Pub Date : 2023-01-05DOI: 10.25016/2541-7487-2022-0-3-05-12
S. Aleksanin, N. A. Alhutova, N. A. Kovyazina, V. Rybnikov
Relevance. Considering that prolonged stress of adaptive mechanisms is associated with an increase in the risk of developing somatic pathology, it is relevant to search for laboratory markers that allow assessing the adaptive status of men working in the Arctic and exposed to the combined effects of occupational stress factors and “polar stress”.Intention. To substantiate directions of scientific search for laboratory markers of adaptation to occupational loads in the Arctic.Methodology. A laboratory examination was performed on 74 practically healthy firefighters-rescuers from 22 to 49 years old, working in the Arctic zone of the Russian Federation. Those examined were divided into groups depending on the conditions of occupational activity, as well as triiodothyronine levels, the adaptive androgen dehydroepiandrosterone sulfate (DHEAS) / cortisol index and the cortisol morning/cortisol evening ratio. The results of the hormonal status study were evaluated.Results and Discussion. Significant differences in triiodothyronine levels were revealed between the groups of local and visiting firefighters-rescuers, with no difference in age and concentrations of thyroid-stimulating hormone and free thyroxine.Firefighters-rescuers who were local residents of the Arctic and had low levels of triiodothyronine tended to a relative androgen deficiency. In firefighters-rescuers with preserved adaptive reserves, DHEAS / cortisol index increased with increasing workload in terms of the number of emergency response trips. In rescuers with HEAS / cortisol index < 2.1, there was no such correlation, and higher index values correlated with a more pronounced rhythm of the daily secretion of triiodothyronine and free thyroxine. In the group with the most pronounced daily rhythm of cortisol secretion, a physiological increase in thyroidstimulating hormone concentration was determined in the evening hours along with uniform prolactin secretion throughout the day. A group with a smoother rhythm of cortisol secretion tended to increased evening secretion of prolactin and smoothened rhythm of thyroid-stimulating hormone production.Conclusion. The data obtained are consistent with current ideas about the polysystemic adaptive response, suggest joint activation of the adrenal and pituitary-thyroid mechanisms of adaptation to occupational loads in the Arctic and indicate the necessity of further study and application of the DHEAS / cortisol index and triiodothyronine, as well as daily oscillations of thyroid hormones, thyroid-stimulating hormone and prolactin as markers of adaptation.
{"title":"Triiodothyronine, DHEAS/cortisol index and daily oscillations of hormones as markers of adaptation to occupational loads in the Arctic: results of hormonal status study in firefighters-rescuers of EMERCOM of Russia","authors":"S. Aleksanin, N. A. Alhutova, N. A. Kovyazina, V. Rybnikov","doi":"10.25016/2541-7487-2022-0-3-05-12","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-3-05-12","url":null,"abstract":"Relevance. Considering that prolonged stress of adaptive mechanisms is associated with an increase in the risk of developing somatic pathology, it is relevant to search for laboratory markers that allow assessing the adaptive status of men working in the Arctic and exposed to the combined effects of occupational stress factors and “polar stress”.Intention. To substantiate directions of scientific search for laboratory markers of adaptation to occupational loads in the Arctic.Methodology. A laboratory examination was performed on 74 practically healthy firefighters-rescuers from 22 to 49 years old, working in the Arctic zone of the Russian Federation. Those examined were divided into groups depending on the conditions of occupational activity, as well as triiodothyronine levels, the adaptive androgen dehydroepiandrosterone sulfate (DHEAS) / cortisol index and the cortisol morning/cortisol evening ratio. The results of the hormonal status study were evaluated.Results and Discussion. Significant differences in triiodothyronine levels were revealed between the groups of local and visiting firefighters-rescuers, with no difference in age and concentrations of thyroid-stimulating hormone and free thyroxine.Firefighters-rescuers who were local residents of the Arctic and had low levels of triiodothyronine tended to a relative androgen deficiency. In firefighters-rescuers with preserved adaptive reserves, DHEAS / cortisol index increased with increasing workload in terms of the number of emergency response trips. In rescuers with HEAS / cortisol index < 2.1, there was no such correlation, and higher index values correlated with a more pronounced rhythm of the daily secretion of triiodothyronine and free thyroxine. In the group with the most pronounced daily rhythm of cortisol secretion, a physiological increase in thyroidstimulating hormone concentration was determined in the evening hours along with uniform prolactin secretion throughout the day. A group with a smoother rhythm of cortisol secretion tended to increased evening secretion of prolactin and smoothened rhythm of thyroid-stimulating hormone production.Conclusion. The data obtained are consistent with current ideas about the polysystemic adaptive response, suggest joint activation of the adrenal and pituitary-thyroid mechanisms of adaptation to occupational loads in the Arctic and indicate the necessity of further study and application of the DHEAS / cortisol index and triiodothyronine, as well as daily oscillations of thyroid hormones, thyroid-stimulating hormone and prolactin as markers of adaptation.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"86 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84022852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-52-59
A. A. Rаssokha, E. Ichitovkina, M. Zlokazova, A. Soloviev
