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

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№4, 2012 (December)

Economic effectiveness of vaccination against chickenpox in conditions close to all-Russian.

Year: 2012 (December) Number: №4 Pages: 5-16

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: T.E. Teplova, E.G. Teplova. 

Organization: Regional Department №172 of FMBA of Russia, Dimitrovgrad, Ulyanovsk region.

Annotation: 

Objective: The objective is to assess the cost-effectiveness of vaccination against chickenpox in conditions close to the all-Russian regarding economic indicators in a settlement given as an example.

Materials and methods: The official data from Federal State Statistics Service were used, the data from the forms of state statistical reporting №2 "Information about infectious and parasitic diseases", №6 "Information about the numbers of children, adolescents and adults vaccinated against infectious diseases", the data of the primary documentation of Federal State Budgetary Healthcare Institution of Hygiene and Epidemiology center №172 of FMBA of Russia (control registers of infectious diseases, form f.060/u). The calculations were carried out using the algorithm analysis, concluded in MS Excel.

Results: The cost of one case of the chickenpox was estimated taking into account the specific economic parameters of the small industrial town. The necessary costs of vaccination were calculated according to the demographic indicators. The value of avoided damage and economic efficiency of vaccination with the prospect of several years were calculated.

Conclusion: Taking into account indicators of our model the economic efficiency of mass universal one-time vaccination against chickenpox was confirmed; it was held at the age of 12 months, provided 97% vaccination coverage (together with the vaccination against diphtheria-tetanus-whooping cough) and 90% efficiency of the vaccine. 

Keywords: 

Chickenpox, the epidemiological situation, vaccination, economic efficiency.

The use of Derinat for the prevention of hematologic toxicity in complex treatment of patients with breast cancer.

Year: 2012 (December) Number: №4 Pages: 17-20

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: N.A. Ognerubov, A.A. Klimovich, V.N. Protsenko. 

Organization: Federal State Healthcare Institution Medical and Sanitary Unit №97 of FMBA of Russia, Voronezh.

Annotation: 

30 women aged 45 to 62 years with breast cancer of II-III stage were examined. Depending on the method of therapy there were allocated two groups that are equal in the quantity and features of clinical picture; the only difference was in the method of treatment. The first group consisted of patients who received systemic polychemotherapy by the scheme CAF; the second were women with the application of the scheme CAF combined with Derinat.  
Derinat was injected intramuscularly, 5 injections of 75 mg a day, then 5 injections of 75 mg in two days. The course of treatment consisted of 10 injections. The evaluation of the immune system of patients with breast cancer after treatment has established positive dynamics in the majority of indicators, which resulted in the restoration of the number of helper T-lymphocytes, natural killer cells, immunoregulatory index.

Keywords: 

Breast cancer, adjuvant chemotherapy, hematological toxicity, Derinat.

The influence of glucocorticoids on frequency of the umbilical cord entanglement.

Year: 2012 (December) Number: №4 Pages: 21-25

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: E.F. Shustikova, S.L. Fedirko. 

Organization: Federal State Healthcare Institution Medical and Sanitary Unit №59 of FMBA of Russia, Zarechniy, Penza region.

Annotation: 

In this article the influence of glucocorticoid therapy on the incidence of such complications as entanglement umbilical cord around the body parts of the fetus is analyzed. Based on a survey of 98 patients the following data were received. Treatment with Corticosteroids during pregnancy leads to chronic stress of fetus, increases motor activity, leading to an increased incidence of umbilical cord entanglement.

Keywords: 

Glucocorticoids, umbilical cord entanglement.

Information technologies in nursing process. Status and opportunities to improve.

Year: 2012 (December) Number: №4 Pages: 26-28

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: V.V. Sesev, T.N. Kashina, K.V. Loginov. 

Organization: Federal State Budgetary Healthcare Institution Medical and Sanitary Unit №92 of FMBA of Russia, Miass, Chelyabinsk region.

Annotation: 

Organization of document management was analyzed. The evaluation of information technologies used to control medical care was performed. The influence of the specialized software on the quality of medical care was revealed. Conditions that are necessary for increasing the efficiency and quality of work were highlighted.

Keywords: 

Nursing process and the electronic document management, software in the work of nurses, ways of improving office work.

Status of primary disability of adult population in the Orenburg region due to diseases of respiratory tract in 2008-2010.

Year: 2012 (December) Number: №4 Pages: 29-35

Heading: Organization and improvement of medical care and the state sanitary and epidemiological supervision. Prevention and liquidation of consequences of emergency situations.

Article type: Scientific article.

Authors: T.V. Voloboeva, T.N. Smagina, L.R. Dankova. 

