Search

The objective of the present study was the retrospective analysis of the cases of rapid diagnostics of the HIV status of the corpses referred to the pathologo-anatomical departments of Moscow. The standard statistical methods were used for this purpose. The structure of H IV infections is described in terms of age and sex of the affected subjects as well as stages of the disease. It was shown that cooperation of forensic medical services with AIDS control and prevention centres is of primary importance for the substantiation of the diagnosis, improvement of the quality of the relevant statistical information about the causes of death, enhancement of the objective value of epldemiological data on the occurrence of HIV infection and HIV-associated diseases in the city of Moscow.

In the article there are considered the main problems of assessing public health risks of the combined effects of high temperatures and air pollution with the account taken of the consequences of abnormally hot weather observed in summer 2010 in Moscow and without equals in the history of meteorological measurements in the city. The daily average concentrations of fine suspended particles matter (PM10) in the city during peatland fires from 4 to 9 August are emphasized to be within the range of 431-906 μ/m3, being 7.2-15.1 times the Russian maximum permissible concentration (MPCs) (60 μ/m3). The anomalous heat and high levels of air pollution in this period were shown to cause a significant increase in excess mortality among the population of Moscow. There was established the relative gain in mortality from all natural causes per 10 μg/m3 increase in daily average concentrations of PM10 and ozone, which was respectively: 0.47% (95%; CI: 0.31-0.63) and 0.41% (95%; CI: 0.31-1.13). On the base of the statistical analysis of daily mortality rates, meteorological indices, the concentrations of PM10 and ozone there was developed marking scale for the risk assessment of these indices accordingly to 4 gradings--low (permissible), warning, alert, and a hazard level. There has been substantiated the importance of the introduction of the system for the early alert for hazard weather events and the unified rating scale for the hazard of high air temperatures and high levels of air pollution with PM10 and ozone, which allows to take timely measures for the protection of the public health.

The objective of the present study was to elucidate the causes of late detection of malignant neoplasms of ENT and oral cavity and low survival of the patents with these tumours in Moscow. The secondary objective was to elaborate the organizational measures for reducing the level of negligence and mortality from these malignancies among the city population. It was shown that the main cause behind the negligence is the late application of the patients for the medical assistance. Next in importance are asymptomatic clinical course of the disease in the absence of the pathognomonic and early signs of malignant neoplasms, a combination of several pathologies, imperfection of medical knowledge, and the poor resolving power of the modern methods. It is emphasized that the lack of vigilance against cancer among the practicing health providers is one of the main causes of medical errors. A few ways to address the problem of negligence with respect to malignant neoplasms of ENT and oral cavity in Moscow are proposed.

Unlabelled: Numerous studies have shown that Helicobacter pylori (H. pylori) is a leading etiologic factor in the development of chronic atrophic gastritis, one gastric ulcer and duodenal ulcer and gastric cancer. Effective prevention of gastroduodenal pathology requires the right information about its prevalence in the population and risk factors. The most reliable information can be obtained during medical examination of the able-bodied population, which provides in-depth clinical examination of contingents with the identification of asymptomatic pathology, detection of risk groups, the substantiation ofprophylactic measures and tracking their efficacy., Material and Methods: During the clinical examination of the manufacturing contingents there was performed a study of the presence of infection Helicobacter pylori (H. pylori) in 2414 people aged 19 to 74 years. For more details on the presence of gastroduodenal pathology 991 people were examined with the use of clinical methods and interviews. The aggregation of information presented in the form of estimates for its geocoding and mapping has been made. Cluster analysis was performed., Results: H. pylori infection was diagnosed in 2,182 people accounting for 90.4% out of 2414 examined cases. Infections occurred equally in males--91.7% and females--89.6%. The risk of development of gastroduodenal pathology in individuals infected with H. pylori is 4.4 times greater than the risk in seronegative individuals (95%, confidence interval 1.9-6.4). Cluster analysis revealed a statistically significant clusters for the strata with a prevalence of 100% (X2 = 45.5204) and below 50% of infection rate (X2 = 7.36). It is in prospect to analyze in more detail the data relating to these areas in order to identify the factors contributing to the different degree of infection rate of residents, including the assessment of drinking water.

