Diseases Of The Circulatory System Research Articles

Mediterranean diet as an element of treatment and prevention of cardiovascular diseases

Currently, the issues of treatment and prevention of cardiovascular diseases are still relevant, as cardiovascular pathology remains one of the leading causes of disability and mortality in all developed countries of the world. In the Russian Federation there is a high incidence of the diseases of the circulatory system, so they have the top priority among health problems, despite a slight decrease in morbidity in recent years. The main purpose of this review is to study the experience of applying the Mediterranean diet and its components in therapy and prevention of cardiovascular pathology. Research method: we searched electronic databases PubMed, Scopus, Web of Science, MedLine, Science Direct and eLIBRARY.RU using the following terms: "Mediterranean diet", "cardiovascular diseases", "prevention of cardiovascular diseases", "diet therapy of cardiovascular diseases". On the basis of numerous world clinical studies analysis, it can be assumed that the Mediterranean diet is one of the most reliable and well-studied in terms of prevention of cardiovascular pathology. The aim of this review is to draw the attention of the medical community to such a long-known, extensively studied, scientifically confirmed, accessible and simple way of rationalizing daily nutrition as the consumption of elements of the Mediterranean diet in the daily one. Further wide informing of patients about this way of nutrition from different specialists (general practitioners, cardiologists, nutritionists, gerontologists and others) is required.

Morbidity rates dynamics among the military women of the Russian Ministry of Defense (2012 to 2021)

Relevance. Extreme military service conditions can reduce functional reserves of the military, provoking early development of occupational disorders.The objective is to study morbidity rates dynamics for the last decade (2012–2021) and evaluate the epidemiological significance of different disease chapters among military women to improve their health status.Methods. The study focused on women serving in the Russian military forces with the aim to analyze their morbidity rates over a decade (2012–2021), as presented in the medical report database (3/MED form) and available publications. Medical and statistical codes for main disease chapters are indicated according to the International Statistical Classification of Diseases and Health Related Problems, 10th revision (ICD-10). Morbidity was calculated per 1,000 military women or in ppm (‰), while mortality was calculated per 100,000 persons or 10–5. The average annual indicators calculated based on absolute data, arithmetic averages, errors (M ± m) are provided in study as well. Trends were assessed using dynamic time serie analysis and a second-order polynomial trend.Results and discussion. The long-term average incidence (total morbidity) was 1653.1 ‰, with primary morbidity – 770.6 ‰, regular follow-up – 186.3 ‰, hospitalization – 347.2 ‰, cases requiring a sick leave due to disability – 898.9 ‰, days of disability-related absence from work – 6964 ‰, dismissal rate – 5.11 ‰, mortality rate – 59.2 ∙ 10–5. Polynomial trends in morbidity tracking indicated decreasing trends, with varying significance of determination coefficients. In terms of their social and epidemiological significance, 8 disease chapters (listed in order of severity according to ICD-10) were the major contributors to the military women morbidity: diseases of the respiratory systems (Chapter X), neoplasms (Chapter II), diseases of the circulatory system (Chapter IX), diseases of the musculoskeletal system and connective tissue (Chapter XIII), diseases of the genitourinary system (Chapter XIV), endocrine, nutritional and metabolic diseases (Chapter IV), injury, poisoning and certain other consequences of external causes (Chapter XIX), diseases of the digestive system (Chapter XI).Conclusion. The diseases presented in the above 8 chapters of the ICD-10 were responsible for 87.8 % of socially and epidemiologically significant morbidities. Thus, timely diagnosis, treatment, rehabilitation, and prevention are required to remarkably improve the health status in military women.

