No abstract

The economic development of the State depends on the work of the able-bodied population. The cardiovascular system is highly reactive and reacts to many harmful production factors: noise, vibration, ionizing radiation, etc. Spastic vascular changes are the precursors of peripheral angiodistonic syndrome, which is part of the symptom complex of vibration disease, and accompanies polyneuropathy from physical overstrain. Detection of the disease at the initial stage of development for the appointment of timely prevention and treatment is the main task of modern medicine. Ultrasound examination, as one of the imaging methods in radiation diagnostics, successfully copes with this problem. The study aims to develop criteria for early diagnosis of occupational pathology of the vessels of the upper extremities in workers of machine-building production. We have examined 126 workers of the machine-building plant using standard clinical and laboratory methods, ultrasound examination of the vessels of the upper extremities and X-ray examination of the hands. The main harmful production factors in the workplace were local and general vibration, the severity of the labor process, noise. The severity of the labor process of at least class 3.1 with a work experience of 21 years contributed to the development of spastic changes in the vessels of the upper extremities in power engineering workers. Patients complained in 25% of cases, although an objective examination by a neurologist revealed no pathological changes characteristic of the pathology of the vascular bed. There were radiological changes in the hands in 83% of the examined workers and manifested as a violation of local circulation: cyst-like rearrangement in the bones of the wrists were in 40% of cases, in the form of periarticular osteopenia - in 70% of cases. The most informative method of early diagnosis of vascular changes in the main arteries of the upper extremities is ultrasound. At the same time, the characteristic signs are an increase in the resistance index with the preservation of speed indicators (recorded in 100% of cases), a violation of venous outflow in 82%, pathological vascular tortuosity in 76%. Ethics. The Local Ethics Committee of the North-Western Scientific Center of Hygiene and Public Health has approved the study, Protocol No. 23.1 of 10/28/2020.

Introduction. Autonomous sensory polyneuropathy of upper extremities is one of the most common occupational diseases of the peripheral nervous system. Materia and methods. Findings of the health state study in two major worker jobs in which occupational polyneuropathies of upper extremities are prevalent, namely: house-painters and plasterers, as well as mining job workers (underground miners, shaft miners, breakage face miners), are reported. The main harmful factor in both professional groups is the heaviness of the working process. Results. Physical overloads are a reason of the occupational pathology’s complex of “working hand”. At the same time, no systemic autoimmune or endocrine diseases with similar polyneuropathy were detected. Other harmful factors in the working process such as occupational dust, intensive noise can cause another occupational pathology (in respiratory or hearing organs). Discussion. In spite of obviously different working conditions, we detected the same professional diseases in both professional groups - “the working hand pathological complex”. Our findings indicated the importance of the regular periodic check-ups. Doctors should search actively the early signs of coexisting with the occupational polyneuropathy illnesses. The results of health state’s research should be taken into account in the patient’s treatment planning.

Introduction. Vibration disease (VD) is an example of the most common pathology due to the systematic exposure of the worker to intense vibration with sufficient work experience, the main manifestation of which is peripheral angiodystonic syndrome. The aim of study was to learn the features of peripheral blood flow in the arteries of the forearm in vibration disease using the ultrasound method. Materials and methods. The radial and ulnar arteries in patients with vibration disease were examined by ultrasound in B- and PW-mode. These materials present the results of an ultrasound assessment of the speed indicators of the main arteries of the forearm in vibration disease stages 1 and 2. The selection criteria for patients in the study ware the presence of pronounced clinical manifestations of angiodystonic syndrome in vibration disease, confirmed by instrumental research methods and data on the sanitary and hygienic characteristics of working conditions, the absence of cardiovascular chronic diseases (ischemic heart disease, heart defects, rhythm and conduction disturbances), rheumatic, oncological, infectious diseases, osteo-traumatic changes in the upper extremities. Results. The groups of patients with the established diagnosis of vibration disease of 1 and 2 degrees were studied. With vibration disease stage 1 a decrease in the pulse velocity of blood flow was observed in isolation on the ulnar artery and an increase in peripheral resistance (pulsation index and resistance index) in the radial and ulnar arteries symmetrically on both upper extremities. The second stage of vibration disease differed from the first by a more significant decrease in speed indicators both on the ulnar and radial arteries on both sides, symmetrically in combination with a more pronounced increase in peripheral resistance indicators on both main arteries of the forearm (pulsation index and resistance index). The revealed changes were determined with the same frequency in men and women. Conclusions. A significant decrease in speed indicators on the ulnar artery and an increase in peripheral resistance indicators are detected already at the initial stages of vibration disease. Thus, the method of ultrasound examination of the main arteries of the middle caliber of the upper extremities is currently the only available and objective method for examining the vascular system in vibration disease.

The analysis showed that the absolute prognostic criterion for the initial stage of the disease is muscle edema and the optimal impulse sequence for its visualization - diffuse-weighted image and a post-contrast T1-weighted image for revealing the disturbance of the histo-hematic barrier penetration.