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Interaction of aviation medical teams with ambulance, emergency medical care teams and hospitals in the management of mechanically ventilated patients 航空医疗队与救护车、急救医疗队和医院在管理机械通气病人方面的互动
Q3 Health Professions Pub Date : 2021-06-02 DOI: 10.25016/2541-7487-2021-0-2-27-35
S. A. Gumenyuk, G. V. Sheptunov, V. I. Potapov
Relevance. Acute respiratory failure (ARF) and acute cardiopulmonary failure (ACPF) are unavoidable, and often – the leading syndromes in any critical condition, especially in case of multiple organ failure syndrome as a regular stage in the course of previously incurable conditions. Even a full range of intensive care measures in this category of patients does not always give the desired result. According to various authors, with the development of acute respiratory distress syndrome, the mortality rate reaches 80 %.Intention is to determine the role of the aviation medical teams of the emergency medical service-disaster medicine in ensuring the timely availability of high-tech methods for patients who need them, regardless of the patient’s location.Methodology. Activities of the aviation medical teams of the Scientific and Practical Center for Emergency Medical Care of the Moscow City Health Department for the medical evacuation of patients and victims in emergency situations with ARF and ACPF were analyzed.Results and Discussion. There were analyzed interactions of aviation medical teams with the emergency medical response units of the territorial center for disaster medicine and with medical organizations during the medical evacuation of patients with ARF and ACPF. An algorithm and a scheme of interaction between air medical teams are proposed to optimize medical evacuation of these patients.Conclusion. An analysis of the activities of air medical teams revealed their advantages in providing care for patients with ARF and ACPF.
的相关性。急性呼吸衰竭(ARF)和急性心肺衰竭(ACPF)是不可避免的,并且往往是任何危重情况下的主要综合征,特别是在多器官衰竭综合征作为先前无法治愈的疾病过程中的常规阶段时。即使对这类患者采取全套重症监护措施,也不一定能达到预期的效果。根据不同作者的说法,随着急性呼吸窘迫综合征的发展,死亡率达到80%。目的是确定紧急医疗服务-灾害医学航空医疗队的作用,以确保无论患者身在何处,都能及时为需要的患者提供高科技方法。分析了莫斯科市卫生局紧急医疗科学与实践中心航空医疗队在紧急情况下与ARF和ACPF一起对病人和受害者进行医疗后送的活动。结果和讨论。分析了航空医疗队在对ARF和ACPF患者进行医疗后送期间与领土灾害医学中心紧急医疗反应单位以及与医疗组织的相互作用。提出了一种优化空中医疗队医疗后送的算法和方案。对空中医疗队活动的分析显示,它们在为ARF和ACPF患者提供护理方面具有优势。
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引用次数: 0
Bone transport over the nail vs Ilizarov method in the treatment of posttraumatic defects of the femur and tibia 甲上骨运输与Ilizarov法治疗创伤后股骨和胫骨缺损的比较
Q3 Health Professions Pub Date : 2021-06-02 DOI: 10.25016/2541-7487-2021-0-2-80-88
E. Shchepkina, N. L. Solomin, K. L. Korchagin, F. Sabirov
Relevance. From the point of view of using the advantages of both external fixation and internal osteosynthesis, the method “Bone transport over the nail” (BTON) deserves attention.Intention: To compare the effectiveness of the BTON and Ilizarov method in the treatment of patients with post-traumatic defects of the long bones of the lower extremities.Methodology. We analyzed 24 BTON cases and 47 cases of defects replacement via the Ilizarov method. The analysis included patients with segmental defects of the tibia, femur and knee joint bone defects complicated by chronic osteomyelitis.Results and Discussion. The external fixation period in BTON group was 3 times less than in the comparison group, as was the external fixation index. In case of monolocal defect replacement, the external fixation period and external fixation index in the BTON group was 4 times less than in the Ilizarov defect replacement group. With bifocal replacement of the defect, the external fixation period was 2.5 times less, and the external fixation index was 2 times less. BTON interventions were associated with complications in 31 cases (129.2 %) vs 82 cases for the Ilizarov method (174.5 %). The most pronounced decrease (3 times) was noted for cases of transosseous elements inflammation.Conclusion. The “Bone transport over the nail” technique reduces the external fixation period by an average of 3 times. This facilitates management of the outpatient phase and reduces the number of complications, especially the pin-tract infection. Cable technique combined with an orthopedic hexapod allows bifocal replacement of extended defects of the distal femur and knee joint applying the apparatus only to the lower leg. Risks of jamming the transported bone fragments by the intramedullary nail are thus excluded. To avoid breaking the traction cable, only designated devices should be used.
