Vol 7, No 4 (2021)
- Year: 2021
- Articles: 12
- URL: https://seamed.bmoc-spb.ru/jour/issue/view/35
MARINE HEALTH ORGANIZATION
А template for establishment of a unified occupational safety and health system for the Russian Federation military personnel
Abstract
This article is devoted to occupational safety issues with regard to members of the services and civilian staff in the course of army and navy normal activity in terms of creation possibility justification of a unified occupational safety and health system for all the Armed Forces of the Russian Federation. The legislative and other statutory and regulatory acts of the Russian Federation, which determine the security procedure for different social categories, incoming and incumbent employees in military units (on boards), were studied. The research found that active service conditions and civilian staff working conditions, as well as corresponding military service and labor security systems in military units (on boards), differ substantially thus creating obstacles for military authorities. The authors propose to create a unified occupational safety and health system for all the Armed Forces of the Russian Federation, which will be based on the principles applicable to the modern occupational health management system, and will account for work factors of the both social categories.
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МЕДИКО-ЭКОЛОГИЧЕСКИЕ И МЕДИКО-СОЦИАЛЬНЫЕ ВОПРОСЫ ОХРАНЫ ЗДОРОВЬЯ
Epidemiological significance of microbiote monitoring of arctic settlements along the Northern Sea Route
Abstract
Monitoring of polar ecosystems is one of the most important areas of research in the use of Arctic territories in economic activities. An important place in such work is occupied by biomedical research aimed at identifying the risks of the occurrence of foci of infectious diseases in the areas of polar settlements.
The purpose: to develop an algorithm for microbiological monitoring in the Arctic region.
Materials and methods: classical bacteriological, mycological research, molecular-genetic, MALDI-TOF mass spectrometric analysis, phenotypic methods for determining antibiotic resistance, methods of mathematical data processing.
Results and their discussion. The paper considers the scientific and methodological principles and the main stages of microbiota monitoring in the areas of polar settlements. The results of the study of samples from several territories along the Northern Sea Route are presented. The main habitats where potentially dangerous microorganisms should be detected are indicated. The role of anthropogenic invasion in the formation of Arctic microbiocenoses is noted. The trends of increasing the number and diversity of pathogenic microorganisms, both in the natural biocenoses of the Arctic and in the areas of polar settlements, are discussed. The necessity of microbiological monitoring as an integral part of epidemiological monitoring in the areas of Arctic settlements along the Northern Sea Route is substantiated.
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The features of changes in adrenal hormones content in mariners during a voyage to different climatic and geographical areas
Abstract
The hard-working conditions of mariners require a high degree of adaptation of the regulatory systems of the organism. In ensuring adaptation, one of the leading ones is the endocrine system (especially the pituitary-adrenal axis.
The aim of the study is to investigate changes in hormonal parameters in mariners during a voyage to various climatic and geographical regions.
Materials and methods: Russian seamen were examined during the dynamics of the voyage to various climatogeographic regions. They have determined the levels of adrenocorticotropic hormone (ACTH) and cortisol four times (before the voyage, at the beginning, in the middle and at the end).
The results of the study and their discussion: at the beginning of the voyage, the level of ACTH and cortisol were increased; by the middle of the voyage, ACTH decreased but cortisol remained at the same values; by the end of the voyage, the levels of both hormones decreased and reached values much lower than before the voyage. Considering the dynamics of hormonal levels, the normal course of the general adaptation process occurs in the first half of the voyage. A significant decrease in ACTH and cortisol levels in the second half of the voyage may be a sign of breakdown of adaptive capacity.
34-39
High-density metals and arsenic in algae of storm emissions from the coastal area of the Severny island of the Novaya Zemlya archipelago
Abstract
Purpose of the Study is to assess the potential hazard in terms of the content of high-density metals (HDMs) and arsenic (As) for the consumption of objects of the Arctic algal flora presented in storm emissions in places of probable disembarkation of a crew, the ship has come in a distress or a disaster in the water area of the northern seas of the Russian Federation.
Materials and methods. The elemental composition of samples of the plants thrown by the wind-wave impact on the coastal area of the Severny island of the Novaya Zemlya archipelago. Before making the analysis, thallus fragments were dried at 80° C to constant weight to determine their dry weight with an accuracy of 1 mg. The material mineralization was carried out using a microwave mineralizer according to the standard technique. The elementary analysis was performed using MGA-915M atomic spectrometer. The data obtained were compared with the maximum permissible levels established by the current regulatory documents. According to the results of measurements, series of decreasing concentrations of HDMs in algae samples were built according to the places of collection and species.
