[Medical and social importance of Acute Myocardial Infarction Register for major industrial enterprises workers (exemplified by Siberian Chemical Works)].

Prevalence of acute myocardial infarction does not differ between groups that were or were not subjected to long radiation of low intensity. Creation and completing of the Acute Myocardial Infarction Register helps to objectively monitor situations, to form risk groups, to provide purposeful measures for lower mortality with and occurrence of acute myocardial infarction.

[Epidemiological studies as an instrument for assessment of society welfare and quality of medical service (examplified by of analysis of myocardial infarction morbidity)].

Dynamics of incidence of myocardial infarction among adult (older than 20 years) population of Seversk in 1998-2006 was studied according to WHO program "Myocardial Infarction Register" updated in concordance with criteria of Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction (2002). Incidence of myocardial infarction in the studied population had steady tendency to growth with equal contribution of such components as first and recurrent myocardial infarction what was related to progressive aging of population. Hospital myocardial infarction mortality showed steady tendency to decline evidencing for improvement of quality of medical service.

[The risk of arterial hypertension development in Siberian Group of Chemical Enterprises personnel].

PURPOSE: to study risk factors of arterial hypertension (AH), their significance for AH pathogenesis in atomic power plants employees occupationally exposed to long-term ionizing radiation in a "low" dose range (cumulative external radiation doses in the range up 1 Sv). The case-control study was carried in the cohort of workers aged 40-50 ever employed at the Siberian Group of Chemical Enterprises (SGCE) between 2003-2005. 970 persons were examined by standardized epidemiological methods. "Case" (n = 359) was found to be a recent AH case (less than 3 years) in SGCE employees whose average length of service is 3 years. "Control" (n = 611) - healthy men of the same age, length of service and working conditions. Risk of AH development (odds ratio (OR) = 1.6 (1.1; 2.37) was found to be higher in radiation workers in comparison with non-radiation ones without any linear dependence of risk upon cumulative external gamma-radiation dose in the range under study (OR in a cumulative external radiation dose range 7.3-21.3 mSv = 1.6 (0.96; 2.51); OR in a cumulative external radiation dose range 21.4-68.5 mSv = 1.7 (1.04; 2.67); OR in a cumulative external radiation dose range 68.6-864 mSv = 1.6 (1.01; 2.57). Not only traditional risk factors such as: obesity (OR = 7.1 (5.06; 10.1), frequent alcohol usage (OR = 1.3 (1.06; 1.63)), dyslipidemia (OR = 2.1 (1.61; 2.08)); hyperhomocisteinemia (OR = 1.4 (1.09; 1.72)); psychoemotional (OR = 1.4(1.11; 1.89)), hereditary aggravation (OR = 2.2 (1.75; 2.9)) in SGCE personnel, but also technogenic explosion descriptions are related to AH development. The long-term occupational external gamma-radiation in a dose range up 1 Sv potentiates a negative influence of CVD traditional risk factors (for hypercholesterinemia OR = 1.9 (1.3; 2.9), for AH OR = 3.1 (2.2; 4.6)) that leads to increase in risk coefficients for 30-60% in persons exposed to traditional and technogenic factors impact (for hypercholesterinemia and ionizing radiation OR = 2.5 (1.7; 3.2); for AH and IR OR = 3.9 (2.8; 5.2)) in comparison with non-radiation personnel.

[Risk factors prevalence for cardiovascular diseases among atomic power industry enterprises personnel].

UNLABELLED: A selective cross-sectional study based on Regional Medico-Dosimetric Register was carried out in some Siberian Group of Chemical Enterprises (SGCE) workers (aged 40-50) with the aim of studying the most important risk factors prevalence for cardiovascular diseases development. 2010 persons examined with the use of standardized epidemiological methods made up 32.6% of total SGCE personnel aged 40-50. PURPOSE: the study of risk factors of cardiovascular diseases, their prevalence, intensity and significance in atomic power plants workers exposed to occupational long-term ionizing radiation in a "low" dose range (cumulative doses in the range up to 1 Sv). The study of prevalence of risk factors for CVDs development in men occupationally exposed to ionizing radiation revealed frequent changes in the type of work performed, higher levels of psychoemotional tension, as well as high prevalence of low levels of high-density lipoprotein cholesterol (HDL-cholesterol) and obesity. Women workers of the main production were found to have hypercholesterolaemia more often than those of the auxiliary production. Annual health checks of nuclear workers should be extended to include waist and hips measurement, body mass index (BMI) calculation, lipid factors evaluation, as well as stress tests (bicycle and/or stress echocardiography) in case there are three or more risk factors for CVDs for workers of the main production.

