Structure of air chemical pollution and environmental zoning for health assessment in large industrial centre

The problem of contamination of the lower layer of the atmosphere in Western Siberia remains relevant more than half a century. The territory of the city of Kemerovo, a major industrial center with well-developed coal-chemical complex is an obvious example of antropotechnogenous burden on the environment and the health of the population with its climatic and geographical, weather and economic features. The aim of the study was to evaluate the structure of chemical contamination during 2005-2011 years, their interaction and the allocation of the factors that determine the ecological zoning on the example of the city of Kemerovo to identify the role of chemical pollution on the health of the population. Factor analysis revealed two latentfactors that determine the structuring of chemical pollution of the city of Kemerovo, in accordance with the wind rose and the chemical nature of the contaminants. The research shows the negative influence of chemical pollution on the health of the population of the city of Kemerovo

ПОТЕРЯ ЗДОРОВЬЯ НАСЕЛЕНИЯ ГОРОДА КЕМЕРОВА ОТ ИНФАРКТА МИОКАРДА за 2006–2012 гг. ПО ИНДЕКСУ DALY

In addition to traditional medical and demographic indicators of public health, such as mortality, morbidity, life expectancy, in some foreign countries DALY index is widely used. Unit of measurement of D ALY index shows losses of healthy life years due to illness, disability or untimely death. In Russia, in the first place, the necessity of comparative studies of health losses touches upon socially significant diseases which include a number of infectious diseases, cancer and cardiovascular diseases. The purpose of this study was to analyze the losses of life years from myocardial infarction (MI) using DALY index.Standard method was used to calculate DALY index. Annual dynamics of changes of life years’ losses has a similar tendency with the same of mortality from myocardial infarction. Men have higher values of D ALY index compared to women. That fact is confirmed by the literature data. The study of health losses from MI depending on the population age distribution has shown a considerable contribution to the total values of D ALY index health losses at the age group of 60 and older The study showed a reduction in the health loses from MI in Kemerovo for the period of 2006–2012 which is caused by similar dynamics of the index in the senior age group. It should be noted that DALY index values in young population are characterized by absolute and relative growth. Health losses are predominantly connected with high mortality from MI among male population and senior age group in Kemerovo.Помимо традиционных медико-демографических показателей состояния здоровья населения, таких как уровни смертности, заболеваемости, ожидаемая продолжительность жизни, в ряде зарубежных стран широко применяется индекс DALY. Единица измерения показателя DALY отражает потери лет здоровой жизни вследствие временной нетрудоспособности, инвалидности или преждевременной смерти. В России в первую очередь необходимость сравнительных исследований потерь здоровья возникает по социально значимым заболеваниям, к числу которых относятся ряд инфекционных, онкологических и сердечно-сосудистых. Целью данного исследования явился анализ потерь лет жизни населения от инфаркта миокарда (ИМ), рассчитанных при помощи индекса DALY.Для расчета индекса DALY применялась стандартная методика. Годовая динамика изменения потерь лет жизни населения имеет схожую тенденцию с таковой для смертности от ИМ. У мужчин по сравнению с женщинами наблюдаются более высокие значения индекса DALY, что соответствует литературным данным. Изучение потерь здоровья от ИМ в зависимости от возрастной структуры населения показало существенный вклад в суммарные значения индекса DALY потерь здоровья возрастной группы 60 лет и старше. Проведенное исследование показало снижение потерь здоровья от ИМ в Кемерове за 2006–2012 гг., что обусловлено аналогичной динамикой показателя в старшей возрастной группе. Обращает на себя внимание то, что значения индекса DALY у молодого населения характеризуются абсолютным и относительным приростом. Потери здоровья преимущественно связаны с высокой смертностью от ИМ среди мужской части населения и старшей возрастной группы Кемерова