的相关性。从利用外固定和内固定的优点来看,“甲上骨运输”(Bone transport over the nail, BTON)方法值得关注。目的:比较BTON与Ilizarov法治疗创伤后下肢长骨缺损的疗效。我们分析了24例BTON和47例Ilizarov法缺损置换。分析包括胫骨、股骨和膝关节骨缺损合并慢性骨髓炎的患者。结果和讨论。BTON组外固定时间比对照组短3倍,外固定指标比对照组短3倍。在单局部缺损置换术中,BTON组外固定时间和外固定指数比Ilizarov缺损置换术组短4倍。双焦点置换缺损后,外固定时间缩短2.5倍,外固定指数减少2倍。BTON干预有31例(129.2%)与Ilizarov方法的82例(174.5%)相关。经骨因子炎症的发生率明显下降,为3倍。“经甲骨转运”技术可将外固定时间平均缩短3倍。这有利于门诊阶段的管理,减少并发症的数量,特别是针道感染。电缆技术与矫形六足架相结合,允许双焦点替代股骨远端和膝关节的扩展缺陷,只需将器械应用于小腿。因此排除了髓内钉堵塞运送骨碎片的风险。为避免拉断牵引电缆,只能使用指定的装置。
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引用次数: 0
Comparison of indicators of injuries in military personnel serving on conscription in the Armed Forces of Russia and the Republic of Belarus (2003–2020) 2003-2020年俄罗斯和白俄罗斯共和国武装部队服兵役军人受伤指标比较
Q3 Health Professions Pub Date : 2021-06-01 DOI: 10.25016/2541-7487-2021-0-2-36-51
V. Evdokimov, D. A. Chernov, P. P. Sivashchenko, A. A. Vetoshkin
Relevance. Injury indicators in military personnel reflect injuries and their consequences that occur in a certain period, as a rule, over a year. Injury indicators in the Armed Forces (AF) are important for assessing occupational safety.Intention: To compare injury indicators in military conscripts between the Russian Armed Forces and the Republic of Belarus for 18 years from 2003 to 2020.Methodology. We carried out a selective statistical analysis of medical reports on the health status of personnel and the activities of the medical service according to 3/MED form in military units where at least 80 % of the total number of conscripts of the Armed Forces of Russia and Belarus served. Groups (blocks) of injuries in Chapter XIX “Injuries, poisoning and certain other consequences of exposure to external causes” were agreed with the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). Injury data were calculated per 1000 military personnel or ‰, mortality rates – per 100 000 military personnel.Results and their Discussion. In the Russian Armed Forces compared to the Belarusian Armed Forces, the average annual injury rates (primary morbidity) of conscripts were (15.91 ± 1.65) ‰ vs (20.23 ± 1.96) ‰, hospitalizations with injuries (14.16 ± 1.29 ) vs (14.50 ± 0.96) ‰, work days lost (303.4 ± 27.0) vs (303.4 ± 27.0) ‰, dismissal due to injuries (0.552 ± 0.066) vs (0.551 ± 0.051) ‰, injury-related mortality (21.96 ± 4.26) vs (24.18 ± 4.29) per 100 000, respectively. As a rule, polynomial trends with high determination coefficients showed a decrease in the levels of injury, hospitalization, work days lost and mortality. Dismissal trends showed decrease in the Russian Armed Forces and increase in the Belarusian Armed Forces. The conscripts of the Armed Forces of Russia and Belarus have a positive statistically significant congruence in indicators of injuries, hospitalizations, work days lost and mortality, which may indicate the influence of the same (unidirectional) factors in the formation of annual indicators. Injuries of the head (Group 1, Chapter XIX by ICD-10), shoulder girdle and upper limbs (Groups 5–7), the area of the hip joint and lower extremities (Groups 8–10), injuries, affecting several areas of the body (Group 11), and the consequences of injuries, poisoning and other external causes (Group 22) are of high military-epidemiological significance for conscripts in the Russian Armed Forces and the Belarusian Armed Forces. These injuries accounted for 78.7 % and 82.8 % of the generalized estimate in the Russian Armed Forces and the Armed Forces of Belarus, respectively.Conclusion. Taking into account the indicators of injuries will allow the medical service to optimize the calculation of forces and assets for treatment and rehabilitation of servicemen with injuries. Injuries are not only a medical problem; it is necessary to involve more extensively military professionals from various services
的相关性。军事人员的受伤指标反映了在某一时期(通常是一年以上)发生的受伤及其后果。武装部队(AF)的伤害指标对于评估职业安全非常重要。目的:比较2003年至2020年18年间俄罗斯武装部队和白俄罗斯共和国应征入伍者的受伤指标。根据3/MED表格,我们对俄罗斯和白俄罗斯武装部队至少80%的应征军人服役的军事单位的人员健康状况和医疗服务活动的医疗报告进行了选择性统计分析。第十九章"伤害、中毒和接触外因的某些其他后果"中的伤害分组(组)符合《疾病和有关健康问题国际统计分类》第十次修订版(ICD-10)。伤情数据按每1000名军事人员或‰(死亡率-每10万名军事人员)计算。结果及其讨论。俄罗斯武装力量的白俄罗斯军队相比,平均受伤率(主要发病率)应征入伍的(15.91±1.65)‰vs(20.23±1.96)‰,住院治疗和伤害(14.16±1.29)和(14.50±0.96)‰,工作日损失(303.4±27.0)和(303.4±27.0)‰,解雇由于伤病(0.552±0.066)和(0.551±0.051)‰,与伤害有关的死亡率(21.96±4.26)和(24.18±4.29)每100人000人,分别。通常,具有高决定系数的多项式趋势表明,受伤、住院、工作日损失和死亡率水平均有所下降。解雇趋势显示俄罗斯武装部队减少,白俄罗斯武装部队增加。俄罗斯和白俄罗斯武装部队的应征入伍者在受伤、住院、工作日损失和死亡率指标方面具有统计学上显著的正一致性,这可能表明相同(单向)因素对年度指标的形成产生了影响。头部损伤(ICD-10第十九章第1组)、肩带和上肢损伤(第5-7组)、髋关节和下肢损伤(第8-10组)、影响身体多个部位的损伤(第11组)以及损伤、中毒和其他外因的后果(第22组)对俄罗斯武装部队和白俄罗斯武装部队的应征入伍者具有很高的军事流行病学意义。这些伤害分别占俄罗斯武装部队和白俄罗斯武装部队总体估计的78.7%和82.8%。考虑到受伤指标将使医务处能够优化伤兵治疗和康复所需部队和资产的计算。受伤不仅仅是一个医学问题;有必要更广泛地让各军种的军事专业人员参与进来,分析伤害的因果关系,并制定预防措施。
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引用次数: 1
On the expediency to organize monitoring of the medical and sanitary consequences of road traffic accidents 便利组织对道路交通事故医疗卫生后果的监测
Q3 Health Professions Pub Date : 2021-04-02 DOI: 10.25016/2541-7487-2021-0-1-31-39