[Regional medico-dosimetric register (RMDR) is a model for evaluation of long-term "low" dose ionizing radiation effects on Siberian group of chemical enterprises main production personnel].

Medico-dosimetric register is an optimal model of epidemiological studies on evaluation of ionizing radiation effects. Regional medico-dosimetric register (RMDR) is a system of interrelating information blocks including data on Siberian Group of Chemical Enterprises (SGCE) personnel. At present SGCE personnel and Seversk residents RMDR database includes information on 138496 persons, 65538 of which are SGCE workers. SGCE personnel and Seversk residents RMDR is a scientific base for researches with the aim of evaluating long-term ionizing radiation effects in a "low" dose range. Information on mortality and morbidity rate as well as "thematic" registers of the main diseases potentiates in evaluating the spectrum of somatic stochastic effects and radiogenic risks in SGCE workers and Seversk residents as well as their offsprings. A practical significance of RMDR database is the formation of the main diseases "risk" groups depending on definite risk factors in certain groups that provides targeted diagnostic and preventive therapy both among high-dose establishments' workers and residents living near-by.

[Novel diagnostic possibilities of transesophageal stress echocardiography with electrical atrial pacing].

In order to develop simple technique of combination of transesophageal echocardiography (TEE) and transesophageal pacing, to create algorithm and protocol of transesophageal stress-echocardiography, and to study possible complications and methods of their elimination we examined 39 subjects (mean age 50 +/- 7.2 years) with suspected ischemic heart disease (IHD), 22 patients with arterial hypertension, 11 patients with episodes of ischemic changes on 24 hour ECG. In 11 patients with high blood pressure (BP) and 2 patients with frequent ventricular extrasystoles veloergometry was contraindicated, and in 3 patients veloergometry was not informative due to complete left bundle branch block. We suggested a device for simultaneous transesophageal echocardiography (TEE) and transesophageal pacing which consisted of transesophageal multiplane ultrasound cardiological transducer and electrode for transesophageal pacing. During test pacing frequency was increased stepwise from 120 140 and to 160 beats per min until appearance of ischemia or achievement of submaximal heart rate (HR). During intubation of esophagus HR and systolic BP increased from 80.2 +/- 11.5 to 102 +/- 12.5 b/min and from 130 +/- 23.6 to 149.1 +/- 17.5 mm Hg, respectively. Magnitude of double product rose from 104.4 +/- 29.4 to 149.4 +/- 32.3. This served as additive stress factor, facilitating more precise diagnosis of IHD. As a result various derangements of regional myocardial contractility were revealed in 14 patients (36%). These derangements were accompanied with ischemic ECG changes in 72% and with mitral regurgitation - in 43% of cases. The test was stopped prematurely in 1 patient because of paroxysm of reciprocal atrioventricular tachycardia. Simplicity of the proposed device, lack of complications allow to recommend it for clinical application. Anatomical proximity of esophagus and the heart, average 20 mm Hg elevation of BP, rising cumulative myocardial oxygen requirements augment reliability of the method in diagnostics of IHD.

[Preclinical diagnosis of cardiovascular diseases in workers engaged into industries with radiation danger].

The authors presented results of single-stage cross study of randomized select from a cohort of long seniority workers of isotope separation plant in Siberian Chemical Enterprise, with studies of inflammation markers, vascular and platelet hemostasis, serum lipid parameters, calculated atherogeneity coefficient, homocysteine levels. Serum atherogeneity coefficient and inflammation markers levels (fibrinogen, C-reactive protein) could be considered as the most informative laboratory indicators of underlying cardiovascular diseases in individuals without ischemic heart disease. Among a list of standard inductors of platelet aggregation, collagen and epinephrine should be considered preferential. Increased platelet aggregation requires disaggregant therapy, especially in smokers. Increased homocysteine level is associated with high frequency of atherosclerotic plaques and smoking.

