Epidemiological aspects of morbidity in the class of digestive organs in Kazakhstan.

AIM: To study epidemiological aspects of disease, class of diseases of the digestive system in the region of the relative risk in Kazakhstan. MATERIALS AND METHODS: Studied epidemiological parameters are first identified in the incidence and prevalence of class XI ICD in regions of Kazakhstan with the identification of risk relative to the average national level. In a dysfunctional region Kyzylorda region analyzed the performance of its regions and compared with data from medical examination of the population and the survey. RESULTS: A significant excess of the average national incidence rate between 1990 and 2015, was noted for 3 of the 14 regions of Kazakhstan (West-Kazakhstan, Kyzylorda, Mangystau). According to the dynamics of the unfavorable situation on the high level of incidence currently is in the Kyzylorda region (COA). From the areas of the COA maximum, the incidence of diseases of the digestive system registered in Kazalinsk district which exceeded the level at RK 4.8 times. The data on examination and survey of the complaints of the population exceeded the epidemiological indicators. In the area identified as the leading neoplasms of the digestive system in the structure of cancer incidence and exceeded the national average on the related class of blood diseases. Unfavorable situation on the incidence of the digestive system in Kyzylorda region of Kazakhstan is associated with the cancer and blood diseases, this is partly due to the presence of pollutants in the environment.

The overweight: obesity and plasma lipids in adults with intellectual disability and mental illness.

BACKGROUND: Previous studies in adults with intellectual disabilities (ID) have reported a higher prevalence of obesity than in the general population, and a trend to an increase in the prevalence of excess weight. However, little information is available on body weight status and lipids levels of adults with ID and co-existing mental illness. The aim of this study was to address this information gap, by conducting a stepwise multiple regression analysis to predict BMI, thereby allowing the investigation of (semi-)partial correlations, which assess the extent to which a particular predictor variable is associated with BMI over and above the other predictors. METHODS: A study of the patients with ID and psychiatric illness registered in the service. Collected data included body mass index (BMI), age, gender, the presence of additional physical conditions, residential status, mental illness and use the psychotropic medication. We analysed the lipid profile including serum cholesterol together with low-density lipoprotein, high-density lipoprotein (HDL), triglycerides and the serum cholesterol/HDL ratio. Data for these variables were entered into a stepwise multiple linear regression to predict BMI. RESULTS: 28% of the participants were overweight and 41% obese. Most of the obese patients were men with mild ID (P = 0.039). Level of ID (P = 0.003), gender (P = 0.001) and serum triglycerides (P = 0.026) had significant predictive value in the regression model. There were no significant differences in either the mean serum cholesterol levels or the mean triglyceride levels between those taking and those not taking first-generation antipsychotics, second-generation antipsychotics or anti-epileptic medication. CONCLUSIONS: The rate of obesity in our sample was higher than in previous studies. The most predictive combination of predictors to predict BMI was ID level, gender and serum triglyceride levels. Serum triglyceride and cholesterol levels did not appear to be unduly affected by first- or second-generation antipsychotic medication or by antiepileptic medication.

[Effect of aortic clamping on hemodynamics at reconstruction of the thoracoabdominal aorta]. / Vliianie perezhatiia aorty na gemodinamiku pri rekonstruktsii grudnoi i briushnoi aorty.

This paper describes an experience with monitoring and computerized follow up of the hemodynamic status in 60 patients at and right after reconstruction of the thoracoabdominal aorta. In addition to the routine control, measurements were made of the pressure in the large vessels and cavities of the heart, duration of each heart contraction and CI. The following parameters were computed automatically: the status of the ventricles for each heart contraction, resistance of the greater end pulmonary circulation, elasticity of the arterial, venous, pulmonary arterial and pulmonary venous reservoirs, also for each cardiac cycle. At the generally accepted monitoring the hemodynamic responses to the surgeon's manipulations on the aorta appear smoothed or are not visualized at all. The control of each heart contraction reveals the responses to application of the clamp and its removal from the aorta, with their hemodynamic significance being not questionable. Aortic clamping and clamp removal from the aorta are associated with the generalized response of the regulatory systems of the body. The slow and thoroughly controlled aortic clamping and graded, controlled blood flow restoration due to clamp removal as well as the use of sodium nitroprusside (trimetafan or isofluran are preferable) allow to avoid an abrupt stroke load of the left ventricle of the heart and, respectively, the generalized response of the regulatory systems of the body.

[New system for diagnosing acute circulatory disorders and assessing drug choice and dosage]. / Novaia sistema postroeniia diagnoza ostrykh rasstroistv krovoobrashcheniia i otsenki podbora i dozirovki lekarstvennykh preparatov.

The assessment of the status of a patient and diagnosis are first made strictly algorithmically. At the same time the procedure is monitored by a physician in terms of his experience and knowledge. The dialogue is made on the basis of a model and images which reflect the pattern of blood circulation. The diagnosis is made by isolating the key pathophysiological link and interpreting it by means of a clinico-mathematical classification. The usual wording based on the evaluation of the severity and stage of a pathological process is supplemented with assessments of compensatory, protective, and other adaptive changes which greatly influence the choice of a therapy. The action of drugs is evaluated by their cumulative effects on the changes in physiological functions determining their properties, direction and magnitude of alterations of the weakest link. The clinical experience has shown that the procedure is beneficial for rapid detection of clinically significant changes, choice and assessment of therapeutical efforts just during an operation and in the early postoperative period.