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МЕЖДИСЦИПЛИНАРНЫЕ ПОДХОДЫ 13 ОХРАНЕ ЗДОРОВЬЯ ДЕТЕЙ И РЕПРОДУКТИВНОГО ЗДОРОВЬЯ
УДК: 575.17: 616/618 - 084 - 053.5
O.V. VASYLIEVA1, PhD , D.V. VASYLYEV2, PhD
THE USE OF THE PEDIGREES ANALYSIS OF SCHOOLCHILDREN FOR THE PREVENTION
OF MULTIFACTOR DISEASES
'Kharkiv National Medical University, Kharkiv, Ukraine 2Kharkiv Medical Academy of Postgraduate Study, Kharkiv, Ukraine
Vasylieva O.V. - Candidate of Medical Sciences, associate professor of physiology Department, phones: +380507399640, +380677667434, e-mail: [email protected].
Abstract. Preservation of health of pupils remains a pressing problem in Ukraine today. The poor health of adolescents is due to the growth of school and social pressures, but also it is necessary to take into account the initial level of health of schoolchildren and their families at all. In order to determine risk of developing the most common multifactor diseases in future and developing methods of prevention the clinical and genealogical analysis of 67 probands (high schoolchildren) was done. It was found that in the pedigrees of both groups the pathology of cardiovascular (ischemic heart disease, hypertension, myocardial infarction, varicose disease), nervous system and sensory systems (stroke, vascular dystonia, encephalopathy, myopia, cataracts) and gastrointestinal tract (chronic gastritis, bile-stone disease, tumors of the gastrointestinal tract, etc.) dominated. Also has a high percentage of the pathology of musculoskeletal system and endocrine diseases.
According to the results of the survey were developed individual memo for high school students to preserve the health of the family, which included recommendations in accordance with the identified multifactor pathology in the pedigree.
Key words: pupils' health, genealogical analysis, multifactor diseases, individual recommendations.
Introduction. Keeping pupils healthy remains an urgent problem in Ukraine today. Doctors, parents, teachers are seriously worried about the fact that in recent years the health of schoolchildren has significantly worsened [1]. Poor health state of adolescents is caused by increasing school and social loads, but also the initial health level of schoolchildren and their families in general should be taken into account [2]. No wonder since ancient times there was a proverb - "As the tree, so the fruit". So what do the "fruit" of modern high school students hide in their genealogical branches?
Objective. To analyze pedigrees of high school pupils in order to determine the risk of the most common multifactorial
diseases in future and development of methods of their prevention.
Materials and Methods. The clinical and genealogical analysis of 67 probands
- schoolchildren of 9-11grades of Kharkiv secondary school of I-III levels № 19 was done. First of all, it was set whether the students are at the dispensary at some specialists and whether they have the signs of chronic diseases (according to the data of medical checkup taken from school medical records).
The group of students that had being studied was divided into 2 subgroups: first group - 26 persons - the children having existing pathology (G1), the second group
- 41 persons - relatively healthy by that moment (G2).
After that the genealogical analysis
of selected groups' pedigrees was done. The pedigrees making started with probands - adolescents, accompanied by a brief record about each member of the generation with the exact description of his ties with regard to the proband (in the pedigree legend). Received information was included in appropriate table and succumbed to statistical analysis.
Results and discussion. The age of the students ranged from 13 to 16 years. The average age of the examined patients - probands was 14.6 years. In order to determine the homogeneity of the studied groups G1 and G2 by sex and age homogeneity criterion x2 was used. For the studied group homogeneous parameters were: according to sex - x2 = 0,73, according to age - x2 = 2,78.
Among G1 pupils who were at the dispensary at various specialists and showed signs of chronic disease (according to the data of medical checkup taken from school medical records) the presence of such nosological forms was found: myopia - 5 (7.4 %), vascular dystonia - 5 (7.4 %), connective tissue dysplasia - 4 (5.9 %), chronic gastroduodenitis - 4 (5.9 %), mitral valve prolapse - 3 (4.5 %), biliary ducts dyskinesia - 1 (1.5 %), obesity of 2nd stage -1 (1.5 %), chronic pyelonephritis - 1 (1.5 %), asthma - 1 (1.5 %), Marfan disease - 1 (1.5 %).
While analyzing the pedigrees of students the presence of complication caused by multifactorial disorders as G1 and so G2 was set. But the fact that the percentage of complication was significantly higher in G1 than in G2 drew
Медицинский журнал Западного Казахстана
3.51.2016 œ.
