Vol 9, No 3 (2023)

The article considers the role and place of maritime medicine as science, as a separate health care industry and as the academic discipline. Maritime medicine is at the crossroads of 2 vast areas of human knowledge – medicine and oceanology. As medical science, maritime medicine explores the impact of Ocean on human health in order to develop means and methods of preserving the Earth’s human potential, first of all, the one of maritime industry and coastal territories. Maritime medicine includes a set of private medical sciences, such as marine hygiene, marine epidemiology, medicine for ships, diving medicine, naval medicine, marine ergonomics, marine physiology and pathophysiology, marine therapy, marine surgery, marine toxicology, marine pharmacy, history of marine medicine, marine health care organizations and some other disciplines. The article discusses the relationship of maritime medicine with other fields of knowledge, sciences and academic disciplines.

OBJECTIVE. Analyze the causes and conditions for chronic generalized periodontitis, study means of preventive health care through individual oral hygiene.

MATERIALS AND METHODS. The study analyzed the scientific literature, devoted to casual factors and conditions of developing chronic generalized periodontitis, its influence on the health of the body and as well as the role of oral hygiene in preventing its onset and progression. Articles in leading domestic dental peer-reviewed publications along with data sources from Pubmed over the past 5 years were analyzed.

RESULTS. The literature analysis found that majority of authors acknowledge microbial biofilm microbiota of the oral cavity as the leading etiological factor of periodontitis; such factors as poor oral hygiene, endogenous and exogenous erythrocyte sorption overload, the impact of physical environmental factors – external electromagnetic fields and vibrations affect the progression of the disease. Meanwhile, measures of professional oral hygiene и normalization of individual oral hygiene allows to significantly reduce the risk of emerging and progressing chronic generalized periodontitis.

DISCUSSION. By category visits patients, suffering from CGP, were distributed as follows: 61,6 ± 0,7 % people – retirees of Russian Defense Ministry, 16,5 ± 0,5 % people – family members of military men and retired of RDM, 16,3 ± 0,5 % – military men, attached to the dentistry clinic of RDM military units and institutions, 5,7 ± 0,3 % – RMD cadets. Means of individual oral hygiene, relevant for the prevention of periodontitis, include about 15 items. Part of them are classified as traditional, and the proper application of some of them requires additional training, including in the framework of special medical training during hygiene education work and health promotion. The authors came to a conclusion about the expediency of increasing the number of dentists to intensify the prevention of dental caries and periodontal diseases among military men through professionally monitored oral hygiene.

CONCLUSION. The high prevalence and intensity of dental system diseases among military men shows the relevance of regular sanitation of their oral cavity. Systematic implementation of individual oral hygiene measures decreases the number of bacteria in the mouth, prevents the development of severe overall body response to inflammation, contributes to a significant reduction in the number of exacerbation of concomitant somatic diseases that improves overall health and people’s quality of life. Professionally monitored oral hygiene, oral hygiene education and motivation for applying modern hygiene products are considered as the basis of oral disease prevention.

OBJECTIVE. To study characteristics of bone metabolism disorders in military personnel in the Arctic regions.

MATERIALS AND METHODS. The survey was conducted and medical documentation of 189 male soldiers aged 23–42 (average age - 29,6±5,6) was studied. Depending on the duty station all the surveyed were divided into two groups: I – 107 soldiers, performing military service in the Arctic regions with at least 2 years of experience, II – 82 soldiers from the Western Military Region. Complaints, anamnesis data, objective status (including anthropometry) and medical documentation were assessed and studied in the surveyed military personnel. For estimating bone-mineral density, the method of calcaneus ultrasonography, using «GE Healthcare Achilles» densitometer was applied. The content of total calcium, inorganic phosphorus as well as the concentration of bone resorption markers – СТХ and NTX in the blood serum were used as analyzed laboratory rate of bone metabolism.

RESULTS. The study showed that almost half of the military personnel in the Arctic regions (48,6%) had the rate of bone-mineral density below the average value for healthy men of the same age group. It was noted that prevalence of osteopenia in the Arctic is significantly higher compared to military personnel from temperate regions. When studying bone resorption markers, it was noted that the group of Arctic military personnel experienced statistically significant increase in NTX, characterizing the rate of degradation in the newly formed bone as well as the tendency towards increase in CTX, reflecting the rate of degradation relative to the old bone.

DISCUSSION. The main link in the pathogenesis of low bone-mineral density in military personnel in the unfavorable Arctic environment is D₃ vitamin metabolism disorder by lowering its formation in the skin and also it limited intake with food. High prevalence of disorder in bone-mineral density among Arctic military personnel might indicate the need for a more rigorous selection process in the Arctic regions with a mandatory in-depth survey of the bone metabolism system (determination of total calcium content, inorganic phosphorus, D₃ vitamin) as well as performing according to osteodensitometry. It is advisable to conduct an annual survey of the Arctic military personnel at the duty station, involving a visiting military-medical commission with a therapist or rheumatologist as its member.

OBJECTIVE. To assess the influence of sea habitat conditions on a vessel on military seamen’s health according to integral health indicators using a computer program.

MATERIALS AND METHODS. Before going to sea and after returning to the base there were measurements of weight and body length, chest circumference, lung capacity, leading hand strength, heart rate, systolic and diastolic pressure at rest, after the load and recovery period (Martinet test) as well as blood lymphocyte content. Physical development, nutritional status, index of functional changes, the state of general non-specific adaptive response and cognitive body functions were defined; integral health assessment was held using computer programs.

