Vol 63, No 2 (2019)

Introduction. The prevalence of myocardial infarction depends on various risk factors, the informativeness of which is insufficiently studied. The aim of the study was to study the Association of myocardial infarction (MI) with risk factors (FR), to determine the level of informativeness of FR for the development of a prognostic model. Material and methods. FR of MI development was studied in 155 patients with this pathology at the age of 50 to 75 years by the method of questioning and laboratory-instrumental study. The control group consisted of 127 people of the same age without THEM, examined similarly. Results. Among the studied FR in patients with THEM, arterial hypertension, hypercholesterolemia and angina pectoris were the most common. To determine the probability of its development, angina pectoris, alcohol abuse, hypercholesterolemia and hypertension are the most informative. Developed regression model to predict THEM highly informative FR. Discussion. The study of risk factors for myocardial infarction on the basis of prevalence and information allows to objectively identify the priority causes of the formation of this pathology. Conclusion. The use of the obtained data on FR and the regression model makes it possible to carry out prevention and correction of FR MORE effectively, taking into account the degree of risk.

Introduction. Improving organizational approaches to the provision of specialized, including high-tech medical care to patients with psoriasis remains one of the main problems of dermatology. Purpose of research. To research the trends in the dynamics of general and primary incidence of psoriasis and to assess the need of the adult population of St. Petersburg in specialized, including high-tech, medical care. Material and methods. The indicators of primary and total morbidity of diseases of the skin and subcutaneous tissue of children and adults in St. Petersburg for 5 years (2013-2017) were researched. The analysis of statistical indicators of the activity of the dermatological department of the Kashkin Research Institute of Medical Mycology (2013-2017) was carried. Results. Over the past 5 years, the total morbility level of diseases of the skin and subcutaneous tissue has increased by 15.1%, and the primary morbility level - by 13.5%. Herewith the total morbility level of psoriasis increased by 9.4%, and that of primary level increased by 31.6%. The highest growth rates of total (by 12.7%) and primary incidence (by 35.5%) were observed in the group of persons over 18 years of age. In the structure of hospitalization in the dermatology department Kashkin Research Institute of Medical Mycology, the proportion of patients with psoriasis was 55.4%. Of these, 35.1% received high-tech medical care. The majority of patients who received high-tech medical care were residents of St. Petersburg (77.0%). Discussion. Indicators of General and primary incidence of psoriasis for 2013-2017 show an unfavorable forecast towards its growth in St. Petersburg over the next years. In the structure of hospitalizations in the dermatological Department, the proportion of patients with psoriasis was 55.4%. Of all those hospitalized for psoriasis, 35.1% received high-tech medical care. They were mostly residents of St. Petersburg (77.0%). Conclusion. The study revealed unfavorable trends in the dynamics of the general and primary incidence of psoriasis in the adult population of St. Petersburg.

Introduction. There are variable patterns of alcohol consumption in Russia that differ significantly between the regions. Awareness and knowledge of those regional differences are key to the effectiveness of measures to prevent and minimise possible damage to public health caused by alcohol consumption. The purpose. To identify regional characteristics of the dynamics of alcoholism and alcoholic psychosis and dependencies with indicators of the implementation and consumption of alcohol in Mari El in 2006-2017. Material and methods. In a retrospective analysis, they included state statistics and bulletins of the Office of Rospotrebnadzor on RME on the primary incidence and prevalence of alcohol dependence syndrome, chronic alcoholism, AP, acute alcohol poisoning, sales of alcohol through a distribution network in 2006-2017. Results. In the reported period of 2006-2017 there was a decline in determination coefficient (R2) from 0.76 to 0.96 for newly diagnosed cases of alcohol dependence in general, alcoholic psychosis and alcoholism in Mari El. There was a significant decline from 221.6 to 47.5 per 100 thousand in the range of values between regions, but higher rates remained among the rural and urban areas (p = 0.0002). The dynamics of the prevalence of alcoholic psychotic disorders and alcoholism were also on decline. Conclusion. The direction and extent of changes in the medical consequences of alcohol consumption (such as primary morbidity and prevalence of alcohol dependence syndrome, alcoholic psychosis and alcoholism, average duration of the course, number of alcoholic psychosis) in the region and indicators of the implementation and consumption of alcoholic beverages in the reported period can be evaluated as positive. It is crucial to ensure the positive trend in the alcohol consumption pattern and impact on public health in the region becomes a long-lasting one. At the same time, it is necessary to increase attention to the assistance and treatment provided to drug users patient.

Introduction. The deterioration in the health of children and adolescents in the dynamics of education in general education organizations dictates the need to minimize the risk factors for the development of school-related diseases based on the development of a methodology for calculating the level of hygienic well-being of these organizations, taking into account existing health care opportunities (preserving and improving the health of students). The purpose of the study is to develop a comprehensive indicator for assessing the sanitary and hygienic well-being of educational institutions from the standpoint of health and safety. Material and methods. The methodology for the integrated assessment of the educational environment includes: a) defining a list of the most significant hygienic indicators from the standpoint of health preservation; b) an assessment of the weight of each of them; c) the development of a comprehensive indicator of sanitary and epidemiological well-being, combining individual indicators into one with its translation into a qualitative assessment. Results. Based on the materials of the research, a rationale for a comprehensive assessment of sanitary and hygienic well-being in educational organizations from the standpoint of health care has been proposed, that is, a technique is proposed, the use of which will help determine the full use of opportunities for maintaining and improving health in an educational organization. Discussion. Developed as a result of the conducted research, the algorithm for constructing a comprehensive indicator for assessing sanitary and hygienic well-being allows objectively characterizing the conditions and modes of education in educational institutions from the standpoint of health and safety, determining the risk factors of the educational environment and predicting the likelihood of school-related diseases. The construction of a complex indicator is proposed to be used as an additional assessment of the educational organization’s capacity to preserve the health of students in the dynamics of learning. Conclusion. The proposed model of an integrated assessment of the educational environment, which is based on quantitative (scoring) and qualitative assessments, identifying the resources for maintaining and promoting health in general education organizations, determines: risk factors of the educational environment; definition and prediction of the probability of changes in the students’ health status (positive and negative); justification of the system of management decisions to minimize risk factors and prevent violations in students’ health.