Endothelial dysfunction in combination of occupational pathology of the respiratory system and atherosclerosis in coal industry workers

Introduction. The increasing prevalence of cardiovascular pathology among industrial workers determines the importance of studying not only occupational diseases, but also their combination with diseases of the circulatory system. Endothelial dysfunction is a key link in the pathogenesis of atherosclerosis. Evaluation of endothelial function indicators in occupational respiratory diseases in combination with atherosclerosis in workers of the coal mining industry is an urgent task. The study aims to consider the indicators of endothelial function in miners with occupational respiratory diseases in combination with atherosclerosis. Materials and methods. The authors have examined 88 miners with previously diagnosed occupational respiratory diseases (chronic dust bronchitis, anthracosilicosis, chronic obstructive pulmonary disease), 45 of them showed signs of atherosclerosis. There were two comparison groups without signs of atherosclerosis: 44 miners who work long-term in harmful working conditions, without lung pathology (control group) and 42 residents of Novokuznetsk who have never worked in harmful working conditions, and without lung pathology (unexposed group). Results. We found that miners with occupational respiratory diseases in combination with atherosclerosis had several forms of endothelial dysfunction: vasomotor (decreased synthesis of nitric oxide, increased endothelin-1 levels), hemostatic (increased levels of Willebrand factor), adhesive (increased levels of endothelial adhesion molecules sVCAM-1). The development of respiratory insufficiency in miners with occupational respiratory diseases increases endothelial dysfunction: miners with respiratory insufficiency have lower levels of nitric oxide (NO), higher levels of endothelin-1 and endothelial adhesion molecules sVCAM-1 than miners without respiratory insufficiency. There are correlations between indicators of endothelial function and production factors: with work experience in harmful working conditions, the level of the average concentration of coal-rock dust in the workplace and the frequency of exceeding the maximum permissible concentration of coal-rock dust. Limitations. The study is limited to a sample of workers in the main professions of coal mines who were examined at the Research Institute of Complex Hygiene Problems and Occupational Diseases, aged 40 to 54 years, with more than 15 years of experience working in underground dust conditions. Conclusion. Miners with occupational respiratory diseases in combination with atherosclerosis develop several forms of endothelial dysfunction: vasomotor, hemostatic, adhesive. The development of respiratory failure increases endothelial dysfunction. Ethics. This medical study involving a human as a subject was carried out in compliance with the Ethical principles presented in the latest version of the Helsinki Declaration, developed by the World Medical Association.

Changes in heart rate variability and subclinical heart failure with preserved left ventricular ejection fraction in workers of the main professions at the coal industry

Introduction. The high prevalence of diseases of the circulatory system necessitates their detection and prevention at an early stage, especially in regions with high industrial potential. The occurrence of subclinical heart failure depends on a cascade of processes that are already occurring in the body and may eventually manifest themselves in clinically pronounced diseases. One of the possible mechanisms of its development is a violation of the balance of the autonomic nervous system with a violation of adaptive capabilities to the labour process, characterized by severe physical overloads among miners. The study aims to evaluate changes in heart rate variability in workers of the main professions at the coal industry with signs of heart failure with a preserved left ventricular ejection fraction. Materials and methods. The study included 78 employees of the main professions at the coal industry. Specialists performed ultrasound examination of the heart according to generally accepted methods with the study of longitudinal deformation of the myocardium. The concentration of NT-proBNP in the blood serum was determined by solid-phase enzyme immunoassay. The authors also conducted an analysis of heart rate variability, determined temporal, spectral and linear parameters. Results. Specialists revealed a decrease in longitudinal myocardial deformation in 38.5% of the examined patients, signs of diastolic dysfunction in 41%; in these groups, a tendency to increase the concentration of NT-proBNP was revealed. In the examined miners with heart failure with preserved ejection fraction, they revealed a significant decrease in the SDNN index and an increase in IC values. The increase in DFA and LF/HF indicators reflects a vegetative imbalance towards sympathetic activation observed in all surveyed miners. Limitations. This study is limited to a sample of employees of the main professions of the coal industry undergoing periodic medical examination at the Research Institute of Complex Problems of Hygiene and Occupational Diseases. Conclusion. The revealed relationship between indicators of heart failure and heart rate variability (SDNN, LF/HF, DFA and IC) in miners allows us to identify a group of people at greatest risk of adverse outcomes. Ethics. The study was conducted in compliance with the standards of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, established in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of Conducting medical Research with human participation as a subject" as amended in 2013 and the "Rules of Good Clinical Practice" approved by Order No. 200n of the Ministry of Health of the Russian Federation dated 04/01/2016. The subjects signed an informed consent to participate in the study.

