According to the World Health Organization, the most common causes of death are 15 diseases, which will be discussed in this article. Statistics show that these diseases account for up to 60% of all deaths or serious complications, including disability.
So, let's tell you about the fifteen most common diseases.
Cardiac ischemia
IHD is a heart disease associated with insufficient blood supply to certain areas of the heart muscle.This disease occupies the top line of this disappointing rating and is the most common pathology of the cardiovascular system. According to statistics, 12.6% of deaths are caused by this disease. With ischemic heart disease, the heart muscle is affected - the myocardium, due to its insufficient or stopped blood supply. In Russia alone, more than 600 thousand people die every year because of this disease.
Ischemia mostly affects the age group of people from 50 to 65 years old. Moreover, men are more susceptible to the development of the disease. At the heart of ischemia is oxygen starvation of the heart tissues due to a decrease in the intensity of the coronary blood supply. Pathology can occur in both acute and chronic form.
In the overwhelming majority of cases, the cause of coronary artery disease is atherosclerosis of the coronary arteries, leading to disorders such as thromboembolism, vasospasm. In addition, risk factors include:
- smoking and drinking alcohol;
- lipid metabolism disorders;
- sedentary lifestyle;
- overweight and;
The consequences of coronary heart disease are very serious: it is disability, and in the worst case, death. To prevent the development of the disease, it is necessary to lead a healthy lifestyle, maintain normal body weight, eat right, monitor the level of blood pressure and not neglect physical activity.
Cerebrovascular disease
Unlike ischemic heart disease, it is characterized by insufficient blood supply not to the heart, but to the brain tissues, which leads to their oxygen starvation. At the heart of the lesion is, in more rare cases, vasculitis, or vascular inflammation. The most dangerous manifestation of pathology is a stroke, which is fatal in almost half of the cases.
It develops due to hemorrhage in the brain or due to the appearance of blood clots or atherosclerotic plaques in its vessels. In accordance with this, hemorrhagic, ischemic and mixed forms of the disease are distinguished. Despite the fact that improvements in the effectiveness of treatment in recent years have reduced deaths from stroke, more and more people remain disabled after a stroke.
The likelihood of a stroke increases in people after 50 years, as well as in people with atherosclerosis, disorders of fat metabolism. Smokers, alcohol lovers are susceptible to pathologies. Risk factors also include:
- congenital and acquired vascular anomalies;
- heart rhythm disturbances;
- skull trauma;
- amyloid angiopathy;
- hormonal changes or disorders, such as pregnancy or diabetes mellitus;
- stress, regular emotional stress.
Lower Respiratory Tract Infections
Pneumonia is more common in children, the elderly and those suffering from immunodeficiencies. Ranked third in the number of deaths and are among the most common diseases. A large number of deaths are characteristic of the following pathologies of the respiratory organs:
- complications ;
- pneumonia, or pneumonia;
- lung abscess;
- empyema of the pleura.
Most often, the causative agents of inflammation are the bacteria Streptocossus pneumonia, or pneumococci, as well as microorganisms such as chlamydia, mycoplasma and staphylococcus. Certain factors contribute to the development of a particular disease.
As for, the risk group includes people with weakened immunity and impaired functioning, with chronic pathologies of the respiratory organs, smokers, drug addicts. Malnutrition, stress, heart failure can provoke an ailment. The incidence of pneumonia increases significantly with age and reaches its peak in the elderly and the elderly.
Empyema of the pleura and abscess of the lung are accompanied by the process of suppuration in the pleural cavity or directly in the lung tissue. According to statistics, the most common reason for the development of these pathologies is complications of pneumonia, and the main risk factors also include:
- elderly age;
- distant foci of infection in the body;
- diseases of the bronchi;
- sepsis;
- decreased immunity.
AIDS
Acquired immunodeficiency syndrome is a developmental stage in which secondary pathologies appear caused by a weakened immune system: from infections to tumor lesions that lead to death. Sad statistics show that in 2014 there were more than 800 thousand Russians.
The pathogen is transmitted through blood, body fluids, and also through breast milk. The main risk factors are:
- unprotected sex (they account for up to 80% of all infections);
- the use of one syringe for injection, therefore drug addicts constitute a large risk group;
- contaminated blood transfusion;
- transmission of the virus from a sick mother to a child.
In more rare cases, infection can occur when using a non-sterile instrument, such as dental treatment, tattooing or piercing. The insidiousness of the disease is that the symptoms of AIDS are detected many years after infection. Once in the body, the virus will always be present there, and treatment is aimed only at maintaining immunity and preventing the development of secondary infections.
Chronic obstructive pulmonary disease
COPD is a serious, long-term progressive disease. It is characterized by the development of inflammation in the lungs due to narrowing of the airway lumen. The consequences of pathology are disability, limitation of a person's physical capabilities, and often death. According to statistics, the incidence trend is growing, with the age group most susceptible to developing COPD is people over 40. The high mortality rate is also explained by the fact that most cases of obstructive pulmonary disease are diagnosed at later stages, when the pathological process becomes irreversible. Experts name the main risk factors:
- smoking: 90% of sick people have a long history of nicotine addiction, in addition, passive smokers, especially of children, are at risk;
- chronic respiratory diseases;
- employment in hazardous industries, in particular with a high content of cadmium and silicon in the air. In this regard, metallurgists, miners, builders, people working in the mining, textile and pulp and paper industries fall into the risk group;
- living in places with a polluted atmosphere - industrial cities, megalopolises.
