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

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№4, 2016 (December)

Analysis of the applied regulatory and legal framework used by the Advisory Councils in establishment of the causal relationship in cases of morbidity, disability and mortality among the Allied States Citizens exposed to radiation in Chernobyl Accident.

Year: 2016 (December) Number: №4 Pages: 8-17

Heading: Medical sciences.

Article type: Scientific article.

Authors: A.Yu. Bushmanov, A.V. Rozhko, A.P. Biryukov, A.S. Kretov, E.A. Nadyrov, E.P. Korovkina.

Organization: Federal State Budgetary Institution, State Research Center – Federal Medical Biophysical Centre named by A.I. Burnasyan, Federal Medical Biological Agency, Moscow; Republican Research Centre for Radiation Medicine and Human Ecology, Republic of Belarus, Gomel.

Annotation:

The article presents analysis of the applied regulatory and legal framework used by the Advisory Councils in establishment of the causal relationship in cases of morbidity, disability and mortality among the Allied States Citizens exposed to radiation in Chernobyl Accident. It reviews Normative documents and legislation, for the Interdepartmental Advisory Councils operations, that acts in establishment of the causal relationship in cases of morbidity, disability and mortality, among the Allied States Citizens, exposed to radiation in Chernobyl Accident. It presents the results of The Interdepartmental Advisory Councils operation in Russian Federation and Byelorussia for 2013.

Keywords:

Interdepartmental advisory councils (IAC), Chernobyl Atomic Power Station (ChAPS), legislative base, organizational structure.

Personalized medicine in available and good quality health care provided to employees working in extremely hazardous and harmful conditions.

Year: 2016 (December) Number: №4 Pages: 18-25

Heading: Medical sciences.

Article type: Scientific article.

Authors: Yu.A. Goltsev, V.N. Kulyga.

Organization: Federal State Budgetary Healthcare Institution Central Medical and Sanitary Unit №119 of FMBA.

Annotation:

The paper presents conducted review, implementation and adjustments for basic principles of personalized medicine in medical care provision to the employees working in extremely hazardous and harmful work conditions.

That personalized approach was used to improve the quality, availability and efficiency of health care. We have analyzed medical and social aspects of the health protection in 530 employees. Scientists and engineering professionals were the focus of our assessment attention. There was developed a program, that in it’s essence be significantly better in quality and availability, than the MHI (Mandatory Health Insurance). Highly qualified experts were invited to the program development.

The application of the personalized medicine significantly (38%) decreased lost time morbidity among employees of the enterprise, along with the mortality from natural cause; there was not a single lethality accident in the workplace in connection with the «human factor».

Personalized medicine — highly effective paradigm for medical support. The quality and availability of medical care in the introduced personalized medicine greatly exceeds the criteria set out in the MHI. The necessary resources can only be achieved with additional support of the program.

Keywords:

Personalized medicine; availability, quality of medical care; employee, enterprise; extremely hazardous and harmful work conditions; chek-up; participativity; medical and psychological care.

Clinical efficacy of preventive dental care provided to employees working in hazardous environment.

Year: 2016 (December) Number: №4 Pages: 26-30

Heading: Medical sciences.

Article type: Scientific article.

Authors: V.V. Uiba, V.N. Olesova, T.N. Novozemtseva, A.Ya. Lerner, E.E. Olesov, A.V. Lesnyak.

Organization: FGBOU DPO «Institute for Advanced Studies» of FMBA of Russia, Moscow.

Annotation:

The article analyzes results of dental examination given to employees working in hazardous and normal environment for Atomenergomash Company. The previous dental care plan was considered in the analysis and it provided clear evidence, that efficient dental care plan does reduce dental treatment needs.

Keywords:

Hazardous work environment, clinical exami nation preventive follow-up, the need for treatment.

New approaches to thyroid pathology diagnostics in people, working in nuclear power and mechanical engineering industries.

Year: 2016 (December) Number: №4 Pages: 31-36

Heading: Medical sciences.

Article type: Scientific article.

Authors: A.V. Pishchugina, N.A. Belyakova, A.G. Ivanov, M.B. Lyasnikova.

Organization: Federal Budget Institution of Healthcare «Central Medical Sanitary Office №141» at the Federal Medical Biological Agency; State Budget Educational Institution of High Education «Tver State Medical University» at The Ministry of Healthcare of the Russian Federation.

Annotation:

There were examined 682 people, aged 42,0 [30,0-51,0], workers of Nuclear Power Stations and Mechanical Engineering Facilities, living in Tver - region with predominant iodine deficiency. The relevance between thyroid US results and clinical laboratory data, collected within the full body examination in employees.

Clinical method of palpation detected only 36% of nodes in thyroid tissue - 1sm in diameter and above, out of nodes detected by ultrasound. Ultrasound showed thyroid gland abnormalities in one third of all examined employees, nodes < 1sm were prevalent - 15,2%) and 9,7% were nodal formations > 1sm. Indirect US sings of morphological changes in thyroid gland were relevant to normal accepted values of its total volume and in euthyroidism. In cases of hereditary nature in thyroid gland structural abnormalities (family history of thyroid pathology), patients were attributed to the risk groups.