Comparative analysis of the targets for reducing adult population mortality by 2024

Introduction. Currently, in the Russian Federation there are realized national projects “Healthcare” and “Demography” aimed at reducing the mortality. For implementation at the regional level in Moscow, there have been developed regional programs with appropriate regional indicators. The purpose of the study is to assess the degree of achievement of the targets of national, federal and regional adult mortality rates. Materials and methods. The study is based on a comparative analysis of targets and actual statistical data. Results. In Moscow and in Russia, there is a decrease in mortality from all causes, diseases of the circulatory system, myocardial and cerebral infarction, neoplasms. Despite the increase in the level in 2020–2021 due to the pandemic, in 2022, mortality rates returned to the pre-pandemic period and have a tendency to further decrease. Current trends point to the high achievability of targets in Moscow, while in the country, most indicators have a chance of not being achieved. In Moscow there is noted a higher cancer mortality rate i to which a significant contribution may be made by cancer patients from other Russian regions who receive medical care in federal cancer centers located in Moscow and who died on its territory. Research limitations. Standardized mortality rates of the population were calculated in the FAISS internal use program. Conclusion. The implementation of national, federal and regional projects has had a positive impact on the effectiveness of demographic policy to reduce mortality.

Analysis of traffic injury trends, and strategies for road safety promotion in Lithuania

Abstract Every year, about 1.3 million people die on the world’s roads. The aim of the study was to analyze the mortality trends from traffic injuries, and to discuss strategies for the prevention of road traffic injuries and road safety promotion in Lithuania. A longitudinal study was conducted, and regression analysis was applied. The study showed that, when analyzing the changes in mortality from the main causes of death over 2009-2019, the greatest progress in mortality reduction was observed in the category of deaths from external causes; whereas, the number of deaths from diseases of the circulatory system did not change, and the number of deaths from malignant tumors increased slightly. In Lithuania, the death rate from traffic injuries per 100,000 inhabitants decreased significantly over a 50-year period (1971-2020) (in the whole population, and in the subgroups of men and women). In Lithuania, during the fifty-year period (1971-2020), pedestrian mortality rates decreased significantly in the whole population, and children and adolescents (0-14, 15-19, and 0-19 years). Over 1998-2020, road traffic injury deaths decreased significantly in children age groups 0-14, 15-19, and 0-19. After exploring the preventive strategies used for road safety promotion, it was revealed that the most effective results were achieved, when education, safe environment creation, and legislation with enforcement were used. It was important to create a safe engineering environment, to separate pedestrian and bicycle paths from high-speed traffic on roads, to improve the visibility of road users, to apply measures that reduce driver’s fatigue, and to combat the usage of mobile phones while driving. Preventive activities were aimed at alcohol control, speed limitation, education of safe behavior of drivers, promotion of safe cars operation. The usage of safety belts and safety seats, helmets for motorcyclists and cyclists were increased through legislative and educational measures.

Thermal indices for evaluating the impact of thermal conditions on human health: a systematic review

Abstract Background Thermal indices assess individuals’ perception of their ambient thermal surroundings (thermal comfort and heat/cold stress) considering several meteorological factors, such as temperature, humidity, wind, and radiation. As climate change progresses, there is an increased demand for accurately monitoring the association between thermal environment and human health. This study summarizes the available evidence on the association between thermal indices and health outcomes. Methods We conducted a systematic search in PubMed, Scopus, and Web of Science until December 31st, 2023, to identify all relevant studies examining the association between thermal indices and health outcomes in outdoor environments. Results A total of 5,034 electronic records were screened. Of these, 310 were considered eligible, examining 1,143 associations. Seventeen indices were identified, with 32 (10.3%) articles using more than one index. The most commonly employed index was Apparent Temperature (articles: n = 141, 38.2%; associations: n = 634, 55.5%). The specific-cause health outcomes examined spanned 18 categories of the International Classification of Diseases. Most associations (n = 304, 26.6%) pertained to mortality/morbidity related to diseases of the circulatory system, followed by all-cause morbidity/mortality (n = 288, 25.2%). The 48.6% (n = 556) of the associations suggested an increased risk of adverse health outcomes when indices increased while 32.5% (n = 372) of the associations were non-significant. The 14.2% (n = 162) of the associations suggested an increased risk of adverse outcomes when indices decreased while 16% (n = 183) of the associations were non-significant. Conclusions The relevant literature revealed associations between thermal indices and health outcomes. Therefore, thermal indices, considering several meteorological variables, could be a useful tool for public health planning. However, there is diversity in their methodologies and reporting. Key messages • Summarizing the published evidence regarding thermal indices is expected to attract the interest of public health professionals and policy makers, and enhance their use. • Implementing integrated methods to monitor the association between thermal conditions and health, including using thermal indices, could be valuable for developing and evaluating policies.

