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Vol 28, No 6 (2022)

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Original Research Articles

Current trends in occupational morbidity of industrial sector workers in the context of economic activities

Polunina N.V., Bezrukova G.A., Novikova T.A., Eliseev Y.Y.


INTRODUCTION: On the basis of competent statistical materials updated in accordance with the All-Russian Classifier of Types of Economic Activity (ARCoToEA 2) and ICD-10, a retrospective analysis of occupational morbidity in different types of economic activity and professional cohorts of the industrial sector of the Saratov region in 2009–2019 was carried out by generally accepted methods.

AIM: This a comprehensive analysis of current trends and trends in the prevalence, dynamics and nosology of occupational morbidity of workers in the industrial sector in the context of types of economic activity on the example of the Saratov region.

MATERIALS AND METHODS: The information base of the study was presented by statistical materials of Rosstat, the Rospotrebnadzor Department for the Saratov Region and the Ministry of Labor and Social Protection of the Saratov Region, updated by us in accordance with ARCoToEA 2 (version OK 029-2014). A retrospective epidemiological statistical analysis of occupational morbidity for the period from 2009 to 2019 was carried out.

RESULTS: During the analyzed period, the number of people employed in the industrial sector of the region’s economy decreased by 17.5% from 380.3 (2009) to 313.7 (2019), while the level of primary occupational morbidity decreased by 2.7 times from 0.68 to 0.25 per 10,000 workers against the background of an increase in the share of workers in harmful working conditions in the extraction of minerals (+27.9 percentage points), in construction (+16.8 percentage points) and manufacturing industries (+11.5 percentage points). The main risk factors for occupational morbidity were physical effects (noise, general and local vibration), pollution of the respiratory zone with industrial aerosols, and the severity of the labor process. The nosological structure of the accumulated occupational morbidity was mainly represented by sensorineural hearing loss (SHL) — 48.7%, vibration sickness (VS) — 15.4%, radiculopathy — 9.6% and chronic dusty non-obstructive bronchitis (CDNB) — 7.7%. Workers in manufacturing industries were mainly identified by SHL (32.4%), VS (17.2%), CDNB (12.4%); transport workers — SHL (77.2%), radiculopathy (10.9%), VS (7.9%); those employed in oil and gas production — SHL (35.7%), VS (28.6%), radiculopathy (17.9%); in construction — VS (22.2%), SHL (18.5%), radiculopathy (18.5%).

CONCLUSION: The results of the identification of deterministic nosologies of the occupational morbidity, characteristic of certain sectors of the economy and professional cohorts, should form associative diagnostic alertness during regulated medical examinations and serve as a scientific basis for the development of targeted regional programs to promote health in the workplace.

Medical Journal of the Russian Federation. 2022;28(6):419-430
pages 419-430 views

Key regional aspects of public health of Krasnodar Krai for 2018–2020

Akhedzhak-Naguze S.K., Shiltsova T.A., Naguze A.A., Khuako S.A., Khurum B.R., Kuksina V.A., Lavrinenko M.N.


BACKGROUND: The regional dimension of public health is one characteristic of public health that reflects the effectiveness of social and economic change in society. The key components of which are health and demographic indicators. The region’s current demographic situation is an essential component of comprehensive medical and social research. Health and demographic indicators describe the dynamics, state, and prospects of social and economic changes in health and society as a whole. The increase in the population and labor resources due to migration growth, the increase in mortality rates, the decline in the birth rate, and the aging of the nation presupposes the development and implementation of additional medico-demographic approaches to the strategic development of the region.

AIMS: Аnalysis of key indicators of public health of Krasnodar Krai, including the main medico-demographic indicators in the dynamics for 2018–2020.

MATERIALS AND METHODS: A retrospective analysis on some aspects of the region’s public health for 2018–2020 was conducted. Included in the development are medico-demographic indicators of the population, fertility, mortality, natural increase (losses), and so forth, in the dynamics for 2018–2020. Data from the Federal Service of State Statistics and statistical data of reporting forms of medical organizations of Krasnodar Krai “Information about medical organization” (p. 30) were used in the study for the period under consideration. The study applied statistical, analytical, and descriptive methods. The statistical processing of the material was carried out with the help of Microsoft Office software package.

