Educational technologies influence on chronic noninfectious diseases risk factors prevalence in unorganized population

То investigate dynamics of structure and prevalence of modified risk factors, 104 patients with metabolic syndrome are surveyed. It is established that therapeutic training has short-term effect (3 months), in later period only repeated training leads to decrease in prevalence of risk factors of chronic noninfectious diseases, the relative probability of achievement of target decrease in body weight,, according to three-year prospective supervision against repeated training is higher in 2,7 times.С целью изучения динамики структуры и распространенности модифицируе-мых факторов риска обследовано 104 пациента с метаболическим синдромом. Установлено, терапевтическое обучение имеет краткосрочный эффект (3 месяца), в более отдаленном периоде только повторное обучение приводит к снижению распространенности факторов риска хронических неинфекционных заболеваний, относительная вероятность достижения целевого снижения массы тела, по данным трехлетнего проспективного наблюдения на фоне повторного обучения выше в 2,7 раза

Syndrome of endogenous intoxication in regular active smokers

We have analyzed the relationship of features smoking status and the presence and severity of endogenous intoxication in regular active smokers. We take into account parameters such as smoking status experience of smoking, smoking intensity, index pack /years, the type of smoking behavior, the degree of nicotine dependence, level of motivation to quit smoking. In addition, the study was conducted levels of anxiety and depression and quality of life assessment. All patients of the study group and the control group were examined in the Health Center. We have found that a regular active smokers showed a statistically significant intensification of catabolic processes in the blood plasma, which manifests an increase total pool of low and medium molecular weight blood plasma, preferential accumulation of these substances in the plasma compared with glycocalyx erythrocytes, moreover increased excretion these substances in the urine. It was found that expression of endogenous intoxication has a statistically significant direct correlation with the experience and intensity of smoking parameters of bronchial obstruction and lung spirographic age, the presence of myocardial hypoxia, impaired psycho-emotional status, and negative correlation with the parameters of the physical, role and social functioning.Проведен анализ взаимосвязи особенностей курительного статуса и наличия и выраженности синдрома эндогенной интоксикации у лиц, подверженных регулярному активному табакокурению. Учитывались такие параметры курительного статуса как стаж курения, его интенсивность, индекс пачка/лет, тип курительного поведения, степень никотиновой зависимости, уровень мотивации к отказу от курения. Кроме того, проводилось исследование уровня тревоги и депрессии, оценка качества жизни. Все пациенты группы исследования прошли обследование в Центре здоровья. Установлено, что при активном регулярном табакокурении отмечается статистически значимая интенсификация катаболических процессов в плазме крови, что проявляется увеличением общего пула веществ низкой и средней молекулярной массы (ВН и СММ) плазмы крови, преимущественным накоплением данных веществ в плазме в сравнении с гликокаликсом эритроцитов, на фоне повышенного уровня экскреции их с мочой. Было установлено, что выраженность синдрома эндогенной интоксикации имеет статистически значимые прямые корреляционные связи со стажем и интенсивностью курения, параметрами бронхообструкции и спирографическим возрастом легких, наличием гипоксии миокарда, нарушениями психо-эмоционального статуса, и отрицательные взаимосвязи с параметрами физического, ролевого и социального функционирования

Population strategy for the prevention of arterial hypertension, the experience in Tyumen region

According to the statistics the main cause of death in Russia are cardio-vascular diseases. Taking into account the difficult demographic situation prevailing today in our country, the state policy is aimed at the timely prevention and increased life expectancy. According to who data, 20 % of the human health depends on hereditary biological factors, 10 % of the health care system and 70 % depends on what type of lifestyle he leads: catering, recreation, harmful habits (Smoking and alcohol abuse). In the Tyumen region there is an active work aimed at the implementation of measures on formation of a healthy way of life of the citizens, developed a plan of measures on realization of the Fundamentals of the state policy of the Russian Federation for the period up to 2020.По статистическим данным основной причиной смертности в России являются сердечно-сосудистые заболевания. Учитывая сложное демографическое положение, сложившееся на сегодняшний день в нашей стране, государственная политика направлена на своевременную профилактику и увеличение продолжительности жизни. По данным ВОЗ, 20 % здоровья человека зависит от наследственно-биологических факторов, 10 % от системы здравоохранения и 70 % зависит от того, какой образ жизни он ведет: питание, отдых, вредные привычки (табакокурение и злоупотребление алкоголем). В Тюменской области проводится активная работа, направленная на реализацию мероприятий по формированию здорового образа жизни граждан, разработан план мероприятий по реализации Основ государственной политики Российской Федерации на период до 2020 года

