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Journal articles on the topic 'Periodic Medical Examination'
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1
Теплякова, E. Teplyakova, Щербаков, and S. Shcherbakov. "Automation of accounting and reporting of preventive medical exams and clinical examination in medical organizations." Journal of New Medical Technologies. eJournal 8, no. 1 (November 5, 2014): 0. http://dx.doi.org/10.12737/7354.
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Implementation of information technology in health care is one of the urgent tasks of modernization. Questions automation of accounting and reporting on clinical examination carried out by certain groups of adults, clinical examination of orphans, professional examinations and adult medical examination of the child population (preventive, preliminary, periodic) make up a significant part of the activities of medical organizations both in terms of achieving the goals of the organization. The implementation of a software system "health card", its implementation and use in the medical organization is effectively used in the integration of medical information system in a medical organization. The functions of the system meet all the requirements necessary to meet its work regulations governing the procedure and forms for clinical examination and professional examinations, monitoring of accounting work, the results of clinical examination and analysis of professional examinations, the acceleration of employees by automatically filling out forms, flexible system configuration. Integration of "health map" with electronic medical records enables to collect card baseline medical examination (clinical examination) of the input specialists medical examinations and investigations.Automation of accounting and reporting of preventive medical exams and clinical examination allows medical organization to reduce the labor of doctors and other staff to fill in the documentation and accounting work to avoid mistakes in documents and reports, provide timely and accurate reporting of the established forms of the Ministry of Health.
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Pham, Thi Thuy, Khac Luong V, Duc Nguyen, Quoc Tran Dau, and Nhu Thao Tran. "Quality of periodic health examination service for employees and associated factors at the New Port Medical Center, Ho Chi Minh city in 2020." Journal of Health and Development Studies 05, no. 04 (July 15, 2021): 38–46. http://dx.doi.org/10.38148/jhds.0504skpt20-086.
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Objectives: A periodic health examination helps people to evaluate the overall health status, so it is of the utmost importance to each individual, including employees. At Saigon Newport Corporation, employees have to do strenuous, hazardous, and dangerous works, so periodic health examination is necessary. Methods: A descriptive cross-sectional study was conducted on 436 employees to measure their perception of the periodic health examination service quality via the SERVPERF scale and associated factors at the New Port Medical Center, Ho Chi Minh City, 2020. Results: Research results indicated that 78% of employees have a good assessment of the quality of periodic health examination, in which reliability was 79.6%, assurance was 79.8%, which were also the least. Conclusions: Gender, level of education, and sector of employment were related to the employees’ perception of the periodic health examination service. Keywords: Periodic health examination, employee, SERVPERF, New Port Medical Center, Saigon Newport Corporation.
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Leontyeva, E. Y., and T. Y. Bykovskaya. "The role of compulsory periodical medical examination in employee’s dental health maintenance." Russian Journal of Occupational Health and Industrial Ecology, no. 9 (March 19, 2020): 678. http://dx.doi.org/10.31089/1026-9428-2019-59-9-678-679.
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The analysis of the appealability for the rehabilitation of the oral cavity of staff subject to mandatory periodic examinations at the dentist. The growth of indicators characterizing the dental activity of employees was noted. Subject to the principle of continuity, annual mandatory periodic examinations can be one of the factors in maintaining the dental health of employees.
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Gurvich, V. B., A. S. Shastin, V. G. Gazimova, E. G. Plotko, and T. S. Ustyugova. "Causes of lost vocational fi tness for work in jeopardy and (or) hazardous work conditions." Occupational Health and Industrial Ecology, no. 2 (March 14, 2019): 107–12. http://dx.doi.org/10.31089/1026-9428-2019-2-107-112.
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Workers’ health should be considered as a strategically important component of governmental economic policy. Nowadays society economic damage due to lost vocational fi tness because of medical causes results mostly from general somatic diseases, but not from occupational diseases. In stable tendency to ageing able-bodied population, studies of medical causes of vocational unfi tness is a topical problem. To analyze causes of lost vocational fitness for work in jeopardy and (or) hazardous work conditions, to determine quantitative parameters of vocational unfi tness in mandatory medical examinations, to evaluate nosologic structure of medical contraindications to work in jeopardy and (or) hazardous work conditions, the authors studied demographic data of Federal service of governmental statistics and data on fi rst diagnosed occupational diseases by materials of Governmental reports of Federal service on supervision in consumers’ rights protection and human well-being. Studies also covered data of FBUN “Ekaterinburg medical research center of prevention and health care for industrial workers” of Rospotrebnadzor (EMNTs): database on fi rst diagnosed occupational diseases in Sverdlovsk region, conclusion reports on periodic medical examination results, and medical records of workers underwent periodic medical examination in EMNTs. Th e data were analyzed with descriptive and inductive statistic methods. In constant medical contraindications structure by nosologic types, according to periodic medical examinations in EMNTs, major part of refused permission to the work was associated with diseases in ICD–10 class VII “Diseases of eye and its appendages”, on the 2nd place — diseases of ICD–10 class VIII “Diseases of ear and mastoid process”, on the 3rd place — diseases of ICD–10 class XI “Digestion diseases”. Recommendations are in Russian Federation Health Ministry to consider necessity of workers’ possibility to receive additional examination and special medical care within governmental program of guaranteed free medical care in cases when the diagnosed disease causes refused permission to work.
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Shchelkanova, E. S. "Rapid noncontact diagnostics of psychophysiological state in workers of hazardous industries." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 2 (June 22, 2019): 111–20. http://dx.doi.org/10.25016/2541-7487-2019-0-2-111-120.
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Relevance. Improvement of the medico-psycho-physiological support of professional activity of employees of hazardous production facilities is associated with the development of methods for rapid diagnostics of psycho-physiological state in order to significantly reduce examination time. In particular, vibration imaging takes only one minute. Currently, there are no quantitative criteria for assessing the psychophysiological state based on vibration imaging in employees involved in hazardous work at the stages of periodic, pre-shift medical examinations and training.Intention. Development of non-contact rapid diagnostics of psychophysiological status of employees involved in hazardous work based on vibration imaging parameters for periodic and pre-shift medical examinations, and assessing their current state during training.Methodology. The object of the study was the psychophysiological state of employees of the temporary storage of spent nuclear fuel and radioactive waste at the stages of periodic and pre-shift medical examination, as well as during training. The subject of the study is assessment of relationship of indicators of psychophysiological state with the parameters of vibration imaging.Results and Discussion. According to comprehensive tests with the use of regulated and non-contact methods of assessing psychophysiological state of the workers of hazardous facilities, the parameters of vibration imaging reflect the systemic response of the body. Using the developed criterion of the rapid diagnostics of psychophysiological state at the stage of periodic medical examinations, it takes 1 minute to identify persons with psychophysiological disorders. For the stage of pre-shift medical examinations, a criterion has been developed to make a decision on admission/non-admission to work. The obtained criterion helps to quantify the psychophysiological “price” of training activities in order to optimize their regimens based on the current psychophysiological state as assessed via vibration image parameters.Conclusion. The developed criteria for rapid diagnostics of psychophysiological status, if introduced in scientific-practical activities, will help to monitor the psychophysiological adaptation of workers of hazardous facilities in order to maintain their occupational health and minimize anthropogenic risks.
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Eselevich, S. A., V. D. Balunov, and V. A. Kolesnikova. "Principles of formation of risk groups among employees at the enterprise in the Leningrad region." Russian Journal of Occupational Health and Industrial Ecology, no. 9 (March 19, 2020): 625–26. http://dx.doi.org/10.31089/1026-9428-2019-59-9-625-626.
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Iordanishvili, A. К., E. K. Barinov, and I. B. Salmanov. "ALGORITHM FOR MEDICAL EXAMINATION OF ENDODONTIC TREATMENT." Russian Journal of Forensic Medicine 5, no. 4 (January 19, 2020): 20–25. http://dx.doi.org/10.19048/2411-8729-2019-5-4-20-25.
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Evaluation (including within the framework of medico-legal examination) of the quality and efectiveness of endodontic dental treatment is a matter of current interest in the clinical dentistry.Obiectives. Te aim of the work was to develop an algorithm of medico-legal examination in case of endodontic treatment, to test this algorithm in the work of the commissions of medical care quality control in the departments of therapeutic dentistry of outpatient dental clinics.Material and methods.Te material of the study was the reports of daily activities of dental clinics of various forms of ownership (municipal, departmental, private) in 3 regions of Russia (Moscow, St. Petersburg, Rostov-on-Don), including periodic reports and reference reports, ofcial statistical reports of the activities of the examined clinics, including registration books of the work of the commissions of the quality of medical care. Tese materials were used as a source of primary statistical information. Afer grouping of the information contained in them, the main data characterizing organization, condition and quality of endodontic care were recovered taking into account nosological entities: pulpitis and periodontitis. Taking into account the medical, statistical and analytical nature of the study, the main conclusions and recommendations were formulated on the basis of a retrospective study of these materials.Results. Based on the studies carried out and recommendations of the European Endodontic Association on provision of the standard of endodontic treatment, an algorithm for medico-legal examination of endodontic treatment was proposed. Tis algorithm allows to assess the quality and efectiveness of endodontic treatment of pulpitis and periodontitis in diferent terms (immediately afer treatment, remote period)Conclusion. Te use of the developed algorithm in clinical practice in internal quality control of endodontic care has shown its efectiveness. A large number of clinical cases of insufcient quality of endodontic treatment and its low efectiveness in the remote period indicate persistence of the potential for claims from patients.
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Klevno, V. A., A. V. Maksimov, S. A. Kuchuk, and O. V. Lysenko. "THE TRAINING OF DOCTORS – FORENSIC EXPERTS: PROBLEMS AND SOLUTIONS." Russian Journal of Forensic Medicine 5, no. 1 (May 4, 2019): 47–51. http://dx.doi.org/10.19048/2411-8729-2019-5-1-47-51.
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The article reflects the stages of primary, primary specialized and periodic accreditation of specialists with higher medical education, the analysis of the main problems arising in the training of doctors of forensic experts, the experience of the state medical institution «Bureau of FME» in the training of medical personnel in the specialty «forensic medical examination».
