT) in stable patients. Gashynova K. Yu. Aim of the study – to enhance the diagnostic and treatment tactics of stable COPD patients management at outpatient stage by studying the serum AAT. Data of 45 outpatients with COPD (GOLD I-IV) and 20 healthy persons were included into analysis. Sex, age, height, weight, body mass index (BMI), smoking status were assessed. Lung function and serum AAT were measured. These results suggest that sex, age, height, weight, BMI do not influence on serum AAT both in stable COPD patients and healthy persons. Serum AAT statistically significant negatively correlate with airways obstruction degree in stable COPD patients. Significant moderate negative correlation between serum AAT and number of exacerbation during last year was found in stable COPD patients. This finding allows to suggest that serum AAT could be used as an indicator for COPD prognosis.
Hlyniana L.A., Rodionova V.V., Gashynova K.Y., Tchebanov K.O., But N.A., Bila E.I., Masurez T.A. The structure of industrially predisposed diseases in workers of the metallurgical enterprise working in harmful conditions
Key words: metallurgical enterprise, industrially determined diseases, medical examinations, working population, rehabilitation
Abstract. The structure of industrially predisposed diseases in workers of the metallurgical enterprise working in harmful conditions. Hlyniana L.A., Rodionova V.V., Gashynova K.Y., Tchebanov K.O., But N.A., Bila E.I., Masurez T.A. The analysis of the medical examination results with the evaluation of health status was conducted in 783 employees of the metallurgical enterprise in Dnіprо city, The data of 295 women (30,2%) and 548 men (69,8%), (mean age – 52.0±8.1 years, work experience – 12.5±5.7 years) were analyzed. The most common were cardiovascular diseases; upper respiratory disorders, low extremities vessels and musculoskeletal diseases, sensoro-neural, deafness follow. The pathology revealed more often occurs in men of some occupations.
Hryniuk S., Matviichuk T. Prerequisites for the development of forecasting system of cerebrovascular diseases development in the patients with vibration disease caused by the actions of the whole-body vibration in the post-exposure period
Key words: vibration disease, whole-body vibration, cerebrovascular diseases, post-exposure period, patients, forecasting, anthropometric indicators, indicators of systemic hemodynamics
Abstract. Prerequisites for the development of forecasting system of cerebrovascular diseases development in the patients with vibration disease caused by the actions of the whole-body vibration in the post-exposure period. Hryniuk S., Matviichuk T. The health of the working population is an important characteristic of the economic and social state of the country. Occupational diseases according to WHO is the cause of 1.7 million deaths in the world. The third place in the structure of occupational morbidity is occupied by vibration-noise pathology (5-18%). In this group, cases of vibration disease (VD) make up 60-70%. In the structure of diseases of the circulatory system (DCS) among the adult population, cerebrovascular diseases (CVD) rank third after hypertension and coronary heart disease and make up 16.8%. Death rate from CVD takes the 4th place in the world. To develop a forecast for the emergence of CVD in patients with VD caused by whole-body vibration, we analyzed a number of anthropometric and physiological indicators. There was performed a profound inpatient examination of 179 patients with VD (149 workers of mining enterprise with surface mining operations with VD caused by whole-body vibration without CVD and 30 patients with diagnosed CVD in addition to CVD). The diagnostic value of individual anthropometric indicators and indicators of systemic hemodynamics (arterial pressure) in VD caused by whole-body vibration and CVD in these patients was proved. Increased body weight with fat distribution by the abdominal type increases the risk of early VD and CVD occurrence. The regularity of dependence of arterial hypertension onset (increase of blood pressure above the level of 140/86 mm Hg) with the duration of the harmful effect of vibration was determined. At the same time, the share of workers with optimal blood pressure figures decreases with increasing duration of the action of the whole-body vibration. Thus, the metabolic and blood pressure indicators can be used to further construct predictive models for the development of CVD in patients with VD caused by whole-body vibration.
Hryniuk S. Biological age and aging rate of patients with vibration disease caused by the actions of the whole-body vibration in the post-exposure period
Key words: vibration disease, whole-body vibration, post-exposure period, patients, biological age, aging rate
Abstract. Biological age and aging rate of patients with vibration disease caused by the actions of the whole-body vibration in the post-exposure period. Hryniuk S. The problem of occupational morbidity in Ukraine has a great importance in the system of health protection of workers. Vibration disease (VD) in the structure of occupational diseases occupies one of the first places. Most of the studies are devoted to the consideration of its manifestations and development before the cessation of patients’ contact with the harmful effects of vibrations. The study of vibration disease in the post-exposure period was done rare. In modern medicine, more attention is paid to assessing the functional state of the human body in general and specifically its "vitality". Therefore, the purpose of our work was to study the biological age (BA) and the aging rate (AR) as health criteria of patients with VD caused by the effects of the whole-body vibration in the period after cessation of working in harmful conditions. 179 patients in the post-exposure period of the VD were examined. All patients were treated with a "Method for determining the biological age of a person and the aging rate" based on the determination of the aging coefficient. It was found that deviations of the biological age from the population standard occurred in 100% of cases. The highest rates of aging took place in the group of patients with less than 13 years of work experience. The greatest aging rates were in the group of drivers of excavators and locomotive drivers. The state of balance of the cardiovascular system was the lowest among those who worked from 13 to 21 years and more than 34 years, respectively. Biological age can be used to develop systems for early diagnosis and improvement of primary and secondary prevention of occupational and work-related diseases.
