Diagnostic features of atherosclerosis development in miners having anthracosilicosis.

To design forecasting system, the authors studied occurrence of atherosclerosis and its risk factors in 152 workers of coal mines in South Kouzbass (tunnellers, cleaning pit-face miners, mining excavator operators), suffering from anthracosilicosis. Atherosclerosis was revealed in 124 (81.6%) workers with anthracosilicosis. With Bayess method for independent signs and Wald's sequential analysis method, the authors created a way to forecast atherosclerosis with coronary, extracranial and peripheral arteries involvement in miners with anthracosilicosis. Maximal risk of atherosclerosis in miners with anthracosilicosis is associated with following parameters: age 45 years and over, arterial hypertension, smoking, abdominal obesity type, diabetes mellitus, metabolic syndrome, respiratory failure, family history of IHD, hypercholesterolemia, increased LDL cholesterol, decreased HDL cholesterol, increased atherogeneity coefficient, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increased C-reactive protein, hypersthenic type according to Reese-Isenc index, andromorphic type according to Tanner index, blood group. markers A (II) and B (III), rhesus negative, MN and NN. Through increased number of factors analyzed and selected additional markers, accuracy of atherosclerosis forecasting is increased - that enables to proceed with opportune treatment and prevention.

[CHRONIC FLUORIDE INTOXICATION AS A RISK FACTOR FOR THE DEVELOPMENT OF ATHEROSCLEROSIS].

In workers employed in the aluminum industry, the main harmful production factor is exposure to fluoride salts, which can cause chronic fluoride intoxication. For the assessment of the impact of chronic fluoride intoxication on the development of atherosclerosis, we conducted a comprehensive survey of 87 aluminum-metal makers with chronic fluoride intoxication and 43 aluminum-metal makers without occupational diseases, mean age--52.1 ± 0.4 years. There were considered the presence and severity of atherosclerosis of brachiocephalic arteries, and the arteries of the lower extremities in the studied group, there was evaluated the effect of other risk factors for atherosclerosis (smoking, presence of hypertension, diabetes, dyslipidemia). With the use of Doppler ultrasound of the arteries it was revealed that in metallurgists with chronic fluoride intoxication atherosclerosis was detected in 73.6% versus 55.8% in persons of the comparison group. The performed analysis of the prevalence of main risk factors for atherosclerosis showed that in metal makers with chronic fluoride intoxication in combination with atherosclerosis hypertension is more common (in 54.7%) than in metallurgists with chronic fluoride intoxication without atherosclerosis--only 26.1%. According to the frequency of occurrence of smoking, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia, there were no significant differences between the metallurgists with chronic fluoride intoxication, with and without atherosclerosis, and the control group, the increase in LDL cholesterol occurs significantly more often in metal-makers with chronic fluoride intoxication in combination with atherosclerosis if compared to workers without occupational diseases. Thus, chronic fluoride intoxication acts as a risk factor in the development of atherosclerosis: atherosclerosis in metal-makers with chronic fluoride intoxication occurs more frequently than in workers who do not have professional pathology. Hypertension and elevated levels of LDL cholesterol were established to increase the relative risk of developing atherosclerosis in metallurgists with chronic fluoride intoxication. At that there are no significant differences in the prevalence of common risk factors for atherosclerosis (smoking, diabetes, hypercholesterolemia, hypertriglyceridemia).

[Hemostasis disorders in coal miners].

Findings are that coal miners having long contact with vibration instruments and coal dust develop endothelial dysfunction, increased platelets aggregation, hypercoagulation and lower anticoagulation activity. The hemostasis disorders revealed could result in earlier coronary atherosclerosis development in workers exposed to vibration.

[Structural and functional changes in myocardium at rest and under exertional test in dust bronchitis patients having coronary heart disease and arterial hypertension].

The estimation of structural-functional state of right and left heart before and after loading test at patients suffered from chronic mechanic bronchitis in combination with ischemic heart disease and arterial hypertension is carried out using an echocardiography method. It is revealed that the combination of chronic mechanic bronchitis, ischemic heart disease and arterial hypertension results in remodelling both ventricles and hastens chronic pulmonary heart development.

[Hemostasis disorders in patients with occupational fluorosis are risk factors for IHD].

The studies covered hemostasis changes in workers with occupational fluorosis. The disorders diagnosed could be a risk factor for IHD in aluminium production workers

[The novel method for selection of preparations for treatment of arterial hypertension based on spectral analysis of heart rhythm variability]. / Novyi sposob podbora preparatov dlia lecheniia arterial'noi gipertonii na osnove spektral'nogo analiza variabel'nosti ritma serdtsa.