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Salagai, Oleg O., Evgenij A. Bryun, Igor V. Bukhtiyarov, Lyudmila P. Kuzmina, Roman V. Vlasovskikh, Mariya M. Kolyaskina, and Aleksey E. Petukhov. "Methodological approaches to identifying markers of alcohol abuse in employees according to medical examination." Russian Journal of Occupational Health and Industrial Ecology 61, no. 2 (March 15, 2021): 72–76. http://dx.doi.org/10.31089/1026-9428-2021-61-2-72-76.
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Introduction. The diagnosis and appointment of adequate therapy for both alcohol dependence syndrome and somatic pathology of alcoholic origin often depends on the timely establishment of the fact of alcohol abuse, for example, during periodic medical examinations, since most patients either deny the use of alcohol, or significantly underestimate its amount. The aim of the study is to develop a methodology for the objective identification of individuals with risk factors for harmful alcohol consumption that contribute to the development of pathological conditions and diseases that increase the likelihood of developing chronic non-communicable diseases. Materials and methods. Within the framework of the study, 204 people (162 men, 42 women) working in various types of economic activities, aged from 18 to 65 years, were surveyed. All patients were sent to the clinic FSBSI "Izmerov Research Institute of Occupational Health" to pre-or periodic inspections in the order of the health Ministry of Russia from 12.04.2011 No. 302n (ed. by 18.05.2020). All the examined patients underwent a biochemical blood test: carbohydrate deficient transferrin (CDT), gamma-glutamyltranspeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT). Also, all the surveyed were conducted a questionnaire aimed at identifying alcoholism. Statistical processing of the obtained results was carried out using the program STATISTICA 13.2 (Stat Soft Inc., USA). Results. The study of the CDT content in the blood serum of the examined patients revealed an increase above the reference values in 10%, while 7% of the examined patients regularly consumed alcohol during the last 2 weeks (CDT≥2.5%), 3% - consumed moderately (CDT1,2-2,4%). The correlation analysis showed a moderate positive correlation between the results of the questionnaire and the CDT content in the blood serum (r=0.24, p=0.002 with the question about the use of 6 or more doses at a time and r=0.30, p=0.0001 with the total score). Conclusion. The most informative marker of chronic alcohol use is the definition of CDT in combination with a questionnaire aimed at identifying alcoholism. The use of these markers during periodic and preliminary medical examinations can allow a high degree of confidence to identify persons who are prone to chronic alcohol consumption in order to carry out preventive measures and prevent them from working with various sources of increased danger, including work related to the management of vehicles.
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Wang, Victor C. "Perspective of Medical Care Providers on Elite Athletes’ Pre-participation Examination and Periodic Health Evaluation." Sports & Exercise Research 18, no. 2 (June 30, 2016): 136–46. http://dx.doi.org/10.5297/ser.1802.006.
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Bobrov, Aleksandr F., N. A. Isaeva, M. Yu Kalinina, V. Yu Sedin, V. Yu Shcheblanov, and E. S. Shchelkanova. "EVALUATION OF OCCUPATIONAL RISKS OF EMPLOYEES OF THE NUCLEAR INDUSTRY, ACCORDING TO A PERIODIC MEDICAL EXAMINATION AND MANDATORY PSYCHO-PHYSIOLOGICAL EXAMINATIONS." Hygiene and sanitation 96, no. 9 (March 27, 2019): 892–96. http://dx.doi.org/10.18821/0016-9900-2017-96-9-892-896.
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The article is devoted to the assessment of occupational risks of employees of the nuclear industry. A literature review on currently used indices of occupational risks and working conditions on high-tech enterprises of the nuclear industry has shown that because of ther lack of occupational diseases related to exposure to ionizing radiation, and low level of industrial injuries, these indices are not appropriate for the inclusion in the evaluation of the individual professional risk. Classes of working conditions according to hazards and risk group health of the worker, work-related diseases and the level of allostatic load are sufficient for the practical assessment. The given formula for the calculation of the index of allostatic load according to psycho-physiological examinations as the part of the modern legislation is required to implement periodic medical examinations of workers of the nuclear industry. A developed one-dimensional multiparameter index and decision rules describe the level of the loss of health of the employee. The constructed regression model for classes of working conditions allows predict the level of losses of health of the employee. A risk matrix was developed for the evaluation of individual professional risk.
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Sagaro, Getu Gamo, Marzio Di Canio, Emanuele Talevi, and Francesco Amenta. "Telemedicine for Pre-Employment Medical Examinations and Follow-Up Visits on Board Ships: A Narrative Review on the Feasibility." Healthcare 9, no. 1 (January 13, 2021): 69. http://dx.doi.org/10.3390/healthcare9010069.
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Background: Telemedicine has already been applied to various medical specialties for diagnosis, treatment, and follow-up visits for the general population. Telemedicine has also proven effective by providing advice, diagnosis, and treatment to seafarers during emergency medical events onboard ships. However, it has not yet been applied for pre-employment medical examinations and follow-up visits on board ships. Objective: This review aimed to assess the possibility of using telemedicine during periodic visits between one pre-employment medical examination and others on board ships, and to recommend necessary medical examination tests with screening intervals for seafarers. Methods: Various databases including PubMed, EMBASE, Scopus, CINAHL, and Cochrane Library were explored using different keywords, titles, and abstracts. Studies published between 1999 and 2019, in English, in peer-reviewed journal articles, and that are conference proceedings were considered. Finally, the studies included in this review were chosen on the basis of the eligibility criteria. Results: Out of a total of 168 studies, 85 studies were kept for further analysis after removing the duplicates. A further independent screening based on the inclusion and exclusion criteria resulted in the withdrawal of 51 studies that were not further considered for our analysis. Finally, 32 studies were left, which were critically reviewed. Out of 32 accepted studies, 10 studies demonstrated the effectiveness of the electrocardiogram (ECG) in monitoring and managing remote patients with heart failure, early diagnosis, and postoperative screening. In 15 studies, telespirometry was found to be effective in diagnosing and ruling out diseases, detecting lung abnormalities, and managing patients with chronic obstructive pulmonary disease (COPD) and asthma. Seven studies reported that telenephrology was effective, precise, accurate, and usable by non-medical personnel and that it reduced sample analysis times and procedures in laboratories. Conclusion: using new technologies such as high-speed internet, video conferencing, and digital examination, personnel are able to make the necessary tests and perform virtual medical examination on board ships with necessary training.
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Derevnina, A. V., and S. A. Avagyan. "Substantiation of the value of dermatoscopy methods for medical examinations in patients working with carcinogens." Russian Journal of Occupational Health and Industrial Ecology 60, no. 11 (December 3, 2020): 760–62. http://dx.doi.org/10.31089/1026-9428-2020-60-11-760-762.
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Introduction. Industrial carcinogens are one of the causes leading to malignancy of epithelial neoplasms of the skin. The aim of study to assess the importance of conducting dermatoscopic research methods during periodic medical examinations of workers with industrial carcinogens. Materials and methods. 108 employees of the enterprise of Moscow were examined at periodic medical examinations of KPO FSBSI Izmerov Research Institute of Occupational Health. According to the special assessment of working conditions for harmful factors and types of work, a contingent of 60 people who had contact with industrial carcinogens and 48 people who did not have contact with industrial factors was identified. A complex of clinical-anamnestic and diagnostic methods was performed. Clinical research-interview of the patient, study of the patient's medical history, complaints, heredity, Constitution, professional activity, skin type and harmful effects; duration of existence and dynamics of changes in the size of the neoplasm. Visual examination of the patient's skin under natural and side lighting using a magnifying glass with 7x magnification. Physical examination of the primary skin tumor: the shape, color, size, and boundaries of the neoplasm were preliminarily evaluated. Epiluminescent surface microscopy (dermatoscopy) of each suspected pigmented neoplasm was performed using a Heine Delta 20 Dermatoscope (Heine Optotechnik, Germany). During dermatoscopy, in order to make the surface layers of the skin more transparent, oil was applied to the surface of the neoplasm. Digital photos during dermatoscopy were taken using a Nikon D 3100 18-55 II Kit digital camera, which was connected to the Dermatoscope by a Nikon UR-E15 adapter ring. Industrial carcinogens are one of the causes leading to malignancy of epithelial neoplasms of the skin. Results. According to the results of the study in a group of patients, it was found that workers who had contact with industrial carcinogens, epithelial skin neoplasms were much more common and more common at a young age (from 18 to 39 years), compared with patients who did not have contact with carcinogens at work. It was also revealed that epithelial neoplasms of the skin are most often diagnosed with longer work experience. It is noted that in patients who have contact with industrial carcinogens, even with work experience of up to 10 years, epithelial skin neoplasms are more often detected. Conclusions. There are good reasons to believe that exposure to industrial carcinogenic factors significantly increases the risk of developing skin neoplasms. The use of dermatoscopic diagnostic methods will allow timely detection of benign skin neoplasms in persons who have contact with industrial carcinogens during preventive medical examinations and thereby reduce the risk of malignant neoplasms.
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Petrukhin, Nikolai N., I. V. Boyko, O. N. Andreenko, N. N. Loginova, and S. V. Grebenkov. "DETECTION RATE OF OCCUPATIONAL DISEASES IN PUBLIC HEALTH EMPLOYEES ACCORDING TO RESULTS OF MEDICAL INSPECTIONS." Hygiene and sanitation 98, no. 6 (October 28, 2019): 642–45. http://dx.doi.org/10.18821/0016-9900-2019-98-6-642-645.