Relevance. Participation in hostilities is a stressful factor affecting the formation of mental disorders in combatants. According to scarce studies, combatants resigned from the security forces have some problems with mental health.Intention. Catamnestic analysis of mental disorders over time in combatants entitled to retirement pension upon their dismissal from the Internal Affairs bodies of Russia.Methodology. A catamnestic survey was conducted in 209 employees of the Ministry of Internal Affairs of Russia in the Kirov region who were retired from 2015 to 2019. Depending on participation in hostilities, the respondents were divided into two groups: main group, 106 retired combatants from the Ministry of Internal Affairs of Russia, and the comparison group, 103 retired persons without combat experience. Catamnestic, clinical and experimental psychological research methods were used. Statistical processing of the results was carried out using the STATISTICA 10.0. Mental disorders rates were calculated per 1000 military. Significant differences between the two groups were determined using Pearson’s χ2 and the Student’s t-test.Results and Discussion. According to the study results, the military personnel from the main group had statistically significantly more mental disorders (p < 0.001), as follows: organic, including symptomatic mental disorders (F00–F09 according to ICD-10), neurotic, associated with stress, and somatoform disorders (F40-F48). At the time of dismissal from service, military personnel from the main group had higher rates of all mental disorders (p < 0.001), i.e. organic ones, including symptomatic mental disorders. During the period of service, the groups demonstrated a significant increase in organic, including symptomatic mental disorders, mental and behavioral disorders associated with the use of psychoactive substances (F10–F19), and a decrease in neurotic stress-related and somatoform disorders. In the main group of pensioners of the Ministry of Internal Affairs of Russia, this dynamics is more pronounced. Therefore, there are shortcomings in the treatment of mental disorders during the period of service in the Ministry of Internal Affairs of Russia.Conclusion. In order to improve the quality of psychiatric care for combatants from the Ministry of Internal Affairs of Russia, it is necessary to improve approaches to providing psychiatric care in the structure of departmental multidisciplinary healthcare institutions with amendments to the current procedure for therapy and medical and psychological rehabilitation when returning employees from combat zones.
{"title":"Dynamics of the formation of mental disorders in combatants from the Ministry of Internal Affairs of Russia","authors":"A. A. Rаssokha, E. Ichitovkina, M. Zlokazova, A. Soloviev","doi":"10.25016/2541-7487-2022-0-2-52-59","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-52-59","url":null,"abstract":"Relevance. Participation in hostilities is a stressful factor affecting the formation of mental disorders in combatants. According to scarce studies, combatants resigned from the security forces have some problems with mental health.Intention. Catamnestic analysis of mental disorders over time in combatants entitled to retirement pension upon their dismissal from the Internal Affairs bodies of Russia.Methodology. A catamnestic survey was conducted in 209 employees of the Ministry of Internal Affairs of Russia in the Kirov region who were retired from 2015 to 2019. Depending on participation in hostilities, the respondents were divided into two groups: main group, 106 retired combatants from the Ministry of Internal Affairs of Russia, and the comparison group, 103 retired persons without combat experience. Catamnestic, clinical and experimental psychological research methods were used. Statistical processing of the results was carried out using the STATISTICA 10.0. Mental disorders rates were calculated per 1000 military. Significant differences between the two groups were determined using Pearson’s χ2 and the Student’s t-test.Results and Discussion. According to the study results, the military personnel from the main group had statistically significantly more mental disorders (p < 0.001), as follows: organic, including symptomatic mental disorders (F00–F09 according to ICD-10), neurotic, associated with stress, and somatoform disorders (F40-F48). At the time of dismissal from service, military personnel from the main group had higher rates of all mental disorders (p < 0.001), i.e. organic ones, including symptomatic mental disorders. During the period of service, the groups demonstrated a significant increase in organic, including symptomatic mental disorders, mental and behavioral disorders associated with the use of psychoactive substances (F10–F19), and a decrease in neurotic stress-related and somatoform disorders. In the main group of pensioners of the Ministry of Internal Affairs of Russia, this dynamics is more pronounced. Therefore, there are shortcomings in the treatment of mental disorders during the period of service in the Ministry of Internal Affairs of Russia.Conclusion. In order to improve the quality of psychiatric care for combatants from the Ministry of Internal Affairs of Russia, it is necessary to improve approaches to providing psychiatric care in the structure of departmental multidisciplinary healthcare institutions with amendments to the current procedure for therapy and medical and psychological rehabilitation when returning employees from combat zones.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75019627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-107-117
N. Goryacheva, Sh. M. Gasanov, N. Bush
Relevance. The main victim of modern armed conflicts is the civilian population. The number of armed conflicts, their scale and severity of consequences steadily increase. The article analyzes the humanitarian consequences and problems of life support for the population of the Syrian Arab Republic during a long armed conflict on its territory. The main factors that led to the difficult humanitarian situation in the country and hindered the initiatives and decisions of political forces and international organizations to stabilize the situation in the country are considered in detail. The importance of political, humanitarian and diplomatic mechanisms in creating favorable conditions for the life support of the population, in accordance with the norms of international law, is confirmed. Particular attention is paid to the analysis of medical support for the population in combat zones in conditions of an acute shortage of medical forces and assets, food