Relationship of depressive disorders with hypertension, its control and other metabolic risk factors in the Tyumen Oblast population of men and women. Data from the study “Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation” (ESSE-RF)

Aim. To study the association between depression and metabolic cardiovascular risk factors, hypertension (HTN) and its control in a random sample of Tyumen Oblast population of men and women aged 25-64 years.Material and methods. The study object was a random sample of the population of the Tyumen and the Tyumen Oblast aged 25-64 years, examined as part of the ESSE-RF epidemiological study. The study included 1658 participants. Among them, 30,3% (n=503) were men, while 69,7% (n=1155) — women. Mean age was 48,9±11,4 years. The prevalence of metabolic risk factors (hyperlipidemia, carbohydrate metabolism disorder, obesity), hypertension and the likelihood of its control in men and women with different levels of depressive disorders diagnosed using the HADS scale were assessed.Results. Compared with participants without depression, persons with psychological disorders were significantly more likely to have HTN (55,5% vs 47,6%, p<0,01), elevated levels of total cholesterol (TC) (63,9% vs 54,0%, p<0,01) and low-density lipoproteins (LDL) (66,7% vs 60,3%, p<0,05), carbohydrate metabolism disorders (8,3% vs 5,2% p<0,05), obesity (49,2% vs 37,7%, p<0,01). Significantly more often hypertensive subjects without depression took antihypertensive drugs effectively (odds ratio (OR) — 1,747, 95% confidence interval (CI), 1,001-3,053) and controlled blood pressure (OR — 1,533, 95% CI, 1,05-2,36). There was no association between the use of antihypertensives and the level of depressive disorders. Among women with depression (HADS>7), dyslipidemia (65,5% vs 57,4% for TC, p<0,05; 71,0% vs 62,9% for LDL, p<0,05), carbohydrate metabolism disorders (10,1% vs 5,2%, p<0,01), obesity (53,3% vs 43,2%, p<0,01), HTN (60,6% vs 45,6%, p<0,01) were more common. Men with clinical depression were more likely to have HTN (69,0% vs 47,7%, p<0,05), with a high level of depression — hyperlipidemia (58,9% vs 46,7% for TC, p<0,05; 67,1% vs 53,9% for LDL, p<0,05). Women with elevated depression levels were less likely to take antihypertensive drugs (30% vs 49,4%, p<0,01) and control hypertension (13,8% vs 21,2%, p<0,05).Conclusion. The data obtained confirm the association of depressive disorders with metabolic risk factors and the likelihood of HTN control, which is especially significant among women

Influence of emotional status and quality of life in patients with cervical disc herniation on the accuracy of topical diagnosis

What factors negatively influence the accuracy of topical diagnosis of spinal nerve root lesion during neurological examination has not been solved until now.Objective: to identify the nature of the relationship between the accuracy of topical diagnosis of spinal nerve lesion from neurological symptoms in patients with cervical disk herniation and the peculiarities of their emotional status and quality of life.Patients and methods. Forty-eight patients with cervical disc herniation were examined. At first, the level of spinal nerve root lesion established during neurological examination was compared with the results of magnetic resonance imaging or computed tomography and surgical intervention. Thereafter, the importance of emotional factors in determining the accuracy of topical diagnosis is studied in these patients.Results and discussion. If there was a divergence between preliminary neurological and final diagnoses, personality traits, such as hysteria, psy-chasthenia, alexithymia, and trait anxiety were most significant. The most substantial differences were found in the index of alexithymia. The accuracy of topical diagnosis was influenced not only by the psychological profile of patients with cervical disc herniation, but also by their qualty-of-life indicators. These are persons who are anxious and suspicious and are characterized by anxiety, fearfulness, indecision, and constant doubt. They use the symptoms of a somatic disease as a means to avoid responsibility. These patients solve all their problems, by escaping into disease, which causes social maladjustment.Conclusion. The features of an individual's psychological profile as increased anxiety, hysteria, and psychasthenia reduce the accuracy of topical diagnosis of the lesion by 25.6%. Patients with cervical disk herniation, low quality-of-life indicators, and high scale scores for hypochondria, depression, psychasthenia, and trait anxiety need their emotional status to be corrected

THE SPECIFICS OF HYPERTENSION PREVALENCE IN TYUMENSKAYA REGION AND ITS TREATMENT EFFICACY AMONG INHABITANTS OF 25-64 YEAR OLD