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Introduction. This article presents the results on the detection rate of occupational diseases (OD) among health workers for an 18-year period (2000-2017) in the North-West Federal District (NWFD). The purpose of the study is to study the structure and dynamics of occupational diseases in medical workers during periodic medical examinations, to assess the effectiveness of the system of periodic medical examinations (PME), and to suggest ways to improve their effectiveness. material and methods. A retrospective analysis of archival data from 2000-2017 was performed on occupational morbidity of health care workers according to the materials of the North-West Scientific Center for Hygiene and Public Health and regional centers of occupational pathology of subjects of the North-West Federal District (N = 259), the average age of the surveyed is 46.1 ± 11.8 years, of which 231 (89%) women, 28 (11%) men, 80 surveyed (30.9%) have the status of a doctor, 124 (47.9%) - nurses and 55 (21.2%) - laboratory technicians, nurses, etc. Results. During the study period from 2000 to 2017 among the medical workers of the NWFD, 259 primary OD cases were officially identified. At the same time, the effectiveness of PME in medical workers was established to be very low. More than 7.2% of patients with OD signs were identified upon the fact that the patient actively sought medical attention. Even the system of clinical examination of the working population (where there is no explicit task to actively detect the OD signs) has a performance index by 3% higher than the PME. Conclusion. The problem we have touched upon is probably related to a complex of both medical (features of the organization of the PME system) and social factors (subjective assessments of the patient with respect to the prospect of benefits or negative effects in terms of continuing their professional career after official registration of the OD) in order to establish more accurately long laborious research.
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Sarker, Sujit Kumar, Geethanjali Bhas, Priyanka Moitra, Ratna Paul, Md Abdullah Yusuf, Vijaya Marakala, Zubair Ahmed Ratan, Ikramul Ahmed, Khan Mohammad Arif, and AM Selim Reza. "Appraisal of the Current Pharmacology Curriculum, Teaching Methodology and Effectiveness in Undergraduate Medical Education: A Student-Centric, Questionnaire-Based Study." Journal of Current and Advance Medical Research 8, no. 1 (March 15, 2021): 30–33. http://dx.doi.org/10.3329/jcamr.v8i1.52479.
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Background: Periodic students’ feedback ensures and enhances the effectiveness of the curriculum of medical subject.
Objective: This study was designed to obtain students appraisal of the undergraduate pharmacology curriculum and teaching methodology.
Methodology: This cross-sectional study was conducted in the Department of Pharmacology at Colonel Malek Medical College, Manikganj, Bangladesh from May to June, 2019 for a period of two months. Questionnaire-based data were collected from students of both sexes who had completed 3rd Professional examination. Likert Scale was applied to collect students’ feedback on pharmacology.
Results: A total number of 40 students were recruited for this study of which 60.0% students were strongly agreed about organized teaching. About 47.5% students were agreed that the course was appropriate at their level and achieved their goals in Pharmacology. However, 55% of them strongly agreed that teacher provided clear constructive feedback during class. Total 60%, were agreed that the course improved their problem-solving skills. Overall, 55% students were agreed regarding their satisfaction on Pharmacology course delivery and conduction.
Conclusion: In conclusion, periodic appraisal from students regarding evaluation of the student-centric undergraduate pharmacology curriculum is vital in developing efficient medical graduates.
Journal of Current and Advance Medical Research, January 2021;8(1):30-33
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Ponto, James A. "Nuclear Pharmacy and the Board of Pharmaceutical Specialties (BPS)." Journal of Pharmacy Practice 2, no. 5 (October 1989): 299–301. http://dx.doi.org/10.1177/089719008900200507.
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Nuclear pharmacy was officially recognized as a specialty area in pharmacy practice, the first specialty area so recognized, by the Board of Pharmaceutical Specialties in 1978. Subsequently, a certification examination was developed and administered for the first time in 1982. By 1988, 112 nuclear pharmacists had become board certified in nuclear pharmacy. Although little tangible value was initially associated with certification, certification is gradually accruing worth with recent recognition and acceptance by the Nuclear Regulatory Commission and the National Association of Boards of Pharmacy. A mechanism for recertification, which has been under development for several years, is nearing completion and will allow for periodic recertification of certified nuclear pharmacists.
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Fujii, Tadashi, Yoshio Matsui, Marehoshi Noboru, Yusuke Inagaki, Yoshinori Kadoya, and Yasuhito Tanaka. "Meniscal Bearing Dislocation of Unicompartmental Knee Arthroplasty with Faint Symptom." Case Reports in Orthopedics 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/217842.
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We experienced two cases of atypical lateral dislocations of meniscal bearing in UKA (unicompartmental knee arthroplasty) without manifest symptoms. The dislocated bearing, which jumped onto the wall of tibial components, was found on radiographs in periodic medical examination although they could walk. Two thicker size bearing exchanges were promptly performed before metallosis and loosening of components. Continual examination is important to mobile bearing type of UKA because slight or less symptoms may disclose such unique dislocation. One case showed malrotation of the femoral component on 3D image. Anteroposterior view hardly disclosed the malrotation of the femoral component. Epicondylar view is an indispensable view of importance, and it can demonstrate the rotation of the femoral component. The the femoral distal end is wedge shaped and is wider posteriorly. If the femoral component is set according to the shape of medial condyle, the femoral component shifts to medial site compared with tibial component in flexion. It can account for such rare dislocation as follows. If excessive force applies on most medial side of the bearing during flexion, the lateral part of the bearing pops and the force squeezes it laterally simultaneously. Finally, the bearing jumps onto the lateral wall of the tibial component.
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Gossart, Rémy, Eve Malthiery, Fanny Aguilar, Jacques-Henri Torres, and Marie-Alix Fauroux. "Fuchs Syndrome: Medical Treatment of 1 Case and Literature Review." Case Reports in Dermatology 9, no. 1 (April 18, 2017): 114–20. http://dx.doi.org/10.1159/000468978.
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Fuchs syndrome is a particular type of erythema multiforme major; the lesions are only found on the mucosae and specifically affect oral, ocular, and genital mucosae. The cause is not always immediately apparent, which is why this pathology requires a rigorous, detailed clinical examination to eliminate a differential diagnosis. The severity of the symptoms, particularly of oral and ocular symptoms, requires immediate treatment. The treatment of this pathology requires a multiple-drug regime. Through a clinical case study, the objective of this work is to help guide practitioners when diagnosing and treating this pathology as no current consensus exists on these 2 subjects. The authors present the case of a 29-year-old patient who was suffering from a recurring outbreak of Fuchs syndrome, suspected of having been triggered by Mycoplasma pneumoniae. After completing the treatment program based on colchicine and prednisolone, the patient was relieved from pain and has not suffered from any further periodic eruptions of erythema multiforme.
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Sannikov, M. V., O. M. Astafjev, N. A. Mukhina, and N. V. Makarova. "Experience of studying the health status of personnel of rescue military units of EMERCOM of Russia." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 4 (February 10, 2019): 40–46. http://dx.doi.org/10.25016/2541-7487-2018-0-4-40-46.
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Relevance. Health maintanance and professional longevity are primary objectives of medical and psychological support for personnel of EMERCOM of Russia. Information about the state of health of military personnel and civilian personnel of rescue military units of Emercom of Russia, as well as military units for radiation, chemical and biological protection was not found in the available literature.Intention. Clarify data on the state of health of military personnel and civilian personnel of rescue military units of Emercom of Russia for developing evidence-based preventive and rehabilitation measures in the future.Methodology. The health status of the personnel of rescue military units of Emercom of Russia was studied on the model of the Federal State-Owned Institution Nevsky Rescue Center of Emercom of Russia (Kolpino, St. Petersburg) based on the results of periodic medical examinations in 2015–2016.Results and Discussion. The overall prevalence of diseases revealed in military and civilian personnel during the annual medical examination was similar, including the main classes of diseases, and averaged 2 diseases per 1 person. The overall prevalence of diseases in the older age group (30–44 years) of military personnel 1.2–1.4-fold (p = 0.021) exceeded that of the younger (18–29) age group of military personnel as well as of both age groups of civilian personnel. No convincing impact of professional experience on the prevalence of diseases was revealed.Conclusion. The levels and structure of pathology revealed during periodic medical examinations in military personnel and civilian personnel of the Nevsky Rescue Center had no statistically significant differences, suggesting the fundamental similarity of the nature and intensity of occupational factors. At the same time, age rather than the duration of professional activities influenced the frequency of the revealed pathology in the studied sample. Weighted indicators of public health over a longer period of time (5+ years) will help eliminate stochastic effects and make reasonable conclusions about the prevalence of diseases in various military rescue specialists.
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Berkheeva, Z. M., N. B. Pigalova, L. K. Yampolskaya, S. A. Marinnikova, and N. G. Mustafina. "State of occupational diseases in Kazan." Kazan medical journal 80, no. 4 (April 7, 1999): 318–19. http://dx.doi.org/10.17816/kazmj70143.
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The occupational diseases in Kazan are studied. The diseases from the effect of physical factors and from overstress of separate organs and systems occupy a prominent plase. The observed tendency to decreasing the level of occupational diseases is determined by output reduction, performance of engineering and sanitary and hygienic measures directed to the improvement of labour conditions as well as decrease of the quality of periodic medical examination. It is urgent to teach physicians the problems of occupational pathology in connection with elimination of medicosanitary service in workchops.
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Bobrov, A. F., V. V. Ivanov, T. M. Novikova, L. I. Kuznecova, and V. Yu Scheblanov. "RAPID ASSESSMENT OF PSYCHO-PHYSIOLOGICAL ADAPTATION OF WORKERS OF HAZARDOUS INDUSTRIES ACCORDING TO THE CHARACTERISTICS OF MULTIPLE INTELLIGENCES." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 3 (October 15, 2019): 74–84. http://dx.doi.org/10.25016/2541-7487-2019-0-3-74-84.
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Relevance. Improving the medico psycho physiological support of professional activity of employees of hazardous industries is associated, in particular, with the development of techniques for rapid assessment of psychophysiological adaptation to significantly reduce examination time. For this, a questionnaire of multiple intelligence by G. Gardner (modified by V.A. Minkin and Ya.N. Nikolaenko) can be used within the VibraMI program. The Vibra program makes it possible to reduce the testing time to only 7–10 minutes vs 1.5–2.0 hours as in conventional examination. Up to date, there are no quantitative criteria for rapid assessment of psychophysiological adaptation by multiple intelligence parameters.Intention. To develop criteria for rapid assessment of psychophysiological adaptation of hazardous industry workers based on the characteristics of multiple intelligence.Methodology. The object of the study was the psychophysiological adaptation of workers at ”Elektrokhimpribor” plant at the stage of periodic medical examination. An integrated psychophysiological study was carried out with the use of specified techniques and methods for assessing multiple intelligence to estimate conscious and unconscious reactions of the participants when answering questions. assess the relationship between the presence/absence of psychophysiological maladjustment and characteristics of multiple intelligence.Results and analysis. According to the results of complex experimental studies, the leading qualities of the workers of the main production of the plant were identified: natural, motor and interpersonal intelligence. The greatest differences between workers with the absence and presence of psychophysiological maladjustment are observed in motor intelligence. It is demonstrated that unconscious manifestations are associated with sincerity of responses and their compliance with internal guidelines. An integral indicator of psychophysiological adaptation disorders is based on conscious and unconscious reactions, and a nomogram of probability of these disorders was developed. Proposed criteria for the rapid assessment reduce duration of psychophysiological examination to 7–10 minutes.Conclusion. The developed criteria of rapid assessment can be used to select professionals for important assignments, to conduct periodic psychophysiological examinations, to evaluate psychophysiological “price” of activities in case of emergencies and elimination of their consequences. This will preserve the professional health of workers in hazardous industries and minimize human related risk factors.
