[The state of cytokine regulation and endothelial dysfunction in the combined course of vibration disease and arterial hypertension].

BACKGROUND: The article presents data on the state of cytokine regulation, indicators of endothelial damage when exposed to industrial vibration (general, local) and in combination with arterial hypertension. AIM: To improve the quality of early diagnosis and prevention of vibration disease in an isolated course and its combination with arterial hypertension based on a study of the cytokine profile, biomarkers of endothelial dysfunction in this pathology. MATERIALS AND METHODS: A comprehensive survey of 84 patients with isolated vibration disease from the effects of local, general, first, second degree and 61 patients with a combined course of vibration disease from the effects of local, general second degree vibration and arterial hypertension, 30 people in the control group without contact with industrial vibration and found healthy by medical examination. The levels of pro-inflammatory (IL-1, IL-8, TNF-) and anti-inflammatory cytokines (IL-4), biomarkers of endothelial damage (EDN-1, TGF-1, VEGF-A, PDGF-BB, fibronectin, Willebrand factor) were determined using the enzyme immunoassay method. RESULTS: The response of the immune system to the effects of industrial vibration is characterized by a cytokine imbalance an increase in the level of pro-inflammatory cytokines (IL-1, IL-8, TNF-) and a decrease in the level of anti-inflammatory cytokine (IL-4). With a combined course of vibratory disease and arterial hypertension, the cytokine imbalance is characterized by an even more significant increase in serum IL-1, IL-8, TNF- and a decrease in serum IL-4 concentration. Endothelial dysfunction with WB from the action of both local and general vibration in combination with hypertension is characterized by a significant increase in serum EDN-1, TGF-1, VEGF-A, PDGF-BB, fibronectin, Willebrand factor. CONCLUSION: The study of the cytokine profile, biomarkers of damage to the vascular endothelium in this pathology will allow for the early diagnosis of vascular disorders and to optimize preventive measures for workers in vibration-hazardous industries.

[Osteoarthrosis in the clinic of internal and occupational diseases: differential diagnostic aspects].

Osteoarthritis is a common pathology, which indicates the great medical and social significance of this disease. The article discusses the issues of pathogenesis, risk factors and diagnosis of professional and professionally caused osteoarthritis: the age of onset of the disease, the specifics of work, the localization of joint damage. Differential diagnosis issues are discussed.

Clinical releveance of hemorrhagic component of endobronchial inflammation in severe chronic obstructive pulmonary disease exacerbation.

AIM: The study aimed at investigating the relationship between severe exacerbations of chronic obstructive pulmonary disease and hemorrhagic component of endobronchial inflammation. MATERIALS AND METHODS: Clinico-endoscopic characteristics of 118 patients presenting with severe infectious exacerbation of chronic obstructive pulmonary disease, bloody expectorations and endoscopically confirmed hemorrhagic component of endobronchial inflammation have been analyzed. All patients underwent a series (5-6) of bronchoscopic examinations accompanied by collection of bronchoalveolar lavage specimens to reveal the presence of acid-resistant mycobacteria and to determine the bacterial flora. The exclusion criteria were the concomitant pulmonary or extrapulmonary pathologic conditions which could lead to hemorrhagic endobronchial manifestations. The other direction of the study was to investigate a correlation between jugulation of the exacerbation and dynamics of such endobronchial symptoms as mucosal edema and hyperemia, quality of bronchial secretions and hemorrhagic component of endobronchial inflammation. RESULTS: All patients were found to have diffuse endobronchitis of severity grade II (39.83%) or III (60.17%) by Lemoine. The neoplastic and tuberculosis genesis of the hemorrhagic component of endobronchial inflammation and its clinical equivalent, the bloody expectorations, had been ruled out. In 50.85% of cases the hemorrhagic component of endobronchial inflammation could not be accounted for by hemolytic properties of cultured microorganisms. The mucosal edema and hyperemia remained stable during jugulation of the exacerbation. Unlike the improvement of quality of bronchial secretions, faster reversal of the hemorrhagic component of endobronchial inflammation showed statistical significance. CONCLUSION: The hemorrhagic component of endobronchial inflammation can represent a non-obligatory manifestation of severe exacerbation of chronic obstructive pulmonary disease, and its relief is the earliest endobronchial sign of incipient remission from severe COPD exacerbation.

Pneumoconiosises: modern view.

The article is devoted to the actual problem - dust diseases of the lungs. The peculiarities of occurrence and course of pulmonary lesions that have a significant place in the overall structure of occupational morbidity are considered. Modern approaches to treatment, diagnostics and prevention issues in pneumoconiosis are discussed.

[Chronic kidney disease in the context of toxic effects the working chemical factors (literature review)].

The article analyzes the publications devoted to the problem of professional renal lesions caused by chemical factors. Classification, prevalence, peculiarities of the clinical picture, diagnosis of professional renal lesions caused by chemical factors of the production environment are reviewed. The frequency of professional renal lesions remains underestimated due to low manifestation of symptoms and the influence of environmental factors, which require further investigation of this issue.

Arterial hypertension at the workplace: risk factors and the population value.