Characteristics of the Cohort of Personnel of the Sublimate Production of the Siberian Chemical Plant Involved in Working with Plutonium-239

239Pu has the property of initiating radiogenic diseases in workers who come into contact with it during their professional activities. To study adverse medical and biological effects and to study in detail the potential consequences of plutonium exposure on the body of personnel at nuclear energy facilities, it is necessary to form a cohort of people involved in working with this isotope. The purpose of the study is to form and characterize a cohort of Siberian Chemical Plant sublimation production employees involved in working with 239Pu in the period 1953–2000. The source of information for forming the cohort was the database of the regional medical and dosimetric register of the population of closed administrative-territorial formation Seversk and the personnel of the Siberian Chemical Plant, containing personal, dosimetric, medical and biological information regarding all current and former employees of the Siberian Chemical Plant (about 65,000 people) since the founding of the enterprise till now. As part of this work, a cohort of sublimation production employees involved in working with 239Pu 9 in 1953–2000 was formed (1,052 people, 577 men and 475 women). The dosimetric, medical and biological characteristics of workers included in the sublimation production cohort are given. The created sublimation production cohort will make it possible to conduct comprehensive retrospective and prospective epidemiological studies to assess the morbidity and mortality of nuclear energy facilities employees, as well as to draw scientifically based conclusions regarding the role of 239Pu in the initiation of the most important socially significant non-infectious diseases (for example, malignant neoplasms, diseases of the circulatory system etc.) and mortality from these diseases. The scientific data obtained as a result of this study will make it possible to determine the main directions for organizing a system for assessing risks to the health of personnel at sites for the decommissioning of nuclear facilities and the formation of a set of measures aimed at improving the health-saving system of nuclear facilities employees and extending their working longevity.

Time-dependent simulation of blood flow through an abdominal aorta with iliac arteries.

Atherosclerosis is one of the important diseases of the circulatory system because atherosclerotic plaques cause significant disruption of blood flow. Therefore, it is very important to properly understand these processes and skillfully simulate blood flow. In our work, we consider blood flow through an abdominal aorta with iliac arteries, assuming that the right iliac artery is narrowed by an atherosclerotic lesion. Blood flow is simulated using the laminar, standard and standard models. The obtained results show that despite the use of identical initial conditions, the distribution of velocity flow and wall shear stress depends on the choice of flow simulation model. For the model, we obtain higher values of speed and wall shear stress on atherosclerotic plaque than in the other two models. The laminar and models predict larger areas where reverse blood flow occurs in the area behind the atherosclerotic lesion. This effect is associated with negative wall shear stress. These two models give very similar results. The results obtained by us, and those reported in the literature, indicate that model is the most suitable for blood flow analysis.

Age trend in the mortality from diseases of the circulatory system during the pandemic under a decrease in air pollution