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Sorokin, G. A., N. D. Chistyakov, and V. L. Suslov. "Influence of fatigue and overwork on the General morbidity of workers." Russian Journal of Occupational Health and Industrial Ecology, no. 8 (September 25, 2019): 494–500. http://dx.doi.org/10.31089/1026-9428-2019-59-8-494-500.
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Introduction.Production-related morbidity occurs as a result of nonspecific effects on the human body increased fatigue and overfatigue. However, there are no studies of the links between the General morbidity of workers with their acute fatigue and chronic fatigue.The aim of the studywas establishment of pattern of connection of acute fatigue with chronic fatigue and with the general morbidity of workers revealed at periodic medical examinations of workers.Material and methods. Fatigue and fatigue were studied using a standardized questionnaire. As an integral assessment of fatigue we used two indicators “degree of usual fatigue” (Fsub) and the duration of the employee in a state of fatigue, hours per week (Hweek). The Hweekindex considers the Fsub, frequency, time of occurrence and disappearance of fatigue, the duration of the working week. In research took part 1733 of different professions. 396 people underwent medical examination.Results.Among the surveyed workers, 5% of women and 2% of men had severe fatigue (Fsub=3). We have shown that the total annual duration of morbidity with temporary disability in very tired workers (Fsub=3) is an average of 24.9 days, and a little tired (Fsub=1) an average of 5.1 days. 38% of women and 20% of men are at risk of fatigue (Hweek>24 hours). The Hweekindicator allows to differentiate the occupational risks associated with fatigue among workers with the same Fsub. At Hweek>24 hours in men and women, all health indicators obtained from both the survey and the medical examination are worsened.Conclusions.Fsubis the most simple, operational and reliable indicator for the etiological study of the risks of fatigue and the causesof professionally caused diseases. In women with Fsub=3, compared with non-tired workers (Fsub=0), the risks of health deteriorationduring the year are repeatedly increased, in moderately tired women (Fsub=2) there is also a significant increase in all risks, but to alesser extent. Hweekallows you to differentiate risks among workers with the same Fsub. With Hweekmore than 24 hours, there is a significant increase in health risks, detected both according to the survey and according to periodic medical examination. The leading cause ofFsub=3 is the share in working time of the periods of stay of workers in a state of increased attention and intensity of the labor process.
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Matsumoto, Isao, Ko Nakashima, Hajime Morita, Koichi Kasahara, Osamu Kataoka, and Kazuyuki Uchida. "Escherichia coli-induced granulomatous colitis in a cat." Journal of Feline Medicine and Surgery Open Reports 5, no. 1 (January 2019): 205511691983653. http://dx.doi.org/10.1177/2055116919836537.
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Case summary A 10-year-old castrated male domestic shorthair cat presented with a 6 month history of diarrhoea that responded poorly to medical treatment. Ultrasonography revealed moderate thickening of the colonic wall (4.8 mm) and right colic and jejunal lymphadenomegalies. Endoscopic examination revealed partial circumferential narrowing of the transverse colon and friable colonic mucosa with multiple haemorrhagic regions. Histopathological and immunohistochemical examinations revealed a large number of Escherichia coli phagocytosed by periodic acid–Schiff-positive macrophages. Bacterial culture also yielded enrofloxacin-sensitive E coli. The cat was initially treated with prednisolone, which resulted in little improvement. Following histopathological examination and bacterial culture, treatment with enrofloxacin was commenced. Antibacterial therapy resulted in remission of the diarrhoea and an increase in body weight within 14 days. Relevance and novel information Granulomatous colitis (GC) or histiocytic ulcerative colitis has been rarely described in cats. There has only been one previously published case study involving a cat, and the aetiology remains largely unknown. The current article describes the regression of E coli-related GC following antibacterial treatment in a cat. Clinical signs, histopathological appearance and response to enrofloxacin were similar to those in canine GC. The current findings suggest that E coli also plays an important role in the development of feline GC.
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Seetharaman, Kavita. "Thyrotoxic Periodic Paralysis." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A965—A966. http://dx.doi.org/10.1210/jendso/bvab048.1973.
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Abstract Thyrotoxic Periodic Paralysis (TPP) is an emergency associated with flaccid paralysis in which the paralysis is reversible with prompt potassium replacement and the attacks are terminated when hyperthyroidism is cured. Timely diagnosis and treatment are therefore prudent. While managing patients with flaccid paralysis, physicians should be aware of TPP as potential etiology and investigate history to identify the triggering factors and provide timely and cautious treatment with replacement of potassium, further addressing permanent approaches to treating thyrotoxicosis to prevent future recurrences of TPP. We report a clinical scenario of a patient who experienced TPP.22-year-old male, laying down at home at around 1:45pm developed sudden onset bilateral lower extremity weakness and was unable to stand up. His weakness was associated with thigh pain with exertion. He was eventually able to walk a few steps, but then fell onto his knees. He reported having a carbohydrate rich lunch at noon. Notably, patient underwent surgery under general anesthesia for a deviated nasal septum the day before. His neurological examination was remarkable for giveaway proximal lower extremity weakness involving only select muscle groups. Examination and CT/CTA of head and neck findings was not consistent with acute stroke. Myopathy secondary to electrolyte imbalance, drug/toxin, infection, or inflammatory disorders, myelopathy and myasthenia gravis were considered in the differential. Labs revealed suppressed TSH <0.01uIU/mL, elevated FT4 of 6ng/dL and low serum potassium of 2.6mmol/L. CT scan of the neck revealed enlarged thyroid gland and thymic enlargement. Patient was given intravenous bolus of potassium chloride 20 mEq and serum potassium normalized in 4 hours to 3.8mmol/L. His lower extremity weakness resolved within 3hours of potassium replacement. The next day his serum potassium was 5.2mmol/L. His thyroid stimulating immunoglobulin index was elevated at 1.4 (normal <1.3). He was started on propranolol, methimazole and advised to return to the endocrinology clinic to discuss permanent treatment options for hyperthyroidism to prevent TPP. Reviewing his prior medical history, he was diagnosed with Graves’ disease 5 months prior to the emergency room evaluation and was started on methimazole. He took methimazole for 2 months and did not return to follow up until the occurrence of TPP. He did not experience symptoms of hyperthyroidism in the interim. Discussion: TPP is a rare disorder with a prevalence of 0.1-0.2% in North America. TPP commonly affects Asian and Latin Americans males. The episodes of TPP are influenced by genetic, environmental, and ethnic factors. Common environmental triggers include carbohydrate rich meals, rest after intense physical exertion, fever, infection, trauma, emotional stress, and smoking. Thymic hyperplasia has also been reported to be associated with hypokalemic periodic paralysis. Clinical Presentation: The motor weakness tends to affect proximal lower extremities as noted in our patient’s presentation and is usually associated with hyporeflexia and is painless. Cardiac arrhythmias due to hypokalemia are rare, though ventricular fibrillation have been reported, and respiratory failure requiring mechanical ventilation is a possibility. Pathophysiology: TPP has been thought to be a channelopathy associated with increased Na+–K+ ATPase activity and loss of function mutation of the Kir 2.6 potassium efflux channel resulting in intracellular pooling of potassium and transient hypokalemia. The attacks are stimulated by thyroid hormone excess and/or hyperadrenergic activity and hyperinsulinemia, most commonly due to carbohydrate load or intravenous fluids containing dextrose. Treatment should include:1.Potassium supplementation to reverse paralysis and prevent life threatening cardiac arrhythmias. Care must be taken to not over replace potassium, as it could result in hyperkalemia when potassium channels revert to functioning normally.2.Propranolol, a non-selective betablocker works by blocking the thyroid hormone mediated adrenergic overstimulation of the Na-K ATPase channel, there by limiting the intracellular pooling of potassium.3.Definitive treatment of thyrotoxicosis should be offered. Studies comparing various modalities of treatment of thyrotoxicosis in the setting of TPP indicate permanent treatment with either radioactive iodine or thyroidectomy are often successful in preventing recurrence of TPP, as relapse events are higher in treatment with antithyroid drugs. Caution should be taken to prevent surge of thyroid hormone release following radioactive iodine treatment, as this can trigger TPP. Higher doses of radioactive iodine might be required to render hypothyroidism and prevent TPP recurrences. There is one case report of hypokalemic periodic paralysis associated with thymic hyperplasia that was treated with thymectomy. Our patient had multiple triggers leading to periodic paralysis, including a prior untreated Graves’ disease due to non-adherence to treatment during COVID-19 pandemic, general anesthesia for nasal septal surgery the day before presenting with TPP, having a carbohydrate rich meal one hour before the episode, and thymic enlargement on neck CT scan. He responded well to potassium replacement, and propranolol. He was started on methimazole and offered permanent treatment options to address hyperthyroidism. References: 1.K Shizume1, Y Shishiba, K Kuma, S Noguchi, J Tajiri, K Ito, J Y Noh. Comparison of the incidence of association of periodic paralysis and hyperthyroidism in Japan in 1957 and 1991. Endocrinol Jpn1992 Jun;39(3):315-8, doi: 10.1507/endocrj1954.39.315 2. R C Griggs, J Resnick, W K Engel. Intravenous treatment of hypokalemic periodic paralysis. Arch Neurol 1983 Sep;40(9):539-40.3. Maciel, R., Lindsey, S. & Dias da Silva, M. Novel etiopathophysiological aspects of thyrotoxic periodic paralysis. Nat Rev Endocrinol7, 657–667 (2011). https://doi.org/10.1038/nrendo.2011.58 4. Chang RY, Lang BH, Chan AC, Wong KP. Evaluating the efficacy of primary treatment for graves’ disease complicated by thyrotoxic periodic paralysis. Int J Endocrinol. 2014; 2014:949068 doi:10.1155/2014/949068 5.Yang R, Jurkat-Rott K, Cao J, et al. Hypokalemic Periodic Paralysis Induced by Thymic Hyperplasia and Relieved by Thymectomy. JAMA Neurol. 2013;70(11):1436–1439. doi:10.1001/jamaneurol.2013.3918
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Esan, OluwaseunTaiwo, AyodejiPatrick Akinyemi, OluwafemiMoses Ayegbusi, ToheebAdemuyiwa Bakare, YakubLekan Balogun, and AlexanderOdunayo Ogunwusi. "Determinants of uptake of periodic medical examination among students of college of health sciences, Obafemi Awolowo University Ile-Ife, South-West Nigeria." Nigerian Journal of Medicine 29, no. 4 (2020): 575. http://dx.doi.org/10.4103/njm.njm_150_20.