Present research results suggested new diagnostic methods for thyroid pathology in males and females, based on calculation of it's relative volume (kSVM) and algorithm of doctor's action in detection of nodes < 1sm in thyroid gland was presented.

Keywords:

Thyroid gland, iodine deficiency, thyroid pathology, focal changes of thyroid tissue industrial facilities employees.

Pegfilgrastim after autologous stem cell transplantation in patients with multple myeloma.

Year: 2016 (December) Number: №4 Pages: 37-44

Heading: Medical sciences.

Article type: Scientific article.

Authors: S.V. Gritsaev, A.A. Kuzyaeva, I.M. Zapreeva, Zh.V. Chubukina, A.V. Seljtser, S.A. Tiranova, N.Yu. Semenova, K.M. Abdulkadyrov, S.S. Bessmeljtsev, A.V. Chechetkin.

Organization: Federal State Budget Institution “Russian Research Institution of Hematology and Transfusiology at Federal Medical Biological Agency”.

Annotation:

The article presents an analysis of patients with multiple myeloma that received pegfilgrastim in posttransplant period. There was performed a comparative assessment of pegfilgrastim and filgrastim. The conclusion: effectiveness of pegfilgrastim and filgrastim is comparable.

Keywords:

Pegfilgrastim, filgrastim, autologous stem cell transplantation, multiple myeloma.

Radioprotective properties of delta-sleep inducing peptide.

Year: 2016 (December) Number: №4 Pages: 45-49

Heading: Medical sciences.

Article type: Scientific article.

Authors: V.B. Voitenkov, A.V. Kartashev.

Organization: Scientific Research Institute of Children’s Infections, St-Petersbug, Russia; Russian Scientific Center of Radiology and Surgical Technologies of the Ministry of Health of Russian Federation. St-Petersbug, Russia.

Annotation:

We have studied radioprotective properties of delta-sleep inducing peptide (DSIP) on SHK mice. All animals were divided into 4 groups: control group was receiving saline, second group was receiving DSIP subcutaneously 120 μg/kg, third group was getting radiation+DSIP and fourth group of animals was getting radiation+saline. Radiation was applied using 60Со system with 0,47 Gr/min and absorbed dose 4 Gr. Some liver, spleen and blood samples were taken in 9 hours, 1, 2, 3 and 5 days after the injections and tested with electronic paramagnetic resonance. Mitochondrial chains of electronic transport, microsomal hydroxylation system in liver cells; free radicals, MtHb, ceruloplasmin, blood transferrin; free radicals and iron-sulfur centers and ribonucleotidereductase in spleen were thoroughly studied. The injections of DSIP have modified postradiation changes of liver, spleen and blood biochemical systems. Features of this influence lead to suggestion that DSIP may modulate adaptation systems activity.

Keywords:

Delta-sleep inducing peptide, radio-protector, stress.

Treatment modality for patients with deep frostbite of limbs.

Year: 2016 (December) Number: №4 Pages: 50-57

Heading: Medical sciences.

Article type: Scientific article.

Authors: A.G. Kardovsky.

Organization: Federal State Budgetary Institution «Kirov Research Institute of Hematology and Blood Transfusion at the FMBA».

Annotation:

Infusion therapy aimed to restore blood circulation in the affected segments and eliminating complications thus plays a leading role in treating patients with deep frostbite of limbs on the early stages of their admission to hospital along with the major therapeutic measures - warming up, primary surgical debridemen.

Some 244 patients with deep local cold injury for the treatment purposes were divided into 5 groups and thoroughly analyzed. The warming up of the limbs was achieved by dressing them up with the heat-sealing bandages. It was demonstrated that infusion therapy with intra-arterial introduction of drugs was effective. Introduction blood substitutes that improve the rheological properties of blood - polioxydin and voluven, in the comprehensive treatment of these patients significantly improve the results. This is shown by an increased number of patients whose treatment was successful without a limb amputation and by the lesser number of operations with a minimal invesion, and the absence of mutilating surgeries as well. There was developed a treatment modality for patients with deep cold trauma of the limbs.

Keywords:

Frostbiting, limbs, warming, infusion therapy, amputation, microcirculation, “Voluven”, “Polioxidin”.

Sudden cardiac death and cardiac arrest among spectators during football matches: according to international experts.

Year: 2016 (December) Number: №4 Pages: 58-62

Heading: Medical sciences.

Article type: Scientific article.

Authors: L.M. Makarov.

Organization: Center for Syncope and Cardiac Arrhythmias in Children and Adolescents, Federal Medical Biological Agency, CDKB FMBA, Moscow.