S. F. Goncharov, A. Baranov, E. Mordovsky
Relevance. Road traffic accidents are a source of significant medical, demographic, social and economic losses. To reduce the volume of medical and sanitary consequences of road accidents, to achieve the targets of the national project “Safe and High-Quality Roads”, it is necessary to further improve the technologies for providing medical care to victims of road accidents at all stages, including their adaptation to the regional characteristics of road traffic traumatism, and the mechanism of interaction between medical organizations performing the functions of trauma centers. This task can be solved provided that a system of information exchange between trauma centers is created, as well as the organization of monitoring of health consequences in road accidents on its basis. To accumulate and analyze information, a polynosological register, a type of distributed database, is to be used.Intention – to substantiate the expediency to organize monitoring of the health consequences of road traffic accidents.Methodology. Regulatory documents were reviewed as well as results of Russian and foreign scientific research of organizational approaches to the provision of specialized medical care to victims of road accidents at the hospital stage, and also algorithms of introducing information technologies into the activities of medical organizations. The search for sources was performed in specialized scientific search systems (eLibrary, National Library of Medicine – PubMed, Scopus etc.).Results and Discussion. The organization of monitoring of the medical and social consequences of road traffic accidents at the level of the territories of the Russian Federation has been substantiated (including its purpose, tasks, coordinators and implementers). The directions of using the monitoring results were determined.Conclusion. Monitoring of medical and social consequences of road traffic accidents will provide a reliable assessment of their scope in the regions of the country. Besides, health authorities will get reliable information to develop effective measures for reducing medical, demographic, social and economic losses associated with road traffic accidents.
的相关性。道路交通事故是造成重大医疗、人口、社会和经济损失的一个原因。为了减少道路交通事故的医疗和卫生后果,实现国家“安全优质道路”项目的目标,有必要进一步改进向道路交通事故受害者提供各阶段医疗服务的技术,包括适应道路交通创伤的区域特点的技术,以及履行创伤中心职能的医疗机构之间的相互作用机制。只要在创伤中心之间建立一个信息交换系统,并在此基础上组织监测道路事故对健康的影响,就可以解决这项任务。为了积累和分析信息,将使用一种多病登记册,一种分布式数据库。意图-证实组织监测道路交通事故对健康影响的便利。方法。审查了规范性文件以及俄罗斯和外国关于在医院阶段向道路事故受害者提供专门医疗护理的组织方法的科学研究结果,以及将信息技术引入医疗组织活动的算法。在专门的科学搜索系统(图书馆,国家医学图书馆- PubMed, Scopus等)中搜索来源。结果和讨论。在俄罗斯联邦领土一级组织对道路交通事故的医疗和社会后果的监测(包括其目的、任务、协调员和执行者)已经得到证实。确定了监测结果的使用方向。监测道路交通事故的医疗和社会后果将可靠地评估其在该国各区域的影响范围。此外,卫生当局将获得可靠的信息,以制定有效措施,减少与道路交通事故有关的医疗、人口、社会和经济损失。
{"title":"On the expediency to organize monitoring of the medical and sanitary consequences of road traffic accidents","authors":"S. F. Goncharov, A. Baranov, E. Mordovsky","doi":"10.25016/2541-7487-2021-0-1-31-39","DOIUrl":"https://doi.org/10.25016/2541-7487-2021-0-1-31-39","url":null,"abstract":"Relevance. Road traffic accidents are a source of significant medical, demographic, social and economic losses. To reduce the volume of medical and sanitary consequences of road accidents, to achieve the targets of the national project “Safe and High-Quality Roads”, it is necessary to further improve the technologies for providing medical care to victims of road accidents at all stages, including their adaptation to the regional characteristics of road traffic traumatism, and the mechanism of interaction between medical organizations performing the functions of trauma centers. This task can be solved provided that a system of information exchange between trauma centers is created, as well as the organization of monitoring of health consequences in road accidents on its basis. To accumulate and analyze information, a polynosological register, a type of distributed database, is to be used.Intention – to substantiate the expediency to organize monitoring of the health consequences of road traffic accidents.Methodology. Regulatory documents were reviewed as well as results of Russian and foreign scientific research of organizational approaches to the provision of specialized medical care to victims of road accidents at the hospital stage, and also algorithms of introducing information technologies into the activities of medical organizations. The search for sources was performed in specialized scientific search systems (eLibrary, National Library of Medicine – PubMed, Scopus etc.).Results and Discussion. The organization of monitoring of the medical and social consequences of road traffic accidents at the level of the territories of the Russian Federation has been substantiated (including its purpose, tasks, coordinators and implementers). The directions of using the monitoring results were determined.Conclusion. Monitoring of medical and social consequences of road traffic accidents will provide a reliable assessment of their scope in the regions of the country. Besides, health authorities will get reliable information to develop effective measures for reducing medical, demographic, social and economic losses associated with road traffic accidents.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81160551","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}