In Moscow region long-livers we have studied distribution of LPL, CETP, APOE, F2, F5, F7, F13, FGB, ITGA2, ITGB3, PAI-1, MTHFR, MTRR, HLA-DRB1, HLA-DQA1, HLA-DQB1 genes polymorphisms, associated with predisposition to age pathology. Long-livers are characterized by favorable course of cardiovascular diseases accompanied by certain genetic factors. We have established that genotype H-H- of LPL, allele epsilon2 of APOE, genotype CC of MTHFR (677C > T), genotype TC of ITGB3, genotype GA of FGB, HLA-DRB1*11 positively correlate with longevity.

The epidemiological study of multiple sclerosis (MS) has been done in the population (927 400 people) of the North-Western Administrative District (SZAO) of Moscow for the period of 2008-2012. In average for the 5 years the prevalence of MS was amounted to 53.38 cases per 100 000 population, incidence was 2.16 cases per 100 000 population and the mortality rate was 0.23 cases per 100 000 population. Thus, the population of SZAO belongs to high-incidence area. An increase in the prevalence of MS as well as a reduction of incidence and mortality were observed during a comparative analysis with the epidemiological indicators of MS in Moscow in the period of 1991-1996. Such dynamics of epidemiological indicators is due to the accumulation of patients in population that, in the first place, is related with the quality improvement of diagnostic and therapeutic-rehabilitative measures which increased the frequency of early diagnosis and patient's life expectancy together with the implementation of disease-modifying therapy (DMT) and modern methods of symptomatic treatment.

New biomarkers of effect of some controlled ambient air pollutants (formaldehyde, carbon monoxide and TSP) were found in two surveys of Moscow residents (apparently healthy and outpatients with allergic diseases) with a help of screening system of biochemical and immunological parameters. Possible mechanisms of the effects, including interference of atmospheric carbon monoxide and sulfur dioxide with corresponding endogenous second messengers, are discussed.

The high prevalence of tobacco smoking among modern-day children and adolescents largely determines a poor prognosis of human health in future. Smoking prevention among children and adolescents in general educational facilities is the most promising measure to solve this sociomedical problem. The investigation was undertaken to study smoking prevalence among middle school age pupils, to identify the major factors contributing to their taking up smoking, and to define information sources and the pupils' awareness about the negative impact of smoking.

The carcinogenic risk to the Moscow population exposed to ambient air pollutants, such as benzene and formaldehyde, discharged by motor transport has been assessed. The ways of lowering the negative impact of motor transport on the urban environment are considered.

Environmental pollution has a negative impact on the health status of the population, on that of children in particular. In-depth developments of primary morbidity of childhood diseases of respiratory organs as a system that is mostly exposed to ambient air pollution have indicated that respiratory diseases, including their chronic forms, are more frequently notified in the children residing in the areas characterized by high levels of air pollution. Formaldehyde and nitric dioxide, i.e. the chemical compounds the concentrations of which exceed the hygienic normal values, make the greatest contribution to risk formation. In-depth analysis of morbidity rates in the children living in the areas along which the heavy-traffic motorways pass has demonstrated that chronic respiratory diseases are more frequently registered in these children than in those residing in the areas remote from the motorways. A role of social factors influencing the increase of the so-called alimentary-dependent diseases is shown.

The ambient atmosphere of Moscow is appraised as unbeneficial to the health of the population, that of children and adolescents in particular. Motor transport is a powerful source of the ambient air pollution of Moscow. The average annual level of atmospheric pollution in 2008 is considered to be moderate. Scientific-and-practical studies using the risk assessment methodology also suggest that the ambient air in Moscow is the leading habitat posing a carcinogenic and non-carcinogenic risk to Muscovites' health.

