Discussed in the paper are the peculiarities related with the morbidity observed in a number of Russia's northern regions; a conclusion is made on that it is necessary to take account of the above specific features while rendering the medical care.
Over 35 years Occupational Diseases Department in Rostov State Medical University works cooperatively with Occupational Diseases Center with Health Ministry Department of Rostov region. The article deals with experience of this cooperation in occupational therapists training, in qualification courses for professional improvement, in writing scientific and methodic materials, in carrying research work based on the Occupational Center facilities.
The levels of lead were determined in snow water, soil, and sludge. Its highest concentration was found in the deposits of the eastern and central areas of the region. These are areas with elevated technogenic loads. The concentration of lead in the snow cover was compared with its levels in the sludge and soil.
The article exposes overall analysis and objective evaluation of personnel potential of orthopedic dental service in southern region of Tyumen oblast. Actual issues of enhancement of orthopedic dental service in this region are discussed.
Tuberculosis is an urgent problem in the North-Western Federal Okrug of the Russian Federation. In the past 5 years, the tuberculosis epidemic situation in the okrug has remained to be of strain despite the fact that the spread of tuberculous infection in the North-West is less than in whole Russia. The proper financing of tuberculosis-controlling measures, the solution of a staff-associated problem, and the improvement of the logistic base of a tuberculosis service facility are required to stabilize the tuberculosis situation.
The study including integral estimates of the tuberculosis epidemic situation in Russia as a whole in the period of 1985 to 2004 and in its regions in 2004 has been undertaken. Its basic difference from numerous studies in this area is a comprehensive assessment using integral estimates derived by the authors' method. A set of single epidemiological parameters that reflect the epidemic situation to the greatest extent and are the basis for calculating integral estimates that adequately reflect the tension of tuberculosis endemia is presented. The use of this procedure has allowed the authors to follow up trends in the tuberculosis epidemic situation in Russia in the past 20 years and to establish its association with socioeconomic upheavals occurring in the country over the study period. An association of tuberculosis endemic ill-being with its location has been established by Federal districts.
In the early 1990s there was a great change in the tuberculosis situation in Vladivostok. Since 1992, the average total tuberculosis morbidity has increased by 22.7% and in 2000 it amounted to 91.0 per 100,000. Its morbidity among children increased by 90% in the same period. The morbidity due to tuberculosis in its risk groups is several times higher than that in the general population. The reasons for this rise were socioeconomic crisis, high population density in Vladivostok, intensive, virtually uncontrolled migration. The basic methods of detection of tuberculosis in Vladivostok, as in Russia as a whole, remain as follows: fluorography, bacteriology, and tuberculin diagnosis. The efficiency of each method is associated with the organization and financing of activities in detecting and with the potentialities of methods, personnel qualification. It is necessary to pay attention to the detection of tuberculosis in the risk groups, by making their register in order to enhance the effectiveness and to reduce the cost of existing methods. Strict control and management of a migration process and solution of social problems are needed.
Mathematical analysis of the basic parameters was used to trace a trend in the epidemiological situation of tuberculosis in the Tver Region. Unfavorable shifts were noted in the increase of the prevalence, incidence, and mortality of tuberculosis among children and adolescents, and a rise in the reservoir of tuberculous infection. New approaches to improving the epidemiological situation by integrating the phthisiological service and general health care facilities, by enhancing a role of a family physician, by applying informational systems for monitoring the epidemic situation, and by introducing the adapted international strategies, WHO recommendations have been developed for the treatment of patients and tested. It is suggested that the tuberculosis-controlling service should closely interact with governmental bodies, social and religious organizations, and the mass media for the optimization of tuberculosis control at a regional level.
The morbidity of primary and secondary drug resistance (DR) of Mycobacterium tuberculosis (MBT) was studied in the North-West of Russia during 1991-2001. The frequency rate and structure of, mainly, secondary DR MBT was investigated in tuberculosis of different localizations on the basis of data provided by clinics of Saint-Petersburg Research Institute for Phthisiopulmonology (PRIP) during 1990-2000. A sharp increase of primary DR MBT (in the North-West of Russia) up to 35-45.5% was detected in the Murmansk, Arkhangelsk and Saint-Petersburg Regions as well as in the Republic of Karelia, an increase of up to 61% was registered in the Kaliningrad Region. The frequency rate of secondary DR MBT went up by 1.5-2 times reaching 80-86% in the Murmansk, Arkhangelsk and Kaliningrad Regions. According to the PRIP clinics, there is also an essential growth of DR MBT in all tuberculosis localizations with a trend of the stability structure shifting towards poly-resistance, which accounts for 65.2% in pulmonary tuberculosis and for 33.6% in extra-pulmonary tuberculosis.