Vol 6, No 1 (2020)

The paper describes the current state of development of seasickness as one of movement disease variants. The given type of pathology occurs when combining different types of ship’s motion (rolling and pitching). Circular, vertical and slow movements induce more pronounced and frequent signs of seasickness than linear, horizontal and quick ones. In the view of majority of researchers, the most likely is an intersensory conflict theory i.e. violation of coherent functioning of afferent body systems performing spatial orientation, statokinetic equilibrium and keeping balance. The leading role is played by the functional dysfunction of the vestibular analyzer. The classification of means of preventing and stopping of motion sickness is given, the mechanisms of their action, specific activity and side effects are described. It has been shown that currently the most effective drugs are M-cholinergic antagonists (scopolamine hydrobromide) and H₁-histamine antagonists of the 1st generation (dimenhydrinate, diphenhydramine, cyclizine, meclizine, promethazine, etc.). Of the antipsychotics and blockers of D₂ receptors, prochlorperazine and metoclopramide are recommended. It is also worth to use prokinetics (domperidone, cisapride, renzapride, etc.), tranquilizers (barbiturates, benzodiazepines), sleeping pills and local anesthetics. Particular attention is paid to combination drugs, consisting of antiemetic and psychostimulating drugs, designed to maintain working capacity under the influence of seasickness factors on the body. Non-pharmacological means of preventing seasickness and alleviating its symptoms are described. The main directions of improving the system of measures aimed at maintaining efficiency in the presence of symptoms of seasickness are determined. 

The modern strategy for the development of health care includes as one of the priorities maximum approach of medical services to the consumer. To solve this problem in the conditions of the Navy, it is advisable to create mobile medical complexes placed on specially equipped vessels. For the full and operational medical support of the fleet forces in specified areas of the world’s ocean at different distances from the main base sites, a system of marine mobile medical complexes should be created. In peacetime the system should include hospital ships, multipurpose vessels with a hospital on board, mobile polyclinic mobile complexes and high-speed ambulance boats. During the period of danger, the possibility should be provided for the rapid re-equipment of hospital and multifunctional vessels, as well as polyclinic complexes with an increase in evacuation capacity and an increase in the volume of medical care. For medical support of an amphibious assault operation on universal amphibious ships, a quick re-equipment of the premises specially allocated during the design process to medical facilities for emergency medical assistance and evacuation of the wounded to coastal medical institutions should be provided. In wartime, for the provision of medical care and evacuation of the wounded, vessels of various purposes must be used, the projects of which contain the capabilities and algorithms for their quick conversion into sanitary transports. Variants of the main tactical and technical characteristics of vessels of various classes intended for medical support of the fleet forces are proposed. A significant problem in the operation of medical vessels is their low patient load in the inter-transit period, which leads to the disqualification of full-time medical staff and reduces the quality of the maintenance of the vessel. When forming the operational-tactical model of operation of medical vessels, special attention should be paid to the staffing algorithms and ensuring that the courts are always ready to perform their tasks.

Almost every sailor during performing his job duties aboard receives injuries of varying severity, among which the most common are deck fractures, including compression vertebral fractures, as well as open and closed vertebral fractures with spinal cord injuries. Besides the recovery of disordered functions of the spinal cord, in cases of spinal cord injury, the fight against numerous neurological, infectious and somatic complications affecting the survival and quality of life of patients is still relevant.

Objective: to study the incidence of complications of traumatic injuries of the spinal cord under initial hospitalization, their impact on the length of hospital stay, to identify and evaluate the role of risk factors in the development of complications.

Materials and methods. A retrospective cohort study was conducted according to the archived case histories of patients hospitalized in neurosurgical hospitals in St. Petersburg. 311 cases of acute spinal cord injury in 2012–2016 were analyzed.

Results: complications not directly related to spinal cord injury, such as bronchitis, pneumonia, bedsores, sepsis, thromboembolism, urinary tract infections, postoperative wound pyogenesis and others (damage to other organs and systems), were found in one third of patients (33,8%), in half of the cases there were multiple complications (2 or more), the most frequent — respiratory (23,5%) and pressure sores (10%). Complications significantly increased the length of hospital stay. The dependence of the frequency of complications on age, the level of spinal cord damage and the severity of the injury was revealed. Risk factors such as concomitant head injury and alcohol intoxication have been found. The revealed positive effect of corticosteroids on the regression of neurological deficit was not statistically confirmed. At the same time, there was a significant increase in the frequency of respiratory complications when using corticosteroids.

