RESUMEN

Smoking effect on oral fluid protein metabolism and oxidative balance were studied in medical school students (15 smokers and 15 none-smokers as a control group, mean age 19,8±1,4 years). Smoking caused intensification of lipoperoxidation and decrease in antioxidation activity thus proving it to be the reason of harmful metabolic shift in oral fluid.

Asunto(s)

RESUMEN

Sugar substitute products impact on oral fluid protein and carbohydrate content, as well as oxidative balance were studied in 60 medical school students in compare with conventional sugar. Sugar intake proved to cause cariesogenic carbohydrate metabolism disorders in oral fluid, intensification of lipoperoxidation and decrease in antioxidation activity. Sugar substitute products help to prevent dental decay.

Asunto(s)

RESUMEN

The study covers 17 hospitals on the territory of the Capital Community, including their clinics, departments and rooms for treating of social significant and other diseases. The analysis reveals a number of negative aspects: inappropriate situation, insufficiency or lack of green areas, unfavourable aspect of the rooms, overcrowding, insufficient area of the windows, irrational heating regime, lack of ventilation regime, etc. Undesirable parameters of the microclimate are observed in the patients' rooms and this leads to discomfort to the patients and prolonging of the convalescent period. A study on a large scale for the town of Sofia is presented which aims at revision of the current building norms and requirements in respect of their correction and the improving the future building of hospitals in our country.

Asunto(s)

RESUMEN

Preserving the environment and human health is an irreversible part of the activity towards stable development. Acknowledging the necessity of such development, the European countries commence working out of plans that subordinate their policy to this object. Concerning the health policy the new strategy requires improving of the integrated system for environmental and health control-an administrative framework that reflects the partnership between health and environmental institutions and the other sectors at all levels of control. The main means and instruments for control of health and the environment are: 1) information system for health and environment; 2) identification and evaluation of the health and environmental risks; 3) a framework of the current legislation; 4) additional measures for control, including economical and fiscal instruments; 5) professional training and qualification; 6) public information and health education; 7) public participation; 8) researches and technological works. The correct functioning of the complex "taking decisions-control system" and the expected results depend on the adequate working out and application of the above mentioned means. The national action plan for environment and health is a fundamental project on a large scale for preserving the health and environmental interests of the country targeting at its stable progress.

Asunto(s)

RESUMEN

Noise, a stressogenic factor adversely affecting the body, is subject to monitoring and control, notably, at sites where health considerations impose a more rigorous acoustic regimen. Where systematic and ubiquitous excesses over admissible noise level occur in an urban environment, a special case of health impact is that produced upon an inpatient's course of recovery from illness. This paper presents evidence from a survey of mean excesses over HEI-regulated noise standards for zones enclosing 16 Sofia inpatient facilities. The procedure used to determine and map mean excesses in cities has been made available to the preventive network of local HEIs countrywide; however, it still has not been put into practice everywhere. This renewed presentation, it is hoped, should contribute to recognizing its necessity and making use of the technique. The most frequently encountered excesses over the admissible noise level were within the range 15-20 dB A. For districts incorporating hospital institutions, this acoustic situation may be qualified as not only inadequate to requirements but also as generating a health risk for vulnerable population groups. Clearly, the noise regimen observed in the surveyed zones in an environmental physical hazard hindering the process of recovery from illness--with all health, social, and economic negative effects entailed.

Asunto(s)

RESUMEN

Forty patients with invasive bladder tumors were consecutively treated and followed between June 1986 and February 1993. The treatment included systemic chemotherapy combining cyclophosphamide, epirubicin and cisplatin (CEP) or methotrexate, vinblastine, epirubicin and cisplatin (M-VEP) along with intravesically applied BCG vaccine. The treatment was well tolerated by the patients. No relevant toxic effects requiring hospitalization or fatalities due to the treatment were observed. Toxic manifestations of a hematologic nature were considerably less frequent than usual, nausea and vomiting being among the most frequently observed toxic signs on the second day of application of cisplatin. The side effects resulting from intravesically applied BCG vaccine showed no significant difference in terms of severity and variety from those due to its application in superficial tumors. A median follow-up of 50.3 months (range 6-80 months) showed an objective response to the treatment as follows: complete and partial response in 27 out of 40 (67.5%) and a complete clinical response in eight out of 40 (20%). Ten patients with partial response and stabilization had complete surgical response after operative treatment. The recurrence rate in patients with a complete response and a complete surgical response was 33% (six out of 18). The survival rate was 78% at 1 year, 70% at 2 years and 68% at 4 years. A complete response to the treatment of concomitant carcinoma in situ was observed in three patients. The lack of comparative and randomized studies and insufficient clinical experience did not allow an overall assessment of the therapeutic opportunities that our combined immunochemotherapy offers.(ABSTRACT TRUNCATED AT 250 WORDS)

Asunto(s)

