[The spa and health resort-based treatment of the women of various employments presenting with arterial hypertension]. / Sanatornoe lechenie zhenshchin razlichnykh professii s arterial'noi gipertenziei.

AIM: The objective of the present study was to evaluate the effectiveness of balneotherapy for the women of various employments presenting with arterial hypertension. MATERIAL AND METHODS: The study included 57 women with stage I (n=29) and II (n=28) hypertension. One study group was comprised of 28 female motor drivers including taxi-drivers (n=12), personal car drivers (n=7), and trolleybus drivers (n=9) at the mean age of 46,2±6,9 years suffering from occupational emotional stress (OES) and systematic psychoemotional tension (PET). Another group consisted of 29 female service system operators and included teachers (n=14), medical professionals (n=8), and social workers (n=7) at the mean age of 46.1±7.0 years whose activities was either associated with PET or involved hard emotional labour (HEL). The severity of the disease, and the age of the members of the two groups exposed to PET or HEL were not significantly different. Both groups were formed by means of random assignment. All the patients were subdivided into two groups: group 1 was comprised of 29 women and included 15 service system operators and 14 those exposed to HEL; the major therapeutic factor chosen for their treatment was taking thermal nitrogen mineral baths (36-37 degrees Celsius during 15 min., 8-10 sessions per treatment course). The patients of group 2 (n=28 including 14 service system operators and 14 those exposed to HEL) underwent treatment with the use of bromiodine mineral baths (36-37 degrees Celsius during 15 min., 8-10 sessions per treatment course). ECG, 24hr arterial blood pressure monitoring (ABPM), and psychophyisiological testing (PPT) were used alongside with the routine general clinical examination and laboratory studies to evaluate the outcome and overall effectiveness of balneotherapy. RESULTS: The clinical and instrumental characteristics of the participants in the study (health status, peripheral and coronary hemodynamics, etc.) gave evidence of the considerable improvement in the general health status of 89.6% and 87.7% of the women suffering from arterial hypertension following their treatment with the use of nitric and bromiodnine thermal baths, respectively. At the same time, the patients of group 1 exhibited the marked improvement in the condition of the fast response system while those of group 2 experienced either the deterioration of the occupationally significant functions and characteristics (in 48.3% cases) or did not show their dynamic whatever (in 51.1% cases). CONCLUSION: The present study has demonstrated the high effectiveness of balneotherapy for the women of various professional employments presenting with stage I and II arterial hypertension making use of bromiodine mineral bath therapy even though such treatment resulted in the deterioration of professional functions and qualities in 48.3% of the cases; in contrast, the nitrogen-thermal therapy improved the working capacity of the patients. Based on these observations, it is recommended that the psychophysiological testing should be practiced following balneotherapy before the women with arterial hypertension resume their occupational activities.

[The spa and resort-based health-promoting treatment of the vehicle drivers suffering from duodenal ulcer disease: the effectiveness and safety].

OBJECTIVE: To evaluate the effectiveness and the safety of the spa and resort-based health-promoting treatment of the vehicle drivers (VD) presenting with duodenal ulcer disease. MATERIAL AND METHODS: A total of 67 men suffering from duodenal ulcer disease (DUD) were allocated to two groups. The patients of group 1 (n = 35) were given the courses of balneotherapy that included bromine-iodine mineral baths with a temperature of 36-37 degrees C (8-9 procedures 10-15 min long each every second day) in combination with 8-9 peloid applications to the epigastric region (temperature 38-40 degrees C for 10-15 min every second day). The patients of group 2 (n = 32) were given the similar courses of therapy that included nitric thermal mineral baths with a temperature of 36-37 degrees C (8-9 procedures 10-15 min long each every second day) in combination with 8-9 peloid applications to the epigastric region (38-40 degrees C for 10-15 min every second day). The effectiveness and safety of these balenotherapeutic procedures for the treatment of duodenal ulcer disease in the subjects of the study and control (n = 47) groups were evaluated based on the results of the routine clinical and endoscopic examination, psychological and psychophysiological tests, and the comparative analysis of medical aid appeal-ability and disability cases during twelve months. RESULTS: Dynamics of clinical and instrumental characteristics (subjective, objective, clinical, endoscopic, psychophysiological) suggested the improvement of the health status in 88.6% and 84.4% of the drivers with duodenum ulcer in the two study groups respectively. Some of the patients comprising group 1 showed significant negative dynamics of the operative reaction system while the patients of group 2 demonstrated the marked improvement of the professionally significant functions and properties (PSF&P). The comparative analysis of medical aid appealability, disability cases, frequency of relapses and complications revealed the favorable clinical course of duodenal ulcer disease in both groups of patients who received the spa and resort-based health-promoting treatment. CONCLUSION: The spa and resort-based health-promoting treatment in the form of nitric thermal and bromine-iodine mineral baths in combination with peloid applications proved to be highly effective and safe for the vehicle drivers with duodenal ulcer disease, its two modalities (bromine-iodine an nitric-thermal baths) being almost similarly beneficial for the patients (88.6% and 84.4% respectively). At the same time, the former modality resulted in the well apparent deterioration of the driving qualityin certain subjects which suggests the necessity of psychophysiological testing for the evaluation of the performance of the operative reaction system. It is concluded that the spa and resort-based health-promoting treatment of the vehicle drivers suffering from duodenal ulcer disease should be considered as an indispensable component of the rational medical-psychological monitoring system providing a basis for the effective health and workability management.