Organization: Federal State Institution the Main Office of Medical and Social Examination of the Orenburg region of FMBA of Russia, Orenburg.

Annotation:

Objective: The objective is to identify the intermediate results of the national project "Health" in conditions of unfavorable ecological situation in the Orenburg region.

Materials and methods: The analysis was conducted on the basis of primary disability of the adult population in Russia, the Volga Federal district and Orenburg region, published in the analytical collections of Federal State Institution the Main Office of Medical and Social Examination and also on the basis of the results obtained by the method of sampling results of examination of citizens with respiratory tract diseases from the “Protocols of the meeting on examination” office branches “The Main Office of Medical and Social Examination in Orenburg region”.

Results: In the dynamics of 2008-2010 the decreased regional indicators of primary disability due to respiratory diseases is demonstrated. Dynamics of decline of the regional level by 10 thousand of adult population is more active than in Russia and the Volga Federal district (in Russia and the Volga Federal district for 0,3-13,6%, in the region for 1,1-34,3%). Positive dynamics was reflected in the ranking of the site of the regional level of primary disability of adults in respiratory diseases in Russia and the Volga region with its movement in Russia from the 9th place on the 15th and in the Volga Federal district from 2nd to the 5th. Disability due to respiratory diseases approximately in 96% of cases is due to chronic obstructive bronchitis and bronchial asthma. Of them in 2 times more often the disability occurs due to chronic obstructive bronchitis and due to this disease the most difficult group of disability is established. In 2010 the specific weight of the first group of disability due to chronic obstructive bronchitis is17 times higher than the specific weight causes of bronchial asthma (5,5% vs. 0,3%). Less specific weight of the first group of disability due to chronic obstructive bronchitis in 2008-2009 is the result of applicable in those years law that shared the disability group on the degree of restriction of labour activities. Regarding respiratory diseases in the region the specific weight of disability group III is lower; it was low as possible in 2010: in RF - 65,5%, in Volga region - 67%, in region – 48,3%; in the prognostic plan it is a negative picture.

Conclusions: The state of the ecological situation didn’t affect on the effectiveness of the national project "Health" in part of "respiratory diseases". Systemic view on medical and social examination of patients with chronic obstructive bronchitis in advanced stages was revealed; additional measures must be done by the Ministry of Health of the region for timely disease identification, qualified annual medical examination and improving of efficiency of medical rehabilitation.

Keywords: 

Ecology, the national project "Health", diseases of the respiratory tract, primary disability.

The registry of measurement methods and procedures of calculations in Federal medical and biological agency.

Year: 2012 (December) Number: №4 Pages: 44-49

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: Yu.S. Stepanov, N.A. Bogdanenko, V.F. Kazenashev, N.N. Dobritskaya, L.S. Danilochkina. 

Organization: Federal Medical and Biophysical center named after A.I. Burnazyan of FMBA of
Russia, Moscow; Department of Organization of Scientific Research of FMBA of Russia, Moscow.

Annotation:

Objective: The objective is to implement by FMBA of Russia requirements of the Federal Law "On ensuring the uniformity of measurement" of 26 June 2008 №102-FZ (Art. 21,2). The activity of institutions and enterprises of the Federal Medical and Biological Agency are under the state regulation of the unity of measurements.

Materials and methods: The materials containing developed and applied methods of measurements, methods of calculations in scientific institutions and enterprises of FMBA of Russia were used.

Results: Creation, maintenance and updating of the Register of measurement methods and procedures of calculations of the FMBA are the main results.

Conclusions: The Registry of measurement methods of FMBA of Russia is a source of information about the basic data of these methods used by agencies in the areas of its activity, developed and certified in accordance with the requirements of Russian Federation Law "On ensuring the uniformity of measurements" and recommendations GOST R 8.563-2009.

Keywords: 

Metrology, registry, method of measurement, calculation methods, attestation of measurement procedures, metrological expertise, the unity of measurements, codes for types of measurements.

Consequences for health of the nuclear weapons use and testing.

Year: 2012 (December) Number: №4 Pages: 50-56

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: A.K. Guskova.

Organization: Federal Medical and Biophysical center named after A.I. Burnazyan of FMBA of Russia, Moscow.

Annotation:

In this article information about the interview, taken by Kazakhstan media to clarify the positions of Russian scientists against nuclear weapons tests at the Semipalatinsk test site is provided. The location of the test site and involvement in a zone of distribution of precipitation explosion of three main areas of Kazakhstan, and also data about distant traces loss (Uglovskiy Altai region) are evaluated. Activities undertaken at different times after the testing of nuclear weapons are listed; the fate of the polygon and the population of nearby areas are discussed. Activity of scientists for prohibition of tests and, especially, application of atomic weapons is reasoned. Recommended literature is given.