Daragan G.M., Krushinska T.Yu., Hrankina N.V., Vorontsova O.V., Stepanskiy D.O. Problematics of proving the fact of occupational TB in health care workers
Key words: tuberculosis, occupational disease, health care workers, infection control
Abstract. Problematics of proving the fact of occupational TB in health care workers. Daragan G.M., Krushinska T.Yu., Hrankina N.V., Vorontsova O.V., Stepanskiy D.O. The incidence of tuberculosis in medical personnel in the Dnipropetrovsk region, incl. TB facilities, was analyzed for the period from 2008 to 2017. Occupational TB is an important indicator of infection control efficacy in health care facilities. Despite reducing trend of incidence in entire population and medical workers, their morbidity rates exceeded Ukrainian average ones by 25.0% and 2.5 times, respectively. There is about one and a half thousand employees in TB facilities of Dnipropetrovsk region. Their TB incidence rate was almost 5 times (p≤0.05) higher than in employees of other health care institutions and 6.6 times (p≤0.05) exceeded incidence of tuberculosis in community. In TB facilities, the highest incidence was registered among nurses – 506.8 per 100000. Non-medical workers have the second rank of incidence (409.4 per 100000). They did not contact TB patients directly, but inhaled air containing Mycobacterium tuberculosis. The incidence of TB in doctors and hospital attendants was lower – 384.6 and 357.1 per 100000, respectively. Nurses prevailed among TB-ill medical personnel of TB facilities – 41±3,4%. Hospital attendants had morbidity of 24±5,4%, non-medical stuff – 22±5,2%, doctors – 13±4,%. The confirmation of healthcare workers’ occupational TB cases is complicated. Taking info account that this infection is widely spread in community, it is necessary to reveal active and latent tuberculosis infection with the quantiferon test and other modern methods, as well as to carry out genotyping of mycobacterium tuberculosis for finding epidemiological links in nosocomial TB transmission. To reduce the risks of occupational disease, it is important to carry out trainings on TB infection control for medical personnel and support staff.
Ivchuk V.V., Kopteva T. Yu., Kovalchuk T.A. Characteristics of sputum cellular composition in patients with chronic obstructive pulmonary disease of professional etiology
Key words: diseases of bronchopulmonary apparatus, inflammation, cytogram, sputum
Abstract. Characteristics of sputum cellular composition in patients with chronic obstructive pulmonary disease of professional etiology. Ivchuk V.V., Kopteva T. Yu., Kovalchuk T.A. Inhalation of high concentrations of various types of dust, in particular of inorganic origin, leads to disruption of the normal mechanism of lung cleaning. A consequence of this is the development of inflammation of the airways with the formation of COPD. The inflammatory response of the airways with exacerbation of COPD is accompanied by the increase in the total number of neutrophils and lymphocytes. This heterogeneous cellular infiltrate is the source of specific biologically active substances that play a significant role in the structural and functional changes in the mucous membrane of the bronchopulmonary system. Sputum formation is one of the main clinical symptoms of respiratory diseases. By the parameters of the cellular composition of sputum, it is possible to determine the pathogenetic variant and the severity of the inflammatory response of the respiratory mucosa. The aim of the work was to study the cellular composition in the spontaneous sputum of COPD patients of mining industry. Cytological and statistical methods of investigation were used to achieve this goal. The study of the characteristics of the cell composition of sputum, depending on the degree of severity of COPD of professional etiology, is relevant and informative and allows to evaluate the activity and role of local inflammation in the development and course of the disease. With an increase in the severity of bronchial obstruction in sputum, the total number of cellular elements, neutrophils and lymphocytes increases. The feature of local inflammation developing in the initial stages of COPD of professional etiology is the predominance of macrophages in sputum. With worsening of the severity of the disease course, when the inflammation acquires a persistent character, the number of neutrophils and lymphocytes increases in sputum.
Kapustnyk V.A., Arkhipkina O.L., Poliakova L.A., Sukhonos N.K. Clinical and pathogenic aspects of vibrational disease and comorbid pathologies
Key words: vibrational disease, arterial hypertension, chronic obstructive pulmonary disease, hormones, cytokines
Abstract. Clinical and pathogenic aspects of vibrational disease and comorbid pathologies. Kapustnyk V.A., Arkhipkina O.L., Poliakova L.A., Sukhonos N.K. Despite the tendency to decrease in the level of vibrational disease morbidity, this pathology is third in the structure of occupational diseases in Ukraine. According to research design, we have examined 178 vibrational disease patients of I and II degree due to local vibration. They have been divided into 3 groups: first — 66 patients with vibrational disease and chronic obstructive pulmonary disease; second — 60 patients with vibrational disease and arterial hypertension of II degree, and group of comparison – 52 patients with isolated course of vibrational disease. We have used clinical and physiological, ELISA methods to estimate cytokines levels in these patients. We have found that clinical signs of vibrational disease depend on vibrational disease progressing and comorbid pathologies. Overlay of chronic obstructive pulmonary disease to vibrational disease significantly worsens disease course, manifested by augmenting of clinical symptoms, neurovascular and trophic violations. Comorbid course of vibrational disease and arterial hypertension leads to respective worsening of cardio-vascular pathology. One of the mechanisms of development and progressing of vibrational disease is imbalance of cytokine chain of immunity — increase of the amount of inflammatory cytokine TNF-α and decrease of anti-inflammatory — IL-10. Overlay of chronic obstructive pulmonary disease enhances this trend. In patients with comorbid course of vibrational disease and arterial hypertension we have observed development of secondary dysregulatory state of immunocompetent system. This is proved by increased levels of inflammatory cytokines (TNF-α by 62.5 % and IL-8 by 46.5 %), and decreased activity of melatonin by 35.0 % in comparison with group of patients with isolated vibrational disease.