One of the aims in the strategy of Moscow health service is perfection of early diagnosis of urological diseases. Examination of about 1.500000 males over 50 years was conducted in 2002-2007. The number of PSA tests rose 5-fold for 5 years. The number of ultrasonographies and transrectal ultrasonic investigations of the prostate rose from 21650 (2002) to 128890 (2007), the number of polyfocal biopsies--from 2165 (2002) to 12219 (2007). The rate of detection of prostatic diseases increased from 1146 cases per 100000 adult male population (1999) to 2097 (2007). Chronic prostatitis was registered in 17.8%, prostatic adenoma in 29.6% examinees, new cases of prostatic cancer were detected in 0.86% examinees. Standard prostatic cancer morbidity rose from 30.4 to 47.0 per 100000 male population. Percentage of early detected prostatic cancer increased from 42.9% in 2000 to 62% in 2007, detection of prostatic cancer stage III-IV reduced from 27.3% in 2000 to 16.6% in 2007. Thus, new prophylactic measures improved efficacy of outpatient urological service, raised rate of detection of chronic prostatitis, prostatic adenoma, prostatic cancer

The paper analyzes morbidity among Moscow schoolchildren in the past 50 years on the basis of the results of in-depth studies of pupils by the researchers of the Research Institute for the Hygiene and Health Care of Children and Adolescents. There is a significant reduction in the number of absolutely healthy children, the proportion of which is 2-4%. There is a considerable increase in the prevalence of dysfunctions and chronic diseases among schoolchildren. Particularly high increment rates of morbidity were observed in the 1990s. The morbidity structure has changed in the past 50 years. Both biomedical and psychosocial factors are responsible for changes in the morbidity levels and structure of children and adolescents.

The Russian Federation and Moscow also show a global tendency for dysfunctions of the locomotor apparatus (LMA) and the organ of vision (OV) to increase. Eight hundred and two adolescents from the Central Administrative District of Moscow were found to have involvements of LMA (35.4%) and OV (22.5%). There were more common abnormal posture (12.9%), spinal axis changes (11.7%), talpes (12.5%), and myopia (17.8%). The follow-ups made from 1997 to 2002 revealed an increase in the number of adolescents with functional changes (D2) with a decrease in that of apparently healthy adolescents (D1). The changes were prevalent in children born in 1986 onward. Examination of the interaction of LMA and OV as the uniform visual motor system revealed sexual dimorphism suggesting that the girls were more susceptible to these changes, which should be considered while developing a adifferential approach to teaching schoolchildren during pubertal period. Schoolchildren's health status should be systematically considered by a wide circle of specialists to estimate the maximum number of parameters in order to determine the reasons resulting in a steady-state tendency for ODA and OV dysfunctions to progress.

The objective of the present study was to analysis results of the follow-up survey involving 1,532 patients with laryngeal cancer residing in Moscow for the period from 1999 till 2005. The five-year survival rates among the patients treated in otolaringological departments of general medical care settings (12.6%) and in specialized oncological centers of Moscow (87.4%) were compared. The difference between the outcomes of the treatment are attributable to a variety of causes. It is emphasized that surgical treatment of patients with stage III and IV laryngeal cancer should be combined with radio- and chemotherapy. The treatment should be given in specialized oncological facilities having the adequately trained personnel and the necessary equipment for the in-depth examination of the patients to ensure planning rational treatment strategies and preventive medical surveillance on a permanent basis.

Analysis of time rows (daily values of mortality, temperature and pollution of ambient air) proved that present climate warming in Moscow, more subnormally hot and cold days influences level of mortality with all causes except external - with cardiovascular diseases (IHD, angina pectoris, cerebrovascular diseases including cerebrovascular accidents), chronic diseases of lower respiratory tract including bronchial asthma - especially in older age group. Heat waves are associated with significantly increased mortality. Zone of temperature comfort for Moscow, associated with minimal mortality values, is within -20 to +20 C interval.

