РОЛЬ ПРОФЕССИОНАЛЬНОГО ОТБОРА В РАСПРОСТРАНЕННОСТИ АРТЕРИАЛЬНОЙ ГИПЕРТЕНЗИИ: «ЭФФЕКТ ЗДОРОВОГО» И «НЕЗДОРОВОГО РАБОЧЕГО»

The importance of occupational selection in prevalence of arterial hypertension in researches of professional cohorts is considered in the article. Because arterial hypertension represents not only the independent disease, but also one of the most important indexes of the functional status of a human body, prevalence of arterial hypertension in professional groups can be substantially caused by occupational selection. As an epidemiological phenomenon of occupational selection "healthy worker effect", known of scientific literature from the middle of last century is considered. Besides, it is offered to consider the regularities of professional selection opposite to "healthy worker effect", as "unhealthy worker effect". The professional conditionality of arterial hypertension considered from epidemiological line items can be distorted by occupational selection. Thus existence of "healthy worker effect" makes impression of absence of direct link between level of occupational influence and frequency of arterial hypertension. At the same time, the increase in prevalence of arterial hypertension not always testifies to its professional conditionality, and can be connected to "unhealthy worker effect". Possible solutions of problems associated with identification of relationships between occupational factors and prevalence of hypertension in the presence of «effects of the healthy» and «unhealthy worker» are discussed. The challenge of considered problem in occupational medicine despite the numerous offered methodological approaches of elimination or decrease in influence of occupational selection is noted. Рассматривается роль профессионального отбора в распространенности артериальной гипертензии в исследованиях профессиональных когорт. В связи с тем, что артериальная гипертензия представляет собой не только самостоятельное заболевание, но и один из важнейших показателей функционального состояния организма человека, распространенность артериальной гипертензии в профессиональных группах может быть в значительной степени обусловлена профессиональным отбором. В качестве эпидемиологического феномена профессионального отбора рассматривается «эффект здорового рабочего», известный из научной литературы с середины прошлого столетия. Кроме того, предлагается учитывать закономерности профессионального отбора, противоположные «эффекту здорового рабочего», как «эффект нездорового рабочего». Рассматриваемая с эпидемиологических позиций профессиональная обусловленность артериальной гипертензии может искажаться профессиональным отбором. При этом наличие «эффекта здорового рабочего» создает впечатление отсутствия прямой связи между уровнем профессионального воздействия и частотой артериальной гипертензии. В то же время, увеличение распространенности артериальной гипертензии не всегда свидетельствует о ее  профессиональной обусловленности, а может быть связано с «эффектом нездорового рабочего». Обсуждаются возможные пути решения проблемы идентификации причинно-следственных связей между профессиональными факторами и распространенностью артериальной гипертензии при наличии «эффекта здорового» и «нездорового рабочего». Отмечается нерешенность рассматриваемой проблемы в медицине труда, несмотря на многочисленные предложенные методологические подходы устранения или снижения влияния профессионального отбора.

НЕКОТОРЫЕ МЕДИКО-СОЦИАЛЬНЫЕ ФАКТОРЫ ВЕРОЯТНОСТИ ГОСПИТАЛЬНОЙ ЛЕТАЛЬНОСТИ ПРИ ИНФАРКТЕ МИОКАРДА

Aim: to study the medical and social aspects of in-hospital mortality after myocardial infarction (MI) in the cardiology center of a major industrial city in Western Siberia. Patients and methods: the material of the study was the database of patients with acute coronary syndrome (19 283 patients), formed by a continuous method retrospectively. The volume of the study were 6463 patients with MI for 2006–2011. Results: in-hospital mortality of patients with MI was 11,8%, with MI complicated by cardiogenic shock — 87,4%, in the primary MI — 7,4%, during the second MI — 22,1%. In-hospital mortality in MI depends on the age of the patients: in group of patients of working age mortality was 4,7%, the retirement age — 12,4%, old age — 22,7%. In the working-age group mortality in men is almost three times higher than in women. The mortality of patients with MI without reperfusion was 13,4%, in the case of reperfusion therapy — 9,2%. Conclusions: hospital mortality depends on the patient's age, type of MI (primary or repeated), the severity of the condition, applied treatments. Цель исследования: изучить медико-социальные аспекты госпитальной летальности при инфаркте миокарда (ИМ) в кардиологическом центре крупного промышленного города Западной Сибири. Пациенты и методы: материалом для исследования послужила база данных пациентов с острым коронарным синдромом (19 283 человека), сформированная ретроспективно, сплошным методом. Объем исследования составил 6463 пациента с ИМ за период 2006–2011 гг. Результаты: госпитальная летальность пациентов с ИМ составила 11,8%; при ИМ, осложненном кардиогенным шоком, — 87,4%; при первичном ИМ — 7,4%, при повторном ИМ — 22,1%. Госпитальная летальность при ИМ зависит от возраста пациентов: в группе больных трудоспособного возраста летальность составила 4,7%, пенсионного возраста — 12,4%, старческого — 22,7%. В трудоспособном возрасте летальность у мужчин практически в 3 раза выше, чем у женщин. Летальность больных с ИМ без реперфузии оказалась равной 13,4%, в случае проведения реперфузионной терапии — 9,2%. Выводы: госпитальная летальность зависит от возраста пациента, вида ИМ (первичный или повторный), степени тяжести состояния, применяемых методов лечения