Diarrheal diseases
Dehydration is often the cause of death in diarrhea. They account for 3.2% of the total number of deaths and are a common cause of death in childhood. More than 2 billion people worldwide fall ill with them annually. Death occurs as a result of severe dehydration caused by diarrhea. According to the etiology, diseases of this group can be functional or infectious. In the first case, the symptoms of diarrhea are caused by factors such as:
- taking antibiotics;
- radiation therapy;
- food toxins;
- functional disorders;
- violation of the production of enzymes.
All these reasons lead to the death of the natural intestinal microflora. In infectious diarrheal diseases, the impetus for the development of acute intestinal disorders is the ingestion of pathogenic microorganisms into the digestive system - Escherichia coli, salmonella, lamblia, rotavirus, dysentery pathogen and others.
The main measures to prevent diarrheal diseases are the use of clean and high-quality food and water, timely treatment of gastrointestinal diseases and low acidity.
Tuberculosis
Pathology, which accounts for 2.7% of deaths on the planet. More than half of the sick people die, and the airborne method of spreading the disease explains the huge number of infected people. Several decades ago, doctors predicted the fate of smallpox for the disease, which was completely defeated and practically disappeared. However, they were mistaken in their assumptions: the causative agent (Koch's bacillus, or mycobacterium tuberculosis) turned out to be terrible not only by the acquired resistance to environmental conditions and drugs, but also by its consequences. These include internal bleeding, dysbiosis and diarrhea, infertility and the inability to give birth to a healthy baby.
Risk groups for the development of the disease:
- people who have recently become infected and have a suspicion of tuberculosis in the past;
- persons in contact with a sick person;
- patients with diabetes and AIDS;
- smokers, drug addicts and alcohol abusers;
- medical staff.
The likelihood increases in the absence of adequate nutrition and a decrease in immunity.
Malaria
It is the cause of death in 2.2% of deaths. The most common pathology in Africa and Asia. Risk factors include visiting these countries, where tourists are often infected with this disease.
The causative agents of the disease are localized in red blood cells, erythrocytes, and feed on hemoglobin. Reproducing in the blood, plasmodia provoke an attack of malaria. The likelihood of infection from a mosquito bite is high during the so-called "malaria" period, which lasts from June to September. 98% of deaths from this disease are caused by tropical malaria, and among its consequences may be coma, anemia.
Cancer of the lungs, trachea and bronchi
It takes 9th place in the list of the most dangerous diseases. Most often, such pathologies affect the age category of people after 45 years. It is significant that more than 80% of deaths in this case are among smokers, so they are the first to fall into the risk group for developing respiratory cancer. Nicotine significantly damages the bronchial tissue, which is the shortest path to tumor development. A separate group should include people who, by the nature of their activity, are in contact with asbestos or radon gas: in the first case, these are builders and workers in the industrial sector, in the second, they are mine workers. Passive smokers and people with chronic lung diseases, for example, are also at risk. and, especially after the age of 65, can also provoke respiratory cancer.
The consequences of the pathology are sad, without timely therapy it is almost always fatal. Treatment of the disease is complex, long-term and can provoke the development of severe complications. Often, a surgical method is used, in which the tissue affected by cancer is removed. However, if at least 1% of the affected cells remain in the body, the tumor process is likely to resume.
Road traffic accidents
We can confidently call it a real disaster of our time. A huge number of people die and remain disabled. There are more and more cars every year, and more than 70 residents of Russia die on the roads every day, and in the world, car accidents claim the lives of more than a million people every year. Why is this happening? Here are the main causes of road accidents:
- drunk driving;
- ignorance and non-observance of traffic rules;
- technical malfunction of vehicles;
- inattention of drivers;
- the deplorable state of the roads.
Diseases of childhood
Many childhood diseases are also among the most common diseases. Listed below are those that are most common and pose the greatest health risks to children:
- salmonellosis: intestinal infection caused by a variety of bacteria from the genus Salmonella. The pathogen enters the child's digestive tract with unprocessed and dirty food, affecting the intestinal mucosa and often internal organs;
- Botkin's disease, or hepatitisA, develops due to the consumption of contaminated food and water, through dirty hands. The disease is very dangerous, the main threat is liver damage. In the prevention of hepatitis, the first place is taken by the heat treatment of food, the observance of hygiene of the child, the obligatory washing of hands after using the toilet, walking, before eating;
- Staphylococcal diseases can be caused by several types of bacteria of this genus and appear in different parts of the body, and Staphylococcus aureus is considered the most dangerous. Infection most often occurs through dirty hands and from carriers of the infection;
- mumps, or mumps: a viral disease that is localized in the tissues of the child's parotid salivary glands and leaves a very strong immunity. However, complications after an infection are quite serious, for example, infertility in men who have had mumps in childhood;
- poliomyelitis, or Heine-Medina disease, is one of the most dangerous childhood illnesses, as in half of the cases it leads to lifelong disorders, including muscle atrophy, internal organ problems, and limb deformities. The causative agent is a virus that infects the gray matter of the central nervous system. Most often, the disease affects children under the age of 10, and infection occurs through household contact and airborne droplets;
- children under 5 years of age are susceptible to whooping cough, the disease is localized in the upper respiratory organs and is manifested by bouts of spastic cough. Timely recognition of the disease avoids complications of whooping cough, among which pneumonia is in the first place;
- - pediatric pathology, the causative agent of which is staphylococcal bacteria. Children 2-7 years old are at risk, the likelihood of infection increases in autumn and winter. Toxic substances released by bacteria have a negative effect on the nervous system.
Accidents
As well as unintentional injuries, they often lead to health problems or death. The factors are varied, as well as the risk groups. Injury can be triggered by weather conditions (examples are sunburn, frostbite, heat fainting, an accident on a slippery road), non-observance of safety at work, the human factor, when people are not aware of the dangers of risk or behavior, poisoning with poisonous plants or substances, and many others.