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Petrosyan, Yurij M., Rauli D. Dumbadze, Ekaterina O. Bakshanskaya, Viktoriya A. Korogodina, Iulianiya P. Koval’, Dmitrii V. Chentsov, Elena V. Frolova, and Anna V. Turusheva. "The effectiveness of atrial fibrillation screening with the MyDyagnostick 1001R device in a population and in a group at risk." Russian Family Doctor 23, no. 4 (February 11, 2020): 41–48. http://dx.doi.org/10.17816/rfd18929.
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Due to the low detectability of atrial fibrillation (AF), more attention is paid to AF screening. Screening procedure requires new diagnostic devices that allow immediate assessment of heart activity. One such portable device is the MyDyagnostick 1001R.
The aim. Сomparison of the clinical effectiveness of screening in people who participated in the preventive health examinations and in patients with AF risk factors admitted to the City geriatric medical hospital.
Materials and methods. 101 patients hospitalized to City geriatric medical center were included using the method of continuous selection. Another sample of patients included 102 volunteers who participated in a preventive health examinations organized by the City center for medical prevention in St. Petersburg (convenience sample). Heart activity was registered with portable device MyDyagnostick 1001R.
Results. AF was diagnosed in 25 (24.8%) patients from geriatric medical center were. Of these, 12 patients were not suspected of having AF. Among the volunteers undergoing a routine examination, AF was found in 5 people, 3 of whom had paroxysmal AF in anamnesis.
Conclusions. In a population of individuals with risk factors, AF was detected in 24.8% of cases; in 48%, AF was not previously detected using standard registration methods, which is in favor of periodic screening of AF in a population with risk factors for its development. In the population of participants of preventive health examinations, AF was found in 5 people, which indicates a low detectability of AF not at risk. Significant signs indicating possible AF were a feeling of palpitations and a history of stroke, which may confirm the need for screening for AF of persons with such symptoms.
In screening purposes portable device MyDyagnostick 1001R may be used effectively.
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Bolotova, Nina V., Andrey P. Averyanov, Natalia Yu Filina, Ekaterina Yu Zaharova, Maria A. Melikyan, Olesya A. Velikotskaya, Tatyana V. Strokova, and Yulia V. Paltseva. "Glycogenosis type IX in a 9-year-old child." Problems of Endocrinology 63, no. 2 (July 4, 2017): 139–42. http://dx.doi.org/10.14341/probl2017632139-142.
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Since the age of 1 year, a child presented with hypoglycemic conditions accompanied by ketosis as well as periodic hyperglycemia, for which reason he was hospitalized to the Pediatric Endocrinology Department of the Mirotvortsev Saratov Clinical Hospital. At the hospital, the child underwent a comprehensive examination that excluded diseases such as hyperinsulinism and diabetes mellitus. In the Laboratory of Hereditary Diseases of Metabolism of the Medical Genetics Research Center, a hemizygotic mutation in the PHKA2 gene (glycogenosis type IX) was detected. The mother was also detected with the heterozygous mutation c.226G>A (p.E76K in the PHKA2 gene). Based on the results of the genetic examination of the child and mother, the patient was finally diagnosed with glycogenosis type IX. The patient was put on an individualized protein diet avoiding edible sugar and fatty foods; corn starch (30 g every 6 h and overnight) was recommended. Strict adherence to the diet resulted in less frequent seizures and decreased severity of episodes.
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Mhaideb, IbrahimMhedb, AhmedMohsen Almtowm, OsamaSaleh Alnafisah, OsamaMansour AlAteeq, and AbdullahHasan Alharmlay. "PERIODIC MEDICAL EXAMINATIONS." International Journal of Advanced Research 4, no. 10 (October 31, 2016): 2051–59. http://dx.doi.org/10.21474/ijar01/2020.
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Melnyk, A. M. "Medical service as a part of everyday life of workers of the ferrous metallurgy enterprises in the first half of 1950s." Науково-теоретичний альманах "Грані" 21, no. 9 (October 12, 2018): 98–104. http://dx.doi.org/10.15421/1718120.
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The aim of the study is to analyze medical aid given to the workers of ferrous metallurgy enterprises in the first half of the 1950s. Primary medical unit provided medical aid for workers of the ferrous metallurgical enterprises. Because of the lack of medical unit at the metallurgical plant or because there was no medical institutions in the organizational structure of the medical unit, local medical institutions provided the workers with medical care. During the first half of the 1950s, was the problem of the lack of medical staff in the medical institutions caused by insufficient material and household support. It did not allow implementing the shop principle of medical service of metallurgists. At the enterprises, individual shops did not have a factory’s sectorial doctor, or the number of workers assigned to a factory’s sectorial doctor exceeded the norm. Because the local hospitals, which controlled the health post at the ferrous metallurgy enterprises of the Zaporizhzhya region, were placed at a considerable distance, ‘the shop principle’ was not implemented there at all. The personnel problem also affected the formation of queues, which were a characteristic feature of the medical care provided to the workers. Work overload of physicians led to a quick examination of the patients, resulting in mistakes in the diagnosis. Contrary to accepted laws aimed at improving the quality of diagnosis, the periodic medical examinations of workers were not always carried out qualitatively, and the medical examination was carried out in a number of plants partly. In the first half of the 1950s the enterprises of the ferrous metallurgy of Zaporizhzhya region had a problem that the medical institutions were on a far distance and the percentage of patients needed medical help reduced. Lack of hospital beds had caused the untimely hospitalization of patients that prevented recovery of their. Many of the medical institutions were located in the old or non-specialized buildings with limited space, stove heating and primitive food units, without household premises and sewage. Characteristic of the medical services of metallurgists were depreciation of the material fund of medical institutions, lack of medicines, medical equipment. Not all medical institutions were provided with ambulances. There were cases of refusal to leave for a challenge or untimely provision of emergency care. It was concluded that the level of medical services given to the metallurgists in the first half of the 1950s was insufficient, despite the fact that they were workers of one of the leading branches of the Soviet economy.
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Petrukhin, Nikolai N., N. N. Loginova, O. N. Andreenko, S. V. Grebenkov, and S. V. Voronkova. "THE ROLE OF THE BIOFACTOR IN THE FORMATION OF OCCUPATIONAL DISEASES IN HEALTHCARE WORKERS." Hygiene and sanitation 97, no. 12 (December 15, 2018): 1231–34. http://dx.doi.org/10.18821/0016-9900-2018-97-12-1231-1234.
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This article presents data on the leading role of the biological factor in the formation of occupational diseases among health workers for an 18-year period of the work at the North-West Scientific Center for Hygiene and Public Health. The purpose of the study is to provide an objective assessment in establishing relationships related to the effects of a biofactor on the health of health workers. A retrospective analysis was made of a sample of case histories with established occupational diseases due to the impact of a biological factor. There were observed in dynamics 67 cases including 52 women (77 %) and 15 men (23%) aged 23-67 years. All of them were examined for the establishment of the relationship between the disease and occupation during the period of 2000-2017. The infectious agent is considered to be the leading harmful production factor when analyzing working conditions. The average work experience with an infectious agent was 14 years. The class of working conditions in most cases was estimated from permissible to harmful of the 1 degree. Based on the data of sanitary and hygienic characteristics of working conditions, the excess of the maximum permissible concentrations of harmful industrial substances in the air of the working area was recorded only in 8% of cases. The detectability of occupational diseases after periodic medical examinations was 6%; by clinical examination - 8%; when contacting a local physician 20%; to the pathologist 20%; as a result of self-reversal 46%. The biological factor is the leading harmful factor in the workplace of medical workers. As the main preventive measure for occupational diseases among physicians, systematic medical examinations followed by preventive, curative and rehabilitative measures are taken. The most effective way to reduce infectious diseases is the compulsory vaccination of medical staff.
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Voronkova, Svetlana V. "ADMINISTRATIVE RULES OF ADMISSION OF MIGRANTS FOR WORK IN DECREED PROFESSIONS." Hygiene and sanitation 96, no. 7 (March 27, 2019): 646–51. http://dx.doi.org/10.18821/0016-9900-2017-96-7-646-651.
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In the article there are considered questions of legal regulation of the admission of foreign nationals (or individuals without nationality) to work in decreed professions in the Russian Federation. To date migration processes are shown to affect not only the demographic situation in our country, but the level of infectious diseases rates, especially in large cities. The health status of the population depends directly on the literacy level of workers in various industries, especially decreed contingents of high epidemiological risk. It is noted that along with the medical examination of foreign citizens (persons without citizenship) for issuance of a work permit or a patent in the Russian Federation in the framework of the immigration laws in Bodies of internal. Affairs, the law provides for obligatory preliminary and periodic medical examinations for certain types of work with registration of personal medical books, the passage of professional hygienic preparation and certification. These kinds of economic activities include organizations associated with the production, storage, transportation and sale of food products and drinking water, the upbringing and education of children, municipal and consumer services. There are considered provisions of the main legal acts in the volume of medical examinations and obligatory knowledge of Russian for obtaining the work permit of migrants. There are identified key organizational-legal and methodological and problematic aspects that require coordination of activities of state structures and functioning of enterprises. The training of the special contingent is noted to contribute to the improvement of medical-hygienic knowledge among foreign citizens and the population, prevention of infectious diseases, the formation of understanding the need for positive changes in lifestyle, and support the desire to change, contributes to the creation of appropriate motivation in relation to their health, development of skills of a healthy lifestyle. There are analyzed issues of the awareness of employees about the necessity of medical prevention, including healthy lifestyle, the main causes of non-compliance of legislation.
