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

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№4, 2018 (December)

RISK OF LEUCOSIS INCIDENCE IN EMPLOYEES OF THE ENTERPRISES OF THE STATE CORPORATION «ROSATOM», PARTICIPATED IN THE ELIMINATION OF THE CONSEQUENCES OF THE ACCIDENT AT THE CHERNOBYL NPP IN 1986–1990.

Year: 2018 (December) Number: №4 Pages: 8

Article type: Scientific article.

Authors: Tukov A.R., Shafransky I.L., Sidorin I.V., Prokhorova O.N.

Organization:

A.I. Burnazyan Federal Medical Biophysical Centre, Moscow, 123182, Russian Federation

Annotation:

Aim of the study. To assess the risk of the development of leukemia in liquidators of the consequences of the accident at the Chernobyl nuclear power plant, employees of the enterprises of Rosatom State Corporation, using the case-control method. Material and methods. in the study there was used the information base of the industry register of per¬sons participated in the aftermath elimination of the accident at the Chernobyl Nuclear Power Plant: men, employees of enterprises and organizations of ROSATOM, more than 12,000 people who have dose load data. An assessment of the odds ratio (OR) of the development of the disease from the leuke mia group, excluding chronic lymphocytic leukemia, was obtained by statistical processing of the mate¬rial using a logistic regression procedure. Results. According to the chosen method of selection of persons in the control group for each liqui¬dator who became ill with leukemia, the odds ratio of the disease exceeds one and is 1.15 and 1.09, respectively, for the two study options ¬

Keywords:

radiation; risk; case-control; Cox regression; follow up period; accident at the Chernobyl NPP; Rosatom Corporation; industry register.

MINI-INVASIVE REINSERTION OF THE DISTAL BICEPS TENDON OF THE SHOULDER BY THE ENDO-BUTTON TECHNOLOGY (PRELIMINARY REPORT)

Year: 2018 (December) Number: №4 Pages: 15

Article type: Scientific article.

Authors: Kaplunov O.A., Nekrasov E.Yu., Khusainov Kh.H.

Organization:

Volgograd Medical Clinical Center of the Russian Federal, Volgograd, 400001, Russian Federation

Annotation:

This report is devoted to the operative treatment of a recent rupture of the distal tendon of the biceps muscle of the shoulder. Injuries to the biceps of the shoulder and its tendons account for more than half of all subcutaneous ruptures of the tendons and muscles. At the moment, not a small number of methods for the treatment of this pathology is known. However, the conservative method of the treatment is mainly applicable to patients of intellectual work and those who have contraindications to the surgical treatment, and the discussion about the use of minimally invasive and standard, “classical”, access and surgical techniques is far from to be complete. We have considered the use of the “cortical button” technique with minimally invasive access to achieve the best performance, reduce the amount of trauma and most speedily restore the anatomical and functional capabilities of the injured limb. ¬

Keywords:

recent rupture of the distal tendon of the biceps muscle of the shoulder; reinsertion of the distal tendon of the biceps of the shoulder; the technique of “cortical buttons”; “Endo-button”; minimally invasive.

LABOR INTENSITY AND SELF COSTS OF MODERN ORTHODONTIC MANAGEMENT

Year: 2018 (December) Number: №4 Pages: 21

Article type: Scientific article.

Authors: Kaganova O.S., Olesov E.E., Uiba V.V., Reva V.V., Tikhonov V.E., Olesov A.E.

Organization:

Clinical Center of Dentistry of the Federal Medical-Biological Agency of Russia, Moscow, 123098, Russian Federation

Annotation:

