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Protecting the health of railway workers of various professional groups is an important and integral part of the work of primary health care. The incidence of circulatory diseases is a significant problem among some groups of railway workers, given the considerable number of occupational risk factors. Among the most unfavorable complications of cardiovascular disease may be sudden cardiac death.Purpose of the study - сonducting an analysis of typical risk factors for sudden death among the main occupational groups of railway workers in Russia.A retrospective analysis was carried out of all cases of sudden death of employees of Russian Railways in the period from 2009 to 2021. All deceased workers were conditionally divided into 6 groups depending on the professions and positions of workers.All 411 deceased patients worked on 16 railways, subordinate to 15 medical directorates of Russian Railways. 84.7% of patients felt the first symptoms during working hours and only 15.3% during non-working hours. The prevalence of cases of sudden death during working hours was noted - 81%. Among the occupational groups under consideration, death at home or outside the home was more often observed in groups I and VI, and at the workplace, from groups II to V (p0.001). 6.8% of those who died had high levels of ethyl alcohol in their blood, and 3 out of 4 of them died at the workplace. Among the deceased, 70.3% of the patients were smokers. 68.1% were overweight or obese. The level of total cholesterol exceeded 5 mmol/l in 20.7% of cases, and the largest number of patients (65%) had a moderate risk according to the SCORE scale.The study sample showed that cardiovascular diseases are the main cause of sudden death. Among the risk factors in the study group, smoking and obesity prevailed.Охрана здоровья железнодорожных рабочих различных профессиональных групп - важная и неотъемлемая часть работы первичного звена здравоохранения. Заболеваемость болезнями кровообращения является значимой проблемой среди части групп работников железных дорог, учитывая немалое количество профессиональных факторов риска. Среди наиболее неблагоприятных осложнений сердечно-сосудистых заболеваний - внезапная сердечная смерть.Цель исследования - проведение анализа типичных факторов риска внезапной смерти среди основных профессиональных групп работников железных дорог в России.Материалы и методы. Проведён ретроспективный анализ всех случаев внезапной смерти работников ОАО «РЖД» в период с 2009 по 2021 г. Все умершие работники условно были поделены на 6 групп в зависимости от профессий и должностей работников.Результаты. Все 411 умерших пациентов работали на 16 железных дорогах, подчиняющиеся 15 медицинским дирекциям ОАО «РЖД». Первые симптомы почувствовали в рабочее время 84,7% пациентов и лишь 15,3% - в нерабочее. Отмечено преобладание случаев внезапной смерти в рабочее время - 81%. Среди рассматриваемых профессиональных групп смерть дома или вне дома чаще наблюдалась в I и VI группах, а на рабочем месте - во II-V группах (p0,001). Высокие показатели уровня этилового спирта в крови имели 6,8% умерших, 3 из 4 из них умерли на рабочем месте. Среди умерших выявлено 70,3% курящих пациента. Избыточной массой тела или ожирением страдали 68,1%. Уровень общего холестерина превышал 5 ммоль/л в 20,7% случаев, а наибольшее количество пациентов (65%) имели умеренный риск по шкале SCORE.Заключение. На исследуемой выборке показано, что сердечно-сосудистые заболевания являются основной причиной внезапной смерти. Среди факторов риска в изучаемой группе преобладали курение и ожирение.

Aim To evaluate clinical practice of primary care physicians with respect of preventing behavioral risk factors in patients as well as objective and subjective factors that influence their motivation for taking preventive measures. Material and methods This study was a cross-sectional survey. The questionnaire was anonymous and included closed questions and multiple-choice questions. Based on the obtained results, prevalence of modifiable risk factors for chronic noninfectious diseases (CNID) was comprehensively evaluated in the survey population. Also, a special quantitative variable was introduced, the Index of Behavioral Risk Factors. that reflected the burden of risk factors. This composite index included the degree of risk factor in a specific respondent, for example, obesity degree, number of cigarettes smoked per day, severity of hypodynamia. Physicians’ knowledge and beliefs about the effect of physical activity (PA) on certain diseases were evaluated. Result 623 physicians (mean age 40 years (31-52), 85.5 % women) participated in the survey. The respondents included general practitioners (7.5%), cardiologists (2.9 %), preventive care physicians (4.8 %), internists (25.4 %), and other specialists (59.4 %). 70.8 % of respondents never smoked, 17.5 % were current smokers. 38.5% (240) of the surveyed had a normal body weight index (BWI); 41.7 % (260) were overweight; 11.6 % (72) had degree 1 obesity; 3.7 % (23) had degree 2 obesity; and 0.8 % had degree 3 obesity. A very low PA level was noticed; most of the surveyed exercised not more than once a week (median, 1 (0-3) time). More than 90 % had behavioral risk factors, low PA and excessive body weight. The physicians with a higher index of behavioral risk factors 50% less frequently checked the body weight of patients (odds ratio (OR), 0.541; 95 % confidence interval (CI): 0.388–0.753, pConclusion Most of the surveyed were aware of the benefits of PA for prevention and treatment of CNID, however, they related the mechanism of this effect only with weight loss. The most frequently mentioned barriers to behavioral risk counseling were uncertainty about whether such counseling was within the physician's professional competence, lack of time, lack of confidence in the provision of advice and the effectiveness of interventions, and lack of patients’ compliance.

The article presents the results of a biomechanical analysis of locomotion (walking and running) on a treadmill under normal conditions and when the weight load on the human musculoskeletal system was reduced to 70% of body weight. The study was conducted with the participation of 24 apparently healthy volunteers aged 25.1 ± 5.2 years, body weight from 66 to 90 kg (77.7 ± 6.7 kg), body length from 172 to 192 cm (179.7 ± 6.3 cm). During the study, volunteers performed two treadmill locomotor tests: walking at a speed of 4.5 km/h and running at a speed of 10 km/h with different body weight unloading values: 100 and 70% of body weight. The change in weight load on the musculoskeletal system was performed by vertical hanging. The kinematic, spatiotemporal parameters, ground reaction forces of locomotions, and electromyographic (EMG) activity of leg muscles were recorded and analyzed. The results of the study revealed significant differences in the ground reaction force values of locomotion, as well as kinematic parameters, which was manifested by a decrease in the angular displacements in the knee and ankle joints in the push-off and swing phases. Analysis of the EMG of leg muscles made it possible to determine the contribution of muscles to the performance of walking and running on a treadmill at different weight loads. During walking, when the musculoskeletal system was unloaded up to 30% of the body weight, a significant reduction in the EMG cost was revealed (within 9–23% compared to normal walking). During running, reduction in the EMG cost with a change in the weight load varied from 8 to 37%. Body weight unloading up to 30% decreases the efforts to perform take-off. In addition, the results of the study indicate a change in the contribution of the lower and upper leg muscles when locomotor exercises were performed under conditions of reduced weight load on the musculoskeletal system.

The effects of anti-orthostatic hypokinesia on the parameters of vertical posture (orthostatic and postural stability) were studied. Anti-orthostatic hypokinesia was followed by orthostatic instability manifested in a decrease in the tolerance time in the orthostatic test, a significant increase in HR and systolic BP starting from the 11th minute of the test. Significant changes in the parameters reflecting postural stability were observed starting from minutes 10-11 of the stabilometric test. Anti-orthostatic hypokinesia was shown to affect all parameters of postural stability; symmetry in paired stabilometric tests was impairmed.