Medicine of Extreme Situations
Scientific and Practical reviewed Journal
of FMBA of Russia

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№3, 2017 (September)

Mucosal immunity of the respiratory tract and it`s role in occupational pathologies.

Year: 2017 (September) Number: №3 Pages: 25-39

Heading: Medical sciences.

Article type: Scientific article.

Authors: M.R. Khaitov, N.I. Ilyna, L.V. Luss, A.A. Babakhin.

Organization: NRC Institute of Immunology FMBA of Russia, Moscow, Russian Federation.

Annotation:

The article presents modern concepts of mucosal immunity (including the structure and function of lymphoid tissue associated with the mucosa), the role of immunoglobulin A (IgA), the role of the mucosa of the respiratory tract in the allergic immune response. Data on the features of mucosal immunity in chronic obstructive pulmonary diseases (COPD) and asthma are presented. The concept of a local allergic response in the mucosa of the respiratory tract is considered. Changes in mucosal immunity in occupational respiratory pathology, as well as in athletes of higher achievements, are considered. Information on the effect on the respiratory system of chemical occupational pollutants, including nanosized particles is also given.

Keywords:

Mucosal immunity, immunoglobulin A, allergic response, occupational pathology of respiratory tract.

Features of enteroviruses circulating in the North-West region of Russia over the period of 1974–2015.

Year: 2017 (September) Number: №3 Pages: 40-46

Heading: Medical sciences.

Article type: Scientific article.

Authors: E.A. Murina, N.V. Skripchenko, O.V. Goleva, Z.A. Osipova, M.V. Ivanova, N.F. Pullman.

Organization: Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg.

Annotation:

At the Department of Virology and Molecular-Biological Studies there has been performed a 40-year observation of enterovirus pathogenic strains circulating in the Northwest Region. Studies were conducted by the Modified Complement Binding Reaction Express Test (m-CBR) to reveal enterovirus antigens in patients followed up in the Medical Center at Scientific Research Institute of Children’s Infections. Due to the developed express-diagnostics of enteroviral infections it has become possible to carry out continuous monitoring of enteroviruse circulation in the region and to reveal the interchangeability of dominat and nondominat serotypes of enteroviruses as well as to characterize the features defining the virulence in the epidemic process. The dominat viruses reach their reproductive maximum at 40°С (Rct40>1.0) and develop a high interferon resistance what results in aggravation of the clinical presentation of the disease, whereas activation of the accompanying viruses ocure at the lowered temperature - near 37°С (Rct40<1.0) and results in less severe forms of the disease. Circulation of the dominat serotypes in adult population stopped in 2–4 years along with the increase of their etiologic importance among children population.

Keywords:

Enteroviruses, dominating serotypes, epidemic process, virulence, diagnostics.

Ways to improve patient satisfaction at the reception desk of an outpatient hospital, rendering medical services within the FMBA system.

Year: 2017 (September) Number: №3 Pages: 47-50

Heading: Medical sciences.

Article type: Scientific article.

Authors: S.V. Romanov, S.A. Dzybak, O.P. Abaeva.

Organization: Volga District Medical Centre under Federal Medical and Biological Agency, Nizhny Novgorod.

Annotation:

The article considers the need for quality improvement in services provided to patients at the reception desk of an out-patient hospital, rendering medical services within the FMBA system. On the grounds of the patient survey, the authors exposed the main reasons of the patient dissatisfaction with the reception desk personnel operation at an out-patient hospital, which called to optimize the logistics, patient flows within the out-patient hospitals and the increase of the proficiency level of medical registrars. The novelty, practical and scientific significance of the conducted research consists of the inculcation of the new service standard and criteria for reception desk personnel performance assessment, working at the out-patient hospital at the FMBA. The effectiveness of the work provided is proven on the basis of the results of the repeated patient survey. In conclusion the authors underline, that despite the absence of high quality performance criteria for the auxiliary departments operation at a medical facility, the importance of the proper reception desk operation at an out-patient hospital, for the improvement of overall patient satisfaction at a medical facility – is very high.

Keywords:

The satisfaction of the patient, the quality of medical service, out-patient hospitals, registry.

