RESUMO
The authors consider the organization of a system for monitoring of ambient air pollution by suspended matter (by fractions of less than 10 microm and less than 2.5 microm) as one of the most urgent tasks in the harmonization of the Russian and western methods for assessing the quality of the environment. The frame plan for organization of ambient air suspended matter monitoring in the countries of Eastern Europe, Caucasia, and Central Asia, proposed by the WHO European Regional Office provides basic guidelines for this system and may be adapted to Russian conditions, as evidenced by the author's experience. The paper summarizes the basic results of the studies that have established the association of respiratory disease in junior schoolchildren with exposure to PM10 and PM2.5.
Assuntos
Poluentes Atmosféricos/efeitos adversos , Poeira , Doença Ambiental/etiologia , Doença Ambiental/prevenção & controle , Monitoramento Ambiental/métodos , Área Programática de Saúde , Criança , Exposição Ambiental/efeitos adversos , Doença Ambiental/epidemiologia , Monitoramento Epidemiológico , Humanos , Federação Russa/epidemiologia , EstudantesRESUMO
Medical rehabilitation of the population living in poor environmental areas has been realized since 1999 and is the basis for environmental safety policy in the Sverdlovsk Region, along with the prevention and reduction of environmental pollution, the rational use, conservation, and replenishment of natural complexes. Medical rehabilitation activities for the population's health are aimed at managing the risks associated with human environmental factors, managing address medical prophylactic services, individual behavioral factors, habits, and awareness of the population. Interaction of the participants of the medical rehabilitation system provides for tackling the set health promotion tasks in the Sverdlovsk Region.
Assuntos
Doença Ambiental/etiologia , Doença Ambiental/reabilitação , Poluição Ambiental/efeitos adversos , Área Programática de Saúde , Doença Ambiental/epidemiologia , Humanos , Vigilância da População/métodos , Federação Russa/epidemiologiaRESUMO
Holter monitoring was performed in 15 patients surviving over 3 months after homotopic cardiac transplantation. The frequency and types of arrhythmias occurring in the grafted innervated heart were studied according to its postoperative period duration. The follow-up lasted 3 to 29 months. Supraventricular arrhythmias were detected in 80%, whereas ventricular ones were found in 86.7%. Ventricular arrhythmias accompanied chronic graft rejection in 2 patients. It was ascertained that Holter monitoring was of greater diagnostic value than routine ECG recording. Innervation is not essential in the occurrence of cardiac arrhythmias.
Assuntos
Arritmias Cardíacas/etiologia , Cardiomiopatia Dilatada/cirurgia , Doença das Coronárias/cirurgia , Transplante de Coração/efeitos adversos , Complicações Pós-Operatórias/etiologia , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/terapia , Eletrocardiografia , Feminino , Humanos , Masculino , Marca-Passo Artificial , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Síndrome do Nó Sinusal/diagnóstico , Síndrome do Nó Sinusal/etiologia , Síndrome do Nó Sinusal/terapia , Taquicardia/diagnóstico , Taquicardia/etiologia , Taquicardia/terapia , Taquicardia Supraventricular/diagnóstico , Taquicardia Supraventricular/etiologia , Taquicardia Supraventricular/terapiaRESUMO
Endomyocardial diagnostic biopsies, recipient heart removed at operation, endomyocardial biopsies of allotransplants and postmortem material were studied using immunofluorescence to specify immunopathological process and to detect humoral rejection. Altogether 306 samples from 55 patients were studied. In the early postoperative period (one year) 8 out of 18 patients with heart transplants repeatedly showed immunopathologic picture of acute humoral (vascular) rejection which was characterized by a widespread immunoglobulin G and complement fixation in the capillary walls accompanied by enhanced capillary permeability and fibrin deposition in intestitial tissue. Such patients often had graft dysfunction. 1 to 5 years after transplantation in 24 out of 37 patients discrete focal immunoglobulin and complement fixation was observed as one of chronic rejection component.
Assuntos
Rejeição de Enxerto/patologia , Transplante de Coração/patologia , Miocárdio/patologia , Adolescente , Adulto , Formação de Anticorpos , Biópsia , Permeabilidade Capilar/fisiologia , Diagnóstico Diferencial , Feminino , Fibrina/metabolismo , Imunofluorescência , Rejeição de Enxerto/imunologia , Transplante de Coração/imunologia , Humanos , Masculino , Miocárdio/imunologia , Miocárdio/metabolismo , Doadores de Tecidos , Transplante HomólogoRESUMO
Compared to healthy controls, patients with transplanted heart have higher baseline heart rate (HR), delayed initial HR reaction, slower changes of HR both during exercise and after it, diminished chronotropic and inotropic reserves. The data obtained contribute to better understanding of physiology of transplanted denervated heart and objective assessment of patients after heart transplantation.
Assuntos
Pressão Sanguínea , Exercício Físico/fisiologia , Frequência Cardíaca , Transplante de Coração/fisiologia , Adolescente , Adulto , Teste de Esforço/métodos , Teste de Esforço/estatística & dados numéricos , Seguimentos , Coração/inervação , Coração/fisiopatologia , Humanos , Pessoa de Meia-IdadeRESUMO
Exercise tolerance in postcardiac transplantation patients versus healthy controls was studied at different intervals after the surgery using bicycle ergometry. Being low after the transplantation, exercise tolerance in the patients increased throughout the rehabilitation period but still did not reach the values characteristic for healthy subjects. Initial heart rate in the above patients was higher, while chronotropic and inotropic reserves of the transplanted heart appeared lower than in the controls. The data obtained help objectively assess the condition of the patients with transplanted heart.