引用次数: 0
Methodical approach to determining permissible time limits of intermittent carbon monoxide exposure in rescuers 确定救援人员间歇性一氧化碳暴露允许时限的方法
Q3 Health Professions Pub Date : 2021-04-02 DOI: 10.25016/2541-7487-2021-0-1-82-88
D. V. Myasnikov, P. Avitisov, A. Zolotukhin, M. Barinov
Relevance. Current operation time limits under hazardous chemical conditions (“emergency regulations”) have been developed mainly for a limited number of emergency situations occurring in spacecraft, submarines or other specific objects. At the same time, many emergencies accompanied by large-scale releases of toxic combustion products from various materials and compounds into the environment are not limited to these facilities. Therefore, risks associated with toxic effects of chemicals should be predicted, since permissible time limits with adequate performance of personnel under certain chemical exposures are used for individual protection (time-based protection).Intention: On the basis of physiological aspects, the peculiarities of the work performed by rescuers and the requirements for organizing and conducting emergency rescue operations, to propose a methodical approach to determining the permissible time for rescuers in conditions of intermittent carbon monoxide release.Methodology. The scientific works and results of experiments in the research area were analyzed. Systematization and generalization of empirical and theoretical data, traditional analysis of documents and publications were used with the least squares approximation.Results and Discussion. Specific effects of various carbon monoxide concentrations are shown for different exposure times. Critical concentrations and exposure times are revealed, functional relationships between permissible time of operation and carbon monoxide concentrations are determined. Carboxyhemoglobin formation and effects were taken into account.Conclusion. The data given in the article are an important basis for organizing and conducting emergency rescue operations at increased concentrations of carbon monoxide.
的相关性。目前在危险化学品条件下的作业时间限制("紧急条例")主要是针对在航天器、潜艇或其他特定物体上发生的有限数量的紧急情况制定的。与此同时,许多伴随着各种材料和化合物的有毒燃烧产物大规模释放到环境中的紧急情况并不局限于这些设施。因此,应预测与化学品毒性作用有关的风险,因为在某些化学品接触下,人员的适当工作能力所允许的时间限制被用于个人保护(基于时间的保护)。目的:从生理学、救援人员工作特点和组织实施应急救援的要求出发,提出一种确定间歇性一氧化碳释放条件下救援人员允许时间的方法。对研究区的科学工作和实验结果进行了分析。将经验和理论数据系统化和一般化,使用最小二乘近似对文献和出版物进行传统分析。结果和讨论。不同一氧化碳浓度对不同暴露时间的特殊影响。揭示了临界浓度和暴露时间,确定了允许操作时间和一氧化碳浓度之间的函数关系。考虑了碳氧血红蛋白的形成及其影响。文中给出的数据是在一氧化碳浓度增加的情况下组织和进行紧急救援行动的重要依据。
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引用次数: 1
Application of time to emesis data for primary triage of radiation accident victims 时间对呕吐数据在辐射事故受害者初步分诊中的应用
Q3 Health Professions Pub Date : 2021-04-02 DOI: 10.25016/2541-7487-2021-0-1-14-21
V. Soloviev, A. Samoilov, A. O. Lebedev, M. Sedankin, E. Gudkov
Relevance. The relevance of the study is due to the risk of developing large-scale radiation accidents with a large number of victims, who will need primary medical triage and early prediction of the severity of injury for correct routing from the source of sanitary losses.Intention. Validation of the method of estimating dose by time-to-emesis under various exposure conditions for pre-hospital triage of victims.Methodology. The object of the study is the data from State Research Center – Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency (Moscow) database of acute radiation injuries.Results and Discussion: We have analyzed individual data for the victims of the 1986 Chernobyl disaster (114 persons) with a separate analysis of the irradiation conditions (short-term exposure for less than 20 minutes and prolonged exposure in selected groups), as well as the data from victims of other radiation accidents in the former USSR (26 persons) and 8 patients with total body radiotherapy without the use of antiemetics. It was shown that for the equal time-to-emesis intervals, predicted radiation injury is more severe in case of prolonged exposure vs short-term exposure. This may be due to varying rate of dose accumulation and so-called “unnecessary dose” effect – when the biological mechanism of vomiting has already been triggered against ongoing exposure. Results are presented as interval estimates of radiation injury severity by time-to-emesis for both short-term and prolonged exposures. We also have formulated two criteria for primary triage purposes in case of moderate or large numbers of victims due to large-scale radiation accidents.Conclusion. Recommendations for pre-hospital triage of victims are proposed.