Lateral flow assay test in detection of biodegrading microorganisms.

Year: 2017 (September) Number: №3 Pages: 51-58

Heading: Medical sciences.

Article type: Scientific article.

Authors: S.P. Yarkov, S.I. Tretyakov, L.A. Basharova, S.N. Skopinskaya, E.K. Shaulina, E.N. Khramov.

Organization: FSUE “State Scientific Research Institute of Biological Engineering” FMBA.

Annotation:

In order to create a mean for the rapid identification of the microbial contamination by the biodegrading microorganisms, residing on the surfaces of closed germ cells, were developed conjugates of gold nanoparticles with polyclonal antibodies to antigenes of microorganisms of species Bacillus(spores), mushrooms of species Aspergillus, yeast-like mushrooms Candida albicans, bacteria E. coli serotypes O+K. On the basis of the received conjugates were designed lateral flow assay tests and investigated analytical parameters (sensitivity and specificity) in relation with known biodegrading microorganisms, residing in closed manned germetic isolated volumes.

Keywords:

Lateral flow assay, colloidal gold nanoparticles, indication, biodegrading micro organisms.

Cryopreservation efficiency of platelet concentrate at –80°C, for clinical application.

Year: 2017 (September) Number: №3 Pages: 59-64

Heading: Medical sciences.

Article type: Scientific article.

Authors: F.S. Sherstnev, S.V. Utemov, A.A. Kostyaev, M.E. Kovtunova, K.A. Vetoshkin.

Organization: «Kirov Scientific Research Institute of Hematology and Blood Transfusion of Federal Medical-Biological Agency», Kirov.

Annotation:

Efficiency of platelet cryopreservation was studied. Therapeutic Platelet concentrates were obtained from 95 donors either with discrete or automated apheresis. After freezing according to exponential program with –30ºС and –80ºС refrigerators recovered 89.7% automated apheresis platelets and 83% discrete apheresis platelets with high functional characteristic. There were no significant quality differences between both types of concentrates, except reaction to osmotic stress, recovery in automated platelets started earlier and was more complete.

Keywords:

Platelet concentrates, cryopreservation, morphofunctional cell integrity.

Assessment of fibrogen activity of single-wall and multi-walled carbon nanotubes in rats in subacute inhalation experiment.

Year: 2017 (September) Number: №3 Pages: 65-75

Heading: Medical sciences.

Article type: Scientific article.

Authors: A.V. Vorobyev, V.I. Sigaev, A.D. Tolchinsky, C.N. Uspenskaya, Yu.V. Ivanova, E.V. Zvyagina, S.P.Rybalkin, L.V. Mikhina, S.G. Besaeva, A.A. Mazanova, N.R. Dyadishchev.

Organization: RCT&HRB AT NRC “Institute of Immunology” of FMBA of Russia Serpukhov, Moscow Region, Russia.

Annotation:

The studies on inhalation exposure to aerosol of the test materials (quartz dust, single-wall carbon nanotubes Tuball, multi-wall carbon nanotubes Taunit-M) during 4–6 weeks in subacute experiment followed by a 3-month period of observation of animals demonstrated cytotoxicity of test materials reflected in different degrees in cytological and biochemical parameters of bronchoalveolar fluid. Development of active fibroplastic process confirmed by pathomorphological studies was observed only when using multi-wall carbon nanotubes Taunit-M.

Keywords:

Single-wall carbon nanotubes, multi-walled carbon nanotubes, rats, fibrogen activity, subacute inhalation experiment.

Diagnosis and surgical treatment for the extravascular celiac trunk compression syndrome (publications review).

Year: 2017 (September) Number: №3 Pages: 76-87

Heading: Medical sciences.

Article type: Scientific article.

Authors: N.P. Istomin, Yu.V. Ivanov, A.V. Chupin, P.Yu. Orekhov.

Organization: FGBOU DPO «Training Institute» FMBA of Russia, Moscow; FSBI «Federal scientific and clinical center of specialized types of medical care and medical technologies» of FMBA of Russia, Moscow.

