Marine Medicine

Modern hematology analyzers make it possible to give an informative evaluation of platelet parameters, which characteristic this lecture is devoted to, being the continuation of the lecture series on clinical blood test, started in 2023. Along with platelet count, mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (%) (P-LCR), platelet crit (РСТ), immature platelet fraction (IPF), mean platelet component (МРС), mean dry platelet mass (MPM), platelet component distribution width (PCDW) are considered. Despite the fact that each platelet parameter has the certain clinical value, the whole combination of them should be evaluated if possible. In some cases, it is important to assess morphology and location of these formed elements in the stained blood smear.

OBJECTIVE. To analyze morbidity and mortality from infectious diseases in the world and Russia, to evaluate their role in factors determining public health.

MATERIALS AND METHODS. There has been analysis of PubMed, Scopus, Web of Science and Google Scholar database in 30 years, from 1993 to 2023. The search was carried out by keywords infectious diseases, epidemiology, risk factors, morbidity, mortality, prevention.

RESULTS. Acute infectious disease of an especially dangerous group (plague, cholera), typhoid fever and typhus, devastating until the twentieth century, have been significantly reduced, smallpox was eradicated at the planetary level. However, prevalence of infectious diseases in Russia has remained high in the last hundred years without the tendency for reduction due to change in the nosological form. There is the growth trend of diseases of viral etiology in the world. Acute respiratory viral infections (вирусы по планете распространяются «со скоростью самолета») take up to 90 % in the overall morbidity. Preventive vaccination remains an available, effective and economically feasible way to fight against infectious diseases. Unfortunately, 20 % of mothers are opposed to their children’s vaccination.

DISCUSSION. Infectiology issues of recent years are characterized by the following notions: “new and recurrent infections”, “tripledemic”, “antibiotic resistance”, “pathogens of pandemic potential”, attesting to increased pressure of infectious diseases on humanity and first of all as the price paid for progressive growth of population on the planet and its density as well as growth of harmful environmental factors and lifestyle (inactivity, obesity) with suppressive effect on the immune system and nonspecific defense factor. In Russia a growing tendency of countering preventive vaccination is one of significant factors, reducing the effectiveness of the fight against infectious diseases.

CONCLUSION. Health of the Russian population heavily depends on widespread infectious diseases without the tendency for reduction. A specific weight of infectious diseases of viral etiology is increasing at the planetary level, including the appearance of nosological forms with potential pandemic spread.

OBJECTIVE. Determine prospects of using kidney stress tests to study water-electrolyte metabolism and kidney function under the action of extreme factors in diving descents.

MATERIALS AND METHODS. There was a review of works from the scientometric databases Scopus, eLibrary.ru (Russian Science Citation Index – RSCI), PubMed, Google Scholar, Ulrichsweb. The analysis was based on keywords and phrases in Russian and English: an astronaut, water-electrolyte metabolism, diver, stress kidney test, excretory system, kidney function, diuresis, kidney. 87 literary sources were selected for the period 1970–2023, of which 36 works were included in the review, which corresponded inclusion and exclusion criteria. Moreover, at least 45 % of the works, included in the review, have been published for the last twenty years, at least 20 % of works – for the last 10 years.

RESULTS. To study kidney function and water-electrolyte metabolism in the practice of space medicine, testes with water load in the volume of 20 ml/kg of body weight, load with 10 % solution of potassium chloride at the rate of 0,55 ml/kg of body weight, sodium chloride and calcium lactate were used. Stress tests have shown that fluid retention after space flight is a compensatory reaction to developing hypohydration and aims to replenish losses of extracellular fluid. Water-sault load was also used to increase human orthostatic resilience both under normal conditions and with exposure of hypoxic hypoxia to the body. Research with the use of kidney stress tests has just begun in diving medicine. Currently obtained data demonstrates the need to develop the system to diagnose changes in water-electrolyte metabolism in divers under the action of hyperbaric factors using functional kidney stress tests.