Results and Discussion. It has been found that the lowest content of HDMs and arsenic in the wind-wave emissions of algae on the Severny Island in the Russkaya Gavan Bay of the Novaya Zemlya archipelago belongs to both Laminaria digitata and vegetative parts of the thallus of most of the other ejected algae. These plants can be used for food in extreme situations by the crews of a ship (an aircraft, etc.) who has come in a distress or a disaster.
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Gum recession as a medical and social problem of marine medicine
Abstract
Introduction. An important role in ensuring the aesthetics of the face and smile is played by the integrity of the teeth, dentition, the absence of dentoalveolar anomalies, as well as periodontal health, including the presence of gum recessions. If there are separate publications for inflammatory periodontal diseases in the crew, then there is no information on the occurrence of gum recessions in the crew.
The aim of the study was to study the incidence of gingival recessions in the crew, to assess the features of their clinical course and the possibility of eliminating them during the voyage.
Material and methods. To identify gingival recessions and the peculiarities of their clinical course after oral sanitation and before a long sea voyage, a dental examination was carried out on 156 men aged 22 to 52 years, who were divided into 2 groups: young (group 1, 105 people) and middle (group 2, 51 people) age. To determine the type of gum recession in the crew, the generally accepted Miller classification was used.
Results and its discussion. The high incidence of gingival recessions among the ship crew was determined, amounting to 33,97%. It was found that gum recessions are more often detected in middle-aged sailors (72,55%) than in young sailors (15,24%). Regardless of the age group of sailors, most often, in 90,57% of cases, there were such clinical forms of gum recessions (I, II and III A classes), with surgical removal of which a favorable treatment result is noted.
Conclusion. The recession of the gums in the ship’s crew is a medical and social problem, which can be solved during a long sea voyage with the presence of a specialist — a dentist-surgeon.
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REVIEW
Climatic and geographical conditions that effect on the health of sailors during marine voyage
Abstract
The prolonged availability of seafarers on board of water vehicle during voyages forms the features of professional labor activity. When assessing the medical and sanitary situation of life and vital activity of the crew on board a ship, it is necessary to take into account a set of conditions that are integrated into a single notion — «ship environment ». The ship’s environment affects the personnel’s body for the entire period while people are on the voyage. It can cause changes in the state of health. The article presents a review of the literature devoted to the study of the influence of climatic and geographical factors accompanying maritime labor. Natural factors occupy a significant share among the large effects of the ship’s environment that affect the health of seafarers and, accordingly, their ability to work. Among them, the greatest contribution is made by temperature, physico-chemical properties of air, photoperiodic fluctuations. The homeostatic systems of the seafarers ‘ body are very closely dependent on the natural situation of the seas. These conditions impose high requirements and can cause the development of premorbid and pathological conditions. To ensure the protection of the health and working capacity of the crew, it is necessary to study the influence of external factors. The main directions for ensuring the safety and strengthening of the health of seafarers are: forecasting and prevention of health disorders, prenosological diagnostics and timely medical support, rehabilitation measures in the post-voyage period.
7-12
INNOVATIVE DEVELOPMENT OF METHODS OF DIAGNOSIS AND TREATMENT OF DISEASES
Innovative technology of information analysis of electrocardiosignals for the purpose of diagnostics of diseases of internal organs at any stage of their development
Abstract
Given the results of years of research information on the properties of electrocardiosignals, set their properties, characteristic of the impulse nature, the proposed methods of information analysis of electrocardiosignals to diagnose diseases of internal organs at any stage of development, protected by patents of the Russian Federation. The main stages of the technology of information analysis of electrocardiosignals for the purpose of diagnostics of diseases of internal organs are described. The rationale for the diagnosis of these diseases at any stage of their development is given. Data were obtained according to which targeted therapeutic and preventive measures at the initial stage of disease development can provide effective prevention of their final stage, which is dangerous for human life due to its complications.
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Choice of optimal antihypertensive therapy in patients with diabetes mellitus type 2
Abstract
Aim of the study: to develop personalized approaches to combined antihypertensive therapy in patients with type 2 diabetes mellitus and arterial hypertension, depending on the parameters of the daily blood pressure profile and heart rate variability.
Material and methods. We examined 322 patients with type 2 diabetes and arterial hypertension who had not previously received antihypertensive drugs on a regular basis. At the first stage, patients were prescribed Perindopril 10 mg per day and Indapamide retard 1,5 mg per day. In the absence of reaching target blood pressure (BP) levels after 28 days, a third antihypertensive drug was added — Amlodipine 5 mg per day, followed by titration to 10 mg 1 r per day (group I) or a b-blocker — Carvedilol at a dose of 12,5 mg 2 r per day, also followed by titration up to 25 mg 2 r per day (group II). Daily monitoring of BP and ECG was carried out, the average daily heart rate (HR), circadian index (CI), as well as heart rate variability were determined.