In modern orthodontics, the use of fixed devices with the use of a bracket system is expanding due to the demand for eliminating dental-maxillo-facial anomalies (DMFA) in adulthood. Such treatment is not paid from the compulsory health insurance funds; therefore, it is important to justify the price list of paid services in the “orthodontic treatment” section. A commission timing of the process of orthodontic treatment of the most common DMFA: deep, open, distal and mesial bite, dental occlusion as well as overcrowding of teeth. There was taken into account the severity of the anomaly; The analysis was carried out differentially using braces with or without the ligature. Taking into account the laboriousness, based on the recommendations of the Decree of the President of the Russian Federation No. 597 “On measures to implement the state social policy”, the wage of an orthodontist and auxiliary staff was calculated. The cost price includes material and depreciation costs, as well as costs for the maintenance of clinical and dental facilities. The laboriousness of orthodontic treatment of DMFA using a bracket system has been determined to not exceed 10.57 hours, it increases depending on the severity of the pathology. Ligature free braces reduced the complexity of treatment. In the structure of the labor the intensity of the treatment, the relatively close in terms of labor costs intrench upon the time at stages of fixing the bracket system, diagnosing and agreeing on a treatment plan with the patient, dynamic treatment and control, removing the bracket system and installing the retainer. The maximum value of the cost of orthodontic treatment of dental maxillo-facial anomalies using a bracket system is 45.6 thousand rubles, which elevates along with an increase in the severity of the anomaly and the use of ligature-free braces. The cost structure of the orthodontic treatment mainly and almost equally consists of labor costs and material costs.

Keywords:

orthodontics; dental maxillo-facial anomaly; treatment; labor intensity; cost price.

ALGORITHM FOR THE DETECTION OF SUICIDAL RISK IN PATIENTS BY MEDICAL STAFF

Year: 2018 (December) Number: №4 Pages: 29

Article type: Scientific article.

Authors: Andrianova M.A., Priyatel V.A., Sereda A.P., Tarasova T.B., Fedotov D.D.

Organization:

Federal Medical and Biological Agency, Moscow, 123182, Russian Federation;
Central Psychiatric Hospital of the Federal Medical and Biological Agency, Elektrostal, 144009, Russian Federation;
Institute of Advanced Training of the Federal Medical and Biological Agency, Moscow, 125310, Russian Federation

Annotation:

Suicide is a serious social and medical problem. The frequency of deaths due to suicide averages up to 11.4 per 100 thousand population. The percentage of completed suicides among suicide-seeking patients significantly exceeds the average population indices. The success of suicide prevention depends on the effectiveness of patient monitoring and the timeliness of the nursing staff. The authors have developed an algorithm for assessing the risk of suicide, summarized in a descriptive table. Patients from risk groups according to nosology, age, sex, and marital status are subject to the assessment by appearance, state-ments, and behavior. The use of this algorithm will significantly reduce the suicidal risk among patients with cancer, surgical and neurological profiles, as well as intensive care units and intensive care. ¬

Keywords:

suicidal risk; general hospital patients; nursing staff.

NORMATIVE AND LEGAL ENSURING OF SANITARY AND EPIDEMIOLOGICAL WELFARE OF COSMODROME PERSONNEL IN WORKING WITH THE HIGHLY TOXIC COMPONENTS OF LIQUID ROCKET FUELS

Year: 2018 (December) Number: №4 Pages: 34

Article type: Scientific article.

Authors:Semenova O.N., Voronin N.F., Ivanov S.E.

Organization:

A.I. Burnazyan Federal Medical Biophysical Centre, Moscow, 123182, Russian Federation

Annotation:

High toxicity and extreme danger of liquid rocket fuel components (LRFC) and their transformation products, high probability of occurrence of emergencies of various scale dictate the need to comply with a set of safety requirements, sanitary and medical and preventive maintenance of personnel of the technical and launch sites at stages of the launch, storage, loading and unloading, refueling and other operations with LRFC, during ground preparation for launching vehicles operation and launching space devices. Based on the provisions of the regulatory legal acts in force in the Russian Federation and the experience of medical and hygienic support of rocket and space activities at the Baikonur and Vostochny cosmodromes, for the first time sanitary and epidemiological requirements were developed to prevent the negative effects of harmful production factors on the health of cosmodrome staff. Sanitary Rules and Regulations project includes compulsory hygienic requirements for the location of cosmodrome objects, production facilities, buildings and structures, organization of the technological process and equipment, storage of LRFC and drainage works, neutralization of drainage gases, spills and industrial flows, heating, ventilation, water supply and sewage, organizing and carrying out repairs, sanitary facilities and personal hygiene of personnel, medical and sanitary provision of personnel, means of individual protection of respiratory organs and skin coverings in workers, the organization of control content both of LRFC and products of their transformation in the working area and the content of 1,1-dimethylhydrazine on the building structure surfaces, equipment, personal protective means for skin of workers, measures for emergency situations on the objects of the cosmodrome. Sanitary Rules and Regulations requirements are mandatory in the design, construction, reconstruction, technical re-equipment and exploitation of ground-based space infrastructure of cosmodromes.