DISCUSSION. When using various water-sault loads, the body’s ability to retain an excess of substances in the depot as well as quickly dispose of others, currently redundant, is of utmost importance. The use of kidney stress tests in diving medicine would make it possible not only to detect mechanisms for regulating kidney functions and to evaluate the state of water-electrolyte metabolism, but also to determine the reserve capacity level of the excretory system of the body.

CONCLUSION. In space medicine the system of measures has been developed to diagnose water-electrolyte metabolism and to manage resistance to adverse factors of orbital flight by changing the hydration of the body tissues using water-sault supplements and diuretics. The development of such system is an important scientific problem in diving medicine. Further research into the use of kidney stress tests will help to form a system of diving disease prevention due to diagnosis of changes in kidney function and developed methods of exposure to water-electrolyte metabolism.

INTRODUCTION. The jaw alveolitis in seafarers during long-term voyage is common, and issues of improving its prevention and treatment are an important medical and social problem of maritime medicine.

OBJECTIVE. Evaluate the incidence of the jaw alveolitis in seafarers under long-term voyage and improve efficacy of its prevention and treatment.

MATERIALS AND METHODS. The study of the incidence of the jaw alveolitis, methods of its prevention and treatment was carried out, involving 118 seafarers, aged 19-42 under long-term voyage (9 months). In the first 3 month of sailing (I stage of the clinical trial; n = 56), dental extraction was performed by the standard procedure, while methods of alveolar socker protection were not used. In the next 3 months (II stage of the clinical trial; n = 62) dental extraction was also performed by the standard procedure, but it was completed, using preservative technique by coating the formed blood clot with one layer of adhesive gingival balm ASEPTA. To treat the jaw alveolitis at stage I of the clinical trial, there was curettage of the alveolar socket or, with the possibility of conservative treatment, the dental gel “Gerpenox” of domestic production was administered into the socket. For conservative treatment of alveolitis at stage II of the clinical trial, ASEPTA dental gel with propolis was used. Pain symptoms in a day as well as periods of time for filling the sockets of the extracted teeth with granulation tissue were taken into account to evaluate efficacy of conservative alveolitis treatment at the stages of the clinical trial.

RESULTS. During long-term voyage seafarers experience acute jaw alveolitis in 30,4 % of cases after tooth extraction in the absence of measures to conserve the socker. The use of generally accepted methods of conservative jaw alveolite treatment has enabled to eliminate pain symptom in seafarers within 10–12 hours after the start of treatment and to ensure filling of sockers with granulation tissue on the 8–12^th day. Socker conservation with the adhesive gingival balm has significantly reduced the incidence of alveolitis as complications of tooth extraction, and use of the gingival gel ASEPTA allowed to shorten the period of filling tooth sockers with granulation tissue by 1–3 days.

DISCUSSION. Use of new domestic means for preventing and treating acute jaw alveolitis by seafarers, occurring after tooth extraction, can significantly improve indicators on prevention and conservative treatment of this disease, mainly due to the technique of socker conservation and rational use of drugs for conservative alveolitis treatment. Use of the adhesive gingival balm ASEPTA for closing the socker after tooth extraction has reduced the incidence of acute jaw alveolitis by 19,07 %.

CONCLUSION. The study results have led to the conclusion about the value of the adhesive gingival balm ASEPTA and the gingival gel ASEPTA with propolis for maritime medicine, which can be used for prevention and treatment of the jaw alveolitis in seafarers during long-term voyage.

OBJECTIVE. Give the epidemiological characteristics of ophthalmological diseases in the adult population of the Novaya Zemlya archipelago during the polar night.

MATERIALS AND METHODS. There was the analysis of ophthalmological morbidity in the adult population of the Novaya Zemlya archipelago during the polar night from November, 20, 2019 to January, 20, 2022. The studied contingent: men, aged 18-55 (n = 1630) and women, aged 22-45 (n = 698), living in the Novaya Zemlya archipelago.