Introduction. The results of large-scale studies of the mortality from diseases of the circulatory system (DCS) during the pandemic require further analysis of the data and the search for modifying factors. The purpose is to identify the features of the trend in the mortality from DCS in the population of an industrial center during a pandemic under changes in air pollution. Materials and methods. The research was carried out in the industrial center – Bratsk. Age-specific mortality rates were studied using exponential models in the background (2017) and pandemic (2021) periods. The contribution of atmospheric air pollution to the mortality rate was calculated in accordance with the “Guidelines for assessing the risk to public health from exposure to chemical substances that pollute the environment.” Results. The age-related increase in the mortality rate from DCS over 2017 was 125%, and during 2021 – 172%. During the pandemic, the excess mortality rate was in cases older 80 years – 35.92‰, 70–79 – 8.48‰, 60–69 – 1.03‰. PM10 levels in the air decreased from high to alarming levels in 2021, resulting in a reduction in excess PM10-related deaths from 194 (CI: 193.6–195.1) to 5.0 (CI: 4.8–5.1) cases. Limitations are associated with incomplete epidemiological knowledge about the dependence of mortality from DCS on exposure to air pollutants. Conclusion. The use of nonlinear regression analysis made it possible to demonstrate changes in trends in age-specific mortality during the background period and during the pandemic. During the pandemic, the level of excess mortality was revealed to relate with PM10 air pollution decreased.

Improving the organization of medical care for patients in the specialty of medical rehabilitation in the Tomsk oblast

More than a third of the total population of the planet needs medical rehabilitation and the need will increase in the future. The prospective increase in life expectancy by the middle of the 21st century will be accompanied by an increase in the share of malignant neoplasms and diseases of the circulatory system in the morbidity structure, and the level of injuries will remain unchanged. These factors will negatively affect a person’s functional capabilities and will contribute to an increase in disability, increasing the relevance of medical rehabilitation. In Russia, according to the current procedure, there is a three-stage organization of medical rehabilitation. The implementation of these stages is carried out within the regional territorial programs of state guarantees (TPSG) of free medical care to citizens, which limits the financial accessibility of the completed cycle of medical rehabilitation for patients, due to budgetary allocations and the compulsory health insurance program, negatively affecting the quality of care provided. The article assesses the volume of medical rehabilitation provided in inpatient settings in the TPSG of the Tomsk oblast for the period of 2019–2022. Currently, three medical organizations in the region of different forms of ownership provide medical rehabilitation. In total, over a four-year-period, 8,804 cases in the specialty of medical rehabilitation were completed in the amount of 378.9 million rubles. An underfulfillment of the volume and costs of medical care during medical rehabilitation approved by the TPSG was recognized, as well as an outflow of patients for treatment to other regions (1,864 people during the study period). The most popular clinical and statistical groups (CSG) for which residents of the Tomsk oblast need rehabilitation measures have been identified, and organizational ways to improve the profile of this medical care have been substantiated.

Mortality from Acute and Chronic Diseases of the Circulatory System in the Period before and after the COVID-19 Pandemic in Moscow

Sudden death from acute forms of cardiovascular diseases, especially in working age, when it is physiologically clearly premature, is evidence of diseases not detected in time: the main task of cardiologists is to avoid the transition of chronic pathologies into an acute form, in which the condition can worsen at lightning speed. Acute and chronic forms of cardiovascular diseases require different clinical approaches. Thus, the division of pathologies into two blocks– acute and chronic conditions– has, in addition to academic, purely practical significance. In this context, the specifics of the metropolis, with its developed medical structure, both emergency and hospital, and outpatient, are extremely interesting. The present study is devoted to identifying differences in the dynamics of acute and chronic forms of circulatory diseases during stable and crisis periods in a metropolis. It demonstrated that the contribution of acute conditions to both mortality from coronary heart disease and CVB, as well as losses from diseases of the circulatory system in general, decreased significantly in the population of Moscow during the study period, which certainly indicates positive changes in mortality. Similar processes were observed in Russia, but in Moscow the proportion of acute conditions was lower than the national one.

THE RESULTS OF THE COURSE ON MASTERING THE ANALYSIS OF INDICATORS OF FUTURE SPECIALISTS IN THE FORMATION OF A HEALTHY LIFESTYLE ((WHOQOL-BREF) KAZ)