Hypertonic disease
Hypertension significantly increases the risk of developing severe, life-threatening, cardiovascular complications - heart attacks, strokes and others. Refers to cardiac pathologies and is characterized by an increase in blood pressure. The disease develops to a greater extent in people after 40 years, women and men are equally susceptible to the development of the disease. Hypertension often becomes the impetus for the onset of atherosclerosis and is estimated by specialists as one of the most common causes of early mortality among the working-age population. Of the risk factors, it is worth noting:
- stress and frequent emotional stress;
- excessive intake of salt in the body, leading to fluid retention and increased pressure;
- hypertension in relatives, since the predisposition to it is inherited;
- diabetes;
- obesity and overweight;
- endocrine diseases, in particular hyperthyroidism;
- chronic infectious diseases.
Against the background of hypertension, pathologies such as angina pectoris, coronary heart disease and myocardial infarction, heart failure, retinal detachment and stroke can develop. The most serious complication is considered, accompanied by a sharp and rapid rise in pressure, vomiting and even loss of consciousness.
Suicide
It causes two deaths on the planet every minute. Every year more than a million people are sent to the next world, committing suicide. What pushes people to take such a step? There are statistics according to which the most common cause of suicide is mental disorders, in particular, depressive conditions. It has been established that more than half of the suicides suffered from depression before they died.
A quarter of suicide cases are related to alcoholism and drug use. The following categories of the population are also included in the risk group:
- recently retired people;
- disabled people;
- people experiencing severe stress;
- prisoners;
- soldiers;
- lonely people;
- teenagers.
In addition, statistics indicate that women commit suicide attempts more often than men, and the latter, in turn, more often than women bring suicide to the end. Some studies have linked suicidal tendencies to inadequate production of serotonin in the body.
Stomach cancer
This neoplastic disease completes the ranking, accounting for one fourth of all cancers and second in prevalence after lung cancer. Men get sick a little more often than women, and the age group prone to stomach cancer is the population over 50 years old.
The following factors contribute to the development of pathology:
- smoking;
- eating spicy, fried, salty, smoked and nitrate-rich foods;
- improper diet, hasty snacks, fast food;
- chronic stomach diseases, for example;
- pernicious anemia;
- environmental reasons: high content of molybdenum, zinc, nickel, asbestos dust in air, water and food;
- disorders in the immune system;
- abuse of strong alcoholic beverages;
- genetic predisposition.
Stomach cancer, originating in the mucous tissue of the organ, eventually spreads through the lymphatic system and affects the pleura, peritoneum, diaphragm, internal genital organs, large arteries and lymph nodes. Advanced forms of cancer can result in disappointing consequences: from removal of the stomach to death. However, at the first stage of the disease, the patient has every chance of a successful recovery.
So, we have compiled a kind of rating of the causes of death of people. As you can see, some of the diseases are caused genetically and by external conditions of life, but the person himself is quite capable of influencing some of the factors and ailments. Prevention measures for major diseases are often simple. Pay close attention to your health and you will live a long, interesting and eventful life.
For decades, people's lives have been changing and, along with it, diseases. Medicine is moving forward, and technical progress is not standing still. We can only hope that the epidemics of infectious diseases that destroyed entire cities in the Middle Ages are irrevocably gone, but the number of cardiovascular diseases, cancer, obesity, anorexia is rapidly growing ...
What ailments are rightfully called diseases of the 21st century? What do people have to suffer with in the near future?
1. Cancer
Cancer, a disease that has persecuted man, is one of the terrible diseases of the century. Caused by multiple causes, such as radiation and chemicals such as organic dyes, exhaust fumes, some food preservatives. Chronic fatigue and stress also, oddly enough, trigger the growth of cancer cells. Cancer can develop due to papilloma viruses and genital herpes, sexually transmitted infections. So promiscuous, unprotected sex life, which is quite common nowadays, is a serious risk factor.
Of course, it will not be possible to avoid all the troubles of life, but it is within the power of everyone to improve the quality of life and prolong it. The key to success in a proper balanced diet, adherence to the daily regimen, in moderate exertion. Well, perhaps the most important thing is to learn how to relax without alcohol and other bad habits, because nowadays there are many interesting hobbies, travel, sports that can maintain an optimistic view of the world at the service of a modern person.
Tuberculosis is a terrible infectious disease that has long ceased to be a disease of alcoholics, homeless people, prisoners, and has changed its social status. Doctors are sounding the alarm because of the mutation of viruses, and drug-resistant forms of tuberculosis arise.
In the 90s, information appeared that with the onset of the 21st century, tuberculosis will disappear, as smallpox once disappeared. However, practice shows that the problem of tuberculosis is growing in scale, medicines are becoming ineffective, and the need for phthisiatricians is growing. And it was not in vain that a huge premium was promised to those who invented a universal means of diagnosing and treating this disease.
A terrible scourge of the 21st century is mental illness - anorexia, a person has an inadequate and pathological desire to lose weight, there is a fear of obesity. In 95% of cases, these are young women who see themselves in the mirror more fully than they really are.
In other words, the lady resembles a skeleton that has been covered with skin, but she still thinks that she has lost a little weight. And every extra 100 grams of weight he perceives as irreparable obesity, and every piece of food that he managed to refuse, on the contrary, he perceives as a victory and an approach to perfection, of course, if a bony, unattractive body with an emaciated appearance can be considered perfection. A person is "addicted" to refusal to eat like drugs.
Whatever the cause of such a disease, but a person suffering from it needs the help of doctors and relatives. Not everyone can realize that a crooked mirror is only an illusion, and must be broken before the consequences become dire.