RESULTS. 352 visits to a doctor on the ophthalmological profile were recorded during the study period in the Novaya Zemlya archipelago: 83 – in 2019, 98 – in 2020, 80 – in 2021 and 91 – 2022. The ration of ophthalmological morbidity in the adult population of the Novaya Zemlya during the polar night was в 38,2 % – in 2019, 39,9 % – in 2020, 38,2 % – in 2021 and 39,6 % – in 2022. The structure of ophthalmological morbidity on nosological groups is presented as follows: 76,7 % – conjunctival diseases, 11 % – eyelid diseases, 7,4 % – refractive errors, 2 % – diseases of the lacrimal apparatus, 1,7 % – lens diseases, 0,6 % – corneal diseases, 0,6 % – retinal diseases.

DISCUSSION. The analysis has shown that the highest ratio in the structure of long-term annual average ophthalmological morbidity in the adult population of the Novaya Zemlya is observed during the polar night – 1^st rank place (the rate of 95 % confidence: from 34,6 to 40,6 ‰). Pathology of inflammatory genesis is 87,8 %. Diseases of the non-inflammatory nature are mainly represented by refractive disorders (7,4 %) and to a lesser extent – pathology of metabolic processes in the body (4,8 %).

CONCLUSION. It is bellieved that ophthalmological morbidity is 23% higher during the polar night than in other light periods of the year. It is determined that в the major risk factors for ophthalmological pathology during the polar night are the lack of natural light, low sub-zero temperature and reduced body reactivity due to hypovitaminosis.

INTRODUCTION. In the face of modern threats and hazards health remains the most important value for people. Health is the basis of human potential, the key to prosperity and sustainable development of the society. Nowadays increasing threats of global terrorism are one of external hazards, which have modern models of weapons, including the ones with radioactive material in their arsenal. The article describes the process of forming the zone of radioactive contamination (RC) of the terrain in case of radiological weapon use that obviously impacts on public health in the affected area.

OBJECTIVE. Develop the model for forming the zone of RC in case of radiological weapon use or emergency situation, associated with violation of the rules for nuclear or radiation safety, including radiation hazardous facilities of the Russian Federation Navy.

MATERIALS AND METHODS. The method is based on creating a two-stage model of RC of the terrain. Mathematical calculations have resulted in a model allowing to determine spatial characteristics of radiation dose rate and to predict the consequences of radiation exposure to objects.

RESULTS. The model makes it possible to evaluate the extent of radiation ionizing effect on human health in the zone of RC.

DISCUSSION. The proposed model for forming the zone of RC, unlike others, allows to determine spatial characteristics of dose rate distribution in case of radioactive substance use for terroristic purposes.

CONCLUSION. The mathematical model for formind the zone of RC in case of radiological weapon use or emergency situations of technogenic nature as well as acts of sabotage at radiation-hazardous facilities of the Navy allows to determine spatial characteristics of radiation dose rate distribution and to predict the consequences of radiation exposure to objects and primarily to the population in radioactively contaminated areas.

INTRODUCTION. A lot of biological, including genetic predictors of specific deviations are associated with gender. Previously performed own studies revealed stable combinations of genetic status indicators, fully correlated with aggressive, suicidal and addictive behavior. These behavioral deviations are the basis for social and criminal tension in society, which justifies the expediency of further study of their genetic etiology based on gender.

OBJECTIVE: describe genetic determination of male and female propensity to aggressive, suicidal and addictive behavior.

MATERIALS AND METHODS. The study involved 300 men and women, aged 18–25 of the Caucasian race, indigenous people of the Crimean Republic, Arkhangelsk and Volgograd regions. The study participants’ propensity to aggressive, suicidal and addictive behavior was evaluated using standard methods of psychological testing. Laboratory genetic study was carried out by polymerase chain reaction (PCR) in real time. SNP were investigated: rs6923492 (GRM1), rs4680 (COMT), rs1851048 (CACNA2D3-1), rs6777055 (CACNA2D3-2), rs2562456 (ZNF-LD), rs1800497 (DRD2), rs6280 (DRD3). Statistical data analysis was performed using the Kruskal-Wallis test