Keywords: 

Atomic explosion, the test site, the testing of nuclear weapons, radiation sickness, long-term stochastic effects, sources of errors in data interpretation.

The incidence of persons evacuated from 30-km zone of the Chernobyl nuclear power station in 1988-2008 years.

Year: 2012 (December) Number: №4 Pages: 57-64

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: A.R. Tukov, N.A. Kleyeva.

Organization: Federal Medical and Biophysical center named after A.I. Burnazyan of FMBA of Russia, Moscow.

Annotation:

Objective: The objective is to assess the incidence of persons evacuated from the 30-km zone of the Chernobyl nuclear power station, its structure, including the incidence of diseases of the circulatory system and malignant neoplasms, and the influence of biological factors such as age and gender by comparative evaluation of morbidity of evacuated men and women, including age-specific indicators in dynamics in 1988-2008.

Materials and methods: The object of the study is the incidence of all diseases and individual classes of diseases in persons evacuated from the 30-km zone of the Chernobyl nuclear power station, men and women who are registered in a Branch register of persons exposed to radiation from the accident at the Chernobyl nuclear power station.

Results: The effect of age and sex factors on morbidity was determined. The higher incidence of all diseases in liquidators-women compared with men over the study period 1988-2008 was revealed. The incidence of all diseases aged 18-29 of all age groups in the first ten years after the accident was the greatest. The incidence of all diseases of the studied cohort of individuals over the study period decreased from 626,5 to 276,3 per 1000 people (in 2.3 times). This decrease morbidity was caused by the decrease in the incidence of diseases of the respiratory system of evacuated persons. At the same time an increase in the incidence of malignant neoplasms and diseases of the circulatory system among evacuated persons is shown.

Conclusions: The growth of detecting neoplasms among the evacuated people from the 30-km zone of the Chernobyl nuclear power station can be explained by the ageing of the population. The increase in the incidence of circulatory system diseases within 20 years after the Chernobyl accident is probably due to the fact that minor groups of the target population with respect to this class of diseases have not been exhausted.

Keywords: 

Persons evacuated from the 30-km zone of the Chernobyl nuclear power station, incidence, morbidity, age-adjusted incidence, disease of respiratory organs, diseases of the circulatory system, malignant neoplasms.

Danger of chronic lead poisoning for a healthy population.

Year: 2012 (December) Number: №4 Pages: 65-76

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: G.V. Shestova, G.A. Livanov, Yu.N. Ostapenko, T.M. Ivanova, K.V. Sizova.

Organization: Federal State Budgetary Institution of Science “Institute of toxicology of Federal Medical Biological Agency”, St. Petersburg; Federal State Institution Scientific and Practical Toxicology center of FMBA of Russia, Moscow.

Annotation:

According to analysis of literary data it was determined that lead is actively used in the national economy and in household activities, despite the fact that refers to the substances of high toxicity. This requires special attention to the development of measures for the prevention and treatment of lead intoxications. Improvement of health interventions should be aimed at early diagnostics of poisoning, especially their prenosological forms. The basis for early diagnostics should be the combination of a differential diagnosis and results of specific and additional laboratory studies of biological materials. Early diagnosis according to manifestations of toxicity of lead does not enable further progression of poisoning and allows to treat already developed intoxication. The success of prevention and treatment is provided by a complex of activities. First of all it is enterosorption. Enterosorbents (alginates and pectin’s) have high selectivity to lead, forming nontoxic compounds, which are excreted from the body. Antidote therapy is presented by chelate compounds that form with lead the low-dissociating complexes, quickly eliminated from the body. Complex therapy also includes adjuvant therapy, consisting of microelements and vitamins. Treatment and prophylactic nutrition, physiotherapy and medical gymnastics are also aimed to increase elimination of lead from the body.

Keywords: 

Lead, chronic poisoning, pathogenesis, diagnostics, treatment.

Inspection of territories covered by FMBA of Russia, for radon indoors.

Year: 2012 (December) Number: №4 Pages: 77-88

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: A.T. Gubin, A.M. Marenniy, V.A. Sakovich, V.I. Astafurov, N.A. Nefedov, A.V. Penezev.

Organization: Federal State Unitary Enterprise Scientific and Technical center of Radiation and Chemistry Defense and Hygiene of FMBA of Russia, Moscow.

Annotation:

Objective: The objective is to obtain data about the level of radon exposure on the population.

Methods: Examinations were conducted by integral track method using the tracking chambers REI-4 from the TREK-REI-1M kit with the duration of exposure 2-4 months. Directly measured volumetric activity of radon and equivalent equilibrium volume activity of radon was calculated using a factor of equilibrium F=0,5. Effective dose from radon was calculated using a dose coefficient 9*10-6mSv / (h*Bq/m3). The results were recorded in the database.

