Integral approach to the prevention of major chronic non-infectious diseases

The essence and the necessity of an integral approach to prevention of major chronic noncommunicable diseases (CNCD) is described proceeding from the example of the integral CNCD prevention programme in one of Moscow districts. The aims and basic directions of preventive activities are demonstrated along with possible ways of integrating medical services with various district nonmedical institutions. The findings of the sample study of the adult population (25-64 years) of the district are provided. The study has been carried out prior to the preventive activities and touched upon information supply of the population in relation to healthy mode of life, prevalence of major risk factors (arterial hypertension, smoking, excessive body weight, hypercholesterolemia) and some CNCD (IHD, chronic bronchitis, diabetes mellitus).     

Prognostic value of behavioral habits (smoking, alcohol use, physical exercise) in a male population aged 40-59 in Moscow

The prognostic significance of some behavioral habits was examined in an open male population aged 40 to 59 years in respect to mortality. The analysis has demonstrated that tobacco-smoking leads to an increase in the total mortality rate and in mortality from cardiovascular and cancer diseases. The total mortality in the population was on the whole 1.5 times higher as a result of frequent alcohol use, mainly at the expense of the mortality growth because of other reasons (traumas, accidents). The work characteristics being the same, the total mortality from cardiovascular diseases and other reasons appeared significantly less in persons who were physically active in their leisure time as compared to those who were inactive. The analysis has also shown that studies into behavioral habits made by questionnaires in patients suffering from coronary heart disease should be performed in combination with other measures. At the same time the use of the questionnaire allowing the assessment of physical activity is advisable only in persons without coronary heart disease.     

Prevention of major cardiovascular diseases

The priority trend in the activity of health service is prevention of the principal noncontagious diseases, cardiovascular diseases being a major part among them. The foundation of the All-Union Cardiology Research Centre of the Academy of Medical Sciences of the USSR and of Cardiology Institutes in the Union Republics has contributed significantly to studies of the prevalence of cardiovascular diseases, in the population of various regions of the country, and to development of organizational forms of mass prophylaxis. Organization of a unified cardiology service in the country has formed the basis for introduction of the research data to public health practice.     

Chondroid syringoma (borderline type)

An overall morphologic evaluation of a case of facial skin chondroid syringoma (CS) provided evidence for CS classification as borderline. Histologically, CS showed signs of cellular elements polymorphism, contained structures typical for CS whereas electron-microscopically there were two types of cells: epithelial and myoepithelial.     

The use of drugs for the inhibition of prostaglandin or leukotriene synthesis from arachidonic acid is theoretically hazardous

It would appear that it has become almost common practice to regard arachidonic acid (AA) as the sole precursor of eicosanoids. The fact that both dihomogamma-linolenic acid (DGLA) and eicosapentaenoic acid (EPA) give rise to distinct families of eicosanoids is commonly almost completely ignored. Elevated tissue levels of AA eicosanoids have been found in and have been implicated in the etiology of a number of diseases. Drugs which selectively block AA mobilization or its eicosanoid metabolism have therefore been developed for therapeutic use in these conditions. The fact that such drugs will also simultaneously block the eicosanoid metabolism from DGLA as well as from EPA is also commonly ignored. It is suggested that the profoundly adverse side-effects displayed by some of these drugs, resulting in some instances in their withdrawal from use, could be the direct result of their concomitant action of interfering with the eicosanoid metabolism of DGLA and EPA. It is further suggested that, before the interactions between the eicosanoids derived from AA and those derived from DGLA and EPA are understood, the use of drugs for the manipulation of AA eicosanoid metabolism in isolation, could be hazardous. This implies that all such drugs currently in use are to be regarded as experimental and provisionally toxic in terms of their effects on the whole system of eicosanoid metabolism. Thus even drugs which have been passed by the FDA and similar Drug Control Councils require total re-evaluation especially in view of the fact that the non-steroidal anti-inflammatory drugs are often prescribed for chronic conditions which require therapy for several years.(ABSTRACT TRUNCATED AT 250 WORDS)     

The role of tissue myocardial dopplerechocardiography in early detection of structural-functional changes in the myocardium of patients with mild and moderate arterial hypertension

AIM: To study structural and functional changes in left ventricular myocardium (LVM) of patients with mild and moderate arterial hypertension (AH) with application of tissue myocardial dopplerechocardiography (TMD), correlation between these changes and parameters of electrophysiological remodeling and circadian profile of blood pressure. MATERIAL AND METHODS: Forty-give hypertensive patients were divided into two groups: the study group 2A consisted of 28 patients with mild AH (144.2 +/- 5.8/89.4 +/- 6.6 mm Hg), group 2B - of 17 patients with moderate AH (160.5 +/- 9.1/101.3 +/- 10.2 mm Hg). The control group consisted of 10 normotensive subjects. All the patients were examined using standard echocardiography with assessment of transmitral blood flow, tissue doppler investigation, circadian monitoring of blood pressure, electro-, vector- and decartocardiography. RESULTS: No significant differences in standard doppler, electro- and vectorcardiographic parameters between the patients with mild and moderate hypertension were found. LVM mass index and LV wall relative thickness significantly increased both in 2A and 2B groups vs controls (p < 0.05). Most patients of group 2A and 50% patients of group 2B had no alterations in LV geometry. Lower blood pressure was associated with LV concentric remodeling, higher - with concentric and excentric hypertrophy. In the presence of LV remodeling hypertensive patients developed more pronounced disorders of diastolic function according to TMD compared to hypertensive patients with normal LV geometry (p < 0.05). TMD detected LV diastolic disorders in 82% patients of group 2A and in 94% - of group 2B, while transmitral doppler study detected diastolic dysfunction only in 14 and 29% patients, respectively. A significant difference by Em/Am was registered between patients with mild and moderate AH only in the area of the mitral ring at the side of LV posterior wall (p < 0.05). CONCLUSION: TMD is able to detect earleast structural-functional myocardial changes in hypertensive patients and to determine significant differences in LV diastolic disorders in patients with mild and moderate AH. No significant differences in LVM mass, standard doppler, electro- and vector-cardiographic parameters were found between AH patients' groups.     

Apnoea induced by airflow obstruction

Total obstruction of the airways caused all respiratory efforts to stop on 15 occasions in 10 preterm babies. This was not seen in 60 studies on 38 term babies. These findings suggest that failure to achieve an oral airway may not be the only mechanism by which upper airway obstruction might cause the cot death syndrome.     

Electrocardiographic picture in patients with congenital defect of atrial septum operated upon in adult age

Electrocardiograms from 30 patients with congenital atrial septal defect operated upon in adult age were analyzed. One of frequent variants of QRS configuration in standard leads was SIqIII type. It was observed in 50% of patients. Most frequent (in 67% of patients) variants of QRS configuration in lead V1 were rSr' and rSR'. Signs of right ventricular hypertrophy were most often found in a group of patients with high pulmonary hypertension. Changes of terminal portion of ventricular complex such as negative or biphasic T waves were found in 29 of 30 patients (in 63% of cases these changes were localized in leads V1-V3).