The article substantiates the relevance of studying the problem of early development and progression of hypertension among the flight personnel of the Russian Aerospace forces. The article analyzes the incidence of hypertension among aircrew in comparison with the incidence in the Armed forces and the population of the country. The article considers the most significant signs of early development and course of hypertension, which lead to early disqualification from flight work for medical reasons. The total risk of developing cardiovascular complications is assessed on the scale for assessing the risk of fatal cardiovascular disease over 10 years in the examined individuals with previously established and newly detected arterial hypertension and high levels of stress. Attention is drawn to the high prevalence of modifiable risk factors for cardiovascular pathology among the examined individuals against the background of occupational stress. It was found that people with diagnosed hypertension under the influence of a high level of professional stress are characterized by irrational changes in eating behavior, high prevalence of Smoking, increased alcohol consumption and low physical activity. In addition, stress-induced hypertension indicates a high risk of developing cardiovascular complications in the next 10 years and necessitates additional expansion of the range of measures for its prevention and correction. Practical recommendations for preventing the development and progression of hypertension among the flight personnel of the Russian Aerospace forces are presented. These recommendations are based on the analysis of the incidence of hypertension in flight personnel at the present stage, as well as the identified risk factors for developing hypertension, taking into account the specifics of flight work and conditions of military service of these specialists.
The article represents data on the history of medicine in Russia in the XVIII–XIX centuries. Data on Peter I medical reforms, the foundation of Moscow, St. Petersburg and Kronshtadt land and sea hospitals, Hospital schools are presented. The names of the first teachers of Hospital schools are presented.
The concept of high-risk pulmonary artery embolism determines that verification of the occlusion of the pulmonary arterial bed requires urgent restoration of pulmonary blood flow in such patients. Thrombolytic therapy is currently recognized as the main treatment for pulmonary artery thromboembolism. It can save patients’ lives, prevent the development of chronic post embolic pulmonary hypertension and thromboembolism recurrence. The literature review presents thrombolytic medications used in the treatment of pulmonary thromboembolism, describes indications for thrombolytic therapy, comparative efficiency and safety of various thrombolytics. The main complications of thrombolytic therapy are described and the issues of increasing its safety are raised. Criteria for the success of thrombolysis are early diagnosis, accurate risk stratification, and adequate use of reperfusion agents in patients with high-risk or transitionally high-risk of pulmonary embolism.
Analysis of clinical effi cacy and safety of alteplase and recombinant prourokinase in 82 patients with pulmonary embolism (PE) of high and intermediate high risk of death during the hospital observation period, whо were divided into two groups depending on the thrombolytic applied: the 1st group — recombinant prourokinase (40 people), the 2nd group — alteplase (42 people). The results of treatment, indicators of eff ectiveness and safety of thrombolytic therapy with alteplase and recombinant prourokinase were analyzed. The eff ectiveness and safety of thrombolytic therapy, evaluated clinically and instrumentally, did not diff er in the use of the drugs studied. However, at the time of development of PE from 5 to 14 days from the onset of the disease, for thrombolysis, it is preferable to use recombinant prourokinase, as it leads to a more signifi cant reduction in the volume of thrombotic masses than with the use of alteplase.
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