RESUMEN

Our health prophylactic badly needs approaches and means for the realization of healthy policy, responding to the changing situations of health risk and shared responsibilities concerning the environment and man's health. The project "Healthy Cities" is a means of applying the already accepted in this country principles of the program "Health for all by the year 2000" on local standard. The city is accepted as a complex organism, which lives, develops and constantly changes. Healthy is this city which improves its environment and manages its resources in such a way as to ensure: high level of the health status; efficient health services; physical environment of high quality, including the living environment; steady ecosystems; society, supporting the health policy; offering good living conditions to every inhabitant; intensive social co-operation; steadfast economics; intensive cultural life and maintaining the connections with the cultural-historic and natural heritage; model and approach to the town planning, corresponding to the above mentioned nine parameters. The requirements of the project, related to the WHO priority strategies are given. A key mechanism in the realization of the health policy has to be the evaluation of the health and demographic state and its periodic reporting to the town authorities by means of suitable health criteria and indicators for the qualities of the environment. The analyses of the health state and the situation of the rural environment have to serve the Governmental decisions for the towns development. Conditions for participating in the project, the international initiatives and national priorities are presented.(ABSTRACT TRUNCATED AT 250 WORDS)

Asunto(s)

RESUMEN

The health and demographic aspects of the ecological problem are treated in scientific and theoretical plan. Data, illustrating the unfavourable changes in the health and demographic situation of the country, are given. They are interpreted as a result of the ecological stress and the existing crisis situation. The indices "local demographic potential" (LDP), "local health potential" (LHP) and "territorial health index" (THI) have the meaning of integral criteria for the urbanized environmental quality. They are elaborated on the basis of complete characteristics on the demographic process (birth-rate, mortality, infant mortality and natural growth) and all basic groups of diseases and nosological units, traced from 1980 up to now. Since 1986 an extremely dangerous tendency of rapid and socially significant deterioration of the health of the population has been observed. This country is in the process of depopulation from 1990. The data from the investigation confirm the priority significance of the activities concerning the protection and steadfast development of the environment with the principle objective--prevention and consolidation of the health of the population.

Asunto(s)

RESUMEN

A study is carried out on the microclimate, physiological reaction of patients, chemical and bacteriological composition of the air in rooms of different location in the ward for cardiovascular pathology during the heating period of the year, according to some basic and integral indices. The characteristics of the interhospital environment in the rooms of the investigated ward is determined mainly by the irrational regime of heating, location, size of the glazed transparent area. In the hospital rooms are formed unsatisfactory hygienic norm parameters of the microclimate and the chemical composition of the air. The specific thermal environment affects the physiological reactions of the patients and leads to creation of conditions of discomfort and loading of the thermoregulation in direction of overheating.

Asunto(s)

RESUMEN

In the conditions of denaturated natural environment, quite complicated ecological conditions and constant deterioration of the health and demographic status, the material represents: a new methodical approach for assessing the interaction "environment-health", giving a picture of its multifactor stimulation; the basic features of the characteristics of the local health and demographic potential of the population of Bulgaria in territorial settlement aspect and underlined the negative tendencies and their changes, observed in dynamics; backed with arguments necessity for introduction of health and demographic criteria and conducting a policy for determination of the ecological risk and solving the problems, related to the evaluation and promotion of the environmental settlements conditions. Without formulation and introduction of criteria there will be no result in the ecological development of the environment of settlements, for they will make possible the evaluation and control of the effectiveness at taking into consideration the health interest of the population.

Asunto(s)

RESUMEN

The significance of the electromagnetic energy in our modern conditions is stipulated on the intensity, the spectrum composition and number of sources of this physical factor of the environment, constantly increasing nowadays. The intensive anthropogenic interference in the settlement system by invasion of this new pollutant, leads to the necessity of reporting its effect on the health. On the basis of data processed for a period of eight years, reflecting with the effect of the electromagnetic field on the organism is estimated the local health potential (LHP) of the population for all towns in the country. In territorial aspect are clarified the differences of LHP, which have to serve as orientation in determining the possibilities of loading the environment, with the treated agent, and to be accepted as imperative in the ecological expert examination of the settlement environment and its perspectives for good health development.

Asunto(s)

RESUMEN

In the conditions of denatured natural environment, rather complex ecological setting and constant deterioration of the health and demographic state of the population, the working out gives: a formulation of a new methodical approach to evaluating the interaction "environment--health", reporting its multifactor stimulation; the basic features of the characteristics of the local health and demographic potential of the population in the country in territory aspect according to the introduced indices: local health potential (LHP), local demographic potential (LDP) and territorial health index (THI) with underlined negative tendencies in their changes, traced in dynamics; the argumentation of the necessity for introducing health and demographic criteria and carrying out policy for determining the ecological risk in solving the problems, related to the evaluation and improvement of the conditions of the urbanized environment. Ecologic-appropriate development of the settlement environment could not achieve its purpose, without the formulation and action of criteria, allowing the evaluation and control of its effectiveness in conformity with the basic health interests of the inhabitants.

