Relevance. Reforms and modernization of the Russian Armed Forces (RAF) make it necessary to increase the requirements to occupational health of women soldiers, whose number is more than 10% of staff. Intention. The purpose of research – to identify the main indicators of the health problems in women soldiers. Methods. Selective statistical analysis of the medical reports on the health of staff and activities of the medical service was performed according to the form 3/MED in military units, which accounted for about 60% of the total number of female soldiers in the RAF from 2003 to 2015. Results and Discussion. Analysis of health disorders in women soldiers showed that the annual rate of overall disease incidence (appealability) was (1618 ± 104) ‰, primary disease incidence (628 ± 59) ‰, follow-up (268 ± 28)‰, hospitalization (282 ± 30)‰, cases and days of labor losses (809 ± 99) and (6681 ± 499)‰, respectively; discharge for health reasons (8.85 ± 1.33)‰, mortality rate per 100 thousand women (69.3 ± 5.4). Polynomial trends in incidence rates (except for discharge) show a tendency to increase. It is believed that the professional activity of military women was associated with overexertion of functional reserves and high risk of developing various health disorders. It also turned out that the overall and primary disease incidence and hospitalization among military women compared with the officers of the RAF were statistically higher, and the death rate per 100 thousand was significantly lower than that of the working-age women in Russia and military officers. Five ICD-10 classes accounted for 68% of the structure of the cumulative indicator of health disorders in women soldiers: IX (circulatory system), II (tumors), X (respiratory), XIX (Injury, poisoning and certain other consequences of external causes ) and XIV (women’s diseases). Conclusion. Prevention of diseases and injuries of the above classes will help improve the health of women soldiers.

Relevance. Unfortunately, the number of victims in emergency situations, road and industrial accidents in Russia remains quite high. The number of serious injuries of the limbs with soft tissue damage increases, including those with skin and subcutaneous tissue detachment. Intention. Assessment of the effectiveness of comprehensive treatment of extensive wounds of limbs in victims of road and industrial accidents using the vacuum and oxygen therapy in addition to conventional treatment. Methods. In the Department of Traumatology and Orthopedics of the A.M. Nikiforov Russian Center for Emergency and Radiation Medicine. EMERCOM of Russia (St. Petersburg), the methods generally accepted in traumatological hospitals were used (group 3, n = 22), with additional negative pressure wound therapy (NPWT) (group 1, n = 22) and NPWT with oxygen barotherapy (OBT) (2nd group, n = 47). The groups were randomized by gender, age, severity of injuries, general health. Indices of disorders severity and recovery were assessed using the scale of clinical and laboratory parameters. Results and Discussion. The results of the monitoring revealed a significant improvement in the estimated indices in all patient groups, however, their better recovery was in the 1st and, especially, in the 2nd group. Compared with the third group of patients, their wounds also tended to demonstrate less suppuration, more frequent preservation of detached soft tissues and faster average recovery. Conclusion. The introduction of NPWT and, especially, NPWT in combination with OBT into the conventional treatment of extensive wounds of the extremities contributed to statistically significant changes in the compared clinical parameters and the restoration of limb functions.

 

 

Relevance. Despite the extensive list of the publications devoted to mitigation of consequences of the Tashkent earthquake on April 26, 1966, medical aspects were not covered sufficiently. This article is the first to fill in this gap within nearly half a century. Intention. To identify the major factors and features of this earthquake which influenced activities of municipal health institutions. To consider causes and nature of damage as well as disease incidence in a local population due to the earthquake. To study approaches to organizational measures for elimination of medical consequences of the earthquake. Methods. This is a retrospective statistical study. This article is the first, among the domestic scientific literature, to analyze an extensive array of publications devoted to various medical aspects of mitigation of consequences of the earthquake in Tashkent on April 26, 1966. Results and Discussion. No more than 16 publications on the subject were found. Municipal health and sanitary service had to operate under unique conditions as compared to emergencies of similar scale. First of all, the earthquake was quite long: more than 1100 aftershocks were registered within the next year. At the same time, their maximum magnitude (7–9 according to the Richter scale) was observed in the first 3 months. The second factor was extensive destruction of most municipal hospitals and outpatient departments (84.3 % of medical institutions were damaged, including 15.7 % completely ruined and 72.5 % more or less disturbed). The third factor was few victims: 8 deaths and more than 200 injured. However, after a detailed study, cardiovascular mortality significantly increased over time. Special attention is paid to medical support of victims, including surgery, assessment of stress influence on cardiovascular diseases and prevalence of disadapative mental responses of the population. Conclusion. Despite the large scale accident, the number of victims was rather small. Most deaths were related to cardiovascular diseases were somewhat delayed. The municipal health service managed to provide health care for the population quickly. Owing to sanitary and hygienic measures, epidemics were prevented. To eliminate medical and sanitary consequences of the earthquake, only limited human resources were required, in particular about 100 healthcare professionals from various regions of the USSR arrived.