It is stated that the relevance of the problem studied in this article depends on the result of the course designed to master the analysis of the indicators of future specialists in the formation of QOL ((WHOQOL-BREF) KAZ). According to the WHO, the countries of the world that followed a healthy lifestyle reached 86.9 years of life, 81.5 years for men, and 84.3 years on average. On the contrary, the death rate in the Republic of Kazakhstan in recent years was 29%, 6.77 per 1000 inhabitants. Mortality from diseases of the circulatory system was -32.7%, from cancer -7.9%, from injuries -5.3%.Due to these conditions, as a result of recent measures taken in the country, by 2025, the share of citizens living a healthy lifestyle will increase to 40%, life expectancy will increase to 75 years, non-infectious diseases will decrease to 7%, and medical rehabilitation services will increase to 75%. coverage is expected.It can be noted that the average life expectancy of people in our country is behind that of many countries in the world, and this situation needs to be studied fundamentally and applied in the economic, social and humanitarian direction in the Republic of Kazakhstan. It is necessary to find a solution to the problems of understanding the tasks of protecting the health, strengthening the body, and increasing the responsibility for improving and strengthening the health of the population. During the analysis of the results of the training program of the course, its goals and objectives are to improve the introduction and use of the KAZZ scale (WHOQOL-BREF) in the field of sports for students of higher educational institutions of the country and to form a model of the education system and the formation of a healthy lifestyle. to increase the competitiveness of teachers; to provide teachers with the necessary knowledge and methodological skills for effective formation of a healthy lifestyle among students; aimed at forming a model of healthy lifestyle formation among teachers and students of higher educational institutions of the country.

Povezanost med vročinskimi valovi in obiski na Internistični prvi pomoči Univerzitetnega kliničnega centra Ljubljana v obdobju 2013–2017

Background: Heatwaves have a severe impact on the number of deaths and emergency department visits, making them the most hazardous natural disaster due to climate change in many regions of the world. Our aim was to assess the short-term association between emergency department visits and heat waves from 2013 to 2017 to see whether any difference in the number of visits occurred at the Emergency Department in Ljubljana University Medical Centre during that period. Methods: The design of our study is a retrospective cross-sectional epidemiologic study. We estimated relative risks (RR) for a number of ED visits during heatwave days and reference period days for the observed diagnoses (all causes, diseases of the circulatory system, respiratory system, endocrine diseases, diseases of the digestive system and genitourinary diseases) sex, and age (from 19 to 74 years old, 75 years old and older), as well as 99.6% confidence intervals (CI) and excess ED visits in percent (%) associated with heatwaves occurring in the years from 2014 to 2017. Data were analyzed for the patients arriving at the Emergency Department of the Ljubljana University Medical Centre during summer time, from May to September. The region covers around 550,000 people and is considered an urban and rural area. Results: The results of our study showed that there was no statistically significant increase in number of ED visits during heatwaves for all causes in all observed years. We noticed even statistically significant protective phenomena between heatwaves and the number of ED visits. These happened in the years 2015 and 2017 for both sexes and circulatory system diseases, in 2016 for men, circulatory system diseases, and in 2015 for respiratory system diseases. We showed a statistically significant association between heatwaves and the number of visits in the ED for endocrine diseases in 2013. Conclusion: Despite the increased heat load in the last observed years, the number of ED visits in Ljubljana has remained stable or even decreased. Further studies on how each intervention affects the behavior of the observed population are needed to clarify whether public health measures and inter-sectoral cooperation impact the number of ED visits.

Analysis of the mass survey data reliability (using the example of smoking prevalence in Russia estimates)

Survey-based estimates of smoking prevalence in Russia, given by various quite respectable organizations for the same period, range from less than 20% to more than 50%. This scatter cannot be explained by differences in the conceptualization of the indicator (who is considered a smoker) and significantly affects the overall picture of smoking in Russia and the assessment of the success of anti-tobacco policy. This raises questions about the reliability of the relevant survey data. It can be solved in at least two ways: by analyzing and eliminating discrepancy factors or by choosing one of the studies as a reference with a thorough check of the reliability of its data. The article substantiates the choice of the second path and the Russia Longitudinal Monitoring Survey (RLMS) as a reference. To check its reliability, three criteria were used: analysis of critical publications about research errors, methodological triangulation (comparison with data from other methods) and analysis of correlation with the consequences of smoking. All three criteria showed a high level of reliability of the RLMS data. The hypothesis about the research error put forward in critical publications does not find empirical confirmation. Comparison with other supposedly reliable data (both survey and non-survey) shows discrepancies below the margin of statistical error. The correlation of RLMS data on smoking with mortality from diseases of the circulatory system turns out to be extremely high. Therefore, it is advisable to consider the RLMS as a reference source of data on the prevalence of smoking in Russia, and indicators from other surveys that differ significantly from it as potentially questionable in their methodological decisions.

