[MEDICAL AND PREVENTIVE TECHNOLOGIES OF THE MANAGEMENT OF THE RISK OF HEALTH DISORDERS ASSOCIATED WITH EXPOSURE TO ADVERSE ENVIRONMENTAL FACTORS].

It the article there are reported methodological approaches to the development of medical and preventive technologies for rendering specialized medical, diagnostic and preventive care to the population residing in polluted areas. There is proposed the classification of medical and preventive technologies of specialized care to the population with risk- associated pathologies based on principles of assessing the character and level of risk, etiopathogenetic regularities of the development of risk-associated pathological process and the extent of its clinical and laboratory manifestation. There were distinguished four groups of medical and preventive technologies having specific goals and tasks, there was determined the group targeting of the medical and preventive actions, the area of there application and forms of their implementation. There were presented the main directions of medical and preventive actions taken within the technologies applied to various groups.

[Scientific and methodological approaches to the organization of the preventive care for children with respiratory diseases associated with the exposure to chemical factors].

There are presented directions of the improvement of strategic approaches to the prevention of respiratory diseases associated with exposure to chemical environmental factors in children. There were substantiated principles of construction of health-preventive technologies, target groups, hygienic and clinical criteria for their formation, volumes and forms of implementation, targeted indices of efficacy.

[Premorbid markers of cardiovascular diseases in mining industry workers].

Functional studies of cardiovascular system in mine cutting machine operators with 10 years of underground length of service under exposure to occupational hazards (air pollution with sylvinite dust, noise, general and local vibration, increased humidity, absent natural illumination, work hardiness and intensity), helped to establish premorbid markers of cardial diseases--labile arterial hypertension, disordered processes of myocardial excitability, conductivity and automatism, higher thickness of intima-media complex in extracranial branches of brachiocephalic arteries. To decrease cardiovascular morbidity in mine cutting machine operators, the authors recommend additional blood pressure monitoring and ultrasound study of intima-media complex of extracranial brachiocephalic arteries within periodic medical examinations.

[Influence of work intensity on development of arterial hypertension in metal-mining workers].

The article covers data on influence of working shifts duration and shift work intensity on cardiovascular system functioning in operators of mining excavators. Findings are that 8 hours shift with regular shift schedule (40 working hours per week) gives significant load on cardiovascular system of workers engaged into underground activities. 50% of mining excavator operators following this working schedule develop transitory arterial hypertension within 10 years. Longer work shift over 8 hours and more intensive shifting schedule over 40 hours per week causes stable arterial hypertension within 3 months in 60% of workers, in 10% of cases associated with lower functioning of sinus node.

[Features of early stages of cardiovascular continuum in workers engaged in oil-extracting enterprise].

The authors present data on metabolic disorders and vascular state in workers of oil extracting enterprise, exposed to complex of occupational hazards (noise, work hardiness, chemical factors). Major role among chemical hazards is played by aromatic hydrocarbons. In clinical and epidemiologic studies, arterial hypertension was reliably more frequent in a group of oil extraction workers. Findings are that oil extraction workers, when compared to the reference group, demonstrate more marked metabolic disorders (dyslipidemia with increased total cholesterol and low density lipoproteins, hyperuricemia, hyperglicemia, increased lipids peroxidation) with endothelial dysfunction. These changes are associated with remodelling of arterial wall, that at early stages involves thickening intima-media complex. That leads to hardness and arteriosclerosis of arteries.

[Scientific and methodological rationale for the pathomorphism of Lamblia infection in children during chemical contamination of the biosphere].

The paper analyzes the clinical and laboratory features of Lamblia infection in children living under long-term low-dose chemical load. The scientific search methodology comprised the meticulous examination of the patients randomized by the presence or absence of protozoonosis and the statistical processing and expert analysis of the results. The comprehensive approach could define the main signs of the pathomorphism of lambliosis in the areas with high anthropogenic loads and identify immunological disorders, intoxication, and hepatobiliary dysfunctions. The impact of environmentally induced chemical contamination of the biosphere on the natural history of protozoonosis should be borne in mind when evaluating the biological hazard and risk of environmental biological factors on the population health and when scheduling and implementing hygienic and sanitary-and-epidemiological measures to prevent lambliosis in the high anthropogenic load areas.

[Epidemiological aspects of study of musculoskeletal diseases in children (in case of the Perm Region)].

There is a steady tendency for musculoskeletal abnormalities to increase in children and adolescents in the Perm Territory. In 75% of the towns of the Perm Territory and in half of the rural areas, the prevalence of musculoskeletal abnormalities, revealed during the 2002-2005 All-Russian clinical examination of children, was 1.03-3.9 times as high as the official morbidity rates. Among locomotor diseases, there was a preponderance of lower extremity deformities, kyphosis, lordosis, and scoliosis. Osteodensitometric studies demonstrated that osteopenia is more common in urban dwellers than in villages. The osteopenic syndrome develops in the girls earlier than in boys and it is mostly associated with the onset of puberty.

[Goiter transformation as a risk factor of the development of bronchial asthma in children under the influence of natural and technogenic factors of the environment].

The paper deals with the comparative characterization of the prevalence of goiter transformation in children with bronchial asthma (BA) in relation to the level of a technogenic load and natural iodine deficiency in case of the Perm Region. There was a wide distribution of goiter transformation in children, which did not correspond to natural iodine supply in the Perm Region, suggesting the contribution of anthropogenic strumogenic factors to the formation of goiter endemia. There was a high prevalence of thyromegaly in children with BA as compared with those with another disease and its high the incidence as man-made pollution increased particularly in the areas exposed to a combination of natural and technogenic factors as compared in relatively pure areas. The findings suggest that goiter transformation is a marker of ecological ill-being and an additional serious risk factor of the development and prolonged course of BA in predisposed children.

[The clinico-epidemiological characteristics of tick-borne encephalitis in Perm Province]. / Kliniko-épidemiologicheskie osobennosti kleshchevogo éntsefalita v Permskoi oblasti.

The epidemiological features and clinical manifestations of tick-borne encephalitis on the territory of Perm Province in 1953-1993 are characterized. In spite of antiepidemic measures a high morbidity level is preserved at the focus of infection with the prevalence of clinical forms accompanied by brain lesions and a tendency to the growth of mortality.

[The interferon system in acute tick-borne encephalitis and effect on the dynamics of clinical laboratory indicators using different methods of interferon therapy]. / Sistema interferona pri ostrom kleshchevom éntsefalite i vliianie na dinamiku kliniko-laboratornykh pokazatelei razlichnykh metodov interferonoterapii.

Study of the interferon system parameters, natural killer activity, and immunologic characteristics in patients with acute tick-borne encephalitis confirmed that addition of interferon preparations to combined therapy is pathogenetically justified. Reaferon was conducive to shortening of the manifest period of the disease and to alleviation of its symptoms, but it depressed its own interferonogenesis. Viferon had not only a positive impact on the time course of clinical parameters, but promoted a more active recovery of interferon production and immunologic parameters.