Annotation:

The article presents a modern review of the publications on the problem of the celiac trunk extravascular compression - diagnostics and surgical treatment. In most cases, the diagnosis the celiac trunk compression syndrome is final when other gastrointestinal diseases are ruled out. Sure, it tells about lack of awareness among the medical community of this specific and rare pathology, as well as a possible skeptical attitude towards it from related professionals.

The main methods used to diagnose the Dunbar syndrome are: ultrasonic duplex scanning of the abdominal aorta, multi-slice computed tomography and angiography with a respiratory samples.

The indication for the surgical treatment is the ineffectiveness of conservative therapy, the presence of the leading symptoms - abdominal ischemia as an outcome of the proven critical compression of the celiac trunk. The desire to minimize the trauma, the operative access and the volume of the main surgery called for the development of a new minimally invasive technology. Currently, laparoscopic decompression of celiac trunk in Dunbar syndrome is a procedure of choice, and with selective endovascular intervention is a reasonable alternative, that minimizes complications associated with an open surgery and celiac trunk extravascular decompression. The obvious advantages of laparoscopic surgery are lesser blood loss, a minimal pain syndrome in the postoperative period, short hospital stay and better cosmetic effect. At the hospital, where surgeons are confident in performing laparoscopic procedures, the surgery can be performed quickly, safely, and efficiently. Additional intervention in the form of endovascular correction is not required in all the patients and can be performed in a delayed order.

To compare all pros and cons of the alternative therapies and tactical approaches used in treatment of celiac trunk compression syndrome, it is necessary to conduct randomized studies and the study of remote outcomes.

For the comparative evaluation of the merits of existing therapies and tactical approaches in the syndrome of celiac trunk compression is necessary to conduct randomized studies with the study of remote results.

Keywords:

Dunbar's syndrome, compression of the celiac trunk, the laparoscopic method, endovascular surgery.

Protection against technogenic accidents, extreme natural disasters, nature-preserving activities, guarantees of environmental safety in the health care system.

Year: 2017 (September) Number: №3 Pages: 88-94

Heading: Occupational safety and security.

Article type: Scientific article.

Authors: L.L. Grossman, N.G. Korshever, S.A. Sidelnikov, Yu.A. Tyutyunnik.

Organization: FSBHI Branch Central Regional Hospital №119 of the Federal Medical-Biological Agency of Russia – Medical and Sanitary Unit №9, Saratov; Saratov State Medical University n.a. V.I. Razumovsky, Ministry of Health of the Russian Federation, Saratov.

Annotation:

The aim of the work has been to investigate the role of protection against the anthropogenic accidents and extreme natural disasters, condition of naturepreserving activities and guarantees of ecological safety in the general system of public health. There has been carried out an anonymous survey of 174 doctors-organizers, 34 experts and 496 nonmedical workers. There have been established the determinants regarding the effects produced on public health by anthropogenic accidents and extreme natural disasters, condition of nature-preserving activities and guarantees of environmental safety, as well as the state and social sectors (administration of the territory – the head of administration team; deputies of the territorial Duma; mass media and press; public health; organs of internal affairs and public prosecution; environmental safety and management of natural resources; sphere of the safety provision to the public livelihood; industrial and energy safety; forestry economy; hunting and fishing economy; transport infrastructure; Public road system; Housing and utilities infrastructure), which can make a significant influence on these determinants and validate the Public Healthcare System in a territorial entity (protection of the population against anthropogenic accidents and extreme nature disasters; Environmental management and provision of the environmental safety; Improving the daily living conditions of the population; Ensuring road safety; Ensuring public safety and law and order; Ensuring fair conditions for hiring and decent performance, Social guarantees and labor protection; Healthy nutrition for the population; Implementation of medical and social expertise of socio-economic and technical plans, projects and programs). The outcomes of the work done can be practiced in in daily care for public health protection.

Keywords:

Anthropogenic accidents, extreme nature disasters, environmental protection, environmental safety, determinants, sectors, factual indicators, health protection.

Ozyorsk children’s health registry: development results, management guidelines, potential and prospects.

Year: 2017 (September) Number: №3 Pages: 95-103

Heading: Occupational safety and security.

Article type: Scientific article.