Aim: To study prevalence of the principal symptoms of gastroesophageal reflux disease (GERD) in Moscow., Material and Methods: A total of 1065 respondents aged 15-85 years (a random representative sample of population of one of the typical Moscow districts) participated in a questionnaire survey using the international questionnaire for detection of GERD incidence., Results: Epigastric burning (EB) occurs in 39.6% examinees. GERD prevalence is 14.2%. Subjects with EB have the following symptoms of GERD: regurgitation (66.3%), epigastric pain (discomfort) (53.0%), nausea (43.6%), vomiting (23.2%), dysphagia (20.6%), chest pain (18.0%), odinophagia (5.5%), singultus (4.6%). There is a direct correlation between incidence rate of EB, height, body mass index, number of alcohol excesses and smoked cigarettes., Conclusion: EB occurs in both young and aged men and women with similar frequency. Significant differences were detected only in the age group 45-59 years in which EB is more frequent in women. All the symptoms excluding cough and singultus were seen in women significantly more frequently. With age, these differences disappeared but noncardial pain in the chest that was less frequent in the elderly. Muscovites with GERD symptoms are older (61.26 +/- 13.47 years) than those without such symptoms (58.44 +/- 16.28, p < 0.0001).

The author presents analysis of occupational morbidity in Moscow over last decade, points out main causes of low quality of preliminary and periodic medical examinations of workers, determines goals and prospective tasks of correcting the situation concerning health care of workers.

The paper presents some indices that characterize morbidity in the Moscow population, which suggest positive trends in the health status in all population groups. These include stabilization of overall morbidity rates; a down-increase in the incidence of respiratory diseases and bronchial asthma; a reduction in overall morbidity in infants of the first year of life, including a reduction in the incidence of life-threatening diseases (perinatal pathology and congenital malformations; a decrease in the incidence of alimentary diseases associated with social factors. The found positive changes reflect the efficiency of introduction of the sociohygienic monitoring (AHM) system. One of the mechanisms of introduction of AHM results is to submit data to the Moscow Government in the annual reports "On the Moscow population's health status" which cover demography, morbidity, female health, and the regional features of the population's health in relation to environmental factors. Based on information, managerial decisions and measures to improve the sanitary-and-epidemiological situation in Moscow are taken and implemented.

The article shows changes in employed population of Moscow over a period of economic changes, in employment structure by economicbranches withsubsequent reduction of individuals employed in industrial branches. Based on analysis of health parameters of employed population according to official statistics, the authors demonstrated trends in those parameters change, with the accent that those changes are less negative in Moscow than generally in Russia.

Aim: To assess 40 years evolution of atherosclerosis of the aorta and coronary arteries among practically healthy Moscow men., Methods: We compared results of 2 studies of prevalence and extent (area) of atherosclerotic lesions in thoracic and abdominal aorta and 2 main coronary arteries. The studies were conducted in 1963-1965 and 2002-2003 according to WHO program., Results: Prevalence of coronary artery stenoses as well as prevalence and area of raised lesions in these arteries were higher among violent death victims studied in 2002-2003. Raised lesions in both parts of aorta and in left anterior descending coronary artery were more pronounced also in men studied in 2002-2003.

During the period of 1953-2001 scarlet fever morbidity level fluctuated from 670.3 to 65.9 per 100,000 of the population in Moscow and from 531.9 to 35.0 per 100,000 of the population of the Russian Federation. In recent years an increased morbidity was more pronounced in Moscow than in the Russian Federation as a whole. Children formed the greater part of scarlet fever patients, the cases of scarlet fever among children in Moscow occurring more often than, on the average, in Russia. As before, annual morbidity among children attending children's institutions was higher 3- to 4-fold than among children brought up at home. This difference was most sharply pronounced among young children during the first two years of their life. In contrast to morbidity observed during previous 20-30 years, a drop in morbidity among children during the first two years of their life was registered, while morbidity level among children aged 3-6 years and 7-14 years increased. Scarlet fever morbidity had a pronounced seasonal (autumn-winter) pattern. In a group of children aged 3-5 years who attended organized groups, on the average, 78.6% of scarlet fever cases fell on seasonal morbidity, the most prolonged one.