Conclusion: Knowledge of the factors affecting the incidence of complications, optimization of their prevention and therapy will shorten the duration of hospitalization and improve the prognosis and quality of life of patients. The issue of use of corticosteroid therapy in the acute period of traumatic injuries of the spinal cord remains debatable. When choosing therapeutic tactics for managing patients with spinal trauma, it is necessary to take into account the risk of respiratory complications and carefully evaluate the ratio of benefits to harm. 

At present time, the compliance of energy costs and the chemical composition of foods in the daily diet with physiological needs of the body gains a particular relevance. Particular attention is paid to the use of functional food products - special products intended for systematic use by all age groups of a healthy population. Functional nutrition compensates for the deficiency of essential amino acids, polyunsaturated fatty acids (PUFA), vitamins, macro- and microelements, etc., as well as protects the body from the effects of pesticides and herbicides, antibiotics, dyes and preservatives, widely used in conventional products, and is used to strengthen health and prevent diseases caused by deficiencies in traditional nutrition. Such diseases include: obesity, non-insulin-dependent diabetes mellitus, hypertension, atherosclerosis, mental depression and others. In some professional groups, for example, in military athletes, the use of functional foods has been practiced for a long time. Currently, a fairly wide range of this group of products has been developed and is being produced. When developing a functional product, environmentally friendly raw materials of animal and vegetable origin, biologically active additives that improve functional and consumer qualities should be used. The high content of amino acids, proteins, carbohydrates, minerals, vitamins and other necessary biologically active substances, as well as good organoleptic characteristics and high consumer properties justify the feasibility of including functional products in the diet of military personnel, whose professional activity is characterized by high physical activity, requiring maximum use of functional resources organism. At the same time, military personnel are capable of completing official tasks at the limit of their physical capabilities, while maintaining relatively constant biochemical constants of the internal environment of the body. The information presented in the paper will be useful to the logistics and medical service specialists of the Russian Army and Navy and will serve as the basis for further development of the direction for the use of functional products for feeding military personnel.

Introduction. The study of the physiological status of representatives of power structures at different stages of service is very relevant.

Purpose: a comprehensive assessment of the functional state of the body of OMON fighters before and after a 4-month business trip on perform a special task associated with health and life risks. Materials and methods. 34 OMON fighters of the Komi Republic were examined before the trip and after a 4-month trip to the North Caucasus, where they constantly experienced stress. To assess the functional state of the body, a complex of anthropometric, physiometric, psychophysiological, physiological and biochemical studies was used.

Results and its discussion. Before the trip, the fighters showed an increase in the time of the visuomotor reaction, the index of functional changes, the myocardium index, the centralization index, the activity index of regulatory systems, blood pressure indicators and other changes that indicate the activation of free radical oxidation processes, and the appearance in individuals of prenosological and even premorbid conditions. In most of the examined patients, a shift in the autonomic balance was found towards strengthening the sympathetic link in the regulation of heart rhythm. Hypovitaminosis was found in many fighters. After a trip, the functional state deteriorated in most indicators (increased blood pressure, personal anxiety, cholesterol, etc., decreased life index and hemoglobin content, etc.) and the number of people with depleted regulatory systems almost doubled.

Conclusion. In general, the body of OMON fighters experiences increased functional stress with signs of obvious stress both before a trip to an area dangerous for health and life, and in the first days after returning to places of permanent residence in the North. In this regard, they need additional health and rehabilitation measures related to optimization of the regime of work and rest, activation of physical education, rationalization of nutrition and strengthening the work on the psychological impact. 

Introduction. Characteristic features of tense and dangerous activities of ship and vessel specialists require constant development of their medical and psychophysiological following-up including at the stage of studying at a university and mastering a marine specialty. Complex education program for cadets often results in dysadaptation disorders and disability for successful completion. Therefore, early detection and prevention of these disorders are extremely necessary. Purpose of work: assessment of the possibilities of using an automated system for dynamic control of the process of adaptation to educational activities among cadets of marine specialties.

