Vol 9, No 4 (2023)

INRODUCTION. Recent decades are characterized by a rapid introduction of modern automated analytical systems in clinical laboratory diagnostics such as hematology analyzers, which provide a high accuracy of results as well as additional (compared to routine tests) and often more valuable information. Automated blood test has made urgent the problem of interpreting both new tests and “routine” parameters that is relevant to any section of clinical medicine. Therefore, this lecture is aimed at doctors of different specialties.

OBJECTIVE. Interpret a clinical blood test.

DISCUSSION. It is hard to review all aspects of hematological analysis within the scope of one lecture, thus part 1 will investigate one of leukocyte populations – neutrophil granulocytes, which include stab and segmented neutrophils. The lecture presents well-known data about neutrophilic leukocytosis and neutropenia. The emphasis is placed on new parameters of automated blood test – IG (immature granulocytes), Neut-RI (reactivity index), Neut-GI (granularity index), MNV (the average volume of neutrophil), structurally dispersed characteristics (NE-WX, NE-SFL, NE-WZ) and some others. Along with modern parameters it was noted the importance of the traditional cytological examination of blood smear, enabling to detect anomalies of neutrophil (degenerative-dystrophic changes of cytoplasm, apoptosis, nucleus pathology).

Overall, recent years have shown a significant improvement in laboratory diagnostic capabilities of reactive changes (with inflammation, injury, etc.) and blood diseases (anemia, myelodysplastic syndromes, hemoblastosis, etc.), based on accumulated knowledge in the field of laboratory hematology, including clinical significance in evaluating neutrophils.

INTRODUCTION. Severe burn injury or burn disease is one of the most dangerous injuries to life. Treatment of burns, as well as subsequent rehabilitation of the burn patients are a serious problem for both civil health care and military medicine. The key component of local treatment of burn wounds is the use of wound dressings. Among the wide variety of used wound dressings the most promising are hydrogel based on seaweed polysaccharides (PS).

OBJECTIVE. Based on the analysis of data from domestic and foreign literature, to justify the use of seaweed polysaccharides (PS) as a basis or as therapeutic components of promising wound dressings for the treatment of wounds and burns.

MATERIALS AND METHODS. The articles included in the databases and information systems are analyzed: the scientific electronic library Elibary.ru, RISC, Web of Science, Pubmed, Scopus, Elsevier and Google Scholar (as of February 2023) by keywords: marine medicine, burn wounds, seaweed polysaccharides, wound dressings, hydrogels

RESULTS. The review presents information about modern biodegradable and biocompatible wounded dressings that have been used in clinical practice or are at the stage of experimental research and developed using seaweed PS (alginates and fucoidans of brown algae, carraginans of red algae, ulvanas of green algae) as a basis or as therapeutic components. A brief characteristic of the physicochemical properties and high biological activity of the PS, important both for macroorganism as a whole and for wounds healing is presented.

DISCUSSION. The use of PS when constructing wound dressings is justified, and the results of their experimental and clinical trials for the treatment of wounds and burns are analyzed. Particular attention is paid to the ability of the PS to form hydrogel, since hydrogel dressings meet the main requirements for the ideal wound dressings for the treatment of wounds of various genesis, including burn wounds.

CONCLUSION. Seaweed PS are widely used in modern technologies for creating wound dressings for the treatment of burn wounds.

OBJECTIVE. Estimate risk factors of professional competence on health grounds in employees of the Azerbaijan Caspian Shipping Company.

MATERIALS AND METHODS. The study used materials of preventive medical examinations of 9904 ACSC employees and the conclusions of the medical and advisory commission for professional competence examination of persons for 2021. The commission recognized professional incompetence in 53 employees.

Statistical processing was carried out using a set of methods of qualitative feature analysis. The frequency of professional incompetence was set per 1000 examined, 95% confidence interval (CI) was calculated at t=1,96. Statistical significance (critical value 0,05) of differences in the proportion of professional incompetence was estimated by χ² criteria.

RESULTS. The frequency of professional incompetence among ACSC employees was 5,4‰ (95% CI 4,9 - 5,8‰). The maximum value of the indicator was observed in workers of “Zigh” Shipyard (8,2‰; 95% CI 6,5 - 10,0‰), basic services of ACSC did not differ significantly from each other in the frequency of professional incompetence cases. Professional incompetence was established among seamen (14,7‰), motormen (11,6‰), mechanics (6,0‰), boatswains (4,1‰), captains (4,3‰), mates (3,7‰), locksmiths (13,9‰) and painters (16,5‰). The comparison against these groups in frequency of professional incompetence refutes the valid null hypothesis (р=0,045).

DISCUSSION. The criteria for the professional suitability of seafarers in Azerbaijan are identical to those in the Russian Federation; the frequency of professional unfitness identified during periodic medical examinations of seafarers in the Sakhalin region was 9.0 ± 2.1 ‰ (2011–2016). The indicator in ACSC (5.4 ± 0.7 ‰) is noticeably lower, but the difference between these indicators is statistically insignificant. The nosological structure of the causes of professional unsuitability of seamen in the Sakhalin region and ACSC is similar: the share of diseases of the circulatory system is 55.5% and 60.4%, respectively, blood 5.5% and 5.7%, injuries 5.5% and 5.7% almost the same. The share of musculoskeletal diseases is 2 times less among the causes of professional incompetence in ACSC.

