Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest. Conclusion In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes. ClinicalTrials identifier ISRCTN43070564

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Improvement and unification of information and analytical technologies is the one of the priorities, the solution of which will provide the gain in the efficacy and appropriateness of management decisions, developed preventive and wellness measures. In the article there is explained the use of generalized indices of the real risk as criteria for the comprehensive assessment of the health state of the population at the regional and the municipal levels. The proposed criteria make it possible to increase the objectivity of the assessment of the health state in the sociohygienic monitoring system and in the implementation of the special studies of epidemiological type. There are presented results of a comprehensive assessment of the health state of the population in the cities of Rostov region for the ten-year period and according to socio-hygienic monitoring in 2014 year. In terms of twenty of markers characteristics ofpopulation health there were used indices of the total mortality and morbidity rate. There was executed the complex assessment of the cancer prevalence rate in the urban population on nine priority localizations of the malignant tumors, including stomach, colon, rectum, lungs, skin, mammary gland, corpus uteri, ovary and thyroid gland. There were identified territories of high and elevated real risk to health state of the population. There is presented the result of the application of mathematical modeling used for the assessment and prediction of the impact of environmental factors on the complex assessment of the health staty of the population. Results of research were used for the shaping of information and analytical materials in the Rostov region.

Introduction. The main task of treating sewage sludge is to obtain the final product, the properties of which would ensure the possibility of its utilization and minimize the damage to the environment. The sanitary and hygiene characteristics of the sediment are assessed by the presence of pathogenic microorganisms and helminths eggs. The degree of disinfection of the sediments is controlled according to SanPiN 2.1.7.573 - 96. The objective of the work. Determination of optimal doses of caustic lime for disinfection of microbial contamination of sewage sludge of household wastewater of sewerage cleaning facilities (SCF) and liquid manure of the swine complex. Material and methods. The object of the study were microbial communities of the sludge of the SCF household wastewater and liquid manure of the swine complex. Standard microbiological research methods were used in the work according to MU 2.1.5.800 - 99 and MR N FTs/4022. For representativeness, analyses were performed in triplicate. Results. Caustic lime was added in the amount of 1 to 10% of the volume (mass) of the sludge under study into the sludge of household wastewater (humidity of 97 - 98%). The contact time was 0.5 hours, 1 hour, 3 hours. At a concentration of caustic lime of 5 and 6%, the absence of microflora was noted after 1 hour, at a concentration of caustic lime 8 - 10% - after 0.5 hours. After 3 hours, for any amount of caustic lime (from 1 to 10%) in the native sludge of wastewater sewerage, all the microorganisms under study were not shown. Into the liquid manure (humidity less than 85%), caustic lime was added in the amount of 4 - 10% of the volume (mass) of the material being examined. The exposure was of 1 and 3 hours. The complete death of microbes at any exposure was observed at a concentration of caustic lime 9 and 10%. Conclusion. The investigations have shown the dynamics of death of microorganisms in studying the impact of caustic lime on both native and sterilized material to be the same. The total death of microorganisms during the treatment of sludge from household wastewater was observed at a concentration of caustic lime of 7 - 9%. The complete death of microbes in liquid manure (native and sterilized) at any exposure was observed at a concentration of caustic lime 9 and 10%.