[Some aspects of cognitive functions in chronic intoxication by organic solvents].

Study covered 20 females with chronic intoxication with organic solvents, who worked long as painters on industrial enterprise. To reveal clinically significant cognitive disorders, Mini-Cog scale was applied. Drawing test helped to reveal visual and spatial disorders, restults were expressed in scores. Memory was evaluated through methods "operative memory", "short-term memory", "memory for figures", "memory for images", "hearing memory"--that proved lower results in the main group of examinees. In 75% of patients with occupational diseases caused by organic solvents, moderate cognitive disorders of amnestic multifunctional type were seen. 100% of individuals having chronic intoxication with organic solvents demonstrated encephalopathy. In comparison with reference group, the main group members had more frequent 1 and 2 degrees encephalopahy.

[Depending on exposure, functional state of left ventricle in combined cardiovascular disease among chronic uranium intoxication patients].

State of left heart contractility in patients having IHD and AH during long-term period of chronic uranium intoxication depends on duration of exposure to toxic radiation factor. The authors revealed left ventricle myocardium weight decreased by 11.7% on exposure up to 10 years and that decreased by 18.9% on the exposure over 10 years, when compared to the reference group. Longer length of service was connected with higher share of patients with pathologic remodelling of left ventricle, mostly due to increased concentric remodelling.

[Psychosomatic disorders in combined occupational and cardiovascular diseases].

A group of individuals with occupational diseases caused by chemical factors demonstrate higher incidence and severity of depression, frustration, rigidity, cognitive and sleep disorders, if compared to the group of individuals with occupational diseases caused by physical factors. In the occupational diseases group, encephalopathy is seen more frequently, individuals subjected to physical factors have prevailing encephalopathy of I and II grades, those subjected to chemical factors--of II-III and III grades, more severe encephalopathy in the group of chemical factors is seen among the individuals subjected to uranium compounds.

[Cognitive disorders in occupational diseases of after contact period, associated with cardiovascular problems].

Vibration disease patients with chronic uranium intoxication in after contact period demonstrate moderate cognitive disorders of amnestic multifunctional type in 100% of cases. Individuals having occupational diseases due to physical, toxic and radiation hazards, associated with cardiovascular problems, in after contact period manifest mostly with visual-spatial functions, short-term, operative, visual and aural memory disorders. Visual-spatial functions, short-term, operative, visual and aural memory are decreased more in patients with remote period of chronic uranium intoxication.

[On functional heart disorders in individuals with occupational diseases caused by physical and chemical factors].

Heterometric mechanism of cardiac autoregulation is characteristic for patients with occupational vibration disease, as an example of physical factor in occupational disease pathogenesis. For chemical factor inducing occupational disease, as exemplified by chronic intoxication with organic solvents, homeometric mechanism of cardiac autoregulation is characteristic.

[Comparative characteristics of intervals Q-T and J-T in patients with unstable angina and myocardial infarction based on standard electrocardiography and electrocardiotopography].

We examined 94 patients (mean age 61,7 +/- 9,9 years) with unstable angina and myocardial infarction. Comparative characterization of prognostic value of Q-T and J-T intervals obtained at conventional 12-lead electrocardiography and 35-lead electrocardiotopography in assessment of risk of repetitive coronary events during follow up for 1 year was carried out. It was found that prolongation of maximal corrected Q-T interval obtained by electrocardiotopography at admission had greater prognostic significance for assessment of risk of unfavorable outcome. Increase of this parameter of Q-T interval was not related to augmentation of area and degree of subendocardial myocardial damage and left ventricular systolic dysfunction.

[Right ventricular function and pulmonary circulation hemodynamics in patients with vibration disease].

AIM: To study contractile and diastolic function of the right ventricle, mechanic activity of the right heart, hemodynamics of the pulmonary circulation in patients with vibration disease (VD). MATERIAL AND METHODS: The study group consisted of patients in contact with vibration (15 subjects without VD symptoms, 44 patients with VD of the first degree and 10 patients with VD of the second degree). 20 control males had no contact with vibration. RESULTS: VD patients developed right ventricular (RIO dysfunction: disturbed diastolic function, hypodynamic syndrome of the first degree accompanied with reduced ejection fraction, stroke output and cardiac index. In VD, RV dysfunction appears in parallel with left ventricular dysfunction due to high pressure in pulmonary circulation and interventricular interaction. CONCLUSION: VD-specific features of the lesser circulation and RV function give rise to formation of heart failure. Thus, early diagnostic and prophylactic measures should be taken in subjects in contact with vibration.