Kovalchuk T.A., Ishchenko L.A.The definition of trends in the age structure of employees of working age
Key words: working age, age structure of employees, ageing index
Abstract. The definition of trends in the age structure of employees of working age. Kovalchuk T.A., Ishchenko L.A. Against the background of demographic processes of population aging in Ukraine today, as in the whole world, there is the process of change in the age structure of the working-age population. The relative number of people older than working age is increasing. Our research aimed at the analysis of the contingents of employees undergoing professional selection and determination of the trends in quantitative and age structure of working-aged people. The materials on the analysis of the massifs of groups of workers undergoing professional selection in the Regional Center of Psychophysiological Examination in the State Institution "Ukrainian Research Institute of Industrial Medicine" are presented. The number of analyzed contingents was 19 486 persons. The study covered the five-year period of 2012-2016. The ageing index for working-aged workers was determined. The conclusions about changes in the quantitative and age structure of the working-aged population were made. The proportion of older people among productive population of Ukraine is increasing, that is caused by demographic changes, socio-economic crisis and the outflow of personnel. This indicates to the necessity of improving preventive measures, considering the potential of older people, in order to maintain their professional health.
Kovalchuk T.A., Savushina I.V. Risk of development of professional pathology of the voice apparatus in teachers of secondary schools
Key words: professional laryngitis, voice load, risk of developing professional pathology of the vocal apparatus, teachers of general educational institutions, experience and age of teacher
Abstract. Risk of development of professional pathology of the voice apparatus in teachers of secondary schools. Kovalchuk T.A., Savushina I.V. The frequency of functional voice disorders associated with profession varies from 13,7% to 70%, which requires the timely identification of the risk of developing professional laryngitis, development and implementation of modern effective risk management models. Aim – to determine the risk of developing professional pathology of the vocal apparatus in teachers of general education schools. The analysis of age and seniority is performed among 5346 teachers. Risk determination of development of professional laryngitis is carried out according to standard methodology by analyzing outpatient cards of 63 teachers. The probability of getting sick with the work experience of up to 5 years is 5% of the number of patients, and with the work experience of 35 years or more is 100%. The probability of getting sick with professional laryngitis is by 95% due to voice load and only by 5% to other factors. The absolute risk of developing professional laryngitis is the highest in the age group of 51-54 (AR=0,21) years and 55-60 years (AR=0.22). The relative risk of developing professional laryngitis with 20-24 years of work experience is 20 with etiological proportion of voice load of 95 %, but with increasing length of service, the relative risk, like etiological proportion of the relative risk, is less than the age-related changes.
Kolisnyk N.S., Dragun U.P., Stadnik A.I., Chabanenko O.L., Rogova A.M., Marchenko N.A., Freivald V.A. Analysis of tuberculosis incidence among health workers in the Dnepropetrovsk region
Key words: tuberculosis, healthcare workers, general medical service departments, antitubercular departments
Abstract. Analysis of tuberculosis incidence among health workers in the Dnepropetrovsk region. Kolisnyk N.S., Dragun U.P., Stadnik A.I., Chabanenko O.L., Rogova A.M., Marchenko N.A., Freivald V.A. The purpose of our study was to conduct a comparative analysis of tuberculosis incidence among healthcare workers in the general medical service departments and anti-tubercular departments in the Dnipropetrovsk region for the period from 2008 to 2017, analysis of the professional, clinical structure of tuberculosis cases for 2015-2017. Despite the decrease in the incidence of tuberculosis in Ukraine, the incidence of morbidity among medical workers in the Dnipropetrovsk region remains unfavorable. Over the past 3 years, 155 employees of health facilities have been infected with tuberculosis, including 134 from the institutions of the general medical profile and 21 employees of the anti-TB clinics. The risk group consists of representatives of scrub staff and nursing staff, as well as auxiliary (other) personnel, regardless of the profile of the medical institution. It was established that the morbidity of the staff of the institutions of the community network and the clinical structure of cases of tuberculosis is unfavorable with a high proportion of destructive changes in the lungs, bacterial discharge, less specific gravity of cases detected during prophylactic examinations.
Kolisnyk N.S., Stadnik A.I., Chabanenko D.V., Chebotar N.Y., Savenkov Y.F., Bakulin P.E. Medical workers of health care institutions as a risk group for chemo-resistant tuberculosis: analysis of incidence, a clinical case
Key words: tuberculosis, risk groups, chemo-resistant tuberculosis, medical workers, surgical stage of treatment
Abstract. Medical workers of health care institutions as a risk group for chemo-resistant tuberculosis: analysis of incidence, a clinical case. Kolisnyk N.S., Stadnik A.I., Chabanenko D.V., Chebotar N.Y., Savenkov Y.F., Bakulin P.E. The purpose of our study was to analyze the prevalence of morbidity of medical workers of health care institutions and anti-tuberculosis institutions, as well as the analysis of resistance of mycobacterium tuberculosis strains among medical personal of health facilities in the Dnipropetrovsk region. Retrospective analysis for 2015 - 2017 of electronic database of the patients register (TB-manager), outpatient cards and case histories of patients which underwent treatment in pulmonary-tuberculosis and surgical departments of CI «Dnepropetrovsk Regional Clinical Treatment and Prophylactic Association "Phthisiology"» DRC» was conducted. The incidence of tuberculosis among medical workers in health care institutions of Ukraine remains at a fairly high, stable level (426 cases of tuberculosis in 2016, 389 cases in 2017) on the background of the decrease in the incidence among the general population (59.5 people per 100 thousand population in 2014 and 51.9 per 100 thousand population in 2017). In Ukraine among tuberculosis patients – medical workers, the overwhelming majority are workers of establishments of the general medical network (GMN) - 351 people, while in anti-tuberculosis institutions (ATI) in 2017, 38 cases of tuberculosis were registered. The article presents the clinical case of multidrug-resistant tuberculosis (MDR) in staff member of the pathoanatomical bureau, one of the medical institutions of the city Dnipro.