4. Drug addiction
Drug addiction has long been social in nature. Most often it happens under the pressure of the environment, for the sake of interest, in order to become "one of the people" in the company. Drug addiction is growing and affects virtually every fifth inhabitant of our country. Today, there is not a single region in Russia where drugs are not used or distributed. They affect the psyche in such a way that irreversible degradation and complete physical exhaustion of the body occurs.
For the sake of the drug, he will go to any immoral acts, which will still lead to irreversible consequences. They say just one trick is enough to become "addicted".
Doctors agree that AIDS is the first global epidemic. With its size, it covered all the epidemics taken together that humanity suffered throughout its development. This terrible disease is provoked by Type I and Type II Immunodeficiency Viruses. Entering the body, the virus slowly kills the cells that support the immune system, and causes a complete and irreversible depletion of the immune system, and the patient dies even from trivial infections.
Nowadays it is very easy to get AIDS... If the lymph nodes are enlarged in different parts of the body, prolonged diarrhea, weight loss for no reason by 10 or more kg, spots and blisters on the skin are the first symptoms in which you immediately need to "run" to the doctor. Despite all efforts, the battle to defeat this disease is far from over. Scientists do not stop fighting the spread of the disease, and are working on obtaining a vaccine, but so far all the successes do not answer the most important question - how to finally defeat AIDS?
Quite recently, all TV channels kept repeating that a terrifying and incurable disease was approaching Russia. Many were indifferent to this, but the Ebola virus is a very serious disease and has a high degree of infection. The number of victims has reached several thousand people. Spreaders of this merciless death virus - inhabitants of africa.
It is believed that Ebola loves hot climates. Scientists also suggested that bats can be the main carriers of the infection, and pets can also be carriers. Fever is transmitted through skin-to-skin contact, resulting in a fight against spread. Tests have shown that there are no vaccines for the Ebola virus, but scientists promise to come up with a cure for a virus that is no doubt trying to kill the entire world. If a person does not recover within 7 to 16 days after the initial symptoms, then the likelihood of death increases.
7. Strokes and heart attacks
Strokes and heart attacks can be considered terrible diseases of the 21st century, and they are getting younger every year. Due to improper lifestyle, frequent stress, bad habits, abuse of fatty foods, overeating, the metabolism of cholesterol and fatty acids is disrupted, which gradually accumulate on the walls of blood vessels and form atherosclerotic plaques. This leads to a narrowing of the diameter of the vessels and, accordingly, to a decrease in their blood supply.
So, physical training, balanced nutrition, sufficient water consumption, rejection of bad habits, a positive emotional attitude - this simple set of measures allows you to prevent the onset and development of unpleasant symptoms accompanied by heart attack and stroke.
Schizophrenia is a mental disorder that is very relevant in our modern society. Depression, social problems, anxiety disorders, unemployment, poverty can all lead to schizophrenia. Such patients live 10-12 years less than healthy people. There are times when a person commits suicide at the time of an attack.
Another dangerous group of effective disorders is depression, which is characterized by low mood, slow movement, and slowness of thought. There are other symptoms of depression, but only a specialist can assess their severity. The tense rhythm of life, neuroses, stress, lack of sleep exhaust the nervous system. Also, with the development of chronic diseases, "hard thoughts" appear, which leads to depression. Scientists call depression the problem of the new century - and, obviously, they are not exaggerating.
According to some reports, overweight and obesity is present in every third inhabitant of the country, which is characteristic of excessive development of adipose tissue, and manifests itself in many symptoms that depend on the degree of obesity. Obesity is a condition in which the body accumulates so much fat that it can pose a threat to the development of serious diseases.
According to statistics in the world about 300 million adults alone are obese, obesity is already common among children. Lack of exercise and excessive consumption of high-calorie foods are perhaps the two most important causes of obesity. But there are all kinds of treatments that obesity can be overcome.
Terrible diseases of the 21st century can be forgotten. Every day, doctors save lives. Thanks to such work, patients have every chance to live a long and happy life. The main thing is to hope and believe!
TEXT: Anastasia Pivovarova
WE LOVE OURSELF AND OUR HEALTH BECAUSE OUR BODY- the closest and most understandable thing we have. But we love sickness no less. Try to complain that you have a toothache - hear a few stories and recipes in response. But some diseases are becoming more popular than others, sometimes it seems that everyone around suffers from one ailment - from the stars to the nearest neighbors. It is not like when a person is afraid and checks himself for everything, rather - for an epidemic, only many fashionable diseases do not spread with the speed of the flu. When and why do diseases become popular?
A disease from which you cannot hide
It is not always possible to understand what people actually suffered from some hundred years ago. They had stomach aches, seizures, dying from strokes and black blood, because medicine was far from today's achievements. It was impossible to protect against disease, even the concept of hygiene was very different from those to which we are accustomed. There was no protection from many diseases, and in such conditions the emergence of fashion can only be explained by a protective mechanism: in order not to be afraid of the disease, one had to be proud of it. In the 18th century, medicine began to develop in Europe - as much as possible. It was at this time that it became fashionable to get sick, and literature and art only fueled interest in ailments: many wanted to be like heroines fainting from an excess of feelings.
Consumption came into vogue. Largely because
until the end of the next century, people did not know how to treat tuberculosis, and they were sick a lot. And also because earlier many diseases, not only tuberculosis itself, fell under the concept of "consumption". It was believed that consumption comes to scientists, to those suffering from unhappy love and to the mourners. You can get romantically sick with tuberculosis
it was in the XX century, as it happened
with the heroines of E. M. Remarque, but after they learned to treat and prevent tuberculosis, he became associated with a low standard of living, and the romanticization ended. Today, tuberculosis is still one of the leading causes of death in the world, but to call it fashionable
and no one can be interesting anymore. There is nothing mysterious about it, and the problem of tuberculosis resistance to antibiotics is of interest to scientists, not public opinion.
