Vol 61, No 3 (2017)

To analyze functioning of health care systems in the European countries, a new listing of preventable causes of death was developed, ignoring impact of policy of population health protection. The following question is arising: does proximity of rates of more than ten-year decreasing of preventable and non-preventable mortality in Russia is conditioned by occurred necessity of adjustment of listing of preventable causes? The study was carried out to investigate applicability of the new listing of preventable causes for analyzing mortality of population of Russia. The comparative analysis was applied to dynamics of preventable mortality evaluated according two listings for Russia and EU countries up to May 2004 (Holland W., 1997; Nolte E., McKee M., 2004). In both listings the causes were assorted in three levels of mortality prevention. The information of European mortality database WHO/Europe was used. The analysis concerned males and females aged from 25 to 64 years during 1999-2013. The results of analysis of dynamics of preventable mortality in the EU counties substantially depend on listing of preventable causes whereas in Russia this dependency is observed only during analysis of female mortality. For the EU countries it is inexpediently to consider causes depending on primarily prevention of diseases as related to controllable mortality. However, in Russia these causes have a crucial impact on level and dynamics of mortality. So, in Russia the old listing of preventable causes continues to be actual and the new listing can be applied only as additional source of information to results of evaluation of functioning of health care system developed on the basis of the old listing.

The bronchial asthma is one of the most widespread multi-factorial diseases developing in interaction of environmental and genetic factors. The purpose of this study was to analyze association of polymorphism of gene TNFA with risk of development of bronchial asthma considering clinical form of disease. The polymerase chain reaction technique was applied to analyze polymorphic locus rs1800629 of gene TNFA in patients with bronchial asthma (n=133) and control group (n=195). The analysis of rate of polymorphism of gene TNFA established reliable increasing of rate of allele A in group of patients with bronchial asthma as compared with control sample. According the coefficient of chances ratio, the risk of development of bronchial asthma if there is allele A of polymorphic locus rs1800629 of gene TNFA increases more than twice (OR=2,53; 95% CI 1,45-4,43). At that, various firms of bronchial asthma have specific features in distribution of rates of genotypes of polymorphic locus rs1800629 of gene TNFA. It is demonstrated that among agents of genotypes GA of polymorphic modification of rs1800629 of gene TNFA patients with mixed form of bronchial asthma were found more frequently than among agents of genotypes GG. The obtained results provide ground to suppose that polymorphic modification of rs1800629 of gene TNFA shows certain damaging effect under various clinical forms of bronchial asthma.

The retrospective epidemiological study was carried out concerning infections related to medical care support registered in population on the territory of the Republic of Tatarstan in 2002-2015. The reason of such a study was because of late identification and registration of infections related to medical care support, significant damage to population health, development of complications in significant percentage of hospitalized patients and necessity of investigation of patterns of development and outspread of nosocomial infections. The epidemiological analysis was implemented using report form of the Federal statistical observation № 2 of the Federal service of control of sector of defense of rights of consumers and human well-being “The data of infectious and parasitic infections”. The dynamics, structure of many years morbidity and main parameters of manifestation of epidemic process were investigated. The derived data was used as a basis to provide epidemiological characteristic of many years' dynamics of various classes of infections related to medical care support. The indices of morbidity are calculated with consideration for average annual population size. The priority nosologic forms of infections related to medical care support were established concerning newborns (pyodermatitis, conjunctivitis, pneumonia, omphalitis, sepsis, etc.), puerpera (pyo-septic infections, mastitis, sepsis), adult population (postoperative and post-injection complications, infections of urinary tracts, nosocomial pneumonia, viral hepatitis, etc.) which dynamics was characterized by positive and negative rate of increment of indicator. The obtained data was compared with indices represented in national and foreign publications. The implemented study testifies the necessity of development of measures epidemiological monitoring of decreasing of morbidity because of infections related to medical care support in medical organizations.

The features of factual nutrition, indices of metabolism processes, immunity condition and adaptation potential of organism of adolescents of the Far North and middle zone of the Russian Federation are examined. The regional features of immunologic and biochemical indices of schoolchildren health condition. The analysis of correlation relationship between clinical laboratory indices of metabolism processes, immunity and antioxidant status of schoolchildren testifies condition of adaptive tension, more intensively expressed in schoolchildren of the Far North.

The methods. The study was implemented within the framework of epidemiological study “The epidemiology of cardio-vascular diseases in the Russian Federation” (ESSE-RF). The analysis was applied to random sampling of male and female population aged from 25 to 64 years (1628 respondents in totality) residents of the Kemerovo region. The type of consumed alcoholic beverages, rate of consumption, average volume of alcohol consumed per one intake were analyzed. The genuine technique was applied to calculate annual volume of consumed alcohol and also to convert volumes of various types of alcoholic beverages in units of “safe” dosage of ethanol. The results. The most preferred alcoholic beverage are vodka (60.6%), beer (51.7%) and vine (52.2%). The males prefer vodka and beer, the females - vine. With increasing of age the consumption of beer decreases linearly from 74.3% in age group 25-34 years to 33.2% in age group 55-64 years. The preference of vodka is typical for individuals aged from 35 to 54 years (about 65%). The volume of consumption of alcohol reaches in average in sample 1.48 ± 2.07 of mean day dosage of ethanol. With age, volumes of consumed alcohol decrease from 2,17 ± 2,04 in younger age group to 0,75 ± 1,36 in elder age group. In females decreasing is linear and in males lenear too from age of 45 years. for females lower total volumes of consumed alcohol are more characteristic in comparison with the males. The alcohol is consumed basically in “rarely/little” (59,3%) and “often/little” (21,1%) degrees. The females predominantly consume alcohol “rarely/little” (77,4%). With age, increasing is noted of percentage of consuming “rarely/little” from 44.2% among individuals of 33-44 years old to 72.5% in age group 55-64 years. Among social economic indices, positive effect on decreasing of consumption of alcohol render higher education, availability of family (males), lacking of work. The conclusion. The established patterns testify significant effect of gender and age on type, volume and rate of alcohol consumption. The social economic factors make much lesser contribution to volumes of consumed alcohol. for a number of social economic factors no effect is established.

The article analyses effect of the order of Minzdravsotsrazvitiya of Russia N 302n on dynamics of occupational incapacity seamen. This order significantly altered procedure of organization and implementation of periodical medical check-ups by eliminating superfluous barrier and from now on employer has no need in concurrence with Rospotrebnadzor agencies. The proposals emerge to revise this order and enhance administration considering that associating to results of special evaluation of labor conditions and only to unhealthy labor conditions provide no guarantees safety of health of working in acceptable conditions. The following indices of group health were analyzed (n=9331 sailors) in 2005-2010 and 2011-2016: pathological affection, primary morbidity, occupational incapacity and its causes. It is established that after the order N 302n came into force, a significant increasing of indices of pathological affection occurred with increment of 56.6% (p<0.0001) and primary morbidity with increment of 92.2% (p<0.0001). However, occupational incapacity of sailors remained unaltered and in its structure, prevail cardio-vascular diseases as before. Thereby, application of the order № 302n had no influence on indicator of occupational incapacity and revision of its provisions with purpose of increasing state administration seems inexpedient.

The article presents algorithm of interaction between physicians of adjacent specialties at detection of positive serological reactions in various hospital departments of medical organizations. The tactics of management of patients in case of diagnosis of syphilis are also considered.