Vol 5, No 3 (2019)

Heart rhythm disorders are presented one of the toughest little studied and, in this regard, current problems in cardiology among different populations living in different climatic and geographical conditions. Changes in normal pesmeker heart activity as identified in diseases of internal organs, and apparently healthy people, civilians and soldiers from various law enforcement agencies. Arrhythmia is a serious problem for both civilian and military health care, in view of the fact that there is a direct correlation with a high risk of cardiovascular complications and sudden (primarily aritmogenic Genesis) death. In addition, arrhythmia entail substantial economic burden in their diagnosis and treatment. Special attention should be paid to heart rhythm disorders in athletes and military personnel at the time of physical training standards. Primarily these are «harmless» violations as episodes or permanent migration of rhythm in the Atria, bradycardia, sinus arrhythmia. On the analysis of the studied Russian and world literature, a definite view on the incidence of various arrhythmias and conduction, residing in various climate and geographical areas, and the data obtained is directly dependent on applied research methodologies.

Surveyed 652 patients with persistent violations of rhythm who applied to the cardiologist of the center of VMA during the 2 years. Of 652 patients was highlighted that some patients (543), in which the rhythm disturbance with daily monitoring Holter ECG were significant, that is, the number of ventricular and supraventricular extrasystoles exceeded the acceptable rate. These patients were divided into 3 groups to assess the frequency of ventricular and supraventricular arrhythmias: Group 1: patients with a primary rhythm disturbance according to the type of ventricular arrhythmia — 96 people (80 men and 16 women). Their average age was 68 years (18–89). Group 2: patients with a primary rhythm disturbance according to the type of supraventricular extrasystole — 343 (271 male and 72 female). Their average age was 67 years (17–83). Group 3: patients with complex arrhythmias (supraventricular and ventricular premature beats) — 106 patients (94 male and 12 female). Their average age was 65 years (18–87). Compulsory medical examination for the patient included a complete medical examination with the filling of a formalized medical history; laboratory studies (clinical blood analysis, biochemical blood — potassium, sodium, magnesium, chlorine, glucose, lipid spectrum, creatinine, total protein, coagulation profile, thyroid hormones T3, T4, TTG); instrumental examinations (ECG, daily monitoring of Holter ECG, radiography of the chest, echocardiography). Identified possible etiologic factors in the occurrence of arrhythmias in patients. The main etiological factors of arrhythmia were: ischemic heart disease (IHD), arterial hypertension (AH), heart failure II–IV FC, the presence of sclerodermatineae acquired heart disease, cardiomyopathy, diabetes mellitus type II, thyroid disease (hyperthyroidism and hypothyroidism), cancer, history of pulmonary embolism (PE), acute violations of cerebral circulation (cerebral vascular accident), coronary artery bypass graft (CABG), family history of coronary heart disease, overweight, menopause. The main provoking factors according to the survey patients were: alcohol abuse and Smoking, daily repeated use of strong tea and coffee, psycho-emotional and physical stress, infectious diseases.48 surveyed (8,84%) did not identify any apparent cause arrhythmias. This group of patients underwent heart MRI for the purpose of clarifying the nature of the arrhythmias. In 32 patients performing MRI of the heart has allowed to establish probable cause rhythm disturbances, draws attention to the high frequency of detection of MR-signs of myocarditis (1⁄3 of the surveyed).