It can be assumed
that "diseases of abundance" are becoming fashionable - those that appear in wealthy people
It can be assumed that "diseases of abundance" are becoming fashionable - those that appear in wealthy people. If earlier the poor simply could not afford illness (due to the lack of medical care and banal hunger, people from the lower classes simply died from any more or less serious illness), then the rich could. Disease tendencies were generally a hallmark of high society. The peasants and workers were supposed to be invariably healthy and strong, because their "simple" nature allegedly was not subject to breakdowns, in contrast to the complex and fine-tuned nature of the aristocrats. “How could you think of suddenly appearing into society without ever being sick? Such good health is only fit for the peasant generation. If you really do not feel any ailments, then hide, please, such a terrible crime against fashion and customs. Please, be ashamed of such a strong build and do not shield yourself from among the gentle and ailing people of the big world ”, - the satirical work of Nikolai Ivanovich Strakhov, published in 1791 and recently republished, just illustrates this.
However, not all common diseases became fashionable. For example, only women were sick with hysteria - it was a mysterious disease with many symptoms, its cause was seen in the uterus, which wandered at will or sent in pairs to the brain. There was nothing attractive about hysteria, despite its prevalence, there was, on the contrary, it was considered a sign of weakness. But melancholy, which can be seen as signs of depression or mood disorders, was much more popular. It is enough to recall the images of Byron or re-read "Eugene Onegin" to understand: in the 19th century, in order to be known as fashionable, you had to declare yourself a melancholic.
The disease that used to be
has not been studied
There is the so-called third-year syndrome: it is at this time that medical students move from the basics to the study of diseases, cram dangerous symptoms and immediately find them in themselves. A similar effect happens when a person feels unwell and opens a medical encyclopedia or types symptoms into the Google search bar: there are many diseases that even a healthy person can easily find in themselves. There are enough nonspecific symptoms that appear with completely different diseases: weakness, dizziness, fever, drowsiness, and so on. Finding a couple of these signs is a simple task, especially if you don't sleep well for a couple of nights or forget to have lunch for a week.
The same mechanism works when a disease becomes the subject of close attention of physicians and scientists: for example, a new method of treatment is discovered or a separate diagnosis is identified, a program of patient support is created. Information about the disease, its symptoms, risk factors appears in the information space, people learn about it and massively detect signs of the disease in themselves. This is also helped by opinion leaders, the same stars who talk about their illnesses or support charitable foundations: against the background of general interest, it is easier to collect donations. For example, autism spectrum disorders and mysterious Asperger's syndrome were very popular a few years ago. After the release of the series about Sherlock, "sociopaths" appeared en masse, along with guides on how to communicate with them.
1Over the past decade, the number of patients with diabetes mellitus has doubled in the world, reaching, according to IDF, 415 million people by 2015. Control and epidemiological studies carried out in Russia showed that the true number of patients with diabetes mellitus is approximately 3-4 times higher than the officially registered one, that is, at least 7% of the country's population. At the same time, the prevalence of diabetes mellitus in the group of people over 60 years old reaches 20%. The second place in the structure of endocrine pathology belongs to various diseases of the thyroid gland. The number of patients who have lost their ability to work due to thyroid pathology is increasing. This article analyzes modern domestic and foreign literary sources on the epidemiology of diseases of the endocrine system, which showed that these diseases are an important medical and social problem of our time.
endocrine diseases
diabetes
thyroid disease
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26. Goma T.V. Clinical and immunological aspects of damage to the cardiovascular system in patients with Graves' disease and chronic heart failure / T.V. Goma, L.Yu. Khamnueva, G.M. Orlova // Clinical. and experiment. thyrodology. - 2011. - T. 7. - No. 3. - S. 42-47.
The proportion of patients with pathology of the endocrine system is constantly increasing in all economically developed countries of the world. The leading place in the structure of all endocrine diseases is diabetes mellitus (DM), which today is one of the most dangerous challenges to the world community and an important priority of national health systems. The second place in the structure of endocrine pathology belongs to various diseases of the thyroid gland. Two decades ago, the number of patients with diabetes in the world did not exceed 130 million people. If in 2013 the number of patients with diabetes in the world amounted to 387 million people, thus increasing more than 2 times over the past 10 years, then in 2015 IDF published data that the number of patients with diabetes in the world exceeded 415 million human .
Such a rapid increase in the prevalence of diabetes, as well as the fact that half of all patients with diabetes are of active working age (from 40 to 60 years), caused the 42nd Assembly of the World Health Organization (WHO) to be held in May 1989, which provided data on an increase in the incidence of diabetes and urged all countries to take measures to prevent this disease.
One of the leading indicators that determine the epidemiological situation of diabetes in the world is prevalence. According to Maslova O.V. and Suntsova Yu.I., “the number of patients with diabetes is constantly increasing due to the growth in the number and age of the population, urbanization of the territory, an increase in the prevalence of obesity and a sedentary lifestyle”. According to the literature, the highest prevalence of diabetes in the world is noted in Tokelau - 37.9%. The lowest value is in Mali (1.28%).