[Features of heart function and morphology in chronic organic solvents intoxication]. / Osobennosti strukturno-funktsional'nogo sostoianiia serdtsa u bol'nykh khronicheskoi intoksikatsiei ogranicheskimi rastvoriteliami.

Patients with chronic organic solvents intoxication are characterized by left ventricle hyperfunction mostly isometric type, with left ventricle diastole disordered due to impaired both passive filling and active relaxation, given the chamber geometry is normal and hypokinetictype hemodynamics is prevalent. Phase analysis of left heart mechanic activity in patients with chronic organic solvents intoxication demonstrated I degree hypodinamia syndrome and left ventricle outlet stenosis.

[Types of autoregulation of cardiac performance in patients with occupational diseases exposed to physical and chemical agents in combination with arterial hypertension]. / Tipy avtoreguliatsii serdechnoi deiatel'nosti u bol'nykh professional'nymi zabolevaniiami pri vozdeistvii fizicheskikh i khimicheskikh faktorov v sochetanii s arterial'noi gipertoniei.

The formation of the heterometric mechanism responsible for the autoregulation of cardiac performance (the development of the left ventricle (LV) mainly as isotonic) is characteristic of patients with vibration disease and arterial hypertension (AH). The homeometric mechanism of autoregulation of cardiac performance (the development of LV hyperfunction mainly as isometric) is typical of patients with chronic intoxications (with organic solvents and uranium). In AH, LV hyperfunction is leveled in the late postconduct period of exposure to a physical agent, but preserved in the late postconduct period of exposure to a chemical agent.

[Functional status of the circulatory system in during dynamics of treating arterial hypertension in patients with vibration disease]. / Funktsional'noe sostoianie sistemy krovoobrashcheniia v dinamike lecheniia arterial'noi gipertonii u bol'nykh vibratsionnoi bolezn'iu.

AIM: To develop medicinal approaches to correction of hemodynamic disturbances in vibration disease (VD) associated with arterial hypertension. MATERIAL AND METHODS: The study compared hypotensive and hypodynamic efficiency of amlodipin, diltiazem, enalapril, perindopril and indapamide in 74 VD patients with arterial hypertension (SAP 140-179 mm Hg, DAP 90-109 mm Hg; mean age 54.8 years, mean exposure to vibration 26.8 years). Before and after the treatment course the patients were examined with ultrasound by the following parameters: left ventricular contractility, left and right ventricular diastolic function, left atrial function. RESULTS: Amlodipin reduced left ventricular volume both in systole and diastole as well as maximal intramyocardial tension without significant change in contractility, raised a contraction reserve of the left atrium, improved ventricular relaxation. Diltiazem potentiates contractility of the left ventricle and atrium without marked impact on relaxation and tension of the myocardium. Enalapril and perindopril cause positive hemodynamic shifts. Perindopril vs enalapril was more effective in easing intramyocardial systolic tension of the left ventricular wall and in improving the diastolic function. Indapamid vs calcium antagonists and ACE inhibitors had a weaker effect on arterial pressure, no significant effect on left ventricular contraction, peripheral hemodynamics. Left atrial function was hyperactive. This was observed also in response to the other drugs. CONCLUSION: Amlodipin produced in patients with VD and AH more positive hemodynamic effects, reduced isotonic hyperfunction of the left ventricle, improves diastolic function of the ventricles. Amlodipin and perindopril are more promising prognostically in relation to reduction of left ventricular myocardial mass.

[Clinical and functional cardiac characteristics in iron-deficiency anemia]. / Kliniko-funktsional'naia kharakteristika serdtsa pri zhelezodefitsitnoi anemii.