Kovalenko O.M., Rodionova V.V. Characteristics of hemostasis system and activity of trypsin-like blood enzymes in comorbid patients with chronic obstructive pulmonary disease and hypertension
Key words: chronic obstructive pulmonary disease, hypertension, hemostasis, activity of trypsin-like enzymes, smoking
Аbstract. Characteristics of hemostasis system and activity of trypsin-like blood enzymes in comorbid patients with chronic obstructive pulmonary disease and hypertension. Kovalenko O.M., Rodionova V.V. This work was aimed at studying the activity of the hemostasis system and trypsin-like blood enzymes (TLE) in patients with chronic obstructive pulmonary disease (COPD) and hypertension (H), depending on anthropometric, clinical features and smoking. The study included 87 patients. I group included 39 patients with COPD A – D, II-IV by GOLD and concomitant with H I-II stage, II group – 38 patients with H I - II stage, and K group – 10 apparently healthy persons. The study was conducted on the background of the use of standard basic therapy by patients from the 1st and 2nd groups in a stable period of disease. The degree of thrombocyte (tr) adhesion in I and II groups of patients was higher than in the K group. Both adhesive activity and the amount of tr in the I group was higher than in the II group. With positive status of smoking and increasing nicotine addiction in comorbid patients with COPD and H, the adhesive activity of tr increased. The level of the procoagulantive parameters of the plasma part of hemostasis in the two studied groups was not statistically different, but was higher than in the K group. Increased BMR and dyspnoea by the mMRS scale in group with COPD and H and increased age of patients with H led to the increase in the activity of plasma coagulation factors. In I and II groups, the increase in blood TLE was observed, which increased with the body weight, while in comorbid patients in the subgroup with FEV1≥50%, the incidence of COPD exacerbation additionaly effects the increase of TLE. In I group correlation between reduction of FEV1 with the decrease of TLE was revealed. In patients with COPD and AH activity of thrombocyte and plasma hemostasis, as well as trypsin-like blood enzymes, increases. Smoking, body weight gain and incidence of COPD exacerbation contribute to increased prothrombotic potential.
Krotova V.Yu., Khomazyuk Т.А. Causes of cognitive impairment and their manifestations in patients with arterial hypertension
Key words: cognitive impairments in arterial hypertension, diagnosis of cognitive disorders, neuropsychological testing
Abstract. Causes of cognitive impairments development and their manifestations in patients with arterial hypertension. Krotova V.Yu., Khomazyuk Т.А. The article considers risk factors for the development of cognitive disorders, the most powerful of which is age. The role of the cardiovascular system diseases in the formation of cognitive impairments, in particular, the development of changes in the cognitive sphere in arterial hypertension, is reflected. The main causes of the appearance and clinical variants of the manifestation of cognitive impairment in patients with arterial hypertension are highlighted. Attention is paid to morpho-functional changes in the brain, large and small cerebral vessels in the increased blood pressure and their relationship to cognitive impairments. The indications to the study of the cognitive sphere and the variants of diagnosis of cognitive impairments in patients with arterial hypertension are reflected.
Kuryata O.V., Shtepa O.O., Halushchak O.V. Changes in parameters of the function of external respiration in patients with end stage of chronic kidney disease who are on substitution therapy
Key words: function of external respiration, end-stage of chronic kidney disease, kidney transplantation
Abstract. Changes in parameters of function of external respiration in patients with end stage of chronic kidney disease who are on substitution therapy. Kuryata O.V., Shtepa O.O., Halushchak O.V. The aim of our study was to evaluate the changes in the parameters of function of external respiration in patients with end-stage of chronic kidney disease after kidney transplantation in connection with chronic kidney disease under conditions of replacement therapy and compare with the results in patients after kidney transplantation. The first group included 40 patients with end-stage of chronic kidney disease under conditions of replacement dialysis therapy. The second group included 19 patients after kidney transplantation. A significant difference (p˂0,05) was found in patients of the first and second groups between the indicators of the FVC (90 [75-110]% и 98 [91-108]%), FEV1 (79 [71-93]% и 96 [84-104]%), PEF (61 [40-87]% и 82 [64-94]%), MEF 25-75 (52,5 [39-71]% и 80 [66-112]%). The indices of both groups were significantly lower relative to the comparison group: FVC (107,5 [105,5-124]%), FEV1 (100,5 [96-105,5]%), PEF (99,5 [95-102,5]%), MEF 25-75 (98,5 [97,5-101,5]%). In both groups, a statistically significant negative correlation was found between the indicators of the VCmax, FEV1, PEF, MEF 25-75 (R = -0,46, p <0,005; R = -0,43, p<0.05; R = -0,73, p <0,05; R = -0,41, p <0,05). Moderate decrease in the parameters of VCmax, FEV1, PEF, MEF 25-75 in patients with end-stage of chronic kidney disease requires monitoring of FVC with spirometry, especially in conditions of hemodialysis.