БАЛАЛАР ДЕНСАУЛЬ^Ы МЕН РЕПРОДУКТИВТ1 ДЕНСАУЛЬДТЫ ^^АУДСЩ
ПЗНАРАЛЫК, ЗД1СТЕМЕС1
the attention. Also in G1 the presence of monogenic syndrome (Marfan syndrome, Klippel-Trenaunay syndrome) was set in 2 cases and chromosome pathology (Down syndrome) in 1 case. In G2 the presence 1 case of monogenic diseases (Parkinson) was recorded.
Then the analysis of multifactor pathology in the pedigrees of both groups of schoolchildren was done (tabl.1).
It was found that in the pedigrees of both groups the pathology of cardiovascular (ischemic heart disease, hypertension, myocardial infarction, varicose disease), nervous system and sensory systems (stroke, vascular dystonia, encephalopathy, myopia, cataracts) and gastrointestinal tract (chronic gastritis, bile-stone disease, tumors of the gastrointestinal tract, etc.) dominated.
Further, in the structure of G1 pedigree complication the pathology of musculoskeletal system was detected (arthritis, scoliosis, platypodia, lameness) at 30.7 % of cases, in G2 - endocrine pathology (thyroid disease, diabetes, obesity) - at 29.7 % of cases. A high percentage of musculoskeletal systems pathology of group G1 can be explained, on the one hand, by every year increase of connective tissue dysplasia at Ukrainian population, on the other hand - by the presence of monogenic diseases with connective tissues lesions in the pedigree [3, 4].
Unexpectedly high percentage of endocrine pathology in the pedigree of G2 - 12 cases (29.7 %) comparing to the pedigree of G1 - 5 cases (19.2 %) was found. That's why the high school students of this group were asked to monitor
Table 1.
Multifactor pathology in the pedigrees of schoolchildren (n = 67).
Affected system G1 G2
Cardiovascular 19 73,1 % 27 65,9 %
Nervous, sense organs 18 69,2 % 25 60,9 %
Digestive 12 46,2 % 18 43,9 %
Respiratory 7 26,9 % 10 24,4 %
Urinary 5 19,2 % 6 14,6 %
Musculoskeletal 8 30,7 % 11 26,9 %
Endocrine 5 19,2 % 12 29,7 %
the weight indicators (according to the Quetelet index) and blood sugar level, as well as a balanced diet with sweets' restriction, visiting the game and dance sports sections were recommended.
Conclusions. According to the results of conducted study individual recommendations for high school students were made in order to preserve the health of the family and the recommendations based on the detected multifactorial pathology of the pedigree were included. At the example of making up his or her own pedigree with such clarifications as "Will you or your children carry one of the following symptoms / diseases?" it is possible to affect the reassessment of students' lifestyle and their families.
Identified prevalence of cardiovascular and nervous diseases in pedigrees of high school pupils we need to use for the assessment of their health status and the working capacity to exclude the tragic events that recently have taken place during physical education lessons (sudden death, etc.). We are planning the next medical examinations of students with using of the index Rufe, which is a simple indirect method of the physical ability determining. The results of this study will
help to objectively identify a group of students at lessons of physical training.
References:
1. Карамышева, Т.Н. Информация о здоровье школьников как основа организации физического воспитания / Т.Н. Карамышева, С.С. Филлипов // Ученые записки унивесрситета им. П.Ф. Лесгафта. - 2009. - № 4 (50). - С. 102105.
2. Куценюк, Я.Б. К вопросу о ранней диагностике и лечении наиболее распространенных заболеваний в Украине / Я.Б. Куценюк, А.Я. Вовченко // Здоровье Украины. - 2013. - [www/ health-ua.org/archives_health.inc].
3. Соединительно-тканная дис-плазия как междисциплинарная проблема / Е.В. Бугаева, Д.В. Васильев, О.В. Васильева // Здоровье, демография, экология финно-угорских народов. -2012. - № 2. - С. 17-19.
4. The effectiveness of musculoskeletal system morpho-functional adaptation to the stress factors combined effects / R. I. Sokol, O. V. Vasylieva, E. N. Sokol, А. N. Zelenskaya // 7th International Scientific Interdisciplinary Congress for medical students and young doctors (1516 May, 2014) : Abstract book. - Kharkiv: KNMU, 2014. - P. 50-51.
3.51.2016 œ.