Aim. To study prevalence of arterial hypertension (AH), mean values of  systolic  (SBP)  and  diastolic  (DBP) levels  of  blood  pressure, awareness of patients on this, antihypertension drugs (AD) intake and treatment  efficacy among inhabitants of Tyumen Region, age 25-64 year old.Material and methods. A cohort of Tyumen Region inhabitants, 25-64 y.o.,  investigated  under  the  framework of multicenter  observational study ESSE-RF. Number of participants  — 1762, of those men 34,4% (n=607), women 65,6% (n=1155), mean age 48,9±11,4 y.o.Results. In Tyumen Region the prevalence of AH was 48,9%, which is 4,9% higher than general  population in ESSE-RF (by 9 regions). The same  high pressure was  found  in general  population  of men  and women, however statistically significantly predominated  in men aged <55 y.o. The prevalence  of AH increased  with age  — from 17,1% in group  25-34  y.o. to 70,6%  in group  55-64  y.o.,  significantly more frequently registered  in rural inhabitants — 58,1% vs 46,8% (р<0,05) and those  with lower educational  level — 57,4% vs 47,9% (p<0,05). The specifics  of Tyumen Region was low level of awareness about having AH. In difference with the general ESSE-RF selection, with this value 73,1%, awareness on their AH in Tyumen Region was 57,6%. Naturally, this value was higher in women — 60,5% vs 50,6% (р=0,03), city inhabitants — 59,3% vs 51,7% (p<0,05) and persons  with middlelevel or higher education  — 58,4% vs 47,9% (p<0,05).  Not high was the portion of those regularly taking AD — 39,5%, of those effectively treated  39,1%.  Women with AH  significantly more  commonly  took AD — 43,9% vs 23,0%, and were doing this more effectively  — 43,2% vs 24,3% (р<0,01). Efficacy of AD was higher among those with higher education  — 44,7% vs 35,9% (р<0,01),  decreased with the age and did not relate  on the type of settlement.  Of the specifics  of Tyumen Region was not high portion of those with AH reached  target values of BP — 15,4% vs 22,7% in general population of ESSE-RF. This value did not have significant differences  depending  on the  age  and  type of settlement, but was significantly higher among women in the age group >35 y.o., citizens, as  rurals. Correlation of effective BP control with educational  level was found only in male population. Among hypertensive males with middle and higher education, BP control was significantly better comparing to AH patients with low educational level. Conclusion. The results determined  the aims of prevention work with AH taking the specifics of this factor prevalence in Tyumen Region

PREVALENCE OF CARDIOVASCULAR RISK FACTORS IN NON-ORGANIZED POPULATION OF 25-64 YEAR OLDS IN TYUMEN REGION. RESULTS OF ESSE-RF STUDY IN TYUMEN REGION

Aim. To study prevalence of risk factors (RF) of cardiovascular diseases (CVD) in Tyumen region.Material and methods. The materials was a selection of Tyumen region inhabitants of the age 25-64 y.o., assessed under multi-center, observational study ESSE-RF (Epidemiology of cardiovascular diseases and  risk factors  in regions  of Russian  Federation).  Total number  of participants  was  1658,  of those  men  — 30,3%  (n=503),  mean  age 48,9±11,4  y. The prevalence  assessed of such  risk factors  as arterial hypertension   (AH), smoking,  obesity,  dyslipidemia,  hypodynamia, excessive salt consumption (ESC), low intake of vegetables  and fruits (LIVF), carbohydrate  metabolism disorders (CMD).Results. In Tyumen region the prevalence  of risk factors  was: AH — 49,0%, hypercholesterolemia  — 56,1%, smoking — 26,8%, obesity — 40,3%, hypodynamia — 35,3%, ESC — 46,8%, LIVF — 34,1%, CMD — 5,9%. Gender differences analysis showed that in female subpopulation there are more common dyslipidemia and obesity. Males more commonly smoke and are hypodynamic. Comparing to the general ESSE-RF population, in Tyumen region there is higher prevalence  of such RF as AH  — 49,0%  vs 44,0%  and  obesity  — 40,3%  vs 29,7%.  However statistics of LIVF appears better — 34,1% vs 41,9% in general population. Conclusion. The ESSE-RF study in Tyumen region showed the specifics of epidemiology  of such  RF as  AH, obesity,  dyslipidemia, ESC, LIVF, hypodynamia, CMD. As a result, there  was very high prevalence  of AH revealed and unacceptably high prevalence of obesity among tyumenians, especially women, comorbid with hypercholesterolemia. This data shall be a direction for prevention management against these serious risk factors