[The stages of development of cardiovascular diseases and the evolution of their pattern in the veterans of the Great Patriotic War (according to the 1946-2015 records of the Saint Petersburg War Veterans Hospital)].

AIM: To determine the stages of development of cardiovascular diseases and the evolution of their pattern in the veterans of the Great Patriotic War during 70 postwar years. SUBJECTS AND METHODS: The investigation used the 1946-2014 annual reports on the hospital's work; analysis of the pattern of therapeutic and cardiovascular diseases over time; the results of laboratory and functional tests in 148 patients who developed in-hospital myocardial infarction (cardiospecific enzymes, electrocardiography, echocardiography (EchoCG), and, if clinically indicated, coronary angiography) and in 112 cardiopulmonary patients who were detected to have a chronic multimorbid heart phenomenon (EchoCG, radiological examination, blood gas tests, and statistical processing of the findings). RESULTS: The postwar evolution of therapeutic and cardiovascular diseases was ascertained to consist of 5 stages, each of which averaged about 15 years. At the same time, the nosological entities typical of the subsequent stage developed in the pattern of those at the preceding stage and gradually became predominant. The form of in-hospital myocardial infarction, as well as the chronic multimorbid heart phenomenon in the presence of comorbidity (chronic obstructive pulmonary disease and hypertensive disease) at Stage IV was described. CONCLUSION: With allowance made for the stages of development of therapeutic diseases and evolution of its pattern in the veterans of the Great Patriotic War, the clinical departments of the hospital, its laboratory and functional diagnosis departments have been reorganized for 70 postwar years in order to render adequate specialized medical care to the patients.

[The International Classification of Functioning, Disability, and Health in the practice of a sociomedical examination service for internal diseases].

The paper gives the International Classification of Functioning, Disability, and Health (ICF), interactions between health changes, the personality and social factors of an individual with therapeutic diseases to define disability criteria and a scientific rationale for the necessity and scope of rehabilitative measures through public health and social protection organizations.

[The work capacity expertise of motor vehicle drivers suffering from IHD with rhythm disorders and the possibilities for their social and vocational rehabilitation]. / Ekspertiza trudosposobnosti voditelei avtotransporta, stradaiushchikh IBS s narusheniiami ritma, i vozmozhnosti ikh sotsial'no-trudovoi reabilitatsii.

The paper presents the results of clinical and labour examinations of 51 drivers with cardiac arrhythmia. Long-term postinfarctional ECG monitoring was attempted in 30 drivers in the course of driving. The frequency of arrhythmia episodes correlated with the presence of extrasystole in acute and subacute period of the disease, anginal functional class, the size and time of myocardial infarction. Single episodes of ventricular extrasystole registered in the course of driving did not interfere with professional activities because such extrasystoles did not imply the risk of more severe arrhythmia. Labour prognosis in drivers with frequent, polytopic ventricular extrasystoles or fibrillation was much worse.

[Myocardial infarct in motor transport drivers and the results of long-term observations]. / Infarkt miokarda u voditelei avtotransporta i rezul'taty otdalennykh nabliudenii.

As many as 283 drivers with a history of acute myocardial infarction were examined. In the long-term postinfarction period, the number of the able-bodied accounted for 22.8%, the number of persons with restricted work fitness was 43.3%, that of the disabled amounted to 33.9%. It should be noted that about 60% of the able-bodied and those with restricted work fitness returned to the driving-related work. However, in some cases, the type of the trucking was either changed of the work scope was to be minimized. Criteria forming the basis for predicting the recovery of work fitness of the drivers were as follows: non-transmural character of myocardial infarction for the most part, the effective staged rehabilitation program, positive dynamics and smoothing of the ECG signs of myocardial infarction, the lack of areas of regional hypo- and akinesia of the myocardium, normalization of the ejection fraction, high and mean indicators of physical work fitness, exercise tolerance, coronary reserves, functional class I and II angina pectoris of effort, either the lack or initial clinical signs of circulatory failure, psychological readaptation, high occupational class, and labour orientation.