Results: Examinations of the placements regarding radon concentration held in settlements of 15 administrative units in several seasons in 2007-2011. Total number of measurements is about 2800. For all examined points there are presented the distribution of density and the average values of equivalent equilibrium volume activity of radon. For a number of settlements the average annual radiation dose of the population from radon was calculated. It is shown that, on the contrary to established opinion, in the examined territories there is no any prevalence regarding increase in the “winter” value of equivalent equilibrium volume activity of radon over the “summer”. For several settlements there is even opposite picture.

Conclusions: In the course of inspections methodological and organizational aspects of conducting large-scale research of radon exposure on the population were worked out. The comparison of mean values of equivalent equilibrium volume activity of radon in examined settlements with the average Russian value (27 Bq/m3) allows to conclude that the risk of radon exposure to the population of the cities of Angarsk, Volgodonsk, Desnogorsk, Zelenogorsk, Polar dawns, Severodvinsk and Snezhnogorsk can be considered as accepted. In cities Glazov, Zheleznogorsk, Miass, Ozersk and Snezhinsk, and in the Kurgan region the examination have to be continued taking into account the received results in a territorial binding to areas of settlements.

Keywords: 

Examinations, volume activity of radon, equivalent equilibrium volume activity of radon, the ratio of balance, placements, residential and public buildings, settlement.

Experience in the use of cyclic nucleotides as molecular and biological markers of individual carcinogenic risk.

Year: 2012 (December) Number: №4 Pages: 89-97

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: E.I. Rabinovich, S.V. Povolotskaya, V.A. Turdakova, S.N. Sokolova.

Organization: Federal State Unitary Enterprise South-Ural Institute of Biophysics FMBA of Russia, Ozersk.

Annotation:

Objective: The objective is the clinical trial regarding in formativeness of molecular biomarker, the ratio of сAMP/cGMP, for prediction of malignant tumors in the cohort of professional employees of Industrial Union “Mayak”. This marker is the basis of our method of preclinical diagnostics of tumor growth in experimental animals (Patent 1 704 563 USSR, MKI 5G 01 N 33/48. Method of detection of the tumor process in experimental animals, 1992).

Materials and Methods: The study Protocol provides the establishment of the monitoring group (based on the existence of excess radiation exposure in the process of professional activity at Industrial Union "Mayak"); carrying out biochemical monitoring on test ratio of сAMP/cGMP in urine (once every 6 months); the selection of a subgroup of persons with persistently elevated сAMP/cGMP test (positive test).

Results: Registration of a positive сAMP/cGMP test allowed from monitoring group (282 people) to select “Test-positive group” of 48 people. By the end of the 7-year follow-up period cumulative output of malignant tumors in “Test-positive group” was significantly higher than that of the rest of the examined contingent in 3 times (relative risk of malignant tumor development was 3,2; DI=1,2 - 8,4). The positive test was accompanied by 100% of hemoblastoses (chronic lymphocytic leukemia and acute myelogenous leukemia), 50% of basal cell carcinoma and 25% of solid tumors.

Conclusions: Steadily increased ratio of сAMP/cGMP in the urine can be considered as a prognostic biomarker; patients should be divided into categories with different probability of oncological pathology. The introduction of the test in clinical practice will ultimately increase the number of patients with detected tumors at early stages, which is an important target indicator of improvement of diagnostics of malignant tumors among the personnel of nuclear-hazardous enterprises.

Keywords: 

сAMP, cGMP, carcinogenesis, ionizing radiation, high-risk groups.

Diagnostic serum of FEMIDASERA® - immunobiological drugs for the complex analysis of micro-objects in forensic sciences expertise.

Year: 2012 (December) Number: №4 Pages: 98-102

Heading: The results of research works in the field of studying the influence on the humans especially dangerous and harmful production factors.

Article type: Scientific article.

Authors: Yu.A. Mladzievskaya, G.N. Reshetova.

Organization: Federal State Unitary Enterprise St. Petersburg Research Institute of Vaccines and Serums and Production Enterprise of Bacteriological drugs of FMBA of Russia, Saint-Petersburg.

Annotation:

The article provides an overview of the drugs from group FEMIDASERA®, intended for group and specific diagnostics of biological samples as the objects of forensic medical examination. These drugs are immune serum of the animals produced by Federal State Unitary Enterprise St. Petersburg Research Institute of Vaccines and Serums of FMBA of Russia for many years, which can be also used in the organizations of the blood transfusion service and in the scientific research.

Keywords: 

FEMIDASERA®, precipitating serum, hemagglutinin serum, forensic biological examination.

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