We present the results of 30-year monitoring over the state of health of the Chernobyl liquidators. An epidemiological analysis of morbidity, disability and mortality of Chernobyl liquidators was performed. Relationship of these indicators with the non-radiation factors was proven. The main mechanisms of somatic pathology in Chernobyl liquidators and the residents of radiation-contaminated areas may include: emotional stress, endocrine imbalance, inflammation, disturbances of metabolism and differentiation, atherogenesis.

Medical and statistical characteristics of case histories of 351 servicemen - liquidators of the Chernobyl Nuclear Power Plant (ChNPP) accident from May to November 1986 are presented. 79.5 % of them were admitted to military hospitals for examination related to a stay in the radioactively contaminated areas. Duration of participation in the liquidation of the Chernobyl accident consiquencies was (29.0 ± 1.1) days, irradiation dose was (20.6 ± 0.4) cGy. There was a significant (r = 0.75; p < 0.01) correlation between these parameters. On admission, the servicemen complained of a general deterioration of health and problems of upper respiratory tract (cough, sore throat). Peripheral blood cell counts were within the normal range, except for increased reticulocytes (32.3 ± 1.5 %o) and the trend to increased platelets (367.9 ± 12,8) • 10⁹/L. Duration of hospital stay was (12.9 ± 0.4) bed-days. In-hospital examination and treatment made it possible to establish the diagnosis of «prolonged combined external y-ß-irradiation without clinical and hematological manifestations» in 40.7 %, «radiation reaction with hematological manifestations (thrombocytosis, reticulocytosis)» - in 20.2 %, and «asthenic syndrome» - in 0.6 % of the servicemen. 38.5 % of servicemen were discharged without clinical diagnosis (apparently healthy). Clinical outcomes were as follows: 11.7 % - recovery, 61.8 % - improvement, and 26.5 % - without changes. Identified health statistical characteristics can be used to simulate medical assistance scenarios in the settings of man-made accidents and catastrophes.

25 patients (32 ears) were examined to evaluate the effectiveness of auditory rehabilitation after ear surgery. Patients of experimental group with head injury in the past (12 cases) received comprehensive auditory rehabilitation including auditory training combined with non-invasive neuromodulation by electrotactile stimulation on the tongue. Control group consisted of 20 patients after ear surgery without any treatment. Pure tone audiometry and speech-in-noise auditory tests with signal-noise ratio of 0 dB were used. Rehabilitation began 1 month after surgery. Auditory training represented a listening to audio scripts which contained speech fragments. Non-invasive neuromodulation was performed via electrotactile stimulation on the tongue with BrainPort device. Rehabilitation was performed twice a day for 20 min over 10 days. Hearing levels were estimated before surgery, and 1, 3 and 12 months after surgery. There was a hearing gain in majority of patients from both groups 1 month after surgery due to improved air conduction (p < 0.01). After auditory rehabilitation, pure tone levels did not change in both groups (p > 0.05), and word recognition improved in 11 patients (91.7 %) from experimental group (p < 0.01) compared to no changes in control group (p > 0.05). Three months after ear surgery there was hearing gain of pure tone levels in all tests both via air and bone in patients from both groups (p < 0.05). Word recognition also improved p < 0.01). Hearing level didn’t change significantly after 12 months from ear surgery compared to 3-month levels. So, we concluded that sensory component of hearing loss due to central disturbances in auditory system after head trauma is reversible and can be improved by ear surgery and rehabilitation procedures. The proposed method of combined auditory rehabilitation improves the effectiveness of treatment in case of head injuries combined with ear trauma.

Effective and easily accessible temporary wound covering is a topical problem in burn care. Stocks of such coverings are particularly important in case of numerous injured with severe burns, in particular after natural and man-made emergencies involving fire. Temporal wound coverings of biological origin are the best. Despite the widespread use of animal skin (freeze-dried porcine skin) in Russia, deep burns of over 40-50 % TBSA almost predetermine death. Human donor skin, which is recognized by experts as the «gold standard» for the temporary closure of wounds, can help to overcome this limitation. As distinct from USSR where human donor skin was widely used, this valuable therapeutic resource is almost never being used in Russia. The current review is dedicated to history of the use of allograft skin in the management of wounds, as well as development of tissue banking across the world and in the Russian Federation.