Retrospective analysis of the epidemic of HIV infection in Moscow allowed to mark out two periods: the first--from 1987 to 1993 and the second one--from 1994 to 2000. The characteristic feature of the first period of the epidemic was the sexual transmission of the agent mainly among homosexuals; the most affected group were persons aged 20-39 years and the number of AIDS patient decreased with a simultaneous growth in lethality. During the second stage of the HIV infection epidemic changes in the prevailing transmission routes of the agent occurred: injection drug addicts took the leading role. Changes in the ratio of HIV-infected men and women took place along with active involvement of persons aged 13-18 years into the epidemic process. The established changes in the epidemiological situation require corrections in the strategy and tactics of epidemic control and prophylactic measures.

The present situation in sexually transmitted diseases (STD) is regarded as unfavorable. Differing tendencies in morbidity levels for various nosological forms have been established. The continuing growth of syphilis morbidity among children is considered to be specially alarming, and an increase in the number of cases of congenital syphilis is noted. The reasons of the growth of STD morbidity have not only medical, but mainly socio-economical, psychological, ethical and moral character. The main trends in the improvement of epidemiological surveillance on STD have been determined.

Simultaneous study of both external and hereditary risk factors of the development of multiple sclerosis (MS) was carried out in Moscow population. As a result of the genotyping of HLA-DR locus on the chromosome 6, there were found markers of the predisposition to MS: by HLA-DR: DR2(15) way, especially, in homozygous heredity and in the absence of such specificity--alleles of DR3 group. The data were confirmed concerning both the elevation of frequency of the alleles of tumor necrosis factor (TNF)a1 and alpha 2 and the decrease of frequency of TNF-alpha 7 allele in MS. There was also confirmed association of the disease with the external factors, such as "predominance of the meat nutrition at the age under 15 years" and "tonsillitis at the age under 15 years". There were two combinations of the external and hereditary factors, when the power of the association increased significantly: "predominance of meat nutrition at the age under 15 years" and DR2(15) and "tonsillitis at the age under 15 years" and DR3. When genetic factors were excluded, the relation of MS with the external factors was considerably reduced; when the external factors were excluded, the association of MS with genetic markers became statistically insignificant. A combination of these external factors, which were the sources for the additional antigenic immunostimulation, with certain genetic factors in DR region suggested the presence of the genetically determined peculiarities of the composition of antigen presentation HLA-DR in the individuals with DR2(15) and DR3. There was no statistically confirmed presence of a combination of the external factors with TNF-alpha alleles which increased additionally MS risk. The presence of immunostimulating antigen-containing external factors may be significant for the influence of TNF-alpha in less degree than for the realization of predisposition in form of the certain composition of HLA molecules.

These investigations have made it possible to establish the extent and scale of the spread of streptococcal infection (group A) and its socioeconomic importance in Moscow, a great mega-police of the world. The deterioration of the epidemiological situation in recent years, accompanied by an increase in morbidity and mortality caused by streptococcal infection, has been demonstrated. The program and conceptual foundations of epidemiological surveillance on this infection in Moscow are presented. The aspects of epidemiological surveillance (informational and analytical, diagnostic, administrative) have been indicated and described. The order and direction of their realization have been determined.

The trends in prevalence of ischemic heart disease (IHD) and risk factors for 1985-1995 have been studied on random representative samples of male population from Moscow. For the decade studied IHD incidence increased, especially in younger males. Changes in IHD risk factors were the following: systolic and diastolic pressures were on the increase. HDLP cholesterol and total cholesterol in the blood lowered, total triglycerides were unchanged, incidence of smoking remained high.

In Moscow for a long time morbidity in acute enteric infections, and in Shigella infections as their main constituent, steadily decreased. In recent years the opposite tendency was noted: a rise in morbidity. A pronounced tendency for Shigella infections, especially Flexner's dysentery, to affect older ages was observed. New risk groups, including adults busy in "shuttle" commerce and different asocial elements, appeared. The number of lethal cases considerably increased. Unusual manifestations of the epidemic process are socially determined and reflect a decrease in the living standards of the population, sharp social changes in its way of life and social instability in the country. Sporadic morbidity with low focality prevails. The so-called chronic multifactor alimentary route of infection transmission is mainly realized; its neutralization presents great objective difficulties.

