RESUMEN
Background@#Air pollution has been increasing intensively during last decade in big cities of Mongolia especially in Ulaanbaatar due to urbanization, poor urban plan, migration from rural areas to urban areas, poverty, unemployment, economic crises, exercise with unclean technology mainly coal for heating and cooking, raise of number of motor vehicle and other air pollution sources; as result of this phenomena population health has been worsening. The Global burden of disease concept, first published in 1996, constituted the most comprehensive and consistent set of estimates of mortality and morbidity and WHO now regularly develops GBD estimates at regional and global level. The goal of this study is to define DALY of air pollution related diseases in Ulaanbaatar. @*Materials and Methods@#This is retrospective study which used air pollution and mortality secondary data 2008-2017. The DALY extends the concept of potential years of life lost due to premature death (YLL) to include equivalent years of ‘healthy’ life lost by virtue of being in states other than good health. DALYs for a disease or health condition are calculated as the sum of the years of life lost due to premature mortality (YLL) in the population and the equivalent ‘healthy’ years lost due to disability (YLD) for incident cases of the health condition. We used WHO recommended estimation methodology and selected 2 disease category of mortality of each RSD (pneumonia, COPD) and CVD (ischemic heart disease, cerebrovascular disease).@*Results@#According to the age group, most of children 0-4 due to RSD and most of adults were died due to CVD. In general, hospitalization is increasing year by year and differing by season. Significant associations were found for all air pollutants such as PM10, PM2.5, CO, SO<sub>2</sub>, and O<sub>3</sub> had a statistically significant association with cold season’s mortality of RSD and CVD. The most common mortality cases were ischemic heart disease, cerebrovascular disease, pneumonia and COPD. In Ulaanbaatar in 2008-2017, 2205 people were died due to RSD and CVD. Hospital admission and mortality has an increasing trend. @*Conclusion@#Residents of Ulaanbaatar were lost in total 249854 years due to pneumonia, COPD, ischemic heart disease, and cerebrovascular disease during 2008-2017. The most vulnerable group of people on air pollution was children and elders of Ulaanbaatar city.
RESUMEN
Pacientes com lesão medular reconhecidamente desenvolvem muitas adaptações sistêmicas. Condições, como fraqueza da musculatura respiratória, paralisia e alterações na função pulmonar e conseqüentemente o aumento do índice de doenças pulmonares, são observadas. Recentemente, o aumento de doenças cardiovasculares também tem ocorrido entre esses pacientes, além das complicações provenientes da osteoporose que já são bem conhecidas. O objetivo deste trabalho foi avaliar as alterações do sistema cardiorrespiratório e esquelético de pacientes com lesão medular em 4 estudos. O estudo 1 avaliou a variabilidade da frequência cardíaca na posição supina e sentada e arritmia sinusal respiratória (ASR) de 37 homens com e sem lesão medular. Os pacientes tetraplégicos apresentaram uma redução dos valores máximos da frequência cardíaca durante ASR. O estudo 2 avaliou a função pulmonar de 23 pacientes com tetraplegia. Os valores de capacidade vital forçada, volume expiratório forçado 1s e ventilação voluntária máxima mostraram que a capacidade pulmonar dos pacientes com lesão medular foi reduzida. O estudo 3 propôs a adaptação do teste de caminhada de 6 minutos para 9 pacientes com paraplegia completa auxiliados por marcha artificial com eletroestimulação neuromuscular e andador. O estudo 4 investigou a densidade mineral óssea e fatores de risco cardiovascular de 44 homens com e sem lesão medular. Os pacientes com lesão medular apresentaram osteoporose e/ou osteopenia e o espessamento da camada íntima-média da carótida, porém os valores do lipidograma e triglicérides foram dentro da faixa de normalidade. A pressão arterial foi menor nos pacientes tetraplégicos. Análise estatística: Os dados foram apresentados em mediana (intervalo interquartil) e/ou média (±DP) e em Box-plot. Diferenças entre grupos foram demonstradas pelo intervalo de confiança da mediana, nível de significância em 5% ou teste t pareado...
It is known that individuals with Spinal Cord Injury (SCI) present systemic adaptation. SCI causes respiratory muscle weakness, paralysis and abnormal pulmonary function. Cardiovascular disease is also increased in spinal cord injured subjects and osteoporosis as well. The aim of this study was to assess cardio respiratory and bone diseases in subjects with SCI. Four studies were performed. The first study assessed heart rate variability in supine and seated position and respiratory sinus arrhythmia (RSA) maneuver in 37 subjects with and without SCI. Tetraplegic subjects showed the lowest values of maximal heart rate during RSA. The second study assessed pulmonary function in 23 tetraplegic subjects. Forced vital capacity, maximal voluntary ventilation, forced expired volume showed that the SCI subjects pulmonary capacity was reduced when compared with able body subjects. The third study adapted the 6 minutes walk test to assess complete patients with SCI during gait therapy. The fourth study investigated the clinical presence of osteoporosis and cardiovascular risk factors in 44 subjects with and without SCI. Subjects showed osteoporosis or osteopenia and increased intima-media thickness, although lipids and triglycerides were with normal ranges. Blood pressure in tetraplegic subjects was lower than in paraplegic and control groups. Statistical Analysis: Data are expressed as median (interquartile interval) and presented in box-plot (median, 1st and 3rd quartiles, minimum and maximum). Differences between groups were demonstrated by confidence interval of median, significance level set at á = 0.05, or mean (±SD) and paired t test...