Effectiveness of Hydrocolloid dressings in the treatment of wounds of various etiologies was assessed in the settings of professional medical care. Outcomes after use of wound dressings Silkofix Fibrotul-Ag and WD.AG-silkofix were analyzed in 30 patients with wounds of different etiology treated in a military base hospital (Smolensk) over 2010-2014. Morphometry, bacteriological research were used. Healing process was described in wounds of various etiology. Wound coverings Fibrotul-Ag and WD.Ag-silkofix provide controlled wound healing. With them, wounds heal under optimal conditions; dressings are well tolerated by patients and should be changed less frequently. Therefore, they can be considered as promising preparations for the local conservative treatment.

Military personnel are at high risk for developing mental disorders, including combat and operational stress reactions and posttraumatic stress disorder. Combat and Operational Stress includes all the physiological and emotional stresses encountered as a direct result of the life threatening dangers of combat and other operational environments, physical and mental injuries. In the U. S. Army Combat and Operational Stress Control (COSC) units provide assistance, education and training available for military personnel throughout entire military career. COSC activities include recruit’s routine screening, continued surveillance throughout military service, and continuous assessment and consultation with medical and other personnel to prevent, identify, and manage adverse Combat and Operational Stress Reactions (COSR). Combat and Operational Stress Control program optimizes mission performance, conserves the fighting strength, and prevents or minimizes negative effects of COSR on military personnel’s mental health. Its main goal is to return soldiers to duty and optimize their overall performance.

The article describes the results of pilot study of the effectiveness of four-dimensional isolation method -chronostructuring human environment. The method was tested for treatment and prevention of desynchronosis in 42 military men serving in the Russian Arctic during the polar night and after a diagonal transmeridian flight. Four-dimensional isolation may be promising for treatment and prevention of desynchronosis in polar explorers and airmen serving in the Far North of the Russian Federation, especially after diagonal and transmeridian flights.

Pulmonary barotrauma is one of the most serious and common diseases in divers. Pulmonary barotrauma diagnosis at the dive point is based on the complaints, physical examination of the patient and analysis of the dive-related circumstances followed by obligatory evaluation of the technical condition of patient’s diving equipment. Medical institutions additionally perform chest radiography. If the clinical symptoms are scarce or atypical, pulmonary barotrauma is difficult to diagnose, which can result in maltreatment and, consequently, development of complications. Three clinical cases of divers with suspected pulmonary barotrauma are considered; in them, computed tomography was used along with well-established diagnostic methods. In two cases pulmonary barotrauma diagnosis was confirmed and the divers underwent therapeutic recompression, while in the third case no specific diving pathology was detected. According to our results, computed tomography used for medical support related to dives enhances efficacy of pulmonary barotrauma diagnosis and treatment.

The peculiarities of treatment of decompression disorders in divers via a long stay under the pressure of artificial gas and water up to 3.1 MPa are considered. It is shown that in case of decompression complicated with antidiffusion oversaturation it is advisable to increase the partial pressure of nitrogen up to 360-400 kPa concomitantly with oxygen enrichment up to 60-80 kPa.

Residents of the settlements exposed to radiation from nuclear tests at the Semipalatinsk nuclear test site are entitled to financial reimbursement. In accordance with Russian law, payments depend on the total (cumulative) effective dose; therefore, victims should be informed. Biological doses were retrospectively evaluated in 82 people who previously lived in the vicinity of Semipalatinsk weapon testing region. For dosimetry, stable chromosome aberrations were assessed using fluorescence in situ hybridization (FISH). FISH analysis of translocations revealed increased frequency of stable aberrations in 21 (26 %) patients compared with control values and helped to estimate irradiation doses. Established biological irradiation doses ranged from 16 to 62 cGy.

The study presents the results of the research of the bottom sediments, aquatic vegetation, fish of the Beloyarskoe storage pond - the cooling pond of the NPP - for the purpose of determination of the artificial radionuclides:⁹⁰Sr,¹³⁷Cs, and²³⁹,²⁴⁰Pu content before the Unit #4 BN-800 commissioning («zero level» survey). It is shown that earlier the pond received¹³⁷Cs and, in small amount,²³⁹,²⁴⁰Pu. The higher content of¹³⁷Cs was found in the bottom sediments of the industrial and storm discharge channel, Teplyi bay, and in the area of the Biophysical station. At that¹³⁷Cs and 239, 240Pu volumetric activity in the water of the Beloyarskoe storage pond was 3-4 orders of magnitude below the intervention level, and 90Sr content was two orders of magnitude below the intervention level, provided by Radiation safety regulations (NRB-99/2009). The data on⁹⁰Sr и¹³⁷Cs content in two species of the aquatic vegetation are presented and the accumulation coefficient for Potamogeton pectinatus and Ceratophyllum demersum were calculated (2656 and 1381 for¹³⁷Cs and 4706 and 2600 for⁹⁰Sr correspondingly).⁹⁰Sr and¹³⁷Cs content in three species of fish (bream, roach, perch) is considerably below the permissible values provided by the Sanitary and epidemiological requirements and codes 2.3.2.1078-01.