Melnyk O.G., Borovyk I.G., Ryabokon А.I., Dyuldyeva T.А., Mоrgun Т.М. Occupational morbidity of engineering industry workers in Kharkov Region in 2012-2016
Key words: occupational morbidity, occupational hazards, record of service, age, engineering industry
Abstract. Occupational morbidity of engineering industry workers in Kharkiv Region in 2012-2016. Melnyk O.G., Borovyk I.G., Ryabokon А.I., Dyuldyeva T.А., Mоrgun Т.М. The occupational morbidity in Kharkov region has been researched over the period of 2012-2016. The dynamics of the number of patients with occupational diseases in this region is practically the same as in Ukraine. Most of such patients are males. However, the number of females increased over this period. According to the record of work in hazardous working environments, the biggest number of patients is observed among those employees who have worked for 20-29 years, then those who have worked for over 30 years, followed by those who have 10-19 years of work record and finally, with less than 10 years of work record. According to the age, the biggest number of patients is among workers at the age of 50-59. They are followed by those who are in their sixties. The third biggest number is among aged 40-49, the fourth – aged 30-39, and the fifth – aged 20-29. In the atructure of occupational pathology (38,67-49,71) of all the occupational diseases accounts for chronic bronchitis, COPD, and pneumoconiosis. The next common disease (29,59-37,33%) is occupational neurosensory hearing loss. It was revealed that 3,37-6,25% of the total number of workers suffer from 4 occupational diseases, 2-3 and 1 occupational diseases were detected in 52,50-72,97% and 21,21-43,82% employees accordingly. The presence of 2-4 occupational diseases points at the combined exposure to hazards of working environment and working process in engineering workers, and inefficient activity of health care institutions that are responsible for periodic medical examinations. The fact that the diseased are mostly people in their fifties and sixties, and those who have a long record of work, indicates to the necessity to implement the time protection technique with a view to reducing the level of occupational morbidity. The highest rate of morbidity was observed in Kharkov engineering industry. That is why it is vitally important to provide the enterprises of this industry with State public health monitoring system.
Oriekhova O.V., Pavlenko О.I. Determination of the risk of professional pathology development in workers of mining and metallurgical industry of Ukraine
Key words: professional risk, professional pathology, mining and metallurgical industry
Abstract. Determination of the risk of professional pathology development in workers of mining and metallurgical industry of Ukraine. Oriekhova O.V., Pavlenko О.I. Professional health is one of the informative indicators of the state of public health, which reacts sensitively to working conditions; this requires the development of new preventive technologies, taking into account the accumulated new scientific developments and the current economic state of the state. An upgradated existing method for determining the individual risk of developing occupational pathology by introducing ratio of class of working conditions, duration of work experience (years) and a ball, depending on the severity of the disease, allows to objectivize the risk of causing harm to health and offer adequate measures to manage occupational risk. There is a significant difference in the levels of relative risk of morbidity for occupational pathology among workers engaged in underground mining of iron ore (RR 5,45 with CI 95% 5,29-5,60 (p <0,05)), open ore extraction ( RR 1,82 at CI 95% 1,67-2,0 (p <0.05)) due to the peculiarities of the technological process and the levels of harmful production factors affecting the organism. The indicator of group relative risk for metallurgical production does not reflect the real state of occupational morbidity, which requires the identification of individual occupational risk in metallurgists. The conducted research opens the prospects for the development and introduction of modern and effective principles of professional risk management in the mining and metallurgy industry of Ukraine in order to improve working conditions and reduce occupational pathologies.
Pertseva T.O., Gashynova K.Yu., Dmytrychenko V.V., Suska K.S. Bronchoectatic disease: the state of art and the clinical case
Key words: bronchoectatic disease, bronchiectasis, computed tomography, Pseudomonas aeruginosa
Abstract. Bronchoectatic disease: the state of art and the clinical case. Pertseva T.O., Gashynova K.Yu., Dmytrychenko V.V., Suska K.S. In connection with the increased diagnostic capabilities of X-ray methods, bronchiectasis is increasingly being diagnosed today. The main problem of patients’ management is the heterogeneity of the etiological factors, as well as the lack of evidence base for the effectiveness of therapy. The article presents a clinical case of bronchiectasis in a patient with chronic carriage of Pseudomonas aeruginosa (mucoid strain) and Klebsiella pneumoniae.
Potabashniy V.A. The phenotypes of chronic heart failure in patients with ischemic heart disease combined with chronic obstructive pulmonary disease
Key words: heart failure, phenotypes, ischaemic heart disease, chronic obstuctive pulmonary disease
Abstract. The phenotypes of chronic heart failure in patients with ischemic heart disease combined with chronic obstructive pulmonary disease. Potabashniy V.A. The aim of this study: on the basis of clinical and instrumental complex investigation of 320 patients with chronic heart failure (CHF) of ischemic etiology combined with chronic obstructive pulmonary disease (COPD) it was proposed to identify several phenotypes of including CHF with preserved ejection fraction (CHFpEF) without right ventricular dysfunction (RVD); CHFpEF with RVD; CHFpEF with right-side failure (RSF); CHF with reduced EF (CHFrEF) plus RSF (biventricular). Identification of these phenotypes creates the pathophysiologic basis to development of rathional pharmacotherapy of CHF in patients with ischemic heart disease combined with COPD.