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Valeyeva, Elvira T., Venera T. Akhmetshina, Elmira R. Shaikhlislamova, Rosa M. Bakieva, and Albina A. Distanova. "Аnalysis of selected indices of disability of adult population and health care workers of the Republic of Bashkortostan." HEALTH CARE OF THE RUSSIAN FEDERATION 65, no. 3 (July 12, 2021): 191–97. http://dx.doi.org/10.47470/0044-197x-2021-65-3-191-197.
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Introduction. The problem of disability of the population includes medical and social, economic, moral, and ethical aspects, since it affects a considerable number of people, mainly of working age. This also applies to health care workers, whose role in solving the tasks of state policy to preserve and prolong the active life of a person is invaluable. Purpose. Analysis of the levels, trend, and structure of primary disability among the Republic of Bashkortostan’s adult population and health care workers. Material and methods. Primary disability was studied according to the annual reports and 936 certificates of examination for disability in the Bureau of medical and Social expertise of the Republic of Bashkortostan for 2015-2017. Results. During the analyzed period, there is practically no tendency to decrease disability indices among the population of the Republic of Bashkortostan; among health care workers, in 2017 this value decreased by 1.1 times compared to 2015, amounting to 49.5 per 10 thousand population. In the structure of primary disability, the most numerous both among the population and among medical workers were persons with group III disability. Among the causes of disability of the adult population of the Republic of Bashkortostan, diseases of malignant aetiology (37.4%) and diseases of the circulatory system (25.9%) hold the top place. The direct access to disability, the cause of neoplasms of malignant aetiology, in medical workers for all the years of observation exceeded the national indices by 1.1-1.4 times. Breast, ovarian, and cervical cancer prevailed in the structure of oncological diseases among doctors. Disability among medical workers due to conditions of the circulatory system is established for every third doctor (32.9%). Conclusion. The basis for early diagnosis of diseases and prevention of disability of health care workers should be high-quality periodic medical examinations with mandatory implementation of the full scope of laboratory and functional research methods.
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Burns, Robert A., J. Stephen Roy, Cavan Woods, Arvind A. Padhye, and David W. Warnock. "Report of the First Human Case of Lobomycosis in the United States." Journal of Clinical Microbiology 38, no. 3 (2000): 1283–85. http://dx.doi.org/10.1128/jcm.38.3.1283-1285.2000.
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We describe the first human case of lobomycosis caused byLacazia loboi in a 42-year-old white male resident of Georgia. The patient had traveled to Venezuela 7 years earlier, where he had planned to rappel down Angel Falls in Canaima. Although he never actually rappelled the falls, he did walk under the falls at least three times, exposing himself to the high water pressures of the falls. He noticed a small pustule with surrounding erythema developing on the skin of his right chest wall. The lesion gradually increased in size and had an appearance of a keloid. For cosmetic reasons, the patient sought medical treatment to remove the lesion. After an uncomplicated excision of the lesion, the patient recovered completely. The excised tissue was fixed in formalin for pathologic examination. Tissue sections stained by hematoxylin and eosin, periodic acid-Schiff stain, and Gomori methenamine silver stain procedures showed numerous histiocytes, multinucleated giant cells, and numerous globose or subglobose, lemon-shaped cells producing multiple blastoconidia connected by narrow tube-like connectors and catenate chains of various lengths characteristic of L. loboi.
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Izmerova, Natalia I., Ilona Ya Chistova, Natalia A. Bogacheva, Yana A. Petinati, and Anastasia V. Derevnina. "Dermatoscopy is effective method for diagnostics of skin neoplasms in workers with industrial carcinogens." Russian Journal of Occupational Health and Industrial Ecology 61, no. 4 (May 25, 2021): 267–74. http://dx.doi.org/10.31089/1026-9428-2021-61-4-267-274.
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Introduction. One of the urgent problems of medicine around the world is the growth of malignant diseases. The impact of the production environment in developing professional and production-related skin malignancies is a sensitive area of occupational health. The high prevalence of precancerosis and the increase in the incidence of skin cancer in people of working age indicates the need to improve diagnostic and preventive measures. One of the most effective recognized non-invasive differential diagnoses of skin tumors with high diagnostic accuracy and sensitivity is dermatoscopy. The study aims to substantiate the importance of dermatoscopic diagnosis of skin neoplasms in workers with industrial carcinogens. The researchers analyzed the available literature and statistical data on the impact of industrial carcinogens on benign and malignant skin lesions in workers in various industries. Specialists from Clinic of the "Izmerov Research Institute of Occupational Health" examined 1,136 people during periodic medical examinations. The features of the signs of neoplasms evaluate according to the principle of their presence or absence. There were two groups: group 1 (n=648) consisted of persons who have contact with industrial carcinogens according to the special assessment of working conditions (SAWC), group 2 (n=488) - persons who do not have contact with carcinogens in the workplace. We found that the frequency of benign skin neoplasms increases depending on the length of work in contact with a production carcinogen. Researchers developed the criteria of clinical and anamnestic signs (the main of which are the working conditions). Dermatoscopic criteria for the initial signs of malignancy of skin neoplasms allow us to form a group of dynamic observations of skin neoplasms in patients working with carcinogens during periodic medical examinations. We formed a group of 38 people (29 from the first and 9 from the second group) for monitoring the dynamics of changes in neoplasms with an appearance to a dermatovenerologist after three months. Specialists sent seven people for additional examination by an oncologist to clarify the degree of existing signs of dysplasia. The formation of a dynamic observation group with the risk of malignancy of skin neoplasms will optimize early diagnosis and ensure high efficiency of treatment in outpatient settings.
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Pransky, Glenn, Radoslaw Wasiak, and Jay Himmelstein. "Legal Update: Social Security Disability Insurance." Guides Newsletter 8, no. 4 (July 1, 2003): 5–12. http://dx.doi.org/10.1001/amaguidesnewsletters.2003.julaug03.
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Abstract The US Social Security Disability Insurance (SSDI) system does not use the AMA Guides to the Evaluation of Permanent Impairment, but examinees who are evaluated for permanent impairment frequently also are receiving SSDI benefits. The latter are restricted to workers who have long-term impairments that are so severe they preclude any type of gainful compensable activity, and the impairment must be medically determinable and expected to last at least a year or result in death. Both SSDI and the Supplemental Security Income plan (primarily for workers who have insufficient past work contributions) require the examining physician to provide specific medical information such as the medical history, physical examination, laboratory findings, and impairment, often using standardized forms. Examiners should know that the observations of the treating physician have legal significance, especially in areas of controversy. Social Security may approve additional diagnostic testing in order to conclusively establish the extent and severity of an illness. Based on the patient's history and observations during the examination, physicians also are asked to report any impairments in daily functioning, but examiners are advised not to address work-relatedness and are discouraged from discussing ability to work, which is determined by the state disability agency. Infrequent follow-up reports may be requested because most accepted claims are reviewed on a periodic (yearly) basis.
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D’Arcy, Joanna L., Olivier Manen, Eddie D. Davenport, Thomas Syburra, Rienk Rienks, Norbert Guettler, Dennis Bron, Gary Gray, and Edward D. Nicol. "Heart muscle disease management in aircrew." Heart 105, Suppl 1 (November 13, 2018): s50—s56. http://dx.doi.org/10.1136/heartjnl-2018-313058.
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This manuscript focuses on the broad aviation medicine considerations that are required to optimally manage aircrew with suspected or confirmed heart muscle disease (both pilots and non-pilot aviation professionals). ECG abnormalities on aircrew periodic medical examination or presentation of a family member with a confirmed cardiomyopathy are the most common reason for investigation of heart muscle disease in aircrew. Holter monitoring and imaging, including cardiac MRI is recommended to confirm or exclude the presence of heart muscle disease and, if confirmed, management should be led by a subspecialist. Confirmed heart muscle disease often requires restriction toflying duties due to concerns regarding arrhythmia. Pericarditis and myocarditis usually require temporary restriction and return to flying duties is usually dependent on a lack of recurrent symptoms and acceptable imaging and electrophysiological investigations.
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Kawazu, Yukiko, Noboru Inamura, Futoshi Kayatani, Nobuhiko Okamoto, and Hiroko Morisaki. "Prenatal complex congenital heart disease with Loeys–Dietz syndrome." Cardiology in the Young 22, no. 1 (July 21, 2011): 116–19. http://dx.doi.org/10.1017/s1047951111001028.
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AbstractWe report an infantile case of Loeys–Dietz syndrome prenatally diagnosed with congenital complex heart disease – double outlet right ventricle and interruption of the aortic arch. The patient also showed prominent dilatation of the main pulmonary artery. Emergency bilateral pulmonary artery banding was performed on the 9th day. However, on the 21st day, the patient died of massive bleeding due to rupture of the right pulmonary artery. Subsequently, a mutation of the TGFBR1 gene was detected. As cardiovascular lesions of Loeys–Dietz syndrome appear early and progress rapidly, the prognosis is generally poor. Patients require periodic examination and early intervention with medical therapy such as Losartan administration and surgical therapy. Early genetic screening is thought to be useful for the prediction of complications as well as vascular disease.
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Rathsam-Pinheiro, Regina Helena, Ney Boa-Sorte, Cristina Castro-Lima-Vargens, Carlos Aldir Pinheiro, Humberto Castro-Lima, and Bernardo Galvão-Castro. "Ocular lesions in HTLV-1 infected patients from Salvador, State of Bahia: the city with the highest prevalence of this infection in Brazil." Revista da Sociedade Brasileira de Medicina Tropical 42, no. 6 (December 2009): 633–37. http://dx.doi.org/10.1590/s0037-86822009000600004.