AIM: To characterize clinically and electrocardiographically the condition of the heart in chronic iron deficient anemia (IDA), to study hemodynamic mechanisms of heart impairment for early detection of diastolic myocardial dysfunction in long-term course of sideropenia. MATERIAL AND METHODS: Clinical and ECG examinations were made in 400 IDA patients. Echocardiography and dopplerechocardiography were made in 95 and 27 patients, respectively. Patients with non-anemic myocardiodystrophy were withdrawn. Mean age of the patients was 35.4 +/- 3.8 years, mean Hb level--79.5 +/- 6.5 g/l, mean anemia duration 6.9 +/- 4.2 years. RESULTS: The severity of cardiac symptoms directly correlated with severity and duration of anemic sideropenic syndrome. 100% had heart complaints, 91.3% had mild chronic cardiac failure, 86.2% patients showed changes on the electrocardiogram. Diastolic insufficiency of both right and left ventricular myocardium was registered in almost all the examinees. CONCLUSION: Long-term anemia due to iron deficiency promotes metabolic and dystrophic alterations in the myocardium manifesting with diastolic dysfunction of both the ventricles prior to systolic failure. The study of cardiac diastolic function in IDA allows detection of early symptoms of cardiac failure which requires pharmacological correction.

[On remodeling of heart in vibration disease]. / K voprosu remodelirovaniia serdtsa pri vibratsionnoi bolezni.

Vibration disease induces disorder of cardiac functional state in accordance with the disease severity. Cardiac dysfunctions are changed geometry and weight of left ventricle, disordered diastole of both ventricles, altered left atrium activity, increased pressure in pulmonary artery, higher postload on right ventricle.

[Aspects of diastolic function of the heart in vibration disease]. / Osobennosti diastolicheskoi funktsii serdtsa pri vibratsionnoi bolezni.

AIM: To study effects of occupational vibrations on the myocardium, to elucidate early alterations in cardiac performance and to introduce approaches to their correction. MATERIALS AND METHODS: Doppler echocardiography was made to evaluate diastolic function of the heart ventricles in 54 men with vibration disease. Mean exposure to local vibration was 22.4 years. The examinees were divided into two groups: 42 men (mean age 46.8 years) with vibration disease of the first degree--group 1; 12 men (mean age 51.2 years) of the first-second and second degree--group 2. RESULTS: In group 2 compared to group 1 there was a decrease of maximal velocity of early filling (MVEF) by 24.2%, early filling phase (EFP) by 27%, ratio MVEF/MVLF 1.17-fold, increase of isometric relation phase by 15.9%. For the right ventricle there was a decrease in MVEF by 15.4%, MVEF/MVLF 1.51-fold, prolongation of EFP by 20%. By these indices, the groups differed significantly in the diseases severity. Trimetasidine had a corrective effect on diastolic function of both left and right ventricles of the heart. CONCLUSION: Patients with vibration disease were diagnosed to have left and right ventricular diastolic dysfunction.

[The characteristics of cardiac diastolic function in myocardiodystrophy in persons subjected to aromatic hydrocarbon exposure]. / Osobennosti diastolicheskoi funktsii serdtsa pri miokardiodistrofii u lits, podvergaiushchikhsia vozdeistviiu aromaticheskikh uglevodorodov.

Left and right ventricular diastolic function was investigated at doppler echocardiography in patients with myocardiodystrophy exposed to organic aromatic solvents (30 female house painters). The control group consisted of healthy females and females with autonomic-dyshormonal myocardiodystrophy. The study group exhibited diastolic dysfunction characterized by disturbed active relaxation assessed by duration of isometric left and right ventricular relaxation.

[Optimization of the diagnosis and treatment of anemias under exposure to aromatic-type organic solvents]. / Optimizatsiia diagnostiki i lecheniia anemii v usloviiakh vozdeistviia organicheskikh rastvoritelei aromaticheskogo riada.

171 iron-deficient painters and 20 subjects with chronic intoxication with aromatic hydrocarbons were studied in a large aircraft construction factory. After correlative analysis of iron metabolism, ferritin, erythrocytes, diameter and perimeter of reticulocytes, length of service three types of iron-deficiency were identified: typical, with evident toxicity, with a high risk of toxic damage. An important role of lipid peroxidation activity and toxic erythrocyto-membranopathy for pathomorphosis of iron deficiency anemia and progress of toxic anemia is demonstrated. A differential approach to treatment of different anemia variants was used. The treatment included membranoprotectors (alpha-tocopherol, essential, lypostabil) and unspecific detoxication (SUMS-enterosorbent, unitiol).