Keywords:

cosmodrome; components of liquid rocket fuel; transformation products; toxicity and danger; sanitary rules and regulations; sanitary-epidemiological requirements; safety; personnel.

FROM CERTIFICATION TO ACCREDITATION: THE HISTORY OF THE DEVELOPMENT OF DOMESTIC MEDICAL EDUCATION AND PROSPECTS FOR TRANSITION TO THE SYSTEM CONTINUING MEDICAL EDUCATION

Year: 2018 (December) Number: №4 Pages: 39

Article type: Scientific article.

Authors: Kuznetsova O.V., Samoilov A.S., Romanov S.V., Abaeva O.P.

Organization:

Federal Medical-Biological Agency of Russia, Moscow, 123182, Russian Federation

Annotation:

The article discusses the main stages of the formation of the system of training medical personnel in our country in the period before the introduction of the system of continuing medical education (CME) and the prospects for the transition to a system of continuing medical education. ¬

Keywords:

medical education; certification; accreditation.

SCIENTIFIC AND METHODOLOGICAL SUBSTANTIATION OF THE MAIN DIRECTIONS OF IMPROVEMENT OF MEDICAL BIOLOGICAL SUPPORT FOR THE TOP-LEVEL SPORTS. ARTICLE ONE: SOME RESULTS OF THE ANALYSIS OF RESEARCH WORKS ON SPORTS THEMATICS, PERFORMED BY THE FEDERAL MEDICAL AND BIOLOGICAL AGENCY OF RUSSIA IN 2011-2017

Year: 2018 (December) Number: №4 Pages: 47

Article type: Scientific article.

Authors: Zholinsky A.V., Komarevtsev V.N., Berzin I.A., Feshenko V.S., Ogannisyan M.G., Razumets E.I., Zhivaev S.N., Kravchuk D.A., Stashchuk K.A., Arutyunov Yu.A., Pushkina T.A., Vykhodez I.T.

Organization:

Federal Scientific and Clinical Center for Sports Medicine Rehabilitation of the Federal Medical and Biological Agency of Russia, Moscow, 121059, Russian Federation;
Federal Medical and Biological Agency, Moscow, 123182, Russian Federation

Annotation:

The staff of the Federal Scientific and Clinical Center for Sports Medicine and Rehabilitation of the Federal Medical and Biological Agency of Russia and the Federal Medical and Biological Agency prepared a series of publications devoted to the scientific and methodological substantiation of the improvement of medical and biological support for top-level sports. The first publication presents materials obtained in the analysis of research projects carried out in the Federal Medical-Biological Agency 2011-2017 on sports topics. -

Keywords:

the top-level sports; medical and biological support; research work; sports topics; qualitative and quantitative characteristics.

TO THE DEVELOPMENT OF THE SYSTEM OF MEDICAL SERVICE OF SEAFARERS: ACTUAL REQUIREMENTS IN RESEARCH AND DEVELOPMENTS

Year: 2018 (December) Number: №4 Pages: 56

Article type: Scientific article.

Authors:Ivanchenko A.V., Bumay O.K., Abakumov A.A., Shesterkin A.V.

Organization:

Research Institute of Industrial and Marine Medicine Federal Medical-Biological Agency;
Federal Medical-Biological Agency of Russia, Moscow, 123182, Russian Federation

Annotation:

There were prepared proposals for the further development and improvement of medical services for the crew as a type of scientific and practical activity based on a combination of forces, facilities, selected technologies, drawn up needs for new knowledge and their implementation in practice, reasonable additional research, and developments. ¬

Keywords:

navigation crew; medical service; normative base; research.