According to experts, in the European Region, which includes 56 countries, the number of people with diabetes is 56.3 million, or 8.5% of the adult population. The highest prevalence of diabetes is found in Turkey - 14.8%. The European countries with the largest numbers of people with diabetes are mostly located in Western Europe. The prevalence of diabetes in Germany is 11.95%, in Spain - 10.83%, Italy - 7.95%, France - 7.50%, in the UK - 6.57%. According to IDF, the minimum national prevalence of diabetes in Europe is observed in Azerbaijan - 2.28%.
According to IDF experts, today China is home to the largest number of people with diabetes - 109.6 million, and the prevalence rate reaches 10.6%.
In North America and the Caribbean, most of the region's population lives in the United States, Mexico and Canada, and the vast majority of people with diabetes are registered in these countries. The national prevalence of diabetes in Mexico is 11.7%, Canada is 10.21%, and the United States is 10.90%.
The prevalence of type 2 diabetes by gender and age was studied in the DECODE (Diabetes Epidemiology Collaborative Analysis of Diabetic Criteria in Europe) study conducted in 8 European countries. During the study, 16931 people aged 30-89 years were observed, among whom 1325 people had newly diagnosed type 2 diabetes. The study showed that the prevalence of diabetes in the group of people under 60 years old was less than 10%, among people 60-79 years old - 10-20%.
In different countries of the world, the frequency of type 1 diabetes varies greatly. According to epidemiological studies, the incidence of type 1 diabetes in the world ranges from 36.8 per 100 thousand population in Finland to 0.8 per 100 thousand population in the countries of the Western Pacific region (China, Japan, Pakistan).
Another important indicator that determines the epidemiological situation with regard to diabetes is morbidity. According to data published in IDF, the incidence of type 1 diabetes in children, especially under the age of 15, is increasing in many countries around the world. There are clear geographical differences in growth trends, but the average annual growth rate is 3%. It has been established that type 1 diabetes in the world annually falls ill 79100 children under the age of 15 years. Of the 497,100 children currently living with type 1 diabetes, 26% are from Europe, which has the most recent and reliable data on the incidence of new cases of diabetes, and 22% from North America and the Caribbean.
There is also a high rate of increase in the incidence of diabetes in Russia. According to the Russian Gosregister of patients with diabetes, at the beginning of 2015, there were about 4.1 million people in terms of accessibility to medical institutions: 340 thousand patients with type 1 diabetes and 3.7 million people with type 2 diabetes. It is also worth taking into account the results of control and epidemiological studies that were carried out in the period in 2002-2010. and showed that the true number of patients with diabetes is approximately 3-4 times higher than the officially registered one, that is, at least 7% of the population of Russia (9-10 million people).
Of interest are the data of the Federal State Budgetary Institution "Endocrinological Research Center" of the Ministry of Health of the Russian Federation (FGBI "ENTs" of the Ministry of Health of the Russian Federation) on the dynamics of the prevalence of type 2 diabetes among Russians for the period from 2000 to 2012: the total number of adult patients increased by 1,736,423 people ... Thus, the annual increase in the national average was 6.23%.
Assessing the dynamics of the main epidemiological indicators in Russia of both types of diabetes (an increase in the incidence of type 2 diabetes by 29.4% among adults and type 1 diabetes by 10.6% among children and adolescents), it is worth noting that they remain below the same indicators in the world. , especially if you focus on type 2 diabetes.
Specialists of the Federal State Budgetary Institution "ESC" of the Ministry of Health of the Russian Federation have identified differences in the incidence of diabetes between the federal districts of Russia located in different geographic zones of the country. There is a so-called. the phenomenon of the gradient of growth of this epidemiological indicator in the South-North directions for type 1 diabetes and East-West for type 2 diabetes.
Comparatively few works have been devoted to detailed information on disability due to diabetes mellitus. The data of the State Register of Diabetic Patients provide detailed information on disability due to diabetic retinopathy: in 2012, more than 45 thousand patients with diabetes in Russia had disabilities due to loss of vision. At the same time, 30 thousand people lost their sight partially, and 18 thousand - completely.
An important indicator of many medical and social aspects, the effectiveness of treatment and prophylactic care for patients is the average life expectancy. Over the period from 2007 to 2012 in Russia, it increased both in patients with type 2 diabetes, reaching 73.1 years, and in patients with type 1 diabetes, reaching 58.8 years.
In 2013, global health spent about US $ 548 billion on the prevention of diabetes complications and on the treatment of the disease itself. This figure is expected to exceed US $ 627 billion by 2035. The volume of expenses for diabetes treatment varies considerably from region to region and from country to country. Only 1/5 of global spending is in middle- and low-income countries, although they are home to about 80% of patients with diabetes. On average, 545 IDs (US $ 356) are spent per patient in middle- and low-income countries per year, and 5305 IDs (US $ 5,621) in high-income countries.
As we have already mentioned, thyroid pathology ranks second in prevalence after diabetes among all endocrinopathies. Since the beginning of the 90s, it has also been characterized by an increase in prevalence, depending on many factors, such as gender, age, genetic predisposition, the presence of goitrogenic substances in food (thioglycosides, thiocyanates), iodine supply of the region, etc. The number of patients who have received temporary and permanent disability due to thyroid pathology is increasing.
Worldwide, the incidence of thyroid cancer is currently increasing. The rate of increase in the detection rate of this disease is 4% per year. Today, this pathology is the most frequent malignant neoplasm of the endocrine system, accounting for 2.2% in the structure of oncological morbidity. In Russia, over the period from 1999 to 2009, the incidence of thyroid cancer has doubled, amounting to 6.1 per 100 thousand population per year (8000 primary cases registered annually). The increase in the incidence of this pathology is affected by iodine deficiency.
Thyroid nodules are a very common pathology that requires a diagnostic search and long-term observation of patients. Most of these formations are benign and do not have any effect on a person's life. In 30% of the world's population, colloid goiter is detected by ultrasound, i.e. for Russia it is more than 40 million people.