Magnetism, Critical Fluctuations and Susceptibility Renormalization in Pd

Some of the most popular ways to treat quantum critical materials, that is, materials close to a magnetic instability, are based on the Landau functional. The central quantity of such approaches is the average magnitude of spin fluctuations, which is very difficult to measure experimentally or compute directly from the first principles. We calculate the parameters of the Landau functional for Pd and use these to connect the critical fluctuations beyond the local-density approximation and the band structure.Comment: Replaced with the revised version accepted for publication. References updated, errors corrected, other change

Experimental evidence of two-band behavior of MgB2

The break-junction tunneling has been systematically investigated in MgB2. Two types of the break-junction contacts have been exploited on the same samples, which demonstrated tunnel contact like (SIS) and point contact like (SnS) behavior. Both of them have shown the existence of the two distinct energy gaps. We have observed also the peculiarities on the I(V)- characteristics related to Leggett's collective mode assisted tunneling. --> Corresponding author address: [email protected]: 14 pages, 6 figures, 1 table; corrected typos and fig

Measurement of RudsR_{\text{uds}} and RR between 3.12 and 3.72 GeV at the KEDR detector

Using the KEDR detector at the VEPP-4M $e^+e^-$ collider, we have measured the values of $R_{\text{uds}}$ and $R$ at seven points of the center-of-mass energy between 3.12 and 3.72 GeV. The total achieved accuracy is about or better than $3.3\%$ at most of energy points with a systematic uncertainty of about $2.1\%$. At the moment it is the most accurate measurement of $R(s)$ in this energy range

New precise determination of the \tau lepton mass at KEDR detector

The status of the experiment on the precise $\tau$ lepton mass measurement running at the VEPP-4M collider with the KEDR detector is reported. The mass value is evaluated from the $\tau^+\tau^-$ cross section behaviour around the production threshold. The preliminary result based on 6.7 pb$^{-1}$ of data is $m_{\tau}=1776.80^{+0.25}_{-0.23} \pm 0.15$ MeV. Using 0.8 pb$^{-1}$ of data collected at the $\psi'$ peak the preliminary result is also obtained: $\Gamma_{ee}B_{\tau\tau}(\psi') = 7.2 \pm 2.1$ eV.Comment: 6 pages, 8 figures; The 9th International Workshop on Tau-Lepton Physics, Tau0

Search for narrow resonances in e+ e- annihilation between 1.85 and 3.1 GeV with the KEDR Detector

We report results of a search for narrow resonances in e+ e- annihilation at center-of-mass energies between 1.85 and 3.1 GeV performed with the KEDR detector at the VEPP-4M e+ e- collider. The upper limit on the leptonic width of a narrow resonance Gamma(R -> ee) Br(R -> hadr) < 120 eV has been obtained (at 90 % C.L.)

Measurement of \Gamma_{ee}(J/\psi)*Br(J/\psi->e^+e^-) and \Gamma_{ee}(J/\psi)*Br(J/\psi->\mu^+\mu^-)

The products of the electron width of the J/\psi meson and the branching fraction of its decays to the lepton pairs were measured using data from the KEDR experiment at the VEPP-4M electron-positron collider. The results are \Gamma_{ee}(J/\psi)*Br(J/\psi->e^+e^-)=(0.3323\pm0.0064\pm0.0048) keV, \Gamma_{ee}(J/\psi)*Br(J/\psi->\mu^+\mu^-)=(0.3318\pm0.0052\pm0.0063) keV. Their combinations \Gamma_{ee}\times(\Gamma_{ee}+\Gamma_{\mu\mu})/\Gamma=(0.6641\pm0.0082\pm0.0100) keV, \Gamma_{ee}/\Gamma_{\mu\mu}=1.002\pm0.021\pm0.013 can be used to improve theaccuracy of the leptonic and full widths and test leptonic universality. Assuming e\mu universality and using the world average value of the lepton branching fraction, we also determine the leptonic \Gamma_{ll}=5.59\pm0.12 keV and total \Gamma=94.1\pm2.7 keV widths of the J/\psi meson.Comment: 7 pages, 6 figure

Measurement of main parameters of the \psi(2S) resonance

A high-precision determination of the main parameters of the \psi(2S) resonance has been performed with the KEDR detector at the VEPP-4M e^{+}e^{-} collider in three scans of the \psi(2S) -- \psi(3770) energy range. Fitting the energy dependence of the multihadron cross section in the vicinity of the \psi(2S) we obtained the mass value M = 3686.114 +- 0.007 +- 0.011 ^{+0.002}_{-0.012} MeV and the product of the electron partial width by the branching fraction into hadrons \Gamma_{ee}*B_{h} = 2.233 +- 0.015 +- 0.037 +- 0.020 keV. The third error quoted is an estimate of the model dependence of the result due to assumptions on the interference effects in the cross section of the single-photon e^{+}e^{-} annihilation to hadrons explicitly considered in this work. Implicitly, the same assumptions were employed to obtain the charmonium leptonic width and the absolute branching fractions in many experiments. Using the result presented and the world average values of the electron and hadron branching fractions, one obtains the electron partial width and the total width of the \psi(2S): \Gamma_{ee} =2.282 +- 0.015 +- 0.038 +- 0.021 keV, \Gamma = 296 +- 2 +- 8 +- 3 keV. These results are consistent with and more than two times more precise than any of the previous experiments