Results and its discussion. Patients with type 2 diabetes have a high variability of blood pressure throughout the day, high pulse blood pressure, as well as a rigid circadian profile of heart rate. The appointment of a standard two-component antihypertensive therapy, including Perindopril 10 mg and Indapamide retard 1,5 mg per day, allows reaching the target blood pressure only in 46% of patients. The addition of amlodipine or carvedilol significantly increases the effectiveness of therapy, allowing more than 80% of patients to achieve the target blood pressure. At the same time, the use of amlodipine leads to a greater extent to a decrease in pulse pressure, and the inclusion of carvedilol improves the circadian profile of blood pressure and heart rate, and has a positive effect on heart rate variability.
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Features of clinical symptom and inflammatory marker regression in the use of thermal oxygen-helium mixture in SARS-CoV-2 pneumonia treatment
Abstract
New coronavirus infection is accompanied by high mortality and socio-economic losses in the world community. Despite the continuous process of including new medication with antiviral and anti-inflammatory effects in the disease treatment, the development of complications, primarily of hypoxic origin, and mortality remain high.
The aim of the study is to evaluate the effect of the use of thermal oxygen-helium mixture in the therapy on the rate of regression of clinical and laboratory signs of inflammation, as well as the length of patient hospital stay.
Material and methods. 59 patient medical records with moderate and severe disease were analyzed. The article summarizes experience of patient management with COVID-19-associated pneumonia who are treated with or without the use of thermal oxygen-helium mixture in one of intensive care units in multi-filed hospital.
Results and discussion. It has been proven that the use of a thermal oxygen-helium mixture in the SARS-CoV-2 pneumonia treatment is effective.
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PHYSIOLOGY AND PSYCHOPHYSIOLOGY OF HUMAN PROFESSIONAL ACTIVITY
Possibilities of ultrasound methods in the diagnosis of decompression sickness
Abstract
Aim of the work: to conduct a comparative analysis of methods of ultrasound examination of the right heart with audio and visual indication of intravascular decompression gas formation in divers after diving.
Materials and methods. An examination of the right heart in divers after 152 man-descents was carried out. Intravascular decompression gas production was assessed by ultrasound using sound location based on the Doppler effect and transthoracic two-dimensional echocardiography.
Results and discussion. Both methods make it possible to determine intravascular decompression gas formation after a diving descent, correlate with the clinical picture of acute decompression sickness and should be used in the medical support of diving descents. At the same time, the method of ultrasound examination based on transthoracic two-dimensional echocardiography turned out to be more sensitive in determining gas bubbles in the right heart as compared to auditory location with the Doppler effect.
75-83
Assessment of the pathogenesis of visual impairment naval specialists of the arctic zone of the russian federation during the polar night
Abstract
Introduction. The climatogeographic conditions of the Arctic Zone of the Russian Federation are determined by the proximity to the North Pole of the Earth and are characterized by a number of certain cyclical changes that do not take place in the middle latitudes — the polar day and the polar night. The high-latitude location determines the long period of the polar night, lasting from 98 to 133 days. Being the hallmark of the Arctic, the polar night is an integral part of service in the Arctic region, it has an impact on every geographically involved person, without exception.
Purpose of work. To assess the mechanisms of the pathogenesis of visual impairment that develop during the polar night in naval specialists.
Materials and research methods. The study involved 92 people. The surveyed contingent is male contract servicemen of the Navy, aged from 21 to 45 years. The analysis of the morbidity structure according to the ophthalmological profile was carried out during the polar night from November 20, 2020 to January 20, 2021 using an epidemiological method of a case-control study. The assessment of unfavorable climatic and geographical factors of the Arctic region during the polar night was carried out by the method of analytical observation and data recording from November 20, 2020 to January 20, 2021 using the example of the Novaya Zemlya archipelago, Belushya Guba village. On the basis of an integral analysis of epidemiological indicators, climatogeographic and clinical and morphological observations, a pathophysiological assessment of diseases of the organ of vision, developing during the polar night in naval specialists, was carried out.
Research results show a high level of ophthalmological morbidity during the polar night among naval specialists serving on the Novaya Zemlya archipelago.
Conclusions. Climatogeographic factors of the Arctic region have a polyetiological effect on the formation of mechanisms of pathogenesis of disorders of visual functions that develop in naval specialists during the polar night.
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EXPERIENCE OF MEDICAL SUPPORT
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