THE IMPACT OF THE LOW-INTENSITY ELECTROMAGNETIC FIELD OF VARIOUS PARAMETERS ON THE CONTENT OF ELEMENTS - METALS IN THE BRAIN AND BLOOD IN RATS

Year: 2018 (December) Number: №4 Pages: 64

Article type: Scientific article.

Authors:Lukyanova S.N., Stepanov V.S., Garibov R.E., Shandala N.K.

Organization:

A.I. Burnazyan Federal Medical Biophysical Centre, Moscow, 123182, Russian Federation

Annotation:

Aim of the study. The study of the impact of the electromagnetic field (EMF) of non-thermal intensity with various values of carrier frequencies, Energy flux density (EDF) and expositions on the content and redistribution of elements-metals in the brain and blood of rats. Material and methods. In experiments on 100 rats, in 15 series, the content of the complex of elements-metals (Zn, Cu, Fe, Ca, Mg, Na, K) in the brain and blood was investigated as a result of the action of EMFs in a continuous mode with various parameters and exposures. A domestic industrial generator G4-121served as the source of EMF. The quantitative content of elements-metals was determined by atomic emission and atomic absorption spectroscopy using the installations ATOMSPEK-H-1580 (Eng¬land), KVANT-2A (Russia) and PERKON (USA). Experiments with EMF were accompanied by control and appropriate statistical data processing. Results. In terms of non-thermal EDF values and short single exposure practically no dependence was observed on the selected values of the parameters of the EMF and exposures. In most cases, changes in the content of elements-metals as in the brain (as well in the blood) were of the same nature. For the brain, the most frequently encountered statistically significant changes appeared as a decrease in cal¬cium, iron, and an increase in zinc levels. An increase in the levels of iron, copper, and manganese was characteristic of blood. The quantitative characteristic of changes reached 40–50% (relative to control values), which (although it was approaching), but did not go beyond the normal range. Conclusion. The obtained statistically significant and repeatedly reproducible changes in the content of elements-metals in the brain and blood of rats indicate this index to be informative for assessing the weak short-term effects of EMF, which are not effective according to other indices.

Keywords:

experiment; metal elements; content; redistribution; brain; blood; electromagnetic field; reaction; dependence on parameters.

SPECIAL ASPECTS OF CHRONIC GENERAL TOXIC AND SPECIFIC ORAL ACTION OF AZIDOPENTONE

Year: 2018 (December) Number: №4 Pages: 75

Article type: Scientific article.

Authors:Maslennikov A.A., Bocharova L.Yu., Tochilkina L.P.,. Khodykina N.V

Organization:

Federal State Unitary Enterprise «Research Institute for Hygiene, Toxicology and Occupational Pathology» at Federal Medical and Biological Agency (FSUE «RIHTOP» FMBA Russia),Volgograd, 400048

Annotation:

Goal of the research. Experimental toxicological assessment of the risk of long-term exposure to azi-dopentone. Material and methods.The component of solid rocket fuels - poly-3,3-bis (azidomethyl) oxetane high molecular weight (azidopentone, p-BAMO, AP) was used as the object of this research. CAS No. 17607- 20-4. The empirical formula is (C5H8N6O)n, where n = 1100-1400. Insoluble in water. Toxicological studies on laboratory animals were performed, based on the requirements of the current guidelines. Results and discussion. In the course of the experimental studies, it was established that the chronic oral intake of poly-3,3-bis (azidomethyl) oxetane of high molecular weight (azidopentone) in the rats at doses of 10.0 mg/kg, 3.0 mg/kg and 1.0 mg/kg was accompanied by changes in the complex of behavior¬al, hematological, biochemical indices and the relative mass of their internal organs. At the same time, the breadth and depth of the deviations decreased as the amount of the substance was reduced, what indicated that the chemotoxicant has the dose-response dependence. In particular, in the animals of the first group 11 significant changes were found, 2 of which went beyond the limits of bisigmal deviations of the control. With a decrease in the xenobiotic level (3.0 mg/kg) there was a decrease in the number of significant abnormalities from control (5), one of which exceeded the limits of the physiological norms of the control parameter. In experimental subjects who received azidopentone in the minimum dose, this ratio was 1/0. The established threshold dose of azidopentone for a chronic general toxic effect was 3.0 mg/kg. The compound showed no mutagenic activity (both on genomic and chromosomal levels) as well as gonadotoxic properties in rats of both sexes. At the same time, the studied substance at the intake of pregnant animals in the highest dose of 10.0 mg/kg showed embryotoxic and teratogenic activity, which was realized in the reducing of females fertility, in the increasing of fetal death and in the appearance of definitely significant malformations of bone system. Based on the analysis of the spectrum and the depth of the established deviations, the specified level of the compound is defined as a threshold. The identified characteristics of the negative effect of poly-3,3-bis (azidomethyl) oxetane of a high molecular weight on the organism of experimental animals and their generation under conditions of prolonged oral intake were taken into account when justifying its MPC in the water reservoirs..