The article presents data of domestic and foreign authors on the relationship between occupational factors and arterial hypertension. The role  of latent arterial hypertension, its frequency in the population, the lesion of the target organs and the prognosis in comparison with normotensive individuals, arterial hypertension of the "white coat" and stable arterial hypertension have been analyzed. Arterial hypertension in the workplace is a form of latent arterial hypertension. The authors review the influence of harmful production factors (physical, chemical), as well as psychosocial stress on the risk of developing arterial hypertension.The risk of developing hypertension in specified groups of workers has been analyzed separately. The place of production-related diseases in modern occupational pathology in the Russian Federation. A wider implementation of measures aimed at early diagnosis and prevention of arterial hypertension in workers is proposed.

[Features of the psychoemotional disorders in patients due to exposure to local and general vibration].

Some indices of the psychological status of patients with a vibration disease have been investigated Significant differences in a psychological condition of patients depending on a type of influencing vibration and a stage of the disease have been revealed.

[Immunopathogenetic features of occupational bronchitis].

The article based on research work covers functional, bronchoscopy, microbiologic and immunologic features of chronic dust bronchitis and chronic bronchitis caused by toxic chemicals.

[Definition of rate of biological aging at vibration disease].

The article presents results of definition of biological aging rate at vibration disease caused by the influence of local and general vibration, at I and II stage of disease; a role of vibrating influence in acceleration of biological aging of people working in the conditions of vibration is underlined.

[Health preservation for working population: problems and optimization methods].

The article deals with problems and ways to optimize health protection for working population. The authors stress the problems reducing quality of periodic medical examinations, of health state of working population. Notion is that nowadays employers, employees and medical officers are not interested in better work conditions and qualitative periodic medical examinations.

[Psychologic profile of vibration disease patients].

The authors studied some psychologic state parameters in vibration disease patients. Findings are marked differences in patients, depending on the acting vibration type and the disease stage.

[Age and gender features of tobacco smoking].

On the basis of the conducted research, prevalence of tobacco smoking and its intensity are described as well as dependence on gender and age in an urban population of the middle Volga region (on the example of the city of Samara). It is proved, that in a general selection among men and women smoke: 49,37 and 14,17%; smoked before: 22,80 and 8,86%; never smoked: 27,83 and 76,97% of inspected men and women, accordingly. The contribution of the education level and marriage status are set in epidemiology of tobacco smoking dependence. Authors consider the development of public and medical measures in a fight against tobacco smoking should be realized, taking into account the gender, age, social and mental features of population, which is a difficult, but necessary process.

[Trends and dynamics of occupational morbidity (according to materials of Samara region)].

The article presents data on occupational morbidity in Samara region over 1980-2008. Increased values are noted, that is due to improved efficiency of occupational therapeutic service, according to the authors.

[The problems of premature senescence in occupational lung diseases].

The article presents the results of researches aimed at estimation of the rate of biological aging at dust diseases of lungs. It is proved that influence of fibrogenic aerosols leads to the increase in biological age of patients with the dust diseases of lungs. It is proved that definition of biological age as a criterion of diagnostics is possible at dust diseases of lungs.

[Peculiarities of occupational bronchitis caused by fibrogenic and chlorine organic aerosols].

The article covers clinical, bronchoscopy, bacteriologic, functional peculiarities of chronic bronchitis caused by fibrogenic (limestone-dolomite dust) and chlorine organic compounds. The peculiarities could serve as a basis for differential diagnosis of chronic bronchitis of occupational and non-occupational etiology.

[Epidemiology of non-infectious diseases; priority tasks of the new field of occupational medicine].

The article describes the principles of epidemiological research management in occupational medicine and methodological approaches to them. The authors define relative risk of diseases and their conditionality by causative environmental factors.

[Prevalence of tobacco smoking among urban population of Samara and causative factors].

AIM: To examine prevalence and intensity of smoking among general population of Samara, physicians and students of Samara Medical University; to study dependence of this prevalence on different social factors. MATERIAL AND METHODS: A representative sample of adult population was selected by the lists of outpatients of Samara outpatient clinic. The study enrolled 2931 outpatients (1272 males, 1659 females aged 15 years and older)--3.95% of all Samara outpatients. The questionnaire survey covered 360 physicians aged 28-57 years (the response 96.5%), 652 senior medical students aged 21-24 years (the response 93.14%). The results were processed with the statistical computer program BIOSTAT. RESULTS: The percentage of smoking men among 15-19-year-olds was 42.94%, 20-29-year-olds--59.29% (p < 0.01), 30-39-year-olds--62.18%, 60-year-olds and older--35.64%. This proportion for smoking women was 15.04%, 27.11% (p < 0.01), 22.92%, 9.06% (p < 0.001), 5.04%, respectively. Among male physicians smokers were 47.37% (14.29% smoked less than 10 cigarettes, 50.79%--10-20 cigarettes, 34.92%--more than 20 cigarettes a day); 16.54% male physicians smoked earlier, 36.09% never smoked. Relevant percentage for female physicians was 25.99 (38.98, 47.46, 13.56, 13.66 and 60.35, respectively). Among male medical students smokers were 58.6% (29.2% less than 10 cigarettes a day, 55.8%--0-20, 14.9%--more than 20 cigarettes a day); 9.1% smoked earlier, 32.3% never smoked. Among female medical students smokers were 20.3% (70.9, 21.5, 7.6, 9.3 and 70.4%, respectively). CONCLUSION: Tobacco smoking depends on education and marital status. Both in men and women the least number of smokers are among persons with higher education and married ones.