САРКОМА ЮИНГА: ОСОБЕННОСТИ ЛИМФОГЕННОГО МЕТАСТАЗИРОВАНИЯ И ФАКТОРЫ ПРОГНОЗА

Background. Lymphogenous metastasis in Ewing sarcoma is a relatively rare and poorly studied event associated with aggressive clinical course and poor prognosis. Until now, no risk factors for lymphogenous metastasis in patients with Ewing sarcoma are reported.The purpose of the study was to evaluate tumor characteristics as predictors for lymphogenous metastasis and to create a mathematical model for assessing the risk of developing lymph node metastases in patients with Ewing sarcoma.Material and Methods. Clinical characteristics of the tumor were studied in 88 patients with Ewing sarcoma: in 8 patients with lymphogenous metastasis and in 80 patients having no lymphogenous metastasis. The primary tumor in all patients with lymphogenous metastasis was found to have an extraskeletal origin. Morphological and immunohistochemical characteristics of the tumor were studied in 31 patients with Ewing sarcoma: in 8 patients with lymphogenous metastasis and in 23 patients without lymphogenous metastasis.Results. Statistical analysis and comparative evaluation of the characteristics of the immunophenotype and histological pattern of the tumor in the two studied groups showed significant differences regarding several of them: the structure of nuclear crowding (fusion of nuclei), focal hemorrhages, nuclear normochromasia, and positive expression of cytokeratins by tumor cells. The above signs (except for nuclear normochromasia) were the basis for creating a mathematical model capable of predicting the risk of lymphogenous metastases in Ewing sarcoma.Conclusion. The revealed association with lymphogenous metastasis of cytokeratin expression can be considered as indirect confirmation of the pathogenetic significance of the mesenchymal-epithelial transition in the mechanism of lymphogenous metastasis.Актуальность. Лимфогенное метастазирование при саркоме Юинга – редкое и малоизученное явление, возникновение которого свидетельствует об агрессивном течении и неблагоприятном прогнозе заболевания. В настоящее время не изучен механизм развития лимфогенного метастазирования и не описаны факторы риска возникновения лимфогенных метастазов при саркоме Юинга.Целью исследования явилось изучение особенностей опухоли, обладающих прогностическими критериями в отношении развития лимфогенных метастазов, и построение на их основе математической модели, позволяющей оценить риск появления метастазов в лимфатических узлах при саркоме Юинга.Материал и методы. Были исследованы клинические характеристики опухоли у 88 пациентов с саркомой Юинга: с наличием лимфогенных метастазов (n=8) и без лимфогенных метастазов (n=80). Установлено, что первичная опухоль во всех случаях саркомы Юинга с лимфогенными метастазами имела экстраскелетное происхождение. Изучены морфологические и иммуногистохимические признаки опухоли у 31 пациента с саркомой Юинга: с лимфогенными метастазами (n=8) и без лимфогенных метастазов (n=23).Результаты. Статистический анализ и сравнительная оценка характеристик иммунофенотипа и гистологического строения опухоли в двух исследуемых группах показал достоверные различия, касающиеся нескольких из них: структуры «nuclear crowding» (скученность ядер), очаговых геморрагий, ядерной нормохромазии и положительной экспрессии опухолевыми клетками цитокератинов. Вышеперечисленные признаки (кроме ядерной нормохромазии) явились основой для построения с помощью метода логистической регрессии математической модели, способной прогнозировать риск возникновения лимфогенных метастазов при саркоме Юинга.Выводы. Обнаруженную связь с лимфогенным метастазированием экспрессии цитокератинов можно рассматривать как косвенное подтверждение патогенетического значения мезенхимально-эпителиального перехода в механизме лимфогенного метастазирования

СВЯЗЬ КУРЕНИЯ С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА И ФАКТОРАМИ СЕРДЕЧНО-СОСУДИСТОГО РИСКА (ИССЛЕДОВАНИЕ ЭССЕ-РФ В КЕМЕРОВСКОЙ ОБЛАСТИ)