 

 

Relevance. On May 28, 1995, an earthquake by the magnitude of up to 9 scores on the Richter scale struck the island of Sakhalin; as a result, the town settlement of Neftegorsk was destroyed. 2040 out of 3197 inhabitants (including 270 children) died; over 100 people died in hospitals. 685 professional rescuers were involved in rectification of the disaster consequences. Medical assistance was provided to the victims by a consolidated medical unit, which consisted of doctors of various specialties (surgeons, traumatologists, therapists, etc.) seconded by leading medical institutions of the Russian Far East. Intention. Provision of psychological assistance to the victims of the earthquake. Methods. The following methods were used: 1) clinical and psychopathological; 2) experimental and psychological; 3) clinical and statistical. Results and Discussion. For the first time in modern Russian history an emergency psychotherapeutic assistance brigade was working. The psychotherapeutic assistance was organized in 2 stages. The duration of the 1st stage was approximately 1 month (from June 2 to July 9, 1995). One part of the group was working directly in the town of Neftegorsk. Another part of the group was working in the city of Okha, in the temporary evacuation area for the victims. At the 2nd stage, the psychotherapeutic assistance group worked from August 15 to September 2, 1995. Out of 369 residents of Neftegorsk and Okha who survived the earthquake, 197 people (or 53.4 % of the total number) received psychotherapethic assistance; men accounted for 45.7 %, women – for 54.3 %, all of them have been previously examined. Immediately after the disaster, all of the victims included in the Group 1 were diagnosed with acute stress reaction, in a severe form (F43.2 according to ICD-10). The psychotherapy was focused on the following symptoms: 1) sleep disorders, somatic vegetative disorders; 2) obsessions, fears; 3) anxiety and depressive feelings; 4) feeling of guilt and suicidal mood. Conclusion. To increase the effectiveness of treatment and rehabilitation measures, it is important to ensure efficient interaction of social, psychological and medical services with differentiation of the latter into emergency medical and emergency psychotherapy service.

 

 

Relevance. There are known negative effects of vital stress on reproductive function. Few studies assessed development of children whose mothers had been exposed to vital stress. Intention: To evaluate peculiarities of sexual development of girls whose mothers suffered vital stress due to the terrorist threat before pregnancy. Methods: Results of preventive medical examinations of 1590 girls in the Republic of Dagestan were analyzed; 800 of these girls were born to women exposed to the terrorist threat in 1999. Results and Discussion: The analysis showed that girls whose mothers experienced vital stress before pregnancy period had earlier and disturbed puberty manifested as earlier menarche and delayed establishment of regular menstrual cycle due to changes in humoral regulation. Conclusion. The obtained results show the long-term effects of mothers’ vital stress on puberty of their offspring.

 

 

Intention. Improving medical and psychological support requires highly informative markers to assess and predict the state of the examined military men. Methodology. A total of 119 healthy male subjects of military age (18 to 26 years) were examined and divided into groups based on their blood pressure (BP) levels. Two-factor analysis of variance was used to assess effects of BP and/or disease attitude on the mental health. Results and Discussion. It is shown that blood pressure more significantly affects the level of neuro-psychological adaptation than the type of disease attitude. In a continuum “normal to high blood pressure”, the number of disharmonious types of disease,attitude increases and the level of mental health decreases. Type of disease attitude predicts the level of mental health. Disharmonious disease attitude may decrease mental health by one level compared with an adaptive type of disease attitude. Conclusion. The medico-psychological support of military men should include assessment of their physiological characteristics.

