[State of the hepatobiliary system on the data of ultrasonic examination in children and adolescents with overweight and obesity].

Currently, a stable increase in the incidence of overweight and obesity is noted, this fact leads to an elevation in comorbidity with them. The relevance of the study is due to the involvement of the hepatobiliary system in the development of metabolic dysfunction and the formation of non-alcoholic fatty liver disease in the future. The aim of the research was to study the effect of overweight and obesity in children and adolescents on the state of the hepatobiliary system on the basis of ultrasound examination. Material and methods. A single-center retrospective comparative study was conducted. The main group consisted of 112 children and adolescents with Z-score body mass index (BMI) above +1SD, the comparison group consisted of 264 persons with a BMI from -2 to +1SD aged 5-17 years. An analysis of the results of anthropometric, including the assessment of BMI, ultrasound and biochemical studies was carried out. Results. The Z-score of BMI corresponding to overweight was recorded in 54 (13.8%) examined persons, and obesity - in 58 (14.8%) patients. In children of the main group, an increase in the size of the liver was recorded 3.6 fold more often, diffuse changes in the liver were revealed 32.4 fold more often, an increase in the volume of the gallbladder - 2.1 fold, signs of excessive aerocolia - 3.3 fold more often (p<0.001). In children with overweight and obesity, the level of triglycerides (p=0.003), low-density lipoprotein cholesterol (p=0.035), glucose (p=0.012), C-reactive protein (p=0.011), malon dyalldehyde (p=0.012), the activity of alaninaminotransferase (p<0.001) and alkaline phosphatase (p=0.001) were statistically significant, with a significantly lower level of high-density lipoprotein cholesterol (p<0.001). Statistically significant logistic models of the probability of an increase in the linear dimensions of the liver, diffuse changes, an increase in the volume of the gallbladder, the presence of excessive aerocolia signs from the Z-score BMI value were obtained. The Nigelkirk determination coefficient was 0.34, 0.17, 0.11 and 0.10 c.u. respectively. Conclusion. The contribution of overweight and obesity to the increase in the linear dimensions of the liver and the volume of the gallbladder, the formation of diffuse changes and excessive aerocolia according to the ultrasound examination was 10-34%.

[Arterial bed stiffness in patients with different cardiovascular risk factors]. / Zhestkost' arterial'nogo rusla u patsientov s razlichnymi faktorami riska razvitiya serdechno-sosudistykh zabolevanii.

AIM: To investigate the specific features of changes in the arterial wall stiffness (AWS) parameters obtained by sphygmomanometry in patients with different risk factors (RFs) for cardiovascular events (CVEs). MATERIALS AND METHODS: A total of 208 mining enterprise workers who had cardiovascular RFs, such as hypertension, abdominal obesity, and smoking, were examined. A comparison group consisted of 75 workers of this enterprise who had no these RFs. AWS was examined using a VaSera VS-1500 (Fukuda Denshi, Japan) to determine CAVI, ABI, UT, %МАР, AI, tb, and tba. RESULTS: The group of patients with a combination of RFs versus the comparison group showed a statistically significant prevalence of virtually all sphygmomanometric indices characterizing AWS, which is suggestive of a less favorable long-term prognosis in this category of patients. CONCLUSION: The patients having abnormal AWS parameters should be included in a group at risk for cardiovascular diseases and CVEs and their existing RFs be further assessed in detail for a preventive purpose. It is appropriate to incorporate volumetric sphygmomanometry in screening examination programs.

Evaluation of functional state in medical personnel with long length of service.

Examination covered 118 medical staffers with length of service 25,7±6,3 years. Materials included work conditons, case histories, physical and laboratory examinations, cardiointervalography. To identify emotional burnout syndrome, the authors used simultaneous testing with <> (MBI) and questionnaire <>. According to emotional burnout syndrome components, somatic disease manifestations, cognitive, emotional, motivational and attitudinal disorders were assessed. Findings are that vegetative nervous system in medical personnel with long length of service is overstrained, functional resources are exhausted, energetic level is under normal level - that is supported by clinical and laboratory data. 36,4% of the medical staffers were diagnosed as having vegetative dysfunction syndrome. Complaints of psycho-physical, social and psychologic and/or behavoral symptoms were seen in 7% of the examinees; hypodynamia - in 53%; excuses for sedatives or psychoactive drugs intake - in 53%. Findings are that according to periodic medical examinations risk groups should be formed and specific medical and prophylactic measures should be provided.

[Thyroid state in workers of mechanical rubber production under complex exposure to occupational factors].

Complex study of thyroid gland covered workers engaged into mechanical rubber production, under exposure to complex of occupational factors. Chemical analytic study revealed 5.5 times excess of acrylonitrile content of expired air in examinees of the study group if compared to the reference group. Ultrasound examination data demonstrate structural changes in thyroid gland in 72% of the workers (diffuse changes and nodular masses). As early dysadaptation markers, findings are 1.3-1.7 times increased antibodies to TPO and higher TSH level. These disorders can indicate autoimmune processes in thyroid tissue and strain of compensatory adaptational mechanisms of pituitary-thyroid regulation.

[State of vegetative nervous system in workers engaged into multiple shifts work with night shifts].

Occupational activity with night shifts and length of service over 5 years is characterized by prevalent sympathetic influence on cardiac activity, vagosympathetic interaction index (LF/HF) is considerably higher than in workers with lower length of service and 1.5 times exceeding upper normal value. VLF indicator exceeds physiologic normal value due to increased activity of ergotropic and humoral metabolic mechanisms of cardiac rhythm regulation. Sympathetic regulation activity level (LF parameter) is also reliably higher than in workers with lower length of service (p = 0.024). Parasympathetic regulation activity level (HF parameter) is below normal value - that indicates decreased influence of parasympathetic vegetative system on cardiac activity (depression of defence mechanisms). Comparative analysis of vegetative regulation spectrum at rest, in accordance with length of service, demonstrated the most marked changes in workers with length of service over 5 years: lower total spectral capacity (TP, msz), lower share of high-frequency waves (HF, %), increase of average vagosympathetic interaction index (LF/HF) and higher share of very low waves (VLF, %) in the spectrum structure. Ihe data prove intensified ergotropic, humoral, sympathetic influences on cardiac activity and, as a result, higher risk of dysmetabolic processes and cardiovascular diseases.

[Lipid metabolism changes in population residing in area influenced by storage of ore-processing waste containing lead, cadmium and arsenic].

Clinical, laboratory and ultrasound examination covered features of lipid metabolism disorders in 137 adults and 170 children, neighbouring storage of ore-processing and extraction waste, in conditions of chronic exposure to metals from various sources (ambient air, water, foods). Findings are that children with higher serum levels of cadmium and arsenic (1.4-2.0 times vs. the reference group) demonstrated 2.2 times more frequent endocrine diseases, up to 2.7 times more frequent obesity related diseases, if compared to the reference group (OR = 2.74; DI = 1.05-7.14; p < 0.05). Chronic noncarcinogenous risk for endocrine system was characterized by jeopardy index (THI) 3.78 - unacceptable risk. With unacceptable risk due'to multi-source exposure to lead, cadmium and arsenic, the findings are: dysfunction of hypothalamus-pituitary-thyroid link, with activated free radical oxidation and accumulation of perioxidation products, depletion of antioxidant defence resources, disorders of neuromediator processes and lipid metabolism, with obesity formation (ICD: E67.8-66.0), mostly related to negative influence of arsenic (r = 0.37-0.59; p = 0.004-0.05).