Aim. To determine the relationships between smoking, coronary artery disease (CAD) and cardiovascular risk factors in the open population of Western Siberia.Methods. A sample of 1628 men and women aged 25 to 64 years was formed in the Kemerovo region as a part of the multicenter epidemiological study “Ep-idemiology of Cardiovascular Diseases and Their Risk Factors in the Russian Federation”. All patients were divided into three groups according to smoking status: non-smokers, ex-smokers and smokers. The following cardiovascular risk factors were analyzed: arterial hypertension, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, overweight, diabetes mellitus, low educational status, unemployment. The statistical data were processed using the logistic regression analysis. The results are presented as odds ratios (ORs) with 95% confidence intervals (CI).Results. Smoking among women was associated with low educational status (OR 1.92; 1.31-2.80) and unemployment (OR 1.51; 1.01-1.09), whereas ex-smoking / smoking with hypertriglyceridemia (OR 1.47; 1.1-2.14) and low educational status (OR 1.49; 1.102.02). Smoking among men was associated with re duced prevalence of overweight (OR 0.61; 0.41-0.91), low educational status (OR 2.92; 1.99-4.27) and unem-ployment (OR 1.86; 1.12-3.10), whereas ex-smoking / smoking with low educational status (OR 2.49; 1.763.52), and unemployment (OR 1.61; 1.01-2.59), smoking cessation with overweight (OR = 2.32; 1.37-3.94) and low educational status (OR 1.93, 95% CI 1.27-2.94). After eliminating the joint effect of modifying cardiovascular risk factors, only smoking in men was associated with increased risk of coronary artery disease (OR, 1.94; 1,01-3,73).Conclusion. The obtained associations between several cardiovascular risk factors are consistent with the recent Russian and foreign studies. The findings suggested smoking to be an independent risk factor for coronary artery disease as well as the factor associated with other cardiovascular risk factors.Цель. Определение связи курения с ишемической болезнью сердца (ИБС) и факторами сердечно-сосудистого риска (ФССР) в открытой популяции Западной Сибири.Материал и методы. В рамках многоцентрового эпидемиологического исследования «Эпидемиология сердечно-сосудистых заболеваний и их факторов ри-ска в Российской Федерации» сформирована выборка из 1628 мужчин и женщин Кемеровской области в возрасте 25-64 лет. По статусу курения выделяли некурящих, бросивших курить и курящих. В качестве ФССР рассматривались артериальная гипертензия (АГ), гиперхолестеринемия (ГХЭ), гипертриглицеридемия (ГТГЭ), гиперглюкоземия (ГГЭ), избыточная масса тела (ИМТ), сахарный диабет (СД), низкий обра-зовательный статус (не высшее образование), отсут-ствие работы. При статистической обработке данных использовался лог-регрессионный анализ, результаты представлялись в виде отношения шансов (ОШ) и 95% доверительного интервала (ДИ).Основные результаты. У женщин курение ассоци-ируется с низким образовательным статусом (ОШ 1,92; 1,31-2,80) и профессиональной незанятостью (ОШ1,51; 1,1-             1,09), экс-курение/курение с ГТГЭ (ОШ 1,47; 1,012,14) и низким образовательным статусом (ОШ 1,49; 1,10-2,02). У мужчин курение ассоциируется со снижением частоты ИМТ (ОШ 0,61; 0,41 -0,91), низким образовательным статусом (ОШ 2,92; 1,99-4,27) и профессиональной незанятостью (ОШ 1,86; 1,12-3,10), экс-курение/ курение с низким образовательным статусом (ОШ 2,49; 1,76-3,52) и профессиональной незанятостью (ОШ 1,61; 1,01-2,59), отказ от курения с ИМТ (ОШ=2,32; 1,373,94) и низким образовательным статусом (ОШ 1,93 при 95% ДИ 1,27-2,94). При устранении модифицирующего влияния ФССР только у мужчин курение ассоциируется с увеличением риска ИБС (ОШ 1,94; 1,01-3,73).Заключение. Полученные ассоциативные связи по ряду ФССР соответствуют результатам российских и зарубежных исследований. Полученные результаты характеризуют курение как независимый фактор риска ИБС, так и как фактор, связанный с другими ФССР

URBANIZATION AND CARDIOVASCULAR DISEASES IN MODERN SOCIETY

Nowadays cardiovascular diseases are the primary cause of death of the population nearly in all over the world. According to WHO data, this kind of pathology will keep its leading positions in future, that is presupposed by ageing of population and urbanization processes. The main aim of current review is gathering and analysis of the data on the influence of urbanization on the prevalence of cardiovascular pathology and risk factors. It is revealed that urbanization of territories, together with active socio-economical processes is ambivalent in its influence on the health. Also in developed countries the positive aspects of living in large cities (result of complex active actions for the fight with risk factors) prevail negative (negative ecological situation), that engines a decline of the mortality rate from cardiovascular diseases. In developing countries, contrary, urbanization is linked with higher risk of adverse outcomes of cardiovascular diseases. It marked that not so many fatherland studies available, focused on the complex influences of urbanization processes on population health and prevalence of cardiovascular diseases. All this together creates the fundamentals for novel approaches to study of the problem in modern society