 

 

Relevance. There have been made some reorganizations in the Armed Forces of Russia lately (changes in the staff structure, enhancing the image of the officers, increasing officer’s salaries and military pension), which could affected the mental health of military personnel. Intention. The aim of our study was to determine the medical-statistical characteristics of mental health in officers of the Armed Forces of Russia as the most combat-capable unit. Methods. The research presents the stastical analysis of mental disorders in officers of the Armed Forces of Russia during the last 13 years (2003–2015). Results and Discussion. The annual average general morbidity (negotiability) of officers with mental disorders was (8.21 ± 0.86) ‰, the primary morbidity rate – (2.73 ± 0.13) ‰, the dynamic level of dispensary observation – (1.29 ± 0.14) ‰, the hospitalization rate – (2.37 ± 0.12) ‰, the inactivity rate measured in days – (51 ± 3) ‰, the dismissal rate – (0.55 ± 0.06) ‰, the mortality ratio – (0.4 ± 0.2) deaths per 100,000 officers in a year. The polynomial trends at low coefficients of determination of almost all indicators predicted their decrease. With a small contribution of mental disorders (1–6 %) to the structure of general morbidity, hospitalization and inactivity, the dismissal rate of officers with mental disorders remained at a high level and ranks 6th among all diseases. In 97.3 % of cases the structure of the generated complex indicator of the mental health status in officers was determined by 6 groups of disorders from Chapter V of ICD-10: mental disorders due to known physiological conditions (F00–F09), mental and behavioral disorders due to psychoactive substance use (F10–F19), schizophrenia, schizotypal, delusional and other non-mood psychotic disorders (F20–F29), mood (affective) disorders (F30– F39), anxiety, dissociative, stress-related and somatoform disorders (F40–F48). The major contribution to the structure of mental pathology is made by the neurotic, stress-related and somatoform disorders, as well as addiction disorders. In addition it is the chemical forms of addiction and neurotic disorders that often lead to the dismissal of officers from the Armed Forces of Russia. It is shown, that some isolated socio-economic factors have influence on the mental health of officers. It is determined, that the «unpopular» reforms carried out until 2011 had negative influence, on the other hand, there is the reduction of the prevalence rate of mental disorders among the officers since the reforms of 2012. Conclusions. It is assumed, that the system of the psychoprophylactic measures existing at present needs to be further improved and primarily focused on the early diagnosis of the addiction and neurotic disorders.

 

Relevance. Treatment of patients with severe thermal injury includes therapy comorbidities and complications, among which the special role played by the central nervous system. Their development is largely determines the weighting of the condition worsens the prognosis, as well as leading the timing of recovery. For burn disease may be accompanied by the development of the cerebral neurological complications, such as burn encephalopathy, acute violation of cerebral circulation, secondary purulent meningitis. Intention – identify the main pathogenetic mechanisms of neurologic complications and their correction have burned. Methods Review and analysis of literature data on neurological complications from burned and their treatment options. Results and Discussion. In the genesis of neurological disorders in the burned main role constitute the hemodynamic, electrolyte disorders, violations, breach the blood-brain barrier in the face of intoxication. Develops complex disorders, which can result in secondary purulent meningitis and meningoencephalitis. A comprehensive treatment, including surgical restoration of the skin integument, infusion therapy, antibiotics, drugs neuroprotektors stimulants avoids a number of severe complications. Conclusion. Timely pathogenetically justified treatment of neurological complications in burned, carried out within the framework of the integrated therapy of burn disease is essential, because such an approach contributes to the best possible outcomes.