CONCLUSIONS. Significant risk factors of professional incompetence on health grounds are age (>45 years) and work experience (>20 years). The work of locksmiths, painters, seamen, motormen and mechanics compared to the work of captains, boatswain and mates creates significantly higher risks for pathology, provoking professional incompetence, the main causes of which are circulatory system diseases.

OBJECTIVE. Study the features of the pathogenesis and clinical picture of musculoskeletal disorders in different categories of the Navy military personnel and pensioners of the Defense Ministry (DM) based on a set of clinical, instrumental, laboratory and genetic examination methods.

MATERIALS AND METHODS. There was screening and study of medical records of 98 Navy military personnel and pensioners of DM in the following groups: I — the Navy military personnel with no hyperbaric exposure in the anamnesis, II — military personnel, belonging to deep water divers with moderate experience (total work experience in hyperbaric conditions: 20–500 hours), III — military personnel, belonging to deep water divers with considerable experience (total work experience in hyperbaric conditions: 700–2500 hours), IV — pensioners of DM, whose professional activities were related to operations on extreme depth (aquanauts), V — pensioners of DM with no hyperbaric exposure in the anamnesis. There was a detailed laboratory and instrumental examination of bone metabolism, including digital radiography, osteodensitometry, MRI, CT and genetic testing.

RESULTS. The Navy diving personnel experience significant osteoarticular manifestations by type of dysbaric osteonecrosis, most pronounced in pensioners of DM – aquanauts.

DISCUSSION. Digital radiography and MRI are found to be an optimal diagnostic method of dysbaric osteonecrosis and “dysbarogenic osteoarthropathy”. As a method of express diagnostics, it is advisable to use innovative urine test strips to determine threshold concentrations of β-crosslaps and α-crosslaps markers of bone resorption.

INTRODUCTION. Malignant neoplasms of the abdominal organs often lead to exacerbation of cardiovascular diseases or trigger their development. Only proper evaluation of cardiovascular risk allows to effectively prepare for the operation, to choose best option of surgery and to decrease the likelihood of complications in the postoperative period.

OBJECTIVE. To study the possibility of a differentiated approach to additional preoperative preparation in the surgical treatment of locally advanced cancer of the abdominal organs in patients with different degrees of cardiovascular risk.

MATERIALS AND METHODS. The first stage included retrospective result analysis of planned surgical treatment of 250 patients under the standard approach to pre-operative examination and preparation. At the second stage, 101 patients were tested a modified algorithm of additional preoperative examination where there was emphasis on persons with an average cardiovascular risk. The observation period did not exceed 30 days. The stratification of perioperative cardiovascular risk was conducted by RCRI and NSQIP-MICA index calculation. Statistical processing of the results was carried out using “Statistica 12.5” application packages (StatSoft, USA).

RESULTS. The standard approach to preoperative preparation was characterized by relatively high mortality in the early postoperative period (18,4%). Most deaths (54,3% on RCRI scale and 69,5% on NSQIP-MICA scale) were among patients of an average cardiovascular risk. Differentiated algorithm implementation of additional preoperative examination has reduced the incidence of postoperative complications by 2,1-5,9 times, the duration of the patient’s stay in intensive care by 1,4 times and hospital mortality by 2,3 times (up to 7,9%).

DISCUSSION. The proposed algorithm is focused on the most problematic subgroup of patients with an average cardiovascular risk (1 risk factor on RCRI scale and/or decreased (indefinite) functional status) which, in standard preparation for surgery, have the same chance of an adverse outcome as persons with high comorbidity.

CONCLUSION. The use of validated methods in evaluating perioperative risk, differentiated approach to additional examination and rational pharmacotherapy reduce hospital mortality in patients with locally advanced cancer of the abdominal organs.

INTRODUCTION. Neurological complications are often observed in patients with a new coronavirus infection. Cerebrovascular diseases prevail among them. There is damage to the peripheral nervous system and spinal cord of various kind, including inflammatory and vascular myelopathy. The incidence of myelopathy syndrome among all neurological complications of the new coronavirus infection reaches 3%.

OBJECTIVE. To characterize clinical and instrumental features of the rare case – “МR-negative” myelopathy amid SARS-CoV-2 infection.

MATERIALS AND METHODS. The article describes a clinical case of myelopathy, associated with COVID-19 without structural changes in the spinal cord on MR-imaging using standard pulse sequences, however, visualized via spinal tractography.

CONCLUSION. COVID-19 associated myelopathy is one of the characteristic complications amid the new coronavirus infection. To verify “MR-negative” damage to the central nervous system in COVID-19, advanced protocols of MRI studies might be used, including the promising method – МR-tractography.