Introduction. The increase in life expectancy, a decrease in mortality rates of the working-age population requires the development of a set of priority measures and justification of their effectiveness in the occupational risk management system based on the transition to a personalized assessment of working conditions and the health status of employees. The study aims to develop a set of priority measures to integrate tools for assessing working conditions and to justify their effectiveness in the occupational risk management system to determine the levels and groups of occupational risks in the workplace, depending on the complex of harmful and/or dangerous factors of the production environment and the labor process and the health status of employees. Materials and methods. The researchers have conducted the analysis of qualitative and quantitative indicators of occupational risk, including indicators of health disorders of employees. We have analyzed the materials of periodic medical examinations to substantiate the algorithm for the formation of risk groups for the development of occupational diseases. Scientists have performed a cross-epidemiological study to assess the risk of developing chronic general somatic diseases in workers. We have calculated the indicators of the total risk of fatal cardiovascular diseases. Experts have studied the features of the current situation with indicators of occupational morbidity in the Russian Federation. Results. There are two groups of qualitative and quantitative indicators at the level of state supervision and enterprise, which allow assessing the effectiveness of the risk management system. Scientists have identified qualitative and quantitative indicators for early detection of violations in the employee's body from the effects of production factors. We have substantiated the algorithm and criteria for the formation of risk groups for the development of occupational diseases. Assessment of the risk of developing general somatic diseases in workers with constant exposure to high levels of harmful factors: vibration, severity and labor intensity, showed a high prevalence and increased risk of diseases of the endocrine, musculoskeletal and circulatory systems, as well as a significant increase in these indicators with an increase in work experience in harmful working conditions, which allows us to consider these diseases as production-related diseases. Individuals with endocrine diseases are significantly more likely to have a very high, high and medium overall risk of developing fatal cardiovascular diseases (CVD). With an increase in work experience, the percentage of people at high risk of developing fatal CVD increased. The level of occupational morbidity calculated for the number of employees employed in harmful working conditions is 32% higher than the indicator calculated for all employees of the enterprise. A similar recalculation of occupational morbidity indicators for individual nosologies also completely changes the picture. Conclusion. We have substantiated the necessity of transition to a personalized assessment of occupational risk among employees. Researchers have developed proposals for adjusting legislation in order to integrate tools for assessing working conditions and improving the effectiveness of the occupational risk management system. Ethics. This study did not require the conclusion of the Ethics committee.
Acute nasopharyngitis is the most common reason for visit a doctor, usually benign, self-limited disease. It is also characterized by a high frequency of complications in children and nonspecific symptoms that require special care from the doctor when examining patients. The clinical and social significance of acute nasopharyngitis is due to their high prevalence, and inadequate treatment leads to a protracted course or to a transition to a chronic one. The relevance of this problem adds to the presence of a large number of various drugs, but not many drugs have evidence-based effectiveness. In the treatment of acute nasopharyngitis local drugs are very important. The drug is a silver proteinate agent with broad antibacterial anti-inflammatory activity. The drug is used to treat infectious rhinitis. This article evaluates the use of a new form of the silver proteinatedrug, the drug is available in the pharmacy, easy to use, long shelf life. This article describes the place of silver proteinate among drugs that help to relieve the symptoms of acute nasopharyngitis and provides data on its effectiveness, safety and features of use in children. The drug can take a worthy place among topical drugs due to its high efficiency in the treatment of acute rhinitis and its possible use at any age.
The objective of the present study was to compare the effectiveness of several extensively used techniques for the correction of the nasal valve in terms of the main clinical manifestations with the application of various scales for subjective evaluation of the outcomes of the treatment. It was demonstrated in the course of this prospective study that the patients described the elimination of nasal valve dysfunction with the help of expanding transplants as the most effective method in terms of the improvement of nasal breathing and the achievement of the acceptable aesthetic results. The plastic correction with the use of local tissues was reported to be less efficacious even if ensuring the stable result. This method did not worsen the shape of the nose but failed to remove its existing cosmetic defect. As far as the aesthetic outcome of the treatment is concerned, the suture correction technique was recognized to be the least efficacious approach because it resulted in the deterioration of the nose shape in more than half of the cases.
The present comparative randomized controlled study was designed to evaluate the effectiveness of the most widely used methods for the surgical treatment of nasal valve dysfunction including sutural extension of the valve, stretching the lateral nasal wall in combination with the application of strengthening transplants, and the introduction of tissue expanders. The objective studies were carried out with the use of anterior active rhinomanometry and acoustic rhinometry performed within 1, 3, and 12 months after surgery. It was shown that the correction of dysfunction of the nasal valve with the application of expanding transplants is the most effective method for the normalization of the parameters of nasal breathing during the mid- and long-term follow up. Plastic surgery with the use of local tissues produces a less pronounced but stable beneficial effect whereas the sutural extension of the valve yields only short-term positive results. On the whole, the effectiveness of the latter approach is inferior to that of the former two methods.
Introduction. Chronic nasal congestion caused by edema of inferior turbinate affect 20% of population and strongly influences their quality of life. Pharmacological treatment of chronic rhinitis is considered to be the first line therapy. However, if conservative treatment is not effective and clinical signs are not disappearing the question about relevant surgical treatment is arising. Nowadays there are many methods of exposure on mucosa of the inferior turbinate. Considering high incidence of the pathology surgical treatment is of current importance in modern otorhinolaryngology.Objective. Assessment of the effectiveness and comparison of the period of rehabilitation after submucosal laser destruction by laser beam with wavelength 1,56 and after submucosal destruction by radiosurgical instruments Ellman Surgitron with a frequency of 4 MHz in patients with chronic rhinitis.Methods. 60 patients were included into the study aged from 18 to 80 years old with chronic rhinitis. All the patients were admitted to the department to perform surgical treatment. Semiconducted laser with wavelength 1,56 and radiosurgical instrument Ellman Surgitron with frequency of 4 MHz were applied to the treatment. We assessed SNOT20 score, endoscopic features, anterior active rhinomanometry and saccharin test results in all patients following the surgery.Conclusions. The data we have obtained provide the basis for choosing semiconductor laser as more effective and safe technique for the treatment of patients with chronic rhinitis.
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