RESULTS. In SNP rs6923492 (GRM1) Т/С genotype shows a minimal indicator intensity of the propensity to aggressive, suicidal and addictive behavior in both men and women. С/С and Т/Т genotypes are equally characterized by relatively increased values of the analyzed indicators. А/А rs4680 (COMT) genotype is characterized by the minimum level of the studied deviation manifestations. Among G/G genotype carriers, indicators of the propensity to aggressive, suicidal and addictive behavior prevail only in the group of men. On the contrary, among G/А genotype representatives, the propensity to aggression and suicide is pronounced only in the group of women. The maximum level of alcoholism and tobacco smoking in the female sample is equally manifested in G/А and G/G genotype representatives. Regardless of gender, G/G rs1851048 (CACNA2D3-1) genotype carriers are characterized by minimum, and G/А genotype carriers – maximum values of risk indicators of developing aggressive, suicidal and addictive behavior. In polymorphism rs6777055 (CACNA2D3-2) carriers of А/А genotype are characterized by minimum, and А/С genotype carriers – maximum expression of suicidality indicators among both men and women. А/А rs2562456 (ZNF-LD) genotype carriers are characterized by minimum intensity of single aggression indicators in men as well as indicators of aggression and suicidality in women. Genotypic analysis of SNP rs1800497 (DRD2) found a significant level of differences in indicators of aggressive and addictive behavior only in women between carriers of С/С (minimum values) and С/Т (maximum values) genotypes. Analysis of rs6280 (DRD3) polymorphism determined that maximum intensity of aggression and suicidality indicators is expressed in carriers of Т/С genotype regardless of gender. Indicators of the propensity to chemical addictions prevail additionally in women with Т/С genotype.

DISCUSSION. There are defined systemic connections between sexual identity, risk indicators of aggressive, suicidal and addictive behavior and analyzed polymorphisms and relevant human genotypes. It has been proven that the genetic status and person’s gender identity should be considered as the main factors of biological predisposition to deviant behavior.

CONCLUSION. As a result, the study has specified biological risks of forming aggressive, suicidal and addictive behavior, that would contribute to the development of effective measures to prevent deviant human behavior.

INTRODUCTION. A reduced level of vitamins in the blood is a widespread condition in the North: on average 30–47 % of the screened have various vitamin deficiency. However, few studies of vitamin status were carried out among residents of the Chukotka Autonomous Okrug– one of the most remote and isolated regions of the Asian part of Russia with harsh climatic conditions.

OBJECTIVE. Carry out research on vitamin sufficiency in residents and visitors of the Chukotka Autonomous Okrug, working on the rotational basis, before and after correcting by vitamin-mineral complex.

MATERIALS AND METHODS. As part of the integrated Arctic expedition locals (n = 13) and visitor (n = 16) of the Chukotka Autonomous Okrug were screened three times (at the beginning of the expedition, 14 days after vitaminizing and 12 after its completion) from August to September. The level of vitamins А, В1, В2, С, Е and 25OH-vitamin D was evaluated by generally accepted methods in venous blood. The nature of the actual nutrition was studied using the questionnaire method.

RESULTS. At the study’s start 25 % of local and 38 % of male visitors experienced polyhypovitaminosis. Overall, the incidence of vitamin А and Е deficiency was higher in local workers, and vitamin В1, В2 deficiency – in visitors. Vitamin В deficiency was high in both groups of persons, but it was 1,56 times higher in visitors. More than 90 % of persons in both groups had an adequate level of vitamin С. After completing the vitaminizing course over 75 % of people had normal level of vitamin В1, Е and С (in both groups) and vitamin В2 (in local workers). The incidence of vitamin А (in both groups) and В2 (in visitors) deficiency remained high. There was further normalization of vitamin status in both groups on the 12^th day after vitaminizing, no cases with polyhypovitamins were detected. The diet was stable in energy value during the entire examination period and was 3974,7 kcal/day on average. There were no statistically significant differences between the actual nutrition indicators in local and imported workers.

CONCLUSION. Despite high energy value of nutrition, the screened groups experienced prevalence of vitamin-deficient status. A 14-day course showed a positive effect, especially in local workers. A slower improvement in vitamin status was observed in visitors. The level of vitamin D, which was not corrected, reduced during the expedition, especially in visitors.