EDITORIALS
The article devoted to the 40-anniversary of medical-prophylactic faculty of the Vladivostok State Medical University. The history of faculty is briefly covered; the role of its graduates and their contribution to development of university is marked. The review of scientific directions and publications is given. It is emphasized, that today the faculty is the center on teaching and re-training of medical-prophylactic experts in the territory of Far East Federal district.
LECTURES
Existing epidemiologic theories do not take into account an opportunity of integration-competitive mutual relations between microorganisms. Meanwhile the opportunity of mutual influence of microorganisms on each other in bio-systems is marked by microbiologists. That, in the author's opinion, should be reflected in the development of the epidemic process. On the example of the diseases caused by respiratory viruses and the (3-hemolytic streptococcus of group A the author proves the necessity of the integration approach to studying of the epidemiology of the infections having the similar primary specific localization and the transfer mechanism, and the concept revealing the mechanism of development of epidemic process is suggested.
Results of long-term researches of biologically active substances from hydrobionts of the Pacific Ocean, done in the institute of epidemiology and microbiology together with scientists of Pacific institute of bioorganic chemistry Far-Eastern branch of the Russian Academy of Science and Pacific research fishing center are presented. It's the brief review of works, devoted to the most active compounds (tinrostim, zosterin, translam, mitilan, fukoidan, salmon DNA) in which mechanisms of the action, creating preconditions for use of these substances as a basis for designing of medications and biologically active additives are explained.
REVIEWS
In structure of the food production supporting and improving the health, biologically active additives take the important place. Their market in Russia is estimated in $2.3 billion every year and grows on 17% annually. The review of the literature, laws and legislative acts regulating the market of biologically active additives in the Russian Federation is presented. The author emphasizes, that advertising of biologically active additives frequently does not correspond to their qualities that raises the responsibility of the physician, prescribing this or that additive as preventive or dietary medication.
The immunology efficiency of vaccines against tickborne encephalitis was described. On an example of the German vaccine «Encepur the Adult» the specificity of antibodies in vaccinated persons to a heterogeneous population of tick-borne encephalitis virus was shown. It was concluded possessed about the high immunologic activity of vaccine «Encepur Adult». This vaccine as a safety and effective specific preventive may be measure recommended in TBE endemic areas.
For an effective use of the results of the retrospective epidemiological analysis of morbidity the main value is played by the drawing up of the anti-epidemic problem plans and target programs. It is natural, that the plan should base on produced and accepted tactics of the anti-epidemic service of the population. Long time the anti-epidemic work was built on an orientation on «three links» of the epidemic process (on L.V. Gromashevskiy). In this article the classifications of factors of the epidemic process, determining morbidity, and also methodical approaches of the epidemiological analysis for their establishment are suggested. On the basis of it the classification of preventive measures for the basic planning is developed.
ORIGINAL RESEARCHES
Main objective of the operative controlling being one parts of the basic direction of development of a management system, is creation of such control system which that is helps effectively to reach the current purposes of the organisation, that is optimizes the cost-benefit ratio also. One of the basic methods of operative controlling is АВС analysis — a way of estimation and accounting of expenses, a way of definition and the account of expenses by kinds of activity of the organization. Modern management of drugs purchases in the health care system is based on formular system. АВС-analysis allows to receive a complete representation how the formular system works at all of its levels, starting from structural division and finishing by health care as a whole. The present work allows to give a recommendations on updating of the territorial formular, and is being a first step in a direction to development of the formular system functioning monitoring.
In the article the regional features of physical development and functional condition of teenagers of 10—17 years of Primorsky Krai are presented. 1900 teenagers of 1st and 2nd groups of health are surveyed. At an individual examination the high percent of children having low and lower than average, disharmonious and sharply disharmonious physical development is revealed. Decrease in functional respiratory parameters is marked. About 30% of teenagers have latent bronchial obstruction. The state of cardiovascular system did not reach definitive level by 17 years. The received materials about physical and functional condition testify the trophic insufficiency and increase in the period of activation of the catabolism.
The factors of persistency at 286 strains of enterobacteriaof8 kinds of Enterobacteriaceae, allocated from patients with mono- and mixt-forms of uro-genital infections are investigated. It is shown, that enterobacteria has a complex of mechanisms, overwhelming the basic resistance components in the organism and forming multicomponent immunodeficiency. It is judged, that at diagnostics of multi-etiologic uro-genital infections it is necessary to take into account the presence, character of the accompanying conditional — pathogenic enterobacteria.
In Primorsky Krai the true growth of the general oncological morbidity at both sexes on a background of decline in population is observed. Standardized parameters of oncological morbidity exceed similar for Russia in general, thus intensive factors are lower than average levels across the Russian Federation. In the case of the development of these epidemiological tendencies the general oncological morbidity of the population of Krai by 2010 can reach a level of 350 cases on 100 thousand population. Growth of number of aged people will lead to the fact that malignancies for a long time will be the major problem of public health of the region.
Results of a complex estimation of distribution of respiratory and urinary diseases in various bioclimatic zones of Primorsky Krai are presented. It is revealed, that on a level of diseases at childhood the factors of bioclimatic character had great influence. The parameters of teenagers' morbidity were nearer to an adult population, except the high level of respiratory morbidity that specifies immaturity of adaptation system of an organism. The level of morbidity among adults substantially depends on an ecological situation. Distribution of the ecology-related pathologies in each age was influenced with the complex of the biological factors.
The epidemiological situation on parasitic diseases in Primorsky Krai remains unsuccessful with the tendency of deterioration on some diseases. It is annually registered more than 9—10 thousand cases of helmint diseases by 10—12 helmints. The high level of the morbidity by contact is caused by quality of medical and anti-epidemic actions in community. Growth of the morbidity by natural helmints in the northern coastal areas is marked. Local trichinella cases are caused by the infected meat of wild animals. Carrying out of a complex of the organizational and practical actions directed on reduction of the helmints morbidity in Primorsky Krai is necessary.