Authors: S.F. Sosnina, N.R. Kabirova, P.V. Okatenko, S.A. Rogacheva, Yu.V. Tsareva, E.A. Gruzdeva, M.E. Sokolnikov.

Organization: Federal State Unitary Enterprise Southern Urals Biophysics Institute of the Federal Medical and Biological Agency of Russia, Ozyorsk, Chelyabinsk region.

Annotation:

The article presents development and functioning results of the child population Health Registry in Ozyorsk with its town-forming enterprise Production Association (PA) 'Mayak' – the first nuclear industrial complex in Russia. Rationale of the Registry is determined by existing contradictions in assessment of both parental exposure effects in the offspring and anthropogenic impact on child population.

The Registry was created in Southern Urals Biophysics Institute’s laboratory of Radiation Epidemiology and by involving modern information technologies represents a computerized database of personal medical information. Currently the Registry contains clinical, epidemiological and social information on 12175 persons under 15 years old, living in Ozyorsk, acquired from the medical records. The system constantly updates.

The Registry is quite unique for the fact of prolonged observation (it follows up children born in 1946 and since), by representativeness of sample, massive amount of medical information from prenatal to adoles cence and by particularity of 'Mayak' Workers’ Cohort, being subjected to occupational chronic radiation exposure.

There was considered the applicability of the Registry, follow-up prospective, compatibility with Child Health Registry dosimetry system and the 'Mayak' Workers’ Cohort Registry - previously created in the Southern Urals Biophysics Institute. Significance of the Register for multifaceted retrospective epidemiological studies is substantiated. Collected data is focused on the health assessment of the offsprings occupationally exposed workers, as well as allows to conduct population-based studies, since provides the opportunity to understand the disease prevalence rate and radiogenic risks assessment.

Obtained results can contribute to the improvement of medical care rendered to persons, exposed to radiation; allow developing of rehabilitation measures. The expedient data collection and data processing, from child medical records, allow for in-depth monitoring of child health in restricted administrative and territorial entities.

Keywords:

Health registry, children, ‘Mayak’ PA, 'Mayak' employeese offsprings, closed nuclear city Ozyorsk, anthropogenic exposure.

Association of Single Nucleotide Polymorphisms in DNA Repair Genes with the Risk of Malignant Neoplasm Development in Persons Exposed to Chronic Radiation.

Year: 2017 (September) Number: №3 Pages: 104-109

Heading: Occupational safety and security.

Article type: Scientific article.

Authors: E.A. Blinova, A.V. Akleev.

Organization: Urals Research Center for Radiation Medicine, FMBA of Russia, Chelyabinsk, Russia; Chelyabinsk State University, Chelyabinsk.

Annotation:

The aim of the current research is to analyze the risk of the development of malignant neoplasms in persons chronically exposed to radiation, depending on the presence of polymorphous variants of genes involved in the base and nucleotide excision repair, nonhomologous end joining. The research involved a study of a group of persons who had been exposed to chronic low-intensity radiation over the period from 1949 through 1960 due to the releases of radioactive waste into the Techa River (South Urals, Russia). The study group included men and women, whose average age was 78 years, the average accumulated dose of red bone marrow in the group of individuals with cancer was 0.79 Gy, in the comparison group was 1 Gy. We examined the association of SNPs of the genes involved in the base excision repair (OGG1 rs1052133, APEX rs1130409), nucleotide excision repair (ERRC2 rs13181, XPC rs2228001, XRCC1 rs1799782, XRCC1 rs25487, PARP1 rs1136410), nonhomologous end joining (NBS1 rs13312840). Two SNPs were associated with the risk of malignant neoplasm development (р<0.05). The polymorphism of the gene OGG1 rs 1052133 is associated with an increased risk of cancer development in the genotype С/G carriers, the adjusted odds ratio (OR) is 2.14 (95% CI – 1.43–3.22). The polymorphism of the gene for nonhomologous end joining NBS1 rs13312840 is also associated with a risk of cancer development in С/Т heterozygotes (OR – 2.25, 95% CI – 1.12-4.51) and in homozygotes C/C (OR – 0.27, 95% CI – 0.08–0.96).

Keywords:

Gene polymorphism, risk of cancer, DNA repair, radiation exposure.

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