[Occupational stress as a factor of left ventricular myocardial remodeling in people with normal arterial pressure].

The authors studied correlations between occupational stress, caused by high tension at work, and disturbances in 24-hour arterial pressure (AP), lipid level, and left ventricular (LM) myocardial remodeling in locomotive engineers with normal AP. Two hundred and five locomotive engineers with NAP (according to 2004 classification by Russian Scientific Society of Cardiologists) aged 20 to 45 years were included in this cross-sectional study; the subjects present a whole sample of the locomotive crew of Chelyabinsk railway station. The control group consisted of III persons working eight fixed working hours a day whose work was not associated with high tension (turners and metalworkers). The examination of the both groups included bifunctional 24-hour AP and ECG monitoring during the subjects'days off, Echo CG, measurement of blood lipids, and measurement of table salt sensitivity threshold. Also evaluated were the prevalence of horizontal and vertical family background of arterial hypertension, excessive body weight, hypokinesia, and smoking. The study demonstrated that the prevalence of the chief factors of chronic non-infectious diseases as well as the values of office and 24-hour systolic and diastolic arterial pressure (SAD; DAD) were the same in both groups. At the same time, the locomotive engineers with normal AP had unfavorable hemodynamic AP profile (24-hour SAD index (p = 0.008) was lower indicating insufficient SAD decrease at night; the speed of morning SAD and DAD increase was elevated 1.5 to 2 times; heart rate was higher as well) which can be considered signs of hypersympathicotonia. By comparison with the controls, the locomotive engineers had more pronounced morphofunctional changes in the left ventricular (LV), myocardium; LV mass was greater, and LV myocardial hypertrophy was more frequent in this group (17.9 and 1.8%, respectively). The data demonstrate the contribution of occupational stress-related non-hemodynamic factors to myocardial remodeling and atherogenic lipid shift in individuals whose occupational activity is connected with high tension.

[A case of primary hyperparathyroidism]. / Sluchai pervichnogo hiperparatireoza.

A case report of primary hyperparathyroidism with symptoms caused by hypercalcemia. Osteoporosis was detected only in thoracic spine. Test for parathormone provided a final diagnosis. The patient was treated surgically.

[Characteristics of urogenital and post-enterocolitis reactive arthritides]. / Kharakteristika urogenital'nogo i posténterokoliticheskogo variantov reaktivnykh artritov.

The immune status and profile of HLA antigens of loci A and B were evaluated in 159 patients with reactive arthritis. Reactive arthritis was caused by urogenital chlamydial infection in 64.2% of cases and by Shigella, Salmonella and Yersinia enterocolitica infection in 18.9% of cases. In patients with different etiology of the disease some variations in its course and outcome, immune status as well as in the HLA antigen profile were established that is indicative of genetic determination of the immune response character. The established specific variations in the immune and immunogenetic status of patients with reactive arthritis of different etiology may be used for improving diagnosis and treatment efficacy.

[Prospective trial of 40-59-year-old males with angina pectoris and essential hypertension (results of 30-35-year prospective studies)]. / Prospektivnoe nabliudenie za muzhchinami v vozraste 40-59 let, bol'nymi stenokardiei, voznikshei na fone gipertonicheskoi bolezni (itogi 30-35-letnikh prospektivnykh nabliudenii).

AIM: To investigate remote prognosis for patients with coronary heart disease and essential hypertension with consideration of the initial total serum cholesterol (TSC) level. MATERIALS AND METHODS: Throughout 30-35 years 103 male patients aged 40-59 years with angina pectoris and essential hypertension were examined (repeated evaluation of protein and lipid spectrum, normal resting and two-step exercise ECG). At the entry, the patients had no history of myocardial infarction (MI), cerebral thrombosis, heart failure, discirculatory encephalopathy. Causes of death were verified by the data of autopsy (70.3%) and registry office's records. Adequate data were obtained on 93 of 103 patients (90.3%). RESULTS: By the end of the trial 89 of 93 patients died. 78 (87.6%) of them died of MI or stroke. 44 deceased from the subgroup with low TSC level lived, on the average, 65.9 +/- 1.3 years, while 45 deceased from the subgroup with high TSC lived 67.9 +/- 1.4 years, i.e. 2 years longer. The worst life prognosis was for patients who developed cancer. They lived 60.5 +/- 5.1 years, i.e. 7.5 years less than the rest of the deceased. In the subgroup with low TSC level there were 5 times more deceased due to cancer than in the subgroup with high TSC level. CONCLUSION: Patients of middle and old age with coronary heart disease require a strictly individual approach to correction of their lipid metabolism and special alertness for cancer in low TSC level.

[The effect of the blood serum cholesterol level on the late prognosis of stenocardia in men 40-59 years old without arterial hypertension]. / Vliianie urovnia kholesterina syvorotki krovi na otdalennyi prognoz bol'nykh stenokardiei muzhchin 40--59 let bez arterial'noi gipertonii.

AIM: To investigate effects of total cholesterol levels in the serum (TC) on angina pectoris (AP) lethality in males. MATERIALS AND METHODS: The study of 112 males aged 40-59 years with AP without myocardial infarction and blood hypertension lasted for 30-35 years. The examination included determination of lipid-protein blood spectrum, ECG at rest and exercise, other tests. By initial TC levels 98 patients were divided into 2 equal subgroups. Causes of death were ascertained at autopsy (72.0%) or records or regional death and birth registration offices were used. Reliable information was obtained for 98 of 112 patients (87.5%). RESULTS: At the end of the study 8 of 98 patients were alive (8.2%). In the subgroup with low TC, 2 patients were alive, 47 decreased patients lived, on the average, 69.4 +/- 1.4 years. In the subgroup with high TC, 6 patients were alive, 43 died at the age 71.2 +/- 1.4 years. CONCLUSION: Individual approach rather than populational is needed for correction of total cholesterol in middle-age and elderly patients with angina pectoris.

[The dynamics of the risk factors for IHD and the physical work capacity of the workers on locomotive teams based on the results of prospective observations]. / Dinamika faktorov riska IBS i fizicheskoi rabotosposobnosti u rabotnikov lokomotivnykh brigad po itogam prospektivnykh nabliudenii.

The paper reports the results of a simultaneous study of muscular performance (MP) and main risk factors (RF) of ischemic heart disease (IHD) in 466 locomotive team members aged 30-49 free of IHD symptoms. A negative relationship has been established between MP and systolic, diastolic pressure, body mass. A 4-6-year follow-up of MP and IHD RF showed that MP improvement was associated with a trend to improvement in RF, while MP worsening entailed greater risk of IHD, especially in a group of 30-39-year-olds.

[Systolic and diastolic arterial blood pressure in patients with angina pectoris (a long-term study)]. / Sistolicheskoe i diastolicheskoe arterial'noe davlenie u bol'nykh stenokardiei (mnogoletnie nabliudeniia).

The prospective follow-up of 190 patients with angina pectoris (males, aged 40-59 years) which lasted for 26 years revealed that only 37 (19.5%) persons survived. Out of 153 patients who expired, 76% were subjected to pathoanatomical or medicolegal examination. It was revealed that cardiovascular lesions were responsible for 71.9% death cases in patients with angina pectoris. The elevation of both systolic and diastolic arterial pressure corresponds with a general tendency to the rise of lethality from ischemic cerebral or heart disease though the impact and character of their influence is different.