RESUMO
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.
Assuntos
Transtornos Cognitivos/fisiopatologia , Doenças Profissionais/fisiopatologia , Exposição Ocupacional/efeitos adversos , Solventes/toxicidade , Adulto , Transtornos Cognitivos/induzido quimicamente , Transtornos Cognitivos/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamenteRESUMO
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.
Assuntos
Contaminação Radioativa do Ar , Doenças Cardiovasculares , Ventrículos do Coração , Exposição Ocupacional , Urânio , Local de Trabalho/normas , Idoso , Contaminação Radioativa do Ar/efeitos adversos , Contaminação Radioativa do Ar/análise , Contaminação Radioativa do Ar/prevenção & controle , Reabilitação Cardíaca , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/fisiopatologia , Ecocardiografia , Feminino , Ventrículos do Coração/patologia , Ventrículos do Coração/fisiopatologia , Ventrículos do Coração/efeitos da radiação , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controle , Saúde Ocupacional , Gestão da Segurança/métodos , Gestão da Segurança/organização & administração , Tempo , Urânio/análise , Urânio/toxicidade , Remodelação Ventricular/efeitos da radiaçãoRESUMO
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.
Assuntos
Doenças Cardiovasculares/psicologia , Doenças Profissionais/psicologia , Exposição Ocupacional/efeitos adversos , Transtornos Psicofisiológicos/etiologia , Idoso , Doenças Cardiovasculares/complicações , Feminino , Humanos , Incidência , Masculino , Doenças Profissionais/complicações , Transtornos Psicofisiológicos/epidemiologia , Transtornos Psicofisiológicos/psicologia , Fatores de Risco , Sibéria/epidemiologiaRESUMO
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.
Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Transtornos Cognitivos , Síndrome da Vibração do Segmento Mão-Braço/epidemiologia , Síndrome da Vibração do Segmento Mão-Braço/psicologia , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/fisiopatologia , Comorbidade , Progressão da Doença , Feminino , Síndrome da Vibração do Segmento Mão-Braço/fisiopatologia , Humanos , Masculino , Prevalência , Qualidade de Vida , Radiação Ionizante , Fatores de RiscoRESUMO
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.
Assuntos
Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Substâncias Perigosas/efeitos adversos , Doenças Profissionais/etiologia , Doenças Profissionais/fisiopatologia , Vibração/efeitos adversos , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , UltrassonografiaRESUMO
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.
Assuntos
Angina Instável/fisiopatologia , Eletrocardiografia , Sistema de Condução Cardíaco/fisiopatologia , Infarto do Miocárdio/fisiopatologia , Idoso , Eletrocardiografia/métodos , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , PrognósticoRESUMO
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.
Assuntos
Doenças Profissionais/fisiopatologia , Circulação Pulmonar/fisiologia , Função Ventricular Direita/fisiologia , Vibração/efeitos adversos , Progressão da Doença , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Contração Miocárdica/fisiologia , Doenças Profissionais/complicações , Prognóstico , Pressão Propulsora Pulmonar/fisiologia , Índice de Gravidade de Doença , Volume Sistólico/fisiologia , Disfunção Ventricular Direita/etiologia , Disfunção Ventricular Direita/fisiopatologiaRESUMO
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.
Assuntos
Substâncias Perigosas/intoxicação , Doenças Profissionais/induzido quimicamente , Solventes/intoxicação , Disfunção Ventricular Esquerda/induzido quimicamente , Adulto , Doença Crônica , Ecocardiografia/métodos , Feminino , Humanos , Doenças Profissionais/epidemiologia , Doenças Profissionais/fisiopatologia , Índice de Gravidade de Doença , Solventes/classificação , Disfunção Ventricular Esquerda/epidemiologia , Disfunção Ventricular Esquerda/fisiopatologiaRESUMO
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.
Assuntos
Cardiopatias , Homeostase/fisiologia , Hipertensão , Doenças Profissionais/epidemiologia , Solventes/efeitos adversos , Vibração/efeitos adversos , Adaptação Fisiológica/fisiologia , Idoso , Feminino , Cardiopatias/complicações , Cardiopatias/etiologia , Cardiopatias/fisiopatologia , Hemodinâmica/fisiologia , Humanos , Hipertensão/complicações , Hipertensão/etiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada de Emissão/métodosRESUMO
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.
Assuntos
Circulação Sanguínea , Hipertensão/fisiopatologia , Vibração/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Humanos , Hipertensão/tratamento farmacológico , Pessoa de Meia-IdadeRESUMO
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.
Assuntos
Anemia Ferropriva/fisiopatologia , Coração/fisiopatologia , Adulto , Anemia Ferropriva/diagnóstico por imagem , Diástole , Ecocardiografia Doppler , Eletrocardiografia , Feminino , Hemodinâmica , HumanosRESUMO
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.
Assuntos
Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologia , Remodelação Ventricular/fisiologia , Vibração/efeitos adversos , Hemodinâmica , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
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.
Assuntos
Diástole , Doenças Profissionais/fisiopatologia , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Direita/diagnóstico , Vibração/efeitos adversos , Interpretação Estatística de Dados , Ecocardiografia Doppler , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico , Doenças Profissionais/etiologia , Fatores de Tempo , Trimetazidina/administração & dosagem , Trimetazidina/uso terapêutico , Vasodilatadores/administração & dosagem , Vasodilatadores/uso terapêutico , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia , Disfunção Ventricular Direita/diagnóstico por imagem , Disfunção Ventricular Direita/fisiopatologiaRESUMO
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.
Assuntos
Cardiomiopatias/induzido quimicamente , Coração/efeitos dos fármacos , Hidrocarbonetos/efeitos adversos , Doenças Profissionais/induzido quimicamente , Solventes/efeitos adversos , Adulto , Poluentes Ocupacionais do Ar/efeitos adversos , Cardiomiopatias/diagnóstico , Cardiomiopatias/fisiopatologia , Doença Crônica , Diástole/efeitos dos fármacos , Ecocardiografia Doppler/efeitos dos fármacos , Eletrocardiografia/efeitos dos fármacos , Feminino , Coração/fisiopatologia , Humanos , Doenças Profissionais/diagnóstico , Doenças Profissionais/fisiopatologia , Pintura/efeitos adversos , Função Ventricular Esquerda/efeitos dos fármacosRESUMO
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).