Influence of industrial allergens on a background of high disease in a cold season is shown by diseases of bodies of breath, in a warm season is shown by diseases of a leather and an eye. Women is more often fall ill, who work in culinary and smoke shops. Men fall ill less often because of smaller time of contact to industrial allergens.
The data about pregnancies and deliveries of 428 women — medical workers are presented with the purpose of predicting of an opportunity of occupational disease. The correlation of fertility and occupation and the experience of work are revealed and that should be taken into account at formation of risk groups and prophylactic supervision.
The analysis of intestinal infections morbidity in Primorsky Krai in 2005 is presented. The presented material testifies the activation of the waterway of transfer of intestinal infections, virus diarrhea, necessities of strengthening of supervision of systems of drinking water supply and their modernization.
The review of materials of research of regional features of a chemical compound of drinking water in water pipes of Primorsky Krai for last 15 years is presented. Regional features of chemical compounds of the drinking water are described including the surplus of iron, silicon, manganese and deficiency of the basic biogenic elements. It is marked, that existing circuits of water-preparation do not allow to correct concentration of these substances that testifies the necessity of their modernization.
For drinking water of municipal water pipes of Vladivostok city which provides the most part of the water, priority parameters of pollution are microbiological, organic, pH, concentration of iron and manganese. During the seasonal deterioration the danger of drinking water in the epidemiology grows. Drinking water of a municipal water-pipe is very soft, ultra fresh, physiologically defective under the contents of biogenic macro- and microelements. As a primary preventive measure for elements deficiency it is recommended to use on buildings input of the systems of additional cleaning and correction of ionic structure of drinking water.
This paper presents a study of the regularities in dynamic spreading narcodependent in condition one of the most tense on this pathology region Far East — among the Primorsky Region population, relationship it with factors of vital activity of the person, including with ecological particularity of the ambience his residences.
The data on studying of the microcirculation of the uterus of rats in the regenerative period after noise-vibrating influence during laboratory and natural (onboard of ships) experiments are resulted. In both cases significant changes of morphologic parameters of the microcirculation especially in endometrium which lasted for not less than 60 days after the termination of noise-vibrating influence are revealed.
In Far East region the tendency of increases in pneumonias morbidity is marked. The examination of healthy young age persons has shown that carrying of some strains in a combination to risk factors causes available rises of pneumonias morbidity. Among the microorganisms streptococci (56.8%) were allocated more often, especially its pathogenic strains S. pneumoniae (29.1%) and S. pyogenes (24.1%), either in a monoculture, or in association.
In this work the results of complex research by information-analytical, epidemiological, hygienic, clinical, functional, laboratory and statistical methods are presented. The research has allowed proving and developing the system (program) of actions which provides the prevention of a respiratory pathology in military groups and provides the interdepartmental multilevel approach with participation of physicians, employees of military registration and enlistment offices, teachers, psychologists, parents.
The plasmida characteristic of S. enteritidis strains, allocated from 1320 patients with salmonellosis, caused by various plasmidovars in Vladivostok in 1995—2001 is investigated. The leading role of plasmidovar 38:1.4 MDa in adults and children morbidity is shown. There was not revealed any plasmidovar S. enteritidis, specifically infecting the certain group of the population. The children till 2 years much more often were involved in the epidemic process caused by all dominating plasmidovars S. enteritidis.
The analysis of the data of demography, morbidity and mortality at children of aborigine nationalities of Dolgano-Nenets area, Evenki area, Hunty-Minsiisk area, Koryak area, Republics of Tyva, Altai, Buryatiya and Khakassia for last ten years is presented. For the aborigine nationalities living in the North, the identical morphotype is determined. For aborigine nationalities of Siberia the morphotype is different from northern. Suggested recommendations of the physicians, administrators and scientists to solve the problems concerning preservation and development of health of children of aborigine nationalities are presented.
Hospital infections result in deterioration of the outcome for patients, increase duration of hospitalization and cost of treatment, reduce efficiency of antibacterial therapy. In work the complex epidemiological method was used. The structure of pathological conditions at patients is presented first of all by brain trauma (63.1%). P. aeruginosa, causing one third of all hospital pneumonias in ICU, plays also a predominating role in the etiology of this infection and at patients with brain trauma.
PUBLIC HEALTH ORGANIZATION
Primorsky Krai on results of last years is included into the list of unsuccessful territories of Russia on HIV; cumulative number HIV-registered on 01.01.2006 was 6277 cases. The percent of HIV-infected women of fertile age increases as well as the risk of perinatal infections. From the start of registration of HIV in Primorsky Krai 589 patients with AIDS in terminal stage have died. There are many problems, concerning prophylactic medical examination, lifelong specific therapy of such patients and preventive maintenance.
It's the information report about development of a priority scientific theme «Immunology of drug-dependence» on medical-prophylactic faculty of Vladivostok State Medical University. Preliminary results of realization of the scientific program are presented, the urgency of a problem is marked, the basic directions of the further work are planned.
The first experience of the Regional Mammology center in Vladivostok is presented. It is characterized by the increase of efficiency of diagnostics and treatment of breast diseases in conditions of the specialized medical institution.
MEDICAL HISTORY
Biographic article about A.M. Gusev — the first dean of the sanitary-hygienic (nowadays — medical-prophylactic) faculty of the Vladivostok State Medical University. The data on A.M. Gusev's scientific and public work are resulted; his role in development of medical school and public health services of region is emphasized.