To substantiate the effectiveness of the set-up center in the early detection of patients with inflammatory bowel diseases (IBD) and in its organization and implementation of current therapeutic programs.
The therapeutic activity of the specialized medical care system set up in St. Petersburg for patients with IBD (ulcerative colitis (UC) and Crohn's disease (CD)), which is based on a multifunctional inflammatory bowel disease center at City Clinical Hospital Thirty-One, was analyzed.
The effective work of the center could reduce time for verification of the diagnosis of UC from 6.4 +/- 1.4 to 3.6 +/- 0.8 months and CD from 28.6 +/- 6.7 to 15.3 +/- 4.2 months, respectively; decline the annual number of patients with moderate and severe UC from 73.4 to 53.6 and CD from 66.7 to 47%, and also set up a centralized system for all required types of current therapeutic and diagnostic care for these patients.
The establishment of the St. Petersburg Center for the diagnosis and treatment of inflammatory bowel diseases could develop and realize in practice a new closed-loop urban system for the early detection and notification of IBD patients, the organization and rendering of individual effective therapeutic-and-prophylactic care.
A comprehensive survey of organized children aged 14-17 years residing in the industrial centers with moderate and high levels of air pollution was performed. On the base of the examination of otorhinolaryngologist in the each of cities there was selected the group of schoolchildren with chronic pathology of the upper respiratory tract at the stage of remission. In these groups there was performed the assessment of the informativeness of immuno-biochemical indices for the identification of pathology caused by the impact of man-made factors. The most informative (relative content of autoantibodies to Ã?2-glycoprotein-1, the average individual immunoreactivity, erythrocyte sedimentation rate, level of a1-antitrypsin) were used in the mathematical model, on the based of which it was possible to calculate the diagnostic coefficient, allowing to identify in the groups observed by ourselves, chronic pathology of upper respiratory tract, formed under the influence of ambient air pollution. The above approach can be used in the formation groups for health promotion of children exposed to the negative impact.
There was made the characterization of the health risk for workers' of pulp and paper industry, under the simultaneous effects of chemicals in the residential and working area. The main adverse effect of chemicals that pollute the air and work environment is related with the impact on the respiratory system. Under the successive exposure (ambient air--air in the workplace) in the adult population working at the Arkhangelsk Pulp and Paper Mill, the risk of occurrence of respiratory diseases (HI = 18.5) and individual carcinogenic risk (CR = 9.7 x 10(-3)) have been rated as high and constitute 86-99% of the total risk.
The paper provides an analysis of the results of a socio-hygienic survey of 2099 residents of Leningrad and Novokuznetsk of Kemerovo Region on the state of public health in the course of a comprehensive economic experiment on the introduction of new economic methods of management. Only 5.6 percent of respondents defined the state of public health as good, 54.1 percent as satisfactory and 40.3 percent as poor. Negative attitude to public health is explained by low level of medical care and poor organization of health care delivery and not by introduction of a new economic mechanism. The majority of respondents (33.4%) believe that their health status to a large degree depends on the system of public health rather than on their efforts to keep healthy lifestyle.
The paper presents guidelines for assessing regional exposure factors (EFs) according to the results of a questionnaire survey of about two thousand persons, including urban workers and/or adult students of the Central Federal District (CFD) and Siberian Federal District (SFD) of Russia. It has been ascertained that in CFD, annual exposure (324 days/year) is less than the standard value defaulted in Guidelines P 18.104.22.1680-04 (350 days/year), which causes a reduction in the chronic average daily dose. Town-dwellers spend the bulk of a day indoors (86 and 87% in CFD and SFD, respectively); 8 and 3% of a day on transport in CFD and SFD, and 7 and 10% indoors in these districts. The findings are in agreement with the data obtained by Russian and foreign investigators and suggest that the daily distribution of a microenvironmental load should be taken into account when health exposures and risks are estimated. The average daily tap water consumption in CFD (2.2 l/day) and SFD (1.7 l/day) is close to 90% percentile of the values recommended by the U.S. EPA (2.4 l/day) and the WHO or less than the value used in the calculation of the Russian maximum permissible concentrations for water (3.0 l/day). The time spent on water procedures by town-dwellers is 36.4 min/day in CFD and 37.6 min/day in SFD (while 29.2 min/day in rural dwellers in SFD) with the standard value of 30 min/day. The findings suggest that the use of the regional values of water-associated EFs increases the chronic average daily dose and therefore a risk upon oral, dermal, and inhalational exposure. The regional features of FEs have been kept in mind on assessing the risk upon multienvironmental exposures to the characteristic components of emission caused by aluminum works in CFD.
Health status of infants in an average city with petroleum refining industry is worse in comparison with that of infants living in a city with automobile industry. Unfavorable impact of air polluted by petroleum enterprises on the functional state of the circulatory system, immunity, intracellular enzymes, degree of body resistance and morbidity rates has been established. The study results specify the necessity of further active environment-protective and other preventive measures in the primary health care system aimed at health promotion of infants, their rehabilitation following the disease under the conditions of average cities with the developed petroleum refining industry.