Marine Medicine

INTRODUCTION. Tuberculosis (TB) is one of major socially significant infectious disease, which continues to be relevant up to date both in Russia and around the world.

OBJECTIVE. Carry out scientific and historical analysis of epidemiological trends and fight against TB in Russia since the beginning of the XX until the present day.

MATERIALS AND METHODS. The search databases Medline, eLibrary, PubMed, https://link.springer.com, ConsultantPlus were used with the keywords-queries: tuberculosis, history, World War I, World War II, perestroika. 6 out of 41 publications, offered on search sites, were chosen, 25 – from 117 archive materials, a total of 158 sources were viewed. The analysis covered 121-year period from 1902 to 2023, with the historical periodization of epidemiological trends in TB prevalence in Russia.

RESULTS. For more than a century Russia has made considerable progress in the fight against TB: its incidence and mortality from 733,0 and 276,8 per 100,000 population in 1913 had decreased up to 29,6 and 3,5 detected cases by 2023 respectively. In 2021 WHO removed Russia from the list of countries with a high global burden of TB. Nevertheless, there is still a very high prevalence of tuberculosis with multi-drug resistance (MDR-TB) and a combination of TB and human immunodeficiency virus (TB/HIV), which proportion among newly diagnosed pulmonary TB in 2023 was 32,8 % and 24,7 % respectively. There is still another problem of high uneven TB spread in various regions of Russia, despite the unity of principles and approaches to its eradication as an epidemic. The lowest incidence of TB in 2023 was recorded in the Nenets Autonomous Okrug – 7,2 cases per 100,000 population, the highest incidence is in the Republic of Tuva and Chukotka Autonomous Okrug – 158,6 and 112,2 cases respectively, with the national average 29,6.

DISCUSSION. Unlike other authors’ publications on the epidemiology of TB in historical aspect, the study has a rigorous periodization of the epidemic process in close connection with historical events, happening in Russia and the world, covering more than a century-long period. Another characteristic of the study is providing annual figures on TB for 1902–1903 and 1955–2023, where historical information is derived from original archival reporting documents of the pre-revolutionary period and the period of Soviet power.

CONCLUSION. Russia, having undergone tremendous social and economic upheavals with excessively high rates on TB at the beginning of the last century, has managed to overcome mass disease spread to date. Nowadays, it is necessary to stop a rise in the incidence of MDR-TB and combined TB/HIV. Scrupulous study of risk factors for TB in regions with high rates is also essential, with subsequent development and implementation of differentiated regional anti-tuberculosis target programs.

OBJECTIVE. To compare the dynamics of mental health indicators of military personnel serving under conscription in the Navy and Army of the Russian Ministry of Defense in order to optimize psychoprophylactic measures in troops.

MATERIALS AND METHODS. We studied the indicators of mental morbidity presented in the database of medical reports on the form 3/MED for 19 years (2003-2021). The medical and statistical indicators were correlated with the groups of mental disorders of chapter V “Mental and Behavioral Disorders” adopted in the International Statistical Classification of Diseases and Health Related Problems, 10th revision (ICD-10). The mental morbidity of conscripted military personnel was calculated per 10,000 people (×10^-4). Due to the nonparametric distribution of signs, medians with upper and lower quartiles were presented (Me [Q₂₅; Q₇₅]).

RESULTS. Military personnel serving under conscription in the Navy, as compared to the Army, have statistically significantly higher levels of general and primary morbidity with mental disorders, hospitalization, days of labor loss, and dismissal rate, while the share of record-keeping types of morbidity was only 2-3% of the structure, and dismissal rate was 55%. In the Navy and Ground Forces, the 1st-2nd ranks of the military epidemiological assessment of mental disorders were made up of the indicators of neurotic, stress-related, and somatoform disorders (F40-F48 according to ICD-10) and disorders of adult personality and behaviour (F60-F69). For example, in the Navy, statistically significantly higher levels of reaction to severe stress, and adjustment disorders (F43) and neurotic disorders have been revealed (F40–F42, F44, F46–F48). The 3rd rank of significance in the Navy was formed by data of behavioural and emotional disorders with onset usually occurring in childhood and adolescence (F90-F98), in the Army – organic, including symptomatic, mental disorders (F01–F09).