Zinc levels were assessed in liquidators of the Chernobyl Nuclear Power Plant (ChNPP) accident aftermath in order to identify the prevalence of zinc deficiency and propose corrective measures. 461 liquidators of the ChPP accident aftermath (residents of the North-West region of Russia) were examine in outpatient settings including 124 people who were tested twice (10 years ago and at present). Their mean age was (48.0 ± 2.5) years. Zinc levels in the body were assessed using hair bioassays via mass spectrometry with inductively coupled plasma. The results show, firstly, the high prevalence of zinc deficiency in the liquidators of the ChNPP accident aftermath and, secondly, age-related increase in zinc deficiency; this should be considered when developing prevention and individual rehabilitation programs.

Modern view of the role of the multilevel detoxification system (biotransformation enzymes, antioxidant and immune systems etc.) in health assessment of people working in contact with organophosphorus toxic chemicals (OPT) is presented. Genetic polymorphism is shown to adjust mechanisms protecting from disorders due to chemical exposure. Along with the known markers of acute exposure to OPT (acetyl and butyryl chonlinesterases), health risk factors include the neurotoxic esterase, albumin adducts of OPTs, paraoxanase 1, cytokine profile, components of the antioxidant system, eotaxin chemokine, semaphorin 3B protein etc., i. e. parameters that relate to the status of protective systems of an organism.

Identification of triggers for psychosomatic gastrointestinal disorders in emergency workers of the EMERCOM of Russia is considered. Weight contribution of the vegetative status into the formation of psychosomatic (pre-nosological) gastrointestinal pathology is assessed in 60 emergency workers of EMERCOM of Russia and 59 civilians. Parameters of dynamic ultrasound cholecystography are compared in patients with gastrointestinal diseases and apparently healthy individuals. The interrelation of vegetative status and dysregulations of the biliary tract is revealed. Key links were established in the pathogenesis of gastroenterological pathology in emergency workers of the EMERCOM of Russia.

Presented are comparative psychological data from 74 military wives staying in a long-term stressful social situation and 64 military wives whose husbands weren’t in regions with a difficult operative situation (group of comparison). The age of wives was (39.5 ± 5.4) years, the family experience - from 3 to 25 years. The women were assessed as a part of medical and psychological rehabilitation over time, taking into the account personality types. Combination treatment using biofeedback and classical psychotherapy which activates the self-regulated behavior and includes complex cognitive and emotional mechanisms of psychological stability of the military wives was proved to be effective.

The article presents psychological characteristics (namely, neurotic complaints, the severity of alexithymia, the structure of subjective control level and self-esteem parameters) of women employees of non-departmental security of the Ministry of Internal Affairs. The study involved 90 women (length of employment in the Ministry of Internal Affairs from 7 to 15 years) who were found fit for military service. Clinical psychology method and psychological tests («The questionnaire of neurotic disorders», «Toronto alexithymia scale», «The questionnaire of personal subjective control level evaluation», Dembo-Rubinstein technique) were used. Significant differences were found between women employees with severe somatic complaints (without differentiation of particular syndromes) and their healthy coworkers. Discovered psychological characteristics of women with maladjustment risk factors manifest as more expressed neurotic personality traits: low behavioral control, affectability, reduced understanding of the interpersonal relationships nuances, reduced criticism of their behavior acceptance, as well as more severe alexithymia. However, the obtained results do not exceed normal limits. Also, these women tend to attribute responsibility for their career and health to external circumstances rather than themselves, along with overestimation of their health, character and abilities. The conclusion was made about the necessity of psychoprophylactic measures.

Notions, definitions and terminology related to human health are considered. Some differences and even contradictions result from dissociation (institutional and even interdepartmental) between institutions and specialists. The necessity to revise and coordinate notions, definitions and terminology is shown to improve management in chemical accidents response and prevention.