[Students' free work at the Department of Internal Propedeutics is an important part of an educational process].

The paper presents different forms of students' free work, which have been approved at the Department of Internal Propedeutics, such patient examination; preparation of a piece and an academic case history; night duties in a clinic; attending conferences on deontology; training in the simulation center, medical practice, assessment of practical skills and knowledge at the examination. These work forms enhance the efficiency of an educational process and extend the capabilities of mastering clinical examination methods and molding deontological culture in students.

[Transportation medicine--experience, problems, prospects, right for recognition].

Analysis of most important Russian and foreign publications dedicated to vehicle drivers health condition, driving quality deterioration due to chronic noninflectional diseases, traffic accidence frequency and their outcome, also lack of considerable scientific and practical projects in this field of science--is a basis to acknowledge traffic medicine in Russian Federation.

[The effectiveness and safety of the balneotherapeutic treatment of the mechanical transport drivers suffering heart rhythm disorders].

AIM: To estimate the effectiveness and safety of the balneotherapeutic treatment of the of mechanical transport drivers (MTD) suffering heart rhythm and cardiac conduction (HR&CC) disorders with concomitant arterial hypertension (AH) treated based at a Nalchik health resort. MATERIAL AND METHODS: A total of 42 MTD (all men) presenting with HR&CC disorders and I-II grade AH were admitted for the balneotherapeutic treatment at a Nalchik health resort using two main approaches, viz. (a) thermal nitrogen mineral baths 36-37 degrees C in the form of 22 courses consisting of 8-10 sessions each (10-15 min every other day) and (b) bromine-iodine mineral baths 36-37 degrees C in the form of 20 courses consistingof 8-10 sessions each (10-15 min every other day). The outcomes of the treatment were estimated based on the results of general clinical examination and laboratory analyses supplemented by round-the-clock monitoring of arterial pressure and ECG, psychological and psychophysiological testing (PPT). RESULTS: The results of clinical and instrumental investigations into dynamics of the general health status, peripheral and coronary hemodynamics in the drivers with HR&CC disorders and AH give evidence of the improvement of their psychosomatic status following the treatment with the use ofthermal nitrogen and bromine-iodine mineral baths in 86.4 and 80.0% of the cases, respectively. In the subjects of the former group, significant changes in the dynamic response system were documented. 75% of MTD included in the latter group were characterized by the absence of improvement of professionally significant functions and skills that were found to deteriorate in the remaining 25%. CONCLUSION: The balneotherapeutic treatment of MTD presenting with HR&CC disorders and I-II grade AH with the use of thermal nitrogen mineral baths proved to be a highly effective, specific, and safe method in 86.4% of the cases. The use of bromine-iodine mineral baths resulted in clinical and hemodynamic changes of the psychosomatic status in 80.0% of the drivers concomitant with the deterioration of their professional activities. It is concluded that PPT is mandatory for the mechanical transport drivers presenting with HR&CC disorders and I-II grade AH before they resume their professional activities after the balneotherapeutic treatment.

[Present-day organization of the teaching process at the Department of Propedeutics of Internal Diseases].

The experience with organization of the teaching process at the Department ofPropedeutics of Internal Diseases is reported. The role of the rating system for knowledge and skill control is discussed along with the possibilities of its application for the improvement of training students in compliance with the Bologna process principles and their integration into the education system.

[The main risk factors of chronic non-infectious diseases in students: prevalence and long-term trends].