AIM: To study spectral characteristics of heart rhythm in patients with arterial hypertension (AH) to select medication for hypertension and control over the treatment efficacy. MATERIAL AND METHODS: 35 AH patients were examined with general clinical methods and using spectral analysis of variability of heart rhythm (VHR). Five spectrograms were registered. Each of them contained three peaks: very low, low and high frequencies (VLF, LF and HF, respectively). Normal values of VLF, LF and HF were estimated on the basis of spectral values obtained in healthy subjects. After registration of spectral values all the patients were given at first placebo, than enalapril, one day after its discontinuation--mifedipine. At each stage VHR was recorded. Changes in the spectral indices were compared to changes in clinical symptoms. RESULTS: VLF proved most important for a rapid choice of adequate antihypertensive therapy. CONCLUSION: Normalization of VLF, LF and HF indicates adequacy of the choice of antihypertensive treatment.

[The prediction of the probability of the development of myocardial infarct by genetic and phenotypic markers]. / Prognozirovanie veroiatnosti razvitiia infarkta miokarda po geneticheskim i fenotipicheskim markeram.

The study was made of marker distribution of 17 hereditary polymorphism systems in 493 patients with myocardial infarction (MI) and 422 healthy subjects. The prognostic system for determination of predisposition or resistance to MI development has been designed in accordance with marker occurrence in the patients and healthy subjects basing on Bayer's method. When the sum of the prognostic ratios of all the markers is +5 scores and more there is a high risk of MI, when this sum is -6 scores and less the resistance to its genesis is predicted. The proposed prognostic system makes it possible to predict predisposition to myocardial infarction at an early age and, therefore, to take preventive measures.

[Predicting the course of the post-infarction period by clinical signs and genetic markers]. / Prognozirovanie techeniia postinfarktnogo perioda po klinicheskim priznakam i geneticheskim markeram.

The course of the postmyocardial infarction period was studied in 452 patients with previously determined genetic markers of 18 genetic polymorphic systems. Clinical and genetic factors related to an unfavourable course of the disease in male and female patients with myocardial infarction were identified. The data obtained enable development of the systems for long-term prognostication of the high risk of an unfavourable course of a 10-year postmyocardial infarction period.

[Effects of local vibration on development of ischemic heart disease in miners of South Kuzbas]. / Vliianie lokal'noi vibratsii na razvitie ishemicheskoi bolezni serdtsa u shakhterov iuga Kuzbasa.

The incidence of ischemic heart disease (IHD) and risk factors of its genesis have been studied in 380 miners of a control group non-exposed to industrial vibration. Constitution type and a number of phenotypic signs have been determined for all examined workers with hemostatic indices defined in 60 miners before and after the performance of vibrational load test. High incidence of IHD, arterial hypertension and hyperholesterolemia have been detected in the miners working with vibration instruments and hemostatic disorders predisposing to ischemic heart disease have been revealed. In the miners of vibrodangerous occupations suffering from ischemic heart disease, hypersthenic constitution type determined by Rees-Eysenc index less than 92.2 and the height below 170 cm was found to occur more frequently.

[Coronary heart disease, its risk factors and somatic types in coal miners having chronic dust-related diseases of lungs]. / Ishemicheskaia bolezn' serdtsa, faktory riska ee razvitiia i somatotipy u shakhterov s khronicheskoi pylevoi patologiei legkikh.

Studies covered incidence of coronary heart disease, its risk factors and features of constitutional types among Kouzbass coal miners suffering from anthracosilicosis and chronic dust bronchitis. Findings are reliably higher incidence of coronary heart disease among coal miners having lung diseases caused by dust. Coronary heart disease among the miners with anthracosilicosis is favored by arterial hypertension, overweight and hypersthenic constitutional type, that among those with dust bronchitis is favored only by overweight.

[Constitutional-morphologic features of coal miners exposed to vibration and suffering from coronary heart disease]. / Konstitutsional'no-morfologicheskie osobennosti shakhterov vibroopasnykh professii, stradaiushchikh ishemicheskoi bolezn'iu serdtsa.

Occurrence of coronary heart disease and its risk factors are studied in individuals working with vibration instruments--in drift miners, miners of breakage face--and in 390 reference group miners who never faced occupational vibration. Findings are higher incidence of coronary heart disease, arterial hypertension and hypercholesterole mia in the miners working with vibration instruments. The main group miners suffering from coronary heart disease demonstrated more frequent hypersthenic constitutional type.