Vol 5, No 2 (2019)

The paper deals with the guidelines for centres of marine medicine, training and accreditation systems for specialists in the area of marine medicine. It was observed that the ratification by Russia in 2012 of the International Labour Organization Convention No. 186 «On Labour in Maritime Navigation» of 2006 and delegation by the Government of the Russian Federation the authorities to comply the requirements of this Conference by the Russian Federation on the Ministry of Healthcare of the Russian Federation set the tasks of improvement of legal and regulatory framework of the marine cluster of the National Healthcare System and its integration into the International Marine Healthcare System. The Russian Federation has wide and positive experience of a medical support of the seafarers of the Soviet Union. The experience of organizing the activities of international medical centers and training and accreditation medical systems for specialists in the area of marine medicine will be useful for development of national medical support system of naval capacity of the state.

Analysis of the current state of the problem of preserving female fertility in cancer and reducing ovarian reserve revealed that there are currently several proven methods for young women — cryopreservation of embryos, oocytes and ovarian tissue, each of which has its own advantages and disadvantages. The promising technologies are cryopreservation of oocytes after in vitro maturation, as well as cryopreservation of embryos derived from oocytes, which were matured in vitro. In vitro maturation of immature oocytes aspirated from primordial follicles allows for the production of many mature oocytes without ovarian stimulation, which makes this technology a potentially effective strategy for preserving fertility. However, the best results can be achieved by combining several methods that must be determined individually in each specific case. Although there was no negative effect of cancer on the results of treatment of oncological obesity in the next generation, long-term observations and studies with a large number of patients are needed. The goal of helping with oncological infertility is not only the preservation of fertility, but the creation of a nationwide system of care for oncological diseases in which interdisciplinary coordination will allow all cancer patients to receive multidisciplinary assistance. The organization and standardization of the treatment of oncological symptoms and the development of modern technologies for preserving the reserve of female fertility outside the body are the urgent tasks of national health care in our country.

The problem of health of students of higher education institutions of different regions of Russia at the present time is considered. The most common diseases of students are noted: diseases of the respiratory and digestive systems. Most authors point to an increase in the incidence of students from junior to senior courses, but a number of studies indicate the reverse trend, which can be explained by increasing the adaptive capacity of students. The characteristics of risk factors for students’ health, including those associated with the educational process, are given. Some risk factors are attributed to ineradicable: high psycho-emotional and mental stress, periodic violation of the daily regimen. The appearance of a high level of stress on the body of students is most typical during the examination session, which contributes to the development of neurotic states. It is possible to minimize the disposable risk factors, for example, characterizing the lifestyle (motor activity, food), and also the organization and availability of medical care for students. The main reasons that encourage students not to seek help in medical institutions, but, on the contrary, to self-medicate are highlighted. Modern health-saving technologies used by different educational organizations are analyzed. It was proposed to create integrated health-saving programs on the basis of universities, including physiological and hygienic substantiation of the schedule of classrooms, monitoring the health status and morbidity of students, creating the necessary infrastructure for physical education and sports. Examples of universities in different regions of Russia with established health Centers and successfully implemented health-saving technologies are given. 

In connection with the growing tension and responsibility of the activities of professional operators, it is necessary to improve the means and methods of their medical and psychophysiological support. Purpose — assessment of the effect of combined physiotherapeutic procedures — CPP (contrasting thermal effects, vibratory massage of the spine and feet, aromatherapy, music therapy) with and without transcranial electrostimulation (TES) on the psychophysiological status and working capacity of operators. Materials and methods. Surveyed 26 professional operators (male) aged 27– 38 years, divided into 2 equal in size groups: the main (MG) and control (CG). All the examined individuals were used the CPP base complex, implemented in a physiotherapy capsule. The complex consisted of 14 daily 45-minute CPP in standard mode. For the MG, the 35-minute TES procedures, also performed in standard mode, were additionally included in the base complex. Prior to the appointment of correctional complexes and after their completion, the subjects were tested for sensorimotor qualities and operator performance. Results. The use of correctional complexes in both groups resulted in positive changes in psychophysiological qualities (acceleration of sensorimotor reactions, reduction in hand tremor) and operator performance (increased attention stability, amount of random access memory, improvement of mental operations). However, in the MG, the identified changes were more pronounced: the level of tremor in this group decreased by 13–14% compared with the baseline, while in the CG — only by 6–7% (p=0,037); the time of the complex sensorimotor reaction decreased on average by 5,1%, in the CG — by 3,8% (p=0,049); the integral indicator of operator’s working capacity in the MG increased on average by 10.8%, in the CG — by 7,7% (p=0,039). Conclusion. The developed correctional complex with the inclusion of TES is a highly effective and safe non-pharmacological technology of emergency optimization of psychophysiological qualities and working capacity of operators.