Environmental influences operating as possible risk factors in MS were studied in Moscow. The study included 155 MS patients from the Neurology Departments and the outpatient clinics of the First City Hospital of Moscow and 155 controls matched for sex, age in 5-year intervals, nationality, and origin (Moscow vs. non Moscow). 72.3% of controls were recruited among patients from the same hospital as the cases. The remaining controls were volunteers from the hospital staff or medical students. Exposures before age 15 were of special interest. MS patients reported a higher frequency of: 1) tonsillitis; 2) allergic reactions age 15; 3) head trauma below age 16; 4) a predominant meat vs. vegetable diet during childhood. Stratified analysis and logistic regression pointed to "meat predominance" as the most significant risk factor. Other associations were confounded by the respondents' occupations/education.

The risk of stroke related to asymptomatic carotid artery stenosis is known to be increased in high-grade or rapidly progressive stenosis. Information of the prevalence in the general population is required for the recommendation of screening methods to detect patients needing prophylactic treatment. We studied the prevalence and the grade of severity of extracranial carotid and vertebral artery obstructions by means of Doppler sonography in 529 asymptomatic Russians (m: 343, f: 186; 36-84 years, mean: 58.4 years) living in Moscow city. Internal carotid artery obstructions of more than 50% stenosis were present in 22 (= 4.2%) subjects, 8 of them (1.5%) had bilateral lesions. Appropriate abnormal findings in vertebral arteries were found in 11 (= 2.1%) subjects, in 1 of them bilaterally. Affection of both the carotid and the vertebral arteries was noted in 4(= 0.8%) individuals. There were no sexual differences. The risk factor which correlated most significantly with cervical arterial lesions was hypertension. Carotid lesions were also significantly associated with age and smoking, but not with diabetes or hyperlipoproteinemia. The prevalence of cervical artery stenoses was found to be lower than in western reports, which may be due to different technical equipment and different study design.

A stable increase in the rate of birth of children with congenital developmental defects in general and, specifically, with cleft lip and palate was observed in Moscow in 1979-1993. Regions of the city with stable high and low annual incidence of birth of children with maxillofacial clefts were distinguished.

The article presents results of descriptive epidemiologic study of bronchial asthma among children in Moscow where the incidence is steadily growing. Since 1947 average prevalence of bronchial asthma in Moscow has increased over 7 times, being considerably uneven over the territory. The average prevalence equals 6.9/1,000, but on 56% of the territory it is double higher. Sites of the higher occurrence are localized in the living area situated near the Zoo, horse races, perfume factory and other enterprises, near major automobile roads. Statistic analysis of the prevalence if correlated with concentrations of pollutants in the air proved that nitrogen oxides induce 60% of the cases. No differences in some risk factors (heredity, living conditions, etc.) were revealed by the poll among families of the ailing children residing in the districts with variable air pollution. The results helped to restructure pediatric allergologic service in the city.

The average morbidity level in scarlet fever for the period of 1972-1990 in Moscow was 230.9 cases per 100,000 of the population and the annual economic damage was 2-2.5 million rubles. The highest morbidity rate values were registered among children attending children's institutions, and in this group among children aged 3-6 years. Cohort and disperse analysis revealed that age-dependent fluctuations of morbidity rate had a regular character and significantly differed. An increase in scarlet fever morbidity was registered simultaneously with elevated levels of morbidity in tonsillitis and acute respiratory diseases and occurred several weeks after a rise in tonsillitis morbidity. Contamination with group A streptococci was higher among "organized" children of preschool age than among other groups of the population. T serovars 4/28, 8/29/Imp.19, 3/13/B3254 and 1, constituting 44% of all isolated Streptococcus pyogenes strains, and OF type 2 (44%) and 22 (20%) occurred most frequently. Among the strains isolated from patients T-4 and OF-2 types prevailed.