and water supplies in the context of full sanctions and a water blockade of the country.Intention: To analyze the main humanitarian consequences of the Syrian crisis and determine priority life support for the population.Methodology. Surveys and statistical analysis were used to assess priority life support of the population under a long-term blockade by terrorist groups on the territory of destroyed settlements. A traditional analysis of documents and literature on the research topic was carried out.Results and Discussion. As a result of the analysis, the main problems in different life support domains were identified. In addition, violations of international humanitarian laws were revealed in the context of an armed conflict (concerning protection of medical personnel, humane treatment of the civilian population, unhindered provision of humanitarian assistance). The role of international humanitarian organizations in solving life support problems has been studied.Conclusion. The material of the article can become an important basis for further study of the priority life support of the population in areas of protracted armed conflicts, taking into account minimum life support indicators necessary to maintain physiological needs, preserve life and maintain public health in an arid climate
{"title":"Humanitarian consequences of the Syrian crisis","authors":"N. Goryacheva, Sh. M. Gasanov, N. Bush","doi":"10.25016/2541-7487-2022-0-2-107-117","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-107-117","url":null,"abstract":"Relevance. The main victim of modern armed conflicts is the civilian population. The number of armed conflicts, their scale and severity of consequences steadily increase. The article analyzes the humanitarian consequences and problems of life support for the population of the Syrian Arab Republic during a long armed conflict on its territory. The main factors that led to the difficult humanitarian situation in the country and hindered the initiatives and decisions of political forces and international organizations to stabilize the situation in the country are considered in detail. The importance of political, humanitarian and diplomatic mechanisms in creating favorable conditions for the life support of the population, in accordance with the norms of international law, is confirmed. Particular attention is paid to the analysis of medical support for the population in combat zones in conditions of an acute shortage of medical forces and assets, food and water supplies in the context of full sanctions and a water blockade of the country.Intention: To analyze the main humanitarian consequences of the Syrian crisis and determine priority life support for the population.Methodology. Surveys and statistical analysis were used to assess priority life support of the population under a long-term blockade by terrorist groups on the territory of destroyed settlements. A traditional analysis of documents and literature on the research topic was carried out.Results and Discussion. As a result of the analysis, the main problems in different life support domains were identified. In addition, violations of international humanitarian laws were revealed in the context of an armed conflict (concerning protection of medical personnel, humane treatment of the civilian population, unhindered provision of humanitarian assistance). The role of international humanitarian organizations in solving life support problems has been studied.Conclusion. The material of the article can become an important basis for further study of the priority life support of the population in areas of protracted armed conflicts, taking into account minimum life support indicators necessary to maintain physiological needs, preserve life and maintain public health in an arid climate","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74593698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-93-99
D. Demin
Relevance. Cold exposure increases sympathetic activity and blood pressure. It can also promote intensification of hypertension symptoms and its progress in winter. However, the mechanisms of this phenomenon are poorly understood.Intention: To determine the dynamics of cardiovascular parameters in young people with different initial autonomic regulation of heart rate during experimental general cold exposure.Methodology. 30 healthy male volunteers aged 18–20 years were examined. In accordance with the initial type of autonomic regulation of the heart rate, all subjects were divided into 3 groups as follows: predominance of vagotonia (Group I, n = 9), optimal autonomic regulation – normotonia (Group II, n = 14), predominance of sympathicotonia (Group III, n = 7). The experiment included three stages: rest at a temperature (+20 0C); exposure to cold (–20 0C) for 10 minutes; warming the body (+20 0C). The heart rate variability (HRV) was recorded during each stage of the study using a portable complex “Varicard 2.8” (Russia). At the same time, blood pressure and temperature in the ear canal were recorded.Results and Discussion. Moderate short-term general air cooling causes generally the same type of temporary reactions of central hemodynamics (increase in blood pressure) and indicators of the total HRV power with an increase in parasympathetic activity. Baseline and dynamic values of heart rate and stress index in Group III were significantly higher than in Groups I and II. During body cooling, the stress index in individuals from Group III was 4 times lower, and in individuals from Group I was 1.5 times lower than before cooling. In Group I, baroreflex was less pronounced (slightly decreased heart rate and HRV) along with a significant increase in blood pressure, thus suggesting a high risk of cold-associated vessel injuries. In Groups II and III, a baroreflex was maintained (significant decrease in heart rate and SI) in response to an increase in blood pressure.Conclusion. Apparently, an increase in blood pressure during moderate exposure to cold does not disturb the protective mechanisms of the cardiovascular system in healthy residents of the North with normotonia and predomination of sympathicotonia. At the same time, a week baroreflex in Northerners with vagotonia can be considered at risk for developing cold arterial hypertension.