Rodionova V.V., Zubov A.L. Appealing the diagnosis of occupational disease (clinical and expert case)
Key words: professional disease, appealing the diagnosis
Abstract. Appealing the diagnosis of occupational disease (clinical and expert case). Rodionova V.V., Zubov A.L. The article presents a clinical and expert case of appealing the diagnosis of occupational disease. Purpose: to provide an example of substantiated answer to the court action concerning the appeal of the diagnosis of occupational disease. A medical history of a patient who worked as an electric welder suffering from chronic bronchitis is described. Data on regulatory documents, acting in accordance with the legislation of Ukraine are presented. The main controversial issues that arise when linking the disease to working conditions are studied.
Rubtsov R.V. The role of clinical-functional research in case of pneumoconiosis associated with chronic obstructive pulmonary disease in workers of mining and metallurgical industry
Key words: pneumoconiosis, chronic obstructive pulmonary disease, clinical features, external respiration function
Abstract. The role of clinical-functional research in case of pneumoconiosis associated with chronic obstructive pulmonary disease in workers of mining and metallurgical industry. Rubtsov R.V. The purpose of the research is to study the features of clinical symptoms (using standard questionnaires), the nature of external respiration disorders according to the spirometry indices in workers of mining and metallurgical industry with pneumoconiosis associated with COPD. The article presents the data of clinical examination of 634 workers with lung pathology of occupational etiology: I group included 98 workers with pneumoconiosis associated with COPD, II group included 21 workers with pneumoconiosis, and III group – 515 workers with COPD of occupational etiology. A comparative analysis of clinical symptoms and external respiration function (ERF) indicators was conducted. It has been revealed that for pneumoconiosis associated with COPD the most informative are indicators of Disease Assessment Test, exceeding 11 points, as well as spirometric volumetric and speed indicators of expiration, indicating combination of obstructive and restrictive disorders of ERF: lung vital capacity (LVC) less than 67.0%, forced lung vital capacity (FLVC) less than 60.0%, peak expiratory flow rate less than 40.0%, increase of the forced expiration volume (FEV1) index after the conducted (bronchodilation test) BDT less than 16.1%. The etiologic proportion of the influence of these indicators ranges from 40.5 to 71.6%, the sensitivity is from 0.22 to 0.39, the conditional possibility of occurrence is from 0.6 to 0.94, and the background capability is from 0.17 to 0.35. The revealed diagnostic criteria allow to carry out timely diagnostics, to determine treatment tactics and prevent PC associated with COPD in workers of mining and metallurgical industry.
Semenov V.V. Arterial stiffness, ambulatory blood pressure monitoring and their association with cardiovascular risk in patients with chronic kidney disease and arterial hypertension
Key words: cardiovascular risk, chronic kidney disease, arterial hypertension, arterial stiffness, endothelial function
Abstract. Arterial stiffness, ambulatory blood pressure monitoring and their association with cardiovascular risk in patients with chronic kidney disease and arterial hypertension. Semenov V.V. The aim – to investigate arterial stiffness, daily profile of blood pressure (BP) and their association with cardiovascular risk (CVR) in patients with chronic kidney disease (CKD) and arterial hypertension (AH). 20 patients with CKD (stage 1-2) and AH (stage 1-2) were enrolled in the study (7 males and 13 females, mean age – 55±8,4 years. Depending on CVR risk patients were distributed into three groups: low (<1%), moderate (1-10%) and high risk (≥10%). The highest proportion – patients with moderate risk (50%). Statistically significant association between age and CVR was discovered. Arterial stiffness (measured by pulse pressure and pulse wave velocity) raised with increase of CVR risk. The best values of endothelial function were observed in the group of high risk patients. More than half of patients had non-dipping daily blood pressure profile. Patients in group of high risk presented the highest mean sysolic BP and morning elevation BP.
Sirchak E.S., Opalenyk S.M. Clinical and epidemiological features of chronic pancreatitis course associated with atherosclerosis
Key words: chronic pancreatitis, epidemiology, 13C-mixed triglyceride respiratory test, 13C-amylase respiratory test, dyslipidemia
Abstract. Clinical and epidemiological features of chronic pancreatitis course associated with atherosclerosis. Sirchak E.S., Opalenyk S.M. The article describes and analyzes dyslipidemic disorders, the degree of pancreatic external secretion insufficiency in patients with chronic pancreatitis. The purpose of our study is to study the changes in the blood lipid profile in patients with chronic pancreatitis depending on the degree of pancreatic external secretion insufficiency in residents of the city and villages. We carried out the 13C-mixed triglyceride respiratory test (13C-MTRT) and the 13C-amylase respiratory test (13C-ART) to detect the pancreatic external secretion insufficiency (PESI). Changes in the blood lipid profile were based on the violations in the lipidogram (determination of total blood cholesterol level (TC), triglycerides (TG), high density lipoproteins (HDL), and low density lipoproteins (LDL), atherogenicity coefficient (CA)). All examined patients with combination of chronic pancreatitis (CP) and atherosclerosis have lipid metabolism disorders, but the changes in the city residents are more significant as compared with the rural population. It was also found that the most pronounced violation of the PESI was observed in patients with CP and lipid metabolism disorders, who were residents of the city. In these patients, during the 13C- MTRT, the maximum concentration of 13СО2 between 150 and 210 minutes were at the level of 4.9±0.7%; total concentration of 13СО2 at the end of the study (360 min.) – 17,1±0,3% and were statistically significant in comparison with the control group.