Cases of schistosomiasis (cercarial dermatitis) were recorded in humans in Moscow in 1991. The authors analyze the ecologic conditions conducive to dissemination of cercariasis in 17 natural and artificial water bodies of Moscow and the Moscow region. They point out that high contamination of the water bodies with organic communal wastes and an abundant overgrowth of macrophytes favor the development of molluscs, intermediate hosts of Schistosoma, and promote the increase of the populations thereof. High number of Lymnaea ovata, L. auticularia, L. stagnalis, Planorbarius corneus, P. planorbis, Anisus sp. were found invaded with Trichobilharzia ocellata (up to 50%) and Bilharziella polonica (as much as 10%). A lot of ducks, end hosts of Schistosoma, were found at all the examined water bodies. in 30% of the examined water bodies the risk of human infection was found high. Recommendations on cercariasis prevention are given.

Conditions favouring the sharp increase of risk to be infected with cercariasis (caused by trematode cercariae Trichobilharzia ocellata Brumpt, 1931, Schistosomatidae) were examined in Moscow region (Russian Federation). Main factors of worsening the cercariasis situation are as follows. a) The increase of environment pollution by everyday wastages and the overgrowing with macrophytes in internal water basins of Moscow, that makes favourable conditions for the development of molluscs, which are intermediate hosts (mainly Lymnaea ovata and L. auricularia). b) The sharp increase of number of ducks (mainly mallard Anas platyrhyncos), which are final hosts, that is a result of bird escaping from farms (approximately in 60-70-th) and of high adaptation of these birds to city water basins. The detailed estimation of the cercariasis situation in 89 water basins of different types in Moscow and recreation zone was carried out. Examples of charting the zones with different risk degree of cercariasis infection are given. It is stated that at current time the cercariasis became a significant and widely distributed medical problem, which is most important in cities (including such large one as Moscow). Prophylaxis recommendations are proposed.

A total of 1331 persons aged 18-53 years were screened for specific markers of hepatitis C virus (HCV) and hepatitis B virus (HBV) infections in their blood, among them 656 primary blood donors, 256 plasmapheresis donors, 111 HBsAg carriers and 306 primary donors with only anti-HBc in the blood. According to the results of assays obtained with the use of assay systems ORTHO ELISA and ABBOTT HCV EIA (USA), the detection rate of anti-HCV-C100-3 among primary blood donors in Moscow was 1.37% and was not different from that among HBsAg carriers (1.8%) and among donors with anti-HCV-C100-3 in the blood (1.6%) (p < 0.01). At the same time differences in the occurrence of anti-HCV-C100-3 circulation in significant plasmapheresis donors were detected: 2.71% (p < 0.01). Antibodies to HCV were detected significantly more frequently among male that female donors. No correlation was found between the detection of anti-HCV-C100-3 in the blood and anti-HBc IgG as the substitute marker of HCV infection.

This study evaluated the mortality and cancer incidence of 1178 men and 2492 women who had worked at least 10 years in a large rubber manufacturing facility up to the cohort assembly period between 1 January 1979 and 31 December 1983. The follow-up period was from 1 January 1979 to 31 December 1988. For all causes of death no increase in risk was observed. The male workers had a nonsignificantly increased standardized mortality ratio (SMR) for all cancers [SMR 116, 95% confidence interval (95% CI) 90-151] and a significantly increased SMR for injuries (SMR 174, 95% CI 111-257). For the men the all-cancer standardized incidence ratio (SIR) was 146 (95% CI 119-172), and the SIR for brain cancer was significantly greater than 100 (SIR 500, 95% CI 233-767). Among the female workers only a significant excess risk for laryngeal tumors (SIR 1430, 95% CI 172-5160) was found. Because of the limited amount of data and the many subgroups formed, the occupational genesis of the cancer excess should not be overinterpreted. In addition, there was a possibility of confounding from smoking and other nonoccupational factors.

Epidemiological survey of 2076 schoolchildren in the city of Moscow aged 7-15 revealed vegetative disorders in 63.8% of the examinees. Sex- and age-specific features of clinical presentation, complaints are described. An original questionnaires were used to enable physicians to distinguish normal children with vegetative lability from patients with vegetative dystonia.