{"title":"Cardiovascular response to whole-body cold exposure in humans with different initial autonomic tone","authors":"D. Demin","doi":"10.25016/2541-7487-2022-0-2-93-99","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-93-99","url":null,"abstract":"Relevance. Cold exposure increases sympathetic activity and blood pressure. It can also promote intensification of hypertension symptoms and its progress in winter. However, the mechanisms of this phenomenon are poorly understood.Intention: To determine the dynamics of cardiovascular parameters in young people with different initial autonomic regulation of heart rate during experimental general cold exposure.Methodology. 30 healthy male volunteers aged 18–20 years were examined. In accordance with the initial type of autonomic regulation of the heart rate, all subjects were divided into 3 groups as follows: predominance of vagotonia (Group I, n = 9), optimal autonomic regulation – normotonia (Group II, n = 14), predominance of sympathicotonia (Group III, n = 7). The experiment included three stages: rest at a temperature (+20 0C); exposure to cold (–20 0C) for 10 minutes; warming the body (+20 0C). The heart rate variability (HRV) was recorded during each stage of the study using a portable complex “Varicard 2.8” (Russia). At the same time, blood pressure and temperature in the ear canal were recorded.Results and Discussion. Moderate short-term general air cooling causes generally the same type of temporary reactions of central hemodynamics (increase in blood pressure) and indicators of the total HRV power with an increase in parasympathetic activity. Baseline and dynamic values of heart rate and stress index in Group III were significantly higher than in Groups I and II. During body cooling, the stress index in individuals from Group III was 4 times lower, and in individuals from Group I was 1.5 times lower than before cooling. In Group I, baroreflex was less pronounced (slightly decreased heart rate and HRV) along with a significant increase in blood pressure, thus suggesting a high risk of cold-associated vessel injuries. In Groups II and III, a baroreflex was maintained (significant decrease in heart rate and SI) in response to an increase in blood pressure.Conclusion. Apparently, an increase in blood pressure during moderate exposure to cold does not disturb the protective mechanisms of the cardiovascular system in healthy residents of the North with normotonia and predomination of sympathicotonia. At the same time, a week baroreflex in Northerners with vagotonia can be considered at risk for developing cold arterial hypertension.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91069393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-29-41
A. Grebenyuk, P. V. Shibalov, L. Gritsay, V. G. Okudzhava
Relevance. The emergence of a large number of cases of a new coronavirus infection (COVID-19) required the formation of a new system of medical care and, above all, the creation of infectious hospitals for the treatment of patients with COVID-19.Intention. Analysis of the organization of the work of a temporary infectious diseases hospital for the treatment of COVID-19 in workers involved in the construction of the Amur Gas Processing Plant (AGPP). Methodology. The object of the study was a temporary infectious diseases hospital organized for the diagnosis and treatment of COVID-19 in workers mobilized for the construction of AGPP. During the study period from March 2020 to April 2022, the total number of employees participating in construction work daily at AGPP ranged from 17,759 to 39,437 people. Construction personnel worked on a rotational basis, the duration of the shift was from 2 to 6 months. Along with citizens of the Russian Federation, citizens of foreign countries from near and far abroad worked on the site. All shift workers lived in hostels on the territory of temporary construction camps, ate in common canteens. Development of the organizational and staff structure, completeness of medical equipment, medicines and property, evaluation of the effectiveness of the temporary infectious hospital performed using the methods of historical analysis and comparison, system and logical analysis, and expert evaluations. Results and Discussion. The results of a retrospective analysis of the measures for the construction and organization of the work of the temporary infectious disease hospital at the AGPP site presented. The hospital built based on a quickly erected building of block-modular type, passed sanitary-epidemiological examination and licensing in 45 days. The hospital has two departments with 44 beds each for the treatment of patients with COVID-19 (88 beds in total), an intensive care unit with 6 beds, two isolation wards with 2 beds each, a clinical and diagnostic laboratory that allows conducting studies by polymerase chain reaction (PCR) methods and immunofluorescence assay (ELISA), as well as the full range of general clinical laboratory tests, computed tomography unit, vaccination unit, medical gas supply station. The organizational and staffing structure and the number of medical personnel changed dynamically, depending on the epidemiological situation and the arising tasks of medical support of AGPP workers; at maximum staffing the hospital had 22 doctors, 1 pharmacist, 45 nurses, 30 paramedics and support personnel. From July 12, 2020 to April 10, 2022, inpatient treatment received 2622 people in the hospital’s infectious disease departments, and 198 people in the intensive care unit. Outpatient treatment provided to 4127 workers, of which 462 hospitalized for inpatient treatment and 3665 discharged to work upon recovery. There are 17,893 lung examinations including 12,582 primary and 5311 repeated (control) examinations per