At present, the number of ships under construction, repairing and upgrading, has increased and, accordingly, their marine outputs, which occur when there is an increased number of participants on board, which significantly impairs the habitability of the ship. In such cases, the dynamics of adaptation reactions of sailors to the conditions of navigation may differ from that on active ships and to a greater extent depend on the initial adaptation potential of the organism. This provision was the main hypothesis of the study performed. The purpose of the work is a comparative assessment of urgent adaptation of marine specialists of construction and active ships at marine outputs. Materials and methods. The control groups of 2 crews under construction ships (19 people) and 4 crews of active ships (36 people) were examined using a specially developed complex of clinical, physiological and psycho-physiological methods. The groups of seamen were divided into subgroups depending on the initial adaptation potential of the organism. Studies were conducted — in the pre-shipping period (1^st stage); twice during the period of sailing — after 7 days from the moment of going to sea (2^nd stage) and 3 days before the end of the voyage (3^rd stage); and 4–6 days after returning to the base (4^th stage). The results of research have shown the process of urgent adaptation among sailors of ships under construction, when going out to sea, is much more stressful and difficult than a similar process in the crews of operating ships. In addition, difficulties in adapting to the conditions of navigation are largely determined by the level of the initial adaptation potential of the organism, which can serve as a prognostic criterion for unacceptable deterioration in the working capacity of marine specialists. In this regard, it is extremely important not only to revise the existing labor regimes of the crews of ships under construction, repair and upgrade, but also to improve the measures of their medical (including physiological and psychophysiological) support.

Introduction. Special conditions for the activity of specialists of the naval crews are often «forced» to function at the limit of the physiological capabilities of the body, requiring constant maintenance of a high level of physical working capacity. The purpose of the study is to evaluate the effectiveness of combined physical and normobaric hypoxic training for an emergency increase in the physical endurance of ship specialists and other representatives of «dangerous» occupations. Materials and methods. Were examined 18 men (10 people — the main group, 8 people — the control group) aged 19–22 years. The subjects of both groups performed workouts on exercise bikes: work power 1,2 W/kg, duration 2 hours, the total number of training sessions 14. For people of the main group, physical training was carried out under conditions of normobaric hypoxia created in the normobaric hypoxic complex, with an oxygen content of about 16% (15,9 kPa). In persons of the control group, hypoxia conditions were imitated: atmospheric air was supplied to the premises of the hypoxic complex. The physical endurance of the subjects was evaluated by the maximum oxygen consumption indicator. Results and its discussion. The studies revealed that the effectiveness of training in individuals of the main group turned out to be significantly higher compared to the control, as evidenced by the results of control tests of physical endurance, carried out both immediately after the training and in the long-term observation period. Thus, the method of combined physical and normobaric hypoxic training can be considered as an effective and safe means of emergency and persistent increase in physical endurance of ship specialists and of other categories of people with difficult and dangerous working conditions.

The influence of mental states on the morbidity of military cadets was investigated. Surveyed 102 cadets 2–3 courses of the Naval Academy. N. G. Kuznetsova at the age of 18–23 years. In terms of incidence, the patients were divided into two groups: n=66 did not suffer during the year of study, n=36 had labor losses during the year from 3 to 25 days (10,06±6,1). For self-assessment of the mental state, a modified method of assessing the mental states of a person, proposed by A. O. Prokhorov. Mathematical modeling of the prediction of the incidence of cadets of a military university was performed using discriminant analysis. Comparative analysis was performed using student’s criterion. On the basis of discriminant modeling, a highly informative model for forecasting the incidence of military cadets’ cadets was developed. Predictors of incidence of military cadets are a combination of indicators of mental states: excitation, gaiety, ease, thoughtfulness, fear, laziness. At the same time, for cadets who have a disease during the year, laziness is typical, aspiration for entertainment and excitement, they are less at ease, more thoughtful, possibly inclined to self-analysis, analysis of their physical condition, critical to the environment. They do not experience a state of fear, and, perhaps, a sense of respect for the collective associated with it, since getting exemption from performing duties on a «non-serious» disease in the military collective is perceived as a desire to evade their duties and disdain for their colleagues. The application of the developed model of the prognosis of the incidence of cadets will make it possible to increase the effectiveness of measures for medical and psychological support of military personnel in military universities.