DISCUSSION. Genetic, psychophysiological, social and other factors were a frequent cause of mental disorders in conscripts, such as personality and behavioral disorders in adulthood, and the conditions of military service were the conditions of their manifestation. During the period of educational and professional activity in the Navy, servicepersons have significant disorders of mental adaptation, which necessitates the need for targeted psychoprophylactic measures at various stages of military service.

CONCLUSION. The conducted studies have shown that a significant part of mental disorders in conscripts are caused by the weakness of “barrier functions” of military commissariats due to underestimation of the state of mental health of conscripts by military medical commissions. At the same time, the main measures of psychoprophylactic work in troops should begin during the period of training of servicemen in military training centers.

OBJECTIVE. Determine seasonal characteristics of shock-producing trauma in road traffic injuries in the coastal region of the Arctic zone of the Arkhangelsk region.

MATERIALS AND METHODS. According to the criteria of the retrospective description of case series, there was analysis of medical record forms in patients with shock-producing injuries during the summer and winter periods of the year as a result of road traffic accidents (RTA).

RESULTS. Road traffic accidents with severe mechanical injuries, accompanied by shock, are more likely to occur in winter, mainly on federal highways. Men in the younger able-bodied category (up to 40) get injuries in the vast majority of cases. Concomitant injuries, mainly accompanied by shock of II degree, prevail among shock-producing trauma. The percentage of women increases among the injured in the summer period and there is a rise in the number of shock-producing injuries on local roads.

DISCUSSION. A significant increase in the risk of RTA and severe shock-producing injuries in winter are likely due to particular road conditions: a short period of natural light, frequent blizzards, strong winds, poor visibility and the ice formation on the road. It can be assumed that an increase in road accidents with severe medical consequences on local roads in summer is due to the fact that people actively leave for green and suburban areas of residential places, summer cottages and outdoor recreation at this time of year, and it means a rise in traffic density on roads, including local ones.

CONCLUSION. For the specification of organizational and therapeutic-tactical issues at the stages of treating shock-producing injuries in road accidents, it is important to pay attention to epidemiological features in specific regions of Russia, especially at the pre-hospital stage of emergency medical care. For instance, the vast majority of severe shock-producing injuries occurred in the Arctic zone of the Arkhangelsk region in winter. This region is characterized by adverse weather and climate conditions and, consequently, ambulances should be equipped with innovative devices and products for local heating of the injured, as well as autonomous heating system for infusion therapy solutions.

INTRODUCTION. The problem of iron deficiency (ID) among donors is relevant and directly affects the provision of hemocomponents for the blood service. Being at risk for developing iron deficiency, donors are screened before donation, including the study of their hemoglobin level. Moreover, there is no information on the state of iron stores, with the depletion of which iron deficiency anemia develops. In turn, anemia is a contraindication to donation and, consequently, causes medical exemption to donation.

OBJECTIVE. To evaluate change in parameters of iron metabolism and the risk of developing iron deficiency in blood donors and its components in the age group of 18 to 25 years.

MATERIALS AND METHODS. The study applied morphological, biochemical and statistical research methods. To achieve this objective, there was a comprehensive analysis of hemogram results and biochemical analysis of blood serum, reflecting iron metabolism in 50 young blood donors and its components, including the assessment of the risk for early iron deficiency development.