Asunto(s)

RESUMEN

The prophylactic, organizing, methodic and governmental purposes of the study in the field of the settlement hygiene, given in systematic way, are put for solving the actual problem of interrelation "man-environment-health" in ecological and health-prophylactic aspect. The study directs at the correct organization of the investigations and the preventive measures at the priority of significance of the risk factors and the expected decrease in the diseases provoked by them. In order to achieve the desirable social-health effect as a consequence of the prophylactic activity, it is performed in strongly affected by the urbanization settlements as well as in such where the negative anthropogenic interference is particularly underlined. The basis of developed, developing and future formation of settlement are given in view of their arrangement according to priority of significance in the programmes for optimizing the environment and achieving the desirable ecology.

Asunto(s)

RESUMEN

A number of requirements, tendencies and trends in the building of health establishments are given in brief, as well as their location in the settlement. The complex of intrahospital factors is pointed out, which appear with slight intensity, but have a constant influence on the patients. In two cardiological wards a complex study of the patients' environment is performed. The study includes the microclimate in the hospital rooms, the physiological state of the patients according to some basic criteria indices, the indoor air with its chemical and bacteriological pollution. The quality of the environment do not respond to the hygienic requirements. There is a considerable impairment of the microclimate parameters and the chemical status of the indoor air and in individual cases, to a slight degree those of the bacteriological status. The air temperature in the hospital rooms for patients with cardio-vascular diseases is standardized. Specific recommendations are given for the new hospital building and the investigation of the intrahospital environment.

Asunto(s)

RESUMEN

Solving the health and hygienic problems in the Strandzha-Sakar district is closely related to the working out a number of social, economic, demographic and other problems which take place in the principle trends of development of our country and are subject to complex study, prognosis and planning by the Unified Territory Planning System of the People's Republic of Bulgaria. The material traces the foundations of the interdiscipline creative scientific management of the region's development; gives the basic moments and objectives of the territorial and settlement system prognosis and directs the specialists in communal hygiene towards control and investigating activity in view of their participation in building and formation an environment for living and rest prerequisite for health promotion of the Strandzha-Sakar District.

Asunto(s)

Asunto(s)

RESUMEN

The urban development and the problems it raises at present, are in direct relation with the conditions, which affect considerably the health of the population. The territorial and settlement system, the urban planning on ecological basis, the new methods of building in applying polymeric materials, the conditions of the environment in health establishments, the regulations of the physical factors, noise and electromagnetic energy are subject to the hygienic studies, in which the Institute of Hygiene and Occupational Health is engaged. The connective unit in the variety of the mentioned fields of investigation is the health of the inhabitants and finding the right way in its protection and keeping. The attitudes of prophylaxis, the creation and establishing of urban environment, corresponding to the conflict-free existence and potentiation of the health development of the inhabitants, are clarified, as they are related to the basic trends of the world Health Organization, whose targets are "Health for All by the year 2000".

Asunto(s)

RESUMEN

The experience of the National System of Control, Restriction and Decrease of the Urban Noise, as unique one in the member countries of Comecon and the interpretation of the results of its activity are of special interest. Amidst the variety of complex problems for environmental protection from the noxious agents effect, of special interest are those related to the elucidation of the mechanism, spreading, rate of effect and undertakings for noise control from the factor noise in the conditions of the urban environment. The analysis on the activity of noise control in the towns all over this country since 1976 has shown as predominating the noise level of range 68-72 dB/A--value above the quota to which the majority of the population is subject. This imposes the carrying out of urban, planning and organization, architectural, organization and technical measures as well as methodical renovation of the Noise Control System, presented in the working out, which will assist in the optimization of the acoustic environment on the towns.

Asunto(s)

RESUMEN

The effect of hospital environment on the course and effectiveness of the curative process has its economic expression. Besides the health and social importance, human health, working capacity and welfare have also definite material interests which if given a correct meaning, could result in improving the quality and the material and technical equipment of our curative and preventive activity. The formula given in the present work for defining the economic effect for implementing the planning and operation of the cardiological departments on differentiated approach and hygienic norms and requirements for the formation of favourable environment for the patients is the first attempt in the field of economic approach for solving the problems for improving the patient's environment in our health establishments.

Asunto(s)

RESUMEN

The hospital environment, studied according to the parameters of microclimate, natural and artificial lighting and acoustic regime, is a factor with an effect on the disposition and healing process. Concrete data are presented, suggesting some failures in the micro-climate kept in the hospital premises studied and substantial unfavourable discrepancies in the existing standardization and the present conditions of stay. The artificial illumination is considerably diminished--20-70 lx, at a norm of 300 lx. The windows proved to be unnecessarily large, guaranteeing increased penetration of natural light but hence - creating conditions for overheating (cooling resp.) - at at a norm 1:5 to 1:4, the established light coefficient is 1:3 up to 1:2. The acoustic regime showed also some great deviations towards the increase of noise levels - at a norm of 35 dB A, the established levels are within the limits of 38 to 72 dB A. The hospital environment is obvious to need some changes that would have a favourable effect only with a strict adherence to the hygienic standardization in the course of design and building.

Asunto(s)