According to L.A. Zhukova. (2009, 2012), nodules of the thyroid gland in the territory of iodine deficiency and the deteriorating environmental situation (after the Chernobyl accident) occur in 33.9% of cases. According to Andreeva N.S. (2004), the incidence of nodular goiter in Kursk increased from 187.4 visits per 100 thousand population in 1997 to 242 in 2003. In conditions of iodine deficiency, the prevalence of nodular goiter increases to 30-40%. The attention of the scientific and medical community to the problem of iodine deficiency has been especially increased in recent years, various epidemiological studies are being carried out. This is due not only to the high prevalence of this pathology, but also to changes in the methods of epidemiological research, as well as to the emergence of new methods for analyzing the content of iodine in the body.
Hypothyroidism is a common condition. Manifest hypothyroidism occurs in 0.2-2% of the population, subclinical - 4-10% (in the elderly - 7-26%). According to the data obtained by M. Vanderpump et al., The prevalence of hypothyroidism ranges from 3 to 16% in men and from 4 to 21% in women and increases with age. Such a high prevalence determines the medico-social significance of hypothyroidism. The most common cause of this pathology is autoimmune thyroiditis (AIT). In general, autoimmune thyroid diseases (AIT, DTZ) occur in 2-5% of the population. The prevalence of carriage of antibodies to thyroperoxidase (AT-TPO) is 12%. The combination of AIT and thyroid cancer is of interest. These two pathologies coexist in 0.3-38% of cases, more often in women. The morphology of thyroid tissue can be clarified during a fine-needle aspiration biopsy (TAB), which, although it is considered a fairly accurate diagnostic method (accuracy up to 98%), gives very limited information in a quarter of cases with AIT due to the small number of cells in the biopsy.
Thyrotoxicosis remains a serious problem in thyrodology, which leads to a worsening life prognosis and is accompanied by an increase in mortality from diseases of the cardiovascular system. Thus, mortality from ischemic heart disease, heart failure, arrhythmias, valvular defects and arterial hypertension in combination with thyrotoxicosis increased by 1.2 times compared with the general population. The reason for this is the development of changes in the cardiovascular system.
Among the manifestations of "thyrotoxic heart" can be called pulmonary hypertension, diastolic dysfunction, the development of heart failure, dilatation of cardiac cavities, atrial fibrillation and left ventricular myocardial hypertrophy. Atrial fibrillation, which occurs in thyrotoxicosis in 2-25% of cases, often persists even after the thyrotoxicosis has been eliminated. In a study of a group of women with thyrotoxicosis and various cardiopathies, it was found that atrial fibrillation develops in 67% of cases, which indicates the existence of factors affecting the risk of developing atrial fibrillation in thyrotoxicosis, which, in addition to the presence of concomitant pathology of the cardiovascular system, include male gender and age. C.W. Siu et al. (2007) showed that atrial fibrillation is an independent predictor of the development of heart failure in thyrotoxicosis.
One of the most common diseases of the thyroid gland is diffuse toxic goiter (DTG). The prevalence of DTD in the population is 1-3%, the incidence is from 5 to 23 cases per 100 thousand of the population per year, the ratio of men and women is 1: 5 - 1: 7. DTZ is primarily dangerous for disorders of the cardiovascular system associated with thyrotoxicosis and leading to a deterioration in the prognosis of the disease and disability.
These data indicate the high importance of endocrine pathology - diabetes mellitus and thyroid diseases. An analysis of publications devoted to their epidemiology suggests that endocrine diseases are important and, unfortunately, far from being solved by the medico-social problem of our time.
Bibliographic reference
Kuznetsov E.V., Zhukova L.A., Pakhomova E.A., Gulamov A.A. ENDOCRINE DISEASES AS A MEDICAL AND SOCIAL PROBLEM OF MODERNITY // Modern problems of science and education. - 2017. - No. 4 .;URL: http: // site / ru / article / view? Id = 26662 (date accessed: 31.12.2019).
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Infections accompany a person throughout his life. And the very history of the development of the human population is, among other things, the history of infections that remain with us, despite the development of medicine, science and the many benefits of civilization. In the modern rapidly changing world, borders between states are disappearing, the population is actively migrating, new types of pathogens resistant to modern drugs appear. As a result, the statistics of infectious diseases is growing steadily. Our expert, infectious disease doctor, head of the 3rd department of the Regional Infectious Diseases Clinical Hospital in Lvov, Sofia Igorevna Kaschevska, tells about infectious diseases with which patients most often turn to doctors today.
Has the picture of infectious diseases changed in 2019 compared to previous years?
Today we can say that yes, it has changed. The beginning of 2019 will be remembered for us by the sharp increase in the number of patients with measles. This situation became a logical continuation of the outbreaks of this infection over the previous 2 years, due to the low level of vaccination of the population and the lack of collective immunity to the measles virus. Fortunately, it can be argued that this year the incidence of measles is starting to decline: from January on, the number of patients began to gradually decrease, and by the spring we transferred our department to normal operation.
By the way, about the season of ARI and influenza. What can children and adults expect this year?
- This season, experts predict the activity of new strains of influenza. It's not about the flu H1N1"California" to which we are "accustomed" and against which many people in our country have formed immunity through preventive vaccination and as a result of the transferred disease. According to forecasts, in the northern hemisphere during the new season, instead of the "familiar" causative agent of influenza, three new strains will dominate at once: A / Briben (H1N1); A / Kansas (H3N2); B / Colorado line B / Victoria / 2/87) and B / Phuket (line B / Yamagata). These strains were identified in the United States, and now we will "meet" them on the European continent, and this once again serves as a confirmation that there are no borders for infections. Influenza risk groups are young children, adolescents, pregnant women, the elderly and patients with chronic diseases.