的相关性。这项研究的相关性是由于发生大规模辐射事故的风险,受害者人数众多,他们将需要初级医疗分类和早期损伤严重程度的预测,以便从卫生损失的源头正确定位。在各种暴露条件下根据呕吐时间估计剂量的方法在院前病人分诊中的验证。方法学。本研究的对象是国家研究中心-联邦医学生物机构(莫斯科)Burnasyan联邦医学生物物理中心急性辐射损伤数据库的数据。结果和讨论:我们分析了1986年切尔诺贝利灾难受害者(114人)的个人数据,并单独分析了辐照条件(少于20分钟的短期照射和选定群体的长时间照射),以及前苏联其他辐射事故受害者(26人)和8名不使用抗吐剂的全身放疗患者的数据。结果表明,在相同的呕吐时间间隔下,预测的辐射损伤在长时间照射下比在短时间照射下更严重。这可能是由于不同的剂量积累率和所谓的“不必要剂量”效应——当呕吐的生物学机制已经被持续暴露所触发时。结果呈现为间隔估计辐射损伤严重程度的时间呕吐为短期和长期暴露。我们亦制订了两项准则,以供在大规模辐射事故中伤亡人数适中或较多的情况下进行主要分类。提出了对受害者进行院前分诊的建议。
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引用次数: 1
Disease-related stress coping and quality of life in patients with surgically treated spinal tumors 手术治疗脊柱肿瘤患者的疾病相关压力应对和生活质量
Q3 Health Professions Pub Date : 2021-04-02 DOI: 10.25016/2541-7487-2021-0-1-97-106
O. Shchelkova, G. Isurina, E. Usmanova, M. Iakovleva, A. Valiev, A. Kulaga
Relevance. The relevance is determined by the need to study quality of life over time in patients with spinal tumors during surgical treatment, as well as to study relationships between quality of life and psychological characteristics, including those responsible for adaptation to a disease, i.e. coping mechanisms (coping strategies and resources).Intention. To study the dynamics of the main quality-of-life parameters in patients with spinal tumors in the perioperative period, as well as to assess relationships between quality-of-life parameters and the psychological mechanisms of disease-related stress coping.Methodology. Quality-of-life parameters were studied over time (before and after surgery) in 62 patients with various spinal tumors (average age 55 years; 22 males [35.5 %]) treated at the Department of Vertebral Surgery of N.N. Blokhin National Research Center of Oncology. The relationships were studied between patients’ quality of life in the early postoperative period and their disease-related stress coping strategies and resources. The following tests were used: the 36-Item Short Form Health Survey Questionnaire (SF-36), questionnaires for studying Quality of Life in oncological disease (QLQ C-30), spine tumors (SOSG OQ), the Ways of Coping Questionnaire (WCQ), the Big Five Personality Test and the Purpose-in-Life Test.Results and Discussion. 23 of 29 studied quality-of-life parameters improved statistically significantly or tended to improve in the post- vs preoperative period, including the general index of health and quality of life, physical, emotional, social and cognitive activity, as well as symptoms of somatic distress (except an increased index of neurological dysfunction). Relationships were revealed between quality-of-life parameters and all the coping-related psychodiagnostic indices (except the “Extraversion” scale). Higher quality-of-life indices positively correlated with mature personality (internality, activity, meaningful goals, seeking social support, etc.). Less mature personality and less effective coping strategies were associated with more pronounced somatic symptoms and their impact on the quality of life in patients.Conclusion. The results of this study can help develop more targeted and individualized programs of psychological assistance and social rehabilitation for patients with spinal tumors.
的相关性。其相关性取决于需要研究手术治疗期间脊柱肿瘤患者的长期生活质量,以及研究生活质量与心理特征之间的关系,包括那些负责适应疾病的心理特征,即应对机制(应对策略和资源)。目的:研究脊柱肿瘤患者围手术期主要生活质量参数的动态变化,探讨生活质量参数与疾病相关应激心理机制的关系。研究了62例不同脊柱肿瘤患者(平均年龄55岁;22名男性[35.5%])在N.N. Blokhin国家肿瘤研究中心椎外科接受治疗。研究术后早期患者生活质量与疾病相关应激应对策略及资源的关系。采用36项健康调查问卷(SF-36)、肿瘤患者生活质量调查问卷(qlqc -30)、脊柱肿瘤患者生活质量调查问卷(SOSG - OQ)、应对方式调查问卷(WCQ)、大五人格测验和生活目的测验。结果与讨论:29例患者中有23例患者的生活质量参数在术后与术前有统计学显著改善或趋于改善,包括总体健康和生活质量指数、身体、情感、社交和认知活动,以及躯体窘迫症状(神经功能障碍指数增加除外)。生活质量参数与所有应对相关的心理诊断指标(“外向性”量表除外)均存在相关性。较高的生活质量指数与成熟人格(内在性、活跃性、有意义的目标、寻求社会支持等)正相关。不成熟的人格和不有效的应对策略与更明显的躯体症状及其对患者生活质量的影响有关。本研究的结果有助于为脊柱肿瘤患者制定更有针对性和个性化的心理援助和社会康复方案。
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引用次数: 2
Behavioural and morphological changes in rats with lead poisoning aggravated by medicinal hypothyroidism 药用性甲状腺功能减退加重铅中毒大鼠的行为学和形态学改变
Q3 Health Professions Pub Date : 2021-04-02 DOI: 10.25016/2541-7487-2021-0-1-89-96
N. Yakimova, E. A. Titov
Relevance. Metals are transported by run-off from human settlements and industrial plants and accumulate in the sediments of water bodies. Lead is found in high concentrations in the soil of agricultural land. Lead can be transported with water, seafood, animal products and plants to humans. Poisoning may occur in workers and in the population in contact with lead. At the same time, hypothyroidism is a widespread disease, often due to living in areas of endemic iodine deficiency in water and soil. Latent hypothyroidism can aggravate occupational effects of heavy metals in exposed workers.Intention. To study behavioural and morphological changes in rats with lead poisoning aggravated by medicinal hypothyroidism. Methodology. 