Assessment of modifiable risk factors and vascular wall stiffness in young people

Objective: to study the characteristics of vascular stiffness in young people, taking into account the presence of the main modifiable risk factors (FR) for the development of cardiovascular diseases (CVD). Materials and methods: a survey was conducted of 38 practically healthy young people (18 boys, 20 girls) — university students, whose average age was 19.8±1.45 years. By filling in the modified diagnostic charts, the subjects assessed the presence of the main behavioral CVD disorders. Volumetric sphygmography on the VaSera-1000 device (Fukuda Denschi, Japan) was used to assess the stiffness of the main vessels and blood pressure (BP) levels in the basins of the upper and lower extremities. Results: in the examined individuals, despite their young age and the documented absence of cardio-vascular pathology, all the main cardiovascular diseases were revealed: an increased body mass index (BMI≥25 kg/m2), smoking, psychosocial factors, sedentary lifestyle, unbalanced diet, alcohol consumption, which were present in various combinations. Vascular stiffness indices — the cardio-ankle index and the biological age of the vessels — were within the normal range, while the ankle-shoulder index was reduced in 24% of the students. Conclusion: the results obtained indicate the need for primary prevention of CVD by lifestyle modification, even in young people, since the FR detected in them and the tendency to change vascular stiffness indicators can subsequently act as triggers for the early onset of diseases of the circulatory system

Determinants of the morbidity of the rural population in Russia during the COVID-19 pandemic: a regional aspect

MATERIAL AND METHODS: Data from the Federal State Statistics Service, as well as statistical materials from the digest “Rural Healthcare in Russia in 2021”, provided by the Federal State Budgetary Institution “Russian Research Institute of Health” of the Russian Ministry of Health were the main sources of information for this study. Analytical procedures included Pearson correlation analysis, factor analysis (principal component method), hierarchical cluster analysis, multiple linear regression with backward elimination method for selecting variables. RESULTS: Six typological groups of regions of the Russian Federation were identified based on the variations in the morbidity rates of the rural population across certain classes of diseases including infectious and parasitic diseases, neoplasms, diseases of the circulatory system, diseases of the respiratory system, digestive system, and external causes. It has been established that there was a differentiation in the regions of Russia in terms of factors influencing the morbidity rate of the rural population by the main classes of diseases during the COVID-19 pandemic in 2021. Healthcare system, medical and social factors had the greatest impact on the overall morbidity in the regions of the fourth and fifth classification groups, on the detection of some infectious and parasitic diseases in the regions of the second, fifth and sixth groups, and respiratory and digestive diseases in the third classification group. The housing quality in the regions of almost all groups was one of the most significant social factors. Economic conditions had a significant impact on the incidence of infectious and parasitic diseases in the regions of the third and sixth groups, as well as on the level of injuries and some consequences of external causes in the regions of the first and third groups. Environmental factors were significant determinants of morbidity in the regions of the fifth group. At the same time, regression analysis showed associations between selected factors for all classification groups of regions for some infectious and parasitic diseases. The smallest number of models has been defined for the incidence of neoplasms and circulatory organs. CONCLUSION: Contribution of socioeconomic, demographic, environmental and natural factors to rural public health should guide the development of policies aimed at development of rural healthcare taking into account regional characteristics.