Sirchak Y.S., Patskun S.V. Influence of compliance of patients with a combination of type 2 diabetes and chronic gastritis on features of course and treatment
Key words: chronic gastritis, type 2 diabetes mellitus, compliance
Abstract. Influence of compliance of patients with a combination of type 2 diabetes and chronic gastritis on features of course and treatment. Sirchak Y.S., Patskun S.V. Diabetes mellitus is a systemic metabolic disease that can affect most of the bodily systems, including the gastrointestinal tract. Some studies report a higher prevalence of HP infection in people with diabetes. A healthy diet, regular physical activity, support of normal body weight and avoiding tobacco use can help prevent or delay the onset of DM 2 type. The purpose of the study – to evaluate the peculiarities of the clinical course and effectiveness of treatment of DM type 2 and chronic gastritis (CG) depending on the presence of higher education in patients. 46 HP positive patients with a combination of CG and type 2 DM were examined, the average age of patients was 55.4±1.3 years. Patients were divided into 2 groups, depending on the presence or absence of higher education, so that 23 (50%) patients with higher education were included in group I, whereas in the II group – 23 (50%) patients with secondary education. The Morisky-Green scale was tested to determine the patient's compliance. Results. Insulin resistance depends on the presence of HP in the body and its eradication subsequently leads to an improvement in insulin sensitivity. According to the results obtained, patients in group I (with higher education) have a higher degree of adherence to treatment, namely, the average score of compliance in the I group was 0.61±0.15 points, and in the II group – 2.74±0.24 points. Hence, the presence of higher education in a patient contributes to better adherence to treatment. Improvement of insulin resistance after eradication of HP in patients with type 2 DM and CG, and these changes are somewhat more significant in patients with higher education.
Sirchak Y.S., Stan M.P. Some factors that affect the formation of gastroesophageal reflux disease in patients with diabetes mellitus type II in the Transcarpathian region
Key words: gastroesophageal reflux disease, type II diabetes mellitus, risk factors
Abstract. Some factors that affect the formation of gastroesophageal reflux disease in patients with diabetes mellitus type II in the Transcarpathian region. Sirchak Y.S., Stan M.P. In 75% of patients with diabetes mellitus (DM) in clinical practice, symptoms of the gastrointestinal tract (GIT) injury can be observed. The purpose of the study: to identify the factors influencing the formation of gastroesophageal reflux disease (GERD) in patients with type II DM in the Transcarpathian region. 76 patients with the combination of type II DM and GERD were examined. All patients were examined according to the general-clinical, anthropometric, laboratory, and instrumental methods. The place of living, as well as the level of education and place of patients’ work was also described. In all patients with type II DM, disease of moderate severity was detected. Endoscopic examination in all patients with type II DM confirmed the diagnosis of GERD. Among the patients, residents of the city prevailed – 48 (63.2%) patients and 28 (36.8%) patients – residents of the village. It has been established that in patients with DM type II, GERD often occurs in patients with higher (47.4%) and secondary education (35.5%), and patients without education account for only 17.1% of the total number of cases. A high percentage of rural residents without regular place of work (42.9%) were observed. In patients with DM type II, living in the Transcarpathian region, GERD is often observed in specialists and officers (educators, bank officers, healthcare workers, accountants), as well public officers. Obesity I and II degrees are more often established in patients living in villages of the Transcarpathian region and with low educational level, and in the city residents – overweight (41.7%) was found more often. Combination of type 2 DM and GERD is more commonly found in patients living in cities of the Transcarpathian region, with higher education who hold management positions, and work in the field of education, health care. Combination of GERD and type II DM in rural areas is often combined with I and II obesity degrees, especially in patients with low education level.
Surmilo N.N., Kovaliova O.V. Correction of microcirculation disorders in diseases of digestion organs of professional etiology in the rehabilitation period in mutimorbid patients
Key words: polymorbidity, central and regional hemodynamics, microcirculation, professional illnesses of organs of digestion, rehabilitation
Abstraсt. Correction of microcirculation disorders in diseases of digestion organs of professional etiology in the rehabilitation period in mutimorbid patients. Surmilo N.N., Kovaliova O.V. In-process on the basis of literary data and own researches a conclusion that gastrovascular continuum is a component part of cardiovascular physiological (during aging) and pathological process as a result of inflammation of microvasculature in acute and relapses of chronic illnesses of organs of digestion is drawn. It is set that in the diseases of digestion organs there is violation of central and regional hemodynamics and connected with them capillary disorders. Treatment regimens for application by family doctors and rehabilitation physicians, by medical attendants during medical rehabilitation of patients with illnesses of digestion organs of professional etiology are offered.
Tyshchenko I.V., Bondareva O.O., Yesaulenko I.A., Kraynyak T.L., Volkova A.Y. Realities of awareness of permanent residents of industrial region on the problem of osteoporosis
Key words: osteoporosis, risk factors, industrial region, sanitary and educational activities, information awareness
Abstract. Realities of awareness of permanent residents of industrial region on the problem of osteoporosis. Tyshchenko I.V., Bondareva O.O., Yesaulenko I.A., Kraynyak T.L., Volkova A.Y. The questionnaire method was used to study the awareness on osteoporosis in 95 patients of the therapeutic hospital, residents of the industrial center (the city of Dnipro). It was established presence of risk factors for osteoporosis, especially in women. Prevalence: age over 65 years, smoking, fractures in anamnesis, associated pathology, early menopause. Low awareness of patients on the diagnosis, prevention and treatment of osteoporosis, as well as lack of motivation for undergoing examination and possible treatment has been established. A third of them did not know the term. Living in the industrial region was not regarded as a risk factor for osteoporosis.