32 albino outbred adult male rats were studied. Lead poisoning was induced by lead acetate at a dose of 60 mg/kg body weight in drinking water tanks for 30 days. Hypothyroidism in rats was induced from the ninth day of the experiment with daily injections of thyrozol (thyroid static substance) at a dose of 30 mg/kg for 21 days. Behavioral responses in rats were studied using open field tests, and survey records were processed using Real Timer. For morphological analysis, layered serial cuts of brain tissue were prepared and painted using the Nissl method, and slides were visualized via observation microscopy.Results and Discussion. Under lead poisoning, animals demonstrated decreased locomotor and exploration activity and increased anxiety with increasing intoxication combined with hypothyroidism. Changes in the rat brain after exposure to lead were confirmed histologically: increased neuron degeneration, neuronophagia and glyosis. New histological data were obtained in case of lead-thyrozol combination: increased neuronal death, decreased number of astroglial cells compared to animals exposed to lead only. This suggests predominant irreversible neurodegeneration due to combined effects of lead poisoning and thyroidstatic exposure.Conclusion. Under combined exposure to lead and tyrozol, the thyroidstatic substance exacerbated decline in locomotor and exploration activity as well as lead-associated neurodegenerative processes in the rat brain.
的相关性。金属由人类住区和工业工厂的径流输送,并在水体沉积物中积累。在农业用地的土壤中发现了高浓度的铅。铅可以通过水、海鲜、动物产品和植物输送给人类。工人和接触铅的人群可能发生中毒。同时,甲状腺功能减退症是一种广泛的疾病,通常是由于生活在水和土壤中地方性缺碘的地区。潜伏性甲状腺功能减退可加重重金属暴露工人的职业效应。目的研究药用性甲状腺功能减退加重铅中毒大鼠的行为学和形态学变化。方法:以32只成年雄性白化病大鼠为研究对象。以60 mg/kg体重剂量的醋酸铅在饮水罐中诱发铅中毒30 d。从实验第9天开始,每天注射甲状腺素(甲状腺静态物质)30 mg/kg,连续21 d诱导大鼠甲状腺功能减退。采用野外实验研究大鼠的行为反应,Real Timer对调查记录进行处理。形态学分析采用尼氏法制备脑组织分层连续切片并涂片,观察显微镜下观察切片。结果和讨论。在铅中毒的情况下,动物表现出运动和探索活动减少,焦虑增加,中毒增加并伴有甲状腺功能减退。在组织学上证实了铅暴露后大鼠脑的变化:神经元变性、神经元吞噬和糖化增加。在铅-甲状腺素联合用药的情况下,获得了新的组织学数据:与仅暴露于铅的动物相比,神经元死亡增加,星形胶质细胞数量减少。这表明主要的不可逆神经变性是由于铅中毒和甲状腺抑制剂暴露的共同作用。在铅和替洛唑的联合暴露下,甲状腺抑制物质加剧了大鼠大脑中运动和探索活动的下降以及铅相关的神经退行性过程。
{"title":"Behavioural and morphological changes in rats with lead poisoning aggravated by medicinal hypothyroidism","authors":"N. Yakimova, E. A. Titov","doi":"10.25016/2541-7487-2021-0-1-89-96","DOIUrl":"https://doi.org/10.25016/2541-7487-2021-0-1-89-96","url":null,"abstract":"Relevance. Metals are transported by run-off from human settlements and industrial plants and accumulate in the sediments of water bodies. Lead is found in high concentrations in the soil of agricultural land. Lead can be transported with water, seafood, animal products and plants to humans. Poisoning may occur in workers and in the population in contact with lead. At the same time, hypothyroidism is a widespread disease, often due to living in areas of endemic iodine deficiency in water and soil. Latent hypothyroidism can aggravate occupational effects of heavy metals in exposed workers.Intention. To study behavioural and morphological changes in rats with lead poisoning aggravated by medicinal hypothyroidism. Methodology. 32 albino outbred adult male rats were studied. Lead poisoning was induced by lead acetate at a dose of 60 mg/kg body weight in drinking water tanks for 30 days. Hypothyroidism in rats was induced from the ninth day of the experiment with daily injections of thyrozol (thyroid static substance) at a dose of 30 mg/kg for 21 days. Behavioral responses in rats were studied using open field tests, and survey records were processed using Real Timer. For morphological analysis, layered serial cuts of brain tissue were prepared and painted using the Nissl method, and slides were visualized via observation microscopy.Results and Discussion. Under lead poisoning, animals demonstrated decreased locomotor and exploration activity and increased anxiety with increasing intoxication combined with hypothyroidism. Changes in the rat brain after exposure to lead were confirmed histologically: increased neuron degeneration, neuronophagia and glyosis. New histological data were obtained in case of lead-thyrozol combination: increased neuronal death, decreased number of astroglial cells compared to animals exposed to lead only. This suggests predominant irreversible neurodegeneration due to combined effects of lead poisoning and thyroidstatic exposure.Conclusion. Under combined exposure to lead and tyrozol, the thyroidstatic substance exacerbated decline in locomotor and exploration activity as well as lead-associated neurodegenerative processes in the rat brain.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"12 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87831991","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}
引用次数: 0
Experience of air medical teams of the Scientific and Practical Center for Emergency Medical Care of the Moscow City Health Department for 2015—2019 2015-2019年莫斯科市卫生局急救医疗科学与实践中心空中医疗队经验
Q3 Health Professions Pub Date : 2020-12-13 DOI: 10.25016/2541-7487-2020-0-4-60-68
S. A. Gumenyuk, S. Fedotov, V. I. Potapov, A. Sysoev