RERESULTS. Initially 66,7% had increased nutrition, after returning – 62,0%; normal status - 37,0% and 40,7%, excessive nutrition – 48,1% and 44,4%, obesity of 1^st degree – 11,1% and obesity of 2^nd degree – 3,7%. The proportion of seafarers with physical development above average decreased by 18,5%, adaptive response - by 7,1% (р=0,001) and body functionality - by 11,5% (р=0,006). Cognitive mental functions did not change. Standard of health decreased by 16,7% (р=0,001).

DISCUSSION. There was confirmed negative impact of living conditions on seafarers’ health. Somatometric and physiometric indices showed negative tendencies in physical development and functionality, nonspecific adaptive body response. Stress test revealed the deterioration of aerobic capacity.

CONCLUSION. The use of algorithm for assessing morphofunctional indicators, cognitive functions and lymphocyte content with computer processing of the results allows to evaluate the health in professional activities of seafarers.

INTRODUCTION. Human labor activity in the Arctic takes place in severe climatic conditions associated with cooling, atmospheric pressure drops, high humidity, photoperiodicity, low oxygen content in the air. Endothelial dysfunction is an early pathophysiological sign and an independent predictor of poor prognosis in most cardiovascular diseases.

OBJECTIVE.Тo analyze the dynamics of the level of metalloproteinase-9 and thrombin activity as predictors of the development of atherosclerosis in sailors during a translatitudinal sea voyage in the Arctic.

MATERIALS AND METHODS. A prospective clinical and laboratory study of crew members was performed during the integrated marine research expedition “Transarctic-2019”. A clinical and laboratory study of the level of metalloprotease-9 (enzyme-linked immunosorbent assay), coagulation analysis of the parameters of the thrombin generation test, as well as ultrasonic dopplerography of the thickness of the intima-media complex were carried out. Statistical data processing was carried out using the methods of descriptive and analytical statistics in the StataCorp Stata 14.2 program. The study protocol was approved by the local ethical committee of the SSMU (protocol No. 03/5 dated May 27, 2015) and supported by the state task reg. No. NIOKTR 121030300111-7.

RESULTS. A statistically significant increase in the level of MMP-9 in sailors after the expedition was noted, the relationship between the level of MMP-9, indicators of the thrombin generation test (lag time, min (p=0.0190), tPeak (p=0.0177), Peak (p= 0.0217) and KIM thickening.

DISCUSSION. MMP-9 levels may be a predictor of early atherosclerosis and atherosclerotic plaque instability, as well as a risk factor for future adverse cardiovascular events. The relationship of MMP-9 with the kinetics of thrombin (one of the regulators of the antithrombotic state of the endothelium) during a translatitudinal voyage in sailors indicates the formation of readiness for prothrombotic events.

CONCLUSION. Thus, in Arctic conditions, under conditions of chronic oxidative stress, which contribute to the progression of the development of endothelial dysfunction in the presence of external risk factors, the likelihood of progression of atherosclerotic vascular lesions increases, and, as a result, the development of vascular events.

INTRODUCTION. In modern realities of peace and military trauma there are an increasing number of scar skin defects, often accompanied by pronounced subjective sensations and tissue functional limitations. An urgent task is the scientific substantiation of effective methods of their correction.

OBJECTIVE. To determine healing effects and safety of using ultraphonophoresis of enzyme gel with high transcutaneous and proteolytic activity in patients with scarring on the skin.

MATERIALS AND METHODS. There was examination of 82 patients with emerging (N=21 study group, N=16 comparison group) and mature (N=25 study group, N=20 comparison group) scar skin of different localizations at the rehabilitation stage after various injuries, burns, removal of skin neoplasms. The study applied clinical and functional methods in the assessment of scar tissue, medical and sociological methods in evaluating patients’ quality of life and safety profile.

RESULTS. There were improved clinical indicators and functional skin properties in the scar area, a significant regression of subjective sensations, an increased quality of life score, more pronounced in the study groups. Dynamics of clinical indicators is more expressed in group 1 and group 3. Vascularization values before and after treatment in the groups were: in group 1 and 3 before treatment - 6,4±0,93 and 5,8±0,25, after - 3,0±0,24 and 2,7±0,31, respectively; in group 2 the values before and after treatment were 5,6±0,26 и 4,2±0,62, respectively, in group 4 – before treatment 4,9±0,53, after - 4,1±0,48. As a result of dynamics of the quality of life indicators, a more significant improvement was found in the study groups with respect to the comparison groups. In the group with emerging scars the sum of points before treatment was 20,4±0,3, after treatment - 12,4±0,3; in the comparison group - 18,7±0,5 and 13,4±0,5 before and after treatment, respectively; in the group with mature scars: before treatment - 23,6±0,3, after - 13,7±0,4; in the comparison group - 21,3±0,4 и 16,2±0,5 before and after treatment, respectively. A favorable safety profile of treatment was defined: adverse events (tingling, burning) were transient and fully cupped after the procedure.

DISCUSSION. Ultraphonophoresis, one of the man methods in the transdermal delivery, contributes to changing the epidermal barrier permeability for molecules of various drugs as well as potentiation for actions of anti-scarring agents at different stages of emerging and existing scar skin defects.

CONCLUSION. Ultraphonophoresis of the enzyme gel with a high transcutaneous and proteolytic activity has fibromodulating and sedative curative effects in patients with scarring skin of different genesis and duration.

Tortuosity of the internal carotid artery with dysplastic changes in the form of aneurysms and diverticula should be attributed to a rare pathology. The pathology of this localization makes open surgery difficult due to access trauma and a high risk of arterio-arterial embolism with the development of cerebrovascular accident. The method of reconstructive intervention is offered, using ultrasound dopplerographic control and there is a result of successful application of the method in the patient with pathological tortuosity of subcranial part of the internal carotid artery combined with diverticula.