 

 

Relevance. Due to the imperfection of the used gas cleaning equipment in the early years of the Production Association «Mayak» existence, the significant additional contribution to the exposure of the population of the south of the Sverdlovsk region were made by the gas and aerosol emissions of radionuclides into the atmosphere. Even today the PA «Mayak» continues to be a source of the radioactive contamination of the surrounding areas, and there is the potential threat of the new large-scale radiation disasters. It is impossible to completely eliminate the occurrence of any emergency situations in the enterprise, as well as the likelihood of the cross-border air transport of the radionuclides from the areas contaminated earlier. Intention. To assess radiation background levels in the southern part of the Sverdlovsk region subject to the probable air transport of radionuclides from the nuclear fuel cycle facilities located in the Chelyabinsk region. Methodology. The conceptual model of the radiation monitoring on the way of the cross-border air transport of radionuclides into the territory of Sverdlovsk region from the nuclear fuel cycle facilities located in the Chelyabinsk region was designed and tested. It includes the determination of the content of the long-lived radionuclides (90Sr and, 137Cs) in the environmental objects playing the role of natural plates. These include snow cover, the upper layer of the soil (0-20 cm), and open ponds water. Results and Discussion. The results confirm that the current atmospheric precipitates for the period of 2004–2016 had no significant effect on the radiation situation at the controlled territory. Soils of the southern part of the Sverdlovsk region and the waters of Chervyanoe lake and the ponds of Komarova village are characterized by a higher content of 90Sr, that may result from the additional radiation contamination in the previous years. Conclusion. The developed conceptual model of the radiation monitoring can be successfully used for studying the impact of the existing nuclear fuel cycle enterprises on the surrounding areas, and also for organizing the protection of the population in various radiation accidents and emergency situations involving the uncontrolled release of the radionuclides into the atmosphere or water objects.

 

 

Relevance. Servicemen wearing body armor (BA) have reduced physical performance as well as quantitative and qualitative indices of training and combat activities. Objective. To assess the influence of modern body armor on direct indicators in servicemen performing standard elements of military professional activity. Methodology. 195 volunteers from motorized rifle units and parachute units equipped with modern body armor were examined. Direct indicators of physical performance were assessed during military-professional activity: 5 km quick march and obstacle course. Exercise time was documented along with specific obstacle elements servicemen could not overcome. Results and Discussion. The research has shown that greater body armor weights disturbed the quality and ability to overcome obstacles typical for combined-arms battle. This weight is undoubtedly one of the most important medical and technical characteristics and should be considered in relation to the body weight of servicemen (SM) to derive the (mBA/mSM) ratio and assess influence on direct indicators of physical performance. Conclusion. Modern trends in body armor development include increased area and protection level; this is associated with increased physical load and lower effectiveness, thus creating additional risks of exposure to enemy fire.

 

Relevance. Specialists of EMERCOM of Russia are engaged in hazardous activities and, therefore, are at risk of mental and physical health disorders. Further measures are required to recover their borderline functional states, preserve and restore mental and physical health, thus increasing the body’s resistance to adverse occupational factors. Intention. To analyze possible effects of the prevailing part of autonomous (vegetative) nervous system on the effectiveness of rehabilitation measures, the choice of the course duration and content of the proposed programs. Methods. The object of research is a long-term medical and psychological rehabilitation, the subject – functional indices reflecting the state of somatic and mental health. The techniques of detailed psychophysiological research are described. Results and Discussion. The results obtained indicate the need to consider the predominant activity of the autonomic nervous system in specialists of EMERCOM of Russia (sympatheticotonia, normotonia, parasympatheticotonia) when implementing rehabilitation programs. Recommendations were made for adapting the basic standard health-promoting long-term program to the current vegetative status of the Russia EMERCOM specialists in order to normalize neurohumoral regulation and increase adaptive reserves. The results indicate the feasibility of correction techniques in parasympatheticotonia (activating regimen to enhance sympathetic and reduce parasympathetic tone) as well as increased number and intensity of rehabilitation measures. In sympatheticotonia, a light regimen was indicated (to reduce sympathetic activity and increase parasympathetic tone); the number and intensity of rehabilitation measures were also decreased. Conclusion. Knowledge of prevailing activity of the autonomic nervous system in Russia EMERCOM specialists helps to predict the risk of psychosomatic diseases and to develop and implement personalized measures for mastering self-control and coping skills.