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In order to determine the prevalence of ocular lesions in HTLV-1 infected patients in Salvador Bahia, a transversal study was conducted on 140 HTLV-1 infected patients (90 asymptomatic and 50 tropical spastic paraparesis/HTLV-1-associated myelopathy) between June 2004 and November 2005. The ophthalmological examination included visual acuity measurement, ocular motility, biomicroscopy of the anterior and posterior chambers, intraocular pressure and evaluation of lachrymal secretion. Observation verified 4 (2.8%) out of 140 patients with uveitis (two patients had intermediate uveitis and two had pan-uveitis) and 39 (36.4%) out of 107 patients with keratoconjunctivitis sicca. The prevalence of Keratoconjunctivitis sicca was significantly higher among the TSP/HAM patients (OR age adjusted=3.64; 95%CI 1.59-8.32). Uveitis and corneal opacities were also important findings, indicating the strong need for periodic ophthalmological follow-up in all HTLV-1 subjects.
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Mcloughlin, D. C. "Aircrew periodic medical examinations." Occupational Medicine 53, no. 1 (February 1, 2003): 11–14. http://dx.doi.org/10.1093/occmed/kqg022.
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Song, Dong Eun, Andrea G. Kahn, Shin Kwang Khang, and Jae Y. Ro. "Pseudofungi in Pericolic Lymph Nodes." Archives of Pathology & Laboratory Medicine 129, no. 4 (April 1, 2005): e97-e100. http://dx.doi.org/10.5858/2005-129-e97-pipln.
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Abstract We report a case of extensive pseudofungi in the pericolic lymph nodes. A 45-year-old man presented with lower abdominal discomfort, and large solid and cystic masses were discovered in the pelvic cavity by computed tomography. Debulking of the masses (by means of a Hartmann operation) was performed under the clinical impression of a pelvic sarcoma, and histologically the masses demonstrated features of a malignant gastrointestinal stromal tumor. All pericolic lymph nodes demonstrated multiple septate hyphae–like structures with pigmentation, particularly in the subcapsular sinuses. These structures showed positive staining with periodic acid–Schiff, but Gomori methenamine silver staining was negative. The structures appeared to be composed of iron, phosphorus, and calcium by Perls iron and von Kossa stains and revealed deposition of electron-dense granules on electron microscopic examination. Energy-dispersive radiographic micro-analysis showed the structures to contain phosphorus, sulfur, potassium, calcium, and iron. Pseudofungi can be misinterpreted as true fungi with septate hyphae; therefore, a careful morphologic examination with appropriate special stains is mandatory.
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Rohr, J. M., S. Pirruccello, and A. Sofronescu. "Elevated Cardiac Troponin in the Setting of Periodic Symptomatology: A Case Report." American Journal of Clinical Pathology 154, Supplement_1 (October 2020): S89—S90. http://dx.doi.org/10.1093/ajcp/aqaa161.196.
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Abstract Introduction/Objective Serial cardiac troponin measurement is a sensitive method to identify recent cardiac injury and is a necessary function of the clinical chemistry laboratory. We present a case of out-of-range cardiac troponin I (cTnI) elevation which remained spuriously elevated for at least 30 days. Methods Cardiac troponins were measured on a DxI (Beckman Coulter), Vitros 5600 (Ortho Clinical Diagnostics), iSTAT (Abbott), and Cobas e602 (Roche) according to the manufacturers’ instructions with appropriate controls. Heterophile antibody blocking (Scantibodies Laboratories) was performed according to the package insert. Results A 58-year-old male with a medical history significant for chronic non-ischemic cardiomyopathy with open valvular repair (ejection fraction 15-20%), chronic atrial fibrillation, and Hodgkin’s lymphoma in remission presented to a rural clinic with chest pain and a cTnI of 0.8 ng/mL (reference <0.04 ng/mL). He was transferred to our tertiary center for open revision. The patient’s cTnI (measured on a Beckman Coulter DxI) was above linearity threshold (>71.00 ng/mL) starting day 1 after surgery. The patient self-discharged against medical advice on day 16. On day 21 he experienced new chest pain and dyspnea and was readmitted with a cardiac troponin T (cTnT) of >35 ng/mL (iSTAT; reference <0.08 ng/mL) and cTnI again above threshold. This value remained elevated for the next five days despite abated symptoms. To address the discordant laboratory and physical findings, dilutional cTnI measurements on serum from day 30 demonstrated linearity. Heterophile antibody testing was negative. cTnI on the DxI machine remained >71.00 ng/mL but was separately measured as 3.4 ng/mL (Vitros 5600, reference <0.08 ng/mL). cTnT was found to be 1.05 ng/mL (Cobas e602; reference 0.00 ng/mL). Comparative examination of all methodologies was unrevealing. Conclusion This case demonstrates a spurious elevation of cardiac troponins which remarkably demonstrated linearity on serial dilution. Multiple testing methodologies were necessary to prove fallacy. The cause of the result remains unclear. The clinical pathologist should be aware of possible false positives and investigate unlikely continuous cardiac troponin elevations.
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Gruszecka, Jolanta, Rafał Filip, and Dorota Gutkowska. "The State of Microbiological Cleanliness of Surfaces and Equipment of an Endoscopic Examination Laboratory—Data from a Reference Tertiary Clinical Endoscopy Center in Southern Poland." International Journal of Environmental Research and Public Health 18, no. 12 (June 11, 2021): 6346. http://dx.doi.org/10.3390/ijerph18126346.
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The increasing number of endoscopic procedures performed and their increasing invasiveness mean that endoscopy of the gastrointestinal tract is associated with the risk of transmitting pathogenic microorganisms through infected equipment or contact with other patients and medical staff. In order to ensure protection of the health of both patients and medical staff, endoscopy laboratories should meet high hygiene standards. The results of tests of the microbiological cleanliness of surfaces and equipment of an endoscopic examination laboratory performed in the period from January to December 2019 at the Provincial Clinical Hospital No. 2 in Rzeszow were assessed retrospectively. Samples for testing were collected by swabbing from places where microbiological contamination was the most likely and cleaning was the most difficult. In the analyzed period, a total of 86 samples were collected for microbiological tests, of which positive results accounted for 6.9%. Positive results were obtained mainly from swabs collected from wet surfaces (66.7%). Most of the isolated microorganisms were Gram-negative bacteria (66.7% of all positive tests) and they were: Acinetobacter junii, Ralstonia pickettii, and Achromobacter denitrificans. The condition of the microbiological cleanliness of the surfaces and equipment of the endoscopic examination laboratory was satisfactory. A very low level of microbiological contamination of the tested items indicates occasional shortcomings in the decontamination processes. Since microorganisms isolated from the collected samples may be the cause of infection in patients and medical personnel, it is necessary to verify the decontamination procedures applied and to continue periodic microbiological monitoring of their effectiveness.
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Kim, Woo Jung, Ji Min Sung, David Sung, Myeong-Hun Chae, Suk Kyoon An, Kee Namkoong, Eun Lee, and Hyuk-Jae Chang. "Cox Proportional Hazard Regression Versus a Deep Learning Algorithm in the Prediction of Dementia: An Analysis Based on Periodic Health Examination." JMIR Medical Informatics 7, no. 3 (August 30, 2019): e13139. http://dx.doi.org/10.2196/13139.
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Background With the increase in the world’s aging population, there is a growing need to prevent and predict dementia among the general population. The availability of national time-series health examination data in South Korea provides an opportunity to use deep learning algorithm, an artificial intelligence technology, to expedite the analysis of mass and sequential data. Objective This study aimed to compare the discriminative accuracy between a time-series deep learning algorithm and conventional statistical methods to predict all-cause dementia and Alzheimer dementia using periodic health examination data. Methods Diagnostic codes in medical claims data from a South Korean national health examination cohort were used to identify individuals who developed dementia or Alzheimer dementia over a 10-year period. As a result, 479,845 and 465,081 individuals, who were aged 40 to 79 years and without all-cause dementia and Alzheimer dementia, respectively, were identified at baseline. The performance of the following 3 models was compared with predictions of which individuals would develop either type of dementia: Cox proportional hazards model using only baseline data (HR-B), Cox proportional hazards model using repeated measurements (HR-R), and deep learning model using repeated measurements (DL-R). Results The discrimination indices (95% CI) for the HR-B, HR-R, and DL-R models to predict all-cause dementia were 0.84 (0.83-0.85), 0.87 (0.86-0.88), and 0.90 (0.90-0.90), respectively, and those to predict Alzheimer dementia were 0.87 (0.86-0.88), 0.90 (0.88-0.91), and 0.91 (0.91-0.91), respectively. The DL-R model showed the best performance, followed by the HR-R model, in predicting both types of dementia. The DL-R model was superior to the HR-R model in all validation groups tested. Conclusions A deep learning algorithm using time-series data can be an accurate and cost-effective method to predict dementia. A combination of deep learning and proportional hazards models might help to enhance prevention strategies for dementia.
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Noyek, Arnold, David Brodovsky, Stephen Coyle, Martin Desrosiers, Saul Frenkiel, Michael Hawke, James D. Kellner, et al. "Classification, Diagnosis and Treatment of Sinusitis: Evidence-Based Clinical Practice Guidelines." Canadian Journal of Infectious Diseases 9, suppl b (1998): 3B—24B. http://dx.doi.org/10.1155/1998/705646.