Materials and methods. In the course of the work, 120 cadets were examined in the initial period of their education at universities. The studies were carried out using an automated system of screening monitoring of functional state, designed on a modular basis and developed for Navy orders’ use.

The research results showed that automated systems of psychophysiological control available at the Navy make it possible to perform diagnostics of maladaptive manifestations in cadets, to carry out objective assessment and detail the revealed violations, and to forecast further dynamics of the functional state. This was evidenced by the presence of a statistically confirmed relationship between the integral indicators of the functional state recorded by the automated system and expert assessments of adaptation to educational and training activities at the university.

Conclusion. The automated system of dynamic control of the functional state and working capacity tested in this work can be effectively used in medical and psychophysiological support of cadets to assess the process of their adaptation to educational activities. 

Introduction. The psycho-emotional sphere is one of the most prone to the hard conditions of maritime labor. When working in the sea on ships of foreign companies, there are often violations of working conditions. It can cause the emergence of socio-psychological conflicts that turn into psycho-emotional stress. In this regard, the study of the emotional sphere of Russian seafarers working on ships under the flags of foreign states is very relevant.

Objective: to determine the characteristics of the state of the emotional sphere of Russian sailors when working in international crews and justify the need for its correction in the voyage and inter-voyage periods.

Materials and methods. The psycho-emotional state of Russian seafarers who worked on ships of foreign companies was studied in real-time mode during a sea voyage using the method of «Diagnostics of interpersonal relationships» by T. Leary, adapted by L. N. Dog.

Results and its discussion. A rather high level of emotional stress was found during the voyage, probably due to the difficulty of communicating with foreign sailors, the severity of work and, as a result, the occurrence of conflict situations.

Conclusion. Emotional stress can result in the emergence of neurotic reactions in seafarers. For work on ships flying a foreign flag, it is recommended to conduct a careful selection of crews and not allow the conclusion of contracts with psychologically unstable persons. 

Purpose of work: to evaluate the reactivity of the spectral density of electroencephalogram theta rhythm power in military seafarers of the submarine fleet during the sanatorium-resort rehabilitation.

Materials and methods: on the first and 20th day of the sanatorium-resort rehabilitation on the basis of the Crimean Sanatorium-Resort Complex and Sudak Health Center, the background activity of the electroencephalogram (EEG) was recorded with closed eyes and when performing a cognitive task in 60 seafarer divers.

Results: analysis of variance showed significant changes in the spectral power of the EEG theta rhythm density in all experimental situations studied. In conditions of relative rest, the changes were expressed mainly in a decrease in the theta rhythm power. At the same time, when performing a cognitive task, multidirectional changes in the spectral density of the theta rhythm power were noted: an increase in the fronto-parietal direction of the predominantly left hemisphere and a decrease in other regions of the cerebral cortex. 

Sample size calculation prior to data collection is still relatively rare in Russian research practice. This situation threatens validity of the conclusion of many projects due to insufficient statistical power to estimate the parameters of interest with desired precision or to detect the differences of interest. Moreover, in a substantial proportion of cases where sample size calculations are performed simplified formulas with assumption of a normal distribution of the studied variables are used in spite of the fact that this assumption does not hold for many research questions in biomedical research. Correlation analysis is still one of the most commonly used methods of statistical analysis used in Russia. Pearson’s correlation coefficient despite its well-known limitations appears in a greater proportion of publications that non-parametric coefficients. We calculated minimal sample sizes for the parametric Pearson’s coefficient as well its non-parametric alternatives — Spearman’s rho and Kendall’s tau-b correlation coefficients to assist junior researchers with the tool to be able to plan data collection and analysis for several types of data, various expected strengths of associations and research questions. The results are presented in ready-for-use tables with required sample size for the three abovementioned coefficients within the range from 0,10 through 0,90 by 0,05 for statistical power 0,8 and 0,9 and alpha-error or 5% as well as for estimation of the same correlation coefficients with the 95% confidence intervals width equal to 0,1 and 0,2.