A prospective comparative study of the effectiveness of rehabilitation treatment and rehabilitation of locomotive crews workers was carried out. The results of treatment were evaluated by the temporary disability of workers. As a result of regular rehabilitation treatment of locomotives’ drivers, the frequency of diseases with a temporary loss of work ability decreases by 2.7 times.
Purpose of the study. The prevalence of diseases of the gastroduodenal zone and cardiovascular pathology among the working population is alarming. In order to develop phenotypes of comorbidity of acid-dependent diseases of the gastroduodenal zone and the syndrome of arterial hypertension in hazardous workers, a study of the state of health was carried out. Materials and methods. 4 observation groups were formed, aged 40 to 60 years, with work experience of more than 10 years. The first group consisted of 51 patients with arterial hypertension, the second - 26 patients with acid-dependent diseases, the third - 25 workers with comorbid pathology. The fourth group consisted of 24 workers without this pathology. The clinical examination was carried out as part of clinical examinations in the conditions of the departmental clinical hospital of Russian Railways. To clarify the psycho-emotional status, psychometric testing was carried out using the Stilberger-Khanin anxiety scale and the SANT test. A biochemical blood test included the determination of the level of alanine aminotransferase, aspartate aminotransferase, glucose, creatinine, lipid spectrum, antibody titer to Helycobacter pylori, the amount of endothelin-1, monocytic chemoattractant protein-1. Instrumental studies: fibrogastroduodenoscopy, daily monitoring of blood pressure. Results and conclusions. Indicators of general morbidity among employees of locomotive crews are higher than those of the industry. In the structure of chronic diseases, the prevalence of isolated arterial hypertension and erosive and ulcerative lesions of the gastroduodenal zone exceeds 60%, and the calculated probability coefficient of the combination is 6 times higher than the population one. The development of comorbidity of arterial hypertension and erosive and ulcerative lesions of the gastroduodenal zone under conditions of long-term exposure to a complex of production factors in trained workers was accompanied by the prevalence of personal and situational anxiety as a reflection of the maladjustment syndrome. The main pathophysiological determining modules in each group of patients were identified: the dyscirculatory-inflammatory module was identified as a phenotype of the comorbidity of the studied pathologies. The data obtained allow us to form a personalized approach to the prevention and treatment of comorbid pathology.
Objective. To estimate the efficiency of using remote technologies and provision of unique service of functional diagnosis in the framework of corporative system of the net of medical institutions, territorially distant from each other.
Nowadays, a wide introduction of IT-technologies in medicine has a perspective and priority significance in conditions of unfavorable epidemiological situation including sickness rate of a new coronavirus infection COVID-19.
Materials and methods. The efficiency of remote methods was analyzed and assessed using the results of studies among the workers of RZhD and contractual enterprises.
Results. Remote consultations permit to increase the number of applied methods of investigation, give the opportunity to obtain qualified conclusions, consolidate information in general database allowing to fill up medical staff deficiency.
Conclusions. Thus, patients obtain operatively made unified medical conclusions, which are transferred via defended channels of Internet.
The experience of the Sverdlovsk railway in the organization of pre-trip medical examinations using an automated system and software and hardware systems, as well as the ability of the psycho-physiological service in preventing accidents, is presented
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