{"title":"Organization of the activities of the infectious diseases hospital for the treatment of a new coronavirus infection (COVID-19) at a large construction site","authors":"A. Grebenyuk, P. V. Shibalov, L. Gritsay, V. G. Okudzhava","doi":"10.25016/2541-7487-2022-0-2-29-41","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-29-41","url":null,"abstract":"Relevance. The emergence of a large number of cases of a new coronavirus infection (COVID-19) required the formation of a new system of medical care and, above all, the creation of infectious hospitals for the treatment of patients with COVID-19.Intention. Analysis of the organization of the work of a temporary infectious diseases hospital for the treatment of COVID-19 in workers involved in the construction of the Amur Gas Processing Plant (AGPP). Methodology. The object of the study was a temporary infectious diseases hospital organized for the diagnosis and treatment of COVID-19 in workers mobilized for the construction of AGPP. During the study period from March 2020 to April 2022, the total number of employees participating in construction work daily at AGPP ranged from 17,759 to 39,437 people. Construction personnel worked on a rotational basis, the duration of the shift was from 2 to 6 months. Along with citizens of the Russian Federation, citizens of foreign countries from near and far abroad worked on the site. All shift workers lived in hostels on the territory of temporary construction camps, ate in common canteens. Development of the organizational and staff structure, completeness of medical equipment, medicines and property, evaluation of the effectiveness of the temporary infectious hospital performed using the methods of historical analysis and comparison, system and logical analysis, and expert evaluations. Results and Discussion. The results of a retrospective analysis of the measures for the construction and organization of the work of the temporary infectious disease hospital at the AGPP site presented. The hospital built based on a quickly erected building of block-modular type, passed sanitary-epidemiological examination and licensing in 45 days. The hospital has two departments with 44 beds each for the treatment of patients with COVID-19 (88 beds in total), an intensive care unit with 6 beds, two isolation wards with 2 beds each, a clinical and diagnostic laboratory that allows conducting studies by polymerase chain reaction (PCR) methods and immunofluorescence assay (ELISA), as well as the full range of general clinical laboratory tests, computed tomography unit, vaccination unit, medical gas supply station. The organizational and staffing structure and the number of medical personnel changed dynamically, depending on the epidemiological situation and the arising tasks of medical support of AGPP workers; at maximum staffing the hospital had 22 doctors, 1 pharmacist, 45 nurses, 30 paramedics and support personnel. From July 12, 2020 to April 10, 2022, inpatient treatment received 2622 people in the hospital’s infectious disease departments, and 198 people in the intensive care unit. Outpatient treatment provided to 4127 workers, of which 462 hospitalized for inpatient treatment and 3665 discharged to work upon recovery. There are 17,893 lung examinations including 12,582 primary and 5311 repeated (control) examinations per","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76671391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-22-28
A. Baranov
Relevance. Road traffic injuries are one of the leading non-natural causes of death in the world. The principles of organizing the provision of medical care to victims of road traffic accidents (RTA) should be adapted to the resource capabilities of regional health care systems, as well as the distribution of the resident population across the territory.Intention: To develop and substantiate the principles of a system for organizing the provision of medical care to RTA victims on federal highways in Russian regions with a low average population density.Methodology. The results of our own, domestic and foreign scientific research were reviewed, along with regulatory legal documents on the organization of medical care for RTA victims in various conditions. Articles published in 1990–2021 were selected for analysis. Information sources were searched for using specialized scientific search engines (eLibrary, PubMed, Scopus) with the keywords: “traffic accident”, “traffic injury”, “polytrauma”, “federal highway”, “injured”, “hospital period “. System analysis was used to determine the shortcomings of the existing system of providing medical care to victims of road accidents that occurred on federal highways in the territories of Russian subjects with a low population density. Organizational experiments were used to substantiate and develop measures, the implementation of which will improve the efficiency of providing first aid and medical care to victims of road accidents on federal highways in Russian regions with a low population density.Results and Discussion. A system for organizing the provision of medical care to victims of road accidents on federal highways in the regions of the Russian Federation with a low density of the population in the pre-hospital and hospital periods has been developed and justified; it consists of 4 principles and their organizational measures.Conclusion. The implementation of the model and the principles of the developed system proposed by the author will reduce negative health consequences associated with road traffic injuries on federal highways in Russian regions with low population density.