RESULTS. The article presents data of own studies regarding iron metabolism in blood donors and its components in the age group of 18 to 25 years. There is a fairly high percentage of developing iron deficiency for persons, belonging to risk groups. The study has shown a decrease in the ferritin level below reference values in 45,8 % of young male donors and 76,9 % – in female donors, which indicates the presence of iron deficiency. Such a high incidence of ID in donors of the age group up to 25 years raises the question about the need for developing the prevention of iron deficiency.

DISCUSSION. Own examination of young donors’ blood and its components and analysis of literature data have determined quite a high percentage of developing iron deficiency in groups at risk, including young donors, that demonstrates the feasibility of applying new approaches to the current standards of donor’s laboratory examination at the level of the blood transfusion department with the prospect of further increase in the volume of donor’s laboratory examinations before donation.

CONCLUSION. A significant part of examined young donors had signs of iron deficiency and was at risk of developing anemia. With increased donor experience the incidence of iron deficiency rises, making it necessary to develop the system of preventing and correcting iron metabolism disorders in order to preserve the donor contingent’s health.

OBJECTIVE. Determine vitamin D status and its effect on cognitive functions and learning success in the fourth-year cadets.

MATERIALS AND METHODS. A pilot survey of 108 cadets (average age – 20 ± 1,4 years), studying in a military higher education institute of St. Petersburg, was conducted. Vitamin D body supply, the level of cognitive function development and success of learning activities were investigated. Vitamin D content was determined on a “Mindray” apparatus by enzyme immunoassay method. To assess the level of the development of cognitive functions, we have used tests aimed at diagnosing spatial figurative and verbal-logical thinking, memory and attention. The average grade for the year was considered as a criterion of success in learning activities.

RESULTS. When evaluating the level of vitamin D content, 31 (28,7 %) cadets experienced severe deficiency, 40 (37 %) – moderate deficiency, 21 (19,4 %) – mild deficiency and 16 (14,8 %) had its optimal level. No differences were found in the results of performing tests aimed at diagnosing thinking, memory and attention in cadets with deficient and optimal levels of vitamin D (p > 0,05). There has been direct correlation between learning success and vitamin D content in the body (p < 0,01).

DISCUSSION. The hypothesis about the effect of vitamin D concentration on level characteristics of thinking, memory and attention at a young age has not been confirmed. The results obtained are echoed in other studies aimed at investigating the effect of vitamin D supplementation on cognitive function in young healthy adults.

CONCLUSION. The study results have shown that low vitamin D status in young adults does not significantly affect the level characteristics of thinking, memory and attention. Vitamin D deficiency in young adults (on the example of military cadets) is a predictor of lower efficiency of cognitive functioning in the process of learning activity performance.

INTRODUCTION. Originally developed functional near-infrared spectroscopy (fNIRS) technology for clinical monitoring of cortical tissue oxygenation has not been widely used in research practice. The combination of functional near-infrared spectroscopy and electroencephalography (EEG) provides a unique opportunity for multimodal visualization of human brain function on several spatial and time scales.

OBJECTIVE. Determine correlation between standardized fNIRS indices and EEG parameters.

MATERIALS AND METHODS. The study involved 100 clinically healthy men and women aged 18-25 of the Caucasian race, native residents of the Republic of Crimea, Volgograd and Arkhangelsk regions. Each subject underwent fNIRS- and EEG-testing consecutively. Statistical data analysis was performed by the Pearson correlation coefficient

RESULTS. At the stage of taking background rates with eyes open and the ones with eyes closed before photostimulation, multiple direct strong correlations of EEG electrical potential with the index of oxygenated (HbO) and inverse strong correlations with the index of deoxygenated (HbR) hemoglobin were revealed. At the stage of photostimulation with the frequency of 5Hz, an inverse correlation was observed with respect to the stages of taking background rates and the ones with eyes closed before the start of photosimulation. Many inverse strong correlations of EEG electric potential with HbO index and direct strong correlations with HbR index were detected. The stage of photostimulation with a frequency of 10 Hz was characterized by the minimum number of correlations of the analyzed parameters. At the stage of photostimulation with a frequency of 15 Hz, strong inverse correlations of EEG electric potential with HbO and direct strong correlations with HbR were revealed.