Качество атмосферного воздуха и риск развития болезней системы кровообращения у населения крупного города европейского севера

Cardiovascular diseases are the most frequent causes of premature mortality associated with ambient air quality. In the Arkhangelsk region, population mortality caused by diseases of the circulatory system is higher than the national average. The aim of this study was to assess ambient air quality in Arkhangelsk and associated health harm in adult population. The study relied on using data of ambient air monitoring in Arkhangelsk collected over 2011–2022. We analyzed average annual levels of 23 pollutants and primary incidence of diseases of the circulatory system (CVD) and calculated hazard quotients under chronic inhalation exposure (HQ), hazard index (HI) for the cardiovascular system, and the number of attributable deaths associated with exposure to PM10 and PM2.5. Over the analyzed period, the average long-term concentrations of most pollutants met hygienic standards. Average levels of formaldehyde, chromium, copper and benzene were found to exceed the MPL by 1.5–2.3 times. Hazard coefficients for formaldehyde (HQ = 2.3), copper (HQ = 1.8) and PM2.5 (HQ = 1.7) were established to be above their permissible value. The risk of developing general toxic effects is determined to be high (HI = 6.6) for the cardiovascular system. The main contribution to the risk level is made by copper and PM2.5. Attributable outcomes of primary cardiovascular incidence among the adult population of Arkhangelsk associated with exposure to PM10 and PM2.5 equaled 10.7 and 2.9 ‰ cases per year. The greatest harm under exposure to PM2.5 is due to the development of coronary artery disease and amounts to 1.9 ‰ cases per year.

Ambient air quality and risk of circulatory diseases for population of a large city in the European north of Russia

Cardiovascular diseases are the most frequent causes of premature mortality associated with ambient air quality. In the Arkhangelsk region, population mortality caused by diseases of the circulatory system is higher than the national average. The aim of this study was to assess ambient air quality in Arkhangelsk and associated health harm in adult population. The study relied on using data of ambient air monitoring in Arkhangelsk collected over 2011–2022. We analyzed average annual levels of 23 pollutants and primary incidence of diseases of the circulatory system (CVD) and calculated hazard quotients under chronic inhalation exposure (HQ), hazard index (HI) for the cardiovascular system, and the number of attributable deaths associated with exposure to PM10 and PM2.5. Over the analyzed period, the average long-term concentrations of most pollutants met hygienic standards. Average levels of formaldehyde, chromium, copper and benzene were found to exceed the MPL by 1.5–2.3 times. Hazard coefficients for formaldehyde (HQ = 2.3), copper (HQ = 1.8) and PM2.5 (HQ = 1.7) were established to be above their permissible value. The risk of developing general toxic effects is determined to be high (HI = 6.6) for the cardiovascular system. The main contribution to the risk level is made by copper and PM2.5. Attributable outcomes of primary cardiovascular incidence among the adult population of Arkhangelsk associated with exposure to PM10 and PM2.5 equaled 10.7 and 2.9 ‰ cases per year. The greatest harm under exposure to PM2.5 is due to the development of coronary artery disease and amounts to 1.9 ‰ cases per year.

Asbestos exposure and asbestosis mortality in Italian cement-asbestos cohorts: Dose-response relationship and the role of competing death causes.

In Italy, asbestos was used intensively until its ban in 1992, which was extended for asbestos cement factories until 1994. The aim of this study was to evaluate the dose-response between asbestos exposure and asbestosis mortality across a pool of Italian occupational cohorts, taking into account the presence of competing risks. Cohorts were followed for vital status and the cause of death was ascertained by a linkage with mortality registers. Cause-specific (CS) Cox-regression models were used to evaluate the dose-exposure relationship between asbestosis mortality and the time-dependent cumulative exposure index (CEI) to asbestos. Fine and Gray regression models were computed to assess the effect of competing risks of death. The cohort included 12,963 asbestos cement workers. During the follow-up period (1960-2012), of a total of 6961 deaths, we observed 416 deaths attributed to asbestosis, 879 to lung cancer, 400 to primary pleural cancer, 135 to peritoneal cancer, and 1825 to diseases of the circulatory system. The CS model showed a strong association between CEI and asbestosis mortality. Dose-response models estimated an increasing trend in mortality even below a CEI of 25 ff/mL-years. Lung cancer and circulatory diseases were the main competing causes of death. Asbestos exposure among Italian asbestos-cement workers has led to a very high number of deaths from asbestosis and asbestos-related diseases. The increasing risk trend associated with excess deaths, even at low exposure levels, suggests that the proposed limit values would not have been adequate to prevent disability and mortality from asbestosis.