Федеральное государственное бюджетное образовательное учреждение высшего образования «Московский государственный медико-стоматологический университет имени А.И. Евдокимова» Министерства здравоохранения Российской Федерации, 127473, г. Москва, Российская Федерация 2 Центральная дирекция здравоохранения -филиал ОАО «РЖД», 123557, г. Москва, Российская Федерация
Corporate health programs are a common measure for the primary and secondary prevention of chronic non-communicable diseases.Aim. To study the first implementation results of a Targeted comprehensive program to reduce morbidity and prevent mortality from circulatory system diseases and early cancer detection in employees of JSC "Russian Railways" for the period from 2019 to 2023.Material and methods. The study used a survey of employees of locomotive crews (RLC), which was conducted twice: in the summer of 2018 and February-March 2021. The survey was conducted using a specially designed questionnaire that takes into account the health status of drivers and their assistants, production, and non-production risk factors. In 2018, 10476 questionnaires were collected (>7% of employees), and in 2021 — 14403 questionnaires (>10% of employees). The age structure of railways has not changed, which made it possible to analyze the frequency of occurrence of risk factors in dynamics.Results. In general, the mention of the RLC of the interfering effect of the noise factor, uncomfortable temperature, and undesirable odors in the driver’s cabin decreased for JSC "Russian Railways". The number of smokers on the South-Eastern Railway significantly increased during the study period. The number of people consuming insufficient amounts of vegetables and fruits has increased on the Far Eastern, West Siberian, Krasnoyarsk, and Volga railways. The frequency of workers’ meals at fast food restaurants has increased on the Southeastern Railway. The number of people with a good commitment to the basic principles of a healthy lifestyle has increased on the East Siberian, Trans-Baikal, West Siberian, Kuibyshev, Oktyabrskaya, Sverdlovsk, North Caucasian, and South Ural railways.Conclusion. The conducted research has shown the effectiveness of the initial stage of the implementation of the corporate program to reduce morbidity and prevent mortality from diseases of the circulatory system in RLC. The heterogeneity of the results for different railways was revealed.
Since 2020, the world has been living in the COVID-19 pandemic caused by the SARS-CoV-2 virus. This situation is due to the high virulence and prevalence of the virus, which has reached epidemic proportions in recent years. Hemostasis disorders are the main marker and prognosis of the severe course of the disease. The virus in the body of a patient with COVID-19 triggers a pathophysiological chain reaction, which, in turn, will lead to the development of a cytokine storm, a disorder in the hemostasis system, and the development of multiple organ disorders. The purpose of the study: to determine and study the influence of various factors on the characteristics of hemostasis in patients with moderate and severe COVID-19. The object of the study were patients with moderate and severe forms of the disease. The following methods were used in the study: standard laboratory diagnostics and hair mineralogram. Results. Moderate and severe courses have clear laboratory markers, with a high probability of developing thrombotic complications, especially in conditions of deficiency of such minerals as zinc, selenium, iron, copper, bismuth, and aluminum, which have immunoregulatory, antioxidant, antiviral, and hemostatic properties, as well as reduce the risk of secondary infection. Conclusions. The results of the study suggest the importance of using minerals and emphasize the significance of using minerals in patients at the very beginning of the disease in order to strengthen the main physiological systems in case of laboratory-confirmed deficiency.
В апреле 2020 г. на территории РФ были введены жесткие карантинные меры с целью профилактики распространения новой коронавирусной инфекции COVID-19. В кратчайшие сроки большое количество стационаров общего профиля было перепрофилировано в COVID-госпитали, на основании имеющегося мирового опыта выпущены рекомендации по ведению пациентов с новой коронавирусной инфекцией. Однако ограниченность ресурсов системы здравоохранения в условиях пандемии требует исследования фармакоэкономических аспектов COVID-19. В ходе исследования проведен сплошной ретроспективный анализ историй болезней 6255 пациентов, госпитализированных в ЧУЗ «ЦКБ "РЖД-Mедицина"». За исследуемый период времени 22% пациентов получили терапию ингибиторами рецептора интерлейкина-6 (ИЛ-6). Средний показатель смертности пациентов, получавших лечение ингибиторами рецептора ИЛ-6, -11,6%. Проводился индивидуальный подбор лечебной дозы низкомолекулярных гепаринов, показавший высокую клиническую эффективность. Разработанные методики были оценены с позиции фармакоэкономики. Увеличение степени поражения легочной ткани у пациентов с COVID-19, а также наличие сопутствующих заболеваний влечет за собой повышение стоимости лечения. Проведение терапии ингибиторами ИЛ-6 позволяет снизить стоимость лечения пациентов с КТ-4 на 16% за счет снижения времени пребывания в отделении реанимации и интенсивной терапии, необходимости искусственной вентиляции легких и снижения смертности.Финансирование. Исследование не имело спонсорской поддержки Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.
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