Relevance. Due to busy roads of large cities and the resulting slow movement of ambulances with severely affected patients in need of specialized emergency care, new organizational technologies for medical evacuation support as well as modern means of transporting patients to qualified hospitals are required.Intention is to analyze activities of the aviation medical teams of the Scientific and Practical Center for Emergency Medical Care in Moscow in 2015-2019.Methodology. Using the automated information-analytical system “Disaster Medicine of the Moscow City”, activities of aviation medical teams over the last 5 years (2015-2019) were analyzed retrospectively in the Scientific and Practical Center of Emergency Medical Care. Ambulance helicopters are fully equipped to provide comprehensive intensive care for severely affected patients without noticeable deterioration of their condition, and utilization of this equipment was also assessed.Results and Discussion. Main stages of air ambulance formation in Moscow are described. Experience of aviation medical teams over the past 5 years in providing emergency medical care at the pre-hospital stage to those affected in emergency situations and severely ill patients is presented. The description of medical equipment of ambulance helicopters intended for providing emergency medical care to adults and children, including newborns, is given. The number of calls for aviation medical teams over the past five years is provided along with basic reasons and amount of night flights.Most often helicopters were used for transporting patients with severe concomitant and multiple injuries as a result of road accidents. Medical team composition of ambulance helicopters and the number of helipads on the territory of medical organizations of the city and the territories attached to Moscow are given.Conclusion. Based on the analysis of aviation medical teams activities, further ways to improve and develop the aviation medical service of the city of Moscow can be outlined to expand its use.
的相关性。由于大城市道路繁忙,救护车运送需要专门紧急护理的严重病人时行动缓慢,因此需要新的组织技术来支持医疗后送以及将病人运送到合格医院的现代手段。目的是分析2015-2019年莫斯科急救医疗科学与实践中心航空医疗队的活动。利用“莫斯科市灾害医学”自动化信息分析系统,回顾性分析了急诊医疗科学与实践中心近5年(2015-2019年)航空医疗队的活动情况。救护直升机的装备齐全,可以为受严重影响的病人提供全面的重症监护,而他们的病情没有明显恶化,并对这些设备的利用情况进行了评估。结果和讨论。描述了莫斯科空中救护编队的主要阶段。介绍了过去5年来航空医疗队在向受紧急情况影响者和重病患者提供院前急救阶段的经验。介绍了用于向成人和儿童(包括新生儿)提供紧急医疗服务的救护直升机的医疗设备。在过去五年中,提供了要求航空医疗队的次数,以及基本原因和夜间飞行的次数。大多数情况下,直升机被用来运送因道路事故而严重伴随和多重受伤的病人。给出了救护直升机医疗队的组成情况以及该市和莫斯科附属领土医疗组织境内的直升机停机坪数量。在分析航空医疗队活动的基础上,可以概述进一步改善和发展莫斯科市航空医疗服务的途径,以扩大其使用。
{"title":"Experience of air medical teams of the Scientific and Practical Center for Emergency Medical Care of the Moscow City Health Department for 2015—2019","authors":"S. A. Gumenyuk, S. Fedotov, V. I. Potapov, A. Sysoev","doi":"10.25016/2541-7487-2020-0-4-60-68","DOIUrl":"https://doi.org/10.25016/2541-7487-2020-0-4-60-68","url":null,"abstract":"Relevance. Due to busy roads of large cities and the resulting slow movement of ambulances with severely affected patients in need of specialized emergency care, new organizational technologies for medical evacuation support as well as modern means of transporting patients to qualified hospitals are required.Intention is to analyze activities of the aviation medical teams of the Scientific and Practical Center for Emergency Medical Care in Moscow in 2015-2019.Methodology. Using the automated information-analytical system “Disaster Medicine of the Moscow City”, activities of aviation medical teams over the last 5 years (2015-2019) were analyzed retrospectively in the Scientific and Practical Center of Emergency Medical Care. Ambulance helicopters are fully equipped to provide comprehensive intensive care for severely affected patients without noticeable deterioration of their condition, and utilization of this equipment was also assessed.Results and Discussion. Main stages of air ambulance formation in Moscow are described. Experience of aviation medical teams over the past 5 years in providing emergency medical care at the pre-hospital stage to those affected in emergency situations and severely ill patients is presented. The description of medical equipment of ambulance helicopters intended for providing emergency medical care to adults and children, including newborns, is given. The number of calls for aviation medical teams over the past five years is provided along with basic reasons and amount of night flights.Most often helicopters were used for transporting patients with severe concomitant and multiple injuries as a result of road accidents. Medical team composition of ambulance helicopters and the number of helipads on the territory of medical organizations of the city and the territories attached to Moscow are given.Conclusion. Based on the analysis of aviation medical teams activities, further ways to improve and develop the aviation medical service of the city of Moscow can be outlined to expand its use.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86657794","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}