Annotation:

The article presents the views of world experts in the field of sports cardiology on how to organize medical care provision to the fans who have suffered cardiac arrest and other cardiovascular crises during the major sporting competitions, especially football matches. The article cites current statistics; cause and outcomes of such cases in football matches; it presents working algorithms for steps in medical care given in cases of cardiovascular crises; the scope of medical professionals and technical support activities needed according to the scale of sports arenas; presents qualification and skill set requirements to medical professionals providing necessary medical assistance.

Keywords:

Cardiac arrest, spectacors, soccer, automatic external defibrillators.

State and prospects of psychophysiological care provided within the integrated system of medical service of crew personnel of sea and river crafts.

Year: 2016 (December) Number: №4 Pages: 63-75

Heading: Occupational safety and security.

Article type: Scientific article.

Authors: A.B. Verveda, A.E. Sosyukin, A.V. Ivanchenko, O.K. Bumay, A.A. Abakumov, R.V. Konstantinov, S.N. Chuprova.

Organization: Federal State Unitary Enterprise «Research Institute of Industrial and Marine Medicine Federal Medical Biological Agency (FSUE RI IMM), St. Petersburg; Federal Medical Biological Agency (FMBA of Russia), Moscow; Federal State Budgetary Institution «Research Institute of Children's Infections Federal Medical Biological Agency» (FSBI RICI FMBA), St. Petersburg.

Annotation:

The analysis of features of professional activity and problems of psychophysiological examination of crew personnel of sea and river crafts is carried out.

It is necessary to develop questions of the theory and practice of psychophysiological care provided to seafaring personnel at all stages of their activity on the basis of experience of FMBA in this area is proved.

Keywords:

Crew personnel, medical service, psycho-physiological maintenance, sea and river crafts, FMBA of Russia.

Medical and hygienic health assessment of the personnel at chemically hazardous facilities «Chemical plant – branch of OAO “Krasnoyarsk machine building plant”».

Year: 2016 (December) Number: №4 Pages: 76-84

Heading: Occupational safety and security.

Article type: Scientific article.

Authors: M.Yu. Kombarova, E.N. Nechaeva, A.S. Radilov, L.V. Yanno.

Organization: Research Institute of Hygiene, Occupational Pathology and Human Ecology Federal State Unitary Enterprise, Federal Medical Biological Agency, Kapitolovo St., Leningrad region.

Annotation:

The article presents medical and hygienic assessment of the health status in personnel employed at the chemically hazardous facility «Chemical Plant — branch of the «Krasnoyarsk Machine Building Plant», OJSC along with the occupational environment assessment. It presents the steps of the conducted research; assessment of sanitary and hygienic hazards to the occupational environment, it considers the degree of negative effect and identifies the most chemically hazardous manufacturing elements on the plant; it presents deep analysis of the personnel and occupational health records, including clinical instrumental assessment of the «Risk Groups». It was proven, with the higher morbidity rates in the «Risk Groups», that the most chemically hazardous manufacturing elements have negative health effect. Likewise the length of employment in harmful work environment defines the overall health status in facility personnel.

Keywords:

Health, workers, chemically hazardous object, working conditions, occupational factors, components of rocket fuels.

Contactless diagnostics of the psycho-physiological state in practical medical examinations of the personnel of the Rosatom's enterprises.

Year: 2016 (December) Number: №4 Pages: 85-93

Heading: Occupational safety and security.

Article type: Scientific article.

Authors: A.F. Bobrov, V.A. Minkin, V.Yu. Shcheblanov.

Organization: Federal Medical Biophysical Center n.a. A.I. Burnazyan at FMBA, Moscow; «ELSYS» Multi-functional company, Saint-Petersburg.

Annotation:

The adoption of the Federal law of March 8, 2011 №35-FZ provided legal grounds to psychophysiological examinations of certain categories of employees at nuclear facilities conducted at medical examinations in medical institutions under FMBA. [11]. That called for a number of actions related to the scientific rationale of the methods and techniques that can detect physiological abnormalities, indicating the presence of conditions that are to be medical contraindications to the professional occupation. As of today, we have scientifically substantiated system-based assessment method developed for results interpretation of psycho-physiological examination, of Rosatom State Corporation employees in their preventive, periodic and pre-shift medical screening [2]. An average psycho-physiological screening with application of psycho-diagnostic, psycho-physiological and physiological methods, takes about 2 hours and requires to place registering detectors. This article describes an innovative method of contactless diagnostics of a psycho-physiological status, that is based on the vibrating-image technology [4;7]. The article presents methodological and methodical considerations of vibrating-image technology, along with the criteria for psycho-physiological status assessment. The results of a comparative assessment of psycho-physiological adaptation, assessed by the known psycho-diagnostic, psycho-physiological and physiological methods and parameters of vibrating-image technology. It describes prospective lines of application for the vibrating-image technology in the nuclear industry.

Keywords:

Non-contact diagnosis, medical examination, physiological examination, vibraimage technology, information, pre-shift control, the staff of atomic industry enterprises.

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