Батыс Казахстан медицина журналы
МЕЖДИСЦИПЛИНАРНЫЕ ПОДХОДЫ 13 ОХРАНЕ ЗДОРОВЬЯ ДЕТЕЙ И РЕПРОДУКТИВНОГО ЗДОРОВЬЯ
О.В. ВАСИЛЬЕВА1, Д.В. ВАСИЛЬЕВ2
К9ПФАКТОРЛЫ АУРУЛАРДЬЩ АЛДЫН АЛУДА О^УШЫЛАРГА ТЕКТ1К САРАПТАМАНЫ КОЛДАНУ
1Харьков улттык, медицина университетi, Харьков, Украина 2Дипломнан кейiнгi бiлiм беру Харьков медициналык академиясы, Харьков, Украина
БYгiнгi танда Украинада окушылар денсаулы^ын сактау мацызды мэселе кYЙiнце калып отыр. Жасeспiрiмцерцiн темен денсаулык жаедайы мектептiк жэне элеуметтiк жYктемелерцiн eсуiмен байланысты, алайда, сонымен катар окушылардыц жэне олардын отбасыларынын бастапкы денсаулык децгейш де ескерген жен. Болашакта неfvрлым кеп тараfан мультифакторлы аурулардыц даму каупiн аныктау Yшiн жэне алдын алу эцiстерiн жасау Yшiн 67 жоfары класс окушысына клиникалык-генеологиялык сараптама жYргiзiлцi. Олардыц тектерiнце жYрек-тамыр жYЙелерi (жYректiн ишемиялык ауруы, миокард инфаркты, варикозды ауру), жYЙке жYЙесi мен сенсорлы жYЙесi (инсульттер, вегето-тамырлык дистония, энцефалопатия, миопия, катаракта) жэне аскорыту жолы (созылмалы гастрит, ет жолдары ауруы, асказан-iшек жолдары iсiктерi жэне т.б.) патологияларыныц Yстемцiгi байкалды. Сонымен катар, тiрек-кимыл жYЙесi мен эндокриндт аурулар патологиясыныц жоfары пайызы аныкталды.
ЖYPгiзiлген тексерулерцiн корытындылары бойынша отбасы ценсаулыfын сактау Yшiн жоfары класс окушыларына тектерiнце аныкталfан мультифакторлы патологияfа сэйкес vсынымцар енгiзiлген дербес жадынамалар жасалды.
Нег'зг'! свздер: окушылар денсаулыт, генеалогиялык сараптама, мультифакторлы аурулар, дербес усыным.
РЕЗЮМЕ
О.В. ВАСИЛЬЕВА1, Д.В. ВАСИЛЬЕВ2 ИСПОЛЬЗОВАНИЕ АНАЛИЗА РОДОСЛОВНЫХ ШКОЛЬНИКОВ ДЛЯ ПРОФИЛАКТИКИ МНОГОФАКТОРНЫХ ЗАБОЛЕВАНИЙ
1Харьковский национальный медицинский университет,
Харьков, Украина 2Харьковская медицинская академия последипломного образования, Украина, Харьков
Сохранение здоровья школьников остается на сегодня актуальной проблемой в Украине. Неудовлетворительное состояние здоровья подростков обусловлено ростом школьных и социальных нагрузок, но также необходимо учитывать исходный уровень здоровья школьников и их семей вообще. Для выяснения риска развития наиболее распространенных мультифакториальных болезней в будущем и разработки методов профилактики был проведен клинико-генеалогический анализ 67 пробандов (учащихся старших классов). Было обнаружено, что в их родословных доминировала патология сердечно-сосудистой системы (ишемическая болезнь сердца, гипертоническая болезнь, инфаркт миокарда, варикозная болезнь), нервной системы и сенсорных систем (инсульты, вегето-сосудистая дистония, энцефалопатия, миопия, катаракта) и пищеварительного тракта (хронический гастрит, желче-каменная болезнь, опухоли желудочно-кишечного тракта и др.). Также, установлен высокий процент патологии опорнодвигательной системы и эндокринных болезней.
По результатам проведенного обследования были разработаны индивидуальные памятки для учащихся старших классов для сохранения здоровья семьи, в которые вошли рекомендации в соответствии с выявленной мультифакторной патологией в их родословной.
Ключевые слова: здоровье школьников, генеалогический анализ, мультифакторные заболевания, индивидуальные рекомендации.
МеЗииинский журнал ЗапаЗного Казахстана
3.51.2016 я.