What other infections can be called "leaders" in terms of the frequency of patient visits to doctors in 2019?
- Rotavirus diarrhea, which in everyday life is called "intestinal flu", was common. It should be noted that rotavirus is most dangerous for young children, because with this disease, acute diarrheal syndrome develops, accompanied by the loss of a large amount of fluid and salt, which literally depletes the child. Fortunately, modern laboratory rapid tests for the detection of rotavirus help to quickly clarify the diagnosis and quickly provide qualified medical care even on an outpatient basis, before the child is admitted to the hospital. It should also be noted that the incidence of "intestinal" flu among children has been increasing since September, when, after summer, preschool institutions and schools begin to work in full force. Another common reason for visits is acute intestinal infections (AEI), which are caused by bacteria, among which Salmonella is in the lead. For bacterial OCI, spring-summer seasonality is characteristic, and epidemic outbreaks occur as a result of violation of hygienic rules and norms. This year, we observed and treated such outbreaks after weddings, graduations, anniversaries, as well as in tourist groups, given the openness and popularity of our city for travelers from different countries.
It is also worth mentioning adenovirus infection, which, although considered a type of ARI, can occur throughout the year. As you know, young children are most susceptible to adenovirus. Adenovirus infection in them can begin under the "mask" of OCI, with which anxious parents of babies turn to an infectious disease doctor. Therefore, in the course of a comprehensive examination of such patients, we also conduct express tests for the detection of adenoviruses. Unlike bacterial OCI, with adenovirus infection, symptoms of ARI in the form of reddening of the oropharynx, runny nose and conjunctivitis against the background of moderately elevated body temperature join as early as on the 2-3rd day of the disease.
Your department specializes in the treatment of acute tonsillitis. In what cases does it become necessary to hospitalize such patients in the infectious diseases department?
Acute inflammation of the palatine tonsils (tonsillitis), or "tonsillitis", occupies a separate "honorable" place in the clinic of infectious diseases. The symptoms of tonsillitis can be observed against the background of many infectious diseases. This is due to the role of the tonsils in the formation of the general and local response of the body to infection. Despite their small size, the tonsils are an important part of the peripheral immune system and the gateway for viruses and bacteria. The need to consult an infectious disease specialist and an ENT specialist arises when the symptoms of tonsillitis increase with suspicion of a certain infectious disease (for example, infectious mononucleosis or diphtheria), as well as the development of complications that require specialized medical care. In our institution, thanks to the presence of otolaryngols on the staff, we are able to form a multidisciplinary team for the successful diagnosis and treatment of acute tonsillitis and their complications.
You mentioned infectious mononucleosis and diphtheria. Not all parents think about these infections when a child has a sore throat. Are there specific symptoms that suggest a hazard?
At the very beginning, there are no specific symptoms. Therefore, if a child has an inflamed palatine tonsils, you should immediately contact a pediatrician or family doctor. These specialists always remember that tonsillitis can be one of the symptoms of diphtheria or infectious mononucleosis. In order to exclude diphtheria, the doctor will take a swab from the throat to determine the pathogen. This approach is absolutely justified today not only in children, but also in adults, given the low level of vaccination in all population groups against this dangerous infection.
Remember that diphtheria starts out like a common sore throat. Taking into account the unfavorable epidemic situation in the country and the low level of vaccination, inflammation of the tonsils requires increased vigilance. You can not self-medicate acute tonsillitis - you should definitely consult a doctor who will exclude diphtheria in the first place.
As for infectious mononucleosis, this disease begins as a common ARI with tonsillitis, then all groups of lymph nodes, liver and spleen enlarge. The listed symptoms are accompanied by characteristic changes in the clinical analysis of blood. This is the analysis that doctors refer all patients with tonsillitis symptoms. Taking into account this peculiarity of the disease, we additionally involve hematologists as consultants. By the way, infectious mononucleosis is called "kissing disease": its causative agent is the Epstein-Barr virus, which is transmitted by airborne droplets. Most often, children aged 3 to 6 years old who attend kindergartens and adolescents (15-16 years old) are sick. Kids lick their own and others' toys and nipples, and teenagers, communicating closely, transmit the virus to each other with kisses. Seasonality is not typical for infectious mononucleosis, patients are consulted and successfully treated all year round.
What advice would you give our readers to reduce the risk of contracting infectious diseases?
Vaccination will help protect against influenza, measles and diphtheria, and this opportunity should not be neglected. In early autumn, the entire staff of our department was vaccinated against influenza with a topical seasonal vaccine. Therefore, we can safely provide qualified care to patients, without "dropping out" from the work process and without putting our loved ones at risk of infection with seasonal flu viruses. As for the prevention of ARI, in addition to the well-known recommendations regarding a healthy lifestyle, during the height of the ARI season, it is advisable to avoid crowded places, after trips in public transport, try not to touch your face with your hands, not rub your eyes and nose, have with you and use, if necessary, wet wipes with antiseptics, especially when traveling with children. The level of culture and human awareness plays an important role in the prevention of infectious diseases. Our level of culture and awareness does not allow us to take food with dirty hands - everyone has already learned this. But there are other ways that infections can spread. It is necessary to explain to children from an early age that you cannot drink with someone from the same cup or bottle, even if this someone is your acquaintance; that kissing is a way of showing tenderness towards loved ones, and not a demonstration of relaxed behavior. All of these precautions are simple, versatile, and good at any time of the year.
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