{"title":"The system of organizing the provision of medical care to victims in traffic accidents on federal highways in regions of Russia with low population density","authors":"A. Baranov","doi":"10.25016/2541-7487-2022-0-2-22-28","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-22-28","url":null,"abstract":"Relevance. Road traffic injuries are one of the leading non-natural causes of death in the world. The principles of organizing the provision of medical care to victims of road traffic accidents (RTA) should be adapted to the resource capabilities of regional health care systems, as well as the distribution of the resident population across the territory.Intention: To develop and substantiate the principles of a system for organizing the provision of medical care to RTA victims on federal highways in Russian regions with a low average population density.Methodology. The results of our own, domestic and foreign scientific research were reviewed, along with regulatory legal documents on the organization of medical care for RTA victims in various conditions. Articles published in 1990–2021 were selected for analysis. Information sources were searched for using specialized scientific search engines (eLibrary, PubMed, Scopus) with the keywords: “traffic accident”, “traffic injury”, “polytrauma”, “federal highway”, “injured”, “hospital period “. System analysis was used to determine the shortcomings of the existing system of providing medical care to victims of road accidents that occurred on federal highways in the territories of Russian subjects with a low population density. Organizational experiments were used to substantiate and develop measures, the implementation of which will improve the efficiency of providing first aid and medical care to victims of road accidents on federal highways in Russian regions with a low population density.Results and Discussion. A system for organizing the provision of medical care to victims of road accidents on federal highways in the regions of the Russian Federation with a low density of the population in the pre-hospital and hospital periods has been developed and justified; it consists of 4 principles and their organizational measures.Conclusion. The implementation of the model and the principles of the developed system proposed by the author will reduce negative health consequences associated with road traffic injuries on federal highways in Russian regions with low population density.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82713987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-82-92
S. G. Shapovalov, A. V. Kcheuso, T. E. Koshelev, D. K. Savchenkov
Relevance. Despite scientific and technological progress and improvement of treatment methods, providing assistance for thermal burns of the skin remains a complex multicomponent problem. Extensive deep burns are not capable of self-healing, and therefore, over the past century, autodermoplasty has become the standard method of treatment. However, the shortage of healthy tissues of the patient often does not allow the transplantation to be performed in full, which entails the need to search for options for replacing auto-tissues.Intention. To present modern possibilities and evaluate the problems of using bioengineered skin substitutes in kombustiology.Methodology. Scientific literary sources published in recent years were searched for using the PubMed database and the platform of Scientific Electronic Library (eLIBRARY.ru ).Results and Discussion. Currently, many skin substitutes have been developed, ranging from single-layer tissue equivalents to artificial leather and genetically modified substitutes. However, all of them are still far from perfect, they have their advantages and disadvantages, which determine the features of their application and necessitate further research.Conclusion. The development of tissue equivalents of the skin has significantly improved the results of treatment of victims with deep burns and is a promising direction in the development of modern combustiology.
{"title":"The possibilities of using bioengineered skin substitutes in combustiology (literature review)","authors":"S. G. Shapovalov, A. V. Kcheuso, T. E. Koshelev, D. K. Savchenkov","doi":"10.25016/2541-7487-2022-0-2-82-92","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-82-92","url":null,"abstract":"Relevance. Despite scientific and technological progress and improvement of treatment methods, providing assistance for thermal burns of the skin remains a complex multicomponent problem. Extensive deep burns are not capable of self-healing, and therefore, over the past century, autodermoplasty has become the standard method of treatment. However, the shortage of healthy tissues of the patient often does not allow the transplantation to be performed in full, which entails the need to search for options for replacing auto-tissues.Intention. To present modern possibilities and evaluate the problems of using bioengineered skin substitutes in kombustiology.Methodology. Scientific literary sources published in recent years were searched for using the PubMed database and the platform of Scientific Electronic Library (eLIBRARY.ru ).Results and Discussion. Currently, many skin substitutes have been developed, ranging from single-layer tissue equivalents to artificial leather and genetically modified substitutes. However, all of them are still far from perfect, they have their advantages and disadvantages, which determine the features of their application and necessitate further research.Conclusion. The development of tissue equivalents of the skin has significantly improved the results of treatment of victims with deep burns and is a promising direction in the development of modern combustiology.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72904380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-60-71
V. Shamrey, A. Marchenko, V. Yusupov, Yu. L. Starenchenko, E. A. Chernyavsky
Relevance. The problem of improving the military personnel psychological and psychiatric care in combat conditions is due to high levels of psychogenic losses, sometimes up to 80 % of the combatants. At the same time, insufficient theoretical development of the problem of reactive states in the combat situation, unclear definitions and boundaries, pronounced differences in terminology, classification and methodological approaches used by different specialists significantly impede specialized care.Intention. Based on the analysis of current conception about combat related stress-induced mental disorders in military personnel, to develop proposals for organizing a staged system for providing psychological and psychiatric care from the standpoint of modern military medical doctrine.Methodology. Approaches to systematization of stress-induced disorders and the related system of psychological and psychiatric care organization were analyzed using a heuristic method. Results and Discussion. Based on the analysis of taxonomic and severity characteristics of stress-induced disorders, 2 subgroups were identified – short-term and prolonged ones, as well as 4 organizational categories (levels) in accordance with the type of required care: psychological, preclinical, borderline (neurotic) and psychotic. It is proposed to consider the first category as not requiring medical and psychological care, the second - as related to short-term casualties (psychogenic losses), the third - mainly to psychiatric sanitary casualties, and the fourth, mainly to irrecoverable casualties. The content of psychological and psychiatric care at the stages of medical evacuation in relation to the selected categories of the casualties is revealed. An idea is given about psychological and psychiatric intelligence, probable factors that need to be taken into account in prediction of psychogenic losses, and an example of such a calculation is given.Conclusion. It is stated that the existing approaches to psychogenic losses prediction do not take into account organizational and staffing changes in the troops and modern forms and methods of armed confrontation. The necessity of developing objective methods for predicting individual resistance to combat negative factors, remote monitoring of the military personnel mental health, as well as improving methods of treatment and prompt correction of stress-induced disorders, including those based on a mobile psychoprophylactic platform, is postulated.