Keywords:

water; azidopentone; oral chronic general toxic action; long-term effects; threshold. doses.

PREVALENCE, STRUCTURE AND PHENOTYPIC VARIANTS OF ALLERGIC DISEASES IN PERSONNEL OF MANUFACTURES WORKING ON TERRITORIES OF PAST PLACES OF MINING AND PROCESSING OF URANIUM ORES

Year: 2018 (December) Number: №4 Pages: 84

Article type: Scientific article.

Authors:Ilina N.I., Luss L.V., Tsarev S.V., Astafurov V.I., Sidorovich O.I., Nazarova E.V., Shartanova N.V., Martynov-Radushinsky A.A.

Organization:

State Research Center Institute of Immunology, Federal Medico-Biological Agency of Russia, Moscow, 115478, Russian Federation;
Scientific-Technical Center for Radiation-Chemical Safety and Hygiene, Federal Medico-Biological Agency of Russia, Moscow, 123103, Russian Federation

Annotation:

The purpose of the study is to investigate the prevalence, a spectrum of allergens, structure and phenotypic variants of allergic diseases of production personnel working in the territories of past uranium ore mining and processing sites. There were obtained data testifying to the high prevalence of allergic diseases (AD) among the employees of OJSC “Hydrometallurgical Plant” (HMP) and LLC “Electromechanical Plant” (EMP): 27.1 and 24.7%, respectively. Pollinosis, allergic rhinitis, bronchial asthma, etc. were found to prevail In AD in employees of OJSC HMP and LLC EMP. Among the phenotypic variants of AD, there was revealed the predominance of the atopic phenotype characterized by a predominance of an IgE-dependent mechanism of the development of the dysfunction of the immune system.

Keywords:

allergic diseases; allergic rhinitis; allergens; bronchial asthma; pollinosis; hydrometallurgical plant; skin tests; drug allergy; food allergies; electromechanical plant.

IMPROVEMENT OF THE SYSTEM FOR THE SUPPORT IN OPERATIONAL READINESS OF THE NORTH-WESTERN REGIONAL EMERGENCY MEDICAL AND DOSIMETRIC CENTER AND NON-STANDING EMERGENCY FORMATIONS OF ORGANIZATIONS AND INSTITUTIONS OF THE FEDERAL MEDICAL-BIOLOGICAL AGENCY OF RUSSIA

Year: 2018 (December) Number: №4 Pages: 98

Article type: Scientific article.

Authors:Arefeva D.V., Bumay O.K., Grabsky Yu.V., Abakumov A.A., Dokhov M.A.1

Organization:

1Scientific-Research Institute of Industrial and Marine Medicine of the Federal Medical-Biological Agency, St. Petersburg, 196143, Russian Federation
Federal Medical and Biological Agency, Moscow, 123182, Russian Federation

Annotation:

The authors proposed measures to improve the system of functioning and maintaining in the operational readiness of the North-West Regional Emergency Medical Dosimetry Center and emergency formations of organizations and institutions of the Federal Medical and Biological Agencyof Russia, which can be recommended for the practical use.

Keywords:

emergency response; non-standard medical units; readiness; professional training; technical equipment.

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