Climatic and ecological risk factors of myocardial infarction in the Far North

Basing on analysis of 1383 hospitalizations because of myocardial infarction during 5 years the following climatic events were found to be associated with development of the disease: rapid changes of atmospheric pressure, temperature or humidity, and magnetic storms. Technogenic ecological factors such as levels of formaldehyde, phenol, nitrogen dioxide and carbon monoxide in atmospheric air were also related to frequency of hospitalizations due to myocardial infarction.     

Philosophic basis of the general pathology theory

The general human pathology is the theoretic basis of practical medicine. However the general theoretical comprehension of pathological process is in growing stage. The number of important problems remain unsolved. In this article a version of construction of the deductive theory of general pathology is presented. The principle of tissue adaptive regeneration is the optimal principle of general theory of pathology.     

Automated intensive care unit risk adjustment: results from a National Veterans Affairs study

CONTEXT: Comparison of outcome among intensive care units (ICUs) requires risk adjustment for differences in severity of illness and risk of death at admission to the ICU, historically obtained by costly chart review and manual data entry. OBJECTIVE: To accurately estimate patient risk of death in the ICU using data easily available in hospital electronic databases to permit automation. DESIGN AND SETTING: Cohort study to develop and validate a model to predict mortality at hospital discharge using multivariate logistic regression with a split derivation (17,731) and validation (11,646) sample formed from 29,377 consecutive first ICU admissions to medical, cardiac, and surgical ICUs in 17 Veterans' Health Administration hospitals between February 1996 and July 1997. MAIN OUTCOME MEASURES: Mortality at hospital discharge adjusted for age, laboratory data, diagnosis, source of ICU admission, and comorbid illness. RESULTS: The overall hospital death rate was 11.3%. In the validation sample, the model separated well between survivors and nonsurvivors (area under the receiver operating characteristic curve = 0.885). Examination of the observed vs. the predicted mortality across the range of mortality showed the model was well calibrated. CONCLUSIONS: Automation could broaden access to risk adjustment of ICU outcomes with only a small trade-off in discrimination. Broader use might promote valid evaluation of ICU outcomes, encouraging effective practices and improving ICU quality.     

Current medico-ecological aspects of internal diseases in the urbanized north

AIM: To define a complex action of extreme climatic and harmful environmental factors of present-day northern industrial city on the course of chronic visceral diseases. MATERIAL AND METHODS: Dynamics of exacerbations of basic therapeutic nosologies was studied basing on the data on 10,169 inpatients treated in therapeutic departments of Surgut hospitals (Khanty-Mansi District) in 1994-1998. In parallel, ambient air of the city was controlled for 3 main climatic and 6 technogenic hazards. The analysis was made by means of medicoecological mapping of residential zones. RESULTS: A common feature of chronic visceral diseases course was determined: maximum number of recurrences in February-March and October-November, minimum number--in July-August. There is a relationship between the recurrences and extreme climatic factors. An increase in the number of exacerbations may be related with suppression of nonspecific resistance of the northerners' organism in these seasons. Differential study of the decompensation rate of chronic noninfectious diseases in residential zones in dependence with the degree of technogenic pollution has shown that areas of the town with high hospitalization rates are exposed to high mean annual pollution with sulfur dioxide, vanadium pentoxide and carbon oxide. Areas with low morbidity had the best environment. CONCLUSION: A combined action of extreme climatic and environment factors of the North plays an essential role in decompensation of chronic diseases in the northerners. Dynamics of recurrent chronic noninfectious diseases may serve a sensitive marker of ecological safety of the region. Design and realization of recreation and rehabilitation measures in ecologically polluted areas of the town are effective for prevention of aggravated chronic visceral diseases.     

Health problems of the urbanized North (review)

Industrial development of northern areas has caused changes in sociosanitary working and living conditions of the population. The indices of public health have become an integral criterion for the environmental situation. A complex approach must be used for ecological and sanitary assessments of the environment. Technogenic stress has lead to the appearance of adverse environmental factors against which the human body has produced no adaptive mechanisms; they may contribute to the development of virtually all diseases. The specific features of the North do not allow the experience accumulated in other regions of the country to be mechanically extended there. To lower the environmental concentration of pollutants will be beneficial to human health.     

抗CD20单抗（Rituximab）作为B细胞淋巴瘤老龄患者初始治疗的新标准

背景侵袭性B细胞淋巴瘤是目前最常见的非霍奇金淋巴瘤类型,主要包括弥漫大B细胞淋巴瘤(DLBCL)和套细胞淋巴瘤(MCL)。超过60%的患者被诊断出B细胞淋巴瘤时年龄都在60岁以上。在过去的30年间,CHOP方案(环磷酰胺、多柔比星、长春新碱、泼尼松)是治疗DLBCL的金标准。年龄较轻的患者