Tkach S.I., Poteiko P.I., Rohozhyn A.V., Shyrapova O.V., Bielykh L.M. The criteria of diagnostic pulmonary tuberculosis activity in patients working in hazardous working conditions
Key words: diagnostics, criteria of pulmonary tuberculosis activity, hazardous working conditions
Abstract. The criteria of diagnostic of pulmonary tuberculosis activity in patients working in hazardous working conditions. Tkach S.I., Poteiko P.I., Rohozhyn A.V., Shyrapova O.V., Bielykh L.M. The article presents the analysis of clinical examination data of 76 patients with tuberculosis: 51 patients (1 group) who worked in hazardous conditions and 25 patients (2 group) who had no contact with hazardous factors. Changes in hematological parameters in patients have been analyzed and a new method for diagnosis of specific tuberculosis activity (SKAT) has been proposed. It was found that in patients under adverse conditions of production (group 1) pulmonary tuberculosis was detected 1,7 times (p<0,05) more often at the age of 40 years and older, unlike the second group, in which the disease was diagnosed 2,9 times more often (p<0,05) at the age of 21-30 years. In patients of the first group Mycobacteria tuberculosis were detected 1,4 times more often (p<0,05) as well. In patients with pulmonary tuberculosis, there were similar changes in hematological parameters (increasing number of leukocytes, eosinophils and erythrocyte sedimentation rate), which is characteristic for granulomatous inflammation. A new method for the diagnosis of tuberculosis specific activity (SKAT) allows to determine the severity of tuberculosis activity and severity of the disease course.
Key words: occupational diseases, etiological classification, overstrain of some bodies and systems
Abstract. Occupational diseases as resalt of overstrain of some bodies and systems. Tkachyshyn V.S. In the article a scries of occupational diseases, which are according to the etiological classification, arise from overstrain of some bodies and systems are submitted. In the presented publication the author focuses on the series of occupational diseases resulted from the overstrain of separate bodies and systems which are insufficiently widely displayed in publications on a professional pathology due to their insufficient distribution until this time. Today a series of them get the increasing urgency, taking into account specificity of modern operating conditions. This became the basic purpose of the work performed. The important problem in modern conditions is significant psyhoemothional loading on the organism of workers, work with video-display terminals and pressure of the voice apparatus. Physical loading on separate bodies and systems in conditions of modern automation has a smaller value, but also takes place in modern conditions. In the article selective data concerning several groups or separate diseases presented in etiological classification of occupational diseases are resulted. The rest of them are presented in previous publications of the author, listed in reference list. Specification concerning professional neuroses, shortsightedness, phonasthenia, chronic laryngitis, nodular and contact ulcers on the voice folds, emphysema of lungs, metroptosis uterine prolapse and coloptosis are submitted. The basic concepts concerning the reasons of occurrence, clinical picture, diagnostics, differential diagnostics, preventive maintenance and working capacity examination in these diseases are considered. The data concerning the forecast, establishment of the link of the disease with occupation are resulted also.
Fesenko V.I. Peculiarities of the clinical course of the postinfarcti on period in the workers of mining production
Key words: myocardial infarction, postinfarction period, heart failure, workers of the ore mining industry
Abstract. Peculiarities of the clinical course of the postinfarcti on period in the workers of mining production. Fesenko V.I. Objective: to study the features of the clinical course of the post-infarction period in mining workers. 102 patients with mining working experience from 12 to 35 years were examined. The diagnosis of a previous myocardial infarction (MI) was verified on the basis of anamnesis (analysis of medical documentation), if there are signs of cicatricial changes in the myocardium and zones of left ventricular myocardial asynergy on the electrocardiogram (ECG) according to the ultrasound of the heart. All patients underwent general clinical examination according to generally accepted standard criteria. ECG registration was performed in the classical 12 lead systems, as well as in the V3R-V5R at rest state and at the state of the dosed physical activity. The structural and functional state of the heart was examined using the "HDI - 1500" apparatus by a standard procedure. It is established that risk of MI in mining workers with CHD increases over the age of 40 years mainly and after 10 years of work in unfavorable industrial environments. Predictors of HF in post-MI miners are: age over 40 years, a segment-elevation myocardial infarction with ST, a front localization of infarction, complications in acute MI period, especially of cardiac arrhythmias and conductivity.
Cherkasova O.G., Hutnik I.O., Marynoha G.D., GusakovaO.A., Kondratieva G.V., Danilova G.V., Rozhko O.V. Clinical case of community-aquaired pneumonia on the background of previously undiagnosed occupational pulmonary fibrosis. Is occupational history important?
Key words: pulmonary fibrosis, occupational diseases, pneumonia, metallurgical industry
Abstract. Clinical case of community-aquaired pneumonia on the background of previously undiagnosed occupational pulmonary fibrosis. Is occupational history important?. Cherkasova O.G., Hutnik I.O., Marynoha G.D., Gusakova O.A., Kondratieva G.V., Danilova G.V., Rozhko O.V. Interstitial lung disease is a systemic concept, which is understood as a group of progressive diseases, characterized by non-infectious inflammation in the wall of the alveoli and interstitial lung tissue and may result in pulmonary fibrosis. The publication deals with the clinical case of community-acquired pneumonia on the background of previously undiagnosed occupational pulmonary fibrosis. The complaints, anamnesis, clinical and instrumental data have been analyzed, special attention is paid to the professional history, which indicates long-term contact with toxic substances and negative factors of the industrial process. The data of pathomorphological research are given. Timely prevention and screening of workers involved in heavy work and work with harmful or hazardous working conditions, even after the cessation of work in a production environment, may contribute to early detection of interstitial lung disease and contribute to a positive prognosis for acute respiratory diseases occurring on its background.