{"title":"Characteristic features of psychological and psychiatric care for military personnel in modern armed conflicts","authors":"V. Shamrey, A. Marchenko, V. Yusupov, Yu. L. Starenchenko, E. A. Chernyavsky","doi":"10.25016/2541-7487-2022-0-2-60-71","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-60-71","url":null,"abstract":"Relevance. The problem of improving the military personnel psychological and psychiatric care in combat conditions is due to high levels of psychogenic losses, sometimes up to 80 % of the combatants. At the same time, insufficient theoretical development of the problem of reactive states in the combat situation, unclear definitions and boundaries, pronounced differences in terminology, classification and methodological approaches used by different specialists significantly impede specialized care.Intention. Based on the analysis of current conception about combat related stress-induced mental disorders in military personnel, to develop proposals for organizing a staged system for providing psychological and psychiatric care from the standpoint of modern military medical doctrine.Methodology. Approaches to systematization of stress-induced disorders and the related system of psychological and psychiatric care organization were analyzed using a heuristic method. Results and Discussion. Based on the analysis of taxonomic and severity characteristics of stress-induced disorders, 2 subgroups were identified – short-term and prolonged ones, as well as 4 organizational categories (levels) in accordance with the type of required care: psychological, preclinical, borderline (neurotic) and psychotic. It is proposed to consider the first category as not requiring medical and psychological care, the second - as related to short-term casualties (psychogenic losses), the third - mainly to psychiatric sanitary casualties, and the fourth, mainly to irrecoverable casualties. The content of psychological and psychiatric care at the stages of medical evacuation in relation to the selected categories of the casualties is revealed. An idea is given about psychological and psychiatric intelligence, probable factors that need to be taken into account in prediction of psychogenic losses, and an example of such a calculation is given.Conclusion. It is stated that the existing approaches to psychogenic losses prediction do not take into account organizational and staffing changes in the troops and modern forms and methods of armed confrontation. The necessity of developing objective methods for predicting individual resistance to combat negative factors, remote monitoring of the military personnel mental health, as well as improving methods of treatment and prompt correction of stress-induced disorders, including those based on a mobile psychoprophylactic platform, is postulated.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87935625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-100-106
Y. V. Yurova, V. Ilina, E. V. Zinovev, R. V. Vashetko
Relevance. The problem of the development of pathological scar tissue in combustiology is still relevant. It is necessary to determine a pathogenetically sound approach to the treatment of a burn wound that reduces the likelihood of the development of pathological scar tissue.Intention: To study the histological structure of the tissues from which skin scars are formed, to develop a diagnostic algorithm for predicting the development of pathological scars.Methodology. Tissue biopsies taken intraoperatively in the center and along the periphery of burn wounds before free autodermoplasty (FADP) were examined in 56 patients with burn injuries. In the selection zone, microcirculation parameters were determined by laser Doppler flowmetry (LDF) at the stage of treatment of burn wounds and during the formation of scar tissue. Clinical observation of patients was carried out for a year. Relationships between histology of tissues from which the scar would subsequently form, their perfusion indices before FADP and types of scar tissue were assessed over a year.Results and Discussion. It was revealed that pathological scar tissue develops from granulation tissue and fibrous-altered dermis. The possibility of predicting the formation of the type of scar tissue by determining perfusion (M) is shown: above 10 perfusion units (PE), pathological scar tissue arises from granulation tissue; less than 4 PE, a high risk of developing pathological scar tissue from fibrous-altered dermis. With perfusion (4≤M≤10) in the zone of burn defects, the dermis, elements of subcutaneous fat, fibrous layer of granulation tissue are histologically determined, and the risk of developing pathological scar tissue is minimal.Conclusion. Taking into account the revealed patterns, principles for predicting the formation of pathological scar tissue were justified based on perfusion parameters in various parts of the burn wound and histology at the early stages of treatment. Based on the results, an algorithm for diagnosing various types of scar tissue has been developed
{"title":"Diagnostic algorithm for determining the risk of developing pathological types of scar tissue in patients with burn injury","authors":"Y. V. Yurova, V. Ilina, E. V. Zinovev, R. V. Vashetko","doi":"10.25016/2541-7487-2022-0-2-100-106","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-100-106","url":null,"abstract":"Relevance. The problem of the development of pathological scar tissue in combustiology is still relevant. It is necessary to determine a pathogenetically sound approach to the treatment of a burn wound that reduces the likelihood of the development of pathological scar tissue.Intention: To study the histological structure of the tissues from which skin scars are formed, to develop a diagnostic algorithm for predicting the development of pathological scars.Methodology. Tissue biopsies taken intraoperatively in the center and along the periphery of burn wounds before free autodermoplasty (FADP) were examined in 56 patients with burn injuries. In the selection zone, microcirculation parameters were determined by laser Doppler flowmetry (LDF) at the stage of treatment of burn wounds and during the formation of scar tissue. Clinical observation of patients was carried out for a year. Relationships between histology of tissues from which the scar would subsequently form, their perfusion indices before FADP and types of scar tissue were assessed over a year.Results and Discussion. It was revealed that pathological scar tissue develops from granulation tissue and fibrous-altered dermis. The possibility of predicting the formation of the type of scar tissue by determining perfusion (M) is shown: above 10 perfusion units (PE), pathological scar tissue arises from granulation tissue; less than 4 PE, a high risk of developing pathological scar tissue from fibrous-altered dermis. With perfusion (4≤M≤10) in the zone of burn defects, the dermis, elements of subcutaneous fat, fibrous layer of granulation tissue are histologically determined, and the risk of developing pathological scar tissue is minimal.Conclusion. Taking into account the revealed patterns, principles for predicting the formation of pathological scar tissue were justified based on perfusion parameters in various parts of the burn wound and histology at the early stages of treatment. Based on the results, an algorithm for diagnosing various types of scar tissue has been developed","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80825154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-08-03DOI: 10.25016/2541-7487-2022-0-2-42-51