RESULTS: Analysis of key regional medico-demographic indicators of Krasnodar Krai for the analyzed period from 2018 to 2020 has made it possible to identify population growth. These indicators include the increase in migration, the number of children, the population under working age, women of childbearing age, the decrease in the total and total fertility rates, the population of working age, and the increase in the overall mortality rate, which includes the working age and population loss. Diseases of the circulatory system, the nervous system, and neoplasm took the largest share in the structure of mortality in 2020. In the structure of mortality, diseases of the circulatory system, nervous system, and neoplasm took the largest share. One of the reasons for the increase in total mortality in 2020 was the death rate from COVID-19.

CONCLUSIONS: The analysis of the main medico-demographic indicators as one of the key components of public health of Krasnodar Krai for 2018–2020 has been conducted.

Medical Journal of the Russian Federation. 2022;28(6):431-440
pages 431-440 views

Nebuliser therapy in complex treatment of chronic obstructive pulmonary disease

Zaslavskaya R.M., Veklenko G.V.


INTRODUCTION: Nebulizer therapy in the complex treatment of patients with bronchospostic syndrome has become firmly established in the practice of its use mainly in bronchial asthma. For chronic obstructive pulmonary disease (COPD) patients, this therapy has not been widely used. Little studied was the study of the dynamics of indicators of the function of external respiration (FER), bronchial patency, acid-base state, oxygen saturation of the blood and the temporary organization of FER, chronosensitivity to fenoterol (Beroteс®) during the day, week, half-week period in COPD.

AIM: To study the effectiveness of nebulizer therapy with Berotec® in the dynamics of treatment against the background of complex traditional therapy of COPD patients.

MATERIALS AND METHODS: To accomplish this task, in addition to the generally accepted clinical and laboratory, X-ray, instrumental studies, the study of FVD indicators, spirometry on the “Metatest” apparatus “Medapparatura” (Ukraine), peak flowmetry by the Ferraris Medical Limited apparatus (UK), computer spirometry with the analysis of the flow-volume curve, hemodynamic parameters using EchoCG, as well as blood pressure measurement by N.S. Korotkov, ECG. The acid-base balance and oxygen saturation of the blood were determined. These comprehensive studies were carried out before and after the end of therapy, as well as every 3 hours by peak flowmetry for a day, a week and half a week in 20 patients with COPD. The time-dependent effects of nebulizer therapy to determine chronosensitivity to Berotec® were studied using an acute clinical and pharmacological test. The whole complex of studies was carried out 2 times a day at 08.00 and 18.00. The information obtained was analyzed by methods of variational statistics using the χ2 Pearson’s criterion and the difference method. Chronobiological information was analyzed by the method of kosinor analysis according to F. Halberg.

RESULTS: The results of the conducted studies indicate the effectiveness of nebulizer therapy with Berotec® in COPD patients. This was manifested in the improvement of clinical symptoms, positive dynamics of indicators of FER, bronchial patency, acid-base balance, blood saturation O2 (SaO2). However, this therapy did not restore the disturbed temporary organization of bronchial patency, BH, hemodynamic parameters. Only the circadian rhythmicity of the parameters of peak flowmetry, DAD, and ADsr was preserved. The average daily, average weekly, average weekly values (mesors) of BH, HR, SAD, DAD, ADsr, double product (DP) decreased and the values of peak flowmetry increased.

CONCLUSION: The results of the conducted studies suggest that 2-time use of nebulizer therapy in the morning and in the evening in the same patients leads to the fact that tachyphylaxis develops more often in the evening on the 8th, 10th, 14th day. Based on the data obtained, it is recommended to use the Berotec® 2 times a day (morning and evening) during the week, and a single application of nebulizer therapy with Berotec® can be carried out in the morning for no more than 12 days.

Medical Journal of the Russian Federation. 2022;28(6):441-449
pages 441-449 views


miRNA-122 as a new player in cardiovascular disease

Alieva A.M., Teplova N.V., Reznik E.V., Baykova I.E., Shnakhova L.M., Totolyan G.G., Valiev R.K., Skripnichenko E.A., Kotikova I.A., Nikitin I.G.