EWING SARCOMA: FEATURES OF LYMPHOGENOUS METASTASIS AND PROGNOSTIC FACTORS

Background. Lymphogenous metastasis in Ewing sarcoma is a relatively rare and poorly studied event associated with aggressive clinical course and poor prognosis. Until now, no risk factors for lymphogenous metastasis in patients with Ewing sarcoma are reported.The purpose of the study was to evaluate tumor characteristics as predictors for lymphogenous metastasis and to create a mathematical model for assessing the risk of developing lymph node metastases in patients with Ewing sarcoma.Material and Methods. Clinical characteristics of the tumor were studied in 88 patients with Ewing sarcoma: in 8 patients with lymphogenous metastasis and in 80 patients having no lymphogenous metastasis. The primary tumor in all patients with lymphogenous metastasis was found to have an extraskeletal origin. Morphological and immunohistochemical characteristics of the tumor were studied in 31 patients with Ewing sarcoma: in 8 patients with lymphogenous metastasis and in 23 patients without lymphogenous metastasis.Results. Statistical analysis and comparative evaluation of the characteristics of the immunophenotype and histological pattern of the tumor in the two studied groups showed significant differences regarding several of them: the structure of nuclear crowding (fusion of nuclei), focal hemorrhages, nuclear normochromasia, and positive expression of cytokeratins by tumor cells. The above signs (except for nuclear normochromasia) were the basis for creating a mathematical model capable of predicting the risk of lymphogenous metastases in Ewing sarcoma.Conclusion. The revealed association with lymphogenous metastasis of cytokeratin expression can be considered as indirect confirmation of the pathogenetic significance of the mesenchymal-epithelial transition in the mechanism of lymphogenous metastasis

Influence of the social, medicinal and environmental factors upon the development of sporadic congenital heart diseases

The epidemiological studies have shown an increase of congenital heart diseases in the industrial regions of the Russian Federation. The etiology and pathogenesis of most congenital heart defects are still unknown despite high achievements in cardiology and cardiac surgery. The purpose of this review is to analyze the literature data devoted to the influence of a complex of exogenous and endogenous factors, including the genetic ones, upon the development of the sporadic congenital heart diseases, which are not associated with the chromosomal abnormalities. It isshown that the sporadic congenital heart diseases associate with the women's social factors such as a low social status and level of education, smoking, and alcohol. The air pollution with nanoparticles smaller than 10 µm is a risk factor for the development of the congenital heart diseases and other pathological conditions of the cardiovascular system. It has been proven that the alleles and genotypes of polymorphic variants of genes GATA6, NPPB (rs198388 and rs198389), CYP1A1, CYP1B1, and NAT2 have the associative links with the congenital heart disease in the children

THE RELATION OF ALCOHOL CONSUMPTION WITH CARDIOVASCULAR DISEASES AND RISK FACTORS (ESSE-RF TRIAL IN KEMEROVSKAYA OBLAST)

Aim. To analyze the relation of alcohol consumption level with cardiovascular diseases and risk factors in the population of Kemerovskaya Oblast.Material and methods. The study was performed under the framework of multicenter epidemiological trial ESSE-RF in Kemerovskaya Oblast, with 1628 participants with the age 25-64 y.o. The data was analyzed concerning the prevalence, volume and type of alcohol beverages by the respondents, as the prevalence of a range of cardiovascular diseases and risk factors. By original formulae, total volume was calculated of the consumed alcohol in units of the “safe” ethanol dose (24 grams) with further grouping to “non consuming” and consuming “moderately”, “in-between” and “over”.Results. Overconsumption of alcohol, comparing to non-consumers, is associated with high risk of hypercholestrolemia (OR 1,76; 95% CI: 1,12-2,75), hypertriglyceridemia (OR 2,69: 1,52-4,77), body overweight (OR 1,68: 1,04-2,71), smoking (OR 2,24: 1,48-3,41). The relation of low physical activity with alcohol consumption is found in all grades. Increase of the mean daily ethanol dosage is positively linearly related with the risk of arterial hypertension (OR 1,04: 1,11-2,75), hypercholesterolemia (OR 1,06: 1,01-1,12), increased level of low density lipoproteins (OR 1,09: 1,02-1,16), smoking (OR 1,17: 1,10-1,24), low physical activity (OR 1,09: 1,02-1,16). There is U-shaped and upside-down J-shaped relation for the level of psychological risk factors (stress, anxiety, depression) and volumes of consumed alcohol. By the considered cardiovascular diseases it can be noted only, the existence of statistically non-significant (0,1>р>0,05) tendency to decrease myocardial infarction risk and stroke in anamnesis, with the increase of the consumed alcohol volumes comparing to non-drinkers.Conclusion. The study shows that overconsumption of alcohol, as the increase of mean daily dosage of ethanol are associated with the range of cardiovascular risk factors. There is U-shaped and upside-down J-shaped relation of psychoemotional risk factors with the volumes of consumed alcohol. By the considered cardiovascular dseases, there are no significant relations for the level of consumed alcohol, however, there is non-significant tendency for myocardial infarction and stroke risk factors diminishing in the anamnesis, with the increase of consumed alcohol volumes