DISCUSSION. The oxygen content in the blood vessels of the brain at rest directly correlates wirh the amplitude of its electrical activity. Given that a state of rest on the EEG is characterized by the dominance of relatively high amplitude and low-frequency alpha activity, this kind of correlation is quite logical. It can be assumed that the brain transition into the state of quiet wakefulness and the mode of waiting for stimulation, which is accompanied by a slowing down of the general rhythm on the EEG and an increase in its absolute amplitude, is associated with a general decrease in the activity of neuronal ensembles, which is expressed in a decrease in the level of metabolism and oxygen consumption by tissues. In this case, a large proportion of hemoglobin remains in the oxygenated form, and the proportion of HbR is relatively small. Photostimulation at frequencies of 5, 10 and 15 Hz leads to changes in the pattern of correlations between fNIRS and EEG indices. This applies to both the number and the nature of statistically significant correlations detected. The least number of correlations was observed during stimulation at 10 Hz, while the general revealed pattern held true: HbO concentration correlated directly with EEG amplitude, and HbR concentration – inversely. In terms of functioning of the brain rhythmogenic structures, photostimulation at a frequency of 10 Hz is the most neutral as it coincides with the adult’s dominant resting rate (alpha rhythm with a frequency of 10 ± 1 Hz). Thus, in can be assumed that the imposition of an external rhythm with a frequency close to the natural frequencies of rhythmogenic structures leads to a decrease in the rigidity of correlations between the electrical activities of the bran and its oxygen supply.

CONCLUSION. The obtained results confirm the prospect of further research on correlations between fNIRS and EEG indices, providing the possibility of multimodal visualization of brain functions under experimental conditions and clinical practice.

OBJECTIVE. To evaluate the prospects of using functional foods to improve the quality of life of military submarine sailors in a long voyage.

MATERIALS AND METHODS. In an exploratory mixed randomized cohort controlled experimental longitudinal pilot study conducted in May-September 2023, the effect of functional foods in the form of instant beverages based on wild plants and berries on the quality of life of military sailors during a long underwater voyage was investigated. The results of the short version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF) and the Russian version of the EQ-5L-3D questionnaire were used as an indicator of effectiveness. Two nuclear submarine crews participated in the study. In each crew, 30 people were selected for the main and control groups.

REESULTS. The dynamics of the quality of life indicators showed a statistically significant decrease in both groups at the end of the trips, which took place in a normal mode in the conditions of the White and Kara Seas. In the group that took the functional food product, at the end of the voyage statistically significantly higher was the score of satisfaction with support from friends, but lower was the score of satisfaction with living conditions compared to the control group. The decrease in the index of the visual analog scale of the European Quality of Life Questionnaire during the voyage in the experimental group that took the functional food product was three times slower compared to the control group. These data were confirmed by regression analysis, which established a statistically significant positive effect of functional food intake in conditions of prolonged underwater navigation on the index of the visual analog scale of the EQ-5L-3D questionnaire.

DISCUSSION. The results of the study, despite the increase in the comfort of working conditions on modern submarine projects, still indicate a decrease in vital signs, accumulation of fatigue, as well as the emergence of various negative changes in the mental sphere of military sailors. At the same time, the use of various methods of maintaining working capacity and endurance, including through proper nutrition of submarine sailors, can increase the efficiency of highly qualified military specialists. One of the directions in solving this problem can be a change in the concept of food provision of servicemen. At the same time, an important element in the modern concept of food provision for servicemen should be functional foods that have therapeutic and preventive effects and can purposefully manage physiological processes in the human body depending on the nature and conditions of the work performed.

CONCLUSION. The results obtained in this study indicate that the use of functional foods has a significant positive potential to improve the quality of life of military submarine sailors in the conditions of a long voyage.