Identification of a new significant level of regulation of gene activity using small non-coding molecules of ribonucleic acid — miRNA — can be confidently considered as one of the most outstanding discoveries of modern science It became clear that the suppression of gene expression caused by miRNA is an extremely important universal mechanism widely involved in most intracellular signaling pathways. Current data on the role of miRNA-122 in the development of cardiovascular diseases is included in this review. miRNA-122 is positioned as a promising biological marker in cardiovascular pathology. miRNA-122 promotes inflammation, oxidative stress, and apoptosis in cardiovascular disease. Clinical and experimental studies support the pathophysiological role of miRNA-122 in fibrosis and cardiac dysfunction. Overexpression of miRNA-122 exacerbates the loss of autophagy and enhances angiotensin II-mediated inflammation, apoptosis, fibrosis, and cardiac dysfunction. miRNA-122 should be considered not only as a promising diagnostic and prognostic tool, but also as a target for modern medicine. Inhibition of miRNA-122 results in antifibrotic, antiapoptotic, anti-inflammatory, antioxidant, and pro-autophagic effects. Further study is required to evaluate the real diagnostic and therapeutic potential of miRNA-122.

Medical Journal of the Russian Federation. 2022;28(6):451-463
pages 451-463 views

Case reports

Follicular occlusion syndrome in the practice of a coloproctologist

Shlyk D.D., Ilyukhina Y.A., Pirogova A.S., Kitsenko Y.E., Tulina I.A., Teplyuk N.P., Tsarkov P.V.


BACKGROUND: Pilonidal disease is the 4th most common disease among inpatient coloproctological patients and surgery remains the “gold standard” of its treatment. However, patients with pilonidal disease often have combined conditions with other follicular occlusion diseases which are most often encountered by dermatologists in their practice. In most cases it is difficult to treat follicular occlusion syndrome with pilonidal disease within one specialty. We demonstrate the complexity of follicular occlusion diseases diagnostics in combination with pilonidal disease, systemize the diagnostic protocol for patient management and present the treatment strategy for coloproctologists.

CLINICAL CASE DESCRIPTION: There was one case of patient with pilonidal disease combined with other conditions of follicular occlusion syndrome noted in the clinic of coloproctology and minimally invasive surgery. Surgery was the first step. There were no complications in the early postoperative period. After hospital discharge, the patient was consulted by a dermatologist, and local and systemic conservative therapy was prescribed for concomitant diseases, which resulted in a significant improvement. There have been no recent reports of recurrence.

CONCLUSION: The treatment of follicular occlusion syndrome with pilonidal disease requires a multidisciplinary approach. At the same time the optimal treatment for pilonidal disease is radical excision of all altered tissues. In cases of such diseases as hidradenitis suppurativa, acne conglobata, dissecting cellulitis of the scalp treatment should be comprehensive and begin with a dermatologist consultation.

Medical Journal of the Russian Federation. 2022;28(6):465-473
pages 465-473 views

Coronary bypass grafting using MICSCAB technique with parallel artificial circulation from mini access

Teshaev U.S., Yarbekov R.R., Omonov S.K., Muradov M.M., Nagaeva G.A.


BACKGROUND: Today, minimally invasive coronary surgery is not only a good alternative to classical sternotomy, but also represents a separate developing area of cardiac surgery with the development of more and more low-traumatic techniques, such as minimally invasive direct coronary artery bypass and minimally invasive direct coronary artery bypass (MICSCAB).

CLINICAL CASE DESCRIPTION: The advantages and disadvantages of these techniques are widely discussed in modern literature, and their practical application is ambiguous. This article describes a clinical case of successful coronary artery bypass grafting using the MICSCAB technique in a patient with a long history of coronary artery disease and a complex multivessel lesion.

CONCLUSION: The presented clinical case proves the advantage of MICSCAB technique in comparison with traditional coronary bypass surgery.

Medical Journal of the Russian Federation. 2022;28(6):475-484
pages 475-484 views

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