The most important medical and social problem of modern health care are diseases of the circulatory system, the high incidence of which is due to the interaction of a number of factors, among which a certain place is occupied by the living environment. The purpose and objectives of the study - to lead ecological and hygienic assessment of the prevalence of diseases of the circulatory system in the population of Primorsky Krai. Material and methods. Ecological and hygienic assessment of the prevalence of diseases of the circulatory system in the population of Primorsky Krai was carried out for the period 2000-2017, depending on the bioclimatic zone, environmental situation and habitat factors. Characteristics of the habitat were carried out according to 8 sanitary-hygienic and 7 natural-climatic modular factors, based on a 10-point system in accordance with the developed assessment scale. The dependences between environmental factors and the level of circulatory diseases were assessed by regression analysis, and the statistical significance was assessed by Chi - square (Pearson) criterion. Results. During the period 2000-2017 in Primorsky Krai there was an increase in the incidence of diseases of the circulatory system by 38%, and since 2006 they have come to the first place in the structure of morbidity and amounted to 43-49%. Among the diseases of the circulatory system is dominated by hypertension, coronary heart disease, cerebrovascular disease. It is established that the prevalence of diseases of the circulatory system in the population is influenced by the following sanitary and hygienic parameters: the level of air pollution, the characteristic of chemical pollution, adverse physical factors, transport loads. The prevalence of diseases of the circulatory system has a strong relationship with a number of climatic parameters: the number of days with the biological activity of solar radiation, latitude, air speed. Discussion. Climatic and ecological factors of the region, social and demographic features can cause deviations of the health status of the population from the all-Russian trends. Conclusion. The dependence of the prevalence of diseases of the circulatory system on the bioclimatic zone, the degree of stress of the environmental situation in the Primorsky territory, as well as environmental factors.
The purpose of the research is to establish the basic social and hygienic mechanisms of the formation of population health in the Primorsky Krai. The study analyzed the main ecodependent diseases: respiratory diseases, urogenital system, skin in the population residing in model points in the coastal and continental bioclimatic zones of the Primorye Territory with a variety of social and environmental performance. According to the suggested hypothesis of social-hygienic study the prevalence rate of ecodependent pathology in the population of the Primorye Territory is influenced by a complex of unfavorable factors of ecological, climatic and socio-hygienic risk, including the underlying factors or their groups not detected by conventional methods, but capable of to have a significant impact. The results showed regional features of the influence of environmental factors, lifestyle on the health of the major demographic groups living in different bio-climatic, social and environmental conditions of urban and rural areas of the region. The backbone force for all groups is a way of life. For urban residents of the coastal zone there is a significant ecological and social impact of environmental factors, while for rural residents - social and hygienic. Under the complex influence of socio-hygienic and climatic factors on the prevalence rate of ecodependent pathology the level of disease was found to be largely dependent on the specific way of life in the ecological and bio-climatic conditions of the region. Among the not detectable factors of socio-hygienic monitoring, a special place was revealed to be occupied by the socio-psychological peculiarities of the production environment and everyday life, which depend on the social (social and educational prospects, social and material satisfaction, job availability and the possibility of further training, environmental comfort, recreation), and individual features (educational level, the possibility of professional, family and individual psycho-emotional characteristics), which confirms the hypothesis of socially-hygienic research. On the basis of survey data with the using the method of multivariate analysis - correlation Pleiades by Terentyev, it was created “Sociometric model conditionality of the formation of population health in the Primorsky Territory.”
There was executed the ecologic-hygienic assessment of the distribution of respiratory diseases prevalence in bioclimatic zones of the Primorsky Krai. The aim of the study was a systematic assessment of the impact of ecological-hygienic factors of environment on the distribution of respiratory diseases in adolescents and children of the Primorsky region. As an information database there were used indices of the prevalence of diseases of the respiratory system of the ICD-10 class of the official statistical report forms for the period of2000-2013 and the parameters of the environment offactor modules (6 - socio-sanitary, 5 - environmental). The numerical values of modules offactors were determined according to a specially developed scoring scale. The study of the prevalence was carried out with the use of a classical method of data analysis - descriptive statistics, Chi-square criteria. By means of the method of regression analysis from the SPSS package software there was established the relationship of environmental factors and the level of the prevalence of diseases, and were calculated values of the factor loadings influencing on the morbidity rate of children and adolescents. The study revealed that in the structure of morbidity diseases of the respiratory system account of 39% in adolescents, 61% - in children. Constructed predictive models describe the trend of the increasing in the prevalence in adolescents and children. Over the past 15 years, the level of respiratory diseases morbidity rate increased by 46.1%. It is established that the prevalence of respiratory diseases in children and adolescents from various districts of the Primorsky territory depends on the features of the bioclimatic zones and the degree of sanitary-hygienic situation, as well as combinations of parameters that form these zones; the highest cumulative level of the prevalence is observed in the bioclimatic zone of the coast, that is caused by the various degree of the impact of biotropic factors of environment; The prevalence of diseases of respiratory system is mainly affected by bioclimatic factors: residence in an area of high humidity, temperature swings, movements of air masses in combination with air pollution
Respiratory muscle (RM) strength was studied in 85 men with exacerbations of chronic obstructive pulmonary disease (COPD). The strength indicators of expiratory (MEP) and inspiratory pressure (MIP, SNIP) in oral cavity were registered by means of the MicroRPM device (CareFusion, UK), as well as intranasal pressure levels by SNIP test. The measured MEP, MIP и SNIP values were compared to the proper indices. Serum concentrations of cytokines (IL-4, IL-6, IL-10, IL-17A, IL-21, TNFα, IFNγ and TGF-β) were determined. The results of the study were processed by means of canonical analysis and by clustering methods. Expiratory RM dysfunction was recorded in mild COPD, expiratory-inspiratory RM dysfunction was recorded in moderate COPD and the diaphragm dysfunction was recorded in severe COPD. Three groups of patients with different combinations of RM strength indicators and immune parameters were identified by means of cluster analysis. The cytokine profile in the first cluster was characterized by maximal concentrations of IL-17A, IL-21, TNFα and TGF-β, whereas RM strength indexes showed minimal values. In the second cluster, a decrease of RM strength indicators by 25-40% against control was associated with a sharp rise of IL-6, along with moderate increase of IL-21 and TGF-βconcentrations. In the third cluster, maximal levels of IL-6, IL-10 and IFNγwere registered, along with low levels of IL-17A, IL-21 and TGF-β concentrations, whereas MEP, MIP и SNIP values did not sufficiently differ from their levels in second cluster. The results of canonical and correlation analysis indicated to interconnections between either certain cytokines, or their pool with the RM strength indicators, dyspnea severity and functional state of COPD patients, thus suggesting involvement of cytokine-mediated mechanisms in pathogenesis of the respiratory muscle dysfunction.
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