The article outlines the modern aspects of the organization of ambulatory dental care (rehabilitation of the oral cavity) to military personnel and attached contingents eligible to receive it in the military medical organizations of the Ministry of Defense of the Russian Federation. The analysis of the results of epidemiological studies of the stamatological morbidity of various groups of servicemen of both the Russian, Soviet and Russian Army and their need for the rehabilitation of the mouth of the mouth has been carried out. There are scientifically based medical standards for the optimal provision of the dispensary form of the organization of outpatient dental care for conscript and contract servicemen. Discussing the main directions of primary prevention of dental caries, it was proposed to use methods and means aimed at eliminating the deficiency of fluoride in drinking water and in food. At the stage of designing or reconstructing centralized water supply systems, it is desirable to conduct an expert assessment by the bodies of the sanitary and epidemiological service of the expediency of organizing water fluoridation at waterworks. Although there is a very small part of tap water for drinking needs, its fluoridation is expedient and economically beneficial, which is confirmed by domestic and foreign experience in the fluoridation of drinking water: taking into account the costs associated with the treatment of a single tooth, the economic effect in terms of the cost of fluoridation and the cost of treatment on average, it reaches 1:100. Also promising is the organization of the centralized supply of military service personnel with fluoride toothpastes, which have existing tive anti-caries effect.

Acute respiratory viral infections (ARVI) are some of the most widely spread diseases worldwide that are of 80% of economic cost of infectious diseases. It is known that specific prophylaxis (vaccination) and, in some clinical cases, direct-acting antiviral prophylaxis are key strategies for the prevention of influenza as one of the most dangerous ARVI viruses. However, there are a number of reasons why specific prophylaxis of influenza does not entirely address the issue of prophylaxis of ARVI that are caused by more than 200 different viruses, such as formation of immune response only to vaccine influenza strains and absence of immune response to other respiratory infections, induction in the case of short-term protection, especially, in the aged and others. Prevention of influenza with antiviral drugs is limited by risks of development of resistant influenza strains aa well as contraindications and limitations of use. Therefore, the use of nonspecific drugs such as broad-spectrum antiviral drugs of interferon type (IFN) and their inducers (II), as well as sanitary and hygienic measures is recommended for prevention. For the purpose of prevention, the use of inducers of endogenic interferons is relevant in unvaccinated persons during pre-epidemic and epidemic ARVI periods; in high-risk group (students, medical professions, transport workers, elderly, patients with comorbid pathologies, people in structured organizations, for example, military personnel), in immunocompromised people. One of the most extensively studied interferon inducers widely used in clinical practice since 2003 for prevention and treatment of influenza and diseases caused by Herpesviruses is an antiviral drug Kagocel®. The paper presents real-time data of the preventive efficacy of Kagocel® in the therapy of acute respiratory viral infections and influenza caused by different viral strains including pandemic ones.

The present lecture provides evidence on the spread of HIV infection in the Russian Federation. Epidemiological situation in maritime regions is described. Some of regions are leaders by HIV spread. To treat and prevent HIV in this group of people, a special branch represented by territorial HIV centers that organize all necessary measures to carry out voluntary examination in different groups of people was created. Common factors of HIV progression and ways of suppression of viral replication are presented. HIV is considered as chronic medicamentally manageable disease with long course. Antiretroviral therapy (ART) is used to treat HIV infection at the present time. HIV medications are designed to affect HIV at the molecular biological level. Current medications are incapable to eliminate genetic material of virus integrated in DNA of human target cells, so, active viral replication in human body and disease progression will go back up again as soon as a patient stops taking ART medications. In the Armed Forces of the Russian Federation, HIV ranks fourth out of the other diseases. At the same time, there is a growing number of primary disease incidence in 2018 in comparison with earlier periods.

The paper presents the biography of Mariya Tsukanova, marine, medical instructor and senior seaman in the 355 th Independent Guards Naval Infantry Battalion of the Pacific Fleet, her correspondence with parents, data of her military career, studies and work in Vladivostok, inauguration of memorial to Mariya Tsukanova on the territory of the Main Military Clinical Hospital of the Pacific Fleet and in Chongjin memorial military cemetery, Korea. Documentary evidence as a result of many years of searching of historical documentation has been used also. Mariya Tsukanova was awarded posthumously with Order of Lenin and she got the title Hero of the Soviet Union. The name of Mariya Tsukanova was immortalized in monuments, memorial plates, names of streets, villages, rivers and bays. Historical documentation and document evidence of Mariya Tsukanova are kept in libraries and museums of Leningrad, Abakan, Tomsk, Barnaul and Vladivostok.