The study was aimed at elucidating the prevalence and long-term trends of chronic non-infectious diseases among students of Kabardino-Balkarian Republic in the period of socio-economic changes for the elaboration and implementation of scientifically sound recommendations for the improvement of their health status. Four population studies were simultaneously conducted between 1999 and 2001 including 1542 subjects (613 men and 929 women) at risk of chronic non-infectious diseases with the low level of physical activity (76.3%), high personal and reactive anxiety level (41.8 and 28.9%), smoking (15.5%), overweight (10.5%), and arterial hypertension (5.7%). A combination of several risk factors of chronic non-infectious diseases was documented in 32.8% of the students. The prevalence of AH, low physical activity, high personal and reactive anxiety decreased in 2005 compared with 1999 but increased again by 2011. The number of smokers and students with a single risk factor of chronic non-infectious diseases decreased while the number of students with several risk factors increased (p<0. 05-0.0001). High frequency of risk factors of chronic non-infectious diseases suggests the necessity of development and realization of regional prophylactic programs.

[Medical and social evaluation of students' health state].

Low health level in the students examined served as a basis to elaborate scientifically justified program for health preservation space formation, that covers complex evaluation of the students' health state and life style with subsequent analysis of the data obtained, specification and realization of educational and health-improving prophylactic projects.

[Medical and psychologic monitoring for police officers: occurrence and secondary prophylaxis of psycho-somatic conditions].

The authors defined occurrence and progression dynamics of psycho-somatic diseases in police officers, in accordance with occupational activities features. The studies covered therapeutic influence of rehabilitation on anxiety depressive disorders and hemodynamic changes.

[Metabolic syndrome and cardiovascular risk in law machinery staffers].

The authors examined male staffers of law machinery to define occurrence of metabolic syndrome and cardiovascular risk, associated with features of the occupational activity.

[Arterial hypertension in females engaged into penal system work].

The authors proved significant prevalence of arterial hypertension and atherosclerosis risk factors in women engaged into penal system work--so these values form cardiovascular risk caused by environmental parameters. Teveten and Nebilet were proved effective in the examinees with arterial hypertension.

[Automobile transport medicine--experience and prospects].

Results of complex long-standing research served as a basis to present social and medical reasons for official acknowledgement of automobile transport medicine in Russia and ways to improve traffic safety.

[Treatment of arterial hypertension in criminal police officers].

The authors demonstrate efficiency and safety of antihypertensives with nootropics and antioxidants in treating early arterial hypertension stages in male officers of special criminal police units. With comparable therapeutic efficiency of Concor and Eprosartan, the results proved favorable influence on operative reactions in the officers, therefore, on their occupational performance.

[Cardiovascular diseases in female workers and methods of their prevention].

The article covers actual incidence of coronary heart disease and arterial hypertension, atherosclerosis risk factors among female workers, its dependence on age and occupation type. The authors studied efficiency and safety of antihypertensive therapy in hypertensive women.

[Influence of occupational environment on coronary heart disease incidence in automobile transport drivers].

The authors revealed quite high incidence of coronary heart disease and its risk factors among automobile transport drivers due to occupational peculiarities, deterioration in operative response system in patients with coronary heart disease and arterial hypertension. The suggestion is to review official medical indications for driving license.

[Epidemiology of arterial hypertension and atherosclerosis risk factors in female Internal Ministry officers].

The authors revealed prevalence of arterial hypertension and atherosclerosis risk factors among female Internal Ministry officers, demonstrated influence of occupational activities on frequency of the studied parameters and on cardiovascular risk.

[Myocardial infarction at young age].

The authors revealed incidence of myocardial infarction and risk factors at young age, clinical peculiarities, prevalence of atherosclerosis risk factors in male workers aged 20-39.

[Register of arterial hypertension in rural region].

The authors determined incidence of arterial hypertension and its risk factors among rural cattle-breeders and car drivers, presented data on prevalence of major cardiovascular diseases in population, on actual situation concerning secondary prophylaxis of arterial hypertension, demonstrated efficiency of antihypertensive therapy for male and female hypertensive patients, stressed the role of systematic training of medical staffers and patients in decreasing cardiovascular morbidity. The data obtained served as a basis for "Register of arterial hypertension in rural region" database to be used for efficient management of arterial hypertension in rural area.

[Myocardial infarction in automobile transport drivers and occupational performance].

The authors revealed significant deterioration in operative response system parameters determining occupational performance of automobile transport drivers after myocardial infarction. Those parameters appeared to depend on age, duration of coronary symptoms, area and depth of myocardial involvement, number of complications,