[Clinical and epidemiological analysis of possibility of acute myocardial infarction development in personnel of radiation dangerous plants].

According to the data of cohort and to the "case-control" studies, dynamics of an acute myocardial infarction (AMI) morbidity during the period 1998-2002 and role of radiation factor in AMI development among personnel of radiation dangerous plants (by the example of Siberian Group of Chemical Enterprises (SGCE) exposed to a long-term impact of ionizing radiation in the range of "low" doses) were being carried out. It was determined that in personnel of the main production (working in contact with IR sources) the gradient increase of AMI morbidity was registered during the study period. Personnel of the main production in comparison to personnel of support production (correlating age, sex and examination level) have statistically significant increase of standardized relative risk coefficients of AMI development. When evaluating standardized relative risk coefficient depending on the cumulative dose of external y-radiation, it was impossible to determine the reliance between the rate of increase of radiation dose and standardized relative risk coefficient. According to logistic regression, was determined that individual features of dose load formation are of great significance in AMI development for the personnel of the main production. Absolute values of standardized regression coefficients peculiar to the values characterizing technogenic impact, exceed correspondent values for "traditional" risk factors to be the components of the regression equation, two-three times as much. The combination of these factors allowed to prognosticate AMI development in 94.3% cases. Obtained data made possible to conclude that in pathogenesis of acute coronary diseases ionizing radiation acts as a factor that aggravate negative influence of "traditional" risk factors of cardio-vascular diseases through pleiotropic effects.

[Evaluation of homeostatic disorders induced by radiation exposure].

Possibilities of correction and prophylaxis. The authors presented results of study covering workers of radiation-dangerous plants of Siberian Chemical Enterprise, who underwent long-term exposure to outer and inner radiation in "low" doses range during the occupational activity. Target-systems for radiation effects were proved to be lipid peroxidation and antioxidant defence systems, cell energy metabolism--severity of disorders in which is correlated with degree of radiation exposure.

[The role of transesophageal dopplerographical assessment of coronary reserve in coronary sinus in diagnosis of hemodynamically significant left coronary artery stenoses]. / Rol' chrespishchevodnoi dopplerograficheskoi otsenki koronarnogo rezerva v koronarnom sinuse v diagnostike gemodinamicheski znachimykh stenozov basseina levoi koronarnoi arterii.

AIM: To assess the role of estimation of coronary reserve in coronary sinus by transesophageal doppler during dipyridamole stress test for diagnosis of hemodynamically significant left coronary artery stenoses. MATERIAL: Patients with angiographically proven left coronary artery stenoses (n=29) and 25 healthy volunteers. METHODS: Coronary reserve was calculated as 1) ratio of peak to basal diastolic coronary flow velocity (V(p)CR), and 2) ratio of volume coronary blood flow velocity before and during hyperemia (VBF CR). Coronary reserve <2 was considered decreased. RESULTS: Compared with healthy subjects patients with coronary heart desease had significantly lower V(p)CR (1.67+/-0.44 and 2.56+/-0.87, respectively, p<0.001) and VBF CR (2.42+/-1.37 and 5.53+/-3.65, respectively, p<0.001). Sensitivity and specificity of coronary reserve below 2 for diagnosis of left coronary artery stenoses was 72 and 72%, respectively, for V(p)CR, and 49 and 96%, respectively, for VBF CR. VBF CR below 2 was a marker of severe double vessel left coronary artery disease. V(p)CR <2 was associated with single vessel stenoses within left coronary artery system. CONCLUSION: The use of evaluation of coronary reserve by transesophageal dopplerography for diagnosis of left coronary artery stenoses is methodologically correct. Level of coronary reserve in coronary sinus can be considered an integral parameter characterizing total left coronary artery atherosclerotic damage.

[Predictive value of echocardiography in infectious endocarditis]. / Prognosticheskoe znachenie ékhokardiografii pri infektsionnom éndokardite.

182 patients with infectious endocarditis (IE) were examined for correlations between valvular bacterial vegetations and IE activity, course, results of bacteriological and morphological findings. 81 of the patients had primary IE, 71 patients had secondary IE which had developed in uncorrected valvular heart disease, in 30 patients secondary IE had developed after surgical correction of rheumatic heart disease. It is shown that echocardiographic detection of bacterial vegetations does not determine IE severity, course and outcome.