引用次数: 1
The level of readiness of the EMERCOM of Russia employees to provide first aid in road and transportation accidents 俄罗斯EMERCOM员工在道路和运输事故中提供急救的准备水平
Q3 Health Professions Pub Date : 2020-12-13 DOI: 10.25016/2541-7487-2020-0-4-42-47
I. S. Melnikova, E. V. Shkatova
Relevance. Timely competent provision of first aid by fire-fighters and rescuers can minimize the complications of injuries related to road traffic accidents, thereby supporting the lives of victims until the arrival of an ambulance team. Effective first aid training of the Emercom employees is a prerequisite for reducing mortality from road accidents at the pre-hospital stage.Intention. To analyze preparedness for first aid provision in the Udmurt Republic (Izhevsk city) among the EMERCOM of Russia employees directly involved in the elimination of the consequences of road accidents.Methodology. 199 employees of the Emercom of Russia were surveyed in the Udmurt Republic (Izhevsk) to assess their preparedness for the first aid provision based on a specially developed questionnaire.Results and Discussion. When processing the questionnaire data, it was found that 46.7 % of the respondents consider their knowledge and skills to be sufficient for providing first aid to victims of road accidents, 53.3 % are not satisfied with their practical skills. Before the arrival of medical workers, first aid was always provided to the injured by 10.5 %, sometimes by 31.2 % of the respondents. When tested on first aid issues, on average, each employee gave (73.1 ± 1.1) % correct answers. Periodically, 45.2 % of the EMERCOM of Russia employees practiced their skills in first aid on dummies.Conclusion. The results of the study showed the need to improve the regular training on the first aid among EMERCOM of Russia employees: to use dummies and simulators more widely. The data obtained can be used in planning the interagency interaction of services involved in the elimination of the consequences of road accidents, developing a work program for extended first aid for EMERCOM of Russia employees.
的相关性。消防人员和救援人员及时提供有能力的急救可以最大限度地减少道路交通事故造成的伤害并发症,从而在救护车队到达之前保障受害者的生命。对急救中心员工进行有效的急救培训是在院前阶段减少交通事故死亡率的先决条件。分析乌德穆尔特共和国(伊热夫斯克市)俄罗斯EMERCOM员工直接参与消除道路事故后果的急救准备情况。在乌德穆尔特共和国(伊热夫斯克)对199名俄罗斯国家安全局雇员进行了调查,根据一份特别编制的调查表评估他们对急救提供的准备情况。结果和讨论。在处理问卷数据时发现,46.7%的受访者认为自己的知识和技能足以为道路交通事故受害者提供急救,53.3%的受访者对自己的实际技能不满意。在医务人员到来之前,10.5%的受访者总是向伤者提供急救,有时为31.2%。当对急救问题进行测试时,平均每位员工给出(73.1±1.1)%的正确率。45.2%的俄罗斯EMERCOM员工定期在假人身上练习急救技能。研究结果表明,需要改进俄罗斯EMERCOM员工的急救常规培训:更广泛地使用假人和模拟器。获得的数据可用于规划消除道路事故后果所涉及的服务的机构间互动,为俄罗斯EMERCOM员工制定扩展急救工作方案。
{"title":"The level of readiness of the EMERCOM of Russia employees to provide first aid in road and transportation accidents","authors":"I. S. Melnikova, E. V. Shkatova","doi":"10.25016/2541-7487-2020-0-4-42-47","DOIUrl":"https://doi.org/10.25016/2541-7487-2020-0-4-42-47","url":null,"abstract":"Relevance. Timely competent provision of first aid by fire-fighters and rescuers can minimize the complications of injuries related to road traffic accidents, thereby supporting the lives of victims until the arrival of an ambulance team. Effective first aid training of the Emercom employees is a prerequisite for reducing mortality from road accidents at the pre-hospital stage.Intention. To analyze preparedness for first aid provision in the Udmurt Republic (Izhevsk city) among the EMERCOM of Russia employees directly involved in the elimination of the consequences of road accidents.Methodology. 199 employees of the Emercom of Russia were surveyed in the Udmurt Republic (Izhevsk) to assess their preparedness for the first aid provision based on a specially developed questionnaire.Results and Discussion. When processing the questionnaire data, it was found that 46.7 % of the respondents consider their knowledge and skills to be sufficient for providing first aid to victims of road accidents, 53.3 % are not satisfied with their practical skills. Before the arrival of medical workers, first aid was always provided to the injured by 10.5 %, sometimes by 31.2 % of the respondents. When tested on first aid issues, on average, each employee gave (73.1 ± 1.1) % correct answers. Periodically, 45.2 % of the EMERCOM of Russia employees practiced their skills in first aid on dummies.Conclusion. The results of the study showed the need to improve the regular training on the first aid among EMERCOM of Russia employees: to use dummies and simulators more widely. The data obtained can be used in planning the interagency interaction of services involved in the elimination of the consequences of road accidents, developing a work program for extended first aid for EMERCOM of Russia employees.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84978519","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}
引用次数: 0
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Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations
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