S. A. Gumenyuk, S. Aleksanin, A. M. Schikota, V. Yarema, I. Pogonchenkova
Relevance. The use of ultrasound diagnostics at the place of providing medical care to an urgent patient is one of the promising directions in the development of emergency medicine. At the same time, of particular interest is the possibility of using diagnostic ultrasound in an ambulance helicopter, given the lack of clear algorithms and standards for its application, as well as the limited number of publications on this problem.Intention. Analysis of publications on the use of urgent ultrasound examination in an ambulance helicopter.Methodology. A search was made for scientific publications on the topic on the electronic resource PubMed, in the Google Scholar search system for the period from 2000 to 2021.Results and discussion. The main algorithms used for ultrasound diagnostics of an urgent patient in an ambulance helicopter are Focused Assessment with Sonography for Trauma (FAST), point-of-care ultrasound (POCUS), Rapid Ultrasound in SHock (RUSH), Bedside Lung Ultrasound in Emergency (BLUЕ), prehospital ultrasonography (PHUS), etc. They help exclude damage to vital organs and emergency pathology – pneumo- and hemothorax, hemoperitoneum, hemopericardium, large fractures and others that affect the tactics of treatment and patient routing; there is also the possibility of ultrasound navigation for a number of medical and diagnostic procedures. According to the results of published studies and clinical observations, prehospital ultrasound examination of urgent patients is successfully used during medical evacuation by an ambulance helicopter in emergency medical services in many countries of the world (both by doctors and other medical personnel), making it possible to diagnose a number of lifethreatening conditions with a fairly high accuracy, without loss of time and without damage to patient’s health. An important aspect of the successful application of the method during flight is the training of qualified personnel. The prospects for the development of the method are the development of more advanced ultrasound scanners and sensors adapted to flight conditions, as well as the use of telemedicine technologies for remote analysis of ultrasound images.Conclusion. The experience of using prehospital diagnostic ultrasound in an ambulance helicopter requires further data accumulation and systematic analysis, but the method is already undoubtedly useful in determining the tactics of treatment and the route of hospitalization of urgent patients with acute trauma and a number of other pathological conditions.
{"title":"Diagnostic ultrasound examinations during evacuation of urgent patients by ambulance helicopters: literature review","authors":"S. A. Gumenyuk, S. Aleksanin, A. M. Schikota, V. Yarema, I. Pogonchenkova","doi":"10.25016/2541-7487-2022-0-2-42-51","DOIUrl":"https://doi.org/10.25016/2541-7487-2022-0-2-42-51","url":null,"abstract":"Relevance. The use of ultrasound diagnostics at the place of providing medical care to an urgent patient is one of the promising directions in the development of emergency medicine. At the same time, of particular interest is the possibility of using diagnostic ultrasound in an ambulance helicopter, given the lack of clear algorithms and standards for its application, as well as the limited number of publications on this problem.Intention. Analysis of publications on the use of urgent ultrasound examination in an ambulance helicopter.Methodology. A search was made for scientific publications on the topic on the electronic resource PubMed, in the Google Scholar search system for the period from 2000 to 2021.Results and discussion. The main algorithms used for ultrasound diagnostics of an urgent patient in an ambulance helicopter are Focused Assessment with Sonography for Trauma (FAST), point-of-care ultrasound (POCUS), Rapid Ultrasound in SHock (RUSH), Bedside Lung Ultrasound in Emergency (BLUЕ), prehospital ultrasonography (PHUS), etc. They help exclude damage to vital organs and emergency pathology – pneumo- and hemothorax, hemoperitoneum, hemopericardium, large fractures and others that affect the tactics of treatment and patient routing; there is also the possibility of ultrasound navigation for a number of medical and diagnostic procedures. According to the results of published studies and clinical observations, prehospital ultrasound examination of urgent patients is successfully used during medical evacuation by an ambulance helicopter in emergency medical services in many countries of the world (both by doctors and other medical personnel), making it possible to diagnose a number of lifethreatening conditions with a fairly high accuracy, without loss of time and without damage to patient’s health. An important aspect of the successful application of the method during flight is the training of qualified personnel. The prospects for the development of the method are the development of more advanced ultrasound scanners and sensors adapted to flight conditions, as well as the use of telemedicine technologies for remote analysis of ultrasound images.Conclusion. The experience of using prehospital diagnostic ultrasound in an ambulance helicopter requires further data accumulation and systematic analysis, but the method is already undoubtedly useful in determining the tactics of treatment and the route of hospitalization of urgent patients with acute trauma and a number of other pathological conditions.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84372764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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