The purpose of the study is to identify the characteristics of pulmonary gas exchange and assess its efficiency during the period of the adaptive voltage stage in the military when moving to the Arctic zone. The survey included 36 men of 18–20 years old who arrived in the Arctic zone from the southern regions of the Russian Federation to the training center of the Navy for military service on conscription. Every month, for 5 months, the servicemen underwent a spirographic study, in addition to this, the composition of exhaled air was selected and analyzed. Statistical processing of the results was carried out using the STATA 12 software. It was established that for recruits, the actual values of oxygen consumption (PO2) in the first two months of observation exceeded the proper values
(225,2±15,9 ml/min) by 48,3 and 20,5% respectively (p<0,00–0,01). However, 3, 4 and 5 months were characterized by the fact that they had a decrease in PO2, respectively, by 4,9; 26,8 (p<0,001) and 29,2% (p<0,001), which was combined with reduced oxygen utilization rates (CIO2) during this period. The decrease in ventilation efficiency coincides with an increase in POvid by 29–35% (p<0,001) and an increase in the O2 content in the exhaled air. In the first two months, the oxygen effect of one respiratory and one cardiac cycle exceeded the proper values by 43 and 14%, respectively, and by 49 and 21% (p<0,05–0,001), which indicates a reduced efficiency of the respiratory and cardiovascular system. Thus, the first two months after the arrival of recruits to the Arctic zone are characterized by a significant intensification of oxidative metabolism, a combination of sufficiently effective ventilation and gas exchange and reduced efficiency of one respiratory and one cardiac cycles. 

The use of narcotic substances is a serious social problem, a threat to the health of an individual and to the security of the country as a whole. The use of narcotic substances affects the safety of the overall productivity of labor, which, ultimately, creates a rather large burden on the economy of the country as a whole. In the framework of federal programs for the prevention of drug addiction, the practice of testing for the use of narcotic drugs at work and study places is being increasingly used. And here the question naturally arises of the significant cost, laboriousness and time-consuming test systems for the use of narcotic substances produced by Russian companies. All this, of course, complicates the process of introducing a testing procedure. In this situation, the importance of developing, improving and introducing new methods for the detection of narcotic substances and their metabolites in human biological fluids increases. The article provides a general overview of world experience in using immunochromatographic tests for identifying psychoactive substances as a screening test, with particular attention being paid to analyzing the specifics of using screening immunochromatographic tests for the initial identification of psychoactive substances in urine and saliva from the standpoint of the contextual feasibility of their applicability in a number of specific cases related to the specifics of the professional activities of the test. Along with this, the author, on the basis of the available statistical information and original research materials, provides an analysis of the Russian market of test systems for the detection of psychoactive substances in saliva and examines the feasibility of expanding its capabilities through wider use of screening psychoactive substances for saliva.

The paper presents the results of analysis of guideline documents that regulate the actions of naval hospitals in the XIXth century. First off, these papers are Regulations developed to control all fields of actions: duties of officials, regulations on reception and discharge of patients, organization of duty shifts, rules of patient conduct, and even fire safety measures. The paper represents principles of the organization of management of naval hospitals, results of the study of subordination of officials in a hospital and to a higher command. The data obtained in the analysis testify the increasing role of medical personnel in the management of the hospital actions throughout. At the same time, it was found that the literature presented a wrong belief about the full subordination of medical officers to a drill command. In particular, the Regulations on essential naval hospitals introduced by order of Emperor Nickolas I were sharply criticized. In further, the matters of hospital management were reflected in the Regulations of naval hospitals of 1858 and 1865. These Regulations defined the statement that the chief doctor was the one director of the hospital, hospital superintendent reported to him directly. The Regulations on naval hospitals of 1887 studied the questions of hospital management as well as common questions of administration of naval medical support. The research rationale is determined by the present work on revising the main guideline documents that regulate the actions of medical support. A historical analysis of such work conducted earlier will allow to except possible errors while attempting to introduce amendments in guideline documents that failed to stand the test of time.