The article reflects the main sections of Clinical guidelines «Hearing loss, noise-induced» (second revision) included in the Rubric of Clinical guidelines of the Ministry of health of the Russian Federation in 2018, CG609 and aimed at streamlining and unification of actions in clinical diagnostic and expert work. The purpose of the of research is to help the practitioner in making the right decision on the assessment of health, treatment of hearing loss caused by industrial noise, on the basis of evidence-based step-by-step protocols. Material and methods. The subject of the development of the CG609 were high rates of occupational hearing loss in employees of “noise-hazardous” industries, classified as “Professional sensorineural hearing loss”. Results. The structure of the CG609 is presented, the importance of unified approaches to the diagnosis, treatment, rehabilitation, prevention, examination of the relationship of the disease of the hearing with the profession and aptitude is shown. The criteria of evidence and credibility of specific recommendations are given. Discussion. CG609 are created on the generally accepted, repeatedly approved methodology of development of SIGN (2014) guaranteeing reliability of recommendations, generalization of the best world experience and modern knowledge, applicability in practice and convenience in use. The use of high-quality clinical guidelines makes it possible to introduce into medical practice the most effective medical technologies, to refuse unreasonable and unsafe interventions and to improve the quality of medical care. Conclusion. CG609 are required for the integrated interaction of specialists otolaryngologists, audiologists-otorhinolaryngologists, pathologists, physicians, occupational health, occupational medicine and all medical professionals involved in diagnostic and expert work of the assessment of hearing in workers «noise hazardous» professions.

Introduction. The range of household chemicals is constantly increasing, as a result of which the population is exposed to new detergents that can directly affect the health of the population, constantly in contact with chemicals in everyday life. These circumstances require sanitary and Toxicological study of household chemicals and the development of preventive measures aimed at protecting public health. Purpose of research. To assess the risk of using synthetic detergent based on anionic and nonionic surface active substance (SAS). Material and methods. To determine the average lethal dose (LD50), a sample of detergent was injected into the stomach of 6 male rats at a dose of 5000 mg per 1 kg of body weight. Irritant effect on the skin was determined with a single application of the working solution (1.25%) to 6 rats and 3 rabbits on the trimmed side section at an exposure of 4 h, followed by flushing and into the conjunctival eye bag to 6 Guinea pigs and 3 rabbits. The follow-up period was 14 days. A single skin-resorptive effect of the working solution was studied in 20 rats of two groups of 10 animals in the control group and 10 in the experimental group. Observation period - 14 days. Multiple resorptive action was studied in 20 rats in two groups (10 animals in the control group and 10 in the experimental group) to determine the peripheral blood of animals in the control and experimental groups. The sensitizing effect of the detergent sample was studied on 20 Guinea pigs in two groups (10 in the control group and 10 in the experimental group) by a combined method. Results. LD50 orally for male rats >5000 mg/kg b.w., with a single application to the skin of rats and rabbits and the mucous membrane of the eyes of guinea pigs and rabbits does not cause irritation, does not have skin-resorbtive action (rats), does not have an allergenic effect (guinea pigs). Discussion. According to the results of studies, in accordance with the classification according to the degree of exposure to harmful substances, the tested sample according to acute oral toxicity belongs to the 4th class of danger, irritating effect on the skin and mucous membranes of the eye - 0 points; clinical signs of intoxication with a single and multiple skin-resorptive action was not revealed; sensitizing effect - 0 points. Conclusions. The studied sample of a synthetic detergent according to the parameters of acute toxicity refers to low-risk compounds (LD50 > 5000 mg/kg b.w.), does not have an irritating effect on the skin and mucous membrane of the eye, sensitizing and skin-resorptive action, which allows us to conclude that there is no risk of using the studied sample, household chemicals for the population.

The issues of medical statistics on mortality from cancer, especially the correctness of such indicators, attract general interest. In a comparative aspect, mortality rates in different countries are given and the possible influence of various factors on the distortion of these indicators is described. The death rates in the Russian Federation, the Republic of Bashkortostan and Ufa are considered in detail. Comparison of the number of doctors and oncologists in the republics of Bashkortostan and Dagestan revealed some differences in the territories by the availability of doctors, especially oncologists. At the same time, the ratio of morbidity and mortality in these territories are in similar and correct parameters. A detailed analysis of the letters of the Ministry of Health of Russia with recommendations relating to the principles of coding for cancer in combination with another pathology. The statistical incident was the change in the coding rules for a post-mortem diagnosis in 2011 and the peculiarities of the translation of the text from ICD-10. According to the results of the analysis, proposals were developed aimed at the objectification of mortality rates and 5-year survival of cancer patients.