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OBJECTIVE: To provide evidence-based recommendations for classification, diagnosis and treatment of acute, chronic and recurrent acute sinusitis in adults and children.DATA SOURCES: Review articles, textbooks, other published guidelines and recommendations of task force members.STUDY SELECTION: One hundred and seventy-one papers addressing one or all of the objectives.DATA EXTRACTION: Relevant data were collated under each objective.DATA SYNTHESIS: Validity of diagnostic and treatment evidence was assessed by using the methodological recommendations of Sackett et al and the canadian Task Force on Periodic Health Examination, respectively. Where there was a paucity of data, consensus of task force members was reached.CONCLUSIONS: Sinusitis is classified as acute, chronic or recurrent acute disease according to duration and frequency of symptoms and response to therapy (expert opinion). Potential risk factors, concomitant diseases and complications are identified (limited evidence). Diagnosis is based on symptoms, history and physical examination. For adults, independentpredictors of acute sinusitis include maxillary toothache, coloured nasal discharge, poor response to nasal decongestants/antihistamines and mucopurulent nasal secretions (good evidence); for children, cough, nasal discharge and fever are common (good evidence). For chronic disease that persists despite adequate therapy and recurrent acutedisease, referral to a specialist for investigative measures (nasal endoscopy, computed tomography) is often necessary to determine predisposing anatomical features. Level I evidence supports the use of antibiotics for the treatment of sinusitis; selection is based on the local pattern of bacterial resistance, relative efficacy, safety and cost. Amoxicillinclavulanate, cefuroxime axetil, cefixime, ciprofloxacin and clarithromycin are approved for the treatment of acute sinusitis in canada. Amoxicillin, amoxicillin-clavulanate and cefuroxime axetil have been shown to be effective in children. Ciprofloxacin, amoxicillin-clavulanate, clarithromycin and erythromycin have been shown to be effective in chronic disease, although no agents have been approved for this indication. Given changing patterns of bacterial resistance, more up-to-date comparative efficacy data are needed.
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Sorokin, Gennadiy A. "The age and work experience dynamics of indices of health of employees as criteria for comparison of occupational and nonoccupational risks." Hygiene and sanitation 95, no. 4 (October 28, 2019): 355–60. http://dx.doi.org/10.18821/0016-9900-2016-95-4-355-360.
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There are reported data of the analysis ofparameters of the general morbidity (hypertension, chronic diseases, organs of respiratory and digestive system , adiposity, vertebral osteochondrosis) in dependence on age and work experience of dockers-mechanizators in seaport at various working conditions. Morbidity rate indices were calculated on results of the profound medical examination at annual periodic surveys of workers. There were analyzed ecological and ergonomic indices of working conditions, including an estimation of physiological intensity of the work. The general hygienic assessment of working conditions was executed on the basis of the measurement of rates of gains in the risk of diseases depending on age and the experience of work (an annual gain of risk). The divergence of these rates was used for the determination of occupational and nonoccupational fractions of the general morbidity in employees working in harmful conditions.
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Recine, Monica A., Maria T. Perez, Beria Cabello-Inchausti, Rogerio C. Lilenbaum, and Morton J. Robinson. "Extranodal Lymphoplasmacytoid Lymphoma (Immunocytoma) Presenting as Small Intestinal Obstruction." Archives of Pathology & Laboratory Medicine 125, no. 5 (May 1, 2001): 677–79. http://dx.doi.org/10.5858/2001-125-0677-ellipa.
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Abstract A 57-year-old woman presented with intermittent symptoms of intestinal obstruction. Workup provided nondiagnostic radiologic studies. An exploratory laparotomy revealed a segmental dilatation in the proximal ileum, which showed diffuse thickening of the intestinal wall. Microscopic examination of the affected area disclosed a diffuse transmural infiltrate composed of small lymphocytes, mature plasma cells, and lymphoplasmacytoid cells in different stages of maturation associated with extracellular periodic acid-Schiff–positive material. In addition, serum protein electrophoresis showed a monoclonal immunoglobulin M κ paraprotein. Postoperative workup did not demonstrate evidence of systemic involvement. The morphologic features and immunohistochemical and molecular analyses were consistent with lymphoplasmacytoid lymphoma (immunocytoma). We report an unusual case of primary extranodal immunocytoma involving the small intestine and discuss its clinicopathologic features.
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Isaeva, N. A., A. P. Bobrov, V. I. Sedin, and V. Yu Scheblanov. "Assessment criteria of individual occupational risks in nuclear industry employees." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 2 (June 22, 2019): 46–52. http://dx.doi.org/10.25016/2541-7487-2019-0-2-46-52.
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Relevance. In the concept of long-term development of social and economic policy of the Russian Federation, the problem of preservation and strengthening of employees’ health is given a top priority and requires improvement of the citizen health protection. Risk assessment and, in particular, occupational risk assessment is part of the process that includes probability analysis of dangerous events for employees’ health and decision-making about the necessity of risk reduction. The principles of prevention and constant improvement of the assessment system and occupational risk management in accordance with the Concept of demographic policy of the Russian Federation have determined the relevance of this research.Purpose: To assess individual occupational risks in employees based on regular medical examination data and obligatory psychophysiological tests.Methodology. Due to the absence of professional diseases associated with the exposure to ionizing radiation and a low level of work-related injuries at high-tech nuclear enterprises, it is not reasonable to consider current indicators of occupational risk and working conditions while assessing individual occupational risks. Classes of working conditions in terms of harm and danger, the employee’s health group, the presence of work-related diseases and the level of allostatic load are sufficient for practical assessment.Results and analysis. The article presents the formula for calculating the allostatic load index based on the psychophysiological examination data, which are mandatory for periodic medical examinations of nuclear industry workers. A one-dimensional multi-parameter indicator and critical rules to assess employee health loss were developed, along with a regression model to forecast the employee health loss by classes of working conditions. The risk matrix was developed to assess the individual occupational risks.Conclusion. For the high-tech nuclear industry, where the safety culture is monitored at the enterprises in accordance with the IAEA recommendations, the classes of working conditions in terms of harm and danger, the employee’s health group, the group of work-related hazards and the level of allostatic load are sufficient for practical assessment of individual occupational risks.
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Abdelmalik, Peter A., Timothy Ambrose, and Rodney Bell. "Herpes Simplex Viral Encephalitis Masquerading as a Classic Left MCA Stroke." Case Reports in Neurological Medicine 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/673724.
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Objective. Stroke is a clinical diagnosis, with a history and physical examination significant for acute onset focal neurological symptoms and signs, often occurring in patients with known vascular risk factors and is frequently confirmed radiographically.Case Report. A 79-year-old right-handed woman, with a past medical history of hypertension, hyperlipidemia, and prior transient ischemic attack (TIA), presented with acute onset global aphasia and right hemiparesis, in the absence of fever or prodrome. This was initially diagnosed as a proximal left middle cerebral artery (MCA) stroke. However, CT perfusion failed to show evidence of reduced blood volume, and CT angiogram did not show evidence of a proximal vessel occlusion. Furthermore, MRI brain did not demonstrate any areas of restricted diffusion. EEG demonstrated left temporal periodic lateralized epileptiform discharges (PLEDs). The patient was empirically loaded with a bolus valproic acid and started on acyclovir, both intravenously. CSF examination demonstrated a pleocytosis and PCR confirmed the diagnosis of herpes simplex viral encephalitis (HSVE).Conclusions. HSVE classically presents in a nonspecific fashion with fever, headache, and altered mental status. However, acute focal neurological signs, mimicking stroke, are possible. A high degree of suspicion is required to institute appropriate therapy and decrease morbidity and mortality associated with HSVE.
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Artaechevarria Artieda, June, Nuria Estébanez-Corrales, Olga Sánchez-Pernaute, and Nicolás Alejandre-Alba. "Peripheral Ulcerative Keratitis in a Patient with Bilateral Scleritis: Medical and Surgical Management." Case Reports in Ophthalmology 11, no. 3 (September 25, 2020): 500–506. http://dx.doi.org/10.1159/000508325.
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Peripheral ulcerative keratitis (PUK) is a group of corneal disorders that cause peripheral corneal thinning, threatening globe integrity in advance stages. It is usually associated with systemic autoimmune diseases and management is based on local and systemic approaches. We present the case of a 47-year-old man with a previous history of bacterial keratitis in his left eye presenting with 1 month of bilateral ocular pain and redness. At examination, diffuse bilateral globe inflammation with paracentral corneal thinning in his left eye was observed. He was diagnosed with bilateral scleritis and PUK in his left eye. Workup for associated systemic autoimmune disease yielded negative results. The patient was started on pulses of intravenous methylprednisolone followed by oral prednisone failing to achieve sufficient control of the inflammatory syndrome. Subsequently, periodic intravenous cyclophosphamide was administered with a favorable response. A multilayer amniotic membrane graft was applied, but there was rapid melting with reabsorption of the tissue, resulting in extreme corneal thinning at the inferior paracentral cornea. A decentered 8.5-mm superficial anterior lamellar keratoplasty (SALK) was then performed obtaining the donor graft with a femtosecond laser but performing manual trepanation in the recipient. At 12 months, visual and biomicroscopic measures do not show deterioration and inflammation remains under control with oral azathioprine as maintenance regime. The management of PUK includes both systemic immunosuppression and tectonic procedures to preserve the globe integrity. Diverse surgical techniques have been attempted, but no definitive guidelines are available. Decentered large SALK is a simple technique that can yield acceptable visual results.
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Smith, K. L., V. DeVos, H. Bryden, L. B. Price, M. E. Hugh-Jones, and P. Keim. "Bacillus anthracis Diversity in Kruger National Park." Journal of Clinical Microbiology 38, no. 10 (2000): 3780–84. http://dx.doi.org/10.1128/jcm.38.10.3780-3784.2000.
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The Kruger National Park (KNP), South Africa, has a recorded history of periodic anthrax epidemics causing widespread disease among wild animals. Bacillus anthracis is the causative agent of anthrax, a disease primarily affecting ungulate herbivores. Worldwide there is little diversity among B. anthracis isolates, but examination of variable-number tandem repeat (VNTR) loci has identified six major clones, with the most dissimilar types split into the A and B branches. Both the A and B types are found in southern Africa, giving this region the greatest genetic diversity of B. anthracis worldwide. Consequently, southern Africa has been hypothesized to be the geographic origin of B. anthracis. In this study, we identify the genotypic types of 98 KNP B. anthracis isolates using multiple-locus VNTR analysis. Two major types are evident, the A branch and the B branch. The spatial and temporal distribution of the different genotypes indicates that anthrax epidemic foci are independent, though correlated through environmental cues. Kruger B isolates were found on significantly higher-calcium and higher-pH soils than were Kruger type A. This relationship between genotype and soil chemistry may be due to adaptive differences among divergent anthrax strains. While this association may be simply fortuitous, adaptation of A types to diverse environmental conditions is consistent with their greater geographic dispersal and genetic dissimilarity.